100 research outputs found
Human herpesvirus 8 and Kaposi sarcoma: how should we screen and manage the transplant recipient?
No full textPurpose of reviewHHV-8-associated diseases are rare but potentially fatal in transplant recipients. Important differences exist in the distribution of HHV-8 seroprevalence, which might contribute to the lack of uniform approach to HHV-8. The aim of this review was to discuss recent updates in screening and management of HHV-8 after transplant.Recent findingsIncreasing attention has been given to the nonmalignant but potentially fatal inflammatory syndrome caused by HHV-8 in solid organ transplant (SOT) recipients. At-risk groups include HHV-8-IgG D+/R-transplant and HHV-8-positive recipients. Severe cases of donor-derived HHV-8 disease, mainly Kaposi sarcoma, frequently without skin involvement and some diagnosed at autopsy, highlight the need to increase clinicians' awareness, to implement effective preemptive strategies and to perform rapid diagnosis. In HSCT setting, HHV-8-associated disorders are very rare.SummaryIdentification of SOT recipients at risk through reliable serology is warranted and the utility of preemptive management and HHV-8-DNA monitoring should be studied. Clinicians should be aware of severe nonmalignant disorders and of early post-SOT Kaposi sarcoma cases with lymph node or transplanted organ involvement in order to provide prompt diagnosis and treatment. No screening for HHV-8 is warranted after HSCT but rapid diagnosis and reduction of immunosuppression remain fundamental
sj-tif-1-ejo-10.1177_11206721221089172 - Supplemental material for Live surgery outcomes in cataract surgery
No full textSupplemental material, sj-tif-1-ejo-10.1177_11206721221089172 for Live surgery outcomes in cataract surgery by Pasquale Puzo, Francesco D’Oria, Aurelio Imburgia, Cosimo Incandela, Alessandra Sborgia, Eleonora B Marchegiani, Laura Rania, Alessandro Mularoni and Giovanni Alessio in European Journal of Ophthalmology</p
Differential diagnosis between kaposi sarcoma-associated herpesvirus cytokine syndrome and hemophagocytic lymphohistiocytosis
No full textHIV infection with viro-immunological dissociation in a patient with polycystic kidney disease: Candidate for transplantation?
No full textHere we describe the case of a HIV-infected patient with polycystic kidney disease and end stage renal diseases not transplantable due to the persistence of a CD4 count <200 notwithstanding a good virological response to highly active antiretroviral therapy and suggest that such limitation to kidney transplantation in such as cases might be bypassed
New Antibiotics for Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia
No full textHospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) represent one of the most common hospital-acquired infections, carrying a significant morbidity and risk of mortality. Increasing antibiotic resistance among the common bacterial pathogens associated with HAP and VAP, especially Enterobacterales and nonfermenting gram-negative bacteria, has made the choice of empiric treatment of these infections increasingly challenging. Moreover, failure of initial empiric therapy to cover the causative agents associated with HAP and VAP has been associated with worse clinical outcomes. This review provides an overview of antibiotics newly approved or in development for the treatment of HAP and VAP. The approved antibiotics include ceftobiprole, ceftolozane-tazobactam, ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, and cefiderocol. Their major advantages include their high activity against multidrug-resistant gram-negative pathogens
Live surgery outcomes in cataract surgery
No full textPurpose To evaluate and compare the outcomes of live surgery (LS) and no-live surgery (NLS) on cataract surgery with implantation of different types of intraocular lenses (IOLs). Methods Retrospective, contralateral eye, case series of patients that underwent cataract surgery in live or non-live view during two consecutive editions of national meetings. Both eyes of the same patients were implanted with the same IOL, one in LS and the other in NLS. Results 108 eyes of 54 patients, aged between 50 and 82 (72 +/- 8.2) and implanted with different types of IOLs, were reviewed. Both eyes in each patient were well matched at baseline in terms of intraocular biometric characteristics, corneal curvature and endothelial cell density (ECD) (p > 0.05). There are no statistically significant differences between the biometric and topographic parameters, aberrometric data and the loss of ECD in the post-operative outcomes (p > 0.05). However, comparing the different types of IOLs, there is a significant loss of ECD in eyes implanted with a toric IOL during LS (p = 0.0014 and p = 0.04, in 2017 and 2018 edition respectively). Conclusions In this series of live cataract surgery, eyes operated in LS or NLS have comparable outcomes, underlying the importance and the benefits of live view in terms of medical education and the low-risk of complications. Nevertheless, we have found a significant increase in ECD loss in patients implanted with toric IOLs during LS
Feminist Science Interventions in Self-Tracking Technology
No full textContemporary self-tracking systems signal a new era of biological monitoring now entangled with the politics of ubiquitous computing. Is self-tracking technology, which is connected to major stakeholders in healthcare, essential for filling in gaps in care, or is it fueling an increasingly commercialized medical industry? This essay examines the complex biases embedded in self-tracking technologies and introduces three manifestations of feminist science that subvert the monetization of personal health information: feminist art collective subRosa, which investigates how personal genetic information is developed into marketable medical products in their web-based project, Cell Track: Mapping the Appropriation of Life Materials; media artist and biohacker Mary Maggic, who makes self-synthesized hormone therapy accessible with their Open Source Estrogen project; artist-researcher Heather Dewey-Hagborg, whose biohacking products provide a DIY science in a world marred by genetic policing. Against the lure of connectivity, feminist science looks to circumvention as a method for understanding and disrupting the gendered and raced politics embedded in self-tracking technology. Tracing alternative techno-politics in these three new media projects, this essay reveals the necessity for artistic interventions in the contemporary healthcare landscape
Feminism and Finitude
No full textThis essay examines the ideological parallels between the transhuman pursuit for immortality and xenofeminism’s call for biological manipulation. Paying particular attention to the patriarchal legacy of technoscience, I identify eugenic principles embedded in the discursive emphasis on anti-naturalism, freedom, and alienation. My intention is to recuperate xenofeminism’s more radical manoeuvres by resituating its aims through a historical materialist approach. Specifically, I suggest a reinterpretation of nature as inherently technological. In so doing, I argue for an alliance between xenofeminism and ecofeminist political economy to engage a discursive redirection toward degrowth and dealienation. I then build on Rosi Braidotti’s (2013) posthuman theory of death to suggest an uncomfortable biopolitical expansion: a biopolitics for the Anthropocene should not only seek an equal right to live, but also an equal predisposition to death. My countervailing materialism centres a politics of finitude through an analysis of the vital-fatal entanglement in the body’s reproductive capacities
Determinants of influenza vaccination among solid organ transplant recipients attending Sicilian reference center
No full textAmong solid organ transplant recipients, influenza infection is commonly associated with higher morbidity and mortality than immunocompetent hosts. Therefore, in these subjects influenza vaccination is of paramount importance. The main objective of the study was to assess compliance to vaccination and analyze factors associated with influenza vaccination of solid organ transplant recipients admitted to the Sicilian solid organ transplant Reference Center IRCCS-ISMETT in Palermo during 2014–2015 influenza season. Thirty one (37.8%) out of 82 solid organ transplant recipients were vaccinated against influenza. The main reason for vaccination refusal was fear of adverse reaction (n = 16, 31.4%), impaired health status (n = 14, 27.4%) and low vaccine efficacy (n = 10, 19.6%). Vaccinated solid organ transplant recipients compare with unvaccinated had smaller hospital admissions for infectious respiratory diseases (9.7% Vs 23.5%) during surveillance period. On multivariate analysis the factors positively associated with influenza vaccination were the advice of Reference Center physicians (OR 53.4, p < 0.001) and to perform vaccine against pneumococcus (OR 7.0, p = 0.016). This study showed that Reference Center physicians play a key role on vaccine communication and recommendation for patients at risk and it underlines the effectiveness of influenza vaccination in solid organ transplant recipients. However, it remains that, although physician advice resulted a strong determinant for vaccination, influenza vaccination coverage in this subset of population remains still unsatisfactory
International survey of human herpes virus 8 screening and management in solid organ transplantation
No full textBackground: HHV-8/Kaposi Sarcoma herpesvirus has been associated with a broad spectrum of diseases in solid organ transplant (SOT) recipients. Primary donor-derived infection can be associated with severe and rapidly fatal non-neoplastic disease, and diagnosis is made with high HHV-8 DNAemia.
Methods: We carried out an international survey to investigate the current approach to HHV-8 screening, and management in SOT since a protocol has not been established by international guidelines.
Results: A total of 51 transplant centers from 15 countries filled out the survey. HHV-8-associated diseases in SOT have been diagnosed during the previous 5 years in 67% of centers. Pretransplant serological screening is performed in 17 centers (33%), and posttransplant HHV-8 nucleic acid testing (NAT) monitoring is performed in 21 centers (41%). Performing HHV-8 NAT monitoring and serological screening were found associated with having diagnosed in the previous 5 years a non-malignant HHV-8-associated disease.
Conclusions: Serological pretransplant screening of donors and recipients and post-transplant HHV-8 NAT monitoring recommendations should be standardized. Even though serological assays are not optimal, they could contribute to increasing knowledge on epidemiology and management of HHV-8-associated diseases after SOT.</p
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