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0%) patient deaths occurred within 90d, 13 (18.8%) in the high-cFLC group. Kaplan-Meier analysis revealed that the two groups differed significantly with respect to 90-d survival (log-rank

 = .012), and Cox regression analysis showed that an cFLC level ≥43.3 mg/L was significantly associated with a 5.0-fold increased risk of death (adjusted hazard ratio [HR], 5.95; 95% confidence interval [CI], 1.04- 33.91;

 = .045) compared with an cFLC level <43.3 mg/L.

Serum cFLC levels were significantly elevated and might be an independent predictor of mortality in patients with AKI following cardiovascular surgery.

Serum cFLC levels were significantly elevated and might be an independent predictor of mortality in patients with AKI following cardiovascular surgery.

The protein equivalent of total nitrogen appearance (PNA) formula, based on the urea nitrogen appearance (UNA), is popularly used by stable continuous ambulatory peritoneal dialysis (CAPD) patients to estimate dietary daily protein intake (DPI). However, we found that the estimated DPI was higher than that directly evaluated from the dietary records of most of our CAPD patients. Therefore, in the present study, we tried to determine possible bias in PNA estimation by UNA with a nitrogen balance study of our CAPD patients.

Thirty-one CAPD patients with stable clinical conditions were included. Their 3-day dietary records were reviewed by a dedicated dietitian to calculate their energy, protein, and nitrogen intake (NI). The nitrogen removal (NR) from urine and dialysate was measured by the Kjeldahl technique. Then, we calculated the proportion of urea nitrogen appearance (UNA) in total nitrogen appearance (TNA) and analyzed the possible factors that could affect this proportion.

Among these patients, 17 males and 14 females, the mean age was 64.19 ± 12.42, and the dialysate drainage volume was 6700 (2540) ml/day. The percentage of UNA in TNA was 63.22 ± 6.66%. Compared with the other classic nitrogen balance studies in the CAPD population, the protein nitrogen and other nonurea nitrogen losses in this study were all lower. Based on these 31 nitrogen balance studies, we proposed a pair of new equations to estimate PNA by UNA. (1) PNA = 9.3 + 7.73 UNA; (2) PNA = PNPNA + TPL = 6.7 + 7.28 UNA + TPL.

Our study suggested that the PNA formula generated from previous European studies overestimated DPI in our CAPD patients.

Our study suggested that the PNA formula generated from previous European studies overestimated DPI in our CAPD patients.Sarcoidosis is a multisystem inflammatory disorder with an unknown origin. Symptomatic cardiac involvement is rare and occurs in about 5% of patients with sarcoidosis. Fatal ventricular arrhythmias are the most severe clinical presentation of the disease. Cardiac magnetic resonance (CMR) is a useful non-invasive tool for the risk stratification of ventricular arrhythmias and sudden cardiac death (SCD) in patients with cardiac sarcoidosis (CS). More specifically, late gadolinium enhancement (LGE), a CMR tool for scar detection, has been found to be significantly associated with arrhythmic events in CS patients. This review aims to present the existing evidence regarding the association of LGE with adverse events and especially with fatal ventricular arrhythmias.

Chronic low back pain (cLBP) is a complex condition that is physically and psychologically debilitating, with vulnerable populations experiencing more severe outcomes. Physical therapy (PT) includes evidence-based treatments that can reduce disability, however the experience of PT can vary amongst different populations. Empirical evidence is largely based on majority samples that are predominantly white with high educational attainment. Little is known regarding how people from vulnerable groups (e.g. low income and racial minority) experience physical therapy treatment for low back pain.

To describe the experience of physical therapy in a predominantly low-income and minority population with cLBP.

This qualitative study was embedded within a randomized controlled trial for patients with cLBP in urban, underserved communities. We used a convenience sample to interview 12 participants from the 102 who participated in the PT arm of the trial and then performed thematic analysis to describe their experienc the value of cognitive-emotional and interpersonal dimensions of PT. These may be particularly important components of PT in populations that have experienced systemic distrust in providers and disparities in services. Future work could use Bandura's model of self-efficacy to build a PT intervention comprised of fear-based movement exercises, interconnectedness, a strong therapeutic alliance, and mindfulness techniques.Candida albicans (C. albicans) is an opportunistic pathogen causing infections ranging from superficial to life-threatening disseminated infections. In a susceptible host, C. albicans is able to translocate through the gut barrier, promoting its dissemination into deeper organs. C. albicans hyphae can invade human epithelial cells by two well-documented mechanisms epithelial-driven endocytosis and C. albicans-driven active penetration. One mechanism by which host cells protect themselves against intracellular C. albicans is termed autophagy. The protective role of autophagy during C. albicans infection has been investigated in myeloid cells; however, far less is known regarding the role of this process during the infection of epithelial cells. In the present study, we investigated the role of autophagy-related proteins during the infection of epithelial cells, including intestinal epithelial cells and gut explants, by C. albicans. Using cell imaging, we show that key molecular players of the autophagy machinery (LC3-II, PI3P, ATG16L1, and WIPI2) were recruited at Candida invasion sites. We deepened these observations by electron microscopy analyses that reveal the presence of autophagosomes in the vicinity of invading hyphae. Importantly, these events occur during active penetration of C. albicans into host cells and are associated with plasma membrane damage. In this context, we show that the autophagy-related key proteins ATG5 and ATG16L1 contribute to plasma membrane repair mediated by lysosomal exocytosis and participate in protecting epithelial cells against C. albicans-induced cell death. Our findings provide a novel mechanism by which epithelial cells, forming the first line of defense against C. albicans in the gut, can react to limit C. albicans invasion.

The co-existence of right ventricular dysfunction (RVD) in heart failure patient with reduced ejection fraction (HFrEF) is an independent maker of poor prognosis. A novel right ventricular hemodynamic composite measure is the pulmonary artery pulsatility index (PAPi), which is the pulmonary artery pressure gradient ratio. It is a strong predictor of RVD in patients with acute inferior myocardial infarction and patients undergoing left ventricular assist device (LVAD) implantation. However, little is known about its prognostic value in patients with HFrEF.

Between September 2010 and July 2013, 172 patients with HFrEF admitted to the tertiary hospital were included in this analysis. We carried out a cardiac catheterisation for each patient, at baseline. Subsequently, we evaluated both PAPi and the other hemodynamic parameters with longitudinal follow-up of adverse outcomes such as cardiac mortality, LVAD, and heart transplantation (HTx).

During a median follow-up period of 52 months we observed 50 cardiac deaths, 12 LVAD implantations and 10 HTx. A threshold for PAPi value of 2.82 was ascertained (Area 0.76,

 < 0.001, CI 0.67-0.85, sensitivity 67%, specificity 69%). After dividing the study population into two groups, PAPi ≤2.82 and PAPi >2.82, no significant difference was demonstrated with respect to the aetiology of heart failure (ischaemic HFrEF

 = 0.29 and non-ischaemic HFrEF

 = 0.29). In Cox regression survival analysis, PAPi was an independent predictor of cardiac death (hazard ratio 0.73 [95% confidence interval 0.53-0.99],

 = 0.045).

In patients with HFrEF, a low PAPi value (<2.82) was associated with increased cardiac mortality risk.

In patients with HFrEF, a low PAPi value ( less then 2.82) was associated with increased cardiac mortality risk.

Patients with haematological malignancies have an increased susceptibility for COVID-19 and higher mortality. They may also have prolonged symptoms and viral shedding. Clinical trials have not specifically addressed the management of this patient group. We present a lymphoma patient with COVID-19 who was treated with remdesivir, and a literature review of similar cases.

SARS-CoV-2 RT-PCR, virus culture and whole-genome sequencing were performed from nasopharyngeal swabs and antibody testing from serum. In addition, SARS-CoV-2 nucleocapsid antigen was tested from serum. Medline was searched for reported cases of lymphoma and COVID-19 treated with remdesivir.

The patient was undergoing lymphoma treatment including chemotherapy, rituximab and prednisolone. After diagnosis of COVID-19, broad-spectrum antibiotics were administered due to neutropenia and fever. Kaempferide clinical trial After 20d of fever with no signs of co-infection, remdesivir was initiated with rapid response. The treatment was continued for 4d. Serum SARS-CoV-2 antibody tests were negative 20, 30 and 66d from symptom onset. Before starting remdesivir, the SARS-CoV-2 PCR and virus culture from the nasopharynx and serum antigen test were positive. From earlier reports, we identified a total of eleven cases of lymphoma and COVID-19 treated with remdesivir accompanied by other antivirals and anti-inflammatory agents.

As shown in this and earlier reports on lymphoma patients, the clinical course of COVID-19 may be protracted and a humoral immune response may remain absent. In addition, optimal management remains undecided. The presented patient responded well to a short course of remdesivir.

As shown in this and earlier reports on lymphoma patients, the clinical course of COVID-19 may be protracted and a humoral immune response may remain absent. In addition, optimal management remains undecided. The presented patient responded well to a short course of remdesivir.Approved vaccines prevent 2 to 3 million deaths per year. There is a lack of equitable access to vaccines in the low- and middle-income developing nations. Challenges in the life cycle of vaccine production include process development, lead time, intellectual property, and local vaccine production. A robust and stable manufacturing process and constant raw material supplies over decades is critical. In a continuously evolving vaccine landscape, the need of the hour for developing nations is to manufacture their own vaccines besides having supply security, control over production scheduling and sustainability, control of costs, socio-economic development, and rapid response to local epidemics. There is a need for capacity building of workforce development, technology transfer, and financial support. Technology transfer has improved vaccine access and reduced prices of vaccines. Capacity building for the manufacturing of vaccines in developing countries has always been an area of paramount importance and more so in a pandemic situation.