Managing atypical and typical herpetic central nervous system infections: results of a multinational study

There have been many studies pertaining to the management of herpetic meningoencephalitis (HME), but the majority of them have focussed on virologically unconfirmed cases or included only small sample sizes. We have conducted a multicentre study aimed at providing management strategies for HME. Overall, 501 adult patients with PCR-proven HME were included retrospectively from 35 referral centres in 10 countries; 496 patients were found to be eligible for the analysis. Cerebrospinal fluid (CSF) analysis using a PCR assay yielded herpes simplex virus (HSV)-1 DNA in 351 patients (70.8%), HSV-2 DNA in 83 patients (16.7%) and undefined HSV DNA type in 62 patients (12.5%). A total of 379 patients (76.4%) had at least one of the specified characteristics of encephalitis, and we placed these patients into the encephalitis presentation group. The remaining 117 patients (23.6%) had none of these findings, and these patients were placed in the nonencephalitis presentation group. Abnormalities suggestive of encephalitis were detected in magnetic resonance imaging (MRI) in 83.9% of the patients and in electroencephalography (EEG) in 91.0% of patients in the encephalitis presentation group. In the nonencephalitis presentation group, MRI and EEG data were suggestive of encephalitis in 33.3 and 61.9% of patients, respectively. However, the concomitant use of MRI and EEG indicated encephalitis in 96.3 and 87.5% of the cases with and without encephalitic clinical presentation, respectively. Considering the subtle nature of HME, CSF HSV PCR, EEG and MRI data should be collected for all patients with a central nervous system infection

European Local Climate Plans - EURO-LCPs: Local Climate Mitigation and Local Climate Adaptation Plans of European Urban Audit Cities

This database shows the availability of local climate mitigation plans, local climate adaptation plans, municipal energy plans, heat wave plans and flood risk plans of all 885 Urban Audit Core Cities of the 28 countries of the European Union. Additionally, it lists per Urban Audit Core City the membership in the largest climate networks [Old Covenant of Mayors Member (2020 goal); New Covenant of Mayors Member (2030 goal); Status (1-2-3); Mayors Adapt Commitment; Compact of Mayors Member (yes/no); Compact of Mayors Stage (Badge)]. Furthermore, based on a typology of plans developed in Reckien et al., 2018 and Reckien et al., 2019, the database categorizes the plans into types, and specifies whether adaptation and mitigation aspects are jointly addressed in one plan ('joint plan')

Tetanus in adults: results of the multicenter ID-IRI study

WOS: 000406290100014PubMed ID: 28353183Tetanus is an acute, severe infection caused by a neurotoxin secreting bacterium. Various prognostic factors affecting mortality in tetanus patients have been described in the literature. In this study, we aimed to analyze the factors affecting mortality in hospitalized tetanus patients in a large case series. This retrospective multicenter study pooled data of tetanus patients from 25 medical centers. The hospitals participating in this study were the collaborating centers of the Infectious Diseases International Research Initiative (ID-IRI). Only adult patients over the age of 15 years with tetanus were included. The diagnosis of tetanus was made by the clinicians at the participant centers. Izmir Bozyaka Education and Research Hospital's Review Board approved the study. Prognostic factors were analyzed by using the multivariate regression analysis method. In this study, 117 adult patients with tetanus were included. Of these, 79 (67.5%) patients survived and 38 (32.5%) patients died. Most of the deaths were observed in patients >60 years of age (60.5%). Generalized type of tetanus, presence of pain at the wound area, presence of generalized spasms, leukocytosis, high alanine aminotransferase (ALT) and C-reactive protein (CRP) values on admission, and the use of equine immunoglobulins in the treatment were found to be statistically associated with mortality (p < 0.05 for all). Here, we describe the prognostic factors for mortality in tetanus. Immunization seems to be the most critical point, considering the advanced age of our patients. A combination of laboratory and clinical parameters indicates mortality. Moreover, human immunoglobulins should be preferred over equine sera to increase survival

Local Climate Mitigation and Local Climate Adaptation Plans of European Urban Audit Cities

This database shows the availability of local climate mitigation plans, local climate adaptation plans, municipal energy plans, heat wave plans and flood risk plans of all 885 Urban Audit Core Cities of the 28 countries of the European Union. Additionally, it lists per Urban Audit Core City the membership in the largest climate networks [Old Covenant of Mayors Member (2020 goal); New Covenant of Mayors Member (2030 goal); Status (1-2-3); Mayors Adapt Commitment; Compact of Mayors Member (yes/no); Compact of Mayors Stage (Badge)]. Furthermore, based on a typology of plans developed in Reckien et al., 2018 and Reckien et al., 2019, the database categorizes the plans into types, and specifies whether adaptation and mitigation aspects are jointly addressed in one plan ('joint plan')

Central Nervous System Infections In The Absence Of Cerebrospinal Fluid Pleocytosis

Previous multicenter/multinational studies were evaluated to determine the frequency of the absence of cerebrospinal fluid pleocytosis in patients with central nervous system infections, as well as the clinical impact of this condition. It was found that 18% of neurosyphilis, 7.9% of herpetic meningoencephalitis, 3% of tuberculous meningitis, 1.7% of Brucella meningitis, and 0.2% of pneumococcal meningitis cases did not display cerebrospinal fluid pleocytosis. Most patients were not immunosuppressed. Patients without pleocytosis had a high rate of unfavorable outcomes and thus this condition should not be underestimated.Scopu