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Jérôme Allyn, Nathalie Coolen-Allou, Bénédicte de Parseval, Thomas Galas, Olivier Belmonte, Nicolas Allou, Guillaume Miltgen
RATIONALE: Patients repatriated from foreign hospitals are sources of extensively drug-resistant (XDR) bacteria outbreaks. Thus, an individual benefit potential for the patient opposes a collective ecological risk potential. These ethical issues have not been well studied. PATIENT CONCERNS: We report the case of a 74-year-old patient repatriated from Mauritius to the French island of Reunion who presented mesenteric infarction evolving over several days, and who suffered a cardiac arrest before transfer...
September 2018: Medicine (Baltimore)
Zihan Chen, Xiaoyan Shi
The off-label uses of tigecycline (TGC) to treat ventilator-associated pneumonia (VAP) have aroused worldwide concerns. The efficacy about TGC has been recently reported. However, the adverse events (AEs) remain controversial. Our study aims to analyze the safety of the high-dose (HD) regimens in the treatment of VAP due to multidrug-resistant (MDR) pathogens.The clinical data of 134 patients who were diagnosed with VAP from January 2013 to December 2015 in the NeuroScience Care Unit (NCU) were analyzed retrospectively...
September 2018: Medicine (Baltimore)
Ailin Luo, Xue Zhang, Shiyong Li, Yilin Zhao
RATIONALE: Anesthesiologists have a well-known increased risk of substance abuse. High-concentration of inhalation anesthetics in exhaled air of operating room personnel is detected. such secondhand exposure produces neurobiological sensitization to the reinforcing effects of inhalation anesthetics. PATIENT CONCERNS: An addictive young male anesthesiologist who was long-term abuse with sevoflurane after 4 years occupational exposure. A 28-year-old anesthesiologist on duty was found deeply sleep in the locker room and coved his nose with Gauze with high-concentration of sevoflurane...
September 2018: Medicine (Baltimore)
Wen-Jing Wang, Zhen Tao, Hui-Ling Wu
This study aimed to analyze the clinical manifestations of patients with pyogenic liver abscess and characteristics of pathogenic that caused their infections, in order to provide guidance for the identification of the pathogens that cause liver abscess and selection of antibiotics for treatment of this disease.In the present study, the clinical characteristics, laboratory results, as well as the species and drug resistance of pathogens in patients with bacterial liver abscesses admitted to our hospital from January 2013 to December 2015 were retrospectively analyzed...
September 2018: Medicine (Baltimore)
Yan Liu, Dong Xiao, Xiao-Hui Shi
This retrospective study tried to find the potential approach for reducing the urinary tract infection (UTI) in intensive care patients (ICPs) among adult population.In total, 96 eligible ICP cases were included. Of these, 48 cases received 10% povidone-iodine and were assigned to the intervention group, while the other 48 cases underwent sterile water, and were assigned to the control group for the prevention of catheter-associated UTI before indwelling urinary catheter insertion in ICP. The primary outcome was the occurrence of an UTI after the indwelling catheter...
September 2018: Medicine (Baltimore)
Aditya Bardia, Marina Parton, Sherko Kümmel, Laura G Estévez, Chiun-Sheng Huang, Javier Cortés, Manuel Ruiz-Borrego, Melinda L Telli, Paloma Martin-Martorell, Rafael López, J Thaddeus Beck, Roohi Ismail-Khan, Shin-Cheh Chen, Sara A Hurvitz, Ingrid A Mayer, Daniel Carreon, Scott Cameron, Serena Liao, José Baselga, Sung-Bae Kim
PURPOSE: There are currently no targeted therapies approved for triple-negative breast cancer (TNBC). A tumor necrosis factor α ( TNFα)-based gene expression signature (GS) predictive of sensitivity to LCL161, inhibitor of apoptosis antagonist, was translated into a clinical assay and evaluated in a neoadjuvant trial. PATIENTS AND METHODS: Women with localized TNBC (T2/N0-2/M0) were prospectively stratified by GS status and randomly assigned (1:1) to receive oral LCL161 (1,800 mg once per week) and intravenous paclitaxel (80 mg/m2 once per week; combination arm) or paclitaxel alone (control arm) for 12 weeks, followed by surgery...
September 20, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Jingcai Lu, Jieshi Guo, Dandan Wang, Jinfei Yu, Tiejun Gu, Chunlai Jiang, Wei Kong, Yongge Wu
Streptococcus pneumoniae is an infectious pathogen mainly infecting host bodies through the respiratory system. An effective pneumococcal vaccine would be targeted to the mucosa and provide not only protection against invasive infection but also against colonization in the respiratory system. In the present work, we applied bacterium-like particles (BLPs) as an adjuvant for the development of a PspA mucosal vaccine, in which the PspA protein was displayed on the surface of BLPs. Intranasal immunization with the PspA-BLP pneumococcal vaccine, comprised of PspA2 from pneumococcal family 1 and PspA4 from pneumococcal family 2, not only induced a high level of serum IgG antibodies but also a high level of mucosal SIgA antibodies...
September 20, 2018: Human Vaccines & Immunotherapeutics
Hongyu Liu, Jun Ni, Ping Xu, Fei Tao
Synthetic biology emerges as a powerful approach for unlocking the potential of cyanobacteria to produce various chemicals. However, the highly oxidative intracellular environment of cyanobacteria is incompatible to numerous introduced enzymes from anaerobes. In this study, we explore a strategy based on natural compartmentalization of cyanobacterial heterocysts to overcome the incompatibility. Hence, the oxygen-sensitive 1,3-propanediol (1,3-PDO) biosynthetic pathway was selected as a model and insulated in heterocysts to evaluate the proposed strategy...
September 20, 2018: ACS Synthetic Biology
Jerry Y Du, Adam J Schell, Chang-Yeon Kim, Nikunj N Trivedi, Uri M Ahn, Nicholas U Ahn
STUDY DESIGN: Retrospective case-control study. OBJECTIVE: To determine incidence and timing of mortality following surgery for spinal epidural abscess (SEA), identify risk factors for mortality, and identify complications associated with mortality. SUMMARY OF BACKGROUND DATA: SEA is a serious condition with potentially devastating sequelae. There is a paucity of literature characterizing mortality following surgery for SEA. METHODS: The National Surgical Quality Improvement Program (NSQIP) database was used...
September 17, 2018: Spine
Ronald E Weir, Christopher S Lyttle, David O Meltzer, Tien S Dong, Gregory W Ruhnke
BACKGROUND: Despite widespread use of comorbidities for population health descriptions and risk adjustment, the ideal method for ascertaining comorbidities is not known. We sought to compare the relative value of several methodologies by which comorbidities may be ascertained. METHODS: This is an observational study of 1596 patients admitted to the University of Chicago for community-acquired pneumonia from 1998 to 2012. We collected data via chart abstraction, administrative data, and patient report, then performed logistic regression analyses, specifying comorbidities as independent variables and in-hospital mortality as the dependent variable...
September 18, 2018: Medical Care
Maryline Chomton, David Brossier, Michaël Sauthier, Emilie Vallières, Josée Dubois, Guillaume Emeriaud, Philippe Jouvet
OBJECTIVES: Ventilator-associated pneumonia is the second most common nosocomial infection in pediatric intensive care. The Centers for Disease Control and Prevention recently issued diagnosis criteria for pediatric ventilator-associated pneumonia and for ventilator-associated events in adults. The objectives of this pediatric study were to determine the prevalence of ventilator-associated pneumonia using these new Centers for Disease Control and Prevention criteria, to describe the risk factors and management of ventilator-associated pneumonia, and to assess a simpler method to detect ventilator-associated pneumonia with ventilator-associated event in critically ill children...
September 17, 2018: Pediatric Critical Care Medicine
Peter W Schreiber, Hugo Sax, Aline Wolfensberger, Lauren Clack, Stefan P Kuster
OBJECTIVE: The preventable proportion of healthcare-associated infections (HAIs) may decrease over time as standards of care improve. We aimed to assess the proportion of HAIs prevented by multifaceted infection control interventions in different economic settings. METHODS: In this systematic review and meta-analysis, we searched OVID Medline, EMBASE, CINAHL, PubMed, and The Cochrane Library for studies published between 2005 and 2016 assessing multifaceted interventions to reduce catheter-associated urinary tract infections (CAUTIs), central-line-associated bloodstream infections (CLABSIs), surgical site infections (SSIs), ventilator-associated pneumonia (VAP), and hospital-acquired pneumonia not associated with mechanical ventilation (HAP) in acute-care or long-term care settings...
September 20, 2018: Infection Control and Hospital Epidemiology
Jasim Alabbad, Fawaz Abdul Raheem, Fatema Alkhalifa, Yousef Hassan, Ahmad Al-Banoun, Wadha Alfouzan
BACKGROUND: We conducted a clinical and microbiologic analysis of patients presenting with anorectal abscess. METHODS: A total of 505 adult patients presenting from January 2011 to December 2017 were analyzed retrospectively. Microbiologic data were available for 211 patients. RESULTS: The mean age at presentation was 39.5 (standard deviation 12.4) years, and 81.4% of the cohort were men. One hundred fifteen patients (22.8%) had diabetes mellitus, and 15 patients (3...
September 20, 2018: Surgical Infections
Tom H Boyles, Adrian Brink, Greg L Calligaro, Cheryl Cohen, Keertan Dheda, Gary Maartens, Guy A Richards, Richard van Zyl Smit, Clifford Smith, Sean Wasserman, Andrew C Whitelaw, Charles Feldman
[This corrects the article DOI: 10.21037/jtd.2017.05.31.].
August 2018: Journal of Thoracic Disease
Xiaoming Zhou, Yu Chen, Li Zhao
No abstract text is available yet for this article.
August 2018: Journal of Thoracic Disease
Eun Seok Kang, Hyeran Kang, Jinsoo Min, Jin Young An, Kang Hyeon Choe, Ki Man Lee, Yoon Mi Shin
No abstract text is available yet for this article.
August 2018: Journal of Thoracic Disease
Satoru Moriyama, Motoki Yano, Hiroshi Haneda, Katsuhiro Okuda, Osamu Kawano, Tadashi Sakane, Risa Oda, Takuya Watanabe, Ryoichi Nakanishi
Background: Pure red cell aplasia (PRCA) associated with thymoma is relatively rare, and relevant reports are limited. We investigated the clinical features and outcomes of PRCA associated with thymoma in this study. Methods: A retrospective review of all PRCA patients who underwent surgical resection of thymoma from April 1, 2004, to December 31, 2015, was performed. Results: We experienced eight patients with PRCA among 146 patients who underwent surgical resection of thymoma...
August 2018: Journal of Thoracic Disease
Richard H Kallet, Kelly Ho, Michael S Lipnick, Michael A Matthay
Background: Common causes of acute respiratory distress syndrome (ARDS) include pneumonia, aspiration, non-pulmonary sepsis and trauma. Little is known about pulmonary mechanics and gas exchange in less-common etiologies of ARDS, which comprises 12-23% of cases. Our hospital's ARDS quality assurance database contained a substantial number of these cases. This descriptive study examines the pulmonary mechanics, and gas exchange characteristics of this diverse cohort of ARDS subjects. Methods: Between March 2010 and April 2017 we identified 94 subjects with less common etiologies of ARDS who had dead space fraction (VD /VT ) and respiratory system compliance (CRS ) measured within 24 hours of ARDS onset; 86 of whom did not have sepsis as a co-diagnosis...
August 2018: Journal of Thoracic Disease
Peiyan Zheng, Xiaoqing Liu, Huimin Huang, Zijun Guo, Ge Wu, Haisheng Hu, Chuanxu Cai, Wenting Luo, Nili Wei, Qian Han, Baoqing Sun
Background: Idiopathic interstitial pneumonia (IIP) can induce type II alveolar epithelial cell proliferation and pulmonary basement membrane damage and subsequent release of Krebs von den Lungen-6 antigen (KL-6) to the bloodstream. This study investigated the diagnostic and prognostic value of serum KL-6 levels for IIP. Methods: One hundred five patients with lung disease were divided into IIP (n=75) and non-IIP groups (n=30) according to pathological and computed tomography findings...
August 2018: Journal of Thoracic Disease
Toby M Maher, Tamera J Corte, Aryeh Fischer, Michael Kreuter, David J Lederer, Maria Molina-Molina, Judit Axmann, Klaus-Uwe Kirchgaessler, Vincent Cottin
Introduction: Despite extensive multidisciplinary team (MDT) assessment, some patients have interstitial lung disease (ILD) that is considered unclassifiable (uILD), for which there are currently no approved treatments. This study will assess the efficacy and safety of the antifibrotic pirfenidone in treating uILD. Methods and analysis: This double-blind, randomised, placebo-controlled phase II trial is enrolling adults with fibrosing ILD, including uILD that fulfils proposed research criteria for interstitial pneumonia with autoimmune features (IPAF), that cannot be classified with moderate or high confidence to any category of ILD following MDT discussion...
2018: BMJ Open Respiratory Research
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