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https://www.readbyqxmd.com/read/29035192/bacillus-cereus-bacteremia-with-central-nervous-system-involvement-a-neuropathological-study
#1
Jean Philippe Brouland, Nathalie Sala, Selin Tusgul, Caterina Rebecchini, Enikö Kovari
Bacillus cereus is a widely-distributed, gram-positive or variable, rod-shaped bacterium frequently considered a contaminant in clinical specimens. It is recognized as a potential pathogen inducing self-limiting emetic or diarrheal food poisoning or localized infection in immunocompetent patients. True B. cereus bacteremia is uncommon and mainly observed in fragile patients, notably in immunocompromised individuals. We report clinical, radiological, and pathological findings of a 64-year-old patient with a history of acute myeloid leukemia who initially presented a fever while neutropenic after the induction of a second cycle of chemotherapy...
October 16, 2017: Clinical Neuropathology
https://www.readbyqxmd.com/read/29034296/diagnosis-of-asthma-in-symptomatic-children-based-on-measures-of-lung-function-an-analysis-of-data-from-a-population-based-birth-cohort-study
#2
Clare Murray, Philip Foden, Lesley Lowe, Hannah Durrington, Adnan Custovic, Angela Simpson
BACKGROUND: Concerns have been expressed about asthma overdiagnosis. The UK National Institute of Health and Care Excellence (NICE) proposed a new diagnostic algorithm applying four lung function measures sequentially (ratio of forced expiratory volume in 1 s [FEV1] to forced vital capacity [FVC] <70%, bronchodilator reversibility ≥12%, fractional exhaled nitric oxide [FeNO] ≥35 parts per billion, and peak expiratory flow variability >20%). We aimed to assess the diagnostic value of three of the tests individually, and then test the proposed algorithm in symptomatic children...
October 2017: Lancet Child Adolesc Health
https://www.readbyqxmd.com/read/29033431/diagnostic-challenge-in-pancreatic-sarcoidosis-using-endoscopic-ultrasonography
#3
Nobuaki Azemoto, Teru Kumagi, Mitsuhito Koizumi, Taira Kuroda, Hirofumi Yamanishi, Yoshinori Ohno, Yoshiki Imamura, Eiji Takeshita, Yoshiko Soga, Yoshiou Ikeda, Morikazu Onji, Yoichi Hiasa
We herein report a 55-year-old woman who presented with erythema and bilateral hilar lymphadenopathy 4 months prior to the detection of pancreatic lesions on an ultrasound. A skin biopsy showed evidence of sarcoidosis. The largest lesion in the tail of the pancreas was hypoechoic on endoscopic ultrasonography (EUS). The lesion was initially iso-enhanced on contrast enhanced-EUS (CE-EUS) but subsequently became hypoenhanced. The lesion revealed heterogeneous components of both soft and hard tissue on EUS elastography...
October 16, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29032549/detection-of-bioluminescent-borrelia-burgdorferi-from-in-vitro-cultivation-and-during-murine-infection
#4
Jenny A Hyde, Jon T Skare
Borrelia burgdorferi, etiologic agent of Lyme disease, is the leading tick-borne disease in the United States with approximately 300,000 cases diagnosed annually. Disease occurs in stages beginning localized infection at the site of a tick bite and progresses to disseminated infection when antibiotic treatment is not administered in a timely manner. A multi-systemic infection develops following dissemination to numerous immunoprotective tissues, such as the heart, bladder, and joints, resulting in late Lyme disease...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29032373/differentiating-clostridium-difficile-colitis-from-clostridium-difficile-colonization-in-ulcerative-colitis-a-role-for-procalcitonin
#5
Andrew R Reinink, Julajak Limsrivilai, Bethany A Reutemann, Tristan Feierabend, Emily Briggs, Krishna Rao, Peter D R Higgins
BACKGROUND/AIMS: Clostridium difficile infection (CDI) frequently complicates ulcerative colitis (UC) and can mimic disease flare. Differentiating UC flare from CDI remains a clinical challenge, particularly due to C. difficile colonization. Procalcitonin (PCT) is a serum biomarker for bacterial infections. We hypothesized that PCT would differentiate acute CDI from UC flare and C. difficile colonization. METHODS: A single-center prospective cohort study was conducted from 2013 to 2016...
October 14, 2017: Digestion
https://www.readbyqxmd.com/read/29031891/low-efficacy-of-atopy-patch-test-in-predicting-tolerance-development-in-non-ige-mediated-cow-s-milk-allergy
#6
T A Gonzaga, F A Alves, M F A Cheik, C P de Barros, E R M A Rezende, G R S Segundo
BACKGROUND: The food atopy patch (APT) test has been used in previous studies to help the diagnosis of non-IgE mediated food allergies (FA). The aim of this study was to evaluate the efficacy of different cow's milk APT preparations to predict oral tolerance in children with previous non-IgE-mediated cow's milk allergy (CMA) diagnosis. METHODS: Thirty-two patients non-IgE-mediated CMA diagnosed by oral food challenge (OFC) were enrolled to perform APT with three different cow's milk preparations (fresh, 2% in saline solution, 2% in petrolatum) and comparing with a new OFC after at least three months of diet exclusion...
October 11, 2017: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/29031289/histological-examination-in-obtaining-a-diagnosis-in-patients-with-lymphadenopathy-in-lima-peru
#7
Daniela E Kirwan, Cesar Ugarte-Gil, Robert H Gilman, Syed M Hasan Rizvi, Gustavo Cerrillo, Jaime Cok, Eduardo Ticona, José Luis Cabrera, Eduardo D Matos, Carlton A Evans, David A J Moore, Jon S Friedland, The Lymph Node Tuberculosis Lntb Working Group
The differential diagnosis for lymphadenopathy is wide and clinical presentations overlap, making obtaining an accurate diagnosis challenging. We sought to characterize the clinical and radiological characteristics, histological findings, and diagnoses for a cohort of patients with lymphadenopathy of unknown etiology. 121 Peruvian adults with lymphadenopathy underwent lymph node biopsy for microbiological and histopathological evaluation. Mean patient age was 41 years (Interquartile Range 26-52), 56% were males, and 39% were HIV positive...
October 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29031156/hiv-misdiagnosis-a-root-cause-analysis-leading-to-improvements-in-hiv-diagnosis-and-patient-care
#8
Raynell Lang, Carmen Charlton, Brenda Beckthold, Kiana Kadivar, Stephanie Lavoie, Doug Caswell, Paul Levett, Greg Horsman, John Kim, M John Gill
BACKGROUND: Standard diagnostic testing for HIV infection has traditionally relied on a high sensitivity HIV antibody screening test using an enzyme-linked immunosorbent assay (ELISA) followed by a high specificity antibody confirmatory test such as a Western Blot. Recently several of the screening assays have been enhanced with an ability to identify p24 antigen thereby narrowing the diagnostic window. OBJECTIVES: To explore the implications of enhanced HIV screening methods that may be leading to HIV misdiagnoses...
October 9, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29030367/patients-with-common-variable-immunodeficiency-paradoxically-have-increased-rates-of-autoimmune-disorders
#9
Ammu Thampi Susheela, Andrew Hale
Common variable immunodeficiency (CVID), characterised by disordered B cell function, is one of the most common primary immunodeficiency disorders. Patients with CVID are at lifelong risk of recurrent infections, particularly of the respiratory and gastrointestinal tracts. Paradoxically, given their immunocompromised state, patients with CVID are also at significantly increased risk of autoimmune disorders, which are seen in almost 25% of cases. The authors report a 24-year-old female patient with CVID, manifested as severe hypogammaglobulinaemia with recurrent sinopulmonary infections and enterocolitis, who presented with transaminitis, chronic diarrhoea and haematemesis...
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29029707/epidemiology-pathophysiology-stratification-and-natural-history-of-pulmonary-embolism
#10
Nicholas J Giordano, Paul S Jansson, Michael N Young, Kaitlin A Hagan, Christopher Kabrhel
Pulmonary embolism (PE) is a common and potentially fatal form of venous thromboembolism that can be challenging to diagnose and manage. PE occurs when there is obstruction of the pulmonary vasculature and is a common cause of morbidity and mortality in the United States. A combination of acquired and inherited factors may contribute to the development of this disease and should be considered, since they have implications for both susceptibility to PE and treatment. Patients with suspected PE should be evaluated efficiently to diagnose and administer therapy as soon as possible, but the presentation of PE is variable and nonspecific so diagnosis is challenging...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029539/therapeutic-evaluation-of-arterio-portal-fistula-related-gastroesophageal-variceal-bleeding
#11
Xiaoquan Huang, Wen Zhang, Shiyao Chen, Chengfeng Liu, Ruofan Sheng, Feng Li, Jian Wang, Jianjun Luo, Pengju Xu
BACKGROUND & AIMS: Intrahepatic arterio-portal fistula is an uncommon etiology of portal hypertension, which presents diagnostic and therapeutic challenges. This study aimed to assess the efficacy and outcomes of gastroesophageal variceal bleeding caused by arterio-portal fistula using different therapeutic approaches. METHODS: Medical records of 451 consecutive patients with arterio-portal fistula were reviewed from January 1, 2009, to July 15, 2016, and patients suffered variceal bleeding were eligible for the study...
September 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29029134/the-natural-history-and-surgical-outcome-of-patients-with-scimitar-syndrome-a-multi-centre-european-study
#12
Vladimiro L Vida, Alvise Guariento, Ornella Milanesi, Dario Gregori, Giovanni Stellin
Aims: Treatment decisions in patients with scimitar syndrome (SS) are often challenging, especially in patients with isolated SS who are often asymptomatic and who might be diagnosed accidentally. We queried a large multi-institutional registry of SS patients to evaluate the natural history of this condition and to determine the efficacy of surgical treatment in terms of survival and clinical status. Methods and results: We collected data on 485 SS patients from 51 institutions; 279 (57%) patients were treated surgically (STPs) and 206 (43%) were clinically monitored (CMPs)...
October 3, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29028662/stool-xpert-mtb-rif-and-urine-lipoarabinomannan-lam-for-diagnosing-tuberculosis-in-hospitalized-hiv-infected-children
#13
Sylvia M Lacourse, Patricia B Pavlinac, Lisa M Cranmer, Irene N Njuguna, Cyrus Mugo, John Gatimu, Joshua Stern, Judd L Walson, Elizabeth Maleche-Obimbo, Julius Oyugi, Dalton Wamalwa, Grace John-Stewart
BACKGROUND: Tuberculosis (TB ) causes substantial morbidity and mortality in HIV-infected children. Sample collection and paucibacillary nature of TB in children makes diagnosis challenging. Rapid diagnostic tools using easily obtained specimens are urgently needed. METHODS: Hospitalized, HIV-infected children ≤12 years enrolled in a randomized controlled trial (NCT02063880) comparing urgent to poststabilization ART initiation in Kenya underwent TB evaluation...
October 12, 2017: AIDS
https://www.readbyqxmd.com/read/29027820/using-cost-effectiveness-analysis-to-quantify-the-value-of-genomic-based-diagnostic-tests-recommendations-for-practice-and-research
#14
Eldon Spackman, Sebastian Hinde, Laura Bojke, Katherine Payne, Mark Sculpher
AIMS: New sequencing technologies allow increased opportunities to use genomic-based diagnostic tests (genomic tests) in routine clinical practice, which will impact healthcare budgets and patients' outcomes. This article aims to generate a list of recommendations on how the principles and methods of cost-effectiveness analysis (CEA) can be used to quantify the costs and benefits of genomic tests. METHODS: A systematic literature search identified publications describing the use of CEA to evaluate genomic tests...
October 13, 2017: Genetic Testing and Molecular Biomarkers
https://www.readbyqxmd.com/read/29027765/factor-xiii-deficiency-diagnosis-challenges-and-tools
#15
REVIEW
M Karimi, F Peyvandi, M Naderi, A Shapiro
Factor XIII deficiency (FXIIID) is a rare hereditary bleeding disorder arising from heterogeneous mutations, which can lead to life-threatening hemorrhage. The diagnosis of FXIIID is challenging due to normal standard coagulation assays requiring specific FXIII assays for diagnosis, which is especially difficult in developing countries. This report presents an overview of FXIIID diagnosis and laboratory methods and suggests an algorithm to improve diagnostic efficiency and prevent missed or delayed FXIIID diagnosis...
October 13, 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29027379/impact-of-omalizumab-in-children-from-a-middle-income-country-with-severe-therapy-resistant-asthma-a-real-life-study
#16
Paulo M Pitrez, Rodrigo G de Souza, Cristian Roncada, Joao P Heinzmann-Filho, Giovana Santos, Leonardo A Pinto, Marcus H Jones, Renato T Stein
BACKGROUND: Severe asthma in children is a global health problem. Severe therapy-resistant asthma (STRA) in children is a major clinical challenge due to persistent symptoms despite high doses of corticosteroids and results in high public health costs. Omalizumab (anti-IgE monoclonal antibody) has been described as an effective add-on therapy in these patients. The characteristics of children with STRA from low- and middle-income countries have scarcely been reported, and no real-life study has been published on the effects of omalizumab in this group of patients...
October 13, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29027110/predicting-the-cancer-burden-in-catalonia-between-2015-and-2025-the-challenge-of-cancer-management-in-the-elderly
#17
R Clèries, A Ameijide, R Marcos-Gragera, L Pareja, M Carulla, M-L Vilardell, L Esteban, M Buxó, J-A Espinàs, A Puigdefàbregas, J Ribes, A Izquierdo, J Galceran, J M Borrás
BACKGROUND: Developing effective cancer control programmes requires information on the future cancer burden in an ageing population. In our study we predicted the burden of cancer in Catalonia from 2015 to 2025. METHODS: Bayesian age-period-cohort models were used to predict the burden of cancer from 2015 to 2025 using incidence data from the Girona and Tarragona cancer registries and cancer mortality data from the Catalan mortality registry. Using the Bashir-Estève method, we divided the net change in the number of cases between 2015 and 2025 into changes due to population size (S), cancer risk (R) and age (A) distribution...
October 12, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29026774/atypical-kleine-levin-syndrome-an-elusive-entity
#18
Swarndeep Singh, Saurabh Kumar, Rohit Verma, Nand Kumar
Kleine-Levin syndrome (KLS) is a rare disorder (around 1.5 cases per million population), often presenting with triad of recurrent episodes of hypersomnia, hyperphagia, and hypersexuality. However, cases of atypical KLS with features opposite to that being commonly reported are often misdiagnosed as psychosis and present as a diagnostic challenge for the physicians, psychiatrists, and neurologists. We describe a case of atypical KLS which was misdiagnosed as unspecified nonorganic psychosis previously, highlighting the various points which would be helpful in identifying and diagnosing cases of atypical KLS in future...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29026635/lytic-lesions-looking-lethal-but-leaving-room-for-a-simple-cure-a-case-of-veillonella-spinal-osteomyelitis
#19
Sarah Baker, Rebecca Allyn
Introduction. Diagnosing clinically significant infection caused by Veillonella species can be a challenge. Veillonella species are usually found in polymicrobial processes and are often regarded as a contaminant. Additionally, they are slow to grow in culture and this can lead to a delay in diagnosis or a missed diagnosis. Veillonella species rarely cause serious infections, but have been found to cause bacteraemia and osteomyelitis. Case presentation. A 67-year-old man with a history of treated prostate cancer presented with 2 weeks of progressive lower back pain and weakness...
August 2017: JMM Case Reports
https://www.readbyqxmd.com/read/29026620/streptococcus-suis-serotype-9-endocarditis-and-subsequent-severe-meningitis-in-a-growing-pig-despite-specific-bactericidal-humoral-immunity
#20
Karoline Rieckmann, Kristin Müller, Annette Moter, Christoph G Baums, Anna Seydel
INTRODUCTION: . Meningitis and endocarditis are common pathologies of Streptococcussuis infections in pigs and humans. S. suis serotype 9 strains contribute substantially to health problems in European pig production, and immune prophylaxis against this serotype is very difficult. CASE PRESENTATION: . We report the clinical course and histopathological picture of a 10-week-old growing pig following experimental intravenous infection with S. suis serotype 9. The piglet showed rapid onset of severe clinical signs of meningitis 11 days post-intravenous challenge following prime-booster vaccination...
May 2017: JMM Case Reports
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