Enteric infections complicating ulcerative colitis

Enteric infections have previously been postulated to play a role in the pathogenesis of inflammatory bowel disease (IBD), however, little evidence exists in the etiologic role of specific enteric infections in the development of IBD. When encountered in the setting of IBD, enteric infections pose a clinical challenge in management given the competing treatment strategies for infectious conditions and autoimmune disorders. Here we present the case of a young male with enteric infections complicating a new diagnosis of IBD. Our patient's initial clinical presentation included diagnoses of Klebsiella oxytoca isolation and Clostridium difficile infection. Directed therapies to include withdrawal of antibiotics and fecal microbiota transplantation were performed without resolution of clinical symptoms. Given persistence of symptoms and active colitis, the patient was diagnosed with ulcerative colitis (UC), requiring treatments directed at severe UC to include cyclosporine therapy. The finding of multiple enteric infections in a newly presenting patient with IBD is an unexpected finding that has treatment implications

Poor Functional Status as a Risk Factor for Severe Clostridium difficile Infection in Hospitalized Older Adults

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/112304/1/jgs12442.pd

The Amount of Weight Loss Six Months after Bariatric Surgery: It Makes a Difference

Background: Bariatric surgery, especially Roux-en-Y gastric bypass (RYGB), has become the most frequently used therapy for morbid obesity. Objectives: The aim of this study was to examine the effects of surgically induced weight loss on cardiopulmonary function 6 months after the procedure, as well as the effect of such an intervention on well-known risk factors for cardiovascular diseases. Methods: This is a cross-sectional study on 66 morbidly obese patients (BMI ≥40 or ≥35 kg/m2 with present comorbidities), comparing their cardiopulmonary function prior to and 6 months after RYGB surgery. Results: The substantial amount of weight loss (29.80 ± 13.27 kg) after RYGB surgery was associated with significant reduction of comorbidities, especially diabetes and sedentary lifestyle (p = 0.005 and p = 0.002, respectively). Regarding functional capacity, there was significant increase in peak oxygen uptake (VO2 peak, p = 0.003), duration of exercise testing, metabolic equivalents (exercise time and METs, p < 0.001), and in peak O2 pulse. These findings were particularly pronounced in a group of patients who had lost more than 18% of initial weight. Conclusions: Reduction of body weight after RYGB surgery is associated with significantly improved cardiorespiratory function 6 months after surgery, especially in patients who lost more than 18% of their initial body weight. In addition, substantial decreases in body weight were also associated with a reduction of cardiovascular risk factors such as diabetes, smoking, hypertriglyceridemia, and sedentary lifestyle

Strukturiranje ekološki prihvatljivih elastomernih kompozitnih materijala

For the waste rubber recycling, it is obligative to know the chemical composition of the waste products, if it is to be used in the new composite elastomeric material formulation. The composite elastomeric materials obtained from the waste rubber powder have a very diverse application (farm floors, sports stadiums, tyres production, in construction as a vibration protection material). The aim of this work was to prepare elastomeric composites based on recycled elastomer powder (REP). A few types of elastomeric materials were synthesized based on natural rubber, polybutadiene rubber, styrene-butadiene rubber, (NR/BR/SBR, 40/40/20 phr), carbon black and recycled elastomer powder were synthesized. It was assessed that composites NR/BR/SBR/REP have shorter optimum curing time tc90 than samples without REP. By increasing the REP content the tc90 value and tensile strength are decreasing, but the abrasion resistance is increasing.Kod recikliranja otpadne gume neophodno je poznavati hemijski sastav otpadnog proizvoda, ukoliko će se on koristiti u recepturama za nove hibridne elastomerne materijale. Kompozitni elastomerni materijali dobijeni od praha otpadne gume imaju veoma raznovrsnu primenu (podovi na farmama, sportski stadioni, dobijanje pneumatika, u građevinarstvu kao materijali za zaštitu od vibracija itd). Cilj ovog rada je bio da se dobiju elastomerni kompoziti na osnovu reciklirane gume. Sintetisano je nekoliko tipova elastomernih materijala na osnovu prirodnog kaučuka, stiren-butadienskog kaučuka i polibutadienskog kaučuka (NR/BR/SBR, 40/40/20 phr), čestica čađi i recikliranog gumenog praha. Ustanovljeno je da kompoziti NR/BR/SBR/REP imaju kraće optimalno vreme umrežavanja u poređenju sa uzorcima NR/BR/SBR bez REP. Porastom količine REP smanjuje se vreme optimalnog umrežavanja i prekidna črstoća, a povećava se otpornost na abraziju

a rare case of pacemaker lead endocarditis successfully treated with open heart surgery

Background: Cardiac device-related endocarditis has emerged as a serious complication in the era of advanced medical technology. Pacemaker related infections are rare and life-threatening with incidence from 0.06% to 7% and high mortality rate (30-35%). Diagnosis is hard, frequently delayed and could be even missed due to poor clinical findings. The average delay in diagnosis is 5.5 month. We report a case of the late-onset of pacemaker lead endocarditis caused by S. epidermidis successfully treated with open heart surgery. Case Report: Patient with persistent high fever for 11 month and suspicion for infective endocarditis was admitted in Cardiovascular Institute. No clinical signs of endocarditis were observed. TTE revealed large vegetation 30 × 17 mm attached to the atrial electrodes with high embolic potential. This finding was verified by transesophageal echocardiography (TEE), although CT scan did not reveal vegetation. Blood cultures were negative. A sternotomy with cardiopulmonary bypass was performed and electrodes were extracted with large vegetation. Intraoperative finding revealed large thrombus with vegetation around pacemaker leads. Cultures of the electrodes and vegetation revealed Staphylococcus epidermidis. Surgery was followed up with antibiotic treatment for 6 weeks. He has been followed up for the next 2 years, and without complications. Conclusion: The absence of criteria for endocarditis and negative blood cultures should not keep the physician from ruling out lead endocarditis. This complication carries high risk of mortality if left untreated

A Systematic Review and Meta-Analysis of Serologic Response following Coronavirus Disease 2019 (COVID-19) Vaccination in Solid Organ Transplant Recipients

Solid organ transplant (SOT) recipients are at greater risk of coronavirus disease 2019 (COVID-19) and have attenuated response to vaccinations. In the present meta-analysis, we aimed to evaluate the serologic response to the COVID-19 vaccine in SOT recipients. A search of electronic databases was conducted to identify SOT studies that reported the serologic response to COVID-19 vaccination. We analyzed 44 observational studies including 6158 SOT recipients. Most studies were on mRNA vaccination (mRNA-1273 or BNT162b2). After a single and two doses of vaccine, serologic response rates were 8.6% (95% CI 6.8–11.0) and 34.2% (95% CI 30.1–38.7), respectively. Compared to controls, response rates were lower after a single and two doses of vaccine (OR 0.0049 [95% CI 0.0021–0.012] and 0.0057 [95% CI 0.0030–0.011], respectively). A third dose improved the rate to 65.6% (95% CI 60.4–70.2), but in a subset of patients who had not achieved a response after two doses, it remained low at 35.7% (95% CI 21.2–53.3). In summary, only a small proportion of SOT recipients achieved serologic response to the COVID-19 mRNA vaccine, and that even the third dose had an insufficient response. Alternative strategies for prophylaxis in SOT patients need to be developed. Key Contribution: In this meta-analysis that included 6158 solid organ transplant recipients, the serologic response to the COVID-19 vaccine was extremely low after one (8.6%) and two doses (34.2%). The third dose of the vaccine improved the rate only to 66%, and in the subset of patients who had not achieved a response after two doses, it remained low at 36%. The results of our study suggest that a significant proportion of solid organ transplant recipients are unable to achieve a sufficient serologic response after completing not only the two series of vaccination but also the third booster dose. There is an urgent need to develop strategies for prophylaxis including modified vaccine schedules or the use of monoclonal antibodies in this vulnerable patient population

The influence of ageing on the morphological and optical properties of thin TPD films

This paper presents the influence of ageing on the morphological and optical properties of TPD (N,N-bis(3-methylphenil)-N,N- diphenylbenzidine) thin films. Understanding of the nucleation mechanism and growth dynamics of molecular thin films is pivotal for controlling their morphology and the film interfacial properties, while the influence of ageing is essential for the potential commercial utilization. Initially, thin films were prepared using a combinatorial physical vapour deposition (CPVD) method, following a cosine-like distribution profile of thickness along mono-crystal silica substrate. Morphology of thin films was investigated by using optical (OM) and atomic force microscopy (AFM). The link between optical properties and the resulting thin film morphology was made by spatially correlated morphological (AFM and OM) and optical (absorption and photoluminescence) measurements. The changes in the absorption and photoluminescence spectra are strongly connected to the ageing-induced changes in the microstructure of thin films. Regardless of morphological and differences in the film thickness (two orders of magnitude), all films show amorphous arrangement just after the deposition. Ageing of these films in regular atmosphere conditions results in morphological and changes in optical properties induced by the crystallization. The crystallization of initially amorphous samples was also confirmed by the differentional scanning calorimetry (DSC) measurements. All results indicate the limited possibility of using TPD films in organic electroluminescent devices

'Therapeutic window' for multiple drug treatment of experimental cerebral ischemia in gerbils

Peer reviewed: YesNRC publication: N