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Background Candidemia is one of the most life-threatening infections among critically ill patients in the intensive care unit. However, the number of studies on the impact of host- and early treatment-related factors on mortality in this cohort is limited. The aim of this study was to investigate the relationship between clinically relevant factors, including early treatment (appropriate antifungal therapy and/or central venous catheter removal) and mortality in intensive care unit patients with candidemia. Methods We performed a retrospective observational study in two Japanese University hospitals between January 2007 and December 2016. Adult intensive care unit patients with candidemia who met the following inclusion criteria: (1) ≥ 18 years old; (2) admitted in intensive care unit at the time of onset; and (3) central venous catheter in situ at the time of onset were included. We performed univariate and multivariate logistic regression analysis to identify factors associated with 30-day crude mortality. Results A total of 68 patients met the inclusion criteria, 47 (69%) of whom were males. The median age was 68.0 (interquartile range, 61.0–76.0) years. The most common causative Candida species was Candida albicans (40 [59%] patients). With respect to the source of infection, central venous catheter-related candidemia was the most frequent (30 [44%] patients). Thirty-day crude mortality was 54% (37 patients). In multivariate logistic regression analysis, Acute Physiology and Chronic Health Evaluation II score (1-point increments) was the only factor that was independently associated with higher 30-day crude mortality. Other variables, including appropriate antifungal therapy and/or central venous catheter removal ≤ 24 h and ≤ 48 h following onset, did not significantly influence mortality. Conclusions Candidemia in intensive care unit patients is still associated with high 30-day crude mortality rates. The only predictor of death was Acute Physiology and Chronic Health Evaluation II score ≤ 24 h following candidemia onset. Early empiric antifungal therapy and/or early CVC removal conferred no significant clinical benefit on survival in this patient population.

Since 2022, cases of hepatitis of unknown origin have been reported in children worldwide. Adeno-associated virus type 2 (AAV2) was identified as a cause, with most affected children having the HLA-DRB1 04:01 genotype. In this study, we hypothesized that HLA-DRB1 04:01 in the host may also be a potential predisposing factor of acute hepatitis caused by other viruses. We report a case that met the definition of severe hepatitis of unknown cause in a child; adenovirus type 2 (AV2) was detected in her specimens. The patient was a 1-year-old girl who visited a doctor because of fever occurring 1–2 days per week, respiratory symptoms, and diarrhea. One month later, the patient was referred to our hospital because of prolonged elevated liver enzyme concentrations. Two weeks after the initial visit, her aspartate aminotransferase (AST) and alanine aminotransferase (ALT) concentrations increased to 1558 and 1843 IU/L, respectively. The patient’s liver enzyme concentrations decreased markedly with only observation and intravenous hydration during hospitalization within a few days. Thereafter, hepatic enzymes were transiently elevated with each common cold, but all recovered spontaneously. The adenovirus (AV) antibody levels increased substantially 2 weeks after admission. The patient’s human leukocyte antigen (HLA) was determined to be of the DRB1 04:01 genotype. The presence of HLA-DRB1 04:01 is consistent with that reported in pediatric patients with AAV2 hepatitis in the United Kingdom, indicating that it may have been involved in the host immune response and acute hepatitis in this child. HLA-DRB1 04:01 may predispose children to acute hepatitis from various viruses, including AV2, AAV2, and possibly respiratory viruses, which requires clinical attention.

[This corrects the article DOI: 10.3389/fimmu.2025.1544622.].

Background The COVID-19 pandemic necessitated infection control for all sporting activities. More careful infection control measures are required in judo, where close contact with opponents cannot be avoided. The Medical Science Committee of the All Japan Judo Federation (AJJF) established infection control guidelines for daily practice and competitions. Infection control measures were also implemented at the national tournament organized by the AJJF. Objective and methods This study aimed to examine the effectiveness of pre-tournament health surveys and PCR testing in guidelines for judo tournaments. Participants had to complete a health survey one to two weeks before the tournament. Initially, PCR testing was performed on all athletes; however, the final policy was to conduct PCR testing only on athletes with an infected person (risk team testing method). The effectiveness of these methods was also examined. Results In 16 competitions between October 2020 and March 2023, 6980 contestants were registered, and PCR testing was performed on 3672 athletes; 29 (0.79%) had a positive PCR test. Only two contestants were unable to attend the tournament because of the health survey. No competition-related cluster outbreaks were observed. From May 2022, the competition was held under the guideline that only teams at risk of infection were tested and could only compete when they tested negative. No teams were tested according to this guideline. In the competitions organized within this guideline, only one person could not compete because of the information provided in the health survey. No clusters were observed in any of the competitions. The incidence of COVID-19 infection in the first week after the convention was 20 (0.60%) in testing only at-risk teams and 21 (0.57%) in testing all competitors, which was not significantly different.(p=0.62) Conclusion During the COVID-19 epidemic, health surveillance was necessary to prevent the registration of competitors at risk of infection prior to tournaments. If teams at risk of infection could be identified, PCR testing of all athletes might not be mandatory, and competitions could be organized safely. The Judo infectious disease control guidelines we have developed might be used for other contact sports in the future when other infectious diseases are prevalent.

Background As of October 2021, sports activities require preventive measures against coronavirus disease 2019 (COVID-19) infection. Judo, a close-contact sport, demands careful prevention with great consideration to the risk of infection. The All Japan Judo Federation Medical Science Committee (AJJF) designed COVID-19 prevention protocols from a medical perspective and developed policies for safe regular practices and tournaments. Objective and Methods We aim to examine the efficacy of health surveys and polymerase chain reaction (PCR) tests prior to judo tournaments, as mandated by the tournament policy. Infection prevention managers were installed prior to tournaments. Two weeks prior to each tournament, these managers drafted health inventory forms for athletes and related parties to check for COVID-19-associated symptoms. Although PCR testing prior to tournaments was not required by policy, the AJJF conducted them (directly and by mail) prior to six tournaments from October 2020 to September 2021 for athletes whose health inventory forms listed no symptoms. Results One of the athletes was not tested and was unable to participate in a tournament due to the symptoms indicated in their health inventory form. Testing began in October 2020 and was conducted until September 2021 for 2,073 athletes over the duration of six tournaments. The SARS-CoV-2 virus was detected in 11 (0.29%) athletes. In tournaments held until April 2021, SARS-CoV-2 was detected in only one of the 1,173 (0.08%) athletes tested. However, prior to tournaments held from July 2021 onward, when variants became prevalent, SARS-CoV-2 was detected in 10 (1.1%) of the 900 athletes tested (p < 0.05). No clusters were reported in association with any tournament. Conclusion We believe that drafting health inventory forms two weeks prior to judo tournaments was essential and kept the participants alert. However, as variants emerged, some participants who were positive could not be detected through their inventory forms; this demonstrates the need for caution when relying on health inventory forms alone.

In this study, we analyzed a relatively large subset of proteins, including 109 kinds of blood-circulating cytokines, and precisely described a cytokine storm in the expression level and the range of fluctuations during hospitalization for COVID-19. Of the proteins analyzed in COVID-19, approximately 70% were detected with Bonferroni-corrected significant differences in comparison with disease severity, clinical outcome, long-term hospitalization, and disease progression and recovery. Specifically, IP-10, sTNF-R1, sTNF-R2, sCD30, sCD163, HGF, SCYB16, IL-16, MIG, SDF-1, and fractalkine were found to be major components of the COVID-19 cytokine storm. Moreover, the 11 cytokines (i.e., SDF-1, SCYB16, sCD30, IL-11, IL-18, IL-8, IFN-γ, TNF-α, sTNF-R2, M-CSF, and I-309) were associated with the infection, mortality, disease progression and recovery, and long-term hospitalization. Increased expression of these cytokines could be explained in sequential pathways from hematopoietic progenitor cell differentiation to Th1-derived hyperinflammation in COVID-19, which might also develop a novel strategy for COVID-19 therapy with recombinant interleukins and anti-chemokine drugs.

Tanino Y, Nishioka K, Yamamoto C, et al. Infect Drug Resist. 2024:17:531-541. Our authors have advised that there are two sentences that needed revision in the abstract section of the published paper. E340A/V792I is incorrectly described as E340K/V791I. The second sentence in \"Results\" section in the Abstract on page 531 should read from \"The day 23 isolate harboring S:E340K/RdRp:V791I was resistant to both sotrovimab and RDV, showing 364- and 2.73-fold higher resistance respectively, compared with the wild-type.\" to \"The day 23 isolate harboring S:E340A/RdRp:V792I was resistant to both sotrovimab and RDV, showing 364- and 2.73-fold higher resistance respectively, compared with the wild-type.\" The first sentence in \"Conclusion\" section in the Abstract on page 531 should read from Drug-resistant variants with double mutations (S:E340K/RdRp:V791I) became dominant within 23 days after starting treatment, suggesting that even a combination therapy involving sotrovimab and RDV, dual-drug resistant viruses may emerge rapidly in immunocompromised patients.\" to \"Drug-resistant variants with double mutations (S:E340A/RdRp:V792I) became dominant within 23 days after starting treatment, suggesting that even a combination therapy involving sotrovimab and RDV, dual-drug resistant viruses may emerge rapidly in immunocompromised patients.\" The authors confirm that these changes do not affect the interpretation of the results and consider them to be typographical error only. The authors apologize for these errors.

COVID‐19 rarely causes lower gastrointestinal bleeding even though its RNA has been detected in patient's stool. Urgent colonoscopy in a COVID‐19 patient with massive bloody stool requires various procedural and equipment considerations. Here, we present a case of colonoscopic hemostasis of a cecal hemorrhagic ulceration in a patient on heparin for COVID‐19 coagulopathy. We also share various management methods for the prevention of COVID‐19 contamination. A 71‐year‐old man was diagnosed with COVID‐19 pneumonia and subsequently underwent hemodiafiltration. Heparin was initiated for COVID‐19 coagulopathy. At day 42, the patient experienced 2000 mL of bloody stool. An operator performed urgent colonoscopy with three assistants in a negative‐pressure room with full personal protective equipment. A hemorrhagic ulceration was detected at the cecum, and endoscopic hemostasis was performed. Immunohistochemistry was positive for cytomegalovirus. Postprocedure, the endoscopic systems were thoroughly cleaned, and specific measures for endoscope reprocessing and disinfection were performed to prevent contamination with COVID‐19. Urgent colonoscopy for a patient with COVID‐19 having massive bloody stool needs various considerations for equipment and procedures. Here, we present the first case report of colonoscopic hemostasis ofcecal hemorrhagic ulceration for a patient receiving heparin for COVID‐19 coagulopathy and also showed various management methods toprevent contamination of COVID‐19.