Postauricular cutaneous mastoid fistula

Postauricular cutaneous mastoid fistula is a rare condition. The cutaneous mastoid fistula is a very rare complication of chronic suppurative otitis media. The fistula tracts are typically difficult to manage because of the surrounding necrotic skin edges. We describe an unusual case of a postauricular cutaneous mastoid fistula and outline the surgical technique used for closure

Laboratory study of toxicity or tolerance of CCA preservative and heavy metal constituents copper, chromium and arsenic to Malaysian tropical fungi

CCA preservative and its constituent heavy metal tolerance and toxicity to 3 Malaysian isolates Phialophora fastigiata (soft rot fungus), Paecilomyces variotii (mould fungus) and an unidentified white rot Basidiomycete, was investigated by the modified ‘Strange-Smith’ agarwell- plate technique with 1.6% CCA concentration and the malt-agar-plate bioassay technique with a range of CCA and constituent metal salt concentrations of 0.0024 – 5%m/m. Daily linear hyphal extension was measured between 6 and 22 days depending on relative fungal growth rates. The slow growing Phialophora fastigiata sustained mean daily hyphal growth (mm) at relatively higher concentrations of CCA preservative (toxic limits: 0.24 – 0.48%m/m) and their heavy metal constituents (copper-salt: 5.0 – 10.0%m/m; chromium-salt: 0.076 – 0.24%m/m) than the faster growing mould isolate Paecilomyces variotii (CCA: 0.019 – 0.076%m/m; chromiumsalt: 0.076 – 0.24%m/m) and the white rot Basidiomycete of intermediate growth rate (CCA: 0.076 – 0.24%m/m; copper-salt: 0.076 – 0.24%m/m; chromium-salt: 0.0095 – 0.019%m/m) except for arsenic-salt (Phialophora fastigiata: 0.076 – 0.24%m/m; Paecilomyces variotii: 0.48 – 0.95%m/m; Basidiomycete: 0.24 – 0.48%m/m). The results showing varying efficacies (toxicity versus tolerance) in vitro of CCA and their metal constituents between these fungi can have implications to ground-contact wood protection capabilities of CCA

Tularaemia: A challenging zoonosis

In recent years, several emerging zoonotic vector-borne infections with potential impact on human health have been identified in Europe, including tularaemia, caused by Francisella tularensis.This remarkable pathogen, one of the most virulent microorganisms currently known, has been detected in increasingly new settings and in a wide range of wild species, including lagomorphs, rodents, carnivores, fish and invertebrate arthropods. Also, a renewed concern has arisen with regard to F. tularensis: its potential use by bioterrorists. Based on the information published concerning the latest outbreaks, the aim of this paper is to review the main features of the agent, its biology, immunology and epidemiology. Moreover, special focus will be given to zoonotic aspects of the disease, as tularaemia outbreaks in human populations have been frequently associated with disease in animals

Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK

Background Nintedanib slows progression of lung function decline in patients with progressive fibrosing (PF) interstitial lung disease (ILD) and was recommended for this indication within the United Kingdom (UK) National Health Service in Scotland in June 2021 and in England, Wales and Northern Ireland in November 2021. To date, there has been no national evaluation of the use of nintedanib for PF-ILD in a real-world setting.Methods 26 UK centres were invited to take part in a national service evaluation between 17 November 2021 and 30 September 2022. Summary data regarding underlying diagnosis, pulmonary function tests, diagnostic criteria, radiological appearance, concurrent immunosuppressive therapy and drug tolerability were collected via electronic survey.Results 24 UK prescribing centres responded to the service evaluation invitation. Between 17 November 2021 and 30 September 2022, 1120 patients received a multidisciplinary team recommendation to commence nintedanib for PF-ILD. The most common underlying diagnoses were hypersensitivity pneumonitis (298 out of 1120, 26.6%), connective tissue disease associated ILD (197 out of 1120, 17.6%), rheumatoid arthritis associated ILD (180 out of 1120, 16.0%), idiopathic nonspecific interstitial pneumonia (125 out of 1120, 11.1%) and unclassifiable ILD (100 out of 1120, 8.9%). Of these, 54.4% (609 out of 1120) were receiving concomitant corticosteroids, 355 (31.7%) out of 1120 were receiving concomitant mycophenolate mofetil and 340 (30.3%) out of 1120 were receiving another immunosuppressive/modulatory therapy. Radiological progression of ILD combined with worsening respiratory symptoms was the most common reason for the diagnosis of PF-ILD.Conclusion We have demonstrated the use of nintedanib for the treatment of PF-ILD across a broad range of underlying conditions. Nintedanib is frequently co-prescribed alongside immunosuppressive and immunomodulatory therapy. The use of nintedanib for the treatment of PF-ILD has demonstrated acceptable tolerability in a real-world setting

Classical Simulation of Relativistic Quantum Mechanics in Periodic Optical Structures

Spatial and/or temporal propagation of light waves in periodic optical structures offers a rather unique possibility to realize in a purely classical setting the optical analogues of a wide variety of quantum phenomena rooted in relativistic wave equations. In this work a brief overview of a few optical analogues of relativistic quantum phenomena, based on either spatial light transport in engineered photonic lattices or on temporal pulse propagation in Bragg grating structures, is presented. Examples include spatial and temporal photonic analogues of the Zitterbewegung of a relativistic electron, Klein tunneling, vacuum decay and pair-production, the Dirac oscillator, the relativistic Kronig-Penney model, and optical realizations of non-Hermitian extensions of relativistic wave equations.Comment: review article (invited), 14 pages, 7 figures, 105 reference