The 2022-23 influenza season shows an early rise in pediatric influenza-associated hospitalizations (1). SARS-CoV-2 viruses also continue to circulate (2). The current influenza season is the first with substantial co-circulation of influenza viruses and SARS-CoV-2 (3). Although both seasonal influenza viruses and SARS-CoV-2 can contribute to substantial pediatric morbidity (3-5), whether coinfection increases disease severity compared with that associated with infection with one virus alone is unknown. This report describes characteristics and prevalence of laboratory-confirmed influenza virus and SARS-CoV-2 coinfections among patients aged <18 years who had been hospitalized or died with influenza as reported to three CDC surveillance platforms during the 2021-22 influenza season. Data from two Respiratory Virus Hospitalizations Surveillance Network (RESP-NET) platforms (October 1, 2021-April 30, 2022), § and notifiable pediatric deaths associated ¶ with influenza virus and SARS-CoV-2 coinfection (October 3, 2021-October 1, 2022)** were analyzed. SARS-CoV-2 coinfections occurred in 6% (32 of 575) of pediatric influenza-associated hospitalizations and in 16% (seven of 44) of pediatric influenza-associated deaths. Compared with patients without coinfection, a higher proportion of those hospitalized with coinfection received invasive mechanical ventilation (4% versus 13%; p = 0.03) and bilevel positive airway pressure or continuous positive airway pressure (BiPAP/ CPAP) (6% versus 16%; p = 0.05). Among seven coinfected patients who died, none had completed influenza vaccination, and only one received influenza antivirals. † † To help prevent severe outcomes, clinicians should follow recommended respiratory virus testing algorithms to guide treatment decisions * These authors contributed equally to this report.† These senior authors contributed equally to this report. § Data from FluSurv-NET beyond April 30, 2022, did not include variables required to determine influenza and SARS-CoV-2 coinfection status. ¶ https://www.cdc.gov/flu/weekly/overview.htm#PediatricMortality ** The 2021-22 influenza season was defined as MMWR week 40 of 2021 through MMWR week 39 of 2022 (October 3, 2021-October 1, 2022). https://ndc.services.cdc.gov/wp-content/uploads/MMWR_Week_overview.pdf † † Receipt of COVID-19 treatment was not collected on patients in this report.
An intramolecular Rauhut-Currier reaction utilizing alkynoates as the initial conjugate acceptor affords densely functionalized 5- and 6-membered rings from ynoate-enoate, ynoate-enenitrile, and alkynyl sulfone-enenitrile substrates. Trialkylphosphines catalyze the reaction, and TMSCN serves as a pronucelophile to effect turnover of the catalyst and the formation of a second C-C bond. Because of the highly electrophilic alkyne acceptor, this reaction yields products that cannot be easily accessed from the traditional Rauhut-Currier reaction.
Purpose:
To investigate the relationship between measured anterior (ACA) and posterior (PCA) keratometric astigmatism and postoperative refractive astigmatism (RA) and to quantify noncorneal astigmatism (NCA) contributions to RA.
Setting:
Penn State College of Medicine, Hershey, Pennsylvania, USA.
Design:
Retrospective consecutive case series.
Methods:
Consecutive eyes underwent preoperative biometry (IOLMaster 700) and tomography/topography using a dual Scheimpflug–placido disk–based device (Galilei G4), cataract surgery with implantation of a monofocal intraocular lens (IOL), and postoperative manifest refractions. RA was compared with keratometric astigmatism using the following methods: IOLMaster, SimK, CorT, SimK + measured PCA, total corneal power at the corneal plane (TCP2), and CorT(Total). An ocular residual astigmatism (ORA) vector was calculated between RA and each measured astigmatism.
Results:
Analysis was based on 296 eyes. ORA centroids were 0.28 @ 179, 0.45 @ 001, 0.37 @ 001, 0.19 @ 003, 0.19 @ 001, and 0.23 @ 178 diopter (D) for the 6 aforementioned methods, respectively (P < .000001 [ORAx, ORAy]). Based on TCP2 measurements, eyes with against-the-rule ACA and with-the-rule (WTR) ACA had ORA centroids of 0.09 @ 082 and 0.58 @ 001 D (P < .000001 [ORAx, ORAy]), respectively. ORA was nonzero and not entirely explained by the cornea, especially in those with WTR ACA.
Conclusions:
Total keratometric astigmatism did not explain all ocular astigmatism. Noncorneal contributions were significant, especially in eyes with WTR ACA.
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