The Child in the Latency Period

Tuberculosis is a chronic infection, most often affecting the lungs, which usually manifests after a latency period from primary infection with Mycobacterium tuberculosis. Symptoms are generally nonspecific, with fever, cough, weight loss and malaise. The diagnosis is based on microscopic examination of sputum smear and rapid diagnostic molecular tests, which are increasingly used today. Genotypic tests for establishing the strain involved and phenotypic antibiograms for early detection of drug resistance should guide the initiation of treatment but are still expensive. Treatment of active tuberculosis is done with combination of antimycobacterial drugs, administered for at least 6 months. The antituberculosis treatment has several purposes: to cure the patient, to reduce the risk of recurrence, to prevent the installation of chemo-resistance, to prevent complications and to reduce mortality, as well as to limit the spread of the infection. Drug combinations are used to prevent the development of resistance. The administration is long-lasting in order to achieve the sterilization of foci that are difficult to access by medicines, ensuring healing and relapse prevention. Generally, standard pharmacological protocols are used. In order to increase the adherence to the treatment and its completion, often the anti-tuberculosis treatment is done under direct observation, in what is called directly observed therapy. Undesirable effects of anti-tuberculosis drugs should be detected early and managed appropriately. Recently, many cases of tuberculosis are resistant to the first-line drugs isoniazid and rifampicin (multidrug-resistant tuberculosis), or to these drugs, fluoroquinolones and at least one injectable antimycobacterial drugs (extensively drug-resistant tuberculosis). Especially the treatment of the latter is difficult to do, because there are not currently too many therapeutic options. That is why it is important to detect the resistance early and to establish the appropriate treatment. Treatment of latent tuberculosis usually involves the administration of isoniazid for 9 months. BCG vaccination is an active immunization method used in countries with high incidence of tuberculosis (Romania being the country of the European Union with the highest incidence of tuberculosis), protecting mainly against miliary tuberculosis, a spread form of tuberculosis, severe especially in children.

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CLINICAL AND ELECTROMYOGRAPHIC PREDICTION OF FACIAL NERVE NEUROPATHY IN CHILDREN

JOURNAL OF NEUROLOGY AND NEUROSURGICAL RESEARCH ◽

10.26739/2181-0982-2020-3-7 ◽

2020 ◽

Vol 3 (1) ◽

pp. 38-40

Author(s):

Nozima Asadova ◽

◽

Aziza Djurabekova ◽

Saodat Igamova

Keyword(s):

Facial Nerve ◽

Children And Adolescents ◽

Medical Literature ◽

Latency Period ◽

Pain Syndrome ◽

Literature Discussions ◽

Clinical Forms ◽

Diagnosis And Prognosis ◽

Neurological Features ◽

Blinking Reflex

In modern medical literature, discussions continue about neuropathies of the facial nerve in children,disease factors, clinical and neurological features, the severity of the course, the difficulties of diagnosis and prognosis of the disease. The work is devoted to the analysis of the neuropathy of the facial nerve in children and adolescents, depending on the clinical forms of the disease, using electroneurosympathetic indicators, the latency period, the blinking reflex and thenatureof the lesion of the facial nerve accompanied by pain syndrome

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Metastatic Extraskeletal Mesenchymal Chondrosarcoma of the Pancreas: Report of an Unusual Case with Review of Literature

Asian Journal of Oncology ◽

10.1055/s-0040-1722807 ◽

2021 ◽

Author(s):

Saloni Naresh Shah ◽

Ashok Parameswaran ◽

Prasanna Kumar Reddy

Keyword(s):

Unusual Case ◽

English Literature ◽

Latency Period ◽

Sudden Onset ◽

Mesenchymal Chondrosarcoma ◽

Pancreatic Tumors ◽

Good Survival ◽

Review Of Literature ◽

Long Latency ◽

Extraskeletal Mesenchymal Chondrosarcoma

AbstractExtraskeletal mesenchymal chondrosarcoma (ESMC) metastasizing to the pancreas in isolation is a rare occurrence. We report a 49-year-old gentleman who had undergone excision of an ESMC of the thigh in 2009 and presented with sudden onset abdominal pain and icterus in 2019. Radiological imaging revealed calcified mass of the pancreas with multiple nodules with extension into the adipose tissue. Distal pancreatectomy was performed and the pathology revealed a bimorphic tumor composed of undifferentiated round blue cells with abrupt transition to hyaline cartilage, typical of mesenchymal chondrosarcoma. To the best of our knowledge, there are only seven prior cases of metastatic ESMC of the pancreas in the English literature. Surgical intervention appears to be the preferred modality of treatment for metastatic pancreatic tumors. These patients may have long latency period before metastasizing and seem to have a good survival period post excision.

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Impact of public health interventions to curb SARS-CoV-2 spread assessed by an evidence-educated Delphi panel and tailored SEIR model

Journal of Public Health ◽

10.1007/s10389-021-01566-2 ◽

2021 ◽

Author(s):

Bernd Brüggenjürgen ◽

Hans-Peter Stricker ◽

Lilian Krist ◽

Miriam Ortiz ◽

Thomas Reinhold ◽

...

Keyword(s):

Public Health ◽

Transmission Rate ◽

Latency Period ◽

Policy Decision ◽

Sensitivity Analyses ◽

Delphi Panel ◽

Time Step ◽

Seir Model ◽

Health Policy Decision ◽

The Impact

Abstract Aim To use a Delphi-panel-based assessment of the effectiveness of different non-pharmaceutical interventions (NPI) in order to retrospectively approximate and to prospectively predict the SARS-CoV-2 pandemic progression via a SEIR model (susceptible, exposed, infectious, removed). Methods We applied an evidence-educated Delphi-panel approach to elicit the impact of NPIs on the SARS-CoV-2 transmission rate R0 in Germany. Effectiveness was defined as the product of efficacy and compliance. A discrete, deterministic SEIR model with time step of 1 day, a latency period of 1.8 days, duration of infectiousness of 5 days, and a share of the total population of 15% assumed to be protected by immunity was developed in order to estimate the impact of selected NPI measures on the course of the pandemic. The model was populated with the Delphi-panel results and varied in sensitivity analyses. Results Efficacy and compliance estimates for the three most effective NPIs were as follows: test and isolate 49% (efficacy)/78% (compliance), keeping distance 42%/74%, personal protection masks (cloth masks or other face masks) 33%/79%. Applying all NPI effectiveness estimates to the SEIR model resulted in a valid replication of reported occurrence of the German SARS-CoV-2 pandemic. A combination of four NPIs at consented compliance rates might curb the CoViD-19 pandemic. Conclusion Employing an evidence-educated Delphi-panel approach can support SARS-CoV-2 modelling. Future curbing scenarios require a combination of NPIs. A Delphi-panel-based NPI assessment and modelling might support public health policy decision making by informing sequence and number of needed public health measures.

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A Hybrid Modeling Technique of Epidemic Outbreaks with Application to COVID-19 Dynamics in West Africa

Biology ◽

10.3390/biology10050365 ◽

2021 ◽

Vol 10 (5) ◽

pp. 365

Author(s):

Chénangnon Frédéric Tovissodé ◽

Jonas Têlé Doumatè ◽

Romain Glèlè Kakaï

Keyword(s):

West Africa ◽

Growth Curve ◽

Exponential Growth ◽

Latency Period ◽

Growth Curves ◽

Exponential Growth Phase ◽

Model Framework ◽

Logistic Regression Models ◽

Containment Measures ◽

Reporting Data

The widely used logistic model for epidemic case reporting data may be either restrictive or unrealistic in presence of containment measures when implemented after an epidemic outbreak. For flexibility in epidemic case reporting data modeling, we combined an exponential growth curve for the early epidemic phase with a flexible growth curve to account for the potential change in growth pattern after implementation of containment measures. We also fitted logistic regression models to recoveries and deaths from the confirmed positive cases. In addition, the growth curves were integrated into a SIQR (Susceptible, Infective, Quarantined, Recovered) model framework to provide an overview on the modeled epidemic wave. We focused on the estimation of: (1) the delay between the appearance of the first infectious case in the population and the outbreak (“epidemic latency period”); (2) the duration of the exponential growth phase; (3) the basic and the time-varying reproduction numbers; and (4) the peaks (time and size) in confirmed positive cases, active cases and new infections. The application of this approach to COVID-19 data from West Africa allowed discussion on the effectiveness of some containment measures implemented across the region.

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Anti-PD-1-Induced Hidradenitis Suppurativa

Dermatopathology ◽

10.3390/dermatopathology8010007 ◽

2021 ◽

Vol 8 (1) ◽

pp. 37-39

Author(s):

Alexia Maillard ◽

Damien Pastor ◽

Rastine Merat

Keyword(s):

Adverse Events ◽

Hidradenitis Suppurativa ◽

Checkpoint Inhibitors ◽

Latency Period ◽

The Body ◽

Skin Reactions ◽

Zinc Gluconate ◽

Severe Acne ◽

Bowel Diseases ◽

Inflammatory Bowel

Mucocutaneous adverse events are commonly observed under immune checkpoint inhibitors (ICIs) therapy. Here, we report the case of a 43-year-old male patient with a stage IIIC melanoma disease who developed hidradenitis suppurativa (HS) three months after the beginning of an anti-PD-1 (nivolumab) adjuvant therapy. The patient had no comorbidities other than obesity and severe acne during adolescence. After an unsuccessful course of lymecycline while he was still treated with nivolumab, he gradually improved under zinc gluconate therapy and, more importantly, after nivolumab cessation. HS is a recurrent follicular inflammatory disease in the apocrine gland-bearing areas of the body often associated with obesity, metabolic syndrome, tobacco smoking, inflammatory bowel diseases, psoriasis, and arthritis. In our patient, the latency period between drug initiation and onset of HS symptoms and the improvement after immunotherapy discontinuation, argued strongly in favor of an anti-PD-1-induced HS. Anti-PD-1 therapies often trigger T cells-mediated adverse events that mimic Th17-mediated inflammatory and neutrophilic diseases. We suggest that HS, as other pustular skin reactions and ICIs-induced neutrophilic colitis, can be part of the anti-PD-1 mucocutaneous adverse event spectrum.

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Paracoccidioidomycosis Diagnosed in Europe—A Systematic Literature Review

Journal of Fungi ◽

10.3390/jof7020157 ◽

2021 ◽

Vol 7 (2) ◽

pp. 157

Author(s):

Gernot Wagner ◽

Deddo Moertl ◽

Anna Glechner ◽

Verena Mayr ◽

Irma Klerings ◽

...

Keyword(s):

Latency Period ◽

European Countries ◽

Systemic Mycosis ◽

Endemic Region ◽

Travel History ◽

Long Latency ◽

Geographical Regions ◽

The World ◽

First Occurrence ◽

Full Text Screening

Paracoccidioidomycosis is a systemic mycosis that is endemic in geographical regions of Central and South America. Cases that occur in nonendemic regions of the world are imported through migration and travel. Due to the limited number of cases in Europe, most physicians are not familiar with paracoccidioidomycosis and its close clinical and histopathological resemblance to other infectious and noninfectious disease. To increase awareness of this insidious mycosis, we conducted a systematic review to summarize the evidence on cases diagnosed and reported in Europe. We searched PubMed and Embase to identify cases of paracoccidioidomycosis diagnosed in European countries. In addition, we used Scopus for citation tracking and manually screened bibliographies of relevant articles. We conducted dual abstract and full-text screening of references yielded by our searches. To identify publications published prior to 1985, we used the previously published review by Ajello et al. Overall, we identified 83 cases of paracoccidioidomycosis diagnosed in 11 European countries, published in 68 articles. Age of patients ranged from 24 to 77 years; the majority were male. Time from leaving the endemic region and first occurrence of symptoms considerably varied. Our review illustrates the challenges of considering systemic mycosis in the differential diagnosis of people returning or immigrating to Europe from endemic areas. Travel history is important for diagnostic-workup, though it might be difficult to obtain due to possible long latency period of the disease.

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Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012–2019

Malaria Journal ◽

10.1186/s12936-020-03551-8 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Tao Zhang ◽

Shuqi Wang ◽

Duoquan Wang ◽

Sarah Auburn ◽

Shenning Lu ◽

...

Keyword(s):

Information System ◽

Disease Control ◽

Latency Period ◽

Anhui Province ◽

Detection Methods ◽

Health Concern ◽

Plasmodium Ovale ◽

Control And Prevention ◽

Endemic Areas ◽

Epidemiological Characteristics

Abstract Background Although autochthonous malaria cases are no longer reported in Anhui Province, China, imported malaria has become a major health concern. The proportion of reported malaria cases caused by Plasmodium ovale spp. increased to levels higher than expected during 2012 to 2019, and showed two peaks, 19.69% in 2015 and 19.35% in 2018. Methods A case-based retrospective study was performed using data collected from the China Information System for Disease Control and Prevention (CISDCP) and Information System for Parasitic Disease Control and Prevention (ISPDCP) from 2012 to 2019 to assess the trends and differences between Plasmodium ovale curtisi (P. o. curtisi) and Plasmodium ovale wallikeri (P. o. wallikeri). Epidemiological characteristics were analyzed using descriptive statistics. Results Plasmodium o. curtisi and P. o. wallikeri were found to simultaneously circulate in 14 African countries. Among 128 patients infected with P. ovale spp., the proportion of co-infection cases was 10.16%. Six cases of co-infection with P. ovale spp. and P. falciparum were noted, each presenting with two clinical attacks (the first attack was due to P. falciparum and the second was due to P. ovale spp.) at different intervals. Accurate identification of the infecting species was achieved among only 20.00% of cases of P. ovale spp. infection. At the reporting units, 32.17% and 6.96% of cases of P. ovale spp. infection were misdiagnosed as P. vivax and P. falciparum infections, respectively. Conclusion The present results indicate that the potential of P. ovale spp. to co-infect with other Plasmodium species has been previously underestimated, as is the incidence of P. ovale spp. in countries where malaria is endemic. P. o. curtisi may have a long latency period of > 3 years and potentially cause residual foci, thus posing challenges to the elimination of malaria in P. ovale spp.-endemic areas. Considering the low rate of species identification, more sensitive point-of-care detection methods need to be developed for P. ovale spp. and introduced in non-endemic areas.

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Drugs Associated With the Development of Palmoplantar Keratoderma: A Systematic Review

Journal of Cutaneous Medicine and Surgery ◽

10.1177/12034754211004560 ◽

2021 ◽

pp. 120347542110045

Author(s):

Sara Mirali ◽

Abrahim Abduelmula ◽

Asfandyar Mufti ◽

Muskaan Sachdeva ◽

Jensen Yeung

Keyword(s):

Systematic Review ◽

Tyrosine Kinase ◽

Tyrosine Kinase Inhibitors ◽

Complete Resolution ◽

Kinase Inhibitors ◽

Healthcare Providers ◽

Latency Period ◽

Braf Inhibitors ◽

Palmoplantar Keratoderma ◽

Drug Induced

Background Palmoplantar keratoderma (PPK) are a heterogenous group of hereditary and acquired disorders that are characterized by excessive epidermal thickening of the palms and/or soles. PPK has been described as a rare adverse event for some medications. The aim of this systematic review was to summarize outcomes in PPK associated with various medications. This data will assist dermatologists and other healthcare providers treating patients with drug-induced PPK. Methods EMBASE and MEDLINE databases were searched in accordance with PRISMA guidelines using the keyword “palmoplantar keratoderma.” 40 studies met the inclusion criteria. Results A total of 247 patients (mean age: 57.0 years) were included in the analysis. Among patients whose sex was reported, 60.3% ( n = 35/58) were male. PPK most frequently developed after treatment with BRAF inhibitors (73.7%, n = 182/247), BRAF inhibitors combined with MEK1/2 inhibitors (15.4%, n = 38/247), tyrosine kinase inhibitors (TKIs) (3.2%, n = 8/247), or chemotherapy (2.4%, n = 6/247). The mean latency period between initiation of the drug and onset of PPK was 7.6 months (range: 0.25-90 months). Improvement of PPK was reported in 24 cases, with 50% ( n = 12/24) achieving complete resolution and 50% ( n = 12/24) achieving partial resolution. All patients who achieved complete resolution stopped the suspected drug, with a mean resolution period of 2.4 months (range: 2 weeks-6 months). The most common treatments for PPK were keratolytic treatments ( n = 10) and topical corticosteroids ( n = 4). Conclusions PPK was most frequently associated with targeted kinase inhibitors, specifically BRAF, MEK1/2, and tyrosine kinase inhibitors.

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