Pulmonary Hydatid Cyst with Complicating Aspergillus Infection Presenting as a Refractory Lung Abscess

Background Hydatid disease is rare in the United States. Rarely the hydatid cyst can become infected with mycotic organisms, such as Aspergillus . We describe a young male who presents with clinical features of suppurative lung abscess whose workup diagnosed hydatid cyst complicated by Aspergillus co-infection. Case presentation A 27-year-old Peruvian male was hospitalized because of fever, chills, and productive cough of three months’ duration. Clinical features were consistent with a suppurative lung abscess. Significant findings included leukocytosis with eosinophilia and a chest x-ray showing a large lingular lobe thick walled cavity with a wavy irregular fluid level. The patient ultimately underwent surgical resection of the lingular lobe. Examination of the surgical specimen revealed the cavity to be a hydatid cyst. Histologic examination of the cyst wall showed intense inflammation and several septate hyphae of Aspergillus species. The patient recovered fully and has remained in good health. Conclusion A thick-walled cavity and a wavy meniscus constitute unusual features for an ordinary pyogenic lung abscess and suggests other possibilities. Endogenous cases of hydatid disease are uncommon in the United States, with the majority of cases occurring in immigrants. There are few published case reports describing incidental findings of Aspergillus in a hydatid cyst. The rare occurrence of such a condition can lead to a delay in diagnosis and treatment

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores

Genetic discoveries of Alzheimer’s disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer’s disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer’s disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer’s disease

KATRIN: Status and Prospects for the Neutrino Mass and Beyond

International audienceThe Karlsruhe Tritium Neutrino (KATRIN) experiment is designed to measure a high-precision integral spectrum of the endpoint region of T2 beta decay, with the primary goal of probing the absolute mass scale of the neutrino. After a first tritium commissioning campaign in 2018, the experiment has been regularly running since 2019, and in its first two measurement campaigns has already achieved a sub-eV sensitivity. After 1000 days of data-taking, KATRIN's design sensitivity is 0.2 eV at the 90% confidence level. In this white paper we describe the current status of KATRIN; explore prospects for measuring the neutrino mass and other physics observables, including sterile neutrinos and other beyond-Standard-Model hypotheses; and discuss research-and-development projects that may further improve the KATRIN sensitivity

KATRIN: Status and Prospects for the Neutrino Mass and Beyond

International audienceThe Karlsruhe Tritium Neutrino (KATRIN) experiment is designed to measure a high-precision integral spectrum of the endpoint region of T2 beta decay, with the primary goal of probing the absolute mass scale of the neutrino. After a first tritium commissioning campaign in 2018, the experiment has been regularly running since 2019, and in its first two measurement campaigns has already achieved a sub-eV sensitivity. After 1000 days of data-taking, KATRIN's design sensitivity is 0.2 eV at the 90% confidence level. In this white paper we describe the current status of KATRIN; explore prospects for measuring the neutrino mass and other physics observables, including sterile neutrinos and other beyond-Standard-Model hypotheses; and discuss research-and-development projects that may further improve the KATRIN sensitivity

KATRIN: status and prospects for the neutrino mass and beyond

International audienceThe Karlsruhe Tritium Neutrino (KATRIN) experiment is designed to measure a high-precision integral spectrum of the endpoint region of T$_{2}$ β decay, with the primary goal of probing the absolute mass scale of the neutrino. After a first tritium commissioning campaign in 2018, the experiment has been regularly running since 2019, and in its first two measurement campaigns has already achieved a sub-eV sensitivity. After 1000 days of data-taking, KATRIN’s design sensitivity is 0.2 eV at the 90% confidence level. In this white paper we describe the current status of KATRIN; explore prospects for measuring the neutrino mass and other physics observables, including sterile neutrinos and other beyond-Standard-Model hypotheses; and discuss research-and-development projects that may further improve the KATRIN sensitivity

KATRIN: Status and Prospects for the Neutrino Mass and Beyond

International audienceThe Karlsruhe Tritium Neutrino (KATRIN) experiment is designed to measure a high-precision integral spectrum of the endpoint region of T2 beta decay, with the primary goal of probing the absolute mass scale of the neutrino. After a first tritium commissioning campaign in 2018, the experiment has been regularly running since 2019, and in its first two measurement campaigns has already achieved a sub-eV sensitivity. After 1000 days of data-taking, KATRIN's design sensitivity is 0.2 eV at the 90% confidence level. In this white paper we describe the current status of KATRIN; explore prospects for measuring the neutrino mass and other physics observables, including sterile neutrinos and other beyond-Standard-Model hypotheses; and discuss research-and-development projects that may further improve the KATRIN sensitivity