Imiquimod Does not Affect Shedding of Viable Chlamydiae in a Murine Model of Chlamydia trachomatis Genital Tract Infection

Objective: We postulated that either oral or vaginal administration of the immune response modifier imiquimod would decrease vaginal shedding of Chlamydia trachomatis, mouse pneumonitis strain (MoPn), in a murine model. Methods: Female BALB/c mice were infected intravaginally withC. trachomatis (MoPn) and were administered imiquimod either orally (30 mg/kg) or vaginally (10 μl of 5%imiquimod cream) prior to infection and every second day after infection for a total of four doses. The course of infection was monitored by collecting cervical–vaginal swabs and isolation in HeLa 229 cell culture. To determine whether the drug affected T helper type 1 or T helper type 2 immune response polarization, immunoglobulinG(IgG) subclass antibody responses were assessed at day 56 after infection. Results: There was no significant difference in the course of infection when imiquimod-treated mice were compared with sham-treated controls, regardless of whether the drug was administered orally or vaginally. IgG subclass antibody responses, and by extension, T helper type 1 to T helper type 2 immune response polarization, were also unaffected. Conclusions: Imiquimod has no efficacy in controllingC. trachomatis (MoPn) infection in the murine model

The underrecognized prothrombotic vascular disease of COVID-19

International audienc

Emergence of institutional antithrombotic protocols for coronavirus 2019

International audienc

Discrepancies in Prevalence of Peripheral Arterial Disease between Lower Extremities at Rest and Postexercise

International audienceBackground  Lower extremity peripheral arterial disease (PAD) is a common medical condition causing substantial morbidity. Limited data exist on whether discrepancies in PAD prevalence exist between the lower extremities using resting ankle-brachial indices (ABIs) and postexercise pressures. Objective  We predicted the prevalence of PAD between the lower extremities. Methods and Results  Consecutive patients who had undergone a noninvasive arterial lower extremity study at Mayo Clinic, Rochester, MN, between January 1996 and December 2012 with suspected PAD were retrospectively reviewed. We identified 12,312 consecutive patients who underwent an arterial lower extremity and an exercise treadmill study. Prevalence of PAD was assessed at rest and after exercise using two criteria: a resting ABI ≤ 0.90 and a postexercise pressure decrease of > 30 mm Hg. Mean age was 67 ± 12 years and there were 4,780 (39%) women studied. At rest, we found a higher prevalence of PAD on the left extremity (27.4%) compared with the right (24.6%) ( p   30 mm Hg, our results suggest that there is a significantly higher prevalence of PAD in the left lower extremity at rest, in contrast to a greater prevalence of abnormal postexercise testing in the right lower extremity. The reason(s) of these discrepancies remain to be studied

Mapping the global geographic potential of Zika virus spread

The Americas are presently experiencing the most serious known outbreak of Zika virus (ZIKV). Here, we present a novel set of analyses using environmental characteristics, vector mosquito distributions, and socioeconomic risk factors to develop the first map to detail global ZIKV transmission risk in multiple dimensions based on ecological niche models. Our model predictions were tested against independent evaluation data sets, and all models had predictive ability significantly better than random expectations. The study addresses urgent knowledge gaps regarding (1) the potential geographic scope of the current ZIKV epidemic, (2) the global potential for spread of ZIKV, and (3) drivers of ZIKV transmission. Our analysis of potential drivers of ZIKV distributions globally identified areas vulnerable in terms of some drivers, but not for others. The results of these analyses can guide regional education and preparedness efforts, such that medical personnel will be better prepared for diagnosis of potential ZIKV cases as they appear

Mapping the global geographic potential of Zika virus spread

The Americas are presently experiencing the most serious known outbreak of Zika virus (ZIKV). Here, we present a novel set of analyses using environmental characteristics, vector mosquito distributions, and socioeconomic risk factors to develop the first map to detail global ZIKV transmission risk in multiple dimensions based on ecological niche models. Our model predictions were tested against independent evaluation data sets, and all models had predictive ability significantly better than random expectations. The study addresses urgent knowledge gaps regarding (1) the potential geographic scope of the current ZIKV epidemic, (2) the global potential for spread of ZIKV, and (3) drivers of ZIKV transmission. Our analysis of potential drivers of ZIKV distributions globally identified areas vulnerable in terms of some drivers, but not for others. The results of these analyses can guide regional education and preparedness efforts, such that medical personnel will be better prepared for diagnosis of potential ZIKV cases as they appear

Discordant Diagnosis of Lower Extremity Peripheral Artery Disease Using American Heart Association Postexercise Guidelines

International audienceTo determine whether postexercise criteria for peripheral artery disease (PAD) diagnosis recommended by the American Heart Association (AHA) identifies the same group of PAD patients.Diagnosis of PAD is performed using ankle-brachial index at rest (resting-ABI). When resting-ABI is not contributive, an AHA scientific statement recommend to use 1 of 2 following criteria: a postexercise ABI decrease of greater than 20% or a postexercise ankle pressure decrease of greater than 30 mm Hg.Between 1996 and 2012, 31,663 consecutive patients underwent lower-extremity arterial study at Mayo Clinic. Among them, only unique patients who had exercise treadmill testing were analyzed. In this retrospective analysis, resting-ABI, postexercise ABI, and postexercise decrease of ankle pressure measured at 1-minute were measured in each patient. We conducted an analysis of agreement between postexercise criteria expressing the agreement separately for the positive and the negative ratings. Twelve thousand three hundred twelve consecutive patients were studied with a mean age of 67 ± 12 years, 61% male. According to resting-ABI, 4317 (35%) patients had PAD. In the whole population, if a clinician diagnoses "PAD" with 1 postexercise criterion, the probability that other clinicians would also diagnose "PAD" is 74.3%. If a clinician diagnoses "no PAD", the probability that other clinicians would also diagnose "no PAD" is 82.4%. In the patients to be of potential benefit from treadmill test when the resting-ABI \textgreater 0.90, if a clinician diagnoses "PAD" with 1 postexercise criterion, the probability that other clinicians would also diagnose "PAD" is 58.4% whereas if a clinician diagnoses "no PAD," the probability that other clinicians would also diagnose "no PAD" is 87.5%.Postexercise criteria do not identify the same group of PAD patients. In our opinion, postexercise criteria to define PAD deserve additional stud