Search Results for: Sclerosi multipla e legame con il virus della mononucleosi

This JAMA Insights explores several aspects of dengue virus infection, including epidemiology, diagnosis, and clinical management, following a global resurgence in both endemic and nonendemic regions.

Introduction
Opioid overdose and blood-borne virus transmission are key health risks for people who inject drugs. Existing study methods that record data on injecting drug risks mostly rely on retrospective self-reporting that, while valid, are limited to being broad and subject to recall bias. The In-The-Moment-Expanded (ITM-Ex) study will evaluate the feasibility and acceptability of multiple novel data collection methods to capture in situ drug injecting data.

Methods and analysis
ITM-Ex will purposively recruit 50 participants from an existing longitudinal cohort (SuperMIX study) of people who inject drugs in Melbourne, Australia. Over a 4-week study period, participants will be asked to complete baseline/endline spirometry, continuously wear a heart rate monitoring device, complete short-form ecological momentary assessment (EMA) questionnaires for every injecting episode during the study period and return previously used needles/syringes for drug residue testing. These multiple data sources will be combined to conduct a comprehensive analysis of the physiological and risk characteristics of an estimated 800 individual injecting drug use episodes (if participants inject four times weekly). Finally, post-participation qualitative interviews will explore the acceptability of the data collection methods.

Ethics and dissemination
Ethics approval for ITM-Ex was obtained from Alfred Hospital Ethics Committee (project number 368/22). Results will be disseminated via national and international scientific and public health conferences and peer-reviewed journal publications.
Results from ITM-Ex may demonstrate vastly more complete and accurate methods of capturing data on injecting drug use risk and support future development and evaluation of devices to monitor and intervene during drug overdose. Further, ITM-Ex may demonstrate innovative methodologies to support myriad future public health research studies.

Virus salirebbe al cervello per il nervo vago favorendo malattia

Introduction
HIV can greatly impact the quality of life of pregnant women and may cause adverse pregnancy outcomes, such as preterm birth (PB) and mother-to-child transmission (MTCT). The purpose of this study was to analyse the influencing factors of PB and MTCT in HIV-positive pregnant women.

Methods
HIV-positive pregnant women in Henan Province between January 2016 and December 2022 were selected for the study. Data were collected through the Management Information System for the Prevention of MTCT of HIV, syphilis and hepatitis B. Information on their demographic and clinical characteristics, treatment status and pregnancy outcomes was collected. A logistic regression model and 2 automatic interaction detector (CHAID) decision tree model were used to analyse the correlation factors of PB and MTCT.

Results
The average age of the 1073 study participants was 28.44 years, with an incidence of 11.93% for PB and 6.71% for MTCT. Hepatitis B virus or hepatitis C virus coinfection (OR=3.686, 95% CI 1.630 to 8.333) and Han nationality (OR=0.426, 95% CI 0.194 to 0.936) were risk factors for PB. Unknown HIV infection prior to pregnancy (OR=2.006, 95% CI 1.233 to 3.264) and primipara (OR=5.125, 95% CI 1.202 to 21.849) were risk factors for MTCT. The CHAID decision tree model was used to screen for the six and two influencing factors of PB and MTCT in HIV-positive women, respectively.

Conclusion
Early HIV testing, scientific counselling, precise maternal HIV infection assessment and targeted prevention measures can help prevent PB and MTCT in HIV-positive pregnant women.

‘VirHoX’ per un nuovo studio sulle dinamiche virus-ospite

Nella regione di Panzi a 700 chilometri dalla capitale Kinshasa, sono oltre 400 i casi e 31 i decessi. A essere coinvolti sono soprattutto i bambini sotto i 5 anni

Introduction
Malnutrition is a common complication of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) typically associated with poor prognosis. Despite nutritional treatment, the outcomes for these patients are limited by the symptoms and complications associated with ACLF. So far, the benefits of nutritional interventions in these populations have not been proven. This study aims to explore a new nutritional intervention method for patients with HBV-ACLF and evaluate its safety and efficacy.

Methods and analysis
This study is an investigator-initiated, nonblind, randomised controlled clinical trial. We will recruit 60 patients with HBV-ACLF according to the Chinese Group on the Study of Severe Hepatitis B criteria hospitalised in the Infectious Diseases Department of the Third Affiliated Hospital of Sun Yat-Sen University. Eligible patients will be randomly allocated to the nutrition support group (intervention group) and the control group in a 1:1 ratio. Patients in the nutrition support group will receive 10 days of tailor-made nutrition therapy consisting of oral nutritional supplements and supplementary parenteral nutrition. Patients in the control group will receive standard nutrition with dietary advice. All assessments will be conducted at baseline, 30 days and 90 days. The primary outcome measure is the liver transplant-free mortality rate. The secondary indicators include the incidence of clinical adverse outcomes and changes in indicators such as muscle mass, muscle strength, physical function and quality of life (EQ-5D scale).

Ethics and dissemination
This study has been approved by the Medical Ethics Committee of the Third Affiliated Hospital of Sun Yat-Sen University (approval number: II2023-242-03). The results and conclusions of the clinical trial will be published in academic conferences or journals.

Trial registration number
NCT06128421.

Ministero: ‘Non c’è allarme ma attenzione’. Nessun volo diretto

Da dicembre estesa anche ai nati nel mese di settembre 2024

Objectives
This systematic review aims to evaluate externally validated models for individualised prediction of recurrence or survival in adults treated with curative intent for oropharyngeal cancer.

Design
Systematic review.

Setting
Hospital care.

Methods
Systematic searches were conducted up to September 2023 and records were screened independently by at least two reviewers. The Prediction model Risk Of Bias ASsessment Tool was used to assess risk of bias (RoB). Model discrimination measures (c-indices) were presented in forest plots. Clinical and methodological heterogeneity precluded meta-analysis.

Results
Fifteen studies developing and/or evaluating 25 individualised risk prediction models were included. The majority (77%) of c-indices for model developments and validations were ≥0.7 indicating ‘good’ discriminatory ability for models predicting overall survival. For disease-specific measures, most (73%) c-indices for model development were also ≥0.7, but fewer (40%) were ≥0.7 for external validations. Comparisons across models and outcome measures were hampered by heterogeneity. Only two studies directly compared models in the same cohort. Since all models were subject to a high RoB, primarily due to concerns with the analysis, the trustworthiness of the findings remains uncertain. Concerns included a lack of accounting for potentially missing data, model overfitting or competing risks as well as small event numbers. There were fewer concerns related to the participant, predictor and outcome domains, although reporting was not always detailed enough to make an informed decision. Where human papilloma virus (HPV) status and/or a radiomics score were included as a variable, models had better discriminative ability.

Conclusions
There were no models assessed as being at low RoB. Given that HPV status or a radiomics score appeared to improve model discriminative performance, further external validation of existing models to assess generalisability should focus on models that include HPV status as a variable. Development and validation of future models should be considered in HPV+ or HPV– cohorts separately to ensure representativeness.

PROSPERO registration number
CRD42021248762.

Efficace nel 30% dei pazienti che non risponde alle altre cure

In questi grandi raduni internazionali serve una sorveglianza epidemiologica per monitorare eventuali focolai di contagio di virus respiratori

On October 3, the World Health Organization (WHO) authorized the first mpox in vitro diagnostic test under its Emergency Use listing procedure. As mpox cases continue to spread regionally in Africa, this measure will help improve both timely treatment and containment of the virus, the WHO stated.

Introduction
Understanding how RNA viral load changes (viral load kinetics) during acute infection in SARS-CoV-2 can help to identify when and which patients are most infectious. We seek to summarise existing data on the longitudinal RNA viral load kinetics of SARS-CoV-2 sampled from different parts of the respiratory tract (nose, nasopharynx, oropharynx, saliva and exhaled breath) and how this may vary with age, sex, ethnicity, immune status, disease severity, vaccination, treatment and virus variant.

Methods and analysis
We will conduct a systematic review and meta-analysis, using studies identified through MEDLINE and EMBASE (via Ovid). All research studies reporting primary data on longitudinal RNA viral load kinetics of infected patients with SARS-CoV-2 will be included. Methodological quality will be assessed using a validated checklist for longitudinal studies as well as predefined quality criteria for assessment of individual-level RNA viral load. Should the data allow, we will aim to perform individual patient-level meta-analysis. Our primary outcomes are duration to, and quantity of peak RNA viral load, and total duration of viral load shedding within different respiratory compartments. Secondary outcomes include duration of lateral flow antigen and virus culture positivity and variation of RNA viral load by age, immune status, disease severity, vaccination, treatment, lateral flow tests, viral culture positivity and SARS-CoV-2 variant. Study-level effects affecting observations, but not related to properties of the patient, such as the PCR platform and gene target will also be recorded. Random-effects models will estimate the population mean and individual-level variation in viral shedding conditional on the aforementioned variables. Finally, we will summarise the key mechanistic models used in the literature to reconstruct individual-level viral kinetics and estimate how different factors shape viral dynamics over time.

Ethics and dissemination
Ethical approval is not needed as data will be obtained from published articles or studies with data that have already received and ethical review for analysis. Manuscript(s) will be prepared for publication.

Systematic review protocol registration
PROSPERO ID: CRD42023385315

The COVID-19 pandemic is officially endemic, with more than 775 million cases now reported by the World Health Organization. Thanks to the effectiveness of vaccination combined with natural immunity, SARS-CoV-2 infection is no longer the novel and life-threatening virus it was in the early days of the pandemic, although it still carries risk to some.

Il vaccino sarà reso disponibile per la fascia d’età 0-2 anni