endemic infections

地方性感染
  • 文章类型: Journal Article
    呼吸道真菌病是一个主要的健康问题,由于免疫抑制和免疫功能低下的患者群体不断扩大,以及对常规抗真菌药物的耐药性及其不良副作用的增加,从而证明开发新的治疗策略是合理的。植物代谢产物,即精油,由于其广泛报道的抗真菌潜力,代表了有希望的预防/治疗策略。然而,关于呼吸道真菌感染,信息是分散的,没有关于当前知识的更新汇编。因此,本综述旨在收集并系统化有关几种精油和挥发性化合物对影响医疗保健系统的主要呼吸道真菌病的抗真菌作用的相关信息。特别注意烟曲霉,与曲霉病有关的主要病原体,耳念珠菌,目前正在成为世界某些地区的主要病原体,和新生隐球菌,肺隐球菌病的主要病原菌之一。此外,介绍了精油抗真菌作用的主要机制和目前在临床翻译中的局限性。总的来说,富含酚类化合物的精油似乎非常有效,但临床翻译需要更全面的体内研究和人体试验,以评估这些化合物在呼吸道真菌病中的功效和耐受性。
    Respiratory mycosis is a major health concern, due to the expanding population of immunosuppressed and immunocompromised patients and the increasing resistance to conventional antifungals and their undesired side-effects, thus justifying the development of new therapeutic strategies. Plant metabolites, namely essential oils, represent promising preventive/therapeutic strategies due to their widely reported antifungal potential. However, regarding fungal infections of the respiratory tract, information is disperse and no updated compilation on current knowledge is available. Therefore, the present review aims to gather and systematize relevant information on the antifungal effects of several essential oils and volatile compounds against the main type of respiratory mycosis that impact health care systems. Particular attention is paid to Aspergillus fumigatus, the main pathogen involved in aspergillosis, Candida auris, currently emerging as a major pathogen in certain parts of the world, and Cryptococcus neoformans, one of the main pathogens involved in pulmonary cryptococcosis. Furthermore, the main mechanisms of action underlying essential oils\' antifungal effects and current limitations in clinical translation are presented. Overall, essential oils rich in phenolic compounds seem to be very effective but clinical translation requires more comprehensive in vivo studies and human trials to assess the efficacy and tolerability of these compounds in respiratory mycosis.
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  • 文章类型: Journal Article
    Traveler\'s diarrhea is the most common travel disease in both children and adults. Adult guidelines for traveler\'s diarrhea have been established, but significant gaps persist in guidance for the evaluation and management of pediatric traveler\'s diarrhea. Adult guidelines are not necessarily applicable in children, and it is essential for clinicians to account for the differences in pediatric pathophysiology, clinical presentations, and treatment recommendations when evaluating and managing pediatric traveler\'s diarrhea.
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  • 文章类型: Journal Article
    目标许多低收入国家的第一波COVID-19大流行浪潮似乎比最初预测的要温和。我们进行了一项国家级生态研究,以描述按国家和地区划分的SARS-CoV-2关键结果的模式,并探索与潜在解释因素的关联。包括人口年龄结构和先前暴露于地方性寄生虫感染。方法我们收集了公开可用的数据,并使用标准化技术进行了比较。然后,我们使用随机森林和线性回归探索暴露与结果之间的关联。我们调整了潜在的混杂因素和合理的效果修改。结果欧洲和美洲地区的平均时变繁殖数量最高,非洲地区的中位死亡年龄较低,病死率大致相似。人群年龄与病例的平均年龄(β=0.01,95%CI,0.005,0.011)和中位年龄(β=-0.40,95%CI,-0.53,-0.26)和死亡(β=0.40,95%CI,0.17,0.62)密切相关。结论人口年龄似乎是解释观察到的病例和死亡的传播性和年龄分布的重要国家因素。地方性感染似乎不太可能,从这个分析,是观察到的流行趋势变化的关键驱动因素。我们的研究受到结果数据的可用性及其不确定的生态设计的限制。
    Objectives The first COVID-19 pandemic waves in many low-income countries appeared milder than initially forecasted. We conducted a country-level ecological study to describe patterns in key SARS-CoV-2 outcomes by country and region and explore associations with potential explanatory factors, including population age structure and prior exposure to endemic parasitic infections. Methods We collected publicly available data and compared them using standardisation techniques. We then explored the association between exposures and outcomes using random forest and linear regression. We adjusted for potential confounders and plausible effect modifications. Results While mean time-varying reproduction number was highest in the European and Americas regions, median age of death was lower in the Africa region, with a broadly similar case-fatality ratio. Population age was strongly associated with mean (β=0.01, 95% CI, 0.005, 0.011) and median age of cases (β=-0.40, 95% CI, -0.53, -0.26) and deaths (β= 0.40, 95% CI, 0.17, 0.62). Conclusions Population age seems an important country-level factor explaining both transmissibility and age distribution of observed cases and deaths. Endemic infections seem unlikely, from this analysis, to be key drivers of the variation in observed epidemic trends. Our study was limited by the availability of outcome data and its causally uncertain ecological design.
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  • 文章类型: Journal Article
    BACKGROUND: Many low-income countries have a human population with a high number of cattle owners depending on their livestock for food and income. Infectious diseases threaten the health and production of cattle, affecting both the farmers and their families as well as other actors in often informal value chains. Many infectious diseases can be prevented by good biosecurity. The objectives of this study were to describe herd management and biosecurity routines with potential impact on the prevalence of infectious diseases, and to estimate the burden of infectious diseases in Ugandan cattle herds, using the seroprevalence of three model infections.
    RESULTS: Farmer interviews (n = 144) showed that biosecurity measures are rarely practised. Visitors\' hand-wash was used by 14%, cleaning of boots or feet by 4 and 79% put new cattle directly into the herd. During the 12 months preceding the interviews, 51% of farmers had cattle that died and 31% had noticed abortions among their cows. Interestingly, 72% were satisfied with the health status of their cattle during the same time period. The prevalence (95% CI) of farms with at least one seropositive animal was 16.7% (11.0;23.8), 23.6% (16.9;31.4), and 53.4% (45.0;61.8) for brucella, salmonella and BVD, respectively. A poisson regression model suggested that having employees looking after the cattle, sharing pasture with other herds, and a higher number of dead cattle were associated with a herd being positive to an increasing number of the diseases. An additive bayesian network model with biosecurity variables and a variable for the number of diseases the herd was positive to resulted in three separate directed acyclic graphs which illustrate how herd characteristics can be grouped together. This model associated the smallest herd size with herds positive to a decreasing number of diseases and having fewer employees.
    CONCLUSIONS: There is potential for improvement of biosecurity practices in Ugandan cattle production. Salmonella, brucella and BVD were prevalent in cattle herds in the study area and these infections are, to some extent, associated with farm management practices.
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