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991.
Charles Varnell Jr Lyndsay A. Harshman Laurie Smith Chunyan Liu Shiran Chen Samhar Al-Akash Gina-Marie Barletta Craig Belsha Paul Brakeman Abanti Chaudhuri Paul Fadakar Rouba Garro Caroline Gluck Jens Goebel David Kershaw Debora Matossian Corina Nailescu Hiren P. Patel Cozumel Pruette Saritha Ranabothu Nancy Rodig Jodi Smith Judith Sebestyen VanSickle Patricia Weng Lara Danziger-Isakov David K. Hooper Michael Seifert 《American journal of transplantation》2021,21(8):2740-2748
There are limited data on the impact of COVID-19 in children with a kidney transplant (KT). We conducted a prospective cohort study through the Improving Renal Outcomes Collaborative (IROC) to collect clinical outcome data about COVID-19 in pediatric KT patients. Twenty-two IROC centers that care for 2732 patients submitted testing and outcomes data for 281 patients tested for SARS-CoV-2 by PCR. Testing indications included symptoms and/or potential exposures to COVID-19 (N = 134, 47.7%) and/or testing per hospital policy (N = 154, 54.8%). Overall, 24 (8.5%) patients tested positive, of which 15 (63%) were symptomatic. Of the COVID-19-positive patients, 16 were managed as outpatients, six received non-ICU inpatient care and two were admitted to the ICU. There were no episodes of respiratory failure, allograft loss, or death associated with COVID-19. To estimate incidence, subanalysis was performed for 13 centers that care for 1686 patients that submitted all negative and positive COVID-19 results. Of the 229 tested patients at these 13 centers, 10 (5 asymptomatic) patients tested positive, yielding an overall incidence of 0.6% and an incidence among tested patients of 4.4%. Pediatric KT patients in the United States had a low estimated incidence of COVID-19 disease and excellent short-term outcomes. 相似文献
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Abdullah Al-Mitwalli Grigorios Kyriazis Omar El-Taji Elizabeth Chandra Wearmouth Deborah Phillipa Burns Youssef Fady Matthew Simms Smith Nicholas 《Current Urology》2021,15(2):115
Background:Urosepsis is a recognized complication of transrectal ultrasound-guided prostate biopsy (TRUS-Bx). Pre-biopsy rectal swabs have been used to identify patients with microorganisms in the rectal flora resistant to the conventionally used empirical prophylaxis. The transperineal route of biopsy (TP-Bx) has a lower complication risk but comes at an increased cost.Materials and methods:Retrospective cohort study including patients undergoing prostate biopsies between October/2015 and April/2018. The intervention cohort, a rectal swab was performed, the result of which dictated the biopsy route; TRUS-Bx against TP-Bx. TP-Bx for patients with fluoroquinolone resistance or extended-spectrum β-lactamase. The control cohort underwent TRUS without a rectal swab receiving empirical antibiotics—oral ciprofloxacin and intravenous gentamicin.Results:Total 1000 patients were included in which 500 underwent a swab, 14 (2.8%) developed post-TRUS biopsy infective complications with 3 having positive bacteremia (0.6%); 500 had no swab, 47 (9.4%) developed post-TRUS biopsy infective complications with 22 (4.4%, p < 0.05) having positive bacteremia. Three patients (0.6%) of patients who underwent swab developed urinary tract infection symptoms whilst 12 (2.4%) had urinary tract infection in the control group. In those patients that underwent a swab, 14 required hospitalization with mean length of stay of 2.5 days versus 43 patients of the control with 3.6 days. Cost analysis concluded savings of this strategy was £18,711.Conclusions:We have demonstrated a protocol that reserves template biopsies for higher risk patients and can significantly reduce sepsis and other infectious complication rates whilst also proving to be a cost-efficient strategy. We recommend that units not utilizing rectal swabs to uncover the fluoroquinolone resistance rate by introducing them. We advocate units that already utilize rectal swabs, to introduce transperineal biopsy for their higher risk patients. 相似文献
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Archives of Sexual Behavior - 相似文献
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Layland Eric K. Ram Nilam Caldwell Linda L. Smith Edward A. Wegner Lisa 《Archives of sexual behavior》2021,50(6):2383-2394
Archives of Sexual Behavior - Sex during adolescence is normative; however, there are substantial individual differences in the timing and context of sexual debut. Leisure boredom is an... 相似文献
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