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low for the selection of patients who are candidates for outpatient treatment.

Necrotizing soft tissue infections (NSTIs) are life-threatening surgical emergencies associated with high morbidity and mortality. Fungal NSTIs are considered rare and have been largely understudied. The purpose of this study was to study the impact of fungal NSTIs and antifungal therapy on mortality after NSTIs.

A retrospective chart review was performed on patients with NSTIs from 2012 to 2018. Patient baseline characteristics, microbiologic data, antimicrobial therapy, and clinical outcomes were collected. Patients were excluded if they had comfort care before excision. The primary outcome measured was in-hospital mortality.

A total of 215 patients met study criteria with a fungal species identified in 29 patients (13.5%). The most prevalent fungal organism was Candida tropicalis (n=11). Fungal NSTIs were more prevalent in patients taking immunosuppressive medications (17.2% versus 3.2%, P=0.01). A fungal NSTI was significantly associated with in-hospital mortality (odds ratio, 3.13; 95% confidence ited with decreased in-hospital mortality in those with fungal NSTIs. Consideration should be given to adding antifungals in empiric treatment regimens, especially in those taking immunosuppressive medications.

Despite the increasing prevalence and severity of childhood obesity, the national utilization of adolescent bariatric surgery has plateaued. Concern about the perioperative safety of adolescent bariatric surgery has limited referrals and insurance coverage. The purpose of this study was to compare the 30-d complication rate of minimally invasive bariatric surgery in adolescents and adults.

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2015 data set was queried for primary minimally invasive bariatric procedures in adolescents and adults. Adolescents were defined as age 19y or younger. Univariate analyses were performed to determine if there was an increased incidence of the adolescent 30-d complication rate as compared with adults.

Of the cases who met inclusion criteria, 1076 (0.8%) were adolescents and 142,704 (99.2%) were adults. Tiplaxtinin mouse Laparoscopic sleeve gastrectomy was the most commonly performed procedure for both patient populations, although at a higher rate in adolescents (73.9% versus 68.8% in adults, P=0<0.0001). The overall 30-d complication rate was comparable in adolescents and adults (6.3% versus 7.3%; P=0.21) with similar rates of intervention, reoperation, readmission, and mortality. There was no significant difference in any specific perioperative complication class reported between adolescents and adults, except wound disruption (0.2% versus 0.0%, P<0.0001) and postlaparoscopic sleeve gastrectomy coma >24h (0.1% versus 0.0%, P<0.0001).

Bariatric surgery in adolescents shares a similar perioperative safety profile as found in adults. This data support the utilization and extension of adult criteria for bariatric surgery to adolescents with morbid obesity.

Bariatric surgery in adolescents shares a similar perioperative safety profile as found in adults. This data support the utilization and extension of adult criteria for bariatric surgery to adolescents with morbid obesity.TPH2, the rate-limiting enzyme in the synthesis of serotonin, has been connected to several psychiatric outcomes. Its allelic variant, rs4570625, has been found to relate to individual differences in cognitive and emotion regulation during infancy with T-carriers of rs4570625 showing a relatively heightened attention bias for fearful faces. A significant gene-environment interaction was also reported with the T-carriers of mothers with depressive symptoms showing the highest fear bias. We investigated these associations in a sample of 8-month old infants (N = 330), whose mothers were prescreened for low/high levels of prenatal depressive and/or anxiety symptoms. Attention disengagement from emotional faces (neutral, happy, fearful, and phase-scrambled control faces) to distractors was assessed with eye tracking and an overlap paradigm. Maternal depressive symptoms were assessed at several time points during pregnancy and postpartum. The mean levels of symptoms at six months postpartum and the trajectories of symptoms from early pregnancy until six months postpartum were used in the analyses (N = 274). No main effect of the rs4570625 genotype on attention disengagement was found. The difference in fear bias between the genotypes was significant but in an opposite direction compared to a previous study. The results regarding the interaction of the genotype and maternal depression were not in accordance with the previous studies. These results show inconsistencies in the effects of the rs4570625 genotype on attention biases in separate samples of infants from the same population with only slight differences in age.Treg cells are the immune system’s in-house combatants against pathological immune activation. Because they are vital to maintenance of peripheral tolerance, it is important to understand how they perform their functions. To this end, various mechanisms have been proposed for Treg-mediated immune inhibition. A major group of mechanisms picture Treg cells as skilled thieves stealing a plethora of molecules that would otherwise promote immune effector functions. This suggests that several million years of evolution have endowed Treg cells with efficient ways to deprive immune effectors of activating stimuli to prevent immunopathology for survival of the host. Although we are still long way from deciphering their complete set of tricks, this review will focus on the types of “crimes” committed by these master thieves in both secondary lymphoid organs and non-lymphoid tissue.Immune responses to non-pathogenic yeasts induced within the draining lymph node remain to be understood. In this study, we have investigated the changes in lymphocytes and their activity in skin-draining lymph nodes in response to transdermally injected zymosan (component of the yeast cell wall). Zymosan elicited the transient increase of B cell number and activation status without affecting the capacity for proliferation. The increased B cell content in the regional lymph nodes was likely due to the reduction of B cell egress from the tissue and in part the increase of homing from the circulation. Zymosan also upregulated the inflammatory cytokines, such as IL-1β, IL-6, IL-12, and IFNγ, regulatory cytokines IL-10 and TGFβ, and lymphoid chemokine CXCL13. Among these, the expression of IL-12 and IL-10 was markedly high in B cells. Altogether, these findings demonstrate a unique B cell-associated response to non-pathogenic yeast component in the draining lymph nodes. This will provide insights into the clinical and healthcare applications of non-pathogenic beneficial microbes.