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  1. Article: Drug-Induced Hidradenitis Suppurativa: A Case Report.

    Kisule, Abraham / Kak, Vivek / Alamelumangapuram, Chidamber / Robinson, Ciji

    Cureus

    2023  Volume 15, Issue 11, Page(s) e49637

    Abstract: Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory disorder of the hair follicles that localizes to the intertriginous and anogenital regions of the body. Lesions are characterized by inflammatory nodules, subcutaneous abscesses, ... ...

    Abstract Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory disorder of the hair follicles that localizes to the intertriginous and anogenital regions of the body. Lesions are characterized by inflammatory nodules, subcutaneous abscesses, fibrosis, and sinus tracts. Crohn's disease (CD) is an idiopathic chronic inflammatory bowel disease that affects any part of the gastrointestinal tract. Multiple treatment options exist for CD, including monoclonal anti-tumor necrosis factor alpha (TNF-α) antibodies like adalimumab (Humira). Adalimumab is an anti-TNF agent that has been approved by the United States Food and Drug Administration (FDA) for the treatment of HS. A 35-year-old African American male with a history of fistulizing CD presented to the hospital for evaluation of severe pain and purulent drainage from open sores in his bilateral axillary regions, groin, buttocks, and face for four days. He was on adalimumab for two years, during which time he noted the development of Hurley stage III HS. The physical exam was remarkable for a cachectic, painful-appearing male, with multiple abscesses on his lower jaw extending to his upper neck draining thick serosanguinous fluid, with similar findings in his bilateral axillary regions, bilateral groin, and perianal regions. He was treated with intravenous antibiotics consisting of a fourth-generation cephalosporin and vancomycin. While the etiology of HS in this patient is inconclusive, the timing of its development closely aligns with the initiation of Humira and is not a manifestation of CD. Paradoxical adverse effects describe a phenomenon in which a medication can induce a condition that it classically can be used to treat. In this patient's case, it was HS.
    Language English
    Publishing date 2023-11-29
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.49637
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: A cohort study for derivation and validation of a clinical prediction scale for hospital-onset Clostridium difficile infection.

    Chandra, Subhash / Latt, Nyan / Jariwala, Ujjwal / Palabindala, Venkataraman / Thapa, Rameet / Alamelumangapuram, Chidamber B / Noel, Margarita / Marur, Surendra / Jani, Niraj

    Canadian journal of gastroenterology = Journal canadien de gastroenterologie

    2012  Volume 26, Issue 12, Page(s) 885–888

    Abstract: Objective: To develop and validate a clinical prediction scale for hospital-onset Clostridium difficile infection (CDI).: Methods: A community-based, 360-bed hospital located in the suburbs of a metropolitan area in the United States served as the ... ...

    Abstract Objective: To develop and validate a clinical prediction scale for hospital-onset Clostridium difficile infection (CDI).
    Methods: A community-based, 360-bed hospital located in the suburbs of a metropolitan area in the United States served as the setting for the present retrospective cohort study. The cohort consisted of patients admitted to the adult medical service over a six-year period from October 2005 to September 2011. The cohort was divided into derivation (October 2005 to September 2009) and validation (October 2009 to September 2011) groups. The primary outcome measure was hospital-onset CDIs identified as stool positive for C difficile after 48 h of hospital admission ordered for new-onset unformed stool by the treating physician.
    Results: In the derivation phase, 35,588 patients were admitted to the medical service and 21,541 stayed in hospital beyond 48 h. A total of 266 cases of CDI were identified, 121 of which were hospital onset. The developed clinical prediction scale included the onset of unformed stool (5 points), length of hospital stay beyond seven days (4 points), age >65 years (3 points), long-term care facility residence (2 points), high-risk antibiotic use (1 point) and hypoalbuminemia (1 point). The scale had an area under the receiver operating curve (AUC) of 0.93 (95% CI 0.82 to 0.94) in predicting hospital-onset CDI, with a sensitivity of 0.94 (95% CI 0.88 to 0.97) and a specificity of 0.80 (95% CI 0.79 to 0.80) at a cut-off score of 9 on the scale. During the validation phase, 16,477 patients were admitted, of whom 10,793 stayed beyond 48 h and 58 acquired CDI during hospitalization. The predictive performance of the score was maintained in the validation cohort (AUC 0.95 [95% CI 0.93 to 0.96]) and the goodness-to-fit model demonstrated good calibration.
    Conclusion: The authors developed and validated a simple clinical prediction scale for hospital-onset CDI. This score can be used for periodical evaluation of hospitalized patients for early initiation of contact precautions and empirical treatment once it is validated externally in a prospective manner.
    MeSH term(s) Cross Infection/diagnosis ; Cross Infection/prevention & control ; Decision Support Techniques ; Enterocolitis, Pseudomembranous/diagnosis ; Enterocolitis, Pseudomembranous/prevention & control ; Humans ; Retrospective Studies ; Sensitivity and Specificity
    Language English
    Publishing date 2012-12-13
    Publishing country Canada
    Document type Journal Article ; Validation Study
    ZDB-ID 639439-5
    ISSN 1916-7237 ; 0835-7900
    ISSN (online) 1916-7237
    ISSN 0835-7900
    DOI 10.1155/2012/919513
    Database MEDical Literature Analysis and Retrieval System OnLINE

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