Difficulties in establishing a timely diagnosis of pulmonary artery sarcoma misdiagnosed as chronic thrombo-embolic pulmonary disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Pulmonary artery sarcomas are rare neoplasms that are often confused with chronic thrombo-embolic disease, as both can have similar clinical and imaging presentation.</p> <p>Case presentation</p> <p>In this report, we present a case of a 50-year-old man initially diagnosed with chronic thrombo-embolic pulmonary disease, but who was later found to have pulmonary artery sarcoma with poor survival prognosis. We review the clinical and imaging characteristics of the two diseases and discuss the difficulties in establishing a timely diagnosis.</p> <p>Conclusion</p> <p>Similar clinical features and imaging presentation of pulmonary artery sarcoma and chronic thrombo-embolic pulmonary disease make definitive diagnosis difficult. This case report also illustrates and emphasizes that in any case with no predisposition factors for embolism, no evidence of deep venous thrombosis and pulmonary emboli, and inadequate relief of symptoms with anticoagulation, an alternative diagnosis of pulmonary artery sarcoma should be considered. If pulmonary artery sarcoma is diagnosed late in the course of the disease, there is usually a poor survival outcome.</p

Salmonella enterica Serovar Typhimurium Lacking hfq Gene Confers Protective Immunity against Murine Typhoid

Salmonella enterica is an important enteric pathogen and its various serovars are involved in causing both systemic and intestinal diseases in humans and domestic animals. The emergence of multidrug-resistant strains of Salmonella leading to increased morbidity and mortality has further complicated its management. Live attenuated vaccines have been proven superior over killed or subunit vaccines due to their ability to induce protective immunity. Of the various strategies used for the generation of live attenuated vaccine strains, focus has gradually shifted towards manipulation of virulence regulator genes. Hfq is a RNA chaperon which mediates the binding of small RNAs to the mRNA and assists in post-transcriptional gene regulation in bacteria. In this study, we evaluated the efficacy of the Salmonella Typhimurium Δhfq strain as a candidate for live oral vaccine in murine model of typhoid fever. Salmonella hfq deletion mutant is highly attenuated in cell culture and animal model implying a significant role of Hfq in bacterial virulence. Oral immunization with the Salmonella hfq deletion mutant efficiently protects mice against subsequent oral challenge with virulent strain of Salmonella Typhimurium. Moreover, protection was induced upon both multiple as well as single dose of immunizations. The vaccine strain appears to be safe for use in pregnant mice and the protection is mediated by the increase in the number of CD4+ T lymphocytes upon vaccination. The levels of serum IgG and secretory-IgA in intestinal washes specific to lipopolysaccharide and outer membrane protein were significantly increased upon vaccination. Furthermore, hfq deletion mutant showed enhanced antigen presentation by dendritic cells compared to the wild type strain. Taken together, the studies in murine immunization model suggest that the Salmonella hfq deletion mutant can be a novel live oral vaccine candidate

Luminescence Sensors Applied to Water Analysis of Organic Pollutants—An Update

The development of chemical sensors for environmental analysis based on fluorescence, phosphorescence and chemiluminescence signals continues to be a dynamic topic within the sensor field. This review covers the fundamentals of this type of sensors, and an update on recent works devoted to quantifying organic pollutants in environmental waters, focusing on advances since about 2005. Among the wide variety of these contaminants, special attention has been paid polycyclic aromatic hydrocarbons, pesticides, explosives and emerging organic pollutants. The potential of coupling optical sensors with multivariate calibration methods in order to improve the selectivity is also discussed

Ovarian cancer molecular pathology.

Peer reviewe

Analysis of inpatient costs in patients with knee osteoarthritis treated by implantation of total condylar knee endoprosthesis

© 2018, Routledge. All rights reserved. Background/Aim. Total knee replacement is an elective and high cost surgical procedure which is performed more frequently as a result of increasing prevalence of knee osteoarthritis. The aim of this study was to provide insight into the value and structure of inpatient costs associated with total knee replacement in Serbia. Methods. This study was conducted as an in-depth, bottom-up, retrospective, case series analysis of services consumption patterns and costs associated with inpatient treatment of patients with knee osteoarthritis by implantation of primary total condylar knee endoprosthesis from perspective of the national Republic Health Insurance Fund. We obtained data on 97 patients treated with primary unilateral or bilateral total knee replacement in 2014 at the Clinic for Orthopaedic Surgery and Traumatology of the Military Medical Academy in Belgrade, a tertiary health care university hospital. Results. Mean age of entire study sample was 67.89 years. Majority of patients (60 patients; 61.9%) had unilateral implantation of total condylar knee endoprosthesis. Bilateral implantation was performed in 37 (38.1%) patients. Mean total inpatient cost per patient for both unilateral and bilateral implantation of total condylar knee endoprosthesis was EUR 2,709.1, ranging from EUR 1,685.2 to EUR 5,356.6. Mean total inpatient cost per patient was EUR 2,093.8 for unilateral implantation and EUR 3,706.8 for bilateral implantation. Two major cost drivers were surgery specific material and surgery. Cost of implants was the highest single cost driver in all observed groups of patients. Conclusion. Our findings imply that inpatient costs associated with implantation of primary total condylar knee endoprosthesis are substantial. It seems that the most important cost drivers are surgery and surgery specific material, with implants being the highest single cost driver. Further research should be focused on analyzing factors that influence these costs in order to develop effective strategies which could contribute to substantial savings in the future

Stem Cells for Periodontal Regeneration

Periodontal regeneration is considered to be biologically possible but clinically unpredictable. In periodontitis, inflammation manifests clinically as loss of supporting periodontal tissues and regeneration of damaged tissue is the main goal of treatment. For decades, periodontists have sought to repair the damage through a variety of surgical procedures, and use of grafting materials and growth factors, and of barrier membranes. Reports have emerged that demonstrate which populations of adult stem cells reside in the periodontal ligaments of humans and other animals. This opens the way for new cell-based therapies for perio-dontal regeneration. This review provides an overview of adult human stem cells and their potential use in perio-dontal regeneration

In situ synchrotron radiation grazing incidence X-ray diffraction—A powerful technique for the characterization of solid-state ion-selective electrode surfaces

An in situ surface study of the iron chalcogenide glass membrane ion-selective electrode (ISE) in aqueous media has been undertaken using a tandem technique of mixed potential/synchrotron radiation grazing incidence X-ray diffraction (SR-GIXRD) and atomic force microscopy (AFM). This work has simultaneously monitored the mixed potential and in situ surface diffraction patterns of this crystalline glassy material, showing that the observed gradual shift of the electrode potential in the anodic direction is linked to the preferential dissolution of the GeSe (1 1 1), GeSe (1 0 1) and GeSe (1 4 1) and/or Sb2Se3 (0 1 3), Sb2Se3 (2 2 1) and Sb2Se3 (0 2 0) surfaces. Expectedly, these observations are internally consistent with preferential oxidative attack of the crystalline regions of the membrane comprising GeSe and/or Sb2Se3, as evidenced by AFM imaging of the electrode surface. Clearly, this work corroborates the results of previous ex situ surface studies on the iron chalcogenide glass ISE, whereby it was shown that alkaline saline solutions have a tendency to alter the surface chemistry and concomitant response characteristics of the ISE