Uncommon Sociodemographic Factors Are Associated With Racial Disparities in Length of Stay Following Oncologic Elective Colectomy.

Introduction: Although outcome disparities by race have been identified in colorectal cancer, these patterns are challenging to explain using variables that are commonly available in databases. In a single institution serving a diverse community, length of stay (LOS) varies by race following elective oncologic colectomy. We investigated previously unexplored variables that may explain the relationship between race and LOS following elective resection of colorectal neoplasms.

Neuroinvasive West Nile virus infection in solid organ transplant recipients.

Background: Literature on the natural course of neuroinvasive West Nile virus (WNV) infection in solid organ transplant (SOT) recipients is sparse. In the setting of a 2021 WNV outbreak in Arizona, we reviewed our institution's experience with neuroinvasive WNV infection in patients with SOT.

Methods: We retrospectively identified SOT recipients treated for neuroinvasive WNV at Mayo Clinic in Arizona from 2007 through 2021.

Male Perineal Carcinoma: Experience in 4 Cases and Literature Review.

Perineal carcinoma of unknown origin is a rare and aggressive disease, so an early diagnosis and adequate treatment are essential to prevent its progression. We report the first series of cases of perineal carcinoma of unknown origin: (I) a 62-year-old male patient being followed up for a urethral stricture treated with periodic dilations with subsequent development of perineal abscesses and perineal carcinoma; (II) a 67-year-old male patient who consults for urinary discomfort associated with a perineal abscess. Recurrence of the abscess in the first month revealed the presence of an underlying perineal carcinoma; (III) a 78-year-old male patient that underwent urethroplasty with graft with subsequent regimen of periodical dilations.

Transanal total mesorectal excision achieves equivalent oncologic resection compared to laparoscopic approach, but with functional consequences.

Background: This study compared transanal total mesorectal excision (taTME) to laparoscopic total mesorectal excision (laTME) for the treatment of low rectal cancer. Adequacy of oncologic resection as well as postoperative outcomes were analyzed.

Methods: We retrospectively reviewed all proctectomy for low rectal cancer by a single surgeon at our institution from January 2014 to September 2019.

Coccidioidomycosis in Patients Treated With Ruxolitinib.

We report 8 cases of coccidioidomycosis associated with ruxolitinib treatment. Among 135 patients living in the coccidioidal-endemic region receiving ruxolitinib, 5 cases were diagnosed after starting and 4 had extrathoracic dissemination. Periodic serological screening while on ruxolitinib is warranted for patients residing in the coccidioidal-endemic region.

therapeutics: guidelines and beyond.

infection (CDI) has become an increasingly common infection both within and outside of the hospital setting. The management of this infection has been evolving as we learn more about the role of the human microbiota in protecting us from this gastrointestinal opportunist. For many years the focus of treatment had been on eradication of the vegetative, toxin-producing form of the organism, with little regard for its collateral impact on the host's microbiota or risk of recurrence.

Why Does Clostridium difficile Infection Recur?

Clostridium (or Clostridioides) difficile infection affects more than 500,000 people annually in the United States, one-third of whom have recurrent symptoms. The evolution of C difficile as a resilient pathogen has to do with its ability to persist in the environment and in the host, leading to recurrence and environmental spread. Understanding the mechanisms by which this microbe interacts with the environment, the host, and the gut microbiota are critical to solving this problem.

A case of Verruconis gallopava infection in a heart transplant recipient successfully treated with posaconazole.

Verruconis gallopava is an environmental dematiaceous fungus that is recognized increasingly as a cause of human disease, especially for immunocompromised persons. Infection can range from superficial and localized lesions to pulmonary involvement and disseminated disease, including central nervous system abscesses. Optimal therapy is undefined.

Resynchronization with the G6G protocol: A retrospective, observational study of second and later timed artificial inseminations on commercial dairy farms.

We recorded conception rates and estimated pregnancy rates following second and later timed artificial inseminations (TAIs) after hormonal resynchronization on commercial dairy farms, using the so-called G6G protocol (PGF day-0; GnRH 2, 8 days; PGF 15, 16 days, GnRH 17 days; TAI 18 days), and the 5-day Ovsynch protocol or 5DO (GnRH day 0; PGF 5, 6 days; GnRH 7 days; TAI 8 days). In four farms, both protocols were implemented in parallel, and these 1,368 s and later TAIs were used for the protocols' comparison based on logistic regression (544 TAIs in primiparous; 824 in multiparous cows; 1,024 TAIs after G6G [600 TAIs in multiparous and 424 in primiparous]; 344 TAIs after 5DO [224 TAIs in multiparous and 120 in primiparous]; 280 TAIs during the hot season; 1,088 during the cool season). Conception rate (CR) was 31.

Mini-Fecal Microbiota Transplantation for Treatment of Clostridium difficile Proctitis Following Total Colectomy.

Rarely, in fulminant Clostridium difficile infection (CDI), the rectal stump is persistently infected following total abdominal colectomy. We report cure of a septic patient with proctitis by fecal microbiota transplant via rectal swabs (mini-FMT). This novel procedure offers a management option for recurrent CDI following total abdominal colectomy.

St. Louis encephalitis virus possibly transmitted through blood transfusion-Arizona, 2015.

Background: St. Louis encephalitis virus is a mosquito-borne flavivirus that infrequently causes epidemic central nervous system infections. In the United States, blood donors are not screened for St.

Influence of practitioner expertise during early pregnancy diagnosis on pregnancy loss rate: A controlled, blinded trial.

A controlled field trial was conducted to assess the potential influence of practitioner inexperience during early pregnancy diagnosis with ultrasound (PD-US) on the risk of pregnancy loss. A veterinarian with more than 10 years' experience in PD-US (Vet-A) and a veterinarian with fewer than 12 months' experience at the start of the study (Vet-B) visited the same dairy farm once a week for 33 and 26 weeks, respectively. The two veterinarians did not interact with each other at any time during the study, nor did they know that their data would later be used in this study.

Vancomycin Taper and Risk of Failure of Fecal Microbiota Transplantation in Patients With Recurrent Clostridium difficile Infection.

We retrospectively analyzed a cohort of 109 subjects treated for recurrent Clostridium difficile infection with fecal microbiota transplantation (FMT) at a tertiary referral center between 2011 and 2014 to determine risk factors for FMT failure. In a multivariate analysis, failure to use an oral vancomycin taper preceding FMT was associated with a significant risk of FMT failure (odds ratio, 0.15; 95% confidence interval, .

Neuroinvasive St. Louis Encephalitis Virus Infection in Solid Organ Transplant Recipients.

In summer 2015, three unrelated solid organ transplant recipients in Phoenix, Arizona, had meningoencephalitis suggestive of West Nile virus (WNV) infection. Testing was inconclusive but was later confirmed as St. Louis encephalitis (SLE).

Integrative Medicine Preferences Among Coccidioidomycosis (Valley Fever) Patients.

Objectives: To understand the extent and modalities of integrative medicine strategies that patients with coccidioidomycosis (valley fever) have incorporated into their treatment regimens.

Design: A direct patient survey was distributed, with 100 unique responses, at a single infectious diseases clinic at an academic medical center in Arizona. Eligible patients, defined as those with confirmed coccidioidomycosis or currently under evaluation, were polled on their personal use of 36 integrative medicine modalities.

Stage IAE Follicular Lymphoma of the Breast: Case Report and Review of the Literature.

Primary lymphoma of the breast is a rare entity in the field of oncological medicine and represents <0.5% of all breast malignancies. A definitive diagnosis is obtained by excisional biopsy as the clinical and radiographical presentation is similar to the more common primary breast carcinoma.

Plasma cell pleocytosis in cerebrospinal fluid in patients with West Nile virus encephalitis.

We describe 4 patients with West Nile virus encephalitis who all displayed previously unreported plasma cell pleocytosis of the cerebrospinal fluid (CSF). Three patients recovered but had varying degrees of mild neurologic disability on discharge from the hospital, and 1 patient died. The finding of significant numbers of plasma cells in CSF may serve as a useful early diagnostic clue for West Nile virus encephalitis.

Pharmacokinetic Interaction between amprenavir and rifabutin or rifampin in healthy males.

The objective of this study was to determine if there is a pharmacokinetic interaction when amprenavir is given with rifabutin or rifampin and to determine the effects of these drugs on the erythromycin breath test (ERMBT). Twenty-four healthy male subjects were randomized to one of two cohorts. All subjects received amprenavir (1,200 mg twice a day) for 4 days, followed by a 7-day washout period, followed by either rifabutin (300 mg once a day [QD]) (cohort 1) or rifampin (600 mg QD) (cohort 2) for 14 days.

Lysostaphin treatment of experimental aortic valve endocarditis caused by a Staphylococcus aureus isolate with reduced susceptibility to vancomycin.

The rabbit model of endocarditis was used to test the effectiveness of vancomycin and two different lysostaphin dosing regimens for the treatment of infections caused by a Staphylococcus aureus strain with reduced susceptibility to vancomycin (glycopeptide-intermediate susceptible S. aureus [GISA]). Vancomycin was ineffective, with no evidence of sterilization of aortic valve vegetations.

Combinations of vancomycin and beta-lactams are synergistic against staphylococci with reduced susceptibilities to vancomycin.

Evidence of synergism between combinations of vancomycin and beta-lactam antibiotics against 59 isolates of methicillin-resistant staphylococci (Staphylococcus aureus, Staphylococcus epidermidis, and Staphylococcus haemolyticus) for which vancomycin MICs ranged from 1 to 16 microg/ml were tested by broth microdilution checkerboard, disk diffusion, agar dilution, and time-kill antimicrobial susceptibility tests. The combination of vancomycin and oxacillin demonstrated synergy by all test methods against 30 of 59 isolates; no antagonism was seen. Synergy with vancomycin was also found by modified disk diffusion testing for ceftriaxone, ceftazidime, cefpodoxime, and amoxicillin-clavulanate but not for aztreonam.

Lysostaphin treatment of experimental methicillin-resistant Staphylococcus aureus aortic valve endocarditis.

The emergence of clinical isolates of methicillin-resistant Staphylococcus aureus with reduced susceptibility to vancomycin has prompted a search for new and novel therapeutic agents active against S. aureus. Lysostaphin, a peptidase produced by Staphylococcus simulans, specifically cleaves the glycine-glycine bonds unique to the interpeptide cross-bridge of the S.

Mechanisms of polar lobe formation in fertilized eggs of molluscs.

Polar lobe formation in the marine mudsnail, Ilyanassa obsoleta, involves formation of a microtubule-, microfilament-dependent furrow that constricts at two rates, then stops and relaxes. Some artificial seawater mixtures allow relatively normal development, facilitate insertion of microelectrode tips, and prevent artifactual bleb formation during such punctures. Membrane events may affect formation of polar lobe constrictions: (1) Brief treatment with digitonin prevents constrictions, but not cytokinesis per se, and the suppression of constrictions is permanent.