Current Bounds on Technicolor with Scalars

Technicolor with scalars is the simplest dynamical symmetry breaking model and one in which the predicted values of many observables may be readily calculated. This letter applies current LEP, Tevatron, CESR, and SLAC data from searches for neutral and charged scalars and from studies of b-quark physics to obtain bounds on technicolor with scalars. Expectations for how upcoming measurements will further probe the theory's parameter space are also discussed.Comment: 9 pages, 2 figures, LaTe

Current bounds on technicolor with scalars

Technicolor with scalars is the simplest dynamical symmetry breaking model and one in which the predicted values of many observables may be readily calculated. This letter applies current LEP, Tevatron, CESR, and SLAC data from searches for neutral and charged scalars and from studies of b-quark physics to obtain bounds on technicolor with scalars. Expectations for how upcoming measurements will further probe the theory's parameter space are also discussed

Acute Febrile Illness and Complications Due to Murine Typhus, Texas, USA

Murine typhus occurs relatively commonly in southern Texas, as well as in California. We reviewed records of 90 adults and children in whom murine typhus was diagnosed during a 3-year period in 2 hospitals in southern Texas, USA. Most patients lacked notable comorbidities; all were immunocompetent. Initial signs and symptoms included fever (99%), malaise (82%), headache (77%), fatigue (70%), myalgias (68%), and rash (39%). Complications, often severe, in 28% of patients included bronchiolitis, pneumonia, meningitis, septic shock, cholecystitis, pancreatitis, myositis, and rhabdomyolysis; the last 3 are previously unreported in murine typhus. Low serum albumin and elevated procalcitonin, consistent with bacterial sepsis, were observed in >70% of cases. Rash was more common in children; thrombocytopenia, hyponatremia, elevated hepatic transaminases, and complications were more frequent in adults. Murine typhus should be considered as a diagnostic possibility in cases of acute febrile illness in southern and even in more northern US states

Skin and soft tissue infection in people living with human immunodeficiency virus in a large, urban, public healthcare system in houston, Texas, 2009-2014

Antecedentes. Las infecciones de la piel y los tejidos blandos (SSTI) afectan de manera desproporcionada a los pacientes con el virus de la inmunodeficiencia humana (VIH). Se han observado disminuciones recientes en la incidencia de SSTI en la población sin VIH. Buscamos estudiar la epidemiología y microbiología de las SSTI en una población de 8597 pacientes seguidos para la atención primaria del VIH en un gran sistema de condado urbano desde enero de 2009 hasta diciembre de 2014. Métodos. Las SSTI se identificaron a partir de la historia clínica electrónica mediante el uso de códigos de facturación de la Clasificación Internacional de Enfermedades-9. Se revisaron los gráficos para confirmar el diagnóstico de SSTI aguda de cada paciente y los datos de cultivo y susceptibilidad abstractos. Calculamos las incidencias anuales de SSTI mediante regresión de Poisson con agrupamiento por paciente. Resultados. Se identificaron 2202 SSTI. De 503 (22,8%) SSTI cultivados, 332 (66,0%) recuperaron Staphylococcus aureus como patógeno, de los cuales 287/332 (86,4%) presentaron S. aureus como único organismo aislado. Entre los aislamientos de S. aureus que mostraron susceptibilidad a los antibióticos, 231/331 (69,8%) fueron resistentes a la meticilina y la proporción no varió por año. La incidencia observada de SSTI fue de 78,0 por 1000 personas-año (intervalo de confianza del 95% 72,9-83,4) y disminuyó de 96,0 infecciones por 1000 personas-año en 2009 a 56,5 infecciones por 1000 personas-año en 2014 ( P<0,001). Otros predictores significativos de la incidencia de SSTI tanto en análisis univariados como multivariados incluyeron un recuento bajo de CD4, una carga viral alta y no ser hispano de habla hispana. Conclusiones. Las SSTI siguen siendo un problema importante en los pacientes ambulatorios que viven con el VIH, aunque las tasas de SSTI parecen haber disminuido en aproximadamente un 40% entre 2009 y 2014.Background. Skin and soft tissue infections (SSTIs) disproportionately impact patients with human immunodeficiency virus (HIV). Recent declines in the incidence of SSTIs have been noted in the non-HIV population. We sought to study the epidemiology and microbiology of SSTIs in a population of 8597 patients followed for HIV primary care in a large, urban county system from January 2009 to December 2014. Methods. SSTIs were identified from the electronic medical record by use of International Classification of Diseases-9 billing codes. Charts were reviewed to confirm each patient’s diagnosis of acute SSTI and abstract culture and susceptibility data. We calculated the yearly SSTI incidences using Poisson regression with clustering by patient. Results. There were 2202 SSTIs identified. Of 503 (22.8%) cultured SSTIs, 332 (66.0%) recovered Staphylococcus aureus as a pathogen, of which 287/332 (86.4%) featured S. aureus as the sole isolated organism. Among the S. aureus isolates that exhibited antibiotic susceptibilities, 231/331 (69.8%) were methicillin resistant, and the proportion did not change by year. The observed incidence of SSTI was 78.0 per 1000 person-years (95% confidence interval 72.9–83.4) and declined from 96.0 infections per 1000 person-years in 2009 to 56.5 infections per 1000 person-years in 2014 (P < .001). Other significant predictors of SSTI incidences in both univariate as well as multivariate analyses included a low CD4 count, high viral load, and not being a Spanish-speaking Hispanic. Conclusions. SSTIs remain a significant problem in the outpatients living with HIV, although rates of SSTIs appear to have declined by approximately 40% between 2009 and 201

Gastric adenocarcinoma in a patient with X-linked agammaglobulinemia and HIV: Case report and review of the literature

X-linked agammaglobulinemia (XLA) is an X-linked inherited disease usually caused by a germline mutation in the BTK gene leading to Bruton’s tyrosine kinase deficiency, which results in the impaired development of B-lymphocytes and a subsequent lack of immunoglobulin production. Patients with XLA have an increased susceptibility to bacterial and viral infections, and multiple case reports have been published regarding an association between XLA and gastrointestinal (GI) malignancy. Here, we describe a case of a 25-year-old man with XLA and HIV, who developed gastric adenocarcinoma. Previously reported cases of XLA and GI malignancy are also reviewed and summarized

Single tablet HIV regimens facilitate virologic suppression and retention in care among treatment naïve patients\u3csup\u3e*\u3c/sup\u3e

Newer HIV regimens are typically taken once daily but vary in the number of pills required. Whether the number of pills in a once-daily HIV regimen affects clinical outcomes is unknown. We retrospectively compared adherence, retention in care, and virologic outcomes between patients starting a once daily single-tablet regimen (STR) to patients starting a once-daily multi-tablet regimen (MTR) in a publicly funded clinic in the United States. Outcomes were measured in the year after starting ART and included retention in care, virologic suppression, and medication possession ratio of at least 80%. Data from patients initiating therapy from 1 January 2008 to 31 December 2011 were analyzed with both unadjusted and propensity-score adjusted regression. Overall, 622 patients started with an STR (100% efavirenz-based) and 406 with an MTR (65% atazanavir-based and 35% darunavir-based) regimen. Retention in care was achieved in 80.7% of STR patients vs. 72.7% of MTR patients (unadjusted OR 1.57, 95% CI 1.17–2.11; adjusted OR 1.49, 95% CI 1.10–2.02). Virologic suppression occurred among 84.4% of STR patients vs. 77.6% of MTR patients (unadjusted OR 1.56; 95% CI 1.14–2.15; adjusted OR 1.41; 95% CI 1.02–1.96). There was no difference in the proportion of patients achieving at least 80% adherence, as measured by medication possession ratio (33.0% of STR patients and 30.1% of MTR patients; unadjusted OR 1.14; 95% CI 0.87–1.50; adjusted OR 1.04, CI 0.79–1.38). While it is difficult to eliminate confounding in this observational study, retention in care and virologic outcomes were better in patients prescribed STRs

Utilization of voriconazole drug monitoring in the treatment of cutaneous Scedosporium apiospermum infection

We report the use of voriconazole troughs to achieve appropriate therapeutic levels in treatment of a cutaneous Scedosporium apiospermum infection. Following heart transplantation, a 63-year-old immunocompromised patient presented with post-traumatic nodular lesions on his right shin. Pathology showed fungal yeasts with culture revealing Scedosporium apiospermum. According to therapeutic drug monitoring, initial voriconazole treatment was subtherapeutic requiring increased dosing until appropriate therapeutic trough levels were attained, and resolution of the fungal infection was achieved. Keywords: Cutaneous Scedosporium apiospermum, Voriconazole, Trough, Transplant, Immunocompromise