Medicine (Abingdon, England : UK ed.)最新文献_第4页

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-03-01 Epub Date: 2026-01-22 DOI: 10.1016/j.mpmed.2025.12.002

Harriet Davidson, Angela Houston

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Diagnosis and treatment of malaria in non-endemic settings 在非流行环境中诊断和治疗疟疾

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-03-01 Epub Date: 2026-02-02 DOI: 10.1016/j.mpmed.2025.12.010

Anna Checkley, Anna Boté-Casamitjana

{"title":"Diagnosis and treatment of malaria in non-endemic settings","authors":"Anna Checkley, Anna Boté-Casamitjana","doi":"10.1016/j.mpmed.2025.12.010","DOIUrl":"10.1016/j.mpmed.2025.12.010","url":null,"abstract":"<div><div>Malaria remains a major global health challenge, with the heaviest burden of cases in the World Health Organization African Region. In the UK, malaria continues to cause substantial morbidity among returning travellers. In 2023, the UK reported its highest number of annual malaria cases since 2001. <em>Plasmodium falciparum</em> causes the most severe and fatal cases, although other species are also imported. The clinical presentation is often non-specific, and a high index of suspicion is required in all unwell travellers returning from endemic areas, as delayed or missed diagnoses can be fatal. Diagnosis relies on microscopy with thick and thin films, which provide species identification, parasitaemia and parasite staging. Assessing severity is essential for proper management. In non-immune travellers, complications can occur at lower parasite densities than in endemic populations, and identifying organ involvement early is critical to avoid progression to multiorgan failure and death. Treatment must be promptly initiated. Intravenous artesunate is first-line therapy for severe malaria, with artemisinin-based combination therapies recommended for uncomplicated malaria. In <em>P. vivax</em> and <em>P. ovale</em> infections, radical cure with primaquine is required to eradicate hypnozoites.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 3","pages":"Pages 178-182"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Helminth infections and differentials of eosinophilia 蠕虫感染与嗜酸性粒细胞的鉴别

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-03-01 Epub Date: 2026-02-05 DOI: 10.1016/j.mpmed.2025.12.008

Andrew K Owusu-Agyei, Laura Nabarro

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Tuberculosis 肺结核

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-03-01 Epub Date: 2026-01-22 DOI: 10.1016/j.mpmed.2025.12.003

Scott Pallett, Angela Houston

{"title":"Tuberculosis","authors":"Scott Pallett, Angela Houston","doi":"10.1016/j.mpmed.2025.12.003","DOIUrl":"10.1016/j.mpmed.2025.12.003","url":null,"abstract":"<div><div>Tuberculosis (TB) is a communicable, airborne infectious disease caused by the bacterium <em>Mycobacterium tuberculosis</em>. A quarter of the world's population is infected with TB, affecting all age groups. Infection with <em>Mycobacterium tuberculosis</em> results in latent or active disease. Latent infection is associated with a 10% lifetime risk of developing active disease, but figures are much higher in those with concurrent immunosuppression. Despite being both preventable and curable, TB remains the leading cause of global death from a single infectious agent. Active disease most commonly affects the lungs but can spread to cause extrapulmonary disease anywhere in the body. Over half of individuals who have TB diagnosed in the UK now present with features of extrapulmonary TB, those with HIV being at particular risk. In all cases, obtaining samples for TB culture is absolutely vital. Standard treatment is with quadruple therapy for 6 months, extended in TB meningitis and often TB bone infection. Adjunctive corticosteroids have proven benefit in TB meningitis and TB pericarditis, and can be considered in other circumstances, such as paradoxical reactions to starting treatment for miliary TB. Despite recent gains in diagnosing and treating TB cases worldwide, the global coronavirus disease (COVID-19) pandemic is likely to have significantly affected recent progress.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 3","pages":"Pages 159-163"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Adenovirus infections 腺病毒感染

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-03-01 Epub Date: 2026-02-12 DOI: 10.1016/j.mpmed.2025.12.012

Daryl Weatherley, Claire Mullender, Amber Arnold

{"title":"Adenovirus infections","authors":"Daryl Weatherley, Claire Mullender, Amber Arnold","doi":"10.1016/j.mpmed.2025.12.012","DOIUrl":"10.1016/j.mpmed.2025.12.012","url":null,"abstract":"<div><div>Adenoviruses are endemic, primarily causing respiratory and ocular (pharyngoconjunctival fever) symptoms and gastroenteritis in infants and children. They also cause epidemic keratoconjunctivitis, pneumonia in military recruits and severe, life-threatening infections in transplant recipients. The hardy non-enveloped virus resists environmental degradation and is transmitted by aerosolized droplets, fomites and faecal–oral spread. Outbreaks occur in medical, day care, military and other facilities where people live in close proximity. Diagnosis is predominantly by nucleic acid amplification technology. Identification and typing of molecular species are not used in routine clinical practice but are important for investigating outbreaks and as research tools. Most infections are subclinical or self-limiting when symptomatic, but adenoviruses cause significant morbidity and mortality, especially in haemopoietic stem cell transplant (HSCT) recipients. Routine viral load surveillance of high-risk HSCT patients is advocated, with high or increasing levels of viraemia prompting, where possible, a reduction in immunosuppression as first-line management. Antiviral treatment is largely limited to cidofovir, an intravenous nucleotide analogue DNA polymerase inhibitor, with robust data from randomized controlled trials and licensing to support its use lacking. Pre-emptive antiviral therapy can reduce plasma viral loads, but whether it reduces mortality is less certain.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 3","pages":"Pages 202-206"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Lower respiratory tract infections 下呼吸道感染

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-03-01 Epub Date: 2026-02-06 DOI: 10.1016/j.mpmed.2025.12.005

Julie-Anne Houlihan

{"title":"Lower respiratory tract infections","authors":"Julie-Anne Houlihan","doi":"10.1016/j.mpmed.2025.12.005","DOIUrl":"10.1016/j.mpmed.2025.12.005","url":null,"abstract":"<div><div>Lower respiratory tract infections (LRTIs) encompass infections occurring below the level of the vocal cords. They cause infection at the site of the trachea, bronchi, bronchioles and lung parenchyma. There are a broad range of causative pathogens including viruses, bacteria and fungi. Pneumonia is the single largest killer of children globally, accounting for 14% of all deaths of children <5 years in 2019. It causes 5–12% of all lower respiratory tract infections of adults in the UK. <em>Streptococcus pneumoniae</em> is the leading cause of pneumonia worldwide. The introduction of the conjugate pneumococcal vaccine has significantly decreased the burden of invasive pneumococcal disease in vaccinated children. However, non-vaccine type strains continue to cause severe infections. <em>Bordetella pertussis</em> is an endemic disease of children worldwide. It is a highly transmissible, vaccine-preventable respiratory infection. Infants <3 months old have the highest risk of severe disease before vaccination. Epidemics occur globally every 3–5 years. An increase in cases has been observed worldwide after lifting of the restrictions imposed during the coronavirus disease (COVID-19) pandemic. This review provides an overview of the causes of LRTIs, focusing on the common causes of community- and hospital-acquired pneumonia, bronchitis and <em>Bordetella pertussis</em>.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 3","pages":"Pages 153-158"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Systemic fungal infections 全身真菌感染

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-03-01 Epub Date: 2026-02-06 DOI: 10.1016/j.mpmed.2025.12.013

Riina Rautemaa-Richardson, Malcolm Dennis Richardson

{"title":"Systemic fungal infections","authors":"Riina Rautemaa-Richardson, Malcolm Dennis Richardson","doi":"10.1016/j.mpmed.2025.12.013","DOIUrl":"10.1016/j.mpmed.2025.12.013","url":null,"abstract":"<div><div>Systemic fungal infections are caused by opportunistic fungal pathogens in immunocompromised hosts. However, invasive disease can occur in immunocompetent individuals if exposure is high or with primary (dimorphic) fungal pathogens (causes of endemic mycoses including <em>Blastomyces</em>, <em>Coccidioides</em>, <em>Histoplasma</em>, <em>Paracoccidioides</em> and <em>Talaromyces</em>). Systemic fungal infections originate either in the lungs (<em>Aspergillus</em>, <em>Cryptococcus</em> or <em>Mucorales</em>, as a result of inhalation) or from endogenous flora (<em>Candida</em> spp. as a result of infected lines or leakage from the gastrointestinal tract), and can spread to other organs. Systemic fungal infections are medical emergencies and have high mortality rates, especially if appropriate therapy is delayed. At the same time, fungal infections are a diagnostic challenge, and a combination of investigations is often required to confirm the diagnosis. Therefore, antifungal treatment is often initiated when infection is suspected clinically, and diagnostic tests should be used as part of antifungal stewardship to guide the cessation of unnecessary therapy. Antifungal resistance is a recognized and persisting problem, and all isolates should be identified and tested for their sensitivity profile.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 3","pages":"Pages 219-226"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Influenza: hospital management, pandemic preparedness and innovation 流感：医院管理、大流行防范和创新

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-03-01 Epub Date: 2026-01-22 DOI: 10.1016/j.mpmed.2025.12.006

Carina SB. Tyrrell, John Lee Y. Allen, Effrossyni Gkrania-Klotsas

{"title":"Influenza: hospital management, pandemic preparedness and innovation","authors":"Carina SB. Tyrrell, John Lee Y. Allen, Effrossyni Gkrania-Klotsas","doi":"10.1016/j.mpmed.2025.12.006","DOIUrl":"10.1016/j.mpmed.2025.12.006","url":null,"abstract":"<div><div>Influenza remains one of the most significant global health security threats, responsible for a billion cases and hundreds of thousands of deaths annually. This underscores the potential for future pandemics. Through continuous antigenic drift, and occasionally antigenic shift, the virus escapes immune protection, sustaining seasonal epidemics and enabling the emergence of novel strains. This paper provides an overview of influenza pathogenesis and pathophysiology, epidemiology and the challenges posed by zoonotic strains such as avian and swine influenza with pandemic potential. To reduce the burden of disease, clinicians must effectively identify and manage cases of influenza, with close alignment with national and global health systems to enable rapid detection, response and containment. Early identification and management of novel influenza strains of concern are essential to mitigate the risk of severe disease and transmission. Alongside these imperatives, advances in vaccines, therapeutics, diagnostics and digital health tools are reshaping influenza preparedness and response. By integrating insights from virology, clinical medicine, public health and technological innovation, this paper underscores the persistent risks posed by influenza, its management and the unprecedented opportunities to strengthen prevention, detection and treatment.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 3","pages":"Pages 164-172"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Toxoplasmosis 弓形体病

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-03-01 Epub Date: 2026-02-06 DOI: 10.1016/j.mpmed.2025.12.004

Stephen J Hadfield

{"title":"Toxoplasmosis","authors":"Stephen J Hadfield","doi":"10.1016/j.mpmed.2025.12.004","DOIUrl":"10.1016/j.mpmed.2025.12.004","url":null,"abstract":"<div><div><em>Toxoplasma gondii</em> can infect all mammalian and avian species, and is estimated to have infected one-third of the world's human population. <em>Toxoplasma</em> oocysts shed in cat faeces can contaminate the environment, and common infection routes for humans are the ingestion of oocysts directly from the environment or potentially on raw, unwashed vegetables and fruit, and the consumption of viable tissue cysts in raw or undercooked meat. <em>Toxoplasma</em> infection in immunocompetent individuals is usually asymptomatic but presents as a self-limiting mild to moderate flu- or glandular fever-like illness in 10–20% of cases. Maternal infection acquired during pregnancy can be transmitted to the unborn child, causing congenital abnormality or fetal death. In immunosuppressed and immunodeficient people, acute infection or reactivation of parasites in latent tissue cysts from previously acquired infection can result in severe or life-threatening disease. Laboratory diagnosis relies primarily on testing for immunoglobulin (Ig) G and IgM to assess infection status. IgG avidity testing can provide a more accurate estimate of duration of infection in pregnant mothers. Detection of active infection relies most commonly on nucleic acid amplification testing, while enhanced immunohistostaining can discriminate between latent and active forms of the parasite in affected tissues.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 3","pages":"Pages 187-191"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Lyme disease 莱姆病

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-03-01 Epub Date: 2026-01-20 DOI: 10.1016/j.mpmed.2025.12.001

David R. Snydman, Linden Hu

{"title":"Lyme disease","authors":"David R. Snydman, Linden Hu","doi":"10.1016/j.mpmed.2025.12.001","DOIUrl":"10.1016/j.mpmed.2025.12.001","url":null,"abstract":"<div><div>Lyme disease is the most common tick-borne illness in the USA and Europe. Pathogens involved include <em>Borrelia burgdorferi</em> in the USA and <em>B. afzelii</em> and <em>B. garinii</em> in Europe. The characteristic rash of erythema migrans occurs in 70–80% of patients. Neurological disease, including facial palsy, meningo-encephalitis, aseptic meningitis and polyradiculopathy, occurs in 10–15%. Cardiac disease, primarily manifest as heart block, is seen in 1–4%. Arthritis is a late complication in about 30% of untreated patients. Patients with erythema migrans can be treated for 10–14 days with doxycycline 100 mg orally twice a day. For those unable to tolerate doxycycline, amoxicillin 500 mg orally three times per day for 14–21 days will be effective as will cefuroxime axetil 500 mg two times per day. For central nervous system disease, oral doxycycline has been shown to be equivalent to parenteral ceftriaxone. Lyme arthritis requires the longest courses of antibiotics (28 days) with a second course of therapy required in a substantial fraction of patients. Initial treatment of Lyme arthritis can be with oral antibiotics but intravenous antibiotics are used if there is a poor initial response. Around 15–20% of patients have some persistence of non-specific symptoms such as fatigue and myalgias, but such post-Lyme disease symptoms have not been shown to respond to additional courses of antibiotic therapy. Prevention measures currently rely on tick avoidance, tick repellents and careful inspection and removal of ticks if present. No vaccine for humans is available.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 3","pages":"Pages 192-195"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147415479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0