This study examined the sociodemographic and clinical characteristics of patients, as well as their clinical outcomes, during a surge in COVID-19 disease in Houston, Texas.
Abstract
Background
Labeled white blood cell scintigraphy (WBCS) has been used for over 40 years to localize an infection source in patients with fever of unknown origin (FUO). It continues to be in ...widespread use for such patients in modern times, despite the tremendous advances in modern radiological imaging and laboratory medicine.
Methods
We critically evaluated the clinical contribution of WBCS performed in 132 patients with FUO at 7 hospitals from mid-2015 to the end of 2019. For each patient, all radiographic and laboratory results and all electronic clinical notes were carefully evaluated as many days before and after the scan as necessary to arrive at a final diagnosis.
Results
Although 50 WBCS (38%) showed positive findings, the majority of these were false positive (FP). Of the 19 true-positive (TP) scans, most were already known or about to become known by tests already ordered at the time of the scan. Only 2 TP scans (1.5%) contributed to the final diagnosis, and these did so only indirectly. FP scans led to 7 unnecessary procedures.
Conclusions
In FUO patients for whom an infection source is not discovered following an appropriate radiographic and laboratory workup, WBCS is not a useful procedure.
The COVID-19 pandemic has led to an increase in SARS-CoV-2-test positive potential organ donors. The benefits of life-saving liver transplantation (LT) must be balanced against the potential risk of ...donor-derived viral transmission. Although emerging evidence suggests that the use of COVID-19-positive donor organs may be safe, granular series thoroughly evaluating safety are still needed. Results of 29 consecutive LTs from COVID-19-positive donors at a single center are presented here.
A retrospective cohort study of LT recipients between April 2020 and December 2022 was conducted. Differences between recipients of COVID-19-positive (n = 29 total; 25 index, 4 redo) and COVID-19-negative (n = 472 total; 454 index, 18 redo) deceased donor liver grafts were compared.
COVID-19-positive donors were significantly younger (
= 0.04) and had lower kidney donor profile indices (
= 0.04) than COVID-19-negative donors. Recipients of COVID-19-positive donor grafts were older (
= 0.04) but otherwise similar to recipients of negative donors. Donor SARS-CoV-2 infection status was not associated with a overall survival of recipients (hazard ratio, 1.11; 95% confidence interval, 0.24-5.04;
= 0.89). There were 3 deaths among recipients of liver grafts from COVID-19-positive donors. No death seemed virally mediated because there was no qualitative association with peri-LT antispike antibody titers, post-LT prophylaxis, or SARS-CoV-2 variants.
The utilization of liver grafts from COVID-19-positive donors was not associated with a decreased overall survival of recipients. There was no suggestion of viral transmission from donor to recipient. The results from this large single-center study suggest that COVID-19-positive donors may be used safely to expand the deceased donor pool.
Ten years ago a bioterrorism event involving Bacillus anthracis spores captured the nation's interest, stimulated extensive new research on this pathogen, and heightened concern about illegitimate ...release of infectious agents. Sporadic reports have described rare, fulminant, and sometimes fatal cases of pneumonia in humans and nonhuman primates caused by strains of Bacillus cereus , a species closely related to Bacillus anthracis.
To describe and investigate a case of rapidly progressive, fatal, anthrax-like pneumonia and the overwhelming infection caused by a Bacillus species of uncertain provenance in a patient residing in rural Texas.
We characterized the genome of the causative strain within days of its recovery from antemortem cultures using next-generation sequencing and performed immunohistochemistry on tissues obtained at autopsy with antibodies directed against virulence proteins of B anthracis and B cereus.
We discovered that the infection was caused by a previously unknown strain of B cereus that was closely related to, but genetically distinct from, B anthracis . The strain contains a plasmid similar to pXO1, a genetic element encoding anthrax toxin and other known virulence factors. Immunohistochemistry demonstrated that several homologs of B anthracis virulence proteins were made in infected tissues, likely contributing to the patient's death.
Rapid genome sequence analysis permitted us to genetically define this strain, rule out the likelihood of bioterrorism, and contribute effectively to the institutional response to this event. Our experience strongly reinforced the critical value of deploying a well-integrated, anatomic, clinical, and genomic strategy to respond rapidly to a potential emerging, infectious threat to public health.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Dual Respiratory Virus Infections Drews, Ashley L.; Atmar, Robert L.; Glezen, W. Paul ...
Clinical infectious diseases,
12/1997, Letnik:
25, Številka:
6
Journal Article, Conference Proceeding
Recenzirano
Odprti dostop
We retrospectively reviewed eight prospective epidemiological studies conducted between 1991 and 1995 for dual respiratory virus infection (DRVI) to determine the frequency, associated comorbid ...conditions, clinical presentations, and morbidity related to DRVI among immunocompetent persons. Two viruses were identified as the cause of 67 (5.0%) of 1,341 acute respiratory virus infections. DRVI was detected in patients from <1 year to 79 years of age, in both sexes, and in many races. Forty-two percent of patients with DRVI were ⩽4 years old. Fifty-eight percent of patients with DRVI had underlying chronic lung disease. DRVI was associated with upper respiratory tract illness; lower respiratory tract illness, including pneumonia; systemic influenza-like illnesses; and exacerbations of asthma or chronic obstructive pulmonary disease. All of the common acute respiratory viruses were identified; picornaviruses and influenzavirus A were the most common. The rate of DRVI (11.6%) was highest in the epidemiological studies in which cell culture, serology, and polymerase chain reaction were used together. Patients with DRVI were hospitalized significantly more often than those with respiratory infection due to a single virus (46.3% vs. 21.7%; P < .01). The percentage of DRVIs increased proportionally with the number of diagnostic methods used.
A video game controller with skin stretch haptic feedback Guinan, A. L.; Caswell, N. A.; Drews, F. A. ...
2013 IEEE International Conference on Consumer Electronics (ICCE),
2013-Jan., 20130101
Conference Proceeding, Journal Article
Recenzirano
This paper presents the design of a game controller with integrated skin stretch feedback, a new form of touch feedback. This form of feedback can be used to provide directional information, as well ...as tactile gaming effects to a user through the input thumb joysticks. Prior testing has shown that a user can perceive and respond to single direction cues given through skin stretch feedback at the thumb joysticks. This paper presents further experiments to characterize user interaction and responses to feedback as a function of the relative timing between skin stretch cues given on both of the controller's thumb joysticks.
Abstract only
A 39‐year‐old male presented with a rapidly progressive hemorrhagic anthrax‐like pneumonia. Within 3 days, the overwhelming systemic infection proved fatal. Microbial culture of ...antemortem and postmortem specimens grew pure cultures of Gram‐positive rods that were provisionally identified as
Bacillus
species. An autopsy was performed, and we characterized the genome of a strain isolated from the patient's blood within days using next‐generation sequencing technology. In addition, the genomes of sixteen strains recovered from different anatomic sites and time points were fully sequenced to assess intra‐host genetic variation. Whole genome analysis demonstrated that the fatal infection was caused by a previously unknown strain of
B. cereus
that was closely related to, but genetically distinct from,
B anthracis
. The exceptional virulence of this
B. cereus
strain was due in part to carriage of a pXO1‐like plasmid that encodes the tripartite anthrax toxin. The sequence data revealed the molecular determinants leading to the exceptional virulence of this organism, helped guide the institutional infection control response, and provided new insight to host‐pathogen interactions. This case exemplifies the value of autopsy and whole genome sequencing technologies to laboratory medicine.
* Context.--Ten years ago a bioterrorism event involving Bacillus anthracis spores captured the nation's interest, stimulated extensive new research on this pathogen, and heightened concern about ...illegitimate release of infectious agents. Sporadic reports have described rare, fulminant, and sometimes fatal cases of pneumonia in humans and nonhuman primates caused by strains of Bacillus cereus,a species closely related to Bacillus anthracis. (Arch Pathol Lab Med. 2011; 135:1447-1459; doi: 10.5858/arpa.2011-0362-SA)
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
BACKGROUND: Serological assays designed to detect SARS-CoV-2 antibodies are being used in serological surveys and other specialized applications. As a result, and to ensure that the outcomes of ...serological testing meet high quality standards, evaluations are required to assess the performance of these assays and the proficiency of laboratories performing them. METHODS: A panel of 60 plasma/serum samples from blood donors who had reverse transcriptase–polymerase chain reaction (RT-PCR) confirmed SARS-CoV-2 infections and 21 SARS-CoV-2 negative samples were secured and distributed to interested laboratories within Canada ( n = 30) and the United States ( n = 1). Participating laboratories were asked to provide details on the diagnostic assays used, the platforms the assays were performed on, and the results obtained for each panel sample. Laboratories were blinded with respect to the expected outcomes. RESULTS: The performance of the different assays evaluated was excellent, with the high-throughput platforms of Roche, Ortho, and Siemens demonstrating 100% sensitivity. Most other high-throughput platforms had sensitivities of >93%, with the exception of the IgG assay using the Abbott ARCHITECT which had an average sensitivity of only 87%. The majority of the high-throughput platforms also demonstrated very good specificities (>97%). CONCLUSION: This proficiency study demonstrates that most of the SARS-CoV-2 serological assays utilized by provincial public health or hospital laboratories in Canada have acceptable sensitivity and excellent specificity.
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