Prevalence and progression of pneumonia in immunocompetent adults with varicella.

Pneumonia is the most common complication of varicella infections. Although previous studies have tended to focus mainly on immunocompromised patients, varicella pneumonia can also occur in healthy adults. Therefore, in this study, we aimed to assess the progression of varicella pneumonia in immunocompetent hosts. This retrospective study involved immunocompetent adult outpatients with varicella who attended the adult Fever Emergency facility of Peking University Third Hospital from April 1, 2020, to October 31, 2022. Varicella pneumonia was defined as a classic chickenpox-type rash in patients with infiltrates on chest computed tomography. The study included 186 patients, 57 of whom had a contact history of chickenpox exposure. Antiviral pneumonia therapy was administered to 175 patients by treating physicians. Computed tomography identified pneumonia in 132 patients, although no deaths from respiratory failure occurred. Seventy of the discharged patients were subsequently contacted, all of whom reported being well. Follow-up information, including computed tomography findings, was available for 37 patients with pneumonia, among whom 24 reported complete resolution whereas the remaining 13 developed persistent calcifications. Notably, we established that the true incidence of varicella pneumonia is higher than that previously reported, although the prognosis for immunocompetent hosts is generally good.

Oseltamivir Treatment for Influenza During the Flu Season of 2018-2019: A Longitudinal Study.

Background: Oseltamivir resistance in influenza virus (IFV) has been of widespread concern. An increase in the frequency of viruses with reduced inhibition was observed. Whether oseltamivir is effective is uncertain. We conducted this study to understand the real-world situation in northern China and the clinical efficacy for patients with IFV infection after the use of oseltamivir. Methods: The longitudinal study was performed on influenza-like illness (ILI) cases in a tertiary general hospital in Beijing, China during the flu season of 2018-2019. All ILI cases (≥18 years) were recruited into the study. We analyzed the effect of the oseltamivir therapy on the number of clinic visits, hospitalization frequency, and the duration of fever and cough. Results: A total of 689 ILI patients were recruited in this study with 355 in the oseltamivir therapy group and 334 in the supportive therapy group. Among the ILI patients, 388 patients were detected for IFV infection (364 IFV-A and 24 IFV-B) and divided into two groups with or without the oseltamivir therapy (302 vs. 86). There were no significant differences in the basic characteristics between the oseltamivir and supportive therapy groups in the ILI patients or in the IFV positive patients (all p < 0.05). After adjusting for the potential confounders, oseltamivir therapy reduced the times of clinic visits in the ILI and IFV positive patients (p = 0.043 and p = 0.011). No effectiveness with oseltamivir therapy was observed in the outcomes of hospitalization frequency, and the duration of fever and cough. Conclusion: Oseltamivir use may reduce the times of clinic visits. However, we did not observe the differences in the duration of fever, cough, and the frequency of hospitalization between oseltamivir therapy and supportive therapy.

Air pollutants and outpatient visits for influenza-like illness in Beijing, China.

BACKGROUND: Air pollution leads to many adverse health conditions, mainly manifested by respiratory or cardiac symptoms. Previous studies are limited as to whether air pollutants were associated to influenza-like illness (ILI). This study aimed to explore the association between air pollutants and outpatient visits for ILI, especially during an outbreak of influenza. METHODS: Daily counts of hospital visits for ILI were obtained from Peking University Third Hospital between January 1, 2015, and March 31, 2018. A generalized additive Poisson model was applied to examine the associations between air pollutants concentrations and daily outpatient visits for ILI when adjusted for the meteorological parameters. RESULTS: There were 35862 outpatient visits at the fever clinic for ILI cases. Air quality index (AQI), PM2.5, PM10, CO and O3 on lag0 days, as well as nitrogen dioxide (NO2) and sulfur dioxide (SO2) on lag1 days, were significantly associated with an increased risk of outpatient visits for ILI from January 2015 to November 2017. From December 2017 to March 2018, on lag0 days, air pollutants PM2.5 [risk ratio (RR) = 0.971, 95% CI: 0.963-0.979], SO2 (RR = 0.892, 95% CI: 0.840-0.948) and CO (RR = 0.306, 95% CI: 0.153-0.612) were significantly associated with a decreased risk of outpatient visits for ILI. Interestingly, on the lag2 days, all the pollutants were significantly associated with a reduced risk of outpatient visits for ILI except for O3. We did not observe the linear correlations between the outpatient visits for ILI and any of air pollutants, which were instead associated via a curvilinear relationship. CONCLUSIONS: We found that the air pollutants may be associated with an increased risk of outpatient visits for ILI during the non-outbreak period and with a decreased risk during the outbreak period, which may be linked with the use of disposable face masks and the change of outdoor activities. These findings expand the current knowledge of ILI outpatient visits correlated with air pollutants during an influenza pandemic.

Research on the association of plasma TGF-ß1 level and blood lymphocyte/monocyte ratio with pathological grade, clinical stage and prognosis of prostate cancer.

PURPOSE: To explore the association of the plasma transforming growth factor-ß1 (TGF-ß1) level and blood lymphocyte/monocyte ratio (LMR) with the pathological grade, clinical stage and prognosis of prostate cancer (PCa). METHODS: A total of 86 PCa patients treated in our hospital were enrolled. The changes in the expression of TGF-ß1 were observed in patients with different clinical stages, different Gleason scores and different ages, and with or without bone metastasis. The correlation between blood LMR and clinicopathological features of PCa patients was detected. Moreover, the univariate and multivariate analyses were performed for clinicopathological factors and progression-free survival (PFS) after treatment, respectively. RESULTS: In terms of the clinical stage II, III and IV, the number of patients with high TGF-ß1 expression was significantly larger than that with low TGF-ß1 expression (p<0.05). Among those with Gleason score of 2-4 points, 5-6 points and 7-10 points, the number of patients with high TGF-ß1 expression was significantly larger than that with low TGF-ß1 expression (p<0.05). Among those aged ≥70 years old and <70 years old, there were more patients with high TGF-ß1 expression than those with low TGF-ß1 expression, but without significant differences (p>0.05). There were also more patients with high TGF-ß1 expression than those with low TGF-ß1 expression regardless of the presence or absence of bone metastasis, showing obvious differences (p<0.05). Besides, the association of LMR with depth of tumor infiltration, stage, grade, size and Gleason score was explored, and the results showed that LMR was negatively correlated with the above indexes (p<0.05). The univariate analysis was performed for 6 indexes, and the patients were divided into progression group (n=52) and non-progression group (n=34) based on the presence or absence of cancer progression after treatment. Obvious differences were found in the comparison of Gleason score, lymph node metastasis, TGF-ß1 level and clinical stage between the two groups (p<0.05). It was found in the multivariate analysis that TGF-ß1, Gleason score, clinical stage and lymph node metastasis were influencing factors for PFS after treatment (p<0.05). CONCLUSIONS: The TGF-ß1 level is positively correlated with the severity, clinical stage and pathological grade of PCa. LMR is negatively correlated with the depth of tumor infiltration, stage and grade. Clinical stage, TGF-ß1, lymph node metastasis and Gleason score are influencing factors for PFS of PCa patients after treatment.

[Epidemiology of bacterial dysentery diagnosed clinically in Beijing: analysis of 652 patients].

OBJECTIVE: To investigate the epidemiological and clinical characteristics of acute bacterial dysentery in recent years in Beijing so as to provide scientific reference for prevention and control of enteric infectious diseases. METHODS: The data of age, occupation, symptoms, signs, pathogen detection of 652 patients with acute bacterial dysentery diagnosed clinically from April 2007 to October 2007 were analyzed retrospectively. RESULTS: The occupations of the 652 patients included office workers and functionaries (31.4%), students (29.4%), retirees (9.8%), unemployed and housewives (7.1%), commercial attendants (6.3), workers (4.8%), teachers (4.1%), and others (7.1%). Diarrhea, stomach ache, and fever were the main symptoms. Tenesmus and tenderness of left lower quadrant abdomen were infrequent. The positive rate of fecal bacterial culture was 17.7%. 8.9% of the patients were diagnosed as with bacterial dysentery by fecal bacterial culture. CONCLUSION: Most of the patients with bacterial dysentery in Beijing are young adults. The positive rate of fecal bacterial culture is low. It is difficult to differentiate bacterial dysentery from other diarrheal diseases.