dengue fever

登革热
  • 文章类型: Editorial
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  • 文章类型: Case Reports
    纵向广泛的横贯性脊髓炎是由登革热感染引起的一种罕见的神经系统表现。这里,我们描述了一名24岁男性的罕见表现,该患者出现发热和斑丘疹,随后出现弛缓性四肢轻瘫伴急性尿潴留。对整个脊柱进行对比的磁共振成像显示,在脐带中发现了长段不明确的高强度信号。患者接受了静脉内类固醇和随后静脉内免疫球蛋白的保守治疗。患者定期随访,情况良好。目前,患者正在服用剂量逐渐减少的强的松龙片剂。
    Longitudinally extensive transverse myelitis is a rare neurological manifestation caused by dengue infection. Here, we describe the uncommon presentation of a 24-year-old male with fever and maculopapular rash followed by flaccid quadriparesis with acute urinary retention. Magnetic resonance imaging of the whole spine with contrast revealed a long-segment ill-defined hyperintense signal noted in the cord. The patient was managed conservatively with intravenous steroids and later intravenous immunoglobulins. The patient is on regular follow-up and doing well. Currently, the patient is on tablet prednisolone with a tapering dose.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    登革热正迅速成为马来西亚最紧迫的健康问题,在过去十年中,报告的病例几乎翻了一番。没有有效的抗病毒药物,媒介控制仍然是抗击登革热的主要策略,而最近引入的四价免疫正在评估中。最近增加的最重要和最危险的风险是媒介传播的疾病。这些疾病引起重大的人类疾病,并通过跳蚤等吸血节肢动物传播,寄生虫,还有蚊子.要全面掌握各种因素,提高预测精度,通常会产生不准确、不稳定的预测,以及机器学习(ML)模型,天气驱动机制,和数值时间序列。
    在这项研究中,我们提出了一种使用径向基函数网络(RBFN)和飞镖游戏优化器(DGO)算法预测媒介传播疾病风险的新方法。
    所提出的方法需要用历史疾病数据训练RBFN并用DGO算法增强它们的参数。为了准备RBFN,我们使用了大量的媒介传播疾病发病率数据集,气候变量,和地理数据。DGO算法熟练地搜索RBFN参数空间,微调模型的架构,以提高预测准确性。
    RBFN-DGO提供了一种预测媒介传播疾病风险的潜在方法。这项研究通过阐明有效控制媒介传播疾病以保护人群,从而促进了公共卫生的预测性证明。我们进行了广泛的测试,以评估所提出的方法与标准优化方法和替代预测方法的性能。
    根据调查结果,RBFN-DGO模型在预测媒介传播疾病发生可能性的准确性和稳健性方面优于其他模型.
    UNASSIGNED: Dengue fever is rapidly becoming Malaysia\'s most pressing health concern, as the reported cases have nearly doubled over the past decade. Without efficacious antiviral medications, vector control remains the primary strategy for battling dengue, while the recently introduced tetravalent immunization is being evaluated. The most significant and dangerous risk increasing recently is vector-borne illnesses. These illnesses induce significant human sickness and are transmitted by blood-feeding arthropods such as fleas, parasites, and mosquitos. A thorough grasp of various factors is necessary to improve prediction accuracy and typically generate inaccurate and unstable predictions, as well as machine learning (ML) models, weather-driven mechanisms, and numerical time series.
    UNASSIGNED: In this research, we propose a novel method for forecasting vector-borne disease risk using Radial Basis Function Networks (RBFNs) and the Darts Game Optimizer (DGO) algorithm.
    UNASSIGNED: The proposed approach entails training the RBFNs with historical disease data and enhancing their parameters with the DGO algorithm. To prepare the RBFNs, we used a massive dataset of vector-borne disease incidences, climate variables, and geographical data. The DGO algorithm proficiently searches the RBFN parameter space, fine-tuning the model\'s architecture to increase forecast accuracy.
    UNASSIGNED: RBFN-DGO provides a potential method for predicting vector-borne disease risk. This study advances predictive demonstrating in public health by shedding light on effectively controlling vector-borne diseases to protect human populations. We conducted extensive testing to evaluate the performance of the proposed method to standard optimization methods and alternative forecasting methods.
    UNASSIGNED: According to the findings, the RBFN-DGO model beats others in terms of accuracy and robustness in predicting the likelihood of vector-borne illness occurrences.
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  • 文章类型: Journal Article
    背景:登革热继续在全球范围内构成重大的健康挑战,比哈尔邦最近爆发的疫情,印度,促使人们寻找有效的治疗干预措施。这项研究评估了孟鲁司特的有效性,传统上用于哮喘,减轻登革热症状的严重程度及其向登革热休克综合征(DSS)的进展。
    目的:评价孟鲁司特对成人登革热预警标志患病率和DSS发生率的影响。
    方法:在英迪拉·甘地医学科学研究所(IGIMS)进行了一项前瞻性观察性研究,巴特那,印度,从2022年8月到2023年10月,招募500名诊断为登革热的患者。参与者分为两组。约250例接受孟鲁司特治疗,250例接受标准护理。测量的结果包括警告标志的发生率,DSS,住院时间,30天死亡率
    结果:与对照组相比,孟鲁司特组的登革热警告信号患病率降低了24%,孟鲁司特组250例患者中有90例(36%),对照组250例患者中有150例(60%)(p<0.001)。孟鲁司特组DSS发生率明显降低,250例患者中有4例(1.6%),对照组250例患者中有21例(8.4%)(比值比:0.178,p<0.001)。此外,蒙鲁克特使用者的住院时间较短(平均4.52天与6.54天,T统计量:-7.59,p=1.58×10-13)和降低的30天死亡率,孟鲁司特组250例患者中有5例(2%),对照组250例患者中有12例(5%)(p<0.03)。
    结论:孟鲁司特可显著降低登革热预警信号和DSS的发生率,缩短住院时间,并降低登革热患者的死亡率,支持其与现有登革热治疗方案的潜在整合。这项研究强调需要进一步的临床试验来证实这些发现,并充分了解孟鲁司特在登革热管理中的治疗机制。
    BACKGROUND: Dengue fever continues to pose significant health challenges globally, with recent outbreaks in Bihar, India, prompting a search for effective therapeutic interventions. This study assesses the effectiveness of Montelukast, traditionally used for asthma, in mitigating the severity of dengue fever symptoms and its progression to dengue shock syndrome (DSS).
    OBJECTIVE: To evaluate the impact of Montelukast on the prevalence of dengue warning signs and the incidence of DSS in adult patients.
    METHODS: A prospective observational study was conducted at the Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, India, from August 2022 to October 2023, enrolling 500 patients diagnosed with dengue fever. Participants were divided into two groups. About 250 were treated with Montelukast and 250 received standard care. Outcomes measured included the incidence of warning signs, DSS, length of hospital stay, and 30-day mortality.
    RESULTS: The Montelukast group exhibited a 24% lower prevalence of dengue warning signs compared to the control group, with 90 out of 250 patients (36%) in the Montelukast group versus 150 out of 250 patients (60%) in the control group (p < 0.001). The incidence of DSS was significantly reduced in the Montelukast group, with 4 out of 250 patients (1.6%) compared to 21 out of 250 patients (8.4%) in the control group (odds ratio: 0.178, p < 0.001). Furthermore, Montelukast users experienced shorter hospital stays (average 4.52 days vs. 6.54 days, T-statistic: -7.59, p = 1.58×10-13) and a reduced 30-day mortality rate, with 5 out of 250 patients (2%) in the Montelukast group versus 12 out of 250 patients (5%) in the control group (p < 0.03).
    CONCLUSIONS: Montelukast significantly lowers the incidence of dengue warning signs and DSS, shortens hospital stays, and decreases mortality rates among dengue patients, supporting its potential integration into existing dengue treatment protocols. This study highlights the need for further clinical trials to confirm these findings and fully understand the therapeutic mechanisms of Montelukast in dengue management.
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  • 文章类型: Journal Article
    背景:登革热(DF)已成为中国重要的公共卫生问题。时空模式和影响其传播的潜在因素,然而,仍然难以捉摸。本研究旨在确定驱动这些变化的因素,并评估中国DF流行的城市风险。
    方法:我们分析了频率,强度,2003年至2022年中国DF病例分布,并评估了11个自然和社会经济因素作为潜在驱动因素。使用随机森林(RF)模型,我们评估了这些因素对当地DF流行的贡献,并预测了相应的城市风险.
    结果:2003年至2022年,本地和输入性DF流行病例数(r=0.41,P<0.01)和受影响城市(r=0.79,P<0.01)之间存在显着相关性。随着输入性疫情发生频率和强度的增加,当地的流行病变得更加严重。它们的发生率从每年5个月增加到8个月,案件数量每月从14到6641。城市级DF流行病的空间分布与Huhuanyong线(Hu线)和秦山淮河线(Q-H线)定义的地理分区一致,并且与蚊媒活动(83.59%)或DF传播(95.74%)的城市级时间窗口非常匹配。当考虑时间窗时,RF模型实现了高性能(AUC=0.92)。重要的是,他们将输入病例确定为主要影响因素,在湖线东部地区(E-H地区)的城市层面上,对当地DF流行的贡献显着(24.82%)。此外,发现进口病例对当地流行病有线性促进作用,而五个气候因素和六个社会经济因素表现出非线性效应(促进或抑制),具有不同的拐点值。此外,该模型在预测中国地方流行病的城市级风险方面表现出出色的准确性(命中率=95.56%)。
    结论:由于输入性DF流行的频率和强度不可避免地较高,中国正在经历零星的局部DF流行的增加。这项研究为卫生当局加强对这种疾病的干预能力提供了有价值的见解。
    BACKGROUND: Dengue fever (DF) has emerged as a significant public health concern in China. The spatiotemporal patterns and underlying influencing its spread, however, remain elusive. This study aims to identify the factors driving these variations and to assess the city-level risk of DF epidemics in China.
    METHODS: We analyzed the frequency, intensity, and distribution of DF cases in China from 2003 to 2022 and evaluated 11 natural and socioeconomic factors as potential drivers. Using the random forest (RF) model, we assessed the contributions of these factors to local DF epidemics and predicted the corresponding city-level risk.
    RESULTS: Between 2003 and 2022, there was a notable correlation between local and imported DF epidemics in case numbers (r = 0.41, P < 0.01) and affected cities (r = 0.79, P < 0.01). With the increase in the frequency and intensity of imported epidemics, local epidemics have become more severe. Their occurrence has increased from five to eight months per year, with case numbers spanning from 14 to 6641 per month. The spatial distribution of city-level DF epidemics aligns with the geographical divisions defined by the Huhuanyong Line (Hu Line) and Qin Mountain-Huai River Line (Q-H Line) and matched well with the city-level time windows for either mosquito vector activity (83.59%) or DF transmission (95.74%). The RF models achieved a high performance (AUC = 0.92) when considering the time windows. Importantly, they identified imported cases as the primary influencing factor, contributing significantly (24.82%) to local DF epidemics at the city level in the eastern region of the Hu Line (E-H region). Moreover, imported cases were found to have a linear promoting impact on local epidemics, while five climatic and six socioeconomic factors exhibited nonlinear effects (promoting or inhibiting) with varying inflection values. Additionally, this model demonstrated outstanding accuracy (hitting ratio = 95.56%) in predicting the city-level risks of local epidemics in China.
    CONCLUSIONS: China is experiencing an increasing occurrence of sporadic local DF epidemics driven by an unavoidably higher frequency and intensity of imported DF epidemics. This research offers valuable insights for health authorities to strengthen their intervention capabilities against this disease.
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  • 文章类型: Journal Article
    登革热是由登革病毒(DENV)引起的蚊媒病毒性疾病。它在全球范围内构成公共卫生威胁,虽然大多数登革热患者症状轻微或无症状,大约5%的受影响个体发展为严重疾病,需要住院治疗.然而,对登革热感染的分子机制以及病毒与其宿主之间的相互作用的了解仍然有限。在本研究中,我们对19例登革热患者和11例健康人的血清进行了定量蛋白质组学和N-糖蛋白质组学分析.结果揭示了两组之间不同的蛋白质组和N-糖蛋白组景观。值得注意的是,我们首次报道了登革热感染后血清N糖基化模式的变化,并提供了有关糖蛋白的丰富信息,糖基化位点,和完整的N-糖肽使用最近开发的位点特异性糖蛋白质组学方法。此外,鉴定了蛋白质组和N-糖蛋白质组中的一系列关键功能通路。总的来说,我们的发现显着提高了对宿主和DENV相互作用以及DENV的一般发病机制和病理学的理解,为登革热感染中糖基化和聚糖结构的功能研究奠定基础。
    Dengue fever is a mosquito-borne viral disease caused by the dengue virus (DENV). It poses a public health threat globally and, while most people with dengue have mild symptoms or are asymptomatic, approximately 5% of affected individuals develop severe disease and need hospital care. However, knowledge of the molecular mechanisms underlying dengue infection and the interaction between the virus and its host remains limited. In the present study, we performed a quantitative proteomic and N-glycoproteomic analysis of serum from 19 patients with dengue and 11 healthy people. The results revealed distinct proteomic and N-glycoproteomic landscapes between the two groups. Notably, we report for the first time the changes in the serum N glycosylation pattern following dengue infection and provide abundant information on glycoproteins, glycosylation sites, and intact N-glycopeptides using recently developed site-specific glycoproteomic approaches. Furthermore, a series of key functional pathways in proteomic and N-glycoproteomic were identified. Collectively, our findings significantly improve understanding of host and DENV interactions and the general pathogenesis and pathology of DENV, laying a foundation for functional studies of glycosylation and glycan structures in dengue infection.
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  • 文章类型: Journal Article
    登革热是一种病毒性疾病,主要由埃及伊蚊和白纹伊蚊传播。随着气候变化和城市化,越来越多的城市化地区正变得适合登革热媒介的生存和繁殖,因此越来越适合在中国传播登革热。重庆,中国西南部的一个大都市,最近受到输入性和本地登革热的影响,2019年经历首次局部疫情。然而,登革热病毒的遗传进化动态以及输入和本地登革热病例的时空模式尚未阐明。因此,这项研究使用2019年和2023年登革热病毒的基因组数据进行了系统发育分析,并对2013年至2022年收集的登革热病例进行了时空分析.我们对E基因的15个核苷酸序列进行了测序。登革热病毒形成单独的簇,与广东省的登革热病毒具有遗传相关性,中国,东南亚国家,包括老挝,泰国,缅甸和柬埔寨。2019年,重庆经历了登革热疫情,报告了168例输入性病例和1243例本地病例,主要在9月和10月。2013-2018年报告的病例很少,由于COVID-19的封锁,从2020年到2022年只有6例进口。我们的发现表明,重庆市的登革热预防应着眼于国内外人口流动,特别是在渝北和万州区,机场和火车站所在的地方,以及8月至10月期间,登革热在流行地区爆发。此外,应实施持续矢量监测,尤其是在8月至10月期间,这将有助于控制伊蚊。本研究对于明确重庆市适宜的登革热防控策略具有重要意义。
    Dengue fever is a viral illness, mainly transmitted by Aedes aegypti and Aedes albopictus. With climate change and urbanisation, more urbanised areas are becoming suitable for the survival and reproduction of dengue vector, consequently are becoming suitable for dengue transmission in China. Chongqing, a metropolis in southwestern China, has recently been hit by imported and local dengue fever, experiencing its first local outbreak in 2019. However, the genetic evolution dynamics of dengue viruses and the spatiotemporal patterns of imported and local dengue cases have not yet been elucidated. Hence, this study implemented phylogenetic analyses using genomic data of dengue viruses in 2019 and 2023 and a spatiotemporal analysis of dengue cases collected from 2013 to 2022. We sequenced a total of 15 nucleotide sequences of E genes. The dengue viruses formed separate clusters and were genetically related to those from Guangdong Province, China, and countries in Southeast Asia, including Laos, Thailand, Myanmar and Cambodia. Chongqing experienced a dengue outbreak in 2019 when 168 imported and 1,243 local cases were reported, mainly in September and October. Few cases were reported in 2013-2018, and only six were imported from 2020 to 2022 due to the COVID-19 lockdowns. Our findings suggest that dengue prevention in Chongqing should focus on domestic and overseas population mobility, especially in the Yubei and Wanzhou districts, where airports and railway stations are located, and the period between August and October when dengue outbreaks occur in endemic regions. Moreover, continuous vector monitoring should be implemented, especially during August-October, which would be useful for controlling the Aedes mosquitoes. This study is significant for defining Chongqing\'s appropriate dengue prevention and control strategies.
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  • 文章类型: Case Reports
    登革热(DF)和结核病(TB)带来了重大的全球健康挑战,通常具有重叠的临床特征,尤其是当并发登革热脑病等疾病时。我们提供了一个案例研究,涉及一名84岁男性,有复杂的病史,包括肺结核再激活,后来患上了登革热脑炎。这突显了在老年人群中管理此类病例的复杂性。登革热脑炎,曾经被认为是非亲神经的,越来越多的人认识到,有神经症状的患者需要考虑作为潜在的鉴别诊断,特别是在流行地区。我们的患者表现出典型的DF症状以及脑病的表现。同时,观察到继发性TB再激活,强调这些疾病之间错综复杂的相互作用。此外,下呼吸道感染(LRTI)进一步复杂化的临床表现。及时识别,综合治理至关重要,正如我们的案例所证明的,及时报告和保守措施导致了有利的结果。
    Dengue fever (DF) and tuberculosis (TB) present significant global health challenges, often with overlapping clinical features, especially when complicated by conditions like dengue encephalopathy. We present a case study involving an 84-year-old male with a complex medical history, encompassing pulmonary tuberculosis reactivation, who subsequently developed dengue encephalitis. This underscores the complexity of managing such cases in the geriatric population. Dengue encephalitis, once considered non-neurotropic, is increasingly recognized, necessitating consideration as a potential differential diagnosis in patients with neurological symptoms, particularly in endemic regions. Our patient exhibited typical DF symptoms alongside manifestations of encephalopathy. Concurrently, secondary TB reactivation was observed, emphasizing the intricate interplay between these diseases. Additionally, lower respiratory tract infection (LRTI) further complicated the clinical picture. Timely recognition and comprehensive management are crucial, as demonstrated in our case, where prompt reporting and conservative measures led to a favorable outcome.
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  • 文章类型: Journal Article
    介绍登革热,由埃及伊蚊传播的登革热病毒引起的,是全球重大公共卫生问题。近年来它的复苏,特别是在低收入和中等收入国家,导致发病率和死亡率上升。非典型表现,涉及心脏,肝脏,gut,gut肾,血,骨头,紧张,和呼吸系统,在登革热中,会使诊断和管理复杂化。本研究旨在探讨登革热感染者肺部表现的发生率及其与患者预后的相关性。背景在过去的二十年中,登革热的患病率急剧上升,亚洲首当其冲,尤其是印度。登革热肺部并发症的病理生理学尚不清楚,但被认为与毛细血管渗漏综合征和血小板减少症有关。研究表明,呼吸道症状可能与严重病例和死亡率增加有关。尽管印度的研究有限,了解登革热的肺部表现对于提高诊断准确性和患者护理至关重要。方法在K.S.Hegde医院进行回顾性研究。位于芒格洛尔的三级护理机构,印度,涉及2019年1月至12月诊断为登革热的18岁及以上患者。收集的数据包括患者人口统计,临床症状,实验室发现,成像结果,包括射线照片,胸部计算机断层扫描(CT)扫描(如果可访问),胸部和腹部的超声检查,和二维超声心动图,以及患者的结果。通过临床评估确定肺部表现的诊断,胸部X光解释,还有胸部的超声波.使用SPSSStatistics(第20版)进行统计分析,显著性设置为p<0.05。结果在255例登革热病例中,10.19%(n=26)出现肺部表现,以胸腔积液最为常见.年龄较大(>50岁)和合并症与肺部受累的发生率较高相关。呼吸道症状,比如呼吸困难,在肺部并发症患者中更为普遍。实验室参数表明有肺部表现的患者有不同的特征,包括增加的总计数,尿素,胆红素,和肝酶,血小板计数减少.肺部受累患者的死亡率更高,年龄较大,和合并症。讨论研究结果强调了识别登革热中呼吸道症状的重要性,尤其是老年患者和有潜在健康状况的患者。肺部受累与不良后果之间的关联强调了早期发现和适当管理策略的必要性。未来的研究应侧重于阐明登革热肺部并发症的病理生理学,并制定有针对性的干预措施以改善患者的预后。结论登革热的肺部表现是一个重要的临床挑战,并与发病率和死亡率增加有关。早期识别呼吸道症状,随着及时的诊断评估和适当的管理,对改善患者预后至关重要。有必要进行进一步的研究,以加深我们对登革热肺部受累的理解,并优化治疗方法以减轻其对患者预后的影响。
    Introduction Dengue fever, caused by the dengue virus transmitted by Aedes aegypti mosquitoes, is a significant public health concern globally. Its resurgence in recent years, particularly in low- and middle-income countries, has led to increased morbidity and mortality rates. Atypical manifestations, involving the cardiac, liver, gut, renal, blood, bone, nervous, and respiratory systems, in dengue, can complicate both diagnosis and management. This study aimed to investigate the incidence of lung manifestations in dengue-infected individuals and their correlation with patient outcomes. Background The prevalence of dengue fever has risen dramatically over the past two decades, with Asia bearing the brunt of the burden, particularly India. The pathophysiology of lung complications in dengue remains unclear but is thought to be related to capillary leak syndrome and thrombocytopenia. Studies suggest that respiratory symptoms may be associated with severe cases and increased mortality rates. Despite limited research in India, understanding lung manifestations in dengue is crucial for improving diagnostic accuracy and patient care. Methods A retrospective study was conducted at K.S. Hegde Hospital, a tertiary care facility located in Mangalore, India, involving patients aged 18 years and above diagnosed with dengue fever between January and December 2019. Data gathered comprised patient demographics, clinical symptoms, laboratory findings, imaging results including radiographs, computed tomography (CT) scans of the chest (if accessible), ultrasound examinations of the chest and abdomen, and 2D echocardiograms, as well as patient outcomes. Diagnosis of lung manifestation was established through clinical assessment, chest X-ray interpretation, and ultrasound of the chest. Statistical analysis was conducted using SPSS Statistics (version 20), with a significance set at p<0.05. Results Out of 255 dengue cases, 10.19% (n=26) exhibited pulmonary manifestations, with pleural effusion being the most common. Older age (>50 years) and comorbidities were associated with a higher incidence of lung involvement. Respiratory symptoms, such as breathlessness, were more prevalent in patients with pulmonary complications. Laboratory parameters indicated distinct profiles in patients with lung manifestations, including elevated total count, urea, bilirubin, and liver enzymes, and reduced platelet counts. Mortality rates were higher in patients with lung involvement, older age, and comorbidities. Discussion The study findings highlight the importance of recognizing respiratory symptoms in dengue fever, particularly in older patients and those with underlying health conditions. The association between pulmonary involvement and adverse outcomes underscores the need for early detection and appropriate management strategies. Future research should focus on elucidating the pathophysiology of lung complications in dengue and developing targeted interventions to improve patient outcomes. Conclusion Lung manifestations in dengue fever represent a significant clinical challenge and are associated with increased morbidity and mortality. Early recognition of respiratory symptoms, along with prompt diagnostic evaluation and appropriate management, is essential for improving patient prognosis. Further studies are warranted to deepen our understanding of lung involvement in dengue and optimize therapeutic approaches to mitigate its impact on patient outcomes.
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