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Objectives: The identification of the specific pathogen responsible for a respiratory infection in patients with hematological malignancies (HM) would ensure relevant treatment and prevent toxicity associated with anti-infective therapy. This large-scale study aimed to explore the clinical impact of fiberoptic bronchoscopy with bronchoalveolar lavage (FOB-BAL) in conjunction with molecular analysis on the diagnosis and management of respiratory infections in hemato-oncological patients. Methods: All consecutive patients with HM and pulmonary infiltrates, who underwent FOB-BAL between January 2008 and January 2013, were included in the analysis. Clinical characteristics, FOB-BAL results, and treatment adjustments were recorded, and factors predicting a positive BAL were assessed. Results: Four hundred and twenty-five FOB-BAL procedures were analyzed. BAL revealed a specific diagnosis in 219 (51.5%) patients, 208 of them with a pulmonary infection. Infectious etiological agents found were mainly Aspergillus spp (n = 142), bacterial species (n = 44), and Pneumocystis jirovecii (n = 34). Multivariate analysis showed that a lymphoproliferative disease, ≥2 symptoms (dyspnea/cough/hemoptysis/pleuritic pain), and less than 4 days between symptom appearance and FOB-BAL, predicted a positive FOB-BAL result. BAL results prompted a treatment modification in 48% of subjects. Conclusions: FOB-BAL in conjunction with molecular assays is efficient in the rapid detection of life-threatening infections, allowing for adjustment of anti-infective therapy, which may result in better outcomes and reduce treatment-related toxicity.

Background: The syndrome of pulmonary hypertension (PHT) in end-stage renal disease (ESRD) has been described in patients on chronic hemodialysis (HD) therapy via arterial-venous (A-V) access. However, the exact timing for the development of the PHT is unknown. This study was designed to evaluate changes in pulmonary artery pressure (PAP) following creation of the vascular access. Patients and Methods: PAP and cardiac-output (CO) values were recorded in 12 pre-dialysis patients without PHT a few months after the access formation, before treatment with HD was started, and the prevalence of PHT was calculated. Clinical data was compared between patients with and without PHT. Results: The systolic PAP values were increased in “ve of the 12 pre-dialysis patients (42%) by 21±9 mm Hg to more than 35 mm Hg. Patients with and without PHT differed only in that CO was signi“cantly higher among the former. Conclusions: The development of PHT following access formation represents a failure of the pulmonary circulation to accommodate the access-mediated elevated CO. Pre-dialysis patients scheduled for access formation should be screened for the presence of sub-clinical PHT. “Positive” patients should proceed to peritoneal dialysis or advance to kidney transplantation; rather than getting access and HD therapy.

O envolvimento pulmonar definido como febre e aparecimento de novos infiltrados são a maior causa de morbilidade e mortalidade entre os doentes com doenças hematológicas malignas e em doentes transplantados de medula óssea (TMO). Os autores decidiram avaliar o valor diagnóstico do lavado broncoalveolar (LBA) neste grupo de doentes. Durante um período de dois anos, de Maio de 2000 a Maio de 2002, realizaram 115 LBA para tentar esclarecer infiltrados pulmonares em 94 doentes com doenças hematológicas malignas (28) e em doentes TMO (87). O BAL foi considerado eficaz desde que tenha feito um diagnóstico específico ou tenha excluído um diagnóstico posto e subsequentemente levado a alteração da terapêutica. O diagnóstico foi conseguido em 30,4% (infecções: 22,6%; hemorragia alveolar: 7,8%) e houve alteração da estratégia terapêutica em 21,8%, produzindo um campo de acção de 52,2%. A etiologia infecciosa foi de 54% de bactérias e de 30,8% de fungos. Houve apenas 3 complicações minor. O estudo destes autores mostrou eficácia do LBA no diagnóstico específico e levou a alterações terapêuticas em metade dos doentes com infiltrados pulmonares. A percentagem relativamente baixa nos diagnósticos específicos, segundo os autores, deve-se à utilização de antibióticos na profilaxia das infecções e na terapêutica empírica usada nestes doentes hematológicos com eventuais sinais de infecção.

Gel lubrication is routinely used during gynecological examination to prevent or reduce pain, yet its impact on microbial composition during sampling remains unclear. This study aimed to investigate whether lubricating gel affects the microbial composition of vaginal samples. We included 31 pregnant women presenting during their third trimester to clinics or emergency room and collected 143 unique vaginal samples for 16S amplicon microbial analysis. Vaginal samples were obtained using sterile swabs under various conditions: without gel-immediately frozen (n = 30), with gel-immediately frozen, without gel-at room temperature (RT) for 5 h before freezing, with gel-at RT for 5 h before freezing, and additional sampling after 24 h without gel-immediate freezing. We found that sample collection with gel lubrication influenced specimen quality-half of the gel samples failing to meet processing limitation compared to those without gel. The effect of gel on testing quality dissipated after 24 h. However, when samples met post-sequencing filters, gel lubrication did not alter the microbial composition, individual taxa abundance or alpha and beta diversity. We recommend sampling either before gel exposure or 24 h after. These findings underscore the importance of considering sample collection methodologies in vaginal microbiome studies to ensure high-quality microbial data for accurate analysis., (© 2024. The Author(s).)

Introduction the: GBA -N370S mutation is one of the most frequent risk factors for dementia with Lewy bodies (DLB) and Parkinson's disease (PD). We looked for genetic variations that contribute to the outcome in N370S-carriers, whether PD or DLB., Methods: Whole-genome sequencing of 95 Ashkenazi-N370S-carriers affected with either DLB (n = 19) or PD (n = 76) was performed, and 564 genes related to dementia and PD analyzed., Results: We identified enrichment of linked alleles in PINK1 locus in DLB patients (false discovery rate P  = .0412). Haplotype analysis delineated 1.8 Mb interval encompassing 29 genes and 87 unique variants, of them, KIF17 -R869C received the highest functional prediction score (Combined Annotation Dependent Depletion = 34). Its frequency was significantly higher in 26 DLB-N370S-carriers compared to 140 PD-N370S-carriers (odds ratio [OR] = 33.4 P  = .001, and OR = 70.2 when only heterozygotes were included)., Discussion: Because KIF17 was shown to be important for learning and memory in mice, our data further suggest, for the first time, its involvement in DLB, and possibly in human dementia., Competing Interests: O.G., M.G.W., T.S., R.A., Y.M., and A.B.S. declare no conflicts of interest. Y.Y.W. is an employee of NRGene Ltd. A.T. has received honoraria from AbbVie Inc. and research grants from the Michael J. Fox Foundation. T.G. reports advisory board membership with honoraria to her and to her institution from AbbVie Israel, Neuroderm Ltd., and Allergan; research support from Phonetica Ltd., Israeli Innovation Authority, Sagol School of Neuroscience (Brain Boost), and the Parkinson's Foundation; and travel support for herself and her team from Abbvie, Allergan, Medisson, Medronic. A.M. has received consulting fees from NeuroDerm and research grants from the Michael J. Fox Foundation, the Israeli Science Foundation, and the US Department of Defense. N.G. serves as a consultant to Intec Pharma, NeuroDerm, Denali, Abbvie, Sanofi‐Genzyme, Biogen, Vibrant, BOL, LTI, Idorsia, and Pharma2B; receives payment for lectures at Abbvie, Sanofi‐Genzyme, Movement Disorder Society, Bial, and UCB; received research support from the Michael J. Fox Foundation, the National Parkinson Foundation, and the Israel Science Foundation as well as from Teva NNE program, Biogen; serves on the advisory board of LTI, NeuroDerm, Sionara, Sanofi‐Genzyme, Biogen, Denali, Intec Pharma, Idorsia; owns stocks in Lysosomal Therapeutic Ltd, Vibrant, BOL; and serves as a member of the Editorial Board for the Journal of Parkinson's Disease. A.O.U. has received research support from the Michael J. Fox Foundation and Chaya Charitable Fund and has received honoraria from Sanofi Genzyme., (© 2021 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.)

Introduction: Different drugs can affect the hair. Among the various types of drug-induced hair changes, hair colour change is a rare phenomenon which is less reported in the literature. Hair colour changes include lightening of the hair, whitening or returning to the original colour and even change to a new colour. In this article we report a patient presenting with hair yellowing due to topical treatment with minoxidil and discuss the phenomenon of drug-induced hair colour changes.

In the aftermath of an extensive Egyptian Rift Valley fever (RVF) epidemic during 1977-78, RVF activity in the adjacent Sinai peninsula has been inferred from the presence of haemagglutination-inhibition (HI) antibodies in sera from indigenous humans and rodents. We attempted to confirm these findings by HI testing of sera from Israeli soldiers serving in the region of the El Arish Wadi system in the Sinai, and from indigenous rodents. Six of 199 human sera (3.0%) and two of 88 rodent sera (2.3%) were positive, but none reacted in the more specific plaque-reduction neutralization test. We conclude that there is no definitive serological evidence for RVF activity in the Sinai and that sera reacting in the HI test must be confirmed by a more specific serological procedure.