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Health Protection and Global Approach to Neglected Communicable Diseases
Published in Vincent La Placa, Julia Morgan, Social Science Perspectives on Global Public Health, 2023
Maria Jacirema Ferreira Gonçalves, Anny Beatriz Costa Antony de Andrade, Amanda Rodrigues Amorim Adegboye
The interaction between NCDs and nutrition is based on competition for nutrients. Infectious organisms (e.g., parasites, viruses, or bacteria) use the host, in this case, a human body, as a source of all nutrients, required by the infectious organisms to live, grow, reproduce, and spread (Hall et al., 2012). However, the impact of infectious organisms goes beyond nutrient requirements. The impact involves the host response to the pathogenic organism leading to an increase in metabolic rate, loss of appetite, immune response cascade, and pathological tissue changes (Farhadi and Ovchinnikov, 2018). Additionally, fever leads to increased energy and micronutrient requirements. These responses are host protective mechanisms against acute infections. However, when the host is faced with chronic or recurrent infections, these reactions can cause undernutrition, particularly when the nutritional status of the host is already compromised (Solomons, 2007). Undernutrition, on the other hand, increases susceptibility to infections, the severity of the disease, and the ability to recover (Katona and Katona-Apte, 2008; Hall et al., 2012) creating a vicious cycle. Therefore, the temporal relationship between NCDs and malnutrition is not yet fully established in terms of what comes first (Figure 22.2).
Postpartum infections
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
The incidence of documented bacteremia following cesarean section is 3% to 4%, compared with 0.1% to 0.4% in patients who have delivered vaginally. Endometritis accounts for the majority of cases, but wound, respiratory and urinary infections, as well as endocarditis may be responsible (59,60). Bacteremia is more commonly found in post-cesarean endometritis (8–30%) compared with endometritis following vaginal delivery (5%) (5,6). Risk for positive blood cultures is correlated with length of labor, number of vaginal exams, duration of ruptured membranes, estimated blood loss, and intra-amniotic infection (61). Bacteremia is rare (<1%) in the postpartum woman with a temperature peak <38.8°C, but occurs in more than 20% of those with higher fevers (61). Organisms isolated from the blood reflect organisms infecting the endometrium and are found in similar proportions (57). While blood culture results may guide antibiotic therapy for endometritis, failure to respond to initial therapy does not correlate with a resistant organism in blood culture (59). Identification of a pathogenic organism resistant to the antibiotics administered warrants broadening the antibiotic coverage despite apparent clinical response. Prolonged therapy may be indicated when S. aureus is isolated from the blood to avoid metastatic infection (8,44). Mortality among obstetric bacteremic patients is extremely low (<1%) compared with other medical or surgical populations (60).
Dendritic Cells Control the Balance between Tolerance and Autoimmunity
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Simon W. F. Milling, G. Gordon MacPherson
T cells are the middle managers of the immune system; they act on instructions from DCs to control potentially damaging situations in the most appropriate fashion. For instance, in response to intracellular microorganisms, CD4+ T cells differentiate into Th1 cells, which secrete interferon-γ (IFN-γ) and support the proliferation of pathogen-specific cytotoxic CD8+ T cells that will kill infected cells. By contrast, the response to extracellular pathogens, such as Schistosomes, requires CD4+ T cells to become Th2 cells which secrete IL-4, IL-5 and IL-10 and support IgE and eosinophil-mediated destruction of the pathogenic organism.38
Click chemistry approaches for developing carbonic anhydrase inhibitors and their applications
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2023
Andrea Angeli, Claudiu T. Supuran
The antiinfectives based on CAIs started to be seriously considered only in the last decade90, and several highly interesting studies for the design of antibacterials91–93 and antifungals94–96 which target CAs present in pathogenic organism have emerged. However, in these cases the use of click chemistry has not yet been contemplated, as it is also the situation for CA activators97, which might be useful for the management of emotional/fear memory therapy and several cognitive disorders98,99. As outlined here, there are many other hot topics in the CA research field in which click chemistry reactions may contribute to the development of highly interesting inhibitors and activators, and hopefully such studies will be stimulated to be performed by this review.
Idiopathic Vitritis after Boston Type 1 Keratoprosthesis Implantation: Incidence, Risk Factors and Outcomes in a Multicentric Cohort
Published in Ocular Immunology and Inflammation, 2022
Clemence Bonnet, Ismael Chehaibou, Reza Ghaffari, Nicholas J. Jackson, Cristina Bostan, Jean-Pierre Hubschman, Mona Harissi-Dagher, Anthony J. Aldave
Vitreous inflammation after KPro implantation can be triggered by many causes such as trauma, aqueous leak, and ocular surgery.6 Nouri and colleagues first postulated that in cases in which a pathogenic organism cannot be identified, an immune mechanism could be a contributing factor, leading to a “sterile” vitritis.7 Other suggested mechanisms include the presence of periprosthetic tissue loss facilitating the intraocular entry of pro-inflammatory factors, and micromotion of the KPro enhancing leukocyte recruitment and metalloproteinase production.8 Postoperative inflammation, corneal necrosis, microbial keratitis, and vitreous hemorrhage have also been associated with idiopathic vitritis in retrospective case series, although formal statistical analysis was not performed to demonstrate a significant association of any of these factors with idiopathic vitritis.6,9 These series have also demonstrated a wider spectrum of presentations and outcomes, including signs and symptoms characteristic of an infectious endophthalmitis, recurrence of episodes, and permanent loss of vision, than earlier series.6,9 Hence, idiopathic vitritis remains a poorly understood disorder, and a diagnosis of exclusion.10 Therefore, the aim of this study was to determine the incidence, risk factors for, and long-term outcomes of idiopathic vitritis in a large, multicentric, consecutive cases series of KPro procedures.
Multifocal osteoarticular tuberculosis in a systemic lupus erythematosus (SLE) patient: a rarity or an underdiagnosed condition?
Published in Modern Rheumatology Case Reports, 2020
Shiau Li Lim, Ping Seung Ong, Chiew Gek Khor
On examination, blood pressure was 113/79 mmHg, heart rate was 73/min and temperature 38.0 °C. Lungs were clear, heart rhythm was regular without murmur and no evidence of synovitis. Laboratory data revealed haemoglobin level of 7.5 g/dL, white blood cell count 2,300/mm3 (lymphocytes 10.3%, neutrophils 85%, monocytes 4.7%) and platelet count 196,000/mm3. Serum urea was 7.8 mmol/L, creatinine 78 umol/L, albumin 27 g/L and lactate dehydrogenase 236 U/L. The urinalysis showed 2+ protein and 1+ blood while 24 h urine protein measured 1152 mg/day with total volume of 2200mls. Complement C3 was 0.44 g/L and complement C4 0.13 g/L respectively. Direct Coomb’s test was negative and urgent full blood picture did not show evidence of haemolysis. C-reactive protein (CRP) was 11.2 mg/L. Cultures from blood and urine did not show pathogenic organism. Intravenous (IV) Methylprednisolone 500 mg daily was given for 3 days, followed by oral Prednisolone 0.5 mg/kg/day. Renal biopsy was performed the following week and revealed diffuse proliferative lupus nephritis Class IV (Active and Chronic lesions) based on International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification.