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Next-generation sequencing diagnostics of bacteremia in pediatric sepsis.

Medicine (Baltimore) 2021 Jun;100(25):e26403

Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen.

Introduction: Sepsis and septic shock are the most severe forms of infection affecting predominantly elderly people, preterm and term neonates, and young infants. Even in high-income countries sepsis causes about 8% of admissions to pediatric intensive care units (PICUs). Early diagnosis, rapid anti-infective treatment, and prompt hemodynamic stabilization are crucial for patient survival. Read More

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Neonatal presentation of genetic epilepsies: Early differentiation from acute provoked seizures.

Epilepsia 2021 Jun 21. Epub 2021 Jun 21.

Department of Pediatrics, Saint-Luc University Hospital, Catholic University of Louvain, Brussels, Belgium.

Objective: Although most seizures in neonates are due to acute brain injury, some represent the first sign of neonatal onset genetic epilepsies. Delay in recognition and lack of expert assessment of neonates with epilepsy may result in worse developmental outcomes. As in older children and adults, seizure semiology in neonates is an essential determinant in diagnosis. Read More

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Incidence of acute kidney injury among COVID-19 patients in Egypt.

Ren Replace Ther 2021 14;7(1):32. Epub 2021 Jun 14.

Department of Gastroenterology, Ahmad Maher Teaching Hospital, Cairo, Egypt.

Background: Despite the fact that the fundamental characteristics of coronavirus disease-2019 (COVID-19) are respiratory manifestations, multi-organ failure including the kidney has been documented. There are no clear comparisons of COVID-19 cases with and without acute kidney injury (AKI) to show whether there are aspects of acute kidney injury progression path or outcome that are unique to this disease.

Methods: In this work, we analyzed the data of 734 COVID-19 cases admitted to the Ahmad Maher Teaching Hospital in Cairo, Egypt, between June 6 and July 25, 2020. Read More

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The relationship between frailty and diabetes: An investigation of self-rated health, depression symptoms and quality of life in the Study of Health Aging and Retirement in Europe.

Arch Gerontol Geriatr 2021 May 29;96:104448. Epub 2021 May 29.

College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway City, Ireland; Department of Endocrinology, Portiuncula University Hospital, Ballinasloe, Co Galway, Ireland. Electronic address:

Aims: To assess the impact of diabetes and frailty on self-rated health, depressive symptoms and quality of life (QoL).

Methods: Data were pooled for participants aged ≥50 years from five waves of the Survey of Health, Ageing and Retirement in Europe. Measures included diabetes (self-reported), physical frailty (≥3/5 criteria), low self-rated health (SRH; "poor" or "fair"), depression (screened using the EURO-D ≥4) and low QoL (CASP-12 <35). Read More

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Human ACE2-Functionalized Gold "Virus-Trap" Nanostructures for Accurate Capture of SARS-CoV-2 and Single-Virus SERS Detection.

Nanomicro Lett 2021 Apr 13;13(1):109. Epub 2021 Apr 13.

State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200032, People's Republic of China.

The current COVID-19 pandemic urges the extremely sensitive and prompt detection of SARS-CoV-2 virus. Here, we present a Human Angiotensin-converting-enzyme 2 (ACE2)-functionalized gold "virus traps" nanostructure as an extremely sensitive SERS biosensor, to selectively capture and rapidly detect S-protein expressed coronavirus, such as the current SARS-CoV-2 in the contaminated water, down to the single-virus level. Such a SERS sensor features extraordinary 10-fold virus enrichment originating from high-affinity of ACE2 with S protein as well as "virus-traps" composed of oblique gold nanoneedles, and 10-fold enhancement of Raman signals originating from multi-component SERS effects. Read More

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Salmonella Paratyphi Infection: Use of Nanopore Sequencing as a Vivid Alternative for the Identification of Invading Bacteria.

Prague Med Rep 2021 ;122(2):96-105

Department of Infectious Diseases, First Faculty of Medicine, Charles University and Military University Hospital Prague, Prague, Czech Republic.

In our study we present an overview of the use of Oxford Nanopore Technologies (ONT) sequencing technology on the background of Enteric fever. Unlike traditional methods (e.g. Read More

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Rapid diagnostic testing for antimicrobial stewardship: Utility in Asia Pacific.

Infect Control Hosp Epidemiol 2021 Jun 15:1-5. Epub 2021 Jun 15.

Clinical Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Rapid diagnostic testing (RDT) can provide prompt, accurate identification of infectious organisms and be a key component of antimicrobial stewardship (AMS) programs. However, their use is less widespread in Asia Pacific than western countries. Cost can be prohibitive, particularly in less resource-replete settings. Read More

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The epidemiology, diagnosis and management of scrub typhus disease in China.

Hum Vaccin Immunother 2021 Jun 14:1-11. Epub 2021 Jun 14.

Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.

Thirty-nine years ago, scrub typhus (ST), a disease, was not among the China's notifiable diseases. However, ST has reemerged to become a growing public health issue in the southwest part of China. The major factors contributing to an increased incidence and prevalence of this disease include rapid globalization, urbanization, expansion of humans into previously uninhabited areas, and climate change. Read More

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Necrotizing Cellulitis and Myositis in a Neutropenic Leukemic Patient.

Cureus 2021 May 10;13(5):e14941. Epub 2021 May 10.

Internal Medicine, Moffitt Cancer Center, Tampa, USA.

In this article, we review a case of necrotizing cellulitis and myositis in a neutropenic leukemic patient. He underwent a series of investigations to reach the diagnosis of pyoderma gangrenosum (PG). The lesion improved dramatically after pertinent identification and initiation of appropriate treatment. Read More

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Delivery sheath tip invagination - An unusual cause of failure to retrieve duct occluder.

Ann Pediatr Cardiol 2021 Apr-Jun;14(2):242-243. Epub 2021 Apr 10.

Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.

Transcatheter closure of patent ductus arteriosus is the standard of care. Retrieval of a duct occluder device is generally easy until it is detached from the delivery cable. We report two instances of failed retrieval of the device due to sheath tip invagination. Read More

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Computed tomography imaging of septic shock. Beyond the cause: the "CT hypoperfusion complex". A pictorial essay.

Insights Imaging 2021 Jun 5;12(1):70. Epub 2021 Jun 5.

Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, Antonio Cardarelli st 9, 80131, Naples, Italy.

Septic shock is a medical emergency that represents one of the most important underlying causes for presentation to the Emergency Department. Sepsis is defined as organ dysfunction, life-threatening event caused by a deregulated inflammatory host response to infection, with a mortality risk ranging from 10 to 40%. Early sepsis identification is the cornerstone of management and diagnostic imaging can play a pivotal role in this clinical context. Read More

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Design of Rapid Detection System for Five Major Carbapenemase Families (, , , and ) by Colorimetric Loop-Mediated Isothermal Amplification.

Infect Drug Resist 2021 24;14:1865-1874. Epub 2021 May 24.

Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.

Purpose: Carbapenemase-producing (CPE) infection constitutes a public health threat. Timely and efficient diagnosis is of paramount importance for prompt and effective therapy. In order to quickly and comprehensively detect the five major families of carbapenemases (, , , , and ), colorimetric loop-mediated isothermal amplification (LAMP) was employed. Read More

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Risk Factors for Mortality in Colombian Patients with Candidemia.

J Fungi (Basel) 2021 May 31;7(6). Epub 2021 May 31.

Fundación Valle de Lili, Cali 760026, Colombia.

The aim of the study was to describe the microbiology and susceptibility profile of candidemia and to identify the risk factors associated with mortality in Colombia. A cohort of patients was followed for 30 days during 2008 to 2010. Microbiological identification and susceptibility assessments were performed in a reference centre. Read More

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Statistical Methods for Degradation Estimation and Anomaly Detection in Photovoltaic Plants.

Sensors (Basel) 2021 May 27;21(11). Epub 2021 May 27.

SAL Silicon Austria Labs GmbH, Europastr. 12, 9524 Villach, Austria.

Photovoltaic (PV) plants typically suffer from a significant degradation in performance over time due to multiple factors. Operation and maintenance systems aim at increasing the efficiency and profitability of PV plants by analyzing the monitoring data and by applying data-driven methods for assessing the causes of such performance degradation. Two main classes of degradation exist, being it either gradual or a sudden anomaly in the PV system. Read More

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The First Application of H NMR Spectroscopy for the Assessment of the Authenticity of Perfumes.

Molecules 2021 May 22;26(11). Epub 2021 May 22.

Institute of Organic Chemistry, Faculty of Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland.

The manufacture of counterfeit goods is one of the world's largest underground businesses and is rapidly growing. Counterfeits can lead not only to the loss of profit for honest producers but also have a negative impact on consumers who pay excessive prices for poor quality goods that may result in health or safety problems. The perfume industry is constantly vulnerable to counterfeits, particularly in the fast developing market of "smell-alike" designer-inspired perfumes because these prompt the identification of the methods that classify their quality. Read More

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"Two for One", Novel Dual Left Anterior Descending Artery (LAD) Variant: Type XIII.

Cureus 2021 Apr 27;13(4):e14717. Epub 2021 Apr 27.

Cardiology, Northwell Health, Manhasset, USA.

Dual left anterior descending artery (LAD) is a rare phenomenon that occurs in less than one percent of the population. To date, 12 variants have been identified. Proper identification of coronary vessels is crucial in emergent situations that require prompt action, such as percutaneous coronary intervention (PCI). Read More

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Intrinsically Resistant Bacteria as Looming Disaster: A Rare Case Report of Meningitis in a Neonate.

J Lab Physicians 2021 Mar 22;13(1):70-73. Epub 2021 Feb 22.

Department of Neonatology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.

is a recognized cause of neonatal meningitis with high mortality rate of approximately 57%, but clinical data detailing these infections remain limited from India. Though this bacteria has a Gram-negative character, it is usually multidrug resistant to antibiotics usually prescribed for Gram-negative bacterial infections and susceptible to antibiotics for Gram-positive bacteria, thus poses a serious challenge to the treating clinicians. Such cases of neonatal meningitis is most commonly associated with prematurity with birth weight < 2,500 g, but here we report an uncommon case of neonatal meningitis due to this rare pathogen in a full-term neonate with weight as per gestational age. Read More

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Prevalence of Polytrauma Clinical Triad Among Active Duty Service Members.

Mil Med 2021 May 29. Epub 2021 May 29.

Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, MD 20814, USA.

Introduction: The polytrauma clinical triad (PCT), encompassing traumatic brain injury, PTSD, and chronic pain, has been identified as a significant concern in the Military Health System (MHS). Conditions in this triad mutually reinforce one another and can pose a significant challenge to treatment for patients and providers. Polytrauma clinical triad has previously been studied in deployed veterans but remains understudied in the active duty military population. Read More

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Prevalence of Bloodstream Infections and their Etiology in COVID-19 Patients Admitted in a Tertiary Care Hospital in Jaipur.

Indian J Crit Care Med 2021 Apr;25(4):369-373

Department of Medical Oncology, Mahatma Gandhi University of Medical Sciences, Jaipur, Rajasthan, India.

Background: World is in grip of coronavirus disease-2019 (COVID-19) pandemic right now. Majority of studies center around its epidemiological and clinical characteristics. Information regarding secondary bacterial infections is limited. Read More

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Comparison of outcome between blood culture positive and negative infective endocarditis patients undergoing cardiac surgery.

J Cardiothorac Surg 2021 May 27;16(1):147. Epub 2021 May 27.

Riga Stradins University, 16 Dzirciema Street, Riga, LV-1007, Latvia.

Background: Up to 30% or even more of all infective endocarditis (IE) cases are recognized as blood culture negative, meaning that the causative agent is left unidentified. The prompt diagnosis together with the identification of causative microorganism and targeted antibiotic treatment can significantly impact the prognosis of the disease and further patient's health status. In some studies, blood culture negative endocarditis has been shown to be associated with delayed diagnosis, worse outcome and course of the disease, and a greater number of intra and postoperative complications. Read More

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Management of belantamab mafodotin-associated corneal events in patients with relapsed or refractory multiple myeloma (RRMM).

Blood Cancer J 2021 May 26;11(5):103. Epub 2021 May 26.

University of Chicago Medical Center, Chicago, IL, USA.

Belantamab mafodotin (belamaf) demonstrated deep and durable responses in patients with heavily pretreated relapsed or refractory multiple myeloma (RRMM) in DREAMM-2 (NCT03525678). Corneal events, specifically keratopathy (including superficial punctate keratopathy and/or microcyst-like epithelial changes (MECs), eye examination findings with/without symptoms), were common, consistent with reports from other antibody-drug conjugates. Given the novel nature of corneal events in RRMM management, guidelines are required for their prompt identification and appropriate management. Read More

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The multifactorial mechanisms of bacterial infection in decompensated cirrhosis.

J Hepatol 2021 Jul;75 Suppl 1:S82-S100

Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain.

Infections, due to a dysfunctional immune response, pose a great risk to patients with decompensated cirrhosis and herald the beginning of the terminal phase of this disease. Infections typically result from breaches in innate immune barriers and inadequate clearance by immune cells. This leads to bacterial and bacterial product translocation to the systemic circulation, which is already primed by ongoing hepatic inflammation in patients with cirrhosis, who are particularly prone to developing organ failure in the presence of an infection. Read More

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Granulomatous Dermatitis Associated With Rubella Virus Infection in an Adult With Immunodeficiency.

JAMA Dermatol 2021 May 26. Epub 2021 May 26.

Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia.

Importance: Immunodeficiency-related, vaccine-derived rubella virus (RuV) as an antigenic trigger of cutaneous and visceral granulomas is a rare, recently described phenomenon in children and young adults treated with immunosuppressant agents.

Objective: To perform a comprehensive clinical, histologic, immunologic, molecular, and genomic evaluation to elucidate the potential cause of an adult patient's atypical cutaneous granulomas.

Design, Setting, And Participants: A prospective evaluation of skin biopsies, nasopharyngeal swabs, and serum samples submitted to the Centers for Disease Control and Prevention was conducted to assess for RuV using real-time reverse-transcriptase polymerase chain reaction (RT-PCR) and viral genomic sequencing. Read More

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Familiar faces as islands of expertise.

Cognition 2021 May 23;214:104765. Epub 2021 May 23.

Psychology, Faculty of Natural Sciences, University of Stirling, Stirling FK9 4LA, United Kingdom. Electronic address:

Most people recognise and match pictures of familiar faces effortlessly, while struggling to match unfamiliar face images. This has led to the suggestion that true human expertise for faces applies only to familiar faces. This paper develops that idea to propose that we have isolated 'islands of expertise' surrounding each familiar face that allow us to perform better with faces that resemble those we already know. Read More

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Developing a stroke alert trigger for clinical decision support at emergency triage using machine learning.

Int J Med Inform 2021 Aug 19;152:104505. Epub 2021 May 19.

Department of Information Management, National Central University, Taoyuan City, Taiwan. Electronic address:

Background: Acute stroke is an urgent medical condition that requires immediate assessment and treatment. Prompt identification of patients with suspected stroke at emergency department (ED) triage followed by timely activation of code stroke systems is the key to successful management of stroke. While false negative detection of stroke may prevent patients from receiving optimal treatment, excessive false positive alarms will substantially burden stroke neurologists. Read More

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The Emerging Role of Hematopathologists and Molecular Pathologists in Detection, Monitoring, and Management of Myeloid Neoplasms with Germline Predisposition.

Curr Hematol Malig Rep 2021 May 24. Epub 2021 May 24.

Department of Hematopathology and Molecular Diagnostics, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.

Purpose Of Review: Awareness, widespread availability, and routine use of sequencing techniques in work-up of myelodysplastic syndromes and acute myeloid leukemia have facilitated increased recognition of these entities arising in a background of germline predisposition disorders (GPD).

Recent Findings: The latest revisions to the WHO classification of myeloid neoplasms incorporate "myeloid neoplasms with germline predisposition" as a separate entity due to the therapeutic implications of this diagnosis. It has become apparent that some of these entities have unique recognizable morphologic findings that can be challenging to interpret at time. Read More

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Pericapsular nerve group (PENG) block for hip fracture in the emergency department: a case series.

Anaesth Rep 2021 Jan-Jun;9(1):97-100. Epub 2021 May 18.

Department of Anaesthesiology and Pain Management University Health Network University of Toronto Canada.

Guidelines for the management of hip fractures recommend timely identification, analgesia and optimisation, in order to facilitate prompt surgical repair. In achieving these aims, multidisciplinary care is essential. In this case series, we present five patients who received bedside pericapsular nerve group (PENG) blocks by emergency physicians in collaboration with the anaesthesia team for pain management following hip fracture. Read More

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Detection of Mechanical Prosthetic Valve Dysfunction.

Am J Cardiol 2021 Jul 18;150:101-109. Epub 2021 May 18.

Department of Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy.

The long-term outcome of mechanical aortic and mitral prosthetic valve (A-PV, M-PV) dysfunction (PVD) remains a serious complication associated with high morbidity and mortality. We sought to evaluate the incremental diagnostic value of combined transthoracic echocardiography (TTE) and fluoroscopy (F) in patients with suspected PVD. A total of 354 patients (178 A-PV, 176 M-PV) were imaged by TTE and F within 5 days of hospital admission. Read More

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Recurrent noncirrhotic hyperammonemia causing acute metabolic encephalopathy in a patient with a continent ileocecal pouch: a case report.

J Med Case Rep 2021 May 22;15(1):294. Epub 2021 May 22.

Department of Internal Medicine, Wake Forest Baptist Medical Center, 1 Medical Center Boulevard, Winston-Salem, NC, USA.

Introduction: Acute encephalopathy, while a common presentation in the emergency department, is typically caused by a variety of metabolic, vascular, infectious, structural, or psychiatric etiologies. Among metabolic causes, hyperammonemia is relatively common and typically occurs in the setting of cirrhosis or liver dysfunction. However, noncirrhotic hyperammonemia is a rare occurrence and poses unique challenges for clinicians. Read More

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