RESUMO
BACKGROUND: We aimed to describe the epidemiology, risk factors, and clinical outcomes of co-infections and superinfections in onco-hematological patients with COVID-19. METHODS: International, multicentre cohort study of cancer patients with COVID-19. All patients were included in the analysis of co-infections at diagnosis, while only patients admitted at least 48 h were included in the analysis of superinfections. RESULTS: 684 patients were included (384 with solid tumors and 300 with hematological malignancies). Co-infections and superinfections were documented in 7.8% (54/684) and 19.1% (113/590) of patients, respectively. Lower respiratory tract infections were the most frequent infectious complications, most often caused by Streptococcus pneumoniae and Pseudomonas aeruginosa. Only seven patients developed opportunistic infections. Compared to patients without infectious complications, those with infections had worse outcomes, with high rates of acute respiratory distress syndrome, intensive care unit (ICU) admission, and case-fatality rates. Neutropenia, ICU admission and high levels of C-reactive protein (CRP) were independent risk factors for infections. CONCLUSIONS: Infectious complications in cancer patients with COVID-19 were lower than expected, affecting mainly neutropenic patients with high levels of CRP and/or ICU admission. The rate of opportunistic infections was unexpectedly low. The use of empiric antimicrobials in cancer patients with COVID-19 needs to be optimized.
Assuntos
COVID-19 , Coinfecção , Neoplasias , Superinfecção , Estudos de Coortes , Coinfecção/epidemiologia , Humanos , Unidades de Terapia Intensiva , Neoplasias/complicações , Neoplasias/epidemiologia , SARS-CoV-2RESUMO
The mechanical and optical properties of TiO2 and Al2O3 films deposited by DC reactive magnetron sputtering were analysed as a function of the deposition conditions. Two different sputtering powers and three different voltages targets which influence the pressure and the deposition rate were studied. The voltage corresponds to two different percentages of the turn down set point of the hysteresis curve and fully poisoned condition. As their optical application is the main functionality of these coatings, the transparency and the refractive index were investigated. However, the mechanical properties are the key factors for determining the performance of these systems in use. For this, the wear resistance of these coatings was studied through the analysis of the evolution of the friction coefficient with time and the analysis of the wear track. The corrosion resistance has been also analysed through electrochemical studies. The results reveal that there is a clear influence of the studied deposition conditions on the mechanical and optical properties of these films. However, while general conclusions could be drawn for Al2O3 films, for TiO2 films the tendency is not so clear and further work needs to be performed.
RESUMO
Kikuchi-Fujimoto disease is an uncommon form of lymphadenitis, firstly described in Japan. Etiology is unknown. It affects mainly young women. It commonly manifests as a painful cervical lymphadenitis usually associated with fever and leukopenia. Clinical course users to be benign, leading spontaneously to a complete recovery. Histological findings include necrotizing changes with cariorrhesis, partial loss of ganglionar architecture and foci of histiocytic infiltrates in the cortical and/or paracortical zones of the lymph nodes. A common finding is the absence of neutrophil granulocytes in the inflammatory infiltrates, in contrast to other necrotizing lymphadenitis. We report four cases of Kikuchi-Fujimoto disease, recently identified in our hospital.
Assuntos
Linfadenite Histiocítica Necrosante/diagnóstico , Adulto , Criança , Diagnóstico Diferencial , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: A prospective study was performed in kidney transplant patients at risk of developing cytomegalovirus (CMV) infection (CMV D+/R-). They were treated with valganciclovir (VGC) for 3 months as prophylactic therapy. The aim was to determine the safety and efficacy of prophylactic therapy with VGC. METHODS: Antigenemia and/or polymerase chain reaction CMV was routinely performed every 2 weeks up to month 3, monthly to month 6, and every other month until the end of the first year posttranplantation, as well as when clinically indicated. RESULTS: From July 2007 to April 2010, 366 renal transplantations were performed at our center, including 34 (9%) high-risk patients for CMV infection. The median age was 47 years; 19 were males and 15 females. Twelve (35%) patients developed CMV infections: 10 (34%) gastrointestinal disease and 3 viral syndromes. The timing of the clinical manifestations was 16% (3/12) between months 1 and 3, 75% (8/12) between months 4 and 6, and 8% (1/12) in month 9 posttransplantation. CONCLUSION: Treatment with intravenous ganciclovir followed by oral VGC was successful in all patients. No opportunistic infections or allograft rejection were observed; only 1 patient developed thrombocytopenia as an adverse event to VGC.