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Invasive fungal infections are a serious complication for haematology patients. However, there is no study on this subject in Reunion Island. The aim of this study was to estimate the incidence of invasive fungal infections in patients with haematological malignancies at the University Hospital of Reunion Island. We conducted a descriptive and ambispective study. We included any patient with haematological malignancy presenting with a putative, possible, probable, or proven invasive fungal infection, defined as per the criteria of the European Organisation for Research and Treatment of Cancer/Mycoses Study Group 2019, from January 2018 to December 2022. Data were collected from medical records and identified by ICD-10 coding and laboratory data. Eighty-nine invasive fungal infections were diagnosed in 76 patients. The 5-year incidence rate of invasive fungal infections was 1.7 per 100 person-years (95% Confidence Interval (CI) 1.3–2). Invasive aspergillosis was the most common infection (35/89, 39%), followed by invasive candidiasis (33/89, 37%), mucormycosis (7/89, 8%), and pneumocystosis (7/89, 8%). Most infections occurred in patients with acute myeloid leukaemia (32/89, 36%) and lymphoma (26/89, 29%). Six-month mortality was higher for mucormycosis (71%) than for aspergillosis (34%) and invasive candidiasis (33%). The incidence and distribution of fungal infections in haematology patients were similar to European cohorts, albeit with more mucormycosis, less pneumocystis, and a high proportion of Candida parapsilosis in candidemia. [ABSTRACT FROM AUTHOR]

The goal of this study is to evaluate the filtration efficiency and breathability of improvised filtration and commonly available mask materials, as well as to assess their reusability. Materials readily available to the general public such as cotton, fragrance and additive-free dry baby cleaning wipes, and those abundantly available in the hospital setting, such as sterilization wraps, were chosen for testing, amongst others. In the COVID-important 2–5 µm particle range, two-layers of cotton provided filtration efficiency between 34%–66%. Amongst potential filter materials, 300-weight sterilization wraps provided approximately 80% filtration efficiency and are readily available in the healthcare setting. The addition of sterilization wrap to cotton fabrics brought the filtration efficiency to above that of the sterilization wrap (80%–90%) at the expense of added pressure drop. Four-layers of dry baby wipes performed very well with a filtration efficiency of 85% and a reasonable pressure drop (1/3 of procedure mask). Since the material is advertised as pure spunlace polypropylene and designed to contact the skin during cleaning, it would appear generally safe as a filter insert. Of improvised filters, polypropylene electrostatic HVAC filters performed the best with filtration efficiencies of >99%, but are not recommended due to the risk of confusion with glass-based HVAC filters and uncertainty regarding trace materials used in the filter. The filtration efficiency of two-layers of cotton fabrics with one-layer of sterilization wrap slightly improved over 10 laundry cycles, while the performance of other non-wovens, like dry baby wipes, degraded more rapidly and should be considered disposable. In summary, we found that two-layers of cotton fabric can provide a comfortable, breathable and reusable option. The addition of a sterilization wrap or four-layers of pure spunlace fragrance free dry baby wipes can significantly improve filtration and block expiratory aerosols at the expense of an added pressure drop. Copyright © 2021 American Association for Aerosol Research [ABSTRACT FROM AUTHOR]

Background. The objective of this study was to determine whether female surgical residents underestimate their surgical abilities relative to males on a standardized test of laparoscopic skill. Methods. Twenty-six male and female general surgery residents and 25 female obstetrics and gynecology residents at two academic centers were asked to predict their score prior to undergoing the Fundamentals of Laparoscopic Surgery standardized skills exam. Actual and predicted score as well as delta values (predicted score minus actual score) were compared between residents. Multivariate linear regression was used to determine variables associated with predicted score, actual score, and delta scores. Results. There was no difference in actual score based on residency or gender. Predicted scores, however, were significantly lower in female versus male general surgery residents (25.8 ± 13.3 versus 56.0 ± 16.0; p<0.01) and in female obstetrics and gynecology residents versus male general surgery residents (mean difference 20.9, 95% CI 11.6–34.8; p<0.01). Male residents more accurately predicted their scores while female residents significantly underestimated their scores. Conclusion. Gender differences in estimating surgical ability exist that do not reflect actual differences in performance. This finding needs to be considered when structuring mentorship in surgical training programs. [ABSTRACT FROM AUTHOR]

Prostatic neuroanatomy is difficult to visualize intraoperatively and can be extremely variable. Damage to these nerves during prostatectomies may lead to postoperative complications such as erectile dysfunction and incontinence. This review aims to discuss the prostatic neuroanatomy, sites of potential nerve damage during a prostatectomy, and nerve-mapping technologies being developed to prevent neural injury. These technologies include stimulation, dyes, and direct visualization. Nerve stimulation works by testing an area and observing a physiologic response but is limited by the long half-life for an erectile response; examples include CaverMap, ProPep, and optical nerve stimulation. Few nerve dyes have been approved by the Food and Drug Administration (FDA) because of the extensive testing required; examples of nerve dyes include compounds from Avelas and General Electric, fluorescent cholera toxin subunit B, indocyanine green, fluorescent inactivated herpes simplex 2, and Fluoro-Gold. Direct visualization techniques have a simpler FDA approval process; examples include optical coherence tomography, multiphoton microscopy, ultrasound, coherent anti-Stokes Raman scattering. Many researchers are developing several novel technologies that can be categorized as stimulation based, dye-based, or direct visualization. As of yet, none has shown clear evidence to improve surgical outcomes and consequently lack wide adoption. Further development of these technologies may lead to improved complication rates after prostatectomies. Clinically, some technologies have demonstrated utility in predicting the development of complications. By using that information, more aggressive rehabilitation programs may lead to improved long-term function. These technologies can also be applied for research to improve our knowledge of the neuroanatomy and physiology of erection and incontinence. [ABSTRACT FROM AUTHOR]

We report a case of a 51-year old man with a severe aplastic anemia who developed an invasive trichosporonosis to Trichosporon faecale with fungemia and skin lesions during severe neutropenia. The treatment was successful before neutrophil recovery with a combination of voriconazole and liposomal amphotericin B. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusions Trial Registration Hypereosinophilic syndromes (HES) are a heterogenous group of eosinophilic disorders. To date, only retrospective studies of limited sample‐size and/or follow‐up duration are available.The COHESion study is a national prospective multicenter multidisciplinary cohort recruiting both adults or children with the spectrum of eosinophilic disorders (including reactive HE/HES [HE/HES‐R], idiopathic HES [HES‐I], lymphocytic HES [HES‐L], neoplastic HE/HES [HE/HES‐N], HE of unknown significance [HE‐US], as well as IgG4‐related disease [IgG4RD] or ANCA‐negative eosinophilic granulomatosis with polyangiitis [EGPA] overlaps). Patients are followed‐up yearly. All data about final diagnosis, organ involvement assessments, and outcome profiles in HES‐I were captured and analyzed centrally by HES expert centers.From May 2019 to November 2023, 779 patients were included. For this preliminary analysis, 550 cases were available for centralized review (mean ± SD age: 56 ± 18 years, 42% of female patients). The final diagnoses were HES‐I (47%), HE/HES‐R (16%), HE‐US (15%), HE/HES‐N (7%), HE/HES‐L (6%), IgG4RD (2%), and ANCA‐negative EGPA (7%). In the 258 HES‐I patients, outcome profiles were classified as follows: 16.3% had a “single‐flare” without further relapse, 28.3% had a “relapsing–remitting” disease when there was at least a 6‐month period free of symptoms between two flares, 46.1% had a “persistent disease” requiring continuous treatment to avoid relapses (9.3% remained unclassified because of insufficient follow‐up).The COHESion cohort is the first nationwide prospective multicenter study collecting data on the full spectrum of HE/HES disorders. This preliminary analysis confirms that idiopathic HES patients have various outcome profiles, suggesting different underlying pathophysiological mechanisms and the need of patient‐specific management.ClinicalTrials.gov identifier: NCT 04018118 [ABSTRACT FROM AUTHOR]