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BMC Infectious Diseases Jan 2022Diphtheria is a contagious vaccine-preventable disease that contributes to the high morbidity and mortality among under 5 children, especially in Yemen. As a consequence...
BACKGROUND
Diphtheria is a contagious vaccine-preventable disease that contributes to the high morbidity and mortality among under 5 children, especially in Yemen. As a consequence of war and collapse of the health system, a fatal epidemic occurred at the end of 2017. This study aims to describe the epidemiology of diphtheria by time, place, and person and vaccination status of affected children.
METHODS
A study was conducted in Sada'a governorate by using accumulative line list of diphtheria from November 2017 to September 2020 at electronic Integrated Disease Early Warning System (eIDEWS). The case definition of WHO was adopted. Data was analyzed by Microsoft Excel and Epi info- version 7.2 and multivariable logistic analysis used for identifying significant associated factors.
RESULTS
747 cases were met of WHO case definition. The annual peak of cases started during week 31 and weak 49. Males were slightly more than females (51% vs 49%) and about 35% of cases involved children aged 10 to < 15 years. The overall incidence of diphtheria and case fatality rate (CFR) were 69/ 100,000 and 6.4%, respectively. The highest CFR was among age groups under 5 years 11% (P < 0.001) and among females was 8%. Dysphagia and swollen lymph nodes were the predominant symptoms 98%, 92%, respectively. Based on the Vaccination status, the percentage of unvaccinated and unknown were 53% and 41% respectively, with CFR 11% among cases who received one dose. Furthermore, the most case were from Sahar 40% with case fatality rate 8% and the highest CFR was significantly higher among cases in border and ongoing conflict district (P < 0.05).
CONCLUSIONS
The findings highlight that diphtheria is still an ongoing cause of morbidity and mortality among under 5 children in Sada'a that is rising with the low diphtheria immunization coverage. Therefore, concomitant efforts should now focus on improving and monitoring routine immunization across all age groups and healthcare services, especially in borders and continuing conflict districts.
Topics: Child; Child, Preschool; Diphtheria; Disease Outbreaks; Female; Humans; Infant; Male; Vaccination; Vaccination Coverage; Yemen
PubMed: 35016630
DOI: 10.1186/s12879-022-07033-x -
Journal of Virus Eradication Jul 2018The human T-cell lymphotropic virus type 1 (HTLV-1) is aetiologically linked to myelopathy/tropical spastic paraparesis (HAM/TSP) and adult T cell leukaemia (ATL)...
INTRODUCTION
The human T-cell lymphotropic virus type 1 (HTLV-1) is aetiologically linked to myelopathy/tropical spastic paraparesis (HAM/TSP) and adult T cell leukaemia (ATL) besides other less incident pathologies, while the type 2 has not been definitively linked to any diseases.
OBJECTIVES
To determine the HTLV-1/2 seroprevalence in two Brazilian communities in northern Brazil.
METHODS
In 2010 and 2015, HTLV-1/2 serological surveys were carried out in the Oiapoque county at the Brazilian border with French Guiana and in Santa Cruz do Arari, Marajó Island. Serum and breast-milk samples from 317 women (pregnant, lactating and non-pregnant non-lactating) resident in the Oiapoque county, together with serum samples from 217 females and 70 males living in Santa Cruz do Arari county, were twice screened by two distinct commercial immunoassay methods for antibodies to HTLV-1/2. Seroreactivity was confirmed by a commercial Western blot technique. Participants were interviewed for data concerning their health, socioeconomic and educational status.
RESULTS
None of the Oiapoque women, mostly young and descendants of migrants, had antibodies to HTLV-1/2, despite the high HTLV-1 prevalence in neighbouring French Guiana and Caribbean Islands, while five females and three males living in Santa Cruz do Arari county were HTLV-1 infected as confirmed by Western blot testing. In contrast, the Santa Cruz do Arari community lives in relative isolation and is descended mostly from black African people with high consanguinity.
CONCLUSION
Despite the proximity between Oiapoque and Santa Cruz do Arari counties, ethnic, age differences, community isolation and consanguinity may explain the distinct HTLV-1/2 epidemiology in these areas of northern Brazil.
PubMed: 30050680
DOI: No ID Found -
Developmental Biology Dec 2018The neural crest has been the main object of my investigations during my career in science, up to now. It is a fascinating topic for an embryologist because of its two... (Review)
Review
The neural crest has been the main object of my investigations during my career in science, up to now. It is a fascinating topic for an embryologist because of its two unique characteristics: its large degree of multipotency and the fact that its development involves a phase during which its component cells migrate all over the embryo and settle in elected sites where they differentiate into a large variety of cell types. Thus, neural crest development raises several specific questions that are at the same time, of general interest: what are the mechanisms controlling the migratory behavior of the cells that detach from the neural plate borders? What are the migration routes taken by the neural crest cells and the environmental factors that make these cells stop in elected sites where they differentiate into a definite series of cell types? When I started to be interested in the neural crest, in the late 1960s, this embryonic structure was the subject of investigations of only a small number of developmental biologists. Fifty years later, it has become the center of interest of many laboratories over the world. The 150 anniversary of its discovery is a relevant opportunity to consider the progress that has been accomplished in our knowledge on the development of this ubiquitous structure, the roles it plays in the physiology of the organism through its numerous and widespread derivatives and its relationships with its environment, as well as the evolutionary advantages it has conferred to the vertebrate phylum. I wish to thank Pr Marianne Bronner, Chief Editor of Developmental Biology and Special Issue Guest Editor, for dedicating a special issue of this journal to this particular structure of the vertebrate embryo. In the following pages, Elisabeth Dupin and I will report some of the highlights of our own acquaintance with the neural crest of the avian embryo, after retracing the main trends of the discoveries of the historical pioneers.
Topics: Animals; Biological Evolution; Body Patterning; Cell Differentiation; Cell Movement; Chick Embryo; Melanocytes; Neural Crest; Neural Plate; Neurogenesis; Quail; Vertebrates
PubMed: 30048640
DOI: 10.1016/j.ydbio.2018.07.019 -
Chest Apr 2020Regional and/or national severe asthma registries provide valuable country-specific information. However, they are often limited in scope within the broader definitions... (Review)
Review
Regional and/or national severe asthma registries provide valuable country-specific information. However, they are often limited in scope within the broader definitions of severe asthma, have insufficient statistical power to answer many research questions, lack intraoperability to share lessons learned, and have fundamental differences in data collected, making cross comparisons difficult. What is missing is a worldwide registry which brings all severe asthma data together in a cohesive way, under a single umbrella, based on standardized data collection protocols, permitting data to be shared seamlessly. The International Severe Asthma Registry (ISAR; http://isaregistries.org/) is the first global adult severe asthma registry. It is a joint initiative where national registries (both newly created and preexisting) retain ownership of their own data but open their borders and share data with ISAR for ethically approved research purposes. Its strength comes from collection of patient-level, anonymous, longitudinal, real-life, standardized, high-quality data (using a core set of variables) from countries across the world, combined with organizational structure, database experience, inclusivity/openness, and clinical, academic, and database expertise. This gives ISAR sufficient statistical power to answer important research questions, sufficient data standardization to compare across countries and regions, and the structure and expertise necessary to ensure its continuance and the scientific integrity and clinical applicability of its research. ISAR offers a unique opportunity to implement existing knowledge, generate new knowledge, and identify the unknown, therefore promoting new research. The aim of this commentary is to fully describe how ISAR may improve our understanding of severe asthma.
Topics: Asthma; Global Health; Humans; International Cooperation; Registries; Severity of Illness Index
PubMed: 31838187
DOI: 10.1016/j.chest.2019.10.051 -
Annals of Global Health 2022In high income countries struggling with escalating health care costs and persistent lack of equity, there is growing interest in searching for innovative solutions... (Review)
Review
BACKGROUND
In high income countries struggling with escalating health care costs and persistent lack of equity, there is growing interest in searching for innovative solutions developed outside national borders, particularly in low- and middle-income countries (LMICs). Engaging with global ideas to apply them to local health equity challenges is becoming increasingly recognized as an approach to shift the health equity landscape in the United States (US) in a significant way. No single name or set of practices yet defines the process of identifying LMIC interventions for adaptation; implementing interventions in high-income countries (HIC) settings; or evaluating the implementation of such projects.
OBJECTIVES
This paper presents a review of the literature describing the practice of adapting global ideas for use in the US, particularly in the area of health equity. Specifically, the authors sought to examine; (i) the literature that advocates for, or describes, adaption of health-related innovations from LMICs to HICs, both generally and for health equity specifically, and (ii) implementation practices, strategies, and evidence-based outcomes in this field, generally and in the area of health equity specifically. The authors also propose terminology and a definition to describe the practice.
METHODS
The literature search included two main concepts: global learning and health equity (using these and related terms). The search consisted of text-words and database-specific terminology (e.g., MeSH, Emtree) using PubMed, Embase (Elsevier), CINAHL (Ebsco), and Scopus in March 2021. The authors also contacted relevant experts to identify grey literature. Identified sources were categorized according to theme to facilitate analysis. In addition, five key interviews with experts engaged with global ideas to promote health equity in the United States were conducted to develop additional data.
RESULTS
The literature review yielded over ninety (n = 92) sources relating to the adaptation of global ideas from low resource to higher resource settings to promote health equity (and related concepts). Identified sources range from those providing general commentaries about the value of seeking health-related innovations outside the US border to sources describing global projects implemented in the US, most without implementation or outcome measures. Other identified sources provide frameworks or guidance to help identify and/or implement global ideas in the US, and some describe the role of the World Health Organization and other international consortia in promoting a global approach to solving domestic health equity and related challenges.
CONCLUSIONS
The literature review demonstrates that there are resources and commentary describing potential benefits of identifying and adapting novel global ideas to address health equity in the US, but there is a dearth of implementation and evaluation data. Terminology is required to define and frame the field. Additional research, particularly in the area of implementation science and evidence-based frameworks to support the practice of what we define as 'global learning' for health equity, is necessary to advance the practice.
Topics: Humans; United States; Health Promotion; Health Equity; Learning
PubMed: 36348705
DOI: 10.5334/aogh.3810 -
Indian Journal of Endocrinology and... Oct 2013The main physiological function of vitamin D is maintenance of calcium homeostasis by its effect on calcium absorption, and bone health in association with parathyroid... (Review)
Review
The main physiological function of vitamin D is maintenance of calcium homeostasis by its effect on calcium absorption, and bone health in association with parathyroid gland. Vitamin D deficiency (VDD) is defined as serum 25-hydroxy vitamin D (25OHD) levels <20 ng/ml. Do all subjects with VDD have clinical disease according to this definition? We hypothesize that there exist an intestinal calcistat, which controls the calcium absorption independent of PTH levels. It consists of calcium sensing receptor (CaSR) on intestinal brush border, which senses calcium in intestinal cells and vitamin D system in intestinal cells. CaSR dampens the generation of active vitamin D metabolite in intestinal cells and decrease active transcellular calcium transport. It also facilitates passive paracellular diffusion of calcium in intestine. This local adaptation adjusts the fractional calcium absorption according the body requirement. Failure of local adaptation due to decreased calcium intake, decreased supply of 25OHD, mutation in CaSR or vitamin D system decreases systemic calcium levels and systemic adaptations comes into the play. Systemic adaptations consist of rise in PTH and increase in active vitamin D metabolites. These adaptations lead to bone resorption and maintenance of calcium homeostasis. Not all subjects with varying levels of VDD manifest with secondary hyperparathyroidism and decreased in bone mineral density. We suggest that rise in PTH is first indicator of VDD along with decrease in BMD depending on duration of VDD. Hence, subjects with any degree of VDD with normal PTH and BMD should not be labeled as vitamin D deficient. These subjects can be called subclinical VDD, and further studies are required to assess beneficial effect of vitamin D supplementation in this subset of population.
PubMed: 24251176
DOI: 10.4103/2230-8210.119497 -
Revista Espanola de Cardiologia May 2011The improvements in cancer detection and therapy have created a new cohort of patients who will experience sufficient survival to develop the cardiac complications of... (Review)
Review
The improvements in cancer detection and therapy have created a new cohort of patients who will experience sufficient survival to develop the cardiac complications of the cancer therapy. Three-dimensional echocardiography has been validated as the ultrasound modality with the best accuracy for the calculation of ejection fraction when compared to magnetic resonance imaging, the current gold standard, making it the tool of choice, when available, for the initial evaluation and follow up of the patient receiving chemotherapy. If three-dimensional echocardiography is not available, or if the quality of the images is inadequate, the use of ultrasound contrast can be useful for the definition of the endocardial border and identification of the true apex of the heart, enhancing the ability of the interpreter to accurately calculate volumes and ejection fraction. Two-dimensional strain appears promising as a tool to identify abnormalities in myocardial mechanics very early on during cardiotoxicity, allowing the prediction of later overt systolic dysfunction. This parameter may be useful in the detection of chemotherapy treated patients who could benefit from alternate therapies, thereby decreasing the incidence of cardiotoxicity and its associated morbidity and mortality.
Topics: Antineoplastic Agents; Heart Diseases; Humans; Neoplasms; Ultrasonography
PubMed: 21492985
DOI: 10.1016/j.recesp.2010.12.013 -
Neurogenesis (Austin, Tex.) 2017The neural crest is a transient cell population that gives rise to various cell types of multiple tissues and organs in the vertebrate embryo. Neural crest cells arise... (Review)
Review
The neural crest is a transient cell population that gives rise to various cell types of multiple tissues and organs in the vertebrate embryo. Neural crest cells arise from the neural plate border, a region localized at the lateral borders of the prospective neural plate. Temporally and spatially coordinated interaction with the adjacent tissues, the non-neural ectoderm, the neural plate and the prospective dorsolateral mesoderm, is required for neural plate border specification. Signaling molecules, namely BMP, Wnt and FGF ligands and corresponding antagonists are derived from these tissues and interact to induce the expression of neural plate border specific genes. The present mini-review focuses on the current understanding of how the NPB territory is formed and accentuates the need for coordinated interaction of BMP and Wnt signaling pathways and precise tissue communication that are required for the definition of the prospective NC in the competent ectoderm.
PubMed: 28352644
DOI: 10.1080/23262133.2017.1292783 -
Medicina 2023Myelolipoma is a benign non-functional tumor. Most of them are asymptomatic and discovered incidentally, either through imaging studies or at autopsy. While it most...
Myelolipoma is a benign non-functional tumor. Most of them are asymptomatic and discovered incidentally, either through imaging studies or at autopsy. While it most commonly occurs in the adrenal gland, it has also been reported at extra-adrenal sites. We present the case of a 65-year-old woman with a primary mediastinal myelolipoma. Computer tomographic scan of the thorax showed an ovoid tumor with well-defined borders of 6.5 × 4.2 cm, located in the posterior mediastinum. A transthoracic biopsy of the lesion was made, and the microscopic observation revealed hematopoietic cells and mature adipose tissue. Although computed tomography and magnetic resonance imaging are effective in diagnosing mediastinal myelolipoma, histopathological examination is essential for the definitive diagnosis.
Topics: Female; Humans; Aged; Mediastinum; Myelolipoma; Thoracic Surgery, Video-Assisted; Radionuclide Imaging; Adrenal Gland Neoplasms
PubMed: 37379542
DOI: No ID Found -
Medical Hypothesis, Discovery &... 2019Corneal pseudoguttata (PG), also known as pseudoguttae or secondary guttata, is a transient, reversible endothelial edema commonly associated with anterior segment... (Review)
Review
Corneal pseudoguttata (PG), also known as pseudoguttae or secondary guttata, is a transient, reversible endothelial edema commonly associated with anterior segment pathology. While considered rare, PG presents on slit-lamp examination more commonly than originally thought. We have clinically observed PG after refractive surgeries, in association with infectious keratitis, and following medication use. PG presents as dark lesions on slit-lamp exam with specular illumination, similar to primary corneal guttata. PG is distinct from guttata because PG resolves over time and does not involve Descemet's membrane. Other ocular findings that may be confused with guttata include endothelial blebs (EB) and endothelial denudation (ED). EB are possibly a type of PG that present after contact lens use or hypoxia. ED is a distinct entity that is characterized by loss of endothelial cells without involvement of Descemet's membrane. Confocal microscopy may be useful in differentiating these four endothelial lesions, with differences in border definition and the presence of hyperreflective areas two main distinctions. PG presents as a hyporeflective, elevated shape without clear borders on confocal microscopy. PG, EB, and ED can resolve with time without the need for surgical intervention, unlike corneal guttata. Treatment of the underlying condition will lead to resolution of both PG and EB.
PubMed: 31598518
DOI: No ID Found