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A cross-sectional study analysis of 160 GIC patients and 100 control subjects indicated significantly higher HCMV prevalence in GIC patients based on the HCMV IgM test. However, a similar analysis based on an IgG test revealed no significant relationship. Further meta-analysis of 11 studies, including 1,044 patients and 991 healthy subjects, displayed HCMV infection as an important risk factor for not only colorectal cancer occurrence and development based on a HCMV DNA test, but also for GIC based on a HCMV IgM test. However, the IgG test again displayed no significant relationship between HCMV infection and GIC occurrence. Key Message Overall, our study revealed that HCMV infection is associated with an increased GIC risk. However, additional studies are warranted to elucidate the molecular mechanism underlying this association.
Different endotypes of rhinitis are known, but its pathomechanism has not been conclusively established. For example, the precise difference between systemic allergic rhinitis (SAR) and local allergic rhinitis (LAR) is still being checked. Comparison of patients with LAR and with allergies to birch of those with intermittent allergic rhinitis, same allergy, or with non-allergic rhinitis (NAR) was the purpose of this study.
Twenty-six patients with LAR, 18 with SAR and allergy to birch, and 21 with NAR were included. Patients who met the inclusion criteria were selected to undergo the following procedures at baseline medical examinations, nasal provocation test (NPT), detection of nasal-specific IgE to birch as well as basophil activation test (BAT). All immunological parameters were detected before and after NPT.
Concentration of nasal IgE to Bet v1 increased comparably in the LAR and SAR groups after NPT to birch as follows in 21 (81%) patients with LAR, 14 (78%) with SAR, and in everyone in the NAR group. Serum concentration of allergen-specific IgE to Bet v1 increased significantly from a median of 20.7 (25-75% interval 11.2-35.6) IU/mL to 29.9 (13.6-44.1) (p = 0.028) after NPT in patients with SAR. Allergen-specific IgE to Bet v1 was absent in all patients with LAR and NAR before and after NPT. selleck products BAT with Bet v1 was positive in 22 (85%) patients with LAR, in 14 (78%) with SAR, and 2 (9.5%) with NAR.
These obtained data suggest there are no potential mechanisms that could explain LAR compared to SAR.
These obtained data suggest there are no potential mechanisms that could explain LAR compared to SAR.Geographic atrophy (GA) represents the non-exudative late stage of age-related macular degeneration and constitutes a leading cause of legal blindness in the developed world. It is characterized by areas of loss of outer retinal layers including photoreceptors, degeneration of the retinal pigment epithelium, and rarefication of the choriocapillaris. As all three layers are functionally connected, the precise temporal sequence and relative contribution of these layers towards the development and progression of GA is unclear. The advent of optical coherence tomography angiography (OCT-A) has allowed for three-dimensional visualization of retinal blood flow. Using OCT-A, recent studies have demonstrated that choriocapillaris flow alterations are particularly associated with the development of GA, exceed atrophy boundaries spatially, and are a prognostic factor for future GA progression. Furthermore, OCT-A may be helpful to differentiate GA from mimicking diseases. Evidence for a potential protective effect of specific forms of choroidal neovascularization in the context of GA has been reported. This article aims to give a comprehensive review of the current literature concerning the application of OCT-A in GA, and summarizes the opportunities and limitations with regard to pathophysiologic considerations, differential diagnosis, study design, and patient assessment.
Low- and middle-income countries (LMICs) are the worst affected by a lack of safe and affordable access to safe surgery. The significant unmet surgical need can be in part attributed to surgical workforce shortages that disproportionately affect rural areas of these countries. To combat this, Malawi has introduced a cadre of non-physician clinicians (NPCs) called clinical officers (COs), trained to the level of a Bachelor of Science (BSc) in Surgery. This study explored the barriers and enablers to their retention in rural district hospitals (DHs), as perceived by the first cohort of COs trained to BSc in Surgery level in Malawi.
A longitudinal qualitative research approach was used based on interviews with 16 COs, practicing at DHs, during their BSc training (2015); and again with 15 of them after their graduation (2019). Data from both time points were analysed and compared using a top-down thematic analysis approach.
Of the 16 COs interviewed in 2015, 11 intended to take up a post at a DH following gsurgery.
The sustainability of surgically trained NPCs in Malawi is not assured and further work is required to develop and implement successful retention strategies, which will require a multi-sector approach. This paper provides insights into barriers and enablers to retention of this newly-introduced cadre and has important lessons for policy-makers in Malawi and other countries employing NPCs to deliver essential surgery.This comment reflects on an article by Oortwijn, Jansen, and Baltussen about the use and features of 'evidence-informed deliberative processes' (EDPs) among health technology assessment (HTA) agencies around the world and the need for more guidance. First, we highlight procedural aspects that are relevant across key steps of EDP, focusing on conflict of interest, the different roles of stakeholders throughout a HTA and public justification of decisions. Second, we discuss new knowledge and models needed to maximize the value of deliberative processes at the expanding frontiers of HTA, paying special attention to when HTA is applied in primary care, employed for public health interventions, and is produced through international collaboration.This commentary considers the impact of the coronavirus disease 2019 (COVID-19) pandemic on the study of populist radical right (PRR) politicians and their influence on public health and health policy. A systematic review of recent research on the influence of PRR politicians on the health and welfare policies shows that health is not a policy arena that these politicians have much experience in. In office, their effects can be destructive, primarily because they subordinate health to their other goals. Brazil, the US and the UK all show this pattern. PRR politicians in opposition such as the Freedom Party of Austria (FPÖ) in Austria or the Lega in Italy, said very little during the actual health crisis, but once the public no longer appeared afraid they lost no time in reactivating anti-European Union (EU) sentiments. Whether in government or in opposition, PRR politicians opted for distraction and denial. Their effects ranged from making the pandemic worse.
