Monkeypox in Patient Immunized with ACAM2000 Smallpox Vaccine During 2022 Outbreak

We report a case of monkeypox in the United States in a patient who had been vaccinated with ACAM2000 smallpox vaccine 8 years earlier. Despite his vaccination status, he still contracted disease. He showed prodromal symptoms preceding development of painless penile lesions that later coalesced.     

Chromomoric acid derivatives from Tectona philippinensis

The air-dried leaves of Tectona philippinensis, an endemic and endangered Philippine medicinal tree, afforded four new chromomoric acid derivatives ( 1, 2, 3a, and 3b). Their structures were elucidated by extensive 1D and 2D NMR spectroscopy. Antimicrobial testing was carried out on 1- 3 against a panel of bacteria and fungi.     

Spontaneous intraperitoneal rupture of a kidney in a patient with tuberous sclerosis

A case is reported of spontaneous intraperitoneal rupture of a kidney in a patient with tuberous sclerosis who presented with left renal colic and left lower quadrant abdominal pain.     

Steroid or tacrolimus withdrawal in renal transplant recipients using sirolimus

Background  

Calcineurin inhibitor (CNI) and steroid (ST) withdrawal are strategies under investigation to reduce long-term toxicities associated with current immunosuppressive regimens. We conducted a single center, prospective trial comparing the efficacy and safety of CNI or ST withdrawal in kidney transplant recipients receiving sirolimus-based immunosuppressive regimen.     

Pregenesys pre-eclampsia markers consensus meeting: What do we require from markers,risk assessment and model systems to tailor preventive strategies?

The Pregenesys Consensus Meeting held in Cambridge on 13 July 2009 was organized by the Pregenesys Consortium to review and critically discuss current knowledge regarding early markers of preeclampsia, to identify priorities and opportunities for future research, to consider issues that may need to be addressed in future recommendations and to highlight key issues in cost effectiveness and national policies concerning prediction and early screening for the risk of developing preeclampsia.This report summarizes the outcome of the Consensus Meeting and draws attention to issues for further investigation with specific regard to single versus multiple markers, early versus late risk identification, and the long-term effects on both maternal and perinatal health and the need to include these in any future cost-benefit assessment.     

Urethral catheterization facilitates preradiation fiducial marker placement in postprostatectomy patients

Surgical absence of the prostate can make placement of fiducial markers difficult, because anatomic landmarks are distorted and there is a paucity of substantial tissue to hold fast the markers. We describe a method for improving the accuracy of fiducial marker placement for the purpose of salvage or adjuvant external beam radiation therapy for prostate cancer in patients who have undergone radical prostatectomy. To assist with identification of the urethrovesical junction and to facilitate placement of the markers, a Foley catheter was placed and the balloon was inflated. Gentle traction on the catheter seated the balloon at the bladder neck to echographically define the anatomy of the urethrovesical junction. Next, a rectal ultrasound probe was inserted into the rectum, allowing visualization of the region of the urethrovesical junction. Fiducial markers were then placed bilaterally in the detrusor muscle at the bladder neck or in the periurethral tissue using the applicator needle. The treating radiation oncologist verified that marker placement was suitable for assisting with radiation therapy in all cases. Preradiation pelvic imaging verified that markers were not in the bladder or urethral lumen, and there were no patient complaints of voiding out the markers with urination.     

Cerebral maturation in IUGR and appropriate for gestational age preterm babies

Intrauterine growth restriction (IUGR) is associated with increased risk of perinatal morbidity and mortality, as well as long-term neurological deficits. However, neurostructural correlations with observed developmental disabilities have not yet been established. Magnetic resonance imaging (MRI) could prove useful for assessing brain development in the early neonatal period. We evaluated cerebral lesions and morphological maturation by MRIs in 59 preterm neonates, in order to verify the hypothesis that IUGR interferes on human brain development. A total of 26 pregnancies were complicated by IUGR and 33 pregnancies delivered preterm at a comparable gestational age with appropriate for gestational age (AGA). Magnetic resonance examination was performed at the completion of 41 weeks' gestation. White matter disease studied with MR included periventricular cavitations and punctuate lesions characterized by increased signal on T1-weighted and decreased signal on T2-weighted images. Cerebral maturation was defined by the total maturation score, on the basis of 4 morphological parameters of cerebral maturation: myelination (M), cortical infolding (C), germinal matrix distribution (GM), and glial cell migration pattern (G). No difference in brain lesions and in the level of cerebral maturation was found between preterm AGA and IUGR neonates. However, myelination was significantly reduced in IUGR neonates with brain sparing compared to IUGR neonates with normal Doppler of middle cerebral artery. Our study could not demonstrate any major significant difference between preterm AGA and IUGR neonates in terms of lesion occurrence and cerebral maturation. We observed, however, a mild delay in myelination in IUGR with brain sparing in utero. The relevance of this finding needs to be investigated with long-term follow-up.