Objective:To investigate the prevalence of viral myocarditis worldwide.Methods:We conducted a systematic search for the prevalence of the most common viruses in myocarditis and 75 studies were included for statistical...Objective:To investigate the prevalence of viral myocarditis worldwide.Methods:We conducted a systematic search for the prevalence of the most common viruses in myocarditis and 75 studies were included for statistical analysis of the prevalence of adenovirus,hepatitis C virus,cytomegalovirus,Ebola virus,human herpesvirus 6,influenza virus,parvovirus,and non-polio enteroviruses.Results:The highest prevalence was related to B19(25.0%)and non-polio enteroviruses(18%).The prevalence of human herpesvirus 6,cytomegalovirus,and Ebola virus was12.8%,5.5%,and 3.1%,respectively.Hepatitis C virus accounted for 6.1%of the disease,the adenoviruses contributed to 5.2%of viral myocarditis.The lowest incidence was related to the influenza virus with 2.0%.Conclusions:Treatment of myocarditis is still problematic and may depend on the etiologic diagnosis.So it is important to know the commonly occurring viral factors in myocarditis and timely diagnosis and treatment are also imperative.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 virus most commonly presents with respiratory symptoms.While gastrointestinal(GI)manifestations either at pres...BACKGROUND Coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 virus most commonly presents with respiratory symptoms.While gastrointestinal(GI)manifestations either at presentation or during hospitalization are also common,their impact on clinical outcomes is controversial.Some studies have described worse outcomes in COVID-19 patients with GI symptoms,while others have shown either no association or a protective effect.There is a need for consistent standards to describe GI symptoms in COVID-19 patients and to assess their effect on clinical outcomes,including mortality and disease severity.AIM To investigate the prevalence of GI symptoms in hospitalized COVID-19 patients and their correlation with disease severity and clinical outcomes.METHODS We retrospectively reviewed 601 consecutive adult COVID-19 patients requiring hospitalization between May 1-15,2020.GI symptoms were recorded at admission and during hospitalization.Demographic,clinical,laboratory,and treatment data were retrieved.Clinical outcomes included all-cause mortality,disease severity at presentation,need for intensive care unit(ICU)admission,development of acute respiratory distress syndrome,and need for mechanical ventilation.Multivariate logistic regression model was used to identify independent predictors of the adverse outcomes.RESULTS The prevalence of any GI symptom at admission was 27.1%and during hospitalization was 19.8%.The most common symptoms were nausea(98 patients),diarrhea(76 patients),vomiting(73 patients),and epigastric pain or discomfort(69 patients).There was no difference in the mortality between the two groups(6.21%vs 5.5%,P=0.7).Patients with GI symptoms were more likely to have severe disease at presentation(33.13%vs 22.5%,P<0.001)and prolonged hospital stay(15 d vs 14 d,P=0.04).There was no difference in other clinical outcomes,including ICU admission,development of acute respiratory distress syndrome,or need for mechanical ventilation.Drugs associated with the development of GI symptoms during hospitalization were ribavirin(diarrhea 26.37%P<0.001,anorexia 17.58%,P=0.02),hydroxychloroquine(vomiting 28.52%,P=0.009)and lopinavir/ritonavir(nausea 32.65%P=0.049,vomiting 31.47%P=0.004,and epigastric pain 12.65%P=0.048).In the multivariate regression analysis,age>65 years was associated with increased mortality risk[odds ratio(OR)7.53,confidence interval(CI):3.09-18.29,P<0.001],ICU admission(OR:1.79,CI:1.13-2.83,P=0.012),and need for mechanical ventilation(OR:1.89,CI:1.94-2.99,P=0.007).Hypertension was an independent risk factor for ICU admission(OR:1.82,CI:1.17-2.84,P=0.008)and need for mechanical ventilation(OR:1.66,CI:1.05-2.62,P=0.028).CONCLUSION Patients with GI symptoms are more likely to have severe disease at presentation;however,mortality and disease progression is not different between the two groups.展开更多
Rationale:Cystic echinococcosis(hydatid disease)is a parasitic infection of humans,but renal hydatid cyst is rare.It is even more uncommon to find hydatid cyst and renal cell carcinoma(RCC)synchronously in one kidney....Rationale:Cystic echinococcosis(hydatid disease)is a parasitic infection of humans,but renal hydatid cyst is rare.It is even more uncommon to find hydatid cyst and renal cell carcinoma(RCC)synchronously in one kidney.Patient concerns:This report presents a 47 years old Iranian man with the chief complaint of lower abdominal pain.Abdominal ultrasound and computed tomographic scan was performed for more evaluation.Diagnosis:RCC was the most probable diagnosis,so he went under left total nephrectomy.Eventually,after histopathologic examination of the excised kidney,cystic echinococcosis came to the first line and papillary RCC was the second diagnosis.Outcomes and lessons:Diagnosis of hydatid cyst and RCC is mostly based on imaging,but,as we noticed in this case,distinguishing between these two may sometimes be difficult due to radiological similarities.展开更多
<strong>Background:</strong> A highly contagious virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a pandemic globally. HIV medications were one of the suggested treatmen...<strong>Background:</strong> A highly contagious virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a pandemic globally. HIV medications were one of the suggested treatments for Coronavirus disease 2019 (COVID-19). Here, we report an unusual adverse drug reaction with darunavir in a SARS-CoV-2-infected patient. <strong>Case Presentation:</strong> This is a case presentation of a 53-year-old male with no past medical history who was diagnosed with COVID-19. One week after initiating treatment, the patient developed acute kidney injury, and his serum creatinine increased significantly. <strong>Conclusion:</strong> As there was no clear justification for renal impairment such as a prerenal or postrenal cause, acute kidney injury, possibly crystal-induced nephropathy, was considered an adverse drug reaction from darunavir.展开更多
Background： The WHO recently has recommended the GenoType MTBDRph/s version 1.0 and MTBDRs/version 1.0 assays for widespread use in countries endemic with drug-resistant tuberculosis. Despite this, these assays have ...Background： The WHO recently has recommended the GenoType MTBDRph/s version 1.0 and MTBDRs/version 1.0 assays for widespread use in countries endemic with drug-resistant tuberculosis. Despite this, these assays have rarely been evaluated in China, where the burden of drug-resistant tuberculosis is among the highest globally. Methods： Mycobacterium tuberculosis clinical isolates were obtained between January 2008 and December 2008. Isolates were tested for drug resistance against rifampicin （RFP） and isoniazid （INH） using the GenoType MTBDRplus assay and drug resistance against ethambutol （EMB）, ofloxacin （OFX）, and kanamycin （KM） using the Genotype MTBDILsl assay. These results were compared with conventional drug-susceptibility testing （DST）. Results： Readable results were obtained from 235 strains by GenoType MTBDRphts assay. Compared to DST, the sensitivity of GenoType MTBDRplus assay to detect RFP, INH, and multidrug resistance was 97.7%, 69.9%, and 69.8%, respectively, whereas the specificity for detecting RFP, INH, and multidrug resistance was 66.7%, 69.2%, and 76.8%, respectively. The sensitivity and specificity of the GenoType MTBDRsl assay were 90.9% and 95.2% for OFX, 77.8% and 99.5% for KM, 63.7% and 86.4% for EMB, respectively. Mutations in codon S531L of the rpoB gene and codon S315T1 ofKatG gene were dominated in multidrug-resistant tuberculosis （MDR-TB） strains. Conclusions： In combination with DST, application of the GenoType MTBDRplus and MTBDRsl assays may be a useful supplementary tool to allow a rapid and sale diagnosis of multidrug resistance and extensively drug-resistant tuberculosis.展开更多
文摘Objective:To investigate the prevalence of viral myocarditis worldwide.Methods:We conducted a systematic search for the prevalence of the most common viruses in myocarditis and 75 studies were included for statistical analysis of the prevalence of adenovirus,hepatitis C virus,cytomegalovirus,Ebola virus,human herpesvirus 6,influenza virus,parvovirus,and non-polio enteroviruses.Results:The highest prevalence was related to B19(25.0%)and non-polio enteroviruses(18%).The prevalence of human herpesvirus 6,cytomegalovirus,and Ebola virus was12.8%,5.5%,and 3.1%,respectively.Hepatitis C virus accounted for 6.1%of the disease,the adenoviruses contributed to 5.2%of viral myocarditis.The lowest incidence was related to the influenza virus with 2.0%.Conclusions:Treatment of myocarditis is still problematic and may depend on the etiologic diagnosis.So it is important to know the commonly occurring viral factors in myocarditis and timely diagnosis and treatment are also imperative.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 virus most commonly presents with respiratory symptoms.While gastrointestinal(GI)manifestations either at presentation or during hospitalization are also common,their impact on clinical outcomes is controversial.Some studies have described worse outcomes in COVID-19 patients with GI symptoms,while others have shown either no association or a protective effect.There is a need for consistent standards to describe GI symptoms in COVID-19 patients and to assess their effect on clinical outcomes,including mortality and disease severity.AIM To investigate the prevalence of GI symptoms in hospitalized COVID-19 patients and their correlation with disease severity and clinical outcomes.METHODS We retrospectively reviewed 601 consecutive adult COVID-19 patients requiring hospitalization between May 1-15,2020.GI symptoms were recorded at admission and during hospitalization.Demographic,clinical,laboratory,and treatment data were retrieved.Clinical outcomes included all-cause mortality,disease severity at presentation,need for intensive care unit(ICU)admission,development of acute respiratory distress syndrome,and need for mechanical ventilation.Multivariate logistic regression model was used to identify independent predictors of the adverse outcomes.RESULTS The prevalence of any GI symptom at admission was 27.1%and during hospitalization was 19.8%.The most common symptoms were nausea(98 patients),diarrhea(76 patients),vomiting(73 patients),and epigastric pain or discomfort(69 patients).There was no difference in the mortality between the two groups(6.21%vs 5.5%,P=0.7).Patients with GI symptoms were more likely to have severe disease at presentation(33.13%vs 22.5%,P<0.001)and prolonged hospital stay(15 d vs 14 d,P=0.04).There was no difference in other clinical outcomes,including ICU admission,development of acute respiratory distress syndrome,or need for mechanical ventilation.Drugs associated with the development of GI symptoms during hospitalization were ribavirin(diarrhea 26.37%P<0.001,anorexia 17.58%,P=0.02),hydroxychloroquine(vomiting 28.52%,P=0.009)and lopinavir/ritonavir(nausea 32.65%P=0.049,vomiting 31.47%P=0.004,and epigastric pain 12.65%P=0.048).In the multivariate regression analysis,age>65 years was associated with increased mortality risk[odds ratio(OR)7.53,confidence interval(CI):3.09-18.29,P<0.001],ICU admission(OR:1.79,CI:1.13-2.83,P=0.012),and need for mechanical ventilation(OR:1.89,CI:1.94-2.99,P=0.007).Hypertension was an independent risk factor for ICU admission(OR:1.82,CI:1.17-2.84,P=0.008)and need for mechanical ventilation(OR:1.66,CI:1.05-2.62,P=0.028).CONCLUSION Patients with GI symptoms are more likely to have severe disease at presentation;however,mortality and disease progression is not different between the two groups.
文摘Rationale:Cystic echinococcosis(hydatid disease)is a parasitic infection of humans,but renal hydatid cyst is rare.It is even more uncommon to find hydatid cyst and renal cell carcinoma(RCC)synchronously in one kidney.Patient concerns:This report presents a 47 years old Iranian man with the chief complaint of lower abdominal pain.Abdominal ultrasound and computed tomographic scan was performed for more evaluation.Diagnosis:RCC was the most probable diagnosis,so he went under left total nephrectomy.Eventually,after histopathologic examination of the excised kidney,cystic echinococcosis came to the first line and papillary RCC was the second diagnosis.Outcomes and lessons:Diagnosis of hydatid cyst and RCC is mostly based on imaging,but,as we noticed in this case,distinguishing between these two may sometimes be difficult due to radiological similarities.
文摘<strong>Background:</strong> A highly contagious virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a pandemic globally. HIV medications were one of the suggested treatments for Coronavirus disease 2019 (COVID-19). Here, we report an unusual adverse drug reaction with darunavir in a SARS-CoV-2-infected patient. <strong>Case Presentation:</strong> This is a case presentation of a 53-year-old male with no past medical history who was diagnosed with COVID-19. One week after initiating treatment, the patient developed acute kidney injury, and his serum creatinine increased significantly. <strong>Conclusion:</strong> As there was no clear justification for renal impairment such as a prerenal or postrenal cause, acute kidney injury, possibly crystal-induced nephropathy, was considered an adverse drug reaction from darunavir.
基金This study was supported by a grant from the National Natural Science Foundation of China （No. 81302480）.
文摘Background： The WHO recently has recommended the GenoType MTBDRph/s version 1.0 and MTBDRs/version 1.0 assays for widespread use in countries endemic with drug-resistant tuberculosis. Despite this, these assays have rarely been evaluated in China, where the burden of drug-resistant tuberculosis is among the highest globally. Methods： Mycobacterium tuberculosis clinical isolates were obtained between January 2008 and December 2008. Isolates were tested for drug resistance against rifampicin （RFP） and isoniazid （INH） using the GenoType MTBDRplus assay and drug resistance against ethambutol （EMB）, ofloxacin （OFX）, and kanamycin （KM） using the Genotype MTBDILsl assay. These results were compared with conventional drug-susceptibility testing （DST）. Results： Readable results were obtained from 235 strains by GenoType MTBDRphts assay. Compared to DST, the sensitivity of GenoType MTBDRplus assay to detect RFP, INH, and multidrug resistance was 97.7%, 69.9%, and 69.8%, respectively, whereas the specificity for detecting RFP, INH, and multidrug resistance was 66.7%, 69.2%, and 76.8%, respectively. The sensitivity and specificity of the GenoType MTBDRsl assay were 90.9% and 95.2% for OFX, 77.8% and 99.5% for KM, 63.7% and 86.4% for EMB, respectively. Mutations in codon S531L of the rpoB gene and codon S315T1 ofKatG gene were dominated in multidrug-resistant tuberculosis （MDR-TB） strains. Conclusions： In combination with DST, application of the GenoType MTBDRplus and MTBDRsl assays may be a useful supplementary tool to allow a rapid and sale diagnosis of multidrug resistance and extensively drug-resistant tuberculosis.
