Mortality risk after herpes zoster infection in end-stage renal disease patients.

BACKGROUND: End-stage renal disease (ESRD) patients have increased risk of developing herpes zoster (zoster) compared with the general population, but mortality risk is unknown. We assessed the risk of mortality in hospitalized ESRD patients with a diagnosis of zoster from the inpatient hospital files (as opposed to outpatient records) of the United States Renal Data System. METHODS: This study analyzed incident ESRD patients from 2006 to 2009. Based on an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code of zoster infection, we determined 2-year mortality following an inpatient diagnosis. Cox proportional hazards models were used to examine the association of mortality and zoster, when controlling for demographic and other clinical risk factors. RESULTS: Zoster was diagnosed in 2784 patients, 51% of whom died within 2 years, with a mean time to death of 8.1 months. Patients who died were more likely to be white and older, score higher on the Charlson Comorbidity Index (CCI) and have other clinical diagnoses besides CCI. Increased risk of death within 2 years was associated with older age (adjusted hazard ratio 1.03), malnutrition (1.31), bacteremia/septicemia (1.16) and increasing CCI (1.10). Zoster vaccine was administered to 27 patients, but the small number precluded analysis of its impact. CONCLUSIONS: Mortality in ESRD patients with an inpatient zoster diagnosis is increased with older age and higher severity of clinical comorbidities. The role of zoster vaccination on mortality in this population remains to be defined.

Enhancing shape selectivity without loss of activity--novel mesostructured ZSM5 catalysts for methylation of toluene to p-xylene.

An increase in p-xylene selectivity was observed without losing the catalytic activity over novel mesoporous nano-sized ZSM5 crystals covered with an external SiO2 overlayer created by deposition of tetraethyl orthosilicate.

Selective homologation routes to 2,2,3-trimethylbutane on solid acids.

Sailing the seven 'C's: 2,2,3-Trimethylbutane (triptane) selectively forms from dimethyl ether at low temperatures on acid zeolites. Selective methylation at less-substituted carbons, relative rates of methylation to hydrogen transfer as a function of chain size, slow skeletal isomerization, and beta-scission cracking of triptyl chains and their precursors are intrinsic properties of carbenium ions and account for the remarkable triptane selectivities within C(7) .