Avian influenza virus in pregnancy
Summary The unprecedented epizootic of avian influenza viruses, such as H5N1, H5N6, H7N1 and H10N8, has continued to cause disease in humans in recent years. In 2013, another novel influenza A (H7N9) virus emerged in China, and 30% of those patients died. Pregnant women are particularly susceptible to avian influenza and are more likely to develop severe complications and to die, especially when infection occurs in the middle and late trimesters. Viremia is believed to occur infrequently, and thus vertical transmission induced by avian influenza appears to be rare. However, avian influenza increases the risk of adverse pregnancy outcomes, including spontaneous abortion, preterm birth and fatal distress. This review summarises 39 cases of pregnant women and their fetuses from different countries dating back to 1997, including 11, 15 and 13 infections with H7N9, H5N1 and the 2009 pandemic influenza (H1N1), respectively. We analysed the epidemic features, following the geographical, population and pregnancy trimester distributions; underlying diseases; exposure history; medical timelines; human‐to‐human transmission; pathogenicity and vertical transmission; antivirus treatments; maternal severity and mortality and pregnancy outcome. The common experiences reported in different countries and areas suggest that early identification and treatment are imperative. In the future, vigilant virologic and epidemiologic surveillance systems should be developed to monitor avian influen...
This study aimed to explore the association between serum syndecan-1 and glypican-3 levels and the adverse perinatal outcome as well as the responses to the treatment of ursodeoxycholic acid (UDCA).MethodsThis prospective, case control study included 88 pregnant women (44 women with ICP and 44 healthy controls). The primary end points were the perinatal outcome and the response to UDCA therapy. A logistic regression model was used to identify the independent risk factors of adverse pregnancy outcomes and reduced response to UDCA therapy.ResultsWomen with ICP had significantly higher serum syndecan-1 (1.27 ± 0.36 ng/...
ConclusionsDental-related pain is often managed by nondental health care professionals in an ED or urgent care setting. An EHR alert may help quickly identify high-risk patients; however, the impact of alerts on prescribing patterns needs further evaluation. The decision regarding the type and quantity of medication to prescribe is complicated by lack of patient access to definitive dental treatment and lack of dental-specific training of prescribers. The limitations of this study include selective inclusion of encounters with specific ICD-9/ICD-10 codes, data limited to objectively searchable criteria, data collection for...
Chikungunya (CHIK) fever is a tropical arbovirosis characterized by sudden fever, headache, rash, and severe arthralgia. The disease has been suggested to act as a trigger for several autoimmune disorders, especially rheumatoid arthritis. This abstract reports 2 cases of Sj ögren syndrome (SS) following CHIK infection. Both patients were female and presented with fever, arthralgia, rash, and arthritis during CHIK outbreak in Recife, Brazil. After several months, they developed severe sicca symptoms and 1 of them presented with parotid enlargement.
Antiphospholipid antibody syndrome (APS) is an autoimmune disease characterized by thromboembolic events or pregnancy-related complications caused by antiphospholipid antibodies. The following case reports a patient diagnosed with APS, osteoporosis, and atherosclerosis. The medication for treatment and control of the diseases were warfarin, low-molecular-weight heparin, aspirin, and alendronate. Clinical and radiographic examination revealed an intraoral fistula, with spontaneous purulent drainage in a 2-month previous tooth extraction area and signs of bone sequestrum both compatible with medication-related osteonecrosis of the jaw (MRONJ).
An 18-year-old female patient who had a 1-year-old daughter came to us presenting a 2-week lesion that has begun as a "bubble." Examination showed an asymptomatic smooth white lesion without ulcerations in lower lip mucosa and minor lesions on tongue. She was a healthy patient, had no previous lesion, and had a normal pregnancy demonstrated by her health card. Blood count had normal parameters. She reports not to have a sexually active life, and denies habits of smoking and alcoholism. After examination, autoimmune lesions were suspected.
This study reports the case of mandibular intraosseous lesion in pregnant women, addressing tomographic dose, type of anesthetic procedure, moment of intervention, and outcome of treatment. The patient is 44 years old with complaint of lack of sensitivity in the mental region. She was on the third gestational month, and had done cone beam tomography. Clinical examination revealed a slight increase in mandibular volume, absence of decayed teeth, or periodontal pocket in the involved teeth.
We present the case of a 49-year-old female patient who presented with a gingival nodule perceived during pregnancy that persisted about 18 years. Histologic sections stained with hematoxylin and eosin (HE) revealed fragments of mucosa with parakeratinized stratified squamous epithelium underlined by highly cellular connective tissue with plump fibroblast arranged in interlacing fascicles was seen.
ConclusionsThrough review of the literature on flu vaccination in immunocompromised patients we show how this could be extrapolated to patients with significant burns. We propose a guideline to aid in the decision to prescribe flu vaccine to patients with significant burns taking into account age, % TBSA burn and comorbidity. The decision to recommend the flu vaccine in this group should be considered on an individual basis. However, flu vaccination represents a simple, low-risk measure which could prevent the dangerous complications of influenza in an at risk group.
GIDEON what’s new summary: December 13 to December 15, 2019 Infectious Diseases – Outbreaks (45 updates) 45 DiseasesMap Infectious Diseases – Diseases (237 updates) 12 Clinical notes73 Diseases152 Country notesMap Infectious Diseases – Vaccines (1 updates) 1 Vaccine Microbiology – Bacteria (1 updates) 1 Bacteria The post Update: December 15, 2019 appeared first on GIDEON - Global Infectious Diseases and Epidemiology Online Network.