Sepsis-related outcomes of patients with Philadelphia-negative myeloproliferative neoplasms.

We analyzed the National Inpatient Sample (NIS) database to study the sepsis-related outcomes in patients with Philadelphia negative myeloproliferative neoplasms (MPN). A total of 82,087 patients were included, most had essential thrombocytosis (83.7%), followed by polycythemia vera (13.7%), and primary myelofibrosis (2.6%). Sepsis was diagnosed in 15,789 (19.2%) patients and their mortality rate was higher than non-septic patients (7.5% vs 1.8%; P<.001). Sepsis was the most significant risk factor of mortality (aOR, 3.84; 95% CI, 3.51-4.21), others included liver disease (aOR, 2.42; 95% CI, 2.11-2.78), pulmonary embolism (aOR, 2.26; 95% CI, 1.83-2.80), cerebrovascular disease (aOR, 2.05; 95% CI, 1.81-2.33), and myocardial infarction (aOR, 1.73; 95% CI, 1.52-1.96).

Sepsis-Related Outcomes of Patients with Philadelphia-Negative Myeloproliferative Neoplasms.

We analyzed the National Inpatient Sample (NIS) database to study the sepsis-related outcomes in patients with Philadelphia negative myeloproliferative neoplasms (MPN). A total of 82,087 patients were included, most had essential thrombocytosis (83.7%), followed by polycythemia vera (13.7%), and primary myelofibrosis (2.6%). Sepsis was diagnosed in 15,789 (19.2%) patients and their mortality rate was higher than nonseptic patients (7.5% vs 1.8%; p < .001). Sepsis was the most significant risk factor of mortality (aOR, 3.84; 95% CI, 3.51-4.21), others included liver disease (aOR, 2.42; 95% CI, 2.11-2.78), pulmonary embolism (aOR, 2.26; 95% CI, 1.83-2.80), cerebrovascular disease (aOR, 2.05; 95% CI, 1.81-2.33), and myocardial infarction (aOR, 1.73; 95% CI, 1.52-1.96).

Unusual presentation of pulmonary blastomycosis complicated by amphotericin-induced refractory electrolyte abnormalities.

Blastomyces dermatitidis is an endemic mold infection commonly seen in the midwestern of the USA and rarely affects pregnant women. The most common presentation is a pulmonary infection with variable degrees of severity. Of note, the clinical and radiographic findings of pulmonary blastomycosis can be mistaken for other pulmonary pathologies, thus earning the title of 'the great pretender'. The treatment of choice of infected pregnant patients is amphotericin B, which is known to produce electrolyte imbalances. However, it infrequently causes severe, prolonged and profound hypokalemia and hypomagnesemia. We present the case of a 27-year-old pregnant patient with pulmonary blastomycosis presenting with a lung mass suspicious of malignancy and treated with amphotericin B with subsequent prolonged refractory hypokalemia and hypomagnesemia. Keywords pulmonary blastomycosis pregnancy biopsy computed tomography angiography liposomal amphotericin B.

Detection of Zika Virus and Human Papilloma Virus in Cervical Cytology Samples using Two Real Time PCR Based Techniques in Ecuadorian Women diagnosed with ASCUS.

OBJECTIVE: Atypical Squamous Cells of Undetermined Significance(ASCUS) is the most reported result on pap smears. It is most commonly related to Human Papillomavirus (HPV) infections. However, other pathogens (EBV, Chlamydia) have been reported on cervical samples with abnormal results. Zika virus(ZIKV) has been found to induce cellular abnormalities on different tissues and its presence has been identified on genital secretions. METHODS: Two real-time PCR has been made on cervical samples from the gynecological service of a third level hospital on Guayaquil-Ecuador. This work was part of a bigger study of ZIKV presence on different body fluids. RESULTS: From 89 samples obtained, 19 received an ASCUS result. From these 5 were positive for ZIKV and 5 were positive for HPV, there were no co infections. CONCLUSION: Given the presence of ZIKV RNA and the absence of HPV DNA on cervical samples diagnosed as ASCUS, it might be plausible that ZIKV could be a triggering factor for the induction of cellular changes observed on these cells.