A survey for viruses was carried out in 2003 in the main olive‐growing areas of Lebanon (South Lebanon, North Lebanon, Mount Lebanon and Bekaa). A total of 300 samples was collected in 31 different locations in 76 different commercial orchards and checked by RT‐PCR for the presence of Arabis mosaic virus (ArMV), Cherry leaf roll virus (CLRV), Strawberry latent ringspot virus (SLRV), Olive latent virus 1 (OLV‐1) and Olive leaf yellowing‐associated virus (OLYaV), using virus‐specific primers reported in the literature. About one third (31%) of the trees were infected. In particular, the closterovirus OLYaV was the most widespread, as it was detected in 23.7% of the samples, followed by the necrovirus OLV‐1 (8.3%), the two nepoviruses CLRV (2%) and ArMV (0.3%), and the sadwavirus SLRV (0.3%). A high variability was detected in the HSP70 gene of Lebanese and Italian OLYaV isolates, for at least nine different patterns were obtained when this genomic region was subjected to single‐strand conformation polymorphism (SSCP) analysis.
ImportanceCancer screening deficits during the first year of the COVID-19 pandemic were found to persist into 2021. Cancer-related deaths over the next decade are projected to increase if these deficits are not addressed.ObjectiveTo assess whether participation in a nationwide quality improvement (QI) collaborative, Return-to-Screening, was associated with restoration of cancer screening.Design, Setting, and ParticipantsAccredited cancer programs electively enrolled in this QI study. Project-specific targets were established on the basis of differences in mean monthly screening test volumes (MTVs) between representative prepandemic (September 2019 and January 2020) and pandemic (September 2020 and January 2021) periods to restore prepandemic volumes and achieve a minimum of 10% increase in MTV. Local QI teams implemented evidence-based screening interventions from June to November 2021 (intervention period), iteratively adjusting interventions according to their MTVs and target. Interrupted time series analyses was used to identify the intervention effect. Data analysis was performed from January to April 2022.ExposuresCollaborative QI support included provision of a Return-to-Screening plan-do-study-act protocol, evidence-based screening interventions, QI education, programmatic coordination, and calculation of screening deficits and targets.Main Outcomes and MeasuresThe primary outcome was the proportion of QI projects reaching target MTV and counterfactual differences in the aggregate number of screening tests across time periods.ResultsOf 859 cancer screening QI projects (452 for breast cancer, 134 for colorectal cancer, 244 for lung cancer, and 29 for cervical cancer) conducted by 786 accredited cancer programs, 676 projects (79%) reached their target MTV. There were no hospital characteristics associated with increased likelihood of reaching target MTV except for disease site (lung vs breast, odds ratio, 2.8; 95% CI, 1.7 to 4.7). During the preintervention period (April to May 2021), there was a decrease in the mean MTV (slope, −13.1 tests per month; 95% CI, −23.1 to −3.2 tests per month). Interventions were associated with a significant immediate (slope, 101.0 tests per month; 95% CI, 49.1 to 153.0 tests per month) and sustained (slope, 36.3 tests per month; 95% CI, 5.3 to 67.3 tests per month) increase in MTVs relative to the preintervention trends. Additional screening tests were performed during the intervention period compared with the prepandemic period (170 748 tests), the pandemic period (210 450 tests), and the preintervention period (722 427 tests).Conclusions and RelevanceIn this QI study, participation in a national Return-to-Screening collaborative with a multifaceted QI intervention was associated with improvements in cancer screening. Future collaborative QI endeavors leveraging accreditation infrastructure may help address other gaps in cancer care.
Patient: Male, 72-year-old Final Diagnosis: Dasatinib induced pleural effusion Symptoms: Cough • shortness of breath Medication: — Clinical Procedure: Chest computed tomography • chest xray • thoracentesis Specialty: Hematology • General and Internal Medicine • Oncology • Pulmonology Objective: Unusual clinical course Background: Pleural effusions are frequently seen among patients with hematopoietic stem cell transplantation (HSCT). In the majority of cases, they are related to infections and volume overload. Medications have also been reported to cause pleural effusion in the general population, albeit very rarely. Dasatinib-induced pleural effusion has been reported in patients with chronic myeloid leukemia but not in those with HSCT. We here report a case of dasatinib-induced pleural effusion following HSCT for acute lymphocytic leukemia (ALL). The proposed mechanism of dasatinib-induced pleural effusion involves build-up of fluid due to an immune-mediated vascular insult. Case Report: A 72-year-old man who received HSCT for ALL was treated with dasatinib to prevent a recurrence. After 6 months, the patient was admitted to the hospital for pneumonia, which was observed as bilateral pleural effusion upon chest X-ray. After completing the antibiotics course, he developed recurrent pleural effusion during hospitalization. Repeated thoracentesis of the fluid revealed an exudative lymphocytic effusion with negative culture and cytology. Dasatinib was withdrawn and the pleural effusion resolved gradually. Conclusions: In patients with dasatinib-induced pleural effusions following HCTS, withdrawal of the drug leads to symptom resolution, thereby avoiding unnecessary procedures. This case illustrates that dasatinib-induced pleural disease typically manifests with lymphocytic exudative fluid. Physicians should be aware that pleural effusion is a possible medication-related adverse effect, which may be missed in cases of infection in patients following HSCT.
SARS-CoV-2 entered the world by storm when it made its appearance at the end of 2019 in Wuhan, China. The severity can range from asymptomatic infection, which occurs in approximately 33% of infected patients, to death. Worldwide deaths due to SARS-CoV-2 are currently approximated at 3.8 million people with close to 600,000 deaths in the United States alone, reiterating the significant impact this virus has on the population. SARS-CoV-2 can affect systems of the body such as respiratory, gastrointestinal tract, neurological, cardiac, renal, and even skeletal muscle tissue. A few cases of rhabdomyolysis are reported in SARS-CoV-2 infection, but the significant level of creatinine kinase in the hundreds of thousands is rare. Our case demonstrates the rarity of SARS-CoV-2 manifestation in a 33-year-old African American male with severe rhabdomyolysis with a creatinine kinase on the admission of 362,445 IU/L. The patient was treated aggressively with intravenous fluids, monitoring electrolytes, renal function, and respiratory status closely. His management includes liberal administration of fluid to treat his rhabdomyolysis, without compromising his respiratory status. He was subsequently discharged home after seven days of hospitalization. We strive to share this information in hopes to share our management for future similar cases.
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