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JOURNAL ARTICLE
Yang Huang, Liangliang Xu, Ning Wang, Yonggang Wei, Wentao Wang, Mingqing Xu, Li Jiang
BACKGROUND: A previous randomized controlled trial (RCT) demonstrated that intermittent Pringle's maneuver (IPM) with a 25-minute ischemic interval can be applied safely and efficiently in hepatectomy for patients with hepatocellular carcinoma (HCC). But prolonging the hepatic inflow clamping time will inevitably aggravate the ischemia-reperfusion injury (IRI). Therefore, we aimed to evaluate the effect of prophylactic dexamethasone on alleviating the surgical stress for HCC patients with a 25-minute ischemic interval...
August 1, 2023: International Journal of Surgery
#22
JOURNAL ARTICLE
Cari Stek, Muki Shey, Khuthala Mnika, Charlotte Schutz, Friedrich Thienemann, Robert J Wilkinson, Lutgarde Lynen, Graeme Meintjes
The development of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) and its prevention using prednisone may potentially be mediated by the LTA4H genotype. We assessed this hypothesis in a clinical trial evaluating prednisone to prevent TB-IRIS. We did not find an association between LTA4H genotype and TB-IRIS incidence or prednisone efficacy.
July 2023: Open Forum Infectious Diseases
#23
JOURNAL ARTICLE
Sunisha Arora, K Upasana, Dhwanee Thakkar, Anjali Yadav, Neha Rastogi, Satya P Yadav
INTRODUCTION: Severe Combined Immunodeficiency (SCID) is a primary immunodeficiency disorder characterized by absent or dysfunctional T lymphocytes, leading to defective cellular and humoral immunity requiring urgent hematopoietic stem cell transplantation (HSCT). We report a case of SCID with disseminated Bacille Calmette-Guérin (BCG) infection who developed cytokine release syndrome (CRS) and possible Immune reconstitution inflammatory syndrome (IRIS) after Haploidentical HSCT with post-transplant cyclophosphamide...
August 1, 2023: Journal of Pediatric Hematology/oncology
#24
JOURNAL ARTICLE
Sola Lee, Nam-Joon Yi, Nakwon Kwak, Haeryoung Kim, Su Young Hong, Jeong-Moo Lee, Suk Kyun Hong, YoungRok Choi, Kwang-Woong Lee, Kyung-Suk Suh
Studies have shown that tuberculosis (TB) incidence is 20 to 70 times higher in solid organ transplantation recipients. Immunosuppression makes transplant recipients more vulnerable to infection and can interfere with the treatment. Our case report describes a patient who experienced immune reconstitution inflammatory syndrome (IRIS) and drug-induced liver injury (DILI) related to TB medications for disseminated pulmonary and hepatic TB. In addition to anti-TB medication, the patient received a high-dose steroid for IRIS and a change of anti-TB medication to a secondary regimen for DILI...
July 17, 2023: Transplantation Proceedings
#25
JOURNAL ARTICLE
Malek Kharrat, Zeineb Kallel, Sana Sayadi, Hamza Krifa, Walid Zbiba
INTRODUCTION: Granulomatous uveitis is mainly defined by the nature of keratic precipitates and iris nodules. Anterior chamber (AC) granulomas, also known as Berlin nodules (BN), are circumscribed granulomatous nodules that form in the iridocorneal angle (ICA) in response to intraocular inflammation. CASES DESCRIPTION: We present three representative cases of anterior uveitis with berlin nodules to insist on the clinical features of this entity. Case 1: A female adult was referred to our department for bilateral redness and gradual blurry vision...
July 12, 2023: European Journal of Ophthalmology
#26
JOURNAL ARTICLE
Tariq Sami Haddad, Luuk van den Dobbelsteen, Sonay K Öztürk, Robin Geene, Isaäc J Nijman, Kiek Verrijp, Nigel B Jamieson, Colin Wood, Shannon van Vliet, Luuk Reuvers, Soumia Achouiti, Natasja Rutgers, Nelleke Brouwer, Femke Simmer, Inti Zlobec, Alessandro Lugli, Iris D Nagtegaal
Tumor budding (TB) is a strong biomarker of poor prognosis in colorectal cancer and other solid cancers. TB is defined as isolated single cancer cells or clusters of up to four cancer cells at the invasive tumor front. In areas with a large inflammatory response at the invasive front, single cells and cell clusters surrounding fragmented glands are observed appearing like TB. Occurrence of these small groups is referred to as pseudobudding (PsB), which arises due to external influences such as inflammation and glandular disruption...
July 4, 2023: Journal of Pathology
#27
JOURNAL ARTICLE
Alpaslan Tanoglu, Hakan Erdem, Jon S Friedland, Handan Ankaralı, Jose Fernando Garcia-Goez, Ayse Albayrak, Amani El-Kholy, Sevil Alkan Ceviker, Fatma Amer, Serpil Erol, Ilad Alavi Darazam, Mohammad Mahdi Rabiei, Muhammad Zeeshan Sarwar, Misbah Zeb, Hassan Nawaz, Mehmet Resat Ceylan, Roxana Cernat, Meltem Tasbakan, Folusakin Ayoade, Yvon Ruch, Elif Tükenmez Tigen, Goffredo Angioni, Dhanji P Rajani, Nasim Akhtar, Serkan Surme, Gonul Sengoz, Gulden Eser Karlıdag, Andrea Marino, Rezaul Karim Ripon, Yasemin Çağ, Özlem Aydın, Yasemin Akkoyunlu, Derya Seyman, Kumar Angamuthu, Antonio Cascio, Corneliu Petru Popescu, Fatma Sirmatel, Esma Eren, Razi Even Dar, Foday Usman Munu, Esra Guzel Tanoglu, Esteban Echeverry, Juan Diego Velez, Cumhur Artuk, Safak Ozer Balin, Nirav Pandya, Aysegul Erdem, Emine Kübra Dindar Demiray, Adalet Aypak
Existing literature about peritoneal tuberculosis (TBP) is relatively insufficient. The majority of reports are from a single center and do not assess predictive factors for mortality. In this international study, we investigated the clinicopathological characteristics of a large series of patients with TBP and determined the key features associated with mortality. TBP patients detected between 2010 and 2022 in 38 medical centers in 13 countries were included in this retrospective cohort. Participating physicians filled out an online questionnaire to report study data...
August 2023: European Journal of Clinical Microbiology & Infectious Diseases
#28
Savina Sahgal, Shivanjali Shankaran, David A Ansell
Immune reconstitution inflammatory syndrome (IRIS) can be triggered in many ways. IRIS has been recognized during tuberculosis (TB) therapy, especially in patients newly initiated on antiretroviral therapy for HIV or those taken off immunosuppressives such as tumor necrosis factor-alpha inhibitors. However, there are still many triggers of IRIS that are less understood. This case report describes a patient with scrofula that was concerning for TB reactivation, who then had subsequent IRIS. The patient had been consistently using low-dose long-term prednisone for suppression of his polymyalgia rheumatica...
May 2023: Curēus
#29
JOURNAL ARTICLE
John-Melle Bokhorst, Francesco Ciompi, Sonay Kus Öztürk, Ayse Selcen Oguz Erdogan, Michael Vieth, Heather Dawson, Richard Kirsch, Femke Simmer, Kieran Sheahan, Alessandro Lugli, Inti Zlobec, Jeroen van der Laak, Iris D Nagtegaal
Tumor budding (TB), the presence of single cells or small clusters of up to four tumor cells, at the invasive front of colorectal cancer (CRC) is a proven risk factor for adverse outcomes. International definitions are necessary to reduce the interobserver variability. According to the current international guideline, hotspots at the invasive front should be counted in Hematoxylin and Eosin (H&E) stained slides. This is time-consuming and prone to interobserver variability, therefore there is a need for computer-aided diagnosis solutions...
May 29, 2023: Modern Pathology
#30
JOURNAL ARTICLE
Prashant Yadav, Md Anwarul Bari, Sushmita Yadav, Amzad H Khan
UNLABELLED: Immune reconstitution inflammatory syndrome (IRIS) is characterized by exuberant and dysregulated inflammatory responses to invading microorganisms. IRIS associated with tuberculosis (TB-IRIS) is widely known in HIV-positive patients after starting highly active antiretroviral therapy (HAART) therapy. However, IRIS has also been observed in solid organ transplant recipients, neutropenic patients, tumor necrosis factor antagonist recipients, and women during the postpartum period despite their HIV status...
May 2023: Annals of Medicine and Surgery
#31
JOURNAL ARTICLE
Long Wen, Lei Shi, Shan-Shan Wan, Tao Xu, Lei Zhang, Zhi-Guo Zhou
Tuberculosis (TB) is the most common opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS) caused by human immunodeficiency virus (HIV) infection and is one of the primary causes of death from AIDS. The increased accessibility to highly active antiretroviral therapy (HAART) has significantly improved the clinical outcome of patients with HIV infection. However, following ART, rapid restoration of the immune system leads to immune reconstitution inflammatory syndrome (IRIS). Oxidative stress and innate immunity play a role in TB-associated IRIS (TB-IRIS)...
June 2023: Experimental and Therapeutic Medicine
#32
Manika Malik, Naman Lodha, Durga S Meena, Binit Sureka
Septic shock due to Mycobacterium tuberculosis (M. tuberculosis) in immunocompromised patients (particularly HIV) is a well-recognized clinical entity. However, tubercular sepsis in the immunocompetent is still underdiagnosed and under-discussed. Moreover, sepsis is usually associated with gram-negative and other gram-positive microorganisms that can cause similar pulmonary and disseminated disease and can further convolute the diagnosis. We herein discuss a case of an elderly female who presented with acute onset fever, cough, and altered talk from the last seven days...
April 2023: Curēus
#33
JOURNAL ARTICLE
Joseph M Rocco, Elizabeth Laidlaw, Frances Galindo, Megan Anderson, Ornella Sortino, Safia Kuriakose, Andrea Lisco, Maura Manion, Irini Sereti
People with HIV (PWH) and mycobacterial infections can develop immune reconstitution inflammatory syndrome (IRIS) after starting antiretroviral therapy. The pathophysiology of mycobacterial-IRIS overlaps with primary hemophagocytic lymphohistiocytosis (pHLH). To assess possible genetic predisposition to IRIS, protein-altering variants in genes associated with HLH were evaluated in 82 PWH and mycobacterial infections who developed IRIS (n = 56) or did not develop IRIS (n = 26). Protein-altering variants in cytotoxicity genes were found in 23...
July 14, 2023: Journal of Infectious Diseases
#34
JOURNAL ARTICLE
Luis Vázquez-Flores, Jessica Castañeda-Casimiro, Luis Vallejo-Castillo, Violeta D Álvarez-Jiménez, Eliud S Peregrino, Mariano García-Martínez, Dante Barreda, Víctor Hugo Rosales-García, C David Segovia-García, Teresa Santos-Mendoza, Carlos Wong-Baeza, Jeanet Serafín-López, Rommel Chacón-Salinas, Sergio Estrada-Parra, Iris Estrada-García, Isabel Wong-Baeza
Tuberculosis remains one of the leading public health problems in the world. The mechanisms that lead to the activation of the immune response against Mycobacterium tuberculosis (Mtb) have been extensively studied, with a focus on the role of cytokines as the main signals for immune cell communication. However, less is known about the role of other signals, such as extracellular vesicles (EVs), in the communication between immune cells, particularly during the activation of the adaptive immune response. In this study, we determined that EVs released by human neutrophils infected with Mtb (EV-Mtb) contained several host proteins that are ectosome markers...
March 29, 2023: Journal of Leukocyte Biology
#35
REVIEW
Ramachandran Vignesh, Pachamuthu Balakrishnan, Hong Yien Tan, Yean Kong Yong, Vijayakumar Velu, Marie Larsson, Esaki M Shankar
The lethal combination involving TB and HIV, known as "syndemic" diseases, synergistically act upon one another to magnify the disease burden. Individuals on anti-retroviral therapy (ART) are at risk of developing TB-associated immune reconstitution inflammatory syndrome (TB-IRIS). The underlying inflammatory complication includes the rapid restoration of immune responses following ART, eventually leading to exaggerated inflammatory responses to MTB antigens. TB-IRIS continues to be a cause of morbidity and mortality among HIV/TB coinfected patients initiating ART, and although a significant quantum of knowledge has been acquired on the pathogenesis of IRIS, the underlying pathomechanisms and identification of a sensitive and specific diagnostic marker still remain a grey area of investigation...
January 29, 2023: Pathogens
#36
JOURNAL ARTICLE
Lucas Armange, Adèle Lacroix, Paul Petitgas, Cédric Arvieux, Caroline Piau-Couapel, Patrice Poubeau, Matthieu Revest, Pierre Tattevin
Paradoxical reaction (PR) and immune reconstitution inflammatory syndrome (IRIS) are common complications of tuberculosis treatment. Corticosteroids are first-line treatment for severe PR or IRIS, particularly neurological. We report four cases of severe PR or IRIS during tuberculosis treatment who required TNF-α antagonists, and identified 20 additional cases through literature review. They were 14 women and 10 men, with a median age of 36 years (interquartile range, 28-52). Twelve were immunocompromised before tuberculosis: untreated HIV infection (n=6), or immunosuppressive treatment (TNF-α antagonists, n=5; tacrolimus, n=1)...
February 16, 2023: European Journal of Clinical Microbiology & Infectious Diseases
#37
JOURNAL ARTICLE
Hakan Erdem, Magdalena Baymakova, Sevil Alkan, Amel Letaief, Wissal Ben Yahia, Farouq Dayyab, Entela Kolovani, Svjetlana Grgic, Federica Cosentino, Imran Hasanoglu, Reham Khedr, Andrea Marino, Abdullah Umut Pekok, Fatma Eser, Jurica Arapovic, Hatice Rahmet Guner, Ionela-Larisa Miftode, Kostadin Poposki, Gamze Sanlidag, Alper Tahmaz, Oguz Resat Sipahi, Egidia Gabriela Miftode, Serkan Oncu, Meliha Cagla-Sonmezer, Syam Kumar Addepalli, Ilad Alavi Darazam, Hema Prakash Kumari, Meliha Meriç Koc, Meela Ranjith Kumar, Suresh Babu Sayana, Ahmed Ashraf Wegdan, Fatma Amer, Mehmet Resat Ceylan, Amani El-Kholy, Taylan Onder, Hamed Azhdari Tehrani, Atousa Hakamifard, Bircan Kayaaslan, Ghaydaa Shehata, Hulya Caskurlu, Nagwa Mostafa El-Sayed, Seyed Erfan Mortazavi, Mohammad Pourali, Umran Elbahr, Sholpan Kulzhanova, Tarkan Yetisyigit, Sahar Ahmed Saad, Yasemin Cag, Gulden Eser-Karlidag, Natalia Pshenichnaya, Maya Belitova, Nasim Akhtar, Fahad Al-Majid, Muge Ayhan, Mumtaz Ali Khan, Massimiliano Lanzafame, Mateja Jankovic Makek, Emmanuel Nsutebu, Antonio Cascio, Emine Kubra Dindar-Demiray, Emine Unal Evren, Rama Kalas, Ayşe Kaya Kalem, Rusmir Baljić, Aamer Ikram, Selcuk Kaya, Anna Liskova, Balint Gergely Szabo, Bilal Ahmad Rahimi, Esmeray Mutlu-Yilmaz, Alper Sener, Jordi Rello
Fever of unknown origin (FUO) is a serious challenge for physicians. The aim of the present study was to consider epidemiology and dynamics of FUO in countries with different economic development. The data of FUO patients hospitalized/followed between 1st July 2016 and 1st July 2021 were collected retrospectively and submitted from referral centers in 21 countries through ID-IRI clinical research platform. The countries were categorized into developing (low-income (LI) and lower middle-income (LMI) economies) and developed countries (upper middle-income (UMI) and high-income (HI) economies)...
April 2023: European Journal of Clinical Microbiology & Infectious Diseases
#38
JOURNAL ARTICLE
Raymond M Moseki, Daniel L Barber, Elsa Du Bruyn, Muki Shey, Helen Van der Plas, Robert J Wilkinson, Graeme Meintjes, Catherine Riou
BACKGROUND: Tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is a frequent complication of cotreatment for TB and human immunodeficiency virus (HIV)-1. We characterized Mycobacterium tuberculosis (Mtb)-specific CD4 T-cell phenotype and transcription factor profile associated with the development of TB-IRIS. METHODS: We examined the role of CD4 T-cell transcription factors in a murine model of mycobacterial IRIS. In humans, we used a longitudinal study design to compare the magnitude of antiretroviral therapy, activation, transcription factor profile, and cytotoxic potential of Mtb-specific CD4 T cells between TB-IRIS ( n = 25) and appropriate non-IRIS control patients ( n = 18) using flow cytometry...
January 2023: Open Forum Infectious Diseases
#39
JOURNAL ARTICLE
Toyohiro Hashiba, Mai Sugahara, Yui Ota, Ken Kaseda, Yusuke Kashiwagi, Motonobu Nakamura, Takayuki Shinohara, Mahoko Ikeda, Shu Okugawa, Kazuma Sugimoto, Kenichi Sasaki, Yoshifumi Hamasaki, Daisuke Yamada, Haruki Kume, Kyoji Moriya, Masaomi Nangaku
Paralytic ileus as tuberculosis-immune reconstitution inflammatory syndrome (TB-IRIS) is extremely rare. We herein report a 44-year-old man with pulmonary and renal tuberculosis who developed paralytic ileus 14 days after starting antituberculosis therapy (ATT) despite an initial favorable response to ATT. Paralytic ileus was successfully managed with conservative care. He initially required hemodialysis because of obstructive uropathy due to renal tuberculosis, but he was able to withdraw from dialysis after placement of ureteral stents...
January 15, 2023: Internal Medicine
#40
JOURNAL ARTICLE
Andrea T Cruz, Jeffrey R Starke
A 17-year-old previously healthy female presented with unilateral chest pain and dyspnea. Chest radiographs demonstrated a unilateral pleural effusion and pneumonia. Pleural fluid bacterial cultures were negative; acid-fast cultures grew Mycobacterium tuberculosis. Two months after starting appropriate therapy, she had a recrudescence of symptoms and reaccumulation of the pleural fluid. Her tuberculosis antibiotic regimen was expanded, the effusion drained, and systemic corticosteroids initiated, resulting in rapid clinical improvement...
December 23, 2022: Journal of Adolescent Health
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