Mycobacterium-avium -Pneumonie bei HIV-negativem Patienten

Zusammenfassung: Ein 79-jähriger Patient mit kurativ behandeltem Lungenkarzinom wurde wegen Fieber, Atemnot und Husten zugewiesen. Eine Antibiotikatherapie zur Pneumoniebehandlung brachte keine Besserung, und radiologisch war die Pneumonie progredient. Ein Erreger konnte nicht gefunden werden. Erst unter einer Steroidtherapie bei vermuteter kryptogener Pneumonitis normalisierten sich die Entzündungszeichen und die Symptomatik war rückläufig. Nach 3-wöchiger Kultivierung konnten im Eintrittssputum Mycobacterium avium Complex (MAC) gefunden und eine MAC-Pneumonie diagnostiziert werde

Hepatitis with Fibrin-Ring Granulomas

Abstract : We describe a 66-year-old woman hospitalized with fever, fatigue and hepatopathy. In her medical history arterial hypertension (treated with propranolol and lisinopril), diabetes mellitus type 2 (no treatment before admission) and a gout arthropathy were noted wherefore a therapy with allopurinol 300 mg per day has been started 4 months before. Liver biopsy revealed fibrin-ring granulomas, compatible with allopurinolinduced hepatitis. Because of persistence of high fever after stopping allopurinol, steroids (1 mg/kg) were started. Under this treatment, she developed pancytopenia and fever. The bone marrow aspiration revealed Leishmania infantum. A second liver biopsy showed amastigotes and a disappearance of the granulomas. The history revealed a travel to Malta 2 years earlier. Despite adequate treatment with liposomal amphotericin B the patient deteriorated and finally died in septic shoc

Discrepancy of target sites between clinician and cytopathological reports in head neck fine needle aspiration: Did I miss the target or did the clinician mistake the organ site?

The diagnostic accuracy of fine needle aspiration cytology (FNAC) of head and neck lesions is relatively high, but cytologic interpretation might be confusing if the sample is lacking typical cytologic features according to labeled site by physician. These errors may have an impact on pathology search engines, healthcare costs or even adverse outcomes. The cytology archive database of multiple institutions in southern Iran and Australia covering the period 2001–2011, were searched using keywords: salivary gland, head, neck, FNAC, and cytology. All the extracted reports were reviewed. The reports which showed discordance between the clinician’s impression of the organ involved and subsequent fine needle biopsy request, and the eventual cytological diagnosis were selected. The cytological diagnosis was confirmed by histology or cell block, with assistance from imaging, clinical outcome, physical examination, molecular studies, or microbiological culture. The total number of 10,200 head and neck superficial FNAC were included in the study, from which 48 cases showed discordance between the clinicians request and the actual site of pathology. Apart from the histopathology, the imaging, clinical history, physical examination, immunohistochemical study, microbiologic culture and molecular testing helped to finalize the target organ of pathology in 23, 6, 7, 8, 2, and 1 cases respectively. The commonest discrepancies were for FNAC of “salivary gland” [total: 20 with actual final pathology in: bone (7), soft tissue (5), lymph node (3), odontogenic (3) and skin (2)], “lymph node” [total: 12 with final pathology in: soft tissue (3), skin (3), bone (1) and brain (1)], “soft tissue” [total: 11 with final pathology in: bone (5), skin (2), salivary gland (1), and ocular region (1)] and “skin” [total: 5 with final pathology in: lymph node (2), bone (1), soft tissue (1) and salivary gland (1)]. The primary physician requesting FNAC of head and neck lesions are incorrect in their clinical impression of the actual site in nearly 0.5 percent of cases, due to the overlapping clinical and imaging findings or possibly due to inadequate history taking or physical examination

ETV4 and ETV5 drive synovial sarcoma through cell cycle and DUX4 embryonic pathway control

Synovial sarcoma is an aggressive malignancy with no effective treatments for patients with metastasis. The synovial sarcoma fusion SS18-SSX, which recruits the SWI/SNF-BAF chromatin remodeling and polycomb repressive complexes, results in epigenetic activation of FGF receptor (FGFR) signaling. In genetic FGFR-knockout models, culture, and xenograft synovial sarcoma models treated with the FGFR inhibitor BGJ398, we show that FGFR1, FGFR2, and FGFR3 were crucial for tumor growth. Transcriptome analyses of BGJ398-treated cells and histological and expression analyses of mouse and human synovial sarcoma tumors revealed prevalent expression of two ETS factors and FGFR targets, ETV4 and ETV5. We further demonstrate that ETV4 and ETV5 acted as drivers of synovial sarcoma growth, most likely through control of the cell cycle. Upon ETV4 and ETV5 knockdown, we observed a striking upregulation of DUX4 and its transcriptional targets that activate the zygotic genome and drive the atrophy program in facioscapulohumeral dystrophy patients. In addition to demonstrating the importance of inhibiting all three FGFRs, the current findings reveal potential nodes of attack for the cancer with the discovery of ETV4 and ETV5 as appropriate biomarkers and molecular targets, and activation of the embryonic DUX4 pathway as a promising approach to block synovial sarcoma tumors

Perinatal distress and depression in culturally and linguistically diverse (CALD) Australian women : the role of psychosocial and obstetric factors

Perinatal distress and depression can have significant impacts on both the mother and baby. The present study investigated psychosocial and obstetric factors associated with perinatal distress and depressive symptoms among culturally and linguistically diverse (CALD) Australian women in Sydney, New South Wales. The study used retrospectively linked maternal and child health data from two Local Health Districts in Australia (N = 25,407). Perinatal distress was measured using the Edinburgh Postnatal Depression Scale (EPDS, scores of 10–12) and depressive symptoms, with EPDS scores of 13 or more. Multivariate multinomial logistic regression models were used to investigate the association between psychosocial and obstetric factors with perinatal distress and depressive symptoms. The prevalence of perinatal distress and depressive symptoms among CALD Australian women was 10.1% for antenatal distress; 7.3% for antenatal depressive symptoms; 6.2% for postnatal distress and 3.7% for postnatal depressive symptoms. Antenatal distress and depressive symptoms were associated with a lack of partner support, intimate partner violence, maternal history of childhood abuse and being known to child protection services. Antenatal distress and depressive symptoms were strongly associated with postnatal distress and depressive symptoms. Higher socioeconomic status had a protective effect on antenatal and postnatal depressive symptoms. Our study suggests that current perinatal mental health screening and referral for clinical assessment is essential, and also supports a re-examination of perinatal mental health policy to ensure access to culturally responsive mental health care that meets patients’ needs

Effectiveness of Protease Inhibitor Monotherapy versus Combination Antiretroviral Maintenance Therapy: A Meta-Analysis

The unparalleled success of combination antiretroviral therapy (cART) is based on the combination of three drugs from two classes. There is insufficient evidence whether simplification to ritonavir boosted protease inhibitor (PI/r) monotherapy in virologically suppressed HIV-infected patients is effective and safe to reduce cART side effects and costs

Влияние бренд-сообществ, основанных на социальных медиа, на доверие к бренду в туристической сфере

Building and maintaining brand trust has long been a major concern for marketers. One of the latest marketing concepts is social media based marketing. This paper aims to determine the impact of social media based brand community on brand trust in tourism industry. For this purpose, we investigated Setareh Almas Hali Tour and Travel Agency as our case study. This is an applied research using descriptive-correlational survey method and structural equation modeling. The required data was collected using questionnaire. The statistical population consisted of Instagram users of Setareh Almas Hali Tour and Travel Agency. After collecting questionnaires, we analyzed the data using LISREL.Створення та підтримання довіри до бренда вже давно є серйозною проблемою для маркетологів. Однією з найбільш нових маркетингових концепцій є маркетинг, що базується на використанні соціальних медіа. Метою статті є з’ясування впливу бренд-спільнот, заснованих на соціальних медіа, на довіру до брендав у сфері туризму. Для цього були досліджені агентства “Setareh Almas Hali Tour” і “Travel Agency”. Дослідження є прикладним з використанням описово-кореляційного методу та моделювання за структурними рівняннями. Необхідні дані були зібрані за допомогою анкети. Статистичну сукупність складали користувачі “Instagram”. Після збору анкет дані були проаналізовані за допомогою LISREL.Создание и поддержка доверия к бренду уже давно является серйозной проблемой для маркетологов. Одной из наиновейших маркетинговых концепций стал маркетинг, который базируется на использование социальных медиа. Целью работы является определение влияния бренд-сообществ, основанных на социальных медиа, на доверие к бренду в сфере туризма. Для этого были исследованы агентства “Setareh Almas Hali Tour” и “Travel Agency”. Исследование имеет прикладной характер з использованием описательно-корреляционного методу и моделирования за структурными уравнениями. Необходимые данные были собраны с помощью анкеты. Статистическую совокупность составляли пользователи “Instagram”. После сбора анкет данные были проанализированы с помощью LISREL

Влияние бренд-сообществ, основанных на социальных медиа, на доверие к бренду в туристической сфере

Building and maintaining brand trust has long been a major concern for marketers. One of the latest marketing concepts is social media based marketing. This paper aims to determine the impact of social media based brand community on brand trust in tourism industry. For this purpose, we investigated Setareh Almas Hali Tour and Travel Agency as our case study. This is an applied research using descriptive-correlational survey method and structural equation modeling. The required data was collected using questionnaire. The statistical population consisted of Instagram users of Setareh Almas Hali Tour and Travel Agency. After collecting questionnaires, we analyzed the data using LISREL.Створення та підтримання довіри до бренда вже давно є серйозною проблемою для маркетологів. Однією з найбільш нових маркетингових концепцій є маркетинг, що базується на використанні соціальних медіа. Метою статті є з’ясування впливу бренд-спільнот, заснованих на соціальних медіа, на довіру до брендав у сфері туризму. Для цього були досліджені агентства “Setareh Almas Hali Tour” і “Travel Agency”. Дослідження є прикладним з використанням описово-кореляційного методу та моделювання за структурними рівняннями. Необхідні дані були зібрані за допомогою анкети. Статистичну сукупність складали користувачі “Instagram”. Після збору анкет дані були проаналізовані за допомогою LISREL.Создание и поддержка доверия к бренду уже давно является серйозной проблемой для маркетологов. Одной из наиновейших маркетинговых концепций стал маркетинг, который базируется на использование социальных медиа. Целью работы является определение влияния бренд-сообществ, основанных на социальных медиа, на доверие к бренду в сфере туризма. Для этого были исследованы агентства “Setareh Almas Hali Tour” и “Travel Agency”. Исследование имеет прикладной характер з использованием описательно-корреляционного методу и моделирования за структурными уравнениями. Необходимые данные были собраны с помощью анкеты. Статистическую совокупность составляли пользователи “Instagram”. После сбора анкет данные были проанализированы с помощью LISREL