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  1. Article ; Online: Remdesivir Resistance in Transplant Recipients With Persistent Coronavirus Disease 2019.

    Hogan, John I / Duerr, Ralf / Dimartino, Dacia / Marier, Christian / Hochman, Sarah E / Mehta, Sapna / Wang, Guiqing / Heguy, Adriana

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2022  Volume 76, Issue 2, Page(s) 342–345

    Abstract: New mutations conferring resistance to SARS-CoV-2 therapeutics have important clinical implications. We describe the first cases of an independently acquired V792I RNA-dependent RNA polymerase mutation developing in renal transplant recipients after ... ...

    Abstract New mutations conferring resistance to SARS-CoV-2 therapeutics have important clinical implications. We describe the first cases of an independently acquired V792I RNA-dependent RNA polymerase mutation developing in renal transplant recipients after remdesivir exposure. Our work underscores the need for augmented efforts to identify concerning mutations and address their clinical implications.
    MeSH term(s) Humans ; COVID-19 ; SARS-CoV-2 ; Antiviral Agents/therapeutic use ; Transplant Recipients ; COVID-19 Drug Treatment
    Chemical Substances remdesivir (3QKI37EEHE) ; Antiviral Agents
    Language English
    Publishing date 2022-09-21
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciac769
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  2. Article ; Online: Conservation Practices for Personal Protective Equipment: A Systematic Review with Focus on Lower-Income Countries.

    Thiel, Cassandra L / Sreedhar, Pallavi / Silva, Genevieve S / Greene, Hannah C / Seetharaman, Meenakshi / Durr, Meghan / Roberts, Timothy / Vedanthan, Rajesh / Lee, Paul H / Andrade, Gizely / El-Shahawy, Omar / Hochman, Sarah E

    International journal of environmental research and public health

    2023  Volume 20, Issue 3

    Abstract: During the start of the COVID-19 pandemic, shortages of personal protective equipment (PPE) necessitated unprecedented and non-validated approaches to conserve PPE at healthcare facilities, especially in high income countries where single-use disposable ... ...

    Abstract During the start of the COVID-19 pandemic, shortages of personal protective equipment (PPE) necessitated unprecedented and non-validated approaches to conserve PPE at healthcare facilities, especially in high income countries where single-use disposable PPE was ubiquitous. Our team conducted a systematic literature review to evaluate historic approaches for conserving single-use PPE, expecting that lower-income countries or developing contexts may already be uniquely conserving PPE. However, of the 50 included studies, only 3 originated from middle-income countries and none originated from low-income countries. Data from the included studies suggest PPE remained effective with extended use and with multiple or repeated use in clinical settings, as long as donning and doffing were performed in a standard manner. Multiple decontamination techniques were effective in disinfecting single use PPE for repeated use. These findings can inform healthcare facilities and providers in establishing protocols for safe conservation of PPE supplies and updating existing protocols to improve sustainability and overall resilience. Future studies should evaluate conservation practices in low-resource settings during non-pandemic times to develop strategies for more sustainable and resilient healthcare worldwide.
    MeSH term(s) Humans ; COVID-19/epidemiology ; COVID-19/prevention & control ; Pandemics/prevention & control ; Health Personnel ; Infectious Disease Transmission, Patient-to-Professional ; Personal Protective Equipment
    Language English
    Publishing date 2023-01-31
    Publishing country Switzerland
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph20032575
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  3. Article ; Online: How Ophthalmologists Can Decarbonize Eye Care: A Review of Existing Sustainability Strategies and Steps Ophthalmologists Can Take.

    Sherry, Brooke / Lee, Samuel / Ramos Cadena, Maria De Los Angeles / Laynor, Gregory / Patel, Sheel R / Simon, Maxine dellaBadia / Romanowski, Eric G / Hochman, Sarah E / Schuman, Joel S / Prescott, Christina / Thiel, Cassandra L

    Ophthalmology

    2023  Volume 130, Issue 7, Page(s) 702–714

    Abstract: Topic: Understanding approaches to sustainability in cataract surgery and their risks and benefits.: Clinical relevance: In the United States, health care is responsible for approximately 8.5% of greenhouse gas (GHG), and cataract surgery is one of ... ...

    Abstract Topic: Understanding approaches to sustainability in cataract surgery and their risks and benefits.
    Clinical relevance: In the United States, health care is responsible for approximately 8.5% of greenhouse gas (GHG), and cataract surgery is one of the most commonly performed surgical procedures. Ophthalmologists can contribute to reducing GHG emissions, which lead to a steadily increasing list of health concerns ranging from trauma to food instability.
    Methods: We conducted a literature review to identify the benefits and risks of sustainability interventions. We then organized these interventions into a decision tree for use by individual surgeons.
    Results: Identified sustainability interventions fall into the domains of advocacy and education, pharmaceuticals, process, and supplies and waste. Existing literature shows certain interventions may be safe, cost-effective, and environmentally friendly. These include dispensing medications at home to patients after surgery, multi-dosing appropriate medications, training staff to properly sort medical waste, reducing the number of supplies used during surgery, and implementing immediate sequential bilateral cataract surgery where clinically appropriate. The literature was lacking on the benefits or risks for some interventions, such as switching specific single-use supplies to reusables or implementing a hub-and-spoke-style operating room setup. Many of the advocacy and education interventions have inadequate literature specific to ophthalmology but are likely to have minimal risks.
    Conclusions: Ophthalmologists can engage in a variety of safe and effective approaches to reduce or eliminate dangerous GHG emissions associated with cataract surgery.
    Financial disclosure(s): Proprietary or commercial disclosure may be found after the references.
    MeSH term(s) Humans ; Ophthalmologists ; Cataract Extraction ; Cataract ; Lens, Crystalline ; Ophthalmology
    Language English
    Publishing date 2023-03-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 392083-5
    ISSN 1549-4713 ; 0161-6420
    ISSN (online) 1549-4713
    ISSN 0161-6420
    DOI 10.1016/j.ophtha.2023.02.028
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  4. Article ; Online: Rapid Diagnostic Testing of Hospitalized Malawian Children Reveals Opportunities for Improved HIV Diagnosis and Treatment.

    Madaline, Theresa F / Hochman, Sarah E / Seydel, Karl B / Liomba, Alice / Saidi, Alex / Matebule, Grace / Mowrey, Wenzhu B / O'Hare, Bernadette / Milner, Danny A / Kim, Kami

    The American journal of tropical medicine and hygiene

    2017  Volume 97, Issue 6, Page(s) 1929–1935

    Abstract: Recent World Health Organization (WHO) guidelines recommend antiretroviral therapy (ART) for all HIV-infected people; previously CD4+ T lymphocyte quantification (CD4 count) or clinical staging determined eligibility for children ≥ 5 years old in low- ... ...

    Abstract Recent World Health Organization (WHO) guidelines recommend antiretroviral therapy (ART) for all HIV-infected people; previously CD4+ T lymphocyte quantification (CD4 count) or clinical staging determined eligibility for children ≥ 5 years old in low- and middle-income countries. We examined positive predictive value (PPV) of a rapid diagnostic test (RDT) algorithm and ART eligibility for hospitalized children with newly diagnosed HIV infection. We enrolled 363 hospitalized Malawian children age 2 months to 16 years with two serial positive HIV RDT from 2013 to 2015. Children aged ≤ 18 months whose nucleic acid testing was negative or unavailable were later excluded from the analysis (
    MeSH term(s) Adolescent ; Antiretroviral Therapy, Highly Active ; CD4-Positive T-Lymphocytes/virology ; Child ; Child, Preschool ; Cohort Studies ; Diagnostic Tests, Routine ; Female ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; HIV-1/isolation & purification ; Humans ; Infant ; Malawi/epidemiology ; Male ; World Health Organization
    Language English
    Publishing date 2017-10-12
    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.17-0067
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  5. Article ; Online: Author Correction for Hochman et al., Fatal Pediatric Cerebral Malaria Is Associated with Intravascular Monocytes and Platelets That Are Increased with HIV Coinfection.

    Hochman, Sarah E / Madaline, Theresa F / Wassmer, Samuel C / Mbale, Emmie / Choi, Namjong / Seydel, Karl B / Whitten, Richard O / Varughese, Julie / Grau, Georges E R / Kamiza, Steve / Molyneux, Malcolm E / Taylor, Terrie E / Lee, Sunhee / Milner, Danny A / Kim, Kami

    mBio

    2016  Volume 7, Issue 1, Page(s) e02068–15

    Language English
    Publishing date 2016-02-02
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 2557172-2
    ISSN 2150-7511 ; 2161-2129
    ISSN (online) 2150-7511
    ISSN 2161-2129
    DOI 10.1128/mBio.02068-15
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  6. Article ; Online: Fatal Pediatric Cerebral Malaria Is Associated with Intravascular Monocytes and Platelets That Are Increased with HIV Coinfection.

    Hochman, Sarah E / Madaline, Theresa F / Wassmer, Samuel C / Mbale, Emmie / Choi, Namjong / Seydel, Karl B / Whitten, Richard O / Varughese, Julie / Grau, Georges E R / Kamiza, Steve / Molyneux, Malcolm E / Taylor, Terrie E / Lee, Sunhee / Milner, Danny A / Kim, Kami

    mBio

    2015  Volume 6, Issue 5, Page(s) e01390–15

    Abstract: Cerebral malaria (CM) is a major contributor to malaria deaths, but its pathophysiology is not well understood. While sequestration of parasitized erythrocytes is thought to be critical, the roles of inflammation and coagulation are controversial. In a ... ...

    Abstract Cerebral malaria (CM) is a major contributor to malaria deaths, but its pathophysiology is not well understood. While sequestration of parasitized erythrocytes is thought to be critical, the roles of inflammation and coagulation are controversial. In a large series of Malawian children hospitalized with CM, HIV coinfection was more prevalent than in pediatric population estimates (15% versus 2%, P < 0.0001, chi-square test), with higher mortality than that seen in HIV-uninfected children (23% versus 17%, P = 0.0178, chi-square test). HIV-infected (HIV(+)) children with autopsy-confirmed CM were older than HIV-uninfected children (median age, 99 months versus 32 months, P = 0.0007, Mann-Whitney U test) and appeared to lack severe immunosuppression. Because HIV infection is associated with dysregulated inflammation and platelet activation, we performed immunohistochemistry analysis for monocytes, platelets, and neutrophils in brain tissue from HIV(+) and HIV-uninfected children with fatal CM. Children with autopsy-confirmed CM had significantly (>9 times) more accumulations of intravascular monocytes and platelets, but not neutrophils, than did children with nonmalarial causes of coma. The monocyte and platelet accumulations were significantly (>2-fold) greater in HIV(+) children than in HIV-uninfected children with autopsy-confirmed CM. Our findings indicate that HIV is a risk factor for CM and for death from CM, independent of traditional measures of HIV disease severity. Brain histopathology supports the hypotheses that inflammation and coagulation contribute to the pathogenesis of pediatric CM and that immune dysregulation in HIV(+) children exacerbates the pathological features associated with CM. IMPORTANCE : There are nearly 1 million malaria deaths yearly, primarily in sub-Saharan African children. Cerebral malaria (CM), marked by coma and sequestered malaria parasites in brain blood vessels, causes half of these deaths, although the mechanisms causing coma and death are uncertain. Sub-Saharan Africa has a high HIV prevalence, with 3 million HIV-infected (HIV(+)) children, but the effects of HIV on CM pathogenesis and mortality are unknown. In a study of pediatric CM in Malawi, HIV prevalence was high and CM-attributed mortality was higher in HIV(+) than in HIV-uninfected children. Brain pathology in children with fatal CM was notable not only for sequestered malaria parasites but also for intravascular accumulations of monocytes and platelets that were more severe in HIV(+) children. Our findings raise the possibility that HIV(+) children at risk for malaria may benefit from targeted malaria prophylaxis and that adjunctive treatments targeting inflammation and/or coagulation may improve CM outcomes.
    MeSH term(s) Blood Platelets ; Brain/pathology ; Coinfection/mortality ; Coinfection/pathology ; HIV Infections/complications ; HIV Infections/pathology ; Humans ; Malaria, Cerebral/epidemiology ; Malaria, Cerebral/mortality ; Malaria, Cerebral/pathology ; Malawi/epidemiology ; Monocytes ; Survival Analysis
    Language English
    Publishing date 2015-09-22
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2557172-2
    ISSN 2150-7511 ; 2161-2129
    ISSN (online) 2150-7511
    ISSN 2161-2129
    DOI 10.1128/mBio.01390-15
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  7. Article ; Online: Linking EPCR-Binding PfEMP1 to Brain Swelling in Pediatric Cerebral Malaria.

    Kessler, Anne / Dankwa, Selasi / Bernabeu, Maria / Harawa, Visopo / Danziger, Samuel A / Duffy, Fergal / Kampondeni, Sam D / Potchen, Michael J / Dambrauskas, Nicholas / Vigdorovich, Vladimir / Oliver, Brian G / Hochman, Sarah E / Mowrey, Wenzhu B / MacCormick, Ian J C / Mandala, Wilson L / Rogerson, Stephen J / Sather, D Noah / Aitchison, John D / Taylor, Terrie E /
    Seydel, Karl B / Smith, Joseph D / Kim, Kami

    Cell host & microbe

    2017  Volume 22, Issue 5, Page(s) 601–614.e5

    Abstract: Brain swelling is a major predictor of mortality in pediatric cerebral malaria (CM). However, the mechanisms leading to swelling remain poorly defined. Here, we combined neuroimaging, parasite transcript profiling, and laboratory blood profiles to ... ...

    Abstract Brain swelling is a major predictor of mortality in pediatric cerebral malaria (CM). However, the mechanisms leading to swelling remain poorly defined. Here, we combined neuroimaging, parasite transcript profiling, and laboratory blood profiles to develop machine-learning models of malarial retinopathy and brain swelling. We found that parasite var transcripts encoding endothelial protein C receptor (EPCR)-binding domains, in combination with high parasite biomass and low platelet levels, are strong indicators of CM cases with malarial retinopathy. Swelling cases presented low platelet levels and increased transcript abundance of parasite PfEMP1 DC8 and group A EPCR-binding domains. Remarkably, the dominant transcript in 50% of swelling cases encoded PfEMP1 group A CIDRα1.7 domains. Furthermore, a recombinant CIDRα1.7 domain from a pediatric CM brain autopsy inhibited the barrier-protective properties of EPCR in human brain endothelial cells in vitro. Together, these findings suggest a detrimental role for EPCR-binding CIDRα1 domains in brain swelling.
    MeSH term(s) Brain/parasitology ; Brain Edema/metabolism ; Brain Edema/parasitology ; Cell Adhesion ; Child ; Child, Preschool ; Endothelial Protein C Receptor/metabolism ; Female ; Humans ; Infant ; Malaria, Cerebral/metabolism ; Malaria, Cerebral/parasitology ; Malaria, Falciparum/metabolism ; Malaria, Falciparum/parasitology ; Malaria, Falciparum/physiopathology ; Malawi ; Male ; Neoplasm Proteins/metabolism ; Plasmodium falciparum/metabolism ; Plasmodium falciparum/pathogenicity ; Protein Binding ; Protein Domains ; Protozoan Proteins/metabolism ; Receptors, Cell Surface/metabolism
    Chemical Substances Endothelial Protein C Receptor ; Neoplasm Proteins ; PROCR protein, human ; Protozoan Proteins ; Receptors, Cell Surface ; epithelial membrane protein-1
    Language English
    Publishing date 2017-10-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2278004-X
    ISSN 1934-6069 ; 1931-3128
    ISSN (online) 1934-6069
    ISSN 1931-3128
    DOI 10.1016/j.chom.2017.09.009
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