66 research outputs found
Is Sjögren's syndrome a retroviral disease?
Circumstantial evidence suggests that retroviruses play a role in the pathogenesis of Sjögren's syndrome. Such evidence, derived from studies of patients with Sjögren's syndrome, includes the following: the presence of serum antibodies cross-reactive with retroviral Gag proteins; the occurrence of reverse transcriptase activity in salivary glands; the detection of retroviral antigens, retrovirus-like particles, or novel retroviral sequences in salivary glands; the occurrence of Sjögren's syndrome-like illnesses in patients having confirmed systematic infections with retroviruses such as human immunodeficiency virus-1 (HIV-1) and human T lymphotropic virus type 1; and the beneficial effect of anti-retroviral treatment on the occurrence of HIV-1-associated sicca syndrome. Additional evidence is provided by animal models
Sexually Transmitted Infections in a Cohort of 15,921 Refugees (1926-1940) in the Region of Imathia, Northern Greece
This historical epidemiological study evaluates sexually transmitted
infections (STIs) among Greek refugees during the Interwar period
in the region of Imathia, Central Macedonia, Greece, as a part of the effort
against sexually transmitted infections in Greece (1910-1940). We examined
the archives of the Refugee Hospital of Veroia – the capital of the regional
unit of Imathia (March 5, 1926 to October 27, 1940). This is a report
of previously unpublished primary material comprising a cohort of 15,921
cases, among whom 41 patients were hospitalized on account of syphilis
and 19 on account of gonococcal infection. Descriptive statistics were estimated.
Primary (n=4), secondary (n=2), tertiary (n=13), congenital (n=7),
and not further specified (n=15) cases of syphilis were identified, whereas
a variety of differential diagnosis problems arose. Syphilis and gonococcal
infection/gonorrhea seemed to affect various social groups, as evidenced
by the variety of professions involved. Refugee patients originated from
various areas such as Caucasus, Thrace, Constantinople, Bithynia, and Pontus.
Lack of information and poor healthcare led to spreading of STIs in
Greece. Law 3032/1922 was crucial for the Greek effort against sexually
transmitted infection
Sexually Transmitted Infections in a Cohort of 15,921 Refugees (1926-1940) in the Region of Imathia, Northern Greece
This historical epidemiological study evaluates sexually transmitted
infections (STIs) among Greek refugees during the Interwar period
in the region of Imathia, Central Macedonia, Greece, as a part of the effort
against sexually transmitted infections in Greece (1910-1940). We examined
the archives of the Refugee Hospital of Veroia – the capital of the regional
unit of Imathia (March 5, 1926 to October 27, 1940). This is a report
of previously unpublished primary material comprising a cohort of 15,921
cases, among whom 41 patients were hospitalized on account of syphilis
and 19 on account of gonococcal infection. Descriptive statistics were estimated.
Primary (n=4), secondary (n=2), tertiary (n=13), congenital (n=7),
and not further specified (n=15) cases of syphilis were identified, whereas
a variety of differential diagnosis problems arose. Syphilis and gonococcal
infection/gonorrhea seemed to affect various social groups, as evidenced
by the variety of professions involved. Refugee patients originated from
various areas such as Caucasus, Thrace, Constantinople, Bithynia, and Pontus.
Lack of information and poor healthcare led to spreading of STIs in
Greece. Law 3032/1922 was crucial for the Greek effort against sexually
transmitted infection
The epidemiology, antifungal use and risk factors of death in elderly patients with candidemia: a multicentre retrospective study
Invasive Fungal Infections in Patients with Hematological Malignancies: Emergence of Resistant Pathogens and New Antifungal Therapies
Invasive fungal infections caused by drug-resistant organisms are an emerging threat to heavily immunosuppressed patients with hematological malignancies. Modern early antifungal treatment strategies, such as prophylaxis and empirical and preemptive therapy, result in long-term exposure to antifungal agents, which is a major driving force for the development of resistance. The extended use of central venous catheters, the nonlinear pharmacokinetics of certain antifungal agents, neutropenia, other forms of intense immunosuppression, and drug toxicities are other contributing factors. The widespread use of agricultural and industrial fungicides with similar chemical structures and mechanisms of action has resulted in the development of environmental reservoirs for some drug-resistant fungi, especially azole-resistant Aspergillus species, which have been reported from four continents. The majority of resistant strains have the mutation TR34/L98H, a finding suggesting that the source of resistance is the environment. The global emergence of new fungal pathogens with inherent resistance, such as Candida auris, is a new public health threat. The most common mechanism of antifungal drug resistance is the induction of efflux pumps, which decrease intracellular drug concentrations. Overexpression, depletion, and alteration of the drug target are other mechanisms of resistance. Mutations in the ERG11 gene alter the protein structure of C-demethylase, reducing the efficacy of antifungal triazoles. Candida species become echinocandin-resistant by mutations in FKS genes. A shift in the epidemiology of Candida towards resistant non-albicans Candida spp. has emerged among patients with hematological malignancies. There is no definite association between antifungal resistance, as defined by elevated minimum inhibitory concentrations, and clinical outcomes in this population. Detection of genes or mutations conferring resistance with the use of molecular methods may offer better predictive values in certain cases. Treatment options for resistant fungal infections are limited and new drugs with novel mechanisms of actions are needed. Prevention of resistance through antifungal stewardship programs is of paramount importance
Therapy of Mucormycosis
Despite the recent introduction of mold-active agents (posaconazole and
isavuconazole), in addition to amphotericin B products, to our
armamentarium against mucormycosis, many uncertainties remain for the
management of this uncommon opportunistic infection, as there are no
data from prospective randomized clinical trials to guide therapy. In
this mini-review, we present the current status of treatment options. In
view of the heterogeneity of the disease (different types of affected
hosts, sites of infection, and infecting Mucorales), mucormycosis
management requires an individualized management plan that takes into
account the net state of immunosuppression of the host, including
comorbidities, certainty of diagnosis, site of infection, and antifungal
pharmacological properties
LEVELS OF THE CIRCULATING CELL-ADHESION MOLECULE E-SELECTIN AND DISEASE PROGRESSION IN HIV-INFECTION
The levels of soluble form of E-Selectin (sEs), or endothelial-leukocyte
adhesion molecule-1, were measured in 96 sera derived from 72
HIV-infected patients at different stages of the disease, 60 healthy
blood donors, and 50 HIV-negative patients with infections, using a
quantitative ELISA, Levels of sEs in HIV-infected individuals without
AIDS, according to the 1993 classification system of the Centers for
Disease Control, were higher than normal- (mean +/- SEM 48 +/- 4 versus
35 +/- 2 ng/ml, p = 0.003). Patients with established AIDS, who were
afebrile and had no evidence of acute concurrent infection, had even
higher sEs serum levels (70 +/- 9 ng/ml, p = 0.009, compared to those
without AIDS), A significant increase in clinical catt:gory disease
progression was present. Individual concentrations of sEs correlated
directly with levels of soluble intercellular adhesion molecule-1 (p <
0.00001) and IL-2 receptor (p = 0.001), but not with CD4(+) T-cell
counts. Zidovudine treatment was not associated with changes in sEs
serum levels, Elevated sEs levels were also found in HIV-seronegative
patients with other bacterial and protozoal infections, Since sEs is a
biologically active molecule, further studies should investigate the
pathogenetic significance of circulating sEs in HIV-related disease
progression, and assess the prognostic value of sEs determination for
these patients
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