Tag: pubmed

Viruses. 2024 Nov 21;16(12):1815. doi: 10.3390/v16121815.

ABSTRACT

The monkeypox outbreak has grown beyond the regions in which it was considered endemic. It has spread from central and west Africa to non-endemic regions like Europe, America, and other parts of the world. It has recently been classified as a public health emergency of international concern. This study evaluated the challenges faced globally and equitable access to monkeypox vaccines. Global competition has been observed in the race to obtain vaccines, with low- and middle-income countries being disadvantaged. Great inequity exists in the distribution of vaccines globally through advance purchase agreements, vaccine stockpiling, vaccine nationalism, the inequitable distribution of existing resources, and insufficient surveillance and reporting mechanisms. To address some of these challenges, there is a need for strengthening the global vaccine manufacturing capacity, targeting countries with elevated risk profiles and limited resources, strengthening surveillance systems, and addressing vaccine hesitancy.

PMID:39772126 | DOI:10.3390/v16121815

Viruses. 2024 Nov 21;16(12):1805. doi: 10.3390/v16121805.

ABSTRACT

INTRODUCTION: Variants of COVID-19 are responsible for 700 million infections and 7 million deaths worldwide. Vaccinations have high efficiency in preventing infection and secondary benefits of reducing COVID-19 hospital admissions, attenuating disease severity and duration of illness. Conflicting reports were published regarding COVID-19 among PLWH.

OBJECTIVE: The aim of this study was to evaluate COVID-19 morbidity, hospitalization, and the magnitude of immunological response to sequential BNT 162b2 mRNA vaccines in PLWH regarding demographic and clinical factors.

RESULTS: Our retrospective study included 784 PLWH who had at least one anti- SARS-CoV-2 antibody test between March 2021 and October 2021. Half of our patients (392) had CD4 cell counts above 500 cells/µL, 40.2% (315) had 200 < CD4 < 500 cells/µL and only 9.8% (77) had CD4 < 200 cells/µL at their last laboratory workup. The mean age was 50.2 ± 12.2 years. About 90% of our patients were given at least two doses of the BNT 162b2 Pfizer vaccines; about 60% received three doses of the vaccine. About a quarter of our patients (27.6%) had COVID-19 infection. Only six patients required hospital admission. All six patients recovered from COVID-19 infection. Titers of COVID-19 antibodies were lower for patients with CD4 cell counts of less than 200 cells/µL in the first, second, and third serological tests with statistical significance. In a multinomial logistic regression, the influence of other factors such as age, sex, and previous COVID-19 infection on first COVID-19 antibody titers was not significant.

CONCLUSIONS: PLWH are responsive to COVID-19 vaccines. As was expected, patients with higher CD4 cell counts had higher titers of COVID-19 antibodies and lower hospitalization rate. Age, sex, and previous COVID-19 infection did not significantly affect antibody titers according to our study. Larger prospective studies with control groups are needed to further characterize immunologic response to COVID-19 vaccination among PLWH.

PMID:39772116 | DOI:10.3390/v16121805

Vaccines (Basel). 2024 Dec 20;12(12):1438. doi: 10.3390/vaccines12121438.

ABSTRACT

BACKGROUND: General practitioners (GPs) and primary care units collaborate with Prevention Departments (PDs) to improve immunization by participating in vaccination campaigns, sharing tools, and implementing educational programs to raise patient awareness. This review aimed to identify effective strategies for involving GPs in PD vaccination practices.

METHODS: A systematic review following PRISMA guidelines was conducted on MEDLINE, TripDatabase, ClinicalTrials, CINAHL, and Cochrane up to January 2024 to identify full-text studies in English evaluating the effectiveness of GP involvement. A meta-analysis was also performed.

RESULTS: Of 1018 records, 15 studies were included, with an intermediate quality assessment. Studies originated from the United States (n = 9), Europe (5), Singapore (1), and China (1). Eight studies investigated educational programs for GPs, while seven focused on organizational or technological interventions to enhance immunization practices. Twelve studies reported increased vaccine uptake after intervention. Vaccines addressed included influenza, SARS-CoV-2, pneumococcal, zoster, and trivalent (diphtheria, tetanus, pertussis). Interventions involving GPs in PD vaccination campaigns, focusing on organizational or technological strategies, demonstrated a significant increase in vaccine uptake (OR = 1.15; 95% CI: 1.03-1.27; p < 0.0001; I² = 96%).

CONCLUSIONS: GPs emerged as valuable allies for PDs due to their extensive territorial reach and trusted relationships with patients. Additionally, up-to-date organizational and technological tools could play a decisive role in increasing vaccine uptakes. This study, offering valuable insights into the effectiveness of GPs involvement, may be useful to implement similar intervention in different contexts.

PMID:39772098 | DOI:10.3390/vaccines12121438

Vaccines (Basel). 2024 Dec 3;12(12):1366. doi: 10.3390/vaccines12121366.

ABSTRACT

Background: Patients receiving heart transplantation require lifelong immunosuppression and compared to the general population, they have a more than five times higher chance of acquiring COVID-19, and their mortality rates are higher. The aim of the present study was to estimate the epidemiological and clinical characteristics of COVID-19 in heart transplant recipients (HTRs) in Slovenia to estimate the vaccination rate and evaluate possible vaccination-hesitant subgroups. Methods: All SARS-CoV-2-positive HTRs (N = 79) between 1 March 2020 and 31 December 2023 at the Infectious Diseases Department, University Medical Centre Ljubljana, Slovenia, were included retrospectively. Demographic, clinical and vaccination data were extracted from medical documentation and a statistical evaluation was performed. Results: The observed vaccination rate was 63.3%, but among patients who received transplants before the pandemic, it was statistically significantly higher (p = 0.027). Vaccinated HTRs were statistically significantly older (p = 0.004) and had a significantly higher Charlson Comorbidity Index (p = 0.018). Our results indicate no significant differences between vaccinated and unvaccinated HTRs regarding acute respiratory insufficiency (p = 0.135), length of hospital stay (p = 0.106), intensive care unit admission (0.414) and in-hospital mortality (p = 0.317), but we observed statistically more frequently an asymptomatic course in those vaccinated (p = 0.050), and a longer length of stay in vector vaccine recipients (p = 0.011) and in those not re-vaccinated (p = 0.030). There was a significantly higher re-vaccination rate in males (p = 0.005). Conclusions: An asymptomatic course of COVID-19 was more often observed in vaccinated HTRs. Our findings suggest statistically significant differences in COVID-19 vaccine acceptance rates; younger HTRs and those transplanted after the pandemic are more hesitant to vaccinate, while females accept booster doses less frequently.

PMID:39772027 | DOI:10.3390/vaccines12121366

Vaccines (Basel). 2024 Nov 29;12(12):1351. doi: 10.3390/vaccines12121351.

ABSTRACT

BACKGROUND/OBJECTIVES: Respiratory syncytial virus (RSV) is the leading cause of severe respiratory disease in infants worldwide. Maternal immunization to protect younger infants is supported by evidence that virus-neutralizing antibodies, which are efficiently transferred across the placenta from mother to fetus, are a primary immune mediator of protection. In maternal RSV vaccine studies, estimates of correlates of protection are elusive because many factors of maternal-fetal immunobiology and disease characteristics must be considered for the estimates.

METHODS: We developed statistical models that aims to predict vaccine efficacy (VE) in infants following maternal immunization by including quantifiable covariates of the antibody titer distribution of the mother (pre- and post-immunization), the transplacental transfer ratio of IgG antibodies, the rate of antibody decay, and RSV disease incidence rate, all of which are season- and time-dependent and vary by infant age.

RESULT: Our model shows that integrating the lower respiratory tract disease risk based on infant airway diameter and associated airway resistance is critical to appropriately model predicted infant VE. The VE predictions by our models, which preceded maternal RSV prefusion F vaccine efficacy trial primary readouts, closely align with the VE outcomes of these field studies.

CONCLUSION: Our models successfully predicted VE of the RSV maternal vaccines and have potential use in modeling the clinical trial out-comes of other respiratory disease vaccines where maternal antibodies play a role in the protection of newborns.

PMID:39772012 | DOI:10.3390/vaccines12121351

Vaccines (Basel). 2024 Nov 27;12(12):1338. doi: 10.3390/vaccines12121338.

ABSTRACT

Background: Global COVID-19 vaccination effort faces the challenges of vaccine hesitancy and resistance, rooted in misinformation and institutional distrust. Addressing these barriers with customized messaging is essential, yet the relationship between vaccine hesitancy and other health-seeking behaviors, like COVID-19 testing, has been underexplored. Method: This study assessed COVID-19 vaccine uptake in Southeastern Louisiana across 10 pharmacies and clinics in areas with historically high rates of COVID-19 infection. Using a longitudinal cohort design from Fall 2022 through Fall 2023, a total of 377 participants from diverse backgrounds were surveyed while seeking routine care at partner organizations. Baseline data was collected on demographics, vaccine knowledge, attitudes, and test-seeking behaviors. Information on COVID-19 testing and vaccination were self-reported and verified, as applicable, in the patient’s medical records. All data was analyzed using descriptive statistics, log-binomial to yield risk ratios, and an ordinal logistic regression for vaccine series completion. Results: Among the 377 participants, 207 were unvaccinated while 170 received the vaccine. Among the unvaccinated individuals, 53 received a half-dose, 97 a full dose, and 14 a booster. Notably, 75% of unvaccinated and 89% of vaccinated participants underwent COVID-19 testing. Individuals who were tested were 1.71 times more likely to be vaccinated (95% CI 1.03, 2.84), while previous vaccine refusal was associated with lower vaccine acceptance (0.77; 95% CI 0.54, 1.09). In the bivariate and multivariate analysis, COVID-19 testing behavior was positively associated with COVID-19 vaccine uptake. Conclusions: Exploring the connection between COVID-19 testing and vaccination provides valuable insights for future public health messaging to mitigate vaccine hesitancy.

PMID:39772000 | DOI:10.3390/vaccines12121338

J Microbiol Immunol Infect. 2024 Dec 20:S1684-1182(24)00229-9. doi: 10.1016/j.jmii.2024.12.002. Online ahead of print.

ABSTRACT

BACKGROUND: This study analyzed the epidemiological trends of three significant respiratory infectious diseases in Taiwan: invasive pneumococcal disease (IPD), influenza with severe complications, and tuberculosis during post-COVID-19 pandemic period.

METHODS: We utilized data from Taiwan’s Centers for Disease Control and Prevention (CDC) website and classified the COVID-19 prevention policies into three phases for the year 2021, 2022, and 2023. We then performed a statistical analysis of reported case numbers for the three respiratory diseases during the 3-year period using the Kruskal-Wallis test, followed by joinpoint regression model for the identification of seasonal distribution and variation.

RESULTS: An annual increase was observed in cases of IPD and influenza with severe complication, with influenza exhibiting a significant surge in 2023 (p < 0.001). IPD showed a non-significant upward trend (p = 0.111), while tuberculosis cases decreased annually (p = 0.114) with the gradual slowdown in the incidence rate reduction. Also, seasonal analysis revealed that IPD peaked in winter and spring, while influenza with severe complication peaked anomalously in the summer of 2023, suggestive of a prominent summer influenza. Finally, imported cases of influenza with severe complication, primarily from East and Southeast Asia, were noted only in 2023.

CONCLUSIONS: The relaxation of COVID-19 preventive measures in Taiwan led to a marked resurgence of respiratory infectious diseases, particularly influenza with severe complication, accompanied by anomalous seasonality in 2023. This study highlights the need for continued vigilance and appropriate public health strategies, including vaccination and non-pharmaceutical interventions, to manage respiratory infectious diseases in the post-pandemic era.

PMID:39765452 | DOI:10.1016/j.jmii.2024.12.002

Foot Ankle Surg. 2025 Jan 3:S1268-7731(25)00005-0. doi: 10.1016/j.fas.2025.01.004. Online ahead of print.

ABSTRACT

BACKGROUND: The optimal treatment of Osteochondral lesion of the talus (OLT) for subchondral bone cysts (SBCs) has not been finalized. The purpose of this systematic review and meta-analysis was to define whether OLT with small SBCs will affect the clinical outcomes of OLTs after arthroscopic microfracture.

METHODS: We searched the Embase, Cochrane Library and PubMed databases up to May 13, 2024 for eligible comparative studies. The methodological index for non-randomized studies (MINORS) were used for assessing the methodological quality. The Review Manager 5.4 software was applied to perform the statistical analysis.

RESULTS: A total of 4 studies involving 257 patients were included in this meta-analysis. No significant difference was noted in American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, the improvement of Foot and Ankle Ability Measure- Activities of Daily Life (FAAM-ADL) and Foot and Ankle Ability Measure (FAAM-SP), Tegner Score and Visual Analogue Scale (VAS) between the cyst and noncyst group. The noncyst group was statistically significant in term of FAAM-ADL and FAAM-SP. Radiological outcomes in the cyst group had improved after arthroscopic microfracture.

CONCLUSIONS: Based on the results of the present study, there are no clinical differences with the technique of bone marrow stimulation between simple and cystic ostechondral lesions of talus with depth smaller than 5-6 mm, with respect to the medial part of talus and referring to age younger than 40 years old.

LEVEL OF CLINICAL EVIDENCE: Level 3.

PMID:39765451 | DOI:10.1016/j.fas.2025.01.004

J Voice. 2025 Jan 6:S0892-1997(24)00467-3. doi: 10.1016/j.jvoice.2024.12.032. Online ahead of print.

ABSTRACT

OBJECTIVE: Current literature involving gender-affirming voice therapy (GAVT) for transgender and nonbinary (TGNB) individuals is limited. This study describes treatment duration and satisfaction at a single institution.

STUDY DESIGN: Retrospective cohort.

SETTING: Tertiary laryngology center.

METHODS: TGNB patients receiving gender-affirming treatment were identified.

DATA COLLECTED: age, sex assigned at birth, gender identity, race, ethnicity, number/frequency of GAVT, Voice Handicap Index-10 (VHI-10), Trans Women Voice Questionnaire (TWVQ) (as appropriate), Gender Congruence Scale (GCS), patient and speech language pathologist (SLP) assessment of treatment satisfaction, and surgical data. Descriptive statistics were reported.

RESULTS: 82 TGNB patients [trans female (n=65), trans male (n=5), nonbinary (n=12)] sought gender-affirming voice care. Mean age was 33.6±10.7years. Majority were assigned male at birth (n=71). Mean presentation VHI-10 was 15.7±8. In the first year of treatment, patients had mean 5.7±3.1 (range 1-16, median 5) GAVT sessions, biweekly (n=36, 44%) or monthly (n=12, 15%). 62% (n=51) of patients were satisfied/very satisfied, 23% (n=19) fairly satisfied, and 10% (n=8) unsatisfied with GAVT outcomes. SLP impression of GAVT outcome was more variable: 15% (n=12) completely met voice goals and 11% (n=9) had excellent GAVT response. Most patients (39%, n=32) were making good progress, with further treatment recommended. SLP referred 11% (n=9) to the laryngologist for surgery consideration; 9% (n=6) underwent Wendler glottoplasty.

CONCLUSIONS: Voice therapy is integral to gender-affirming voice care and often requires more sessions (mean 5.7) than the literature-reported average (∼4) for other voice diagnoses. Appropriate expectations should be set for patients, treating clinicians, and third-party payors about the increased anticipated duration of GAVT.

PMID:39765446 | DOI:10.1016/j.jvoice.2024.12.032

J Hand Ther. 2025 Jan 6:S0894-1130(24)00061-9. doi: 10.1016/j.jht.2024.08.004. Online ahead of print.

ABSTRACT

BACKGROUND: Shoulder pain is a major musculoskeletal problem after wrist-hand immobilization. There is limited evidence regarding the relationship of kinesiophobia or pain catastrophizing with shoulder pain and disability after wrist-hand injury.

PURPOSE: To explore associations between kinesiophobia and pain catastrophizing with ipsilateral persistent shoulder disability in patients with wrist-hand injury after 6 months.

STUDY DESIGN: Prospective study.

METHODS: Participants aged ≥18 years referred to hand therapy after wrist-hand injury requiring wrist-hand immobilization were recruited and completed the Numeric Pain Scale, Shoulder Pain and Disability Index, Pain Catastrophizing Scale (PCS), and Tampa scale for kinesiophobia (TSK) at baseline, after an immobilization period, and after 6 months.

RESULTS: A total of 107 patients were included in the study. Scaphoid fractures were found in 49 (45.8%) of patients, and 58 (54.2%) had distal radius fractures. For each week of increased time spent in immobilization, the Shoulder Pain and Disability Index score increased by 10.2 points, 95% confidence interval (CI) [6.76, 13.57], with higher levels of immobilization being associated with increased shoulder pain and disability. The baseline TSK score was 17.4 and 11.2 at follow-up. The PCS score was initially 14.8 and decreased to 9.3 at follow-up. The addition of TSK and PCS to the predictive model led to a statistically significant increase in R² of 0.163, F(2,100) = 47.471, p < 0.001.

CONCLUSIONS: The duration of wrist immobilization following an injury may play a crucial role in the level of shoulder disability experienced at the 6-month mark post-injury. This shoulder disability may be influenced by factors such as fear of movement.

PMID:39765429 | DOI:10.1016/j.jht.2024.08.004