Rosai‐Dorfman disease presenting with solitary liver mass without lymphadenopathy: A case report

Rosai‐Dorfman disease (RDD), as a lymphoproliferative disorder with unknown etiology, is commonly identified with systemic clinical manifestations in various organs. In this case study, RDD occurrence was reported with an exceedingly liver mass.     

Comb and Branch-on-Branch Model Polystyrenes with Exceptionally High Strain Hardening Factor SHF > 1000 and Their Impact on Physical Foaming

The influence of topology on the strain hardening in uniaxial elongation is investigated using monodisperse comb and dendrigraft model polystyrenes (PS) synthesized via living anionic polymerization. A backbone with a molecular weight of M_w,bb = 310 kg mol⁻¹ is used for all materials, while a number of 100 short (SCB, M_w,scb = 15 kg mol⁻¹) or long chain branches (LCB, M_w,lcb = 40 kg mol⁻¹) are grafted onto the backbone. The synthesized LCB comb serves as precursor for the dendrigraft-type branch-on-branch (bob) structures to add a second generation of branches (SCB, M_w,scb ≈ 14 kg mol⁻¹) that is varied in number from 120 to 460. The SCB and LCB combs achieve remarkable strain hardening factors (SHF) of around 200 at strain rates greater than 0.1 s⁻¹. In contrast, the bob PS reach exceptionally high SHF of 1750 at very low strain rates of 0.005 s⁻¹ using a tilted sample placement to extend the maximum Hencky strain from 4 to 6. To the best of the authors’ knowledge, SHF this high have never been reported for polymer melts. Furthermore, the batch foaming with CO₂ is investigated and the volume expansions of the resulting polymer foams are correlated to the uniaxial elongational properties.     

Comparing inhaled colistin with inhaled fosfomycin/tobramycin as an adjunctive treatment for ventilator-associated pneumonia: An open-label randomized controlled trial

Purpose

Although investigations are limited, adjunctive aerosolized antibiotics have been advised in the setting of gram-negative ventilator-associated pneumonia (VAP). This study aimed to compare the efficiency of inhaled colistin with inhaled fosfomycin/tobramycin in treating VAP due to extensively drug-resistant (XDR) Acinetobacter baumannii.

Methods

This single center open-label randomized controlled trial included 60 patients who developed XDR A. bumannii VAP. Eligible participants were randomly assigned to two groups (no. 30). Regardless of the assignment, all participants received meropenem (2 g as a 3-h extended infusion every 8 h) plus intravenous colistin (a loading dose of 9 million IU and then 4.5 million IU every 12 h). The control group was given inhaled colistin (1 million IU every 8 h), and the case group received inhaled tobramycin/fosfomycin (300 mg every 12 h/80 mg every 12 h) as adjunctive therapy. The primary outcome was treatment duration, and the secondary outcomes were Clinical Pulmonary Infection Score (CPIS) trend and mortality rate in the groups. The decision to stop treatment was made by the treating physician.

Results

The mean treatment duration was 13.73 ± 3.22 days in the colistin group and 10.85 ± 2.84 days in the tobramycin/fosfomycin group; the mean treatment duration in the latter group was lower significantly (P = 0.001). CPIS was decreased in the groups significantly (P < 0.001), but the mean changes of CPIS were significantly different between the groups, and in the inhaled tobramycin/fosfomycin group, a greater reduction (P = 0.005) was observed. Two (6.67%) patients in the control group and three (10%) patients in the case group died.

Conclusion

The use of inhaled tobramycin/fosfomycin in cases with XDR A. bumannii VAP was associated with a shorter treatment duration in this open-label trial.