Giardia lamblia Reactive Arthritis Mimicking Acute Periprosthetic Knee Infection: A Case Report

Background: The difficulty in diagnosing Periprosthetic joint infection (PJI) is exacerbated by the more varied presentation of PJI and the lower synovial fluid WBC count thresholds applied when a prosthesis is present. Multiple reports have described pseudosepsis after total knee arthroplasty (TKA) due to gout or pseudogout. Further confusing the picture, periprosthetic infection also frequently coexists with crystalline arthropathy. Our review of the literature revealed no reports describing reactive arthritis (ReA) mimicking acute infection in the setting of previous TKA. In this case report, we describe a pseudo-periprosthetic infection of a well-functioning TKA secondary to ReA in the setting of Giardia lamblia gastroenteritis. Case: A healthy 49-year-old man with a well-functioning total knee replacement developed a painful swollen knee. The erythrocyte sedimentation rate was 12 mm/hour, and C-reactive protein was 20.3 mg/L. Aspiration revealed 24,440 white blood cells and 5% neutrophils. His 2018 International Consensus Meeting (ICM) definition score of 5 met criteria for “possibly infected.” He was diagnosed with ReA secondary to Giardia lamblia, mimicking acute periprosthetic infection. He was successfully treated with a 10-week course of multiple oral antiparasitic medications. Conclusion: Systemic parasitic infectious ReA can mimic acute infection in the presence of total knee arthroplasty. Careful application of the 2018 ICM criteria can be critical for workup and the treatment of suspected periprosthetic infection

Recurrent Hemarthrosis Secondary to Erosive Patellofemoral Arthritis Treated with Arthroplasty: A Report of 3 Cases

Background: Spontaneous hemarthrosis of the knee joint in the elderly population is a rare phenomenon and is mostly seen in those with osteoarthritis. The identified causes of spontaneous hemarthrosis in this demographic include subchondral bone bleeding, meniscal tear, genicular artery bleeding, and the use of anticoagulants. Hemarthrosis caused by isolated patellofemoral bleeding, as in this case series, has been rarely documented and poorly described. Case: Three patients presented with recurrent hemarthrosis secondary to erosive patellofemoral arthritis. Recurrent hemarthrosis from the eroded patellofemoral subchondral bone has not been well described. Each patient presented with symptoms secondary to painful effusions that were identified by aspiration. Each patient was successfully treated with patellofemoral or total knee arthroplasty Conclusion: Spontaneous or recurrent effusions in the setting of erosivepatellofemoral arthritis should prompt orthopaedic surgeons to consider hemarthrosis as the cause of such effusions. Patellofemoral or total knee arthroplasty is effective in resolving the hemarthroses, resolving pain, and restoring function in these patients

Cosmological Tracking Solutions

A substantial fraction of the energy density of the universe may consist of quintessence in the form of a slowly-rolling scalar field. Since the energy density of the scalar field generally decreases more slowly than the matter energy density, it appears that the ratio of the two densities must be set to a special, infinitesimal value in the early universe in order to have the two densities nearly coincide today. Recently, we introduced the notion of tracker fields to avoid this initial conditions problem. In the paper, we address the following questions: What is the general condition to have tracker fields? What is the relation between the matter energy density and the equation-of-state of the universe imposed by tracker solutions? And, can tracker solutions explain why quintessence is becoming important today rather than during the early universe

The Middle Way: East Asian masters students’ perceptions of critical argumentation in U.K. universities.

The paper explores the learning experiences of East Asian masters students in dealing with Western academic norms of critical thinking in classroom debate and assignment writing. The research takes a cultural approach, and employs grounded theory and case study methodology, the aims being for students to explain their perceptions of their personal learning journeys. The data suggest that the majority of students interviewed rejected full academic acculturation into Western norms of argumentation. They instead opted for a ‘Middle Way’ that synergizes the traditional cultural academic values held by many East Asian students with those elements of Western academic norms that are perceived to be aligned with these. This is a relatively new area of research which represents a challenge for British lecturers and students

The effects of identification with a support group on the mental health of people with multiple sclerosis

Objective: Multiple Sclerosis (MS) is associated with various psychological problems, including depression and anxiety. Whilst MS support groups are intended to improve mental health, this goal is not always achieved. Taking a social identity approach, we hypothesise that it is the level of subjective identification with a support group (rather than simply support group membership per se) that positively affects the mental health of people with MS. Methods: 152 individuals with MS were recruited via UK MS support groups and completed a questionnaire. This included measures of support group identification, depression, anxiety and satisfaction with life, as well as control variables (education level and age). Results: Analyses revealed that, as hypothesised, support group identification was significantly linked to depression, anxiety and satisfaction with life. Moreover, group identification explained a significant amount of variance in addition to that explained by education and age on each health outcome. Repeating the analysis to compare each of the three main sub-types of MS revealed these effects to be present for individuals with Relapsing-Remitting (RR) and Primary Progressive (PP) MS, but not for those with Secondary Progressive (SP) MS. Conclusions: We suggest that identifying highly with an MS support group has important positive outcomes for MS patients’ mental health. This has implications for practicing clinicians: people with MS (particularly RRMS and PPMS) should be encouraged to engage with support groups, but more must be done to ensure they subjectively identify with these groups, rather than merely attend them

A first-in-human phase I study to determine the maximum tolerated dose of the oral Src/ABL inhibitor AZD0424

BACKGROUND: Src is involved in cancer invasion and metastasis. AZD0424, an oral inhibitor of Src and ABL1, has shown evidence of anti-tumour activity in pre-clinical studies. METHODS: A phase Ia, dose escalation study was performed to assess the safety of continuous oral dosing with AZD0424 in advanced solid tumours. Secondary objectives included investigation of AZD0424 pharmacokinetics, effect on Src activity using markers of bone turnover, and anti-tumour activity. RESULTS: 41 patients were treated; 34 received AZD0424 once-daily at doses ranging from 5 mg to 150 mg, and 7 received 40 mg bi-daily 41.5% of patients experienced at least one AZD0424-related adverse event that was Grade 3-5 in severity, with patients treated at doses above 60 mg per day experiencing multiple treatment-related toxicities. The most commonly observed AZD0424-related adverse events were nausea, fatigue, anorexia and alopecia. Cmaxand AUC increased linearly with dose and the mean±standard deviation t1/2was 8.4±2.8 h. Clear evidence of Src target inhibition was seen at doses ⩾20 mg per day. No responses were observed and 7 patients (17.1%) achieved stable disease lasting 6 weeks or more. CONCLUSIONS: AZD0424 displayed no evidence of efficacy as monotherapy despite a clear pharmacodynamic effect. Further evaluation of AZD0424 monotherapy in patients with solid tumours is not recommended

Trading Methods and Family Strategies of Genoese People. Almería, XVIII century

Artículo de la sección: EstudiosEnfatizar la importancia de la documentación notarial para el estudio de un grupo social parece una valoración innecesaria. Este estudio pretende, a partir fundamentalmente de los protocolos notariales como núcleo de la investigación y del Catastro de Ensenada, complementados con otras fuentes, libros de Contadurías e Hipotecas de la sección de hacienda del Archivo Histórico Provincial de Almería, documentos de hidalguía y matrícula de extranjeros del Archivo Municipal de Almería, acercarse al flujo de mercaderes genoveses que, durante el siglo XVIII, se avecinda en la ciudad de Almería. La investigación se centra en los mecanismos que cuatro familias genovesas, domiciliadas en la ciudad de Almería durante el Setecientos: Schiafino-Aste, Schiafino- Schiafino, Schiafino-Ansaldo e Iluminatti-Marín, desarrollaron para conseguir la intervención en la administración local y la creación de unas prácticas mercantiles que, desde la ciudad de Almería y su jurisdicción, se extenderían hacia las villas del interior de la provincia y hacia una importante ramificación a lo largo de las costas del levante peninsular y de Andalucía occidental. No olvidaremos las relaciones que el grupo ligur almeriense mantuvo durante el siglo con su Génova natal, que cristalizaron en la creación de una compañía mercantil desarrollada en base a los intereses económicos de familias genovesas de Santa María de Camogli y de la ciudad de Almería. El análisis es un acercamiento, más que hacia aspectos económicos y al mundo del comercio, a la relación que se establece entre la formación de las familias y la creación de estrategias mercantiles que les llevará a la intervención en los mercados.To emphasize the notarial documentation for the study of a social group it seems to be an unnecessary valuation. This research expects basically, from the notarial protocols as the essence of the research work and from the Catastro of Ensenada, completed with other sources, Accountancy books and Mortgages of the section of finance from the Almerías 's Provincial Historical Record Office, nobility documents, and registration of foreigners from the Almería"s Town Record Office, to approach to the flow of Genoese merchants who, during the 18th century, comes near the town of Almería. The investigation is centred in the processes that four Genoese families established in the town of Almería during the Seven hundred, Schiafino-Aste, Shiafino-Shiafino,Shiafino-Ansaldo and Iluminatti-Marin, developped to get the participation in the local administration and the establishment of some trading methods which, from the city of Almería and its jurisdiction, would be spread over the inner small towns of the province and towards an important branch along the levant peninsular coasts and the west of Andalucía. We must not forget the relationship that the almeriense ligur group kept up during the century with its home town Genoa, crystallizing in the establishment of a trading company developped on tha basis of economical interests of Genoese families from Santa Maria of Camogli and the city of Almería. The analysis is a approach, more than to economical aspects and the business world, to the relationship that it is set up between the formation of the families and the establishment of trading strategies that will take them to the participation in the markets.Departamento de Historia Moderna y de América, Universidad de Granad

Imprints of Short Distance Physics On Inflationary Cosmology

We analyze the impact of certain modifications to short distance physics on the inflationary perturbation spectrum. For the specific case of power-law inflation, we find distinctive -- and possibly observable -- effects on the spectrum of density perturbations.Comment: Revtex 4, 3 eps figs, 4 page

Fermionic partner of Quintessence field as candidate for dark matter

Quintessence is a possible candidate for dark energy. In this paper we study the phenomenologies of the fermionic partner of Quintessence, the Quintessino. Our results show that, for suitable choices of the model parameters, the Quintessino is a good candidate for cold or warm dark matter. In our scenario, dark energy and dark matter of the Universe are connected in one chiral superfield.Comment: 4 pages, 3 figures, version to appear in PR

Magnetic fields in protoplanetary disks

Magnetic fields likely play a key role in the dynamics and evolution of protoplanetary discs. They have the potential to efficiently transport angular momentum by MHD turbulence or via the magnetocentrifugal acceleration of outflows from the disk surface, and magnetically-driven mixing has implications for disk chemistry and evolution of the grain population. However, the weak ionisation of protoplanetary discs means that magnetic fields may not be able to effectively couple to the matter. I present calculations of the ionisation equilibrium and magnetic diffusivity as a function of height from the disk midplane at radii of 1 and 5 AU. Dust grains tend to suppress magnetic coupling by soaking up electrons and ions from the gas phase and reducing the conductivity of the gas by many orders of magnitude. However, once grains have grown to a few microns in size their effect starts to wane and magnetic fields can begin to couple to the gas even at the disk midplane. Because ions are generally decoupled from the magnetic field by neutral collisions while electrons are not, the Hall effect tends to dominate the diffusion of the magnetic field when it is able to partially couple to the gas. For a standard population of 0.1 micron grains the active surface layers have a combined column of about 2 g/cm^2 at 1 AU; by the time grains have aggregated to 3 microns the active surface density is 80 g/cm^2. In the absence of grains, x-rays maintain magnetic coupling to 10% of the disk material at 1 AU (150 g/cm^2). At 5 AU the entire disk thickness becomes active once grains have aggregated to 1 micron in size.Comment: 11 pages, 11 figs, aastex.cls. Accepted for publication in Astrophysics & Space Science. v3 corrects bibliograph