Podcasts about lancet infect dis

Un nouvel épisode du Pharmascope est maintenant disponible! Dans de ce 136ème épisode, Nicolas, Isabelle et un invité discutent de la prophylaxie pré-exposition au VIH dans diverses situations à risque.  Les objectifs pour cet épisode sont : Résumer et comparer les modalités de prise en charge de la PrEP Identifier les patients pouvant bénéficier de la PrEP Discuter des avantages et des risques associés à la prise de la PrEP   Ressources pertinentes en lien avec l'épisode Baril JG et coll. La prophylaxie préexposition au virus de l'immunodéficience humaine : Guide pour les professionnels de la santé du Québec. Ministère de la santé et des services sociaux. Janvier 2019. Disponible, en ligne. US Public Health Services.Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2021 Update. A Clinical Practice Guideline. 2021. Disponible, en ligne. Grant RM et coll; iPrEx Study Team. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363:2587-99. Grant RM et coll; iPrEx study team. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis. 2014;14:820-9. McCormack S et coll. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2016;387:53-60. Molina JM et coll; ANRS IPERGAY Study Group. On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection. N Engl J Med. 2015;373:2237-46. Baeten JM et coll; Partners PrEP Study Team. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367:399-410. Choopanya K et coll; Bangkok Tenofovir Study Group. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2013;381:2083-90.

In this episode, Phil Russo talks to Brett Mitchell and Kate Browne about a study that did not make it over the line. Following a systematic review in 2021 that examined the issue of UTIs in those who self catheterise, a study to examine whether previous work demonstrating a reduction in CAUTI in indwelling catheters through the use of Chlorhexidine for meatal cleansing would be effective was designed. The team discuss the complexities of getting what was essentially a community-based study over the line and why ultimately it did not progress, much to the sadness of the team. previous relevant work is listed below. Mitchell BG, Prael G, Curryer C, Russo PL, Fasugba O, Lowthian J, et al. The frequency of urinary tract infections and the value of antiseptics in community-dwelling people who undertake intermittent urinary catheterization: A systematic review. Am J Infect Control 2021;49(8):1058-65. https://doi.org/10.1016/j.ajic.2021.01.009. Fasugba O, Cheng AC, Gregory V, Graves N, Koerner J, Collignon P, et al. Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomised controlled trial. Lancet Infect Dis 2019;19(6):611-9. https://doi.org/10.1016/S1473-3099(18)30736-9.  

In this episode, Phil Russo talks to Brett Mitchell and Kate Browne about a study that did not make it over the line. Following a systematic review in 2021 that examined the issue of UTIs in those who self catheterise, a study to examine whether previous work demonstrating a reduction in CAUTI in indwelling catheters through the use of Chlorhexidine for meatal cleansing would be effective was designed. The team discuss the complexities of getting what was essentially a community-based study over the line and why ultimately it did not progress, much to the sadness of the team. previous relevant work is listed below. Mitchell BG, Prael G, Curryer C, Russo PL, Fasugba O, Lowthian J, et al. The frequency of urinary tract infections and the value of antiseptics in community-dwelling people who undertake intermittent urinary catheterization: A systematic review. Am J Infect Control 2021;49(8):1058-65. https://doi.org/10.1016/j.ajic.2021.01.009. Fasugba O, Cheng AC, Gregory V, Graves N, Koerner J, Collignon P, et al. Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomised controlled trial. Lancet Infect Dis 2019;19(6):611-9. https://doi.org/10.1016/S1473-3099(18)30736-9.  

Carbapenemase producers are a nightmare for clinicians. Not only are they resistant to carbapenems, a last resort β-lactam antibiotic, they are notorious for developing multidrug and pandrug resistances resulting in limited to no treatment options.  In this episode of Communicable, hosts Angela Huttner and Thomas Tängdén sit down with Dr. David Paterson (National University of Singapore) and Dr. Souha Kanj (American University of Beirut Medical Center, Lebanon), two ID physicians from regions where carbapenem-resistant Enterobacteriaceae or CRE, and carbapenem-resistant Acinetobacter are widespread.  The episode begins with the history and emergence of CRE and reviews current epidemiology, diagnosis (including the Ambler classification of β-lactamases) and treatment options. Lessons and insights from personal experiences are shared to reflect the current clinical challenges caused by carbapenem-resistant bacteria and the importance of infection prevention and control measures to mitigate further spread. This episode was edited by Kathryn Hostettler and peer-reviewed by Dr. Filippo Medioli of Policlinico di Modena, Italy. For more related content on the WHO Priority Pathogens List and new antibiotics in the pipeline, check out our previous episodes, Communicable E3 and E10 (see Literature).Literature Communicable E3 - The New WHO Priority Pathogens List: which bugs to target first? June 2024. https://communicable.transistor.fm/episodes/communicable-e3-the-new-who-priority-pathogens-list-which-bacteria-to-target-first  Communicable E10 - Pipeline update: new antibiotics & other antimicrobials that you might actually use. Sep 2024. https://communicable.transistor.fm/episodes/communicable-e10-pipeline-update-new-antibiotics-other-antimicrobials-that-you-might-actually-use  Wagenlehner FM, et al. Cefepime-Taniborbactam in Complicated Urinary Tract Infection. N Engl J Med 2024 Feb. doi: 10.1056/NEJMoa2304748 Cohn J, et al. Accelerating antibiotic access and stewardship: a new model to safeguard public health. Lancet Infect Dis 2024 Sep. doi:  10.1016/S1473-3099(24)00070-7 Timsit JF, et al. When should I start broad-spectrum antibiotics? Intensive Care Med 2024 Sep. doi: 10.1007/s00134-024-07654-7  Paterson DL. Antibacterial agents active against Gram Negative Bacilli in phase I, II, or III clinical trials. Expert Opin Investig Drugs 2024 Apr. doi: 10.1080/13543784.2024.2326028 

On the verge of a post-antibiotic reality, there is an urgent clinical need for new antibiotics. Luckily, new candidates are in the pipeline and older agents are getting a second breath of life through combination therapy.  In this episode of Communicable, host Erin McCreary invites Dr. Markus Zeitlinger of the University of Vienna (Austria) and scientific expert for the European Medicines Agency (EMA) and Dr. Michael Dudley, president and CEO of Qpex Biopharma, to discuss antimicrobials in the clinical development pipeline.  Together they unpack how the WHO curate the priority list of pathogens and how companies adapt such lists into their antimicrobial development business plans. They also discuss the unique challenges and complexities of developing antibiotics, from return on investments and defining the ‘novelty' of an agent to the conundrum of balancing post-market approval and antimicrobial stewardship. Beta-lactamase inhibitors and oral carbapenems in the pipeline targeting ‘the big three' (Enterobacterales, Pseudomonas and Acinetobacter) are the primary focus. This episode was edited by Kathryn Hostettler and peer-reviewed by Dr. Benjamin Berinson of the Medical Centre Hamburg-Eppendorf (UKE), Germany. For more information on the WHO Priority Pathogens List and its 2024 update, check out our previous episode, Communicable E3 (see Literature).  Literature  Communicable E3 - The New WHO Priority Pathogens List: which bugs to target first? 17 June 2024. https://communicable.transistor.fm/episodes/communicable-e3-the-new-who-priority-pathogens-list-which-bacteria-to-target-first  WHO Bacterial Priority Pathogens List, 2024: bacterial pathogens of public health importance to guide research, development and strategies to prevent and control antimicrobial resistance. Geneva: World Health Organization; 17 May 2024. https://www.who.int/publications/i/item/9789240093461  C. Le Terrier et al, NDM-9 resistance to taniborbactam. Lancet Infect Dis 23, 401-402 (2023). doi 10.1016/S1473-3099(23)00069-5      P. B. Eckburg et al, Oral Tebipenem Pivoxil Hydrobromide in Complicated Urinary Tract Infection. N Engl J Med 386, 1327-1338 (2022). doi: 10.1056/NEJMoa2105462  A Study of Oral Tebipenem Pivoxil Hydrobromide (TBP-PI-HBr) Compared to Intravenous Imipenem-cilastatin in Participants With Complicated Urinary Tract Infection (cUTI) or Acute Pyelonephritis (AP) (PIVOT-PO). https://clinicaltrials.gov/study/NCT06059846 Meiji Seika Pharma Initiated the Global Phase III Clinical Trials of OP0595, a Novel beta-Lactamase Inhibitor for Combatting Antimicrobial Resistance (AMR). Tokyo: Meiji Seika Pharma Ltd; 26 April 2023. https://www.meiji.com/global/news/2023/pdf/230426_01.pdf

Today we provide you with an update on the sexually transmitted infection: Trichomonas vaginalis, a protozoan which infects the vagina, urethra and paraurethral glands. It is an uncommon cause of vaginal discharge and penile urethritis and can persist for a long time if left untreated. Up to 50% of people with vaginal infections and especially people with urethral infections remain asymptomatic. Persistent trichomonas infection has been associated with facilitating the transmission of human immunodeficiency virus (HIV) and adverse poor reproductive health outcomes. Dr Christina Munzy, Professor in Infectious Diseases at University of Alabama, Birmingham, USA, will present on published clinical trial data on novel treatment against trichomoniasis. Relevant publications: Van Gerwen OT, Aaron KJ, Schroeder J, et al. Spontaneous resolution of Trichomonas vaginalis infection in men. Sexually Transmitted Infections. Published Online First: 27 June 2024. Muzny CA, Van Gerwen OT, Kaufman G, Chavoustie S. Efficacy of single-dose oral secnidazole for the treatment of trichomoniasis in women co-infected with trichomoniasis and bacterial vaginosis: a post hoc subgroup analysis of phase 3 clinical trial data. BMJ Open. 2023;13:e072071 Kissinger PJ, Gaydos CA, Seña AC, McClelland RS, Soper, Secor WE, Legendre D, Workowski KA, Muzny CA, Diagnosis and Management of Trichomonas vaginalis: Summary of Evidence Reviewed for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines, Clinical Infectious Diseases, Clinical Infectious Diseases, Volume 74, Issue Supplement_2, 15 April 2022 Howe K and Kissinger PJ. Single-dose compared with multidose metronidazole for the treatment of trichomoniasis in women: a meta-analysis. Sex Transm Dis 2017; 44: 29–34. Kissinger P, Muzny CA, Mena LA, et al. Single-dose versus 7- day-dose metronidazole for the treatment of trichomoniasis in women: an open-label, randomised controlled trial. Lancet Infect Dis 2018; 18: 1251–1259. Sherrard J, Pitt R, Hobbs KR, Maynard M, Cochrane E, Wilson J, Tipple C. British Association for Sexual Health and HIV (BASHH) United Kingdom national guideline on the management of Trichomonas vaginalis 2021. Int J STD AIDS. 2022 Jul;33(8):740-750. STI Guidelines Australia - Trichomoniasis Host: Dr Fabiola Martin, STI BMJ Podcast editor, a Sexual Health, HIV and HTLV Specialist, Canberra & University of Queensland, Brisbane, Australia Guest: Dr Christina Munzy, Professor in Infectious Diseases at University of Alabama, Birmingham, USA

In this episode, hosts Josh Davis (Newcastle, Australia) and Angela Huttner (Geneva, Switzerland) interview the phage ‘microbiologist-clinician duo', Drs. Shawna McCallin and Lorenz Leitner (Balgrist Hospital, Zurich, Switzerland). They explore the history of phages, the process of bringing phage therapy to a patient, potential resistance to phages, availability of individualized therapy versus phage cocktails, and the place of phage therapy in the future. Drs. Leitner and McCallin reflect on the challenges and lessons of their recently published randomized trial comparing phage therapy to antibiotics for urinary tract infection. Episode peer-reviewed by Dr. Olivia Funk of Long Island University. LiteratureLeitner L, Ujmajuridze A, Chanishvili N et al.  Intravesical bacteriophages for treating urinary tract infections in patients undergoing transurethral resection of the prostate: a randomised, placebo-controlled, double-blind clinical trial. Lancet Infect Dis. 2021 Mar;21(3):427-436. doi: 10.1016/S1473-3099(20)30330-3. 

Les infections microbiennes sont souvent synonymes d'infections bactériennes ou virales, comme la pneumonie ou l'influenza. Mais qu'en est-il des infections fongiques? En fait, elles ne sont pas à négliger : les infections fongiques graves, qui affectent surtout les patients plus vulnérables, sont associées à près de deux millions de décès chaque année. Pour cet épisode, Trait pharmacien reçoit Alexandre Rivard et François Bourdeau, pharmaciens au Centre universitaire de santé McGill, pour discuter des antifongiques et des particularités de leur suivi. François est également membre du Regroupement de pharmaciens experts en infectiologie de l'A.P.E.S. et récipiendaire du Prix d'excellence pour la relève 2024. Références : Lignes directrices du programme d'antibiogouvernance du Centre universitaire de santé McGill : https://www.muhcasp.com/ Pappas PG, Kauffman CA, Andes DR et coll. Clinical practice guideline for the management of candidiasis: 2016 update by the IDSA. Clin Infect Dis 2016;62(4):e1-50. Patterson TF, Thompson GR III, Denning DW et coll. Clinical practice guideline for the diagnosis and management of aspergillosis: 2016 update by the IDSA. Clin Infect Dis 2016;63(4):e1-60. Cornely OA, Alastruey-Izquierdo A, Arenz D et coll. Global guideline for the diagnosis and management of mucormycosis: An initiative of the ECMM in cooperation with the MSGERC. Lancet Infect Dis 2016;19(12):e405-21. Laverdiere M, Bow EJ, Rotstein C et coll. Therapeutic drug monitoring for triazoles: A needs assessment review and recommendations from a Canadian perspective. Can J Infect Dis Med Microbiol 2014;25(6):327-43.

Un nouvel épisode du Pharmascope est maintenant disponible! Dans de ce 136ème épisode, Nicolas, Isabelle et un invité discutent de la prophylaxie pré-exposition au VIH dans diverses situations à risque.  Les objectifs pour cet épisode sont les suivants: Résumer et comparer les modalités de prise en charge de la PrEP Identifier les patients pouvant bénéficier de la PrEP Discuter des avantages et des risques associés à la prise de la PrEP Ressources pertinentes en lien avec l'épisode Baril JG et coll. La prophylaxie préexposition au virus de l'immunodéficience humaine : Guide pour les professionnels de la santé du Québec. Ministère de la santé et des services sociaux. Janvier 2019. Disponible, en ligne. US Public Health Services.Preexposure Prophylaxis for the Prevention of HIV Infection in the United States - 2021 Update. A Clinical Practice Guideline. 2021. Disponible, en ligne. Grant RM et coll; iPrEx Study Team. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363:2587-99. Grant RM et coll; iPrEx study team. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis. 2014;14:820-9. McCormack S et coll. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2016;387:53-60. Molina JM et coll; ANRS IPERGAY Study Group. On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection. N Engl J Med. 2015;373:2237-46. Baeten JM et coll; Partners PrEP Study Team. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367:399-410. Choopanya K et coll; Bangkok Tenofovir Study Group. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2013;381:2083-90.

Send us a Text Message.This episode is on Skin problems in Long Covid. In this first part, I talk about the symptoms, diagnosis and causes of Long Covid skin problems. In the second part, I will talk about the treatments, management and outcomes.I am Dr Tim Robinson, formerly a GP for 30 years, retired as planned at the start of the Covid pandemic. Since then I have become involved in the world of Long Covid. Currently I am GP clinical lead for Long Covid NHS in  South West England, as well as GP lead for three NHS Long Covid Services - Dorset, Bristol and South Devon. I am also Clinical Lead for Hope for the Community CIC. I have research involvement as co-investigator in a study on breathlessness in Long Covid, University of Bristol.Long Covid Doctor is an educational series for Long Covid sufferers; each talk covers the many aspects of Long Covid, the symptoms, causes, treatments, management and expected outcomes.Episodes are found on:Apple PodcastsSpotifyGoogle PodcastsYouTubeTranscripts of the individual episodes are available on:www.LongCovidDoctor.comEpisodes are accessed on:TwitterFacebookInstagramLinked inDisclaimer: Long Covid Doctor is an educational series. Any advice, diagnosis, treatments mentioned should only be considered after discussion with your own GP or qualified professional health provider.Links, resources:NICE Covid-19 rapid guideline:https://www.nice.org.uk/guidance/ng188/chapter/5-ManagementHow to manage post viral fatigue after Covid-19:https://www.rcot.co.uk/how-manage-post-viral-fatigue-after-covid-19-0References:Michael Gottlieb, Brit Long. Dermatologic manifestations and complications of COVID-19. American Journal of Emergency Medicine 38 (2020) 1715–1721.  McMahon et al. Long COVID in the skin: a registry analysis of COVID-19 dermatological duration. Lancet Infect Dis. 2021 Mar; 21(3): 313–314. Freeman et al. Three years on, COVID-19 and the skin: long-term impacts, emerging trends and clinical practice. British Journal of Dermatology, Volume 189, Issue 1, July 2023.

Send us a Text Message.In this episode I talk about Skin problems as experienced by Long Covid sufferers. In Part 1, I talked about the symptoms, diagnosis and causes. In this  second part, I will talk about the treatments, management and outcomes for Long Covid skin problems.I am Dr Tim Robinson, formerly a GP for 30 years, retired as planned at the start of the Covid pandemic. Since then I have become involved in the world of Long Covid. Currently I am GP clinical lead for Long Covid NHS in  South West England, as well as GP lead for three NHS Long Covid Services - Dorset, Bristol and South Devon. I am also Clinical Lead for Hope for the Community CIC. I have research involvement as co-investigator in a study on breathlessness in Long Covid, University of Bristol.Long Covid Doctor is an educational series for Long Covid sufferers; each talk covers the many aspects of Long Covid, the symptoms, causes, treatments, management and expected outcomes.Episodes are found on:Apple PodcastsSpotifyGoogle PodcastsYouTubeTranscripts of the individual episodes are available on:www.LongCovidDoctor.comEpisodes are accessed on:TwitterFacebookInstagramLinked inDisclaimer: Long Covid Doctor is an educational series. Any advice, diagnosis, treatments mentioned should only be considered after discussion with your own GP or qualified professional health provider.Links, resources:NICE Covid-19 rapid guideline:https://www.nice.org.uk/guidance/ng188/chapter/5-ManagementHow to manage post viral fatigue after Covid-19:https://www.rcot.co.uk/how-manage-post-viral-fatigue-after-covid-19-0References:Michael Gottlieb, Brit Long. Dermatologic manifestations and complications of COVID-19. American Journal of Emergency Medicine 38 (2020) 1715–1721.  McMahon et al. Long COVID in the skin: a registry analysis of COVID-19 dermatological duration. Lancet Infect Dis. 2021 Mar; 21(3): 313–314. Freeman et al. Three years on, COVID-19 and the skin: long-term impacts, emerging trends and clinical practice. British Journal of Dermatology, Volume 189, Issue 1, July 2023.

Post-publication, Callum and Jame give a little extra information on the SABATO trial in its final form compared to it's pre-publication state. Final article here:Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus bloodstream infection (SABATO): an international, open-label, parallel-group, randomised, controlled, non-inferiority trial, Kaasch, Achim J Valiente, Adoración et al. Lancet Infect Dis. 2024 Jan 17:S1473-3099(23)00756-9.PMID: 38244557.https://doi.org/10.1016/S1473-3099(23)00756-9Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or on X/Threads @IDiots_podPrep notes for completed episodes can be found here (Not all episodes have prep notes).If you are enjoying the podcast please leave a review on your preferred podcast app!Feel like giving back? Donations of caffeine gratefully received!https://www.buymeacoffee.com/idiotspod

JOURNAL CLUB, YO, IT'S A SABATO!!!Join Jame and Callum as we travel back in time to when we recorded this deep dive into the SABATO trial pre-print, now peer-reviewed and published in the Lancet ID!In the next episode we'll give a little update as to how the final article differs from the preprint (not much). We also talked about in our FIS Highlights Episode 3. We loved this trial and we hope you'll all give it a read, it's well worth it! Article here:Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus bloodstream infection (SABATO): an international, open-label, parallel-group, randomised, controlled, non-inferiority trial, Kaasch, Achim J Valiente, Adoración et al. Lancet Infect Dis. 2024 Jan 17:S1473-3099(23)00756-9. PMID: 38244557.https://doi.org/10.1016/S1473-3099(23)00756-9 Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or on X/Threads @IDiots_podPrep notes for completed episodes can be found here (Not all episodes have prep notes).If you are enjoying the podcast please leave a review on your preferred podcast app!Feel like giving back? Donations of caffeine gratefully received!https://www.buymeacoffee.com/idiotspod

In our usual Christmas episode, Brett, Phil and Martin choose our papers and podcasts of 2023. Also this time, Martin set the three of us a challenge: to find an interesting IPC-related paper from the years of our birth (more challenging for some than others..). Martin also reveals the No 1 single in our respective countries on the day of our birth. For Martin, a near miss. For Phil, a very apt song and for Brett... well, his karaoke debut cannot be far off.. Happy holidays everyone!   Martin's 1955 paper: Lowbury, E. J. (1955). "Cross-infection of wounds with antibiotic-resistant organisms." Br Med J 1(4920): 985-990. https://doi.org/10.1136/bmj.1.4920.985 Phil's 1964 paper: Murray, D. G. (1964). "Wound Infections after Surgery for Fractured Hip. A Follow-up Study." JAMA 190: 505-508. https://doi.org/10.1001/jama.1964.03070190025005 Brett's 1979 paper: Ehrenkranz, N. J. and S. J. Pfaff (1979). "Growth of hospital infection control programme and the infection control nurse." J R Soc Med 72(12): 888. https://doi.org/10.1177/014107687907201204 Our top papers   Martin's favourite paper: Wolfensberger, A., L. Clack, S. von Felten, M. Faes Hesse, D. Saleschus, M. T. Meier, K. Kusejko, R. Kouyos, L. Held and H. Sax (2023). "Prevention of non-ventilator-associated hospital-acquired pneumonia in Switzerland: a type 2 hybrid effectiveness-implementation trial." Lancet Infect Dis 23(7): 836-846. https://doi.org/10.1016/S1473-3099(22)00812-X Phil's favourite paper: Peel, T. N., S. Astbury, A. C. Cheng, D. L. Paterson, K. L. Buising, T. Spelman, A. Tran-Duy, S. Adie, G. Boyce, C. McDougall, R. Molnar, J. Mulford, P. Rehfisch, M. Solomon, R. Crawford, T. Harris-Brown, J. Roney, J. Wisniewski, R. de Steiger and A. T. Group (2023). "Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty." N Engl J Med 389(16): 1488-1498. https://doi.org/10.1056/NEJMoa2301401 Brett's favourite paper: Seidelman, J. L., C. R. Mantyh and D. J. Anderson (2023). "Surgical Site Infection Prevention: A Review." JAMA 329(3): 244-252. https://doi.org/10.1001/jama.2022.24075

In our usual Christmas episode, Brett, Phil and Martin choose our papers and podcasts of 2023. Also this time, Martin set the three of us a challenge: to find an interesting IPC-related paper from the years of our birth (more challenging for some than others..). Martin also reveals the No 1 single in our respective countries on the day of our birth. For Martin, a near miss. For Phil, a very apt song and for Brett... well, his karaoke debut cannot be far off.. Happy holidays everyone!   Martin's 1955 paper: Lowbury, E. J. (1955). "Cross-infection of wounds with antibiotic-resistant organisms." Br Med J 1(4920): 985-990. https://doi.org/10.1136/bmj.1.4920.985 Phil's 1964 paper: Murray, D. G. (1964). "Wound Infections after Surgery for Fractured Hip. A Follow-up Study." JAMA 190: 505-508. https://doi.org/10.1001/jama.1964.03070190025005 Brett's 1979 paper: Ehrenkranz, N. J. and S. J. Pfaff (1979). "Growth of hospital infection control programme and the infection control nurse." J R Soc Med 72(12): 888. https://doi.org/10.1177/014107687907201204 Our top papers   Martin's favourite paper: Wolfensberger, A., L. Clack, S. von Felten, M. Faes Hesse, D. Saleschus, M. T. Meier, K. Kusejko, R. Kouyos, L. Held and H. Sax (2023). "Prevention of non-ventilator-associated hospital-acquired pneumonia in Switzerland: a type 2 hybrid effectiveness-implementation trial." Lancet Infect Dis 23(7): 836-846. https://doi.org/10.1016/S1473-3099(22)00812-X Phil's favourite paper: Peel, T. N., S. Astbury, A. C. Cheng, D. L. Paterson, K. L. Buising, T. Spelman, A. Tran-Duy, S. Adie, G. Boyce, C. McDougall, R. Molnar, J. Mulford, P. Rehfisch, M. Solomon, R. Crawford, T. Harris-Brown, J. Roney, J. Wisniewski, R. de Steiger and A. T. Group (2023). "Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty." N Engl J Med 389(16): 1488-1498. https://doi.org/10.1056/NEJMoa2301401 Brett's favourite paper: Seidelman, J. L., C. R. Mantyh and D. J. Anderson (2023). "Surgical Site Infection Prevention: A Review." JAMA 329(3): 244-252. https://doi.org/10.1001/jama.2022.24075

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: July 18, 2017 I am not sure there are many things more terrifying than watching your child experience what looks like “just a cold” and then, over the course of a few hours, become paralyzed. In this episode, Drs. Ana Cristancho and Sarah Hopkins describe what we know about this recent polio-like outbreak in the United States. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. This episode was vetted and approved by Dr. Sarah Hopkins. REFERENCES Aliabadi N, Messacar K, Pastula DM, et al. Enterovirus D68 infection in children with acute flaccid myelitis, Colorado, USA, 2014. Emerg Infect Dis 2016;22(8):1387-94. PMID 27434186Greninger AL, Naccache SN, Messacar K, et al. A novel outbreak enterovirus D68 strain associated with acute flaccid myelitis cases in the USA (2012-14): a retrospective cohort study. Lancet Infect Dis 2015;15(6):671-82. PMID 25837569Messacar K, Schreiner TL, Van Haren K, et al. Acute flaccid myelitis: a clinical review of US cases 2012-2015. Ann Neurol 2016;80(3):326-38. PMID 27422805  We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

Episode Notes Drs. Paul Ambrose and Michael Dudley (@MikeMndudley) join Dr. Julie Ann Justo (@julie_justo) for a review of beta-lactamase inhibitor (BLI) pharmacokinetics & pharmacodynamics. They discuss factors affecting BLI's restorative activity, the convoluted math behind establishing exposure-response relationships for BLIs, some geeky medicinal chemistry, and a little-known easter egg in the published literature. Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/ References SIDP Insight on Tazobactam for ESBLs: Monogue M, et al. Pharmacotherapy. 2021 Oct;41(10):864-880. doi: 10.1002/phar.2623. PMID 34689349. Tazobactam with cefepime: VanScoy BD, et al. Antimicrob Agents Chemother. 2017 Nov 22;61(12):e01052-17. doi: 10.1128/AAC.01052-17. PMID: 28947475. Another great review of BLIs: Ambrose PG, et al. Curr Opin Pharmacol. 2017 Oct;36:86-93. doi: 10.1016/j.coph.2017.09.001. PMID: 29096172. Meropenem-vaborbactam target attainment: Bhavnani SM, et al. Antimicrob Agents Chemother. 2022 Dec 20;66(12):e0213021. doi: 10.1128/aac.02130-21. PMID: 36374023. Meropenem-vaborbactam pulmonary exposures: Wenzler E, et al. Antimicrob Agents Chemother. 2015 Dec;59(12):7232-9. doi: 10.1128/AAC.01713-15. PMID: 26349830. Stand-alone BLI discussion based on CB-618: Ambrose PG, et al.. Antimicrob Agents Chemother. 2017 Nov 22;61(12):e00630-17. doi: 10.1128/AAC.00630-17. PMID: 28947474. NDM-9 resistance to taniborbactam: Le Terrier C, et al. Lancet Infect Dis. 2023 Apr;23(4):401-402. doi: 10.1016/S1473-3099(23)00069-5. PMID: 36796395. New boronate drugs and NDM: Lomovskaya O, et al. Antimicrob Agents Chemother. 2023 Aug 31:e0057923. doi: 10.1128/aac.00579-23. PMID: 37650617. Helpful BLI PK-PD review: Crass R, Pai MP. Pharmacotherapy. 2019 Feb;39(2):182–195. doi: 10.1002/phar.2210. PMID 30589457. Discovery of QPX7728 (Xeruborbactam): Hecker SJ, et al. J Med Chem. 2020 Jul 23;63(14):7491-7507. doi: 10.1021/acs.jmedchem.9b01976. PMID 32150407. Xeruborbactam binding to PBPs directly: Lomovskaya O, et al. Antimicrob Agents Chemother. 2022 Feb 15;66(2):e0216821. doi: 10.1128/AAC.02168-21. PMID: 34902261. Xeruborbactam predicted best by fAUC/MIC with oral ceftibuten: Tarazi Z, et al. Open Forum Infect Dis. Volume 9, Issue Supplement_2, December 2022, ofac492.666, https://doi.org/10.1093/ofid/ofac492.666 (Poster 614) Xeruborbactam predicted best by fAUC/MIC with meropenem: Tarazi Z, et al. Open Forum Infect Dis. Volume 9, Issue Supplement_2, December 2022, ofac492.667, https://doi.org/10.1093/ofid/ofac492.667 (Poster 615) First 2013 AAC paper on tazobactam with ceftolozane from Ambrose group: VanScoy B, et al. Antimicrob Agents Chemother. 2013 Jun;57(6):2809-14. doi: 10.1128/AAC.02513-12. PMID: 23629705. Second 2013 AAC paper on tazobactam with ceftolozane from Ambrose group: Vanscoy B, et al. Antimicrob Agents Chemother. 2013 Dec;57(12):5924-30. doi: 10.1128/AAC.00656-13. PMID: 24041895. Electric Telescope, 52 Class 530 Series 1080p LCD/HD; Samsung Group, Seoul, South Korea, available at: https://www.samsung.com/ca/support/model/LN52C530F1FXZC/ Tazobactam with Piperacillin from Ambrose group: Nicasio AM, et al. Antimicrob Agents Chemother. 2016 Mar 25;60(4):2075-80. doi: 10.1128/AAC.02747-15. PMID: 26787689. Check out our podcast host, Pinecast. Start your own podcast for free with no credit card required. If you decide to upgrade, use coupon code r-7e7a98 for 40% off for 4 months, and support Breakpoints.

Ruben Dyrhovden er overlege og mikrobiolog som nylig har disputert. Vi snakker om funnene fra doktorgradsarbeidet hans, og munnhulens bakterier. Kanskje er tannhelse viktigere enn vi tror?Referanser:1. Gianos E, Jackson EA, Tejpal A, Aspry K, O'Keefe J, Aggarwal M, et al. Oral health and atherosclerotic cardiovascular disease: A review. Am J Prev Cardiol. 2021;7:100179.2. Labeau SO, Van de Vyver K, Brusselaers N, Vogelaers D, Blot SI. Prevention of ventilator-associated pneumonia with oral antiseptics: a systematic review and meta-analysis. Lancet Infect Dis. 2011;11(11):845-54.3. Fischer, L. A., Demerath, E., Bittner-Eddy, P. & Costalonga, M. Placental colonization with periodontal pathogens: the potential missing link. Am J Obstet Gynecol 221, 383-392 e3 (2019).4. Blanc, V. et al. Oral bacteria in placental tissues: increased molecular detection in pregnant periodontitis patients. Oral Dis 21, 905–912 (2015).5. Han, Y. W. et al. Term Stillbirth Caused by Oral Fusobacterium nucleatum. Obstetrics Gynecol 115, 442–445 (2010).6. Fardini, Y., Chung, P., Dumm, R., Joshi, N. & Han, Y. W. Transmission of Diverse Oral Bacteria to Murine Placenta: Evidence for the Oral Microbiome as a Potential Source of Intrauterine Infection▿ †. Infect Immun 78, 1789–1796 (2010).7. Han, Y. W. et al. Fusobacterium nucleatum Induces Premature and Term Stillbirths in Pregnant Mice: Implication of Oral Bacteria in Preterm Birth. Infect Immun 72, 2272–2279 (2004). Hosted on Acast. See acast.com/privacy for more information.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: July 18, 2017 The Landry-Guillain-Barre-Strohl Syndrome, aka Guillain-Barre Syndrome, is classically thought of as a painless ascending weakness with areflexia that typically follows an infectious prodrome. But there are a dozen variants with unusual clinical presentations, from back pain to pandysautonomia. And sometimes Guillain-Barre Syndrome follows a vaccination rather than a viral infection. In this BrainWaves episode, we discuss these and other unique facts regarding the history, clinical manifestations, and treatment of this polyneuropathy. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. REFERENCES Afifi AK. The Landry-Guillain-Barré Strohl syndrome 1859 to 1992 a historical perspective. J Family Community Med 1994;1(1):30-4. PMID 23008532Asbury AK. Guillain-Barré syndrome: historical aspects. Ann Neurol 1990;27 Suppl:S2-6. PMID 2194421Bril V, Katzberg HD. Acquired immune axonal neuropathies. Continuum (Minneap Minn) 2014;20(5 Peripheral Nervous System Disorders):1261-73. PMID 25299281Dimachkie MM, Saperstein DS. Acquired immune demyelinating neuropathies. Continuum (Minneap Minn) 2014;20(5 Peripheral Nervous System Disorders):1241-60. PMID 25299280Iodice V, Sandroni P. Autonomic neuropathies. Continuum (Minneap Minn) 2014;20(5 Peripheral Nervous System Disorders):1373-97. PMID 25299288Lehmann HC, Hartung HP, Kieseier BC, Hughes RA. Guillain-Barré syndrome after exposure to influenza virus. Lancet Infect Dis 2010;10(9):643-51. PMID 20797646Tam CC, O'Brien SJ, Petersen I, Islam A, Hayward A, Rodrigues LC. Guillain-Barré syndrome and preceding infection with campylobacter, influenza and Epstein-Barr virus in the general practice research database. PLoS One 2007;2(4):e344. PMID 17406668 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

In this podcast, an experienced conference and webinar moderator is joined by two doctors in the field of paediatric infectious diseases: David Greenberg and Maria Hemming-Harlo. In this podcast, our guest experts provide information and their perspectives on the following topics: The disease burden of rotavirus The related morbidity and mortality of rotavirus How rotavirus is transmitted The clinical picture of rotavirus infection The evidence supporting routine vaccination with RotaTeq (Rotavirus Vaccine, Live, Oral, Pentavalent) This podcast was funded by Merck Sharp & Dohme LLC. Below please find the reference list for Vax Voices, Podcast 1: The Global Burden of Rotavirus Disease and Evidence Supporting Routine Vaccination With RotaTeq to ensure listeners can further explore the content discussed. View the product information and indication for RotaTeq here. View the Select Safety Information from MSD below. Select Safety Information RotaTeq should not be administered to infants with a demonstrated history of hypersensitivity to the vaccine or any component of the vaccine. Infants with a history of intussusception or who have congenital malformation of the gastrointestinal tract that could predispose infants to intussusception should not receive RotaTeq. Infants with Severe Combined Immunodeficiency Disease or SCID should not receive RotaTeq. Administration of RotaTeq should be postponed in infants suffering from acute severe febrile illness. The presence of a minor infection is not a contraindication for immunisation. The administration of RotaTeq should be postponed in subjects suffering from acute diarrhoea or vomiting. No safety or efficacy data are available from clinical trials regarding the administration of RotaTeq to infants who are potentially immunocompromised. Cases of gastroenteritis associated with vaccine virus have been reported post marketing in infants with severe combined immunodeficiency. Vaccine virus transmission from vaccine recipient to nonvaccinated contacts has been reported. Caution is advised when considering whether to administer RotaTeq to individuals with immunodeficient contacts. In post-marketing experience, intussusception (including death) and Kawasaki disease have been reported in infants who have received RotaTeq. As a precaution, healthcare professionals should follow-up on any symptoms indicative of intussusception (severe abdominal pain, persistent vomiting, bloody stools, abdominal bloating and/or high fever) since data from observational studies indicate an increased risk of intussusception, mostly within 7 days after rotavirus vaccination. Parents/guardians should be advised to promptly report such symptoms to their healthcare provider. The level of protection provided by RotaTeq is based on the completion of all 3 doses. As with any vaccine, vaccination with RotaTeq may not result in complete protection in all recipients. HQ-ROT-00133 | 02/23   Podcast References: 1.Nelson R. COVID-19 disrupts vaccine delivery. Lancet Infect Dis. 2020;20(5):546. 2.Centers for Disease Control and Prevention (CDC). Epidemiology and Prevention of Vaccine-Preventable Diseases. 14th ed. Chapter 19: Rotavirus. Available at: https://www.cdc.gov/vaccines/pubs/pinkbook/rota.html. Last accessed: 6 March 2023. 3.Dormitzer PR. "Rotaviruses," Mandell GL, et al, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier Saunders; 2019:1983-96. 4.Centers for Disease Control and Prevention (CDC). Rotavirus. Clinical information. 2021. Available at: https://www.cdc.gov/rotavirus/clinical.html. Last accessed: 13 October 2022. 5.Troeger C et al. Rotavirus vaccination and the global burden of rotavirus diarrhea among children younger than 5 years. JAMA Pediatr. 2018;172(10):958-965. Erratum in: JAMA Pediatr. 2022;176(2):208. 6.GBD Diarrhoeal Diseases Collaborators. Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017;17(9):909-948. Erratum in: Lancet Infect Dis. 2017 Sep;17(9):897. 7.Van Damme P et al. Rotavirus vaccines: considerations for successful implementation in Europe. Lancet Infect Dis. 2006;6(12):805-12. 8.Paul MO, Erinle EA. Influence of humidity on rotavirus prevalence among Nigerian infants and young children with gastroenteritis. J Clin Microbiol. 1982;15(2):212-5. 9.Finnish Institute for Health and Welfare. Infectious diseases and vaccines: rotavirus vaccine. 2020. Available at: https://thl.fi/en/web/infectious-diseases-and-vaccinations/vaccines-a-to-z/rotavirus-vaccine. Last accessed: 16 September 2022. 10.GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117-71. 11.Franco MA et al. Immunity and correlates of protection for rotavirus vaccines. Vaccine. 2006;24(15):2718-31. 12.Gentsch JR et al. Serotype diversity and reassortment between human and animal rotavirus strains: implications for rotavirus vaccine programs. J Infect Dis. 2005;192(Suppl 1):S146-59. 13.Merck & Co. RotaTeq®. Prescribing information. 2022. Available at: https://www.merck.com/product/usa/pi_circulars/r/rotateq/rotateq_pi.pdf. Last accessed: 4 January 2023. 14.European Medicine Agency (EMA). RotaTeq. Summary of product characteristics. 2022. Available at: https://www.ema.europa.eu/en/documents/product-information/rotateq-epar-product-information_en.pdf. Last accessed: 4 January 2023. 15.Velasquez-Portocarrero DE et al. Head-to-head comparison of the immunogenicity of RotaTeq and Rotarix rotavirus vaccines and factors associated with seroresponse in infants in Bangladesh: a randomised, controlled, open-label, parallel, phase 4 trial. Lancet Infect Dis. 2022;22(11):1606-16. 16.Cortese MM, Parashar UD; Centers for Disease Control and Prevention (CDC). Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2009;58(RR-2):1-25. 17.Vesikari T et al.; Rotavirus Efficacy and Safety Trial (REST) Study Team. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med. 2006;354(1):23-33. 18.Vesikari T et al. Efficacy of a pentavalent rotavirus vaccine in reducing rotavirus-associated health care utilization across three regions (11 countries). Int J Infect Dis. 2007;11(Suppl 2):S29-35. 19.Heyse JF; REST Study Team. Evaluating the safety of a rotavirus vaccine: the REST of the story. Clin Trials. 2008;5(2):131-9. 20.World Health Organization (WHO). Rotavirus vaccines: WHO position paper. Wkly Epidemiol Rec. 2021;96(28):301-20.  

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.Originally released: September 19, 2019In this week's clinical case, Dr. Mike Bradshaw (Chicago Medical School and Billings Clinic) walks us through the case of a young woman with HSV encephalitis. With a twist. SPOILER ALERT: If you don't want to know the answer, DON'T LOOK AT THE SHOWNOTES!Produced by James E Siegler and Mike Bradshaw. Music courtesy of Yan Terrien, Unheard Music Concepts, Steve Combs, and Montplaisir. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.REFERENCESArmangue T, Leypoldt F, Dalmau J. Autoimmune encephalitis as differential diagnosis of infectious encephalitis. Curr Opin Neurol 2014;27(3):361-8. PMID 24792345Armangue T, Leypoldt F, Málaga I, et al. Herpes simplex virus encephalitis is a trigger of brain autoimmunity. Ann Neurol 2014;75(2):317-23. PMID 24318406Armangue T, Spatola M, Vlagea A, et al. Frequency, symptoms, risk factors, and outcomes of autoimmune encephalitis after herpes simplex encephalitis: a prospective observational study and retrospective analysis. Lancet Neurol 2018;17(9):760-72. PMID 30049614Bacon TH, Boon RJ, Schultz M, Hodges-Savola C. Surveillance for antiviral-agent-resistant herpes simplex virus in the general population with recurrent herpes labialis. Antimicrob Agents Chemother 2002;46(9):3042-4. PMID 12183267Dubey D, Pittock SJ, Kelly CR, et al. Autoimmune encephalitis epidemiology and a comparison to infectious encephalitis. Ann Neurol 2018;83(1):166-77. PMID 29293273Gable MS, Sheriff H, Dalmau J, Tilley DH, Glaser CA. The frequency of autoimmune N-methyl-D-aspartate receptor encephalitis surpasses that of individual viral etiologies in young individuals enrolled in the California Encephalitis Project. Clin Infect Dis 2012;54(7):899-904. PMID 22281844Granerod J, Ambrose HE, Davies NW, et al. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis 2010;10(12):835-44. PMID 20952256Linnoila JJ, Binnicker MJ, Majed M, Klein CJ, McKeon A. CSF herpes virus and autoantibody profiles in the evaluation of encephalitis. Neurol Neuroimmunol Neuroinflamm 2016;3(4):e245. PMID 27308306Prüss H, Finke C, Höltje M, et al. N-methyl-D-aspartate receptor antibodies in herpes simplex encephalitis. Ann Neurol 2012;72(6):902-11. PMID 23280840Steiner I, Budka H, Chaudhuri A, et al. Viral meningoencephalitis: a review of diagnostic methods and guidelines for management. Eur J Neurol 2010;17(8):999-e57. PMID 20236175Venkatesan A, Benavides DR. Autoimmune encephalitis and its relation to infection. Curr Neurol Neurosci Rep 2015;15(3):3. PMID 25637289We belie

Host: Matt Birnholz, MD Guest: David Canaday, MD As we age, our immune system becomes weaker and is therefore unable to ward off infection as easily as in our younger years.1 This is particularly troublesome during flu season. In fact, the CDC's Advisory Committee on Immunization Practices (ACIP) recently looked at flu vaccine data for adults aged 65 years and older, and they now recommend that this age group preferentially receive higher dose or adjuvanted vaccines over standard dose unadjuvanted vaccines when available.2 So what was the data that led to these updated recommendations? Joining Dr. Matt Birnholz to share those key findings and the role of adjuvanted vaccines like FLUAD® QUADRIVALENT (Influenza Vaccine, Adjuvanted) in preventing influenza in older adults is Dr. David Canaday, Professor in the Division of Infectious Diseases & HIV Medicine at Case Western Reserve University in Cleveland. Avoid use in patients who have experienced any severe allergic reactions to any component of the vaccine. For more risk information please see below or consult the Full US Prescribing Information for FLUAD® QUADRIVALENT here. References:1. Gavazzi G, Krause KH. Ageing and infection. Lancet Infect Dis. 2002;2(11):659-666.2. Centers for Disease Control and Prevention. Past seasons estimated influenza disease …

Drs. Debbie Goff (@idpharmd), Khalid Eljaaly (@khalideljaaly), and Angeliki Messina (@AngPharmID) join Dr. David Ha (@DHpharmd) as part of a global panel discussion on international antimicrobial stewardship practices. Listen in to learn about pharmacy practice in South Africa and Saudi Arabia, antimicrobial stewardship practices in these and other countries, and how you too can get involved in global stewardship. Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ References 2022 ACCP Global Conference on Clinical Pharmacy. https://www.accp.com/meetings/abstracts.aspx Alhazzani W, Alshahrani M, Alshamsi F, Aljuhani O, Eljaaly K, Hashim S, et al. The Saudi Critical Care Society practice guidelines on the management of COVID-19 in the ICU: Therapy section. J Infect Public Health. 2022;15(1):142-151. doi:10.1016/j.jiph.2021.10.005. Brink AJ, Messina AP, Feldman C, et al. Antimicrobial stewardship across 47 South African hospitals: an implementation study. Lancet Infect Dis. 2016;16(9):1017-1025. doi:10.1016/S1473-3099(16)30012-3 Goff DA, Ashiru‐Oredope D, Cairns KA, et al. Global contributions of pharmacists during the COVID‐19 pandemic. J Am Coll Clin Pharm. Published online October 2, 2020:10.1002/jac5.1329. doi:10.1002/jac5.1329 Eljaaly K, Elarabi S, Alshehri S, Nix DE. Impact of requiring re-authorization of restricted antibiotics on day three of therapy. J Antimicrob Chemother 2018;73(2):527-530. doi:10.1093/jac/dkx384. Korayem GB, Badreldin HA, Eljaaly K, et al. Clinical pharmacy definition, required education, training and practice in Saudi Arabia: A position statement by the Saudi society of clinical pharmacy. Saudi Pharm J. 2021;29(11):1343-1347. doi:10.1016/j.jsps.2021.09.008. International Pharmaceutical Federation Development Goals: Antimicrobial Stewardship. https://developmentgoals.fip.org/dg17/ Messina AP, van den Bergh D, Goff DA. Antimicrobial Stewardship with Pharmacist Intervention Improves Timeliness of Antimicrobials Across Thirty-three Hospitals in South Africa. Infect Dis Ther. 2015;4(Suppl 1):5-14. doi:10.1007/s40121-015-0082-x Open Access BSAC eBook "Antimicrobial Stewardship: From Principles to Practice". https://www.bsac.org.uk/antimicrobialstewardshipebook/BSAC-AntimicrobialStewardship-FromPrinciplestoPractice-eBook.pdf Open Access BSAC course "Antimicrobial Stewardship for the Gulf, Middle East and North Africa". https://www.futurelearn.com/courses/antimicrobial-stewardship-for-the-middle-east Saudi Society of Clinical Pharmacy Infectious Disease Pharmacy Specialty Network. https://sscp.org.sa/infectious-disease/ World Health Organization. Antimicrobial Stewardship Programmes in Health-Care Facilities in Low- and Middle-Income Countries: A WHO Practical Toolkit. World Health Organization; 2019. Accessed March 9, 2022. http://apps.who.int/iris/handle/10665/329404

Is this episode clinically relevant? No. Is it important? I think so! The story of Bartonella features a cast of characters, including a medical student who died trying to understand the disease, as well as some scientists with some less than ethical experiments. Enjoy! Intro :01 Welcome to another exciting episode of Rheuminations :11 About today's episode 1:12 More discussion of Bartonella quintana 2:52 How did we figure out the lice were actually the problem? 7:32 When do we figure out what this infection organism is? 11:51 A quick refresher of Koch's postulates 12:58 How did they get the volunteers to do this? 13:33 The story of how Bartonella got its name 17:00 What is Bartonella bacilliformis? 17:38 Who is Richard Strong? 26:29 How do we finally prove that Carrion's disease is what Carrion had proven? 28:25 About Bartonella henselae 32:21 Recapping the episode 36:39 Thanks for listening 37:24 We'd love to hear from you! Send your comments/questions to Dr. Brown at rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum. Disclosure: Brown reports no relevant financial disclosures. References:  Anstead GM. Lancet Infect Dis. 2016;16:e164–172. Salinas-Flores D.  Revista de la Facultad de Medicina, Universidad Nacional de Colombia. 2016;64:517. Schultz MG. Am J Trop Med Hyg. 1968;17:503-515. Vinson JW, et al. Am J Trop Med Hyg. 1969;18:713-22.

Este episodio (BS18) se grabó el viernes, 13 de septiembre de 2021 y con él comenzamos la 3ª temporada del programa. Tras volver de su estancia de investigación, Silvana se incorpora a la tertulia y nos comenta el primer artículo del episodio: se trata de un estudio en el que se muestra una correlación entre la microbiota de bebés prematuros y la incidencia de daño cerebral (la referencia es: Seki et al. (2021). Aberrant gut-microbiota-immune-brain axis development in premature neonates with brain damage. Cell Host Microbe.). En (bio)noticias comentamos 3 asuntos interesantes que nos trae Íker: la controversia por un artículo en el que se afirma que la tasa de hospitalización es mayor en pacientes Covid con la variante delta (la referencia es: Twohig et al. (2021). Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study. Lancet Infect Dis.). Francis, nos da su opinión sobre el sesgo del tratamiento estadístico que los autores han utilizado para sacar conclusiones de los datos epidemiológicos. Otro asunto que nos trae Íker es el de los fichajes de grandes expertos en envejecimiento -entre ellos los españoles Manuel Serrano y Juan Carlos Izpisua- por la empresa Altos Labs, fundada y financiada por varios multimillonarios (Jeff Bezos entre ellos), cuyo objetivo es impulsar tecnologías para vivir más años con salud. Entre los responsables de esta empresa se encuentran también algunos de los fundadores de los premios Breakthrough, que se acaban de anunciar. Hemos aprovechado esta coincidencia para dedicar una buena parte de la sección a comentar los premiados de este año en el área de Ciencias de la Vida (con especial atención al premio a Katalin Karikó y Drew Weissman por desarrollar la tecnología de vacunas basadas en ARN, que ha permitido disponer de las vacunas Pfizer y Moderna contra la Covid19 en tiempo récord). También hemos aprovechado para comparar los premios Breakthrough con los Nobel y proponer a los oyentes que participen en nuestra quiniela para los Nobel de este año. Finalizamos la sección de (bio)noticias comentando los recientes fallecimientos de Edmond Fischer (Nobel de medicina en 1992) y del investigador español Dionisio Martín-Zanca. Silvana también nos anuncia el evento de divulgación científica “Desgranando Ciencia” (Granada). A continuación, Pepe nos comenta un artículo de señalización celular y cáncer, en el que se identifica la fosfatas de ciclo celular CDC25 como un nuevo sustrato de la quinasa DYRK2. Comentamos las implicaciones funcionales de este descubrimiento y entrevistamos al responsable del grupo investigador, Marco A. Calzado (IMIBIC, Córdoba) (la referencia del artículo es: Lara-Chica et al. (2021). A novel CDC25A/DYRK2 regulatory switch modulates cell cycle and survival. Cell Death Differ 1–13.). Esperamos que este episodio os resulte interesante y entretenido. ¡Bienvenidos!

This week on the program, we have remastered one of our earliest (and most interesting!) episodes on Guillain-Barre syndrome. With an important announcement from Jim Siegler. Produced by James E. Siegler. Music courtesy of Lee Rosevere. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES Dimachkie MM and Saperstein DS. Acquired immune demyelinating neuropathies. Continuum (Minneap Minn). 2014;20:1241-60. Osler W. The principles and practice of medicine. New York: Appleton; 1892. Gray H. History of lumbar puncture (rachicentesis): The operation and the idea. Arch Neurol Psych. 1921;6:61-69. Asbury AK. Guillain-Barre syndrome: historical aspects. Annals of neurology. 1990;27 Suppl:S2-6. Afifi AK. The landry-guillain-barre strohl syndrome 1859 to 1992 a historical perspective. J Family Community Med. 1994;1:30-4. Bril V and Katzberg HD. Acquired immune axonal neuropathies. Continuum (Minneap Minn). 2014;20:1261-73. Iodice V and Sandroni P. Autonomic neuropathies. Continuum (Minneap Minn). 2014;20:1373-97. Lehmann HC, Hartung HP, Kieseier BC and Hughes RA. Guillain-Barre syndrome after exposure to influenza virus. Lancet Infect Dis. 2010;10:643-51. Sivadon-Tardy V, Orlikowski D, Porcher R, Sharshar T, Durand MC, Enouf V, Rozenberg F, Caudie C, Annane D, van der Werf S, Lebon P, Raphael JC, Gaillard JL and Gault E. Guillain-Barre syndrome and influenza virus infection. Clin Infect Dis. 2009;48:48-56. Stowe J, Andrews N, Wise L and Miller E. Investigation of the temporal association of Guillain-Barre syndrome with influenza vaccine and influenzalike illness using the United Kingdom General Practice Research Database. American journal of epidemiology. 2009;169:382-8. Tam CC, O'Brien SJ, Petersen I, Islam A, Hayward A and Rodrigues LC. Guillain-Barre syndrome and preceding infection with campylobacter, influenza and Epstein-Barr virus in the general practice research database. PloS one. 2007;2:e344. Tam CC, O'Brien SJ and Rodrigues LC. Influenza, Campylobacter and Mycoplasma infections, and hospital admissions for Guillain-Barre syndrome, England. Emerg Infect Dis. 2006;12:1880-7. Dawood FS, Chaves SS, Perez A, Reingold A, Meek J, Farley MM, Ryan P, Lynfield R, Morin C, Baumbach J, Bennett NM, Zansky S, Thomas A, Lindegren ML, Schaffner W, Finelli L and Emerging Infections Program N. Complications and associated bacterial coinfections among children hospitalized with seasonal or pandemic influenza, United States, 2003-2010. The Journal of infectious diseases. 2014;209:686-94. McDermott M, Gelb DJ, Wilson K, Pawloski M, Burke JF, Shelgikar AV and London ZN. Sex Differences in Academic Rank and Publication Rate at Top-Ranked US Neurology Programs. JAMA Neurol. 2018;75:956-961. Keddie S, Pakpoor J, Mousele C, Pipis M, Machado PM, Foster M, Record CJ, Keh RYS, Fehmi J, Paterson RW, Bharambe V, Clayton LM, Allen C, Price O, Wall J, Kiss-Csenki A, Rathnasabapathi DP, Geraldes R, Yermakova T, King-Robson J, Zosmer M, Rajakulendran S, Sumaria S, Farmer SF, Nortley R, Marshall CR, Newman EJ, Nirmalananthan N, Kumar G, Pinto AA, Holt J, Lavin TM, Brennan KM, Zandi MS, Jayaseelan DL, Pritchard J, Hadden RDM, Manji H, Willison HJ, Rinaldi S, Carr AS and Lunn MP. Epidemiological and cohort study finds no association between COVID-19 and Guillain-Barre syndrome. Brain. 2021;144:682-693. Lunn MP, Cornblath DR, Jacobs BC, Querol L, van Doorn PA, Hughes RA and Willison HJ. COVID-19 vaccine and Guillain-Barre syndrome: let's not leap to associations. Brain. 2021;144:357-360.

Au Pharmascope, on est de plus en plus confiant que l’influenza ne se pointera pas le bout du nez cette année, mais on ne prend aucune chance! Dans ce 67ème épisode, Nicolas, Sébastien et Isabelle discutent du traitement de l’influenza. Les objectifs pour cet épisode sont: Décrire les objectifs de traitement de l’influenzaIdentifier les patients qui peuvent bénéficier d’un traitement de l’influenzaExpliquer les bénéfices et les risques des traitements antiviraux contre l’influenza Ressources pertinentes en lien avec l’épisode Revue systématique et méta-analyse portant sur les traitements antivirauxJefferson T et coll. Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children. Cochrane Database Syst Rev. 2014;2014:CD008965. Étude portant sur l’oseltamivirButler CC et coll. Oseltamivir plus usual care versus usual care for influenza-like illness in primary care: an open-label, pragmatic, randomised controlled trial. Lancet. 2020;395:42-52. Études CAPSTONE-1 et 2 portant sur le baloxavirHayden FG et coll. Baloxavir Marboxil for Uncomplicated Influenza in Adults and Adolescents. N Engl J Med. 2018;379:913-23. Ison MG et coll. Early treatment with baloxavir marboxil in high-risk adolescent and adult outpatients with uncomplicated influenza (CAPSTONE-2): a randomised, placebo-controlled, phase 3 trial. Lancet Infect Dis. 2020; 20:1204-14. Guide de l’INESSSInstitut national d’excellence en santé et en services sociaux. Guide d’usage optimal -  Traitement et prophylaxie de l’influenza chez l’enfant et l’adulte dans le contexte de la covid-19. Décembre 2020. Lignes directrices de l’IDSAUyeki TM et coll. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza. Clin Infect Dis. 2019;68:e1-47. Lignes directrices canadiennesAoki FY et coll. Use of antiviral drugs for seasonal influenza: Foundation document for practitioners - Update 2019. JAMMI. 2019;4:60-82. Rapports d’activité grippale au Canada (ÉpiGrippe)Gouvernement du Canada. Grippe (influenza): Surveillance ÉpiGrippe. 2020. Tableau comparatif des symptômes de l’influenza, de la COVID-19 et du rhumeAlberta Health Services. Disponible en ligne.

The COVID-19 pandemic laid bare the racial health disparities in the United States, with markedly increased mortality especially among Blacks and Native Americans. In this episode, Tony Breu and I discuss the conception of race, racism, and the social determinants of health through three historic plagues in the United States -- from yellow fever in New Orleans, to poliomyelitis, and finally the early days of HIV/AIDS -- and what lessons we can draw for COVID-19. Along the way, we’ll discuss the unique social capital afforded by acclimation, immunity passports, the concept of the “original antigenic sin,” and constitutionalism and eugenics. This presentation was performed live at the annual meeting of the Massachusetts American College of Physicians, and is only lightly edited.   SOURCES:   Monath TP, Yellow fever: an update. Lancet Infect Dis. 2001 Aug;1(1):11-20. doi: 10.1016/S1473-3099(01)00016-0. Kallas EG, D'Elia Zanella LGFAB, Moreira CHV, Buccheri R, Diniz GBF, Castiñeiras ACP, Costa PR, Dias JZC, Marmorato MP, Song ATW, Maestri A, Borges IC, Joelsons D, Cerqueira NB, Santiago E Souza NC, Morales Claro I, Sabino EC, Levi JE, Avelino-Silva VI, Ho YL. Predictors of mortality in patients with yellow fever: an observational cohort study. Lancet Infect Dis. 2019 Jul;19(7):750-758. doi: 10.1016/S1473-3099(19)30125-2. Epub 2019 May 16. Erratum in: Lancet Infect Dis. 2019 Nov;19(11):e370. PMID: 31104909. Blake LE, Garcia-Blanco MA. Human genetic variation and yellow fever mortality during 19th century U.S. epidemics. mBio. 2014 Jun 3;5(3):e01253-14. doi: 10.1128/mBio.01253-14. PMID: 24895309; PMCID: PMC4049105. Jelili Ojodu, MPH1, Mary M. Hulihan, MPH2, Shammara N. Pope, MPH2, Althea M. Grant, PhD2,, MMWR, Incidence of Sickle Cell Trait — United States, 2010. IthaMaps, Haemoglobin Epidemiology. https://www.ithanet.eu/db/ithamaps?country=GR Serjeant GR, The natural history of sickle cell disease. Cold Spring Harb Perspect Med. 2013 Oct; 3(10): a011783. Hamosh A, FitzSimmons SC, Macek M Jr, Knowles MR, Rosenstein BJ, Cutting GR. Comparison of the clinical manifestations of cystic fibrosis in black and white patients. J Pediatr. 1998 Feb;132(2):255-9. doi: 10.1016/s0022-3476(98)70441-x. PMID: 9506637. Gershman KD et al, Yellow Fever Vaccine & Malaria Prophylaxis Information, by Country. CDC.  Kofler N and Baylis F, Ten reasons why immunity passports are a bad idea. Nature 21 May 2020. NASEM, National Academies Release Framework for Equitable Allocation of a COVID-19 Vaccine for Adoption by HHS, State, Tribal, Local, and Territorial Authorities. Schmidt H et al, Covid-19: how to prioritize worse-off populations in allocating safe and effective vaccines.BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3795 (Published 05 October 2020). Siegal FP, Lopez C, Hammer GS, Brown AE, Kornfeld SJ, Gold J, Hassett J, Hirschman SZ, Cunningham-Rundles C, Adelsberg BR, et al. Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions. N Engl J Med. 1981 Dec 10;305(24):1439-44. doi: 10.1056/NEJM198112103052403. PMID: 6272110. Lushniak BD, Surgeon General’s Perspectives. Public Health Rep. 2014 Mar-Apr; 129(2): 112–114. Booske BC et al, “Different Perspectives For Assigning Weights to Determinants of Health,” University of Wisconsin Population Health Institute.  Marc LG et al,HIV among Haitian-born persons in the United States, 1985–2007, AIDS. Author manuscript; available in PMC 2011 Aug 24. Rogers N, Race and the Politics of Polio: Warm Springs, Tuskegee, and the March of Dimes. Am J Public Health. 2007 May; 97(5): 784–795. Curran JW and Jaffe HW, AIDS: the Early Years and CDC’s Response. MMWR. Olivarius Kathryn, Immunity, Capital, and Power in Antebellum New Orleans. The American Historical Review, Volume 124, Issue 2, April 2019, Pages 425–455,

Ryan Shields and Erin McCreary discuss notable infectious diseases publications from the first half of 2020. Papers discussed: 1) Van Duin D, et al. Lancet Infect Dis. 2020 Jun;20(6):731-741. doi: 10.1016/S1473-3099(19)30755-8. 2) Livermore DM, et al. Clin Infect Dis. 2020 Feb 6;ciaa122. doi: 10.1093/cid/ciaa122. 3) Falcone M, et al. Clin Infect Dis. 2020 May 19;ciaa586. doi: 10.1093/cid/ciaa586. 4) Lodise TP, et al. J Antimicrob Chemother. 2020 May 28;dkaa197. doi: 10.1093/jac/dkaa197. 5) O’Donnell JN, et al. Clin Ther. 2020 Jul 16;S0149-2918(20)30315-5. doi: 10.1016/j.clinthera.2020.06.005. 6) Abdul-Aziz MH, et al. Intensive Care Med. 2020 Jun;46(6):1127-1153. doi: 10.1007/s00134-020-06050-1. 7) Cusumano JA, et al. Am J Health Syst Pharm. 2020 Jul 7;77(14):1104-1112. doi: 10.1093/ajhp/zxaa128. 8) Roberts JA, et al. Clin Infect Dis. 2020 Mar 9;ciaa224. doi: 10.1093/cid/ciaa224. 9) Ackerman A, et al. Antimicrob Agents Chemother. 2020 May 21;64(6):e00066-20. doi: 10.1128/AAC.00066-20. 10) Tong SYC, et al. JAMA. 2020 Feb 11;323(6):527-537. doi: 10.1001/jama.2020.0103. 11) Jones BE, et al. JAMA Intern Med. 2020 Feb 17;180(4):552-560. doi: 10.1001/jamainternmed.2019.7495. 12) Cheng MP, et al. Clin Infect Dis. 2020 Jul 15;ciaa1000. doi: 10.1093/cid/ciaa1000. For BCIDP credit, visit https://sidp.org/BCIDP Follow SIDP on Twitter: @SIDPharm

Ryan Shields and Erin McCreary discuss notable infectious diseases publications from the first half of 2020! Papers discussed: 1) Rybak MJ, et al. Am J Health Syst Pharm. 2020 May 19;77(11):835-864. doi: 10.1093/ajhp/zxaa036. 2) Scheetz MH. Am J Health Syst Pharm. 2020 May 19;77(11):810-811. doi: 10.1093/ajhp/zxaa076. 3) Alosaimy S, et al. Clin Infect Dis. 2020 July 27;ciaa1039. doi: 10.1093/cid/ciaa1039. 4) Rhee C, et al. Clin Infect Dis. 2020 May 6;ciaa059. doi: 10.1093/cid/ciaa059. 5) Heil EL, et al. Pharmacotherapy. 2020 Apr;40(4):368-371. doi: 10.1002/phar.2384. 6) Townsend SR, et al. Clin Infect Dis. 2020 May 6;ciaa458. doi: 10.1093/cid/ciaa458. 7) Satlin MJ, et al. Clin Infect Dis. 2020 Feb 13;ciaa121. doi: 10.1093/cid/ciaa121. 8) Pogue JM, et al. Antimicrob Agents Chemother. 2020 Jan 27;64(2):e01495-19. doi: 10.1128/AAC.01495-19. 9) Ambrose PG, et al. Open Forum Infect Dis. 2020 Mar 13;7(7):ofaa084. doi: 10.1093/ofid/ofaa084. 10) Singh N, et al. JAMA. 2020 Apr 14;323(14):1378-1387. doi: 10.1001/jama.2020.3138. 11) van Delden C, et al. Clin Infect Dis. 2020 Jan 9;ciz1113. doi: 10.1093/cid/ciz1113. 12) Niederman MS, et al. Lancet Infect Dis. 2020 Mar;20(3):330-340. doi: 10.1016/S1473-3099(19)30574-2. 13) von Dach E, et al. JAMA. 2020 Jun 2;323(21):2160-2169. doi: 10.1001/jama.2020.6348. 14) Mergenhagen KA, et al. Antimicrob Agents Chemother. 2020 Feb 21;64(3):e02167-19. doi: 10.1128/AAC.02167-19. For BCIDP credit, visit https://sidp.org/BCIDP Follow SIDP on Twitter: @SIDPharm

REFERÊNCES1.Offringa A, Montijn R, Singh S, Paul M, Pinto YM, Pinto-Sietsma SJ. The mechanistic overview of SARS-CoV-2 using angiotensin-converting enzyme 2 to enter the cell for replication: possible treatment options related to the renin-angiotensin system. Eur Heart J Cardiovasc Pharmacother. 2020.2.Santamarina MG, Boisier D, Contreras R, Baque M, Volpacchio M, Beddings I. COVID-19: a hypothesis regarding the ventilation-perfusion mismatch. Crit Care. 2020;24(1):395.3.Merrill JT, Erkan D, Winakur J, James JA. Emerging evidence of a COVID-19 thrombotic syndrome has treatment implications. Nat Rev Rheumatol. 2020.4.Teuwen LA, Geldhof V, Pasut A, Carmeliet P. COVID-19: the vasculature unleashed. Nat Rev Immunol. 2020;20(7):389-91.5.Potus F, Mai V, Lebret M, Malenfant S, Breton-Gagnon E, Lajoie AC, et al. Novel insights on the pulmonary vascular consequences of COVID-19. Am J Physiol Lung Cell Mol Physiol. 2020;319(2):L277-L88.6.Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-8.7.Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med. 2020;383(2):120-8.8.McGonagle D. Immune Mechanisms of Pulmonary Intravascular Coagulopathy in COVID-19 Pneumonia. lancet Rheumatol. 2020.9.Perricone C, Bartoloni E, Bursi R, Cafaro G, Guidelli GM, Shoenfeld Y, et al. COVID-19 as part of the hyperferritinemic syndromes: the role of iron depletion therapy. Immunol Res. 2020;68(4):213-24.10.Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. 2020;38(7):1504-7.11.Price LC, McCabe C, Garfield B, Wort SJ. Thrombosis and COVID-19 pneumonia: the clot thickens! Eur Respir J. 2020;56(1).12.Parry AH, Wani AH, Yaseen M, Dar MI. Demystifying pulmonary vascular complications in severe coronavirus disease-19 pneumonia (COVID-19) in the light of clinico-radiologic-pathologic correlation. Thromb Res. 2020.13.Polak SB, Van Gool IC, Cohen D, von der Thusen JH, van Paassen J. A systematic review of pathological findings in COVID-19: a pathophysiological timeline and possible mechanisms of disease progression. Mod Pathol. 2020.14.von der Thusen J, van der Eerden M. Histopathology and genetic susceptibility in COVID-19 pneumonia. Eur J Clin Invest. 2020:e13259.15.Behzad S, Aghaghazvini L, Radmard AR, Gholamrezanezhad A. Extrapulmonary manifestations of COVID-19: Radiologic and clinical overview. Clin Imaging. 2020;66:35-41.16.Qanadli SD, Beigelman-Aubry C, Rotzinger DC. Vascular Changes Detected With Thoracic CT in Coronavirus Disease (COVID-19) Might Be Significant Determinants for Accurate Diagnosis and Optimal Patient Management. AJR Am J Roentgenol. 2020;215(1):W15.17.Moreira BL, Santana PRP, Zanetti G, Marchiori E. COVID-19 and acute pulmonary embolism: what should be considered to indicate a computed tomography pulmonary angiography scan? Rev Soc Bras Med Trop. 2020;53:e20200267.18.Oudkerk M, Kuijpers D, Oudkerk SF, van Beek EJ. The vascular nature of COVID-19. Br J Radiol. 2020:20200718.19.Lang M, Som A, Mendoza DP, Flores EJ, Reid N, Carey D, et al. Hypoxaemia related to COVID-19: vascular and perfusion abnormalities on dual-energy CT. Lancet Infect Dis. 2020.20.Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected by Pulmonary CT Angiography. Radiology. 2020:201544.21.Poyiadji N, Cormier P, Patel PY, Hadied MO, Bhargava P, Khanna K, et al. Acute Pulmonary Embolism and COVID-19. Radiology. 2020:201955.22.Lang M. Pulmonary Vascular Manifestations of COVID-19 Pneumonia. Radiol Cardiothorac Imaging. 2020.23.Kaminetzky M. Pulmonary Embolism on CTPA in COVID-19 Patients. Radiol Cardiothorac Imaging. 2020.24.Thachil J, Srivastava A. SARS-2 Coronavirus-Associated Hemostatic Lung Abnormality in COVID-19: Is It Pulmonary Thrombosis or Pulmonary Embolism? Semin Thromb Hemost. 2020.25.Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected with Pulmonary CT Angiography. Radiology. 2020;296(3):E186-E8.26.Saba L, Sverzellati N. Is COVID Evolution Due to Occurrence of Pulmonary Vascular Thrombosis? J Thorac Imaging. 2020.27.E C. Pulmonary Thromboembolism in COVID-19: Venous Thromboembolism or Arterial Thrombosis? Radiol Cardiothorac Imaging. 2020.28.Provencher S, Potus F, Bonnet S. COVID-19 and the pulmonary vasculature. Pulm Circ. 2020;10(3):2045894020933088.

REFERENCES1.Offringa A, Montijn R, Singh S, Paul M, Pinto YM, Pinto-Sietsma SJ. The mechanistic overview of SARS-CoV-2 using angiotensin-converting enzyme 2 to enter the cell for replication: possible treatment options related to the renin-angiotensin system. Eur Heart J Cardiovasc Pharmacother. 2020.2.Santamarina MG, Boisier D, Contreras R, Baque M, Volpacchio M, Beddings I. COVID-19: a hypothesis regarding the ventilation-perfusion mismatch. Crit Care. 2020;24(1):395.3.Merrill JT, Erkan D, Winakur J, James JA. Emerging evidence of a COVID-19 thrombotic syndrome has treatment implications. Nat Rev Rheumatol. 2020.4.Teuwen LA, Geldhof V, Pasut A, Carmeliet P. COVID-19: the vasculature unleashed. Nat Rev Immunol. 2020;20(7):389-91.5.Potus F, Mai V, Lebret M, Malenfant S, Breton-Gagnon E, Lajoie AC, et al. Novel insights on the pulmonary vascular consequences of COVID-19. Am J Physiol Lung Cell Mol Physiol. 2020;319(2):L277-L88.6.Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-8.7.Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med. 2020;383(2):120-8.8.McGonagle D. Immune Mechanisms of Pulmonary Intravascular Coagulopathy in COVID-19 Pneumonia. lancet Rheumatol. 2020.9.Perricone C, Bartoloni E, Bursi R, Cafaro G, Guidelli GM, Shoenfeld Y, et al. COVID-19 as part of the hyperferritinemic syndromes: the role of iron depletion therapy. Immunol Res. 2020;68(4):213-24.10.Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. 2020;38(7):1504-7.11.Price LC, McCabe C, Garfield B, Wort SJ. Thrombosis and COVID-19 pneumonia: the clot thickens! Eur Respir J. 2020;56(1).12.Parry AH, Wani AH, Yaseen M, Dar MI. Demystifying pulmonary vascular complications in severe coronavirus disease-19 pneumonia (COVID-19) in the light of clinico-radiologic-pathologic correlation. Thromb Res. 2020.13.Polak SB, Van Gool IC, Cohen D, von der Thusen JH, van Paassen J. A systematic review of pathological findings in COVID-19: a pathophysiological timeline and possible mechanisms of disease progression. Mod Pathol. 2020.14.von der Thusen J, van der Eerden M. Histopathology and genetic susceptibility in COVID-19 pneumonia. Eur J Clin Invest. 2020:e13259.15.Behzad S, Aghaghazvini L, Radmard AR, Gholamrezanezhad A. Extrapulmonary manifestations of COVID-19: Radiologic and clinical overview. Clin Imaging. 2020;66:35-41.16.Qanadli SD, Beigelman-Aubry C, Rotzinger DC. Vascular Changes Detected With Thoracic CT in Coronavirus Disease (COVID-19) Might Be Significant Determinants for Accurate Diagnosis and Optimal Patient Management. AJR Am J Roentgenol. 2020;215(1):W15.17.Moreira BL, Santana PRP, Zanetti G, Marchiori E. COVID-19 and acute pulmonary embolism: what should be considered to indicate a computed tomography pulmonary angiography scan? Rev Soc Bras Med Trop. 2020;53:e20200267.18.Oudkerk M, Kuijpers D, Oudkerk SF, van Beek EJ. The vascular nature of COVID-19. Br J Radiol. 2020:20200718.19.Lang M, Som A, Mendoza DP, Flores EJ, Reid N, Carey D, et al. Hypoxaemia related to COVID-19: vascular and perfusion abnormalities on dual-energy CT. Lancet Infect Dis. 2020.20.Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected by Pulmonary CT Angiography. Radiology. 2020:201544.21.Poyiadji N, Cormier P, Patel PY, Hadied MO, Bhargava P, Khanna K, et al. Acute Pulmonary Embolism and COVID-19. Radiology. 2020:201955.22.Lang M. Pulmonary Vascular Manifestations of COVID-19 Pneumonia. Radiol Cardiothorac Imaging. 2020.23.Kaminetzky M. Pulmonary Embolism on CTPA in COVID-19 Patients. Radiol Cardiothorac Imaging. 2020.24.Thachil J, Srivastava A. SARS-2 Coronavirus-Associated Hemostatic Lung Abnormality in COVID-19: Is It Pulmonary Thrombosis or Pulmonary Embolism? Semin Thromb Hemost. 2020.25.Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected with Pulmonary CT Angiography. Radiology. 2020;296(3):E186-E8.26.Saba L, Sverzellati N. Is COVID Evolution Due to Occurrence of Pulmonary Vascular Thrombosis? J Thorac Imaging. 2020.27.E C. Pulmonary Thromboembolism in COVID-19: Venous Thromboembolism or Arterial Thrombosis? Radiol Cardiothorac Imaging. 2020.28.Provencher S, Potus F, Bonnet S. COVID-19 and the pulmonary vasculature. Pulm Circ. 2020;10(3):2045894020933088.

REFERÊNCES1.Offringa A, Montijn R, Singh S, Paul M, Pinto YM, Pinto-Sietsma SJ. The mechanistic overview of SARS-CoV-2 using angiotensin-converting enzyme 2 to enter the cell for replication: possible treatment options related to the renin-angiotensin system. Eur Heart J Cardiovasc Pharmacother. 2020.2.Santamarina MG, Boisier D, Contreras R, Baque M, Volpacchio M, Beddings I. COVID-19: a hypothesis regarding the ventilation-perfusion mismatch. Crit Care. 2020;24(1):395.3.Merrill JT, Erkan D, Winakur J, James JA. Emerging evidence of a COVID-19 thrombotic syndrome has treatment implications. Nat Rev Rheumatol. 2020.4.Teuwen LA, Geldhof V, Pasut A, Carmeliet P. COVID-19: the vasculature unleashed. Nat Rev Immunol. 2020;20(7):389-91.5.Potus F, Mai V, Lebret M, Malenfant S, Breton-Gagnon E, Lajoie AC, et al. Novel insights on the pulmonary vascular consequences of COVID-19. Am J Physiol Lung Cell Mol Physiol. 2020;319(2):L277-L88.6.Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-8.7.Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med. 2020;383(2):120-8.8.McGonagle D. Immune Mechanisms of Pulmonary Intravascular Coagulopathy in COVID-19 Pneumonia. lancet Rheumatol. 2020.9.Perricone C, Bartoloni E, Bursi R, Cafaro G, Guidelli GM, Shoenfeld Y, et al. COVID-19 as part of the hyperferritinemic syndromes: the role of iron depletion therapy. Immunol Res. 2020;68(4):213-24.10.Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. 2020;38(7):1504-7.11.Price LC, McCabe C, Garfield B, Wort SJ. Thrombosis and COVID-19 pneumonia: the clot thickens! Eur Respir J. 2020;56(1).12.Parry AH, Wani AH, Yaseen M, Dar MI. Demystifying pulmonary vascular complications in severe coronavirus disease-19 pneumonia (COVID-19) in the light of clinico-radiologic-pathologic correlation. Thromb Res. 2020.13.Polak SB, Van Gool IC, Cohen D, von der Thusen JH, van Paassen J. A systematic review of pathological findings in COVID-19: a pathophysiological timeline and possible mechanisms of disease progression. Mod Pathol. 2020.14.von der Thusen J, van der Eerden M. Histopathology and genetic susceptibility in COVID-19 pneumonia. Eur J Clin Invest. 2020:e13259.15.Behzad S, Aghaghazvini L, Radmard AR, Gholamrezanezhad A. Extrapulmonary manifestations of COVID-19: Radiologic and clinical overview. Clin Imaging. 2020;66:35-41.16.Qanadli SD, Beigelman-Aubry C, Rotzinger DC. Vascular Changes Detected With Thoracic CT in Coronavirus Disease (COVID-19) Might Be Significant Determinants for Accurate Diagnosis and Optimal Patient Management. AJR Am J Roentgenol. 2020;215(1):W15.17.Moreira BL, Santana PRP, Zanetti G, Marchiori E. COVID-19 and acute pulmonary embolism: what should be considered to indicate a computed tomography pulmonary angiography scan? Rev Soc Bras Med Trop. 2020;53:e20200267.18.Oudkerk M, Kuijpers D, Oudkerk SF, van Beek EJ. The vascular nature of COVID-19. Br J Radiol. 2020:20200718.19.Lang M, Som A, Mendoza DP, Flores EJ, Reid N, Carey D, et al. Hypoxaemia related to COVID-19: vascular and perfusion abnormalities on dual-energy CT. Lancet Infect Dis. 2020.20.Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected by Pulmonary CT Angiography. Radiology. 2020:201544.21.Poyiadji N, Cormier P, Patel PY, Hadied MO, Bhargava P, Khanna K, et al. Acute Pulmonary Embolism and COVID-19. Radiology. 2020:201955.22.Lang M. Pulmonary Vascular Manifestations of COVID-19 Pneumonia. Radiol Cardiothorac Imaging. 2020.23.Kaminetzky M. Pulmonary Embolism on CTPA in COVID-19 Patients. Radiol Cardiothorac Imaging. 2020.24.Thachil J, Srivastava A. SARS-2 Coronavirus-Associated Hemostatic Lung Abnormality in COVID-19: Is It Pulmonary Thrombosis or Pulmonary Embolism? Semin Thromb Hemost. 2020.25.Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected with Pulmonary CT Angiography. Radiology. 2020;296(3):E186-E8.26.Saba L, Sverzellati N. Is COVID Evolution Due to Occurrence of Pulmonary Vascular Thrombosis? J Thorac Imaging. 2020.27.E C. Pulmonary Thromboembolism in COVID-19: Venous Thromboembolism or Arterial Thrombosis? Radiol Cardiothorac Imaging. 2020.28.Provencher S, Potus F, Bonnet S. COVID-19 and the pulmonary vasculature. Pulm Circ. 2020;10(3):2045894020933088.

Where did cinchona, the first medication to cure malaria, come from? This episode explores the murky history of the bark of the fever tree and its derivative chloroquine with mysterious pre-Columbian Pacific crossings of the plasmodium parasite, Jesuit priests and Inca healers, a Chinese Emperor performing a clinical trial to treat his fever, chemistry leading to the first modern pharmaceuticals, and imperialism on a global scale. This episode is the first of a multi-part series exploring how hydroxychloroquine became the great hope for treating COVID-19.   Sources: Jaramillo‐Arango, J. A Critical Review of the Basic Facts in the History of Cinchona. J Linn Soc Lond Botany 53, 272–311 (1949). Smith, N. K. A Cure for Ague. J Roy Soc Med 90, 589–590 (1997). Potter, C. W. A history of influenza. J Appl Microbiol 91, 572–579 (2001). Cunha, C. B. & Cunha, B. A. Brief history of the clinical diagnosis of malaria: from Hippocrates to Osler. J Vector Dis 45, 194–9 (2008). Goss, A. Building the world’s supply of quinine: Dutch colonialism and the origins of a global pharmaceutical industry. Endeavour 38, 8–18 (2014). Al-Bari, Md. A. A. Chloroquine analogues in drug discovery: new directions of uses, mechanisms of actions and toxic manifestations from malaria to multifarious diseases. J Antimicrob Chemoth 70, 1608–1621 (2015). Guastalegname, M. & Vallone, A. Could chloroquine /hydroxychloroquine be harmful in Coronavirus Disease 2019 (COVID-19) treatment? Clin Infect Dis (2020) doi:10.1093/cid/ciaa321. Alia, E. & Grant-Kels, J. M. Does Hydroxychloroquine Combat COVID-19? A Timeline of Evidence. J Am Acad Dermatol (2020) doi:10.1016/j.jaad.2020.04.031. Seeler, A. O., Graessle, O. & Ott, W. H. Effect of Quinine on Influenza Virus Infections in Mice. J Infect Dis 79, 156–158 (1946). Savarino, A., Boelaert, J. R., Cassone, A., Majori, G. & Cauda, R. Effects of chloroquine on viral infections: an old drug against today’s diseases. Lancet Infect Dis 3, 722–727 (2003). Chakrabarti, P. Empire and Alternatives: Swietenia febrifuga and the Cinchona Substitutes. Med Hist 54, 75–94 (2010). Lonie, I. M. Fever pathology in the sixteenth century: tradition and innovation. Med Hist 25, 19–44 (1981). Luke, T. C. et al. Hark back: Passive immunotherapy for influenza and other serious infections. Crit Care Med 38, e66–e73 (2010). Shanks, G. D. Historical Review: Problematic Malaria Prophylaxis with Quinine. Am J Tropical Medicine Hyg 95, 269–272 (2016). Harrison, N. In celebration of the Jesuit’s powder: a history of malaria treatment. Lancet Infect Dis 15, 1143 (2015). Gerszten, E., Allison, M. J. & Maguire, B. Paleopathology in South American Mummies: A Review and New Findings. Pathobiology 79, 247–256 (2012). Haas, L. F. Pierre Joseph Pelletier (1788-1842) and Jean Bienaime Caventou (1795-1887). J Neurology Neurosurg Psychiatry 57, 1333 (1994). PROPHYLACTIC QUININE IN INFLUENZA. Lancet 204, 1152 (1924). Gensini, G. F. & Conti, A. A. The evolution of the concept of ‘fever’ in the history of medicine: from pathological picture per se to clinical epiphenomenon (and vice versa). J Infection 49, 85–87 (2004). Bergman, G. J. The history and importance of cinchona bark as an anti‐malarial febrifuge. Sci Educ 32, 93–103 (1948). Thompson, C. & MBE. The History and Lore of Cinchona. (n.d.). THE HUXLEY MEMORIAL. Lancet 146, 1381 (1895). Urdang, G. The Legend on Cinchona. (n.d.). Castro, M. C. de & Singer, B. H. Was malaria present in the Amazon before the European conquest? Available evidence and future research agenda. J Archaeol Sci 32, 337–340 (2005). Kummu M et al, How Close Do We Live to Water? A Global Analysis of Population Distance to Freshwater Bodies. PLoS One. 2011; 6(6): e20578. Dawson WT et al, IDIOSYNCRASY TO QUININE, CINCHONIDINE AND ETHYLHYDROCUPREINEv AND OTHER LEVOROTATORY ALKALOIDS OF THE CINCHONA SERIES: PRELIMINARY REPORT. JAMA 8 Mar 1930. Bynum WF, Cullen and the study of fevers in Bitain, 1760-1820. Medical History, supplement no 1, 1981.   Rodrigues PT et al, Human migration and the spread of malaria parasites to the New World. Nature, 31 January 2018.  Achan J et al, Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria. Malar J. 2011; 10: 144. Norn PH, On the history of Cinchona bark in the treatment of Malaria.Dansk Medicinhistorisk Arbog, 31 Dec 2015, 44:9-30. Cook H (2010). Testing the effects of Jesuit’s bark in the Chinese Emperor’s court. JLL Bulletin: Commentaries on the history of treatment evaluation (https://www.jameslindlibrary.org/articles/testing-the-effects-of-jesuits-bark-in-the-chinese-emperors-court/)

¡Gracias por escuchar! En este episodio hablaré acerca de los mecanismos de lesión tisular que se asocian a neumonía grave en pacientes infectados por SARS-CoV2 y el potencial de varios tratamientos antireumáticos para mejorar los desenlaces en estos pacientes.Agradezco su continuada atención y sus amables comentarios en tukua.podbean.com, youtube.com y sus calificaciones en iTunes. Estas son algunas referencias útiles:Chen J, Subbarao K: The Immunobiology of SARS. Annu Rev Immunol 2007; 25: 443-72De Lauretis A, Sestini P, Pantelidis P et al.: Serum interleukin 6 is predictive of early functional decline and mortality in interstitial lung disease associated with systemic sclerosis. J Rheumatol 2013; 40: 435-46.Diao B, Wang C, Tan Y et al.: Reduction and Functional Exhaustion of T Cells in Patients with Coronavirus Disease 2019 (COVID-19). MedRxiv 2020: 2020.02.18.20024364.Fu Y, Cheng Y, Wu Y, Understanding SARS-CoV-2-Mediated Inflammatory Responses: From Mechanisms to Potential Therapeutic Tools. Virol Sin 2020 Mar 3Huang C, Wang Y, Li X et al.: Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506.Li G, Fan Y, Lai Y et al.: Coronavirus infections and immune responses. J Med Virol 2020; 92: 424-32.Li H, Yang Sg, Gu L et al.: Effect of low-to- moderate-dose corticosteroids on mortality of hospitalized adolescents and adults with influenza A(H1N1)pdm09 viral pneumonia. Influenza Other Respir Viruses 2017; 11: 345-54.Stebbing J, Phelan A, Griffin I et al.: COV- ID-19: combining antiviral and anti-inflammatory treatments. Lancet Infect Dis 2020. Zhang Y, Li J, Zhan Y et al.: Analysis of serum cytokines in patients with severe acute respiratory syndrome. Infect Immun 2004; 72: 4410-5.

Aspectos clínico-radiológicos da infecção em crianças.Referências Bibliográficas:1- Xia W, Shao J, Guo Y, et al. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults [published online ahead of print, 2020 Mar 5]. Pediatr Pulmonol 2020; 10.1002/ppul.247182- Liu W, Zhang Q, Chen J, et al. Detection of Covid-19 in Children in Early January 2020 in Wuhan, China. N Engl J Med 2020; 382(14): 1370–13713- Lee PI, Hu YL, Chen PY et al. Are children less susceptible to COVID-19? [published online ahead of print, 2020 Feb 25]. J Microbiol Immunol Infect. 20204- Li W, Cui H, Li K, Fang Y et al. Chest computed tomography in children with COVID-19 respiratory infection [published online ahead of print, 2020 Mar 11]. Pediatr Radiol 2020; 10.1007/s00247-020-04656-75- Qiu H, Wu J, Hong L et al. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study [published online ahead of print, 2020 Mar 25]. Lancet Infect Dis 2020; S1473-3099(20)30198-56- Cai J, Xu J, Lin D, et al. A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features [published online ahead of print, 2020 Feb 28]. Clin Infect Dis 2020;ciaa1987- Ji LN, Chao S, Wang YJ, et al. Clinical features of pediatric patients with COVID-19: a report of two family cluster cases [published online ahead of print, 2020 Mar 16]. World J Pediatr 2020; 10.1007/s12519-020-00356-28- Hong H, Wang Y, Chung HT et al. Clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children [published online ahead of print, 2020 Mar 10]. Pediatr Neonatol 2020; S1875-9572(20)30026-7.

Contributor: John Winkler Educational Pearls: There is increasing resistance to antimalarial drugs, especially in P. falciparum. This trend started with chloroquine, but is now spreading to the other first-line drugs.  Resistant strains have been identified in Cambodia and Thailand 220 million people were infected last year The best treatment of malaria is prevention from bites - DEET and permethrin are typical effective options. Permethrin may be applied to clothing items before travel, and will last through 6-8 wash cycles. While malaria is rare in the US, it should be considered in those having recently travelled References Hamilton WL, Amato R, van der Pluijm RW, et al. Evolution and expansion of multidrug-resistant malaria in southeast Asia: a genomic epidemiology study. Lancet Infect Dis. 2019;19(9):943–951. doi:10.1016/S1473-3099(19)30392-5 Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD

In this week's clinical case, Dr. Mike Bradshaw (Chicago Medical School and Billings Clinic) walks us through the case of a young woman with HSV encephalitis. With a twist. SPOILER ALERT: If you don't want to know the answer, DON'T LOOK AT THE SHOWNOTES! Produced by James E. Siegler and Mike Bradshaw. Music courtesy of Yan Terrien, Unheard Music Concepts, Steve Combs, and Montplaisir. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES Bacon TH, Boon RJ, Schultz M and Hodges-Savola C. Surveillance for antiviral-agent-resistant herpes simplex virus in the general population with recurrent herpes labialis. Antimicrob Agents Chemother. 2002;46:3042-4. Granerod J, Ambrose HE, Davies NW, Clewley JP, Walsh AL, Morgan D, Cunningham R, Zuckerman M, Mutton KJ, Solomon T, Ward KN, Lunn MP, Irani SR, Vincent A, Brown DW, Crowcroft NS and Group UKHPAAoES. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis. 2010;10:835-44. Steiner I, Budka H, Chaudhuri A, Koskiniemi M, Sainio K, Salonen O and Kennedy PG. Viral meningoencephalitis: a review of diagnostic methods and guidelines for management. European journal of neurology : the official journal of the European Federation of Neurological Societies. 2010;17:999-e57. Gable MS, Sheriff H, Dalmau J, Tilley DH and Glaser CA. The frequency of autoimmune N-methyl-D-aspartate receptor encephalitis surpasses that of individual viral etiologies in young individuals enrolled in the California Encephalitis Project. Clin Infect Dis. 2012;54:899-904. Pruss H, Finke C, Holtje M, Hofmann J, Klingbeil C, Probst C, Borowski K, Ahnert-Hilger G, Harms L, Schwab JM, Ploner CJ, Komorowski L, Stoecker W, Dalmau J and Wandinger KP. N-methyl-D-aspartate receptor antibodies in herpes simplex encephalitis. Annals of neurology. 2012;72:902-11. Armangue T, Leypoldt F and Dalmau J. Autoimmune encephalitis as differential diagnosis of infectious encephalitis. Curr Opin Neurol. 2014;27:361-8. Armangue T, Leypoldt F, Malaga I, Raspall-Chaure M, Marti I, Nichter C, Pugh J, Vicente-Rasoamalala M, Lafuente-Hidalgo M, Macaya A, Ke M, Titulaer MJ, Hoftberger R, Sheriff H, Glaser C and Dalmau J. Herpes simplex virus encephalitis is a trigger of brain autoimmunity. Annals of neurology. 2014;75:317-23. Venkatesan A and Benavides DR. Autoimmune encephalitis and its relation to infection. Current neurology and neuroscience reports. 2015;15:3. Linnoila JJ, Binnicker MJ, Majed M, Klein CJ and McKeon A. CSF herpes virus and autoantibody profiles in the evaluation of encephalitis. Neurol Neuroimmunol Neuroinflamm. 2016;3:e245. Armangue T, Spatola M, Vlagea A, Mattozzi S, Carceles-Cordon M, Martinez-Heras E, Llufriu S, Muchart J, Erro ME, Abraira L, Moris G, Monros-Gimenez L, Corral-Corral I, Montejo C, Toledo M, Bataller L, Secondi G, Arino H, Martinez-Hernandez E, Juan M, Marcos MA, Alsina L, Saiz A, Rosenfeld MR, Graus F, Dalmau J and Spanish Herpes Simplex Encephalitis Study G. Frequency, symptoms, risk factors, and outcomes of autoimmune encephalitis after herpes simplex encephalitis: a prospective observational study and retrospective analysis. The Lancet Neurology. 2018;17:760-772. Dubey D, Pittock SJ, Kelly CR, McKeon A, Lopez-Chiriboga AS, Lennon VA, Gadoth A, Smith CY, Bryant SC, Klein CJ, Aksamit AJ, Toledano M, Boeve BF, Tillema JM and Flanagan EP. Autoimmune encephalitis epidemiology and a comparison to infectious encephalitis. Annals of neurology. 2018;83:166-177.

El programa de esta semana lo dedicamos a discutir el tema de la recaída de malaria por infecciones con Plamodium vivax, aprovechando tres articulo recientes que tienen que ver con el tema.    Referencias: Robert j Commons y colaboradores. The effect of chloroquine dose and primaquine on Plasmodium vivaxrecurrence: a WorldWide Antimalarial Resistance Network systematic review and individual patient pooled meta-analysis.  Lancet Infect Dis, Sept 01, 2018. M.V.G Lacerda y colaboradores. Single-Dose Tafenoquine to Prevent Relapse of Plasmodium vivax Malaria. New Engl J Med  Jan 17, 2019. Alejandro Llanos-Cuentas y colaboradores. Tafenoquine versus Primaquine to Prevent Relapse of Plasmodium vivax Malaria. New Engl J Med  Jan 17, 2019.   La Frase de la Semana:  Esta vez la tomamos de  William Faulkner. Nacido el 25 de septiembre de 1897 en Oxford Mississippi y fallecido el 6 de julio de 1962. Faulkner es uno de los más celebrados escritores estadounidenses. Fue el ganador del Premio Nobel de Literatura en 1949. Faulkner escribió novelas, cuentos, guiones, poesía, ensayos y una obra de teatro. La frase dice:   “La sabiduría suprema es tener sueños bastante grandes para no perderlos de vista mientras se persiguen”        

En el programa de esta semana comentamos varios artículos de reciente publicación referentes a la epidemiologia, tratamiento y prevención de la infección por Clostridiodes difficile.     Referencias:  LY Kong y colaboradores. Clostridium difficile: Investigating Transmission Patterns between Infected and Colonized Patients using whole Genome Sequencing. Clin Infect Dis. May 2018 Benot Guery y colaboradores. Extended-pulsed daxomicin versus vancomycin for Clostridium di cile infection in patients 60 years and older (EXTEND): a randomised, controlled, open-label, phase 3b/4 trial . Lancet Infect Dis. March 2018. Thomas Birch y colaboradores. Efficacy of bezlotoxumab based on timing of administration relative to start of antibacterial therapy for Clostridium difficile infection. J Antimicrob Chemother. May 2018.  WE Trivk y colaboradores. Effectiveness of Probiotic for Primary Prevention of Clostridium difficile Infection: A Single-Center Before-and-After Quality Improvement Intervention at a Tertiary-Care Medical Center. Hosp Epidemiol Infect Control. May 2018. Bradley C. Johnson y colaboradores. Microbial Preparations (Probiotics) for the Prevention of Clostridium difficile Infection in Adults and Children: An Individual Patient Data Meta-analysis of 6,851 Participants. Hosp Epidemiol Infect Control. May 2018   FE Juul y colaboradores. Fecal Microbiota Transplantation for Primary Clostridium difficile Infection. New Engl J Med. June 2, 2018.   La Frase de la Semana:   La tomamos de JF Kennedy. John Fitzgerald "Jack" Kennedy (29 de mayo de 1917 - 22 de noviembre de 1963), comúnmente conocido por sus iniciales JFK, fue un político estadounidense que sirvió como el 35º presidente de los Estados Unidos desde enero de 1961 hasta su asesinato el 22 de noviembre de 1963 en Dallas, Texas.  La frase dice:   “Perdona a tus enemigos, pero nunca olvides sus nombres”    

El programa de hoy lo dedicamos a hablar sobre la Neisseria gonorrhoeae, bacteria a la que se le esta asignando el calificativo de superbacteria al encontrarse cepas multiresistentes y porque al parecer nos acercamos a una era en la que no tendremos antibioticoterapia efectiva contra este microorganismo. Revisamos la microbiologías, epidemiologia y tratamiento de la misma.   Referencia:  Magnus Unemo y William M. Shafer Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future. Clin Microbiol Rev. Julio 2014. Simon R. Harris y colaboradores. Public health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe: a genomic survey. Lancet Infect Dis. May 2018.   Frase de la Semana:   Esta semana la tomamos de Andrew M. Greeley (5 de febrero de 1928 - 29 de mayo de 2013) quien fuera un sacerdote católico, sociólogo, periodista y novelista estadounidense.  La frase dice: “Nacemos con dos enfermedades incurables, la vida, de la que morimos, y la esperanza, que dice que tal vez la muerte no sea el final”

Esta semana hablamos del resultado del Estudio AIDA, que busco evaluar el uso de colistina versus la combinación de colistina y meropenem en el tratamiento de infecciones por gérmenes Gram-negativos resistentes a carbapenemicos, pero cuyos resultados, como explicaremos, son básicamente relevantes para el caso de infecciones por Acinetobacter sp. resistentes a carbapenemicos.   Referencias: Mical Paul y colaboradores. Colistin alone versus colistin plus meropenem for treatment of severe infections caused by carbapenem-resistant Gram-negative bacteria: an open-label, randomised controlled trial. Lancet Infect Dis.  Feb 15, 2018.   Frase de la Semana: Recurrimos nuevamente a Mark Twain para la frase de esta semana. Escritor, humorista, empresario, editor y conferencista estadounidense. Entre sus novelas se encuentran Las aventuras de Tom Sawyer (1876) y su secuela, Las aventuras de Huckleberry Finn (1885), esta última a menudo llamada "La gran novela estadounidense". “Es más fácil engañar a la gente que convencerlos de que han sido engañados”.

Ep. 287: Should I Get a Flu Shot? In this episode, Stacy and Sarah answer a question from a healthcare professional about mandatory flu shots. Click here to listen in iTunes or download and listen by clicking the PodBean Player below If you enjoy the show, please review it in iTunes!   The Paleo View (TPV), Episode 287: Should I Get a Flu Shot? Intro (0:00) News and Views (0:40) Backstreet's Back, and so are Sarah and Stacy! Reminiscing about the 90s, and Stacy breaking out into song- a rare treat! Stacy is working on The Body Love series. Her free ebook will be launching with this series - sign up to get it here. It encourages never dieting again, a sustainable lifestyle perspective. It's about finding what works for you. Stacy hears feedback of people noting reduced illness and increased immune function with a health diet. This is an interesting metric of health. Stacy avoided the flu in multiple instances this year. Sarah woke up feeling the yuk one morning, took good care of herself and never got sick. As an adult its hard to take it easy and take care of yourself when you're sick. Sarah has several friends who had complications from this year's flu. Sarah is sick far less often that she was pre-Paleo. Stacy attributes "souping" to her staying health when exposed to illness. Stacy's post on Souping here. Sarah's post on Souping here. The nutrients in soup are quite different than other liquid-type diets like juicing. It's a balanced meal with a lot of nutrient density. Soup is more efficiently digested and filling than things like smoothies or juice. Sometimes things like souping and vitamin C aren't enough and medicine is needed. Listener Question - Science with Sarah (13:01) Kelly asks, "I work in skilled nursing as an occupational therapist. My company requires taking the flu vaccine or wearing a mask from November to February. I understand the company's position looking at lost work time and revenue due to sick days. My direct supervisor says her reason for wanting all employees to take the vaccine is that if we don’t we are at an increased risk of passing the flu to our residents even if we don’t have the flu ourselves (she quotes a 30% increase). I have looked and cannot find studies to support this. I actually found from the Cochrane review and PubMed that no relation is found. I have opted not to vaccinate this year, I’m the only employee in my department to not vaccinate this season. I am wearing a mask daily and actually feel like it will decrease my risk of catching a cold. I was just wondering if there was any evidence that not taking the vaccine increases the risk for my residents. Last year I did take the vaccine in October and in January in a 2 week period was diagnosed with strep throat, sinus infection, bilateral eye, and bilateral ear infections. Was not tested for flu due to having had the vaccine." Disclaimer: we realize that vaccination is a highly debated and hot topic, and all the information we are presenting is based in science. Please take this information and decide what is right for you, we are not medical professionals. References for this show can be found below. The flu vaccine is different than most other vaccines. With all vaccines there is a very small risk of allergic reactions or adverse reactions. Aside from those reactions, vaccines are completely safe. Diseases like Polio, Measles, and Tetnis, which had a very high morbidity rate and were killing tens of thousands of people every year, is a different equation compared to the flu vaccine. The flu virus mutates rapidly, which means the vaccine isn't as effective as other types of vaccines. The flu is very virulent- with around 3 million cases every year. The number of flu-related deaths every year differs quite a bit. It is not usually associated with intestinal symptoms, bur rather fever, aches and pains, runny nose, sore throat, cough, and fatigue. Flu increases risk of secondary infections, which is what usually causes death, not the flu itself. Flu is spread through respiratory secretions. Microscopic droplets of saliva are spread through coughing, even breathing. The flu vaccine is based off an educated guess every year. Based on data and modeling as to how it is going to mutate in the coming year. Vaccines contain inactivated or dead virus for typically 2-4 strains of flu. The immunity we get from flu vaccines in often very transient. Estimates are that immunity from the flu vaccine lasts about 6 months. This is why it is recommended to get one every year. When they guess well and the vaccine matches up with the actual dominant flu viruses for the year, the vaccine is at best 50-60% effective. This would decrease your chance of getting the flu by 50-60%. A study showed between 2010-2015 the average flu vaccine was 41% effective. During a bad guessing year, the vaccine was 14% effective. The Cochrane review that Kelly referenced was a 2010 meta-analysis of 50 different studies. It showed the absolute difference in the incidence of flu during a year when the vaccine was a good match was a 3% difference. Unvaccinated risk of getting the flu was 4%. Vaccinated risk of getting the flu was 1%. A recent paper updated those statistics and shows that on average your risk of getting the flu if you are unvaccinated is 2.3% , compared to 0.9% if you are not. This is on a good match year. Rationale for getting the vaccine includes: You are less likely to get sick, even though the percentage seems small, it is significant. 2 out of 100 who would have gotten the flu, won't if they are vaccinated. Risk of hospitalization showed 14.7% chance if unvaccinated, and 14.1% in vaccinated population. Benefit was much higher in the elderly. The elderly (vaguely defined as those over 65) have less robust immune systems. This raises the question of if the elderly are actually developing immunity against the flu. Unvaccinated elderly have 6% chance of getting flu, compared to 2.4% in vaccinated. The statistics regarding the flu will mean different things to different people. Some people will hear there is a 2% difference in chance and want to get the vaccine. Some people will hear there is a 2% difference and won't want to bother. No matter how you develop immunity against the flu, whether you get the flu or the flu vaccine, it will still be incomplete immunity. This is because the flu virus mutates so quickly. There is always some cross-protection in both situations. The flu vaccine become a really individual choice in terms of if you are an at-risk individual or you have at-risk individuals in your life. Kelly mentioned that last year when she got the flu vaccine she got a lot of other infections. There have been robust studies that showed no difference in side effects after vaccination. Those who got the flu vaccine had more arm soreness and mild fever in the few days after. There was no difference in non flu-related infections or symptoms. There is a perception that if we get sick after getting a vaccine, it was the vaccine that made us sick. This is unfortunate timing. You were likely exposed to something before you got the vaccine. Some illness can have incubation periods of two weeks or more. Mandatory vaccines for health care professionals- part of Kelly's questions. You are typically most contagious right before you develop symptoms. This is part of the reason why the flu can spread so quickly. We are out doing normal activities, not realizing we are sharing the virus with others. Even when symptoms just start, we often do our normal activities. Kelly reference the Cochrane paper, which was looking at whether or not health care workers getting vaccinated protected patients from the flu. It showed a lack of sufficient evidence to make claims. More recent evidence probably refutes this somewhat. Another study looked at flu season mortality in residents of chronic care institutions. There was a 10-20% decrease in mortality where staff vaccination rates were higher. Staff vaccination rates of 60-70% versus 20% showed up in the mortality of the patients. Healthy care givers and an at-risk population give a sensitive statistical model. There is compelling evidence that health care workerss getting vaccinated can protect patients in a hospital or residential care setting. This could be mostly related to herd immunity. The flu won't spread as quickly when there are less hosts around to get it. Wearing a mask versus getting a vaccine as a health care provider. Best practices say to get as many staff vaccinated as possible. Recommendation #2 is to have people wear masks. Have hand sanitizer readily available and encourage hand washing. Kelly thinks wearing a mask will protect her from getting a cold. She is absolutely right- many illness are spread through respiratory secretions. This is a great way to protect yourself and those around you. There are valid arguments for the flu vaccine and not really many to be made against it. Vaccines are safe and the risks are low. Those with autoimmune disease don't like to vaccines because the adjuvants can cause symptoms or a flare. This is often transient. This definitely changes the equations, as a flare is an awful thing to go through. We need a better way to vaccinate against the flu. This is the number one conclusion that can be drawn from looking at the research and statistics. There is a lot of information out there, and you should make the best decision for yourself. In regard to Kelly's question whether or not her getting the vaccine can protect residents of the facility she works in, the science does say yes. Getting the flu itself can also trigger for an autoimmune flare. Stacy doesn't consider herself in a high risk category for getting the flu. Even though she does have kids, she doesn't work in a medical setting, and she has the ability to take off work if she needs to should she become ill. She made the best choice for her. Other adults in her household have made other decisions regarding the flu vaccine. Know your body and what you are comfortable with - it's your decision. She feels the Doterra OnGuard blend has helped her in avoiding the flu this year. We talked about essential oils in this podcast. Stacy used the hand sanitizer and diffused the blend in her office. She was one of only a few from her office to not get the flu this year. She is also supporting her immune system with diet and lifestyle. We all need to own that this is our choice and our body. Vaccination against illness other than the flu, such as Measeles, Mumps, Diptheria is different than the flu. The mortality rate is higher, as is the effectiveness of the vaccines. This becomes a no-brainer to get those vaccines and contribute to herd immunity. We should be able to put more than just Small Pox into extinction. This is a different conversation than the flu vaccine one, because the statistics aren't as strong. Stay well everybody! If you have follow-up questions, reach out through the contact forms on our websites or social media. Real Everything The Paleo Mom If you've enjoyed the show, please recommend it to someone who might enjoy it. We love when you share and when you leave reviews for us! Thanks for listening! Support us by shopping through links on our sidebars- thanks! Citations: Osterholm MT, Kelley NS, Sommer A, Belongia EA. Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(1):36–44. Erratum in: Lancet Infect Dis. 2012;12(9):655. van den Dool C, Bonten MJ, Hak E, Wallinga J. Modeling the effects of influenza vaccination of health care workers in hospital departments. Vaccine. 2009;27(44):6261–7. Jefferson T, Di Pietrantonj C, Rivetti A, Bawazeer GA, Al-Ansary LA, Ferroni E. Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev. 2010(7):CD001269.

En el programa de esta semana hablamos de meningitis tuberculosa. Revisamos rápidamente algunos elementos claves del diagnostico y comentamos uno articulo publicado en Feb 2018 en el cual se plantea un modelo pronostico de mortalidad a los 9 meses para esta enfermedad en pacientes con o sin confección con el VIH.    Referencias:  Tao LTP y colaboradores. Prognostic Models for 9-Month Mortality in Tuberculous Meningitis. Clin Infect Dis. 2018 Feb 1;66(4):523-532. Nathan C Barh y colaboradores. Diagnostic accuracy of Xpert MTB/RIF Ultra for tuberculous meningitis in HIV-infected adults: a prospective cohort study. Lancet Infect Dis. Jan 2018.   Risk calculator for the absolute risk of death within 9 months in HIV-uninfected and HIV-infected patients with tuberculous meningitis   Frase de la Semana La tomamos de Thomas Edison. Thomas Alva Edison (11 de febrero de 1847 a 18 de octubre de 1931) fue un inventor considerado uno de los principales hombres de negocios de los Estados Unidos. Edison ascendió desde sus humildes comienzos a inventor de tecnología importante, incluida el primer bombillo incandescente comercialmente viable y le fonógrafo. Logro más de 1000 patentes por sus invenciones. “La mayoría de las personas no reconocen la oportunidad cuando se les presenta porque generalmente, esta vestida de un overol y se parece mucho al trabajo”      

En el podcast de esta semana analizamos un estudio que sugiere que no es necesaria la evaluación oftalmológica rutinaria en pacientes con candidemia. Luego hablamos de la disminución de la eficacia de la vacuna de influenza a medida que avanza el tiempo post-vacunacion, y finalmente del incremento de casos de escarlatina.   Referencias: Antonio Vena y colaboradores. Is routine ophthalmoscopy really necessary in candidemic patients?  PLOS One. Octubre 2017. Theresa Lamgni y colaboradores. Resurgence of scarlet fever in England, 2014–16: a population-based surveillance study. Lancet Infect Dis.  Diciembre 2017. Barnaby Young y colaboradores. The Duration of Influenza Vaccine E ffe ctiveness : A S ystemat ic Re view, Meta - analysis and Meta - regression of Test - N egative Design Case - control S tudies. J Infect Dis. Diciembre 2017.   La Frase de la Semana:  La tomo esta vez de la escritora y abogada norteamericana Elizabeth L. Silver. Se encuentra en su libro más reciente The Tincture of Time, A Memoir of Medical Uncertainty el cual recomiendo ampliamente:  “El tiempo es inherentemente redefinido en momentos crisis, y cuando nos perdemos en ellos, nos olvidamos de sus marcadores adecuados” http://elizabethlsilver.com

El programa de esta semana lo dedicamos a discutir varios temas relacionados con malaria a propósito del reporte de la Organización Mundial de la Salud correspondiente al 2017 (con datos del 2016) referente a este tema.   Referencias: WHO. World Malaria Report 2017 La malaria avanza sin frenos. Por Marielba Nunez. El Nacional. Nov 26, 2017. Polycarp Mogeni y colaboradores. Detecting Malaria Hotspots: A Comparison of Rapid Diagnostic Test, Microscopy, and Polymerase Chain Reaction. J Infect Dis. Nov 2017. Patricia Solis, Mariano Gustavo Zolis y colaboradores. Outbreak of human malaria caused by Plasmodium simium in the Atlantic Forest in Rio de Janeiro: a molecular epidemiological investigation  Lancet Glob Health 2017. A. Ashley y colaboradores. Spread of Artemisinin Resistance in Plasmodium falciparum Malaria. N Engl J Med. 2014 Mallika Imwong y colaboradores. The spread of artemisinin-resistant Plasmodiumfalciparumin the Greater Mekongs ubregion: amolecular epidemiology observational study. Lancet Infectious Dis. May 2017 Mallika Imwong y colaboradores. Spread of a single multidrug resistant malaria parasite lineage (PfPailin) to Vietnam. Lancet Infect Dis. Octubre 2017. WHO . Status Report on Aatemisinin and artemisinin-based combination therapy resistance. April 2017   La Frase de la Semana: La tomamos de Richard Phillips Feynman (11 de mayo de 1918 - 15 de febrero de 1988) fue un físico teórico estadounidense conocido por su trabajo en la formulación integral de ruta de la mecánica cuántica, la teoría de la electrodinámica cuántica, así como en la física de partículas. Ayudó en el desarrollo de la bomba atómica, amplió la comprensión de la electrodinámica cuántica, tradujo jeroglíficos mayas y e identifico la base del desastre del transbordador espacial Challenger. Por sus contribuciones al desarrollo de la electrodinámica cuántica, Feynman, , recibió el Premio Nobel de Física en 1965.  La frase dice asi: “La religión es la cultura de la fe; la ciencia es la cultura de la duda.”      

El programa de esta semana es variado. Empezamos por discutir las implicaciones de la bacteriemia por bacilos Gram-negativos resistentes en pacientes con trasplantes de medula ósea. Posteriormente comentamos un articulo sobre el tiempo apropiado de tratamiento en bacteriemia por bacilos Gram-negativos. También comentamos los beneficios del tratamiento combinado vs. el tratamiento simple con oseltamivir en la infección por Influenza. Finalmente hablamos sobre neumonía adquirida en la comunidad, sobre fosfomicina, y nitrofurantoina.   Referencias:   Diana Averbuch y colaboradores. Antimicrobial Resistance in Gram-Negative Rods Causing Bacteremia in Hematopoietic Stem Cell Transplant Recipients: Intercontinental Prospective Study of the Infectious Diseases Working Party of the European Bone Marrow Transplantation Group. Clin Infect Diseases 2017.   Julio A. Ramirez y colaboradores. Adults Hospitalized with Pneumonia in the United States: Incidence, Epidemiology, and Mortality. Clin Infect Dis 2017.   Darunee Chotiprasitsakul  y colaboradores Comparing the Outcomes of Adults With  Enterobacteriaceae Bacteremia Receiving Short-Course  Versus Prolonged-Course Antibiotic therapy in a  Multicenter, Propensity Score–Matched Cohort . Clin Infect Dis 2017   John H Beigel y colaboradores. Oseltamivir, amantadine, and ribavirin combination antiviral therapy versus oseltamivir monotherapy for the treatment of influenza: a multicentre, double-blind, randomised phase 2 trial. Lancet Infect Dis. Dec 2017.   Fiona Fransen y colaboradores. Pharmacodynamics of fosfomycin against ESBL- and/or carbapenemase-producing Enterobacteriaceae. J Antimicrob Chemother. Dec 2017.   Fiona Fransen y colaboradores.  Pharmacodynamics of nitrofurantoin at different pH levels against pathogens involved in urinary tract infections. J Antimicrob Chemother. December 2007     La Frase de la Semana:  La tomamos del poeta Chileno Pablo Neruda. Pablo Neruda Era el seudónimo y, más tarde, el nombre legal del poeta, diplomático y político chileno Ricardo Eliécer Neftalí Reyes Basoalto (12 de julio de 1904 - 23 de septiembre de 1973). Derivó su seudónimo del poeta checo Jan Neruda. Pablo Neruda ganó el Premio Nobel de Literatura en 1971  “Algún día en cualquier parte, en cualquier lugar indefectiblemente te encontrarás a ti mismo, y ésa, sólo ésa, puede ser la más feliz o la más amarga de tus horas”.      

En el programa de esta semana utilizamos dos estudios publicados en el mes de octubre y noviembre del 2017 sobre el efecto comparativo de la infusion corta versus infusión prologada de betalactamicos en lo que respecta a la mortalidad.    Referencias: Konstantino Z Vardakaz  y colaboradores. Prolonged versus short-term intravenous infusion of antipseudomonal β-lactams for patients with sepsis:
a systematic review and meta-analysis of randomised trials. Lancet Infect Dis. Octubre 2017. Nathaniel J Rodes y colaboradores. Prolonged Infusion Piperacillin-Tazobactam Decreases Mortality and Improves Outcomes in Severely Ill Patients: Results of a Systematic Review and Meta-Analysis. Critical Care Med. Nov 7,  2017.    La Frase de la Semana:  La tomamos de León Trosky : (nacido el 7 de noviembre [26 de octubre, estilo antiguo], 1879, Yanovka, Ucrania, Imperio ruso-murió asesinado el 21 de agosto de 1940, Coyoacán, México), teórico y agitador comunista, uno de los lideres  en la revolución de octubre de Rusia en 1917, y más tarde comisario de asuntos exteriores y de guerra en la Unión Soviética (1917-24). En la lucha por el poder después de la muerte de Vladimir Ilich Lenin, sin embargo, Joseph Stalin emergió como vencedor, mientras que Trotsky fue removido de todas las posiciones de poder y luego exiliado (1929). Siguió siendo el líder de una oposición antiestalinista en el extranjero hasta que fue asesinado por un agente estalinista.   “La vida no es un asunto fácil ... No puedes vivir sin caer en la frustración y el cinismo a menos que tengas ante ti una gran idea que te eleve por encima de la miseria personal, por encima de la debilidad, sobre todo de la perfidia y la bajeza”.

En el programa de esta semana hablamos sobre la persistencia de sintomatologia de forma crónica en pacientes afectados por el virus de Chikungunya,  a propósito de un articulo que evaluar este aspecto en Curazao.  Luego hablamos del articulo mas reciente sobre la utilidad del uso de procalcitonina para guiar el tratamiento antibiótico en pacientes con infecciones respiratorias.   Referencias:  Jelte Elsinga y colaboradores. Long-term Chikungunya Sequelae in Curaçao: Burden, Determinants, and a Novel Classification Tool. J Infect Dis. Sep 1, 2017. Eriq Bouqillard y colaboradores. Rheumatic manifestations associated with Chikungunya virus infection: A study of 307 patients with 32-month follow-up (RHUMATOCHIK study). Joint Bone Spine. Feb 24,  2017   Cosmina Zianna y colaboradores. Post-chikungunya rheumatic disorders in travelers after return from the Caribbean. Travel Med Infect Dis. Jan – Feb 2016. Philipp Schuetz y colaboradores. Effect of procalcitonin-guided antibiotic treatment on mortality in acute respiratory infections: a patient level meta-analysis. Lancet Infect Dis. Octubre  13, 2017.   La frase de la Semana: La tomamos esta semana de Leonardo Da Vinci Leonardo da Vinci (15 de abril de 1452 a 2 de mayo de 1519) fue pintor, escultor, arquitecto, inventor, ingeniero militar y dibujante, el epítome de un "hombre del Renacimiento". Con una mente curiosa y un intelecto agudo, da Vinci estudió las leyes de la ciencia y la naturaleza, que informaron en gran medida su trabajo. Sus ideas y su trabajo influenciaron a innumerables artistas e hicieron de Da Vinci una de las principales luces del Renacimiento italiano.   “El aprendizaje nunca canso a la mente”.      

In 2005, a mysterious plague called Corrupted Blood hit the online denizens of World of Warcraft, ripping through cities and decimating player characters. After the smoke cleared, it became clear that this virtual plague shared many characteristics with real-world diseases and almost immediately attracted the attention of researchers. In this Summer Short, I go over the details of the in-game Corrupted Blood incident, and the very real-world epidemiological research that followed. Learn about all this and more on the latest short of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine.   Sources: Bohannon J. Slaying monsters for science. Science  20 Jun 2008. Messner S. How Blizzard coped with World of Warcraft's blood plague and other early disasters. PC Gamer. Henderson M. Analysis: Absence of risk limits parallels with real life. Times Online. October 28, 2008 Oultram S. Virtual plagues and real-world pandemics: reflecting on the potential for online computer role-playing games to inform real world epidemic research. BMJ. Lofgren E, Fefferman N. The untapped potential of virtual game worlds to shed light on real world epidemics. Lancet Infect Dis 2007;9:625–9.

I am not sure there are many more things terrifying than watching your child experience what looks like, just a cold, and then over the course of a few hours becomes paralyzed. In this episode, Drs. Ana Cristancho and Sarah Hopkins describe what we know about this recent polio-like outbreak in the US. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision making in routine clinical practice. This episode was vetted and approved by Dr. Sarah Hopkins. REFERENCES 1. Aliabadi N, Messacar K, Pastula DM, Robinson CC, Leshem E, Sejvar JJ, Nix WA, Oberste MS, Feikin DR and Dominguez SR. Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014. Emerg Infect Dis. 2016;22:1387-94. 2. Greninger AL, Naccache SN, Messacar K, Clayton A, Yu G, Somasekar S, Federman S, Stryke D, Anderson C, Yagi S, Messenger S, Wadford D, Xia D, Watt JP, Van Haren K, Dominguez SR, Glaser C, Aldrovandi G and Chiu CY. A novel outbreak enterovirus D68 strain associated with acute flaccid myelitis cases in the USA (2012-14): a retrospective cohort study. Lancet Infect Dis. 2015;15:671-82. 3. Messacar K, Schreiner TL, Van Haren K, Yang M, Glaser CA, Tyler KL and Dominguez SR. Acute flaccid myelitis: A clinical review of US cases 2012-2015. Annals of neurology. 2016;80:326-38.

The Landry-Guillain-Barre-Strohl Syndrome, aka Guillain-Barre Syndrome, is classically thought of as a painless ascending weakness with areflexia that typically follows an infectious prodrome. But there are a dozen variants with unusual clinical presentations, from back pain to pandysautonomia. And sometimes GBS follows a vaccination rather than viral infection. In this BrainWaves episode, we discuss these and other unique facts regarding the history, clinical manifestations, and treatment of this polyneuropathy. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health identifying information. REFERENCES 1. Dimachkie MM and Saperstein DS. Acquired immune demyelinating neuropathies. Continuum (Minneap Minn). 2014;20:1241-60. 2. Asbury AK. Guillain-Barre syndrome: historical aspects. Annals of neurology. 1990;27 Suppl:S2-6. 3. Afifi AK. The landry-guillain-barre strohl syndrome 1859 to 1992 a historical perspective. J Family Community Med. 1994;1:30-4. 4. Bril V and Katzberg HD. Acquired immune axonal neuropathies. Continuum (Minneap Minn). 2014;20:1261-73. 5. Iodice V and Sandroni P. Autonomic neuropathies. Continuum (Minneap Minn). 2014;20:1373-97. 6. Lehmann HC, Hartung HP, Kieseier BC and Hughes RA. Guillain-Barre syndrome after exposure to influenza virus. Lancet Infect Dis. 2010;10:643-51. 7. Tam CC, O'Brien SJ, Petersen I, Islam A, Hayward A and Rodrigues LC. Guillain-Barre syndrome and preceding infection with campylobacter, influenza and Epstein-Barr virus in the general practice research database. PloS one. 2007;2:e344.

Nesse episódio do NeuroPod vamos elucidar a relação entre Zika e Microcefalia em 5 perguntas-chave. Também teremos a entrevista exclusivíssima com a neurocientista Patricia P. Garcez, professora da UFRJ, especialista em microcefalia e pioneira nos estudos com Zika. Link para o Lattes da prof. Patricia P. Garcez: http://lattes.cnpq.br/7284551536353300 Referências bibliográficas do episódio: 1.        Secretaria de Vigilância em Saúde, Ministério da Saúde. Boletim Epidemiológico. Vol 47 número 14, semana epidemiológica 8; 2016. 2.        Centro de Operações de Emergências emSaúde Pública sobre Microcefalias COES. MONITORAMENTO DOS CASOS DEMICROCEFALIA NO BRASIL. Vol 19. SE 12; 2016. 3.        Paixão ES, Barreto F, da Glória TeixeiraM, da Conceição N. Costa M, Rodrigues LC. History, Epidemiology, and ClinicalManifestations of Zika: A Systematic Review. Am J Public Health.2016;106(4):606-612. doi:10.2105/AJPH.2016.303112. 4.        Zanluca C, de Melo VCA, Mosimann ALP, dosSantos GIV, dos Santos CND, Luz K. First report of autochthonous transmissionof Zika virus in Brazil. Mem Inst Oswaldo Cruz. 2015;110(4):569-572.doi:10.1590/0074-02760150192. 5.        Instituto Nacional de Salud. Boletín EpidemiológicoSemanal. Vol Semana 5; 2016. Colômbia 6.        Instituto Nacional de Salud. Boletín EpidemiológicoSemanal. 2016; Semana 11. Colômbia 7.        Cruz R. Dados preliminares confirmam apresença do Zika vírus em Sergipe. Portal da saúde.http://saude.se.gov.br/index.php/2016/03/11/dados-preliminares-confirmam-a-presenca-do-zika-virus-em-sergipe/.Published 2016. 8.        Escobar E. Zika e microcefalia : O mistériode Sergipe – resolvido. Estadão.http://ciencia.estadao.com.br/blogs/herton-escobar/zika-e-microcefalia-o-misterio-de-sergipe-resolvido/.Published 2016. Accessed April 3, 2016. 9.        Butler D. Zika and birth defects: what weknow and what we don’t. Nature. 2016:1-7. doi:10.1038/nature.2016.19596. 10.      World Health Organization. Microcephaly. Mediacentre, fact sheet.http://www.who.int/mediacentre/factsheets/microcephaly/en/. Published March 2,2016. 11.      Calvet1 G, Aguiarv RS, Melo AS, et al.Detection and sequecing of Zika virus from amniotic fluid of fetuses withmicrocephaly in Brazil: a case study. Lancet Infect Dis.2016;3099(16):In press. doi:10.1017/CBO9781107415324.004. 12.      Fountora R. Zika atinge placenta emqualquer fase da gestação. Agência fiocruz de notícias.https://agencia.fiocruz.br/zika-atinge-placenta-em-qualquer-fase-da-gestacao.Published March 14, 2016. 13.      Garcez PP, Loiola EC, Costa RM da, et al.Zika virus impairs growth in human neurospheres and brain organoids. PeerJPrepr. 2016:1-21. Créditos da música: Adam Selzer, Charmed Life.