Tuberculose Muscular e Subcutânea Multifocal num Jovem Imunocompetente: Descrição de um Caso Clínico e Revisão da Literatura

Due to unfavorable conditions for survival and multiplication of Mycobacterium tuberculosis, muscle and soft tissue involvement is probably the rarest form of presentation of musculoskeletal tuberculosis, particularly without a clinically or radiologically apparent primary focus. As in other extrapulmonary forms of tuberculosis, its relative incidence is higher among immunocompromised patients. A progressive swelling is the most common complaint at presentation, which is otherwise mild and nonspecific. We present a case of multifocal (seven) subcutaneous and muscular tuberculous abscesses in a 29-year-old Indian patient who had no apparent underlying risk factors, nor any other organ involvement. Provisional diagnosis was initially made upon Mycobacterium tuberculosis complex nucleic acid detection in an aspirate of one of the collections and later confirmed by a positive culture on Lowenstein-Jensen medium. Two abscesses required aspiration and two others drained spontaneously. The patient responded well to nine months of anti-tuberculous therapy. An extensive review of the literature was made.info:eu-repo/semantics/publishedVersio

Searching for Dark Particles with Quantum Optics

We propose a way to use optical tools from quantum imaging and quantum communication to search for physics beyond the standard model. Spontaneous parametric down-conversion (SPDC) is a commonly used source of entangled photons in which pump photons convert to a signal-idler pair. We propose to search for "dark-SPDC"(dSPDC) events in which a new dark-sector particle replaces the idler. Though it does not interact, the presence of a dark particle can be inferred by the properties of the signal photon. Examples of dark states include axionlike particles and dark photons. We show that the presence of an optical medium opens the phase space of the down-conversion process, or decay, which would be forbidden in a vacuum. Search schemes are proposed that employ optical imaging and/or spectroscopy of the signal photons. The signal rates in our proposal scales with the second power of the small coupling to new physics, as opposed to light-shining-through-wall experiments, the signal of which scales with coupling to the fourth power. We analyze the characteristics of the optical media needed to enhance dSPDC and estimate the rate.Fil: Estrada, J.. Fermi National Accelerator Laboratory; Estados UnidosFil: Harnik, R.. Fermi National Accelerator Laboratory; Estados UnidosFil: Rodrigues Ferreira Maltez, Dario Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Física de Buenos Aires; Argentina. Fermi National Accelerator Laboratory; Estados UnidosFil: Senger, M.. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física; Argentina. Universitat Zurich; Suiz

A Case of Central Nervous System Infection by Candida Famata in an Immunosuppressed Patient with HIV-1 Infection

Invasive fungal infections caused by Candida species are increasingly observed in immunosuppressed patients. Candida albicans is the more often identified species and neurocandidiasis is associated with high mortality rates. Diagnosis and treatment of these infections are frequently challenging. We report a case of central nervous system infection caused by Candida famata in an HIV-1 infected patient. To our best knowledge this is just the second published case of neural infection by this agent.info:eu-repo/semantics/publishedVersio

Hepatite E Aguda Severa em Mulher com História Auto-Imune

Hepatitis E virus genotype 3 infections are normally asymptomatic in immunocompetent individuals. Symptomatic cases of acute icteric hepatitis E are seldom observed among women, younger men and children but are particularly seen in middle-aged/elderly men. We report a case of severe acute hepatitis E caused by genotype 3 in an immunocompetent 40-year-old woman that required prolonged hospitalization. Her medical history included an autoimmune background, namely atrophic gastritis and Graves' disease. She presented an extensive hepatic necrosis as revealed by the high levels of aminotransferases (ALT 4893 U/L; AST 3138 U/L). She showed also a coagulation disorder (prothrombin time; INR = 1.33). Serological markers for hepatitis viruses A, B and C were negative but serum was positive for hepatitis E virus RNA. Sequencing and phylogenetic analysis revealed that the hepatitis E virus strain belonged to subgenotype 3a. This is suggestive of an association between the severe acute hepatitis E virus genotype 3 infection and the autoimmune background.info:eu-repo/semantics/publishedVersio

Non-AIDS-related comorbidities in people living with HIV-1 aged 50 years and older: The AGING POSITIVE study.

OBJECTIVE: To characterize the profile of non-AIDS-related comorbidities (NARC) in the older HIV-1-infected population and to explore the factors associated with multiple NARC. METHODS: This was a multicentre, cross-sectional study including HIV-1-infected patients aged ≥50 years, who were virologically suppressed and had been on a stable antiretroviral therapy (ART) regimen for at least 6 months. A multiple regression model explored the association between demographic and clinical variables and the number of NARC. RESULTS: Overall, 401 patients were enrolled. The mean age of the patients was 59.3 years and 72.6% were male. The mean duration of HIV-1 infection was 12.0 years and the median exposure to ART was 10.0 years. The mean number of NARC was 2.1, and 34.7% of patients had three or more NARC. Hypercholesterolemia was the most frequent NARC (60.8%), followed by arterial hypertension (39.7%) and chronic depression/anxiety (23.9%). Arterial hypertension and diabetes mellitus were the most frequently treated NARC (95.6% and 92.6% of cases, respectively). The linear regression analysis showed a positive relationship between age and NARC (B=0.032, 95% confidence interval 0.015-0.049; p=0.0003) and between the duration of HIV-1 infection and NARC (B=0.039, 95% confidence interval 0.017-0.059; p=0.0005). CONCLUSIONS: A high prevalence of NARC was found, the most common being metabolic, cardiovascular, and psychological conditions. NARC rates were similar to those reported for the general population, suggesting a larger societal problem beyond HIV infection. A multidisciplinary approach is essential to reduce the burden of complex multi-morbid conditions in the HIV-1-infected population.info:eu-repo/semantics/publishedVersio

HIV-Associated Facial Lipodystrophy: Experience of a Tertiary Referral Center With Fat and Dermis-Fat Compound Graft Transfer

Objectives: HIV-associated lipodystrophy is a common comorbidity in HIV-infected patients, having a profound impact on every aspect of patients' lives, particularly when involving the face. Hence, it is of the utmost importance to evaluate the result of any potential therapies that may help solve HIV-associated facial lipodystrophy. The aim of this article was to evaluate the outcome of patients undergoing facial lipodystrophy correction surgery within our institution. Methods: A retrospective analysis of the clinical charts and iconographic information of patients regarding demographics, morphologic changes, surgical option, postoperative complications, results, and patient satisfaction assessed by a 1- to 10-point scale and by the Assessment of Body Change and Distress questionnaire. Results: Twenty-three patients were operated on from March 2011 to April 2015. Seventy-five percent of cases were treated with fat graft injection, whereas dermis-fat grafts were applied in 25% of patients. The former had their fat harvested more commonly from the abdomen, whereas in the latter case, the graft was harvested mostly from the inner aspect of arms. The mean volume of fat injected on each side of the face was 28.5 ± 22.7 mL. On a scale from 1 to 10, mean patient satisfaction was 7.7 ± 2.8. The Assessment of Body Change and Distress questionnaire revealed statistically significant improvements. Complications occurred in 25% of cases, the most frequent being significant reabsorption. No major complications occurred. Conclusions: Treatment of HIV-associated facial lipodystrophy with autologous fat or dermis-fat compound graft is a safe procedure with long-lasting results and unquestionable aesthetic and social benefits.info:eu-repo/semantics/publishedVersio

Experimental and theoretical observations on DDT in smooth narrow channels

International audienceA combined experimental and theoretical study of deflagration-to-detonation transition (DDT) in smooth narrow channels is presented. Some of the distinguishing features characterizing the late stages of DDT are shown to be qualitatively captured by a simple one-dimensional scalar equation. Inspection of the structure and stability of the traveling wave solutions found in the model, and comparison with experimental observations, suggest a possible mechanism responsible for front acceleration and transition to detonation

Tuberculose em Transplantados Hepáticos: Uma Série de Oito Casos Durante um Período de Cinco Anos

Introduction: Tuberculosis incidence in Portugal ranged from 20 to 22 cases per 100 000 inhabitants between 2010 and 2014. Tuberculosis incidence in liver transplant recipients is not precisely known, but it is estimated to be higher than among the general population. Tuberculosis in liver transplant recipients is particularly challenging because of the atypical clinical presentation and side effects of the antibacillary drugs and their potential interactions with immunosuppressive therapies. Material and Methods: We retrospectively reviewed the clinical records of liver transplant recipients with post-transplant tuberculosis occurring from January 2010 to December 2014 at a liver transplantation unit in Lisbon, Portugal. Demographic data, baseline and clinical features, as well as treatment regimen, toxicities and outcomes, were analyzed. Results: Among 1005 recipients, active tuberculosis was diagnosed in eight patients between January 2010 and December 2014 (frequency = 0.8%). Late onset tuberculosis was more frequent than early tuberculosis. Mycobacterium tuberculosis complex was isolated from cultures in almost every case (7; 87.5%). Extra-pulmonary involvement and disseminated tuberculosis were frequent. Two patients developed rejection without allograft loss. Crude mortality was 37.5%, with 2 deaths being related to tuberculosis. Discussion: Despite the uncertainty regarding treatment duration in liver transplant recipients, disease severity, as well as number of active drugs against TB infection, should be taken into account. There was a need for a rifampin-free regimen and immunosuppression adjustment in patients who experienced acute graf rejection. Conclusion: Although the number of cases of tuberculosis is low, its post-transplant frequency is significant and the observed mortality rate is not to be neglected. The cases of hepatotoxicity and graft rejection seen in this case series demonstrate the challenges associated with tuberculosis diagnosis in liver transplant recipients and management of the interactions between immunosuppressors and rifampin. This study strengthens the recommendation of latent tuberculosis infection screening and treatment in liver transplant candidates or recipients.info:eu-repo/semantics/publishedVersio