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The Zika prevention handbook : everything you need to know to stay safe
\"As the Zika virus continues to spread throughout North America, people need answers. What are the origins of this virus? How does it spread? Should we be concerned? How can we stop the spread of infected mosquitos? With the increasing prevalence of Zika, concrete answers are needed now more than ever - The Zika Prevention Handbook serves as the best reference for readers to stay informed about side-effects and symptoms, and to minimize your chance of contracting the virus. The Zika virus is a mosquito-borne infection that is estimated to have originated in Africa in the mid 1940's. In the last several years, the Zika virus has infected thousands of people around the world and has spread to over 60 countries. As of August 2016, Zika-infected mosquitoes have found a new home, the United States. The Zika virus has been reported in all 50 U.S. states, in addition to hundreds of reported cases throughout Mexico and Canada. With the assistance of infectious disease expert, Laura D. Kramer, PhD, author Alexander Webb has compiled the leading research from the U.S. Centers for Disease Control and Prevention (CDC). Whether you're an expectant mother worried about microcephaly (a side effect of Zika that causes babies to be born with abnormally small heads), planning a vacation to a tropical area, or living in an area where these contagious mosquitoes reside, this book is guaranteed to answer all your questions and ease your fears. Readers will learn about Zika's origins, transmission of the infection, leading prevention techniques, medical testing, symptoms and diagnosis, and much more.\" --Publisher's description.
Book
Myocarditis and inflammatory cardiomyopathy: current evidence and future directions
Inflammatory cardiomyopathy, characterized by inflammatory cell infiltration into the myocardium and a high risk of deteriorating cardiac function, has a heterogeneous aetiology. Inflammatory cardiomyopathy is predominantly mediated by viral infection, but can also be induced by bacterial, protozoal or fungal infections as well as a wide variety of toxic substances and drugs and systemic immune-mediated diseases. Despite extensive research, inflammatory cardiomyopathy complicated by left ventricular dysfunction, heart failure or arrhythmia is associated with a poor prognosis. At present, the reason why some patients recover without residual myocardial injury whereas others develop dilated cardiomyopathy is unclear. The relative roles of the pathogen, host genomics and environmental factors in disease progression and healing are still under discussion, including which viruses are active inducers and which are only bystanders. As a consequence, treatment strategies are not well established. In this Review, we summarize and evaluate the available evidence on the pathogenesis, diagnosis and treatment of myocarditis and inflammatory cardiomyopathy, with a special focus on virus-induced and virus-associated myocarditis. Furthermore, we identify knowledge gaps, appraise the available experimental models and propose future directions for the field. The current knowledge and open questions regarding the cardiovascular effects associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are also discussed. This Review is the result of scientific cooperation of members of the Heart Failure Association of the ESC, the Heart Failure Society of America and the Japanese Heart Failure Society.In this Review, Tschöpe and colleagues summarize and evaluate the available evidence on the pathogenesis, diagnosis and treatment of myocarditis and inflammatory cardiomyopathy, with special focus on virus-induced and virus-associated myocarditis. The authors also identify knowledge gaps, appraise available experimental models and propose future directions for the field.
Journal Article
Deadly companions : how microbes shaped our history
Follow the interlinked history of microbes and man, taking an up-to-date look at ancient plagues and epidemics and exploring how changes in the way humans have lived throughout history have made us vulnerable to microbe attack. The idea of a world free of dangerous microbes is an illusion and we will never fully shake off our deadly companions.
Book
The Culture of AIDS in Africa
This book enters into the many worlds of expression brought forth across Africa by the ravaging presence of HIV/AIDS. Africans and non-Africans, physicians and social scientists, journalists and documentarians share here a common and essential interest in understanding creative expression in crushing and uncertain times. Chapters investigate and engage the social networks, power relationships, and cultural structures that enable the arts to convey messages of hope and healing, and of knowledge and good counsel to the wider community. And from Africa to the wider world, the text here brings intimate, inspiring portraits of the performers, artists, communities, and organizations that have shared here their insights and the sense they have made of their lives and actions from deep within this devastating epidemic. Covering the wide expanse of the African continent, the chapters include explorations of, for example, the use of music to cope with AIDS; the relationship between music, HIV/AIDS, and social change; visual approaches to HIV literacy; radio and television as tools for “edutainment”; several individual artists’ confrontations with HIV/AIDS; various performance groups’ response to the epidemic; combating HIV/AIDS with local cultural performance; and more. Source material, such as song lyrics and interviews, weaves throughout the collection, which is a nuanced and profoundly affective portrayal of the intricate relationship between HIV/AIDS and the arts in Africa.
eBook
Staphylococcus aureus Screening and Decolonization in Orthopaedic Surgery and Reduction of Surgical Site Infections
Background
Staphylococcus aureus is the most common organism responsible for orthopaedic surgical site infections (SSIs). Patients who are carriers for methicillin-sensitive S. aureus or methicillin-resistant S. aureus (MRSA) have a higher likelihood of having invasive S. aureus infections. Although some have advocated screening for S. aureus and decolonizing it is unclear whether these efforts reduce SSIs.
Questions/purposes
The purposes of this study were to determine (1) whether S. aureus screening and decolonization reduce SSIs in orthopaedic patients and (2) if implementing this protocol is cost-effective.
Methods
Studies for this systematic review were identified by searching PubMed, which includes MEDLINE (1946–present), EMBASE.com (1974–present), and the Cochrane Library’s (John Wiley & Sons) Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database (HTAD), and the NHS Economic Evaluation Database (NHSEED). Comprehensive literature searches were developed using EMTREE, MeSH, and keywords for each of the search concepts of decolonization, MRSA, and orthopedics/orthopedic surgery. Studies published before 1968 were excluded. We analyzed 19 studies examining the ability of the decolonization protocol to reduce SSIs and 10 studies detailing the cost-effectiveness of S. aureus screening and decolonization.
Results
All 19 studies showed a reduction in SSIs or wound complications by instituting a S. aureus screening and decolonization protocol in elective orthopaedic (total joints, spine, and sports) and trauma patients. The S. aureus screening and decolonization protocol also saved costs in orthopaedic patients when comparing the costs of screening and decolonization with the reduction of SSIs.
Conclusions
Preoperative screening and decolonization of S. aureus in orthopaedic patients is a cost-effective means to reduce SSIs.
Level of Evidence
Level IV, systematic review of Level I–IV studies. See the Guidelines for Authors for a complete description of levels of evidence.
Journal Article
Risks and features of secondary infections in severe and critical ill COVID-19 patients
Objectives Severe or critical COVID-19 is associated with intensive care unit admission, increased secondary infection rate, and would lead to significant worsened prognosis. Risks and characteristics relating to secondary infections in severe COVID-19 have not been described. Methods Severe and critical COVID-19 patients from Shanghai were included. We collected lower respiratory, urine, catheters, and blood samples according to clinical necessity and culture and mNGS were performed. Clinical and laboratory data were archived. Results We found 57.89% (22/38) patients developed secondary infections. The patient receiving invasive mechanical ventilation or in critical state has a higher chance of secondary infections (P<0.0001). The most common infections were respiratory, blood-stream and urinary infections, and in respiratory infections, the most detected pathogens were gram-negative bacteria (26, 50.00%), following by gram-positive bacteria (14, 26.92%), virus (6, 11.54%), fungi (4, 7.69%), and others (2, 3.85%). Respiratory Infection rate post high flow, tracheal intubation, and tracheotomy were 12.90% (4/31), 30.43% (7/23), and 92.31% (12/13) respectively. Secondary infections would lead to lower discharge rate and higher mortality rate. Conclusion Our study originally illustrated secondary infection proportion in severe and critical COVID-19 patients. Culture accompanied with metagenomics sequencing increased pathogen diagnostic rate. Secondary infections risks increased after receiving invasive respiratory ventilations and intravascular devices, and would lead to a lower discharge rate and a higher mortality rate.
Journal Article
Device associated –health care associated infections monitoring, prevention and cost assessment at intensive care unit of University Hospital in Poland (2015–2017)
Background
Device-associated health care-associated infections (DA-HAIs) in intensive care unit (ICU) patients constitute a major therapeutic issue complicating the regular hospitalisation process and having influence on patients’ condition, length of hospitalisation, mortality and therapy cost.
Methods
The study involved all patients treated > 48 h at ICU of the Medical University Teaching Hospital (Poland) from 1.01.2015 to 31.12.2017. The study showed the surveillance and prevention of DA-HAIs on International Nosocomial Infection Control Consortium (INICC) Surveillance Online System (ISOS) 3 online platform according to methodology of the INICC multidimensional approach (IMA).
Results
During study period 252 HAIs were found in 1353 (549F/804M) patients and 14,700 patient-days of hospitalisation. The crude infections rate and incidence density of DA-HAIs was 18.69% and 17.49 ± 2.56 /1000 patient-days. Incidence density of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLA-BSI) and catheter-associated urinary tract infection (CA-UTI) per 1000 device-days were 12.63 ± 1.49, 1.83 ± 0.65 and 6.5 ± 1.2, respectively. VAP(137) constituted 54.4% of HAIs, whereas CA-UTI(91) 36%, CLA-BSI(24) 9.6%.The most common pathogens in VAP and CA-UTI was multidrug-resistant (MDR)
Acinetobacter baumannii
(57 and 31%), and methicillin-resistant
Staphylococcus epidermidis
(MRSE
)
in CLA-BSI (45%). MDR Gram negative bacteria (GNB) 159 were responsible for 63.09% of HAIs. The length of hospitalisation of patients with a single DA-HAI at ICU was 21(14–33) days, while without infections it was 6.0 (3–11) days;
p
= 0.0001. The mortality rates in the hospital-acquired infection group and no infection group were 26.1% vs 26.9%;
p
= 0.838; OR 0.9633;95% CI (0.6733–1.3782). Extra cost of therapy caused by one ICU acquired HAI was US$ 11,475/Euro 10,035. Hand hygiene standards compliance rate was 64.7%, while VAP, CLA-BSI bundles compliance ranges were 96.2–76.8 and 29–100, respectively.
Conclusions
DA-HAIs was diagnosed at nearly 1/5 of patients. They were more frequent than in European Centre Disease Control report (except for CLA-BSI), more frequent than the USA CDC report, yet less frequent than in limited-resource countries (except for CA-UTI). They prolonged the hospitalisation period at ICU and generated substantial additional costs of treatment with no influence on mortality. The
Acinetobacter baumannii MDR
infections were the most problematic therapeutic issue. DA-HAIs preventive methods compliance rate needs improvement.
Journal Article