-
Cureus May 2024Tuberculosis can present at various extrapulmonary sites. However, even in endemic countries, concomitant involvement of different sites in the same patient is rarely...
Tuberculosis can present at various extrapulmonary sites. However, even in endemic countries, concomitant involvement of different sites in the same patient is rarely reported. Further, tuberculous pericarditis represents a fraction of all tuberculosis infections and is an uncommon form of extrapulmonary tuberculosis. In underdeveloped nations, it is the most frequent cause of massive pericardial effusion. Additionally, it is the most common cause of constrictive pericarditis in adults, which has a high death rate and a poor prognosis. Furthermore, concomitant pleural effusion due to is infrequently reported. Herein, a case of concomitant pericardial and left-sided pleural effusion in an Indian female is reported. She came with complaints of breathlessness, chest pain, night sweats, and loss of appetite. A diagnostic pleural thoracentesis and pericardiocentesis helped establish the diagnosis, and she was commenced on antituberculous treatment for 168 days.
PubMed: 38832191
DOI: 10.7759/cureus.59546 -
Journal of Veterinary Internal Medicine Jun 2024Detailed descriptions of clinical signs associated with radiological findings of the caudal cervical vertebral column are not available.
BACKGROUND
Detailed descriptions of clinical signs associated with radiological findings of the caudal cervical vertebral column are not available.
OBJECTIVES/HYPOTHESES
Describe the clinical features associated with neck pain or stiffness, neck-related thoracic limb lameness, proprioceptive ataxia consistent with a cervicothoracic spinal cord or nerve lesion, and their frequency of occurrence compared with control horses.
ANIMALS
A total of 223 Warmblood horses.
METHODS
Case-control study. Controls and cases were recruited prospectively. All horses underwent predetermined lameness and neurologic examinations. The frequency of occurrence of each clinical feature was compared between cases and controls and relative risk (RR) were calculated.
RESULTS
Ninety-six cases and 127 controls were included. Forty-seven (49%) of the cases were classified as neurologic, 31 (32.3%) had thoracic limb lameness, and 18 (18.7%) had neck stiffness or pain or both. Focal caudal cervical muscle atrophy (46, 47.9%), hypoesthesia (38, 39.6%), patchy sweating (16, 16.7%), hyperesthesia (11, 11.5%), and pain upon firm pressure applied over the caudal cervical articular process joints and transverse processes (58, 60.4%) were only observed in cases (P < .001). Sideways flexion of the neck was restricted in a higher proportion of cases (47/96, 49%) compared with controls (40/127, 31.8%; P = .009, RR 1.5). Hopping-type thoracic limb lameness was only observed in cases, (30, 31.6%). Deterioration in lameness after diagnostic anesthesia occurred in 13/31 (41.9%) cases.
CONCLUSIONS AND CLINICAL IMPORTANCE
Systematic clinical evaluation using the methods described should enable clinical differentiation between horses with caudal cervical lesions and horses with other causes of gait abnormalities.
PubMed: 38829000
DOI: 10.1111/jvim.17125 -
Radiology Case Reports Aug 2024We report a case of acute myocardial infarction in a patient with polycythemia rubra vera, who has been treated with hydroxyurea. The patient presented with chest pain...
We report a case of acute myocardial infarction in a patient with polycythemia rubra vera, who has been treated with hydroxyurea. The patient presented with chest pain extending to both arms accompanied by nausea and sweating. Hemoglobin was 18.1 mg/dL, hematocrit 53.2%, white blood cells 9600/mm³, and platelets 745,000/mm³. The levels of specific cardiac injury markers were increased, troponin I increased to 110 ng/mL and creatine kinase-MB to 361 U/l, respectively. Electrocardiography showed sinus rhythm with ST-segment elevation in leads V2-6, D1, and aVL as well as ST depression in D2, D3 and aVF. Echocardiography demonstrated hypokinesis of the interventricular septum and lateral wall with mildly reduced left ventricle (LV) ejection fraction (EF≈45%). Coronary angiography revealed proximal-LAD subtotal occlusion and 80% mid-LAD stenosis with distal-LAD vasospasm. Percutaneous coronary intervention was performed with a drug-eluting stent in mid- and proximal-LAD. Hypercoagulable state of polycythemia rubra vera may be complicated with acute myocardial infarction, in addition to the vasospastic effect and endothelium lesions of hydroxyurea regardless its favorable effect as a standard therapy.
PubMed: 38827039
DOI: 10.1016/j.radcr.2024.05.014 -
Scientific Reports May 2024Due to growing interest in the investigation of exercise induced sweat biomarkers to assess an individual's health and the increasing prevalence of tattoos in the...
Due to growing interest in the investigation of exercise induced sweat biomarkers to assess an individual's health and the increasing prevalence of tattoos in the world's population, investigators sought to determine whether local sweat concentrations and excretion rates of epidermal growth factor (EGF), interleukin (IL) -1α, IL-6, IL-8, cortisol, glucose, blood urea nitrogen (BUN), and lactate differ between tattooed and contralateral non-tattooed skin during exercise. Sixteen recreational exercisers [female (50%)] (age = 25-48 years) with ≥ 1 unilateral permanent tattoo [median tattoo age = 6 years, IQR = 5] on the arm/torso completed an outdoor group fitness session. There were no significant differences between tattooed and non-tattooed skin for sweat EGF, IL-1α, IL-8, cortisol, glucose, BUN, or lactate concentrations. There were no significant differences between tattooed and non-tattooed skin for sweat EGF, IL-1α, IL-8, cortisol, glucose, BUN, or lactate excretion rate. Findings suggest that permanent tattoos older than 1 year may not impact local sweat EGF, IL-1α, IL-8, cortisol, glucose, BUN, and lactate concentrations or excretion rates during exercise.Clinical trial identifier NCT04920266 was registered on June 9, 2021.
Topics: Adult; Female; Humans; Male; Middle Aged; Biomarkers; Blood Urea Nitrogen; Cytokines; Exercise; Glucose; Hydrocortisone; Lactic Acid; Sweat; Tattooing
PubMed: 38821996
DOI: 10.1038/s41598-024-63057-0 -
PloS One 2024Inflammation is a key driver in the pathogenesis of cystic fibrosis (CF). We assessed the effectiveness of elexacaftor/tezacaftor/ivacaftor (ETI) therapy on...
Inflammation is a key driver in the pathogenesis of cystic fibrosis (CF). We assessed the effectiveness of elexacaftor/tezacaftor/ivacaftor (ETI) therapy on downregulating systemic and immune cell-derived inflammatory cytokines. We also monitored the impact of ETI therapy on clinical outcome. Adults with CF, heterozygous for F508del (n = 19), were assessed at baseline, one month and three months following ETI therapy, and clinical outcomes were measured, including sweat chloride, lung function, weight, neutrophil count and C-reactive protein (CRP). Cytokine quantifications were measured in serum and following stimulation of peripheral blood mononuclear cells (PBMCs) with lipopolysaccharide (LPS) and adenosine triphosphate and analysed using LEGEND plex™ Human Inflammation Panel 1 by flow cytometry (n = 19). ASC specks were measured in serum and caspase-1 activity and mRNA levels determined from stimulated PBMCs were determined. Patients remained stable over the study period. ETI therapy resulted in decreased sweat chloride concentrations (p < 0.0001), CRP (p = 0.0112) and neutrophil count (p = 0.0216) and increased percent predicted forced expiratory volume (ppFEV1) (p = 0.0399) from baseline to three months, alongside a trend increase in weight. Three months of ETI significantly decreased IL-18 (p< 0.0011, p < 0.0001), IL-1β (p<0.0013, p = 0.0476), IL-6 (p = 0.0109, p = 0.0216) and TNF (p = 0.0028, p = 0.0033) levels in CF serum and following PBMCs stimulation respectively. The corresponding mRNA levels were also found to be reduced in stimulated PBMCs, as well as reduced ASC specks and caspase-1 levels, indicative of NLRP3-mediated production of pro-inflammatory cytokines, IL-1β and IL-18. While ETI therapy is highly effective at reducing sweat chloride and improving lung function, it also displays potent anti-inflammatory properties, which are likely to contribute to improved long-term clinical outcomes.
Topics: Humans; Cystic Fibrosis; Benzodioxoles; Adult; Aminophenols; Female; Indoles; Male; Cystic Fibrosis Transmembrane Conductance Regulator; Quinolones; Anti-Inflammatory Agents; Cytokines; Pyrazoles; Young Adult; Pyridines; Leukocytes, Mononuclear; C-Reactive Protein; Pyrroles; Sweat; Pyrrolidines
PubMed: 38820269
DOI: 10.1371/journal.pone.0304555 -
Practical Laboratory Medicine May 2024The advent of CFTR modulators highlighted that the sweat test (ST) for CF can be used also as an outcome measure for the basic defect of CFTR. Despite the technological...
BACKGROUND
The advent of CFTR modulators highlighted that the sweat test (ST) for CF can be used also as an outcome measure for the basic defect of CFTR. Despite the technological advances, ST still remains operator-dependent and its execution should be strongly paired with guidelines. In 2022, due to the advent of CFTR modulators, the Italian CF Society introduced a specific ST report. The aim of the present paper is to discuss the impact of this new report in the 2022-23 round of the Italian External Quality Assessment program for ST (I-EQA-SCT).
METHODS
The scheme of the I-EQA-SCT is prospective, enrolment is voluntary, the payment of a fee is required and results are shared through a web-facility. Assessment covers analysis, interpretation, and reporting of results. In the 2022-23 round, 2 out of the 3 mock clinical information referred to patients who started modulators.
RESULTS
Fourteen laboratories completed the 2022-23 I-EQA-SCT round. Three of them failed in the interpretation of results from these two mock cases and/or used a wrong report not consistent with the more recent Italian Sweat Test Recommendations.
CONCLUSIONS
The overall results obtained from the laboratories involved in the I-EQA-SCT program clearly showed that the laboratories' qualitative and quantitative performance improved significantly. Results emerged from this round highlighted an issue in the report form used for monitoring patients on CFTR modulator therapy thus stressing the importance of these programs in improving both the performance of lab services and ameliorating the sweat test recommendations.
PubMed: 38818249
DOI: 10.1016/j.plabm.2024.e00403 -
Heliyon May 2024A comprehensive analysis is carried out for achieving hygrothermal comfort by using bidirectional heat and mass fluxes between the human skin and its surroundings during...
A comprehensive analysis is carried out for achieving hygrothermal comfort by using bidirectional heat and mass fluxes between the human skin and its surroundings during cooling seasons, considering the main characteristics of climate, metabolic rate, and clothing fabrics. As hygrothermal comfort is mainly seen as one-direction heat and mass flux from the close surroundings to the human body, without the emitted heat and mass by the human skin, the purpose of the analysis is to find out proper features of the respective clothing fabric according to the inlet boundary conditions, i.e. heat and mass flux from the human body, and the outlet boundary features, i.e. heat and mass flux due to the climate conditions. Thereby, a novel mathematical modelling is developed for heat and mass transfer, respectively. Then, the software Wolfram Mathematica is applied for the numerical solutions of the model. After the model is validated, a sensitivity analysis is carried out. Thereby, it is found that the sensible heat removal by convection, dependent on both airflow and humidity rates, has a great influence on the hygrothermal comfort. Furthermore, solar reflectivity for shortwave radiation, along with longwave radiation from the skin, have influence on the hygrothermal comfort when both ventilation and sweating are set as minimum. Therefore, if the conditions of temperature and relative humidity are proper, both high conductivity and air permeability clothes are recommended. Nevertheless, regarding the reflectivity, it depends on the presence of shortwave radiation, sweating, ventilation, and longwave radiation to consider light-toned or dark colors.
PubMed: 38818186
DOI: 10.1016/j.heliyon.2024.e31564 -
SAGE Open Medical Case Reports 2024Ecrrine porocarcinoma, a rare aggressive skin tumor, develops from sweat glands located in lower limbs, followed by the head and neck, trunk, and upper limbs. The...
Ecrrine porocarcinoma, a rare aggressive skin tumor, develops from sweat glands located in lower limbs, followed by the head and neck, trunk, and upper limbs. The incidence represents only about 0.005% of all cutaneous malignant tumors. The most common site is the lower extremities in elderly patients. As it has a high chance of metastases and recurrence after surgery, mainstay of treatment modality is wide local excision or Mohs (micrographically oriented histographic surgery) micrographic surgery. Mohs micrographic surgery (MMS) is a more effective treatment modality for tumors located in cosmetically and functionally important areas of the head and neck. We present a 56-years-old male patient with a large fungating eccrine tumor on the left axilla with ipsilateral nodal involvement on histomorphological grounds supported with immunohistochemical studies.
PubMed: 38812832
DOI: 10.1177/2050313X241256868 -
PloS One 2024The sweat bee Halictus rubicundus is an important pollinator with a large latitudinal range and many potential barriers to gene flow. Alongside typical physical...
The sweat bee Halictus rubicundus is an important pollinator with a large latitudinal range and many potential barriers to gene flow. Alongside typical physical barriers, including mountain ranges and oceans, the climate may also impose restrictions on gene flow in this species. The climate influences voltinism and sociality in H. rubicundus, which is bivoltine and can nest socially at warmer lower latitudes but tends to be univoltine and solitary in the cooler north. Variation in voltinism could result in phenological differences, potentially limiting gene flow, but a previous study found no evidence for this in H. rubicundus populations in mainland Britain. Here we extend the previous study to consider populations of H. rubicundus at extreme northern and southern latitudes in the UK. We found that bees from a population in the far north of Scotland were genetically differentiated from bees collected in Cornwall in the south-west of England. In contrast, bees collected across the Irish Sea in Northern Ireland showed slight genetic overlap with both the Scottish and Cornish bees. Our results suggest that when populations at extreme latitudes are considered, phenology and the climate may act alongside physical barriers such as the Scottish Highlands and the Irish Sea to restrict gene flow in H. rubicundus. We discuss the implications of our results for local adaptation in the face of rapidly changing selection pressures which are likely under climate change.
Topics: Animals; Bees; Gene Flow; Genetic Variation; Microsatellite Repeats; Scotland; Genetics, Population
PubMed: 38809856
DOI: 10.1371/journal.pone.0302688 -
PloS One 2024One of the most challenging aspects of bee ecology and conservation is species-level identification, which is costly, time consuming, and requires taxonomic expertise....
One of the most challenging aspects of bee ecology and conservation is species-level identification, which is costly, time consuming, and requires taxonomic expertise. Recent advances in the application of deep learning and computer vision have shown promise for identifying large bumble bee (Bombus) species. However, most bees, such as sweat bees in the genus Lasioglossum, are much smaller and can be difficult, even for trained taxonomists, to identify. For this reason, the great majority of bees are poorly represented in the crowdsourced image datasets often used to train computer vision models. But even larger bees, such as bumble bees from the B. vagans complex, can be difficult to separate morphologically. Using images of specimens from our research collections, we assessed how deep learning classification models perform on these more challenging taxa, qualitatively comparing models trained on images of whole pinned specimens or on images of bee forewings. The pinned specimen and wing image datasets represent 20 and 18 species from 6 and 4 genera, respectively, and were used to train the EfficientNetV2L convolutional neural network. Mean test precision was 94.9% and 98.1% for pinned and wing images respectively. Results show that computer vision holds great promise for classifying smaller, more difficult to identify bees that are poorly represented in crowdsourced datasets. Images from research and museum collections will be valuable for expanding classification models to include additional species, which will be essential for large scale conservation monitoring efforts.
Topics: Bees; Animals; Deep Learning; Wings, Animal; Image Processing, Computer-Assisted; Neural Networks, Computer; Species Specificity
PubMed: 38805521
DOI: 10.1371/journal.pone.0303383