Pulmonary tuberculosis followed by sarcoidosis in an HIV-infected patient: a case report and a simplified diagnostic flowchart for diagnosis and treatment of sarcoidosis

The diagnosis of sarcoidosis in a patient living with HIV infection is an uncommon event and a challenge for clinicians. Clinical manifestations are variable and fluctuating depending to adherence to ARV therapy and to the level of CD4 count. We analyze here one chronic case in which sarcoidosis appeared clinically two years after pulmonary tuberculosis. The course of the disease was influenced and prolonged by frequent interruptions of antiretroviral therapy. Moreover the diagnosis and the decision to treat have been delayed by the need of exclusion of other pathologies, principally tuberculosis reactivation/reinfection, other mycobacterial diseases, hematologic malignancies. We propose a simplified flowchart for diagnosis and follow up of sarcoidosis, which may also be applied to patients with HIV infection. Diagnosis of latent tuberculosis infection (LTBI) may be difficult in these patients, because the immunological paradox of sarcoidosis. For this reason, following exclusion of active tuberculosis, we advise to submit all sarcoidosis patients to IPT (isoniazid preventive therapy), when immunosuppressive therapy is started

The 40s Omega-loop plays a critical role in the stability and the alkaline conformational transition of cytochrome c

The structural and redox properties of a non-covalent complex reconstituted upon mixing two non-contiguous fragments of horse cytochrome c, the residues 1 - 38 heme-containing N-fragment with the residues 57 - 104 C-fragment, have been investigated. With respect to native cyt c, the complex lacks a segment of 18 residues, corresponding, in the native protein, to an omega ( W)loop region. The fragment complex shows compact structure, native-like alpha-helix content but a less rigid atomic packing and reduced stability with respect to the native protein. Structural heterogeneity is observed at pH 7.0, involving formation of an axially misligated low-spin species and consequent partial displacement of Met80 from the sixth coordination position of the heme-iron. Spectroscopic data suggest that a lysine ( located in the Met80-containing loop, namely Lys72, Lys73, or Lys79) replaces the methionine residue. The residues 1 - 38/57 - 104 fragment complex shows an unusual biphasic alkaline titration characterized by a low (pK(a1)= 6.72) and a high pK(a)-associated state transition (pK(a2)= 8.56); this behavior differs from that of native cyt c, which shows a monophasic alkaline transition ( pK(a)= 8.9). The data indicate that the 40s Omega-loop plays an important role in the stability of cyt c and in ensuring a correct alkaline conformational transition of the protein

The interaction of representation and reasoning

Automated reasoning is an enabling technology for many applications of informatics. These applications include verifying that a computer program meets its specification; enabling a robot to form a plan to achieve a task and answering questions by combining information from diverse sources, e.g. on the Internet, etc. How is automated reasoning possible? Firstly, knowledge of a domain must be stored in a computer, usually in the form of logical formulae. This knowledge might, for instance, have been entered manually, retrieved from the Internet or perceived in the environment via sensors, such as cameras. Secondly, rules of inference are applied to old knowledge to derive new knowledge. Automated reasoning techniques have been adapted from logic, a branch of mathematics that was originally designed to formalize the reasoning of humans, especially mathematicians. My special interest is in the way that representation and reasoning interact. Successful reasoning is dependent on appropriate representation of both knowledge and successful methods of reasoning. Failures of reasoning can suggest changes of representation. This process of representational change can also be automated. We will illustrate the automation of representational change by drawing on recent work in my research group

Endovascular Management of Juxtarenal and Pararenal Abdominal Aortic Aneurysms: Role of Chimney Technique

The use of chimney technique in endovascular repair of abdominal aortic aneurysms (ChEVAR) has had a secondary role. Although it was first developed in an emergent/urgent setting, the publication of various important studies has helped overcome scepticism towards this technique in elective procedures. This paper reviews current evidence about ChEVAR, focusing on clinical results, technical notes and comparisons with other techniques. The new ChEVAR findings show favourable mid- and long-term clinical outcomes, even in elective patients. These results, comparable to those related to fenestrated endografts, have been achieved through standardisation in planning and materials. An adequate endograft oversizing associated to the right aortic neck length is fundamental to avoid ChEVAR-related complications, such as type 1a endoleaks. These data indicate that ChEVAR, compared to other complex endovascular treatments, has comparable outcomes along with features that could make it an essential option in every clinical settin

Human herpesvirus 8-associated primary effusion lymphoma in human immunodeficiency virus-negative patients: a clinico-epidemiologic variant resembling classic Kaposi's sarcoma

No abstract availabl

HHV-8 transmission via saliva to soothe blood-sucking arthropod bites

The British Journal of Cance

Circuit analysis of the <i>Drosophila</i> brain using connectivity-based neuronal classification reveals organization of key communication pathways

AbstractWe present a functionally relevant, quantitative characterization of the neural circuitry of Drosophila melanogaster at the mesoscopic level of neuron types as classified exclusively based on potential network connectivity. Starting from a large neuron-to-neuron brain-wide connectome of the fruit fly, we use stochastic block modeling and spectral graph clustering to group neurons together into a common “cell class” if they connect to neurons of other classes according to the same probability distributions. We then characterize the connectivity-based cell classes with standard neuronal biomarkers, including neurotransmitters, developmental birthtimes, morphological features, spatial embedding, and functional anatomy. Mutual information indicates that connectivity-based classification reveals aspects of neurons that are not adequately captured by traditional classification schemes. Next, using graph theoretic and random walk analyses to identify neuron classes as hubs, sources, or destinations, we detect pathways and patterns of directional connectivity that potentially underpin specific functional interactions in the Drosophila brain. We uncover a core of highly interconnected dopaminergic cell classes functioning as the backbone communication pathway for multisensory integration. Additional predicted pathways pertain to the facilitation of circadian rhythmic activity, spatial orientation, fight-or-flight response, and olfactory learning. Our analysis provides experimentally testable hypotheses critically deconstructing complex brain function from organized connectomic architecture

Evaluation of different protocols of epidural anesthesia for relaxing cervical in Santa Inês sheep.

Proceedings of the 28th Annual Meeting of the Brazilian Embryo Technology Society (SBTE), August, 2014, Natal, RN, Brazil. Abstracts

Neuromorphometric characterization with shape functionals

This work presents a procedure to extract morphological information from neuronal cells based on the variation of shape functionals as the cell geometry undergoes a dilation through a wide interval of spatial scales. The targeted shapes are alpha and beta cat retinal ganglion cells, which are characterized by different ranges of dendritic field diameter. Image functionals are expected to act as descriptors of the shape, gathering relevant geometric and topological features of the complex cell form. We present a comparative study of classification performance of additive shape descriptors, namely, Minkowski functionals, and the nonadditive multiscale fractal. We found that the proposed measures perform efficiently the task of identifying the two main classes alpha and beta based solely on scale invariant information, while also providing intraclass morphological assessment