Evaluating potential modifications to the Centers for Disease Control and Prevention's Adult Sepsis Event definition: impact on sepsis incidence, outcomes, and clinical validity.

Objective: To evaluate potential modifications to the Centers for Disease Control and Prevention (CDC)'s Adult Sepsis Event (ASE) definition aimed at mitigating variable blood culturing practices, better-capturing cases where timely care may have prevented deterioration, and improving clinical credibility.

Design: Retrospective observational study.

Setting: 5 US hospitals.

Reassessing Procalcitonin-Guided Antibiotic Therapy in Critically Ill Patients with Sepsis: Lessons from the ADAPT-Sepsis Trial.

Randomized trials of procalcitonin-guided algorithms to discontinue antibiotics in critically ill patients with sepsis report reduced antibiotic duration and possible mortality benefit. However, open-label trial designs, inconsistent algorithm adherence, and unclear stewardship practices have limited confidence in procalcitonin's benefit. The ADAPT-Sepsis trial addressed several of these gaps through a concealed intervention, robust stewardship, and head-to-head comparison with CRP.

Comparative Evaluation of Shear Bond Strength of Fifth, Seventh, and Eighth-generation Bonding Agents in Permanent Teeth: An Study.

Aims And Background: In achieving clinical success with adhesive materials, bond strength holds significant importance. The goal of testing the strength of the bond is to establish a value for how strong the binding of an adhesive system is to the dental structures. The aim of this study is to comparatively evaluate the shear bond strength of fifth, seventh, and eighth-generations of bonding agents.

Tandem Biocatalysis to Generate Hydrogen Sulfide and Promote Endogenous Antioxidant Response.

Promoting cellular protective responses during oxidative stress conditions through the generation of antioxidant persulfide (RS-SH) and hydrogen sulfide (HS) has tremendous therapeutic potential. Here, we report a bioinspired glycoconjugate, a candidate for tandem biocatalysis and generates persulfide/ HS in response to oxidative stress. The glycoconjugate is cleaved by β-galactosidase, an enzyme that is expressed during oxidative stress; the product of this reaction is a substrate for 3-mercaptopyruvate sulfurtransferase (3-MST), an enzyme that is involved in persulfide/ HS biosynthesis.

Mercapto-NSAIDs generate a non-steroidal anti-inflammatory drug (NSAID) and hydrogen sulfide.

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the frontline treatments for inflammation and pain. Hydrogen sulfide (HS) and related persulfide (RS-SH) are important mediators of antioxidant response and protect cells from oxidative stress. Hybrids of these pharmacological agents have shown promise in clinical trials and are superior to the parent NSAID.

Outcomes of Coccidioides Seropositive Solid Organ Transplant Recipients After Self-discontinuation of Antifungal Prophylaxis: The EIA-IgM-only Conundrum.

Background: Solid organ transplant recipients are at risk of severe coccidioidomycosis and are given prophylaxis to mitigate the risk. Patients with seropositive testing typically receive lifelong prophylaxis; currently, this prophylaxis strategy includes patients who are positive only for IgM by enzyme immunoassay (EIA-IgM-only), although this result may be falsely positive.

Methods: We conducted a retrospective study at a large-volume transplant center in an endemic coccidioidomycosis region to compare outcomes of non-lung transplant recipients who were seropositive for Coccidioides but discontinued prophylaxis (case patients) to outcomes of patients who continued prophylaxis (controls).

Social Media Savvy, It's More Than Just the #Hashtags: How the Use of Social Media in Transplant Infectious Diseases Can Impact the Field and Patients.

Social media provides platforms for transplant infectious diseases (TIDs) clinicians to network, exchange ideas, and educate each other and the broader public. A #TxIDChat on the social media platform X was conducted on the perceptions of social media in TID by the account @TxID_Fellows. This article examines the current usage of social media by TID clinicians, and its role in education, patient outreach, and networking.

Vitamin D Fortification: A Promising Approach to Overcome Drug Resistance and Tolerance in Therapeutic Interventions.

The issue of drug resistance and tolerance presents a significant challenge as it diminishes the efficacy and potency of medications, posing a formidable obstacle for physicians striving to enhance pharmacological therapy worldwide. These resistance mechanisms can arise from genetic predispositions or as a consequence of medical interventions. Notably, acquired resistance or tolerance may extend to other drugs within the same or different classes, despite differing mechanisms of action.

Clinical utility of EBV DNA testing of blood in immunocompetent and immunocompromised patients: A single-center experience.

Objectives: Epstein-Barr virus (EBV) causes different clinical presentations in immunocompetent and immunocompromised persons, and thus indications for testing vary between these populations. We reviewed our institution's EBV DNA testing across these populations to understand its clinical utility and appropriateness.

Methods: We conducted a retrospective chart review of adult patients with positive EBV nucleic acid amplification (NAAT) testing from November 2022 to 2023.

Are sodium-glucose co-transporter-2 inhibitors associated with improved outcomes in diabetic patients admitted to intensive care units with septic shock?

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been shown to reduce organ dysfunction in renal and cardiovascular disease. There are limited data on the role of SGLT2i in acute organ dysfunction. We conducted a study to assess the effect of SGLT2i taken prior to intensive care unit (ICU) admission in diabetic patients admitted with septic shock.

Comparative evaluation of arch form among the Nepalese population: A morphological study.

Aims: The study aims to identify sexual dimorphic features in the arch patterns based on tooth arrangement patterns and the maxillary and mandibular arches using Euclidean Distance Matrix Analysis (EDMA).

Settings And Design: A total of 96 Nepalese subjects, aged 18 to 25 were assessed using casts and photographs.

Materials And Methods: Thirteen landmarks representing the most facial portions of the proximal contact areas on the maxillary and mandibular casts were digitised.

Impact of Early Rejection Treatment on Infection Development in Kidney Transplant Recipients: A Propensity Analysis.

Introduction: The impact of renal allograft rejection treatment on infection development has not been formally defined in the literature.

Methods: We conducted a retrospective cohort study of 185 rejection (case) and 185 nonrejection (control) kidney transplant patients treated at our institution from 2014 to 2020 to understand the impact of rejection on infection development. Propensity scoring was used to match cohorts.

'I Thought It Was My Diabetes': An Acute Presentation of Neuromyelitis Optica Spectrum Disorder.

Neuromyelitis Optica Spectrum Disorder (NMOSD) is an immune-mediated neuroinflammatory disease of the central nervous system. Patients typically present with sensory deficits, weakness, and incontinence. This is a case of a 43-year-old female with diabetes mellitus admitted for acute onset leg weakness and stool incontinence.

Invasive Nocardia Infections across Distinct Geographic Regions, United States.

We reviewed invasive infections in 3 noncontiguous geographic areas in the United States during 2011–2018. Among 268 patients with invasive nocardiosis, 48.2% were from Minnesota, 32.

Infections and antimicrobial prescribing in patients hospitalized with coronavirus disease 2019 (COVID-19) during the first pandemic wave.

Objective: To evaluate the rate of coinfections and secondary infections seen in hospitalized patients with COVID-19 and antimicrobial prescribing patterns.

Methods: This single-center, retrospective study included all patients aged ≥18 years admitted with COVID-19 for at least 24 hours to a 280-bed, academic, tertiary-care hospital between March 1, 2020, and August 31, 2020. Coinfections, secondary infections, and antimicrobials prescribed for these patients were collected.

"I Felt Like I Had Something I Could Do About It": Pediatric Clinician Experiences With a Food Insecurity-Focused Produce Prescription Program.

Efforts to address food insecurity (FI) in pediatric clinics have increased over the last decade, particularly after a groundbreaking 2015 American Academy of Pediatrics policy statement supporting universal routine screening and intervening. Produce prescription programs are a novel strategy addressing FI. Limited data exist on effectiveness and feasibility in pediatric clinical settings.

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.

Fluconazole Failure in the Treatment of Coccidioidal Meningitis.

Introduction: Coccidioidal meningitis (CM) is the most lethal form of disseminated coccidioidomycosis. Current guidelines recommend fluconazole as initial therapy but there has been a paucity of data regarding failure of fluconazole and optimal fluconazole dosage in the treatment of CM. We conducted this study to understand risk factors for fluconazole failure.

Infections following rejection therapies in kidney and liver transplant recipients.

Introduction: Infections are known complications of solid-organ transplant. Treatment for rejection may increase risk of infection. We aimed to study frequency of infection and identify the risk factors for infections in solid organ transplant (SOT) (liver and kidney) recipients treated for rejection.

Impact of COVID-19 on diagnosis of primary pulmonary coccidioidomycosis.

The COVID-19 pandemic has disrupted medical care worldwide and caused delays in care for many illnesses and procedures unrelated to COVID-19; however, less clear is how it may have affected diagnosis of conditions that present with similar symptoms, such as primary pulmonary coccidioidomycosis (PPC). We conducted an observational cohort study of patients diagnosed with PPC between March 1 and December 1 in 2 years: 2019 (before COVID-19) and in 2020 (after COVID-19) to compare the time from symptom onset to PPC diagnosis. Relevant demographic and clinical variables were collected, and statistical analyses were performed with the χ2 test, Wilcoxon rank sum test, and Cox proportional hazards regression analysis.