SUMMARY:Autosomal dominant polycystic kidney disease is a genetic disorder affecting 1 in 1000 people worldwide and is associated with an increased risk of intracranial aneurysms. It remains unclear whether there is sufficient net benefit to screening this patient population for IA, considering recent developments in imaging and treatment and our evolving understanding of the natural history of unruptured aneurysms. There is currently no standardized screening protocol for IA in patients with ADPCKD. Our review of the literature focused on the above issues and presents our appraisal of the estimated value of screening for IA in the setting of ADPCKD.ABBREVIATIONS: ADPCKD ϭ autosomal dominant polycystic kidney disease; GFR ϭ glomerular filtration rate; IA ϭ intracranial aneurysm; QALY ϭ quality-
Parainfluenza virus (PIV) is a negative-sense single-stranded RNA virus in the Paramyxoviridae family. There are 4 serotypes that follow seasonal patterns with varying rates of infection for each serotype. PIV is an established cause of disease and death in the pediatric and immunocompromised populations, and its impact on the hospitalized adult is becoming more apparent with the increased use of multiplex molecular assays in the clinical setting. The clinical presentation of PIV in hospitalized adults varies widely and includes upper respiratory tract infections, severe lower respiratory tract infections, and exacerbations of underlying disease; 0.2%-11.5% of hospitalized patients with pneumonia have been found to have PIV infection. Currently no licensed treatment is available for PIV infection. Ribavirin has been used, but case studies show no impact on mortality rates. DAS181, an inhaled sialidase, is undergoing clinical development for the treatment of PIV in adults and children.
PIV infection is associated with substantial morbidity in hospitalized adults. Such data will be useful in understanding the impact on epidemiology and outcomes if a PIV-specific vaccine becomes available. Furthermore, this highlights the need for novel preventive and therapeutic approaches to PIV infection.
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