Severe Mycoplasma pneumoniae infections with prolonged fever in a child: Delayed treatment is as important as macrolide resistance

We report a 7-year-old girl who got Mycoplasma pneumoniae infection with prolonged fever. Macrolide was used on day 14 of illness but fever persisted with progressive lung consolidation. Oral prednisolone was administered on day 33 then fever subsided with dramatically clinical improvement (decreased CRP and resolution of lung consolidation). In this case, delayed effective antibiotic treatment with inflammation may be the major factor contributing to the fever rather than ongoing infection.     

Facile Synthesis of Well‐Defined Telechelic Alkyne‐Terminated Polystyrene in Polar Media Using ATRP With Mixed Fe/Cu Transition Metal Catalyst

The synthesis of polystyrene (PS) by atom transfer radical polymerization using the Fe(0)/CuBr₂ catalytic system in dimethylformamide is reported. The effects of temperature, ligand, initiator structure, and monomer to solvent ratio on the polymerization kinetics are evaluated. PS with high molecular weight, low polydispersity, and telechelic structure are achieved and successfully used for further reinitiation or the copper(I)‐catalyzed Huisgen 1,3‐dipolar cycloaddition click reaction between alkyne‐ and azide‐terminated PS. For the first time, suitable styrene polymerization rates are achieved using this cost‐effective and environmentally attractive catalytic system. This method can be very useful in macromolecular engineering to afford PS‐based materials with well‐controlled structure.     

Invasive fungal diseases in haematopoietic cell transplant recipients and in patients with acute myeloid leukaemia or myelodysplasia in Brazil

Invasive fungal disease (IFD) shows distinct regional incidence patterns and epidemiological features depending on the geographic region. We conducted a prospective survey in eight centres in Brazil from May 2007 to July 2009. All haematopoietic cell transplant (HCT) recipients and patients with acute myeloid leukaemia (AML) or myelodysplasia (MDS) were followed from admission until 1 year (HCT) or end of consolidation therapy (AML/MDS). The 12-month cumulative incidence (CI) of proven or probable IFD was calculated, and curves were compared using the Grey test. Among 237 AML/MDS patients and 700 HCT recipients (378 allogeneic, 322 autologous), the 1-year CI of IFD in AML/MDS, allogeneic HCT and autologous HCT was 18.7%, 11.3% and 1.9% (p <0.001), respectively. Fusariosis (23 episodes), aspergillosis (20 episodes) and candidiasis (11 episodes) were the most frequent IFD. The 1-year CI of aspergillosis and fusariosis in AML/MDS, allogeneic HCT and autologous HCT were 13.4%, 2.3% and 0% (p <0.001), and 5.2%, 3.8% and 0.6% (p 0.01), respectively. The 6-week probability of survival was 53%, and was lower in cases of fusariosis (41%). We observed a high burden of IFD and a high incidence and mortality for fusariosis in this first multicentre epidemiological study of IFD in haematological patients in Brazil.     

Influence of postoperative complications on long-term outcome after oncologic lung resection surgery. Substudy of a randomized control trial

Journal of Clinical Monitoring and Computing - Lung resection surgery (LRS) causes an intense local and systemic inflammatory response. There is a relationship between inflammation and...     

Systematic review of pressure injury prevalence in Australian and New Zealand hospitals

BackgroundPressure injuries have a major impact on patients and healthcare organisations. The complications of pressure injuries increase morbidity and mortality rates and are costly to individuals and healthcare systems. The total prevalence rate of pressure injuries within acute care hospitals in Australia and New Zealand is unknown, and despite a focus on prevention, pressure injuries still occur within these hospital settings.AimTo report the prevalence of pressure injuries within acute care settings in Australian and New Zealand hospitals and to identify the stage and location of pressure injuries and analyse the methods used to conduct pressure injury point prevalence studies.MethodsA systematic review of studies published in CINAHL, MEDLINE and Cochrane databases and a two-part grey literature search, including a customised Google search and a targeted website search, was undertaken up to July 2019. The systematic review was prospectively registered with PROSPERO (CRD42018105566).FindingsThe overall prevalence of pressure injuries in acute-care hospitals in Australia and New Zealand is 12.9% (95% CI, 9.5%–16.8%) and the hospital-acquired pressure injury prevalence is 7.9% (95% CI, 5.7%–10.3%). Stage I and stage II are the most common pressure injuries. The most frequent locations for pressure injuries are the sacrum/buttock/coccyx area (41%) and the heels (31%). The reporting of details about methodology varies considerably between studies.DiscussionPressure injuries remain a significant problem within acute-care hospital settings. Total prevalence rates are decreasing over time with the numbers of stage I and II pressure injuries decreasing faster than other pressure injuries.ConclusionThe findings from this study can be used to set performance benchmarks within acute-care hospitals in Australia and New Zealand. Pressure injuries are preventable and pressure injury prevalence studies can be used to monitor the effectiveness of nursing care processes to improve patient outcomes.