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We hereby report a case of a 40-year-old male with a recent dog bite, a past history of immune thrombocytopenic purpura (ITP) and therapeutic splenectomy. He presented to the hospital with abdominal pain and shortness of breath, which progressed to sepsis and disseminated intravascular coagulation (DIC). Based on clinical presentation, Capnocytophaga-induced sepsis was suspected, and the diagnosis was confirmed through blood culture. Upon confirmation of the diagnosis, the patient was started on IV ampicillin/sulbactam which improved his condition and led to complete recovery without any long-term effects. Capnocytophaga is a genus of Gram-negative bacteria that are commensal to the oral cavity of common household pets such as dogs and cats. This case highlights the importance of considering Capnocytophaga as a potential pathogen in asplenic patients with recent pet-bites and emphasizes how early recognition and intervention can significantly improve outcomes in these critically-ill patients. It also warrants the need for healthcare providers to consider Capnocytophaga infections from minor pet-bites as a differential diagnosis in immunocompromised as well as immunocompetent individuals.

The differential diagnosis of CD5 positive B cell neoplasms can be difficult to resolve given the overlapping expression of surface markers. In the two major CD5 expressing B cell neoplasms (mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL)) CD23 is an important marker that contributes to their diagnostic differentiation. Reproducible diagnosis of chronic lymphocytic leukemia by flow cytometry: an European Research Initiative on CLL (ERIC) & European Society for Clinical Cell Analysis (ESCCA) harmonisation project. [Extracted from the article]

Abstract: Background/Aim: To estimate the reduction in blood volume loss and impact on diagnostic test quality associated with introduction of small volume blood tubes in a cohort of haematology inpatients compared to a historical comparator group. Methods: Prospective cohort study of haematology inpatients admitted to a tertiary referral hospital in Adelaide. Small volume blood tubes were used in an intervention cohort admitted between 2012 and 2013 and compared to a control cohort admitted between 2009 and 2010 where standard volume blood tubes had been used. The diagnostic test quality, specimen integrity and total reduction in blood loss associated with small volume blood tubes were estimated. Results: Small volume blood tubes demonstrated acceptable collinearity on commonly assayed haematological and biochemical parameters. Small volume tubes were associated with a 42% reduction in blood volume loss equating to a saving of 8.5 mL per patient per day or 180 mL of blood loss over a 3‐week admission. Small volume blood tubes were associated with a slight but significantly increased rate of fibrin contamination of ethylenediaminetetraacetic acid samples (0.2–0.5% of specimens). Conclusion: Small volume blood tubes are associated with a substantial reduction in total blood volume collected per day in haematology inpatients. They have similar diagnostic validity and sample integrity to that of standard volume containers. [ABSTRACT FROM AUTHOR]

Objective: There have been substantial changes in workforce and employment patterns in Australia over the past 50 years as a result of economic globalisation. This has resulted in substantial reduction in employment in the manufacturing industry often with large-scale job losses in concentrated sectors and communities. Large-scale job loss events receive significant community attention. To what extent these mass unemployment events contribute to increased psychological distress, mental illness and suicide in affected individuals warrants further consideration. Methods: Here we undertake a narrative review of published job loss literature. We discuss the impact that large-scale job loss events in the manufacturing sector may have on population mental health, with particular reference to contemporary trends in the Australian economy. We also provide a commentary on the expected outcomes of future job loss events in this context and the implications for Australian public mental health care services. Results and conclusion: Job loss due to plant closure results in a doubling of psychological distress that peaks 9 months following the unemployment event. The link between job loss and increased rates of mental illness and suicide is less clear. The threat of impending job loss and the social context in which job loss occurs has a significant bearing on psychological outcomes. The implications for Australian public mental health services are discussed. [ABSTRACT FROM AUTHOR]

Previous studies have shown that people with schizophrenia have high rates of Obstructive Sleep Apnoea (OSA). Despite this, intervention studies to treat OSA in this population have not been undertaken. The ASSET (Assessing Sleep in Schizophrenia and Evaluating Treatment) pilot study investigated Continuous Positive Airway Pressure (CPAP) treatment of severe OSA in participants recruited from a clozapine clinic in Adelaide. Participants with severe untreated OSA (Apnoea-Hypopnoea Index (AHI) > 30), were provided with CPAP treatment, and assessed at baseline and six months across the following domains: physical health, quality of sleep, sleepiness, cognition, psychiatric symptoms and CPAP adherence. Six of the eight ASSET participants with severe OSA accepted CPAP. At baseline, half of the cohort had hypertension, all were obese with a mean BMI of 45, and they scored on average 1.47 standard deviations below the normal population in cognitive testing. The mean AHI was 76.8 and sleep architecture was markedly impaired with mean rapid eye movement (REM) sleep 4.1% and mean slow wave sleep (SWS) 4.8%. After six months of treatment there were improvements in cognition (BACS Z score improved by an average of 0.59) and weight loss (mean weight loss 7.3 ± 9 kg). Half of the participants no longer had hypertension and sleep architecture improved with mean REM sleep 31.4% of the night and mean SWS 24% of the night. Our data suggests CPAP may offer novel benefits to address cognitive impairment and sleep disturbance in people with schizophrenia.