Low prevalence of Chlamydia psittaci in ocular adnexal lymphomas from Cuban patients

Most ocular adnexal lymphomas (OAL) are extranodal marginal zone B-cell lymphomas (EMZL) of mucosa-associated lymphoid tissue (MALT)-type. Chronic antigen stimulation has been suggested to have a pathogenetic role in EMZL and Chlamydia psittaci chronic infection has been recently associated with the development of OAL in a series of patients from Italy. To assess this association, an evaluation of the presence of C. psittaci was made in a different OAL population. DNA samples were obtained from formalin-fixed, paraffin-embedded sections samples of 26 patients with OAL, 20 non-OAL and 20 benign ocular lesions, diagnosed and treated between 1998 and 2003 at National Institute of Oncology in Havana, Cuba. All samples were histologically reviewed by an expert pathologist. Fluorescence in situ hybrization (FISH) analysis of translocations involving MALT1 was performed. The presence of bacterial DNA was assessed with a multiplex touchdown enzyme time release polymerase chain reaction. DNA sequencing was performed to confirm suspicious bands. Seventy-three percent of the OAL cases were EMZL and 81% were in stage IE. FISH analysis was performed in 13 OAL cases and none of them evidenced MALT1 translocations. DNA of C. psittaci was detected in 11% of the 46 lymphomas: two orbital EMZL and three non-OAL. All 20 benign ocular lesions were negative for C. psittaci. The low prevalence of C. psittaci in OAL suggests geographical differences in the etiology of this entity. International studies are needed to clarify the role of C. psittaci in OALs.     

Psychological impact of burns on children treated in a severe burns unit

The aims of this study were to analyse the types of incident which cause children's burns, to investigate emotional reactions and associated behaviour afterward and to ascertain post-admission sequelae. A total of 83 young people took part, aged 1-17 years, with a mean 12% (range 1.5-47%, S.D. 8.0) total body surface area burned. According to the results from the psychometric scales and questionnaire used, most burns were the result of domestic incidents. Older children scored higher in anxiety. The most common behavioural reactions observed (attachment, wish to go back home) reflect the particularity of these patients compared with other samples of children in hospital. With respect to post-admission sequelae, no relevant results were obtained.     

Effect of indexed glomerular filtration rate according to age

Clinical and Experimental Nephrology - To find out up to what age there is dispersion in glomerular filtration rate (GFR) values when normalised by body surface area (BSA) and extracellular fluid...     

Pilot Testing Three Interventions For Symptom Management in HIV/AIDS Fever

Fever is a common symptom in hospitalized HIV/AIDS patients (Holtzclaw, 1998; Jones, Holloman & Coffin, 1998). Nurses caring for patients with AIDS use antipyretic medications plus physical cooling methods for fever management (Jones, 1998). However, no studies were found that evaluated the efficacy of these interventions with patients who have HIV/AIDS. Additionally, no research reports were found that evaluated the use of a cooling scarf, a new physical cooling method used by the lay public while exercising, as a method that could be applied in the clinical setting.     

Asynchronous Testing of 2 Specimen-Diversion Devices to Reduce Blood Culture Contamination: A Single-Site Product Supply Quality Improvement Project

ObjectiveBlood culture contamination above the national threshold has been a consistent clinical issue in the ED setting. Two commercially available devices were examined that divert an initial small volume of the specimen before the collection of blood culture to reduce skin contamination.MethodsProspectively, 2 different blood culture–diversion devices were made available in the unit supplies to ED clinicians at a single site during 2 different periods of time as a follow-up strategy to an ongoing quality improvement project. Blood samples were collected in the emergency department over a period of 16 months. A retrospective record review study was conducted comparing the use of the 2 specimen-diversion devices with no device (control group) for blood culture contamination rates. The main outcome of monthly blood culture contamination per device was tested using a Bayesian Poisson multilevel regression model.ResultsA total of 4030 blood samples were collected and analyzed from November 2017 to February 2019. The model estimated that the mean incidence of contaminated blood draws in the device A group was 0.29 (0.14-0.55) times the incidence of contaminated draws in the control group. The mean incidence of contaminated blood draws in the device B group was 0.23 (0.13-0.37) times the incidence of contaminated draws in the control group, suggesting that initial-diversion methods reduced blood culture contamination.ConclusionInitial specimen–diversion devices supplement present standard phlebotomy protocols to bring down the blood culture contamination rate.     

Local allergic rhinitis: Implications for management

A significant proportion of rhinitis patients without systemic IgE‐sensitisation tested by skin prick test and serum allergen‐specific IgE (sIgE) display nasal reactivity upon nasal allergen provocation test (NAPT). This disease phenotype has been termed local allergic rhinitis (LAR). LAR is an underdiagnosed entity affecting children and adults from different parts of the world, with moderate‐to‐severe symptoms, impairment of quality of life and rapid progression to symptom worsening. LAR is a stable phenotype and not merely an initial state of AR. Allergic rhinitis and LAR share many clinical features including a positive NAPT response, markers of type 2 nasal inflammation including sIgE in nasal secretions and a significant rate of asthma development. LAR should be considered as a differential diagnosis in those subjects of any age with symptoms suggestive of AR but no evidence of systemic atopy. Although LAR pathophysiology is partially unknown, in some patients sIgE can be demonstrated directly in the nasal secretions and/or indirectly via positive responses in basophil activation test (BAT). LAR can coexist with other rhinitis phenotypes, especially AR. The diagnosis currently relies on the positivity of NAPT to a single or multiple allergens. NAPT has high sensitivity, specificity and reproducibility, and it is considered the gold standard. BAT and the measurement of nasal sIgE can also contribute to LAR diagnosis. LAR patients benefit from the same therapeutic strategies than AR individuals, including the avoidance of allergen exposure and the pharmacotherapy. Moreover, several recent studies support the effectiveness and safety of allergen immunotherapy for LAR, which opens a window of treatment opportunity in these patients.