Successful treatment of disseminated candidiasis resistant to amphotericin B by liposomal amphotericin B: a case report

The case of a female patient with acute lymphoblastic leukaemia and chronic disseminated candidiasis, who was refractory to 1.8 g conventional amphotericin B therapy, is reported. She experienced severe amphotericin-B-related side-effects in spite of pretreatment, but was subsequently successfully treated with 3 g of a small unilamellar liposome formulation of amphotericin B prepared from soya phosphatidylcholine and cholesterol in a 73 molar ratio at our institute. The patient experienced minimal side-effects with this preparation, although no pretreatment was given. Liposomal amphotericin B prepared in our institute appears to be a safe and effective therapy for systemic fungal infections. However, large controlled studies are required to determine more precisely the potential of liposomal amphotericin B in the treatment of severe systemic fungal infection.     

Laparoscopic management of a rare urogenital fistula

Ureteral injury is usually iatrogenic after gynecologic or obstetric surgeries. Ureterouterine fistula is a rare complication. It most commonly occurs after a caesarean section. A 24-year-old woman presented with paradoxic incontinence 1 week after caesarean section. Intravenous urography revealed a left ureterouterine fistula. She was treated successfully by laparoscopic ureteroneocystostomy.     

Autosomal dominant polycystic kidney disease with situs inversus

Situs inversus totalis and autosomal dominant polycystic kidney disease (ADPKD) occur with an incidence of 1/10,000 in the general population and 1 in 1000 live births, respectively. Association of the two conditions is rare and there are few pediatric case reports. Association of situs inversus totalis and autosomal recessive polycystic kidney disease has also been reported. Recent studies have revealed ciliary dysfunction as a cause of both conditions.     

Artificial intelligence in clinical and translational science: Successes,challenges and opportunities

Artificial intelligence (AI) is transforming many domains, including finance, agriculture, defense, and biomedicine. In this paper, we focus on the role of AI in clinical and translational research (CTR), including preclinical research (T1), clinical research (T2), clinical implementation (T3), and public (or population) health (T4). Given the rapid evolution of AI in CTR, we present three complementary perspectives: (1) scoping literature review, (2) survey, and (3) analysis of federally funded projects. For each CTR phase, we addressed challenges, successes, failures, and opportunities for AI. We surveyed Clinical and Translational Science Award (CTSA) hubs regarding AI projects at their institutions. Nineteen of 63 CTSA hubs (30%) responded to the survey. The most common funding source (48.5%) was the federal government. The most common translational phase was T2 (clinical research, 40.2%). Clinicians were the intended users in 44.6% of projects and researchers in 32.3% of projects. The most common computational approaches were supervised machine learning (38.6%) and deep learning (34.2%). The number of projects steadily increased from 2012 to 2020. Finally, we analyzed 2604 AI projects at CTSA hubs using the National Institutes of Health Research Portfolio Online Reporting Tools (RePORTER) database for 2011–2019. We mapped available abstracts to medical subject headings and found that nervous system (16.3%) and mental disorders (16.2) were the most common topics addressed. From a computational perspective, big data (32.3%) and deep learning (30.0%) were most common. This work represents a snapshot in time of the role of AI in the CTSA program.     

Mental health and the ageing population

The ageing population of the world presents major challenges for society and for health services. Mental health issues are extremely important, as mental disorders, notably dementia and depression, are common in old age. Mental ill health can profoundly affect the quality of people's old age and has a significant impact upon the use of health and social services. In this paper, we examine these problems from the point of view of older people as consumers, and discuss the role of health promotion, primary care, social services and specialist mental health services for older people. Certain groups within the population, including women, people from minority ethnic backgrounds, very old people, people with learning disabilities, and gay and lesbian older people face some particular issues, which are briefly discussed. Although this paper takes a mainly UK perspective, the mental health of older people is a huge global public health issue. Good epidemiology is central to understanding the needs of ageing populations and responding to them appropriately. Further research is needed in other areas, especially as to which service interventions are effective and efficient.