British medical bulletin
-
Human cytomegalovirus (HCMV) is a threat to immunologically weak patients. HCMV cannot yet be eliminated with a vaccine, despite recent advances. ⋯ We need to understand what immune responses are required to control HCMV, and how best to raise these immune responses with a vaccine.
-
British medical bulletin · Sep 2019
Community-acquired acute bacterial meningitis in adults: a clinical update.
Acute bacterial meningitis (ABM) in adults is associated with a mortality that may exceed 30%. Immunization programs have reduced the global burden; in the UK, declining incidence but persistently high mortality and morbidity mean that clinicians must remain vigilant. ⋯ Research should be focused on optimization of vaccines (e.g. pneumococcal conjugate vaccines with extended serotype coverage), targeting groups at risk for disease and reservoirs for transmission; improving adherence to management guidelines; development of new faster, more accurate diagnostic platforms (e.g. novel point-of-care molecular diagnostics); and development of new adjunctive therapies (aimed at the host-inflammatory response and bacterial virulence factors).
-
Clostridium difficile infection is transmitted via spores, and the disease is mediated via secreted toxins. It represents a significant healthcare problem, and clinical presentation can range from asymptomatic carriage to life-threatening pseudomembranous colitis. ⋯ role of specific microbiota-mediated interventions and vaccination in the treatment and prevention of C. difficile infection.
-
During the past decades, several rating scales have been developed to assess the functional status of patients with hip pain. ⋯ Although many scoring systems have been used to evaluate hip function, we are still far from a single outcome evaluation system which is reliable, valid and sensitive.