Scrub typhus: An imported rickettsial disease

Summary A case of scrub typhus due toRickettsia tsutsugamushi is reported. This imported rickettsial disease was contracted by a 30-year-old woman while traveling in Thailand, and was transmitted by an infected mite's bite. Diagnosis was confirmed by specific serology and resolution was obtained by tetracycline therapy. Current concepts of the disease are reviewed.

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Scrub-Typhus: Eine wichtige Rickettsiose

Zusammenfassung Ein Fall von Scrub-Typhus, verursacht durchRickettsia tsutsugamushi wird beschrieben. Eine 30 Jahre alte Frau zog sich diese importierte Rickettsiose zu, als sie in Thailand reiste und von einer infizierten Milbe gebissen wurde. Die Diagnose wurde durch spezifische serologische Befunde gesichert. Behandlung mit Tetrazyklin führte zur Heilung. Das aktuelle Krankheitskonzept wird diskutiert.

     

Predictive factors of significant coronary stenosis in women. Review of 230 patients

To evaluate the predictive factors of significant coronary stenosis in women, we have studied retrospectively data from 230 women explored by coronary angiography. The population has been divided in 2 groups: one (G1) without significant coronary lesions; the second (G2) having at least one significant coronary stenosis (> 50%). The prevalence of the significant disease was 54.3%. Coronary risk factors associated with a significant disease were : age > 55 years, diabetes mellitus, menopause, high lipid levels, and the association of at least 3 risk factors. Typical angina and history of myocardial infarction were significantly more prevalent in the G2 as like as Q necrosis wave, ST segment modifications percritically and premature ventricular beats. A regional abnormal wall motion at rest echocardiography was independently associated with significant coronary artery lesions (OR = 7.35). Using these data we have established a score of prediction of significant disease in women. This score aided to classify our female patients into different levels of risk and to better indicate subsequent explorations. Thus. with a good evaluation of the clinical and at rest data in women, we could obtain a more accurate degree of suspicion of a significant coronary artery disease before the indication of a coronary angiography.     

Ultrastructural heterogeneity in primary ciliary dyskinesia syndrome. A case report

One of the causes of middle lobe syndrome is primary ciliary dyskinesia. This diagnosis was established in an eight-year-old girl by functional studies of the cilia on bronchial and nasal biopsy specimens. The clinical approach to this disease is emphasized and the technical difficulties raised by the diagnosis are discussed.     

A high‐resolution tape sensor improves the accuracy of applied pressure profiles during lower‐leg bandaging – results from a study using a fibre‐optic sensing tape

Compression bandaging is a mainstay practice in the treatment of conditions such as chronic wounds and lymphoedema. However, the ability of practitioners to measure bandage application to a desired pressure profile is difficult because of sensor limitations. We have used a novel fibre‐optic‐based, high‐resolution sub‐bandage pressure monitor to measure adherence to a target pressure gradient during compression bandaging. Participants of various experience (n = 46) were asked to bandage a lower‐leg manikin to a gradient of 40 (ankle) to 20 mmHg (proximal calf) in both a blinded trial and subsequently with sensor feedback. Mean pressures across all sensors for both the blind and sensor‐guided trials approximated a target mean of 30 mmHg. However, the mean gradient achieved in the blinded trial showed an inverse pressure gradient to the target with a high‐pressure region at the mid‐calf (44 ± 19 mmHg). Correlation to the target gradient improved from R² = 0·62 during the blind trial to 0·93 using sensor feedback, with a gradient that closely approximated the target. This demonstrates the use of high‐resolution sub‐bandage pressure sensing in improving the ability of practitioners to achieve a target pressure gradient in compression bandaging for clinical use and training.     

CBA、C57BL/6bkl小鼠对脉冲性噪音损伤敏感性的研究

目的研究CBA、C57BL／6bkl小鼠对脉冲性噪音损伤的敏感性。方法小鼠共分为8组，第1、2、3组为CBA小鼠（n分别为9、10、10）分别给予160 dB SPL 50、100、150次脉冲噪音暴露，第4、5、6组为C57BL／6bkl小鼠（n皆为10），分别给予160dB SPL 50、100、150次脉冲噪音暴露，第7、8组为CBA和C57BL／6bkl小鼠对照组（n=10），无噪音暴露。在噪音暴露前、噪音后24h及28d测听觉脑干诱发电位。结果给予160 dB SPL 50次脉冲噪音暴露后，CBA只出现暂时性阈值漂移，C57BL／6bkl出现暂时性和永久的阈值漂移，给予160 dB 100次和150次脉冲噪音暴露后，CBA和C57BL／6bkl均出现暂时性和永久性阈值漂移。对照组无阈值漂移。结论C57BL／6bkl小鼠对脉冲性噪音更敏感。耳蜗铺片形态学亦支持上述结论。     

Second-Line Cabazitaxel Treatment in Castration-Resistant Prostate Cancer Clinical Trials Compared to Standard of Care in CAPRI: Observational Study in the Netherlands

BackgroundCabazitaxel has been shown to improve overall survival (OS) in metastatic castration-resistant prostate cancer (mCRPC) patients after docetaxel in the TROPIC trial. However, trial populations may not reflect the real-world population. We compared patient characteristics and outcomes of cabazitaxel within and outside trials (standard of care, SOC).Patients and MethodsmCRPC patients treated with cabazitaxel directly after docetaxel therapy before 2017 were retrospectively identified and followed to 2018. Patients were grouped on the basis of treatment within a trial or SOC. Outcomes included OS and prostate-specific antigen (PSA) response.ResultsFrom 3616 patients in the CAPRI registry, we identified 356 patients treated with cabazitaxel, with 173 patients treated in the second line. Trial patients had favorable prognostic factors: fewer symptoms, less visceral disease, lower lactate dehydrogenase, higher hemoglobin, more docetaxel cycles, and longer treatment-free interval since docetaxel therapy. PSA response (≥ 50% decline) was 28 versus 12%, respectively (P = .209). Median OS was 13.6 versus 9.6 months for trial and SOC subgroups, respectively (hazard ratio = 0.73, P = .067). After correction for prognostic factors, there was no difference in survival (hazard ratio = 1.00, P = .999). Longer duration of androgen deprivation therapy treatment, lower lactate dehydrogenase, and lower PSA were associated with longer OS; visceral disease had a trend for shorter OS.ConclusionPatients treated with cabazitaxel in trials were fitter and showed outcomes comparable to registration trials. Conversely, those treated in daily practice showed features of more aggressive disease and worse outcome. This underlines the importance of adequate estimation of trial eligibility and health status of mCRPC patients in daily practice to ensure optimal outcomes.