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Clinical Severity Score Infection

Shu-Yi Lin, Zheng-Hao Huang, Hsiang-Cheng Chen, Deh-Ming Chang, Chun-Chi Lu
INTRODUCTION: Multidrug-resistant Acinetobacter baumannii (MDRAB) pneumonia with severe sepsis in a patient with rheumatoid arthritis (RA), who is predisposed after treatment with tumor necrosis factor inhibitor (TNFI), is a rare severe infection and can be successfully treated with prompt antibiotics. CASE PRESENTATION: A 75-year-old woman was diagnosed with RA >30 years previously. After inadequate treatment responses to conventional disease-modifying antirheumatic drugs (DMARDs), she developed progressive RA, including swollen joints in both hands, and had a high disease activity score of 4...
August 2018: Medicine (Baltimore)
Yannick Wirz, Marc A Meier, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Stefan Schroeder, Vandack Nobre, Djillali Annane, Konrad Reinhart, Pierre Damas, Maarten Nijsten, Arezoo Shajiei, Dylan W deLange, Rodrigo O Deliberato, Carolina F Oliveira, Yahya Shehabi, Jos A H van Oers, Albertus Beishuizen, Armand R J Girbes, Evelien de Jong, Beat Mueller, Philipp Schuetz
BACKGROUND: The clinical utility of serum procalcitonin levels in guiding antibiotic treatment decisions in patients with sepsis remains unclear. This patient-level meta-analysis based on 11 randomized trials investigates the impact of procalcitonin-guided antibiotic therapy on mortality in intensive care unit (ICU) patients with infection, both overall and stratified according to sepsis definition, severity, and type of infection. METHODS: For this meta-analysis focusing on procalcitonin-guided antibiotic management in critically ill patients with sepsis of any type, in February 2018 we updated the database of a previous individual patient data meta-analysis which was limited to patients with respiratory infections only...
August 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
Ruan Yuan, Yang Boyu, Zhao Fujun, Jiang Chengyi, Jing Yifeng, Wang Xiaohai, Cui Di, Xia Shujie, Han Bangmin
This study aimed to compare the clinical outcomes between transurethral thulium laser enucleation of the prostate (ThuLEP) and transurethral thulium laser resection of the prostate (ThuLRP) for treating benign prostatic hyperplasia (BPH). From May 2014 to August 2015, 212 patients underwent ThuLRP and 188 patients underwent ThuLEP. The ThuLEP group was further divided into two subgroups according to the ways the prostate was taken out. The perioperative parameters were recorded and analyzed. The international prostate symptom score (IPSS), quality-of-life (QoL) score, maximum flow rate (Qmax), and postvoid residual urine volume (PVR) in both groups were estimated and compared 3, 6, and 12 months after surgery...
August 14, 2018: Lasers in Medical Science
Sarfaraz Ahmad Ejazi, Anirban Bhattacharyya, Somsubhra Thakur Choudhury, Sneha Ghosh, Abdus Sabur, Krishna Pandey, Vidya Nand Ravi Das, Pradeep Das, Mehebubar Rahaman, Rama Prosad Goswami, Nahid Ali
Visceral leishmaniasis (VL), a potentially fatal disease is an outcome of infection caused by the parasite Leishmania donovani. The clinical diagnostic tests for this disease are still related to invasive tissue aspiration or serological immunochromatography. Advancements in immunoproteomics such as two-dimensional gel electrophoresis, mass spectrometry, B cell epitope prediction, and peptide synthesis have enabled researchers to discover newer biomarkers for disease diagnosis. In this study, we have screened several urine-reactive leishmanial membrane proteins as potential biomarker candidates...
August 14, 2018: Scientific Reports
QiQi Zhou, Meghan L Verne, Jeremy Z Fields, John J Lefante, Sarpreet Basra, Habeeb Salameh, G Nicholas Verne
BACKGROUND: More effective treatments are needed for patients with postinfectious, diarrhoea-predominant, irritable bowel syndrome (IBS-D). Accordingly, we conducted a randomised, double-blind, placebo-controlled, 8-week-long trial to assess the efficacy and safety of oral glutamine therapy in patients who developed IBS-D with increased intestinal permeability following an enteric infection. METHODS: Eligible adults were randomised to glutamine (5 g/t.i.d.) or placebo for 8 weeks...
August 14, 2018: Gut
S L Sun, W W Ding, B C Liu, X X Fan, X J Wu, J S Li
Objective: To evaluate the application of intestinal stomas in mesenteric ischemia (MI) according to the concept of damage control surgery. Methods: Clinical data of 59 MI patients received intestinal stomas at Jinling Hospital, Nanjing University School of Medicine from January 2010 to June 2017 were analyzed retrospectively. There were 41 male and 18 female patients aging of (51±14) years (ranging from 20 to 86 years). All the patients were divided to two groups according to the degree of bowel ischemia: acute MI group (AMI, bowel necrosis, n =43) and chronic MI group (CMI, bowel stricture, n =16)...
August 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Chao Liu, Jiaojiao Shi, Jun Guo
Purpose: Aerobactin is a critical factor for hypervirulent Klebsiella pneumoniae (hvKp) in genetic backgrounds, but data based on the genotype for the elderly is limited. Materials and methods: A retrospective study was conducted on elderly patients from June 2008 to July 2017 in 2 teaching hospitals. The clinical and microbiological data, including antimicrobial susceptibility testing, string test, extended-spectrum β-lactamase (ESBL) production, virulence gene, and multilocus sequence typing, of the hvKp group defined as aerobactin positive were compared with those of classic K...
2018: Infection and Drug Resistance
Adrian Sousa, María Teresa Pérez-Rodríguez, Adriana Soto, Lorena Rodríguez, Antonio Pérez-Landeiro, Lucia Martínez-Lamas, Andrés Nodar, Manuel Crespo
Background: Experience in real clinical practice with ceftazidime/avibactam is limited, and there are even fewer data on infections due to OXA-48-producing Enterobacteriaceae. Methods: We designed an observational study of a prospectively collected cohort of adult patients receiving ceftazidime/avibactam in our centre. Only the first treatment course of each patient was analysed. Efficacy and safety were evaluated as 14 and 30 day mortality, recurrence rate at 90 days, resistance development and occurrence of adverse effects...
August 7, 2018: Journal of Antimicrobial Chemotherapy
Susan Morgello, Michelle Jacobs, Jacinta Murray, Desiree Byrd, Eric Neibart, Letty Mintz, Gregory Meloni, Christina Chon, John Crary
With aging of HIV populations, there is concern that Alzheimer's disease (AD) may become prevalent and difficult to distinguish from HIV-associated neurocognitive disorders. To date, there are no reports documenting histologically verified Alzheimer's neuropathology in individuals with HIV and dementia. Herein, we report two antiretroviral-treated, virally suppressed, HIV-infected individuals autopsied by the Manhattan HIV Brain Bank. Subject A presented to study at 52 years, already dependent in instrumental activities of daily living (ADLs), with severe cognitive impairment inclusive of learning and memory dysfunction...
August 9, 2018: Journal of Neurovirology
Cristina Margini, Giuseppe Murgia, Guido Stirnimann, Andrea De Gottardi, Nasser Semmo, Stefania Casu, Jaime Bosch, Jean-François Dufour, Annalisa Berzigotti
Obesity and steatosis have been associated with liver disease progression in patients with compensated advanced chronic liver disease (cACLD) (liver stiffness measurement [LSM] ≥ 10 kPa). The controlled attenuation parameter (CAP) estimates steatosis during LSM by transient elastography. We aimed to evaluate whether CAP is associated with the development of clinically relevant events in cACLD. Consecutive patients with cACLD and CAP measurements observed between September 2013 and September 2015 were retrospectively studied...
August 2018: Hepatology communications
Vijay Gayam, Mazin Khalid, Sumit Dahal, Pavani Garlapati, Arshpal Gill
Fluconazole is a triazole antifungal medication used in the treatment of various fungal infections. It is available in both oral and parenteral formulations. Liver damage has been reported with fluconazole use, but most commonly it is benign elevated liver transaminases. Acute liver failure (ALF) in fluconazole use is rare, with cases being reported sporadically in literature and large cohorts describing incidence rates of acute liver injury ranging from 0.0 to 31.6/10,000 patients. We present a case of a 45-year-old African-American male with no history of liver disease who presented with superficial candidiasis and superimposed bacterial cellulitis...
March 2018: Journal of Family Medicine and Primary Care
Tian Li, Yan Liu, Weihong Zhang
BACKGROUND: Breast prosthesis implants have been safely and efficiently used in the plastic surgery department. With the increasing demand for aesthetics, these silicon implants were not only used in breast augmentation surgery but also in breast reconstruction after mastectomy. Nevertheless, breast prosthesis implantation brings a lot of complications, such as: postoperative chronic pain, capsule contracture, prosthesis displacement and prosthesis rupture and infection in severe cases...
August 6, 2018: Aesthetic Plastic Surgery
Norman J Galbraith, Stephen J O'Brien, Samuel P Walker, Sarah A Gardner, Hiram C Polk, Stephen L Barnes
BACKGROUND: Severe injury can lead to immune dysfunction and predispose patients to infection and death. Micro-RNAs regulate gene expression and may act as biomarkers for susceptibility to infection. The aim of this study was to examine the temporal and differential expression of previously identified dysregulated micro-RNAs in patients with severe injury. METHODS: Fourteen severely injured patients requiring transfusion were enrolled prospectively in this study approved by our institutional review board...
August 1, 2018: Surgery
Diana L N Jere, Chimwemwe K Banda, Lily C Kumbani, Li Liu, Linda L McCreary, Chang Gi Park, Crystal L Patil, Kathleen F Norr
BACKGROUND: Scaling-up evidence-based behavior change interventions can make a major contribution to meeting the UNAIDS goal of no new HIV infections by 2030. We developed an evidence-based peer group intervention for HIV prevention and testing in Malawi that is ready for wider dissemination. Our innovative approach turns over ownership of implementation to rural communities. We adapted a 3-Step Implementation Model (prepare, roll-out and sustain) for communities to use. Using a hybrid design, we simultaneously evaluate community implementation processes and program effectiveness...
August 2, 2018: BMC Public Health
Elvire Berthenet, Koji Yahara, Kaisa Thorell, Ben Pascoe, Guillaume Meric, Jane M Mikhail, Lars Engstrand, Helena Enroth, Alain Burette, Francis Megraud, Christine Varon, John C Atherton, Sinead Smith, Thomas S Wilkinson, Matthew D Hitchings, Daniel Falush, Samuel K Sheppard
BACKGROUND: Helicobacter pylori are stomach-dwelling bacteria that are present in about 50% of the global population. Infection is asymptomatic in most cases, but it has been associated with gastritis, gastric ulcers and gastric cancer. Epidemiological evidence shows that progression to cancer depends upon the host and pathogen factors, but questions remain about why cancer phenotypes develop in a minority of infected people. Here, we use comparative genomics approaches to understand how genetic variation amongst bacterial strains influences disease progression...
August 2, 2018: BMC Biology
Min Xu, Yiqi Fu, Haishen Kong, Xiao Chen, Yu Chen, Lanjuan Li, Qing Yang
BACKGROUND: Klebsiella pneumoniae bloodstream infections (BSIs) occur with significant prevalence and high mortality worldwide. Antimicrobial resistance and virulence are two main factors participating in the pathogenicity of K. pneumoniae. Here we investigated the prevalence of blaKPC and virulence factors in K. pneumoniae isolated from patients with BSIs and their association with clinical outcome. METHODS: The clinical data of 285 K. pneumoniae BSI cases diagnosed from January 2013 to December 2015 in a Chinese university hospital were retrospectively evaluated...
July 31, 2018: BMC Infectious Diseases
Aurélie Daumas, Julie Alingrin, Richard Ouedraogo, Patrick Villani, Marc Leone, Jean-Louis Mege
BACKGROUND: MALDI-TOF mass spectrometry (MS) on whole cells enables the detection of different cell types and cell activation. Here, we wondered whether this approach would be useful to investigate the host response in sepsis. METHODS: Peripheral blood mononuclear cells (PBMCs) from patients with severe sepsis and healthy donors were analyzed with MALDI-TOF MS. PBMCs from healthy donors were also stimulated with lipopolysaccharide, peptidoglycan, CpG oligonucleotides, polyinosinic polycytidylic acid, and with heat-inactivated bacteria...
July 31, 2018: BMC Infectious Diseases
Aldo A M Lima, Pedro H Q S Medeiros, Alexandre Havt
PURPOSE OF REVIEW: The current review is to update the results on epidemiology, pathobiology, and genes related to virulence, clinical presentation, molecular diagnosis, antimicrobial resistance, and extraintestinal infection of enteroaggregative Escherichia coli (EAEC). RECENT FINDINGS: EAEC subclinical infection was significantly associated with reduced length at 2 years of age and EAEC and coinfections were associated with reduced delta weight-for-length and weight-for-age z-scores in the first 6 months of age in the MAL-ED birth cohort study...
July 30, 2018: Current Opinion in Infectious Diseases
Clemens Maedel, Katharina Kainz, Thomas Frischer, Matthias Reinweber, Angela Zacharasiewicz
OBJECTIVE: Aim of this study was to analyze whether children with objectively measured second-hand cigarette smoke (SHS) exposure suffer from a more severe course of disease when hospitalized with lower respiratory tract infection (LRTI) due to respiratory syncytial virus (RSV). METHODS: This prospective study was conducted at the Department of Pediatrics, Wilhelminen-Hospital, Vienna, Austria in children aged below 1 year without a history of preceding lung disease and with acute symptoms of LRTI and a positive nasopharyngeal swab for RSV...
July 30, 2018: Pediatric Pulmonology
S L Liu, X Sun, H Xu, D G Zhao, X J Yang, J Jin, J Wang, J H Fu, G H Guo, Q Guo
Objective: To investigate the clinical characteristics of extremely severe burn patients complicated with severe inhalation injury caused by dust explosion. Methods: The medical records of 13 extremely severe burn patients complicated with severe inhalation injury in August 2nd Kunshan factory aluminum dust explosion accident, who were admitted to the First Affiliated Hospital of Soochow University on August 2nd, 2014, were retrospectively analyzed. The following indicators were collected: (1) Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and Sequential Organ Failure Assessment (SOFA) score at post admission hour (PAH) 24...
July 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
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