bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bats are a potential reservoir of pathogenic Leptospira species in Colombia
Authors: Mateus Jose , Gómez Natalia , Herrera-Sepúlveda María Teresa , Hidalgo Marylin , Pérez-Torres Jairo , Cuervo Claudia 
Published: May 2019

Introduction: Bats have become an epidemiologically significant source of pathogenic microorganisms, such as leptospires, the causative agents of leptospirosis. However, little information exists about bats and their potential role as a reservoir of pathogenic Leptospira spp. in Colombia. The aim of this study was to evaluate the presence of pathogenic Leptospira spp. in the kidneys of bats from the Caribbean region of Colombia deposited in the collection of mammals of the Museo Javeriano de Historia Natural (MPUJ-MAMM).
Methodology: DNA was extracted from twenty-six kidney samples from a total of 13 species of bats captured in Colombia. First, 16S ribosomal RNA conventional PCR was performed to detect the presence of Leptospira spp. Then, in samples that tested positive, LipL32 PCR was performed to detect pathogenic Leptospira spp. by sequencing and phylogenetic analysis.
Results: The presence of Leptospira spp. was observed in 7/26 (26.9%) bats from the following 6 species: Carollia perspicillata, Glossophaga soricina, Dermanura phaeotis, Uroderma bilobatum, Desmodus rotundus, and Lophostoma silvicolum, and pathogenic Leptospira spp. were detected in 4/26 samples (15.4%).
Conclusions: This study suggests that bats present in the Caribbean region of Colombia could be potential reservoirs of pathogenic Leptospira spp.
Epidemiology and economic losses of rotavirus infection associated with hospitalization of Armenian children
Authors: Hovhannisyan Alvard , Mkhoyan Anna , Gyulazyan Naira , Asoyan Vigen , Navoyan Tsoghik , Gevorgyan Zaruhi , Simonyan Marta 
Published: May 2019

Introduction: Rotavirus (RV) is the leading cause of severe diarrhea-associated morbidity and mortality among children worldwide. Limited data exist on the epidemiology and burden of rotavirus gastroenteritis in Armenia. The purpose of this study is to estimate the economic losses and describe the epidemiological characteristics of rotavirus infections in hospitalized children in Armenia.
Methodology: A retrospective chart review was performed of all children (aged < 5 years) with Rotavirus infection admitted to the “Nork” Republican Infection Clinical Hospital in Yerevan, the capital of Armenia, between January and July 2014. Criteria of inclusion were age under 5 years old and presence of RV antigen in stool by enzyme linked immunosorbent assay.
Results: The total number of patients was 126; average age was 28.7 ± 13.3 months; 54.8% were male. The highest number of cases (31.8%) was observed in April. Most of the patients (71.4%) were hospitalized in the first three days, demonstrating an acute onset of the disease. In total 19% of the patients had received RV vaccine and, despite this, were infected with RV. Based on bacteriological examination of stool, 18.3% of patients had RV infection combined with pathogenic or conditional pathogenic microflora. All patients spent 817 days in total in the hospital. Economic losses associated with hospitalization were 16340000 AMD (≈ 33346 USD).
Conclusion: Rotavirus carries significant morbidity and economic losses. Comprehensive estimates of the disease characteristics and introduction of a national immunization program against RV initiated in 2012 may decrease this burden. Further studies to evaluate the feasibility and cost-effectiveness of such a program are warranted.
Enterobacterial infection in Saudi Arabia: First record of Klebsiella pneumoniae with triple carbapenemase genes resistance
Authors: Khan Mubashir Ahmad , Mohamed Amr M , Faiz Aftab , Ahmad Jawwad 
Published: May 2019

Introduction: Carbapenemase producing Enterobacteriaceae are emerging as important pathogens worldwide with serious effects on patients’ outcome. The study aimed to investigate the emergence of carbapenemases associated with enterobacterial infection in Western region of Saudi Arabia.
Methodology: Clinical isolates from suspected patients with enterobacterial infection were investigated over a one-year period from four tertiary care hospitals of Makkah, Saudi Arabia. All isolates were identified using Vitek-2 system and then screened for potential carbapenemase production using disk diffusion test. Suspected isolates with reduced susceptibility to carbapenems were further investigated for blaNDM-1, blaKPC and blaOXA-48 resistant genes.
Results: Out of 120 confirmed Enterobacteriaceae isolates, Klebsiella pneumoniae and Escherichia coli comprised the largest proportion (35% and 34.2%, respectively) of encountered infections. Twenty-six (21.7%) isolates showed resistance to carbapenems, the majority of which (21/26) were K. pneumoniae. Remarkably, 17 isolates carried triple resistant genes KPC/NDM-1/OXA-48 while the other 4 carried double resistant genes (KPC/OXA-48) or (NDM-1/OXA-48). The current study revealed that the mentioned triple resistance genes have the higher incidence with significant association risk among males (COR 4.5; CI: 1.9-17.3; P = 0.018), non-Saudi nationalities (COR 4.9; CI: 1.5-19.3; P = 0.003), ICU-obtained specimens (COR 3.6; CI: 1.5-8.4; P = 0.002) and blood specimens (COR 2.8; CI: 1.1-6.9; P = 0.02).
Conclusion: Multidrug-resistant Enterobacteriaceae isolates in particular K. pneumoniae co-harboring KPC, NDM-1 and OXA-48 genes are emerging in Western region, Saudi Arabia. This is the first record of triple carbapenemase genes co-producing K. pneumoniae associated with enterobacterial infection.
Norovirus outbreak among students of a boarding school in Kluang, Johor, Malaysia
Authors: Subahir Mohamad Nizam , Jeffree Mohammad Saffree , Hassan Mohd Rohaizat , Razak Md Faizul Abd , Mohamad Syarifah Noor Ghulam , Fong Siat Yee , Ahmed Kamruddin 
Published: May 2019

Introduction: Norovirus (NoV) is a contagious virus causing acute gastroenteritis and is mainly responsible for diarrheal outbreak in closed settings. The aims of this study were to describe the epidemiological characteristic of an outbreak in a boarding school, to assess the extent of the outbreak and to implement appropriate control measures.
Methodology: A descriptive study was conducted to describe the epidemiological characteristics of the outbreak. Data on demographic details, onset of abdominal symptoms, food intake history and contact with ill person three days prior to illness were obtained.
Results: Twelve fresh stool and 14 food samples were tested for NoV and enteric pathogens, respectively. Out of 745 students, 42 (5.6%) were infected during this outbreak. Predominant clinical features were diarrhea (76.1%), vomiting (71.4%) and abdominal pain (67%). Eight (67%) stool samples and six (43.9%)food samples were positive for NoV and total coliforms, respectively. The dissemination of the disease was due to poor hygiene practices among students. Quarantine was imposed until the last case on September 28, 2016. The outbreak was declared over on September 30, 2016.
Conclusions: A NoV outbreak was determined first time in Malaysia. Environmental assessment showed poor hygienic conditions in the school’s kitchen. The number of infected students increased considerably despite the implementation of preventive and control measures. Quarantine was effective to stop the outbreak which is characteristics of NoV outbreak.
Enterobacteria in the 21st century: a review focused on taxonomic changes
Authors: Morales-López Soraya , Yepes Jayr A , Prada-Herrera Juan C , Torres-Jiménez Augusto 
Published: May 2019

Introduction: Enterobacteria are the main group causing infections in humans. The aim of this review is to present the new genera and the taxonomic changes that the Enterobacteriacea family has experienced in recent years.
Methodology: a systematic search of papers published in databases from January 2000 to July 2018 was done. Additionally, the bibliographic references of each document were reviewed and each paper citing the article was reviewed in search of clinical cases.
Results: Nineteen new genera of Enterobacteria have been described since 2000. The genera Yersinia, Morganella and Erwinia do not belong to the family Enterobacteriacea anymore.
Conclusions: for an adequate clinical and epidemiological interpretation, it is advisable to update the libraries of the commercial systems used for the identification of the microorganisms, as well as to train the staff in the taxonomic changes of microorganisms.
Avaliação higiênico-sanitária dos estabelecimentos com o selo "açaí bom" da vigilância sanitária
Authors: Silva Fernanda Silva , Macedo Silva Alana França , Sousa Consuelo Lúcia , Souza Jesus Nazareno 
Published: May 2019

O presente trabalho teve como objetivo avaliar as condições higiênico-sanitárias de estabelecimentos que processam e comercializam a bebida de açaí e que possuem o selo de qualidade “Açaí Bom” do Departamento de Vigilância Sanitária da cidade de Belém/PA. Foram avaliados, 37 dos 163 estabelecimentos processadores de açaí com selo de qualidade. Para avaliação das BPF, foi elaborado um checklist, composto por 121 requisitos de verificação agrupados em 5 itens por assunto. Após a aplicação do checklist os estabelecimentos foram classificados em grupos em função da conformidade dos itens. Assim o Grupo 1 - BOM (76 a 100% de atendimento dos itens), Grupo 2 - REGULAR (51 a 75% de atendimento dos itens) e Grupo 3 - RUIM (0 a 50% de atendimento dos itens). De acordo com o percentual de conformidades geral dos estabelecimentos inspecionados, verificou-se que 62 % foram classificados no grupo 2 (REGULAR), por terem atendido de 51 a 75 % dos itens preconizados no checklist, e 38 % no grupo 3 (RUIM) por terem apresentado percentual de conformidade abaixo de 50 % . Embora a vigilância sanitária através da Casa do Açaí realize o monitoramento dos estabelecimentos com vistorias frequentes, coleta da bebida para análises e o treinamento dos manipuladores faz-se necessário uma maior conscientização dos mesmos em relação à importância da correta manipulação e processamento do fruto evitando assim potenciais riscos a saúde do consumidor, bem como a conscientização dos consumidores para assumirem uma conduta mais exigente em relação aos estabelecimentos em que adquirem a bebida.
Neutrophil Extracellular Traps May Contribute to the Pathogenesis in Adult-onset Still Disease
Authors: Ahn Mi-Hyun , Han Jae Ho , Chwae Young-Jun , Jung Ju-Yang , Suh Chang-Hee , Kwon Ji Eun , Kim Hyoun-Ah 
Published: May 2019

Objective.Release of neutrophil extracellular traps (NET) has been described as an effector mechanism of polymorphonuclear neutrophils in several inflammatory diseases. Thus, this study was performed to evaluate the role of NET in the pathogenesis of adult-onset Still disease (AOSD).Methods.We determined the serum levels of NET molecules and investigated their associations with clinical disease activities in patients with AOSD. Further, we analyzed the differences in the NETosis response in AOSD patients compared to healthy controls (HC). To explore the in vivo involvement of NET in AOSD, we performed immunohistochemical analysis of skin and lymph node (LN) biopsies for proteins related to NET in patients with active AOSD.Results.Serum levels of cell-free DNA, myeloperoxidase (MPO)-DNA complex, and α-defensin were significantly increased in patients with AOSD compared to HC. Serum levels of the NET molecules, cell-free DNA, MPO-DNA, and α-defensin were correlated with several disease activity markers for AOSD. In followup of patients with AOSD after treatment with corticosteroid, the levels of cell-free DNA and α-defensin decreased significantly. On immunohistochemistry, neutrophil elastase–positive and MPO-positive inflammatory cells were detected in skin and LN of patients with AOSD, and were expressed in fiber form in the lesions. The serum from patients with active AOSD induced NETosis in neutrophils from HC. NET molecules induced interleukin 1β production in monocytes, representing a novel mechanism in the pathogenesis of AOSD.Conclusion.The findings presented here suggest that NET may contribute to the inflammatory response and pathogenesis in AOSD.
Effect of Osteoarthritis on Work Participation and Loss of Working Life–years
Authors: Kontio Tea , Viikari-Juntura Eira , Solovieva Svetlana 
Published: May 2019

Objective.To examine to what extent disabling osteoarthritis (OA), leading to a prolonged sickness absence (SA), interferes with work participation and shortens working life–years.Methods.A total of 4704 wage earners aged 30 to 59 years, whose SA due to OA started in 2006, were followed until October 31, 2014. Kaplan–Meier analysis was used to plot sustained (at least 28 consecutive days) return-to-work curves. The associations of potential determinants with early exit from paid employment were examined applying Cox proportional hazards regression analysis. Years expected to be spent in different work participation statuses until statutory retirement age were estimated based on daily work participation statuses using adapted Sullivan method.Results.Persons with knee OA showed the fastest, and persons with hip OA the slowest, sustained return to work. Although most participants typically were at work during the first year of followup, a considerable proportion was permanently retired. Male sex, older age, low education, long initial SA, and having not returned to work sustainably, as well as receiving vocational rehabilitation, predicted early exit from paid employment during the followup. Overall, only 45–53% of potential working life–years were estimated to be spent at work, being highest for the oldest age group.Conclusion.Our study showed a considerable effect of OA on work participation and working life duration. Clinicians should avoid prescription of long SA or temporary work disability due to OA without a clear treatment or return-to-work plan.
Association of 17 Definitions of Remission with Functional Status in a Large Clinical Practice Cohort of Patients with Rheumatoid Arthritis
Authors: Carvalho Pedro D. , Ferreira Ricardo J.O. , Landewé Robert , Vega-Morales David , Salomon-Escoto Karen , Veale Douglas J. , Chopra Arvind , da Silva José A.P. , Machado Pedro M. 
Published: May 2019

Objective.To compare the association between different remission criteria and physical function in patients with rheumatoid arthritis followed in clinical practice.Methods.Longitudinal data from the METEOR database were used. Seventeen definitions of remission were tested: American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Boolean-based; Simplified/Clinical Disease Activity Index (SDAI/CDAI); and 14 Disease Activity Score (DAS)-based definitions. Health Assessment Questionnaire (HAQ) ≤ 0.5 was defined as good functional status. Associations were investigated using generalized estimating equations. Potential confounders were tested and sensitivity analyses performed.Results.Data from 32,915 patients (157,899 visits) were available. The most stringent definition of remission was the ACR/EULAR Boolean-based definition (1.9%). The proportion of patients with HAQ ≤ 0.5 was higher for the most stringent definitions, although it never reached 100%. However, this also meant that, for the most stringent criteria, many patients in nonremission had HAQ ≤ 0.5. All remission definitions were associated with better function, with the strongest degree of association observed for the SDAI (adjusted OR 3.36, 95% CI 3.01–3.74).Conclusion.The 17 definitions of remission confirmed their validity against physical function in a large international clinical practice setting. Achievement of remission according to any of the indices may be more important than the use of a specific index. A multidimensional approach, targeted at wider goals than disease control, is necessary to help all patients achieve the best possible functional status.
Diffuse Idiopathic Skeletal Hyperostosis in Smokers and Restrictive Spirometry Pattern: An Analysis of the COPDGene Cohort
Authors: Oudkerk Sytse F. , Mohamed Hoesein Firdaus A.A. , Öner F. Cumhur , Verlaan Jorrit-Jan , de Jong Pim A. , Kuperus Jonneke S. , Cho Michael , McDonald Merry-Lynn , Lynch David A. , Silverman Edwin K. , Crapo James D. , Make Barry J. , Lowe Katherine E. , Regan Elizabeth A. 
Published: May 2019

Objective.Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by bony proliferation at sites of tendinous and ligamentous insertions in the spine. Spinal mobility is reduced in DISH and may affect movement in the thorax, potentially leading to restrictive pulmonary function. This study investigated whether DISH is associated with restrictive spirometric pattern (RSP) in former and current smokers.Methods.Participants (n = 1784) with complete postbronchodilator spirometry who did not meet spirometric criteria for chronic obstructive pulmonary disease (COPD) at time of enrollment in the COPDGene study were included in this study. Subjects were classified as RSP if they had forced expiratory volume in 1 s(FEV1) to forced vital capacity (FVC) ratio > 0.7 with an FVC < 80%. Computed tomography (CT) scans were scored for the presence of DISH in accordance with the Resnick criteria. Chest CT measures of interstitial and alveolar lung disease, clinical symptoms, health surveys, and 6-min walking distance were recorded. Uni- and multivariable analyses were performed to test the association of DISH with RSP.Results.DISH was present in 236 subjects (13.2%). RSP was twice as common in participants with DISH (n = 90/236, 38.1%) compared to those without DISH (n = 301/1548, 19.4%; p < 0.001). In multivariable analysis, DISH was significantly associated with RSP (OR 1.78; 95% CI 1.22–2.60; p = 0.003) after adjusting for potential confounders. The RSP group with and without DISH had significantly worse spirometry, dyspnea, St. George’s Respiratory Questionnaire score, BODE index (Body mass index, airflow Obstruction, Dyspnea and Exercise capacity), and Medical Outcomes Study Short Form-36 questionnaire score.Conclusion.In heavy smokers with an FEV1/FVC ratio > 0.70, DISH is associated with RSP after adjustment for intrinsic and extrinsic causes of restrictive lung function. (Clinical trial registration number: NCT00608764.)
A Monogenic Disease with a Variety of Phenotypes: Deficiency of Adenosine Deaminase 2
Authors: Özen Seza , Batu Ezgi Deniz , Taşkıran Ekim Z. , Özkara Hatice Asuman , Ünal Şule , Güleray Naz , Erden Abdulsamet , Karadağ Ömer , Gümrük Fatma , Çetin Mualla , Sönmez Hafize Emine , Bilginer Yelda , Ayvaz Deniz Çağdaş , Tezcan Ilhan 
Published: May 2019

Objective.Deficiency of adenosine deaminase 2 (DADA2) is an autosomal recessive autoinflammatory disorder associated with ADA2 mutations. We aimed to investigate the characteristics and ADA2 enzyme activities of patients with DADA2 compared to non-DADA2 patients.Methods.This is a descriptive study of 24 patients with DADA2 who were admitted to the Adult and Pediatric Rheumatology, Pediatric Haematology, and Pediatric Immunology Departments of Hacettepe University. All ADA2 exons were screened by Sanger sequencing. Serum ADA2 enzyme activity was measured by modified spectrophotometric method.Results.Twenty-four patients with DADA2 were included: 14 with polyarteritis nodosa (PAN)-like phenotype (Group 1); 9 with Diamond-Blackfan anemia (DBA)-like features, and 1 with immunodeficiency (Group 2). Fourteen PAN-like DADA2 patients did not have the typical thrombocytosis seen in classic PAN. Inflammatory attacks were evident only in Group 1 patients. Serum ADA2 activity was low in all patients with DADA2 except one, who was tested after hematopoietic stem cell transplantation. There was no significant difference in ADA2 activities between PAN-like and DBA-like patients. In DADA2 patients with one ADA2 mutation, serum ADA2 activities were as low as those of patients with homozygote DADA2. ADA2 activities were normal in non-DADA2 patients. ADA2 mutations were affecting the dimerization domain in Group 1 patients and the catalytic domain in Group 2 patients.Conclusion.We suggest assessing ADA2 activity along with genetic analysis because there are patients with one ADA2 mutation and absent enzyme activity. Our data suggest a possible genotype–phenotype correlation in which dimerization domain mutations are associated with PAN-like phenotype, and catalytic domain mutations are associated with hematological manifestations.
Identifying Possible Outcome Domains from Existing Outcome Measures to Inform an OMERACT Core Domain Set for Safety in Rheumatology Trials
Authors: Klokker Louise , Berthelsen Dorthe B. , Woodworth Thasia , Andersen Kathleen M. , Furst Daniel E. , Devoe Dan , Williamson Paula R. , Suarez-Almazor Maria E. , Strand Vibeke , Leong Amye L. , Goel Niti , Boers Maarten , Brooks Peter M. , March Lyn , Sloan Victor S. , Tugwell Peter , Simon Lee S. , Christensen Robin 
Published: May 2019

Objective.The Outcome Measures in Rheumatology (OMERACT) Safety Working Group objective was to identify harm domains from existing outcome measurements in rheumatology.Methods.Systematically searching the MEDLINE database on January 24, 2017, we identified full-text articles that could be used for harm outcomes in rheumatology. Domains/items from the identified instruments were described and the content synthesized to provide a preliminary framework for harm outcomes.Results.From 435 possible references, 24 were read in full text and 9 were included: 7 measurement instruments were identified. Investigation of domains/items revealed considerable heterogeneity in the grouping and approach.Conclusion.The ideal way to assess harm aspects from the patients’ perspective has not yet been ascertained.
L’évolution démographique récente de la France. Naissances, décès, unions et migrations : à chacun sa saison
Authors: Breton Didier , Barbieri Magali , d’Albis Hippolyte , Mazuy Magali 
Published: May 2019

Au premier janvier 2018, la France comptait près de 66,9 millions d’habitants, soit 122 300 personnes de plus que l’année précédente, mais l’accroissement annuel moyen, et tout particulièrement l’accroissement naturel, n’ont jamais été aussi faibles depuis 20 ans, voire 40 ans. L’indice conjoncturel de fécondité poursuit sa baisse, observée notamment chez les femmes les plus jeunes. Le nombre de titres de séjour délivrés augmente en 2016 (près de 220 000). La nuptialité continue de diminuer, tant pour les couples hétérosexuels que pour les couples de même sexe. En 2017, la mortalité recule de nouveau, mais le nombre de décès dépasse 600 000, chiffre lié au vieillissement de la population. Les causes de mortalité dont les évolutions sont les plus préoccupantes sont le cancer chez les femmes, les maladies par troubles mentaux et les maladies du système nerveux. Les événements démographiques ne se répartissent pas uniformément au fil de l’année : les mariages et mises en union libre sont plus souvent observés au printemps et en été, les naissances en été et à l’automne, tout comme les entrées sur le territoire ; alors que l’hiver et la fin de l’année marquent une recrudescence d’enregistrements de pacs et des pics de mortalité.