Distribution and predictors of F-18-FDG uptake values of non-malignant cervical lymph nodes in pediatric patients.

BACKGROUND: F-18-flurodeoxyglucose (FDG) PET/CT is routinely used for staging, evaluation of response to treatment and follow-up of most pediatric malignancies. Cervical lymph nodes can be involved in some pediatric malignancies, but increased uptake in non-malignant cervical lymph nodes is not exceptional in this population. The aim of the present study is to identify predictors of the maximum uptake in non-malignant cervical lymph nodes in the pediatric population. METHODS: 191 FDG PET/CT studies of pediatric patients without malignant involvement of cervical lymph nodes were retrospectively reviewed. The maximal Standard Uptake Value in the hottest cervical lymph node (SUVmaxCLN), as well as demographic, technical and imaging variables were recorded. The predictive effect of those variables on SUVmaxCLN was estimated using linear regression models. RESULTS: Increased FDG activity in cervical nodes was observed in 136/191 studies (71%). The mean SUVmaxCLN was 2.2 ± 1.3. Ipsilateral palatine tonsil SUVmax, mean liver uptake, and treatment status were all statistically significant predictors of SUVmaxCLN. However, in multivariate regression analysis, only ipsilateral palatine tonsil SUVmax was found to be significant. In addition, SUVmaxCLN was greater than the mean liver uptake in 50% of all studies. This proportion was higher in younger children, reaching 77% of studies of children younger than six years. CONCLUSION: SUVmax in ipsilateral palatine tonsil is a strong predictor of the maximal uptake value of non-malignant cervical lymph nodes in children. The intensity of uptake in non-malignant cervical lymph nodes is frequently higher than liver uptake in children, and this tendency increases for younger patients. TRIAL WAS REGISTERED: In the internal hospital registry under TRN 0209-22-HMO on date 23.04.2022.

What explains the socioeconomic status-health gradient? Evidence from workplace COVID-19 infections.

This paper studies the contribution of the workplace to the SES-health gradient. Our analysis is based on a unique dataset that tracks various health outcomes and workplace risks among healthcare workers during the first four months of the coronavirus 2019 (COVID-19) pandemic. The setting provides an exceptional opportunity to test for work-related disparities in health, while controlling for confounding determinants of the SES-health gradient. We find that low-SES nurses were systematically more likely to contract COVID-19 as a result of workplace exposure. These differentials existed in all healthcare institutions, but were particularly large in non-hospital settings. In contrast, we find no relationship between SES and nonwork-related infection rates. The differences in workplace infection rates are substantially larger than those implied by standard 'task-based' indices of transmission risk, and cannot be attributable to easily identifiable metrics of workplace risk. Together, our results show how subtle differences in work conditions or job duties can substantially contribute to the SES-health gradient.

Respiratory Syncytial Virus Infection: Its Propensity for Bacterial Coinfection and Related Mortality in Elderly Adults.

Respiratory syncytial virus (RSV) is an increasingly recognized cause of acute respiratory infection (ARI) in adults. We compared the crude in-hospital mortality of patients with RSV infection alone with that of patients with RSV-bacterial coinfection. Overall, 12 144 hospitalized patients with ARI were screened for RSV detection by polymerase chain reaction between February 2014 and April 2019. In total, 701 (5.8%) had a positive RSV result, including 85 (12.1%) with bacterial coinfection. RSV-bacterial coinfection was associated with an increase in crude in-hospital mortality in patients >65 years old (hazard ratio, 2.94; 95% CI, 1.30-6.60; P = .010). Optimized prevention and management strategies to reduce this burden are needed.

Deciphering the Urinary Microbiota Repertoire by Culturomics Reveals Mostly Anaerobic Bacteria From the Gut.

Human urine was considered sterile for a long time. However, 416 species have been previously cultured, including only 40 anaerobic species. Here, we used culturomics, particularly those targeting anaerobes, to better understand the urinary microbiota. By testing 435 urine samples, we isolated 450 different bacterial species, including 256 never described in urine of which 18 were new species. Among the bacterial species identified, 161 were anaerobes (35%). This study increased the known urine repertoire by 39%. Among the 672 bacterial species isolated now at least once from urine microbiota, 431 (64.1%) were previously isolated from gut microbiota, while only 213 (31.7%) were previously isolated from vagina. These results suggest that many members of the microbiota in the urinary tract are in fact derived from the gut, and a paradigm shift is thus needed in our understanding.

Estimates of COVID-19 Cases across Four Canadian Provinces.

This article estimates population infection rates from coronavirus disease 2019 (COVID-19) across four Canadian provinces from late March to early May 2020. The analysis combines daily data on the number of conducted tests and diagnosed cases with a methodology that corrects for non-random testing. We estimate the relationship between daily changes in the number of conducted tests and the fraction of positive cases in the non-random sample (typically less than 1 percent of the population) and apply this gradient to extrapolate the predicted fraction of positive cases if testing were expanded to the entire population. Over the sample period, the estimated population infection rates were 1.7-2.6 percent in Quebec, 0.7-1.4 percent in Ontario, 0.5-1.2 percent in Alberta, and 0.2-0.4 percent in British Columbia. In each province, these estimates are substantially below the average positive case rate, consistent with non-random testing of higher-risk populations. The results also imply widespread undiagnosed COVID-19 infection. For each identified case by mid-April, we estimate there were roughly 12 population infections.

Les auteurs estiment les taux d'infection par le coronavirus 2019 (COVID­19) de la population de quatre provinces canadiennes, de la fin de mars au début de mai 2020. Dans leur analyse, ils associent les données quotidiennes relatives au nombre de tests effectués et au nombre de cas diagnostiqués au moyen d'une méthodologie grâce à laquelle les données sont corrigées pour tenir compte du caractère non aléatoire des tests. Ils estiment la relation entre l'évolution quotidienne du nombre de tests effectués et de la proportion de cas positifs dans l'échantillon non aléatoire (généralement moins de 1 pour cent de la population) et utilisent ce gradient pour extrapoler une prédiction quant à la proportion de cas positifs qui seraient diagnostiqués si les tests étaient administrés à la population entière. Au cours de la période d'échantillonnage, les taux estimatifs d'infection de la population se situent dans les intervalles suivants : 1,7 à 2,6 pour cent au Québec, 0,7 à 1,4 pour cent en Ontario, 0,5 à 1,2 pour cent en Alberta et 0,2 à 0,4 pour cent en Colombie-Britannique. Dans chaque province, ces estimations se révèlent largement inférieures au taux moyen de cas positifs, ce qui s'explique par l'administration non aléatoire des tests aux populations qui présentent un risque plus élevé. Ces résultats indiquent également que les cas de COVID­19 non diagnostiqués sont largement répandus. Pour chaque cas diagnostiqué jusqu'à la mi-avril, les auteurs estiment à environ 12 le nombre de cas d'infection dans la population.

Measles outbreak in a French Roma community in the Provence-Alpes-Côte d'Azur region, France, May to July 2017.

OBJECTIVES: To analyse a measles outbreak in a Roma community. METHODS: We describe a community-wide outbreak of genotype D8 measles that took place in southeastern France, between May and July 2017, along with the control measures adopted. RESULTS: We identified a total of eighteen cases, between six months and 24 years old. All cases were unvaccinated or incompletely vaccinated and belonged to a sedentary French Roma community. Most of them (67%) were hospitalised, with three cases (17%) of severe measles including one death of a 16-year-old girl who had previously received oral corticosteroids. The latter was the only lethal case notified in France during the year 2017. Control measures included intensification of surveillance, isolation of cases, and a large vaccination campaign in this Roma community. During the outbreak period, there was no case of healthcare-associated measles transmission. A broad adherence to vaccination through the mediating role of both the chief of the community and the pastor allowed reaching completed vaccination coverage of 90%. CONCLUSIONS: Efforts should be concentrated to enhance access to health services for minorities such as the Roma community characterized by low vaccination coverage. A trustful relationship with leaders of the community is essential to ensure adherence to vaccination. In France, attributable mortality to measles is low and concerns mainly unvaccinated and immunodepressed patients.