Large Nosocomial Outbreak Associated with a Norwegian Scabies Index Case Undergoing TNF-α Inhibitor Treatment: Management and Control

2015 ◽  
Vol 36 (11) ◽  
pp. 1358-1360 ◽  
Author(s):  
Valeria Belvisi ◽  
Giovanni Battista Orsi ◽  
Cosmo Del Borgo ◽  
Paolo Fabietti ◽  
Adriana Ianari ◽  
...  
Keyword(s):  
Index Case ◽  
Immunocompromised Patient ◽  
Parasitic Infection ◽  
Nosocomial Outbreak ◽  
Biologic Therapies ◽  
Psoriasis Arthritis ◽  
Tnf Α ◽  
Large Outbreak ◽  
And Control ◽  
Inhibitor Treatment

We describe a large outbreak associated with a crusted (Norwegian) scabies case in an immunocompromised patient following treatment with TNF-α inhibitor (adalimumab) for psoriasis arthritis. The increasing use of TNF-α inhibitors should induce clinicians to consider this serious parasitic infection when evaluating skin rashes in patients receiving biologic therapies.Infect. Control Hosp. Epidemiol. 2015;36(11):1358–1360

scholarly journals Pattern of Mosquito Borne Parasitic Infection in the Night Blood Samples of Patients with Elevated TNF-α of> 5.0 pg/ml

2021 ◽  
Vol 9 (2) ◽  
pp. 16
Author(s):  
Mathew Folaranmi Olaniyan ◽  
Tolulope Busayo Ojediran ◽  
Donatus Fn Ozuruoke
Keyword(s):  
Parasitic Infection ◽  
Wuchereria Bancrofti ◽  
Blood Film ◽  
Parasitic Infections ◽  
Social Implication ◽  
Blood Samples ◽  
Acid Fast Bacilli ◽  
Control Subjects ◽  
Tnf Α ◽  
And Control

Study Background: Plasmodium spp., (Protozoan) and Wuchereria bancrofti (Nematode) are transmitted by mosquitos to cause insect borne diseases known as malaria and Lymphatic filariasis/Elephantiasis. Apart from the social implication of these parasitic infections the infections can also elicit immune responses. Aim and Objective: This work was therefore designed to determine the pattern of mosquito borne parasitic infection in the night blood samples of patients with elevated TNF-α of > 5.0 pg/ml. Materials and Methods: Seventy (70; aged 31 – 76 years; Male- 35; Female-35) volunteers with plasma TNFα of 5.8 ±0.7 pg/including age-matched control participants ( n= 50 ; TNFα of 2.2 ± 0.3 pg/ml). All participants were negative to Acid Fast Bacilli, ant-HCV, HBsAg and HIV tests were recruited for the study. Night blood samples and sputum samples were obtained from the participants. Blood sample was used for determination of TNFα, HIVp24ag-Ab, anti-HCV, HBsAg by ELISA and identification of Plasmodium and Wuchereria by Geimsha thick blood film staining while sputum samples were used for the demonstration of Acid Fast Bacilli by Ziehl Neelsen staining. Results: The results showed a frequency of Plasmodium spp., in individuals with plasma TNF-α of 5.8 ±0.7 pg/ml as 31.4%(22) as against a frequency of 18%(9) in subjects with plasma TNF-α of 2.2 ± 0.3 pg/ml.. The results also showed a frequency of 5.71%(4) and2%(1) Wuchereria bancrofti in subjects with plasma TNF-α of 5.8 ±0.7 pg/ml and TNF-α of 2.2 ± 0.3 pg/ml. respectively. The overall frequency of parasitic infection obtained in both test and control subjects include: 33.3% (40)Plasmodium spp., and 4.2%(5) Wuchereria bancrofti.The overall results from both test and control subjects also showed a gender distribution of 20%(24) and 13.3%(16) Plasmodium spp.,in female and males respectively while a distribution of 1.7%(2) and 2.5%(3) Wuchereria bancrofti in females and males respectively. Conclusion: This work revealed increase in the frequency of Plasmodium spp. and Wuchereria bancrofti infections with increase in plasma TNF-α while the overall frequency of parasitic infection obtained in both test and control subjects was found to be 33.3% (40)Plasmodium spp., and 4.2%(5) Wuchereria bancrofti with possible variations in regional and gender distributions. Mosquito borne parasitic infection of Plasmodium spp., was found to be more prevalent in patients with elevated TNF-α of> 5.0 pg/ml.

Operative Verfahren bei Psoriasis-Arthritis

2010 ◽  
Vol 30 (03) ◽  
pp. 157-162
Author(s):  
M. Henniger ◽  
S. Rehart
Keyword(s):  
Operative Therapie ◽  
Operative Verfahren ◽  
Psoriasis Arthritis ◽  
Tnf Α

ZusammenfassungIn den vergangenen Jahren zeichnet sich ab, dass die Prävalenz der Psoriasis-Arthritis mit 30 Prozent der Psoriasis-Patienten wahrscheinlich höher und ihr Verlauf deutlich schwerer ist als bisher angenommen. Bei der medikamentösen Behandlung der Psoriasis-Arthritis konnten zwar durch den Einsatz der TNF-α-Inhibitoren große Fortschritte erzielt werden, die operative Therapie spielt jedoch weiterhin eine wichtige Rolle im Therapieregime. Die verschiedenen operativen Verfahren werden gelenkbezogen und stadienadaptiert eingesetzt. Aufgrund der Besonderheiten der Erkrankung und deren medikamentöser Behandlung gilt es, bestimmte Regeln zu beachten. Postoperativ ist mit einer höheren allgemeinen und lokalen Infektanfälligkeit sowie einer erschwerten Mobilisation insbesondere bei langjährigem Verlauf und generalisiertem Befall des muskuloskelettalen Systems zu rechnen. Die operative rheumaorthopädische Versorgung wird über eine besondere Ausbildung vermittelt und folgt etablierten Grundsätzen. Ausgewiesene Zentren bieten eine gezielte und hohe Qualität der operativen orthopädischen Rheumatologie an.

Rheumaorthopädische Therapie der Psoriasis-Arthritis

2013 ◽  
Vol 33 (03) ◽  
pp. 169-171
Author(s):  
M. Henniger ◽  
S. Rehart
Keyword(s):  
Operative Therapie ◽  
Psoriasis Arthritis ◽  
Tnf Α

ZusammenfassungDie Psoriasis-Arthritis weist einige Besonderheiten auf, die nicht zuletzt bei der Therapieplanung berücksichtigt werden müssen. Obwohl durch den Einsatz der TNF-α-Inhibitoren große Fortschritte bei der medikamentösen Behandlung der Psoriasis-Arthritis erzielt werden konnten, spielt die operative Therapie weiterhin eine wichtige Rolle im Therapieregime. Die verschiedenen operativen Verfahren werden je nach Gelenk und Zustand des Gelenkes eingesetzt. Unterschiede der Erkrankung und ihrer Behandlung im Vergleich mit degenerativen Leiden, aber auch der rheumatoiden Arthritis sind zu beachten. Perioperativ ist mit einem erhöhten Komplikationsrisiko und einer erschwerten Mobilisation insbesondere bei langjährigem Verlauf und generalisiertem Befall des muskuloskelettalen Systems zu rechnen.

Pentoxifylline and Oxypurinol: Potential Drugs to Prevent the “Cytokine Release (Storm) Syndrome” Caused by SARS-CoV-2?

2020 ◽  
Vol 26 (35) ◽  
pp. 4515-4521
Author(s):  
Francisco J. López-Iranzo ◽  
Ana M. López-Rodas ◽  
Luis Franco ◽  
Gerardo López-Rodas
Keyword(s):  
Lung Parenchyma ◽  
Interstitial Tissue ◽  
Cytokine Release ◽  
Phase I Clinical Trials ◽  
Infected People ◽  
Tnf Α ◽  
Transient Loss ◽  
Anti Inflammatory ◽  
And Control ◽  
Inflammatory Action

Background: COVID-19, caused by SARS-CoV-2, is a potentially lethal, rapidly-expanding pandemic and many efforts are being carried out worldwide to understand and control the disease. COVID-19 patients may display a cytokine release syndrome, which causes severe lung inflammation, leading, in many instances, to death. Objective: This paper is intended to explore the possibilities of controlling the COVID-19-associated hyperinflammation by using licensed drugs with anti-inflammatory effects. Hypothesis: We have previously described that pentoxifylline alone, or in combination with oxypurinol, reduces the systemic inflammation caused by experimentally-induced pancreatitis in rats. Pentoxifylline is an inhibitor of TNF-α production and oxypurinol inhibits xanthine oxidase. TNF-α, in turn, activates other inflammatory genes such as Nos2, Icam or IL-6, which regulate migration and infiltration of neutrophils into the pulmonary interstitial tissue, causing injury to the lung parenchyma. In acute pancreatitis, the anti-inflammatory action of pentoxifylline seems to be mediated by the prevention of the rapid and presumably transient loss of PP2A activity. This may also occur in the hyperinflammatory -cytokine releasing phase- of SARS-CoV-2 infection. Therefore, it may be hypothesized that early treatment of COVID-19 patients with pentoxifylline, alone or in combination with oxypurinol, would prevent the potentially lethal acute respiratory distress syndrome. Conclusion: Pentoxifylline and oxypurinol are licensed drugs used for diseases other than COVID-19 and, therefore, phase I clinical trials would not be necessary for the administration to SARS-CoV-2- infected people. It would be worth investigating their potential effects against the hyperinflammatory response to SARS-CoV-2 infection.

Melatonin Improves Erythropoietin Hyporesponsiveness via Suppression of Inflammation

2019 ◽  
Vol 14 (3) ◽  
pp. 203-208
Author(s):  
Evan Noori Hameed ◽  
Haydar F. Hadi AL Tukmagi ◽  
Hayder Ch Assad Allami
Keyword(s):  
Iron Status ◽  
Transferrin Saturation ◽  
Control Group ◽  
Base Line ◽  
Inadequate Response ◽  
Inflammatory Parameters ◽  
Tnf Α ◽  
Before And After ◽  
And Control ◽  
Controlled Clinical Study

Background: Inadequate response to Erythropoietin Stimulating Agents (ESA) despite using relatively larger doses regimen represents a potential risk factor of Cardiovascular (CV) related mortality in addition to health-care economic problems in anemic patients with Chronic Kidney Disease (CKD). Erythropoietin (EPO) hyporesponsiveness related to inflammation has been increased progressively. Melatonin is well known as a potent anti-inflammatory agent. Therefore, the current study was designed to evaluate whether melatonin could improve anemic patients response to EPO. Methods: This single controlled clinical study was carried out in 41 CKD patients with hemoglobin (Hb) levels less than 11g/dl divided randomly in a 1:1 ratio into 2 groups; treatment group who received 5mg melatonin plus their regular treatments and control group who received their regular treatments only. Hematological and iron status parameters include Hb level, serum iron (S. iron), Transferrin Saturation Ratio (TSAT) and serum ferritin (S. ferritin) in addition to inflammatory parameters that include tissue necrotic factor alfa (TNF-α), interleukin-1beta (IL-1β) and interleukin-6 (IL-6) determined before and after 12 weeks of treatment. Results: Melatonin remarkably increases the Hb level with a significant increase in S. iron and TSAT compared to baseline. The elevation of S. iron and TSAT was significantly higher in the melatonin group. Additionally, all inflammatory markers estimated were reduced significantly by melatonin compared to base line and control group. Conclusion: The results of the current study showed that melatonin has an advantageous effect on improving EPO response in anemic patients with CKD.

A Unique Case of Cutaneous Cunninghamella infection in an Immunocompromised Patient (Preprint)

2020 ◽  
Author(s):  
Mauricio Portillo ◽  
Shyam Allamaneni ◽  
Richard Goodman
Keyword(s):  
Fungal Infections ◽  
Immunocompromised Patient ◽  
Lymphocytic Leukemia ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Unique Case ◽  
Systemic Complications ◽  
Prompt Treatment ◽  
Mode Of Transmission ◽  
And Control

UNSTRUCTURED Cunninghamella species are an extremely rare cause of fungal infections. The usual mode of transmission is through inhalation however rare cases of cutaneous spread have been reported. The objective of this clinical case report is to highlight the uniqueness of which the patient acquired the infection, the progression, and control of it. A 57-year-old male with chronic lymphocytic leukemia was found to have an abscess next to his peripherally inserted central catheter (PICC) line. The abscess culture grew back Cunninghamella and was debrided and treated with a novel antifungal. The fungal infection was controlled and the total timeframe took 28 days. Rapid recognition and prompt treatment demonstrate the prevention of rapidly progressive angioinvasian and further systemic complications. This case also proves that a novel antifungal may be appropriate in controlling the spread of Cunninghamella species.

scholarly journals Association of Tumor Necrosis Factor-α -308G>A, -238G>A and -376G>A polymorphisms with recurrent pregnancy loss risk in the Greek population

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sofoklis Stavros ◽  
Despoina Mavrogianni ◽  
Myrto Papamentzelopoulou ◽  
Evaggelos Basamakis ◽  
Hend Khudeir ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Pcr Amplification ◽  
Greek Population ◽  
Control Group ◽  
Increased Risk ◽  
Tnf Α ◽  
Caucasian Women ◽  
Factor Α ◽  
And Control

Abstract Background Promoter region SNPs in TNF-α have been studied in association with Recurrent Pregnancy Loss (RPL) occurrence in various populations. Among them, −238G > A, −308G > A and − 376G > A have been frequently investigated for their potential role in recurrent abortions. The aim of the present study is to evaluate the correlation among TNF-α 238, TNF-α 308 and TNF-α 376 polymorphisms and recurrent pregnancy loss risk in Greek women. Methods This study included 94 Caucasian women with at least two miscarriages of unexplained aetiology, before the 20th week of gestation. The control group consisted of 89 Caucasian women of proven fertility, with no history of pregnancy loss. DNA samples were subjected to PCR amplification using specific primers. Sanger sequencing was applied to investigate the presence of TNF-α 238, TNF-α 308, TNF-α 376 polymorphisms in all samples. Results The TNF-α 238 and TNF-α 308 variants were both detected in RPL and control groups (7.45% vs 4.49 and 45.16% vs 36.73%, respectively), but with no statistically significant association (p-value 0.396 and 0.374, respectively). The TNF-α 376 variant was not detected at all in both control and RPL groups. When TNF-α 238 and TNF-α 308 genotypes were combined no association with RPL was detected (p-value = 0.694). In subgroup analysis by parity, RPL patients carrying the A allele reported less previous births. Conclusions This is the first study demonstrating TNF-α 238 and TNF-α 308 gene expression and the absence of TNF-α 376 variant in Greek women with RPL. However, no association emerged between each polymorphism studied and the occurrence of recurrent pregnancy loss. Accordingly, TNF-α -308G > A, −238G > A and -376G > A variants are not considered genetic markers for identifying women at increased risk of recurrent pregnancy loss in the Greek population.

scholarly journals A large outbreak of influenza A and B on a cruise ship causing widespread morbidity

2003 ◽  
Vol 130 (2) ◽  
pp. 263-271 ◽  
Author(s):  
J. M. L. BROTHERTON ◽  
V. C. DELPECH ◽  
G. L. GILBERT ◽  
S. HATZI ◽  
P. D. PARASKEVOPOULOS ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Influenza A ◽  
Surveillance Systems ◽  
Cruise Ship ◽  
Influenza Like Illness ◽  
Antiviral Therapies ◽  
Intervention Measures ◽  
Large Outbreak ◽  
And Control ◽  
Control Study

In September 2000 an outbreak of influenza-like illness was reported on a cruise ship sailing between Sydney and Noumea with over 1100 passengers and 400 crew on board. Laboratory testing of passengers and crew indicated that both influenza A and B had been circulating on the ship. The cruise coincided with the peak influenza period in Sydney. Morbidity was high with 40 passengers hospitalized, two of whom died. A questionnaire was sent to passengers 3 weeks after the cruise and 836 of 1119 (75%) responded. A total of 310 passengers (37%) reported suffering from an influenza-like illness (defined as cough, fever, myalgia and weakness) and 528 (63%) had seen a doctor for illness related to the cruise. One-third of passengers reported receipt of influenza vaccination in 2000; however neither their rates of influenza-like illness nor hospitalization were significantly different from those in unvaccinated passengers. A case–control study also found no significant protective effect of influenza vaccination. With the increasing popularity of cruise vacations, such outbreaks are likely to affect increasing numbers of people. Whilst influenza vaccination of passengers and crew may afford some protection, uptake and effectiveness may not be sufficient to prevent outbreaks. Surveillance systems and early intervention measures, such as antiviral therapies, should be considered to detect and control such outbreaks.

scholarly journals In Vivo Study of the Action of a Topical Anti-Inflammatory Drug In Rat Teeth Submitted To Dental Bleaching

2018 ◽  
Vol 29 (6) ◽  
pp. 555-561 ◽  
Author(s):  
Francine Benetti ◽  
André Luiz Fraga Briso ◽  
Luciana Louzada Ferreira ◽  
Marina Carminatti ◽  
Larissa Álamo ◽  
...  
Keyword(s):  
Statistical Tests ◽  
Control Groups ◽  
Pulp Tissue ◽  
Necrosis Factor Alpha ◽  
Dental Bleaching ◽  
Tnf Α ◽  
Pulp Inflammation ◽  
Significant Difference ◽  
Anti Inflammatory ◽  
And Control

Abstract Bleaching gel containing hydrogen peroxide (H2O2) cause damages in pulp tissue. This study investigated the action of a topical anti-inflammatory, the Otosporin®, in rats’ bleached teeth with the null hypothesis of which the Otosporin® is no able to minimize the pulp inflammation that bleaching gel generates. The rat’s molars were divided into groups: BLE: bleached (35% H2O2 concentration /single application of 30 min); BLE-O: bleached followed by Otosporin® (10 min); and control: placebo gel. In the second day after dental bleaching, the rats were killed, and the jaws were processed for hematoxylin-eosin and immunohistochemistry analysis for tumor necrosis factor alpha (TNF-α), interleukin (IL)-6 and IL-17. The data collected were subjected to Kruskal-Wallis and Dunn statistical tests with at a 5% level of significance (p<0.05). The BLE group had moderate to strong inflammation in the occlusal third of the coronary pulp, with necrotic areas; and BLE-O, mild inflammation (p<0.05). There was a significant difference in the occlusal and middle thirds of the coronary pulp between the BLE with BLE-O and control groups (p<0.05). There was no difference in the cervical third (p>0.05). The BLE group had a high immunoexpression of TNF-α than BLE-O and control groups (p<0.05), with moderate and mild immunoexpression, respectively. Regarding IL-6 and IL-17, the BLE group had higher immunoexpression than control (p<0.05); the BLE-O was similar to the control (p>0.05). The topical anti-inflammatory Otosporin® can reduce pulp inflammation after dental bleaching in the rat teeth.

scholarly journals Treatment with Tumor Necrosis Factor-α Inhibitors, History of Allergy, and Hypercalcemia Are Risk Factors of Immune Reconstitution Inflammatory Syndrome in HIV-Negative Pulmonary Tuberculosis Patients

2019 ◽  
Vol 9 (1) ◽  
pp. 96
Author(s):  
Yoshimasa Hachisu ◽  
Yasuhiko Koga ◽  
Shu Kasama ◽  
Kyoichi Kaira ◽  
Masakiyo Yatomi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Immune Reconstitution ◽  
Tumor Necrosis ◽  
Hiv Patients ◽  
Tnf Α ◽  
History Of ◽  
Inflammatory Syndrome ◽  
Necrosis Factor ◽  
Inhibitor Treatment

Immune reconstitution inflammatory syndrome (IRIS) is an immune reaction that occurs along with the recovery of the patient’s immunity. Tuberculosis-related IRIS (TB-IRIS) upon tumor necrosis factor (TNF)-α inhibitor treatment has been reported in non-human immunodeficiency virus (HIV) patients. However, the importance of biological treatment, as a risk factor of IRIS, has not yet been established. In this study, we examined TB-IRIS in non-HIV patients to explore the role of TNF-α inhibitor treatment. Out of 188 patients with pulmonary TB, seven patients had IRIS. We examined univariate logistic and multivariate analysis to elucidate risk factors of TB-IRIS. Univariate analysis indicated that usage of immunosuppressive drugs, TNF-α inhibitors, and history of food or drug allergy were significantly related with TB-IRIS. On initial treatment, the values of serological markers such as serum albumin and serum calcium were significantly related with TB-IRIS. There was a higher mortality rate in patients with TB-IRIS. Furthermore, multivariate analysis revealed that usage of TNF-α inhibitors, history of allergy, and serum hypercalcemia were related to TB-IRIS. Usage of TNF-α inhibitors, history of allergy, and serum hypercalcemia may be independent predictors of TB-IRIS in non-HIV patients. Since higher mortality has been reported for TB-IRIS, we should pay attention to TB patients with these risk factors.

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