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https://www.readbyqxmd.com/read/27913043/evaluation-of-the-genexpert-mtb-rif-assay-on-extrapulmonary-and-respiratory-samples-other-than%C3%A2-sputum-a-low-burden-country-experience
#1
Sushil Pandey, Jacob Congdon, Bradley McInnes, Alina Pop, Christopher Coulter
The aim of this study was to assess the performance of the GeneXpert MTB/RIF assay on extrapulmonary (EP) and respiratory (non-sputum) clinical samples of patients suspected of having tuberculosis (TB) from Queensland, Australia. A total of 269 EP and respiratory (non-sputum) clinical samples collected from Qld patients who were suspected of having TB were subjected to the GeneXpert MTB/RIF analysis, Ziehl-Neelsen (ZN) staining, Mycobacterium tuberculosis (MTB) culture and drug susceptibility testing. Phenotypic and genotypic data were compared...
November 29, 2016: Pathology
https://www.readbyqxmd.com/read/27900363/integration-of-genomics-and-histology-revises-diagnosis-and-enables-effective-therapy-of-refractory-cancer-of-unknown-primary-with-pdl1-amplification
#2
Stefan Gröschel, Martin Bommer, Barbara Hutter, Jan Budczies, David Bonekamp, Christoph Heining, Peter Horak, Martina Fröhlich, Sebastian Uhrig, Daniel Hübschmann, Christina Geörg, Daniela Richter, Nicole Pfarr, Katrin Pfütze, Stephan Wolf, Peter Schirmacher, Dirk Jäger, Christof von Kalle, Benedikt Brors, Hanno Glimm, Wilko Weichert, Albrecht Stenzinger, Stefan Fröhling
Identification of the tissue of origin in cancer of unknown primary (CUP) poses a diagnostic challenge and is critical for directing site-specific therapy. Currently, clinical decision-making in patients with CUP primarily relies on histopathology and clinical features. Comprehensive molecular profiling has the potential to contribute to diagnostic categorization and, most importantly, guide CUP therapy through identification of actionable lesions. We here report the case of an advanced-stage malignancy initially mimicking poorly differentiated soft-tissue sarcoma that did not respond to multiagent chemotherapy...
November 2016: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/27899756/coagulation-testing-in-acute-ischemic-stroke-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants
#3
Jan C Purrucker, Kirsten Haas, Timolaos Rizos, Shujah Khan, Sven Poli, Peter Kraft, Christoph Kleinschnitz, Rainer Dziewas, Andreas Binder, Frederick Palm, Sebastian Jander, Hassan Soda, Peter U Heuschmann, Roland Veltkamp
BACKGROUND AND PURPOSE: In patients who present with acute ischemic stroke while on treatment with non-vitamin K antagonist oral anticoagulants (NOACs), coagulation testing is necessary to confirm the eligibility for thrombolytic therapy. We evaluated the current use of coagulation testing in routine clinical practice in patients who were on NOAC treatment at the time of acute ischemic stroke. METHODS: Prospective multicenter observational RASUNOA registry (Registry of Acute Stroke Under New Oral Anticoagulants; February 2012-2015)...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27886161/cardiac-ct-in-the-emergency-department-in-the-era-of-highly-sensitive-troponins-is-there-still-a-role
#4
Admir Dedic, Koen Nieman, Udo Hoffmann, Maros Ferencik
INTRODUCTION: Physicians practicing cardiovascular medicine are every day confronted with patients presenting with symptoms suggestive of an acute coronary syndrome (ACS). Over the years, there have been substantial technical advances, such as the introduction of new non-invasive imaging techniques and the introduction of new highly sensitive cardiac biomarkers. EVIDENCE ACQUISITION AND SYNTHESIS: Physicians have adopted these new assets and have become more experienced with them thus improving medical care...
November 25, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27882677/utility-of-endobronchial-ultrasound-guided-transbronchial-needle-aspiration-in-diagnosing-non-specific-inflammatory-intrathorcacic-lymphadenitis
#5
Huizhen Yang, Shenglan Wang, Jiajun Teng, Baohui Han, Jiayuan Sun
BACKGROUND AND OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a minimally invasive technique for diagnosing intrathoracic malignancies and some benignancies; however, there are no data available on the utility of EBUS-TBNA for the diagnosis of non-specific inflammatory intrathoracic lymphadenitis. METHODS: A prospective analysis was performed from 104 patients with enlarged lymphadenopathy suspected of non-specific lymphadenitis referred for EBUS-TBNA between October 2009 and March 2012...
November 7, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27878432/histopathologic-diagnosis-of-brain-metastases-current-trends-in-management-and-future-considerations
#6
Lien Bekaert, Evelyne Emery, Guénaëlle Levallet, Emmanuèle Lechapt-Zalcman
Confronted with brain metastases (BM), pathologists aim to rule out a primary central nervous system (CNS) tumor and to identify or verify the primary tumor site to guide the clinician to specific therapies. Apart from morphological features, ancillary immunohistochemical analysis is the most effective tool for characterizing a metastatic neoplasm of unknown origin. A limited array of antibodies is used, taking into account relevant clinical information and the known brain tropism of lung cancer, breast cancer and melanoma...
November 22, 2016: Brain Tumor Pathology
https://www.readbyqxmd.com/read/27872533/role-of-imaging-in-peritoneal-surface-malignancies
#7
Santosh Krishnamurthy, Raghav Balasubramaniam
Imaging plays a vital role in the evaluation of peritoneal malignancies. The presence of peritoneal metastases (PM) alters tumor staging, with direct implications in treatment choice and prognosis. Cytoreductive surgery (CRS) and Hyperthermic intraperitoneal chemotherapy (HIPEC) as a combined modality treatment have led to prolonged survival and even cure in selected patients with PM. Better outcomes are seen in patients with limited disease spread. Therefore, early diagnosis of peritoneal tumor seeding is essential...
December 2016: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27865234/rapid-detection-of-extensively-drug-resistant-xdr-tb-strains-from-multidrug-resistant-tuberculosis-mdr-tb-cases-isolated-from-smear-negative-pulmonary-samples-in-an-intermediate-reference-laboratory-in-india
#8
Himanshu Vashistha, M Hanif, Sanjeev Saini, Ashwani Khanna, Srashty Sharma, Zeeshan Sidiq, Vasim Ahmed, Manoj Dubey, K K Chopra, Divya Shrivastava
BACKGROUND: Direct sputum smear microscopy is commonly used for diagnosing tuberculosis (TB). The objectives of the study were first, to determine the recovery of Mycobacterium tuberculosis in smear-negative sputum samples through liquid culture (using MGIT 960) and solid culture (using LJ slant) and second, to screen multidrug-resistant isolates through line probe assay and further third, to identify XDR isolates through MGIT second-line DST from these positive MDR cultures in Delhi region...
July 2016: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/27857946/can-bedside-ultrasound-inferior-vena-cava-measurements-accurately-diagnose-congestive-heart-failure-in-the-emergency-department-a-clin-iq
#9
Miranda Gaskamp, Mark Blubaugh, Laine H McCarthy, Dewey C Scheid
Congestive heart failure (CHF) is a major cause of morbidity and mortality. Early diagnosis of CHF in patients presenting to the emergency department (ED) with undifferentiated dyspnea would allow clinicians to begin appropriate treatment more promptly. Current guidelines recommend B-type natriuretic peptide (BNP) levels for more accurate diagnosis of CHF in dyspneic patients. Although BNP levels are relatively inexpensive, the test is not usually performed at bedside and results may take up to an hour or more...
October 2016: Journal of Patient-centered Research and Reviews
https://www.readbyqxmd.com/read/27853279/controlled-mycobacterium-tuberculosis-infection-in-mice-under-treatment-with-anti-il-17a-or-il-17f-antibodies-in-contrast-to-tnf%C3%AE-neutralization
#10
Noria Segueni, Elaine Tritto, Marie-Laure Bourigault, Stéphanie Rose, François Erard, Marc Le Bert, Muazzam Jacobs, Franco Di Padova, Daniel P Stiehl, Pierre Moulin, Dominique Brees, Salah-Dine Chibout, Bernhard Ryffel, Michael Kammüller, Valerie F Quesniaux
Antibodies targeting IL-17A or its receptor IL-17RA show unprecedented efficacy in the treatment of autoimmune diseases such as psoriasis. These therapies, by neutralizing critical mediators of immunity, may increase susceptibility to infections. Here, we compared the effect of antibodies neutralizing IL-17A, IL-17F or TNFα on murine host responses to Mycobacterium tuberculosis infection by evaluating lung transcriptomic, microbiological and histological analyses. Coinciding with a significant increase of mycobacterial burden and pathological changes following TNFα blockade, gene array analyses of infected lungs revealed major changes of inflammatory and immune gene expression signatures 4 weeks post-infection...
November 17, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27824634/the-differential-diagnosis-and-treatment-of-catatonia-in-children-and-adolescents
#11
Aaron J Hauptman, Sheldon Benjamin
LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Assess the etiologies associated with catatonia in children and adolescents• Evaluate the differential diagnosis of pediatric catatonia• Interpret the literature regarding the treatment of children and adolescents with catatonia OBJECTIVE: Pediatric catatonia is associated with many medical and psychiatric conditions. Mortality is high, and proper treatment can be lifesaving. Catatonia is increasingly recognized in pediatric populations, in which about 20% of cases are related to underlying medical conditions...
November 2016: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/27823689/safety-and-efficacy-of-the-0-h-3-h-protocol-for-rapid-rule-out-of-myocardial-infarction
#12
Karin Wildi, Berit Nelles, Raphael Twerenbold, Maria Rubini Giménez, Tobias Reichlin, Hélène Singeisen, Sophie Druey, Philip Haaf, Zaid Sabti, Petra Hillinger, Cedric Jaeger, Isabel Campodarve, Philip Kreutzinger, Christian Puelacher, Zoraida Moreno Weidmann, Mathias Gugala, Gilles Pretre, Stephanie Doerflinger, Max Wagener, Fabio Stallone, Michael Freese, Claudia Stelzig, Katharina Rentsch, Stefano Bassetti, Roland Bingisser, Stefan Osswald, Christian Mueller
BACKGROUND: The early and accurate diagnosis of acute myocardial infarction (AMI) is an important medical and economic challenge. We aimed to prospectively evaluate the performance of the new European Society of Cardiology rapid 0-hour/3-hour (0 h/3 h) rule out protocol for AMI. METHODS: We enrolled 2,727 consecutive patients presenting with suspected AMI without persistent ST-segment elevation to the emergency department in a prospective international multicenter study...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27813146/the-matrix-verb-as-a-source-of-comprehension-difficulty-in-object-relative-sentences
#13
Adrian Staub, Brian Dillon, Charles Clifton
Two experiments used eyetracking during reading to examine the processing of the matrix verb following object and subject relative clauses. The experiments show that the processing of the matrix verb following an object relative is indeed slowed compared to the processing of the same verb following a subject relative. However, this difficulty is entirely eliminated if additional material intervenes between the object gap and the matrix verb. An explanation in terms of spillover processing is ruled out, suggesting that it is the gap-matrix verb sequence that is itself responsible for the difficulty...
November 4, 2016: Cognitive Science
https://www.readbyqxmd.com/read/27811203/rapid-rule-out-of-acute-myocardial-injury-using-a-single-high-sensitivity-cardiac-troponin-i-measurement
#14
Yader Sandoval, Stephen W Smith, Anoop S V Shah, Atul Anand, Andrew R Chapman, Sara A Love, Karen Schulz, Jing Cao, Nicholas L Mills, Fred S Apple
BACKGROUND: Rapid rule-out strategies using high-sensitivity cardiac troponin assays are largely supported by studies performed outside the US in selected cohorts of patients with chest pain that are atypical of US practice, and focused exclusively on ruling out acute myocardial infarction (AMI), rather than acute myocardial injury, which is more common and associated with a poor prognosis. METHODS: Prospective, observational study of consecutive patients presenting to emergency departments [derivation (n = 1647) and validation (n = 2198) cohorts], where high-sensitivity cardiac troponin I (hs-cTnI) was measured on clinical indication...
November 3, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27808487/pathophysiology-of-non-celiac-gluten-sensitivity-where-are-we-now-in-2016
#15
Giacomo Caio, Gabriele Riegler, Marta Patturelli, Angela Facchiano, Laura DE Magistris, Anna Sapone
Non-celiac gluten sensitivity (NCGS) is the term used to describe individuals complaining of intestinal and extra-intestinal symptoms related to gluten ingestion and rapidly improving after its withdrawal, and in which both celiac disease (CD) and wheat allergy (WA) were properly ruled out. The prevalence of this condition remains unknown and a lot of questions about the possible pathogenetic mechanisms are still unclarified. It is believed that NCGS represents a heterogeneous condition with different subgroups potentially characterized by different pathogenesis, clinical history, and clinical course...
November 3, 2016: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/27806176/abrupt-onset-of-refractory-heart-failure-associated-with-light-chain-amyloidosis-in-hypertrophic-cardiomyopathy
#16
Benedetta Tomberli, Francesco Cappelli, Federico Perfetto, Iacopo Olivotto
Importance: The natural history of hypertrophic cardiomyopathy (HCM) is complex and may include progressive heart failure and severe left ventricular dysfunction. When disease progression is abrupt, however, other coexisting diseases should be ruled out. This may be difficult in the case of amyloidosis, which classically mimics HCM. Results: We present an example of severe clinical deterioration in a patient with HCM due to superimposed amyloid light-chain amyloidosis...
November 2, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27801465/lipid-bilayer-thickness-determines-cholesterol-s-location-in-model-membranes
#17
Drew Marquardt, Frederick A Heberle, Denise V Greathouse, Roger E Koeppe, Robert F Standaert, Brad J Van Oosten, Thad A Harroun, Jacob J Kinnun, Justin A Williams, Stephen R Wassall, John Katsaras
Cholesterol is an essential biomolecule of animal cell membranes, and an important precursor for the biosynthesis of certain hormones and vitamins. It is also thought to play a key role in cell signaling processes associated with functional plasma membrane microdomains (domains enriched in cholesterol), commonly referred to as rafts. In all of these diverse biological phenomena, the transverse location of cholesterol in the membrane is almost certainly an important structural feature. Using a combination of neutron scattering and solid-state (2)H NMR, we have determined the location and orientation of cholesterol in phosphatidylcholine (PC) model membranes having fatty acids of different lengths and degrees of unsaturation...
November 1, 2016: Soft Matter
https://www.readbyqxmd.com/read/27798497/recent-advances-in-the-diagnosis-and-management-of-tuberculous-meningitis
#18
Nguyen T H Mai, Guy E Thwaites
PURPOSE OF REVIEW: Tuberculous meningitis is a devastating infection that is hard to diagnose and treat. We have reviewed tuberculous meningitis original research published within the past 18 months, selecting studies which we consider have most advanced knowledge. RECENT FINDINGS: We review advances in diagnostic methods, anti-tuberculosis chemotherapy, and the common complications of tuberculous meningitis. New commercial molecular diagnostic tests, such as GeneXpert MTB/RIF, have an important role in tuberculous meningitis diagnosis, but as with all other available tests, they lack sensitivity and cannot rule out the disease...
October 27, 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/27780008/severe-hemophilia-a-in-a-male-old-english-sheep-dog-with-a-c%C3%A2-t-transition-that-created-a-premature-stop-codon-in-factor-viii
#19
Jay N Lozier, Mark T Kloos, Elizabeth P Merricks, Nathaly Lemoine, Margaret H Whitford, Robin A Raymer, Dwight A Bellinger, Timothy C Nichols
Animals with hemophilia are models for gene therapy, factor replacement, and inhibitor development in humans. We have actively sought dogs with severe hemophilia A that have novel factor VIII mutations unlike the previously described factor VIII intron 22 inversion. A male Old English Sheepdog with recurrent soft-tissue hemorrhage and hemarthrosis was diagnosed with severe hemophilia A (factor VIII activity less than 1% of normal). We purified genomic DNA from this dog and ruled out the common intron 22 inversion; we then sequenced all 26 exons...
2016: Comparative Medicine
https://www.readbyqxmd.com/read/27762577/saccadic-eye-movements-impose-a-natural-bottleneck-on-visual-short-term-memory
#20
Sven Ohl, Martin Rolfs
Visual short-term memory (VSTM) is a crucial repository of information when events unfold rapidly before our eyes, yet it maintains only a fraction of the sensory information encoded by the visual system. Here, we tested the hypothesis that saccadic eye movements provide a natural bottleneck for the transition of fragile content in sensory memory to VSTM. In 4 experiments, we show that saccades, planned and executed after the disappearance of a memory array, markedly bias visual memory performance. First, items that had appeared at the saccade target were more readily remembered than items that had appeared elsewhere, even though the saccade was irrelevant to the memory task (Experiment 1)...
October 20, 2016: Journal of Experimental Psychology. Learning, Memory, and Cognition
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