Background Gastrointestinal pathogen panels (GPPs) are increasingly used to identify stool pathogens, but their impact in people with HIV (PWH) is unknown. We performed a retrospective cohort study comparing GPP and conventional stool evaluation in PWH. Methods We included all PWH who underwent GPP (Biofire Diagnostics; implemented September 15, 2015) or conventional testing, including stool culture, Clostridium difficile polymerase chain reaction testing, fluorescent smears for Cryptosporidium or Giardia, and ova and parasite exams (O&P) from 2013 to 2017. A total of 1941 specimens were tested, with 169 positive specimens detected in 144 patients. We compared result turnaround time, pathogen co-infection, antibiotic treatment, and treatment outcomes between positive specimens detected by conventional testing vs GPP. Results Overall, 124 patient samples tested positive by GPP, compared with 45 patient specimens by conventional testing. The GPP group demonstrated a higher co-infection rate (48.4% vs 13.3%; P < .001) and quicker turnaround time (23.4 vs 71.4 hours; P < .001). The GPP identified 29 potential viral infections that were undetectable by conventional stool tests. Unnecessary anti-infective therapy was avoided in 9 of 11 exclusively viral infections. Exclusively nonpathogenic parasites (n = 13) were detected by conventional stool tests, the majority of which were treated with metronidazole. There were no significant differences in clinical outcomes between groups. Conclusions In PWH, GPP implementation improved antibiotic stewardship through shorter turnaround times and detection of enteric viral pathogens.

Background:Bridging heart failure patients with mechanical ventricular assist devices (VAD) enables access to transplantation. However, VAD is associated with increased risk for anti-HLA antibodies associated with rejection of subsequent allografts.Factors determining alloantibody formation in these patients remain undefined. Methods:We performed a single-center retrospective cohort study of 164 patients undergoing heart transplantation from 2014 to 2017. Medical records including use of VAD, transfused blood products, anti-HLA antibody testing, crossmatch, and time to transplant were evaluated. Results:Patients received an average of 13.8 red blood cell and 1.9 single-donor platelet units associated with VAD. There was a 28.7% increase in the incidence of anti-HLA antibodies after VAD. Development of anti-HLA antibodies did not correlate with volume or type of blood products, but with pre-VAD HLA sensitization status; relative risk of new alloantibodies in patients with pre-VAD antibodies was 3.5-fold higher than those without prior antibodies (P = .008). Development of new anti-HLA antibodies was associated with an increased time to transplant (169 vs 330 days, P = .013). Conclusions:Our findings indicate that the presence of anti-HLA antibodies pre-VAD was the most significant risk factor for developing additional antibodies post-VAD, suggesting that a subset of patients may be predisposed to alloantibody formation. K E Y W O R D Santibodies, heart transplant, HLA, sensitization, transfusion, ventricular assist device

Background:Prolonged alcohol abuse as a chronic disease may increase inflammation and lead to hepatic disorders. Liver fibrosis results from chronic damage to the liver in conjunction with the accumulation of ECM proteins, which is characteristic of most types of chronic liver diseases. The main cause of liver fibrosis include alcohol abuse. The pathological features of hepatic cirrhosis induced by ethanol and other factors are similar. Monocyte chemotactic protein - 1 (MCP-1) is a protein related to inflammation and fibrosis.The aim of this study was to assess of MCP-1in serum of alcohol dependent women.Methods:Study group consisted of 40 inpatients treated in Inpatients Clinic in Toruń. Mean age of females in the study group was 43+/-7 yrs, duration of alcohol dependence 8+/-6 yrs. Control group consisted of 35 healthy women. Monocyte chemotactic protein - 1 (MCP-1) in the serum was determined by ELISA, serum AST and ALT on automatic analyzer.Results:Average serum AST was 32,88+/-32,95, ALT 29,76+/-24,48 (U/l). The concentration of MCP-1 was significantly higher in alcohol-dependent female group compared to healthy subjects (360,34ng/ml +/-273,95 vs 240,27ng/ml+/-178,31; p=0,030).Conclusions:These results imply that prolonged alcohol abuse leads to increased concentrations of MCP-1 and may in consequence have impact on the pro-inflammatory state related to increased risk of liver fibrosis. Our results suggests that prolonged alcohol abuseas as chronic disease can be a factor of inflammation and lead to hepatic disorders.

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Rapid and widespread implementation of infectious disease surveillance is a critical component in the response to novel health threats. Molecular assays are the preferred method to detect a broad range of viral pathogens with high sensitivity and specificity. The implementation of molecular assay testing in a rapidly evolving public health emergency, such as the ongoing COVID-19 pandemic, can be hindered by resource availability or technical constraints. We present a screening strategy that is easily scaled up to support a sustained large volume of testing over long periods of time. This non-adaptive pooled-sample screening protocol employs Bayesian inference to yield a reportable outcome for each individual sample in a single testing step (no confirmation of positive results required). The proposed method is validated using clinical specimens tested using a real-time reverse transcription polymerase chain reaction test for SARS-CoV-2. This screening protocol has substantial advantages for its implementation, including higher sample throughput, faster time to results, no need to retrieve previously screened samples from storage to undergo retesting, and excellent performance of the algorithm's sensitivity and specificity compared with the individual test's metrics.