Incidence Of Severe Disease Research Articles

The significance of amniotic fluid immunological analysis for the prediction of intrauterine infection

Intrauterine infection, a dangerous condition for a pregnant woman and her fetus, increases the risk of neonatal death and the incidence of severe diseases like cerebral palsy, chronic lung illnesses and psychomotor disorders. Better prediction of intrauterine infection would support the choice of an appropriate treatment plan during pregnancy and suitable healthcare for the mother and newborn after birth. Herein, we review the immunological analysis of amniotic fluid for prediction of intrauterine infection and survey advances in the field that are bringing us closer to clinical implementation.

Analysis of factors affecting the prognosis of COVID-19 patients and viral shedding duration.

The clinical characteristics of patients with COVID-19 were analysed to determine the factors influencing the prognosis and virus shedding time to facilitate early detection of disease progression. Logistic regression analysis was used to explore the relationships among prognosis, clinical characteristics and laboratory indexes. The predictive value of this model was assessed with receiver operating characteristic curve analysis, calibration and internal validation. The viral shedding duration was calculated using the Kaplan-Meier method, and the prognostic factors were analysed by univariate log-rank analysis and the Cox proportional hazards model. A retrospective study was carried out with patients with COVID-19 in Tianjin, China. A total of 185 patients were included, 27 (14.59%) of whom were severely ill at the time of discharge and three (1.6%) of whom died. Our findings demonstrate that patients with an advanced age, diabetes, a low PaO2/FiO2 value and delayed treatment should be carefully monitored for disease progression to reduce the incidence of severe disease. Hypoproteinaemia and the fever duration warrant special attention. Timely interventions in symptomatic patients and a time from symptom onset to treatment <4 days can shorten the duration of viral shedding.

Management of early blight of tomato (&lt;em&gt;Alternaria solani&lt;/em&gt;) through new generation fungicides under field condition

Early blight of tomato is serious threat to tomato cultivation and causes major yield loss. Fungicides application is only the practical way of management of diseases under severe disease incidence condition. In present study, new fungicidal molecules were evaluated against early blight of tomato under field condition. Among different fungicides, Azoxystrobin 11% + Tebuconazole 18.3% SC with 1000 ml/ha dosage (17.14% PDI) showed the least incidence of the early blight compared to other tested fungicides and untreated control (63.63%) after 3rdfoliar sprays. Maximum fruit yield (418.30 Q/ha) was recorded in treatment Azoxystrobin 11% + Tebuconazole 18.3% SC @ 1000 ml/ha and significantly superior over rest of the treatments.

Association of maternal ethnicity and urbanicity on severe pediatric disease: a nationwide cohort study

BackgroundA healthy migrant effect on birth outcomes has been reported, however, whether this protective effect persists throughout childhood is unknown. The effect of urbanicity on child health among an immigrant population is unclear. The objective of this study was to compare the incidence rate and cumulative incidence of severe diseases among urban children of Taiwan-born mothers, rural children of Taiwan-born mothers, urban children of foreign-born mothers, and rural children of foreign-born mothers.MethodsA nationwide cohort study was conducted for children born in Taiwan during 2004–2011 and follow-up till age 4 to 11 years old by linkage the Taiwan Birth Registry 2004–2011, Taiwan Death Registry 2004–2015, and National Health Insurance Research Database 2004–2015. Cox proportional hazards model (multivariable) was used to examine differences among the four study groups.ResultsThere were 682,982 urban children of Taiwan-born mothers, 662,818 rural children of Taiwan-born mothers, 61,570 urban children of foreign-born mothers, 87,473 rural children of foreign-born mothers. Children of foreign-born mothers had a lower incidence of vasculitis, mainly Kawasaki disease. The incidences of congenital disorders did not differ between children of foreign-born mothers and children of Taiwan-born mothers. The incidence of psychotic disorders was higher in urban children. However, children in rural areas had a higher incidence of major trauma/burn and a higher mortality rate.ConclusionsA healthy migrant effect was only seen for Kawasaki disease. The mental health of urban children born to immigrant mothers warrants concern.

Abstract P2065: Effect of Denture-Related Stomatitis on Blood Pressure and Heart Rate Variability

Denture-related stomatitis (DRS) has recently been associated with harmful cardiovascular effects, including arterial hypertension. This study evaluated salivary parameters, blood pressure (BP) and heart rate variability (HRV), before and after the DRS treatment in edentulous patients (n=14). Collection of unstimulated and stimulated saliva, as well as blood pressure BP measurements and electrocardiogram recordings, were performed before and after ten days of DRS treatment. The salivary flow (mL/min) was found similar at both times while the pH was smaller (more neutral) after the treatment (7.3±2.2 vs. 7.1±0.24). The systolic BP (mmHg) showed a trend, but not a significant reduction after the DRS treatment (158±25.68 vs. 148±16,72, p=0,062) while diastolic BP was found similar in both times (86±13.93 and 84±9.38). Overall, the HRV measured by the standard deviation of RR intervals was not affected by DRS treatment (24±4 vs. 18±2 ms); but the differences of successive RR intervals (an index of parasympathetic cardiac modulation) increased after the treatment (26±4 vs. 19±2 ms). Moreover, another index of vagal modulation of the heart, i.e., the power of RR interval spectra at high-frequency, was also markedly higher after the DRS treatment (236±63 vs. 135±32 ms 2 ). Overall, these findings strongly suggest that the DRS is associated with an autonomic imbalance, particularly with sympathetic overactivity. Therefore, the DRS may be significantly harmful, increasing cardiovascular risk and the incidence of several diseases, for instance, arterial hypertension.

Detection of bioactive compounds in persimmon (Diospyros kaki) using UPLC-ESI-Orbitrap-MS/MS and fluorescence analyses

Persimmon (Diospyros kaki L.) contains a number of metabolites, especially polyphenols and carotenoids, and persimmon is one of the most healthy fruits linking to a diet with reduced incidences of several diseases. However, little data are available on the persimmon in connection with its metabolites and properties. In recent study the differences between polar and non-polar extracts by 1H NMR-based metabolomics was done. The present work presents a complete qualitative analytical characterization by UPLC-ESI-Orbitrap-MS/MS analysis and fluorescence studies in six persimmon cultivars. The metabolic differences were shown as well in the results of bioactivities and antioxidant capacities. The results of binding properties of persimmon polyphenols towards human serum albumin support polyphenol-albumin interactions with human plasma and characteristic to other plants. The presented methods can be widely used for quantitation of multiple compounds in many plants and biological samples, especially in vegetables and fruits.

Seasonal Clock Changes Are Underappreciated Health Risks-Also in IBD?

Today, daylight saving time is observed in nearly 80 countries around the world, including the European Union, the USA, Canada, and Russia. The benefits of daylight saving time in energy management have been questioned since it was first introduced during World War I and the latest research has led to varying results. Meanwhile, adverse effects of seasonal time shifts on human biology have been postulated and the European Union is planning to abandon the biannual clock change completely. Medical studies have revealed a correlation of seasonal time shifts with increased incidences of several diseases including stroke, myocardial infarction, and unipolar depressive episodes. Moreover, studies in mice have provided convincing evidence, that circadian rhythm disruption may be involved in the pathogenesis of inflammatory bowel diseases, mainly by disturbing the intestinal barrier integrity. Here, we present previously unpublished data from a large German cohort indicating a correlation of seasonal clock changes and medical leaves due to ulcerative colitis and Crohn's disease. Furthermore, we discuss the health risks of clock changes and the current attempts on reforming daylight saving time from a medical perspective.

PCV74 COST REDUCTION AFTER THE INDUCTION OF THE RESIDENT ENLIGHTMENT BASED ON MEDICAL CHECKUP IN A JAPANESE RURAL AREA

The increase of healthcare expenditure is more serious for local governments in rural area, because of lower tax revenue and rapid population aging. Hirosaki University started a checkup in 2005 in Iwaki Town located in Aomori Prefecture, northern side of Japan, which shows the worst mortality rate in Japan over a few decades, and established Center of Healthy Aging Innovation (COI) program in 2013 for enlightening residents based on checkup results. The aim of this study is evaluating the effect of COI program on the prevention of stroke or cardiovascular disease (CVD) and estimating the medical cost reduction. Using checkup data from 2009 to 2016, risk-scores corresponding to 10-years incidence rate of stroke or CVD were calculated for all subjects in each year. The multivariate models were constructed for explaining the distribution of risk-scores from 2010 to 2012 (“before COI”) and from 2012 to 2016 (“after COI”). Applying two models to data in 2010, we predicted the distribution of risk-scores in 2017 and the incidence of stroke or CVD in the following 10-years. For both stroke and CVD, the distribution of risk-scores improved in “after COI model”. The numbers of stroke/CVD onsets under "after COI” model were decreased for 32 (48 vs. 80) and 63 (27 vs. 90) compared to "before COI” model in 10 years. For the whole population of Aomori prefecture, the introduction of COI program can avoid 6,329 (9,583 vs. 15,912) and 11,470 (5,238 vs. 16,708) patients from stroke/CVD, with the saving of JPY19.6bil. for medical costs within 10 years. Due to COI program, the incidence of severe diseases with high medical cost was predicted to decrease. For local governments in the Japanese rural area, this program is considered to be an effective solution.

Rhesus conflict during pregnancy: what one need to know

Rhesus-conflict is a pathological condition that manifests itself in the formation of antibodies against fetal erythrocytes in the body of pregnant woman due to the incompatibility of maternal and fetal Rh-factors. The main causes of morbidityand mortality in rhesus conflict are intrauterine hemolytic anemia, fetal hydrops, hemolytic neonatal disease. In addition, an important factor contributing to the increase in perinatal losses in this pathology is the high birth rate of extremely immature children. The reason for this is a preterm labor induction in case of a threat to the life of the fetus, as well as premature births associated with a variety of fetal manipulations. The number of cases of this pathology has declined dramatically throughout the world over the last decades, due to the widespread coverage of women at risk of immunization (anti-D - immunoglobulin). Unfortunately, in Ukraine this situation is not uncommon to this day.The article covers the main modern views on the causes, pathogenesis, course and prevention of immunological conflict associated with incompatibility of the Rh factor in terms of evidence-based medicine. The article describes the experience gained during recent years and attempts to unify the prognostic and preventive approaches in this area.Conclusions:1. Rhesus-conflict remains a serious problem of domestic medicine with a significant contribution to perinatal loss.2. Proper and timely anti-Rh immune prophylaxis among all non-immunized women can significantly reduce the incidence of severe disease in fetuses and newborns.3. There are no remedies for Rhesus conflict. Treatment is subjected to severe hemolytic disease only that occurs before the fetal maturity. Intrauterine hemotransfusion allows prolonging such pregnancy and preventing antenatal fetal death.

Antigenic cross-reactivity between Zika and dengue viruses: is it time to develop a universal vaccine?

Zika and the four serotypes of dengue are closely related flaviviruses that share a high degree of structural and sequence homology and co-circulate in many regions of the world. Here, we review recent studies investigating antigenic cross-reactivity between the two viruses. We discuss the pathogenic and protective roles of cross-reactive anti-viral antibody and T cell responses, respectively, in modulating the outcome of secondary dengue or Zika infection. Based on recent findings and increased incidence of severe disease in seronegative recipients of the first dengue vaccine to be licensed, we propose that the time has come to focus on developing pan-flavivirus vaccines that protect against Zika and four dengue serotypes by eliciting protective cross-reactive T cell responses while concomitantly reducing production of cross-reactive antibodies that can exacerbate disease.

Paenibacillus polymyxa biofilm polysaccharides antagonise Fusarium graminearum

Fusarium Head Blight (FHB) caused by Fusarium graminearum pathogens constitutes a major threat to agricultural production because it frequently reduces the yield and quality of the crop. The disease severity is predicted to increase in various regions owing to climate change. Integrated management where biocontrol plays an important role has been suggested in order to fight FHB. P. polymyxa A26 is known to be an effective antagonist against F. graminearum. Deeper understanding of the mode of action of P. polymyxa A26 is needed to develop strategies for its application under natural settings in order to effectively overcome the pathogenic effects. This study aims to re-evaluate a former study and reveal whether compounds other than non-ribosomal antibiotic lipopeptides could be responsible for the antagonistic effect, despite what is often reported. Wheat seedlings were grown to maturity and the spikes infected with the pathogen under greenhouse conditions. The development of FHB infection, quantified via the disease incidence severity and 100-kernel weight, was strongly correlated (r > 0.78, p < 0.01) with the content of the polysaccharide component D-glucuronic acid in the biofilm. Furthermore, while increased inoculum density from 106 to 108 cells/ml did not affect wild type performance, a significant increase was observed with the P. polymyxa mutant deficient in nonribosomal lipopeptide synthesis. Our results show that P. polymyxa A26 biofilm extracellular polysaccharides are capable of antagonizing F. graminearum and that the uronate content of the polysaccharides is of critical importance in the antagonism.

Comparison of Severe Disease Incidence among Eligible Insureds to Expand Coverage for Substandard Risks

Comparison of Severe Disease Incidence among Eligible Insureds to Expand Coverage for Substandard Risks

CIScoSI Study [Children Immunization Status and cases of Systemic Illness

To determine the immunization status of pediatric patients under age of 5 years visiting pediatric department of tertiary care hospitals in South East Asia. The aim of this study was to appreciate the awareness and implementation of vaccination in pediatric patients who came into pediatric outpatient Department with presenting complain other than routine vaccination. we can also know the count of patients who do not complete their vaccination after birth. we can differentiate between vaccinated and unvaccinated patients and incidence of severe disease in both groups. Immunization is a protective process which makes a person resistant to the harmful diseases prevailing in the community, typically by vaccine administration either orally or intravenously. It is proven for controlling and eliminating many threatening diseases from the community. WHO report that licensed vaccines are available for the prevention of many infectious diseases. After the implementation of effective immunization the rate of many infectious diseases have declined in many countries of the world. South-East Asia is far behind in the immunization coverage. An estimated total coverage is 56%-88% for a fully immunized child, which is variable between countries. Also the coverage is highest for BCG and lowest for Polio.

Structure⁻Activity Relationship and Molecular Docking of Natural Product Library Reveal Chrysin as a Novel Dipeptidyl Peptidase-4 (DPP-4) Inhibitor: An Integrated In Silico and In Vitro Study.

Numerous studies indicate that diets with a variety of fruits and vegetables decrease the incidence of severe diseases, like diabetes, obesity, and cancer. Diets contain a variety of bioactive compounds, and their features, like diverge scaffolds, and structural complexity make them the most successful source of potential leads or hits in the process of drug discovery and drug development. Recently, novel serine protease dipeptidyl peptidase-4 (DPP-4) inhibitors played a role in the management of diabetes, obesity, and cancer. This study describes the development of field template, field-based qualitative structure–activity relationship (SAR) model demonstrating DPP-4 inhibitors of natural origin, and the same model is used to screen virtually focused food database composed of polyphenols as potential DPP-4 inhibitors. Compounds’ similarity to field template, and novelty score “high and very high”, were used as primary criteria to identify novel DPP-4 inhibitors. Molecular docking simulations were performed on the resulting natural compounds using FlexX algorithm. Finally, one natural compound, chrysin, was chosen to be evaluated experimentally to demonstrate the applicability of constructed SAR model. This study provides the molecular insights necessary in the discovery of new leads as DPP-4 inhibitors, to improve the potency of existing DPP-4 natural inhibitors.

Role of Interferon-γ in promoting disease severity in neonatal Bordetella pertussis infection

Abstract Pertussis is an infectious disease caused by the bacterial pathogen Bordetella pertussis. In recent years, there has been a re-emergence of pertussis disease. Pertussis morbidity is extensive and spans across all age groups, but a higher incidence of severe disease and mortality is exhibited in young infants. Mortality is associated with severe respiratory infection and other systemic secondary co-morbidities. The infant immune system has reduced capacity to generate proinflammatory/T-helper (Th) 1 cell polarizing responses. Secretion of Interferon gamma (IFN-γ), a Th1 polarizing cytokine, by immune cells plays a critical role in macrophage activation and microbicidal activity in the lung. Furthermore, B. pertussis respiratory challenge of adult IFN-γ receptor deficient mice results in systemic dissemination and lethality. We hypothesize that the dissemination and lethality observed in our neonatal mouse model is a result of inadequate IFN-γ signaling or production, which contribute to insufficient control of the infection. We found that B. pertussis infection results in a significantly lower level of transcription of IFN-γ in the lungs and increased bacterial dissemination in neonatal mice when compared to adult mice. Additionally, infected neonatal mice deficient in IL-10, a potent regulator of IFN-γ, showed reduced dissemination and significantly increased IFN-γ and other pro-inflammatory cytokines as compared to age-matched wild type mice. Future studies include characterization of IFN-γ secreting immune cells during infection. Results generated by this work will contribute to a better understanding of severe disease in infants, addressing the limitations of infant immunity and treatment options for pertussis.

Unintended consequences and the paradox of control: Management of emerging pathogens with age-specific virulence.

We project forward total Zika virus disease (ZVD) under varying hazards of infection and consider how the age distribution of disease burden varies between these scenarios. Pathogens with age structured disease outcomes, such as rubella and Zika virus, require that management decisions consider their impact not only on total disease incidence but also on distribution of disease burden within a population. Some situations exhibit a “paradox of control” in which reductions of overall transmission decrease the total incidence but increase the incidence of severe disease. This happens because of corresponding increases in the average age of infection. Beginning with the current population structure and demographic rates of Brazil, we project forward total ZVD burden as measured by cases occurring in pregnant women and document the scenarios under which a paradox of control for ZVD management emerges. We conclude that while a paradox of control can occur for ZVD, the higher total costs from increasing the average age of infection will only be realized after several decades and vanish under conservative discounting of future costs. This indicates that managers faced with an emerging pathogen are justified to prioritize current disease incidence over potential increases in severe disease outcomes in the endemic state.

First report of twig blight of ban tulsi (Croton bonplandianus Bail.) caused by Choanephora cucurbitarum (Berk. &amp; Ravenel) Thaxt. in India

Abstract In August 2015, twig blight disease of ban tulsi (Croton bonplandianus Bail.) caused by Choanephora cucurbitarum (Berk. &amp; Ravenel) Thaxt. was observed for the first time, in the Gangetic alluvial region of West Bengal, India. A severe disease incidence (40-50%) showed twig blight symptoms starting with shoot apical meristem (SAM), leaf, and blossom blight symptoms. Typical symptoms were characterized by over-projecting black pin head like emerging sporangiola which formed mycelial cushion on the infected surface. The present report describes the identification of the causal pathogen as C. cucurbitarum based on its morphology and the internal transcribed spacer of its ribosomal DNA (rDNA - ITS) sequences with 100% identity of NCBI-GenBank published Choanephora database. Optimum temperatures, 28-30°C, coupled with high relative humidity (80-90%) during the monsoon season enhances the disease’s progress. To the best of our knowledge this is the first report of twig blight of C. bonplandianus, caused by C. cucurbitarum, in India as well as globally.

The long‐term effects of faecal microbiota transplantation for gastrointestinal symptoms and general health in patients with recurrent Clostridium difficile infection

Faecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection. In short-term the treatment has been shown to be safe, however, there are no large, long-term follow-up studies looking into the potential adverse effects. To analyse the long-term effect of FMT treatment in patients with recurrent C. difficile infection and to compare the outcome to antibiotic treated patients. Altogether 84 patients of which 45 received a FMT treatment and 39 served as controls receiving antibiotics for the infection were followed on average for 3.8years. Their recovery and medical status was evaluated using a retrospective questionnaire, determining their quality of life, gastrointestinal symptoms and new diseases potentially related to the FMT. There was no difference in the incidence of severe diseases (inflammatory bowel disease, cancer, autoimmune disease, allergy, neurological diseases) between the patient groups. In addition, weight gain did not differ between treatment groups. The FMT treated patients reported that their bowel habits improved significantly faster, they had less irregular bowel function and less symptoms of upper GI-tract when compared to the patients treated with antibiotics. Significantly more patients in FMT-group reported that their mental health improved after the treatment. The willingness to receive FMT treatment for potential new C. difficile infection was significantly higher in both treatment groups compared to other treatment options. Our study highlights that FMT is a durable, safe and acceptable treatment option for patients with recurrent C. difficile infection also in long term, and it shows potential benefits over antimicrobial treatment.

Intranasal immunization with dry powder vaccines

Vaccination represents a cost-effective weapon for disease prevention and has proven to dramatically reduce the incidences of several diseases that once were responsible for significant mortality and morbidity worldwide. The nasal cavity constitutes the initial stage of the respiratory system and the first contact with inhaled pathogens. The intranasal (IN) route for vaccine administration is an attractive alternative to injection, due to the ease of administration as well as better patient compliance. Many published studies have demonstrated the safety and effectiveness of IN immunization with liquid vaccines. Currently, two liquid IN vaccines are available and both contain live attenuated influenza viruses. FluMist® was approved in 2003 in the United States, and Nasovac® H1N1 vaccine was approved in India in 2010. Preclinical studies showed that IN immunization with dry powder vaccines (DPVs) is feasible. Although there is not a commercially available DPV yet, DPVs have the inherent advantage of being relatively more stable than liquid vaccines. This review focuses on recent developments of DPVs as next-generation IN vaccines.

Increased Mortality and Comorbidity Associated With Leber's Hereditary Optic Neuropathy: A Nationwide Cohort Study

Leber's hereditary optic neuropathy (LHON) is a mitochondrial genetic disease in which optic neuropathy is considered a key feature. Several other manifestations of LHON have been reported; however, only little is known of their incidence and the life expectancy in LHON patients. This study, based on Danish nationwide health registries, included 141 patients diagnosed with LHON and 297 unaffected family members in the maternal line. The incidence of comorbidities and mortality for patients with LHON and unaffected family members was compared with that in the general population. Having LHON was associated with an almost 2-fold risk of mortality with a rate ratio (RR) of 1.95 (95% confidence interval [CI]: 1.47-2.59; P < 0.001). The incidence of several diseases was increased for LHON patients, but not for family members. The incidence of stroke was 5.73 per 1000 patient-years for LHON patients compared to 2.33 for the general population, and the RR was 2.38 (95% CI: 1.58-3.58; P < 0.001). The incidence of demyelinating disorders was 2.24 compared to 0.21 for the general population; RR was 12.89 (95% CI: 6.70-24.77; P < 0.001). A 4-fold risk of dementia was seen for LHON patients (RR: 4.26, 95% CI: 1.91-9.48; P < 0.001), incidence 1.45 for LHON and 0.37 for the general population. Moreover, LHON patients had an increased risk of epilepsy, atherosclerosis, nerve symptoms, neuropathy, and alcohol-related disorders. The manifestation of LHON was associated with increased mortality and increased incidence of several disorders including stroke, demyelinating disorder, dementia, and epilepsy.