Unlabelled: Invasive fungal infection (IFI) is frequent in patients with hematologic malignancies or submitted hematopoietic stem cell transplantation (HSCT).
Objectives: To evaluate the role of the GM (galactomannan) test in prescribing therapeutic antifungals; to determine invasive aspergillosis (IA) frequency, the factors associated with positive GM test, and the in-hospital mortality.
Methods: We conducted a retrospective observational study including patients aged 18 or over with hematological malignancy or submitted to HSCT. GM test was measured twice weekly. The hypothesis of IFI was considered in patients with neutropenia and persistent fever despite broad-spectrum antibiotics.
Results: A total of 496 patients were evaluated; the mean of GM tests performed per patient was 4.2 (+3.1), and 86 (17.3 %) had positive results. IFI was diagnosed in 166 (33.5 %) and IA in 22 (24.6 %) patients. Positive GM test was more frequent in patients with IFI (72.2 % and 25.1 %; OR 8.1; 95 % CI 4.8 - 13.8), and was associated with therapeutic antifungals prescription (52, 9 % and 20.5 %; OR 4.3, 95CI% 2.0 - 9.4), as well as lung abnormalities on HRCT (45.3% vs. 21.5 %; OR 3.0, 95 %CI 1.4 - 6.5). Mortality was 31.6 %. In the multivariate analysis, the variables associated with mortality were the hypothesis of IFI (OR 6.35; 95 % CI 3.63-11.12.0), lung abnormalities on HRCT (57.9 % and 26.9 %; OR 2 0.6; 95 % CI 1.5 - 4.4), and positive GM test (57.9 % and 26.9 %; OR 2.7 95 % CI 1.6 - 4.5).
Conclusions: Positive GM test was associated with lung abnormalities on HRCT and with the introduction of therapeutic antifungals. If adequate anti-mold prophylaxis is available, the GM test should not be used as screening, but to investigate IFI in high-risk patients. The diagnosis of IFI, positive GM test and lung abnormalities on HRCT were predictors of hospital mortality in patients with hematological malignancies or undergoing HSCT.
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http://dx.doi.org/10.1016/j.bjid.2024.103718 | DOI Listing |
J Evid Based Med
January 2025
School of Teacher Education, Dali University, Dali, China.
Objective: Extraversion is a fundamental personality dimension that contributes to an individual's overall health and well-being. Many studies have examined the neural bases of extraversion but these results are inconsistent. This study adopted a meta-analysis approach to examine the brain activity correlates of extraversion by incorporating functional neuroimaging studies in the context of positive affect/emotional stimuli.
View Article and Find Full Text PDFGerontologist
January 2025
School of Social Work, University of Washington, Seattle, Washington, USA.
Background And Objectives: The importance of social participation for older adults has been well articulated. Missing from this discourse is a critical consideration of how social participation is shaped by political, economic, and social contexts that marginalize aging and disabled bodies. We bridge this gap by applying critical gerontology and critical disability frameworks to our analysis of how access to health and social services and individual and environmental factors, are associated with engagement in valued social activities among disabled older adults.
View Article and Find Full Text PDFFront Public Health
January 2025
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Introduction: HIV self-testing (HIVST) is an innovative strategy that has been shown to increase uptake of HIV testing compared to conventional facility-based testing. HIVST implementation with digital-based supports may help facilitate testing accessibility and linkage to care after a reactive self-test. Economic evidence around community-based implementation of HIVST is growing; however, economic evidence around digital-based HIVST approaches remains limited.
View Article and Find Full Text PDFFront Public Health
January 2025
Orcasitas Health Care Center, Madrid, Spain.
Introduction: Functional dependence on the performance of basic activities of daily living (ADLs) is associated with increased mortality. In this study, the Barthel index and its activities discriminate long-term mortality risk, and whether changes in this index are necessary to adapt it to detect mortality risk is examined.
Methods: Longitudinal study, carried out at the Orcasitas Health Center, Madrid (Spain), on the functional dependent population (Barthel ≤ 60).
Front Public Health
January 2025
Clinical Medical College of Shenzhen, Guangzhou University of Chinese Medicine, Shenzhen, China.
Objective: This study aimed to uncover the patterns of Human papillomavirus (HPV) infection outcomes in women and assess the risk factors that may affect these outcomes.
Methods: A retrospective study was conducted on 608 women who tested positive for HPV-DNA during their initial visit to the outpatient department of Shenzhen Longgang Central Hospital from 2018 to 2023 and who had subsequent HPV-DNA testing as part of their post-visit monitoring. The monitoring intervals were every 6 months.
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