Risk Of Infection Research Articles

Antipyretic and Anti-inflammatory Effects of Sanchen Pediatric Antipyretic Paste

Objective:: This study aimed to investigate the antipyretic and anti-inflammatory effects and mechanisms of Sanchen Pediatric antipyretic Paste (SPAP). Methods:: Rats were randomly divided into 7 groups: negative control group, positive control group, positive treatment group, SPAP high-dose, medium-dose and low-dose groups, and blank substrate group. Except normal control group, rats in other groups were subcutaneously injected with 10% dry yeast suspension (10mL/kg) on the back to establish a fever model, and the normal group was given the same volume of saline. At the 4 h and 7 h after modeling, each treatment group was subjected to corresponding SPAP intervention. Anal temperature was measured every one hour after modeling for 10 consecutive times. The average temperature-rise curve, maximum temperature and body temperature response index (TRI) were calculated to evaluate the efficacy of SPAP. After the last temperature measurement, abdominal aortic blood was collected, and serum was separated from blood. The levels of IL-6, TNF-α and CRP in serum were determined by enzyme-linked immunosorbent assay. Results:: The body temperature of the positive control group was significantly increased (p < 0.01) 4 hours after model establishment, and that of the SPAP groups significantly decreased (p < 0.01) after 5 hours of the model establishment. The levels of Serum IL-6, TNF-α and CRP were significantly decreased (p < 0.01) in a dose-dependent manner. Conclusion:: SPAP has an obvious antipyretic effect on fever caused by dry yeast in rats. One of its antipyretic mechanisms may be associated with inhibiting inflammatory reactions by reducing the production or accelerating the degradation of endogenous thermogenic cytokines, such as IL-6, TNF- α, and CRP.

Cellular immunity against cytomegalovirus and risk of infection after kidney transplantation

Cellular immunity against cytomegalovirus and risk of infection after kidney transplantation

A robust and biodegradable hydroxyapatite/poly(lactide-co-ε-caprolactone) electrospun membrane for dura repair.

Typically occurring after trauma or neurosurgery treatments, dura mater defect and the ensuing cerebrospinal fluid (CSF) leakage could lead to a number of serious complications and even patient's death. Although numerous natural and synthetic dura mater substitutes have been reported, none of them have been able to fulfill the essential properties, such as anti-adhesion, leakage blockage, and pro-dura rebuilding. In this study, we devised and prepared a series of robust and biodegradable hydroxyapatite/poly(lactide-co-ε-caprolactone) (nHA/PLCL) membranes for dura repair via an electrospinning technique. In particular, PLLA/PCL (80/20) was selected for electrospinning due to its mechanical properties that most closely resembled natural dural tissue. Studies by SEM, XRD, water contact angle and in vitro degradation showed that the introduction of nHA would destroy PLCL's crystalline structure, which would further affect the mechanical properties of the nHA/PLCL membranes. When the amount of nHA added increased, so did the wettability and in vitro degradation rate, which accelerated the release of nHA. In addition, the high biocompatibility of nHA/PLCL membranes was demonstrated by in vitro cytotoxicity data. The in vivo rabbit dura repair model results showed that nHA/PLCL membranes provided a strong physical barrier to stop tissue adhesion at dura defects. Meanwhile, the nHA/PLCL and commercial group's CSF had a significantly lower number of inflammatory cells than the control groups, validating the nHA/PLCL's ability to effectively lower the risk of intracranial infection. Findings from H&E and Masson-trichrome staining verified that the nHA/PLCL electrospun membrane was more favorable for fostering dural defect repair and skull regeneration. Moreover, the relative molecular weight of PLCL declined dramatically after 3 months of implantation, according to the results of the in vivo degradation test, but it retained the fiber network structure and promoted tissue growth, demonstrating the good stability of the nHA/PLCL membranes. Collectively, the nHA/PLCL electrospun membrane presents itself as a viable option for dura repair.

Semaglutide outperforms insulin in restoring neutrophil function against implant-related infection in diabetic and obese mice: experimental research.

Bone and joint infections (BJI) are a significant complication after arthroplasty and fracture fixation, particularly challenging in patients with type 2 diabetes mellitus (T2DM) and obesity. Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), have shown efficacy in managing T2DM and obesity. However, its impact on BJI risk and neutrophil function remains unclear. To investigate whether preoperative semaglutide treatment (1) reduces the risk of BJI in diabetic and obese mice undergoing intra-articular implants, and (2) outperforms insulin in restoring neutrophil function to mitigate implant-related infection. A C57BL/6 mouse model of T2DM/obesity was induced using a high-fat diet (HFD) for 12 weeks. Mice received preoperative insulin or semaglutide therapy for 1-28 days. BJI risk was assessed using an intraarticular-implant model challenged with S. aureus or E. coli. Neutrophil function was evaluated through bactericidal activity, superoxide production, and migration ability. Semaglutide treatment led to a significant and sustained reduction in body weight and improved glucose tolerance in HFD mice. Both insulin and semaglutide therapies significantly reduced BJI risk, with semaglutide showing a more pronounced effect over time. Semaglutide therapy also enhanced neutrophil bactericidal activity, superoxide production, and migration ability compared to insulin therapy. Preoperative semaglutide treatment effectively reduces BJI risk and improves neutrophil function in diabetic and obese mouse models. These findings suggest that semaglutide may be a promising pharmacological intervention to mitigate infection risk in orthopedic patients with T2DM or obesity.

Cryptococcosis associated with biologic therapy – a narrative review

Abstract Cryptococcus is an opportunistic fungal pathogen that can cause disseminated infection with predominant central nervous system involvement in patients with compromised immunity. Biologics are increasingly used in the treatment of neoplasms and autoimmune/inflammatory conditions and prevention of transplant rejection, which may affect human defence mechanisms against cryptococcosis. In this review, we comprehensively investigated the association between cryptococcosis and various biologics, highlighting their risks of infection, clinical manifestations, and clinical outcomes. Clinicians should remain vigilant for the risk of cryptococcosis in patients receiving biologics that affects the Th1/macrophage activation pathways, such as tumour necrosis factor-α (TNF- α) antagonists, Bruton tyrosine kinase (BTK) inhibitors, fingolimod, JAK/STAT inhibitors, and monoclonal antibody against CD52. Other risk factors, such as age, underlying condition, and concurrent immunosuppressants especially corticosteroids, should also be taken into account during risk stratification.

Emotional Regulation, Adult Attachment Orientations, and Risk of COVID-19 Infection: Virtual Reality Simulation

Emotional Regulation, Adult Attachment Orientations, and Risk of COVID-19 Infection: Virtual Reality Simulation

Alcohol-Associated liver disease: Emerging therapeutic strategies.

The large and growing burden of alcohol-related liver disease (ALD) - and the considerable burden of morbidity and mortality associated with it - has been a drive towards ongoing research into novel strategies for its treatment, with a particular focus upon alcohol-related hepatitis (AH). Management of alcohol-use disorder (AUD) forms the central pillar of ALD care, with evidence-based psychological and pharmacological approaches being well-established, and certain models demonstrating improved clinical outcomes when hepatology and addiction services are co-located. Corticosteroids have previously been used somewhat indiscriminately in patients with severe AH, but effective tools now exist to assess early response (and limit futile ongoing exposure). Techniques to predict risk of corticosteroid-related infection are also available, although current clinical strategies to mitigate this risk are limited. A variety of novel therapeutic approaches to AH are at different phases of trials and evidence-gathering, with some of the most promising signals related to cytokine manipulation, epigenetic modulation, and targeting of the gut microbiota (i.e. via faecal microbiota transplant). While remaining an ongoing source of debate, early liver transplant in severe AH has grown in interest and acceptability over the past decade as evidence supporting its efficacy builds, in the process challenging paradigms about mandatory pre-transplant sobriety periods. However, uncertainty remains regarding the optimal selection criteria, and whether liver transplant has a role for only a highly-limited proportion of AH patients or more widespread application. This review aims to provide an overview of this fast-moving field.

Fungal-associated pneumonia in patients with hematological malignancies

PurposePatients with hematologic malignancies (HM) are at high risk of invasive lung fungal infections (ILFI). To describe the main characteristics, treatment, and outcomes for five years in adult patients with HM and fungal pneumonia. MethodsWe conducted a retrospective study at Instituto Nacional de Cancerología (INCan), a referral tertiary care oncology hospital with 135 beds in Mexico City, Mexico. We included all cases of fungal pneumonia in patients with HM from January 1, 2017, to December 31, 2022. Cases were classified as proven, probable, and possible according to EORTC/MSG criteria 2021. ResultsTwo hundred ten patients were included; the mean age was 40 years. The most frequent HM was acute lymphoblastic leukemia (n = 74) and acute myeloid leukemia (n = 68). One hundred forty patients (66.7%) had severe neutropenia for a median of 16 days. All patients had a CT thorax scan; in 132 (62.9%), multiple nodules were documented. Serum galactomannan (GM) was positive in 21/192 (10.9%) and bronchoalveolar lavage in 9/36 (25%). Fifty-three patients (25.2%) died in the first month. In the multivariate analysis for mortality in the first 30 days, hypoalbuminemia, shock, possible ILFI, and inappropriate antifungal treatment were statistically associated. ConclusionsIn high-risk HM patients, CT thorax scan and GM help diagnose ILFI. An appropriate antifungal improves mortality.

Real-World Effectiveness and Safety of Tixagevimab-Cilgavimab: A Target Trial Emulation Study.

Immunocompromised individuals are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and subsequent severe or fatal coronavirus disease 2019 (COVID-19), yet they have suboptimal responses to mRNA and inactivated COVID-19 vaccines. The efficacy of tixagevimab-cilgavimab in reducing symptomatic SARS-CoV-2 infection was demonstrated in phase III clinical trials. Nevertheless, real-world data on the effectiveness and safety of tixagevimab-cilgavimab remain limited. The aim was to evaluate the effectiveness and safety of tixagevimab-cilgavimab among immunocompromised individuals. Adults who were immunocompromised or receiving immunosuppressive therapies were included in this target trial emulation using territory-wide electronic health records in Hong Kong. A sequential trial emulation approach was adopted to compare effectiveness and safety outcomes between individuals who received tixagevimab-cilgavimab and individuals who did not. A total of 746 tixagevimab-cilgavimab recipients and 2980 controls were included from 1 May 2022 to 30 November 2022. Tixagevimab-cilgavimab significantly reduced the risk of COVID-19 infection (hazard ratio [HR] 0.708, 95% confidence interval [CI] 0.527-0.951) during a median follow-up of 60 days. No significant difference was observed in the risk of COVID-19-related hospitalisation. Zero versus eight COVID-19 mortality cases and zero versus two severe COVID-19 cases were observed in tixagevimab-cilgavimab recipients and controls, respectively. Notably, significant risk reduction in COVID-19 infection was also observed among immunocompromised individuals who had been previously vaccinated with three or more doses of COVID-19 vaccine, or had no prior COVID-19 infection history. Tixagevimab-cilgavimab was effective in reducing COVID-19 infection among immunocompromised patients during the Omicron wave. Findings were consistent among individuals who previously received three or more doses of COVID-19 vaccine, or had no previous history of COVID-19 infection.

Pathogenesis and clinical features of severe hepatitis E virus infection

The hepatitis E virus (HEV), a member of the Hepeviridae family, is a small, non-enveloped icosahedral virus divided into eight distinct genotypes (HEV-1 to HEV-8). Only genotypes 1 to 4 are known to cause diseases in humans. Genotypes 1 and 2 commonly spread via fecal-oral transmission, often through the consumption of contaminated water. Genotypes 3 and 4 are known to infect pigs, deer, and wild boars, often transferring to humans through inadequately cooked meat. Acute hepatitis caused by HEV in healthy individuals is mostly asymptomatic or associated with minor symptoms, such as jaundice. However, in immunosuppressed individuals, the disease can progress to chronic hepatitis and even escalate to cirrhosis. For pregnant women, an HEV infection can cause fulminant liver failure, with a potential mortality rate of 25%. Mortality rates also rise amongst cirrhotic patients when they contract an acute HEV infection, which can even trigger acute-on-chronic liver failure if layered onto pre-existing chronic liver disease. As the prevalence of HEV infection continues to rise worldwide, highlighting the particular risks associated with severe HEV infection is of major medical interest. This text offers a brief summary of the characteristics of hepatitis developed by patient groups at an elevated risk of severe HEV infection.

Optimizing information-driven awareness allocation for controlling activity-triggered epidemic spread

Abstract In the contemporary era, the advent of epidemics instigates a substantial upswing in relevant information dissemination, bolstering individuals’ resistance to infection by concurrently reducing activity contacts and reinforcing personal protective measures. To elucidate this intricate dynamics, we introduce a composite four-layer network model designed to capture the interplay among information-driven awareness, human activity, and epidemic spread, with a focus on the allocation of individuals’ limited attention in diminishing activity frequency and self-infection rates. One intriguing observation from our findings is an anomalous, concave non-monotonic relationship between awareness trade-off and epidemic spread, with a more pronounced prevalence at an intermediate least awareness efficacy. This underscores the inadvisability of relaxing self-protection through reduced activity frequency or compensating for increased activity frequency by enhancing self-protection. Especially noteworthy is the significance of enhancing self-protection in response to heightened information dissemination and inherent activity demands to curtail infection risk. However, in scenarios with increasing ancillary activity frequency, the emphasis should exclusively shift towards reducing activity exposure. The model establishes a theoretical threshold for accurately predicting awareness efficacy in epidemic outbreaks. Optimal awareness allocation consistently resides at the extremes - either completely avoiding unnecessary activity contact or adopting full self-protection. This guidance, contingent on information level and activity demand, offers valuable insights into the delicate balance between individual behaviors and epidemic prevention.

Sexually transmitted infections and the vaginal microbiome after vaginoplasty.

Transgender and gender-diverse individuals (TGD) are at risk for sexually transmitted infections. Gender affirmation surgery is a cornerstone of care for many TGD individuals. For genital gender affirmation, the surgical creation of a vagina may be performed through a number of techniques. Those who have undergone vaginoplasty have unique anatomical and biopsychosocial considerations, which we discuss. While sexually-transmitted infections including HPV, HSV, HIV, gonorrhea, and chlamydia, have been described in TGD individuals after vaginoplasty, the reports are very rare, and the provider should maintain an index of suspicion and maintain a broad differential for symptoms including neovaginal discharge. We discuss the association of the neovaginal microbiota composition with bacterial vaginosis, and how its modulation could potentially reduce bacterial vaginosis and sexually transmitted infection risk. We examine the literature regarding sexually-transmitted infections following vaginoplasty, and the neovaginal microbiome and its similarities and differences relative to the natal vaginal microbiome.

Quantifying quanta: Determining emission rates from clinical data

It is important to quantify uncertainty in the viable genomic material encapsulated in the respiratory particles emitted by infected people so that it can be converted into an emission rate as a function of respiratory and metabolic activities and used to estimate the probability of infection for an indoor scenario. Clinical measurements of viral loads for SARS-CoV-2 made using infection surveys, Gesundheit-II samplers, and human challenge studies are evaluated and a mathematical model is derived to estimate the quantum emission rate as a function of the genomic and viable viral loads. Modelled emission rates for SARS-CoV-2 agree with clinical data above detection limits. The viral load is found to vary over at least 6 orders of magnitude because it is person and time dependent, and contingent on many other factors that are difficult to quantify. It is similarly large for other respiratory pathogens. Therefore, the genomic and viable-virion emission rates display similar heterogeneity. When emission rates are used to estimate absolute infection risk using the Wells-Riley model, the predictions are so uncertain that they cannot be used in any meaningful way to provide useful quantitative guidance for designing indoor spaces.

Effectiveness and safety of primary prophylaxis with G-CSF during chemotherapy for invasive breast cancer: a systematic review and meta-analysis from Clinical Practice Guidelines for the Use of G-CSF 2022.

Chemotherapy for breast cancer can cause neutropenia, increasing the risk of febrile neutropenia (FN) and serious infections. The use of granulocyte colony-stimulating factors (G-CSF) as primary prophylaxis has been explored to mitigate these risks. To evaluate the efficacy and safety of primary G-CSF prophylaxis in patients with invasive breast cancer undergoing chemotherapy. A systematic literature review was conducted according to the "Minds Handbook for Clinical Practice Guideline Development" using PubMed, Ichushi-Web, and the Cochrane Library databases. Randomized controlled trials (RCTs) and cohort studies assessing using G-CSF as primary prophylaxis in invasive breast cancer were included. The primary outcomes were overall survival (OS) and FN incidence. Meta-analyses were performed for outcomes with sufficient data. Eight RCTs were included in the qualitative analysis, and five RCTs were meta-analyzed for FN incidence. The meta-analysis showed a significant reduction in FN incidence with primary G-CSF prophylaxis (risk difference [RD] = 0.22, 95% CI: 0.01-0.43, p = 0.04). Evidence for improvement in OS with G-CSF was inconclusive. Four RCTs suggested a tendency for increased pain with G-CSF, but statistical significance was not reported. Primary prophylactic use of G-CSF is strongly recommended for breast cancer patients undergoing chemotherapy, as it has been shown to reduce the incidence of FN. While the impact on OS is unclear, the benefits of reducing FN are considered to outweigh the potential harm of increased pain.

A Multicenter, Retrospective Outcome Analysis of Vancomycin Area Under the Curve versus Trough-Based Dosing Strategies in Patients with Burn OR Inhalational Injuries (MONITOR).

Vancomycin is a glycopeptide antibiotic that requires close therapeutic monitoring. Prolonged exposure to elevated concentrations increases risk for serious adverse effects such as nephrotoxicity. However, sub-therapeutic concentrations may lead to bacterial resistance and clinical failure or death. The most recent Infectious Diseases Society of America (IDSA) publication regarding therapeutic monitoring of vancomycin recommends utilizing area under the curve (AUC)-based monitoring to maximize clinical success. Despite the guideline recommendation for AUC-guided dosing, many institutions still use trough-only monitoring in their practices, including those caring for patients with acute burn injuries. Following burn injury, patients are at a higher risk for infections, multi-organ failure, and pharmacokinetic alterations. The primary objective of this multi-center retrospective study is to determine optimal therapeutic monitoring of vancomycin by comparing clinical success between AUC vs. trough-based monitoring in burn patients. MONITOR was a multicenter, retrospective study of patients with thermal or inhalation injury admitted to one of 13 burn centers from 1/1/17 to 8/31/22 who received vancomycin. Demographic and clinical course data, including acute kidney injury (AKI) incidence and clinical success were obtained. Patients were evaluated for clinical success and grouped according to method of monitoring and adjusting doses: AUC vs. trough-based monitoring. Clinical success was a composite definition and lack of meeting any 1 of 5 criteria: 1) persistent infection, 2) relapse, 3) antibiotic failure (clinical worsening), 4) AKI, 5) death. Five-hundred seventeen vancomycin courses were assessed from 485 patients. There was no difference in the rate of clinical success between AUC monitored and the trough-only monitored groups. Incidence of AKI was higher in the trough-only group; however, was not statistically significant after controlling for renal function on admission, past medical history of chronic kidney disease (CKD), and concomitant nephrotoxins.

Seroprevalence of SARS-CoV-2 and humoral immune responses to COVID-19 mRNA vaccines among people who use drugs - in the light of tailored mitigating strategies

BackgroundDuring the initial wave of the COVID-19 pandemic, there was a surprisingly low incidence of SARS-CoV-2 among People Who Use Drugs (PWUD) in Oslo, Norway, despite their heightened vulnerability regarding risk of infection and severe courses of the disease.This study aims to investigate the seroprevalence of SARS-CoV-2 antibodies among PWUD, their antibody responses to relevant virus infections and COVID-19 mRNA vaccines, and their vaccination coverage compared to the general population.MethodsConducted as a prospective cohort study, data was collected from residents in six institutions for homeless PWUD and users of a low-threshold clinic for opioid agonist treatment. Ninety-seven participants were recruited for SARS-CoV-2 seroprevalence analysis. Additional two participants with known positive SARS-CoV-2 test results were recruited for further analyses. Twenty-five participants completed follow-up. Data included questionnaires, nasal swabs and blood samples. Data on vaccination coverage was obtained from the National Vaccine Register. Serologic methods included detection of antibodies to relevant virus proteins, neutralizing antibodies to SARS-CoV-2, antibodies to the full-length spike protein, and receptor-binding domain from SARS-CoV-2.ResultsAmong PWUD, antibodies to SARS-CoV-2 were detected in 2 out of 97 samples before vaccines against SARS-CoV-2 were available, comparable to a 2.8% frequency in population-based screening. Levels of serum antibodies to seasonal coronaviruses and Epstein-Barr-Virus (EBV) in PWUD were similar to population-based levels. After the second vaccine dose, binding and neutralizing antibody levels to SARS-CoV-2 in PWUD were comparable to controls. Eighty-four of PWUD received at least one dose of COVID-19 mRNA vaccine, compared to 89% in the general population.ConclusionResults indicate that PWUD did not exhibit increased SARS-CoV-2 seroprevalence or elevated serum antibodies to seasonal coronaviruses and EBV. Moreover, vaccine responses in PWUD were comparable to controls, suggesting that vaccination is effective in conferring protection against SARS-CoV-2 also in this population.

The prevention of infectious complications of caesarean section in the context of the global rise of antibiotic resistance

In the context of the global rise of antibiotic resistance, optimising the prevention of infectious complications of caesarean section (CS) with a reassessment of the guidelines for ultra-short antibiotic (AB) regimens is becoming increasingly important. Given the current data on the negative consequences of the use of AB in pregnant women for the fetal microbiota, the role of antiseptics that are used locally, do not pass to the child, and are less likely to cause resistance, have a wider range of antimicrobial activity is increasing.The objective: to provide clinical evidence for the prevention of infectious complications of CS by topical application of an antiseptic with decamethoxin.Materials and methods. A comparative study of two homogeneous groups of women with low infectious risk delivered by elective CS was conducted. In the 1st group (55 women) an antiseptic with decamethoxin was used at all stages of abdominal delivery: preoperative treatment of the skin and vagina, intraoperative irrigation of the inner surface of the uterus, uterine sutures, and subcutaneous tissue. The 2nd group (55 patients) received conventional antibacterial prophylaxis. In the course of clinical and microbiological parallels, ultrasound monitoring of uterine involution, the results of the examination on the 42nd day after CS and information on the condition of the newborn child were used.Results. The absence of infectious complications of puerperium, infection of the surgical site, trends and signs of inflammatory reactions in both groups was revealed.In the 2nd group 5.5% of patients had partial skin suture separation due to seroma formation and transient infiltration of the subcutaneous tissue. The absence of such phenomena in the 1st group should be considered a consequence of the cytoprotective effect of decametoxin. The use of an antiseptic with decametoxin has pharmacoeconomic advantages over antibiotic prophylaxis regimens.Conclusions. The use of antiseptic with decametoxin in the perioperative care of caesarean section combines the possibility of safe reduction of antibiotics, effective antiinfective protection with guaranteed safety for the child.

PEMANFAATAN SOFTWARE IMITOMEASURE UNTUK PENGUKURAN LUAS DAN KELILING PERMUKAAN LUKA AKUT STADIUM II PADA HEWAN UJI MENCIT (Mus musculus)

Wound is the loss of tissue caused by trauma due to wounds exposed to cuts, collisions, or chemicals, wounds can cause a person to lose productivity during the wound healing process,in addition to good wound care methods to accelerate the wound healing process, it is necessary to have a reliable wound healing monitoring method and not be an additional risk of infection in the wound, imitomeasure software based on the android system can be a safe wound measurement solution and does not provide additional risk of infection in the wound. In the test results by comparing the use of software, verniers and rulers, the results were not significantly different (P>0.05) in the independent sample T test so it can be concluded that the use of imitomeasure software is quite accurate when compared to conventional measurementmethods, besides that this software is very easy and can run on any android and ios-based smartphone so that it can be used by all health personnel.

Variation in immunoglobulin use and impact on survival in myeloma

AbstractSerious infection is common in patients with multiple myeloma due to immune deficiency from the underlying disease and/or its treatment. Immunoglobulin replacement is one approach to reduce infection risk in these patients. However, few real‐world data exist on its use in patients with myeloma. We investigated immunoglobulin use in Australia, New Zealand and Asia‐Pacific using registry data and explored its association with survival outcomes. A total of 2374 patients with a median follow‐up time of 29.5 months (interquartile range 13.3–54.3 months) were included in the analysis – 1673 from Australia, 313 Korea, 281 New Zealand and 107 Singapore. Overall, 7.1% of participants received immunoglobulin replacement within 24 months of diagnosis. Patients who received immunoglobulin replacement were likely to be younger, had lower baseline IgG levels (excluding paraprotein), were more likely to have baseline hypogammaglobulinaemia, baseline severe hypogammaglobulinaemia and abnormal baseline fluorescent in‐situ hybridisation status, receive first‐line myeloma treatment with immunomodulatory drugs or anti‐CD38 therapy and undergo upfront autologous stem cell transplant. In our patient cohort, the use of immunoglobulin was not associated with overall survival benefit at the time of last follow‐up (adjusted hazard ratio 0.72, 95% CI 0.46–1.14, p = 0.16). Understanding treatment approaches in clinical practice can help support future planning and provision of immunoglobulin resources.

The risk of genito-urinary infections with sodium-glucose cotransporter-2 inhibitors: duration rather than dose matter?

The risk of genito-urinary infections with sodium-glucose cotransporter-2 inhibitors: duration rather than dose matter?