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PubMed2026

Intra-amniotic infection: diagnosis, nomenclature, clinical significance, management, and microbiologic tools used for the diagnosis.

SUMMARYIntra-amniotic infection is the main cause of spontaneous preterm birth and adverse maternal-fetal outcomes; therefore, rapid, robust, and accurate diagnosis remains a clinical priority. Conventional microbiological techniques, especially culture-based methods, are limited by long turnaround times and the inability to detect fastidious or unculturable organisms. This review summarizes the diagnosis, nomenclature, clinical significance, management, and laboratory approaches for diagnosing intra-amniotic infection. Targeted nucleic acid amplification methods, including species-specific polymerase chain reaction and broad-range 16S rRNA gene sequencing, have improved the detection of bacterial DNA and enabled the identification of organisms that evade routine culture in intra-amniotic infection. More recently, whole-genome sequencing and metagenomic next-generation sequencing have provided culture-independent strategies for comprehensive pathogen profiling, allowing simultaneous detection of bacteria, viruses, and fungi, as well as characterization of antimicrobial resistance determinants and virulence-associated genes. However, challenges remain, particularly in low-biomass samples such as amniotic fluid, where contamination, host DNA background, and data interpretation can compromise specificity. This review critically evaluates the advantages and limitations of each molecular modality and discusses pre-analytical, analytical, and bioinformatic considerations essential for reliable implementation. Integration of molecular diagnostics into clinical workflows holds promise for improving etiological diagnosis and guiding targeted therapy in intra-amniotic infection, thereby improving maternal and fetal outcomes.

Humans↗

PubMed2026

Micro- and nanoplastics-induced neurotoxicity: a CNS-centered, evidence-graded adverse outcome pathway framework based on systematic weight-of-evidence assessment.

Micro- and nanoplastics (MPs/NPs) are ubiquitous anthropogenic particulate pollutants posing emerging threats to human neurological health. Severe heterogeneity in particle physicochemical properties, environmental aging status, exposure paradigms and experimental platforms has created persistent mechanistic uncertainties in MP/NP neurotoxicology, hindering reliable hazard characterization and risk translation. Here, we systematically consolidate empirical toxicological evidence and construct a dedicated central nervous system (CNS)-targeted adverse outcome pathway (AOP) network integrated with rigorous weight-of-evidence (WoE) grading to elucidate the hierarchical, particle-specific toxic cascades underlying MP/NP-induced neural injury. Our synthesis overturns the conventional linear toxicity paradigm, demonstrating that MPs/NPs trigger neurotoxicity via a complex multi-input mechanistic network. We definitively establish oxidative stress as a robust early convergent key event-rather than a universal molecular initiating event-orchestrating ROS overproduction, lipid peroxidation, mitochondrial dysfunction, and neuroinflammation to propagate neuronal damage. This core module is driven by five distinct particulate upstream triggers: particle-biomolecule interfacial perturbation, corona-facilitated cellular internalization, plastic-associated chemical leaching, aging-derived free radical reactivity, and gut-borne systemic neurotoxic signaling. Downstream pathogenic outcomes encompass glial overactivation, neurotransmitter dyshomeostasis, autophagy-lysosome dysfunction, metabolic reprogramming, regulated neuronal cell death, and behavioral impairments. Tiered WoE analysis confirms strong validation for early oxidative/inflammatory cascades, moderate support for gut-brain axis crosstalk and intracellular trafficking disruption, and nascent evidence for synaptic dysfunction and neurodegeneration-linked proteostatic defects. Extrapolation to human health risk remains constrained by the frequent use of high-dose exposure paradigms, limited validated data on internal dosimetry in the human brain, discrepancies between effective concentrations in experimental models and environmentally relevant human tissue burdens, and insufficient causal validation of distal adverse outcomes. We highlight key research priorities including aged mixed-particle exposure systems, leachate-controlled assays, quantitative internal dose evaluation, and mechanistic intervention verification. This evidence-stratified AOP framework resolves longstanding mechanistic ambiguities in particulate neurotoxicity, providing a standardized, causality-based foundation for future mechanistic exploration and health risk assessment of global plastic pollution.

Adverse outcome pathway↗

PubMed1995

[Cryptosporidia and other endoparasites in heifers imported into the Czech Republic].

Totally 887 heifers of Holstein-Friesian breed mostly in late pregnancy imported to the Czech Republic from France (597), Germany (89), Denmark (181) and Holland (20) were examined coprologically from September 1993 to March 1995 in the parasitological laboratory of the National Veterinary Institute (NVI). Prague. Feces were sampled individually, rectally, always on days 1-3 following importation from heifers housed in particular quarantine sheds. In compliance with presently valid veterinary regulations, all animals were examined for liver fluke disease (fascioliasis) and lungworm. Moreover, 634 heifers were submitted to qualitative coprological examination aimed at revealing the presence of cysts and oocysts of protozoa, eggs of taenias and nematodes of gastrointestinal tract. The method according to Pavlásek (1991), especially designed for proving oocysts of the genus Cryptosporidium, was applied in all fecal specimens delivered to the SVI from animals in quarantine (N = 887). From trematodes, 12 heifers imported from France were positive for eggs of Fasciola hepatica and in other two animals eggs of the genus Paramphistomum were found. None of the imported heifers showed lungworm disease. Summary of data on occurrence of endoparasites gained during qualitative examination of samples of feces taken from heifers imported from France, Germany and Denmark is presented in Tab. I. Parasitologically, 91.2 to 100% of imported animals were positive. Taeniasis (the genus Moniezia) was detected in 2.8% of heifers imported from France and in 9.8% animals from Denmark. Protozoal parasites were found in 58.8% (Denmark) and 92.8% (Germany) heifers. Coccidial oocysts most frequently observed represented the genus Eimeria (E. bovis, E. auburnensis and E. zuernii). Gastrointestinal nematodes of nine genera were found in 72.5 to 80.8% of heifers. The most frequent findings were genera Ostertagia, Haemonchus and Trichostrongylus. Oocysts, morphologically identical with Cryptosporidium muris Tyzzer (1907), 1910, were detected in 4.5% of heifers imported into the Czech Republic from France and in 7.9% of those from Germany. In view of the fact the imported heifers were sampled always on days 1-3 of their quarantine following their importation it is quite impossible, considering the development of the protozoon, they could become infected just in the territory of the Czech Republic. Therefore, with the highest probability, our findings of C. muris-like oocysts in heifers are of priority importance for France and Germany because in the literature these countries do not report cattle as a host of this protozoon. We have found out 57.9% out of 19 animals positive for C. muris on one farm of a private cattle keeper. On the basis of a long-term monitoring of three dairy cows and one bull, the duration of the patent period is longer than 18 months, while we do not know precise onset of shedding oocysts of the protozoon in these naturally infected animals. Furthermore, the paper discusses the need of future studies of C. muris from the point of view of spread, pathogenicity, specificity and host spectrum. The author proposes and recommends obligatory examinations of imported animals with special attention paid to presence of coccidia of the genus Cryptosporidium in order to maintain, with respect to their zoonotic character, these protozoal infections under proper control. At present the parasitological laboratory of the NVI in Prague has a bank of oocyst isolates of the C. muris type from cattle (Bos taurus), from desert hamsters (Phodopus roborovskii Satunin, 1903) and camels (Camelus bactrianus). Experimental infections is permanently kept in laboratory mice following successful transmission from desert hamsters.

Animals↗

PubMed1989

Recent developments in trace element metabolism and function: trace elements, disease resistance and immune responsiveness in ruminants.

Evidence for the influence of trace elements on disease resistance in ruminants is reviewed with emphasis on susceptibility to infection in vivo during the more common deficiencies (copper, selenium and cobalt). Copper deficiency associated with increases in pasture molybdenum increased the susceptibility of lambs to microbial infections. Under experimental conditions, dietary molybdenum decreased the establishment of abomasal and intestinal nematodes but not their pathogenicity to lambs. Molybdenum may enhance inflammatory responses leading to parasite rejection by the host. Decreased incidence of metritis in selenium-treated dairy cows provides a rare example of an association between selenium deficiency and decreased disease resistance. Improved antibody responses following selenium administration have also been found in sheep. Cobalt deficiency has reduced lamb survival and increased susceptibility to parasitic infection transiently in cattle and lastingly in sheep. In copper-, selenium- or cobalt-deficient sheep and cattle, there are many reports of impaired leucocyte and lymphocyte responses to in vitro challenges, but their relevance to disease resistance in vivo is unproven. Disease resistance may have priority for limited micronutrient supplies, leaving other processes vulnerable.

Animals↗

PubMed2004

Helicobacter pylori infection: diagnosis and treatment.

Helicobacter pylori is one of the most common infections worldwide. Eradication of this important pathogen would lead to virtual elimination of the second most common cancer worldwide - gastric cancer. A variety of accurate diagnostic tests are available but current therapeutic regimens are generally unsatisfactory, with failure rates of between 20 and 40%. Difficulty in curing the infection has led to a three-step approach: diagnosis, therapy and confirmation of cure. Better studies, including head-to-head comparison of different drugs, drug formulations, dosing intervals, dosing in relation to meals, and duration of therapy are needed. The high rates of reinfection and the lack of improvements in standards of living in developing countries makes the development of a vaccine a high priority.

Adult↗

PubMed2004

Methods for isolation and confirmation of Vibrio vulnificus from oysters and environmental sources: a review.

The gram-negative bacterium Vibrio vulnificus is a natural inhabitant of estuarine waters and poses a significant health threat to humans who suffer from immune disorders, liver disease, or hemochromatosis (iron overload). V. vulnificus enters human hosts via wound infections or consumption of raw shellfish (primarily oysters), and infections frequently progress to septicemia and death in susceptible individuals. Prevalence in waters and shellfish is not correlated with fecal indicator organisms; therefore, species-specific detection and enumeration of V. vulnificus in the environment has become a priority for agencies that are responsible for shellfish safety. The many selective-differential media developed for isolation of Vibrio spp., and specifically for V. vulnificus detection, are reviewed here; however, none of the media developed to date combines the sensitivity to low numbers with the specificity necessary to inhibit growth of other organisms. Therefore, immunological and molecular protocols are needed for confirmation of the identity of the organism and are discussed in detail. Methods under development that hold promise for rapid, accurate, and sensitive detection and enumeration of the organism include multiplex and real-time PCR. Developing technologies that have proven useful for detection and investigation of other pathogens such as biosensors, spectroscopy and microarrays may provide the next generation of tools for investigation of the prevalence and ecology of V. vulnificus.

Animals↗

PubMed2004

Healthcare-associated infections among neonates in Brazil.

OBJECTIVE: To describe the epidemiology of healthcare-associated infections (HAIs) among neonates. DESIGN: Prospective surveillance of HAIs was conducted during 2 years. Infections beginning within 48 hours of birth were defined as HAIs of maternal origin. Death occurring during an active episode of HAI was considered related to HAI. SETTING: Seven neonatal units located in three Brazilian cities. PATIENTS: All admitted neonates were included and observed until discharge. RESULTS: Twenty-two percent of 4,878 neonates had at least one HAI. The overall incidence density was 24.9 per 1,000 patient-days, and 28.1% of all HAIs were maternally acquired. HAI rates ranged from 12.3% in the group with a birth weight (BW) of more than 2,500 g to 51.9% in the group with a BW of 1,000 g or less. The main HAIs were bloodstream infection (BSI) and pneumonia. Coagulase-negative staphylococci, Enterobacter species, Staphylococcus aureus, and Klebsiella pneumoniae were the main pathogens. Forty percent of all deaths were related to HAI. Central venous catheter (CVC)-associated BSIs per 1,000 CVC-days ranged from 17.3 (BW, 1,501 to 2,500 g; device utilization [DU], 0.11) to 34.9 (BW, < or = 1,000 g; DU, 34.92). Ventilator-associated pneumonia per 1,000 ventilator-days ranged from 7.0 (BW, < or = 1,000 g; DU, 0.34) to 9.2 (BW, 1,001 to 1,500 g; DU, 0.14). CONCLUSIONS: The high proportion of HAIs of maternal origin highlights perinatal care issues in Brazil and the need to improve the diagnosis of neonatal HAIs. The very low BW group and device-associated infections should be priorities for prevention strategies in this population.

Brazil↗

PubMed2001

Biological control in greenhouse systems.

The controlled environment of greenhouses, the high value of the crops, and the limited number of registered fungicides offer a unique niche for the biological control of plant diseases. During the past ten years, over 80 biocontrol products have been marketed worldwide. A large percentage of these have been developed for greenhouse crops. Products to control soilborne pathogens such as Sclerotinia, Pythium, Rhizoctonia and Fusarium include Coniothyrium minitans, species of Gliocladium, Trichoderma, Streptomyces, and Bacillus, and nonpathogenic Fusarium. Products containing Trichoderma, Ampelomyces quisqualis, Bacillus, and Ulocladium are being developed to control the primary foliar diseases, Botrytis and powdery mildew. The development of Pseudomonas for the control of Pythium diseases in hydroponics and Pseudozyma flocculosa for the control of powdery mildew by two Canadian research programs is presented. In the future, biological control of diseases in greenhouses could predominate over chemical pesticides, in the same way that biological control of greenhouse insects predominates in the United Kingdom. The limitations in formulation, registration, and commercialization are discussed, along with suggested future research priorities.

Canada↗

PubMed2001

Evaluation of a successful vancomycin-resistant Enterococcus prevention intervention in a community of health care facilities.

BACKGROUND: In April 1997, vancomycin-resistant enterococci (VRE) emerged in several health care facilities in the Siouxland region and a VRE Task Force was formed. From 1997 through 1999, an evaluation of VRE prevalence at 30 facilities was performed. METHODS: In 1999, we conducted a survey and focus groups of health care workers to address initial reactions to VRE, feasibility of the Task Force recommendations, and lessons learned. RESULTS: Personnel at 29 (97%) facilities surveyed completed the questionnaire, and 15 health care workers from 11 facilities participated in 5 focus groups. The outcomes of expanded education and improved awareness of VRE for patients and health care workers were ranked the No. 1 priority overall and by long-term care facility personnel. Respondents agreed that Task Force recommendation adherence had significantly improved infection control (83%) and that the Task Force was an appropriate mechanism to coordinate infection control efforts (90%). Focus groups commented that it was most difficult to educate family members about VRE; they expressed concern about variation between VRE policies, especially between acute care and long-term care facilities, and about the quality of life of isolated patients. CONCLUSIONS: Our data illustrate that this intervention has been far-reaching and include the development of a health care infrastructure that may be used as a model to address additional health care issues (eg, emerging pathogens or biological threats).

Enterococcus↗

PubMed2005

Foodborne infections in France.

To quantify the impact of foodborne diseases on health, and set priorities for data collection, prevention and control of these diseases, we compiled and analyzed information from surveillance systems and other sources on the morbidity and mortality due to foodborne infectious diseases in mainland France in the last decade of the 20th century. Illness due to 13 bacteria, two viruses, and eight parasites were studied. The number of foodborne infections, hospitalizations, and deaths were estimated from multiple data sources. For each agent, several estimates were derived from the different sources. Estimates were ranked according to their plausibility, based on an assessment of the validity of the data source, and are presented as a "plausible interval" consisting of a low and high estimate. We estimate that these pathogens caused 10,200-17,800 hospitalizations per year. Salmonella is the most frequent cause (5,700-10,200 cases), followed by Campylobacter (2,600-3,500 cases) and Listeria (304 cases). Toxoplasmosis accounts for the majority of hospitalizations (426 cases) attributable to the studied parasitic infections. The number of deaths related to foodborne infection was estimated between 228 and 691. Bacterial pathogens account for the majority (191 to 652) of deaths of which 92 to 535 are attributable to salmonellosis, ranking as the first cause of death, and 78 to listeriosis, the second cause. Salmonella, Campylobacter, and Listeria are the main causes of severe foodborne illness in France. For several pathogens, data are insufficient to derive exact estimates of the disease burden. Nevertheless, it has been possible to derive plausible estimates for the majority, and to rank them according to their impact on public health.

Campylobacter Infections↗

PubMed2002

Wildlife and pastoral society--shifting paradigms in disease control.

The dramatic changes in the human and animal populations in Africa over the last century demand the re-examination of priorities and policies. The introduction of developed medical and other human technologies into the continent has contributed to increases in population and a rapid, unsustainable increase in the utilization of resources. This in turn has led to the destruction of flora and fauna on an unprecedented scale with little real improvement in the human condition. One factor in this has been the increase in livestock in line with human demographic growth, as it is a traditional livelihood of many African peoples. In recent years the growth in livestock populations has slowed owing to a cycle of degradation and disease, affecting especially traditional pastoral systems with a close physical association between people, livestock, and wild animals. Pathogens benefit hugely from the dynamic state created by animal migration, although to some extent the livestock and certainly wildlife show considerable tolerance to this. One of the grave economic consequences of this increase in disease has been collapse of the export trade. In order for Africa to fully benefit and share in world trade, the zoosanitary situation must show improvement. To do this without destroying the natural resource base and traditional pastoral systems, will require a careful, future-oriented land-use policy along ecologically sound criteria. Export livestock will have to be maintained in areas, probably free of ruminant wildlife, with strict veterinary controls. If this can be balanced with sufficient areas retained for traditional pastoralism and wildlife, with perhaps the main income from recreational tourism and local consumption, the benefits will be considerable. The answer may be community-based, low-cost, decentralized health systems for pastoral communities, with less stringent sanitary mandates, a private/parastatal sector servicing, with specialization in wildlife, dairy or export livestock and a central veterinary policy, related to surveillance and monitoring using small well-resourced professional teams to carry out regulatory and statutory duties.

Africa↗

PubMed1990

[Streptococcal disease: a current problem in public health].

The high priority and prevalence of streptococcal diseases and complications, particularly among children and young adults, is emphasized. The attention is focused on group A and B streptococci and on the need to develop the laboratory diagnosis of streptococcal diseases as the basis for the development of their epidemiology and prevention. The literature data and the author's own reports concerning streptococcal cells, their antigens, receptors, and intracellular products are reviewed. Based on this, the following major aspects are discussed: the mechanism of streptococcal adhesion, the role played by immunoglobulin Fc-receptors and anti-immunoglobulins in the genesis of post-streptococcal complications; the genetics of streptococcal cell and, in the first instance, of its pathogenicity. Streptococcus is also viewed as an object of genetic engineering and biotechnology. The required minimal approaches to the microbe and its antigen identification are analysed. Recent 12-15 years' research findings are generalized.

Adult↗

PubMed2002

New directions in foodborne disease prevention.

Food safety is an important part of public health linking health to agriculture and other food production sectors. For over a century, developments in food production and new control philosophies have contributed to food safety systems in most developed countries perceived by many to be efficient in the prevention of foodborne disease. Nevertheless, a number of problems still remain dominant, one of these being the high level of foodborne microbiological diseases which seem, for some pathogens, to have increased over the last decades. Although there is an urgent need for better foodborne disease data in most countries, the paper attempts an analysis of the background to these problems using available data to illustrate the developments for some of the major foodborne pathogens. Some of the shortcomings of present food safety systems are discussed, as are new principles to improve food safety strategies. A new paradigm for the integration of research data, food-control monitoring, epidemiological investigations and disease surveillance in a renewed effort to manage and lower foodborne risk is presented. Within this paradigm, the development of an interdisciplinary approach with direct interaction between surveillance and risk analysis systems is described as a potential basis for improved foodborne disease prevention. Specific consideration is given to the situation in developing countries, suggesting a leap forward past the experience of noncollaboration between the disciplines in many developed countries. Today, food safety is one of WHO's top 11 priorities and the Organisation calls for more systematic and aggressive steps to be taken to significantly reduce the risk of microbiological foodborne diseases. Dealing with this challenge is one of the major challenges for the 21st century in regard to food safety, implying a significant redirection of food microbiology efforts in many parts of the world.

Animals↗

PubMed2004

Situation analysis of prenatal diagnosis technology utilization in China: current situation, main issues, and policy implications.

OBJECTIVES: The purpose of this study is to describe the situation with the distribution and utilization of prenatal diagnosis technology in China, to identify some important barriers to prenatal diagnosis use, and to suggest changes to improve the present situation. METHODS: The study uses cross-sectional surveys to capture quantitative data from both providers and consumers. Qualitative information based on focus group discussions is also presented. RESULTS: A mail survey of the provincial Bureaus of Health (BOHs) reveals that sixteen provincial prenatal diagnosis centers and twelve city level centers were accredited by the BOHs by July of 2001. These centers were located in thirteen provinces, of thirty in all of China. Of 147 selected institutions surveyed separately, 90.5 percent offer ultrasound examination, 72.1 percent provide pathogen tests (mainly Toxoplasma, rubella virus, cytomegalovirus, and herpes simplex or TORCH), 57.1 percent do biochemical tests, 21.8 percent have genetic counseling, 13.6 percent do karyotype testing, 7.5 percent do enzymology testing, and 5.4 percent carry out molecular genetic testing. Chromosome diseases, congenital diseases, and several gene diseases are the target diseases. According to qualitative data, macromanagement for prenatal diagnosis, supplier provision of tests, and population demand are the main influences on prenatal diagnosis use. CONCLUSIONS: From the quantitative and qualitative analysis, it is clear that the technology of prenatal diagnosis is not diffusing well throughout China and is apparently not appropriately used. The situation of prenatal diagnosis has implications for policy-makers, including identification of priorities, regulation of prenatal diagnosis, strategic planning, development of guidelines based on health technology assessment, and consumer orientation.

China↗

PubMed2002

A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States.

OBJECTIVE: To determine the prevalence of intensive care unit-acquired infections, a major cause of morbidity in pediatric intensive care unit (PICU) patients. METHODS: Pediatric Prevention Network hospitals (n = 31) participated in a point-prevalence survey on August 4, 1999. Data collected for all PICU inpatients included demographics, infections, therapeutic interventions, and outcomes. RESULTS: There were 512 patients in 35 PICUs. The median age was 2.2 years (range, <1 day-35.4 years). Seventy-five PICU-acquired infections occurred among 61 (11.9%) patients. The most frequently reported sites were bloodstream (31 [41.3%]), lower respiratory tract (17 [22.7%]), urinary tract (10 [13.3%]), or skin/soft tissue (6 [8.0%]). The most frequent pathogens were coagulase-negative staphylococci (in 16 [21.3%] infections), Candida spp. (13 [17.3%]), enterococci (10 [13.3%]), Staphylococcus aureus (9 [12.0%]), or Pseudomonas aeruginosa (8 [10.7%]). Age-adjusted risk factors for infection included central intravenous catheters (relative risk [RR], 4.1; 95% confidence intervals [CI], 2.4-7.1), arterial catheters (RR, 2.4; 95% CI, 1.5-3.9), total parenteral nutrition (RR, 5.5; 95% CI, 3.6-8.5), or mechanical ventilation (RR, 3.9; 95% CI, 2.2-6.8). Infection was associated with higher age-adjusted risk of death within 4 weeks of the survey (RR, 3.4; 95% CI, 1.7-6.5). CONCLUSIONS: This national multicenter study documented the high prevalence of PICU-acquired infections. Preventing these infections should be a national priority.

Adolescent↗

PubMed2006

Preventing ventilator-associated pneumonia in adults: sowing seeds of change.

Ventilator-associated pneumonia (VAP), a major cause of ICU infection, results in high morbidity, mortality, and health-care costs. Multiple risk factors for VAP involve complex host factors and ubiquitous pathogens that require several different types of prevention strategies. Prevention efforts should focus on reducing bacterial colonization, and limiting aspiration, antibiotic exposure, and use of invasive devices. Although evidence-based prevention guidelines are available, they are lengthy, often ignored, and not implemented. New insights into the barriers to implementation of effective prevention programs are emerging. This article provides highlights from recent guidelines and publications discussing VAP prevention strategies and examines barriers to their implementation. Prevention and implementation of cost-effective strategies to reduce risk and improve patient outcomes should be prioritized. Clearly, prevention programs should be population specific and may vary among hospitals, but a multidisciplinary prevention team led by a "champion" is recommended to help set priorities, benchmarking goals, analyze data, and sow the seeds of change for risk reduction.

Adult↗

PubMed2004

Gas gangrene and necrotizing fasciitis in the upper extremity.

Necrotizing soft tissue infections encompass a wide variety of clinical syndromes resulting from introduction of various pathogens into injured or devitalized tissue. The extent of microbial involvement in such tissue may range from simple contamination to overt and progressive local tissue necrosis, which, if untreated, may lead to septicemia and death. Early differentiation among these infections is not always possible, as there are overlapping classification criteria. These infections exist along a continuum of clinical severity with different etiological agents and associated medical conditions. The often subtle clues heralding the presence of a necrotizing soft tissue infection must be sought so that expeditious surgical debridement and broad-spectrum antibiotic management are initiated. Although experience enables the clinician to make a specific diagnosis based on early findings, aggressive and proper treatment of suspected infections remains the priority. The purpose of the article is to provide an overview of necrotizing soft tissue infections in the upper extremity, focusing on gas gangrene, or clostridial myonecrosis, and necrotizing fasciitis, to facilitate early diagnosis and optimal management of these lethal diseases.

Cellulitis↗

PubMed1995

Pathogenesis of respiratory syncytial virus vaccine-augmented pathology.

Respiratory syncytial virus (RSV) is an important respiratory pathogen for which vaccine development has been thwarted by the legacy of vaccine-enhanced illness. A formalin-inactivated, alum-precipitated, whole virus vaccine did not protect children from infection and was associated with severe illness. Clues from clinical studies of RSV and vaccine-induced atypical measles illness suggest that an aberrant CD4+ lymphocyte response occurred in vaccinees. There is a growing body of evidence from murine models that show vaccine formulations can selectively activate different populations of CD4+ T helper lymphocytes that produce distinct cytokine expression patterns. The cytokine milieu in turn can influence the composition of the immune response and thereby impact the efficiency of virus clearance, type of pathology, and magnitude of illness. Major priorities of current vaccine development are to define the optimal combination of T lymphocyte subsets to safely clear RSV and to learn ways to modulate the composition of the immune response to vaccine antigens.

CD4-Positive T-Lymphocytes↗