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1.
《Clinical microbiology and infection》2022,28(8):1120-1125
ObjectivesOur aim was to evaluate the effect of the updated European Organization for Research and Treatment of Cancer (EORTC) and Mycoses Study Group 2019 definitions for invasive pulmonary aspergillosis (IPA) on patient classification and the related all-cause 12-week mortality.MethodsIn this retrospective cohort study from our tertiary care centre, we reclassified patients with haematological malignancy who underwent bronchoalveolar lavage between 2014 and 2019 for suspected IPA using the novel EORTC 2019 criteria. We performed receiver operating characteristic curve analysis to define the optimal cut-off for positive PCR and galactomannan and present survival analyses and their possible association with these diagnostic criteria through post hoc comparisons with log rank and Cox regression.ResultsFrom 323 episodes of suspected IPA in 282 patients, 73 were reclassified: 31 (42.5%) from possible to probable IPA, 5 (6.8%) from EORTC criteria not met to probable IPA, and 37 (50.7%) from EORTC criteria not met to possible IPA. Probable IPA increased therefore 11.1% (64/323, 19.8% to 100/323, 30.9%), mostly due to positive PCR (31/36, 86.1%). There was no difference in mortality between newly defined possible and probable IPA (log rank p = 0.950). Mortality was higher in probable cases with lower cycle thresholds (Ct values) versus higher Ct values (p = 0.004). Receiver operating characteristic curve analysis showed an optimal Ct value cut-off of 36.8 with a sensitivity of 75% (95% CI 64.9%–85.1%) and a specificity of 61.7% (95% CI 53.5–69.9) for 12-week mortality.DiscussionThe new EORTC criteria led to 11.1% more probable IPA diagnoses, mostly due to Aspergillus PCR. Restricting positive PCR to below a certain threshold might improve the discrimination of the new EORTC IPA categories for mortality. 相似文献
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Marie V. Plaisime PhD MPH Marie Jipguep-Akhtar PhD Joseph J. Locascio PhD Harolyn M. E. Belcher MD MHS Rachel R. Hardeman PhD MPH Katherine Picho-Kiroga PhD Sylvia P. Perry PhD Sean M. Phelan PhD MPH Michelle van Ryn PhD LMFT MPH John F. Dovidio PhD 《Health services research》2023,58(Z2):229-237
Objective
To examine the experience of interracial anxiety among health professionals and how it may affect the quality of their interactions with patients from racially marginalized populations. We explored the influence of prior interracial exposure—specifically through childhood neighborhoods, college student bodies, and friend groups—on interracial anxiety among medical students and residents. We also examined whether levels of interracial anxiety change from medical school through residency.Data Source
Web-based longitudinal survey data from the Medical Student Cognitive Habits and Growth Evaluation Study.Study Design
We used a retrospective longitudinal design with four observations for each trainee. The study population consisted of non-Black US medical trainees surveyed in their 1st and 4th years of medical school and 2nd and 3rd years of residency. Mixed effects longitudinal models were used to assess predictors of interracial anxiety and assess changes in interracial anxiety scores over time.Principal Findings
In total, 3155 non-Black medical trainees were followed for 7 years. Seventy-eight percent grew up in predominantly White neighborhoods. Living in predominantly White neighborhoods and having less racially diverse friends were associated with higher levels of interracial anxiety among medical trainees. Trainees' interracial anxiety scores did not substantially change over time; interracial anxiety was highest in the 1st year of medical school, lowest in the 4th year, and increased slightly during residency.Conclusions
Neighborhood and friend group composition had independent effects on interracial anxiety, indicating that premedical racial socialization may affect medical trainees' preparedness to interact effectively with diverse patient populations. Additionally, the lack of substantial change in interracial anxiety throughout medical training suggests the importance of providing curricular tools and structure (e.g., instituting interracial cooperative learning activities) to foster the development of healthy interracial relationships. 相似文献5.
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Background
The significance of a positive culture at reimplantation remains an important topic of consideration given the lack of clear metrics for when reimplantation can be performed. The purpose of this study is thus to investigate the (1) association between a positive culture during reimplantation and failure following 2-stage exchange arthroplasty and the (2) influence of prolonged antibiotics on these patients.Methods
We retrospectively reviewed 117 patients undergoing 2-stage exchange hip arthroplasty from 2012 to 2016. Of them, 23 had positive culture during reimplantation and were treated with 2 weeks of intravenous and 4 weeks of oral antibiotics following reimplantation. All patients had a minimum follow-up of 1 year. Logistic regression models were performed to identify association between positive culture and subsequent treatment failure. A meta-analysis was also performed to validate findings. A subgroup analysis was performed to explore whether 6-week antibiotics (oral, intravenous, or both) after reimplantation improved outcomes.Results
A total of 11 studies, which included 141 cases with a positive culture at reimplantation and 784 with negative cultures, were included in the meta-analysis. The pooled data showed a higher risk of failure in patients with a positive culture than those with a negative culture (41.1% vs 14.8%, odds ratio 4.58). The subgroup analysis revealed that 6 weeks of antibiotic administration following reimplantation decreased the odds of reinfection from 9.35 to 3.12. The findings in the retrospective cohort were consistent with those of the meta-analysis; the failure rate was significantly higher in patients with a positive culture than those with negative cultures (26.1% vs 6.4%, P < .001).Conclusion
Six weeks of antibiotics appear to decrease the odds of reinfection after reimplantation. However, despite patients receiving 6 weeks of antibiotics after reimplantation, the risk of reinfection in patients with a positive culture at reimplantation is still more than 3 times higher than those with negative cultures. Further studies are needed to investigate optimal management for such patients. 相似文献7.
Katalin Vermes 《Body, Movement and Dance in Psychotherapy: An International Journal for Theory, Research and Practice》2019,14(1):26-40
This paper examines the cultural situation and special responsibility of dance movement therapy, delineating certain philosophical and cultural-theoretical interpretations of the ‘corporeal turn’ and ‘therapeutic turn’ of contemporary culture. It aims to show how dance movement therapy’s theoretical horizon is inseparable from the body-mind integration of contemporary philosophies, and how corporeal turn is present in consumer culture, including some of its destructive forms of idealisation and malign regression. The question of how DMT is able to turn malignant regression to the body into benign regression is addressed, and an analysis of the correlating postmodern idea of resilience is offered. Finally, DMT groups are interpreted as social microcosms, and the way Hungarian psychodynamic movement and dance therapists apply their group therapeutic method for the development of democratic culture in the Civil Group Project is described. 相似文献
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《Indian journal of medical microbiology》2019,37(1):99-101
We evaluated the diagnostic utility of sonication of antibiotic loaded cement spacers comparing with periprosthetic tissue cultures for the detection of persisting infection in 14 patients undergoing staged procedures. Sonication improved microbial detection of intraoperative cultures from 14.2% to 28.5% (P = 0.481). Routine sonication of spacers is recommended. 相似文献
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《Vaccine》2019,37(47):6996-7002
Vero cells are considered as the most widely accepted continuous cell line by the regulatory authorities (such as WHO) for the manufacture of viral vaccines for human use. The growth of Vero cells is anchorage-dependent. Scale-up and manufacturing in adherent cultures are labor intensive and complicated. Adaptation of Vero cells to grow in suspension will simplify subcultivation and process scale-up significantly, and therefore reduce the production cost.Here we report on a successful adaptation of adherent Vero cells to grow in suspension in a serum-free and animal component-free medium (IHM03) developed in-house. The suspension adapted Vero cell cultures in IHM03 grew to similar or better maximum cell density as what was observed for the adherent Vero cells grown in commercial serum-free media and with a cell doubling time of 40–44 h. Much higher cell density (8 × 106 cells/mL) was achieved in a batch culture when three volume of the culture medium was replaced during the batch culture process.Both adherent and suspension Vero cells from various stages were tested for their authenticity using short tandem repeat analysis. Testing result indicates that all Vero cell samples had 100% concordance with the Vero DNA control sample, indicating the suspension cells maintained their genetic stability. Furthermore, suspension Vero cells at a passage number of 163 were assayed for tumorigenicity, and were not found to be tumorigenic.The viral productivity of suspension Vero cells was evaluated by using vesicular stomatitis virus (VSV) as a model. The suspension cell culture showed a better productivity of VSV than the adherent Vero cell culture. In addition, the suspension culture could be infected at higher cell densities, thus improving the volumetric virus productivity. More than one log of increase in the VSV productivity was achieved in a 3L bioreactor perfusion culture infected at a cell density of 6.8 × 106 cells/mL. 相似文献
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