Notes

Worse Outcomes Associated With Liver Transplants: An escalating Trend.
OBJECTIVE This study aimed to assess early mortality (within 1 and 3 months) in patients with primary central nervous system lymphoma (PCNSL) and to identify risk factors associated with early mortality. METHODS We extracted data of PCNSL patients from the Surveillance, Epidemiology, and End Results (SEER) dataset by using the SEER*Stat 8.3.5 software. RESULTS A total of 8091 patients with PCNSL were enrolled in this study. Among them, 57.94% were male, and 42.06% were female. The mean age was 59.50±16.11 years. Death within 1 and 3 months was 10.67% and 29.16%, respectively. Over the past 20 years, early mortality has declined significantly. The common causes of early death were non-Hodgkin lymphoma and other infectious and parasitic diseases, including HIV. Our results showed that gender, age at diagnosis, ethnicity, histological subtype, marital status, tumor location, surgery, radiation, and chemotherapy were associated with early mortality within 1 or 3 months. CONCLUSION The early mortality has declined significantly over the past 20 years. Risk factors for early mortality within 1 or 3 months after PCNSL diagnosis included advanced age, male gender, black race, frontal lobe, unmarried, diffuse large B-cell lymphoma, no surgery, no chemotherapy, and no radiotherapy. BACKGROUND Percutaneous endoscopic surgery is a popular surgery to treat lumbar spinal disorders. However, seizure following percutaneous endoscopic surgery is an unpredictable complication. The only prodromal sign for seizure currently known is neck pain. OBJECTIVES To review incidence, risk factors of seizure during percutaneous endoscopic surgery. To present three cases with seizure and our management. METHODS From October 2006 to March 2019, three of 816 patients (0.34%) with thoracic lumbar disorders who had received percutaneous endoscopic surgery experienced a seizure episode. Those three cases were carefully reviewed. Articles on risk factors for seizure following the spinal procedures published before 06/13/2019 were identified through a PubMed search. B022 cost RESULTS We observed the infusion fluid containing cefazolin, infusion rate, prolonged surgery time, dura tear, and sevoflurane anesthesia may be associated with the seizure attack as described in the literature. Three patients who experienced a seizure episode were under general anesthesia with sevoflurane, and the surgical approach used was interlaminar for herniated disc in L5-S1. We noticed a red flag sign, namely an uncontrollable hypertension episode combined with decreasing pulse rate, in all patients who experienced seizure, which was not observed in other patients. All three patients received antihypertensive medication (labetalol) three times or more without response. CONCLUSION Seizure following percutaneous endoscopic surgery is rare but lethal. Although it's cause remain unknown, we should check all risk factors for seizure and corrected immediately when a red flag sign, uncontrolled hypertension, appears. OBJECTIVES This study aims to summarize the clinical characteristics of death cases with COVID-19 and to identify critically ill patients of COVID-19 early and reduce their mortality. METHODS The clinical records, laboratory findings and radiological assessments included chest X-ray or computed tomography were extracted from electronic medical records of 25 died patients with COVID-19 in Renmin Hospital of Wuhan University from Jan 14 to Feb 13, 2020. Two experienced clinicians reviewed and abstracted the data. RESULTS The age and underlying diseases (hypertension, diabetes, etc.) were the most important risk factors for death of COVID-19 pneumonia. Bacterial infections may play an important role in promoting the death of patients. Malnutrition was common to severe patients. Multiple organ dysfunction can be observed, the most common organ damage was lung, followed by heart, kidney and liver. The rising of neutrophils, SAA, PCT, CRP, cTnI, D-dimer, LDH and lactate levels can be used as indicators of disease progression, as well as the decline of lymphocytes counts. CONCLUSIONS The clinical characteristics of 25 death cases with COVID-19 we summarized, which would be helpful to identify critically ill patients of COVID-19 early and reduce their mortality. OBJECTIVES This study aimed to verify the frequency, genotypes and etiological role of Human Bocavirus (HBoV) in younger Amazonian children with either acute gastroenteritis (AGE) or respiratory infections (ARI). The influence of Rotarix™ vaccination and co-infection status was investigated. DESIGN HBoV quantitative polymerase chain reaction (qPCR) testing of both fecal and saliva (1468 samples) from 734 children less then 5 months old living in the Amazon (Brazil, Guyana and Venezuela). High and median HBoV viral load samples were used for extraction, nested PCR amplification and sequencing for genotyping. HBoV mRNA detection was done by reverse transcription following DNA amplification. RESULTS The overall HBoV frequencies were 14.2% (69/485; AGE) and 14.1% (35/249; ARI) (p =  0.83). HBoV exclusively infected 4.5% (22/485; AGE) and 4% (10/249) of the Amazonian children (Odds ratios 1.13, 95% confidence interval= 2.42-0.52). HBoV 1 was mainly detected in feces and saliva from AGE children; and HBoV2, from ARI children. HBoV mRNA was detected only in feces. The Rotarix™ vaccination status did not affect the HBoV frequencies. CONCLUSIONS We suggested that, after entry into the air/oral pathways, HBoV1 continues infecting towards the intestinal tract causing AGE. HBoV2 can be a causative agent of AGE and ARI in younger Amazonian children. OBJECTIVES The China-Laos border has been identified as an important origin of imported malaria outside China. The aim of this study was to describe the asymptomatic malaria infections and epidemic trend of malaria in China-Laos border region. METHODS A prevalence survey and surveillance of mosquito vectors was conducted in Muang Khua District of Phongsaly Province, China-Laos border, to determine the parasite carrying rate using nested PCR and microscopy and the species composition of malaria vectors by overnight trapping. Blood samples were collected from 354 local residents aged 1-72 years in Sankang village in 2016. A total of 2430 adult mosquitoes were collected from other 4 villages in Muang Khua District from June to August 2016. RESULTS The parasite-carrying rate was 7.63% (27/354) by microscopy or 7.91% (28/354) by nested PCR. The surveillance results of mosquito vectors revealed the predominant genera of adult mosquitoes were Culex (69.92%, 1699/2430) and Anopheles (21.48%, 522/2430). Anopheles sinensis (82.95%, 433/522) was identified as the predominant species among 7 members of the Anopheles in this border region. CONCLUSIONS A high prevalence of asymptomatic malaria was present and the most important malaria vector was Anopheles sinensis, suggesting the malaria epidemic situation was serious in China-Laos border. OBJECTIVES We assessed C-reactive protein (CRP) and plasma albumin (PA) kinetics to evaluate community-acquired bloodstream infection (CA-BSI) patients' 1-year outcomes. METHODS Population-based study, with CRP and PA measurements on day 1 (D1) and D4. Relative CRP variations in relation to D1 CRP value were evaluated (CRP-ratio). Patients were classified as fast response, slow response, non-response, and biphasic response. RESULTS A total of 935 patients were included. At D4, the CRP-ratio was lower in survivors on D365 in comparison with D4-D30 non-survivors and D30-D365 non-survivors (p  less then  0.001). In comparison with fast response patients, non-response and biphasic response patients had 2.74 and 5.29 increased risk, respectively, of death in D4-D30 and 2.77 and 3.16 increased risk, respectively, of death in D31-D365. PA levels remained roughly unchanged from D1-D4, but lower D1 PA predicted higher short and long-term mortality (p  less then  0.001). The discriminative performance of the CRP-ratio and D1 PA to identify patients with poor short and long-term mortality after adjustments was acceptable (AUROC = 0.79). CONCLUSIONS Serial CRP measurements at D1 and D4 after CA-BSI is clinically useful to identify patients with poor outcome. Individual patterns of CRP-ratio response with PA at D1 further refine our ability of predicting short or long-term mortality. BACKGROUND Patients with mixed-strain Mycobacterium tuberculosis infections may be at a high risk of poor treatment outcomes. However, the mechanisms through which mixed infections affect the clinical manifestations are not well recognized. Evidence suggests that failure to detect the pathogen diversity within the host can influence the clinical results. We aimed to investigate the effects of different genotypes in mixed infections and determine their relationship with heteroresistance in the treatment of Iranian tuberculosis patients. METHODS One of the genotypes was identified in the culture and another genotype pattern in the mixed infection was predicted by comparing the pattern of MIRU-VNTR between the clinical specimens and their respective cultures in each patient. For all patients, the drug susceptibility testing was carried out on three single colonies from each clinical sample. The follow-up of patients was carried out during six months of treatment. RESULTS Based on MIRU-VNTR profiles of clinical samples, we showed that 55.6% (25/45) of the Iranian patients included in the study had mixed infections. Patients with mixed infections had a higher rate of treatment failure, compared to others (P =  0.03). By comparing clinical sample profiles to profiles obtained after culture, we were able to distinguish between major and hidden genotypes. Among hidden genotypes, Haarlem (L4.1.2) and Beijing (L2) were associated to treatment failure (6/8 patients). CONCLUSIONS To conclude, we propose a procedure using the MIRU-VNTR method to identify the different genotypes in mixed infections. The present findings suggest that genotypes with potentially higher pathogenicity may not be detected when performing experimental culture in patients with mixed infections. PURPOSE The aims of our study were to (1) evaluate the concordance of both methods for detecting prosthetic joint infection (PJI) pathogens in joint fluid and to (2) clarify whether broad-range polymerase chain reaction (BR-PCR) can be used as a verification method for metagenomic next-generation sequencing (mNGS) for PJI diagnosis. METHODS In total, 63 patients underwent total joint arthroplasty, with 45 PJI and 18 aseptic failure patients included. Joint fluids were sampled after antibiotics were withheld for more than 2 weeks, and then, culture, BR-PCR and mNGS were performed for all samples. RESULTS The joint fluid BR-PCR sensitivity was 82.2%, which was not significantly different from that of mNGS (95.6%) or culture (77.8%). The specificities of the 3 methods were all 94.4%. BR-PCR failed to identify the pathogens in 1 polymicrobial infection patient and 4 fungal infection patients. CONCLUSION mNGS was more sensitive than BR-PCR for detecting PJI pathogens in joint fluid. BR-PCR is insufficient for use as an mNGS verification method. OBJECTIVE To investigate the diagnostic value of serological testing and dynamic variance of serum antibody in coronavirus disease 2019 (COVID-19). METHODS This study retrospectively included 43 patients with a laboratory-confirmed infection and 33 patients with a suspected infection, in whom the disease was eventually excluded. The IgM/IgG titer of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was measured by chemiluminescence immunoassay analysis. RESULTS Compared to molecular detection, the sensitivities of serum IgM and IgG antibodies to diagnose COVID-19 were 48.1% and 88.9%, and the specificities were 100% and 90.9%, respectively.In the COVID-19 group, the IgM-positive rate increased slightly at first and then decreased over time; in contrast, the IgG-positive rate increased to 100% and was higher than IgM at all times. The IgM-positive rate and titer were not significantly different before and after conversion to virus-negative. The IgG-positive rate was up to 90% and not significantly different before and after conversion to virus-negative.
Read More: https://www.selleckchem.com/products/b022.html