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A systematic review and meta-analysis found resistance to cefiderocol was low overall but “alarmingly high” among certain types of carbapenem-resistant bacteria, Greek researchers reported late last week in Clinical Microbiology and Infection. Sold under the brand name Fetroja, cefiderocol is a cephalosporin antibiotic with a novel method of penetrating the tough outer membrane of gram-negative bacteria, including multidrug-resistant pathogens. Approved for the treatment of complicated urinary tract infections by the US Food and Drug Administration (FDA) in 2019 and for the treatment of nosocomial pneumonia in 2020, cefiderocol is considered a last-resort option for carbapenem-resistant bacterial infections. Higher resistance in certain carbapenem-resistant isolates With resistance to cefiderocol being increasingly reported, researchers from the University of Crete set out to estimate the global cefiderocol non-susceptibility (CFDC-NS) in clinical isolates of the gram-negative pathogens considered to be among the most serious antimicrobial resistance threats: Enterobacterales, Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia. The 78 studies they reviewed included 82,035 clinical isolates from Europe (50%), the Americas (33%), and the Western Pacific Region (17%). CFDC-NS was low overall but varied by species, with a rate of 8.8% for A baumannii, 3% for Enterobacterales, 1.4% for P aeruginosa, and 0.4% for S maltophilia. And while cefiderocol appeared to retain relatively good activity against carbapenem-resistant bacteria overall, CFDC-NS was much higher in carbapenem-resistant A baumannii (13.2%) and carbapenem-resistant Enterobacterales (12.4%) and significantly higher in New Delhi metallo-beta-lactamase (NDM)–producing A baumannii (44.7%), NDM–producing Enterobacterales, and cefatazidime/avibactam-resistant Enterobacterales (36.6%). Among other limitations, the study authors note that CFDC-NS varied by breakpoint definition, with the FDA, Clinical Laboratory Standards Institute (CLSI), and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) all having different susceptibility thresholds. “Antimicrobial stewardship, infection control and continued surveillance at the local level, as well as regular updating and reporting of global CFDC-NS estimates, are imperative for preventing or delaying emerging resistance against cefiderocol,” they wrote. “Harmonization of EUCAST and CLSI breakpoints would help such efforts.”
John Voltolino, Jr., of Toms River, was charged with aggravated arson, burglary, theft, and criminal mischief, in connection with the incidents that occurred on Monday, Sept. 4, according to Ocean County Prosecutor Bradley D. Billhimer. Officers from the Toms River Township Police Department responded to a residence on Sun Valley Road for a report of a burglary. The homeowner reported that his son broke into the residence and stole a laptop, the prosecutor said. Responding Officers observed a broken window in the bathroom on the first floor, as well as blood throughout the residence. Additionally, a strong odor of gasoline was detected, and an extinguished fire on the living room floor — adjacent to a gasoline container —was observed. Voltolino, Jr. was subsequently discovered in a wooded area behind the residence and placed under arrest for burglary and theft, Billhimer said. He was later charged with arson and criminal mischief after further investigation. Voltolino, Jr. was being held in the Ocean County Jail. Click here to follow Daily Voice Ocean and receive free news updates.
Share this Article You are free to share this article under the Attribution 4.0 International license. <!– Topic <!– –> Children living in racially segregated neighborhoods have higher levels of lead in their blood, a new study shows. The findings, published in the journal Pediatrics, underscore the negative health effects of policies stemming from systemic racism. The study is the latest from the University of Notre Dame’s Children’s Environmental Health Initiative (CEHI), which examines the adverse and disproportionate environmental burdens experienced by communities in racially segregated areas. The study shows that from 1990 to 2015 blood lead levels in children declined substantially—but levels in non-Hispanic Black children living in racially segregated neighborhoods remain higher than in children living outside those communities. “In the United States, one of the clearest examples of the link between racial residential segregation and environmental exposures is childhood lead exposure—which has been shown to be disproportionately burdensome to members of the Black community,” says Marie Lynn Miranda, director of CEHI and adjunct professor in the applied and computational mathematics and statistics department. “We found that in 1990 there was a strong relationship between communities that were very segregated and children who had more elevated blood lead levels,” Miranda says. “When we look at the data for 2015 we see, unfortunately, that relationship has persisted.” The Centers for Disease Control and Prevention has stated there is no amount of lead in the body that is considered safe—and that children are especially sensitive to lead exposure, which can cause damage to the brain and nervous system and result in learning, behavior, hearing, and speech problems. Today, the primary source of exposure is contact with deteriorating lead-based paints which were used in homes built prior to 1978, when lead in paint was banned. As the paint ages, it starts to “chalk,” creating dust that can be inhaled or ingested. Children may also ingest lead-containing paint chips, which, unfortunately, taste sweet. Lead pipes and fixtures can create exposure through drinking water, and lead has been found in certain candies, spices, and herbal remedies. For the study, the researchers analyzed spatial measures of neighborhood-level racial residential segregation—the geographic separation of one racial/ethnic group from others—along with blood lead levels recorded over a 25-year-period in more than 320,000 children under the age of 7 across all 100 counties in North Carolina. “Childhood lead exposure is a classic environmental justice problem,” Miranda says. “Children of color, in particular, non-Hispanic Black children, are exposed to more lead- and racially segregated communities not only have higher levels of lead exposure, but must contend with other adverse social and environmental exposures going on at the same time.” Blood lead testing data was made available by the Childhood Lead Poisoning Prevention Program of the North Carolina Department of Health and Human Services in Raleigh. Miranda says partnering with state and local health departments and community organizations is critical for using what we learn from scientific research to improve children’s lives. “If we can leverage the enormous amount of data that’s out there about where children live, what they’re exposed to, and how that exposure shapes their outcomes, we can determine what kinds of interventions are most needed and most likely to be successful.” The racial residential segregation measure, which CEHI developed, represents a weighted average proportion of the non-Hispanic Black population at the neighborhood level. By using a local, spatial measure of racial residential segregation rather than race itself, CEHI hopes to shift the conversation from using race, which is non-modifiable, as an explanatory variable—to using the experience of racial minorities as a root cause of health disparities. The data is free and available to the public at cehidatahub.org. Source: University of Notre Dame Original Study DOI: 10.1542/peds.2022-058661
COLUMBUS, Ohio – New research from The Ohio State University College of Medicine finds COVID-19 vaccine mandates are highly effective at reducing the spread of the virus and increasing immunity in a university setting. The study, published in the journal PLOS Pathogens, found net viral loads among all community members declined after university vaccine requirements went into effect. Masking, isolation and antibodies from getting sick weren’t enough to decrease infection rates. “Before the vaccine was required, the virus was becoming more concentrated in saliva and easier to spread to vulnerable populations like young children and older adults,” said Richard Robinson, PhD, principal investigator and associate professor in the Department of Microbial Infection and Immunity. “Once the requirements were in place, we saw on average a 100% decrease in virus in saliva and up to 12,000% increase in antibody levels to block its spread.” Researchers looked at data generated as part of The Ohio State University’s COVID monitoring program, which occurred from August 2020 to June 2022. As part of this program, saliva specimens were collected on a weekly basis from asymptomatic students, staff and faculty. More than 850,000 diagnostic COVID tests were performed. “The COVID monitoring program focused on asymptomatic adults for several reasons,” Robinson said. “Asymptomatic infections are more common in young adults, asymptomatic individuals would still spread the virus and the isolation of symptomatic individuals alone wasn’t enough to flatten the curve of COVID infections.” Six Ohio State campuses in Columbus, Newark, Mansfield, Lima, Marion and Wooster participated in the monitoring program. The data found COVID positivity in asymptomatic adults occurred in waves which mirrored the infection rates in the regions surrounding the university campuses and were driven by newly emerging variants such as Delta and Omicron. “At the time, there was growing concern that college students were creating new waves and peaks in infection when they would return to communities after distance learning and breaks in their education, but that wasn’t the case,” Robinson said. “The rates of infection were already increasing when classes resumed, even in rural areas.” Additionally, researchers explored the causes of breakthrough infections in vaccinated people. They compared the antibody responses of uninfected vaccinated people with those of infected vaccinated people. The study found breakthrough infections in vaccinated people were not due to an absence of antibodies but depend on antibody levels at the time of exposure, the neutralizing ability of the antibodies and the amount of virus to which the person is exposed. Future research will focus on the conditions that make people more resistant to COVID infection. Other researchers involved in this study were Marlena R. Merling, Amanda Williams, Najmus S. Mahfooz, Marisa Ruane-Foster, Jacob Smith, Jeff Jahnes, Leona W. Ayers, MD, Jose A. Bazan, DO, Alison Norris, MD, PhD, Abigail Norris Turner, PhD, Michael Oglesbee, DVM, PhD, Seth A. Faith, PhD, and Mikkel B. Quam. ### Media Contact: Serena Smith, Wexner Medical Center Media Relations, [email protected]
2000s nostalgia is about to get way more insane in 2024 now that 3 Inches Of Blood appears to be teasing a reunion. The band hasn’t issued any statement or footage of any kind, but they have returned to social media with a big ol’ blacked out photo of themselves with the year 2024 under it. So y’know – 2024 reunion makes sense to assume. Advertisement. Scroll to continue reading. It’s worth noting that 3 Inches Of Blood‘s classic 2004 album Advance And Vanquish turns 20 on September 28, 2024. The album features songs like “Deadly Sinners” and “Destroy The Orcs”, and will likely sell out very quickly if an anniversary tour is announced. Want More Metal? Subscribe To Our Daily Newsletter Enter your information below to get a daily update with all of our headlines and receive The Orchard Metal newsletter.
So much for Canada’s mass graves. Two years ago, ground-penetrating radar supposedly discovered mass burial sites near several so-called residential schools for indigenous children funded by the Canadian government and operated by churches (often Catholic ones) from the late 19th century to the late 20th century. The “discovery” prompted a good old-fashioned racial reckoning. You know, the kind necessitating arson and wanton destruction. In response to the radar findings, the government of Prime Minister Justin Trudeau condemned the apparent mass murder (of kids!). Dozens of Canadian churches, including many that served indigenous communities, were burned to the ground by enraged activists—acts Trudeau described as “understandable,” given the enormity of the racist crimes. The executive director of the British Columbia Civil Liberties Union, Harsha Walia, brayed for more, tweeting, “Burn it all down!” Advertisement Now, two years later, we learn that “a series of recent excavations at suspected sites has turned up no human remains,” as the New York Post reported over the weekend. The Pine Creek First Nation dug up fourteen sites near a residential school in Manitoba over the summer, and turned up zilch. As Spiked noted, this latest excavation is only the latest among several similar digs at former residential-school sites, including the Mohawk School in Brantford, the Shubenacadie Indian Residential School in Nova Scotia, the Charles Camsell Hospital in Edmonton, and the Kuper Island Residential School in British Columbia. All have turned up exactly zero human remains. Other sites almost certainly hold bodies, but these aren’t mass graves of murdered children. Remember the prime minister’s photo-op that showed him holding a teddy bear near a residential school in Cowessess First Nation? The local chief has made clear that that site merely contained unmarked graves, as less-than-sturdy grave markers at the local Catholic cemetery gradually deteriorated under weather. There is no denying that some indigenous children were mistreated in residential schools. But the mass murders and mass burials used to justify attacking churches in general and the Canadian Catholic Church in particular were quite literally a piece of agitprop mythology. Yet amid the mass-graves fever, many Canadian journalists and scholars, including men and women of the left, found themselves ostracized or even out of a job for daring to question the mythology. The Mount Royal University in Calgary, for example, fired the progressive political scientist Frances Widdowson for promoting anti-indigenous views (her real “crime” was questioning the NGO-advocacy industrial complex that, in her view, hinders real development for the community by ginning up fake grievances). The few reporters who did real digging came under severe fire, as Terry Glavin documented for Canada’s National Post. Why did this madness take such deep roots in Canada? Writing for Compact, the progressive anthropologist Kathleen Lowrey has argued that harping on nonexistent or massively exaggerated historical crimes allows Canada’s liberal ruling class to legitimate an economic status quo that has left working- and middle-class Canadians poorer and more miserable than any time since the postwar era. If vast swaths of Canadian society can be written off as the sons and daughters of historical mass murderers, then extraction and austerity—and the crushing of those who opposed extra-draconian Covid policies—could be justified. Advertisement As Lowrey wrote: Subscribe Today Get weekly emails in your inbox The real lesson being delivered is that most Canadians have had it far too good for far too long, and deserve much less than they have got right now. Employment? Bah. The right to squeak about loss of employment? Humbug. A voice in public policy making? Pshaw. The right to protest or even to have a bank account? Um, honk-honk? But I think another explanation for the mass-graves hysteria is naked anti-Catholic bigotry. Against a Canadian medical system that increasingly encourages ailing and disabled people to avail themselves of suicide-by-doctor, sometimes in a less-than-voluntary way, there stands one institution, the Roman church. But what if that institution itself were guilty of mass murdering and mass-burying children? Then its credibility in the public square would be shot, that’s what. Call this what it is: an anti-Catholic blood libel.
What is Agammaglobulinemia?
Agammaglobulinemia is a set of inherited immunological disorders marked by low antibody levels in the blood due to a lack of certain lymphocytes in the blood and lymph. Agammaglobulinemia is a set of inherited immunological disorders marked by low antibody levels in the blood due to a lack of certain lymphocytes in the blood and lymph. Image Credit: Kateryna Kon/Shutterstock.com While X-linked agammaglobulinemia (XLA) is the most frequent cause of congenital agammaglobulinemia, accounting for about 85% of cases, other genetic types of agammaglobulinemia have been discovered. X-linked agammaglobulinemia (XLA), autosomal recessive agammaglobulinemia (ARAG), and autosomal dominant agammaglobulinemia are the three kinds of agammaglobulinemia. Serial bacterial infections are the main symptoms of agammaglobulinemia, which are caused by deficiencies in certain immunological responses caused by abnormalities in B-lymphocytes. Infections commonly occur in the gastrointestinal tract, lungs, skin, joints, and upper respiratory tracts. XLA A mutation in Bruton’s tyrosine kinase (BTK) causes this X-linked agammaglobulinemia. BTK is a cytoplasmic tyrosine kinase that is mostly expressed in hematopoietic cells. There have been over 600 mutations discovered in BTK, with the bulk of them involving 1–4 base pairs. Recurrent, pyogenic bacterial infections in young boys and a near-complete absence of all immunoglobulin isotypes are among the clinical manifestations of XLA. Streptococcus pneumoniae, Staphylococcus spp., Pseudomonas spp., and Haemophilus influenzae are among the most prevalent pathogens found in XLA. Prior to diagnosis, recurrent otitis is the most frequent infection. In addition, conjunctivitis, sinopulmonary infections, diarrhea, and skin infections are common. When people with XLA acquire a serious, life-threatening condition such as pneumonia, empyema, meningitis, sepsis, or septic arthritis, they are diagnosed with immunodeficiency. Neutropenia has been identified as a prevalent XLA symptom. The prevalence of XLA varies between 1:100,000 and 1:200,000. There is no known ethnic predilection, but the White race has the highest documented occurrence. Males with early-onset bacterial infections, substantial reductions in all classes of blood immunoglobulins, and missing B cells are suspected of having XLA. The prognosis for people with XLA has improved dramatically in the last 25 years as a result of earlier diagnosis, the discovery of gammaglobulin preparations that allow for normal blood IgG concentrations, and more liberal antibiotic use. Autosomal recessive and autosomal dominant agammaglobulinemia In comparison to XLA, autosomal recessive agammaglobulinemia is a rare cause of agammaglobulinemia. Mutations have been found in the mu heavy chain, Lambda 5, Ig alpha, Ig beta, BLNK, PI3K, and TCF3 genes so far. Due to mu heavy chain mutations, BLNK insufficiency, and Ig alpha deficit, neutropenia has been found in some ARA patients. These diseases are more severe and manifest earlier than XLA instances. Some patients with early B cell developmental abnormalities have yet to be diagnosed with a genetic etiology, though this is changing because of breakthroughs in diagnostic and genetic testing. Mutations in numerous different genes have been linked to autosomal recessive agammaglobulinemia, including the heavy chain gene, 5, Ig, Ig, BLNK, PIK3R, and TCF3. Mutations in the LRRC8A gene on chromosome 9q34 and the TCF3 gene on 19p13.3 have been linked to autosomal dominant agammaglobulinemia. Diagnosis and treatment Immunoglobulin levels are measured in blood tests to confirm the condition. Flow cytometry, immunoelectrophoresis, and nephelometry to quantify immunoglobulins (IgG, IgA, IgM) are among the tests used to determine the number of circulating B lymphocytes. The presence of a missing B cell in a maternal uncle or male cousin essentially guarantees the diagnosis. Males with a hemizygous BTK pathogenic mutation and females with a heterozygous BTK pathogenic variant have their XLA diagnosis confirmed. Treatment entails taking actions to limit the number of infections and their severity. Bacterial infections frequently necessitate the use of antibiotics. Immunoglobulins are injected or given through a vein to enhance the immune system. A bone marrow transplant is a possibility. Molecular genetic testing of at-risk male relatives as soon as feasible after delivery guarantees that affected individuals receive gammaglobulin substitution therapy as soon as possible. Corticosteroids and other immune-suppressing medicines (immunosuppressant drugs) should be avoided as much as possible. Patients should also avoid strenuous activity that could harm their spleen, such as harsh contact sports. Immunoglobulin replacement comes in a variety of forms and can be given intravenously or subcutaneously. The patient receives intravenous immunoglobulin replenishment every 3–4 weeks. Although no current published guidelines exist, prophylactic antibiotics can be used to avoid infection. Prophylactic antibiotics may be considered, especially if patients continue to get infections despite receiving appropriate immunoglobulin replacement therapy. X linked agammaglobulinemia | Agammaglobulinemia | XLA |USMLE step 1Play Agammaglobulinemia in COVID-19 patients With the outbreak of the SARS-CoV-2 pandemic in 2019, it is expected that immunocompromised patients will be particularly vulnerable. Patients with agammaglobulinemia with coronavirus disease 2019 (COVID-19) infection have been described in a small number of cases. Seven patients, one with XLA, one with autosomal recessive agammaglobulinemia, and five with CVID (common variable immune deficiency) with COVID, were described by a group of researchers. The investigators reported that the two patients with agammaglobulinemia had mild clinical outcomes, but the five with CVID had severe disease and one fatality. Another study identified two patients with XLA who developed COVID-19 with a complete lack of B lymphocytes in their peripheral blood. According to their findings, XLA patients are at a higher risk of developing pneumonia as a result of SARS-CoV-2 infection, but they can recover. While additional research is needed, observations and case reports have revealed that certain people with XLA had a milder type of COVID-19 than those with other underlying immunodeficiencies. References Cardenas-Morales M, & Hernandez-Trujillo, VP (2021). Agammaglobulinemia: from X-linked to Autosomal Forms of Disease. Clinical Reviews in Allergy & Immunology, 1–14. Advance online publication. doi: https://doi.org/10.1007/s12016-021-08870-5 Lackey AE, Ahmad F. X-linked Agammaglobulinemia. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549865/ Soresina A, Moratto D, Chiarini M, et al. (2020). Two X-linked agammaglobulinemia patients develop pneumonia as COVID-19 manifestation but recover. Pediatric Allergy and Immunology: Official Publication of the European Society of Pediatric Allergy and Immunology, 31(5), 565–569. doi: https://doi.org/10.1111/pai.13263 El-Sayed ZA,
Marcia de Rousse, who recurred as Dr. Ludwig on HBO’s True Blood and appeared with Kate Beckinsale in The Disappointments Room, has died. She was 70. Her reps at Beverly Hecht Agency said she died September 2 after a long illness. The diminutive De Rousse got her start in the 1981 Chevy Chase-Carrie Fisher comedy Under the Rainbow and went on to appear in episodes of The Fall Guy and St. Elsewhere during that decade. She had a few roles in the 2000s before being cast in True Blood as Dr. Patricia Ludwig, who treated illnesses acquired by supernatural beings. She appeared in three episodes from the second, fourth and seventh season, last seen fleeing at the mention of Niall Brigant’s name. In The Disappointments Room, de Rousse played a local historian who informs Blacker Estate buyer Dana (Beckinsale) that her new house’s previous occupants had a secret “disappointments room” in the attic, where wealthy socialite families cruelly shuttered their deformed or disabled children.
There is insufficient evidence that probiotics prevent Clostridioides difficile infection (CDI) in older hospitalized patients taking antibiotics, according to a study published in Frontiers in Medicine. The researchers noted that CDI is most prevalent in older patients receiving broad-spectrum antibiotics, nursing home residents, and hospitalized older patients. They explained that intestinal microbiota disruption, particularly in older adults, is a significant risk factor for CDI, as the microbiota protect against pathogenic bacteria. A patient’s intestinal microbiota balance could be disturbed by various factors, including antibiotic therapy exposure and the natural aging process. Despite this, the current standard therapeutic measure is antibiotic therapy, which the researchers noted increases the recurrence risk of infection. Because of this, probiotics are emerging as a potential alternative preventive and therapeutic strategy for managing gastrointestinal conditions like diarrhea. Some past studies found positive effects of probiotics on patients with CDI, while others found that probiotics were ineffective. Consequently, the researchers conducted a review to find a more definitive consensus on whether probiotics prevent CDI by reviewing more recent studies. The researchers conducted their search between September 2021 and January 2022, limiting their search to English studies published between 2011 and 2021 across databases PubMed, the Web of Science, and Scopus using specific keyword combinations. Advertisement They included studies with clinical and cohort trials that addressed the effect of probiotic microorganism intervention in preventing CDI in older adults using a concurrent or retrospective control group that received no treatment or only a placebo; studies with outcomes like watery stools, stool consistency, self-reported diarrhea, and physician-defined diarrhea were also included in this analysis. On the other hand, the researchers excluded articles not available in full, dissertations, review articles, letters, opinions, commentaries, and reviews. The researchers categorized data from the studies analyzed based on their respective publications, research objectives, study types, and levels of evidence. They also recorded study population demographics, sample sizes, outcome variables, probiotics used, and the dose administered. The researchers narrowed their population by grading each article “according to its level of evidence and assessed for study quality in the domains of sample selection, analysis of exposures and outcomes, and data analysis.” Digestive system | Image credit: sdecoret – stock.adobe.com Through their literature search, the researchers found 7 eligible studies, 3 of which were conducted in the United States, 2 in the United Kingdom, 1 in Denmark, and 1 in Japan. Each study’s population consisted of hospitalized patients. The mean age of the probiotic group was 74.8 years and the mean age of the placebo group was 74.6 years (P = .693). Three studies demonstrated that older patients using probiotics could decrease CDI. The studies evaluated a variety of probiotic strains, but Saccharomyces boulardii was found to be most beneficial as it “can produce a protease that inactivates the receptor site for C difficile toxin A, conferring biological plausibility to its use in CDI.” Despite this, the researchers did not find consensus among all studies analyzed that probiotic use could decrease CDI. The researchers noted several limitations to their study, including possible selection biases. They mostly reviewed retrospective cohort studies, meaning the results of the included clinical trials may not apply to the general population due to their strict eligibility criteria. Because of the study’s limitations and insufficient findings, the researchers explained that more evidence is needed to prove that probiotics prevent CDI in older, hospitalized patients taking antibiotics. In terms of future research, they concluded that “robust clinical studies that include the S boulardii strain are needed to address the scientific and clinical gaps on the potential protective effect of probiotics on CDI.” Reference Barbosa MLL, Albano MO, Martins CDS, Warren CA, Brito GAC. Role of probiotics in preventing Clostridioides difficile infection in older adults: an integrative review. Front Med (Lausanne). 2023;10:1219225. doi:10.3389/fmed.2023.1219225