The incidence of smear-positive PTB among migratory nomads is approximately nine-fold higher than in the general population. Active screening of TB in migratory nomads should be integrated into Iran's national TB control programme. The issue of destigmatisation, particularly among female TB patients, should also be addressed.
Background
The effect of neuraminidase inhibitor (NAI) treatment on length of stay (LoS) in patients hospitalized with influenza is unclear.
Methods
We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. Using mixed-effects negative binomial regression and adjusting for the propensity to receive NAI, antibiotic, and corticosteroid treatment, we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Patients with a LoS of <1 day and those who died while hospitalized were excluded.
Results
We analyzed data on 18 309 patients from 70 clinical centers. After adjustment, NAI treatment initiated at hospitalization was associated with a 19% reduction in the LoS among patients with clinically suspected or laboratory-confirmed influenza A(H1N1)pdm09 infection (IRR, 0.81; 95% CI, .78–.85), compared with later or no initiation of NAI treatment. Similar statistically significant associations were seen in all clinical subgroups. NAI treatment (at any time), compared with no NAI treatment, and NAI treatment initiated <2 days after symptom onset, compared with later or no initiation of NAI treatment, showed mixed patterns of association with the LoS.
Conclusions
When patients hospitalized with influenza are treated with NAIs, treatment initiated on admission, regardless of time since symptom onset, is associated with a reduced LoS, compared with later or no initiation of treatment.
To assess the risk of venous thromboembolism [VTE] associated with hyperhomocysteinaemia [hyper-Hcy] and hyperlipidaemia, we performed a case-control study. Fasting total homocysteine [Hcy], triglyceride and cholesterol levels were assessed in 43 patients with VTE and 43 controls. Mean Hcy level was significantly higher in the test group. Odds ratio [OR] for VTE in patients with hyper-Hcy was 2.7, with the association stronger in women and those under 50. The OR for those with both hypertriglyceridaemia and hypercholesterolaemia was significantly greater in those under 50. Increased risk for venous thrombosis was found among those under 50 having both lipid abnormalities
We present a 24-year-old man who developed primary cytomegalovirus peritonitis without gut perforation, but with concomitant colitis 6 weeks after liver transplant from a deceased donor for end-stage liver disease because of primary sclerosing cholangitis. The patient was treated only medically, with no need for surgery, and is well at 12 months. This case represents the need for suspicious for cytomegalovirus peritonitis in the appropriate setting in post liver transplant even in the absence of perforation.
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