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Renal complications of influenza A virus infections are uncommon but can contribute to a deterioration in the patient’s condition, which include acute kidney injury (AKI) in critically ill patients, rhabdomyolysis, hemolytic uremic syndrome (HUS), acute glomerulonephritis (AGN), disseminated intravascular coagulation (DIC), Goodpasture’s syndrome, and acute tubulointerstitial nephritis (TIN). The clinical characteristics of AKI in critically ill patients with pandemic influenza A(H1N1) 2009 virus (A(H1N1)pdm09) infection are similar to uninfected patients. Underlying conditions associated with AKI include older age, diabetes mellitus, obesity, pregnancy, history of asthma, and chronic kidney disease. Histologic examination of the kidneys from patients with A(H1N1)pdm09 infection who died include acute tubular necrosis (ATN), myoglobin pigment, and DIC. A(H1N1)pdm09 is present in the kidneys of some patients. The clinical characteristics of patients with rhabdomyolysis associated with influenza A include younger age and the frequent occurrence of muscle symptoms. AKI occurs in approximately one third of patients with rhabdomyolysis due to influenza A. HUS is associated with A(H1N1)pdm09 as follows: Streptococcus pneumoniae -associated HUS following A(H1N1)pdm09 infection, HUS triggered by A(H1N1)pdm09 in patients with genetic complement dysregulation, and HUS associated with A(H1N1)pdm09 without known underlying disorder. AGN, Goodpasture’s syndrome, and acute TIN are extremely rare complications of influenza A virus infection. Although the pathogenesis underlying renal injuries due to influenza A virus has not been delineated, some hypotheses have been advanced, including ATN due to renal hypoperfusion or rhabdomyolysis, glomerular microthrombosis due to DIC, direct viral injury to the kidney, and an altered immune system with systemic mononuclear cell activation following influenza A virus infections.

Although the etiology of Henoch-Schönlein purpura (HSP) remains unclear, influenza vaccinations have been implicated as possible triggers for HSP. We describe four patients with HSP following influenza vaccinations which developed during the pandemic of influenza A (H1N1) 2009 and review the literature concerning HSP associated with this vaccine. HSP in patients developed in October and November, 2009. Four patients exhibited purpura, three patients complained of arthralgias, and one patient had both abdominal pains and renal involvement. Reviewing the literature, 11 patients with HSP following influenza vaccinations have been reported. Eight patients were children and five patients had past histories of immunologically mediated diseases including HSP, drug eruptions, and food allergy. While a favorable outcome was noted in most patients, one patient developed end-stage renal failure and another patient exhibited chronic glomerulonephritis. Although the precise reason for clustering of our patients with HSP following influenza vaccination was unclear, increasing use of the recent influenza vaccine associated with the pandemic of influenza A (H1N1) 2009 might explain this phenomenon. Because the incidence of HSP caused by influenza vaccination was very low, influenza vaccination should not be limited for this reason. However, caution may be required with its use in children with immunologically mediated diseases such as HSP.

Atrial fibrillation (AF) and chronic kidney disease share risk factors and pathophysiologic mechanisms, suggesting that two conditions have close relationships. This is a prospective community-based observational cohort study including 235,818 subjects based upon a voluntary annual health check-up program in Japan. We studied the association of kidney dysfunction at entry with subsequent new-onset AF and the association of AF at entry with the development of kidney disease. During a follow-up of 5.9 ± 2.4 years, AF developed in 2947 subjects (1.3%). Baseline serum creatinine and estimated glomerular filtration rate (GFR) were associated with risk of subsequent AF. The HRs (95% CI) for AF were 1.32 (1.08-1.62) and 1.57 (0.89-2.77) for GFR 30 to 59 and <30 mL/min per 1.73 m 2, respectively. The effect of kidney disease on risk of new-onset AF remained significant in subjects without treated hypertension or diabetes. During the follow-up, 7791 subjects (3.3%) developed kidney dysfunction (GFR <60 mL/min per 1.73 m 2), and 11 307 subjects (4.9%) developed proteinuria. Atrial fibrillation at entry was associated with development of kidney dysfunction (HRs [95% CI], 1.77 [1.50-2.10]) and proteinuria (HR [95% CI], 2.20 [1.92-2.52]). The association persisted in subjects without treated hypertension or diabetes. Kidney dysfunction increased the risk of new onset of AF, and AF increased the risk of development of kidney disease. This finding supports the concept that the two conditions share common abnormal molecular signaling pathways contributing to their pathogenesis.

INTRODUCTION: Crohn’s disease (CD) can be complicated by complex fistulas and abscesses, and laparoscopic surgery for such cases is difficult. We report a patient with CD who developed a complex fistula and retroperitoneal abscess that were treated using single-incision laparoscopic surgery.CASE PRESENTATION: A 34-year-old man presented to the hospital after collapsing and losing consciousness while at work. Blood tests showed a white blood cell count of 20000/μL and severe anemia. Abdominal CT showed a right retroperitoneal abscess, which was drained under CT guidance. After gastrointestinal bleeding and an anal fistula were observed, CD was suspected and confirmed by total colonoscopy. The patient was eventually discharged but readmitted 2 months later for abscess recurrence and a colocutaneous fistula. Once the inflammation had improved after 3 weeks of fasting and intravenous antibiotics, the patient underwent single-incision laparoscopic subtotal colectomy, duodenal fistula closure, and seton drainage.CONCLUSIONS: Single-incision laparoscopic subtotal colectomy can be performed safely to treat CD-related abscesses and complicated fistulas after inflammation has improved.

This study surveyed the hospital wastewater characters focusing on antibiotic contamination in seven hospitals in Bangkok. It detected 19 antibiotics of which the high-frequent detection were quinolones such as ofloxacin + levofloxacin, norfloxacin, ciprofloxacin including sulfamethoxazole. Norfloxacin and ciprofloxacin appeared the highest concentrations of 12.11 and 9.60 μg/L, respectively. Most antibiotic concentrations in the wastewaters of the studied hospitals gave a good correlation ( r 2  = 0.77–0.99) to the amount of usage. In this study, batch acute toxicity tests were performed to assess the toxicity of hospital wastewater on mixed liquor, freshwater algae ( Chlorella vulgaris and Scenedesmus quadricauda ), and microcrustacean ( Moina macrocopa ). The hospital wastewaters could inhibit the mixed liquor growth and gave similar toxic levels among test species: algae and microcrustacean (9.81–13.63 and 2.62–3.09 TU, respectively). The conventional activated sludge (CAS) and rotating biological contactor (RBC) could remove fluoroquinolones and tetracycline via biomass adsorption. After treatment, most of treatment could reduce the toxicity. Nevertheless, the effluent gave slight toxicity on some test species which might be caused from chlorination and a common toxicant (NH 3 -N).

Foodborne illnesses remain a persistent threat to public health as well as the reputation and the sustainability of food service businesses. This study examined 225 food service establishment (FSE) inspection records (2022–2023) classified into outbreak-associated, routine, and control groups to identify the compliance factors most strongly linked to outbreak risk. Comparative analysis, and network-based analysis were applied to assess compliance trends, identify key risk elements, and explore interaction patterns among violations. Outbreak-associated establishments exhibited higher non-compliance, particularly in critical control (PR1), supplier verification (PR2), cross-contamination prevention (PR3), flooring (B5), and food contact surfaces (E13). Routine and control inspections showed similar compliance profiles, indicating comparable baseline standards. Network analysis uncovered distinct interaction structures in outbreak-associated networks, with structural integrity (B6, B5) and food handler training (FH12) functioning as highly influential nodes. Strong co-occurrences, such as B5–equipment (E15) and PR3–drainage system maintenance (D20), highlight how operational and structural lapses combine to elevate outbreak risks. These findings carry important implications for food service businesses and regulators. For operators, monitoring high-risk compliance areas provides a basis for proactive risk management, reducing the likelihood that minor issues evolve into major outbreaks. For regulators, the findings suggest that the inspection framework should evolve beyond isolated violations to prioritize risk-sensitive and system-based indicators. Together, these insights provide both business and policy stakeholders with a roadmap for strengthening food safety resilience, safeguarding public health, and protecting customer trust in food service operations.

Currently available numerical models that describe the fecal contamination of aquatic environments using Escherichia coli as an indicator bacterium did not consider its survival in sediments. We conducted a series of comparative experiments to reveal the independent and interactive effects of sediment factors, including temperature, pH, water-extractable total dissolved solids (TDSs), coexisting microbes, and sampling sites, in lake environments on E. coli survival. In experiments, E. coli survival was observed by controlling any two factors at a time. Consequently, the decrease in pH and presence of coexisting microbes enhanced E. coli die-off, whereas the addition of water-extractable TDSs promoted its growth. To select factors to be considered for modelling E. coli survival in sediments, the independent effects of each factor and the interaction effect of the two factors were statistically compared based on their effect sizes (η2). As a result, pH (η2 = 59.5–89.0%) affected E. coli survival most significantly, followed by coexisting microbes (1.7–48.4%). Among the interactions affecting E. coli survival, including pH or coexisting microbes—which had larger independent effects—relatively larger statistically significant interactions were observed between pH and coexisting microbes (31.1%), coexisting microbes and water-extractable TDSs (85.4%), and coexisting microbes and temperature (26.4%).

Because salicylate intoxication may lead to proximal renal tubular dysfunction, urinalysis and renal tubular function should be evaluated in patients with normal anion gap metabolic acidosis after a salicylate overdose.

Changes in dissolved organic matter (DOM) characteristics were investigated in two mountainous streams with closed-type sabo dams. Surface water was collected from four stations along the two mountainous streams and analyzed using ultraviolet-visible spectrophotometry and excitation-emission fluorescence matrix (EEM) methods. Optical properties of DOM indicated an increase in molecular weight and aromaticity at stations near the sabo dams. Average spectral ratio values were low before and after the dam (i.e., < 0.72) compared to other sections of the stream. Specific ultraviolet absorbance (SUVA 254 ) increased in the vicinities of the dams. While chromophoric DOM characteristics from two sites were influenced by the dam, fluorescence components, however, did not show notable changes around dams. Instead, the three chromophoric components distinguished by EEM-parallel factor analysis, that is, humic-like (C1 and C2) and protein-like (C3) increase along the stream. Fulvic-like component (C1) had a high fluorescence intensity at all stations; all the three components were more abundant in the downstream section. Chromophoric DOM properties varied along the stream based on alterations in molecular size and aromaticity. Using multivariate analysis, the studied sites were grouped into three clusters related to sabo dams and other activities. We conclude that sabo dams modify DOM characteristics which influence the behavior of DOM transported along the stream.

The separation of P, K, and Mg from surplus activated sludge (SAS) was investigated using existing sludge treatment facilities and the thickened primary sludge (TPS). The addition of the TPS to the SAS storage tank accelerated the anaerobic release of the three elements from SAS with maximum efficiencies of about 60%. The efficiency of P release showed a significant correlation with the oxidation–reduction potential. Increasing the total solid concentration increased the release of elements. The released elements could be transferred to a separate liquid (SL) from a screw-press thickener, and maximum concentrations of P, K, and Mg were about 200, 60, and 35 mg/L, respectively. The addition of CaCl2 and NaOH solutions to SL precipitated P as hydroxyapatite. However, no precipitation of K and Mg occurred simultaneously with P, even when the pH of SL was increased to 9. These findings suggest that about 60% of P, K, and Mg can be separated from SAS into SL using existing sludge treatment facilities and TPS; however, a method other than precipitation would be needed to recover P and K from SL simultaneously.