A possible case of serum sickness after ocrelizumab infusion – Commentary

Serum sickness is a type III delayed hypersensitivity reaction which causes deposition of immune-complexes in the tissues. It has been reported with rituximab, and in this issue of the journal, there is a case report of a patient with relapsing remitting multiple sclerosis who developed a possible serum sickness after the third infusion of ocrelizumab. In this commentary, we discuss the current literature on serum sickness, and how to diagnose and manage it. We provide our opinion on this particular case, and encourage neurologists and patients to remain vigilant of such a possibility

Escherichia coli strains as Major secondary bacterial pathogen isolated from an outbreak of swollen head syndrome in layers, in Al-Diwaniyah, Iraq

A cross-sectional study was conducted to identify the involvement of E. coli as a secondary pathogen in cases of Swollen Head infection and to detect drug susceptibility pattern of these isolates. This study was carried out on 20 chickens that were purchased from Al-Safaa Company from an outbreak of a sudden increase in mortality in layers farm and experienced clinical signs included difficult breath, coughing, rales, swollen of infraorbital and supraorbital sinuses, and conjunctivitis, as well as severe depression. The main gross lesions demonstrated among the infected chicken including gaseous exudate in the trachea, nasal passages, and sinuses. There was yellowish gaseous exudate on the air sacs, ovaries, and the peritoneum. The samples were inoculated on different bacteriological culture media, the isolates were identified by morphological, and biochemical tests, in which the result revealed that the major pathogens associated with the swollen head syndrome in layers were E.coli. The majority of isolates were resistant to ciprofloxacin (94.4%), Ampicillin (100%), Erythromycin (100%), azithromycin (100%), trimethoprim (88.9%), and levofloxacin (94.4%). Nonetheless, however majority of APEC isolates were susceptible to nitrofurantoin (72.3%). Moreover, all E.coli strains recovered in the current study showed multidrug-resistant to three or more different antibacterial classes. In conclusion, the present findings showed that MDR E. coli is prevalent SHS. The MDR E. coli is an alarming signal because these bacteria can transfer their MDR trait to potential human and animal pathogens. Therefore, the introduction of surveillance programs to monitor antimicrobial resistance strains is strongly recommended to protect human and animal health

Automatic modulation classification using interacting multiple model - Kalman filter for channel estimation

YesA rigorous model for automatic modulation classification (AMC) in cognitive radio (CR) systems is proposed in this paper. This is achieved by exploiting the Kalman filter (KF) integrated with an adaptive interacting multiple model (IMM) for resilient estimation of the channel state information (CSI). A novel approach is proposed, in adding up the squareroot singular values (SRSV) of the decomposed channel using the singular value decompositions (SVD) algorithm. This new scheme, termed Frobenius eigenmode transmission (FET), is chiefly intended to maintain the total power of all individual effective eigenmodes, as opposed to keeping only the dominant one. The analysis is applied over multiple-input multiple-output (MIMO) antennas in combination with a Rayleigh fading channel using a quasi likelihood ratio test (QLRT) algorithm for AMC. The expectation-maximization (EM) is employed for recursive computation of the underlying estimation and classification algorithms. Novel simulations demonstrate the advantages of the combined IMM-KF structure when compared to the perfectly known channel and maximum likelihood estimate (MLE), in terms of achieving the targeted optimal performance with the desirable benefit of less computational complexity loads

Performance evaluation of the time delay digital tanlock loop architectures

This article presents the architectures, theoretical analyses and testing results of modified time delay digital tanlock loop (TDTLs) system. The modifications to the original TDTL architecture were introduced to overcome some of the limitations of the original TDTL and to enhance the overall performance of the particular systems. The limitations addressed in this article include the non-linearity of the phase detector, the restricted width of the locking range and the overall system acquisition speed. Each of the modified architectures was tested by subjecting the system to sudden positive and negative frequency steps and comparing its response with that of the original TDTL. In addition, the performance of all the architectures was evaluated under noise-free as well as noisy environments. The extensive simulation results using MATLAB/SIMULINK demonstrate that the new architectures overcome the limitations they addressed and the overall results confirmed significant improvements in performance compared to the conventional TDTL system

Acute retroperitoneal bleeding due to inferior mesenteric artery aneurysm: Case report

<p>Abstract</p> <p>Background</p> <p>Visceral artery aneurysms (VAA), although uncommon, are increasingly being detected. We describe a case of spontaneous retroperitoneal hemorrhage from a ruptured IMA aneurysm associated with stenosis of the superior mesenteric artery (SMA) and celiac trunk, successfully treated with surgery.</p> <p>Methods</p> <p>A 65-year-old man presented with abdominal pain and hypovolemic shock. Abdominal CT scan showed an aneurysm of the inferior mesenteric artery with retroperitoneal hematoma. In addition, an obstructive disease of the superior mesenteric artery and celiac axis was observed.</p> <p>Results</p> <p>Upon emergency laparotomy a ruptured inferior mesenteric artery aneurysm was detected. The aneurysm was excised and the artery reconstructed by end-to-end anastomosis.</p> <p>Conclusions</p> <p>This report discusses the etiology, presentation, diagnosis and case management of inferior mesenteric artery aneurysms.</p

Role of age and comorbidities in mortality of patients with infective endocarditis

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015. Patients were stratified into three age groups:<65 years, 65 to 80 years, and = 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 = 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients =80 years who underwent surgery were significantly lower compared with other age groups (14.3%, 65 years; 20.5%, 65-79 years; 31.3%, =80 years). In-hospital mortality was lower in the <65-year group (20.3%, <65 years;30.1%, 65-79 years;34.7%, =80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%, =80 years; p = 0.003).Independent predictors of mortality were age = 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI = 3 (HR:1.62; 95% CI:1.39–1.88), and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared, the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. Conclusion: There were no differences in the clinical presentation of IE between the groups. Age = 80 years, high comorbidity (measured by CCI), and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

A general perspective on software-hardware defined cognitive radio based on emergency ad-hoc network topology

NoThis paper presents a different perspective on the collective concept of software-hardware defined radio (SHDR) in cognitive radio (CR) networks. The SHDR is proposed considering the multiple hardware functionalities conceived by software defined radio, which generally reflects on the adaptable recognition of network services and operational conditions. An ad-hoc network scheme is envisaged as an alternative to a conventional cellular network to accommodate for emergency situations. The connection to such emergency backup network could be established on CR engines built in normal or dedicated smart phone handsets