Aguirremckee2810

This study adds information on the presentation and results of SARS-CoV-2-infected patients who require mechanical ventilation.

This study adds information on the presentation and results of SARS-CoV-2-infected patients who require mechanical ventilation.

Shear-wave elastography (SWE) has been shown to be predictive of malignancy in thyroid nodules.

To determine, by SWE, the stiffness cutoff point with the highest specificity and sensitivity to detect thyroid nodules that require surgery.

Cross-sectional study of ultrasonographically-evaluated patients for thyroid nodules over a period of three years; the TI-RADS classification system was used, and nodule stiffness was determined by SWE. Histopathological specimens were classified using the Bethesda system, and the stiffness cutoff point with the highest specificity and sensitivity was obtained using ROC curves.

Forty-one percent of the nodules were classified as TI-RADS 5, and 59 %, as TI-RADS 1-4. In TI-RADS 5 nodules, median stiffness of those in Bethesda system IV-VI categories was 35.9 kPa; in nodules with TI-RADS 1-4, 21.6 kPa. In TI-RADS 5 nodules, a cutoff point > 32.5 kPa had a specificity of 75 % and sensitivity of 57 % to detect those requiring surgery; in TI-RADS 1 to 4 nodules, a cutoff point of 21.5 kPa had a specificity of 63 % and sensitivity of 51 %.

SWE-determined stiffness is useful to detect nodules that require surgical evaluation.

SWE-determined stiffness is useful to detect nodules that require surgical evaluation.

Adverse childhood experiences (ACEs) have been associated with the acquisition of risk behaviors and development of chronic and mental diseases since adolescence and in adult life.

To identify the knowledge and the frequency pediatrics residents ask about ACEs with.

Through an online survey sent to all resident physicians of the 2017-2018 academic year of a tertiary care children's hospital, demographic variables, knowledge, use, training and barriers to interrogate and search for ACEs were collected.

21% of residents answered the survey; the majority were women (70 %), less than 5 % of participants were familiar with ACEs, 31 % enquired about them in parents and their children, and 71 % considered having some barrier to interrogate about them.

Participants in this study showed limited knowledge about ACEs, which had an impact on the frequency they enquired about them with in their patients and their parents; at least half had the perception that it is beyond the reach of the pediatrician to identify them.

Participants in this study showed limited knowledge about ACEs, which had an impact on the frequency they enquired about them with in their patients and their parents; at least half had the perception that it is beyond the reach of the pediatrician to identify them.

In the context of the COVID-19 pandemic, there is concern regarding the impact of the influenza season.

To analyze the impact of influenza immunization history on patients with SARS-CoV-2 infection.

Patients older than 18 years with COVID-19, registered between March and August 2020, were included. Data were analyzed using Fisher's exact test and Student's t-test. To evaluate the impact on mortality, a logistic regression model was used; the relationship between the percentage of patients who received the influenza vaccine and mortality was determined with Pearson's correlation coefficient.

16,879 participants were included; 17 % had a history of influenza vaccination. Mortality was lower in the group with a history of vaccination (3.5 % vs. 7 %, p < 0.0001). The vaccination rate had an inverse relationship with the mortality rate (Pearson's r -0.922, p = 0.026).

Previous influenza immunization was an independent protective factor for mortality in patients with COVID-19. Although further studies are needed to determine a causal relationship, it would be reasonable to increase influenza immunization in the general population.

Previous influenza immunization was an independent protective factor for mortality in patients with COVID-19. Although further studies are needed to determine a causal relationship, it would be reasonable to increase influenza immunization in the general population.

Clostridioides difficile causes diarrhea and pseudomembranous colitis. Its diagnosis is made with glutamate dehydrogenase (GDH) or toxins A and B detection and is confirmed with nucleic acid amplification tests.

To define if GDH determination is redundant to that of toxins.

Retrospective, observational study in diarrheal stools of patients with suspected Clostridioides difficile infection. (R)-2-Hydroxyglutarate Toxins and GDH were determined by immunochromatography. Bayesian simulation was performed with likelihood ratios; a p-value < 0.05 was regarded as significant.

329 GDH and toxin A and B results were analyzed. Clostridioides difficile infection prevalence was 18.2 %. Sensitivity and specificity of the GDH test were 0.90 and 0.89, respectively. Positive likelihood ratio was 8.9, and negative was 0.11.

A negative GDH result considerably reduces the probability of infection but does not rule it out. Clostridioides difficile toxins detection may be necessary in institutions where nucleic acid amplification is not affordable or accessible.

A negative GDH result considerably reduces the probability of infection but does not rule it out. Clostridioides difficile toxins detection may be necessary in institutions where nucleic acid amplification is not affordable or accessible.Maple syrup urine disease (MSUD) is an autosomal recessive inherited metabolic disorder, caused by branched-chain alpha-ketoacid dehydrogenase (BCKD) deficiency, leading to toxic accumulation of branched-chain amino acids (BCAAs) including leucine, isoleucine and valine and their corresponding a-ketoacids. The diagnosis of MSUD is based on elevated BCAAs and allo-isoleucine in plasma, and branched-chain hydroxyacids and ketoacids in urine. The identification of alloisoleucine >5 µmol/L is considered pathognomonic. Moreover, brain magnetic resonance imaging (MRI) showing atypical signal intensity and oedema is characteristic of MSUD. Recognition of the classical neuro-radiological findings of MSUD is particularly useful in local settings as many healthcare facilities lack the resources to measure Plasma Amino Acids (PAA). We report three cases of MSUD, in whom the disorder was strongly suspected at presentation, based on classical brain MRI findings, which was urgently confirmed by PAA analysis.