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The Viruses
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Infections in the very young often result in persistence of infection throughout the life span of the individual. In persistently infected people, the virus may replicate in the hepatocytes, may exist in a quiescent episomal state, or may be integrated into the host cell DNA. Integrated viral DNA is frequently incomplete and no longer gives rise to new virus, but may still program production of surface antigens. Persistent infection may be asymptomatic or may cause liver inflammation, which frequently results in liver cirrhosis and, after many years, hepatocellular carcinoma.
West Nile Virus: The Silent Neuro-Invasive Terror
Published in Jagriti Narang, Manika Khanuja, Small Bite, Big Threat, 2020
Vinod Joshi, Annette Angel, Bennet Angel, Neelam Yadav, Jagriti Narang, Surender Yadav
When an adult mosquito takes a blood meal, it inoculates the virus inside it. The virus then replicates within the midgut epithelium and finally reaches the salivary glands. The mosquito is now capable of infecting a new host during another blood meal. The virus that enters the human system (skin) is accompanied by many proteins of the mosquito’s salivary gland to combat the host’s hemostatic system. Within the skin, the Langerhans dendritic cells first encounter the virus (Byrne et al., 2001). Keratinocytes and neutrophils are also reported to first encounter the pathogen (Bai et al., 2010; Lim et al., 2011; Welte et al., 2009). A variety of factors are responsible for WNV transmission depending on the host infected. From there the virus enters the lymph nodes and later infects other tissues such as spleen and kidneys. Usually by the end of the first week of infection, the virus gets cleared from the system but may enter the central nervous system of immunocompromised patients. Persistent infection has also been seen in such cases where the primary infection was not detected until 60 days of infection (Brenner et al., 2005). The WNV is also known to be transmitted via blood transfusion, organ transplantation, and transplacental transmission via breast milk (CDC, 2002a, 2002b, 2002c; Hinckley et al., 2007; Iwamoto et al., 2003; Pealer et al., 2003).
Abdominal surgery
Published in Roy Palmer, Diana Wetherill, Medicine for Lawyers, 2020
Infective conditions around the anus are common. Small glands can become infected and patients can present with extremely painful abscesses. Superficial abscesses (perianal abscesses) are easy to treat by simple surgical excision. Given that these glands arise in the anal canal they may leave a false tract from the anal canal to the surface giving rise to a fistula. A fistula is an abnormal communication between two epithelial surfaces, the lining of the bowel and the skin. These can result in persistent infection and require specialist treatment. A deeper abscess may point into the ischio-rectal space (the space alongside the rectum). These abscesses are much deeper and will eventually point to the surface. Their drainage will inevitably lead to the development of a fistula, which again requires specialist treatment. When a patient presents with an abscess it is important to take a history and to examine and drain the abscess. There is no place for the management of abscesses by antibiotics alone.
[18F] FDG PET/CT can improve the diagnostic accuracy for aortic endograft infection
Published in Acta Cardiologica, 2022
Samuel Bruls, Imane El Hassani, Rebecka Hultgren, Roland Hustinx, Audrey Courtois, Amanda Dumortier, Jean-Olivier Defraigne, Natzi Sakalihasan
Aortic endograft infection is rare, but associated with high mortality; therefore, it is important to certify the correct diagnosis as soon as possible. Since the alternative is to treat patients with suspected endograft infections with life-long antibiotics or challenging aortic repair, it is imperative to improve the accuracy of this diagnosis. Diagnosis and management often represent a clinical challenge, albeit the diagnosis is often overlooked or delayed. Given the non-specific clinical features, imaging plays an important role. The present study on EVAR/TEVAR patients followed prospectively confirm that functional imaging such as PET/CT imaging can represent a predictive indicator of persistent infection, also in order to confirm the non-infected patients. Our findings support that the [18F] FDG PET/CT may be the most reliable contemporary diagnostic tool for aortic graft infection. Further prospective studies are warranted to confirm the findings. The results support a possible clinical adjunct tool that can support that life-long antibiotics in some patients can be halted with low risk for false negative results.
Targeting Ebola virus replication through pharmaceutical intervention
Published in Expert Opinion on Investigational Drugs, 2021
Frederick Hansen, Heinz Feldmann, Michael A Jarvis
An area that warrants further attention is combination therapy, with drugs ideally targeting different individual aspects of the filovirus lifecycle susceptible to therapeutic control. A number of studies have identified combinations of host-directed drugs that functioned synergistically against EBOV in vitro [123,215]. An obvious choice is the combination of mAbs, which function at the level of entry, with direct-acting antivirals such as GS-5734 that inhibit at the level of the RdRp. This approach may also address the issue of virus persistence, by potentially preventing the establishment of persistent infection within immune privileged sites. Therapies and combinations more amenable to use following high-risk exposure, such as those able to rapidly achieve necessary systemic levels following oral administration, should also be developed, particularly as at this early stage of infection, the virus may be more susceptible to pharmacologic control.
Liposome-based combination therapy for acne treatment
Published in Journal of Liposome Research, 2020
İpek Eroğlu, Minela Aslan, Ümran Yaman, Merve Gultekinoglu, Semih Çalamak, Didem Kart, Kezban Ulubayram
Long-term administration of antibiotic drugs might result in the decrease in susceptibility of some bacteria species due to biofilm formation, which causes antibacterial resistance. Therefore, it is a critical parameter to be considered during treatment of chronic clinical infections. In order to overcome this challenge, formulations having anti-biofilm activity became more crucial for the treatment of persistent infection (Dogan et al.2017). In terms of biofilm susceptibility assay, we have evaluated only gel formulations that are classified as the final product formulated. In this case, improved effect liposomal formulation that contains tetracycline HCl and tretinoin (Gel-Lipo2Comb coded formulation) was observed in terms of minimal biofilm inhibition concentration (MBIC) when compared to the results of gels containing both of the APIs in powder form. On the other hand, minimal biofilm eradication concentrations (MBECs) were found to be the same for gels containing liposomes and gels containing APIs in powder form. However, both of them were found effective in terms of MBEC, when compared with the blank gel formulation (Table 11).