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Anaphylactic and also nonanaphylactic reactions to be able to SARS-CoV-2 vaccinations: a deliberate review and meta-analysis.
The objective was to study ceftazidime-avibactam resistant and susceptible Klebsiella pneumoniae isolated from a patient admitted to the Policlinico Umberto I of Rome for SARS-CoV2. Data on the evolution of patient's conditions, antimicrobial therapies, and microbiological data were collected. Whole-genome sequencing performed by Illumina and Nanopore sequencing methods were used to type the strains. During the hospitalization, a SARS-CoV2-infected patient was colonized by a KPC-producing K. pneumoniae strain and empirically treated with ceftazidime-avibactam (CZA) when presenting spiking fever symptoms. Successively, ST2502 CZA-resistant strain producing the KPC-31 variant gave a pulmonary infection to the patient. find more The infection was treated with high doses of meropenem. The KPC-31-producing strain disappeared but the patient remained colonized by a KPC-3-producing K. pneumoniae strain. An interplay between highly conserved KPC-31- and KPC-3-producing ST2502 strains occurred in the SARS-CoV2 patient during the hospitalization, selected by CZA and carbapenem treatments, respectively.Both bacterioplankton and eukaryoplankton communities play important roles in the geochemical cycles and energy flows of river ecosystems. However, whether a seasonal change in bacterioplankton and eukaryoplankton communities is synchronous remains unclear. To test the synchronicity and analyze how physical and chemical environmental factors affect these communities, we compared bacterioplankton and eukaryoplankton communities in surface water samples between March (dry season) and June (rainfall season) considering water environmental factors. Our results showed that there was no significant difference in operational taxonomic unit number, Shannon index, and Chao1 index in bacterioplankton and eukaryoplankton communities between March and June. However, principal component analysis showed that the communities were significantly different between the sampling times and sampling sites. Water temperature (WT), oxidation-reduction potential (ORP), water transparency (SD), NO3-N, and NH3 significantly influenced bacterioplankton communities, and WT, SD, ORP, and NH4-N significantly influenced eukaryoplankton communities in the river. These results implied that compared with the sampling sites, sampling times more significantly affected the bacterioplankton and eukaryoplankton river communities by influencing WT, ORP, SD, and nitrogen forms.
Selection of anatomic region of spine for decompression in patients with symptomatic tandem spinal stenosis (TSS) remains a challenge due to the confusing clinical presentation as well as uncertain evidence. A systematic review and meta-analysis of observational studies were conducted to compare the outcomes between simultaneous decompression of all stenotic regions (cervical and lumbar, Group 1) and decompression of only the most symptomatic stenotic region (cervical/lumbar, Group 2) in patients with TSS.

A systematic review was conducted, and a comprehensive literature search with well-established inclusion and exclusion criteria with JOA score as an outcome measure was done on PubMed, Google Scholar, and EMBASE database (till January 2021). Observational studies reporting outcomes after simultaneous decompression or only the most symptomatic region were included. NIH quality assessment tool was used to check the quality of each study, and treatment effects were calculated using Dersimonian and Laird ran patients with TSS.
The expansion of crustose lichens in the Negev is principally determined by dew and that of fruticose lichens by fog. Crustose and fruticose lichens are largely adapted to dew and fog, respectively. Although crustose and fruticosea lichens were shown to efficiently use dew and fog, the link between their expansion and the occurrence of dew and fog has never been shown experimentally. This is also the case for the Negev Desert Highlands, where (i) dewless habitats were not inhabited by lichens and (ii) an increase in fruticose lichens with high-altitude fog-prone areas was noted, leading us to hypothesize that the expansion of crustose and fruticose lichens is mainly linked to dew and fog, respectively. Experiments aiming to compare the non-rainfall water (NRW) were conducted. We used cloths attached to 7cm-high cobbles to mimic crustose lichens (MCL), cloths placed horizontally aboveground to evaluate the amount of NRW without the presence of the cobble (CoP), cloths attached to a wire scaffold mimicking frelded substantially higher amounts of NRW (0.09 mm) in comparison to MFL (0.04 mm) during dew events, similar amounts were obtained by both substrates (0.15-0.16 mm) following fog. However, fog interception increased substantially with wind speed. The findings may explain the expansion of crustose lichens in extreme deserts benefiting mainly from dew (but also fog), and the proliferation of fruticose lichens in fog-prone areas, especially when accompanied by high-speed winds. While (mainly) high proliferation of crustose lichens may serve as bioindicators for dew in extreme deserts, fruticose lichens may serve as bioindicators for fog.
After the surge of burst stimulation, different waveforms were developed to optimize results in spinal cord stimulation. Studies have shown higher responder rates for multiwave therapy, but since the launch of such multiwave systems, little is known about the patients' preference regarding waveforms in the long-term follow-up. No study connected particular waveforms to specific pain etiologies or required stimulation parameters so far.

Thirty-four patients with refractory chronic neuropathic pain were treated with spinal cord stimulation systems providing multiwave therapy between September 2018 and October 2019. Patients with a follow-up of at least 6months were selected; 10 subjects were excluded due to revision surgery, infection, and loss to follow-up. Data regarding pain intensity and preferred waveform for the trial, the implantation, 3-month and 6-month follow-up were recorded.

During the trial phase, 10 patients (43.5%) achieved significant pain relief using tonic stimulation, 5 using burst (21.options in complex cases.Hippocampus and amygdala play central roles in the development of post-traumatic stress disorder (PTSD). Changes in neurological structures due to surgery leading to PTSD have previously been reported. In this case, we present a patient that develops PTSD right after epilepsy surgery in the right temporal lobe. The case adds knowledge to the mechanisms of storage of PTSD memories. A 56-year-old male suffering from refractory temporal lobe epilepsy was treated with an anteromesial temporal lobe resection on the right side. A few weeks after the surgery, he developed strong PTSD symptoms. They included flashbacks from a robbery he was subjected to three decades ago when he was 25 years old. In addition, he suffered from hypervigilance, irritability, and avoidance behavior. Psychotherapy eventually eased his symptoms. No previous disorders were recorded. No psychiatry symptoms were present before surgery. This case is one of few reports on the sudden occurrence of PTSD after epilepsy-surgery in the form of right-sided anteromesial temporal lobe resection. The disorder may not have been detected if not included in the Danish Epilepsy-Surgery-Protocol, among them both the pre-surgery psychiatric management and in the post-operative monitoring.
Pancreatic ductal adenocarcinoma (PDAC) is the most malignant cancer of the gastrointestinal system, and is associated with high rates of postoperative complications, including surgical site infections (SSIs). Perioperative oral care is an effective measure for preventing postoperative pneumonia. However, the preventive effects of perioperative oral care on SSIs have not been reported. We investigated the preventive effects of perioperative oral care on SSIs after pancreatic cancer surgery.

A total of 103 patients with PDAC who underwent radical resection at Hiroshima Prefectural Hospital (2011-2018) were enrolled in this retrospective study. Of the 103 patients, 75 received perioperative oral care by dentists and dental hygienists (oral care group), whereas 28 did not (control group). Univariate and multivariate analyses with propensity score as a covariate were used to investigate the incidence and risk factors of SSIs in the oral care and control groups.

The incidence of SSIs was significantly lower in the oral care group than in the control group (12.0% vs. 39.3%, P = 0.004). Logistic regression analysis revealed that a soft pancreas, the surgical procedure (pancreaticoduodenectomy), blood transfusion, diabetes mellitus, and the absence of oral care intervention were risk factors for SSIs. The odds ratio for the absence of oral care intervention was 6.090 (95% confidence interval 1.750-21.200, P = 0.004).

Our results suggest that perioperative oral care may reduce the risk of developing SSIs after pancreatic cancer surgery. These findings need to be evaluated in future prospective studies.

UMIN registration number UMIN000042082; October 15, 2020, retrospectively registered.
UMIN registration number UMIN000042082; October 15, 2020, retrospectively registered.
Talking about illness experience can be challenging for adolescents and young adults (AYAs) with cancer. Visual tools, in addition to spoken language, might make this easier, such as rich pictures and photovoice. We aimed to obtain a comprehensive view of the cancer experience of AYAs by using rich pictures and photovoice.

AYAs (18-35 years old) who had any type of cancer, or were in remission from cancer, were eligible. AYAs drew rich pictures about their experience of living with cancer and explained these during subsequent interviews. Some of the AYAs also participated in photovoice and spent two days with a photographer to make photos about their illness experience. Rich pictures and photos were first analyzed separately, using open coding, after which the identified themes were compared.

Twelve AYAs made rich pictures (RPs), of whom seven also participated in photovoice. The two most predominant themes emerging from the data were struggles related to the future and defining one's identity. The AYAs expressed concerns for the future related to relationships, education, and employment. Relating to defining one's identity, many AYAs expressed that the cancer had a negative impact on their body- and self-image. The main themes were visible in the RPs as well as in the photovoice; however, subtle differences in sub-themes were found.

We found that cancer has an effect on many aspects of AYAs' lives. Further research on how the identified themes play a role in the lives of AYAs with cancer is needed.
We found that cancer has an effect on many aspects of AYAs' lives. Further research on how the identified themes play a role in the lives of AYAs with cancer is needed.
The influence of innovative chimeric antigen receptor T cell (CAR-T) therapy for hematological malignancies on nutritional status remains unknown. Therefore, we aim to explore the alterations of nutritional status after CAR-Tcell therapy in patients with hematological malignancies.

We retrospectively collected the data of patients with acute leukemia (AL), lymphoma, and multiple myeloma (MM), who underwent CAR-T therapy at our hospital from 2018 to 2020. The serum albumin, triglyceride, and cholesterol before and 7, 14, and 21days after CAR-T cell infusion were compared and analyzed.

A total of 117 patients were enrolled, consisting of 39 AL, 23 lymphoma, and 55 MM patients. The baseline albumin, triglyceride, and cholesterol were 37.43 ± 5.08mg/L, 1.63 ± 0.74mmol/L, and 3.62 ± 1.03mmol/L, respectively. The lowest albumin level was found at 7days after CAR-T cellinfusion compared with baseline (P < 0.001), while the levels of triglyceride increased at 14 and 21days (P < 0.001, P = 0.036). The levels of cholesterol at 7, 14, and 21days after CAR-Tcell infusion were lower than baseline (all P < 0.
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