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Background: Avoiding rectal thermometry is recommended in patients with neutropenic fever. Permeability of the anal mucosa may result in a higher risk of bacteremia in these patients. Still, this recommendation is based on only a few studies. Methods: This retrospective study included all individuals admitted to our emergency department during 2014–2017 with afebrile (body temperature <38.3°C) neutropenia (neutrophil count <500 cells/microL) who were over the age of 18. Patients were stratified by the presence or absence of a rectal temperature measurement. The primary outcome was bacteremia during the first five days of index hospitalization; the secondary outcome was in-hospital mortality. Results: The study included 40 patients with rectal temperature measurements and 407 patients whose temperatures were only measured orally. Among patients with oral temperature measurements, 10.6% had bacteremia, compared to 5.1% among patients who had rectal temperature measurements. Rectal temperature measurement was not associated with bacteremia, neither in non-matched (odds ratio [OR] 0.36, 95% confidence interval [CI] 0.07–1.77) nor in matched cohort analyses (OR 0.37, 95% CI 0.04–3.29). In-hospital mortality was also similar between the groups. Conclusions: Patients with neutropenia who had their temperature taken using a rectal thermometer did not experience a higher frequency of events of documented bacteremia or increased in-hospital mortality. [ABSTRACT FROM AUTHOR]

Heavy metals are required by all organisms for normal function, but high levels of heavy metals are toxic. Therefore, homeostasis of these metals is crucial. In the human malaria-causing agent Plasmodiumfalciparum, the mechanisms of heavy metal transport have yet to be characterized. We have developed a P. falciparum line resistant to heavy metals from a wild-type line sensitive to heavy metals. A molecular and biochemical analysis of the involvement of the P. falciparum multidrug resistance 2 (pfmdr2) gene, an ABC-type transporter, in heavy metal homeostasis was studied. Using a novel uptake assay applied on these two strains, it was demonstrated that, when exposed to heavy metals, the sensitive line accumulates metal, whereas no accumulation was observed in the resistant line. The accumulation occurs within the parasite itself and not in the cytoplasm of the red blood cell. This difference in the accumulation pattern is not a result of amplification of the pfmdr2 gene or of a change in the expression pattern of the gene in the two lines. Sequencing of the gene from both lines revealed a major difference; a stop codon is found in the sensitive line upstream of the normal termination, resulting in a truncated protein that lacks 188 amino acids that contain a portion of the essential cytoplasmatic transporter domain, thereby rendering it inactive. In contrast, the resistant line harbors a full-length, active protein. These findings strongly suggest that the PFMDR2 protein acts as an efflux pump of heavy metals. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the incidence of ocular, periocular, and systemic inflammatory conditions among patients with pterygium and assess if these conditions are risk factors of pterygium development., Methods: A case-control study was conducted using electronic medical records from Clalit Health Services in Israel between 2001 and 2022. Patients diagnosed with pterygium were included; for each case, 3 controls were matched based on birth year, sex, and ethnicity. Mixed models were used to assess differences in the groups' demographic characteristics of ocular and systemic diseases. Generalized estimating equation logistic regression was used to estimate the odds ratios (ORs) and adjust for confounders., Results: A total of 94,652 patients diagnosed with pterygium and 378,608 matched controls were included in the study. The average age of patients with pterygium was 53 ± 16 years; 54% were male. A significant association was found between pterygium and vernal keratoconjunctivitis (OR 2.12, 95% confidence interval [CI], 1.90-2.36), chronic allergic conjunctivitis (OR 1.69, 95% CI 1.58-1.82), blepharitis (OR 1.66, 95% CI 1.61-1.70), and chalazion (OR 1.27, 95% CI 1.23-1.33). A significant association was also found between pterygium and systemic conditions as unspecified systemic allergy (OR 1.08, 95% CI 1.04-1.13), asthma (OR 1.08, 95% CI 1.04-1.11), and atopic dermatitis (OR 1.14, 95% CI 1.08-1.19)., Conclusions: Various inflammatory and allergic diseases-ocular, periocular, and systemic-increase the risk of pterygium. Further research is needed to investigate the role of inflammation in pterygium development., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Neurofibromatosis type 1 is an autosomal dominant disease with high penetrance, affecting 1:3,000 pregnancies. Meningiomas and other benign central nervous system tumors, such as ependymomas, are common features., Case: A patient with neurofibromatosis underwent cesarean section due to intrauterine growth restriction and nonreassuring fetal heart rate patterns. Examination of the abdominal cavity and intestines revealed a large (diameter, 12 cm), rubbery, fibrin-coated appendicular mass. The appendix was removed, and pathologic analysis confirmed the diagnosis of neuroma of the appendix., Conclusion: The case stresses the importance of careful inspection and evaluation of the abdominal cavity during surgery on patients with neurofibromatosis for the detection of possible associated masses.