Nutritional management of enterocutaneous fistula: a retrospective study at a Malaysian university medical center

Abstract Background Antibody detection is the main method for diagnosis of coccidioidomycosis, but it has limitations. The Coccidioides antigen enzyme immunoassay is recommended for testing cerebrospinal fluid in suspected meningitis. Reports on urine and serum antigen detection evaluated small numbers of patients who were mostly immunocompromised. The purpose of this study was to assess the accuracy of combined antibody and antigen detection for diagnosis. Methods A retrospective study, including all patients in whom Coccidioides antigen detection in serum was performed between January 2013 and May 2017, was conducted at Valleywise Health Medical Center (formerly Maricopa Integrated Health System). Sensitivity and specificity of antigen and antibody were evaluated in 158 cases and 487 controls. Results The sensitivity of antibody detection by immunodiffusion (ID) was 84.2%. The sensitivity of antigen detection was 57.0% if both urine and serum were tested and 36.7% if urine alone was tested. The sensitivity of combining antigen and ID antibody detection was 93.0%. The sensitivity of urine and serum antigen detection was 55.4% in proven and 58.7% in probable cases, 79.1% in disseminated and 41.6% in pulmonary cases, and 74.7% in immunocompromised and 40.0% in immunocompetent patients. Specificity was 99.4% for antigen detection and 96.5% for ID antibody detection. Diagnostic accuracy was 95.4% for ID antibody and antigen detection, 93.6% for ID antibody alone, and 89.1% for pathology or culture. Conclusions These findings support combined antibody and antigen detection for diagnosis of progressive coccidioidomycosis. The diagnosis may have been missed if antigen detection was not performed.

Download Full-text

Automated computed tomography quantification of fibrosis predicts prognosis in combined pulmonary fibrosis and emphysema in a real-world setting: a single-centre, retrospective study

Respiratory Research ◽

10.1186/s12931-020-01545-3 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Masahiro Nemoto ◽

Yuichiro Nei ◽

Brian Bartholmai ◽

Kazuki Yoshida ◽

Hiroki Matsui ◽

...

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Pulmonary Fibrosis ◽

Acute Exacerbation ◽

Real World ◽

Medical Center ◽

Pulmonary Function Tests ◽

Quantitative Computed Tomography ◽

Single Centre ◽

Real World Setting

Abstract Background Combined pulmonary fibrosis and emphysema (CPFE) is a heterogeneous clinico-radiological syndrome without a consensus definition. There are limited data on the relation between the amount of parenchymal fibrosis and prognosis. In this study, we assessed the prognostic implications of the extent of fibrosis assessed by an automated quantitative computed tomography (CT) technique and the radiological and functional change over time in patients with a broad spectrum of fibrotic interstitial lung diseases (ILDs) encountered in a real-world setting. Methods We conducted a single-centre, retrospective study of 228 consecutive patients with CPFE, encountered from 2007 to 2015 at Kameda Medical Center, Chiba, Japan. We investigated the prognostic value of automated CT fibrosis quantification and the subsequent course of CPFE. Results Among 228 patients with CPFE, 89 had fibrosis affecting < 5% of their lungs, 54 had 5 to < 10% fibrosis, and 85 had ≥ 10% fibrosis at the time of diagnosis. Lower volume of fibrosis correlated with lower rates of mortality and acute exacerbation (p < 0.001). In particular, among those with < 5% fibrosis, only 4.5% died and none experienced acute exacerbation during follow-up, whereas 57.6% and 29.4% of those with ≥ 10% fibrosis experienced death and acute exacerbation, respectively. Although, the ≥ 10% fibrosis group had the poorest overall survival as well as the highest incidence of acute exacerbation, the incidence of decline in pulmonary function tests, change per year in total lung volume, and progression of fibrosis on chest CT was highest in the 5 to < 10% fibrosis group. The Cox proportional hazard model for CPFE progression (defined by composite criteria of death, acute exacerbation, and decline in forced vital capacity or diffusing capacity) showed fibrosis proportion was a risk factor independent of age, sex, smoking pack-years, the Charlson Comorbidity Index, lung cancer, connective tissue disease, and idiopathic pulmonary fibrosis. Conclusions Less severe (< 5%) fibrosis at baseline was associated with disease stability and better prognosis compared to more severe fibrosis in CPFE occurring with fibrotic ILDs. Further studies including a validation cohort will be needed. Trial Registration Retrospectively registered.

Download Full-text

Utility of Anakinra in Acute Crystalline Diseases: A Retrospective Study Comparing a University Hospital with a Veterans Affairs Medical Center

The Journal of Rheumatology ◽

10.3899/jrheum.180393 ◽

2018 ◽

Vol 46 (7) ◽

pp. 748-750 ◽

Cited By ~ 8

Author(s):

Julianna Desmarais ◽

Cong-Qiu Chu

Keyword(s):

Retrospective Study ◽

Adverse Effects ◽

Medical Center ◽

Veterans Affairs ◽

Hospitalized Patients ◽

University Hospital ◽

Acute Gout ◽

Efficacy And Safety ◽

Inpatient Management ◽

Gout Flares

Objective.To evaluate the efficacy and safety of anakinra in inpatient management of acute gout and pseudogout.Methods.Hospitalized patients with acute gout (n = 77) or pseudogout (n = 11) or both (n = 3) were analyzed for response to anakinra and adverse effects.Results.Half of all patients had comorbidities limiting the treatment choice. Anakinra was well tolerated, and 92% of gout flares and 79% of pseudogout flares responded to treatment.Conclusion.Anakinra is an effective and safe treatment for acute gout and pseudogout in hospitalized patients, particularly in those with comorbidities.

Download Full-text

Impact of add-on laboratory testing at an academic medical center: a five year retrospective study

BMC Clinical Pathology ◽

10.1186/s12907-015-0011-7 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 6

Author(s):

Louis S. Nelson ◽

Scott R. Davis ◽

Robert M. Humble ◽

Jeff Kulhavy ◽

Dean R. Aman ◽

...

Keyword(s):

Retrospective Study ◽

Laboratory Testing ◽

Medical Center ◽

Academic Medical Center ◽

Academic Medical

Download Full-text

The VP7 Genes of Two G9 Rotaviruses Isolated in 1980 from Diarrheal Stool Samples Collected in Washington, DC, Are Unique Molecularly and Serotypically

Journal of Virology ◽

10.1128/jvi.02537-07 ◽

2008 ◽

Vol 82 (8) ◽

pp. 4175-4179 ◽

Cited By ~ 14

Author(s):

Dianjun Cao ◽

Norma Santos ◽

Ronald W. Jones ◽

Masatoshi Tatsumi ◽

Jon R. Gentsch ◽

...

Keyword(s):

Retrospective Study ◽

Amino Acid ◽

Amino Acid Sequence ◽

Medical Center ◽

Washington Dc ◽

Sequence Analyses ◽

National Medical ◽

Lineage 2 ◽

Stool Samples ◽

Vp7 Gene

ABSTRACT In a retrospective study of archival diarrheal stool samples collected from 1974 to 1991 at Children's Hospital National Medical Center, Washington, DC, we detected three genotype G9P[8] viruses in specimens collected in 1980, which represented the earliest human G9 viruses ever isolated. The VP7 genes of two culture-adapted 1980 G9 viruses were phylogenetically related closely to the lineage 2 G9 virus VP7 gene. Unexpectedly, however, the VP7s of the 1980 G9 viruses were more closely related serotypically to lineage 3 VP7s than to lineage 2 VP7, which may be supported by amino acid sequence analyses of the VP7 proteins.

Download Full-text