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Lancet (London, England) Apr 2024
Topics: Humans; Tonsillitis; Tonsillectomy; Recurrence; Child; Treatment Outcome
PubMed: 38677857
DOI: 10.1016/S0140-6736(24)00190-9 -
Lancet (London, England) Apr 2024
Topics: Humans; Tonsillitis; Tonsillectomy; Recurrence; Child; Treatment Outcome
PubMed: 38677856
DOI: 10.1016/S0140-6736(24)00189-2 -
Lancet (London, England) Apr 2024
Topics: Humans; Tonsillitis; Tonsillectomy; Recurrence; Child; Treatment Outcome
PubMed: 38677855
DOI: 10.1016/S0140-6736(24)00191-0 -
Lancet (London, England) Apr 2024
Topics: Humans; Tonsillitis; Tonsillectomy; Recurrence; Child; Treatment Outcome
PubMed: 38677854
DOI: 10.1016/S0140-6736(24)00188-0 -
Vaccines Apr 2024Vaccine development against group A (GAS) has gained traction in the last decade, fuelled by recognition of the significant worldwide burden of the disease. Several...
Vaccine development against group A (GAS) has gained traction in the last decade, fuelled by recognition of the significant worldwide burden of the disease. Several vaccine candidates are currently being evaluated in preclinical and early clinical studies. Here, we investigate two conjugate vaccine candidates that have shown promise in mouse models of infection. Two antigens, the J8 peptide from the conserved C-terminal end of the M protein, and the group A carbohydrate lacking -acetylglucosamine side chain (ΔGAC) were each conjugated to arginine deiminase (ADI), an anchorless surface protein from GAS. Both conjugate vaccine candidates combined with alum adjuvant were tested in a non-human primate (NHP) model of pharyngeal infection. High antibody titres were detected against J8 and ADI antigens, while high background antibody titres in NHP sera hindered accurate quantification of ΔGAC-specific antibodies. The severity of pharyngitis and tonsillitis signs, as well as the level of GAS colonisation, showed no significant differences in NHPs immunised with either conjugate vaccine candidate compared to NHPs in the negative control group.
PubMed: 38675764
DOI: 10.3390/vaccines12040382 -
Revue Des Maladies Respiratoires May 2024Asthma is a pathology that remains severe and is inadequately controlled in 4% of patients. Identification of multiple pathophysiological mechanisms has led to the... (Review)
Review
INTRODUCTION
Asthma is a pathology that remains severe and is inadequately controlled in 4% of patients. Identification of multiple pathophysiological mechanisms has led to the development of biomedicines, of which there are currently five available in France, with a safety profile that appears favorable but remains uncertain due to a lack of real-life experience with these new molecules.
STATE OF KNOWLEDGE
Although relatively benign, the adverse effects of biologics are diverse. Headache, joint pain, skin reactions at the injection site, fever and asthenia are commonly observed during the different treatments. Ophthalmological complications seem restricted to dupilumab, with numerous cases of keratitis and conjunctivitis in patients with atopic dermatitis. Several respiratory complications have also been observed, essentially consisting in pharyngitis and other upper respiratory infections. Hypereosinophilia may occur, mainly with dupilumab, requiring investigation of systemic repercussions or vasculitis. Allergic reactions are uncommon but require careful monitoring during initial injections.
CONCLUSION
Biologics for severe asthma are recent drugs with a favorable safety profile, but with little real-life experience, justifying increased vigilance by prescribing physicians.
Topics: Humans; Asthma; Biological Products; Anti-Asthmatic Agents; Severity of Illness Index; Antibodies, Monoclonal, Humanized; Omalizumab; France
PubMed: 38653607
DOI: 10.1016/j.rmr.2024.04.001 -
American Family Physician Apr 2024Group A beta-hemolytic streptococcal pharyngitis is a common infection responsible for more than 6 million office visits in the United States annually. Only 10% of... (Review)
Review
Group A beta-hemolytic streptococcal pharyngitis is a common infection responsible for more than 6 million office visits in the United States annually. Only 10% of adults seeking care for a sore throat have group A beta-hemolytic streptococcal pharyngitis; however, 60% or more are prescribed antibiotics. Guidelines recommend using clinical decision rules to assess the risk of group A beta-hemolytic streptococcal infection, followed by rapid antigen testing if a diagnosis is unclear, before prescribing antibiotics. Fever, tonsillar exudate, cervical lymphadenitis, and patient ages of 3 to 15 years increase clinical suspicion. A cough is more suggestive of a viral etiology. The limited history used in these decision rules is amenable to virtual visits. After a negative rapid antigen test result, a throat culture is recommended in children and adolescents. Penicillin and amoxicillin are first-line antibiotics, with a recommended course of 10 days; first-generation cephalosporins are recommended for patients with nonanaphylactic allergies to penicillin. There is significant resistance to azithromycin and clarithromycin in some parts of the United States. Steroids are not recommended for symptomatic treatment. Patients with worsening symptoms after appropriate antibiotic initiation or with symptoms lasting 5 days after the start of treatment should be reevaluated. Tonsillectomy is rarely recommended as a preventive measure: seven episodes of streptococcal pharyngitis in 1 year, five episodes in each of the past 2 years, or three episodes in each of the past 3 years are commonly used thresholds for considering surgery.
Topics: Humans; Pharyngitis; Streptococcal Infections; Anti-Bacterial Agents; Streptococcus pyogenes; Child; Practice Guidelines as Topic; Adolescent; United States; Adult
PubMed: 38648833
DOI: No ID Found -
American Family Physician Apr 2024
Topics: Humans; Pharyngitis; Anti-Bacterial Agents
PubMed: 38648823
DOI: No ID Found -
Radiology Case Reports Jul 2024, found as normal flora in healthy individuals, is an unusual culprit for pharyngitis and sinusitis in young adults, rarely leading to severe infections. Here, we...
, found as normal flora in healthy individuals, is an unusual culprit for pharyngitis and sinusitis in young adults, rarely leading to severe infections. Here, we present a singular case involving a 19-year-old immunocompetent male who experienced complications arising from sinusitis, leading to orbital and intracranial sinogenic complications. The patient developed severe cerebral vasospasm with delayed cerebral ischemia, necessitating aggressive management encompassing daily catheter-directed intra-arterial infusions, surgical source control, and maximal medical therapy. This case explores the challenging diagnostic and management aspects associated with cerebral artery vasospasm secondary to bacterial meningoencephalitis. The abrupt neurological decline in such patients presents a dilemma in recognizing the occurrence of cerebral vasospasm versus the progression of meningoencephalitis. By utilizing computed tomography brain perfusion scans, we were able to identify delayed cerebral ischemia due to cerebral vasospasm, acknowledging that this modality was not used to identify classical territorial stroke infarcts. This decision was made based on the understanding of the potential for bacterial-induced cerebral vasospasm to involve both hemispheres.
PubMed: 38645946
DOI: 10.1016/j.radcr.2024.03.029 -
Clinical Case Reports Apr 2024When seeing patients who present with atypical lymphocytes and abdominal pain without accompanying symptoms of pharyngitis or lymphadenopathy, acalculous cholecystitis...
KEY CLINICAL MESSAGE
When seeing patients who present with atypical lymphocytes and abdominal pain without accompanying symptoms of pharyngitis or lymphadenopathy, acalculous cholecystitis caused by CMV infection should be considered as a differential diagnosis.
ABSTRACT
A teenage man presented with a fever and epigastric pain. The patient tested positive for cytomegalovirus IgG and IgM. Abdominal ultrasonography and contrast-enhanced CT revealed hepatosplenomegaly and gallbladder wall thickening. MRI did not identify gallstones or tumorous lesions. He was diagnosed with infectious mononucleosis and acalculous cholecystitis caused by cytomegalovirus.
PubMed: 38634095
DOI: 10.1002/ccr3.8771