“A total of 1,870 nonduplicate clinical Enterobacteriaceae


“A total of 1,870 nonduplicate clinical Enterobacteriaceae from 13 teaching hospitals located in 11 provinces of mainland China from 2011 to 2012 were screened for the presence of the bla(NDM) gene. The high-throughput mTOR inhibitor MiSeq sequencing method and comparative genomics were used to analyze the genetic environment of bla(NDM) among these isolates. Three bla(NDM-1)-carrying Klebsiella pneumoniae (0.16%, 3/1,870), isolated from a teaching hospital in Xi’an, exhibited high levels of resistance to all -lactams, but remained susceptible to amikacin, tigecycline, and polymyxin B. These three isolates, belonging to ST147,

presented an identical pulsed-field gel electrophoresis pattern. The IncX3 plasmid, pNDM-SX04 (KC876051) showed 99% identity with plasmid pNDM-HN380 (JX104760). Comparative analysis of the genetic environment of bla(NDM-1) with previously published plasmids revealed the same 7,830-bp basic mobile element, which may have been derived from Acinetobacter spp. Partial ISAba125, ISAba125 promoter, bla(NDM-1), and ble(MBL) could serve as the minimal mobile vehicle facilitating horizontal

transfer of the bla(NDM-1) gene. To our knowledge, this is the first report of an outbreak of bla(NDM-1)-carrying ST147 K. pneumoniae. Although the prevalence spread by the bla(NDM-1) gene prevalence is at a low frequency in mainland China, a dynamic national surveillance of this gene is needed due to its potential transferability.”
“This review briefly addresses what has selleck screening library been

learned FRAX597 about resistance durability in recent years, as well as the questions that still remain. Molecular analyses of major gene interactions have potential to contribute to both breeding for resistance and improved understanding of virulence impacts on pathogen fitness. Though the molecular basis of quantitative resistance is less clear, substantial evidence has accumulated for the relative simplicity of inheritance. There is increasing evidence for specific interactions with quantitative resistance, though implications of this for durability are still unknown. Mechanisms by which resistance gene pyramids contribute to durability remain elusive, though ideas have been generated for identifying gene combinations that may be more durable. Though cultivar mixtures and related approaches have been used successfully, identifying the diseases and conditions that are most conducive to the use of diversity has been surprisingly difficult, and the selective influence of diversity on pathogen populations is complex. The importance of considering resistance durability in a landscape context has received increasing emphasis and is an important future area of research. Experimental systems are being developed to test resistance gene deployment strategies that previously could be addressed only with logic and observation.

05), but in subjects aged < 60 years, only SBP and PP increase

05), but in subjects aged < 60 years, only SBP and PP increased risk of total mortality significantly.

In multivariate analyses, a 1SD increase in SBP, PP and MAP were associated with 35%, 31% and 28% increased risk of CVD mortality (p < 0.05). In terms of fitness and discrimination of models, DBP, PP and MAP were not superior to SBP. In conclusion, our findings provided further evidence from a Middle Eastern population, in support of SBP predictability for CVD events and CVD and all-cause mortality compared with other BP measures.”
“In up to 4% of laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures, anastomotic leaks occur. Early detection of gastrointestinal leakage is important for successful treatment. Consequently, many centers advocate routine postoperative upper gastrointestinal (UGI) series. The aim of this study was to determine the utility of this practice after Autophagy Compound Library research buy LRYGB.

Eight hundred four consecutive patients undergoing LRYGB from June 2000 to April 2010 were analyzed prospectively. The first 382 patients received routine UGI series between the third and fifth postoperative days (group A). Thereafter, the test was only performed when clinical findings (tachycardia, fever, and drainage content) were suspicious for a leak of the gastrointestinal

anastomosis (group B; n = 422).

Overall, nine of 804 (1.1%) patients suffered from leaks at the gastroenterostomy. In group A, four of 382 (1%) patients had learn more a leak, but only two were detected by the routine UGI series. This corresponds to a sensitivity of 50%. In group B, the sensitivity was higher with 80%. Specificities were comparable with 97% and 91%, respectively. Routine UGI series cost only 1.6% of the overall costs of a non-complicated gastric bypass

procedure. With this leak rate and sensitivity, US $86,800 would have to be spent on 200 routine UGI series to find Napabucasin mouse one leak which is not justified.

This study shows that routine UGI series have a low sensitivity for the detection of anastomotic leaks after LRYGB. In most cases, the diagnosis is initiated by clinical findings. Therefore, routine upper gastrointestinal series are of limited value for the diagnosis of a leak.”
“Aims: To evaluate the efficacy of intradetrusor injection of Botulinum-A toxin (BoNT/A) in children with neuropathic bladder dysfunction and poor bladder compliance, due to meningomyelocele. Methods: We retrospectively reviewed the charts of 11 children (mean age 6.7 +/- 5.3 years) with neuropathic bladder and poor bladder compliance (mean 7 ml/cmH(2)O) treated with intradetrusor injection of BoNT/A. After urodynamic evaluation a standardized injection was performed. The authors describe their results in 11 children after the first (5x) or repeated (6x) BoNT/A injections. Re-evaluation was performed 3 and 12 months after each injection. Results: Three months after injection detrusor pressure decreased by 17% and bladder capacity increased by 33%.

Consistent with this finding, mice with a

Consistent with this finding, mice with a Selleckchem HSP inhibitor null mutation of the short splice variant of Ltbp4 (Ltbp4S) develop pulmonary emphysema that is reminiscent of COPD. Here, we report that the mutational inactivation of the antioxidant protein sestrin 2 (sesn2) partially rescues the emphysema phenotype of Ltbp4S mice and is associated with activation of

the TGF-beta and mammalian target of rapamycin (mTOR) signal transduction pathways. The results suggest that sesn2 could be clinically relevant to patients with COPD who might benefit from antagonists of sestrin function.”
“Photoluminescence (PL) and photoreflectance (PR) were used to characterize ZnxCd1-xSe/MgSe multiple quantum well (MQW) structures grown on InP substrates by molecular beam epitaxy for mid-infrared (IR) device applications. The PL spectra yielded information of the fundamental excitonic recombination and ZnxCd1-xSe cap/spacer band edge emission of the samples. The PR spectra

revealed multitude Pitavastatin ic50 of possible interband transitions in MQW structures. The ground state transitions were assigned by comparing with the PL emission signals taken from the same structures. A comprehensive analysis of the PR spectra led to the identification of various interband transitions. The intersubband transitions were then estimated and found to be in a good agreement with the

previous report of Fourier-transform IR absorption measurements [Li et al., Appl. Phys. Lett. 92, 261104 (2008)]. The results demonstrate the potential of using PL and PR as nondestructive optical techniques for characterization of ZnxCd1-xSe/MgSe MQWs for mid-IR device applications. (c) 2010 American Institute of Physics. [doi: 10.1063/1.3520477]“
“Although chronic hepatitis B (CHB) affects approximately 2 million United States residents, there is no systematic screening of at-risk individuals, and most CUDC-907 mw remain unaware of their hepatitis B virus (HBV) infection. Unmonitored and untreated, CHB results in a 25-30% risk of death from liver cancer and/or cirrhosis, inflicting an increasing healthcare burden in high-prevalence regions. Despite high prevalence in immigrant Asians and Pacific Islanders, among whom CHB is a leading cause of death, community and healthcare provider awareness remains low. Because safe and effective vaccines and effective antiviral treatments exist, there is an urgent need for integrated programmes that identify, follow and treat people with existing CHB, while vaccinating the susceptible. We describe an extant San Francisco programme that integrates culturally targeted, population-based, HBV screening, vaccination or reassurance, management and research.

Methods: Fifty full-term infants with neonatal jaundice

w

Methods: Fifty full-term infants with neonatal jaundice

were included. All patients were subjected to a routine hematologic evaluation, total and indirect serum bilirubin levels, direct Coombs test, qualitative evaluation of G6PD enzyme activity, and detection of G6PD Mediterranean and silent mutations by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique.

Results: There were 21(42%) patients who were G6PD deficient; 29 (58%) had normal activity of the enzyme. Among the G6PD deficient patients, 7/21 (33.3%) had Mediterranean mutation and 6/21 (28.6%) had silent mutation.

Conclusion: Our findings, together with other reports, provide data on the prevalence of the Mediterranean variant in Egyptian infants. Further characterization of the G6PD variants requires molecular studies, including analysis of the entire G6PD coding sequence.”
“Objective: To test the fluorescent brightening ATM/ATR inhibitor (FB) staining

method, in which fungi are grown on cellulose nitrate filter membranes, dried, and rendered transparent with oil after staining with lactophenol cotton blue and to encourage use of FBs to eliminate the need for drying and clearing the membranes, therefore simplifying the procedure and reducing the time to perform it.

Methods: Uvitex 2B (U2B) and 9 calcofluor white (CFW) reagents Selleckchem Metabolism inhibitor were used with 25 genera or species of fungi grown on nitrocellulose (NC), nylon (N), and polyvinyl chloride (PVC) filter membranes placed on a variety of growth media. For microscopic examination, membranes were removed from the surface of the growth medium and placed on. microscope slides, with a drop of FB added to each; the preparations were then coverslipped and examined via violet light epi-illumination.

Results: With many of the fungi tested, if growth was not completely inhibited, it was restricted on the PVC compared to that on the NC and N membranes and directly on a medium surface. The fluorescence of fungal structures and their contrast with the background were favorable with all 3 types of membranes and all the FBs tested. For staining https://www.selleckchem.com/products/apo866-fk866.html yeasts on membranes from media containing polysorbate 80 (TWEEN 80), U2B is preferable to CFW because

TWEEN 80 interferes with CFW staining.

Conclusion: FB staining of fungi grown on NC or N membrane filters provides a rapid and simple method to examine fungal growth, especially young cultures, with minimal disturbance.”
“The present study was designed to explore the total flavonoid and taxifolin contents and the radical scavenging activity of 50% ethanol extracts of Polygonum orientale leaf, stem and seed by 2,2-diphenyl-1-picrythydrazyl (DPPH) assay. The extract with higher total flavonoid content has higher radical scavenging activity. Taxifolin (IC50 = 2.83 mu mol/L) has stronger antioxidant activity than that of rutin (IC50 = 3.08 mu mol/L). The free radical scavenging potential of the chloroform, ethyl acetate, water, ethanol and methanol extracts of P.

Summary odds ratios (ORs) and 95% confidence intervals (95% CIs)

Summary odds ratios (ORs) and 95% confidence intervals (95% CIs) for CYP1A2 polymorphisms and the risk of cancer

were calculated in a fixed-effects model (the Mantel-Haenszel method) and a random-effects model (the DerSimonian and Laird method) when appropriate. For rs762551, 37 studies were eligible (16 825 cases and 21 513 controls); for rs2069514, 15 studies were eligible (3677 cases and 5127 controls); DZNeP inhibitor and for rs3569413, eight studies were eligible (1607 cases and 2043 controls). The results showed that no significant associations with the risk of cancer were found in any model (allele contrast, codominant, dominant, or recessive model) in terms of rs2069514 and rs3569413 when all studies were pooled into a meta-analysis. However, when stratified by cancer type, a statistically significantly elevated risk of cancer was only found in lung cancer for rs3569413 (delT-allele vs. T-allele: OR=1.50, 95% CI=1.16-1.95). In the subgroup analysis by ethnicity, a significantly increased risk of Selleck PD98059 cancer was found in the Caucasian population for rs3569413 (delT-allele vs. T-allele: OR=1.63, 95% CI=1.01-2.63). With respect to rs762551, we found that carriers of the C-allele showed an increased overall risk of developing cancer compared with A-allele carriers (C-allele vs. A-allele: OR=1.08, 95% CI=1.01-1.16). Further subgroup analyses showed that the rs762551 polymorphism was associated with an increased risk of cancer in the subgroup

of Caucasians (C-allele vs. A-allele: OR=1.14, 95% CI=1.00-1.28; selleck kinase inhibitor dominant model: OR=1.19, 95% CI=1.02-1.37). These results suggest that the rs3569413 polymorphism of the CYP1A2 gene is associated with an increased risk of lung cancer and the rs762551 polymorphism of the CYP1A2 gene might be a potential biomarker for the risk of cancer among Caucasians. Further large and well-designed studies are required

to confirm this conclusion. (C) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.”
“Airway and respiratory complications are the most common causes of morbidity during general anesthesia in children. The airway changes in size, shape and position throughout its development from the neonate to the adult (1). Knowledge of the functional anatomy of the airway in children forms the basis of understanding the pathological conditions that may occur. This in turn allows a comprehensive assessment of the pediatric airway to take place, including a detailed medical history, clinical examination and specific investigative procedures.”
“Introduction: Ace b/l polymorphism in rats is associated with differential tissue angiotensin-converting enzyme (ACE) expression and activity, and susceptibility to renal damage. Same polymorphism was recently found in outbred Wistar rat strain with b allele accounting for higher renal ACE, and provided a model for studying renin-angiotensin-aldosterone system (RAAS) response behind the innate high or low ACE conditions.

The results of chemical analyses revealed the following contents

The results of chemical analyses revealed the following contents of the main constituents: cellulose (20.8%), hemicelluloses

(12.5%), proteins (18.8%), tannins (13.8%), extractives soluble in dichloromethane (5.0%) and ash (7.8%). Cellulose of grape skins is typical cellulose I polymorph with a degree of crystallinity of 66.1% as assessed by X-ray scattering. The hemicelluloses were analyzed by neutral sugars analysis, methylation analysis and 1D/2D H-1 NMR. The water-soluble compounds (26.4%) are composed mainly of monomeric sugars (glucose and fructose) and a complex mixture of hemicelluloses, the most abundant being pectin and acetylated glucomannan. The major part of structural polysaccharides (cellulose, selleck chemical xylan, xyloglucan, etc.) is embedded in cuticular layer and is poorly accessible to the acid click here hydrolysis. The cuticular substances contributed to ca. 8.5% of grape skins and their chemical structure has been evaluated by methanolysis. The possibility of comprehensive utilization of grape skins has been discussed. (C) 2012 Elsevier B.V. All rights reserved.”
“Incisional hernias are one of the most often complications in abdominal surgery and therefore present a significant surgical and socioeconomic problem. To date, incisional hernias are always an indication for surgery, regardless

of the patient’s symptoms. However, it remains unclear to what extent the surgery actually results in symptomatic improvement and whether a relevant ML323 risk of incarceration exists. The purpose of this study was to investigate the motivation that led to incisional hernia repairs and whether patients benefit from surgery with regard to pain and subjective criteria.

This prospective study included patients who underwent open abdominal incisional hernia repair using mesh implantation. Data collection was done preoperatively and 6 months postoperatively. The intensity of pain was evaluated using the Numeric Analog Scale (NAS). Patients were divided according to their preoperative level of pain into oligosymptomatic (NAS 0-3) and symptomatic

(NAS 4-10) groups, and the postoperative outcome of both groups was compared.

Ninety patients were prospectively enrolled: 45 males (50.0%) and 45 females (50.0%); 43 patients (47.8%) were oligosymptomatic preoperatively, while 47 patients (52.2%) reported relevant pain. The most frequent motivation for surgery named by the oligosymptomatic patients was fear of incarceration (79.1%), while the symptomatic patients mostly mentioned pain (76.6%). At 6 months postoperatively, significantly more oligosymptomatic patients complained of relevant pain (p < 0.001). In the symptomatic patient group, there was a significant reduction in relevant pain (p < 0.001). At that time, the level of relevant pain was comparable in both groups (33.3% versus 35.6%). Seven of 87 patients (8.

The study was divided into two time periods; Group 1 (1995-2007);

The study was divided into two time periods; Group 1 (1995-2007); where there was no formal guidance for managing post-CEA hypertension (PEH) and Group 2 (2008-2012); where written guidelines for treating PEH were available.

Results: 11/1024 patients in Group 1 (1.1%) suffered a stroke due to HS/ICH, compared to 0/426 patients (0.0%) in Group 2 (p = 0.02). In Group 1; intra-operative increases >100% in mean/peak MCAV and PI at 1 and 10-min post-clamp release had positive predictive values (PPV) of 1.2%, 6.3% and 20.0% and 2.9%, 8.0% and 16.6% respectively. Post-operatively; a >100% increase in mean and peak MCAV had a PPV of 6.3% and 2.7% respectively.

Conclusion: BTK inhibitor We were unable to demonstrate

that significant increases in MCAV and PI were able to predict patients at increased risk of suffering a post-operative stroke due to HS or ICH. The provision of written guidance for managing PEH in Group 2 patients was associated with virtual abolition of ICH/HS. (C) 2013 European Society for Vascular Surgery.

Published by Elsevier Ltd. All rights reserve’d.”
“Low-level X chromosome mosaicism and its clinical relevance are still under debate. It could be interpreted as a technical artefact, genuine mosaicism or as being age-related. This study evaluated the contribution of X chromosome mosaicism in phenotypically normal women with sporadic premature ovarian failure (POF). During 1999-2008, 114 patients VE-821 mw with POF and 64 age matched controls were karyotyped. Smoothened Agonist ic50 Thirteen patients (11.4%) had true X chromosome mosaicism (>10% of aneuploid cells) and 12 had (10.5%) low-level X-mosaicism (between 6-10% of aneuploid cells). The mean age of women with true and low-level mosaicism was 26.0 +/- 5.65 years and 35.92 +/- 3.87 years, respectively (P < 0.001). In the control group the incidence of cells with an abnormal number of X chromosomes was 1-3%. The results have practical implications for genetic counselling and fertility treatment. To search and confirm the low-level

mosaicism, a higher number of metaphases should be analysed or additional fluorescence in-situ hybridization analysis must be performed. Although peripheral blood does not reflect the situation in ovarian tissue well, it is presumed that there are different aetiological causes for true and low-level X chromosome mosaicism. The possible causes and reproductive significance of low-level X chromosome mosaicism are discussed. (C) 2011, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.”
“Type 2 diabetes is characterized by hyperglycemia resulting from insulin resistance in the setting of inadequate beta-cell compensation. Recent studies indicate that for attaining a well-functioning beta-cell mass, parathyroid hormone-related protein (PTHrP) is a very promising candidate among several insulinotropic peptides.

MLR induced an increase in relative receptor abundance as follows

MLR induced an increase in relative receptor abundance as follows: NPRA > NPRB > NPRC. ANF and BNP ASK inhibitor significantly inhibited up to similar to 50% lymphocyte proliferation in a dose-dependent manner in the range of 10(-11) to 10(-6) mol/liter, whereas CNP significantly decreased lymphocyte proliferation only modestly (similar to 20%) at 10(-8) mol/liter and at 10(-6) mol/liter.

CONCLUSIONS:

Both ANF and BNP have immunomodulatory functions, although the response to cardiac rejection observed clinically involves increases in plasma levels of BNP only. This is likely related to BNP gene promoter sequences previously reported to be responsive to specific cytokines and related substances. The modulation of the MLR by NP suggests a possible clinical use of these peptides in transplantation immunity. J Heart Lung Transplant 2010;29:323-6 (C) 2010 International Society for Heart and Lung Transplantation. GSK3235025 datasheet All

rights reserved.”
“Background: The objective was to study if an association exists between the incidence of malaria and some weather parameters in tropical Maputo province, Mozambique.

Methods: A Bayesian hierarchical model to malaria count data aggregated at district level over a two years period is formulated. This model made it possible to account for spatial area variations. The model was extended to include environmental covariates temperature and rainfall. Study period was then divided into two climate conditions: rainy and dry seasons. The incidences of malaria between the two seasons were compared. Parameter estimation and inference were

carried out using MCMC simulation techniques based on Poisson www.selleckchem.com/products/AC-220.html variation. Model comparisons are made using DIC.

Results: For winter season, in 2001 the temperature covariate with estimated value of -8.88 shows no association to malaria incidence. In year 2002, the parameter estimation of the same covariate resulted in 5.498 of positive level of association. In both years rainfall covariate determines no dependency to malaria incidence. Malaria transmission is higher in wet season with both covariates positively related to malaria with posterior means 1.99 and 2.83 in year 2001. For 2002 only temperature is associated to malaria incidence with estimated value 2.23.

Conclusions: The incidence of malaria in year 2001, presents an independent spatial pattern for temperature in summer and for rainfall in winter seasons respectively. In year 2002 temperature determines the spatial pattern of malaria incidence in the region. Temperature influences the model in cases where both covariates are introduced in winter and summer season. Its influence is extended to the summer model with temperature covariate only. It is reasonable to state that with the occurrence of high temperatures, malaria incidence had certainly escalated in this year.”
“BACKGROUND: Pre-ischemic surfactant treatment attenuates ischemia/reperfusion (I/R) injury.

In addition to the four known crystalline forms, mechanic propert

In addition to the four known crystalline forms, mechanic properties of five theoretically predicted crystalline forms of PVDF are also investigated. The all-trans Quizartinib mouse form I-p exhibits the largest cohesive energy, bulk, and Young’s modulus among the nine crystalline forms. The DFT calculations suggest that the delta crystalline forms (IIIau, IIIpu, IIIpd, and IIIad) possess poor chain rigidity among the nine PVDF crystalline forms. In contrast, a change of relative orientation of PVDF chains does

not lead to significant change in cohesive energy and mechanic properties. A comparison of the cohesive energies of nine crystalline forms of PVDF suggests that the theoretically proposed crystalline forms of PVDF are quite stable. (C) 2011 American Institute of Physics. [doi: 10.1063/1.3574653]“
“Purpose: To determine if serotonin production by pancreatic endocrine neoplasms is associated with the pancreatic duct stenosis seen in patients with stenosis that is out of proportion to the size of the tumors seen on computed tomographic images.

Materials and Methods: Institutional approval was obtained for this HIPAA-compliant study. Informed consent was waived. Clinical and radiologic findings in six patients were reviewed. Gross and histologic findings in the resected pancreata were also assessed.

Formalin-fixed paraffin-embedded tumor sections were immunolabeled Epoxomicin cell line with antibodies to serotonin. Tissue microarrays constructed from 47 pancreatic endocrine neoplasms from the institutional tissue bank served as controls. Histologic and serotonin immunoreactivity findings were compared between the two groups. The

Fisher exact test was used to compare serotonin immunoreactivity.

Results: Only one of the six study patients had a large dominant tumor Fosbretabulin (4 cm in the pancreatic head). All others were 2.5 cm or smaller. Four of the six pancreatic endocrine neoplasms with associated pancreatic duct stricture had prominent stromal fibrosis. Serotonin immunoreactivity was present in five (83%) patients, and this labeling was strong and diffuse in the four patients with prominent fibrosis. By contrast, stromal fibrosis was minimal in the nonimmunoreactive case. Only three (6%) of the 47 control pancreatic endocrine neoplasms were immunoreactive for serotonin (P<.01, Fisher exact test).

Conclusion: These data suggest that serotonin produced by pancreatic endocrine neoplasms may be associated with local fibrosis and stenosis of the pancreatic duct. Clinicians should be aware that small pancreatic endocrine neoplasms can produce pancreatic duct stenosis resulting in ductal dilatation and/or upstream pancreatic atrophy out of proportion to the size of the tumor. (C) RSNA, 2010″
“Youth with mild spastic cerebral palsy (n = 14) and a peer control group were compared on an oddball paradigm.

The data support the view that the microtubule cytoskeleton is a

The data support the view that the microtubule cytoskeleton is a valid therapeutic target in AD. Copyright (C) 2011 S. Karger AG, Basel”
“Esparto (Stipa tenacissima) is a highly fibrous herbaceous plant. In addition, the fiber properties (suppleness, thinness, and cellulose content) make this plant a valuable raw material for papermaking in terms of both quality and quantity. In Tunisia, esparto is the only source of

raw material for papermaking. In this paper, the chemical characteristics (cellulose, hemicelluloses, lignin, extractives, and ashes) of esparto leaves are analyzed in relation to growing conditions and plant biology. Four localized sites in the Kasserine region (central Tunisia) selleck are examined. The chemical properties of esparto fibers INCB024360 vary significantly with site and season. In fall, esparto leaves contain more cellulose (46.4%) than in other seasons. In winter, esparto leaves have lower cellulose content (43.3%) and higher extractive content. The pulp properties across seasons indicate that pulp yield and strength properties are superior when leaves are harvested in fall. (C) 2012 Elsevier B.V.

All rights reserved.”
“Objective: (1) To describe a case of necrotizing group A streptococcal periorbital infection in a patient receiving treatment with adalimumab (Humira, Abbott)-a fully humanized monoclonal anti-TNF-alpha agent. (2) To identify bacterial species responsible for infection with different forms of biological therapy.

Design:

Single interventional case report and literature review.

Case: A 57-year-old woman developed severe right-sided necrotizing periorbital infection whilst receiving treatment with adalimumab for rheumatoid arthritis (RA). Cultures grew Lancefield Group A Streptococcus pyogenes. An extensive literature search for reports of ocular infections associated with biological therapy was conducted.

Results: Dinaciclib cell line Adalimumab therapy was discontinued and the patient was admitted to an intensive care unit. The patient made a complete recovery after receiving appropriate antibiotic therapy. Overall Gram-positive cocci are the most common infection associated with use of biological therapy.

Conclusions: Anti-TNF-alpha agents are powerful immune-modulating drugs with potentially serious side effects. This case is the first to link adalimumab to necrotizing periorbital infection. Resolved infection does not preclude reintroduction of anti-TNF therapy however, careful assessment of the risks versus benefits of therapy is required at the individual patient level.”
“Background

Late occurrence of cytomegalovirus (CMV) infection remains a concern in CMV-seronegative kidney and/or pancreas transplant recipients of CMV-seropositive organs (donor positive/recipient negative, D+/R-) despite the use of prophylaxis. We investigated the impact of various antibody induction regimens on CMV infection in this group of patients.