Conectar
by Jakob Morén, Barbro Persson, Anna Sörman, Åke Lundkvist, Hanin Shihab, Marie Studahl, Malin Veje, Göran Günther, Gabriel Westman
BackgroundTick-borne encephalitis is a viral infection of the central nervous system that may cause severe illness and long-term sequelae, to which underlying mechanisms are not completely understood. Autoantibodies against the N-methyl-D-aspartate receptor (anti-NMDAR) may be triggered by immunologic events, occur sporadically, and can cause autoimmune encephalitis. Following herpes simplex encephalitis and Japanese encephalitis, anti-NMDAR autoantibodies may develop and have been associated with relapse or impaired cognitive recovery. Tick-borne encephalitis has been shown to trigger anti-NMDAR encephalitis in sporadic cases, but the frequency of autoimmunization is unknown.
ObjectivesThe objective of this study was to assess the frequency of intrathecal anti-NMDAR antibody development following tick-borne encephalitis and to explore whether such antibodies could be relevant to cognitive complaints.
MethodsAdult patients with tick-borne encephalitis were included retrospectively from one cohort and prospectively from another. A stored post-acute cerebrospinal fluid sample was required for anti-NMDAR analysis. Two commercial kits (Euroimmun AG, Lübeck, Germany) were used to detect anti-NMDAR IgG antibodies in cerebrospinal fluid.
ResultsA total of 71 cerebrospinal fluid samples from 53 patients were analyzed for anti-NMDAR antibodies. Samples were obtained at a median of 91 days (range 21–471) after onset of central nervous system symptoms. Anti-NMDAR antibodies were detected in two samples from a single tick-borne encephalitis patient, corresponding to 1.9% of patients (95% CI: 0.05–10.1%).
ConclusionsThe development of intrathecal anti-NMDAR autoantibodies following tick-borne encephalitis is a rare event, and further studies are needed to clarify their potential relevance to cognitive outcomes in a minority of cases. Testing for anti-NMDAR antibodies in cerebrospinal fluid may be considered in patients who experience clinical deterioration following an initial recovery.
To explore implementation patterns and perceived value of the SEXIT (SEXual health Identification Tool) method in the school health care (SHC) setting in Sweden.
Mixed method survey using an online questionnaire with closed and free-text response options.
115 SHC professionals who had completed SEXIT training responded to an online questionnaire (response rate 26%), between March and May 2024. Closed questions were answered on a five-point Likert scale, and responses trichotomised. Quantitative data were analysed using descriptive statistics, qualitative data with a deductive qualitative content analysis. CROSS guideline was used.
70 of 115 SHC professionals used SEXIT in their work. Findings suggest that SEXIT is appropriate and useful, supporting communication about topics such as sexual health and violence that both pupils and professionals may avoid addressing. Implementation patterns showed that 61% of those who had completed training also used SEXIT. 63% of those used SEXIT during regular health dialogues, but some did not use it with all pupils. The perceived value was that most SHC professionals felt that SEXIT helped them get a better understanding of the pupil's situation, an objection that it was too time-consuming.
Most SHC professionals who had completed SEXIT training used the method regularly and perceived the method as valuable and facilitating discussions about sexual ill health and experiences of violence with pupils. There are indications that SHC services fail to identify particularly at-risk young people. Sexual health inequity persists, as some structurally marginalised and vulnerable youths are excluded from the SEXIT dialogues. A follow-up study will focus on pupils' experiences.
This study validates SEXIT in a new setting, SHC, and is relevant for the promotion of sexual and reproductive health for all, and for preventing violence and sexual ill health among young people.
Sepsis-related myocardial injury is common in sepsis patients and has been repeatedly associated with poor patient outcomes. While experimental animal studies suggest that direct and indirect myocardial damage occurs via a wide range of inflammatory mediators, including bacterial toxins, the extent of bacterial-driven myocardial injury in human sepsis remains unclear. This scoping review aims to map existing evidence, identify knowledge gaps and guide future research priorities.
This scoping review will follow the Joanna Briggs Institute methodology for scoping reviews. The review is anticipated to start on 12 December 2024 and be completed by 31 October 2025. A comprehensive search will be conducted in MEDLINE (PubMed), Web of Science and EMBASE. Two independent reviewers will screen titles and abstracts, followed by a full-text review of potentially eligible studies. Studies focusing on the role of bacteria and/or their toxins in myocardial injury in adult patients with sepsis will be included. Data will be independently extracted using predefined forms, and findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews guidelines.
Ethical approval is not required for this scoping review. On completion, findings will be submitted for publication in a peer-reviewed medical journal and presented at scientific conferences. The results will help identify and analyse knowledge gaps, providing valuable insights to inform future research in patients with sepsis.
Registered on Open Science Framework 3 March 2025.
In the first year after ostomy creation, affected persons require substantial support to manage potential complications and adjust to their new life situation. This study aimed to describe the number of visits to the stoma care nurse, the occurrence of leakage and peristomal skin complications, and the use of ostomy products to prevent these complications among persons consulting a stoma care nurse during the first year after surgery. A descriptive study was conducted using data from medical charts for 240 adults with ileostomy or colostomy. Persons with an ileostomy were more burdened by leakage and peristomal skin complications and visited the stoma care nurse more often than those with a colostomy. On average, across ostomy types, episodes of leakage and peristomal skin complications each elicited around one additional nurse visit and increased use of supporting ostomy products. Persons undergoing acute surgery, with a high ASA classification, and females experienced more episodes of leakage, peristomal skin complications and nurse visits. A patient-tailored approach based on risk factors, such as surgery type, ASA class and sex, could potentially reduce the occurrence of complications and the associated healthcare resource utilisation, including stoma care nurse visits. High variability in results further underscores the importance of personalised care.
by Ingrid Andreasson, Hanna C. Persson, Ann Björkdahl
PurposeThe aim was to longitudinally explore changes in fatigue- and cognition-related symptoms during the first year after hospital treatment for COVID-19.
MethodPatients hospitalized for COVID-19 in Gothenburg, Sweden, were consecutively included from 01-07-2020 to 28-02-2021. Patients were assessed at the hospital (acute) and at 3 and 12 months after hospital discharge. Cognition was assessed with the Montreal Cognitive Assessment (MoCA), the Trail Making Test B (TMTB), and the Cognitive Failure Questionnaire (CFQ). Fatigue was assessed using the Multidimensional Fatigue Inventory-20 (MFI-20) and the Mental Fatigue Scale (MFS). Data was analyzed with demographics and changes over time calculated with univariable mixed-effects models.
ResultIn total, 122 participants were included. Analyzes of Z-scores for MoCA indicated improvement over the year, however the results were 1 SD below norm at all assessments. Alertness (TMTB scores) improved significantly from the acute assessment to the 12- month follow-up (p = Conclusion
In the first year after hospitalization for COVID-19, most patients experienced fatigue and cognitive impairment. Alertness improved, but improvements in other domains were limited.
FreshRSS 