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  1. Article ; Online: COVID-19 and Corticosteroids: Unfamiliar but Potentially Fatal Infections That Can Arise following Short-Course Steroid Treatment.

    Shirley, Debbie-Ann / Moonah, Shannon

    The American journal of tropical medicine and hygiene

    2021  Volume 104, Issue 3, Page(s) 790–793

    Abstract: Corticosteroid use is increasing worldwide as recent studies confer survival benefit of corticosteroids in the management of patients with severe COVID-19. Strongyloides and amebic infections are neglected diseases that can progress to catastrophic ... ...

    Abstract Corticosteroid use is increasing worldwide as recent studies confer survival benefit of corticosteroids in the management of patients with severe COVID-19. Strongyloides and amebic infections are neglected diseases that can progress to catastrophic complications in patients exposed to corticosteroids, even with short treatment courses. To prevent lethal outcomes, clinicians should be aware of the threat these two parasitic infections pose to at-risk patients receiving corticosteroids, especially in the era of COVID-19.
    MeSH term(s) Adrenal Cortex Hormones/adverse effects ; Adrenal Cortex Hormones/classification ; Adrenal Cortex Hormones/therapeutic use ; Drug Administration Schedule ; Humans ; Parasitic Diseases/classification ; Parasitic Diseases/etiology ; Parasitic Diseases/mortality ; Parasitic Diseases/parasitology ; Prospective Studies ; Systemic Inflammatory Response Syndrome/drug therapy ; COVID-19 Drug Treatment
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2021-01-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2942-7
    ISSN 1476-1645 ; 0002-9637
    ISSN (online) 1476-1645
    ISSN 0002-9637
    DOI 10.4269/ajtmh.20-1471
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Clostridioides difficile Infection in Children: Recent Updates on Epidemiology, Diagnosis, Therapy.

    Shirley, Debbie-Ann / Tornel, William / Warren, Cirle A / Moonah, Shannon

    Pediatrics

    2023  Volume 152, Issue 3

    Abstract: Clostridioides (formerly Clostridium) difficile is the most important infectious cause of antibiotic-associated diarrhea worldwide and a leading cause of healthcare-associated infection in the United States. The incidence of C. difficile infection (CDI) ... ...

    Abstract Clostridioides (formerly Clostridium) difficile is the most important infectious cause of antibiotic-associated diarrhea worldwide and a leading cause of healthcare-associated infection in the United States. The incidence of C. difficile infection (CDI) in children has increased, with 20 000 cases now reported annually, also posing indirect educational and economic consequences. In contrast to infection in adults, CDI in children is more commonly community-associated, accounting for three-quarters of all cases. A wide spectrum of disease severity ranging from asymptomatic carriage to severe diarrhea can occur, varying by age. Fulminant disease, although rare in children, is associated with high morbidity and even fatality. Diagnosis of CDI can be challenging as currently available tests detect either the presence of organism or disease-causing toxin but cannot distinguish colonization from infection. Since colonization can be high in specific pediatric groups, such as infants and young children, biomarkers to aid in accurate diagnosis are urgently needed. Similar to disease in adults, recurrence of CDI in children is common, affecting 20% to 30% of incident cases. Metronidazole has long been considered the mainstay therapy for CDI in children. However, new evidence supports the safety and efficacy of oral vancomycin and fidaxomicin as additional treatment options, whereas fecal microbiota transplantation is gaining popularity for recurrent infection. Recent advancements in our understanding of emerging epidemiologic trends and management of CDI unique to children are highlighted in this review. Despite encouraging therapeutic advancements, there remains a pressing need to optimize CDI therapy in children, particularly as it pertains to severe and recurrent disease.
    MeSH term(s) Adult ; Child ; Humans ; Child, Preschool ; Anti-Bacterial Agents/adverse effects ; Clostridioides difficile ; Vancomycin/adverse effects ; Clostridium Infections/diagnosis ; Clostridium Infections/drug therapy ; Clostridium Infections/epidemiology ; Diarrhea/drug therapy
    Chemical Substances Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU)
    Language English
    Publishing date 2023-08-09
    Publishing country United States
    Document type Review ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2023-062307
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Extended Interval Aminoglycoside Treatment for

    Simpkins, Justin / Miller, Sarah / Shirley, Debbie-Ann

    The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG

    2021  Volume 27, Issue 1, Page(s) 85–89

    Abstract: Infective endocarditis (IE) in neonates is associated with high mortality and incidence has been increasing over the past two decades. The majority of very low birth weight infants will be treated with at least one nephrotoxic medication during their ... ...

    Abstract Infective endocarditis (IE) in neonates is associated with high mortality and incidence has been increasing over the past two decades. The majority of very low birth weight infants will be treated with at least one nephrotoxic medication during their hospital course. Over one-quarter of very low birth weight neonates exposed to gentamicin may develop acute kidney injury (AKI); this is particularly worrisome as AKI is an independent factor associated with increased neonatal mortality and increased length of stay. AKI during periods of neonatal nephrogenesis, which continues until 34-36 weeks postmenstrual age, may also have serious effects on the long-term nephron development which subsequently puts infants at risk of chronic kidney disease. Extended interval (EI) aminoglycoside (AMG) dosing has been used for decades in adult populations and has proven to reduce AKI while being at least as effective as traditional dosing, although there is limited published research for using an EI AMG in endocarditis in adults or pediatric patients. We describe an extremely low birth weight neonate, born preterm at 24 weeks gestation treated for
    Language English
    Publishing date 2021-12-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3028543-4
    ISSN 1551-6776
    ISSN 1551-6776
    DOI 10.5863/1551-6776-27.1.85
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Drug Repurposing of the Alcohol Abuse Medication Disulfiram as an Anti-Parasitic Agent.

    Shirley, Debbie-Ann / Sharma, Ishrya / Warren, Cirle A / Moonah, Shannon

    Frontiers in cellular and infection microbiology

    2021  Volume 11, Page(s) 633194

    Abstract: Parasitic infections contribute significantly to worldwide morbidity and mortality. Antibiotic treatment is essential for managing patients infected with these parasites since control is otherwise challenging and there are no vaccines available for ... ...

    Abstract Parasitic infections contribute significantly to worldwide morbidity and mortality. Antibiotic treatment is essential for managing patients infected with these parasites since control is otherwise challenging and there are no vaccines available for prevention. However, new antimicrobial therapies are urgently needed as significant problems exist with current treatments such as drug resistance, limited options, poor efficacy, as well as toxicity. This situation is made worse by the challenges of drug discovery and development which is costly especially for non-profitable infectious diseases, time-consuming, and risky with a high failure rate. Drug repurposing which involves finding new use for existing drugs may help to more rapidly identify therapeutic candidates while drastically cutting costs of drug research and development. In this perspective article, we discuss the importance of drug repurposing, review disulfiram pharmacology, and highlight emerging data that supports repurposing disulfiram as an anti-parasitic, exemplified by the major diarrhea-causing parasite
    MeSH term(s) Alcoholism ; Animals ; Anti-Bacterial Agents ; Disulfiram ; Drug Repositioning ; Humans ; Parasites
    Chemical Substances Anti-Bacterial Agents ; Disulfiram (TR3MLJ1UAI)
    Language English
    Publishing date 2021-03-11
    Publishing country Switzerland
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2619676-1
    ISSN 2235-2988 ; 2235-2988
    ISSN (online) 2235-2988
    ISSN 2235-2988
    DOI 10.3389/fcimb.2021.633194
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Significance of amebiasis

    Debbie-Ann T Shirley / Koji Watanabe / Shannon Moonah

    PLoS Neglected Tropical Diseases, Vol 13, Iss 11, p e

    10 reasons why neglecting amebiasis might come back to bite us in the gut.

    2019  Volume 0007744

    Keywords Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2019-11-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Significance of amebiasis: 10 reasons why neglecting amebiasis might come back to bite us in the gut.

    Shirley, Debbie-Ann T / Watanabe, Koji / Moonah, Shannon

    PLoS neglected tropical diseases

    2019  Volume 13, Issue 11, Page(s) e0007744

    MeSH term(s) Amebiasis/epidemiology ; Amebiasis/parasitology ; Amebiasis/transmission ; Colitis/epidemiology ; Colitis/parasitology ; Disease Outbreaks ; Drug Development ; Dysentery, Amebic/epidemiology ; Dysentery, Amebic/parasitology ; Dysentery, Amebic/transmission ; Entamoeba histolytica/pathogenicity ; Humans ; Inflammatory Bowel Diseases/epidemiology ; Inflammatory Bowel Diseases/parasitology ; Prevalence ; Research ; Vaccines ; Virulence
    Chemical Substances Vaccines
    Language English
    Publishing date 2019-11-14
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2429704-5
    ISSN 1935-2735 ; 1935-2727
    ISSN (online) 1935-2735
    ISSN 1935-2727
    DOI 10.1371/journal.pntd.0007744
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Fulminant Amebic Colitis after Corticosteroid Therapy

    Debbie-Ann Shirley / Shannon Moonah

    PLoS Neglected Tropical Diseases, Vol 10, Iss 7, p e

    A Systematic Review.

    2016  Volume 0004879

    Abstract: BACKGROUND:Amebic colitis, caused by intestinal infection with the parasite, Entamoeba histolytica, is a common cause of diarrhea worldwide. Fulminant amebic colitis is the most devastating complication of this infection, associated with both high ... ...

    Abstract BACKGROUND:Amebic colitis, caused by intestinal infection with the parasite, Entamoeba histolytica, is a common cause of diarrhea worldwide. Fulminant amebic colitis is the most devastating complication of this infection, associated with both high mortality and morbidity. We conducted a review of the English literature to describe cases of fulminant amebic colitis associated with exposure to corticosteroid medications in order to identify the risk factors for poor outcome and determine difficulties in diagnosis and treatment. METHODOLOGY AND PRINCIPAL FINDINGS:Articles reporting severe and fulminant forms of amebic colitis between 1991 and 2016 were collected. 525 records were screened to identify 24 cases for qualitative analysis associated with corticosteroid use. Cases arose from areas of high endemicity or travel to such areas. Most cases (14 of 24, 58%) were given corticosteroids for initially misdiagnosed colitis, mainly inflammatory bowel, resulting in rapid progression of disease. Nearly half of all cases underwent surgical intervention, and 25% of cases died, despite all patients eventually receiving treatment with metronidazole. The odds of death did not differ significantly by prior misdiagnosis, co-morbidities, bowel perforation or need for surgery. CONCLUSIONS AND SIGNIFICANCE:Infection with E. histolytica should be considered prior to the administration of corticosteroids, in particular for patients residing in endemic areas or those with appropriate travel history, especially prior to the diagnosis of inflammatory bowel disease. The development of preventative and treatment interventions are needed to improve outcomes of fulminant disease.
    Keywords Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2016-07-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review.

    Shirley, Debbie-Ann / Moonah, Shannon

    PLoS neglected tropical diseases

    2016  Volume 10, Issue 7, Page(s) e0004879

    Abstract: Background: Amebic colitis, caused by intestinal infection with the parasite, Entamoeba histolytica, is a common cause of diarrhea worldwide. Fulminant amebic colitis is the most devastating complication of this infection, associated with both high ... ...

    Abstract Background: Amebic colitis, caused by intestinal infection with the parasite, Entamoeba histolytica, is a common cause of diarrhea worldwide. Fulminant amebic colitis is the most devastating complication of this infection, associated with both high mortality and morbidity. We conducted a review of the English literature to describe cases of fulminant amebic colitis associated with exposure to corticosteroid medications in order to identify the risk factors for poor outcome and determine difficulties in diagnosis and treatment.
    Methodology and principal findings: Articles reporting severe and fulminant forms of amebic colitis between 1991 and 2016 were collected. 525 records were screened to identify 24 cases for qualitative analysis associated with corticosteroid use. Cases arose from areas of high endemicity or travel to such areas. Most cases (14 of 24, 58%) were given corticosteroids for initially misdiagnosed colitis, mainly inflammatory bowel, resulting in rapid progression of disease. Nearly half of all cases underwent surgical intervention, and 25% of cases died, despite all patients eventually receiving treatment with metronidazole. The odds of death did not differ significantly by prior misdiagnosis, co-morbidities, bowel perforation or need for surgery.
    Conclusions and significance: Infection with E. histolytica should be considered prior to the administration of corticosteroids, in particular for patients residing in endemic areas or those with appropriate travel history, especially prior to the diagnosis of inflammatory bowel disease. The development of preventative and treatment interventions are needed to improve outcomes of fulminant disease.
    MeSH term(s) Adrenal Cortex Hormones/adverse effects ; Dysentery, Amebic/etiology ; Dysentery, Amebic/pathology ; Humans ; Immunosuppression
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2016-07-28
    Publishing country United States
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 2429704-5
    ISSN 1935-2735 ; 1935-2727
    ISSN (online) 1935-2735
    ISSN 1935-2727
    DOI 10.1371/journal.pntd.0004879
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Case Report: Lower Gastrointestinal Bleeding due to

    Madden, Gregory R / Shirley, Debbie-Ann / Townsend, Gregory / Moonah, Shannon

    The American journal of tropical medicine and hygiene

    2019  Volume 101, Issue 6, Page(s) 1380–1383

    Abstract: We report a case ... ...

    Abstract We report a case of
    MeSH term(s) Adult ; Amebiasis/diagnosis ; DNA, Protozoan/genetics ; Diarrhea ; Entamoeba histolytica/isolation & purification ; Entamoebiasis/complications ; Entamoebiasis/diagnosis ; Feces/parasitology ; Gastrointestinal Hemorrhage/diagnosis ; Gastrointestinal Hemorrhage/parasitology ; Humans ; Male ; Multiplex Polymerase Chain Reaction ; Sensitivity and Specificity
    Chemical Substances DNA, Protozoan
    Language English
    Publishing date 2019-11-01
    Publishing country United States
    Document type Case Reports ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2942-7
    ISSN 1476-1645 ; 0002-9637
    ISSN (online) 1476-1645
    ISSN 0002-9637
    DOI 10.4269/ajtmh.19-0237
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: A Review of the Global Burden, New Diagnostics, and Current Therapeutics for Amebiasis.

    Shirley, Debbie-Ann T / Farr, Laura / Watanabe, Koji / Moonah, Shannon

    Open forum infectious diseases

    2018  Volume 5, Issue 7, Page(s) ofy161

    Abstract: Amebiasis, due to the pathogenic ... ...

    Abstract Amebiasis, due to the pathogenic parasite
    Language English
    Publishing date 2018-07-05
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2757767-3
    ISSN 2328-8957
    ISSN 2328-8957
    DOI 10.1093/ofid/ofy161
    Database MEDical Literature Analysis and Retrieval System OnLINE

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