BCG reaction in a Health Worker – A Medical Error

Exposure to blood-borne pathogens from sharp injuries continue to pose a significant risk to healthcare workers (HCW). The number of sharps injuries sustained by HCW is still unclear, primarily due to under-reporting of events. Healthcare professionals are at risk of sustaining such injuries from hollow-bore needles. Sharps injuries are associated with risk of infection with blood-borne pathogens such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) hepatitis C virus (HCV) and other live organisms. Here we are reporting a case of an adverse reaction in a HCW due to an accidental sharps injury by a needle used to administer the Bacillus Calmittee Gurien (BCG) vaccine

GdVO4 modified fluorine doped graphene nanosheets as dispersed photocatalyst for mitigation of phenolic compounds in aqueous environment and bacterial disinfection

The agglomeration of graphene based photocatalysts is major bottleneck for their applicability in slurry type photoreactors. In this work, we have prepared fluorine doped graphene (FG) as high dispersed adsorbent by sonochemical exfoliation method. GdVO4 nanoparticles were anchored on FG to fabricate GdVO4/FG photo catalyst. The high-dispersion of FG and GdVO4/FG was ascertained by zeta potential measurements and Tyndall effect. The atomic force microscope analysis depicted that thickness of FG and GdVO4/FG was less than 2.0 nm. The band gap of GdVO4/FG was 2.1 eV. The high surface area of GdVO4/FG was suited for adsorption coupled photocatalysis involving mineralization of phenol and 2, 4-dinitrophenol (DNP) in aqueous medium. The photodegradation process followed pseudo first order kinetics. The simultaneous adsorption and photocatalysis was most efficient process for degradation of selected phenolic compounds. Under visible light, both phenol and DNP mineralized in 7 and 9 h, respectively. The high performance liquid chromatography and mass spectrometry confirmed the formation of intermediate during degradation process which ultimately mineralized into CO2 and H2O. The photocatalytic activity of GdVO4/FG was also tested for bacterial disinfection of Pseudomonas fluorescence, Staphylococcus aureus, Streptococcus enterica, Bacillus subtilis and Escherichia coli bacteria. The oxidative radical species OH center dot and O-2(center dot-) played vital role in photodegradation and disinfection process. Due to high dispersion and recyclability, GdVO4/FG could be used as an efficient photocatalyst for removal of both biotic and abiotic pollutants present in water

Fabrication of fluorine doped graphene and SmVO4 based dispersed and adsorptive photocatalyst for abatement of phenolic compounds from water and bacterial disinfection

During heterogeneous photocatalysis, high dispersion of photocatalyst is vital for efficiency of slurry type photoreactors. In this work, we have prepared fluorine doped graphene (FG24) as a highly dispersible adsorbent by sonochemical exfoliation method. Moreover, SmVO4 (SV) nanoparticles were immobilized onto the surface of FG24 to prepare SV/FG24 photocatalyst, using post synthesis method. The zeta potential and Tyndall effect experiments confirmed the formation of highly dispersed SV/FG24 photocatalyst. The thickness of both FG24 and SV/FG24 was less than 2.0 nm. The band gap of SV/FG24 was 2.28 eV. The high surface area of SV/FG24 was suitable for adsorptive removal of phenol and 2, 4-dinitrophenol (DNP). The simultaneous process of adsorption and photocatalysis was the most effective for the degradation of selected phenolic compounds. Both phenol and DNP were mineralized in 10 h under visible light. The intermediates formation during the degradation process was proved by high-performance liquid chromatography and mass spectrometry analysis. The photocatalytic activity of SV/FG24 was also tested for photocatalytic bacterial disinfection of Escherichia coli, Bacillus subtilis, Pseudomonas fluorescence, Staphylococcus aureus, and Streptococcus enterica bacteria. The selected bacteria were deactivated using SV/FG24 in 3 h under visible light. Both OH˙ and O2˙¯ radicals played an important role during both degradation and disinfection process. Due to significant recyclability, SV/FG24 could be used as cost-effective photocatalyst for wastewater treatment. Unlike conventional slurry photo-reactors, no magnetic stirring was used during photocatalytic degradation reactions. We have successfully fabricated high-dispersed photocatalyst which remained dispersed for 10 h and effectively used for photocatalytic water purification process

Islanding of EuVO4 on high-dispersed fluorine doped few layered graphene sheets for efficient photocatalytic mineralization of phenolic compounds and bacterial disinfection

In present work, EuVO4 (EV) nanoparticles were dispersed over fluorine doped graphene sheets (FG24) to synthesize EV/FG24 nanocomposite. Few layered fluorine doped graphene sheets were prepared by sonochemical exfoliation method using NaF as fluorine source. FG24 and EV/FG24 composites were successfully characterized by FESEM, TEM, RAMAN, XRD, TGA, XPS, BET isotherm, FTIR, photoluminescence and UV–visible spectral techniques. AFM and RAMAN analysis confirmed the formation of fluorine doped graphene sheets. The high dispersion of EV/FG24 in water was ascertained by zeta potential measurement and Tyndall scattering experiment. The photocatalytic activity of EV/FG24 was tested for the degradation of phenolic compounds and bacterial disinfection under visible light. As compared to conventional slurry photocatalytic system, no magnetic stirring was used during degradation experiments. The photodegradation rate was substantially influenced by adsorption of 2, 4-dinitrophenol (DNP) and phenol onto EV/FG24. The DNP and phenol were completely mineralized in 10 h. The selected bacteria were inactivated by EV/FG24 in 3 h. The effect of various radical scavengers revealed the pivotal role of hydroxyl radicals during disinfection mechanism. EV/FG24 exhibited significant recycle efficiency during photocatalytic process. EV/FG24 was used as a stable photocatalyst to depollute contaminated water

Role of Imaging in the Evaluation of Male Infertility

Infertility is defined herein as the inability to achieve pregnancy after frequently engaging in unprotected sexual intercourse for 1 year. Among infertile couples, the cause of infertility involves the male partner in approximately 50% of cases. Male infertility is usually caused by conditions affecting sperm production, sperm function, or both, or blockages that prevent the delivery of sperm. Chronic health problems, injuries, lifestyle choices, anatomic problems, hormonal imbalances, and genetic defects can have a role in male infertility. The diagnostic workup of male infertility should include a thorough medical and reproductive history, physical examination, and semen analysis, followed by imaging. The main role of imaging is identification of the causes of infertility, such as congenital anomalies and disorders that obstruct sperm transport and may be correctable. Scrotal ultrasonography is the most common initially performed noninvasive examination used to image the male reproductive system, including the testes and extratesticular structures such as the epididymis. Magnetic resonance (MR) imaging is another noninvasive imaging modality used in the pelvis to evaluate possible obstructive lesions involving the ductal system. MR imaging of the brain is extremely useful for evaluating relevant neurologic abnormalities, such as pituitary gland disorders, that are suspected on the basis of hormone analysis results. Invasive techniques are usually reserved for therapeutic interventions in patients with known abnormalities. In this article, the causes and imaging findings of obstructive and nonobstructive azoospermia are discussed. In addition to detecting treatable conditions that are related to male infertility, identifying the life-threatening entities associated with infertility and the genetic conditions that could be transmitted to offspring-especially in patients who undergo assisted reproduction-is critical. (C) RSNA, 20176 month embargo; Published: May 2017This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Paraduodenal pancreatitis: benign and malignant mimics at MRI

Paraduodenal pancreatitis, also known as groove pancreatitis, is a rare form of chronic pancreatitis that masquerades as pancreatic adenocarcinoma affecting the pancreaticoduodenal groove, a potential space between the head of the pancreas, duodenum, and common bile duct. Two forms of groove pancreatitis have been described. The segmental form involves the pancreatic head with development of scar tissue within the groove, whereas the pure form affects the groove only, sparing the pancreatic head. Imaging findings of groove pancreatitis often overlap with primary duodenal, ampullary, or pancreatic neoplasms, which often results in a diagnostic challenge. In addition, paraduodenal pancreatitis can be mistaken for cystic pancreatic lesions, especially when there is involvement of the duodenal wall. Preoperative recognition of this entity is very important in order to avoid unnecessary procedures, although surgery, such as pancreaticoduodenectomy, may still be required to relieve obstructive symptoms. In this article, the pathophysiology and magnetic resonance imaging characteristics of paraduodenal pancreatitis and important benign and malignant mimics are discussed

Hematospermia Evaluation at MR Imaging

Hematospermia is a challenging and anxiety-provoking condition that can manifest as a single episode or recur over the course of weeks to months. It is usually a benign self-limiting condition in younger sexually active males without a history of risk factors such as cancer, urogenital malformations, bleeding disorders, and their associated symptoms. However, patients with recurrent, refractory and painful hematospermia with associated symptoms, such as fever, pain, or weight loss, require evaluation through clinical assessment and noninvasive investigations to rule out underlying pathologic conditions such as ejaculatory obstruction, infectious and inflammatory causes, malignancy, vascular malformations, and systemic disorders that increase the risk of bleeding, especially when presenting in older men. If these investigations are negative, the patient should be reassured and treated accordingly. In the recent past, magnetic resonance (MR) imaging has assumed a major role in the investigation of hematospermia due to its excellent soft-tissue contrast and multiplanar capabilities. In this review, we will discuss the potential causes of hematospermia and its diagnostic workup, including pathophysiology, anatomic considerations, the imaging appearance of associated pathologic conditions, and management. (C) RSNA, 2016 . radiographics.rsna.org6 month embargo; published online: 12 August 2016This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Pancreatic ductal adenocarcinomas associated with intraductal papillary mucinous neoplasms (IPMNs) versus pseudo-IPMNs: relative frequency, clinicopathologic characteristics and differential diagnosis

The literature is highly conflicted on what percentage of pancreatic ductal adenocarcinomas (PDACs) arise in association with intraductal papillary mucinous neoplasms (IPMNs). Some studies have claimed that even small (Sendai-negative) IPMNs frequently lead to PDAC. Recently, more refined pathologic definitions for mucin-lined cysts were provided in consensus manuscripts, but so far there is no systematic analysis regarding the frequency and clinicopathologic characteristics of IPMN-mimickers, i.e., pseudo-IPMNs. In this study, as the first step in establishing frequency, we performed a systematic review of the pathologic findings in 501 consecutive ordinary PDACs, which disclosed that 10% of PDACs had associated cysts >= 1 cm. While 31 (6.2%) of these were IPMN or mucinous cystic neoplasm (MCN), 19 (3.8%) were other cyst types that mimicked IPMN (pseudo-IPMNs) per recent WHO/consensus criteria. As the second step of the study, we performed a comparative clinicopathologic analysis by also including our entire surgical pathology/consultation databases that was comprised of 60 IPMN-associated PDACs, 30 MCN-associated PDACs and 40 pseudo-IPMN-associated PDACs. We found that 84% of true IPMNs were pre-operatively recognized, whereas IPMN was considered in differential diagnosis of 33% of pseudo-IPMNs. Of the 40 pseudo-IPMNs, there were 15 secondary duct ectasias; 6 large-duct-type PDACs; 5 pseudocysts; 5 cystic tumor necrosis; 4 simple mucinous cysts; 3 groove pancreatitis-associated paraduodenal wall cysts; and 2 congenital cysts. Microscopically, pseudo-IPMNs had at least partial mucinous-lining mimicking IPMN but had smaller cystic (mean = 1.9 cm) and larger PDAC (mean = 3.8 cm) components compared to true IPMNs (cyst = 5.7 cm; PDAC = 2.0 cm). In summary, in this pathologically verified analysis that utilized refined criteria, 10% of PDACs were discovered to have cysts >= 1 cm, about two-thirds of which were IPMN/MCN but about one-third were pseudo-IPMNs. True IPMNs underlying the PDACs are often large and are already diagnosed pre-operatively as having an IPMN component, whereas only a third of the pseudo-IPMNs receive IPMN diagnosis by imaging and their cysts are smaller. At the histopathologic level, pseudo-IPMNs are highly prone to misdiagnosis as IPMN, which presumably accounts for much higher association of IPMNs with PDAC as reported in some studies. The subtle but salient characteristics of pseudo-IPMNs elucidated in this study should be combined with careful radiological/clinical correlation in order to exclude pseudo-IPMNs

Paraduodenal Pancreatitis Imaging and Pathologic Correlation of 47 Cases Elucidates Distinct Subtypes and the Factors Involved in its Etiopathogenesis

Clinicopathologic characteristics of paraduodenal (groove) pancreatitis (PDP) remain to be fully unraveled. In this study, 47 PDPs with preoperative enhanced images available were subjected to detailed comparative analysis in conjunction with pathologic findings. PDP were predominantly in males (3: 1) with a mean age of 50 years, and 60% had a preoperative diagnosis of cancer. Mean lesional size was 3.1 cm. Three distinct subtypes were identified by imaging. Solid-tumoral (type-1) with groove-predominant (type-1A, 36%) forming a distinct solid band between the duodenum and pancreas often with histologic microabscesses (69% vs. 33% in others), and pancreas-involving (type-1B, 19%) forming a pseudotumoral mass spanning into the head-groove area, always diagnosed preoperatively as "cancer," but often lacked parenchymal atrophy of the body (44% vs. 92%). Cyst-forming (type-2) had groove-predominant (type-2A, 15%), often accompanied by Brunner gland hyperplasia, and pancreas-predominant (type-2B, 15%) were in younger (mean: 44 y) females (57% vs. 18%) and had less alcohol/tobacco abuse (50/33% vs. 81/69%). Ill-defined (type-3; 15%) often had main pancreatic duct dilatation (mean: 5.6 vs. 2.8mm). The capricious presentations of PDP could be attributed to variable effects of different mechanistic and precipitative etiopathogenetic factors such as disturbed accessory duct outflow (dilated Santorini duct, 87%), aggravated by alcohol (77%) with superimposed stasis in the main ampulla (previous cholecystectomy, 47%; choledocholithiasis, 9%), strictured Wirsung duct (68%), and some likely exacerbated by ischemia (hypertension [59%], tobacco abuse [64%], arteriosclerosis in the tissue [23%]). In conclusion, our study identified 3 distinct types of PDP and each may reflect different pathogenetic contributing factors