An unusual case of empyema with septicaemia secondary to eggerthella lenta

Eggerthella lenta is an anaerobic, non-spore-forming, nonmotile, gram-positive bacillus commensal in human intestine. It causes genitourinary tract infection, abscess, and wound infection but can lead to disseminated life-threatening septicemia. Risk factors to develop infection secondary to E. Lenta are immunocompromised and elderly patients with pre-existing co-morbidities such as cancer and diabetes mellitus. A 53-year-old man otherwise fit and healthy presented with pleuritic chest pain, cough, and breathlessness associated with shivering and the patient had diminished air entry on his left side of his chest. Blood workup revealed raised WBC count elevated C reactive protein (CRP). Chest radiograph revealed opacification of the left hemithorax, two distinct fluid levels and a computed tomography (CT) scan of his chest revealed loculated left sided empyema. Diagnostic aspiration revealed Pleural fluid indicated the presence of streptococcus anginosus and E. Lenta. Blood culture yielded the unusual growth of E. lenta. The patient was admitted to the intensive care unit and required drainage of the left pleural cavity with an intercostal drain. He was treated empirically with intravenous benzylpenicillin and oral clarithromycin. intravenous piperacillin/tazobactam and metronidazole. Within three days of starting piperacillin/tazobactam and metronidazole, a good clinical response to the therapy was observed. Follow up in clinic confirmed good resolution of the left sided empyema. The case report highlights E. Lenta as potential cause of septicemia following Pneumonia and empyema responding well to intercostal drainage and broad-spectrum antibiotics

Unusual case of pulmonary artery dissection presenting as an exacerbation of COPD

A 61-year-old male with a background of COPD and non-small cell lung carcinoma diagnosed ten years prior to presentation was seen with chest symptoms. He was an ex-smoker and presented with exertional dyspnoea, chest pain, cough, and wheeze. He had been on chemoradiotherapy for his cancer. The patient was seen in the clinic and admitted intermittently due to shortness of breath, pleural effusion, and exacerbations of COPD. He had undergone CT, MRI, PET scan and missed the PAD diagnosis due to post-chemo-radiotherapy effects. The patient was diagnosed with PAD incidentally through CTPA. The patient was treated medically throughout for Pulmonary hypertension. He was not fit for any surgical intervention and passed away approximately 21 months after diagnosis of Pulmonary artery dissection. The case highlight survival of months in a case of Pulmonary artery dissection without any intervention therapy, including surger

Efficient Tiled Sparse Matrix Multiplication through Matrix Signatures

International audienceTiling is a key technique to reduce data movement in matrix computations. While tiling is well understood and widely used for dense matrix/tensor computations, effective tiling of sparse matrix computations remains a challenging problem. This paper proposes a novel method to efficiently summarize the impact of the sparsity structure of a matrix on achievable data reuse as a one-dimensional signature, which is then used to build an analytical cost model for tile size optimization for sparse matrix computations. The proposed model-driven approach to sparse tiling is evaluated on two key sparse matrix kernels: Sparse Matrix-Dense Matrix Multiplication (SpMM) and Sampled Dense-Dense Matrix Multiplication (SDDMM). Experimental results demonstrate that model-based tiled SpMM and SDDMM achieve high performance relative to the current state-of-the-art

Register Optimizations for Stencils on GPUs

International audienceThe recent advent of compute-intensive GPU architecture has allowed application developers to explore high-order 3D stencils for better computational accuracy. A common optimization strategy for such stencils is to expose sufficient data reuse by means such as loop unrolling, with the expectation of register-level reuse. However, the resulting code is often highly constrained by register pressure. While current state-of-the-art register allocators are satisfactory for most applications, they are unable to effectively manage register pressure for such complex high-order stencils, resulting in sub-optimal code with a large number of register spills. In this paper, we develop a statement reordering framework that models stencil computations as a DAG of trees with shared leaves, and adapts an optimal scheduling algorithm for minimizing register usage for expression trees. The effectiveness of the approach is demonstrated through experimental results on a range of stencils extracted from application codes

Associative Instruction Reordering to Alleviate Register Pressure

International audienceRegister allocation is generally considered a practically solved problem. For most applications, the register allocation strategies in production compilers are very effective in controlling the number of loads/stores and register spills. However, existing register allocation strategies are not effective and result in excessive register spilling for computation patterns with a high degree of many-to-many data reuse, e.g., high-order stencils and tensor contractions. We develop a source-to-source instruction reordering strategy that exploits the flexibility of reordering associative operations to alleviate register pressure. The developed transformation module implements an adaptable strategy that can appropriately control the degree of instruction-level parallelism, while relieving register pressure. The effectiveness of the approach is demonstrated through experimental results using multiple production compilers (GCC, Clang/LLVM) and target platforms (Intel Xeon Phi, and Intel x86 multi-core)

False positive diagnosis of malignancy in a case of cryptogenic organising pneumonia presenting as a pulmonary mass with mediastinal nodes detected on fluorodeoxyglucose-positron emission tomography: a case report

<p>Abstract</p> <p>Introduction</p> <p>We report the case of a patient with positive findings on a lung emission tomography/computed tomography (PET/CT) scan, with possible contra lateral mediastinal involvement, which strongly suggested an inoperable lung carcinoma. The lung mass proved to be a cryptogenic organising pneumonia. While the latter has previously been shown to be PET/CT positive, mediastinal involvement simulating malignant spread has not been previously reported.</p> <p>Case presentation</p> <p>A 50-year-old Caucasian woman presented with a history of unproductive cough and was found to have a mass in the right upper lobe as shown on chest X-ray and a computed tomography scan. A subsequent PET/CT scan showed strong uptake in the right upper lobe (maximum standard uptake values (SUVmax) 9.6) with increased uptake in the adjacent mediastinum and contralateral mediastinal nodes. Surgical resection and mediastinoscopy revealed cryptogenic organising pneumonia, with enlarged reactive mediastinal lymph nodes.</p> <p>Conclusion</p> <p>The case illustrates the limits of PET/CT scanning as a diagnostic tool, and emphasizes the importance of obtaining histological confirmation of malignant diseases whenever possible.</p

Non-tuberculous mycobacterial pulmonary disease (NTM-PD): Epidemiology, diagnosis and multidisciplinary management

Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause significant disease in both immunocompromised and immunocompetent individuals. The incidence of NTM pulmonary disease (NTM-PD) is rising globally. Diagnostic challenges persist and treatment efficacy is variable. This article provides an overview of NTM-PD for clinicians. We discuss how common it is, who is at risk, how it is diagnosed and the multidisciplinary approach to its clinical management

Non-tuberculous mycobacterial pulmonary disease (NTM-PD): Epidemiology, diagnosis and multidisciplinary management

Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause significant disease in both immunocompromised and immunocompetent individuals. The incidence of NTM pulmonary disease (NTM-PD) is rising globally. Diagnostic challenges persist and treatment efficacy is variable. This article provides an overview of NTM-PD for clinicians. We discuss how common it is, who is at risk, how it is diagnosed and the multidisciplinary approach to its clinical management. [Abstract copyright: Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.