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Journal of Investigative Medicine High... 2024Hemophagocytic lymphohistiocytosis (HLH) secondary to is rare, impacting <1% globally, with a mortality rate of up to 31%. Herein, we present a rare case of HLH... (Review)
Review
Hemophagocytic lymphohistiocytosis (HLH) secondary to is rare, impacting <1% globally, with a mortality rate of up to 31%. Herein, we present a rare case of HLH secondary to , affecting a 57-year-old female with rheumatoid arthritis. Extensive investigations were unrevealing and despite broad-spectrum antibiotics, her condition worsened, leading to respiratory failure requiring extracorporeal membrane oxygenation (ECMO) support, shock requiring multiple vasopressors, and acute kidney injury (AKI) requiring hemodialysis. Diagnosis confirmed disseminated histoplasmosis (DHP), prompting Amphotericin B and methylprednisolone treatment, resulting in significant improvement and discharge with posaconazole therapy. Secondary HLH, primarily arising from severe infections like DHP, is discussed. Limited research exists on this condition in human immunodeficiency virus (HIV)-seronegative individuals. Diagnosis involves HLH-2004 and HScore criteria. Managing histoplasmosis-associated HLH remains challenging due to multiorgan failure risks and treatment complexities and needs further research.
Topics: Humans; Lymphohistiocytosis, Hemophagocytic; Histoplasmosis; Female; Middle Aged; Antifungal Agents; Histoplasma; Amphotericin B
PubMed: 38813977
DOI: 10.1177/23247096241258074 -
Folia Parasitologica Apr 2024Coccidiosis is a protozoan intestinal disease that reduces the production of the sheep industry and causes large economic losses for sheep. Although chemically...
Coccidiosis is a protozoan intestinal disease that reduces the production of the sheep industry and causes large economic losses for sheep. Although chemically synthesised drugs are routinely employed to treat coccidiosis in sheep, the anticoccidial drug resistance and drug residues in edible meat have prompted an urgent search for alternatives. Herein, the anticoccidial properties of diclazuril, a conventional anticoccidial drug, and Allium sativum, Houttuynia cordata and Portulaca oleracea were assessed. Forty 45-day-old lambs naturally infected with Eimeria spp. were selected and randomly divided into five groups. The results showed that the sheep treated for coccidiosis had considerably decreased average daily gain (ADG) during both administration and withdrawal of the drug compared to the control group. Furthermore, at days 14, 21, 28 and 35, respectively, the three herbs and diclazuril had similar anticoccidial effects, with lower oocysts per gram (OPG) than the control group. On day 78, OPG in the three herbal groups was significantly lower than in the diclazuril group. In addition, the abundance and composition of the gut microbiota were changed in sheep treated with the three herbs and diclazuril compared to the untreated sheep. Moreover, some intestinal microorganisms have a correlation with OPG and ADG when using Spearman correlation analysis. In summary, our results suggest that all three herbs produce anticoccidial effects similar to diclazuril and modulate the balance of gut microbiota in growing lambs.
Topics: Animals; Coccidiosis; Gastrointestinal Microbiome; Sheep; Sheep Diseases; Drugs, Chinese Herbal; Oocysts; Coccidiostats; Eimeria; Triazines
PubMed: 38813809
DOI: 10.14411/fp.2024.009 -
PloS One 2024The dispensation of medicines in some low- and middle-income countries is often carried out by private vendors operating under constrained conditions. The aim of this...
INTRODUCTION
The dispensation of medicines in some low- and middle-income countries is often carried out by private vendors operating under constrained conditions. The aim of this study was to understand the challenges reported by employees of dispensaries, specifically, chemical and herbal shops and pharmacies in Accra, Ghana. Our objectives were twofold: (1) to assess challenges faced by medicine vendors related to dispensing antimicrobials (antibiotic and antimalarial medications), and (2) to identify opportunities for improving their stewardship of antimicrobials.
METHODS
Data were collected in 79 dispensaries throughout Accra, in 2021, using a survey questionnaire. We used open-ended questions, grounded on an adapted socioecological model of public health, to analyze these data and determine challenges faced by respondents.
RESULTS
We identified multiple, interlocking challenges faced by medicine vendors. Many of these relate to challenges of antimicrobial stewardship (following evidence-based practices when dispensing medicines). Overall, medicine vendors frequently reported challenges at the Customer and Community levels. These included strained interactions with customers and the prohibitive costs of medications. The consequences of these challenges reverberated and manifested through all levels of the socioecological model of public health (Entity, Customer, Community, Global).
DISCUSSION
The safe and effective distribution of medications was truncated by strained interactions, often related to the cost of medicines and gaps in knowledge. While addressing these challenges requires multifaceted approaches, we identified several areas that, if intervened upon, could unlock the great potential of antimicrobal stewardship. The effective and efficient implementation of key interventions could facilitate efforts spearheaded by medicine vendors and leverage the benefits of their role as health educators and service providers.
CONCLUSION
Addressing barriers faced by medicine vendors would provide an opportunity to significantly improve the provision of medications, and ultimately population health. Such efforts will likely expand access to populations who may otherwise be unable to access medications and treatment in formal institutions of care such as hospitals. Our findings also highlight the broad range of care provided by shopkeepers and vendors at dispensaries. These findings suggest that the meaningful engagement of dispensaries as valued conduits of community health is a promising pathway for interventions aiming to improve antimicrobial stewardship.
Topics: Ghana; Humans; Pharmacies; Surveys and Questionnaires; Antimicrobial Stewardship; Anti-Infective Agents; Commerce; Anti-Bacterial Agents; Antimalarials; Public Health
PubMed: 38809832
DOI: 10.1371/journal.pone.0281699 -
Ugeskrift For Laeger May 2024
Topics: Humans; Male; Testicular Diseases; Schistosomiasis; Anthelmintics; Praziquantel; Adult
PubMed: 38808760
DOI: 10.61409/V72026 -
Drug Design, Development and Therapy 2024The aim of this study is to uncover the anti-inflammatory propertity of andrographolide (AGP) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and...
PURPOSE
The aim of this study is to uncover the anti-inflammatory propertity of andrographolide (AGP) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and the underlying mechanisms related to the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome pathway.
METHODS
An in vivo experiment was conducted on murine model of AECOPD through endotracheal atomization of elastase and lipopolysaccharide (LPS). Intraperitoneal AGP was administered four times. NLRP3 inflammasome pathway molecules were examined using real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot analysis. By using enzyme-linked immunosorbent assay (ELISA), we tested interleukin (IL)-1β levels in bronchoalveolar lavage fluid. An in vitro study was conducted to determine how AGP impacts the NLRP3 inflammasome in THP-1 derived macrophages. The levels of molecules involved in the pathway were measured. Furthermore, molecular docking analyses were carried out to investigate the interactions between AGP and pathway targets.
RESULTS
In the in vivo study, NLRP3 inflammasome activation was observed in mice experiencing AECOPD. The administration of high-dose AGP demonstrated a mitigating effect on inflammatory cells infiltration in the lungs. Moreover, AGP administration effectively suppressed the expression of NLRP3, apoptosis associated speck-like protein that contains a CARD (PYCARD), cysteinyl aspartate-specific protease-1 (Caspase-1), IL-1β, and IL-18 at both the genetic and protein levels. In the in vitro experiment, IL-1β levels were significantly elevated in THP-1 derived macrophages with activated inflammasome compared to the control group. Furthermore, the downregulation of NLRP3, CASP1, and IL1B genes was observed upon the inhibition of NLRP3 expression through small interfering RNA (siRNA). AGP demonstrated inhibitory effects on the gene expression and protein levels of NLRP3, Caspase-1, and IL-1β. Additionally, molecular docking analysis confirmed that AGP exhibited a favorable binding affinity with all five targets of the pathway.
CONCLUSION
AGP effectively inhibited NLRP3 inflammasome activation and mitigated the inflammatory reaction of AECOPD both in animal models and in vitro experiments, highlighting the potential of AGP as a treatment for AECOPD with anti-inflammatory properties.
Topics: NLR Family, Pyrin Domain-Containing 3 Protein; Pulmonary Disease, Chronic Obstructive; Animals; Diterpenes; Mice; Inflammasomes; Humans; Mice, Inbred C57BL; Molecular Docking Simulation; Male; Inflammation; Disease Models, Animal; Dose-Response Relationship, Drug; Anti-Inflammatory Agents; Lipopolysaccharides; Structure-Activity Relationship
PubMed: 38808326
DOI: 10.2147/DDDT.S445788 -
Frontiers in Cellular and Infection... 2024The genus harbors opportunistic pathogenic species, among which is pathogenic for honeybees although little studied. Recently, virulent strains of colonizing the...
The genus harbors opportunistic pathogenic species, among which is pathogenic for honeybees although little studied. Recently, virulent strains of colonizing the mite's mouth were found vectored into the honeybee body, leading to septicemia and death. also occurs as an opportunistic pathogen in the honeybee's gut with a low absolute abundance. The population seems controlled by the host immune system, but its presence may represent a hidden threat, ready to arise when honeybees are weakened by biotic and abiotic stressors. To shed light on the pathogen, this research aims at studying 's development dynamics in the honeybee body and its interactions with the co-occurring fungal pathogen . Firstly, the degree of pathogenicity and the ability to permeate the gut epithelial barrier of three strains, isolated from honeybees and belonging to different species (, , and ), were assessed by artificial inoculation of newborn honeybees with different doses (10, 10, and 10 cells/mL). The absolute abundance of in the gut and in the hemocoel was assessed in qPCR with primers targeting the gene. Moreover, the absolute abundance of was assessed in the gut of honeybees infected with at different development stages and supplied with beneficial microorganisms and fumagillin. Our results showed that all tested strains could pass through the gut epithelial barrier and proliferate in the hemocoel, with being the most pathogenic. Moreover, under cage conditions, better proliferates when a infection is co-occurring, with a positive and significant correlation. Finally, fumagillin and some of the tested beneficial microorganisms could control both and development. Our findings suggest a correlation between the two pathogens under laboratory conditions, a co-occurring infection that should be taken into consideration by researches when testing antimicrobial compounds active against , and the related honeybees survival rate. Moreover, our findings suggest a positive control of by the environmental microorganism in a in vivo model, confirming the potential of this specie as beneficial bacteria for honeybees.
Topics: Animals; Bees; Serratia; Nosema; Serratia marcescens; Gastrointestinal Tract; Serratia Infections; Cyclohexanes; Serratia liquefaciens; Fatty Acids, Unsaturated; Sesquiterpenes
PubMed: 38808063
DOI: 10.3389/fcimb.2024.1323157 -
Heliyon May 2024Cystic echinococcosis (CE) is a significant global public health concern, particularly in regions where livestock rearing is prevalent. Despite its impact on morbidity...
Cystic echinococcosis (CE) is a significant global public health concern, particularly in regions where livestock rearing is prevalent. Despite its impact on morbidity and mortality, CE has received insufficient attention compared to other neglected tropical diseases. The complexities in CE management arise from challenges in early detection, effective treatment, and parasite eradication. The present study addresses this gap by exploring innovative therapeutic approaches using amide-based compounds. In recent years, computational approaches and studies have become prominent in neglected tropical disease drug discovery. Leveraging insights from previous studies on amide-based compounds with anti-parasitic potential, this study systematically designed, synthesized, and characterized a library of 30 amide compounds. The research integrated screening, molecular docking, and experimentation to assess the anti-echinococcal potential of these compounds. The study identified five promising amide compounds, namely 3,5-dinitro-N-p-tolylbenzamide, N-p-tolyl-1-naphthamide, N-p-tolyl-4-(trifluoromethoxy)benzamide, 4-pentyl-N-p-tolylbenzamide, and 2,3,4,5,6-pentafluoro-N-p-tolylbenzamide, based on their docking scores. These compounds were synthesized and characterized through various spectroscopic techniques, confirming their structural integrity. The cytotoxicity assay on HepG2 cell lines revealed varying degrees of cytotoxicity for the synthesized compounds. Notably, 4-pentyl-N-p-tolylbenzamide demonstrated the least cytotoxicity. Subsequent scolicidal activity assessments on protoscoleces demonstrated the potent protoscolicidal activity of N-p-tolyl-1-naphthamide, indicating its potential as an effective anti-echinococcal agent. Overall, this study presents a comprehensive exploration of amide-based compounds as potential therapeutic agents against CE. The findings contribute to the development of innovative strategies for CE treatment, addressing the urgent need for effective and safe drugs in managing this neglected tropical disease.
PubMed: 38807875
DOI: 10.1016/j.heliyon.2024.e31205 -
World Journal of Urology May 2024To evaluate antibiotic prophylaxis in transrectal prostate biopsies due to the recommendation of the European Medicines Agency (EMA): We describe our single center... (Comparative Study)
Comparative Study
BACKGROUND
To evaluate antibiotic prophylaxis in transrectal prostate biopsies due to the recommendation of the European Medicines Agency (EMA): We describe our single center experience switching from ciprofloxacin to fosfomycin trometamol (FMT) alone and to an augmented prophylaxis combining fosfomycin and trimethoprim/sulfamethoxazole (TMP/SMX).
METHODS
Between 01/2019 and 12/2020 we compared three different regimes. The primary endpoint was the clinical diagnosis of an infection within 4 weeks after biopsy. We enrolled 822 men, 398 (48%) of whom received ciprofloxacin (group-C), 136 (16.5%) received FMT (group-F) and 288 (35%) received the combination of TMP/SMX and FMT (group-BF).
RESULTS
Baseline characteristics were similar between groups. In total 37/398 (5%) postinterventional infections were detected, of which 13/398 (3%) vs 18/136 (13.2%) vs 6/288 (2.1%) were detected in group-C, group-F and group-BF respectively. The relative risk of infectious complication was 1.3 (CI 0.7-2.6) for group-C vs. group-BF and 2.8 (CI 1.4-5.7) for group-F vs. group-BF respectively.
CONCLUSION
The replacement of ciprofloxacin by fosfomycin alone resulted in a significant increase of postinterventional infections, while the combination of FMT and TMP/SMX had a comparable infection rate to FQ without apparent adverse events. Therefore, this combined regimen of FMT and TMP/SMX is recommended.
Topics: Humans; Male; Fosfomycin; Ciprofloxacin; Trimethoprim, Sulfamethoxazole Drug Combination; Antibiotic Prophylaxis; Aged; Middle Aged; Prostate; Anti-Bacterial Agents; Drug Therapy, Combination; Biopsy; Retrospective Studies; Rectum; Postoperative Complications
PubMed: 38806739
DOI: 10.1007/s00345-024-05048-4 -
PloS One 2024Despite integrated prevention and control measures, the prevalence of hookworm is still high in Ethiopia. The re-infection rates and predictors are poorly addressed....
BACKGROUND
Despite integrated prevention and control measures, the prevalence of hookworm is still high in Ethiopia. The re-infection rates and predictors are poorly addressed. Therefore, this study aimed to determine the patterns of hookworm re-infection rates and predictors among schoolchildren in northwest Ethiopia.
METHODS
A prospective follow-up study was conducted among 86 schoolchildren from May to December 2022. Data on predictors was collected using a questionnaire. Stool samples were collected and processed via Kato-Katz, McMaster, and spontaneous tube sedimentation techniques. All hookworm-infected children were treated with albendazole and followed for six months. The re-infection rates of hookworm were checked in the 4th and 6th months. Data was entered into Epi-data version 3.1 and analysed using SPSS version 25. Descriptive statistics were used to compute the re-infection rate. The associations of predictors with hookworm re-infection rates were calculated by logistic regression. Variables with a p-value < 0.05 were considered statistically significant.
RESULTS
Of the 86, 81 schoolchildren completed the study. The prevalence of hookworm re-infection in the 4th and 6th months was 23.5% and 33.3%, respectively. Living with family members greater than five (p = .017), poor utilization of latrine (p = .008), infrequent shoe wear (p = .039), and participating in irrigation (p = .020) were the predictors significantly associated with hookworm re-infections.
CONCLUSIONS
The re-infection rate was high during the fourth and sixth months. Participating in irrigation, infrequent shoe wear, and poor latrine utilization were predictors of hookworm re-infection. Therefore, mass drug administration, regular shoe wearing, and health education should be advocated.
Topics: Humans; Ethiopia; Child; Male; Female; Hookworm Infections; Prospective Studies; Albendazole; Prevalence; Reinfection; Adolescent; Feces; Follow-Up Studies; Anthelmintics; Ancylostomatoidea; Schools; Animals
PubMed: 38805475
DOI: 10.1371/journal.pone.0303502 -
Medical Sciences (Basel, Switzerland) May 2024Phospholipidosis is a rare disorder which consists of an excessive intracellular accumulation of phospholipids and the appearance of zebra bodies or lamellar bodies when... (Review)
Review
Double Hit of Hydroxichloroquine and Amiodarone Induced Renal Phospholipidosis in a Patient with Monoclonal Gammopathy and Sclerodermiform Syndrome: A Case Report and Review of the Literature.
Phospholipidosis is a rare disorder which consists of an excessive intracellular accumulation of phospholipids and the appearance of zebra bodies or lamellar bodies when looking at them using electron microscopy. This disease is associated with certain genetic diseases or is secondary to drugs or toxins. Drug-induced phospholipidosis encompasses many types of pharmaceuticals, most notably chloroquine, amiodarone or ciprofloxacin. Clinically and histologically, renal involvement can be highly variable, with the diagnosis not being made until the zebra bodies are seen under an electron microscope. These findings may require genetic testing to discount Fabry disease, as its histological findings are indistinguishable. Most of the chemicals responsible are cationic amphiphilic drugs, and several mechanisms have been hypothesized for the formation of zebra bodies and their pathogenic significance. However, the relationship between drug toxicity and phospholipid accumulation, zebra bodies and organ dysfunction remains enigmatic, as do the renal consequences of drug withdrawal. We present, to our knowledge, the first case report of acute renal injury with a monoclonal gammopathy of renal significance, lesions, and sclerodermiform syndrome, with zebra bodies that were associated with the initiation of a hydroxychloroquine and amiodarone treatment, as an example of drug-induced-phospholipidosis.
Topics: Humans; Acute Kidney Injury; Amiodarone; Hydroxychloroquine; Lipidoses; Paraproteinemias; Phospholipids; Female; Aged
PubMed: 38804381
DOI: 10.3390/medsci12020025