Background: Invasive fungal sinusitis (IFS) profoundly impacts individuals with hematological malignancies, with rapid progression and high mortality rates. In an evolving therapeutic landscape, outcomes for patients with hematological malignancies who develop IFS warrant further evaluation. Methods: We performed a descriptive case series and retrospective review of patients with hematologic malignancies who developed proven IFS (per European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria) between 2005 and 2024 at a tertiary academic center. Clinical data and outcomes were collected from electronic medical records. Statistical analyses included Fisher exact tests, t tests, or Wilcoxon rank-sum tests. Kaplan-Meier curves were used to estimate survival probability, and log-rank tests were compared across groups. Results: Thirty-one patients with confirmed IFS were identified. Most patients had acute myeloid leukemia (61.3%) and received cytotoxic chemotherapy (96.8%). Targeted oncologic therapies included BCL2 inhibitors (29.0%), FLT3 inhibitors (19.4%), antibody-based therapies (12.9%), BTK inhibitors (6.4%), and antibody–drug conjugates (6.4%). The most common fungal isolates were Aspergillus (22.6%), Fusarium (16.1%), and Rhizopus (9.7%). Amphotericin B (96.8%) and voriconazole (71.0%) were frequently used, and newer antifungals included isavuconazole (38.7%), olorofim (3.3%), and fosmanogepix (3.3%). Necrotic tissue (45.2%) and mucosal thickening (87.1%) were common on sinonasal endoscopy and computed tomography scan, respectively. Orbital (25.8%) and intracranial (9.7%) extension occurred in a minority. Most patients underwent functional endoscopic sinus surgery (80.6%). Serum fungal biomarkers were infrequently positive, with (1,3)-ß-D-glucan in 19.4% and galactomannan in 9.7%. Overall mortality was 71.0% at the end of the study period, with a median survival (interquartile range) of 101 (21–299) days. Mortality was 22.6% at 1 month, 25.8% at 2 months, 32.3% at 3 months, 41.9% at 6 months, 54.8% at 1 year, 58.1% at 2 years, and 64.5% at 3 years. Conclusions: Despite novel therapies and aggressive surgical interventions, patients with IFS had high mortality.

Background: Exposure to environmental pollution, particularly air pollutants, and its relationship with childhood central nervous system (CNS) tumors is a growing public health concern. Understanding these associations is crucial for the implementation of protective measures for children and the development of strategic public policies. Objective: This systematic review examines the association between air pollution exposure and the risk of CNS tumors in the pediatric population aged 0-19 years. Methods: Following PRISMA guidelines, we used PubMed, SCOPUS, EMBASE, Google Scholar, and CENTRAL baselines up to May 2024. We included only observational studies focusing on children exposed to air pollutants, excluding tobacco-related exposures. Data on study design, population characteristics, exposure assessment, and types of CNS tumors were extracted and analyzed. Results: We included 25 studies (case-control and cohort) conducted across North America, Europe, Australia, and Asia. The studies assessed pollutants such as benzene, nitrogen dioxide (NO2), particulate matter (PM2.5), and polycyclic aromatic hydrocarbons (PAHs). Some studies reported positive associations between specific pollutants and increased CNS tumor risk, while others found no significant links. Variability in exposure assessment methods contributed to inconsistent findings. Conclusion: The evidence linking air pollution to childhood CNS tumors remains inconclusive. Further research, with standardized exposure assessments and consideration of critical exposure windows, is needed to clarify these associations and inform public health policies to reduce environmental risks to children.

Background: Filamentous fungi are an emergent cause of severe infections in immunocompromised patients. Timely and accurate identification is crucial to initiate appropriate therapy. Traditional identification methods are time-consuming, labor-intensive, and operator-dependent. Ma-trix-assisted laser desorption/ionization-time-of-flight (MALDI-TOF) mass spectrometry is a rapid and easy-to-perform identification method. This study evaluates the effectiveness of a commercial MALDI-TOF MS platform to identify filamentous fungi in a routine laboratory. Material and Methods: We included 67 fungal isolates from 35 species/species complexes within 15 genera, confirmed in mycology reference laboratories. 33 were from clinical samples and 34 from strain collections. The study used the VITEK MS system (v3.2.0 database), after sample extraction by VITEK MS Mould Kit. Results were classified into categories: ‘correct species’, ‘correct species complex’, ‘correct genus’, ‘incorrect identification’, and ‘no identification’. We also evaluated the practicality of the kit. Results: VITEK MS correctly identified 91.0% of isolates (58.2% to species, 29.9% to species complex, and 1.5% to genus level). In 82%, the result matched the species/species complex identified by reference methods. No misidentifications were observed. The kit was rapid and easy to use. Conclusion: The VITEK MS system showed a high capability to accurately identify filamentous fungi in a routine laboratory.

Among 132 people with hematologic malignancies and invasive fungal disease, invasive fungal sinusitis was associated with greater dissemination, lower biomarker sensitivity, more diverse fungal pathogens, and higher rates of chronic rhinosinusitis and sinonasal defects than invasive fungal pneumonia. These findings suggest distinct clinical syndromes with different risk factors and diagnostic considerations.

Introduction: Understanding the clinical course and outcomes of patients with Covid-19 in underrepresented populations like Latin America is paramount. In this study, we report the clinical characteristics of Covid-19 in Chile, with a focus on subjects requiring hospitalization during the initial phases of the SARS-CoV-2 pandemic. Methods: This is a single center study including all consecutive patients diagnosed with Covid-19 during the first month of the pandemic. Demographics, clinical characteristics and laboratory data were collected within 24 hours of admission. The primary outcome was a composite of ICU admission or all-cause, in-hospital mortality. Results: During the first month of the pandemic, 381 patients were confirmed as positive for SARS-CoV-2 by molecular testing; 88 (23.1%) of them eventually required hospitalization. Median age of the cohort was 39 years (IQR 31-49). Overall mortality was 0.7% and 18 (3.7%) out of the 88 subjects who required hospitalization either died and/or required ICU. Increased body mass index (BMI), C-reactive protein levels (CRP) and the SaTO2/FiO2 index on admission were independently associated with a higher risk of ICU care or death. Discussion: The lower mortality observed in our prospective cohort during the first month of SARS-Cov-2 pandemic was lower than previously reported. This finding could be due to a lower threshold for admission, a healthcare system not yet overburdened and a younger population, among other factors. BMI, CRP on admission were strong predictors for ICU care or all-cause, in-hospital mortality. Our data provide important information regarding the clinical course of Covid-19 in Latin America.