Summary
Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse reactions to drugs that cause a life‐threatening eruption of mucocutaneous blistering and epithelial ...sloughing. While the acute complications of SJS/TEN are well described, it is increasingly recognized that survivors may develop delayed sequelae, some of which can be associated with significant morbidity. Studies of long‐term SJS/TEN outcomes mostly focus on mucocutaneous and ocular complications. However, other internal organs, such as the respiratory tract and gastrointestinal tract, can be affected. Psychological sequelae are also frequent following the trauma of widespread epidermal necrolysis. An appreciation of the ‘chronic’ phase of SJS/TEN is needed by clinicians caring for individuals who have survived the acute illness. This review aims to provide an update on the breadth and range of sequelae that can affect patients in the months and years following an acute episode of SJS/TEN.
What's already known about this topic?
Survivors of SJS/TEN suffer from cutaneous and ocular long‐term sequelae.
What does this study add?
This review highlights the spectrum and morbidity of chronic cutaneous, ocular and other systemic complications.
The review proposes a multidisciplinary framework for long‐term follow‐up.
Plain language summary available online
This book enters into the many worlds of expression brought forth across Africa by the ravaging presence of HIV/AIDS. Africans and non-Africans, physicians and social scientists, journalists and ...documentarians share here a common and essential interest in understanding creative expression in crushing and uncertain times. Chapters investigate and engage the social networks, power relationships, and cultural structures that enable the arts to convey messages of hope and healing, and of knowledge and good counsel to the wider community. And from Africa to the wider world, the text here brings intimate, inspiring portraits of the performers, artists, communities, and organizations that have shared here their insights and the sense they have made of their lives and actions from deep within this devastating epidemic. Covering the wide expanse of the African continent, the chapters include explorations of, for example, the use of music to cope with AIDS; the relationship between music, HIV/AIDS, and social change; visual approaches to HIV literacy; radio and television as tools for “edutainment”; several individual artists’ confrontations with HIV/AIDS; various performance groups’ response to the epidemic; combating HIV/AIDS with local cultural performance; and more. Source material, such as song lyrics and interviews, weaves throughout the collection, which is a nuanced and profoundly affective portrayal of the intricate relationship between HIV/AIDS and the arts in Africa.
Capripoxviruses are the cause of sheeppox, goatpox and lumpy skin disease (LSD) of cattle. These diseases are of great economic significance to farmers in regions in which they are endemic and are a ...major constraint to international trade in livestock and their products. Although the distribution of capripoxviruses is considerably reduced from what it was even 50 years ago, they are now expanding their territory, with recent outbreaks of sheeppox or goatpox in Vietnam, Mongolia and Greece, and outbreaks of LSD in Ethiopia, Egypt and Israel. Increased legal and illegal trade in live animals provides the potential for further spread, with, for instance, the possibility of LSD becoming firmly established in Asia. This review briefly summarizes what is known about capripoxviruses, including their impact on livestock production, their geographic range, host-specificity, clinical disease, transmission and genomics, and considers current developments in diagnostic tests and vaccines. Capripoxviruses have the potential to become emerging disease threats because of global climate change and changes in patterns of trade in animals and animal products. They also could be used as economic bioterrorism agents.
Abstract
The MODOMICS database has been, since 2006, a manually curated and centralized resource, storing and distributing comprehensive information about modified ribonucleosides. Originally, it ...only contained data on the chemical structures of modified ribonucleosides, their biosynthetic pathways, the location of modified residues in RNA sequences, and RNA-modifying enzymes. Over the years, prompted by the accumulation of new knowledge and new types of data, it has been updated with new information and functionalities. In this new release, we have created a catalog of RNA modifications linked to human diseases, e.g., due to mutations in genes encoding modification enzymes. MODOMICS has been linked extensively to RCSB Protein Data Bank, and sequences of experimentally determined RNA structures with modified residues have been added. This expansion was accompanied by including nucleotide 5′-monophosphate residues. We redesigned the web interface and upgraded the database backend. In addition, a search engine for chemically similar modified residues has been included that can be queried by SMILES codes or by drawing chemical molecules. Finally, previously available datasets of modified residues, biosynthetic pathways, and RNA-modifying enzymes have been updated. Overall, we provide users with a new, enhanced, and restyled tool for research on RNA modification. MODOMICS is available at https://iimcb.genesilico.pl/modomics/.
Managing comorbidities in COPD Hillas, Georgios; Perlikos, Fotis; Tsiligianni, Ioanna ...
International journal of chronic obstructive pulmonary disease,
01/2015, Letnik:
10, Številka:
default
Journal Article
Recenzirano
Odprti dostop
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Age and smoking are common risk factors for COPD and other illnesses, often leading COPD patients ...to demonstrate multiple coexisting comorbidities. COPD exacerbations and comorbidities contribute to the overall severity in individual patients. Clinical trials investigating the treatment of COPD routinely exclude patients with multiple comorbidities or advanced age. Clinical practice guidelines for a specific disease do not usually address comorbidities in their recommendations. However, the management and the medical intervention in COPD patients with comorbidities need a holistic approach that is not clearly established worldwide. This holistic approach should include the specific burden of each comorbidity in the COPD severity classification scale. Further, the pharmacological and nonpharmacological management should also include optimal interventions and risk factor modifications simultaneously for all diseases. All health care specialists in COPD management need to work together with professionals specialized in the management of the other major chronic diseases in order to provide a multidisciplinary approach to COPD patients with multiple diseases. In this review, we focus on the major comorbidities that affect COPD patients. We present an overview of the problems faced, the reasons and risk factors for the most commonly encountered comorbidities, and the burden on health care costs. We also provide a rationale for approaching the therapeutic options of the COPD patient afflicted by comorbidity.
This review provides the reader with the up‐to‐date evidence‐based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, ...stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo‐skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.
The Ecohealth strategy is a multidisciplinary data-driven approach used to improve the quality of people's lives in Chagas disease endemic areas, such as regions of Central America. Chagas is a ...vector-borne disease caused by the parasite Trypanosoma cruzi. In Central America, the main vector is Triatoma dimidiata. Because successful implementation of the Ecohealth approach reduced home infestation in Jutiapa department, Guatemala, it was scaled-up to three localities, one in each of three Central American countries (Texistepeque, El Salvador; San Marcos de la Sierra, Honduras and Olopa, Guatemala). As a basis for the house improvement phase of the Ecohealth program, we determined if the localities differ in the role of sylvatic, synanthropic and domestic animals in the Chagas transmission cycle by measuring entomological indices, blood meal sources and parasite infection from vectors collected in and around houses. The Polymerase Chain Reaction (PCR) with taxa specific primers to detect both, blood sources and parasite infection, was used to assess 71 T. dimidiata from Texistepeque, 84 from San Marcos de la Sierra and 568 from Olopa. Our results show that infestation (12.98%) and colonization (8.95%) indices were highest in Olopa; whereas T. cruzi prevalence was higher in Texistepeque and San Marcos de la Sierra (>40%) than Olopa (8%). The blood meal source profiles showed that in Olopa, opossum might be important in linking the sylvatic and domestic Chagas transmission cycle, whereas in San Marcos de la Sierra dogs play a major role in maintaining domestic transmission. For Texistepeque, bird was the major blood meal source followed by human. When examining the different life stages, we found that in Olopa, the proportion bugs infected with T. cruzi is higher in adults than nymphs. These findings highlight the importance of location-based recommendations for decreasing human-vector contact in the control of Chagas disease.
Research has shown that a greater adherence to the Mediterranean diet is associated with a reduced risk of major chronic disease. However, the existing literature leads to debate for different ...issues, such as the measurement of the adherence to the Mediterranean diet, the use of a wide variety of dietary indices with various food components and the large heterogeneity across the studies. In order to summarise the evidence and evaluate the validity of the association between the adherence to the Mediterranean diet and multiple health outcomes, an umbrella review of the evidence across meta-analyses of observational studies and randomised clinical trials (RCTs) was performed. Thirteen meta-analyses of observational studies and 16 meta-analyses of RCTs investigating the association between the adherence to the Mediterranean diet and 37 different health outcomes, for a total population of over than 12 800 000 subjects, were identified. A robust evidence, supported by a P-value<0.001, a large simple size, and not a considerable heterogeneity between studies, for a greater adherence to the Mediterranean diet and a reduced the risk of overall mortality, cardiovascular diseases, coronary heart disease, myocardial infarction, overall cancer incidence, neurodegenerative diseases and diabetes was found. For most of the site-specific cancers, as well as for inflammatory and metabolic parameters, the evidence was only suggestive or weak and further studies are needed to draw firmer conclusions. No evidence, on the other hand, was reported for bladder, endometrial and ovarian cancers, as well as for LDL (low density lipoprotein)-cholesterol levels.
Periodontal disease (PD) is one of the most frequent and widespread inflammatory diseases in dogs. The onset of PD pathogenesis is prompted by the dental microbial biofilm combined with the animal ...immune-inflammatory response. Along with local effects, systemic consequences can occur secondary to dental plaque-associated bacteraemia, affecting distant tissues and organs. The main goal of this retrospective study was to access and evaluate the association between PD and systemic consequences (renal, hepatic and cardiac) in a group of 136 dogs. Clinical records of all animals were assessed for general and systemic information, further analysed by general linear model and Odds-Ratio.
Animals were organized in two groups, PD group and control group, formed by animals without PD. In this population, increasing age was proven to be a risk factor (OR = 1.04, p < .01) for PD establishment. Small breeds (<10 Kg) were the most prevalent in the PD group, being more susceptible to this disease. On the other hand, no influence of gender or reproductive status in PD progression was observed. Regarding systemic diseases, a statistically significant association (p = .026) was obtained between PD and cardiac disease.
Results show that PD can have a significant adverse impact on animals' health, being related with systemic consequences, which may increase morbidity and mortality rates of these animals. PD prevention, with focus on owner's information about this disease and its management, are essential points for an active PD control program.
•Periodontal disease (PD) is one of the most widespread inflammatory diseases in dogs.•Systemic consequences can occur secondary to dental plaque-associated bacteraemia.•Several factors may influence PD development, including age and weight/breed.•Systemic diseases, as cardiac, renal and hepatic conditions may be related to PD.•In this study, a positive relationship was observed between PD and cardiac disease.
•The COVID-19 pandemic is a significant source of psychological distress globally.•The novel coronavirus and host immunologic response may also directly affect brain and behavior.•Acute and delayed ...neuropsychiatric sequelae have been associated with past viral pandemics.•Prospective monitoring of COVID-19 patients is needed to determine neuropsychiatric outcomes.•A psychoneuroimmunology perspective will aid in promoting post-pandemic public mental health.
The coronavirus disease 19 (COVID-19) pandemic is a significant psychological stressor in addition to its tremendous impact on every facet of individuals’ lives and organizations in virtually all social and economic sectors worldwide. Fear of illness and uncertainty about the future precipitate anxiety- and stress-related disorders, and several groups have rightfully called for the creation and dissemination of robust mental health screening and treatment programs for the general public and front-line healthcare workers. However, in addition to pandemic-associated psychological distress, the direct effects of the virus itself (several acute respiratory syndrome coronavirus; SARS-CoV-2), and the subsequent host immunologic response, on the human central nervous system (CNS) and related outcomes are unknown. We discuss currently available evidence of COVID-19 related neuropsychiatric sequelae while drawing parallels to past viral pandemic-related outcomes. Past pandemics have demonstrated that diverse types of neuropsychiatric symptoms, such as encephalopathy, mood changes, psychosis, neuromuscular dysfunction, or demyelinating processes, may accompany acute viral infection, or may follow infection by weeks, months, or longer in recovered patients. The potential mechanisms are also discussed, including viral and immunological underpinnings. Therefore, prospective neuropsychiatric monitoring of individuals exposed to SARS-CoV-2 at various points in the life course, as well as their neuroimmune status, are needed to fully understand the long-term impact of COVID-19, and to establish a framework for integrating psychoneuroimmunology into epidemiologic studies of pandemics.
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