Background: Few antiviral therapies have been studied in patients with coronavirus disease 2019 (COVID-19) and kidney impairment. Herein, the efficacy, safety, and pharmacokinetics of remdesivir, its metabolites, and sulfobutylether-β-cyclodextrin excipient were evaluated in hospitalized patients with COVID-19 and severe kidney impairment.
Methods: In REDPINE, a phase 3, randomized, double-blind, placebo-controlled study, participants aged ≥12 years hospitalized for COVID-19 pneumonia with acute kidney injury, chronic kidney disease, or kidney failure were randomized 2:1 to receive intravenous remdesivir (200 mg on day 1; 100 mg daily up to day 5) or placebo (enrollment from March 2021 to March 2022).
We conducted a post hoc analysis of an antibiotic stewardship intervention implemented across our health system's urgent-care network to determine whether there was a differential impact among patient groups. Respiratory urgent-care antibiotic prescribing decreased for all racial, ethnic, and preferred language groups, but disparities in antibiotic prescribing persisted.
View Article and Find Full Text PDFMicrobial community changes in response to climate change drivers have the potential to alter the trajectory of important ecosystem functions. In this paper, we show that while microbial communities in peatland systems responded to manipulations of temperature and CO concentrations, these changes were not associated with similar responses in peat decomposition rates over 3 years. It is unclear however from our current studies whether this functional resiliency over 3 years will continue over the longer time scales relevant to peatland ecosystem functions.
View Article and Find Full Text PDFAntimicrob Steward Healthc Epidemiol
September 2023
Introduction: In patients with severe auditory impairment, partial hearing restoration can be achieved by sensory prostheses for the electrical stimulation of the central nervous system. However, these state-of-the-art approaches suffer from limited spectral resolution: electrical field spread depends on the impedance of the surrounding medium, impeding spatially focused electrical stimulation in neural tissue. To overcome these limitations, optogenetic activation could be applied in such prostheses to achieve enhanced resolution through precise and differential stimulation of nearby neuronal ensembles.
View Article and Find Full Text PDFImportance: Urgent Care (UC) encounters result in more inappropriate antibiotic prescriptions than other outpatient setting. Few stewardship interventions have focused on UC.
Objective: To evaluate the effectiveness of an antibiotic stewardship initiative to reduce antibiotic prescribing for respiratory conditions in a UC network.
Solid organ transplant recipients (SOTRs) remain at high risk for infection throughout their post-transplant course. Dosing of immunosuppressive medications, strategies that prevent infection, and choice of empiric antimicrobial treatment could be optimized by a better understanding of an individual patient's risk for infectious complications. Diagnostic tests that qualitatively or quantitatively measure the function of the immune system and/or its response to infection may be useful for individualized management decisions.
View Article and Find Full Text PDFGordonia bronchialis is a partially acid-fast, gram-positive rod that has been found in a variety of nosocomial infections, most frequently sternal wound infection following coronary artery bypass surgery. We report a case of a mycetomalike infection due to G bronchialis in an immunocompetent patient with complete resolution after 3 months of oral antibiotics.
View Article and Find Full Text PDFAntimicrob Steward Healthc Epidemiol
November 2022
Healthcare disparities and inequities exist in a variety of environments and manifest in diagnostic and therapeutic measures. In this commentary, we highlight our experience examining our organization's urgent care respiratory encounter antibiotic prescribing practices. We identified differences in prescribing based on several individual characteristics including patient age, race, ethnicity, preferred language, and patient and/or clinician gender.
View Article and Find Full Text PDFBackground: Baricitinib and dexamethasone have randomised trials supporting their use for the treatment of patients with COVID-19. We assessed the combination of baricitinib plus remdesivir versus dexamethasone plus remdesivir in preventing progression to mechanical ventilation or death in hospitalised patients with COVID-19.
Methods: In this randomised, double-blind, double placebo-controlled trial, patients were enrolled at 67 trial sites in the USA (60 sites), South Korea (two sites), Mexico (two sites), Singapore (two sites), and Japan (one site).
Currently, pathological evaluation of stage I/II colon cancer, following the Union Internationale Contre Le Cancer (UICC) guidelines, is insufficient to identify patients that would benefit from adjuvant treatment. In our study, we analyzed tissue samples from 276 patients with colon cancer utilizing mass spectrometry imaging. Two distinct approaches are herein presented for data processing and analysis.
View Article and Find Full Text PDFTenosynovial giant cell tumors (TGCT) are a rare class of benign proliferative tumors that are classified according to their presentation: localized-type (L-TGCT) or diffuse-type (D-TGCT). TGCT is synonymous with pigmented villonodular synovitis (PVNS). We describe the unique case of a 56-year-old obese male with type 2 diabetes who had polymicrobial septic arthritis of his left knee joint with concurrent D-TGCT in the same knee.
View Article and Find Full Text PDFEven though the pulse-echo ultrasonic technique is commonly used for the assessment of metal structures, it has some inherent limitations. Vibro-acoustography (VA) is a relatively new ultrasonic technique which has demonstrated a great potential in revealing defects in objects, however it is traditionally used to analyze the integrity of specimens made of low-stiffness materials. This work presents the evaluation of the performance of VA technique for the inspection of a steel structure, which was manufactured with defects of known geometry on its inner surface.
View Article and Find Full Text PDFInconsistencies persist regarding the efficacy of treating asymptomatic group B Streptococcus bacteriuria in pregnant individuals with colony counts below 10 (100,000) CFU/mL. Despite these discrepancies, treatment still occurs. This article examines the role of screening and treatment, evidence-based guidelines, and practice patterns to provide clarification and resolve local practice disparities.
View Article and Find Full Text PDFJ Am Coll Emerg Physicians Open
April 2020
A novel coronavirus (COVID-19) causing acute illness with severe symptoms has been isolated in Wuhan, Hubei Province, China. Since its emergence, cases have been found worldwide, reminiscent of severe acute respiratory syndrome and Middle East respiratory syndrome outbreaks over the past 2 decades. Current understanding of this epidemic remains limited due to its rapid development and available data.
View Article and Find Full Text PDFObjective: To determine patient, institution, and machine characteristics that contribute to variation in radiation doses used for computed tomography (CT).
Design: Prospective cohort study.
Setting: Data were assembled and analyzed from the University of California San Francisco CT International Dose Registry.
A new type of uranium binary hydride, UH, with the CaF crystal structure, was synthesized in a thin-film form using reactive sputter deposition at low temperatures. The material has a grain size of 50-100 nm. The lattice parameter a = (535.
View Article and Find Full Text PDFJ Investig Med High Impact Case Rep
March 2018
Amyloidosis is a rare disorder with a wide spectrum of presentations and anomalies. It is subdivided into 2 broad categories based on protein deposition; primary and secondary amyloidosis. It can present as a single-organ involvement or as a diffuse infiltrative multi-organ process.
View Article and Find Full Text PDFImportance: Radiation doses for computed tomography (CT) vary substantially across institutions.
Objective: To assess the impact of institutional-level audit and collaborative efforts to share best practices on CT radiation doses across 5 University of California (UC) medical centers.
Design, Setting, And Participants: In this before/after interventional study, we prospectively collected radiation dose metrics on all diagnostic CT examinations performed between October 1, 2013, and December 31, 2014, at 5 medical centers.
Objective: Since it has been suggested that benign renal cysts can be diagnosed at unenhanced CT on the basis of homogeneity and attenuations of 20 HU or less, we determined the prevalence of renal cell carcinomas (RCCs) with these characteristics using two different methods of measuring attenuation.
Materials And Methods: After IRB approval, two radiologists obtained unenhanced attenuation values of 104 RCCs (mean size 5.6 cm) using a single, large region of interest (ROI), two-thirds the size of the mass.
Purpose To determine patient, vendor, and institutional factors that influence computed tomography (CT) radiation dose. Materials and Methods The relevant institutional review boards approved this HIPAA-compliant study, with waiver of informed consent. Volume CT dose index (CTDI) and effective dose in 274 124 head, chest, and abdominal CT examinations performed in adult patients at 12 facilities in 2013 were collected prospectively.
View Article and Find Full Text PDFThe Barbastelle bat (Barbastella barbastellus) preys almost exclusively on tympanate moths. While foraging, this species alternates between two different signal types. We investigated whether these signals differ in emission direction or source level (SL) as assumed from earlier single microphone recordings.
View Article and Find Full Text PDFPurpose: To summarize data on computed tomographic (CT) radiation doses collected from consecutive CT examinations performed at 12 facilities that can contribute to the creation of reference levels.
Materials And Methods: The study was approved by the institutional review boards of the collaborating institutions and was compliant with HIPAA. Radiation dose metrics were prospectively and electronically collected from 199 656 consecutive CT examinations in 83 181 adults and 3871 consecutive CT examinations in 2609 children at the five University of California medical centers during 2013.
Purpose: To determine the accuracy and radiation dose reduction of a limited abdominopelvic CT from the bottom of T10 to the top of the pubic symphysis in patients with suspected acute appendicitis.
Methods: We performed a HIPAA compliant and IRB-approved retrospective study of adult patients who underwent CT abdomen/pelvis for suspected appendicitis. The Z-axis length and whole body effective doses of the original full scan and theoretical limited scan from the bottom of T10 to the top of the pubic symphysis were recorded.