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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been characterized by high transmission rates and high mortality in adults with predisposing factors, including age>70 years, obesity, diabetes, systemic hypertension and other underlying diseases. During the second week of viral pneumonia, acute respiratory distress syndrome can occur and carries high mortality. Unlike most common respiratory viruses, children seem to be less susceptible to SARS-CoV-2 infection, and generally develop mild disease with low mortality. However, clusters of severe shock associated with high levels of cardiac biomarkers and unusual vasoplegia requiring inotropes, vasopressors and volume loading have recently been described. Both the clinical symptoms (i.e. Pterostilbene high and persistent fever, gastrointestinal disorders, skin rash, conjunctival injection and dry cracked lips) and the biological signs (e.g. elevated C-reactive protein/procalcitonin and high levels of ferritinaemia) mimicked Kawasaki disease. In most cases, intravenous immunoglobin therapy improved cardiac function and led to full recovery within a few days. Adjunctive steroid therapy and sometimes biotherapy (e.g. anti-interleukin 1Ra and anti-interleukin 6 monoclonal antibodies) were often necessary. Although almost all children fully recovered within a week, some of them later developed coronary artery dilation or aneurysm. Thus, a new "multisystem inflammatory syndrome in children" related to SARS-CoV-2 has recently been described. Similarities with Kawasaki disease and the physiopathology of this syndrome still need further exploration.We report 4 cases of neonatal sepsis caused by Streptococcus gallolyticus. The clinical course was quite similar to early-and late-onset group B streptococcus disease. None of the mothers had group B streptococcus (GBS) colonization on prenatal screening nor received intrapartum antibiotics. We proposed the sporadic distribution of S. gallolyticus sepsis among neonates was partly due to relatively low colonization rate in adults compared with GBS. Species determination of S. gallolyticus may not be available using conventional microbiological methods and may contribute to underestimation or misclassification. In our series, we highlighted the importance of S. gallolyticus as an important pathogen in neonatal sepsis deserving further surveillance.
We presented the performance of a Chinese-made cryptococcal glucuronoxylomannan (GXM) antigen test using serum and bronchoalveolar lavage fluid (BALF) samples in the HIV-negative Chinese population.

Between February 2017 and January 2019, HIV-negative patients with pulmonary cryptococcosis were recruited and followed-up every three months, including completion of a chest CT examination and collection of serum and BALF samples.

Here, thirty-seven confirmed and ten clinically diagnosed patients were recruited. Furthermore, samples from 174 noncryptococcosis patients that may cause false positives were also collected. The sensitivity of a lateral flow assay (LFA) for detecting cryptococcal GXM antigen in serum and BALF samples from confirmed cases was 97% and 95%, respectively, and the specificity was 98.2% and 93%, respectively, and the differences in these values between the BALF and serum samples were not significant. The serum cryptococcal GXM antigen value showed a positive correlation (r 0.581, p<0.001) with pulmonary lesion size, while the BALF value showed no correlation (r 0.253, p 0.13). The positivity rate of BALF was higher than that of serum when the diameter of the pulmonary lesion was small (diameter less than 20mm). Moreover, the serum cryptococcal GXM antigen levels showed an overall decreasing trend with the decrease in pulmonary lesion size after antifungal therapy in patient follow-up.

The Chinese-made cryptococcal GXM antigen test has better sensitivity and specificity for diagnosing pulmonary cryptococcosis in the HIV-negative Chinese population, and it could be used to diagnose and to monitor this disease.
The Chinese-made cryptococcal GXM antigen test has better sensitivity and specificity for diagnosing pulmonary cryptococcosis in the HIV-negative Chinese population, and it could be used to diagnose and to monitor this disease.
We describe the feasibility of transitioning simulated skills assessments during general surgery interviews from an in-person to virtual format.

Technical and nontechnical skill multiple mini-interviews (MMIs) were performed virtually and assessed for 109 applicants during virtual general surgery interviews over 2 days at a tertiary academic medical center.

We demonstrate the feasibility of virtually assessing general surgery residency applicants' technical and non-technical skills. Using a virtual MMI format during general surgery interviews, we assessed communication, emotional intelligence, anatomical knowledge, interpretation of medical tests, knot tying, and suturing. Four tasks (communication, emotional intelligence , anatomical knowledge, and interpretation of tests) were assessed synchronously by trained general surgery interns. Applicants submitted a recording of themselves performing knot tying and suturing tasks, which were asynchronously assessed after the interview day. Applicants rated therson is not feasible.
The Orthopaedic In-Training Examination (OITE) is given annually to residents to assess their knowledge of clinical orthopaedics and orthopaedic basic science. This study sought to determine what resources orthopaedic residency programs recommend and/or require for residents as preparative tools for the OITE and to understand which resources are most beneficial.

An anonymous electronic survey was distributed to program directors of orthopaedic surgery residency programs. It included questions about resources that program directors recommended or required residents to use when preparing for the OITE.

The survey was prepared and the results analyzed at two academic medical institutions in Louisiana. The survey was available to respondents in December 2019 and January 2020.

The survey was delivered to program directors of 148 ACGME accredited orthopaedic surgery residency programs in the United States.

148 orthopaedic surgery residency program directors received the survey and 44 responded (response rag residents to use practice questions/old OITE tests, setting a goal/threshold score and avoiding formal/required preparation programs may improve resident performance on the OITE.
Superficial mycoses are some of the most common diseases worldwide. The usual culprits-yeasts belonging to the genera Malassezia and Candida-are commensal species in the skin that can cause opportunistic infections. We aimed to determine whether these yeasts use glycosaminoglycans (GAGs) as adhesion receptors to mediate binding to epithelial cells.

In keratinocyte and dermal fibroblast cultures, we used rhodamine B and genistein to inhibit GAG synthesis to study the role these molecules play in the adhesion of Candida albicans and Malassezia species to cells. We also analyzed GAG involvement by means of enzyme digestion, using specific lyases.

Rhodamine B partially inhibited the adhesion of both fungi to keratinocytes but not to fibroblasts. Selective digestion of heparan sulfate enhanced the binding of Malassezia species to keratinocytes and of both fungi to fibroblasts. Chondroitin sulfate digestion decreased Calbicans adhesion to keratinocytes, but increased the adhesion of the filamentous forms of this species to fibroblasts.

Cell surface GAGs appear to play a role in the adhesion of Calbicans and Malasezzia species to keratinocytes. In contrast, their adhesion to fibroblasts appears to be enhanced by GAG inhibition, suggesting that some other type of receptor is the mediator.
Cell surface GAGs appear to play a role in the adhesion of Calbicans and Malasezzia species to keratinocytes. In contrast, their adhesion to fibroblasts appears to be enhanced by GAG inhibition, suggesting that some other type of receptor is the mediator.Malignant syphilis (MS) is a rare manifestation of secondary syphilis which mainly occurs in immunocompromised individuals such as those coinfected with human immunodeficiency virus (HIV). However, recent reports have described MS in immunocompetent individuals. To describe the characteristics of individuals with MS and associated risk factors, a review of case reports published from 2014 to 2018 was conducted. Out of 45 published case reports, 33 cases (73%) occurred in HIV-positive individuals with majority having CD4 counts less then 500 cells/mm3. Of the 12 cases (27%) in HIV-negative individuals, half had comorbidities such as diabetes mellitus, alcoholism, drug abuse, psoriasis, and hepatitis. The most frequent manifestation of MS was ulceronodular cutaneous lesions with central adherent crust, which affected the face, trunk, and limbs. Given the increasing number of MS regardless of the immune status, dermatologists and general practitioners should be vigilant to allow early diagnosis and treatment, hence reducing their morbidity.Replication stress results from obstacles to replication fork progression, including ongoing transcription, which can cause transcription-replication conflicts. Oncogenic signaling can promote global increases in transcription activity, also termed hypertranscription. Despite the widely accepted importance of oncogene-induced hypertranscription, its study remains neglected compared with other causes of replication stress and genomic instability in cancer. A growing number of recent studies are reporting that oncogenes, such as RAS, and targeted cancer treatments, such as bromodomain and extraterminal motif (BET) bromodomain inhibitors, increase global transcription, leading to R-loop accumulation, transcription-replication conflicts, and the activation of replication stress responses. Here we discuss our mechanistic understanding of hypertranscription-induced replication stress and the resulting cellular responses, in the context of oncogenes and targeted cancer therapies.
The saphenous nerve has great importance on the sensitivity of the lower limb. In its normal course, it enters the adductor canal and travels under the sartorius muscle, on the medial side of the thigh.

The anatomical variation was found accidentally during routine cadaveric dissection of the thigh at the Human Anatomy Laboratory of the Department of Morphophysiology of the Faculty of Medical Sciences of Minas Gerais (FCMMG).

A different pattern of path of the saphenous nerve was found, which appears to perforate the sartorius muscle.

Complaints of pain in the lower limbs are highly prevalent in the adult population. Saphenous neuropathy is a pathological entity that is associated with such a clinic and may have compression or trauma as its etiology. In the context of compression, it can be caused due to the unusual nerve path, as described in the present study. In trauma, knowledge of this variation is important to prevent iatrogenic damage to nervous tissue during surgical procedures.

The anatomic variation presented may be related to the symptom of pain in the lower limbs and is also relevant in the surgical context, in order to prevent complications.
The anatomic variation presented may be related to the symptom of pain in the lower limbs and is also relevant in the surgical context, in order to prevent complications.
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