Search

The role of educational facilities, including schools and universities, in the SARS-CoV-2 pandemic is heavily debated. Specifically, the risk of infection in student dormitories has not been studied. This cohort study monitored students living in dormitories in Bochum, Germany, throughout the winter term of 2020/2021. Over the course of four months, participants were tested repeatedly for SARS-CoV-2 infections using RT-PCR from gargle samples and serological testing. An online questionnaire identified individual risk factors. A total of 810 (46.5% female) students participated. Of these, 590 (72.8%) students participated in the final visit. The cross-sectional antibody prevalence was n = 23 (2.8%) in November 2020 and n = 29 (4.9%) in February 2021. Of 2513 gargle samples analyzed, 19 (0.8%) tested positive for SARS-CoV-2, corresponding to 14 (2.4%) infections detected within the study period. Gargle samples available of cases with confirmed present infection were always positive. The person-time incidence rate was 112.7 (95% CI: 54.11–207.2) per 100,000 person weeks. The standardized incidence ratio was 0.9 (95% CI 0.51–1.46, p = 0.69). In conclusion, students living in student dormitories do not appear to be major drivers of SARS-CoV-2 infections. RT-PCR from gargle samples is a patient-friendly and scalable surveillance tool for detection of SARS-CoV-2 infections.

A 76-year-old Moroccan patient with a medical history of sigmoid carcinoma suffered from weight loss of 15 kg and abdominal pain. Laparoscopy showed disseminated miliary peritoneal lesions, prima vista suspicious for disseminated peritoneal cancer spread. Patient’s medical history was reprocessed and compared to recent literature via PubMed. Pathological evaluation revealed granulomas and an infection with miliary intraabdominal tuberculosis (TB) was proven. Symptoms of TB may vary and findings can be misleading. An interdisciplinary approach is needed for diagnosis and treatment.

Clostridium difficile ist der haufigste Erreger einer nosokomialen antibiotikaassoziierten Diarrho. Das Spektrum C.-difficile-assoziierter Erkrankungen reicht von einer milden wassrigen Diarrho bis hin zur pseudomembranosen Enterokolitis mit fulminantem Verlauf und hoher Mortalitat. Die Pathogenese ist multifaktoriell: Neben der Akquisition des toxinbildenden Erregers sowie Alteration der Darmflora durch eine antibiotische/zytostatische Therapie spielen patientenspezifische Faktoren (hohes Lebensalter, Komorbiditat, eingeschrankte Immunitat) eine Rolle. Die Diagnostik erfolgt durch Erreger-/Toxinnachweis im Stuhl und das charakteristische endoskopische Bild. Die Beendigung der verursachenden Antibiotikagabe ist die entscheidende therapeutische Saule, eine spezifische Therapie kann primar mit Metronidazol oder Vancomycin erfolgen. Die Rezidivrate ist mit 15–30% sehr hoch. Die Isolierung des Patienten und adaquate Handehygiene sind unabdingbare Masnahmen zur Vermeidung der nosokomialen Verbreitung des sporenbildenden Keims.

Familial Mediterranean fever (FMF) can be associated with splenomegaly. Prospective quantitative data are lacking. We performed a sonographic assessment of spleen size in patients with FMF and healthy control participants to assess its diagnostic value.Patients with FMF according to the criteria of Livneh et al (Arthritis Rheum 1997; 40:1879-1885) who were in an asymptomatic interval and control participants were prospectively included in this study in Germany and underwent sonographic measurement of the spleen as well as a structured interview and a physical examination. Patients and controls were Turkish migrants.Thirty-six patients and 27 controls were included. Patients and controls did not differ significantly in age (mean ± SD, 34.8 ± 9.7 versus 33.3 ± 10.0 years, respectively; P = .56), sex, height, weight, or body mass index (26.7 ± 4.7 versus 26.1 ± 4.3 kg/m(2); P = .63). Spleen size was greater in patients than controls in width (4.3 ± 1.0 versus 3.7 ± 0.7 cm; P = .008) and also length (12.1 ± 1.9 versus 10.5 ± 1.4 cm; P = .001). Twenty-six of 36 patients (72.2%) had a history of appendectomy compared to 3 of 27 controls (11.1%; P.001). The combination of an enlarged spleen (length11 cm and/or width4 cm) gave specificity of 100% (95% confidence interval, 87%-100%) and a positive predictive value of 100% (95% confidence interval, 78%-100%) for the diagnosis of FMF in our study.Spleen size as evaluated by sonography is larger in patients with FMF compared to healthy controls. Most patients with FMF included in this study had undergone appendectomy. Familial Mediterranean fever should be considered as a differential diagnosis in Turkish migrants in Germany if the spleen is enlarged and a history of appendectomy is reported.

Study Design: A prospective analysis of intraoperative bile duct cultures in patients undergoing surgery for both, malignant or benign periampullary diseases at the Department of Surgery, St Josef Hospital, Bochum, Germany, during a period of 18 months, between January 2004 and June 2005. Goals: The goals of the presented study were to investigate the effects of preoperative bile duct stenting on intraoperative bile duct cultures and postoperative outcome in patients undergoing pancreatic surgery. Background: In pancreatic surgery, bile duct stenting is often aimed at improving postoperative outcome. As implantation of xenograft material in the main bile duct facilitates bacterial contamination and cholangitis, a critical evaluation of stenting is mandatory. Study: In all patients with a hepaticojejunostomy (n = 80), a bile duct culture was collected during the operation. All patients received antibiotic prophylaxis perioperatively and a retrograde flushing of bile ducts with warm saline after bile duct resection. Fifty-one percent (41/80) patients had biliary drainage before surgery, whereas 49% (39/80) were operated without preoperative draining procedures. Results: After bile duct stenting, 98% of patients had a positive bile culture, whereas only 21% of infected bile was seen in patients without drainage (P

Supplementation with uridine offers the possibility of a new and promising approach to nucleoside analogue reverse transcriptase inhibitor-associated mitochondrial toxicity. We investigated the metabolic effects of short-course treatment with the uridine-enriched food supplement NucleomaxX on hepatic mitochondrial function in thymidine-analogue treated HIV-infected patients. Mitochondrial function was assessed by a recently introduced non-invasive 13 C-methionine breath test. NucleomaxX supplementation enhanced mitochondrial decarboxylation function reversibly but reproducibly in all patients. Repeated administration in shorter treatment intervals may maintain this effect.

To assess mitochondrial respiratory chain dysfunction in different treatment groups of HIV-infected patients with normal serum lactate by measuring hepatic mitochondrial decarboxylation capacity by the C-methionine breath test (MeBT) and to correlate MeBT results with mitochondrial DNA (mtDNA) content in peripheral blood mononuclear cells (PBMCs).Four groups were studied: HIV-negative controls (n = 10), treatment-naive patients (n = 15), antiretroviral therapy (ART)-treated patients with asymptomatic disease (n = 15), and patients with long-term treatment and clinical evidence of lipoatrophy (n = 15). After oral administration of C-methionine, CO2 exhalation was determined by infrared spectroscopy. MtDNA content in PBMCs was assessed by real-time polymerase chain reaction quantification.CO2 exhalation in lipoatrophic patients and therapy-naive patients was distinctly decreased when compared with that in healthy controls and asymptomatic patients (P0.001). The functional mitochondrial impairment in lipoatrophic patients was associated with a 47% decline in mtDNA content. MeBT results and mtDNA were significantly correlated in ART-treated patients (r = 0.77, P0.0001).MeBT is a simple noninvasive method to detect mitochondrial dysfunction in HIV-infected patients that correlates with mtDNA depletion in PBMCs of ART-treated individuals. Decreased hepatic methionine metabolism in therapy-naive patients may reflect the functional relevance of viral-mediated mitochondrial toxicity.

Sir, Leucocytoclastic vasculitis (LV) is a common disorder of small dermal vessels characterized by a polymorphonuclear infiltrate and ‘nuclear dust’ as well as fibrinoid change. The clinical presentation may be purely urticarial, purpuric or necrotic (1). The sexes are affected equally, the disorder occurs at all ages and some patients with LV have infections and malignant diseases. Here we report a severe recalcitrant necrotizing LV in a patient with non-Hodgkin’s lymphoma and hepatitis C infection. The LV was successfully treated with a combination of antiviral and immunosuppressive therapy.