Med (New York, N.y.)最新文献

{"title":"Deadly COVID-19 among the elderly: Innate immune memory helping those most in need.","authors":"Yahya Sohrabi, Holger Reinecke, Leo A B Joosten, Mihai G Netea","doi":"10.1016/j.medj.2021.02.004","DOIUrl":"10.1016/j.medj.2021.02.004","url":null,"abstract":"<p><p>Age is a key risk factor associated with the severity of symptoms caused by SARS-CoV-2, and there is an urgent need to reduce COVID-19 morbidity and mortality in elderly individuals. We discuss evidence suggesting that trained immunity elicited by BCG vaccination may improve immune responses and can serve as a strategy to combat COVID-19 in this population.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"378-383"},"PeriodicalIF":0.0,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25420122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a risk score using complete blood count to predict in-hospital mortality in COVID-19 patients.","authors":"Hui Liu,&nbsp;Jing Chen,&nbsp;Qin Yang,&nbsp;Fang Lei,&nbsp;Changjiang Zhang,&nbsp;Juan-Juan Qin,&nbsp;Ze Chen,&nbsp;Lihua Zhu,&nbsp;Xiaohui Song,&nbsp;Liangjie Bai,&nbsp;Xuewei Huang,&nbsp;Weifang Liu,&nbsp;Feng Zhou,&nbsp;Ming-Ming Chen,&nbsp;Yan-Ci Zhao,&nbsp;Xiao-Jing Zhang,&nbsp;Zhi-Gang She,&nbsp;Qingbo Xu,&nbsp;Xinliang Ma,&nbsp;Peng Zhang,&nbsp;Yan-Xiao Ji,&nbsp;Xin Zhang,&nbsp;Juan Yang,&nbsp;Jing Xie,&nbsp;Ping Ye,&nbsp;Elena Azzolini,&nbsp;Alessio Aghemo,&nbsp;Michele Ciccarelli,&nbsp;Gianluigi Condorelli,&nbsp;Giulio G Stefanini,&nbsp;Jiahong Xia,&nbsp;Bing-Hong Zhang,&nbsp;Yufeng Yuan,&nbsp;Xiang Wei,&nbsp;Yibin Wang,&nbsp;Jingjing Cai,&nbsp;Hongliang Li","doi":"10.1016/j.medj.2020.12.013","DOIUrl":"https://doi.org/10.1016/j.medj.2020.12.013","url":null,"abstract":"<p><strong>Background: </strong>To develop a sensitive risk score predicting the risk of mortality in patients with coronavirus disease 2019 (COVID-19) using complete blood count (CBC).</p><p><strong>Methods: </strong>We performed a retrospective cohort study from a total of 13,138 inpatients with COVID-19 in Hubei, China, and Milan, Italy. Among them, 9,810 patients with <b>≥</b>2 CBC records from Hubei were assigned to the training cohort. CBC parameters were analyzed as potential predictors for all-cause mortality and were selected by the generalized linear mixed model (GLMM).</p><p><strong>Findings: </strong>Five risk factors were derived to construct a composite score (PAWNN score) using the Cox regression model, including platelet counts, age, white blood cell counts, neutrophil counts, and neutrophil:lymphocyte ratio. The PAWNN score showed good accuracy for predicting mortality in 10-fold cross-validation (AUROCs 0.92-0.93) and subsets with different quartile intervals of follow-up and preexisting diseases. The performance of the score was further validated in 2,949 patients with only 1 CBC record from the Hubei cohort (AUROC 0.97) and 227 patients from the Italian cohort (AUROC 0.80). The latent Markov model (LMM) demonstrated that the PAWNN score has good prediction power for transition probabilities between different latent conditions.</p><p><strong>Conclusions: </strong>The PAWNN score is a simple and accurate risk assessment tool that can predict the mortality for COVID-19 patients during their entire hospitalization. This tool can assist clinicians in prioritizing medical treatment of COVID-19 patients.</p><p><strong>Funding: </strong>This work was supported by National Key R&D Program of China (2016YFF0101504, 2016YFF0101505, 2020YFC2004702, 2020YFC0845500), the Key R&D Program of Guangdong Province (2020B1111330003), and the medical flight plan of Wuhan University (TFJH2018006).</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"435-447.e4"},"PeriodicalIF":17.0,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2020.12.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25317190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving path-dependent equity for global COVID-19 vaccine allocation.","authors":"Anthony D So,&nbsp;Joshua Woo","doi":"10.1016/j.medj.2021.03.004","DOIUrl":"https://doi.org/10.1016/j.medj.2021.03.004","url":null,"abstract":"<p><p>Committing to global access for COVID-19 vaccines is key to avoiding a resurgence of the pandemic. However, agreements between countries and vaccine manufacturers have undermined a globally coordinated approach, and the ongoing vaccine rollout highlights long-standing inequities in health. Yet, the surest path out of this pandemic is one toward greater equity.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"373-377"},"PeriodicalIF":17.0,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2021.03.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25510761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How did Jordan combat COVID-19: Lessons learned for scaling.","authors":"Akeel T Al-Kazwini,&nbsp;Walid Al-Zyoud,&nbsp;Samira Al-Nasser,&nbsp;Salem A Alswaiti,&nbsp;Dalia S Khankan,&nbsp;Rana Dajani","doi":"10.1016/j.medj.2021.03.016","DOIUrl":"https://doi.org/10.1016/j.medj.2021.03.016","url":null,"abstract":"","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"348-349"},"PeriodicalIF":17.0,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2021.03.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38886616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis endotypes to guide stratified host-directed therapy.","authors":"Andrew R DiNardo,&nbsp;Tomoki Nishiguchi,&nbsp;Sandra L Grimm,&nbsp;Larry S Schlesinger,&nbsp;Edward A Graviss,&nbsp;Jeffrey D Cirillo,&nbsp;Cristian Coarfa,&nbsp;Anna M Mandalakas,&nbsp;Jan Heyckendorf,&nbsp;Stefan H E Kaufmann,&nbsp;Christoph Lange,&nbsp;Mihai G Netea,&nbsp;Reinout Van Crevel","doi":"10.1016/j.medj.2020.11.003","DOIUrl":"https://doi.org/10.1016/j.medj.2020.11.003","url":null,"abstract":"<p><p>There is hope that host-directed therapy (HDT) for Tuberculosis (TB) can either shorten treatment duration, help cure drug resistant disease or limit the immunopathology. Many candidate HDT drugs have been proposed, however solid evidence only exists for a few select patient groups. The clinical presentation of TB is variable, with differences in severity, tissue pathology, and bacillary burden. TB clinical phenotypes likely determine the potential benefit of HDT. Underlying TB clinical phenotypes, there are TB \"endotypes,\" defined as distinct molecular profiles, with specific metabolic, epigenetic, transcriptional, and immune phenotypes. TB endotypes can be characterized by either immunodeficiency or pathologic excessive inflammation. Additional factors, like comorbidities (HIV, diabetes, helminth infection), structural lung disease or <i>Mycobacterial</i> virulence also drive TB endotypes. Precise disease phenotyping, combined with in-depth immunologic and molecular profiling and multimodal omics integration, can identify TB endotypes, guide endotype-specific HDT, and improve TB outcomes, similar to advances in cancer medicine.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"217-232"},"PeriodicalIF":17.0,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2020.11.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39556930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal to fetal transmission of cancer: implications for molecular tumor testing, immune regulation, and pediatric malignancies.","authors":"Ramez N Eskander,&nbsp;Razelle Kurzrock","doi":"10.1016/j.medj.2021.02.006","DOIUrl":"https://doi.org/10.1016/j.medj.2021.02.006","url":null,"abstract":"<p><p>Molecular tumor testing has transformed the treatment of patients with malignancies and is helping catalyze the development of novel therapeutic strategies. In a recent issue of <i>The New England Journal of Medicine</i>, Arakawa et al. describe two cases of pediatric lung cancer resulting from mother-to-infant transmission, diagnosed remote from delivery.¹.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"211-213"},"PeriodicalIF":17.0,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2021.02.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38875042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capturing pathogenic immune cells before they home to brain.","authors":"Lawrence Steinman","doi":"10.1016/j.medj.2021.02.005","DOIUrl":"https://doi.org/10.1016/j.medj.2021.02.005","url":null,"abstract":"<p><p>In this issue, Kaufmann and colleagues¹ describe a population of immune cells that home to brain in multiple sclerosis (MS). Using an approved therapeutic, targeting α4β1integrin, they demonstrated how to trap these cells in blood, opening the possibility for their elimination before they cross into brain.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"214-216"},"PeriodicalIF":17.0,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2021.02.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25540968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ironing Out Vaccine Efficacy.","authors":"Christian G Peace,&nbsp;Luke A J O'Neill","doi":"10.1016/j.medj.2021.01.003","DOIUrl":"https://doi.org/10.1016/j.medj.2021.01.003","url":null,"abstract":"<p><p>Iron deficiency has been linked to impaired humoral immunity to vaccines. In this issue of <i>Med</i>, Frost et al. demonstrate the importance of serum iron levels for lymphocyte function during vaccination and infection, pointing to iron supplementation as a strategy to boost vaccine efficacy, including against COVID19.¹.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"113-114"},"PeriodicalIF":17.0,"publicationDate":"2021-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2021.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39815728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Undergraduate Research Experiences: More Than a Pandemic Stopgap.","authors":"Tahoura Samad,&nbsp;Heather E Fleming,&nbsp;Sangeeta N Bhatia","doi":"10.1016/j.medj.2021.01.007","DOIUrl":"https://doi.org/10.1016/j.medj.2021.01.007","url":null,"abstract":"<p><p>During the SARS-CoV-2 pandemic, experimental research groups face a unique challenge: how to train undergraduates without access to labs. We share our experience developing entirely virtual undergraduate research internships and make a case for virtual research as a complement to traditional undergraduate mentoring, even after the resolution of the pandemic.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"118-121"},"PeriodicalIF":17.0,"publicationDate":"2021-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2021.01.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39815729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccination Is the Only Acceptable Path to Herd Immunity.","authors":"Angela L Rasmussen","doi":"10.1016/j.medj.2020.12.004","DOIUrl":"https://doi.org/10.1016/j.medj.2020.12.004","url":null,"abstract":"<p><p>Population-level herd immunity is critical for long-term control of SARS-CoV-2. However, proposals to reach the herd immunity threshold through naturally acquired infection, rather than vaccination, have complicated public health efforts and popularized policies that will lead to widespread transmission and mortality. Vaccination is the only viable path to herd immunity.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"21-23"},"PeriodicalIF":17.0,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25316698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}