Dominance of variant A in Human Herpesvirus 6 viraemia after renal transplantation

<p>Abstract</p> <p>Background</p> <p>Human herpesvirus 6 (HHV-6), mostly variant B reactivation in renal transplant patients has been published by other authors, but the pathogenetic role of HHV-6 variant A has not been clarified. Our aims were to examine the prevalence of HHV-6, to determine the variants, and to investigate the interaction between HHV-6 viraemia, human cytomegalovirus (HCMV) infection and clinical symptoms.</p> <p>Methods</p> <p>Variant-specific HHV-6 nested PCR and quantitative real-time PCR were used to examine blood samples from renal transplant patients and healthy blood donors for the presence and load of HHV-6 DNA and to determine the variants. Active HHV-6 infection was proved by RT-PCR, and active HCMV infection was diagnosed by pp65 antigenaemia test.</p> <p>Results</p> <p>HHV-6 viraemia was significantly more frequent in renal transplant patients compared to healthy blood donors (9/200 vs. 0/200; p = 0.004), while prevalence of HHV-6 latency was not significantly different (13/200 vs. 19/200; p > 0.05). Dominance of variant A was revealed in viraemias (8/9), and the frequency of HHV-6A was significantly higher in active infections compared with latency in renal transplant patients (8/9 vs. 2/13; p = 0.0015). Latency was established predominantly by HHV-6B both in renal transplant patients and in healthy blood donors (11/13 and 18/19). There was no statistical significant difference in occurrence of HCMV and HHV-6 viraemia in renal transplant patients (7/200 vs. 9/200). Statistical analysis did not reveal interaction between HHV-6 viraemia and clinical symptoms in our study.</p> <p>Conclusions</p> <p>Contrary to previous publications HHV-6A viraemia was found to be predominant in renal transplant patients. Frequency of variant A was significantly higher in cases of active infection then in latency.</p

A Near-peer Point-of-care Ultrasound Elective for Medical Students: Impact on Anatomy Knowledge, Perceptions About Ultrasound, and Self-reported Skill Level

Rationale and Objectives We aimed to assess the impact of our institution's recently created point-of-care ultrasound (POCUS) course for preclinical medical students by examining its effect on first–year-level medical knowledge, self-reported skill level, and beliefs regarding the importance of ultrasound in future clinical practice. Materials and Methods A total of 18 first-year medical students completed a 5-month near–peer-led training program in POCUS consisting of 3-hour teaching sessions (7), 4-hour clinical sessions (10–12), and an independent study. Students completed pre- and postprogram assessments examining (1) student perceptions about ultrasound and its importance to future careers, (2) students' self-reported skill level with ultrasound, and (3) performance on an anatomy and physiology knowledge quiz. Scores and responses were compared to 20 controls. Results The majority of students believed that ultrasound was useful for learning anatomy and would be important in their future clinical practice. Students who completed our training program tended to perform better than controls on a test of medical knowledge. Despite reporting far fewer hours of formal ultrasound training, control students rated their skill level comparably to POCUS-trained students. Conclusions This study provides evidence that ultrasound is well received by medical students and may be useful for teaching basic anatomy concepts