Autochthonous Human and Canine Strongyloides stercoralis Infection in Europe: Report of a Human Case in An Italian Teen and Systematic Review of the Literature

Autochthonous human and canine strongyloidiasis is reported in Europe but is unclear whether the transmission of infection still occurs. We report a previously unpublished human case in an Italian teen and perform a systematic review of literature on autochthonous human and canine strongyloidiasis in Europe to investigate the current dynamic of transmission. Overall, 109 papers published after 1987 were included and one previously unpublished Italian case was added. Eighty case reports were retrieved and 42 of them (52.5%) had severe strongyloidiasis. Most cases were diagnosed in Spain, Italy and France. The median age was 58, the most represented age group was 61–70 years, 11 patients were under 30, and 7 of them were diagnosed after 2000. Epidemiological studies on human strongyloidiasis showed prevalence ranging from 0.56% to 28%. Overall, agriculture work, mine work and walking barefoot were the most commonly reported risk factors for infection. Canine strongyloidiasis was reported mainly in Italy (68 cases), but a few cases occurred also in Iceland, Finland, England, Germany, France, Switzerland, Russia, Slovakia, Romania and Greece. Autochthonous strongyloidiasis is still reported in Europe and sporadic transmission still occurs. Health care professionals should be aware of this issue to identify infected subjects and avoid adverse outcomes, especially in immunosuppressed patients. Further investigations are needed to clarify the zoonotic transmission of this nematode.

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Risk Factors, and Clinical and Etiological Characteristics of Ischemic Strokes in COVID-19-Infected Patients: A Systematic Review of Literature

Cerebrovascular Diseases ◽

10.1159/000514267 ◽

2021 ◽

pp. 1-4

Author(s):

Simone Vidale

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Clinical Features ◽

Case Reports ◽

Clinical Severity ◽

Large Artery ◽

Causal Association ◽

Review Of Literature ◽

Increased Risk ◽

Long Time

Background and Purpose: Coronavirus disease 2019 (COVID-19) infection is an ongoing pandemic and worldwide health emergency that has caused important changes in healthcare systems. Previous studies reported an increased risk of thromboembolic events, including stroke. This systematic review aims to describe the clinical features and etiological characteristics of ischemic stroke patients with COVID-19 infection. Method: A literature search was performed in principal databases for studies and case reports containing data concerning risk factors, clinical features, and etiological characteristics of patients infected with COVID-19 and suffering from stroke. Descriptive and analytical statistics were applied. Results: Overall, 14 articles were included for a total of 93 patients. Median age was 65 (IQR: 55–75) years with prevalence in males. Stroke occurred after a median of 6 days from COVID-19 infection diagnosis. Median National of Institute of Health Stroke Scale (NIHSS) score was 19. Cryptogenic (Cry) strokes were more frequent (51.8%), followed by cardioembolic etiology, and they occurred a long time after COVID-19 diagnosis compared with large-artery atherosclerosis strokes (ptrend: 0.03). The clinical severity of stroke was significantly associated with the severity grade of COVID-19 infection (ptrend: 0.03). Conclusions: Ischemic strokes in COVID-19-infected patients were clinically severe, affecting younger patients mainly with Cry and cardioembolic etiologies. Further multicenter prospective registries are needed to better describe the causal association and the effect of COVID-19 infection on stroke.

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A systematic review of historical and current trends in Chagas disease

Therapeutic Advances in Infectious Disease ◽

10.1177/20499361211033715 ◽

2021 ◽

Vol 8 ◽

pp. 204993612110337

Author(s):

Diego-Abelardo Álvarez-Hernández ◽

Rodolfo García-Rodríguez-Arana ◽

Alejandro Ortiz-Hernández ◽

Mariana Álvarez-Sánchez ◽

Meng Wu ◽

...

Keyword(s):

Systematic Review ◽

Chagas Disease ◽

Case Reports ◽

Clinical Manifestations ◽

Human Case ◽

Acute Stage ◽

Diagnostic Tools ◽

Chronic Stage ◽

Pubmed Database ◽

Trypanocidal Drugs

Introduction: Chagas disease (CD) is caused by Trypanosoma cruzi. When acquired, the disease develops in stages. For diagnosis, laboratory confirmation is required, and an extensive assessment of the patient’s health should be performed. Treatment consists of the administration of trypanocidal drugs, which may cause severe adverse effects. The objective of our systematic review was to analyze data contained in the CD published case reports to understand the challenges that patients and clinicians face worldwide. Materials and methods: We performed a systematic review following the PRISMA guidance. PubMed database was explored using the terms ‘American trypanosomiasis’ or ‘Chagas disease’. Results were limited to human case reports written in English or Spanish. A total of 258 reports (322 patients) were included in the analysis. Metadata was obtained from each article. Following this, it was analyzed to obtain descriptive measures. Results: From the sample, 56.2% were males and 43.8% were females. Most cases were from endemic countries (85.4%). The most common clinical manifestations were fever during the acute stage (70.0%), dyspnea during the chronic stage in its cardiac form (53.7%), and constipation during the chronic stage in its digestive form (73.7%). Most patients were diagnosed in the chronic stage (72.0%). Treatment was administered in 56.2% of cases. The mortality rate for the acute stage cases was 24.4%, while for the chronic stage this was 28.4%. Discussion: CD is a parasitic disease endemic to Latin America, with increasing importance due to human and vector migration. In this review, we report reasons for delays in diagnosis and treatment, and trends in medical practices. Community awareness must be increased to improve CD’s diagnoses; health professionals should be appropriately trained to detect and treat infected individuals. Furthermore, public health policies are needed to increase the availability of screening and diagnostic tools, trypanocidal drugs, and, eventually, vaccines.

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Metabolomics for predicting fetal growth restriction: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-022743 ◽

2018 ◽

Vol 8 (12) ◽

pp. e022743 ◽

Cited By ~ 4

Author(s):

Debora Farias Batista Leite ◽

Aude-Claire Morillon ◽

Elias F Melo Júnior ◽

Renato T Souza ◽

Ali S Khashan ◽

...

Keyword(s):

Systematic Review ◽

Diagnostic Accuracy ◽

Fetal Growth ◽

Gestational Age ◽

Fetal Growth Restriction ◽

Case Reports ◽

Meta Analysis ◽

Adverse Outcomes ◽

Growth Restriction ◽

Sample Collection

IntroductionFetal growth restriction (FGR) is a relevant research and clinical concern since it is related to higher risks of adverse outcomes at any period of life. Current predictive tools in pregnancy (clinical factors, ultrasound scan, placenta-related biomarkers) fail to identify the true growth-restricted fetus. However, technologies based on metabolomics have generated interesting findings and seem promising. In this systematic review, we will address diagnostic accuracy of metabolomics analyses in predicting FGR.Methods and analysisOur primary outcome is small for gestational age infant, as a surrogate for FGR, defined as birth weight below the 10th centile by customised or population-based curves for gestational age. A detailed systematic literature search will be carried in electronic databases and conference abstracts, using the keywords ‘fetal growth retardation’, ‘metabolomics’, ‘pregnancy’ and ‘screening’ (and their variations). We will include original peer-reviewed articles published from 1998 to 2018, involving pregnancies of fetuses without congenital malformations; sample collection must have been performed before clinical recognition of growth impairment. If additional information is required, authors will be contacted. Reviews, case reports, cross-sectional studies, non-human research and commentaries papers will be excluded. Sample characteristics and the diagnostic accuracy data will be retrieved and analysed. If data allows, we will perform a meta-analysis.Ethics and disseminationAs this is a systematic review, no ethical approval is necessary. This protocol will be publicised in our institutional websites and results will be submitted for publication in a peer-reviewed journal.PROSPERO registration numberCRD42018089985.

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Chlorambucil-Induced Acute Interstitial Pneumonitis

Case Reports in Hematology ◽

10.1155/2014/575417 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5

Author(s):

Hammad Shafqat ◽

Adam J. Olszewski

Keyword(s):

Systematic Review ◽

Interstitial Pneumonitis ◽

Pulmonary Toxicity ◽

Alkylating Agent ◽

Randomized Trials ◽

Case Reports ◽

Lymphocytic Leukemia ◽

Mechanism Of Injury ◽

Review Of Literature ◽

Drug Induced

Chlorambucil is an alkylating agent commonly used in treatment of chronic lymphocytic leukemia (CLL). We report a case of interstitial pneumonitis developing in an 83-year-old man 1.5 months after completing a six-month course of chlorambucil for CLL. The interstitial pneumonitis responded to therapy with prednisone. We performed a systematic review of literature and identified 13 other case reports of chlorambucil-induced pulmonary toxicity, particularly interstitial pneumonitis. No unifying risk factor could be discerned and the mechanism of injury remains unknown. In contrast, major randomized trials of chlorambucil therapy in CLL have not reported interstitial pneumonitis as an adverse effect, which may be due to the rarity of the phenomenon or due to underreporting of events occurring after completion of treatment. Clinicians should consider drug-induced interstitial pneumonitis in the differential diagnosis of a suggestive syndrome developing even after discontinuation of chlorambucil.

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A systematic review of the use of magnetic resonance imaging in non-conditional pacemakers and implantable defibrillators

European Heart Journal ◽

10.1093/eurheartj/ehab724.0229 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

R Murphy ◽

R K Kerley ◽

P K Kearney

Keyword(s):

Magnetic Resonance Imaging ◽

Systematic Review ◽

Magnetic Resonance ◽

Case Reports ◽

Case Series ◽

Adverse Outcomes ◽

Resonance Imaging ◽

Cardiac Implantable Electronic Devices ◽

Relative Safety ◽

Mri Conditional

Abstract Background Cardiac implantable electronic devices (CIEDs) were long considered a contraindication for magnetic resonance imaging (MRI). Modern devices are now MRI conditional, but still the majority of CIEDs in the population are legacy devices and are classified as unsafe for MRI. There is growing consensus that MRI is also safe in these patients. Purpose The purpose of this study was to perform an up to date systematic review of the evidence evaluating the use of MRI in patients with non-conditional CIEDs. Methods Searches of the PubMed, CINAHL and Embase databases were performed. Studies that assessed the rate of adverse outcomes after MRI in patients with non-conditional CIEDs were included. Studies were excluded if they did not disclose the conditionality of patients CIEDs. Case reports or case series were not included. Results 36 cohort studies were identified. No patient in these studies died during or immediately after MRI. Symptom associated with either torque or heating occurred in <1% of patients. Electrical resets occurred 1–2% of patients. There were no cases of non-conditional lead or generator failure. Inappropriate pacing occurred in <1% of patients. No ICD shocks occurred during MRI. Changes in CIED parameters occurred in 1–4% of patients. Conclusions This systematic review highlights the relative safety of the use of MRI in patients with non-conditional CIEDs. Demonstrated be the fact that no deaths or device shocks have been suffered as a consequence of MRI in any of these studies, and the extremely low incidence of device or lead related complications. Still strict selection and monitoring protocol should be used when imaging these patients. FUNDunding Acknowledgement Type of funding sources: None.

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Zika Virus and the Risk of Developing Microcephaly in Infants: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17113806 ◽

2020 ◽

Vol 17 (11) ◽

pp. 3806 ◽

Cited By ~ 1

Author(s):

Evangelia Antoniou ◽

Eirini Orovou ◽

Angeliki Sarella ◽

Maria Iliadou ◽

Nikolaos Rigas ◽

...

Keyword(s):

Systematic Review ◽

Zika Virus ◽

Case Reports ◽

Public Health Problem ◽

First Trimester ◽

Viral Disease ◽

Epidemiological Studies ◽

Major Public Health Problem ◽

Full Spectrum ◽

Adverse Pregnancy

The global epidemic of Zika virus has been a major public health problem affecting pregnant women and their infants. Zika virus causes a viral disease transmitted to humans mainly by the infected Aedes mosquito bite. The infection is not severe in most cases; however, there is evidence that infection during pregnancy may be associated with fetal genetic abnormalities (including microcephaly). In addition to microcephaly and other malformations, some specific lesions in the central nervous system have been reported. The aim of this systematic review was to determine the risk of developing microcephaly in infants whose mothers were infected with Zika virus in pregnancy. Epidemiological studies and case reports were incorporated in our review, finally including 15 articles from an initial pool of 355 related papers. Most studies have linked maternal infection during pregnancy to the development of neonatal microcephaly. The period considered most dangerous is the first trimester and the beginning or the whole of the second trimester. In order to understand the relationship between Zika virus and microcephaly in infants, a cohort study will be able to estimate the time from the onset of Zika infection and the full spectrum of adverse pregnancy outcomes.

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Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis

Patient Safety in Surgery ◽

10.1186/s13037-020-00262-6 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Semagn Mekonnen Abate ◽

Bahiru Mantefardo ◽

Bivash Basu

Keyword(s):

Systematic Review ◽

Case Reports ◽

Meta Analysis ◽

Postoperative Mortality ◽

Admission Rate ◽

Adverse Outcomes ◽

Surgical Safety ◽

Global Rate ◽

Language Restriction ◽

Critical Appraisal Tool

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic puts perioperative providers and staff at risk of viral exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) during aerosol-generating procedures, particularly in asymptomatic carriers.However, the perioperative risk for adverse outcomes in SARS-CoV-2 infected patients remain uncertain and the topic of debate. The current study was designed to determine the postoperative mortality in COVID-19 patients based on a systematic review and meta-analysis of the global published peer-reviewed literature. Methods A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 29, 2019, to August15, 2020, without language restriction. All observational studies reporting the prevalence of mortality were included while case reports and reviews were excluded. The data from each study were extracted with two independent authors with a customized format excel sheet and the disagreements were resolved by the third author. The methodological quality of included studies was evaluated using a standardized critical appraisal Tool adapted from the Joanna Briggs Institute. Results A total of 715 articles were identified from different databases and 45 articles were selected for evaluation after the successive screening. Twenty-three articles with 2947 participants were included. The meta-analysis revealed a very high global rate of postoperative mortality among COVID-19 patients of 20% (95% CI: 15 to 26) and a postoperative ICU admission rate of 15% (95% confidence interval (CI):10 to 21). Conclusion The unexpected high postoperative mortality rate in SARS-CoV-2 infected patients of 20% in the global literature mandates further scrutiny in assuring appropriate surgical indications and perioperative surgical safety measures in this vulnerable cohort of patients. Registration This systematic review and meta-analysis was registered in Prospero’s international prospective register of systematic reviews (CRD42020203362) on August 10, 2020.

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Prevalence of Postoperative Pain Following Hospital Discharge: Protocol for a Systematic Review

JMIR Research Protocols ◽

10.2196/22437 ◽

2020 ◽

Vol 9 (12) ◽

pp. e22437

Author(s):

Rex Park ◽

Mohammed Mohiuddin ◽

Ramiro Arellano ◽

Esther Pogatzki-Zahn ◽

Gregory Klar ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Postoperative Pain ◽

Hospital Discharge ◽

Epidemiological Studies ◽

Adverse Outcomes ◽

Chronic Postsurgical Pain ◽

Severe Postoperative Pain ◽

At Home

Background Pain is one of the most common, feared, and unpleasant symptoms associated with surgery. However, there is a clear gap in patient care after surgical patients are discharged from hospital, resulting in poorly controlled postoperative pain. Inadequate pain management after discharge can have detrimental effects on quality of life and lead to the development of chronic postsurgical pain. The severity of postoperative pain before discharge is well described, but less emphasis has been placed on assessing pain at home after hospital discharge. Objective The objective of this review is to summarize the prevalence of moderate-to-severe postoperative pain within the first 1 to 14 days after hospital discharge. Methods A detailed search of epidemiological studies investigating postoperative pain will be conducted on MEDLINE and EMBASE from their inception until the date the searches are run. The primary outcome will be the proportion of patients reporting moderate-to-severe postoperative pain at rest and with movement within the first 1 to 14 days after hospital discharge. The secondary outcomes will include a comparison of postoperative pain after discharge between patients who underwent ambulatory and inpatient surgery, and adverse outcomes attributable to poor pain control after hospital discharge (eg, readmission to hospital, emergency room or other unplanned medical visits, or a decrease in quality of life). Results The protocol has been registered in PROSPERO (registration number CRD42020194346). The search strategies for MEDLINE and EMBASE have been completed. The final results are expected to be published in May 2021. Conclusions This systematic review is expected to synthesize evidence describing the prevalence of postoperative pain after hospital discharge. Available epidemiological evidence may help inform the magnitude of the problem of postoperative pain at home after hospital discharge. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020194346; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=194346 International Registered Report Identifier (IRRID) PRR1-10.2196/22437

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Steroids and Varicella

PEDIATRICS ◽

10.1542/peds.92.2.288 ◽

1993 ◽

Vol 92 (2) ◽

pp. 288-289

Author(s):

NANCY A. REICHES ◽

JAMES F. JONES

Keyword(s):

Infectious Diseases ◽

Varicella Zoster Virus ◽

Low Dose ◽

Retrospective Studies ◽

Case Reports ◽

Fatal Outcome ◽

Adverse Outcomes ◽

High Dose ◽

Varicella Zoster ◽

Immunosuppressed Patients

Reasons for adverse outcomes of infectious diseases are always under scrutiny. We expect infectious illnesses to have a specific course and outcome. Outcomes outside of the expected range are unacceptable, although the natural course of each infection includes them. Adverse outcomes that are products of medical invention are of particular import because they imply changes inpractice. One such situation is corticosteroid-induced fatal or severe varicella-zoster virus (VZV) infections. This topic, although not new, has received considerable interest because of recent warnings by the Food and Drug Administration.1 Case reports, retrospective studies, and reviews that have appeared since the 1950s suggest that high-dose (<1 to 2 mg/kg per day) but not low-dose (5 to 20 mg/day) systemic use of corticosteroids in both immunocompetent and particularly in immunosuppressed patients may be associated with severe or fatal outcome, particularly if the drugs are given immediately prior to or during the incubation period.

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