Rankin Kryger (piketoast2)

Objectives Characteristics of the Mycobacterium avium-intracellulare complex pulmonary disease (MAC-PD) caused by distinct subspecies remain uncertain. Methods This study was conducted from 2013 to 2015 in three hospitals in Taiwan. Results Among the 144 patients with MAC-PD, 57(39.6%), 37(25.7%), 37(25.7%), and 13(9.0%) were infected with M. intracellulare subspecies intracellulare (MIsI), M. avium subspecies hominissuis (MAsH), M. intracellulare subspecies chimaera (MIsC), and others, respectively. Patients with MAsH-PD were younger (P = 0.010) with higher human immunodeficiency virus infection rate (27.0%, 0.0%, 0.0% and 7.7% for MAsH-PD, MIsC-PD, MIsI-PD and others, respectively; P less then 0.001). Twenty-two (15.3%) patients reported spontaneous culture-negative conversion, but 15 (10.4%) and 33 (22.9%) patients developed radiographic progression and unfavorable outcomes, especially MAsH-PD. The susceptibility rates to clarithromycin and inhaled amikacin were both 98.6%. MAsH demonstrated the lowest rate of resistance to moxifloxacin (66.7%, 97.3%, 89.1% and 92.3% for MAsH-PD, MIsC-PD, MIsI-PD and others, respectively; P = 0.001) and MIsI isolates had the highest rate of resistance to intravenous amikacin (25%, 13.5%, 38.2% and 15.4% for MAsH-PD, MIsC-PD, MIsI-PD and others, respectively; P = 0.024). Conclusions Pulmonary disease caused by distinct MAC subspecies had different outcomes and drug susceptibility. The local prevalence of species needs to be monitored.Background Reactive case detection (RCD) is a commonly used strategy for malaria surveillance and response in elimination settings. Many approaches to RCD assume detectable infections are clustered within and around homes of passively detected cases (index households), which has been evaluated in a number of settings with disparate results. Methods Household questionnaires and diagnostic testing were conducted following RCD investigations in Zanzibar, Tanzania, including the index household and up to 9 additional neighboring households. Results Of 12,487 participants tested by malaria rapid diagnostic test (RDT), 3·2% of those residing in index households and 0·4% of those residing in non-index households tested positive (OR = 8·4; 95%CI 5·7, 12·5). Of 6,281 participants tested by quantitative polymerase chain reaction (qPCR), 8·4% of those residing in index households and 1·3% of those residing in non-index households tested positive (OR = 7·1; 95%CI 6·1, 10·9). Within households of index cases defined as imported, odds of qPCR-positivity amongst members reporting recent travel were 1·4 times higher than among those without travel history (95%CI 0·2, 4·4). Amongst non-index households, odds of qPCR-detectable infection were no different between households located within 50 m of the index household as compared with those located farther away (OR = 0·8, 95%CI 0·5, 1·4). Sensitivity of RDT to detect qPCR-detectable infections was 34% (95%CI 26·4, 42·3). Conclusions Malaria prevalence in index households in Zanzibar is much higher than in non-index households, in which prevalence is very low. Travelers represent a high-risk population. Low sensitivity of RDTs due to a high prevalence of low-density infections results in an RCD system missing a large proportion of the parasite reservoir.Background Postoperative C5 palsy is not an uncommon complication in patients who undergo expansive open-door laminoplasty. However, the etiology is unclear and likely multifactorial. Nerve root lesions and spinal cord lesions have been previously proposed theories. Purpose To investigate the anatomical mechanism of postoperative C5 palsy after cervical expansive open-door laminoplasty. Study design A dissection-based study of 8 embalmed human cadavers. Methods The anatomy was studied in 8 whole cervical cadavers (3 females, 5males), prepared with formaldehyde, whose ages at the time of death ranged from 54 to 78 years. Dissection was performed on the intervertebral foramen and spi