Coexistence of Peripheral Spondyloarthritis and Familial Adenomatous Polyposis: A Rare Case Report with Treatment Contradictions and Review of the Literature

BACKGROUND: The coexistence of familial adenomatous polyposis and spondyloarthritis is rarely defined in literature. The primary aim of this presentation is to report a development of peripheral arthritis in 3 years following colon surgery with the diagnosis of familial adenomatous polyposis (FAP). The secondary aim is to discuss the challenge of in treatment of refractory arthritis, which needs to be treated with biologics. However, it is not yet known well about their safety on patients who have risks for cancer development.CASE DETAILS: A 25-year-old female patient was admitted to the rheumotology outpatient clinic. The patient had undergone total colectomy and ileoanal anastomosis because of FAP three years ago. On her physical examination, there was arthritis on her left ankle and enthesitis on both Achilles tendons.CONCLUSION: This case report presents a 25-year-old female patient with Ankylosing spondylitis (AS) and FAP whose treatment with biologics is critical due to the risk of cancer development due FAP. Although the potential risk of development of malignancies with TNF-blocking therapy seems to be no more than TNF-naïve patients and general population. But the safety of these drugs on patients with risks for cancer development is still unknown.KEYWORDS: Spondyloarthtritis, familial adenomatous polyposis, nonsteroid anti-inflammatory drugs, disease modifying anti-rheumatic drugs, biologic

Comparison of The Effects of Dietary Supplementation of Natural Antimicrobial Feed Additives on Lipid Oxidation, Microbial Content and Quality of Broiler Raw Meat

The study aimed to compare the effects of dietary supplementation of probiotic and olive leaf-, grape seed- and pomegranate peel extracts as natural antimicrobial on lipid oxidation, microbiological content and quality of raw broiler meat. Chickens were fed the control diet (CONT) and diets supplemented with probiotic (P), oleuropein (olive leaf extract, OLE100 and OLE200), proanthocyanidin (grape seed extract, GSE100 and GSE200) and proanthocyanidin (pomegranate peel extract, PPE100 and PPE200) at 100 and 200 mg/kg levels to the CONT diet. All dietary treatments significantly reduced MDA value of breast meat at 9th day, total aerobe bacteria and coliform bacteria contents of breast meat at 14th day. The P, OLE200, PPE100 and PPE200 diets significantly decreased lactic acid bacteria content of breast meat at 14th day. The pH value of raw breast meat at 24 h was significantly reduced by dietary treatments compared to the CONT diet. Feeding the P, PPE100 and PPE200 diets significantly increased water holding capacity of breast meat compared to those of broilers fed the CONT, GSE100 and GSE200 diets. The P, OLE200, PPE100 and PPE200 diets significantly reduced drip loss of breast meat at 7th day compared to the CONT, OLE100, GSE100 and GSE200 diets. Cooking loss of breast meat was significantly decreased by all dietary treatments except GSE diet compared to the CONT diet. It was concluded that probiotic, olive leaf- and pomegranate peel- extracts have potential to be used as natural antimicrobial feed additives in terms of the lipid oxidation, microbial content and quality of broiler meat

A pan-resistant Myroides odoratimimus catheter-related bacteremia in a COVID-19 patient and review of the literature

Myroides spp. are opportunistic environmental Gram-negative bacteria. These affect mostly immunocompromised hosts and generally lead to soft tissue, and urinary tract infections. Bacteremia most commonly develop secondary to soft tissue or catheter related infections and may lead rarely to mortality. Myroides spp. are generally suscetible to fluoroquinolones, piperacillin/tazobactam, trimethoprim/sulfamethoxazole, carbapenems or tetracyclines however, pan-resistant isolates and multiple resistance genes have been reported in clinical isolates of Myroides spp. We report a pan-resistant Myroides odoratimimus bacteremia in a patient with severe COVID-19 ending with fatality and in this context a review of reported Myroides bacteremias are also described. In this study, a 64-year old male patient with history of coronary artery bypass was admitted to ICU with severe COVID-19 pneumonia accompanied by pneumomediastinum and pneumopericardium. Continous renal replacement therapy and extracorporeal membraneous-oxygenation were initiated due to acute renal failure and persistent hypercarbia/hypoxia, respectively. Within four weeks of hospitalization various episodes of bacteremia developed and multiple antibiotics were used. On the 5th week of follow-up, acute phase reactants increased and empirical broad spectrum antibiotics were initiated. Blood culture revealed Gram-negative rods. The patient became hypotensive and despite maximum medical care he was lost due to cardiac arrest. M. odoratimimus was identified by MALDI-TOF and the bacterium was pan-resistant. According to Center for Genomic Epidemiology results the strain was identified as M. odoratimimus PR63039 and the genome analysis revealed antibiotic resistance genes associated with resistance to beta-lactams (bla(OXA-347), bla(MUS-1), bla(EBR-1)), tetracyclines (tetX), sulfonamides (sul2), macrolides (ereD), (ermF)

Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project

Purpose: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). Methods: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. Results: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. Conclusion: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection

Enquiry into the effects of bilingual teaching

This paper considers the advantages and disadvantages of the bilingual teaching of Mathematics to a class with a large number of Turkish speaking students in a mainstream secondary school. The paper begins with an outline of the research methodology, evaluates the research materials and findings and goes on to reflect on the effectiveness of bilingual teaching based on personal, direct experience. Information was gathered by means of qualitative research methods using questionnaires and observations. Accumulated personal experience in education indicated that bilingual students benefit from hearing explanations in their first language or having the opportunity to use the language in the classroom. This inspired the exploration of whether having access to information bilingually affects students’ motivation and attainment, with particular reference to Turkish Speaking (TS) students, and whether there are benefits for the whole class (mixed class) or whether teaching part of the lesson bilingually has negative effects for the non Turkish speaking class members. The data obtained from initial finds appear to suggest that there are positive correlations between the contextualisation of mathematical concepts in a bilingual environment and students’ access to mathematical knowledge

Determining Spot Price and Economic Dispatch in Deregulated Power Systems

This paper presents a new formula for determining spot price and a new algorithm for economic dispatch in deregulated power systems. According to participant’s biddings, an independent system operator (ISO) manages deregulated power systems (DPS) and decides transaction between participants. ISO aims to obtain minimum cost for entire power system. However each participant aims to work with minimum cost for only themselves. Each participant in DPS shares expensive operating and upkeep costs. Energy sources are used more efficient. Energy prices are determined according to the costs. The proposed algorithm considers price / power bids, generating / demand balance and generating units’ constraints. The results are shown on the IEEE 30 bus standart test system

The place and importance of the application in the critical edition process: three memories from shaykh shuaib al arna'ut

The critical edition process is seen as one of the most important tools to work on Islamic culture and antiquities. In essence, it is a skill based on scientific knowledge, requires healthy methods and involves more than one branch. Therefore, neither the concept of takhrij and the ability to make perfect takhrij examples, nor the familiarity with manuscripts can meet the framework of the notion of critical edition alone; on the contrary more than one factor such as skill, criticism capacity and applied work must be added to these two issues in order for the critical edition to make sense and achieve its purpose. Shaykh Shuaib al Arna'ut (d. 2016) was one of the most prominent figures in this field of expertise in the Islamic world and one of the most publications on the subject. He had verified basic works of which quality and usefulness were known to its competent in many branches such as Tafsir, Hadith, History and Arabic Language. At the same time, he had worked day and night for forty years in the critical edition center he established in Amman and trained students who performed the investigation process at a high level. During our time in Amman in 1999, we had the opportunity to attend the critical edition lessons he gave us privately and recorded these lessons every week with his permission. This research is based on the aforementioned sound recordings and the preliminaries written by Shaykh Shuaib al Arna'ut books and aims to examine his views on the subject in comparison with the contents of other experts' theoretical critical edition books. The research is divided into two parts; The first part deals with the place and importance of the application in text analysis and approaches the issue from five angles: The scope and requirements of the art of critical edition, not being content with theoretical knowledge, introducing the student to the sources of the critical edition, basing the concept of the author on a solid mental basis, not hesitating to use criticism when needed. The second part of the research covers three pages selected from the diaries that we wrote in Amman and which include the scientific determinations and unique recommendations of the late Shaykh Shuaib al Arna'ut

Design and Application of Chitosan/biphasic Calcium Phosphate Porous Scaffolds for Bone Tissue Engineering

159 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2006.Cell loaded tissue engineered constructs were produced in vitro at clinically relevant sizes and implanted with and without bFGF into a porcine mandibular defect model. Tissue engineered constructs facilitated the healing of mandibular defects only if combined with delivery of bFGF via gelatin microspheres. bFGF release from the constructs improved neovascularization in the defect area and subsequently enhanced new bone formation. Although the rate and extent of bone formation was similar in bFGF group to those in empty defects for the period of the study, existence of woven bone in bFGF group suggests that bone formation is continuing while the lamellar structure in empty defects indicates that bone formation in that group was finalized.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD