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배경: Despite the known clinical benefit of remdesivir in SARS-CoV-2 infection, its usage has been limited in patients with impaired renal function due to concern about the liver and renal toxicities by the accumulation of sulfobutylether-β-cyclodextrin. We compared adverse events between remdesivir-treated and non-remdesivir-treated groups in COVID-19 patients with renal impairment. 방법: Adult COVID-19 patients with a glomerular filtration rate of <30 ml/min/1.73 m2 at admission to a tertiary care hospital between November 2020 and March 2022 were retrospectively enrolled. Data on serum creatinine and liver chemistry tests at day 3 or 5, 10, 15, and 30 from admission or the start of remdesivir therapy were collected. 결과: A total of 101 patients with impaired renal function were enrolled including 34 patients receiving renal replacement therapy. Of 101 patients, 64 received remdesivir, while 37 did not. The median duration of remdesivir therapy was 4 (interquartile range, 3-5). Among patients who did not need dialysis initially, 18% (7/38) of remdesivir-treated patients developed acute kidney injury (AKI) at day 3-5, while 43% (16/29) of non-remdesivir-treated patients did. The proportion of patients with AKI decreased over time in remdesivir-treated patients (Figure 1). At day 3-5, 20% (13/64) of remdesivir-treated patients developed liver injury (mostly mild injury), while 30% (11/37) of non-remdesivir-treated patients did. There was no significant increase in alanine aminotransferase level over time in remdesivir-treated patients (Figure 1). No serious renal and hepatic adverse events related to remdesivir were observed. 결론: No significant increases in liver and kidney injury associated with remdesivir therapy were observed. These findings suggest that remdesivir therapy should not be easily withheld due to safety concerns of sulfobutylether-β-cyclodextrin in COVID-19 patients with renal impairment. [ABSTRACT FROM AUTHOR]

배경: Bacteremia caused by carbapenemase-producing Enterobacterales (CPE) is a growing concern due to its high mortality and limited treatment option. We evaluated the characteristics of subsequent CPE bacteremia in CPE stool carriers and analyzed risk factors for CPE bacteremia compared with non-CPE Enterobacter bacteremia. 방법: We retrospectively analyzed adult patients confirmed to have CPE colonization in stool surveillance culture in a tertiary hospital between January 2018 and February 2022. All episodes of Enterobacterales bacteremia within 6 months after CPE colonization were identified. 결과: During the study periods, a total of 1,174 patients were identified as CPE stool carriers. Of these patients, 58 (4.9%) experienced 70 episodes of subsequent CPE bacteremia after CPE colonization, whereas 102 (8.7%) had 123 episodes of subsequent non-CPE Enterobacterales bacteremia. Colonization with KPC producer, K. pneumoniae, and E. coli was significantly associated with CPE bacteremia (Table 1). Subsequent Enterobacterales bacteremia in CPE carriers was more frequently caused by non-CPE than by CPE (8.7% vs. 4.9%, p <0.001). When comparing the first episode of Enterobacterales bacteremia according to carbapenemase production, colonization with KPC producer and K. pneumoniae, multiple sites colonization, high Pitt’s score, ICU care, recent abdominal surgery, and prior carbapenem use were significantly associated with CPE bacteremia (Table 2). Multivariable analysis revealed that ICU care (adjusted odds ratio [aOR]: 4.09, 95% confidence interval 1.52 to 11.01, p <0.01), KPC colonizer (aOR: 4.22, p <0.01) and abdominal surgery within a week (aOR: 13.15, p =0.03) were independent risk factors for CPE bacteremia. 결론: In CPE carriers, non-CPE Enterobacterales were 1.8 times more likely to cause bacteremia than CPE. In a CPE carrier in ICU, colonized with KPC, and recent history of intraabdominal surgery, empirical therapy for CPE should be considered when sepsis is suspected. [ABSTRACT FROM AUTHOR]

Ordered mesoporous carbons (OMCs) have attracted considerable interest owing to their broad utility. OMCs reported to date comprise amorphous rod‐like or tubular or graphitic rod‐like frameworks, which exhibit tradeoffs between conductivity and surface area. Here we report ordered mesoporous carbons constructed with graphitic tubular frameworks (OMGCs) with tunable pore sizes and mesostructures via dual templating, using mesoporous silica and molybdenum carbide as exo‐ and endo‐templates, respectively. OMGCs simultaneously realize high electrical conductivity and large surface area and pore volume. Benefitting from these features, Ru nanoparticles (NPs) supported on OMGC exhibit superior catalytic activity for alkaline hydrogen evolution reaction and single‐cell performance for anion exchange membrane water electrolysis compared to Ru NPs on other OMCs and commercial catalysts. Further, the OMGC‐based full‐carbon symmetric cell demonstrates excellent performances for Li‐ion capacitors. [ABSTRACT FROM AUTHOR]

Background: To determine whether a minimal stimulation (MS) or high-dose stimulation (HDS) protocol is a better option for patients classified as poor ovarian responders (POR) in terms of reproductive and pregnancy outcomes. Materials and methods: A database search for evaluation of the study outcome by using meta-analysis method was carried out. The primary outcome was the clinical pregnancy (CP) rate for each of two groups, namely, the MS and HDS groups. The secondary outcomes were the gonadotropin dose used, duration of stimulation, cancellation rate, number of oocytes retrieved, number of fertilized oocytes, number of embryos transferred and live birth rates. Results: Across five databases, 4670 potential studies for further screening were selected. But ultimately only six studies, three RCTs and three retrospective or case control studies were selected that meet the Bologna criteria for POR. In all there were 624 cycles. Our meta-analysis indicated that the CP rates, cycle cancellation rates, durations of stimulation, numbers of oocytes fertilized and numbers of embryos transferred were not statistically significant. Clearly, the number of oocytes retrieved in the MS group was significantly lower than in the HDS group, while the HDS group consumed significantly higher doses of gonadotropins than the MS group. The live birth rates were significantly higher in the MS group than in the HDS group. Conclusion: MS should be the first-line protocol for managing POR because the live birth rate is significantly higher, even with fewer oocytes retrieved. [ABSTRACT FROM AUTHOR]