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Background Pneumonia frequently affects solid organ transplant (SOT) recipients, with high morbidity and mortality. However, the few studies on pneumonia in this population are mainly retrospective, single-center, and long-term studies, or include patients with only one type of SOT or a specific etiology. We performed a point prevalence study to investigate epidemiology, diagnosis, therapy, and outcome of pneumonia in an unselected SOT population. Methods Italian and Spanish transplant centers were invited to report on all SOT recipients with pneumonia treated during 2 separate weeks (1 each in February and June 2012). Results In total, 35 centers (18 in Italy, 17 in Spain) agreed to participate and collected 54 cases. The incidence of pneumonia was 10.1 episodes/1000 recipients/year. Pneumonia was classified as late (>6 months) in 70.4% of cases. Pneumonia was also classified as community-acquired (CAP), healthcare-associated (HCAP), and hospital-acquired (HAP) pneumonia in 40.7%, 38.9%, and 20.4% of cases, respectively. An attempt to microbiological diagnosis (≥1 sample) was made in 94.4% of patients, with a diagnostic yield of 60.7%. Causative agents included bacteria (87.1%), virus (29%), and fungi (6.4%). A multidrug-resistant bacterium was isolated in 18.2%, 40%, and 100% of patients with CAP, HCAP, and HAP (P = 0.007), respectively. Overall, 11.1% of patients were admitted to the intensive care unit, 3.7% developed graft rejection, and graft function deteriorated in 18.5%. In-hospital mortality was 1.9%. Conclusion Pneumonia remains a frequent problem in SOT recipients, although it occurs later in patients who are in better physical health. Therefore, harmful pathogens and worse outcome are less common than previously thought.

Determination of very low-level activity in samples using α-spectrometry is possible due to the low background. In order to determine the chemical yield in the separation of the element of interest, a spike must be added to the sample. In many practical cases there is no adequate spike or it is not available in the laboratory. In these cases a spike of the radionuclide already pesent in the sample can be used as the so-called inner standard method. In order to achieve the best results the optimal quantity and the spike to choose must be determined to reduce the uncertainties associated with the activities. The present work is a systematic study of these problems. These considerations were used to the determination of thorium in environmental samples.

The most difficult task in alpha spectrometry is perhaps making the source to be measured, but once sources are prepared, the gathering and analysis of results is an activity which can be developed in undergraduate laboratories. Energy calibration, determinations of counting yield and energy resolution, calculation of areas under the peaks in the spectrum (overlapping and well separated), determination of activities, etc., are frequently tasks that students find straightforward and informative. Neither is the cost of the experimental setup needed for such measurements excessive. Some educational applications of alpha spectrometry are described.

Using a silicon PIPS detector, a number of alpha-particle spectra were recorded from sources of different nuclide activities. These spectra were fitted using a “Simplex” computer programme. The fitting function contains a term which is the convolution of a truncated exponential with a Gaussian function. We have studied the variation of the value of the characteristic energy in the exponential with the value of the variance of the Gaussian. Both values are obtained from the best fits in the least-squares sense. After subtraction of baseline values, we find a significant correlation between the two parameters, which is attributed to the skewed distribution of the energy losses of the alpha-particles prior to detection.

We present the case of a 31-year-old man hospitalized for the study of a fever syndrome. The patient developed acute respiratory failure, with anemia and hepatic affection. In the histological examination of the liver and bone marrow, the presence of granulomas suggesting a tuberculous etiology was demonstrated. Antibodies IgG anti-Coxiella burnetti were detected, using indirect immunofluorescence, at the level of 1/200, with latter seroconversion to 1/800. Therapy with doxycycline was administered (200 mg/day during 14 days). Fever subsided in 24 hours and the other clinico-biochemical disorders disappeared in the following days. After the literature review, we conclude that Q fever must be taken into account for the differential diagnosis of any granulomatous disease observed in the liver and/or bone marrow. We can confirm that any granuloma is specific of just one pathological entity. The diagnosis must be always supported by other clinical, supplementary and serological data.

Syphilis is an ever changing disease with an increasing incidence in the last years. Diagnosis of neurological damage remains on cerebrospinal fluid studies and serologic test in patients with appropriate clinical manifestations. Modern neuroimaging techniques are now available in the diagnostic workup of patients with neurosyphilis. Our experience with such techniques in two patients with meningo-vascular syphilis and general paresis points out to the role of magnetic resonance imaging in disclosing ischemic lesions in these patients, although these lesions were not absolutely specific of the disease.