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Microbiology Spectrum Jun 2022Staphylococcus aureus causes a variety of debilitating and life-threatening diseases, and thus remains a challenging global health threat. S. aureus is remarkably...
Staphylococcus aureus causes a variety of debilitating and life-threatening diseases, and thus remains a challenging global health threat. S. aureus is remarkably diverse, yet only a minority of methicillin-resistant S. aureus (MRSA) clones have caused pandemic proportions of diseases. The genetic drivers of the successful dissemination of some clones across wide geographical expanses remain poorly understood. We analyzed 386 recently published MRSA genomes from bloodstream infections sampled in North, Central, and South America from 2011 to 2018. Here, we show that MRSA-associated bloodstream infections were attributable to two genetically distinct lineages. One lineage consisted almost exclusively of sequence type (ST) 8, which emerged in 1964. A second lineage emerged in 1986 and consisted of STs 5, 105, and 231. The two lineages have simultaneously disseminated across geographically distant sites. Sublineages rapidly diverged within locations in the early 2000s. Their diversification was associated with independent acquisitions of unique variants of the mobile -carrying chromosomal cassette and distinct repertoires of antimicrobial resistance genes. We show that the evolution and spread of invasive multidrug-resistant MRSA in the Americas was driven by transcontinental dissemination, followed by more recent establishment and divergence of local pathogen populations. Our study highlights the need for continued international surveillance of high-risk clones to control the global health threat of multidrug resistance. Bloodstream infections due to S. aureus cause significant patient morbidity and mortality worldwide, exacerbated by the emergence and spread of methicillin resistant S. aureus (MRSA). This study provides important insights on the evolution and long-distance geographic expansion of two distinct MRSA lineages that predominate in bloodstream infections in the past 5 decades. The success of these two lineages partly lies on their acquisition of a diverse set of antimicrobial resistance genes and of unique variants of the mobile genetic element SCC that carries the gene conferring resistance to beta-lactams. High-risk antimicrobial resistant clones can therefore rapidly disseminate across long distances and establish within local communities within a short period of time. These results have important implications for global initiatives and local epidemiological efforts to monitor and control invasive MRSA infections and transcontinental spread of multidrug resistance.
Topics: Americas; Anti-Bacterial Agents; Evolution, Molecular; Humans; Methicillin-Resistant Staphylococcus aureus; Sepsis; Staphylococcal Infections; Staphylococcus aureus
PubMed: 35638778
DOI: 10.1128/spectrum.00201-22 -
The Nursing Clinics of North America Dec 2022Despite the unprecedented obstacles created by the COVID-19 pandemic, nursing professional development practitioners and nurse educators successfully harnessed... (Review)
Review
Despite the unprecedented obstacles created by the COVID-19 pandemic, nursing professional development practitioners and nurse educators successfully harnessed educational technology to disseminate an extraordinary amount of vital information needed to provide care to a society in crisis. The agile adoption of educational technology allowed rapid access and dissemination of information that carried institutions through the uncharted waters of the pandemic and created a roadmap for mass education techniques to guide not only future disaster preparedness and crisis intervention but also application of nursing education in all arenas.
Topics: Humans; Pandemics; COVID-19; Education, Nursing; Faculty, Nursing; Technology
PubMed: 36280294
DOI: 10.1016/j.cnur.2022.06.005 -
Applied Geography (Sevenoaks, England) Aug 2021COVID-19 has emerged as a global pandemic caused by its highly transmissible nature during the incubation period. In the absence of vaccination, containment is seen as...
COVID-19 has emerged as a global pandemic caused by its highly transmissible nature during the incubation period. In the absence of vaccination, containment is seen as the best strategy to stop virus diffusion. However, public awareness has been adversely affected by discourses in social media that have downplayed the severity of the virus and disseminated false information. This article investigates COVID-19 related Twitter activity in May and June 2020 to examine the origin and nature of misinformation and its relationship with the COVID-19 incidence rate at the state and county level. A geodatabase of all geotagged COVID-19 related tweets was compiled. Multiscale Geographically Weighted Regression was employed to examine the association between social media activity and the spatial variability of disease incidence. Findings suggest that MGWR could explain 80% of the COVID-19 incidence rate variations indicating a strong spatial relationship between social media activity and spread of the Covid-19 virus. Discourse analysis was conducted on tweets to index tweets downplaying the pandemic or disseminating misinformation. Findings indicate that sites of Twitter misinformation showed more resistance to pandemic management measures in May and June 2020 later experienced a rise in the number of cases in July.
PubMed: 34103772
DOI: 10.1016/j.apgeog.2021.102473 -
Frontiers in Neurology 2022Newly emerged or constantly enlarged contrast-enhancing (CE) lesions were the necessary signs for the diagnosis of glioblastoma (GBM) progression. This study aimed to...
PURPOSE
Newly emerged or constantly enlarged contrast-enhancing (CE) lesions were the necessary signs for the diagnosis of glioblastoma (GBM) progression. This study aimed to investigate whether the T2-weighted-Fluid-Attenuated Inversion Recovery (T2/FLAIR) abnormal transformation could predict and assess progression for GBMs, especially for tumor dissemination.
METHODS
A consecutive cohort of 246 GBM patients with regular follow-up and sufficient radiological data was included in this study. The series of T2/FLAIR and T1CE images were retrospectively reviewed. The patients were separated into T2/FLAIR and T1CE discordant and accordant subgroups based on the initial progression images.
RESULTS
A total of 170 qualified patients were finally analyzed. The incidence of discordant T2/FLAIR and T1CE images was 25.9% (44/170). The median time-span of T2/FLAIR indicated tumor progression was 119.5 days (ranging from 57 days-unreached) prior to T1CE. Nearly half of patients (20/44, 45.5%) in the discordant subgroup suffered from tumor dissemination, substantially higher than accordant patients (23/126, 20.6%, < 0.001). The median time to progression (TTP), post-progression survival (PPS), and overall survival (OS) were not statistically different (all > 0.05) between discordant and accordant patients.
CONCLUSIONS
T2/FLAIR abnormity could be the sign of GBM progression, especially for newly emerged lesions disseminating from the primary cavity. Physicians should cast more attention on the dynamic change of T2/FLAIR images, which might be of great significance for progression assessment and subsequent clinical decision-making.
PubMed: 35185770
DOI: 10.3389/fneur.2022.819216 -
Cancer Letters Jun 2024Tumor cells disseminate in various distant organs at early stages of cancer progression. These disseminated tumor cells (DTCs) can stay dormant/quiescent without causing... (Review)
Review
Tumor cells disseminate in various distant organs at early stages of cancer progression. These disseminated tumor cells (DTCs) can stay dormant/quiescent without causing patient symptoms for years or decades. These dormant tumor cells survive despite curative treatments by entering growth arrest, escaping immune surveillance, and/or developing drug resistance. However, these dormant cells can reactivate to proliferate, causing metastatic progression and/or relapse, posing a threat to patients' survival. It's unclear how cancer cells maintain dormancy and what triggers their reactivation. What are better approaches to prevent metastatic progression and relapse through harnessing cancer dormancy? To answer these remaining questions, we reviewed the studies of tumor dormancy and reactivation in various types of cancer using different model systems, including the brief history of dormancy studies, the intrinsic characteristics of dormant cells, and the external cues at the cellular and molecular levels. Furthermore, we discussed future directions in the field and the strategies for manipulating dormancy to prevent metastatic progression and recurrence.
Topics: Humans; Neoplasms; Animals; Neoplasm Metastasis; Tumor Microenvironment; Disease Progression; Signal Transduction; Neoplasm Recurrence, Local; Cell Proliferation
PubMed: 38649107
DOI: 10.1016/j.canlet.2024.216899 -
Microorganisms Jun 2021is a Gram-negative pathogen responsible for community-acquired and nosocomial infections. The strains of this species belong to the opportunistic group, which is... (Review)
Review
is a Gram-negative pathogen responsible for community-acquired and nosocomial infections. The strains of this species belong to the opportunistic group, which is comprised of the multidrug-resistant strains, or the hypervirulent group, depending on their accessory genome, which determines bacterial pathogenicity and the host immune response. The aim of this survey is to present an overview of the murine models mimicking infectious processes (i.e., gastrointestinal colonization, urinary, pulmonary, and systemic infections), and the bacterial functions deployed to colonize and disseminate into the host. These in vivo approaches are pivotal to develop new therapeutics to limit infections via a modulation of the immune responses and/or microbiota.
PubMed: 34204632
DOI: 10.3390/microorganisms9061282 -
Cureus May 2021Disseminated cryptococcosis in children is a classic affliction associated with human immunodeficiency virus (HIV) infection or primary inherited immunodeficiency...
Disseminated cryptococcosis in children is a classic affliction associated with human immunodeficiency virus (HIV) infection or primary inherited immunodeficiency disorders (PID) with central nervous system being the most common site of dissemination. We report a rare case of disseminated cryptococcosis in an 11-year-old girl who presented with pulmonary involvement, hepatosplenomegaly, and generalized lymphadenopathy. No known inherited or acquired immune deficiencies were identified after a comprehensive laboratory work-up including genetic sequencing. She responded well to anti-fungal therapy (flucytosine and amphotericin followed by fluconazole) and is on regular follow-up.
PubMed: 34239794
DOI: 10.7759/cureus.15362 -
BMJ Open Dec 2023Healthcare systems are currently facing challenges in enhancing access and improving the quality of healthcare services around the world, and one of the innovative...
INTRODUCTION
Healthcare systems are currently facing challenges in enhancing access and improving the quality of healthcare services around the world, and one of the innovative strategies that have been used to address such challenges is the positive deviance (PD) approach. The approach assumes that identifying, examining, understanding and disseminating solutions to problems that are already available within the community and organisations including the healthcare system can help in bringing improvements at scale. However, to the best of the researcher's knowledge, there is no scoping review, that is, conducted to map and synthesise the available evidence on the use of the PD approach for healthcare system service improvements. Hence, this scoping review aims to map and synthesise resources on the methodologies and reported outcomes and identify gaps and potentials regarding the use of the PD approach in the healthcare system.
METHODS AND ANALYSIS
Articles will be searched and retrieved in research databases such as PubMed, Embase and Scopus. Retrieved articles will be screened independently for inclusion through a title and, or abstract review. Then, articles that passed the title and abstract review will be screened by reading the full texts. A descriptive mapping and synthesis of the literature will be employed to present data using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews checklist and data will be presented in text, figure and table formats.
ETHICS AND DISSEMINATION
The results of this scoping review will be published in peer-reviewed reputable international journals. Furthermore, it will also be disseminated through conference presentations, and popular press to the wider community. However, formal ethical approval is not required as primary data will not be collected.
Topics: Humans; Checklist; Databases, Factual; Delivery of Health Care; Peer Review; Research Design; Review Literature as Topic; Systematic Reviews as Topic; Clinical Protocols
PubMed: 38101832
DOI: 10.1136/bmjopen-2023-078809 -
Cureus Oct 2022Histoplasmosis is a chronic, infectious disease caused by the environmental fungus , primarily affecting the respiratory system. In immunocompromised patients,...
Histoplasmosis is a chronic, infectious disease caused by the environmental fungus , primarily affecting the respiratory system. In immunocompromised patients, histoplasmosis can become severely complicated due to dissemination into various other organ systems. Adrenal insufficiency is an uncommon complication of disseminated histoplasmosis, as its manifestation requires necrotizing granulomatous inflammation of both adrenal glands. We describe a rare case of delayed histoplasmosis in the bilateral adrenal glands and liver of an immunocompromised patient with development of symptoms at 21 years after liver transplant and nine years after renal transplant. In addition, this patient presented with secondary adrenal insufficiency due to long-term use of corticosteroids rather than the typical primary adrenal insufficiency seen in histoplasmosis with adrenal involvement.
PubMed: 36426344
DOI: 10.7759/cureus.30614 -
Pediatric Research Mar 2021
Topics: Access to Information; Black or African American; Clinical Trials as Topic; Communication; Focus Groups; Hispanic or Latino; Humans; Information Dissemination; Publications; Randomized Controlled Trials as Topic; Research Subjects; United States
PubMed: 32492697
DOI: 10.1038/s41390-020-0995-2