Carverbruus8851

Even though most screening tests occurred at fixed venues located in high-prevalence areas, screening of residents from lower-prevalence areas was mostly proportional to the prevalence of HIV and rates of new HIV and STI diagnoses in those locales. Conclusions This study supported the ability of a small number of standalone testing centers to reach at-risk populations dispersed across SD County. These methods can also be used to highlight geographic areas or demographic segments that may benefit from more intensive screening. © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.We report yellow fever infection in a Dutch traveler returning from Brazil. Yellow fever virus (YFV) was identified in serum and urine samples over a period of 1 month. Yellow fever virus genome sequences from the patient clustered with recent Brazilian YFV and showed with limited nucleotide changes during the resolving infection. © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.Background There is a paucity of data evaluating the strategy of suppressing broader-spectrum antibiotic susceptibilities on utilization. Cascade reporting (CR) is a strategy of reporting antimicrobial susceptibility test results in which secondary (eg, broader-spectrum, costlier) agents may only be reported if an organism is resistant to primary agents within a particular drug class. Our objective was to evaluate the impact of ceftriaxone-based cascade reporting on utilization of cefepime and clinical outcomes in patients with ceftriaxone-susceptible Escherichia and Klebsiella clinical cultures. Methods We compared post-CR (July 2014-June 2015) with baseline (July 2013-June 2014), evaluating utilization of cefepime, cefazolin, ceftriaxone, ampicillin derivatives, fluoroquinolones, piperacillin/tazobactam, ertapenem, and meropenem; new Clostridium difficile infection; and length of stay (LOS) after the positive culture, 30-day readmission, and in-hospital all-cause mortality. Results Mean days of therapy (DOTital mortality. © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.Introduction Cervical lymphadenopathy in lung cancer indicates advanced disease. The presence of mediastinal lymphadenopathy is commonly associated with involvement of neck lymph nodes and some studies suggest routine neck ultrasound (NUS) in this group of patients. We conducted a two-phase study looking at training a respiratory physician to perform ultrasound-guided neck lymph node aspiration in patients with suspected lung cancer. Methods In the first phase of the study, one of the authors underwent training in NUS according to predetermined criteria. The adequacy of sampling was prospectively recorded. In the second phase, consecutive patients with suspected lung cancer and mediastinal lymphadenopathy underwent NUS and sampling of abnormal lymph nodes. The outcomes were the adequacy of samples for pathological analysis and molecular analysis, prevalence of cervical lymphadenopathy, and change in stage. Results Following the period of training, 35 patients underwent neck node sampling with an overall adequacy of 88.6% (95% CI 78.1-99.1%). selleckchem Cervical lymph node involvement was confirmed in 13 out of 30 patients with lung cancer (43.3%, 95% CI 25.5-62.6%). Further immunohistochemistry and molecular studies were possible in all patients when it was required (nine cases). NUS led to nodal upstaging in four out of 30 (13.3%) cases. Conclusion Training a respiratory physician to perform NUS and needle sampling to an acceptable level is feasible. Benefits of embedding this procedure in lung cancer diagnosis and pathway staging need to be explored in further studies. Copyright ©ERS 2020.Background On high-resolution computed tomography (HRCT), pulmonary artery (PA) dimensions may hint at the presence of pulmonary hypertension. We aimed to determine how accurately various measures of the PA, as viewed on HRCT, predict right heart catheterisation (RHC)-confirmed pulmonary hypertension. Methods We retrospectively reviewed patients who had HRCT and RHC between 2010 and 2018. Analyses considered respiratory cycle, pulmonary hypertension diagnostic criteria, time between HRCT and RHC, and subgroup analysis in interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD). Results Of 620 patients, 375 had pulmonary hypertension. For pulmonary hypertension (defined as mean PA pressure (mPAP) ≥25 mmHg) and from HRCT performed within 60 days of RHC, main PA diameter (MPAD) ≥29 mm had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 88%, 42%, 0.70 and 0.70, respectively, while ratio of the diameter of the PA to the diameter of the ascending aorta (PAAo) ≥1.0 showed 53%, 85%, 0.84 and 0.54, respectively. In general, results were similar when the interval between HRCT and RHC varied from 7 to 60 days and when measured on expiratory images. In ILD, the sensitivity of MPAD was higher; in COPD, the specificity of PAAo was higher. There was moderately positive correlation between mPAP and inspiratory MPAD, PAAo, right PA diameter (RPAD), left PA diameter (LPAD) and (RPAD+LPAD)/2 (r=0.48, 0.51, 0.34, 0.34 and 0.36, respectively), whereas there was weak negative correlation between mPAP and PA angle (r= -0.24). Conclusions Findings on HRCT may assist in the diagnosis of RHC-confirmed pulmonary hypertension. MPAD ≥29 mm had high sensitivity and PAAo ≥1.0 had high specificity. Compared with the entire cohort, MPAD had greater sensitivity in ILD and PAAo had higher specificity in COPD. Copyright ©ERS 2020.Introduction In this cohort study, we evaluated whether the particles in exhaled air (PExA) device can be used in conjunction with mechanical ventilation during surgery. The PExA device consists of an optical particle counter and an impactor that collects particles in exhaled air. Our aim was to establish the feasibility of the PExA device in combination with mechanical ventilation (MV) during surgery and if collected particles could be analysed. Patients with and without nonsmall cell lung cancer (NSCLC) undergoing lung surgery were compared to normal breathing (NB) patients with NSCLC. Methods A total of 32 patients were included, 17 patients with NSCLC (MV-NSCLC), nine patients without NSCLC (MV-C) and six patients with NSCLC and not intubated (NB). The PEx samples were analysed for the most common phospholipids in surfactant using liquid-chromatography-mass-spectrometry (LCMS). Results MV-NSCLC and MV-C had significantly lower numbers of particles exhaled per minute (particle flow rate; PFR) compared to NB.