Notes

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Bronchoscopy and EBUS were performed once again. Transbronchial lung biopsy from the right upper lobe and EBUS-TBNA from the right lower paratracheal lymph node revealed adenocarcinoma from the lung. CONCLUSIONS Although coexistence of sarcoidosis and lung cancer is very rare, the clinician should consider the possibility of accompanying lung cancer in sarcoidosis patients who are not responding to initial corticosteroid therapy.BACKGROUND Locally advanced nasopharyngeal carcinoma (LA-NPC) is a relatively rare disease in the west but more common in East Asia and areas of the Middle East like Saudi Arabia. Despite the advances in radiation therapy techniques, some patients relapse after treatment. In the coming era of cancer immunotherapy, prognostic factors for LA-NPC need to be further defined using immune-relevant markers. Several markers are available; however, the most robust and accessible/affordable marker is not well-defined. METHODS Retrospectively, tumor-infiltrating lymphocytes (TIL), their subsets as well as tumoral PD-L1 expression were analyzed in tumor tissues from 63 LA-NPC patients treated with platinum-based concurrent chemo-radiotherapy (CCRT) in addition to 20 cases with metastatic (MET) disease. Immunostaining was done using a validated and fully automated system. Scoring was done by two independent pathologists and results were compared. RESULTS There was no statistical difference between LA-NPC and MET disease ih a combination of low CD3+ TIL and lack of PD-L1 expression had the worst OS (p  less then  0.001). CONCLUSIONS CD3+ TIL is promising as a robust and independent prognostic marker for DFS and OS of LA-NPC patients treated with platinum-based CCRT. We would suggest the use of CD3 + TIL as a stratifying factor for LA-NPC, which warrants further validation in prospective trials.BACKGROUND In an ageing population, pain, frailty and disability frequently coexist across a wide range of musculoskeletal diagnoses, but their associations remain incompletely understood. The Investigating Musculoskeletal Health and Wellbeing (IMH&W) study aims to measure and characterise the development and progression of pain, frailty and disability, and to identify discrete subgroups and their associations. The survey will form a longitudinal context for nested research, permitting targeted recruitment of participants for qualitative, observational and interventional studies; helping to understand recruitment bias in clinical studies; and providing a source cohort for cohort randomised controlled trials. METHODS IMH&W will comprise a prospective cohort of 10,000 adults recruited through primary and secondary care, and through non-clinical settings. Data collection will be at baseline, and then through annual follow-ups for 4 years. Questionnaires will address demographic characteristics, pain severity (0-the cohort with people with MSK problems with high representation of elderly and unwell people. TRIAL REGISTRATION Clinicaltrials.gov NCT03696134. Date of Registration 04 October 2018.BACKGROUND This study aimed to evaluate in vitro susceptibility to ceftobiprole of clinical strains identified from prosthetic joint infections (PJIs) compared to that of the associations currently recommended for post-operative empirical antibiotic therapy (PEAT) (vancomycin with either cefepime, third-generation cephalosporin or piperacillin-tazobactam). METHODS We performed a 1-year retrospective study on all the surgical procedures performed in our hospital for PJI. Susceptibility profiles of all the strains cultured from surgical samples were reviewed to compare ceftobiprole to current used associations. RESULTS During the study period (from January 2018 to December 2018), we identified 106 patients managed for PJI and a total of 216 surgical interventions. One hundred-fifty strains were identified from intraoperative samples, excluding redundant strains. Staphylococcus spp. represented 52.7% of all strains and Enterobacteriales 13.3%. Twenty-three patients had polymicrobial infection (22%). Among 149 surgical procedures with positive culture results, ceftobiprole covered the bacterial strains in 138 (92.6%) cases. In comparison, this percentage was 94.6% for vancomycin plus cefepime (p = 0.64), 92.6% for vancomycin plus a third-generation cephalosporin in 138 cases (p = 1) and 94.6% for vancomycin plus piperacillin-tazobactam) (p = 0.64). CONCLUSION Based on antimicrobial susceptibility testing, our results suggest that ceftobiprole could be an interesting option for PEAT in PJIs, allowing the use of a single agent.BACKGROUND Psoriasis is the most common chronic inflammatory condition involving the T helper cell system. Population studies have demonstrated that patients with psoriasis and/or psoriatic arthritis have an increased risk of developing vascular risk factors, including diabetes, hypertension, and obesity, and increased risk of adverse vascular events, including myocardial infarction and stroke. Population studies have generally investigated the individual contributions of psoriasis and psoriatic arthritis to development of vascular risk factors; fewer studies have investigated the additive contribution of comorbid inflammatory disorders. We present a case of a woman with psoriasis, psoriatic arthritis, and comorbid vascular risk factors. CASE PRESENTATION A 49 year-old Caucasian woman with a history of severe psoriasis and psoriatic arthritis since adolescence presented with bilateral lower extremity weakness. She was found to have acute bilateral watershed infarcts and multifocal subacute infarcts. Her evalu vascular risk factors and vascular events. Dysregulation of the Th1 and Th17 system has been implicated in the development of atherosclerosis and may explain the severe atherosclerosis seen in such chronic inflammatory conditions. Further research will help refine screening and management guidelines to account for comorbid inflammatory disorders and related disease severity.BACKGROUND Despite Guatemala's large indigenous population, indigenous health is often neglected in reported health data and interventions. Although this data is limited in scope, it shows that indigenous people have poorer health outcomes. Sexually transmitted infections (STIs) are now a growing threat in Guatemala and pose great risk to the wellbeing of its indigenous population. METHODS This qualitative pilot study assessed the knowledge, attitudes, and beliefs of STIs through semi-structured interviews among a previously unstudied population of indigenous Maya women (n = 35, ages 18-50) in the six municipalities of Santa Cruz La Laguna, Guatemala. RESULTS Four key themes were identified 1) indigenous Maya women have limited factual knowledge about sex and STIs; 2) widespread partner infidelity minimizes women's control over preventing STI contraction; 3) close-knit communities and the resulting heightened fear of gossip prevents communication and hinders care seeking; and 4) lack of quality medical care and inaccessibility of biomedical healthcare systems pose barriers to seeking care for potential STIs. CONCLUSIONS To address these findings, we suggest methods to improve sexual education, combat male infidelity, promote condom use, and improve health services to reduce the incidence of STIs in Maya Guatemala.BACKGROUND Synthetic particulate hydroxyapatite (HAP; Ca5(PO4)3(OH)) is used as ingredient in oral care products but its effects on cariogenic biofilms are not clear yet. Saracatinib clinical trial The primary mode of action of HAP may be acting as a calcium phosphate reservoir when deposited in oral biofilms and release Ca2+ and (hydrogen) phosphate ions upon bacterial acid challenge. The aim of this in vitro study was to test this hypothesis by investigating release of Ca2+ ions and potential buffering effects from HAP upon bacterial acid challenge in planktonic cultures and biofilms of Streptococcus mutans. METHODS Planktonic cultures of S. mutans were grown in BHI broth with 1% sucrose or with additional 5% HAP or 5% silica for up to 48 h. Separately, biofilms of S. mutans were grown in BHI for 72 h in total. After 24 h of this biofilm culture, either BHI alone or BHI with additional 0.5% HAP or 0.5% silica was added. After 48 h, BHI with 1% sucrose was added to allow bacterial acid formation. Ca2+ release was determined colorimetrically and pH measurements were performed using a pH electrode. For statistical analysis, non-parametrical procedures were applied (n ≥ 10; Mann-Whitney U test; α = 0.05). RESULTS Relevant release of Ca2+ was only evident in planktonic cultures or biofilms with HAP but not in both other groups (p ≤ 0.001). In suspended biofilms with HAP, median pH was 4.77 after 72 h and about 0.5 pH units higher as compared to both other groups (4.28 or 4.32, respectively; p ≤ 0.001). CONCLUSIONS Under the tested conditions, synthetic HAP releases Ca2+ ions upon bacterial acid challenge and may also show some buffering capacity but further studies are needed to investigate whether the concentrations tested here can also be reached clinically in dental biofilms.Corrected affiliation of 3rd author Pediatric Allergy & Clinical Immunology Research Unit, Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand.We study the critical Casimir interaction between two spherical colloids immersed in a binary liquid mixture close to its critical demixing point. The surface of each colloid prefers one species of the mixture with the exception of a circular patch of arbitrary size, where the other species is preferred. For such objects, we calculate, within the Derjaguin approximation, the scaling function describing the critical Casimir potential, and we use it to derive the scaling functions for all components of the forces and torques acting on both colloids. The results are compared with available experimental data. Moreover, the general relation between the scaling function for the potential and the scaling functions for the force and the torque is derived.Light-to-heat conversion in plasmonic nanoparticles (NPs) inside polymeric membranes is beneficial for improving the efficiency of membrane distillation for seawater desalination. However, the physical mechanisms ruling photothermal membrane distillation are unclear yet. Here, we model the plasmonic photothermal light-to-heat conversion from Ag, Au, and Cu nanofillers in polymeric membranes for membrane distillation. Photothermal effects in the cases of isolated metallic NPs and their assembly are investigated considering size effects and excitation sources. The increasing content of metallic NPs improves the efficiency of the light-to-heat conversion. For a polymeric membrane, filled with 25% Ag NPs, our model well reproduces the experimental temperature increase of 10 K. Specifically, we find that Ag NPs with a radius of around 30-40 nm are favorite candidates for membrane heating with excitation energy in the visible/near-UV range. The incorporation of a term associated with heat losses into the heat transfer equation well reproduces the cooling effect associated with vaporization at the membrane surface. Compared to Ag NPs, Au and Cu NPs show a broadened absorption cross section and their resonance has a nonlinear behavior with varying the excitation energy, better matching with sunlight radiation spectrum.
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