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  1. Disseminated nocardiosis masquerading as metastatic malignancy

    PubMed Central

    Arjun, Rajalakshmi; Padmanabhan, Arjun; Reddy Attunuru, Bhanu Prakash; Gupta, Prerna

    2016-01-01

    Nocardiosis is an uncommon gram-positive bacterial infection caused by aerobic actinomycetes of the genus Nocardia. It can be localized or systemic and is regarded as an opportunistic infection that is commonly seen in immunocompromised hosts. We report a case of disseminated nocardiosis caused by Nocardia cyriacigeorgica in a patient with underlying malignancy in whom the clinical presentation was highly suggestive of a metastatic disease. PMID:27578940

  2. Chest Wall Dissemination of Nocardiosis after Percutaneous Transthoracic Needle Biopsy

    SciTech Connect

    Shimamoto, Hiroshi Inaba, Yoshitaka; Yamaura, Hidekazu; Sato, Yozo; Kamiya, Mika; Miyazaki, Masaya; Arai, Yasuaki; Horio, Yoshitsugu

    2007-07-15

    We described a case of chest wall dissemination after percutaneous transthoracic needle biopsy. A 65-year-old man had a lung nodule which was suspected to be lung carcinoma. He underwent percutaneous transthoracic needle biopsy using an 18G semiautomated biopsy needle and pathologic diagnosis showed organizing pneumonia. Two months after the biopsy, chest wall dissemination occurred. Implantation of carcinoma along the biopsy route was suspected, but the mass was actually due to pulmonary nocardiosis.

  3. Nocardia mikamii a Novel Species Causing Disseminated Nocardiosis: A Literature Review of Disseminated Nocardiosis

    PubMed Central

    Adnan, Mohammed Muqeet; Mujeeb, Sufyan Abdul

    2014-01-01

    Nocardia is an uncommon Gram-positive organism. It typically appears as delicate filamentous Gram-positive branching rods. In the United States it was estimated to be approximately 500 to 1000 new cases per year. The organism causes disease in immunocompromised individuals with pulmonary infection representing the most common site of infection. Nocardia mikamii has been a recently isolated pathogen and not many cases of disseminated infection with this organism has been reported in the literature; we present a case of disseminated nocardiosis (mikamii sp.) in an immunocompromised patient. We also present a literature review on nocardiosis. PMID:27437492

  4. [Disseminated Nocardiosis Complicated by Multiple Brain Abscesses: A Case Report].

    PubMed

    Koh, Masaki; Tomita, Takahiro; Kashiwazaki, Daina; Ashizawa, Nobuyuki; Yamamoto, Yoshihiro; Kuroda, Satoshi

    2015-12-01

    We report a relatively rare case of a disseminated type of nocardiosis without lung involvement. A 75-year-old man developed moderate fever and disturbed consciousness and was admitted to our hospital. Laboratory examinations revealed signs of inflammation. Chest X-rays indicated no abnormalities, but brain MRI showed ring-like enhancement lesions in the right temporal and left frontal lobes. Similar lesions were identified in the left kidney and right leg. The brain lesions were purulent and were surgically irrigated. Gram- and Kinyoun-positive bacteria were identified, and the patient was diagnosed as suffering from a disseminated type of nocardiosis without lung involvement. He was treated with trimethoprim-sulfamethoxazole for over 10 months. The postoperative course was uneventful, and he was discharged without any neurological sequelae two months after surgery. Kinyoun staining was important in early diagnosis and hence providing appropriate therapy for life-threatening nocardiosis. PMID:26646175

  5. A Case of Disseminated Nocardiosis Secondary to the Skin Nodules in an Elderly Woman

    PubMed Central

    In, Seung Gyun; Han, Sung Hyup; Shin, Jeong Hyun; Chung, Moon Hyun

    2008-01-01

    Nocardiosis refers to a locally invasive or disseminated infection associated with the Nocardia species. Most infections enter through the respiratory tract and then disseminate systemically. Rarely can a primary nocardial infection of the skin spread to contiguous structures or disseminate to other internal organs in immunocompromised hosts. We describe a 70-year-old woman who suffered from recurrent nodular skin lesions on her right hand, forearm and elbow following inoculation of a traumatic injury. Analysis of the purulent exudates obtained from the nodule revealed Nocardia species. After 20 days, a chest X-ray showed newly developed multiple nodules in both lungs. The diagnosis of systemic nocardiosis was established, and we treated this case with trimethoprim-sulfamethoxazole. PMID:27303166

  6. Primary cutaneous nocardiosis.

    PubMed

    Jiang, Shan; Jiang, Guan; Lei, Tie-Chi

    2014-11-01

    Nocardiosis is a rare human infection due to ubiquitous soil born gram-positive, filametous aerobic bacteria. First signs are frequently cutaneous either as part of systemic infection disseminated to the skin, or as primary cutaneous inoculation. An 88 years old man presented with a 3-day history of red papules and pustules with pain on his forehead. The combination of the unusual clinical presentation, laboratory examinations, and a favorable response to co-trimoxazole therapy were consistent with a diagnosis of primary cuteneous nocardiosis. Early recognition and treatment of the disease will improve the cure rate. PMID:25518763

  7. Pulmonary nocardiosis due to Nocardia farcinica in a renal transplant recipient.

    PubMed

    Gowrinath, K; Baig, Waqas Wahid; Prabhu, Attur Ravindra; Chawla, Kiran; Bairy, Indira

    2009-01-01

    Nocardia farcinica is an infrequent cause of nocardiosis among the renal transplant recipients and it has not been reported so far from India. We report a case of pulmonary nocardiosis due to N. farcinica in a 32-year-old woman with hypothyroidism and post-renal transplant status, currently on immunosuppressive therapy (prednisolone, azathioprine and tacrolimus). The N. farcinica isolate was susceptible to trimethoprim-sulfamethoxazole (TMP-SMZ), linezolid, imipenem, gentamicin but resistant to ceftriaxone, ciprofloxacin, tobramycin, erythromycin, amoxycillin-clavulanic acid and tetracycline. Treatment with TMP-SMZ and linezolid resulted in marked clinico-radiological improvement but after two weeks both of the drugs had to be stopped due to severe pancytopenia as adverse effect of their use. Currently, the patient is on imipenem and remains stable after four weeks of treatment. In N. farcinica infections, multi antibiotic resistance and toxicity of some specific drugs enhances the risk of therapeutic failure in renal transplant recipients. PMID:20073376

  8. [Pulmonary Nocardiosis due to Nocardia asiatica in a Patient with ANCA-associated Vasculitis].

    PubMed

    Suemori, Koichiro; Miyamoto, Hitoshi; Murakami, Shinobu; Yamazaki, Hitoshi; Ishizaki, Jun; Matsumoto, Takuya; Murakami, Yuichi; Hasegawa, Hitoshi; Yasukawa, Masaki

    2015-07-01

    Nocardia asiatica is a rare causative organism responsible for opportunistic infection, and was first reported by Kageyama et al. in 2004. We report herein on a very rare case of N. asiatica infection in a 76-year old male patient with ANCA-associated vasculitis and a history of pulmonary tuberculosis. The patient developed pulmonary nocardiosis due to N. asiatica while receiving glucocorticoid therapy. Chest computed tomography demonstrated multiple granules and cavity formation mainly in the left lower lobe. From the images, we suspected opportunistic infection, possibly pulmonary tuberculosis or pulmonary damage due to ANCA-associated vasculitis. Nocardia sp. was detected from a bronchoalveolar lavage culture and N. asiatica was identified by 16S ribosomal DNA gene sequencing. Cranial magnetic resonance imaging revealed no abnormality. Administration of Doripenem (1.5g/day) and sulfamethoxazole-trimethoprim (4g/day) was started, and the patient's clinical and imaging findings promptly improved. Thereafter, he received sulfamethoxazole-trimethoprim (2g/day) and prednisolone (10 mg/day) as maintenance therapy for ANCA-associated vasculitis for more than one year, and there has since been no recurrence of the Nocardia infection. PMID:26554223

  9. Disseminated nocardiosis in a patient with nephrotic syndrome following HIV infection.

    PubMed

    Zhou, Letian; Liu, Hong; Yuan, Fang; Yuan, Shuguang

    2014-10-01

    In the present study, a case of disseminated abscesses caused by Nocardia in a patient undergoing immunosuppressive therapy for nephrotic syndrome and infected with human immunodeficiency virus (HIV) is described. To the best of our knowledge, this is the first such case to be reported. The patient had membranous nephropathy and received systemic corticosteroid therapy for one year. During this time, the patient was diagnosed with HIV and developed disseminated abscesses in the lungs, brain and hip. Pathogens isolated from sputum and pus were identified as Nocardia asteroides. The patient was successfully treated following surgical drainage of the abscesses and by oral administration of trimethoprim-sulfamethoxazole. PMID:25187812

  10. Disseminated nocardiosis in a patient on infliximab and methylprednisolone for treatment-resistant Sweet's syndrome.

    PubMed

    Drone, Elizabeth R; McCrory, Allison L; Lane, Natalie; Fiala, Katherine

    2014-07-01

    A 62-year-old white man with a 10-year history of treatment-refractory Sweet's syndrome was admitted to the hospital with the onset of purpuric lesions. Methylprednisolone and infliximab were administered. Our patient developed disseminated Nocardia infection and eventually succumbed. Opportunistic infections such as Nocardia have been associated with infliximab and other tumour necrosis factor (TNF)-α inhibitors. The astute clinician should be aware of the risk of rare opportunistic infections, particularly in patients on TNF-α inhibitors and systemic corticosteroids. PMID:25165648

  11. Pulmonary nocardiosis

    MedlinePlus

    ... infection from returning. Alternative Names Nocardiosis - pulmonary Images Respiratory system References Limper AH. Overview of pneumonia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: ... of Respiratory Medicine . 5th ed. Philadelphia, PA: Elsevier Saunders; 2010: ...

  12. Pulmonary Nocardiosis: Review of Cases and an Update

    PubMed Central

    Shariff, Malini; Gunasekaran, Jayanthi

    2016-01-01

    Nocardia, a branching, filamentous bacteria, is widely distributed in the environment and can cause human infection in immune-compromised hosts. Inhalation of Nocardia leads to pulmonary disease. Microbiology laboratory processed the clinical samples from patients with respiratory infections. Smears were prepared from the samples and were stained and cultured. Five cases were positive for Nocardia. They were treated with the trimethoprim-sulfamethoxazole combination. The disease was cured in three patients, and two died due to other comorbid conditions leading to complications. Nocardiosis is encountered in parts of the world even where it is not endemic due to increased world travel. So physicians and laboratory staff should be aware of this and try to diagnose it. Early detection can lead to the prompt initiation of treatment and reduced mortality in these patients. Patients with disseminated or severe nocardiosis should be treated with combination therapy with two or more active agents.

  13. Pulmonary Nocardiosis: Review of Cases and an Update.

    PubMed

    Shariff, Malini; Gunasekaran, Jayanthi

    2016-01-01

    Nocardia, a branching, filamentous bacteria, is widely distributed in the environment and can cause human infection in immune-compromised hosts. Inhalation of Nocardia leads to pulmonary disease. Microbiology laboratory processed the clinical samples from patients with respiratory infections. Smears were prepared from the samples and were stained and cultured. Five cases were positive for Nocardia. They were treated with the trimethoprim-sulfamethoxazole combination. The disease was cured in three patients, and two died due to other comorbid conditions leading to complications. Nocardiosis is encountered in parts of the world even where it is not endemic due to increased world travel. So physicians and laboratory staff should be aware of this and try to diagnose it. Early detection can lead to the prompt initiation of treatment and reduced mortality in these patients. Patients with disseminated or severe nocardiosis should be treated with combination therapy with two or more active agents. PMID:27445562

  14. Disseminated cutaneous phaeohyphomycosis due to Cladophialophora bantiana.

    PubMed

    Khader, Anza; Ambooken, Betsy; Binitha, Manikoth Payyanadan; Francis, Saji; Kuttiyil, Ashokan K; Sureshan, Deepthi Nalini

    2015-01-01

    Cladophialophora bantiana is a neurotropic dematiaceous fungus which only rarely affects the skin. We report a case of disseminated cutaneous phaeohyphomycosis caused by Cladophialophora bantiana in an immunocompromised female who presented with multiple pyogenic granuloma-like nodules, dermatophytosis-like plaque, and subcutaneous cysts on the upper and lower extremities without systemic involvement. Biopsy revealed black yeasts resembling sclerotic bodies and culture yielded irregular, velvety, grey colonies with black reverse. Excision of the nodules and treatment with oral itraconazole 100 mg twice daily resulted in complete clinical resolution within two months, following which itraconazole was administered for another 4 months. PMID:26261143

  15. [Thoracic nocardiosis - a clinical report].

    PubMed

    Vale, Artur; Guerra, Miguel; Martins, Daniel; Lameiras, Angelina; Miranda, José; Vouga, Luís

    2014-01-01

    Nocardia genus microorganisms are ubiquitous, Gram positive aerobic bacterias, responsible for disease mainly in immunocompromised hosts, with cellular immune response commitment. Inhalation is the main form of transmition and pulmonary disease is the most frequent presentation. Dissemination may occur by contiguity and also via hematogenous. The clinical and imaging presentation is not specific, and diagnosis is obtained after identification of Nocardia bacteria in biological samples. Since there are no reliable studies that indicate the best therapeutic option, treatment should be individualized and based on antimicrobial susceptibility testing. Surgical drainage should also be considered in all patients. The authors present a clinical case of a patient with thoracic nocardiosis, and make a short literature review on the theme. PMID:25596394

  16. Clinical Analysis of Pulmonary Nocardiosis in Patients With Autoimmune Disease.

    PubMed

    Li, Shan; Song, Xin yu; Zhao, Yu yue; Xu, Kai; Bi, Ya Lan; Huang, Hui; Xu, Zuo jun

    2015-09-01

    presentation at younger age. Immunosuppressant therapy, lymphocytopenia, particularly low CD4+ T-lymphocyte counts, and low serum albumin levels may be disease susceptibility factors. Air-space opacities and nodules were the most common chest imaging features, and disseminated nocardiosis with lung and skin involvement was more common among them. Early diagnosis and anti-nocardial antibiotics with modulation of the basic immunosuppressive therapy were important for them. PMID:26426628

  17. Clinical Analysis of Pulmonary Nocardiosis in Patients With Autoimmune Disease

    PubMed Central

    Li, Shan; Song, Xin yu; Zhao, Yu yue; Xu, Kai; Bi, Ya lan; Huang, Hui; Xu, Zuo jun

    2015-01-01

    predominance and presentation at younger age. Immunosuppressant therapy, lymphocytopenia, particularly low CD4+ T-lymphocyte counts, and low serum albumin levels may be disease susceptibility factors. Air-space opacities and nodules were the most common chest imaging features, and disseminated nocardiosis with lung and skin involvement was more common among them. Early diagnosis and anti-nocardial antibiotics with modulation of the basic immunosuppressive therapy were important for them. PMID:26426628

  18. Nocardiosis in Heart Transplant Recipients.

    PubMed

    Koerner, Michael M; El-Banayosy, Aly; Schulz, Uwe; Zeriouh, Mohamad; Koerfer, Reiner; Tenderich, Gero; Ghodsizad, Ali

    2015-01-01

    Nocardia has emerged as an important opportunistic pathogen, especially in organ transplant recipients. Heart transplant (HT) recipients initially had an especially high rate of Nocardia infection, but this could be reduced by the routine use of cyclosporine. Our objective was to clarify the prevalence and presentation of Nocardiosis in HT recipients in a retrospective cross-sectional analysis. PMID:26726715

  19. Disseminated Zygomycosis Due to Rhizopus schipperae after Heatstroke

    PubMed Central

    Anstead, Gregory M.; Sutton, Deanna A.; Thompson, Elizabeth H.; Weitzman, Irene; Otto, Randal A.; Ahuja, Sunil K.

    1999-01-01

    A 21-year-old woman suffered heatstroke and developed diarrhea while trekking across south Texas. The heatstroke was complicated by seizures, rhabdomyolysis, pneumonia, renal failure, and disseminated intravascular coagulation. The patient’s stool and blood cultures grew Campylobacter jejuni. The patient subsequently developed paranasal and gastrointestinal zygomycosis and required surgical debridement and a prolonged course of amphotericin B. The zygomycete cultured was Rhizopus schipperae. This is only the second isolate of R. schipperae that has been described. R. schipperae is characterized by the production of clusters of up to 10 sporangiophores arising from simple but well-developed rhizoids. These asexual reproductive propagules are produced on Czapek Dox agar but are absent on routine mycology media, where only chlamydospores are observed. Despite multiorgan failure, bacteremia, and disseminated zygomycosis, the patient survived and had a good neurological outcome. Heatstroke has not been previously described as a risk factor for the development of disseminated zygomycosis. PMID:10405417

  20. Disseminated intravascular coagulation and hepatocellular necrosis due to clove oil.

    PubMed

    Brown, S A; Biggerstaff, J; Savidge, G F

    1992-10-01

    We describe the case of a 2-year-old child who suffered from disseminated intravascular coagulation (DIC) and hepatocellular necrosis, following ingestion of clove oil. The patient was treated with heparin and fresh frozen plasma, and, following specific haemostasis assays, with appropriate coagulation factor and inhibitor concentrates. The case demonstrates how this approach can be successfully used in the management of DIC with coexisting liver failure. PMID:1450336

  1. Rare Dysuria: Prostatic Abscess due to Disseminated Coccidioidomycosis.

    PubMed

    Ansari Pirsaraei, Pedram; Tabsh, Kareem; Lentz, Jacob

    2016-11-01

    We present a case of disseminated coccidioidomycosis with formation of a prostatic abscess in a 28-year-old diabetic male. Though rare, Coccidiodes prostatitis should be included in the differential for patients who have spent time in endemic areas and present with prostatitis or other genitourinary tract symptoms, especially in the setting of immunocompromise. The small number of Coccidiodes prostatitis cases described in the literature previously are reviewed, along with a wider discussion of coccidioidomycosis. Treatment modalities for this challenging fungal disease are also discussed. PMID:27617214

  2. Probable acute disseminated encephalomyelitis due to Haemophilus influenzae meningitis.

    PubMed

    Beleza, Pedro; Ribeiro, Manuel; Pereira, João; Ferreira, Carla; Jordão, Maria José; Almeida, Fátima

    2008-05-01

    We report the case of a 17-year-old male on long-term steroid therapy for minimal lesion glomerulopathy who, after an upper respiratory infection, presented with Haemophilus influenzae type b meningitis. Twenty-four hours later he developed depression of consciousness which progressed to coma and left hemiparesis. Brain magnetic resonance imaging (MRI) revealed multiple lesions (hyperintense on T2 and slightly hypointense on Tl) involving mainly white matter suggestive of inflammation. MRI features were compatible with acute disseminated encephalomyelitis (ADEM), although a differential diagnosis included cerebritis or vasculitis, secondary to bacterial meningitis. The patient was treated with high-dose steroids which resulted in a gradual improvement followed by complete clinical recovery. We propose a diagnosis of ADEM was the best diagnosis because of the radiological features and response to steroids. The occurrence of ADEM associated with acute meningitis, however rare, represents an important diagnostic challenge for the clinician. PMID:18355336

  3. Nocardiosis: Updates and Clinical Overview

    PubMed Central

    Wilson, John W.

    2012-01-01

    Nocardia, a gram-positive bacillus with the microscopic appearance of branching hyphae, can produce considerable disease in the appropriate host. The taxonomy of Nocardia continues to evolve; more than 50 species have been described. Early recognition and effective therapy are imperative to achieve successful outcomes. Although nocardiosis typically occurs in patients with cell-mediated immunosuppressive conditions, infection may occasionally develop in immunocompetent patients as well. This review addresses the microbiology of Nocardia, risk factors for infection, clinical presentations, and management strategies. PMID:22469352

  4. Pleural Nocardiosis in an Immunocompetent Patient: A Case Report

    PubMed Central

    Mantur, Prakash

    2016-01-01

    Nocardiosis is a rare infection that has attracted attention with its increased rate of occurrence in the recent years. In India there is a rare documentation of the pleural involvement in nocardiosis. We report here a case of pleural nocardiosis caused by Nocardia brasiliensis in an immunocompetent patient. This case highlights the importance of considering nocardiosis as a differential diagnosis in patients with pleural lesions. PMID:26894067

  5. Pulmonary Nocardiosis in the Immunocompetent Host: Case Series

    PubMed Central

    Singh, Inderjit; West, Frances Mae; Sanders, Abraham; Hartman, Barry; Zappetti, Dana

    2015-01-01

    Pulmonary nocardiosis is commonly recognized as an opportunistic infection in patients with predisposing immunosuppressive conditions. However, reports of pulmonary nocardiosis in the immunocompetent host are rare. Here, we report a case series of four patients with pulmonary nocardiosis without a predisposing condition. PMID:26491594

  6. Nocardia, nocardiosis and mycetoma.

    PubMed

    Boiron, P; Locci, R; Goodfellow, M; Gumaa, S A; Isik, K; Kim, B; McNeil, M M; Salinas-Carmona, M C; Shojaei, H

    1998-01-01

    The recent emergence of invasive infections due to Nocardia spp., including nosocomial outbreak, is now evident. Newer molecular diagnostic and typing methods are developed. Although sulfonamide-based therapy is generally effective, optimal treatment may be guided by antimicrobial susceptibility testing of isolates. The improved classification of nocardiae and other related genera such as actinomadurae, using the 16S ribosomal RNA sequencing, provide a sound basis for improved diagnostic methods for the identification of members of clinically significant species. The commonest cause of eumycetoma in Sudan is Madurella mycetomatis, and Streptomyces somaliensis and Actinomadura madurae for actinomycetoma. The humoral immunity response in actinomycetoma patients and in experimental mice was measured and significant titre of anti-P24 antibody was demonstrated. PMID:9988489

  7. Disseminated Nocardia farcinica in an immunocompetent patient.

    PubMed

    Boamah, H; Puranam, P; Sandre, R M

    2016-01-01

    Nocardia farcinica is a gram-positive, partially acid-fast, methenamine silver-positive aerobic actinomycete that is infrequently associated with nocardiosis. The relative frequency of Nocardia farcinica isolates in nocardiosis is unknown but thought to be under diagnosis. It is increasingly been recognized in immunocompetent patients. We report a case of disseminated Nocardia farcinica causing brain abscess in 55 year old immunocompetent man who was successfully treated with long term antibiotics. The present report illustrates that early detection and treatment of disseminated Nocardia farcinica can lead to a good outcome. PMID:27617207

  8. A fatal case of pulmonary nocardiosis

    PubMed Central

    Patil, Mahantesh; C, Shivaprasad; Varghese, Jaicob; Rajagopalan, Natarajan

    2012-01-01

    Pulmonary nocardiosis is a serious, most often considered an opportunistic infection affecting the respiratory tract. Even though it is more common in immunocompromised hosts, it is not infrequently seen in immunocompetent patients as well. The aerosol route is the main portal of entry in to the body. Molecular techniques have revolutionised the identification of Nocardia species. However such tests are limited to referral laboratories. The radiographic appearances of Nocardia infection vary from a small nodule to bilateral infiltrates with cavitation. Traditionally sulphonamides have been considered the treatment of choice. However, resistance to sulphonamides is increasingly recognised. Carbapenems and linezolid have been found to be uniformly active against all the pathogenic species of Nocardia that affect human beings. The authors report a case of pulmonary nocardiosis in an immunocompetent patient, in whom the infection relentlessly progressed to florid sepsis despite prompt institution of right antibiotics. Florid sepsis relating to pulmonary nocardiosis is rare. PMID:22665550

  9. Comparative pathology of nocardiosis in marine mammals.

    PubMed

    St Leger, J A; Begeman, L; Fleetwood, M; Frasca, S; Garner, M M; Lair, S; Trembley, S; Linn, M J; Terio, K A

    2009-03-01

    Nocardia spp. infections in mammals cause pyogranulomatous lesions in a variety of organs, most typically the lung. Members of the Nocardia asteroides complex are the most frequently recognized pathogens. Nine cases of nocardiosis in free-ranging pinnipeds and 10 cases of nocardiosis in cetaceans were evaluated. Host species included the hooded seal (Cystophora cristata, n = 8), leopard seal (Hydrurga leptonyx, n = 1), Atlantic bottlenose dolphin (Tursiops truncatus, n = 4), beluga whale (Delphinapterus leucas, n = 4), and killer whale (Orcinus orca, n = 2). The most common presentation of nocardiosis in both pinnipeds and cetaceans was the systemic form, involving 2 or more organs. Organs most frequently affected were lung and thoracic lymph nodes in 7 of 9 cases in pinnipeds and 8 of 10 cases in cetaceans. Molecular identification and bacterial isolation demonstrated a variety of pathogenic species. N. asteroides, N. farcinica, N. brasiliensis, and N. otitisdiscaviarum are pathogenic for pinnipeds. In cetaceans N. asteroides, N. farcinica, N. brasiliensis, N. cyriacigeorgica, and N. levis are pathogenic. Hematoxylin and eosin and acid fast staining failed to reveal bacteria in every case, whereas modified acid fast and Grocott's methenamine silver consistently demonstrated the characteristic organisms. In both pinnipeds and cetaceans, juvenile animals were affected more often than adults. Hooded seals demonstrated more cases of nocardiosis than other pinnipeds. PMID:19261643

  10. Long-term treatment of persistent disseminated Nocardia cyriacigeorgica infection.

    PubMed

    Ozgenç, Onur; Avcı, Meltem; Arı, Alpay; Celebi, Ismail Yunus; Coşkuner, Seher Ayten

    2014-01-01

    In this paper a disseminated persistent Nocardia cyriacigeorgica infection in an immunocompetent patient is described. The patient's long-term treatment, as well as its implications for managing similar cases in the future, is emphasized. Presenting with high fever, multiple nodules, and ulcerative cutaneous lesions of body sites, the patient was treated with various antimicrobials. Under combined therapy, empyema and arthritis, leading to disseminated nocardiosis, were seen. The overall treatment course was 28 months. It can be concluded that the choice of the antibiotics and optimal duration of treatment are uncertain; therefore the treatment of nocardiosis requires expertise. PMID:24833199

  11. A man with unilateral endophthalmitis: a case of disseminated nocardiosis.

    PubMed

    Navarrete-Navarrete, N; Escobar Sevilla, J; Toribio García, M; Urbano, F; Sabio, J M; Jiménez-Alonso, J

    2015-01-01

    We present the case of a patient with an infection by Nocardia which manifested itself with monocular endophthalmitis. Nocardia infection is not common and ocular involvement is one of the most uncommon presentations. In these cases it is very important to make an early diagnosis and intensive treatment to prevent the visual prognosis. PMID:25878910

  12. Nocardia veterana: disseminated infection with urinary tract infection.

    PubMed

    Poisnel, Elodie; Roseau, Jean-Baptiste; Landais, Cécile; Rodriguez-Nava, Veronica; Bussy, Emmanuel; Gaillard, Tiphaine

    2015-01-01

    Nocardia spp. are a group of aerobic actinomycetes widely distributed in soil, and associated with severe opportunistic infections, essentially pulmonary infections. We report the first case of disseminated infection associated with urinary tract infection caused by Nocardia veterana. The diagnosis was difficult; despite the presence of pulmonary nodules, the lung biopsies remained negative while only one aerobic blood culture and the urine culture were positive for N. veterana, identified after a 16S rDNA gene sequence analysis. Few cases of clinical importance due to N. veterana have been published since its characterization. The bacteriological diagnosis of nocardiosis can be difficult to establish because of the delayed growth and the specific techniques that are required. This case illustrates the necessity of performing specific investigations in immunocompromised patients who present with infectious disease because the severity of this infection requires early diagnosis and quick initiation of appropriate antibiotic therapy. PMID:25636185

  13. [Potential nosocomial disseminated infection due to Nocardia asteroides after a prosthesis insertion in an immunocompetent patient].

    PubMed

    Mrozek, N; Hamizi, S; Gourdon, F; Laurichesse, H; Beytout, J; Lesens, O

    2008-12-01

    Nocardia infections are rare and usually occurred in immunocompromised patients with systemic dissemination from a lung infection. We report a case of an immunocompetent patient in whom Nocardia asteroides had cause psoas and cerebral abcess without pulmonary infection, a short period after a hip prosthesis insertion. The clinical history is highly suggestive of a hospital-acquired infection. PMID:18395304

  14. Asphyxia by Drowning Induces Massive Bleeding Due To Hyperfibrinolytic Disseminated Intravascular Coagulation

    PubMed Central

    Schwameis, Michael; Schober, Andreas; Schörgenhofer, Christian; Sperr, Wolfgang Reinhard; Schöchl, Herbert; Janata-Schwatczek, Karin; Kürkciyan, Erol Istepan; Sterz, Fritz

    2015-01-01

    Objective: To date, no study has systematically investigated the impact of drowning-induced asphyxia on hemostasis. Our objective was to test the hypothesis that asphyxia induces bleeding by hyperfibrinolytic disseminated intravascular coagulation. Design: Observational study. Setting: A 2,100-bed tertiary care facility in Vienna, Austria, Europe. Patients: All cases of drowning-induced asphyxia (n = 49) were compared with other patients with cardiopulmonary resuscitation (n = 116) and to patients with acute promyelocytic leukemia (n = 83). Six drowning victims were investigated prospectively. To study the mechanism, a forearm-ischemia model was used in 20 volunteers to investigate whether hypoxia releases tissue plasminogen activator. Interventions: None. Measurements and Main Results: Eighty percent of patients with drowning-induced asphyxia developed overt disseminated intravascular coagulation within 24 hours. When compared with nondrowning cardiac arrest patients, drowning patients had a 13 times higher prevalence of overt disseminated intravascular coagulation at admission (55% vs 4%; p < 0.001). Despite comparable disseminated intravascular coagulation scores, acute promyelocytic leukemia patients had higher fibrinogen but lower d-dimer levels and platelet counts than drowning patients (p < 0.001). Drowning victims had a three-fold longer activated partial thromboplastin time (124 s; p < 0.001) than both nondrowning cardiac arrest and acute promyelocytic leukemia patients. Hyperfibrinolysis was reflected by up to 1,000-fold increased d-dimer levels, greater than 5-fold elevated plasmin antiplasmin levels, and a complete absence of thrombelastometric clotting patterns, which was reversed by antifibrinolytics and heparinase. Thirty minutes of forearm-ischemia increased tissue plasminogen activator 31-fold (p < 0.001). Conclusions: The vast majority of drowning patients develops overt hyperfibrinolytic disseminated intravascular coagulation, partly caused by

  15. Pulmonary Nocardiosis in an Adolescent Patient with Crohn’s Disease Treated with Infliximab: a Serious Complication of TNF-Alpha Blockers

    PubMed Central

    Verma, Rishi; Walia, Ritu; Sondike, Stephen B.; Khan, Raheel

    2016-01-01

    Nocardiosis is a serious complication of tumor necrosis factor (TNF) alpha blockers. With the increasing use of biologics for inflammatory bowel disease, it is to be anticipated that opportunistic infections such as nocardia will be more frequently encountered in children. We present the case of a 16 year old male with Crohn’s disease who developed pulmonary nocardiosis during the course of his treatment with infliximab. This case illustrates the diagnostic and therapeutic challenges faced in patients with inflammatory bowel disease infected with opportunistic organisms. Pediatric health care providers need to be aware so that early diagnosis and treatment can be provided thereby preventing disseminated disease and having favorable outcomes. Although TNF blocker therapy must be discontinued in the presence of such infections, biologic therapy may be reintroduced after successful treatment with trimethoprim-sulfamethoxazole to control underlying symptoms of inflammatory bowel disease. PMID:26050296

  16. Testicular nocardiosis accompanied by cutaneous lesions in an immunocompetent man.

    PubMed

    Yamaguchi, Hiroshi; Sekimoto, Etsuko; Shirakami, Atsuhisa; Shibata, Hironobu; Ozaki, Shuji; Shigekiyo, Toshio; Noda, Toshinori; Shikiji, Takanori; Kanda, Kazuya; Hirose, Takanori; Matsuzawa, Tetsuhiro; Gonoi, Tohru

    2013-01-01

    We herein report the case of a 77-year-old man admitted for an acute cutaneous infection and persistent fever. A physical examination revealed systemic small blisters and scrotal swelling. He was suspected of having complications from chickenpox or bullous impetigo as the initial diagnosis. Nocardia was detected on an aspiration biopsy of the small blisters and the surgically removed testis at a later date. Testicular nocardiosis is a rare condition; however, we should consider nocardiosis in the differential diagnosis because delay in providing treatment may worsen a patient's general condition. PMID:23291688

  17. Acute Hydrocephalus due to Secondary Leptomeningeal Dissemination of an Anaplastic Oligodendroglioma

    PubMed Central

    Stark, Andreas M.; Hugo, Heinz-Herrmann; Mehdorn, H. Maximilian; Knerlich-Lukoschus, Friederike

    2009-01-01

    Secondary leptomeningeal dissemination of oligodendroglioma is very rare. We report the case of a 38-year-old Caucasian male who presented with acute hydrocephalus. 8 months before, the patient had undergone craniotomy for right frontal anaplastic oligodendroglioma, WHO grade III. By that time, there was no evidence of tumor dissemination. MRI now ruled out local tumor progression but revealed meningeal contrast enhancement along the medulla, the myelon, and the cauda equina. Repeated lumbar puncture revealed increased cerebro-spinal fluid (CSF) pressure and protein content. Malignant cells were not detectable. Surgical treatment consisted in (1) placement of an ommaya reservoir for daily CSF puncture, (2) Spinal dural biopsy confirming leptomeningeal oligodendroglioma metastasis, and (3) ventriculo-peritoneal shunt placement after CSF protein has decreased to 1500–2000 mg/l. PMID:20052406

  18. Efficacy of amikacin combinations for nocardiosis.

    PubMed

    Kanemitsu, Keiji; Kunishima, Hiroyuki; Saga, Tomoo; Harigae, Hideo; Ishikawa, Shiho; Takemura, Hiromu; Kaku, Mitsuo

    2003-11-01

    We isolated five bacterial strains from patients diagnosed as having nocardiosis. Bacterial species were identified based on the similarities in the nucleotide sequences of 16S ribosomal RNAs. Three of the five strains were identified as Nocardia asteroids, but unexpectedly other two were Streptomyces hygroscopicus and Rothia dentocariosa. The latter two species are not members of the family Nocardiaceae. We investigated the susceptibilities of these five strains to the following nine antimicrobial agents: trimethoprim/sulfamethoxazole (TMP/SMX), minocycline (MINO), erythromycin (EM), amikacin (AMK), cefotaxime (CTX), faropenem (FRPM), imipenem (IPM), ciprofloxacin (CPFX), and sparfloxacin (SPFX). The minimum inhibitory concentration (MIC) ranges (mg/ml) were as follows: TMP-SMX, 4- > 32; MINO, 0.125-8; EM, < or = 0.016- > 32; AMK, 1-2; CTX, 0.063- > 32; FRPM, 0.063-16; IPM, 0.125-2; CPFX, 4-32; and SPFX, 0.5-16. Moreover, the synergistic effects of AMK in combination with each of TMP-SMX, MINO, EM, CTX, IPM, and SPFX were investigated by checkerboard synergy testing. No antagonism was recognized for the three N. asteroides strains. Synergistic and additive effects were observed for the combinations of AMK with CTX, IPM, or SPFX. PMID:14649737

  19. Development of Vaccines Against Nocardiosis in Fishes.

    PubMed

    Nayak, Sukanta K; Nakanishi, Teruyuki

    2016-01-01

    Nocardiosis, one of the most systemic and devastating diseases, is currently emerging as an important disease of cultured marine and freshwater fishes. The causative agent of this disease is Nocardia seriolae, a Gram-positive acid-fast bacterium. An effective vaccine/vaccination strategy against this pathogen is necessary to control the significant loss in aquaculture practices. In this chapter, we present the vaccination/immunization protocol in fish against both live (sublethal) and inactivated form of N. seriolae using ginbuna crucian carp (Carassius auratus langsdorfii) as a model. N. seriolae either in live (sublethal) form or inactivated antigenic form is found to elevate immunity in ginbuna and also can induce protective immunity upon challenge. In order to develop live vaccine, determination of sublethal dose is critical and needs to be established in the host fish species through pathogenicity and persistence studies. Herein for ginbuna, a sublethal dose of 10(6) CFU/mL was determined by pathogenicity study through a series of challenge doses followed by pathogen persistence study by microbiological and molecular techniques. On the other hand, for inactivated antigenic form, the concentration of the N. seriolae was approximately 10(8) CFU/mL. Although this study showed significant potential of both the forms of N. seriolae as candidate for vaccination, factors such as dose, duration and form need to be optimized in individual fish species. PMID:27076299

  20. Acute kidney injury and disseminated intravascular coagulation due to mercuric chloride poisoning.

    PubMed

    Dhanapriya, J; Gopalakrishnan, N; Arun, V; Dineshkumar, T; Sakthirajan, R; Balasubramaniyan, T; Haris, M

    2016-01-01

    Mercury is a toxic heavy metal and occurs in organic and inorganic forms. Inorganic mercury includes elemental mercury and mercury salts. Mercury salts are usually white powder or crystals, and widely used in indigenous medicines and folk remedies in Asia. Inorganic mercury poisoning causes acute kidney injury (AKI) and gastrointestinal manifestations and can be life-threatening. We describe a case with unknown substance poisoning who developed AKI and disseminated intravascular coagulation (DIC). Renal biopsy showed acute tubular necrosis. Later, the consumed substance was proven to be mercuric chloride. His renal failure improved over time, and his creatinine normalized after 2 months. PMID:27194836

  1. [A child presenting with fever and arthritis due to disseminated gonorrhoea].

    PubMed

    Wiggers, M N L; Oudesluys-Murphy, A M

    2006-07-01

    A 12-year-old boy with Down's syndrome presented with fever, arthritis and petechiae. Investigations revealed the presence of disseminated gonorrhoea. The patient made a good recovery after antibiotic therapy. A contact investigation was carried out, as well as talks with the family and school, and the case was reported to the Child Abuse Advice and Report Centre. The gonorrhoea was found to be caused by incest. Sexual abuse should be suspected in every child (certainly over the age of 1 year) with a sexually transmitted disease. PMID:16875268

  2. Acute kidney injury and disseminated intravascular coagulation due to mercuric chloride poisoning

    PubMed Central

    Dhanapriya, J.; Gopalakrishnan, N.; Arun, V.; Dineshkumar, T.; Sakthirajan, R.; Balasubramaniyan, T.; Haris, M.

    2016-01-01

    Mercury is a toxic heavy metal and occurs in organic and inorganic forms. Inorganic mercury includes elemental mercury and mercury salts. Mercury salts are usually white powder or crystals, and widely used in indigenous medicines and folk remedies in Asia. Inorganic mercury poisoning causes acute kidney injury (AKI) and gastrointestinal manifestations and can be life-threatening. We describe a case with unknown substance poisoning who developed AKI and disseminated intravascular coagulation (DIC). Renal biopsy showed acute tubular necrosis. Later, the consumed substance was proven to be mercuric chloride. His renal failure improved over time, and his creatinine normalized after 2 months. PMID:27194836

  3. Pulmonary nocardiosis in a patient receiving immunosuppressive agent.

    PubMed

    Aswapokee, P; Aswapokee, N; Chirawong, P; Leelarasamee, A

    1977-09-01

    A 20-year-old woman receiving corticosteroid treatment for systemic lupus erythematosus developed pulmonary nocardiosis with hydrophneumothorax. The organism identified as Nocardia asteroides resisted to sulfonamide and cotrimoxazole but sensitive to chloramphenicaol and streptomycin in vitro. She seemed to respond to chloramphenicol but subsequently had peritonitis and succumbed later. PMID:607422

  4. Clinical spectrum and outcome of pulmonary nocardiosis: 5-year experience

    PubMed Central

    Singh, Akashdeep; Chhina, Deepinder; Soni, RK; Kakkar, Chandan; Sidhu, US

    2016-01-01

    Background: Pulmonary nocardiosis is a rare but a life-threatening infection caused by Nocardia spp. The diagnosis is often missed and delayed resulting in delay in appropriate treatment and thus higher mortality. Aim: In this study, we aim to evaluate the clinical spectrum and outcome of patients with pulmonary nocardiosis. Methods: A retrospective, 5-year (2009–2014) review of demographic profile, risk factors, clinical manifestations, imaging findings, treatment, and outcome of patients with pulmonary nocardiosis admitted to a tertiary care hospital. Results: The median age of the study subjects was 54 years (range, 16–76) and majority of them (75%) were males. The risk factors for pulmonary nocardiosis identified in our study were long-term steroid use (55.6%), chronic lung disease (52.8%), diabetes (27.8%), and solid-organ transplantation (22.2%). All the patients were symptomatic, and the most common symptoms were cough (91.7%), fever (78%), and expectoration (72%). Almost two-third of the patients were initially misdiagnosed and the alternative diagnosis included pulmonary tuberculosis (n = 7), community-acquired pneumonia (n = 5), lung abscess (n = 4), invasive fungal infection (n = 3), lung cancer (n = 2), and Wegener's granulomatosis (n = 2). The most common radiographic features were consolidation (77.8%) and nodules (56%). The mortality rate for indoor patients was 33% despite treatment. Higher mortality rate was observed among those who had brain abscess (100.0%), HIV positivity (100%), need for mechanical ventilation (87.5%), solid-organ transplantation (50%), and elderly (age > 60 years) patients (43%). Conclusion: The diagnosis of pulmonary nocardiosis is often missed and delayed resulting in delay in appropriate treatment and thus high mortality. A lower threshold for diagnosing pulmonary nocardiosis needs to be exercised, in chest symptomatic patients with underlying chronic lung diseases or systemic immunosuppression, for the early diagnosis

  5. Molecular study of nosocomial nocardiosis outbreak involving heart transplant recipients.

    PubMed

    Exmelin, L; Malbruny, B; Vergnaud, M; Prosvost, F; Boiron, P; Morel, C

    1996-04-01

    Randomly amplified polymorphic DNA analysis and rRNA gene restriction patterns (ribotyping) were compared as methods of investigating a nosocomial outbreak of nocardiosis involving three heart transplant recipients. No clear distinctions between three clinically related isolates and four unrelated strains were obtained by ribotyping. On the contrary, randomly amplified polymorphic DNA analysis with two selected primers, primers 2650 and DKU49, showed one pattern for the three related isolates and four patterns for the unrelated strains. PMID:8815073

  6. Experimental Granulomatous Pulmonary Nocardiosis in BALB/C Mice

    PubMed Central

    Mifuji Lira, Roque M.; Limón Flores, Alberto Yairh; Salinas Carmona, Mario César

    2016-01-01

    Pulmonary nocardiosis is a granulomatous disease with high mortality that affects both immunosuppressed and immunocompetent patients. The mechanisms leading to the establishment and progression of the infection are currently unknown. An animal model to study these mechanisms is sorely needed. We report the first in vivo model of granulomatous pulmonary nocardiosis that closely resembles human pathology. BALB/c mice infected intranasally with two different doses of GFP-expressing Nocardia brasiliensis ATCC700358 (NbGFP), develop weight loss and pulmonary granulomas. Mice infected with 109 CFUs progressed towards death within a week while mice infected with 108 CFUs died after five to six months. Histological examination of the lungs revealed that both the higher and lower doses of NbGFP induced granulomas with NbGFP clearly identifiable at the center of the lesions. Mice exposed to 108 CFUs and subsequently to 109 CFUs were not protected against disease severity but had less granulomas suggesting some degree of protection. Attempts to identify a cellular target for the infection were unsuccessful but we found that bacterial microcolonies in the suspension used to infect mice were responsible for the establishment of the disease. Small microcolonies of NbGFP, incompatible with nocardial doubling times starting from unicellular organisms, were identified in the lung as early as six hours after infection. Mice infected with highly purified unicellular preparations of NbGFP did not develop granulomas despite showing weight loss. Finally, intranasal delivery of nocardial microcolonies was enough for mice to develop granulomas with minimal weight loss. Taken together these results show that Nocardia brasiliensis microcolonies are both necessary and sufficient for the development of granulomatous pulmonary nocardiosis in mice. PMID:27303806

  7. Pulmonary nocardiosis in a 3-year-old child

    PubMed Central

    Holdaway, M. D.; Kennedy, J.; Ashcroft, T.; Kay-Butler, J. J.

    1967-01-01

    Until 1960, 179 cases of infection with Nocardia asteroides had been described in the world literature. Seventeen cases in children were reported by 1963. The organism is a common saprophyte in nature with probably a world-wide distribution. Infection can be primary but is more common in patients with underlying malignancy, auto-immune disease or preceding tuberculosis. Sulphonamides, particularly sulphadiazine, are the drugs of choice in treatment; the value of antibiotics is less clearly established. The indications for surgical treatment have not yet been defined. We record a further case of primary pulmonary nocardiosis in a 3-year-old child. Images PMID:6035802

  8. Fatal nocardiosis in a dog caused by multiresistant Nocardia veterana.

    PubMed

    Uhde, Ann-Kathrin; Kilwinski, Jochen; Peters, Martin; Verspohl, Jutta; Feßler, Andrea T; Schwarz, Stefan; Wohlsein, Peter

    2016-02-01

    Among pathogenic Nocardia species in humans and animals, infections caused by Nocardia (N.) veterana have rarely been described and so far, all non-human cases are linked to bovine mastitis in Brazil. The aim of this study was to identify the causative microorganism involved in the death of a three-month-old dog suffering from dyspnea and neurological deficits ante mortem. Pathomorphological investigation revealed (pyo-)granulomatous lesions in various organs. Bacteriological examination was performed and the respective bacteria were subjected to matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS), 16S rDNA sequencing, and antimicrobial susceptibility testing by broth microdilution. Gram-staining and colony morphology suggested the presence of an actinomycete which was identified as N. veterana by MALDI-TOF MS. This identification was confirmed by 16S rDNA sequence analysis. Distemper-associated immunosuppression may have played a role in the pathogenesis of systemic nocardiosis in this dog. Retrospective analysis of the antimicrobial susceptibility status showed that the N. veterana isolate was multiresistant and displayed high minimal inhibitory concentrations to all antimicrobial agents used for the dog's therapy. To the best of our knowledge, this is the first report of a systemic nocardiosis caused by N. veterana in a dog with a concurrent canine distemper virus infection. PMID:26790938

  9. Rituximab as Successful Adjunct Treatment in a Patient With Disseminated Nontuberculous Mycobacterial Infection Due to Acquired Anti–Interferon-γ Autoantibody

    PubMed Central

    Czaja, Christopher A.; Merkel, Patricia A.; Chan, Edward D.; Lenz, Laurel L.; Wolf, Molly L.; Alam, Rafeul; Frankel, Stephen K.; Fischer, Aryeh; Gogate, Shaila; Perez-Velez, Carlos M.; Knight, Vijaya

    2014-01-01

    An acquired immune deficiency due to interferon gamma (IFN-γ) autoantibodies was diagnosed in a 78-year-old Japanese man with treatment-refractory disseminated nontuberculous mycobacterial infection. In addition to standard antimycobacterial therapy, he was successfully treated with rituximab to eliminate B cells and thereby the autoantibody. Subsequently, he obtained a sustained remission from infection. PMID:24336756

  10. Computed Tomography Features of Pulmonary Nocardiosis in Immunocompromised and Immunocompetent Patients

    PubMed Central

    Mehrian, Payam; Esfandiari, Ehsan; Karimi, Mohammad Ali; Memari, Behzad

    2015-01-01

    Summary Background Nocardiosis primarily occurs in the setting of immunocompromising conditions. However, it may also occur in immunocompetent patients. We described computed tomography features of pulmonary nocardiosis and compared immunocompetent and immunocompromised patients. Material/Methods CT images of 25 patients (Mean age of 39.5 years; 76% male) with pulmonary nocardiosis proved by bronchoalveolar lavage or biopsy were reviewed by two experienced pulmonary radiologists and detailed findings were reported on. Fourteen patients (56%) were immunocompetent, while 44% had an underlying immunocompromising condition, including chronic granulomatous disease (CGD) (n=4), diabetes mellitus (DM) (n=2), malignancy (n=2), HIV (n=1), concomitant CGD and DM (n=1), and steroid therapy for nephrotic syndrome (n=1). Results Most patients had bilateral involvement with no zonal predominance. Multiple pulmonary nodules (96%) were the most common CT findings, followed by consolidation (76%) and cavity (52%). Other findings included bronchiectasis (48%), pleural thickening (40%), ground glass opacity (32%), mass-like consolidation (20%), intrathoracic lymphadenopathy (16%), pleural effusion (12%), reticular infiltration (4%), and pericardial effusion (4%). There was no statistically significant difference in the CT findings of immunocompromised and immunocompetent groups. Conclusions Pulmonary nocardiosis presents mainly as multiple pulmonary nodules, consolidations, and cavity in both immunocompromised and immunocompetent patients. However, these features are more suggestive of nocardiosis in the setting of an underling immunocompromised condition. PMID:25584096

  11. Primary Cutaneous Nocardiosis in a Patient With Nephrotic Syndrome: A Case Report and Review of the Literature.

    PubMed

    Chen, Bing; Tang, Jin; Lu, Zeyuan; Wang, Niansong; Gao, Xuping; Wang, Feng

    2016-01-01

    Nocardia infection is not common in clinical practice and most cases occur as an opportunistic infection in immunocompromised patients.We report a case of primary cutaneous nocardiosis characterized by multiple subcutaneous abscesses due to Nocardia brasiliensis in a patient with nephrotic syndrome undergoing long-term corticosteroid therapy. The patient was diagnosed with nephrotic syndrome 9 months ago, and mesangial proliferative glomerulonephritis was confirmed by renal biopsy. Subsequently, his renal disease was stable under low-dose methylprednisolone (8 mg/d). All of the pus cultures, which were aspirated from 5 different complete abscesses, presented Nocardia. Gene sequencing confirmed that they were all N. brasiliensis. The patient was cured by surgical drainage and a combination of linezolid and Trimethoprim-Sulfamethoxazole.The case highlights that even during the period of maintenance therapy with low-dose corticosteroid agents, an opportunistic infection still could occur in patients with nephrotic syndrome. PMID:26817885

  12. Impact of immune status on the clinical characteristics and treatment outcomes of nocardiosis.

    PubMed

    Kim, Yong Kyun; Sung, Heungsup; Jung, Jiwon; Yu, Shi Nae; Lee, Ju Young; Kim, Sung-Han; Choi, Sang-Ho; Kim, Yang Soo; Woo, Jun Hee; Lee, Sang-Oh; Chong, Yong Pil

    2016-08-01

    Nocardiosis occurs in both immunocompromised and immunocompetent patients. We aimed to assess how its characteristics differ depending on patients' immune status. Of a total of 54 patients with culture-proven nocardiosis diagnosed over 13 years, 18 (33%) were immunocompetent. Half of immunocompetent patients had chronic lung disease and were not receiving systemic corticosteroid. There were no significant differences in clinical, radiographic, and microbiologic characteristics, and treatment outcomes according to immune status, except that pulmonary cavitation (47% vs. 8%) and coexisting infections (17% vs. 0%) were more frequent in immunocompromised hosts. Nocardia farcinica, the most commonly identified isolates at the species level (51%), was highly susceptible to trimethoprim-sulfamethoxazole (100%) and highly resistant to ceftriaxone (94%). Nocardiosis should be considered in differential diagnosis of pneumonia, brain abscess, or soft tissue infection that does not respond to conventional antibiotic therapy such as ceftriaxone, regardless of whether the patient is immunocompromised or not. PMID:27241370

  13. Acute Kidney Injury due to Menstruation-related Disseminated Intravascular Coagulation in an Adenomyosis Patient: A Case Report

    PubMed Central

    Son, Jungmin; Seong, Eun Young; Song, Sang Heon; Lee, Soo Bong; Kang, Jin; Yang, Byeong Yun; Lee, Su Jin; Choi, Jong-Ryeol; Lee, Kyu-Sup; Kwak, Ihm Soo

    2010-01-01

    The authors report a case of acute kidney injury (AKI) resulting from menstruation-related disseminated intravascular coagulation (DIC) in an adenomyosis patient. A 40-yr-old woman who had received gonadotropin for ovulation induction therapy presented with anuria and an elevated serum creatinine level. Her medical history showed primary infertility with diffuse adenomyosis. On admission, her pregnancy test was negative and her menstrual cycle had started 1 day previously. Laboratory data were consistent with DIC, and it was believed to be related to myometrial injury resulting from heavy intramyometrial menstrual flow. Gonadotropin is considered to play an important role in the development of fulminant DIC. This rare case suggests that physicians should be aware that gonadotropin may provoke fulminant DIC in women with adenomyosis. PMID:20808684

  14. Atypical clinical variants in New World cutaneous leishmaniasis: disseminated, erysipeloid, and recidiva cutis due to Leishmania (V.) panamensis.

    PubMed

    Calvopina, Manuel; Gomez, Eduardo A; Uezato, Hiroshi; Kato, Hirotomo; Nonaka, Shigeo; Hashiguchi, Yoshihisa

    2005-08-01

    In recent times, there has been an increase in the number of reports for new and rare variants of cutaneous leishmaniasis (CL). Here, we describe three unusual clinical forms of CL identified in Ecuadorian children. A total of 131 patients with CL were diagnosed over a 2-year period of active search. In 3 (2.29%), the lesions were very unusual; these included erysipeloid, recidiva cutis (LRC), and disseminated leishmaniasis (DL). The erysipeloid case is characterized by erythematous and indurated plaque seen on the face of a 5-year-old boy; the LRC one is differentiated by slowly progressing red-brown papules around large scars of healed sores in a 6-year-old girl, and the DL case is characterized by dozens of cutaneous ulcers distributed in the whole body of a 1-year-old girl. Leishmania parasites were isolated by lesion aspirate and analyzed by the technique multilocus enzyme electrophoresis (MLEE). All three isolates were identified as Leishmania (Viannia) panamensis. These distinct clinical variants rarely have been reported previously in the American cutaneous leishmaniasis, and for the first time L. (V.) panamensis was identified as the etiologic agent. Our cases extend the spectrum of clinical presentations in New World leishmaniasis. PMID:16103590

  15. Soil-acquired cutaneous nocardiosis on the forearm of a healthy male contracted in a swamp in rural eastern Virginia.

    PubMed

    Palmieri, James R; Santo, Arben; Johnson, Shawn E

    2014-01-01

    A 45-year-old man complained of pain and swelling on his right wrist after receiving a scratch while playing paintball in a swampy area of eastern Virginia. Two weeks later, he noticed a pimple-like lesion developing, which quickly grew in size and then ulcerated. Because of the severity of his condition, the patient was taken to the emergency room where surgical drainage of the abscess was carried out and the pus was sent for culture and sensitivity testing. Enlarged and tender lymph nodes were palpable going up the arm and surrounding the right axillary area. Three days following culture of pus from his lesion, colonies of Nocardia brasiliensis were isolated. He was successfully treated with an extended regimen of trimethoprim-sulfamethoxazole. Because of its low incidence, nocardiosis is usually not considered in the initial diagnosis. The rapidity with which his infection developed from a pimple-like lesion into an extensive ulcerated area, the involvement of his lymphatic system, the extended time needed to successfully treat his infection, and the potential for infection to rapidly disseminate, reinforces the necessity for laboratory identification and immediate treatment of severe pyogenic cutaneous lesions. PMID:24634589

  16. [A case of pulmonary alveolar proteinosis which initially deteriorated rapidly with exacerbation of pulmonary nocardiosis, responded promptly to treatment of the pulmonary nocardiosis].

    PubMed

    Yamaguchi, Shozaburo; Takayanagi, Noboru; Tokunaga, Daido; Sugita, Yutaka; Kawabata, Yoshinori

    2010-08-01

    A 37-year-old man was admitted with complaints of continuous cough and sputum production for 1 month. Computed tomography (CT) of the chest revealed a solitary mass with a cavity in the apex of the left lung and bilateral ground-glass opacities (GGO). Thereafter, the patient complained of fever, and an increase in the mass shadow size and expansion of the ground-glass opacities were observed on serial CT. The patient was given diagnoses of pulmonary nocardiosis and pulmonary alveolar proteinosis by bronchoscopic examination. Serum anti-GM-CSF antibody tests were positive. On the basis of these findings, we diagnosed autoimmune pulmonary alveolar proteinosis. After beginning antituberculosis drugs and antibiotics, the tumor shadow and GGO reduced. The pulmonary alveolar proteinosis rapidly worsened on exacerbation of the pulmonary nocardiosis, but prompt overall improvement was obtained after treating the latter. We believe this to be a valuable case for examining the time progression of autoimmune pulmonary alveolar protein syndrome, because of the clinical course of the exacerbation, and the improvement in the pulmonary alveolar proteinosis after treatment of pulmonary nocardiosis. PMID:20803974

  17. Molecular Identification of Nocardia Isolates from Clinical Samples and an Overview of Human Nocardiosis in Brazil

    PubMed Central

    Baio, Paulo Victor Pereira; Ramos, Juliana Nunes; dos Santos, Louisy Sanches; Soriano, Morgana Fonseca; Ladeira, Elisa Martins; Souza, Mônica Cristina; Camello, Thereza Cristina Ferreira; Ribeiro, Marcio Garcia; Hirata Junior, Raphael; Vieira, Verônica Viana; Mattos-Guaraldi, Ana Luíza

    2013-01-01

    Background Nocardia sp. causes a variety of clinical presentations. The incidence of nocardiosis varies geographically according to several factors, such as the prevalence of HIV infections, transplants, neoplastic and rheumatic diseases, as well as climate, socio-economic conditions and laboratory procedures for Nocardia detection and identification. In Brazil the paucity of clinical reports of Nocardia infections suggests that this genus may be underestimated as a cause of human diseases and/or either neglected or misidentified in laboratory specimens. Accurate identification of Nocardia species has become increasingly important for clinical and epidemiological investigations. In this study, seven clinical Nocardia isolates were identified by multilocus sequence analysis (MLSA) and their antimicrobial susceptibility was also determined. Most Nocardia isolates were associated to pulmonary disease. Methodology/Principal Findings The majority of Brazilian human isolates in cases reported in literature were identified as Nocardia sp. Molecular characterization was used for species identification of Nocardia nova, Nocardia cyriacigeorgica, Nocardia asiatica and Nocardia exalbida/gamkensis. Data indicated that molecular analysis provided a different Nocardia speciation than the initial biochemical identification for most Brazilian isolates. All Nocardia isolates showed susceptibility to trimethoprim-sulfamethoxazole, the antimicrobial of choice in the treatment nocardiosis. N. nova isolated from different clinical specimens from one patient showed identical antimicrobial susceptibility patterns and two distinct clones. Conclusions/Significance Although Brazil is the world's fifth-largest country in terms of land mass and population, pulmonary, extrapulmonary and systemic forms of nocardiosis were reported in only 6 of the 26 Brazilian states from 1970 to 2013. A least 33.8% of these 46 cases of nocardiosis proved fatal. Interestingly, coinfection by two clones may

  18. Disseminated sporotrichosis

    PubMed Central

    Romero-Cabello, Raúl; Bonifaz, Alexandro; Romero-Feregrino, Raúl; Sánchez, Carlos Javier; Linares, Yancy; Zavala, Jorge Tay; Romero, Leticia Calderón; Romero-Feregrino, Rodrigo; Vega, José T Sánchez

    2011-01-01

    Sporotrichosis is a subacute or chronic infection caused by Sporothrix schenckii. It is a primary cutaneous infection and it has different clinical forms: disseminated by lymphatic vessels (75%), localised cutaneous form (20%), disseminated cutaneous and extracuteus rarely. The systemic disseminated sporotrichosis is considered a severe opportunistic infection. The best diagnostic test is the culture. The authors report a case of a 36-year-old man, originally from Puebla, Mexico, with a diagnosis of disseminated sporotrichosis. Differential diagnosis with other pathologies includes leishmaniasis, chromoblastomycosis, tuberculosis verrucose and lymphangitis. The development of unusual presentations in immunocompromised patients has been reported. PMID:22700076

  19. Central nervous system nocardiosis with granulomatous pachymeningitis and osteomyelitis of skull vault.

    PubMed

    Nalini, Atchayaram; Saini, Jitender; Mahadevan, Anita

    2014-01-01

    A 34-year-old immunocompetent man weighing 95 kg was operated for a small left parietal scalp swelling in the year 2002. He was well until 2008, when he developed chronic diffuse headache, vomiting and drowsiness. The left parietal dura and overlying vault biopsy showed evidence of granulomatous pachymeningitis with osteomyelitis secondary to nocardiosis. He had responded well to inadequate antibiotic therapy. After a dormant period of 3 years, there was recrudescence of severe raised intracranial tension symptoms in 2011. Magnetic resonance imaging showed diffuse pachymeningeal thickening mainly involving the occipital dura, posterior falx, and tentorium cerebelli. In addition, well-defined small nodules with hypointense signals on both T1- and T2-weighted images were seen in occipital lobes. Patient was treated with three drug regime with good recovery at 3 months follow-up. This is a rare case of central nervous system nocardiosis with skull vault osteomyelitis and a protracted clinical course. PMID:24943782

  20. Transmission of nocardiosis and molecular typing of Nocardia species: a short review.

    PubMed

    Provost, F; Laurent, F; Blanc, M V; Boiron, P

    1997-02-01

    Nocardia species are ubiquitous in the environment and may be found in the soil. They are generally responsible for sporadic pulmonary diseases acquired by inhalation of spores, with secondary localizations in the central nervous system and subcutaneous tissues. There is no absolute evidence for person to person transmission. Presumptive outbreaks of nocardiosis were observed in immunocompromised patients, more frequently in kidney transplant patients than in cardiac transplant patients. Nocardia spp., being present in dust particles, closure and disinfection of the transplantation unit with formaldehyde arrested the sequence of cases of nocardiosis. The original sources of the Nocardia sp. remain doubtful. Other possible sources of contamination are other patients, medical staff and the hospital environment. The first studies of Nocardia spp. typing were based on the detection of extracellular antigens, on the susceptibility of actinomycete strains to killer yeasts, and on the biochemical profiles with fluorogenic substrate. The use of molecular typing techniques have given very promising results. Analysis of plasmid profiles is an interesting way to compare the identity of isolates, although the reliability of this method depends of the presence of plasmids in the isolates. Other typing methods, including analysis of restriction length fragment polymorphism of total DNA, ribosomal DNA fingerprinting, require further investigations to evaluate their discriminating power or to be easily interpretable, whereas a random amplified polymorphic DNA (RAPD) assay was successful for epidemiological purposes. Progress in epidemiological analysis of cases of nocardiosis will be consistent when an improved diagnosis of this infection (molecular and serological diagnosis) will be available, when the genetic diversity of Nocardia spp. isolates will be better known, and when molecular typing, that hold promise in complementing investigations of outbreak of these infections, will

  1. Disseminating research.

    PubMed

    Baillie, Lesley

    2015-07-01

    THE THEME of this edition of Nurse Researcher, 'disseminating research', is pertinent to researchers across the career spectrum and tackles two important issues: open access publishing and originality in PhD research. In the first paper, Suzanne Fredericks examines and contrasts two models of open access publishing, revealing some notable advantages of 'green' open access, achieved through repositories, as opposed to the more well-known 'gold' open access offered by journals ( Fredericks 2015 ). In the second paper, Paul Gill and Gina Dolan discuss originality in PhD studies, exploring the nature of the concept and how doctoral students can demonstrate originality, which is an essential consideration in their research dissemination activities as well as their thesis preparation ( Gill and Dolan 2015 ). PMID:26168806

  2. Pulmonary nocardiosis in Chronic Obstructive Pulmonary Disease: A new clinical challenge

    PubMed Central

    Castellana, Giorgio; Grimaldi, Anna; Castellana, Marco; Farina, Claudio; Castellana, Giuseppe

    2016-01-01

    Pulmonary nocardiosis (PN) is a rare but severe disease caused by Nocardia spp. Despite the traditional description as opportunistic infection, case reports and case series of pulmonary nocardiosis have recently been reported in immunocompetent patients too, in particular among people with chronic pulmonary diseases such as advanced Chronic Obstructive Pulmonary Disease (COPD). PN is characterized by non-specific symptoms and radiological findings; bacteriological culture can be difficult. For the reasons above, diagnosis of PN is challenging, sometimes resulting in a misdiagnosis of tuberculosis. We report an interesting case of PN in a 75-year-old male with COPD. He complained a 3-months history of fatigue, evening rise in body temperature, night sweats, unexplained weight loss of 5 kg, worsening dyspnea, cough and mucopurulent sputum. The chest X-ray showed multiple nodules with cavitations bilaterally in the apical and subclavian regions. Nocardia cyriacigeorgica with 100% identity was identified in three sputum samples. Since the patient has never undergone a systemic and/or inhaled steroid therapy, and has no respiratory failure and comorbidities entailing immunodepression, it is conceivable that, in this immunocompetent patient, the COPD could represent an isolated risk factor for PN. Risk factors, clinical presentations, radiographic findings, differential diagnosis and review of the literature of PN cases in COPD, pointing out the similarities and differences, are also described. PMID:27144111

  3. Disseminated infection due to Cylindrocarpon (Fusarium) lichenicola in a neutropenic patient with acute leukaemia: report of a case and review of the literature.

    PubMed

    Rodríguez-Villalobos, H; Georgala, A; Beguin, H; Heymans, C; Pye, G; Crokaert, F; Aoun, M

    2003-01-01

    Described here is an unusual case of disseminated Cylindrocarpon lichenicola (Fusarium lichenicola) infection originating from a toenail lesion of a neutropenic woman with cellulitis of the foot and underlying acute leukaemia. A computed tomography scan of the chest showed multiple, ill-defined, nodular infiltrates with alveolar consolidation. The fungus was isolated from both the nail and the skin of the infected toe. Susceptibility testing revealed low minimum inhibitory concentrations for amphotericin B (0.78 micro g/ml) and voriconazole (1.56 micro g/ml) and high minimum inhibitory concentrations (>100 micro g/ml) for fluconazole, ketoconazole and itraconazole. The infection resolved after treatment with a total dose of 1 g of amphotericin B followed by oral itraconazole and bone marrow regeneration. PMID:12582748

  4. Disseminated, Persistent, and Fatal Infection Due to the Vaccine Strain of Varicella-Zoster Virus in an Adult Following Stem Cell Transplantation

    PubMed Central

    Bhalla, Preeti; Forrest, Graeme N.; Gershon, Michael; Zhou, Yan; Chen, Jason; LaRussa, Philip; Steinberg, Sharon; Gershon, Anne A.

    2015-01-01

    Live attenuated varicella vaccine is recommended for healthy individuals who are susceptible to varicella. Although the vaccine is safe, effective, and used worldwide, serious adverse events have been reported, mainly in immunocompromised patients who subsequently recovered. Here, we describe the fatality of an immunocompromised patient who received the varicella vaccine. His medical history provides a cautionary lens through which to view the decision of when vaccination is appropriate. A middle-aged man with non-Hodgkin lymphoma received chemotherapy and a stem cell transplant. He was vaccinated 4 years post-transplantation, despite diagnosis of a new low-grade lymphoma confined to the lymph nodes. Within 3 months of vaccination, he developed recurrent rashes with fever, malaise, weakness, hepatitis, weight loss, and renal failure. The syndrome was eventually determined to be associated with persistent disseminated zoster caused by the vaccine virus. This case illustrates a circumstance when a live viral vaccine should not be used. PMID:25452596

  5. Nocardia thailandica Pulmonary Nocardiosis in a Post-Solid Organ Transplant Patient

    PubMed Central

    Canterino, Joseph; Brown-Elliott, Barbara A.; Vientos, Wilson; Vasireddy, Ravikiran; Wallace, Richard J.; Campbell, Sheldon

    2015-01-01

    Nocardia thailandica is a rare pathogen related to Nocardia asteroides, Nocardia neocaledoniensis, and Nocardia caishijiensis that, since its original description in 2004, has only been reported to cause wound and ocular infections in humans. We report a case of pulmonary nocardiosis caused by Nocardia thailandica in a 66-year-old solid organ transplant patient from Connecticut, which was identified at the molecular taxonomic level by secA1 analysis, 16S rRNA gene sequencing, and matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS). To our knowledge, this is the first reported case of N. thailandica in the United States and the first report of pulmonary infection by this pathogen in the literature. PMID:26292312

  6. Nocardia thailandica Pulmonary Nocardiosis in a Post-Solid Organ Transplant Patient.

    PubMed

    Canterino, Joseph; Paniz-Mondolfi, Alberto; Brown-Elliott, Barbara A; Vientos, Wilson; Vasireddy, Ravikiran; Wallace, Richard J; Campbell, Sheldon

    2015-11-01

    Nocardia thailandica is a rare pathogen related to Nocardia asteroides, Nocardia neocaledoniensis, and Nocardia caishijiensis that, since its original description in 2004, has only been reported to cause wound and ocular infections in humans. We report a case of pulmonary nocardiosis caused by Nocardia thailandica in a 66-year-old solid organ transplant patient from Connecticut, which was identified at the molecular taxonomic level by secA1 analysis, 16S rRNA gene sequencing, and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). To our knowledge, this is the first reported case of N. thailandica in the United States and the first report of pulmonary infection by this pathogen in the literature. PMID:26292312

  7. Disseminated pheohyphomycosis.

    PubMed

    Shivaswamy, Kanakapura N; Pradhan, Prashanth; Laxmisha, Chandrashekar; Thappa, Devinder M; Jayanthi, Soundararaghavan

    2007-03-01

    . 3). Fine needle aspiration cytology from one of the swellings showed the presence of filamentous fungi on KOH examination and brown-pigmented distorted filaments and yeast-like cells on Masson-Fontana staining (Fig. 4a,b). The positive Masson-Fontana stain was indicative of the presence of melanin in the fungal hyphae, even when the fungal hyphae were not pigmented in the hematoxylin and eosin-stained section. Periodic acid-Schiff reagent also stained the fungal elements, thus confirming our diagnosis of pheohyphomycosis and ruling out the possibility of hyalohyphomycosis. The culture for fungus from the swelling aspirate grew contaminants. The chest X-ray showed dense nodular shadows in the left lower and mid pulmonary lobes. Sputum for acid-fast bacilli and Mantoux test were negative. During the hospital stay, the patient developed high fever and showed altered behavior, for which a computed tomography scan of the brain was performed; this showed evidence of multiple ring enhancing lesions in both frontal lobes. Ultrasound of the abdomen was normal. On the basis of the above findings, a diagnosis of disseminated subcutaneous pheohyphomycosis was made. The patient was given itraconazole, 100 mg twice daily, and his diabetes was managed with insulin. The fever stopped within a week and the altered behavior also started to show an improvement. There was obvious improvement in neurologic signs and symptoms. His skin lesions, however, responded slowly to the treatment. The patient did not report for further follow-up after 1 month. PMID:17343584

  8. Pulmonary nocardiosis with brain abscess in a sensitized kidney transplant recipient with a history of repeated graft loss and HLA-antibody depletion treatment--a case report.

    PubMed

    Biglarnia, Ali-Reza; Wadström, Jonas; Tufveson, Gunnar; Eriksson, Britt-Marie

    2008-01-01

    Nocardiosis is an opportunistic infection with unfavourable prognosis and is predominantly seen in immunocompromised patients. We here present a kidney transplant recipient with a history of two early graft losses who subsequently developed Human Leukocyte Antigen (HLA)-antibodies and underwent a desensitization treatment with plasmapheresis and monoclonal anti-CD20 antibody application. However, 3 months after a third HLA-identical kidney transplantation he developed Nocardiosis with pulmonary and asymptomatic brain manifestation. The present case report exemplifies this opportunistic infection and gives an overview of the literature. PMID:18521805

  9. Report of an immunocompetent case with disseminated infection due to Nocardia otitidiscaviarum: Identification by 16S rRNA gene sequencing.

    PubMed

    Eren, Esma; Ulu-Kilic, Aysegul; Atalay, Altay; Demiraslan, Hayati; Parkan, Omur; Koc, Nedret

    2016-03-01

    Nocardia otitidiscaviarum belongs to the agents of opportunistic infections seen in immunocompromised patients, but may occur rarely in immunocompetent patients. In this report we described a case of a previously healthy 69-year-old woman with cerebral and retroperitoneal abscess due to Nocardia otitidiscaviarum. The patient was admitted to hospital because of loss of strength in her right arm and leg. Nocardia spp. was isolated from the abscess material. The intracranial lesions were drained by stereotactic craniotomy. The large abscess located around the left kidney was drained and microscopic examination of aspirated material showed Nocardia spp. For species identification, 16S rRNA gene sequencing was carried out and was 100% concordant with Nocardia otitidiscaviarum. Use of 16S rDNA gene sequencing for identification permits detection of rare aetiologic agents that cause brain abscesses. PMID:27031902

  10. Pulmonary Nocardiosis in a Multiple Myeloma Patient Treated with Proteasome Inhibitors

    PubMed Central

    Mendonca, Nikolai P.; Kadayakkara, Deepak K.; Forde, Inga C.; Rudkovaskaia, Anastasiia; Saul, Zane K.; Lobo, David J.

    2016-01-01

    Patient: Male, 71 Final Diagnosis: Pulmonary nocardiosis Symptoms: Cough • dyspnea • fever Medication: Carfillzomib Clinical Procedure: Bronchoscopy Specialty: Infectious Diseases Objective: Rare co-existance of disease or pathology Background: The use of proteasome inhibitors like Bortezomib to treat multiple myeloma has been associated with increased rates of opportunistic infections, including Nocardia, especially when lymphopenia is present. The prevalence or association of such infections with newer agents like Carfilzomib is not known. Case Report: A 71-year-old man with multiple myeloma presented with a 6-week history of respiratory symptoms and cyclic fevers. He was undergoing chemotherapy with Carfilzomib. Work-up revealed severe lymphopenia and a CT chest showed multiple lung nodules and a mass-like consolidation. He underwent a bronchoscopy, and respiratory cultures grew Nocardia species. He responded well to intravenous antibiotics with resolution of symptoms and CT findings. Conclusions: With the introduction of newer agents like Carfilzomib for the treatment of multiple myeloma, clinicians must maintain a high degree of suspicion for opportunistic infections to achieve early diagnosis and treatment. PMID:26861506

  11. Genetic diversity and antimicrobial susceptibility of Nocardia species among patients with nocardiosis

    PubMed Central

    Hashemi-Shahraki, Abodolrazagh; Heidarieh, Parvin; Bostanabad, Saeed Zaker; Hashemzadeh, Mohamad; Feizabadi, Mohamad Mehdi; Schraufnagel, Dean; Mirsaeidi, Mehdi

    2015-01-01

    The aim of this multicenter study was to determine the genetic diversity and antibiotic susceptibility of clinically isolated Nocardia species. One hundred twenty-seven patients with nocardiosis were randomly selected from 5 provinces of Iran. Molecular diagnosis of Nocardia species was performed using multilocus sequence analysis of gyrase B of the β subunit of DNA topoisomerase (gyrB), and 16S rRNA and subunit A of SecA preproteintranslocase (secA1). Antimicrobial susceptibility testing was performed following the Clinical and Laboratory Standards Institute recommendations. Thirty-five N. cyriacigeorgica, 30 N. asteroides, 26 N. farcinica, 12 N. otitidiscaviarum, and 10 N. abscessus cultures were studied. All isolates were susceptible to linezolid. All isolates of N. cyriacigeorgica, N. asteroides, N. abscessus, and N. otitidiscaviarum were susceptible to trimethoprim-sulfamethoxazole, while 8% of N. farcinica isolates were resistant to this drug. All N. otitidiscaviarum isolates were highly resistant to imipenem, but N. cyriacigeorgica, N. asteroides, N. farcinica, and N. abscessus were only moderate resistant. The susceptibility patterns vary with different species of Nocardia. Resistance to trimethoprim-sulfamethoxazole in Iran is low and this drug should be first line therapy, unless drug susceptibility testing shows resistance. Linezolid also covers Nocardia well and could be a second line agent. PMID:26638771

  12. Disseminated intravascular coagulation (DIC)

    MedlinePlus

    ... medlineplus.gov/ency/article/000573.htm Disseminated intravascular coagulation (DIC) To use the sharing features on this page, please enable JavaScript. Disseminated intravascular coagulation is a serious disorder in which the proteins ...

  13. Disseminated histoplasmosis (image)

    MedlinePlus

    Histoplasmosis is a fungal infection caused by inhaling dust from spore-infected bird droppings. In the disseminated ... fairly high for people with untreated widespread (disseminated) histoplasmosis, but is reduced significantly with treatment.

  14. Dissemination Activities Report

    ERIC Educational Resources Information Center

    Barclay, Hanna; Batatia, Hudj; Bauters, Merja; Ben Ami, Zvi; Drachman, Raul; Flouris, Giorgos; Jadin, Tanja; Jalonen, Satu; Karlgren, Klas; Karpati, Andrea; Kotzinos, Dimitris; Lakkala, Minna; Lallimo, Jiri; Moen, Anne; Nygard, Kathrine; Paavola, Sami; Padiglia, Sheila; Scapolla, Marina; Sins, Patrick; Vasileva, Tania

    2008-01-01

    In the first 24 months of the project, KP-Lab members were highly dedicated to dissemination and were engaged in various dissemination activities that contributed to the prime objective of the KP-Lab dissemination efforts which is "to make the project widely known to a variety of prospective users and, at a later stage, to promote the…

  15. Acute Disseminated Encephalomyelitis.

    PubMed

    Gray, Matthew Philip; Gorelick, Marc H

    2016-06-01

    Acute disseminated encephalomyelitis is a primarily pediatric, immune-mediated disease characterized by demyelination and polyfocal neurologic symptoms that typically occur after a preceding viral infection or recent immunization. This article presents the pathophysiology, diagnostic criteria, and magnetic resonance imaging characteristics of acute disseminated encephalomyelitis. We also present evaluation and management strategies. PMID:27253358

  16. Development of a loop-mediated isothermal amplification assay for rapid detection of Nocardia salmonicida, the causative agent of nocardiosis in fish.

    PubMed

    Xia, Liqun; Zhang, Honglian; Lu, Yishan; Cai, Jia; Wang, Bei; Jian, Jichang

    2015-03-01

    Nocardia salmonicida is one of the main pathogens of fish nocardiosis. The purpose of this study was to build a loop-mediated isothermal amplification (LAMP) method for the rapid and sensitive detection of N. salmonicida. A set of four primers were designed from the 16S-23S rRNA intergenic spacer region of N. salmonicida, and conditions for LAMP were optimized as incubating all the reagents for 60 min at 64°C. LAMP products were judged with agar gel electrophoresis as well as with the naked eye after the addition of SYBR Green I. Results showed the sensitivity of the LAMP assay was 1.68 × 10(3) CFU/ml (16.8 CFU per reaction) and 10-fold higher than that of PCR. The LAMP method was also effectively applied to detect N. salmonicida in diseased fish samples, and it may potentially facilitate the surveillance and early diagnosis of fish nocardiosis. PMID:25262681

  17. Vaginal bleeding before 20 weeks gestation due to placental abruption leading to disseminated intravascular coagulation and fetal loss after appearing to satisfy criteria for routine threatened abortion: a case report and brief review of the literature.

    PubMed

    Hodgson, Danner T; Lotfipour, Shahram; Fox, J Christian

    2007-05-01

    We present a case of placental abruption with concomitant disseminated intravascular coagulation in a woman who presented with vaginal bleeding. A 32-year-old pregnant woman at 17 and 4/7 weeks gestation with a 1-month history of intermittent abdominal pain presented to our Emergency Department (ED) with 1 h of vaginal bleeding. Upon initial history, the patient reported that she was diagnosed with "blood behind the placenta" the day before and was discharged on pelvic precautions. An ED ultrasound confirmed the sub-amniotic hematoma with placental hematoma and a viable intrauterine fetus. A low fibrinogen level was suggested for disseminated intravascular coagulation and increasing hemorrhage necessitated dilation and evacuation and multiple units of blood products on an emergent basis. Only a few cases have been described in the literature demonstrating disseminated intravascular coagulation in patients at fewer than 20 weeks gestation with routine ultrasound findings of live intrauterine pregnancy and subchorionic hemorrhage. PMID:17499692

  18. Disseminated intravascular coagulation (DIC)

    MedlinePlus

    ... Jr, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice . 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 141. Thachil J, Toh CH. Current concepts in the management of disseminated intravascular coagulation. Thromb Res . 2012;129 ...

  19. Nocardia transvalensis Disseminated Infection in an Immunocompromised Patient with Idiopathic Thrombocytopenic Purpura

    PubMed Central

    García-Méndez, Jorge; Carrillo-Casas, Erika M.; Rangel-Cordero, Andrea; Leyva-Leyva, Margarita; Xicohtencatl-Cortes, Juan; Arenas, Roberto; Hernández-Castro, Rigoberto

    2016-01-01

    Nocardia transvalensis complex includes a wide range of microorganisms with specific antimicrobial resistance patterns. N. transvalensis is an unusual Nocardia species. However, it must be differentiated due to its natural resistance to aminoglycosides while other Nocardia species are susceptible. The present report describes a Nocardia species involved in an uncommon clinical case of a patient with idiopathic thrombocytopenic purpura and pulmonary nocardiosis. Microbiological and molecular techniques based on the sequencing of the 16S rRNA gene allowed diagnosis of Nocardia transvalensis sensu stricto. The successful treatment was based on trimethoprim-sulfamethoxazole and other drugs. We conclude that molecular identification of Nocardia species is a valuable technique to guide good treatment and prognosis and recommend its use for daily bases diagnosis. PMID:27313917

  20. Nocardia transvalensis Disseminated Infection in an Immunocompromised Patient with Idiopathic Thrombocytopenic Purpura.

    PubMed

    García-Méndez, Jorge; Carrillo-Casas, Erika M; Rangel-Cordero, Andrea; Leyva-Leyva, Margarita; Xicohtencatl-Cortes, Juan; Arenas, Roberto; Hernández-Castro, Rigoberto

    2016-01-01

    Nocardia transvalensis complex includes a wide range of microorganisms with specific antimicrobial resistance patterns. N. transvalensis is an unusual Nocardia species. However, it must be differentiated due to its natural resistance to aminoglycosides while other Nocardia species are susceptible. The present report describes a Nocardia species involved in an uncommon clinical case of a patient with idiopathic thrombocytopenic purpura and pulmonary nocardiosis. Microbiological and molecular techniques based on the sequencing of the 16S rRNA gene allowed diagnosis of Nocardia transvalensis sensu stricto. The successful treatment was based on trimethoprim-sulfamethoxazole and other drugs. We conclude that molecular identification of Nocardia species is a valuable technique to guide good treatment and prognosis and recommend its use for daily bases diagnosis. PMID:27313917

  1. Disseminated Balamuthia mandrillaris Infection

    PubMed Central

    Shah, Neil; Almira-Suarez, M. I.; Reese, Jennifer M.; Hoke, George M.; Mandell, James W.; Roy, Sharon L.; Visvesvara, Govinda

    2015-01-01

    Balamuthia mandrillaris is a rare cause of human infection, but when infections do occur, they result in high rates of morbidity and mortality. A case of disseminated Balamuthia infection is presented. Early diagnosis and initiation of recommended therapy are essential for increased chances of successful outcomes. PMID:26135864

  2. Validity, not Dissemination

    NASA Astrophysics Data System (ADS)

    Mitra, Samindranath

    2015-03-01

    Science journals have been transformed by the internet. In particular, increasingly their role appears to be to validate research, not to disseminate it. How are journals, and the communities they interact with, adapting? In this context, are alternatives to peer review on the horizon? Are these challenges unique to physics journals, or also seen in other publication scenarios?

  3. Disseminated Histoplasmosis with Haemophagocytic Lymphohistiocytosis in an Immunocompetent Host

    PubMed Central

    Sonawane, Pratibha Balasaheb; Chandak, Sachet Vijay; Rathi, Pravin M

    2016-01-01

    Haemophagocytic lymphohistiocytosis (HLH) is a devastating syndrome due to uninhibited immune activation. Disseminated histoplasmosis is a rare cause of HLH. There have been few case reports and series demonstrating a relation between the two disease entities in immunosuppressed hosts. HLH secondary to disseminated histoplasmosis is even rarer in an immunocompetant host. We report a rare case of HLH triggered by disseminated histoplasmosis in an immunocompetant patient. PMID:27134914

  4. Disseminated Histoplasmosis with Haemophagocytic Lymphohistiocytosis in an Immunocompetent Host.

    PubMed

    Sonavane, Amey Dilip; Sonawane, Pratibha Balasaheb; Chandak, Sachet Vijay; Rathi, Pravin M

    2016-03-01

    Haemophagocytic lymphohistiocytosis (HLH) is a devastating syndrome due to uninhibited immune activation. Disseminated histoplasmosis is a rare cause of HLH. There have been few case reports and series demonstrating a relation between the two disease entities in immunosuppressed hosts. HLH secondary to disseminated histoplasmosis is even rarer in an immunocompetant host. We report a rare case of HLH triggered by disseminated histoplasmosis in an immunocompetant patient. PMID:27134914

  5. Disseminated histoplasmosis presenting as pelvic inflammatory disease.

    PubMed

    Rimtepathip, Parin P; Erickson, Alex; Katner, Harold; Bakri, Younes

    2016-01-01

    A 39-year-old female patient was presented with acute abdominal pain. Diagnostic laparoscopy revealed extensive granulomas throughout the abdomen. Disseminated TB was suspected, but the biopsies were negative. Due to a high degree of suspicion, a urine antigen test was performed and was strongly positive for histoplasmosis. PMID:26783441

  6. Weather dissemination and public usage

    NASA Technical Reports Server (NTRS)

    Stacey, M. S.

    1973-01-01

    The existing public usage of weather information was examined. A survey was conducted to substantiate the general public's needs for dissemination of current (0-12 hours) weather information, needs which, in a previous study, were found to be extensive and urgent. The goal of the study was to discover how the general public obtains weather information, what information they seek and why they seek it, to what use this information is put, and to further ascertain the public's attitudes and beliefs regarding weather reporting and the diffusion of weather information. Major findings from the study include: 1. The public has a real need for weather information in the 0-6 hour bracket. 2. The visual medium is preferred but due to the lack of frequent (0-6 hours) forecasts, the audio media only, i.e., telephone recordings and radio weathercasts, were more frequently used. 3. Weather information usage is sporadic.

  7. Delusions of Disseminated Fungosis

    PubMed Central

    Griffin, Paul Matthew

    2014-01-01

    Introduction. Delusional infestation is a rare monosymptomatic hypochondriacal psychosis according to The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). It can be a primary disorder or associated with an underlying psychological or physical disorder. It commonly presents as delusional parasitosis, and less than 1% may be fungi related. We present this case as it is a rare presentation of a rare condition. Case Presentation. Our patient is a 60-year-old Caucasian man who presented with a 7-year history of delusional infestation manifested as a disseminated fungal infection. He had previously been reviewed by multiple physicians for the same with no systemic illness diagnosed. After multiple reviews and thorough investigation we diagnosed him with a likely delusional disorder. As is common with this patient cohort he refused psychiatric review or antipsychotic medication. Conclusion. A delusion of a disseminated fungal infestation is a rare condition. It is exceedingly difficult to treat as these patients often refuse to believe the investigation results and diagnosis. Furthermore, they either refuse or are noncompliant with treatment. Multidisciplinary outpatient evaluation may be the best way to allay patient fears and improve treatment compliance. PMID:25610675

  8. DDDRC: decentralised data dissemination in VANET using raptor codes

    NASA Astrophysics Data System (ADS)

    Kumar, Rakesh; Dave, Mayank

    2015-06-01

    The design of data dissemination protocol has been a great challenge due to the highly dynamic and unreliable wireless channel in vehicular ad hoc networks (VANET). In literature, several interesting solutions are proposed to perform data dissemination for this environment. But these solutions either use architectures requiring centralised coordination or global network knowledge or large intermediate buffers. In this paper, we propose a decentralised technique that overcomes above requirements and provides reliable and scalable communication in both dense and sparse traffic for VANET. Random walks are used in the proposed technique to disseminate data from one vehicle to other vehicles in the network. We use raptor codes to provide low decoding complexity and more scalability for data dissemination. Simulation results demonstrate that the proposed technique has better fault tolerance with lower complexity than general random-walk-based dissemination process and more scalability as compared to the other protocols.

  9. Disseminated cryptococcosis in a diabetic patient.

    PubMed

    Poojary, Shital; Khatu, Swapna

    2014-08-01

    Cryptococcosis is an opportunistic infection caused by Cryptococcus neoformans that typically presents in immunocompromised patients, most commonly in those with human immunodeficiency virus (HIV) infection. It rarely has been described in patients with diabetes mellitus (DM). Defects in the host defense mechanisms due to hyperglycemia predispose diabetic patients to opportunistic infections such as cryptococcosis. We present a rare case of disseminated cryptococcosis in a 48-year-old HIV-negative man with DM. PMID:25184644

  10. Disseminated intravascular coagulation.

    PubMed

    Gando, Satoshi; Levi, Marcel; Toh, Cheng-Hock

    2016-01-01

    Disseminated intravascular coagulation (DIC) is an acquired syndrome characterized by widespread intravascular activation of coagulation that can be caused by infectious insults (such as sepsis) and non-infectious insults (such as trauma). The main pathophysiological mechanisms of DIC are inflammatory cytokine-initiated activation of tissue factor-dependent coagulation, insufficient control of anticoagulant pathways and plasminogen activator inhibitor 1-mediated suppression of fibrinolysis. Together, these changes give rise to endothelial dysfunction and microvascular thrombosis, which can cause organ dysfunction and seriously affect patient prognosis. Recent observations have pointed to an important role for extracellular DNA and DNA-binding proteins, such as histones, in the pathogenesis of DIC. The International Society on Thrombosis and Haemostasis (ISTH) established a DIC diagnostic scoring system consisting of global haemostatic test parameters. This scoring system has now been well validated in diverse clinical settings. The theoretical cornerstone of DIC management is the specific and vigorous treatment of the underlying conditions, and DIC should be simultaneously managed to improve patient outcomes. The ISTH guidance for the treatment of DIC recommends treatment strategies that are based on current evidence. In this Primer, we provide an updated overview of the pathophysiology, diagnosis and management of DIC and discuss the future directions of basic and clinical research in this field. PMID:27250996

  11. How Is Disseminated Intravascular Coagulation Treated?

    MedlinePlus

    ... the NHLBI on Twitter. How Is Disseminated Intravascular Coagulation Treated? Treatment for disseminated intravascular coagulation (DIC) depends ... and treat the underlying cause. Acute Disseminated Intravascular Coagulation People who have acute DIC may have severe ...

  12. Cutaneous Cryptococcus: marker for disseminated infection.

    PubMed

    Srivastava, G N; Tilak, Ragini; Yadav, Jyoti; Bansal, Manish

    2015-01-01

    Cryptococcosis is an infection caused by the encapsulated yeast, Cryptococcus neoformans, a dimorphic fungus recovered from pigeon excreta, soil, dust and human skin. After a primary infection in the lungs, the disease can disseminate via a haematogenous route to various organs, including the central nervous system and skin, in susceptible individuals. Cryptococcosis can present with a variety of skin and soft tissue manifestations including acneiform lesions, purpura, vesicles, nodules, abscesses, ulcers, granulomas, pustules, draining sinuses and cellulitis. We present a case of a young man with HIV infection who developed molluscum-like cutaneous lesions secondary to pulmonary cryptococcosis. The diagnosis was confirmed by Indian ink preparation of the cutaneous lesions. Primary cutaneous infection occurs rarely due to direct inoculation. Cutaneous lesions are usually secondary and act as a key marker of disseminated infection, especially in patients with impaired cell-mediated immunity, such as those infected with HIV, solid-organ transplant recipients, and those on chronic corticosteroid therapy. PMID:26199299

  13. Herpes zoster (shingles), disseminated (image)

    MedlinePlus

    Herpes zoster (shingles) normally occurs in a limited area that follows a dermatome (see the "dermatome" picture). In individuals with damaged immune systems, herpes zoster may be widespread (disseminated), causing serious illness. ...

  14. A chronic disseminated dermatophytosis due to Trichophyton violaceum.

    PubMed

    Zhan, Ping; Li, Zhi-hua; Geng, Chengfang; Jiang, Qing; Jin, Yun; Dolatabadi, Somayeh; Liu, Weida; de Hoog, G Sybren

    2015-02-01

    A 48-year-old female had presented dandruff and breakable hair for more than 40 years, dry scaly erythema on bilateral palms and feet accompanying with nail destruction for 20 years, and scaling papules on the buttock for 5 years. Direct microscopic examination showed endothrix anthroconidia within broken hair and septate and branched hyphae within skin and nail lesion. Fungal cultures from all infected sites were examined by morphology, ITS sequencing, and random amplified polymorphic DNA fingerprinting, and were identified as Trichophyton violaceum from the same source. The patient was treated with oral terbinafine 0.25 g/day as well as with 1% terbinafine gel for external use and with 2% ketoconazole lotion for shampoo and bath. A follow-up after 4 weeks showed that the lesions decreased significantly. PMID:25322706

  15. Report and Recommendations, Interstate Project on Dissemination.

    ERIC Educational Resources Information Center

    1976

    An extensive study was made of information dissemination by a compact of seven state education agencies which formed the Interstate Project on Dissemination. First an historical perspective for information dissemination was developed, followed by an examination of legislation and regulations pertaining to dissemination. Suggestions were formulated…

  16. Virulence, persistence and dissemination of Mycoplasma bovis.

    PubMed

    Bürki, Sibylle; Frey, Joachim; Pilo, Paola

    2015-08-31

    Bovine mycoplasmosis due to Mycoplasma bovis causes several important bovine diseases such as pneumonia, mastitis, arthritis, otitis, genital disorders or keratoconjunctivitis. Variable surface lipoproteins, adhesion, invasion of host cells, modulation of the host immune system, biofilm formation and the release of secondary metabolites like hydrogen peroxide, as well as synergistic infections with other bacterial or viral pathogens are among the more significantly studied characteristics of the bacterium. The aim of this review is to summarize the current knowledge regarding the virulence of M. bovis and additionally, factors contributing to the dissemination and persistence of this pathogen in the bovine host will be discussed. PMID:25824130

  17. Disseminated nontuberculous mycobacterial infections in sickle cell anemia patients.

    PubMed

    Thorell, Emily A; Sharma, Mukta; Jackson, Mary Anne; Selvarangan, Rangaraj; Woods, Gerald M

    2006-10-01

    Nontuberculous mycobacteria (NTM) are ubiquitous in nature and have been implicated in skin/soft-tissue, pulmonary, middle ear, bone, and surgical/traumatic wound infections. Disseminated disease occurs infrequently and almost exclusively in the immunocompromised. We describe the first 2 reported cases of disseminated Mycobacterium fortuitum infection in teenagers with sickle hemoglobinopathy. Both had central venous catheters (CVCs), frequent admissions for vaso-occlusive painful episode and received hydroxyurea. Diagnosis was confirmed by multiple positive blood cultures and pulmonary dissemination occurred in both. Both had successful treatment after CVC removal and combination drug therapy. Positive cultures persisted in 1 patient due to drug resistance emphasizing the need for accurate susceptibility data. NTM infection should be added to the list of pathogens in sickle cell patients with CVCs and fever. Investigation for disseminated disease should be undertaken based on clinical signs and symptoms. Although some routine blood culture systems can identify NTM, specific mycobacterial blood culture is optimal. Removal of involved CVCs is essential and treatment of NTM must be guided by susceptibilities. As dissemination almost always occurs in those with impaired cellular immunity, human immunodeficiency virus testing should be performed. Hydroxyurea may be a risk factor for dissemination and needs further evaluation. PMID:17023829

  18. Disseminating Educational Research with IT.

    ERIC Educational Resources Information Center

    Davis, Niki

    Teachers and researchers need to use the research produced in education to improve their practice. However, the current modes of dissemination through journals and papers are often written for the expert community. The Telematics Centre at the University of Exeter (United Kingdom), School of Education provides creative solutions for the effective…

  19. The Dissemination of Pedagogical Patterns

    ERIC Educational Resources Information Center

    Bennedsen, Jens

    2006-01-01

    Pedagogical patterns have been around since 1995, but several authors claim their impact is limited. However, these claims are based on authors' own observations and not on methodical evaluations of the use and dissemination of pedagogical patterns. This claim is in contrast to the vision of the creators of pedagogical patterns--they think…

  20. Disseminating and Using Research Reports.

    ERIC Educational Resources Information Center

    Overs, Robert P.; Trotter, Ann B.

    The authors offer some practical guidelines in four areas of rehabilitation research information dissemination: (1) filing and retrieval problems; (2) level and styles of writing, listing, abstracting, summarizing, and reconceptualizing; (3) profiling the average practitioner-consumers; and (4) leveling attitudinal barriers. Filing and retrieval…

  1. Thyrotoxicosis followed by Hypothyroidism due to Suppurative Thyroiditis Caused by Nocardia brasiliensis in a Patient with Advanced Acquired Immunodeficiency Syndrome.

    PubMed

    Teckie, G2; Bhana, S A; Tsitsi, J M L; Shires, R

    2014-03-01

    Acute thyroiditis is an extremely rare complication of nocardiosis. We report a patient with hyperthyroidism due to suppurative thyroiditis caused by Nocardia brasiliensis. A 38-year-old Black male presented with features of thyrotoxicosis, sepsis and airway obstruction. He had no evidence of underlying thyroid disease, but was severely immunocompromised as a result of acquired immunodeficiency syndrome. He had previously been diagnosed with pulmonary nocardiosis and also had nocardial abscesses on his anterior chest wall. Investigations revealed thyrotoxicosis, with a FT4 of 43.2 pmol/l and a suppressed TSH <0.01 mIU/l. Serum anti-thyroperoxidase and anti-thyroglobulin antibodies were absent. Computed tomography scan showed a large abscess in the anterior neck involving the left lobe and isthmus, as well as inhomogeneous changes in the right lobe of the thyroid. The radioisotopic scan showed absent uptake of tracer in keeping with thyroiditis. Although the initial presentation was that of hyperthyroidism, destruction of the gland later resulted in sustained hypothyroidism, necessitating thyroid hormone supplementation. The hyperthyroidism can be explained by the release of presynthesized and stored thyroid hormone into the circulation as a result of inflammation and disruption of the thyroid follicles, and the subsequent hypothyroidism by the fact that much of the gland was destroyed by the abscess and the extensive inflammatory process. This is the first documented case of hyperthyroidism in a patient with acute suppurative thyroiditis caused by Nocardia. PMID:24847469

  2. Creating new realities: program development and dissemination.

    PubMed Central

    Fixsen, D L; Blase, K A

    1993-01-01

    Program development and dissemination in human services present challenges and opportunities for social scientists. Over the past 27 years the Teaching-Family Model of group home treatment has moved from prototype development to widespread dissemination across North America. Reviewing concepts in industry related to product development and dissemination, the application of these concepts to a human services delivery system, and program replication and dissemination data offer information about how innovative human services can be widely adapted and adopted. PMID:8307838

  3. [Treatment of disseminated breast cancer].

    PubMed

    Mattson, Johanna; Huovinen, Riikka

    2015-01-01

    Although several effective drugs have in recent years been introduced for the treatment of disseminated breast cancer, it is still an incurable illness. Many patients live a fairly normal life with their illness for a long time, and some of them are able to continue working in spite of the therapies. Factors considered in tailoring the treatment include tumor subtype, extent of the disease, symptoms, previous treatments and the achieved treatment outcome, and adverse effects of the treatments. PMID:26245064

  4. Disseminated histoplasmosis mimicking secondary syphilis.

    PubMed

    Pastor, Tony A; Holcomb, Maura J; Motaparthi, Kiran; Grekin, Sarah J; Hsu, Sylvia

    2011-01-01

    A 34-year-old, HIV-positive man living in Texas presented with a 2-week history of fever, malaise, myalgias, oral ulcers, and papules on his chest, back, face, and extremities, including the palms. Initially secondary syphilis was suspected. However, RPR was negative. Histopathologic examination revealed a lymphocytic infiltrate with numerous intra-histiocytic fungal organisms. GMS and PAS stains were positive, consistent with the diagnosis of histoplasmosis. We report a case of disseminated histoplasmosis clinically mimicking secondary syphilis. PMID:22136866

  5. Dissemination Manual for Enhancing Program Improvement.

    ERIC Educational Resources Information Center

    Russell, Earl B.; And Others

    This manual is intended for use by all involved in dissemination of program improvement products--users, linkers, developers, and funders--in Illinois. Section 1 provides guidelines for content usage by dissemination group and usage of charts, forms, and samples. Section 2, Conceptual Framework, defines dissemination, discusses the dissemination…

  6. Disseminated sporotrichosis in an immunocompetent patient.

    PubMed

    Hassan, Kareem; Turker, Tolga; Zangeneh, Tirdad

    2016-01-01

    Sporothrix schenckii, the causative agent of sporotrichosis, is a relatively rare infection. Local infection usually occurs through direct inoculation of the organism through the skin; disseminated disease is rarely seen. This article describes a case of disseminated sporotrichosis in a middle-aged man without the commonly seen risk factors for dissemination. PMID:27583270

  7. Disseminated sporotrichosis in an immunocompetent patient

    PubMed Central

    Hassan, Kareem; Turker, Tolga; Zangeneh, Tirdad

    2016-01-01

    Abstract Sporothrix schenckii, the causative agent of sporotrichosis, is a relatively rare infection. Local infection usually occurs through direct inoculation of the organism through the skin; disseminated disease is rarely seen. This article describes a case of disseminated sporotrichosis in a middle-aged man without the commonly seen risk factors for dissemination.

  8. Federal Mechanisms to Support Intervention Dissemination.

    PubMed

    Diana, Augusto; Bennett, Nicole

    2015-01-01

    This paper examines federal mechanisms that support program developers and researchers in disseminating effective interventions for public benefit. The purpose of this paper is not to discuss the dissemination of intervention research (i.e., how to inform stakeholders about research findings), nor is it intended to discuss the research of intervention dissemination (i.e., what is the best approach to disseminate an intervention). Rather, the paper discusses the challenges specific to finding pathways to disseminate an intervention and describes federal opportunities to support intervention dissemination. Three specific mechanisms are discussed: Federal Registries of Evidence-Based Programs, the Tiered Evidence Grant Programs, and the Small Business Innovative Research (SBIR) and the Small Technology Transfer Research (STTR) programs. The article presents some limitations associated with federal mechanisms for dissemination of effective interventions, but is intended to highlight current and future opportunities they may offer. PMID:26375192

  9. 45 CFR 1388.7 - Program criteria-dissemination.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    .... (a) Introduction to dissemination: The UAP disseminates information and research findings, including... best practices. (c) Specific target audiences must be identified for dissemination activities and... Affiliated Programs, and State service systems to disseminate information to target audiences. (e)...

  10. Disseminating best practice through workshops.

    PubMed

    Price, B

    This article, the fourth in a five-part series, explores the ways in which best practice might be successfully disseminated through workshops. A workshop provides an exciting opportunity to engage nurses in new ways of thinking and the exploration of ideas applied to practice. It involves the nurse innovator in managing a learning experience that enables colleagues to explore their current and possible future practice. The article describes the different types of workshops available, the role of the workshop leader and the sorts of activities that might be used to encourage participation and practice development. PMID:20391674

  11. NIST Mechanisms for Disseminating Measurements

    PubMed Central

    Gills, T. E.; Dittman, S.; Rumble, J. R.; Brickenkamp, C. S.; Harris, G. L.; Trahey, N. M.

    2001-01-01

    The national responsibilities assigned to the National Bureau of Standards (NBS) early in the last century for providing measurement assistance and service are carried out today by the four programs that comprise the National Institute of Standards and Technology (NIST) Office of Measurement Services (OMS). They are the Calibration Program (CP), the Standard Reference Materials Program (SRMP), the Standard Reference Data Program (SRDP), and the Weights and Measures Program (W&MP). Organized when the U.S. Congress changed the NBS name to NIST, the OMS facilitates access to the measurement and standards activities of NIST laboratories and programs through the dissemination of NIST products, data, and services. A brief historical introduction followed by a perspective of pivotal measurement developments from 1901 to the present and concluding with a look to the future of NIST measurement services in the next decade of the new millennium are presented for each OMS program. PMID:27500025

  12. Disseminated Fusarium solani infection with cutaneous nodules in a bone marrow transplant patient.

    PubMed

    Mowbray, D N; Paller, A S; Nelson, P E; Kaplan, R L

    1988-12-01

    Fusarium is a ubiquitous fungus that commonly colonizes ulcerated, burned, or traumatized skin and may cause keratitis and onychomycosis in healthy hosts. Serious disseminated infection due to Fusarium has been reported with increasing frequency in immunocompromised patients. We describe a bone marrow transplant patient who developed fungal septicemia and disseminated skin nodules due to Fusarium solani. Fusarium should be recognized as a potential cause of deep fungal infection in immunocompromised patients. PMID:3069758

  13. 14 CFR 1203.303 - Dissemination considerations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Dissemination considerations. 1203.303 Section 1203.303 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Classification Principles and Considerations § 1203.303 Dissemination considerations. The...

  14. 14 CFR 1203.303 - Dissemination considerations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Dissemination considerations. 1203.303 Section 1203.303 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Classification Principles and Considerations § 1203.303 Dissemination considerations. The...

  15. 14 CFR 1203.303 - Dissemination considerations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Dissemination considerations. 1203.303 Section 1203.303 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Classification Principles and Considerations § 1203.303 Dissemination considerations. The...

  16. Federal Mechanisms to Support Intervention Dissemination

    ERIC Educational Resources Information Center

    Diana, Augusto; Bennett, Nicole

    2015-01-01

    This paper examines federal mechanisms that support program developers and researchers in disseminating effective interventions for public benefit. The purpose of this paper is not to discuss the dissemination of intervention research (i.e., how to inform stakeholders about research findings), nor is it intended to discuss the research of…

  17. Producing Dissemination Materials. Final Draft Version.

    ERIC Educational Resources Information Center

    Degener, David, Comp.; And Others

    This manual is intended to help projects approved by the Joint Dissemination Review Panel produce materials that will support their dissemination activities. Specifically directed toward career education projects, it should be equally useful for other projects. Section 1 discusses diffusion/adoption and these topics regarding materials: purpose,…

  18. 34 CFR 75.192 - Dissemination.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of Curricula Or Instructional Materials § 75.192 Dissemination. If an applicant proposes to publish and disseminate curricula or instructional materials under a grant, the applicant shall include an assurance in its application that the curricula or materials will reach the populations for which...

  19. The Effectiveness of Selected Dissemination Activities.

    ERIC Educational Resources Information Center

    Chapman, David W.; Johnson, Russell H.

    1981-01-01

    The dissemination activities through which college admissions officers heard about Project CHOICE, a three-year project to help colleges improve the information they provided to prospective students, were investigated. The study involved determining how well various dissemination methods (newsletter, journal articles, conference presentations,…

  20. Disseminated Scopulariopsis-culture is required to distinguish from other disseminated mould infections.

    PubMed

    Swick, Brian L; Reddy, Sindhura C; Friedrichs, Amanda; Stone, Mary Seabury

    2010-06-01

    Disseminated fungal infections are a major cause of mortality in severely immunocompromised bone marrow transplant (BMT) patients. Scopulariopsis is a soil saprophytic mould that is typically associated with onychomycosis and only rarely associated with disseminated infection with cutaneous findings. We describe a case of fatal disseminated Scopulariopsis infection in a 56-year-old neutropenic male with chronic myelogenous leukemia status post peripheral blood stem cell transplant that was clinically and histologically indistinguishable from disseminated Aspergillus, Fusarium or zygomycosis infection. Distinguishing the above listed fungi by tissue culture is crucial because disseminated Scopulariopsis is difficult to eradicate and associated with a high mortality rate in the immunocompromised BMT patient population. PMID:19615008

  1. The dissemination of pedagogical patterns

    NASA Astrophysics Data System (ADS)

    Bennedsen, Jens

    2006-06-01

    Pedagogical patterns have been around since 1995, but several authors claim their impact is limited. However, these claims are based on authors' own observations and not on methodical evaluations of the use and dissemination of pedagogical patterns. This claim is in contrast to the vision of the creators of pedagogical patterns—they think pedagogical patterns can be used for capturing and transferring knowledge of teaching within the community. In this article, I analyse the results of a questionnaire and try to answer whether the creators of the pedagogical patterns have reached their vision among computer science teachers at universities around the world. The results indicate a rather high familiarity with pedagogical patterns. The attitude towards pedagogical patterns is positive among both teachers with knowledge and teachers without knowledge of pedagogical patterns. The attitude towards pedagogical patterns as a tool for further development of teaching is to some extent positive. The results show that the group with knowledge of pedagogical patterns, as well as the group with a positive attitude towards pedagogical patterns, is difficult to describe.

  2. [Respiratory failure in disseminated sclerosis].

    PubMed

    Popova, L M; Avdiunina, I A; Alferova, V P

    2000-01-01

    The development and patterns of respiratory failure (RF) are analyzed in 9 patients with disseminated sclerosis (DS). Forced ventilation of the lungs was carried out with consideration for main location of the process. Relationship between patterns of respiratory disorders and neuroanatomy of respiratory regulation is discussed. Involvement of the corticospinal routes is paralleled by dissociation during functional pulmonary tests: spontaneous volumes are less than controlled inspirations. The most severe symptom complexes were observed in RF of predominantly bulbar localization: respiratory anarchy, blocking of airways caused by impaired swallowing, impaired mechanism of coughing reflex, loss of spontaneous respiration, sometimes apnea during sleeping. Involvement of the respiratory nuclei of medullary respiratory center and airways and of the corticonuclear routes of caudal cranial nerves causes the development of a triad of symptoms: glossopharyngolaryngeal paralysis, dysfunction of respiratory nuclei of medulla oblongata, and decreased sensitivity of respiratory center to CO2. Aspiration complications caused by dysphagia are characteristic of bulbar DS. Respiratory function in 5 patients without clinical picture of RF are specially discussed. The authors emphasize unfavorable prognostic significance of signs of extracorporeal obstruction indicating the probability of RF long before its manifestation. Special attention is paid to early diagnosis of symptoms of coming RF when evaluating the status of patients with DS during treatment. Timely use of respiratory resuscitation methods reduces the mortality and ensures a good chance for remissions with recovery of respiratory function, which are characteristic of RF. PMID:11014001

  3. GOES satellite time code dissemination

    NASA Technical Reports Server (NTRS)

    Beehler, R. E.

    1983-01-01

    The GOES time code system, the performance achieved to date, and some potential improvements in the future are discussed. The disseminated time code is originated from a triply redundant set of atomic standards, time code generators and related equipment maintained by NBS at NOAA's Wallops Island, VA satellite control facility. It is relayed by two GOES satellites located at 75 W and 135 W longitude on a continuous basis to users within North and South America (with overlapping coverage) and well out into the Atlantic and Pacific ocean areas. Downlink frequencies are near 468 MHz. The signals from both satellites are monitored and controlled from the NBS labs at Boulder, CO with additional monitoring input from geographically separated receivers in Washington, D.C. and Hawaii. Performance experience with the received time codes for periods ranging from several years to one day is discussed. Results are also presented for simultaneous, common-view reception by co-located receivers and by receivers separated by several thousand kilometers.

  4. A Case of Disseminated Intravascular Coagulation after Thoracic Endovascular Aortic Repair

    PubMed Central

    2015-01-01

    I report a hemorrhagic complication due to disseminated intravascular coagulation after thoracic endovascular aortic repair for a dissecting aortic aneurysm. A 74-year-old man underwent thoracic endovascular aortic repair and carotid-carotid artery bypass to close the primary entry site of the dissecting aortic aneurysm. Postoperatively, he developed a gradually expanding cervical hematoma. Laboratory data showed disseminated intravascular coagulation. He could not extubated until postoperative day 6 because of the risk of airway obstruction. He was treated with transfusion to replenish the coagulation factor. Disseminated intravascular coagulation may occur secondary to thrombus formation in the false lumen after thoracic endovascular aortic repair. PMID:26730263

  5. Transbronchial Dissemination of Squamous Cell Lung Cancer

    PubMed Central

    Tadokoro, Akira; Kanaji, Nobuhiro; Ishii, Tomoya; Watanabe, Naoki; Inoue, Takuya; Kadowaki, Norimitsu; Bandoh, Shuji

    2015-01-01

    We report a case of squamous cell lung cancer with transbronchial dissemination in a 73-year-old man. Bronchoscopic examination revealed multiple bronchial mucosal nodules that existed independently of one another. We reviewed 16 previous cases of endobronchial metastasis in lung cancer. All patients were men. Among the reports that described the smoking history, most patients were smokers (6/7), and the most frequent histological type of cancer was squamous cell carcinoma (11/17). Although hematogenous and lymphogenous routes have been reported as metastatic mechanisms, no previous cases involving transbronchial dissemination have been described. Transbronchial dissemination may be an alternative pathway of endobronchial metastasis. PMID:26672760

  6. Acute Disseminated Intravascular Coagulation in Neuroendocrine Carcinoma

    PubMed Central

    Teh, Ru-Wen; Tsoi, Daphne T.

    2012-01-01

    Malignancy is a common cause of disseminated intravascular coagulation and usually presents as a chronic disorder in solid organ tumours. We present a rare case of recurrent acute disseminated intravascular coagulation in neuroendocrine carcinoma after manipulation, firstly, by core biopsy and, later, by cytotoxic therapy causing a release of procoagulants and cytokines from lysed tumour cells. This is reminiscent of tumour lysis syndrome where massive quantities of intracellular electrolytes and nucleic acid are released, causing acute metabolic imbalance and renal failure. This case highlights the potential complication of acute disseminated intravascular coagulation after trauma to malignant cells. PMID:23139666

  7. [A case of rheumatoid arthritis involving disseminated torichosporonosis].

    PubMed

    Ueda, Yo; Yamashita, Hiroyuki; Yoshida, Yuji; Takahashi, Yuko; Mimori, Akio

    2011-09-01

    A 75-year-old man who developed disseminated trichosporonosis had a long history of immunosuppressive therapy with weekly methotrexate and low-dose prednisolone for rheumatoid arthritis (RA). He had been administered 30 mg of prednisolone per day for organizing pneumonia, probably due to the RA, for about 3 months before admission for a lumbar compression fracture. He then developed bilateral aspiration pneumonia with pleural effusion, treated successfully with broad-spectrum antibiotics meropenem and ciprofloxacin, and fluid management. He then developed acute, progressive respiratory failure with changes in both lung lobes in chest computed tomography (CT). Meropenem, ciprofloxacin, micafungin, and pulsed steroid administration were ineffective. He died of respiratory failure, after which Trichosporon asahii was first detected in blood and urine culture. Disseminated trichosporonosis was determined based on positive blood culture, elevated serum glucuronoxylomannan antigen and beta-D glucan, and the man's lack of clinical progress. He had numerous risk factors for trichosporonosis, including neutrophilic dysfunction due to prolonged steroid therapy, administration of broad-spectrum antibiotics and micafungin, and central venous catheterization. Disseminated trichosporonosis is a chiefly hematological infection and case reports without hematological disorders are rare, so we report this instructive case. PMID:22117385

  8. Modelling information dissemination under privacy concerns in social media

    NASA Astrophysics Data System (ADS)

    Zhu, Hui; Huang, Cheng; Lu, Rongxing; Li, Hui

    2016-05-01

    Social media has recently become an important platform for users to share news, express views, and post messages. However, due to user privacy preservation in social media, many privacy setting tools are employed, which inevitably change the patterns and dynamics of information dissemination. In this study, a general stochastic model using dynamic evolution equations was introduced to illustrate how privacy concerns impact the process of information dissemination. Extensive simulations and analyzes involving the privacy settings of general users, privileged users, and pure observers were conducted on real-world networks, and the results demonstrated that user privacy settings affect information differently. Finally, we also studied the process of information diffusion analytically and numerically with different privacy settings using two classic networks.

  9. Fatal, disseminated Acremonium strictum infection in a neutropenic host.

    PubMed Central

    Schell, W A; Perfect, J R

    1996-01-01

    Disseminated Acremonium strictum infection in a neutropenic patient is reported. Positive fecal cultures preceded positive cutaneous and blood cultures by 18 and 21 days, respectively, which suggests gastrointestinal colonization and invasion as initiating events. Microscopic examination of cutaneous biopsy and pulmonary specimens revealed hyphae, phialides, and phialoconidia in vivo. These adventitious forms also can occur in infections due to other phialidic fungi such as Fusarium and Paecilomyces species and can be misdiagnosed as Candida species. Budding cells also can occur in vivo for species of Fusarium, Paecilomyces, and apparently Acremonium, further adding to the potential for misdiagnosis. The occurrence of adventitious forms in infections caused by species of Acremonium, Fusarium, Paecilomyces, Scedosporium, and Blastoschizomyces is suggested as a mechanism for dissemination of infection and as an explanation of the relatively higher frequency of positive blood cultures in these cases. PMID:8727935

  10. Disseminated Scedosporium prolificans infection in a Labrador retriever with immune mediated haemolytic anaemia.

    PubMed

    Taylor, Amanda; Talbot, Jessica; Bennett, Peter; Martin, Patricia; Makara, Mariano; Barrs, Vanessa R

    2014-10-01

    Disseminated scedosporiosis is rare in dogs and is usually reported in German Shepherds with suspected heritable immunodeficiency. This is the first report of disseminated scedosporiosis due to Scedosporium prolificans in a Labrador retriever dog that was receiving immunosuppressive drug therapy for treatment of immune-mediated haemolytic anaemia. Despite cessation of immunosuppressive medications and an initial response to aggressive treatment with voriconazole and terbinafine the dog developed progressive disease with neurological signs necessitating euthanasia six months from diagnosis. PMID:25473599

  11. Disseminated Scedosporium prolificans infection in a Labrador retriever with immune mediated haemolytic anaemia

    PubMed Central

    Taylor, Amanda; Talbot, Jessica; Bennett, Peter; Martin, Patricia; Makara, Mariano; Barrs, Vanessa R.

    2014-01-01

    Disseminated scedosporiosis is rare in dogs and is usually reported in German Shepherds with suspected heritable immunodeficiency. This is the first report of disseminated scedosporiosis due to Scedosporium prolificans in a Labrador retriever dog that was receiving immunosuppressive drug therapy for treatment of immune-mediated haemolytic anaemia. Despite cessation of immunosuppressive medications and an initial response to aggressive treatment with voriconazole and terbinafine the dog developed progressive disease with neurological signs necessitating euthanasia six months from diagnosis. PMID:25473599

  12. Disseminated intravascular coagulation after multiple honeybee stings.

    PubMed

    V, Dharma Rao; Bodepudi, Sravan Kumar; Krishna, Murali

    2014-01-01

    Honeybee venom contains apitoxin which can cause anaphylaxis, cardiovascular collapse and death. Disseminated intravascular coagulation is rare following honeybee stings. We describe the case of a farmer who developed this complication. PMID:25668084

  13. [Combined chemotherapy of disseminated skin melanoma].

    PubMed

    Dement'eva, N P; Voznyĭ, E K; Koroleva, L A

    1978-01-01

    The author's experience with nitrosomethylurea+prospidine treatment in 37 patients having disseminated melanoma is described. The mentioned scheme of the combination therapy is proved to be effective. PMID:741699

  14. Disseminated Trichosporonosis Caused by Trichosporon loubieri

    PubMed Central

    Marty, Francisco M.; Barouch, Dan H.; Coakley, Eoin P.; Baden, Lindsey R.

    2003-01-01

    Trichosporonosis is an emerging invasive fungal infection in immunosuppressed patients; a case of disseminated infection caused by Trichosporon loubieri presented confirms its role as a human pathogen. PMID:14605194

  15. Functional genomics identifies drivers of medulloblastoma dissemination.

    PubMed

    Mumert, Michael; Dubuc, Adrian; Wu, Xiaochong; Northcott, Paul A; Chin, Steven S; Pedone, Carolyn A; Taylor, Michael D; Fults, Daniel W

    2012-10-01

    Medulloblastomas are malignant brain tumors that arise in the cerebellum in children and disseminate via the cerebrospinal fluid to the leptomeningeal spaces of the brain and spinal cord. Challenged by the poor prognosis for patients with metastatic dissemination, pediatric oncologists have developed aggressive treatment protocols, combining surgery, craniospinal radiation, and high-dose chemotherapy, that often cause disabling neurotoxic effects in long-term survivors. Insights into the genetic control of medulloblastoma dissemination have come from transposon insertion mutagenesis studies. Mobilizing the Sleeping Beauty transposon in cerebellar neural progenitor cells caused widespread dissemination of typically nonmetastatic medulloblastomas in Patched(+/-) mice, in which Shh signaling is hyperactive. Candidate metastasis genes were identified by sequencing the insertion sites and then mapping these sequences back to the mouse genome. To determine whether genes located at transposon insertion sites directly caused medulloblastomas to disseminate, we overexpressed candidate genes in Nestin(+) neural progenitors in the cerebella of mice by retroviral transfer in combination with Shh. We show here that ectopic expression of Eras, Lhx1, Ccrk, and Akt shifted the in vivo growth characteristics of Shh-induced medulloblastomas from a localized pattern to a disseminated pattern in which tumor cells seeded the leptomeningeal spaces of the brain and spinal cord. PMID:22875024

  16. Source Authentication for Code Dissemination Supporting Dynamic Packet Size in Wireless Sensor Networks †

    PubMed Central

    Kim, Daehee; Kim, Dongwan; An, Sunshin

    2016-01-01

    Code dissemination in wireless sensor networks (WSNs) is a procedure for distributing a new code image over the air in order to update programs. Due to the fact that WSNs are mostly deployed in unattended and hostile environments, secure code dissemination ensuring authenticity and integrity is essential. Recent works on dynamic packet size control in WSNs allow enhancing the energy efficiency of code dissemination by dynamically changing the packet size on the basis of link quality. However, the authentication tokens attached by the base station become useless in the next hop where the packet size can vary according to the link quality of the next hop. In this paper, we propose three source authentication schemes for code dissemination supporting dynamic packet size. Compared to traditional source authentication schemes such as μTESLA and digital signatures, our schemes provide secure source authentication under the environment, where the packet size changes in each hop, with smaller energy consumption. PMID:27409616

  17. Source Authentication for Code Dissemination Supporting Dynamic Packet Size in Wireless Sensor Networks.

    PubMed

    Kim, Daehee; Kim, Dongwan; An, Sunshin

    2016-01-01

    Code dissemination in wireless sensor networks (WSNs) is a procedure for distributing a new code image over the air in order to update programs. Due to the fact that WSNs are mostly deployed in unattended and hostile environments, secure code dissemination ensuring authenticity and integrity is essential. Recent works on dynamic packet size control in WSNs allow enhancing the energy efficiency of code dissemination by dynamically changing the packet size on the basis of link quality. However, the authentication tokens attached by the base station become useless in the next hop where the packet size can vary according to the link quality of the next hop. In this paper, we propose three source authentication schemes for code dissemination supporting dynamic packet size. Compared to traditional source authentication schemes such as μTESLA and digital signatures, our schemes provide secure source authentication under the environment, where the packet size changes in each hop, with smaller energy consumption. PMID:27409616

  18. A Rare Sequela of Acute Disseminated Encephalomyelitis

    PubMed Central

    Kodadhala, Vijay; Kurukumbi, Mohankumar; Jayam-Trouth, Annapurni

    2014-01-01

    Acute disseminated encephalomyelitis is a demyelinating disease, typically occurring in children following a febrile infection or a vaccination. Primary and secondary immune responses contribute to inflammation and subsequent demyelination, but the exact pathogenesis is still unknown. Diagnosis of acute disseminated encephalomyelitis is strongly suggested by temporal relationship between an infection or an immunization and the onset of neurological symptoms. Biopsy is definitive. In general, the disease is self-limiting and the prognostic outcome is favorable with anti-inflammatory and immunosuppressive agents. Locked-in syndrome describes patients who are awake and conscious but have no means of producing limb, speech, or facial movements. Locked-in syndrome is a rare complication of acute disseminated encephalomyelitis. We present a case of incomplete locked-in syndrome occurring in a 34-year-old male secondary to acute disseminated encephalomyelitis. Our case is unique, as acute disseminated encephalomyelitis occurred in a 34-year-old which was poorly responsive to immunosuppression resulting in severe disability. PMID:24977089

  19. Precise time dissemination via portable atomic clocks

    NASA Technical Reports Server (NTRS)

    Putkovich, K.

    1982-01-01

    The most precise operational method of time dissemination over long distances presently available to the Precise Time and Time Interval (PTTI) community of users is by means of portable atomic clocks. The Global Positioning System (GPS), the latest system showing promise of replacing portable clocks for global PTTI dissemination, was evaluated. Although GPS has the technical capability of providing superior world-wide dissemination, the question of present cost and future accessibility may require a continued reliance on portable clocks for a number of years. For these reasons a study of portable clock operations as they are carried out today was made. The portable clock system that was utilized by the U.S. Naval Observatory (NAVOBSY) in the global synchronization of clocks over the past 17 years is described and the concepts on which it is based are explained. Some of its capabilities and limitations are also discussed.

  20. Public information, dissemination, and behavior analysis

    PubMed Central

    Morris, Edward K.

    1985-01-01

    Behavior analysts have become increasingly concerned about inaccuracies and misconceptions in the public, educational, and professional information portraying their activities, but have done little to correct these views. The present paper has two purposes in this regard. First, the paper describes some of the conditions that have given rise to these concerns. Second, and more important, the paper surveys various procedures and programs for the dissemination of public information that may correct inaccuracies and misconceptions. Special consideration is also given to issues involving (a) the assessment of the problem, (b) the content and means of dissemination, (c) the possible contributions of behavior analysts to current misunderstandings, and (d) relationships between behavior analysts and the media. The dissemination of accurate and unbiased information constitutes an important new undertaking for behavior analysis. The future of the field may depend in part on such activity. PMID:22478623

  1. Disseminated Kaposi's Sarcoma in an HIV-Positive Patient: A Rare Entity in an Indian Patient

    PubMed Central

    Behera, Biswanath; Chandrashekar, Laxmisha; Thappa, Devinder Mohan; Toi, Pampa Ch; Vinod, Kolar Vishwanath

    2016-01-01

    AIDS-associated disseminated Kaposi sarcoma (KS) is a rare entity, especially in India due to the low prevalence of human herpes virus-8 infections in Indian population. Due to its rapid and progressive nature, early diagnosis and institution of highly active antiretroviral therapy is crucial in AIDS-associated KS, with a view to achieving favorable prognosis. We report a case of disseminated KS in an HIV-1 positive patient, who presented with two months history of multiple violaceous patches and plaques over the trunk, bilateral upper limbs, lower limbs, and hard palate. The patient died of recurrent massive pleural effusion before starting antiretroviral therapy. This case is being reported due to the paucity of KS in the Indian literature, especially the disseminated type and to highlight its rapidly progressive course which can be fatal. PMID:27293276

  2. ADHD as Sequel to Acute Disseminated Encephalomyelitis.

    PubMed

    Millichap, J Gordon

    2016-02-01

    Investigators from Ruth Children's Hospital, Haifa, and Schneider Medical Center, Petah Tikuah, Israel, evaluated the long-term motor and neurocognitive outcome of 43 children hospitalized during 2002-2012 with acute disseminated encephalomyelitis (ADEM), and identified prognostic risk factors. PMID:27053911

  3. Building State Capacity in Dissemination: Literature Review.

    ERIC Educational Resources Information Center

    Strang, Ernest W.

    This review was developed by and principally for the National Testing Service (NTS) Dissemination Project Staff. It is one of eight activities being used by NTS to develop a design for an evaluation of the State Capacity Building Program. The review is in two parts. The first part provides background information, evaluation methodologies and…

  4. Computer software management, evaluation, and dissemination

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The activities of the Computer Software Management and Information Center involving the collection, processing, and distribution of software developed under the auspices of NASA and certain other federal agencies are reported. Program checkout and evaluation, inventory control, customer services and marketing, dissemination, program maintenance, and special development tasks are discussed.

  5. Disseminated granulomatous meningoencephalomyelitis in a dog.

    PubMed

    Fisher, Margaret

    2002-01-01

    A 6-year-old, intact, female miniature Doberman pinscher was evaluated for lethargy, intermittent back pain, and unstable gait. Physical and neurological findings included bradycardia, hypothermia, hyperesthesia, progressive and ascending ataxia, and proprioceptive deficits in all limbs. Laboratory findings and magnetic resonance imaging were consistent with disseminated granulomatous meningoencephalomyelitis, confirmed later by microscopy. PMID:11802671

  6. Factors that Influence Dissemination in Engineering Education

    ERIC Educational Resources Information Center

    Hazen, B. T.; Wu, Yun; Sankar, C. S.

    2012-01-01

    Although the need for new educational materials and methods in engineering education is increasing, the process of disseminating (making target groups become aware of, accept, and use) these innovations remains a challenge. A literature review shows that few studies have thoroughly investigated this area. The purpose of this article is to identify…

  7. Macrophages and the Viral Dissemination Super Highway

    PubMed Central

    Klepper, Arielle; Branch, Andrea D

    2016-01-01

    Monocytes and macrophages are key components of the innate immune system yet they are often the victims of attack by infectious agents. This review examines the significance of viral infection of macrophages. The central hypothesis is that macrophage tropism enhances viral dissemination and persistence, but these changes may come at the cost of reduced replication in cells other than macrophages. PMID:26949751

  8. Active Tools for Better Knowledge Dissemination.

    ERIC Educational Resources Information Center

    Mikulecky, Peter; Mikulecka, Jaroslava

    1999-01-01

    Suggests that a solution to the inadequacy and passivity problems with push and pull technologies could be in a combination of both, with an active component, adding more intelligence to the whole process of information and knowledge dissemination and supply. Describes basic principles of activity components in intelligent systems, and some…

  9. 14 CFR 1203.303 - Dissemination considerations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Section 1203.303 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY... of intended dissemination, use of the information and whether the end purpose to be served renders effective security control impractical are considerations during the classification process. These...

  10. Knowledge Management and Global Information Dissemination

    ERIC Educational Resources Information Center

    Umunadi, Ejiwoke Kennedy

    2014-01-01

    The paper looked at knowledge management and global information dissemination. Knowledge is a very powerful tool for survival, growth and development. It can be seen as the information, understanding and skills that you gain through education or experience. The paper was addressed under the following sub-headings: Knowledge management knowledge…

  11. Disseminated Enteroviral Infection Associated with Obinutuzumab

    PubMed Central

    Gilbertson, Michael; Korman, Tony M.; Golder, Vera; Morand, Eric; Opat, Stephen

    2015-01-01

    Two cases of disseminated enteroviral infection occurred in patients who received the CD20 monoclonal antibody obinutuzumab. Clinical features included hepatitis, edema, and a dermatomyositis-like syndrome. These manifestations may be unfamiliar to clinicians and are possibly responsive to intravenous immunoglobulin. Clinicians should remain vigilant for enteroviral infections in patients receiving obinutuzumab. PMID:26291712

  12. Groupware: Improving Group Communication and Information Dissemination.

    ERIC Educational Resources Information Center

    Saka, Thomas; Shiigi, Clyde

    1996-01-01

    Faced with increased public expectations and decreased funding, the Hawaii Department of Education chose Lotus Notes groupware technology as an efficient means to support statewide collaboration and information dissemination among 4,200 users in 231 schools. Although initially resistant, respondents to a year-end evaluation of the project in one…

  13. Disseminated Mycobacterium abscessus Infection Following Septic Arthritis

    PubMed Central

    Fukui, Shoichi; Sekiya, Noritaka; Takizawa, Yasunobu; Morioka, Hiroshi; Kato, Hirofumi; Aono, Akio; Chikamatsu, Kinuyo; Mitarai, Satoshi; Kobayashi, Satomi; Kamei, Satoshi; Setoguchi, Keigo

    2015-01-01

    Abstract Mycobacterium abscessus is a rapidly growing mycobacterium found mainly in patients with respiratory or cutaneous infections, but it rarely causes disseminated infections. Little is known about the clinical characteristics, treatment, and prognosis of disseminated M abscessus infection. A 75-year-old Japanese woman who had been treated for 17 years with a corticosteroid for antisynthetase syndrome with antithreonyl-tRNA synthetase antibody developed swelling of her right elbow. X-ray of her right elbow joint showed osteolysis, and magnetic resonance imaging revealed fluid in her right elbow joint. M abscessus grew in joint fluid and blood cultures. She was diagnosed with a disseminated M abscessus infection following septic arthritis. Antimicrobial treatment by clarithromycin, amikacin, and imipenem/cilastatin combined with surgical debridement was administered. Although blood and joint fluid cultures became negative 1 week later, the patient died at 6 weeks from starting antimicrobial treatment. We reviewed 34 cases of disseminated M abscessus infections from the literature. Most of the patients had immunosuppressive backgrounds such as transplantation, use of immunosuppressive agents, hematological malignancy, and end stage renal disease. The duration from onset of symptoms to diagnosis was over 3 months in half of the cases. All fatal cases had positive blood cultures or use of immunosuppressive agents. Clinicians should bear in mind that mycobacterial infections including M abscessus are one of the differential diagnoses in patients with subacute arthritis and soft tissue infections. PMID:26020393

  14. A Proposed Framework for Educational Innovation Dissemination

    ERIC Educational Resources Information Center

    Hazen, Benjamin T.; Wu, Yun; Sankar, Chetan S.; Jones-Farmer, L. Allison

    2012-01-01

    Although the need for new educational technologies is increasing, the process for disseminating these innovations remains a challenge. A literature review shows that few studies have thoroughly investigated this area. Furthermore, there is no comprehensive framework or coordinated research agenda that may be used to guide such investigation. This…

  15. CHRONIC DISSEMINATED HISTOPLASMOSIS WITH PROLONGED LATENCY

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A case of chronic disseminated histoplasmosis in an ex-serviceman is described. Evidence is presented to support a latency period of over sixty years between acquisition of infection and clinical manifestation. This is the longest latency period for histoplasmosis described in the medical literature...

  16. Disseminated cutaneous histoplasmosis in newly diagnosed HIV.

    PubMed

    Soza, Gabriela M; Patel, Mahir; Readinger, Allison; Ryan, Caitriona

    2016-01-01

    We present a woman with a widespread severe papulopustular eruption, fever, and fatigue of 5 weeks' duration. HIV infection was diagnosed, with an absolute CD4(+) count of 3 cells/µL. The eruption was consistent with disseminated cutaneous histoplasmosis. The clinical manifestations and management of cutaneous histoplasmosis are reviewed. PMID:26722169

  17. Disseminated cutaneous histoplasmosis in newly diagnosed HIV

    PubMed Central

    Soza, Gabriela M.; Patel, Mahir; Readinger, Allison

    2016-01-01

    We present a woman with a widespread severe papulopustular eruption, fever, and fatigue of 5 weeks' duration. HIV infection was diagnosed, with an absolute CD4+ count of 3 cells/µL. The eruption was consistent with disseminated cutaneous histoplasmosis. The clinical manifestations and management of cutaneous histoplasmosis are reviewed. PMID:26722169

  18. A Primer on Disseminating Applied Quantitative Research

    ERIC Educational Resources Information Center

    Bell, Bethany A.; DiStefano, Christine; Morgan, Grant B.

    2010-01-01

    Transparency and replication are essential features of scientific inquiry, yet scientific communications of applied quantitative research are often lacking in much-needed procedural information. In an effort to promote researchers dissemination of their quantitative studies in a cohesive, detailed, and informative manner, the authors delineate…

  19. Information, Vol. 1, Number 4. Teacher Corps Dissemination Project Bulletin.

    ERIC Educational Resources Information Center

    Rosenau, Fred S., Ed.

    Guidelines are provided for disseminating information on teacher corps projects. Information is given on experienced disseminators such as existing networks that are available to help in planning. Suggestions are made on targeting information and marketing. (JD)

  20. Brain Abscesses Caused by Nocardia paucivorans in a Multiple Myeloma Patient Treated with Lenalidomide and Dexamethasone: a Case Report and Review of Literature.

    PubMed

    Monticelli, Jacopo; Luzzati, Roberto; Maurel, Cristina; Rosin, Chiara; Valentinotti, Romina; Farina, Claudio

    2015-01-01

    We report the first case of multiple brain abscesses caused by Nocardia paucivorans in a patient suffering from multiple myeloma on treatment with lenalidomide and dexamethasone. N. paucivorans is a recently described species of the genus Nocardia, which is supposed to have a heightened neurotropism in cases of disseminated infection. Although nocardiosis itself is an uncommon infectious complication in multiple myeloma so far, nocardial brain abscess should be added to the spectrum of adverse effects due to this novel chemotherapy regimen. PMID:25574370

  1. Dissemination to research subjects: operationalizing investigator accountability.

    PubMed

    Zlotnik Shaul, Randi; Reid, Lynette; Essue, Beverley; Gibson, Julie; Marzinotto, Velma; Daneman, Denis

    2005-01-01

    Recent articles have argued from principles of bioethics for the right of research subjects to receive the results of the studies in which they have participated. We argue that accountability is a powerful tool of meso-level analysis appropriate to reasoning about answerability in research ethics, and that it captures the responsibility of researchers to disseminate study results to research subjects. We offer the following features of the research situation as relevant to the manner of dissemination to study subject, in addition to factors already proposed in the literature (risk and impact on health outcome): (a) features of the research subject in relation to identity, personal investment, disease, and community; (b) characteristics of the research study and field of inquiry in relation to certainty and significance; and (c) relationships among the research subjects and the healthcare workers involved in their care and in the research. PMID:16021788

  2. Disseminated Intravascular Coagulation Induced with Leukocyte Procoagulant

    PubMed Central

    Kociba, Gary J.; Griesemer, Richard A.

    1972-01-01

    The procoagulant activity of rabbit peritoneal leukocytes significantly increased when the leukocytes were incubated in suspension cultures at 37 C for 24 hours. Intravenous infusions of Iysates of 232 × 106 rabbit leukocytes which had been incubated in cultures at 37 C for 24 hours produced disseminated intravascular coagulation and vasculitis involving the pulmonary arteries in normal rabbits. Intraaortic infusions of lysates of 230 × 106 similarly incubated leukocytes produced renal thrombosis and renal cortical necrosis in normal rabbits. These observations suggest that the procoagulant of granulocytic leukocytes could play a role in the generalized Shwartzman reaction and other syndromes of disseminated intravascular coagulation. ImagesFig 3Fig 4Fig 5Fig 6Fig 7Fig 1Fig 2 PMID:5086898

  3. Multifocal brain radionecrosis masquerading as tumor dissemination

    SciTech Connect

    Safdari, H.; Boluix, B.; Gros, C.

    1984-01-01

    The authors report on an autopsy-proven case of multifocal widespread radionecrosis involving both cerebral hemispheres and masquerading as tumor dissemination on a CT scan done 13 months after complete resection of an oligodendroglioma followed by radiation therapy. This case demonstrates that radiation damage may be present in a CT scan as a multifocal, disseminated lesion. Since the survival of brain-tumor patients who have undergone radiation therapy is prolonged by aggressive therapy, the incidence and variability of radiation-induced complications in such cases is likely to increase. For similar reasons, the radionecrosis in such cases should be taken into consideration. A short review of the CT scan findings and diagnostic and therapeutic considerations in a case of widespread radionecrosis is presented. The need for appropriate diagnosis and subsequent life-saving management is emphasized.

  4. Time dissemination in the Hydro Quebec network

    NASA Technical Reports Server (NTRS)

    Missout, G.; Lefrancois, W.; Laroche, L.

    1979-01-01

    The ever increasing complexity of electrical networks combined with the increasing cost of power losses during a network failure has led public utilities to become equipped with more powerful and precise tools for pinpointing the causes of such a fault. Hydro Quebec has developed and is now using a time dissemination system which uses a modified IRIG B code transmitted on its own telecommunication network. The reasons for using such a system and the way it was carried out are discrete.

  5. [Treatment of disseminated granuloma annulare with anthralin].

    PubMed

    Jantke, M E; Bertsch, H-P; Schön, M P; Fuchs, T

    2011-12-01

    Granuloma annulare is a benign, often asymptomatic and self-limiting granulomatous skin disease. In cases of disseminated granuloma annulare, spontaneous regression is considerably less frequent than in localized forms so that therapy is often desired. Systemic treatments should always be assessed critically and reserved for patients who are severely affected and in whom treatment approaches with few side effects such as local application of anthralin do not suffice to achieve a satisfactory effect. PMID:21656108

  6. Computational scalability of large size image dissemination

    NASA Astrophysics Data System (ADS)

    Kooper, Rob; Bajcsy, Peter

    2011-01-01

    We have investigated the computational scalability of image pyramid building needed for dissemination of very large image data. The sources of large images include high resolution microscopes and telescopes, remote sensing and airborne imaging, and high resolution scanners. The term 'large' is understood from a user perspective which means either larger than a display size or larger than a memory/disk to hold the image data. The application drivers for our work are digitization projects such as the Lincoln Papers project (each image scan is about 100-150MB or about 5000x8000 pixels with the total number to be around 200,000) and the UIUC library scanning project for historical maps from 17th and 18th century (smaller number but larger images). The goal of our work is understand computational scalability of the web-based dissemination using image pyramids for these large image scans, as well as the preservation aspects of the data. We report our computational benchmarks for (a) building image pyramids to be disseminated using the Microsoft Seadragon library, (b) a computation execution approach using hyper-threading to generate image pyramids and to utilize the underlying hardware, and (c) an image pyramid preservation approach using various hard drive configurations of Redundant Array of Independent Disks (RAID) drives for input/output operations. The benchmarks are obtained with a map (334.61 MB, JPEG format, 17591x15014 pixels). The discussion combines the speed and preservation objectives.

  7. [Cancer cell plasticity and metastatic dissemination].

    PubMed

    Moyret-Lalle, Caroline; Pommier, Roxane; Bouard, Charlotte; Nouri, Ebticem; Richard, Geoffrey; Puisieux, Alain

    Metastatic dissemination consists of a sequence of events resulting in the invasion by cancer cells of tissues located away from the primary tumour. This process is highly inefficient, since each event represents an obstacle that only a limited number of cells can overcome. However, two biological phenomena intrinsically linked with tumour development facilitate the dissemination of cancer cells throughout the body and promote the formation of metastases, namely the genetic diversity of cancer cells within a given tumour, which arises from their genetic instability and from successive clonal expansions, and cellular plasticity conveyed to the cells by micro-environmental signals. Genetic diversity increases the probability of selecting cells that are intrinsically resistant to biological and physical constraints encountered during metastatic dissemination, whereas cellular plasticity provides cells with the capacity to adapt to stressful conditions and to changes in the microenvironment. The epithelial-mesenchymal transition, an embryonic trans-differentiation process frequently reactivated during tumour development, plays an important role in that context by endowing tumor cells with a unique capacity of motility, survival and adaptability to the novel environments and stresses encountered during the invasion-metastasis cascade. PMID:27615180

  8. 10 CFR 470.20 - Dissemination of information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Dissemination of information. 470.20 Section 470.20 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION APPROPRIATE TECHNOLOGY SMALL GRANTS PROGRAM § 470.20 Dissemination of information. DOE shall disseminate to the public, in an appropriate manner, information of...

  9. State Dissemination Planning as Part of Program Improvement.

    ERIC Educational Resources Information Center

    Wall, James E.

    Knowing and understanding the principles and tenets underlying dissemination, utilization, and impact collection facilitate the "how." Dissemination is a communication process involving interactional relationships among individuals. Involvement of multiple agencies gives rise to networking. Disseminating is also a major facet of planned change,…

  10. 48 CFR 5.101 - Methods of disseminating information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Methods of disseminating... ACQUISITION PLANNING PUBLICIZING CONTRACT ACTIONS Dissemination of Information 5.101 Methods of disseminating... various methods of satisfying the requirements of 5.207(c). For example, the contracting officer may...

  11. 40 CFR 56.6 - Dissemination of policy and guidance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Dissemination of policy and guidance... (CONTINUED) REGIONAL CONSISTENCY § 56.6 Dissemination of policy and guidance. The Assistant Administrators of... to disseminate policy and guidance. They shall distribute material under foregoing systems to...

  12. Dissemination of Information in Developing Countries: The Personal Computer and beyond

    ERIC Educational Resources Information Center

    Wong, Wai-Man

    2005-01-01

    With the blooming of information in digital format, dissemination of information is becoming a big challenge for developing countries. It is not only due to the limited provision of personal computers--in addition, the technological infrastructure and the ability to access information are also becoming major concerns in developing countries. This…

  13. [Disseminated BCG disease revealing a partial deficiency in receptor 1 interferon gamma].

    PubMed

    Antonietti, J; Retornaz, K; Bernasconi, A; Laporte, R-J; Minodier, P; Bustamante, J-C; Dubus, J-C

    2015-09-01

    We report on a case of disseminated BCGitis with an unusual presentation in a 4-month-old infant revealing a syndrome of Mendelian susceptibility to mycobacteria due to a partial dominant mutation of the interferon gamma receptor 1 gene. PMID:26251056

  14. Summary - National Dissemination and the Five Target States, Part 3, Final Report for Phase II--Dissemination, Rural Shared Services.

    ERIC Educational Resources Information Center

    Northern Montana Coll., Havre.

    The dissemination phase (Phase II) of the Rural Shared Services Project is reported in this document. Efforts of the dissemination phase were concentrated in 5 target states: Vermont, Georgia, Wyoming, Montana, and New Mexico; national dissemination was limited to attendance at national conferences, the U. S. Office of Education PREP materials for…

  15. A framework for disseminating evidence-based health promotion practices.

    PubMed

    Harris, Jeffrey R; Cheadle, Allen; Hannon, Peggy A; Forehand, Mark; Lichiello, Patricia; Mahoney, Eustacia; Snyder, Susan; Yarrow, Judith

    2012-01-01

    Wider adoption of evidence-based, health promotion practices depends on developing and testing effective dissemination approaches. To assist in developing these approaches, we created a practical framework drawn from the literature on dissemination and our experiences disseminating evidence-based practices. The main elements of our framework are 1) a close partnership between researchers and a disseminating organization that takes ownership of the dissemination process and 2) use of social marketing principles to work closely with potential user organizations. We present 2 examples illustrating the framework: EnhanceFitness, for physical activity among older adults, and American Cancer Society Workplace Solutions, for chronic disease prevention among workers. We also discuss 7 practical roles that researchers play in dissemination and related research: sorting through the evidence, conducting formative research, assessing readiness of user organizations, balancing fidelity and reinvention, monitoring and evaluating, influencing the outer context, and testing dissemination approaches. PMID:22172189

  16. The future of time and frequency dissemination

    NASA Technical Reports Server (NTRS)

    Levine, Judah

    1994-01-01

    I will try to extrapolate the changes in the dissemination of time and frequency information that have taken place during the last 25 years to predict the future developments both in the methods of disseminating time and frequency and in the kinds of customers we will be asked to serve. Two important developments are likely to play pivotal roles in driving the evolution of dissemination. The first is the commercial availability of very high quality clocks -- devices whose performance may eventually rival that of the current generation of primary frequency standards. The widespread use of these devices may blur the traditional distinction between client and server, and may replace it with a more symmetrical interchange of data among peers. The second is the increasing demand for digital time and frequency information driven by the increasing sophistication of everything from traffic lights to electric power meters. The needs of these individual users may not tax the state of the art of primary frequency standards in principle, but their large numbers and wide geographical distribution present a technological challenge that is difficult to meet at a reasonable price using existing methods. Some of these problems may be solved (or at least addressed) using developments in communications and consumer electronics such as the increasing use of fiber-optic telephone circuits and the increasing bandwidth and sophistication of the cable network used to transmit television pictures. To be useful, these advances in hardware must stimulate parallel advances in software algorithms and methods. These advances are more difficult to predict with great confidence, but the developments of the last few years will be examined to provide some indications of the future.

  17. Disseminated Pleural Siliconoma Mimicking Malignant Pleural Mesothelioma.

    PubMed

    Tanaka, Toshiki; Tao, Hiroyuki; Hayashi, Tatsuro; Yoshiyama, Koichi; Furukawa, Masashi; Yoshida, Kumiko; Okabe, Kazunori

    2015-12-01

    A 48-year-old woman with a 3-month history of back pain was admitted for further examination of multiple left pleural nodules. She had undergone bilateral breast augmentation with silicone implants 10 years previously. Nine years after the operation, both ruptured implants were removed, and autologous fat was injected. Computed tomography revealed multiple pleural nodules suggestive of malignant pleural mesothelioma. Thoracoscopic exploration revealed multiple pleural nodules with massive pleural adhesions. The nodules were filled with viscous liquid and were histologically determined to be siliconomas. Disseminated pleural siliconoma should be recognized as a late adverse event of silicone breast implantation. PMID:26652527

  18. EUMETCast: The Meteorological Data Dissemination Service

    NASA Astrophysics Data System (ADS)

    Gaertner, V. K.; Koenig, M.

    2006-05-01

    EUMETCast is EUMETSAT's broadcast system for environmental data. It utilises telecommunications satellites and the services of telecommunication providers to distribute data files using Digital Video Broadcast (DVB) standards to a wide audience located within the combined geographical coverage zones of the individual telecommunication satellites used to transmit the data. The telecommunication zones are now covering Europe, Africa, South America and parts of Asia and North America. This service has been established to provide the meteorological communities with satellite data and other meteorological products in near real-time for operational, but also research, education and training purposes. The following EUMETSAT services are currently available via EUMETCast: - Second Generation Meteosat - High Rate SEVIRI Image Data (every 15 minutes) - First Generation Meteosat - Indian Ocean Data Coverage (IODC) (every 30 minutes) - Other Geostationary Data from NOAA (GOES E/W) and JMA (MTSAT), (every 3 hours) - Data Collection and Retransmission (DCP) and Meteorological Data Dissemination (MDD) - Basic Meteorological Data (BMD) (Ku-band Europe only) - Meteorological Products (including some Satellite Application Facility products) - EUMETSAT Advanced Retransmission Service (EARS) (Ku-band Europe only) - DWDSAT (Ku-band Europe only) - VEGETATION data (C-band Africa only) Progressively during 2006 users will find an increasing amount of polar satellite data and products available on EUMETCast. As part of the extension of the EUMETCast Advanced Retransmission Service (EARS), ERS scatterometer data and NOAA satellite AVHRR data have already been introduced in early 2006. The ERS- SCAT demonstration service is a forerunner for the future pilot EARS-ASCAT service and the pilot EARS- AVHRR service will continue to expand during 2006 with the inclusion of data from additional AVHRR stations in the EARS network. The EUMETCast System will be also be used to provide dissemination of

  19. Risk of CNS dissemination in extranodal lymphomas.

    PubMed

    Ferreri, Andrés J M

    2014-04-01

    Extranodal lymphomas constitute a heterogeneous group of malignancies, accounting for roughly 60% of all non-Hodgkin lymphomas. The extranodal organ where lymphomas arise is an important determining factor of biological, molecular, and aetio-pathogenic features, and of presentation, dissemination pattern, and outcome. An increased risk of CNS involvement, an uncommon but lethal event, has been suggested in some extranodal lymphomas, but the absolute risk is still debatable for most of these malignancies. This debate is because of the presence of selection biases and other confounding factors in related literature, which inevitably has led to conflicting recommendations. The identification of extranodal lymphomas at increased risk of CNS dissemination is an important unmet clinical need; affected patients could benefit from early CNS assessment by neuroimaging and cerebrospinal fluid analysis and adequate CNS prophylaxis, avoiding unnecessary prophylaxis and related toxicity in low-risk patients. This Review discusses relevant confounding factors and identifies high-risk extranodal lymphomas analysing histopathological category, involved organ, and other specific risk factors, which could be helpful for result interpretation and patient stratification in future clinical trials. Finally, a recommendation is provided for CNS-directed management of high-risk extranodal lymphoma patients in daily practice. PMID:24694639

  20. [Introduction of Chemotherapy for Advanced Gastric Cancer Showing Oncologic Emergency Caused by Peritoneal Dissemination--Report of Tow Cases].

    PubMed

    Fujiwara, Yoshiyuki; Omori, Takeshi; Sugimura, Keijiro; Miyata, Hiroshi; Miyoshi, Norikatsu; Akita, Hirofumi; Gotoh, Kunihito; Takahashi, Hidenori; Kobayashi, Shogo; Noura, Shingo; Ohue, Masayuki; Sakon, Masato; Yano, Masahiko

    2015-11-01

    Here, we report 2 patients with gastric cancer and peritoneal dissemination who were successfully treated with chemotherapy after undergoing treatment for an oncologic emergency caused by peritoneal dissemination. Case 1 involved obstruction of the sigmoid colon caused by peritoneal dissemination. After urgent colostomy, S-1/IP IV paclitaxel chemotherapy was introduced. The patient continued the therapy for 2 years and 2 months. Case 2 involved acute renal failure due to bilateral ureter obstruction and obstructive jaundice caused by peritoneal dissemination. This patient underwent emergency treatment consisting of Double-J ureteral stent insertion and endoscopic nasobiliary drainage. He was successfully started on chemotherapy with S-1/oxaliplatin/IP paclitaxel. He continued the therapy for 8 months without symptoms. Aggressive treatment might be effective for advanced gastric cancer showing oncologic emergency. PMID:26805263

  1. Hydrogen Technical Analysis -- Dissemination of Information

    SciTech Connect

    George Kervitsky, Jr.

    2006-03-20

    SENTECH is a small energy and environmental consulting firm providing technical, analytical, and communications solutions to technology management issues. The activities proposed by SENTECH focused on gathering and developing communications materials and information, and various dissemination activities to present the benefits of hydrogen energy to a broad audience while at the same time establishing permanent communications channels to enable continued two-way dialog with these audiences in future years. Effective communications and information dissemination is critical to the acceptance of new technology. Hydrogen technologies face the additional challenge of safety preconceptions formed primarily as a result of the crash of the Hindenburg. Effective communications play a key role in all aspects of human interaction, and will help to overcome the perceptual barriers, whether of safety, economics, or benefits. As originally proposed SENTECH identified three distinct information dissemination activities to address three distinct but important audiences; these formed the basis for the task structure used in phases 1 and 2. The tasks were: (1) Print information--Brochures that target the certain segment of the population and will be distributed via relevant technical conferences and traditional distribution channels. (2) Face-to-face meetings--With industries identified to have a stake in hydrogen energy. The three industry audiences are architect/engineering firms, renewable energy firms, and energy companies that have not made a commitment to hydrogen (3) Educational Forums--The final audience is students--the future engineers, technicians, and energy consumers. SENTECH will expand on its previous educational work in this area. The communications activities proposed by SENTECH and completed as a result of this cooperative agreement was designed to compliment the research and development work funded by the DOE by presenting the technical achievements and validations

  2. Information Dissemination of Public Health Emergency on Social Networks and Intelligent Computation.

    PubMed

    Hu, Hongzhi; Mao, Huajuan; Hu, Xiaohua; Hu, Feng; Sun, Xuemin; Jing, Zaiping; Duan, Yunsuo

    2015-01-01

    Due to the extensive social influence, public health emergency has attracted great attention in today's society. The booming social network is becoming a main information dissemination platform of those events and caused high concerns in emergency management, among which a good prediction of information dissemination in social networks is necessary for estimating the event's social impacts and making a proper strategy. However, information dissemination is largely affected by complex interactive activities and group behaviors in social network; the existing methods and models are limited to achieve a satisfactory prediction result due to the open changeable social connections and uncertain information processing behaviors. ACP (artificial societies, computational experiments, and parallel execution) provides an effective way to simulate the real situation. In order to obtain better information dissemination prediction in social networks, this paper proposes an intelligent computation method under the framework of TDF (Theory-Data-Feedback) based on ACP simulation system which was successfully applied to the analysis of A (H1N1) Flu emergency. PMID:26609303

  3. Information Dissemination of Public Health Emergency on Social Networks and Intelligent Computation

    PubMed Central

    Hu, Hongzhi; Mao, Huajuan; Hu, Xiaohua; Hu, Feng; Sun, Xuemin; Jing, Zaiping; Duan, Yunsuo

    2015-01-01

    Due to the extensive social influence, public health emergency has attracted great attention in today's society. The booming social network is becoming a main information dissemination platform of those events and caused high concerns in emergency management, among which a good prediction of information dissemination in social networks is necessary for estimating the event's social impacts and making a proper strategy. However, information dissemination is largely affected by complex interactive activities and group behaviors in social network; the existing methods and models are limited to achieve a satisfactory prediction result due to the open changeable social connections and uncertain information processing behaviors. ACP (artificial societies, computational experiments, and parallel execution) provides an effective way to simulate the real situation. In order to obtain better information dissemination prediction in social networks, this paper proposes an intelligent computation method under the framework of TDF (Theory-Data-Feedback) based on ACP simulation system which was successfully applied to the analysis of A (H1N1) Flu emergency. PMID:26609303

  4. Detection of disseminated peritoneal tumors by fluorescein diacrylate in mice

    NASA Astrophysics Data System (ADS)

    Harada, Yoshinori; Furuta, Hirokazu; Murayama, Yasutoshi; Dai, Ping; Fujikawa, Yuta; Urano, Yasuteru; Nagano, Tetsuo; Morishita, Koki; Hasegawa, Akira; Takamatsu, Tetsuro

    2009-02-01

    Tumor invasion to the peritoneum is a poor prognostic factor in cancer patients. Accurate diagnosis of disseminated peritoneal tumors is essential to accurate cancer staging. To date, peritoneal washing cytology during laparotomy has been used for diagnosis of peritoneal dissemination of gastrointestinal cancer, but its sensitivity has not been satisfactory. Thus, a more direct approach is indispensable to detect peritoneal dissemination in vivo. Fluorescein diacrylate (FDAcr) is an esterase-sensitive fluorescent probe derived from fluorescein. In cancer cells, fluorescent fluorescein generated by exogenous application of FDAcr selectively deposits owing to its stronger hydrolytic enzyme activity and its lower leakage rate. We examined whether FDAcr can specifically detect disseminated peritoneal tumors in athymic nude mouse models. Intraperitoneally administered FDAcr revealed disseminated peritoneal microscopic tumors not readily recognized on white-light imaging. These results suggest that FDAcr is a useful probe for detecting disseminated peritoneal tumors.

  5. Cancer Metastases: Early Dissemination and Late Recurrences

    PubMed Central

    Friberg, Sten; Nyström, Andreas

    2015-01-01

    BACKGROUND Metastatic cells from a primary tumor can occur before the primary cancer is detected. Metastatic cells can also remain in the patient for many years after removal of the primary tumor without proliferating. These dormant malignant cells can awaken and cause recurrent disease decades after the primary treatment. The purpose of this article is to review the clinical evidence for early dissemination and late recurrences in human malignant tumors. We used the following definitions: dormancy of cells may be defined as a nonproliferating state or an arrest in the cell cycle that results in a prolonged G0 phase. If one accepts the term “late metastases” to indicate a period exceeding 10 years from the removal of the primary tumor, then the two malignancies in which this occurs most frequently are cutaneous malignant melanoma (CMM) and renal cell carcinoma (RCC). METHODS PubMed, Web of Science, and Scopus were searched with the keywords “metastases,” “early dissemination,” “late recurrences,” “inadvertently transmitted cancer,” “tumor growth rate,” “dormancy,” “circulating tumor cells,” and “transplantation of cancer.” RESULTS Several case reports of early dissemination and late recurrences of various types of malignancies were found. Analyses of the growth rates of several malignant tumors in the original host indicated that the majority of cancers had metastasized years before they were detected. CMM, RCC, and malignant glioblastoma were the three most common malignancies resulting from an organ transplantation. CMM and RCC were also the two most common malignancies that showed dormancy. In several cases of transplanted CMM and RCC, the donor did not have any known malignancy or had had the malignancy removed so long ago that the donor was regarded as cured. CONCLUSION (1) Metastases can frequently exist prior to the detection of the primary tumor. (2) Metastatic cells may reside in organs in the original host that are not

  6. Disseminated visceral coccidiosis in sandhill cranes

    USGS Publications Warehouse

    Carpenter, J.W.; Novilla, M.N.; Fayer, R.; Iverson, G.C.

    1984-01-01

    Disseminated visceral coccidiosis (DVC) caused by Eimeria spp was first recognized as a disease entity in captive sandhill cranes (Grus canadensis) and whooping cranes (G americana) at the Patuxent Wildlife Research Center. Because cranes produced at the Center are reintroduced to the wild to augment wild populations, studies involving both experimentally induced and natural infections were initiated to determine the potential or actual occurrence of DVC in wild Gruidae. Nine sandhill cranes dosed orally with eimerian oocysts of wild origin developed lesions characteristic of DVC. Extraintestinal granulomas associated with developing schizonts were found in 6 birds. Similar lesions were observed in wild sandhill cranes throughout parts of midwestern United States, Alaska, and Saskatchewan. These studies revealed the wide geographic distribution and the high frequency of occurrence of DVC in wild cranes.

  7. Neuroborreliosis presenting as acute disseminated encephalomyelitis.

    PubMed

    Rocha, Ruben; Lisboa, Lurdes; Neves, João; García López, Milagros; Santos, Elsa; Ribeiro, Augusto

    2012-12-01

    We report a case of a 5-year-old boy with acute disseminated encephalomyelitis as the initial presentation of neuroborreliosis. Parents report an upper-airway infection a few days before the development of acute encephalopathy, mild facial palsy, and seizures. The patient needed mechanical ventilation for 10 days, and after extubation, he presented hypotonia, ataxia, dysarthria, as well as weak gag and cough reflexes. Brain magnetic resonance imaging showed hyperintense lesions on T2- and fluid-attenuated inversion recovery sequences on the right subcortical occipital and parietal region, left posterior arm of the internal capsule, and in the medulla oblongata. Borrelia burgdorferi was identified in the plasma and cerebrospinal fluid by polymerase chain reaction and in the plasma by Western blotting. He was treated with ceftriaxone, methylprednisolone, and human immunoglobulin. Recovery was partial. PMID:23222106

  8. Multilocular Disseminated Tarlov Cysts: Importance of Imaging

    PubMed Central

    Padma, Subramanyam; Sundaram, P. Shanmuga

    2014-01-01

    With technological advancements and wider availability of multimodality imaging, incidental lesions are frequently identified in patients undergoing various imaging studies. We report here a case of multiloculated disseminated perineural or Tarlov cysts (TCs). The primary aim of our study was to (1) provide a comprehensive review of the clinical, imaging and histopathological features of TCs (2) to draw attention to the fact that multiple lumbo-sacral and dorsal TCs can produce nerve injuries and serious movement disturbances (3) to document the usefulness of the magnetic resonance imaging (MRI) and bone scan in noninvasive diagnosis and guiding management in such cases. These cysts are clearly identified by MR and computerized tomography imaging of the lumbosacral spine. However, there are no reports on the scintigraphic findings of TCs in literature. TCs are typically benign, asymptomatic lesions that can simply be monitored. Until date, no consensus exists about the best surgical strategy to be followed for their management. PMID:25191117

  9. Multilocular disseminated tarlov cysts: importance of imaging.

    PubMed

    Padma, Subramanyam; Sundaram, P Shanmuga

    2014-01-01

    With technological advancements and wider availability of multimodality imaging, incidental lesions are frequently identified in patients undergoing various imaging studies. We report here a case of multiloculated disseminated perineural or Tarlov cysts (TCs). The primary aim of our study was to (1) provide a comprehensive review of the clinical, imaging and histopathological features of TCs (2) to draw attention to the fact that multiple lumbo-sacral and dorsal TCs can produce nerve injuries and serious movement disturbances (3) to document the usefulness of the magnetic resonance imaging (MRI) and bone scan in noninvasive diagnosis and guiding management in such cases. These cysts are clearly identified by MR and computerized tomography imaging of the lumbosacral spine. However, there are no reports on the scintigraphic findings of TCs in literature. TCs are typically benign, asymptomatic lesions that can simply be monitored. Until date, no consensus exists about the best surgical strategy to be followed for their management. PMID:25191117

  10. Quinine-Induced Disseminated Intravascular Coagulation

    PubMed Central

    2016-01-01

    Every drug comes with some side effect. It is the benefit/risk ratio that determines the medical use of the drug. Quinine, a known antimalarial drug, has been used for nocturnal leg cramps since the 1930s; it is associated with severe life-threatening hematological and cardiovascular side effects. Disseminated intravascular coagulation (DIC), albeit rare, is a known coagulopathy associated with Quinine. It is imperative to inquire about the Quinine intake in medication history in patients with coagulopathy, as most patients still consider it a harmless home remedy for nocturnal leg cramps. In this report, we present a case of coagulopathy in a middle-aged woman, who gave a history of taking Quinine for nocturnal leg cramps, as her home remedy. Early identification of the offending agent led to the diagnosis, prompt discontinuation of the medication, and complete recovery and prevented the future possibility of recurrence. PMID:27293443

  11. Subcapsular sinus macrophages limit acute gammaherpesvirus dissemination

    PubMed Central

    Frederico, Bruno; Chao, Brittany; Lawler, Clara; May, Janet S.

    2015-01-01

    Lymphocyte proliferation, mobility and longevity make them prime targets for virus infection. Myeloid cells that process and present environmental antigens to lymphocytes are consequently an important line of defence. Subcapsular sinus macrophages (SSMs) filter the afferent lymph and communicate with B-cells. How they interact with B-cell-tropic viruses is unknown. We analysed their encounter with murid herpesvirus-4 (MuHV-4), an experimentally accessible gammaherpesvirus related to Kaposi's sarcoma-associated herpesvirus. MuHV-4 disseminated via lymph nodes, and intranasally or subcutaneously inoculated virions readily infected SSMs. However, this infection was poorly productive. SSM depletion with clodronate-loaded liposomes or with diphtheria toxin in CD169–diphtheria toxin receptor transgenic mice increased B-cell infection and hastened virus spread to the spleen. Dendritic cells provided the main route to B-cells, and SSMs slowed host colonization, apparently by absorbing virions non-productively from the afferent lymph. PMID:25872742

  12. Quinine-Induced Disseminated Intravascular Coagulation.

    PubMed

    Abed, Firas; Baniya, Ramkaji; Bachuwa, Ghassan

    2016-01-01

    Every drug comes with some side effect. It is the benefit/risk ratio that determines the medical use of the drug. Quinine, a known antimalarial drug, has been used for nocturnal leg cramps since the 1930s; it is associated with severe life-threatening hematological and cardiovascular side effects. Disseminated intravascular coagulation (DIC), albeit rare, is a known coagulopathy associated with Quinine. It is imperative to inquire about the Quinine intake in medication history in patients with coagulopathy, as most patients still consider it a harmless home remedy for nocturnal leg cramps. In this report, we present a case of coagulopathy in a middle-aged woman, who gave a history of taking Quinine for nocturnal leg cramps, as her home remedy. Early identification of the offending agent led to the diagnosis, prompt discontinuation of the medication, and complete recovery and prevented the future possibility of recurrence. PMID:27293443

  13. Disseminated gonococcal infection: an unusual presentation.

    PubMed

    Lohani, Saroj; Nazir, Salik; Tachamo, Niranjan; Patel, Nitin

    2016-01-01

    Gonococcus typically affects the mucosal surfaces but in rare cases can spread to bloodstream causing disseminated gonococcal infection (DGI). The usual presentation of DGI is rash, polyarthralgia, and tenosynovitis. We present the case of a 23-year-old female who presented to our hospital with pustular rash and tenosynovitis of hand and was sent home on Augmentin. Her symptoms worsened despite treatment and she presented back to the ED. On investigation, she was found to have DGI and was appropriately treated. DGI should be kept in mind in sexually active youngsters who have only one or two features of the classic triad of rash, tenosynovitis, and arthritis. Timely management and appropriate treatment of DGI is very important to avoid complications and morbidity. PMID:27406461

  14. Disseminated gonococcal infection: an unusual presentation

    PubMed Central

    Lohani, Saroj; Nazir, Salik; Tachamo, Niranjan; Patel, Nitin

    2016-01-01

    Gonococcus typically affects the mucosal surfaces but in rare cases can spread to bloodstream causing disseminated gonococcal infection (DGI). The usual presentation of DGI is rash, polyarthralgia, and tenosynovitis. We present the case of a 23-year-old female who presented to our hospital with pustular rash and tenosynovitis of hand and was sent home on Augmentin. Her symptoms worsened despite treatment and she presented back to the ED. On investigation, she was found to have DGI and was appropriately treated. DGI should be kept in mind in sexually active youngsters who have only one or two features of the classic triad of rash, tenosynovitis, and arthritis. Timely management and appropriate treatment of DGI is very important to avoid complications and morbidity. PMID:27406461

  15. Subcapsular sinus macrophages limit acute gammaherpesvirus dissemination.

    PubMed

    Frederico, Bruno; Chao, Brittany; Lawler, Clara; May, Janet S; Stevenson, Philip G

    2015-08-01

    Lymphocyte proliferation, mobility and longevity make them prime targets for virus infection. Myeloid cells that process and present environmental antigens to lymphocytes are consequently an important line of defence. Subcapsular sinus macrophages (SSMs) filter the afferent lymph and communicate with B-cells. How they interact with B-cell-tropic viruses is unknown. We analysed their encounter with murid herpesvirus-4 (MuHV-4), an experimentally accessible gammaherpesvirus related to Kaposi's sarcoma-associated herpesvirus. MuHV-4 disseminated via lymph nodes, and intranasally or subcutaneously inoculated virions readily infected SSMs. However, this infection was poorly productive. SSM depletion with clodronate-loaded liposomes or with diphtheria toxin in CD169-diphtheria toxin receptor transgenic mice increased B-cell infection and hastened virus spread to the spleen. Dendritic cells provided the main route to B-cells, and SSMs slowed host colonization, apparently by absorbing virions non-productively from the afferent lymph. PMID:25872742

  16. [HYPEREOSINOPHILIC SYNDROME ASSOCIATED WITH SEPSIS DUE TO PAECILOMYCES FUNGI DISSEMINATED INTO THE LIVER].

    PubMed

    Akhunov, V M; Akhunova, A M; Lavrent'eva, T P

    2016-01-01

    A 49 year old woman with signs of chronic sepsis, hepatomegaly, and high eosinophil count was under long-term examination including consultations with an oncologist, parasitologist, and hematologist, diagnostic laparotomy, and studies of liver biopsies. Seeding blood samples onto Saburo's medium resulted in the growth of Paecilomyces variotii Bainier colonies. Counting mature spherules of the fungus revealed 59000 spherules per 1 mcl compared with the normal value of 1000-6000 which suggested paecilomycotic etiology of sepsis. The histological study of liver biopsies demonstrated hemorrhagic foci and eosinophilic infiltrates around fungal spherules. The clinical recovery of the patient was achieved after 3 courses of pulsed terbinafine therapy (500 mg/d every other day for 14 days during a month) in combination with vitamins and i/v infusion of 100 ml of a fluconazole solution (2 mg/ml) every third day (10 procedures during a course of therapy). PMID:27459766

  17. Delamination of tantalum porous coating from a TKA due to regional dissemination of debris.

    PubMed

    Bonutti, Peter M; Pivec, Robert; Issa, Kimona; Kapadia, Bhaveen H; Banerjee, Samik; Harwin, Steven F; Mont, Michael A; Bauer, Thomas W

    2013-08-01

    Metallic debris from metal-on-metal bearings is a recognized mode of failure that may lead to implant loosening and periprosthetic soft tissue reactions. The sequelae of metallosis have been most commonly reported with respect to total hip arthroplasty. The authors report a rare case of metallosis following a hybrid metal-on-polyethylene total knee arthroplasty that used a porous tantalum tibial knee component. A total knee arthroplasty patient who presented with knee pain but normal radiographs was found to have delamination of her tibial component that resulted in marked periprosthetic soft tissue metallosis. PMID:23937736

  18. Hypothesis: Disseminated Intravascular Inflammation as the Inflammatory Counterpart to Disseminated Intravascular Coagulation

    NASA Astrophysics Data System (ADS)

    Bull, Brian S.; Bull, Maureen H.

    1994-08-01

    We have identified a leukocyte activation syndrome that is occasionally associated with the transfusion of intraoperatively recovered erythrocytes. This syndrome appears to result from intravascular damage caused by leukocytes activated during the erythrocyte salvage process. We hypothesize that this syndrome is part of a larger disease grouping: disseminated intravascular inflammation (DII). DII is the analog of the coagulation disorder disseminated intravascular coagulation. In disseminated intravascular coagulation, the organ damage results from uncontrolled activation of the clotting pathway; in DII the damage is caused by leukocytes that have become activated by direct contact with bacteria or in rare instances-such as erythrocyte salvage-in the absence of bacteria and bacterial products. Recent studies of the hazards associated with intraoperative blood salvage indicate that activation of leukocytes can be achieved by exposure to activated platelets alone. If such activated leukocytes are reinfused along with the washed erythrocytes, widespread organ damage may result. The lung is the organ most severely affected by activated leukocytes. Adult respiratory distress syndrome is one outcome. It is likely that DII is a presently unrecognized pathophysiological process that complicates a variety of primary disease states and increases their lethality.

  19. Hypothesis: disseminated intravascular inflammation as the inflammatory counterpart to disseminated intravascular coagulation.

    PubMed Central

    Bull, B S; Bull, M H

    1994-01-01

    We have identified a leukocyte activation syndrome that is occasionally associated with the transfusion of intraoperatively recovered erythrocytes. This syndrome appears to result from intravascular damage caused by leukocytes activated during the erythrocyte salvage process. We hypothesize that this syndrome is part of a larger disease grouping: disseminated intravascular inflammation (DII). DII is the analog of the coagulation disorder disseminated intravascular coagulation. In disseminated intravascular coagulation, the organ damage results from uncontrolled activation of the clotting pathway; in DII the damage is caused by leukocytes that have become activated by direct contact with bacteria or in rare instances--such as erythrocyte salvage--in the absence of bacteria and bacterial products. Recent studies of the hazards associated with intraoperative blood salvage indicate that activation of leukocytes can be achieved by exposure to activated platelets alone. If such activated leukocytes are reinfused along with the washed erythrocytes, widespread organ damage may result. The lung is the organ most severely affected by activated leukocytes. Adult respiratory distress syndrome is one outcome. It is likely that DII is a presently unrecognized pathophysiological process that complicates a variety of primary disease states and increases their lethality. Images PMID:8058778

  20. [Primary disseminated pulmonary hydatid cyst manifesting with right-side cardiac failure: case report].

    PubMed

    Çakın, Özlem; Üstün, Cemal; Akçay, Selahattin; İnci, Mehmet Fatih; Altınsoy, Hasan Baki

    2011-01-01

    Hydatid disease is a parasitic infection caused by a tapeworm of the genus Echinococcus. There are three known species of Echinococcus that lead to the disease among humans. E. granulosus is the most common of the three. A 26-year-old man admitted to emergency room with a cough, dyspnea, tachycardia, and chest pain was hospitalized with suspected pneumonia. The patient was in poor general condition and was conscious. On physical examination, fever: 37.3°C/axillary, blood pressure: 165/100 mmHg, cardiac pulse: 114/min, remarkable bilateral pretibial edema, peripheral cyanosis, and disseminated rales and rhonchi were found. Chest radiography showed the multiple disseminated cystic formations, and thorax computed tomography showed remarkable dilatation in the ring of pulmonary artery, and multiple cystic formations in the lung area. The disseminated pulmonary hydatid cyst disease was diagnosed according to clinical and laboratory findings. Albendazole 800 mg/kg daily was administered to the patient for three months. The patient recovered markedly after this treatment. To our knowledge, this is the first case of primary disseminated pulmonary hydatid cyst to manifest with right-side cardiac failure. In endemic areas, the morbidity and mortality due to hydatid cyst may be decreased if hydatid cyst is considered among patients with suspected radiologic findings. PMID:22198927

  1. Nocardia infections among immunomodulated inflammatory bowel disease patients: A review.

    PubMed

    Abreu, Cândida; Rocha-Pereira, Nuno; Sarmento, António; Magro, Fernando

    2015-06-01

    Human nocardiosis, caused by Nocardia spp., an ubiquitous soil-borne bacteria, is a rare granulomatous disease close related to immune dysfunctions. Clinically can occur as an acute life-threatening disease, with lung, brain and skin being commonly affected. The infection was classically diagnosed in HIV infected persons, organ transplanted recipients and long term corticosteroid treated patients. Currently the widespread use of immunomodulators and immunossupressors in the treatment of inflammatory diseases changed this scenario. Our purpose is to review all published cases of nocardiosis in immunomodulated patients due to inflammatory diseases and describe clinical and laboratory findings. We reviewed the literature concerning human cases of nocardiosis published between 1980 and 2014 in peer reviewed journals. Eleven cases of nocardiosis associated with anti-tumor necrosis factor (TNF) prescription (9 related with infliximab and 2 with adalimumab) were identified; 7 patients had inflammatory bowel disease (IBD), 4 had rheumatological conditions; nocardia infection presented as cutaneous involvement in 3 patients, lung disease in 4 patients, hepatic in one and disseminated disease in 3 patients. From the 10 cases described in IBD patients 7 were associated with anti-TNF and 3 with steroids and azathioprine. In conclusion, nocardiosis requires high levels of clinical suspicion and experience of laboratory staff, in order to establish a timely diagnosis and by doing so avoid worst outcomes. Treatment for long periods tailored by the susceptibility of the isolated species whenever possible is essential. The safety of restarting immunomodulators or anti-TNF after the disease or the value of prophylaxis with cotrimoxazole is still debated. PMID:26074688

  2. Disseminated Candida tropicalis presenting with Ecthyma-Gangrenosum-like Lesions.

    PubMed

    Beasley, Knox; Panach, Kamaldeep; Dominguez, Arturo R

    2016-01-01

    Disseminated candidiasis in immunosuppressed patients has been classically associated with an erythematous papular eruption, however more severe presentations are possible. We present a patient who developed disseminated Candida tropicalis that presented with hemorrhagic bullae that progressed to large necrotic ulcers. PMID:26990472

  3. 10 CFR 1009.6 - Dissemination of prices and charges.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Dissemination of prices and charges. 1009.6 Section 1009.6 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) GENERAL POLICY FOR PRICING AND CHARGING FOR MATERIALS AND SERVICES SOLD BY DOE § 1009.6 Dissemination of prices and charges. Current prices and charges...

  4. 10 CFR 470.20 - Dissemination of information.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Dissemination of information. 470.20 Section 470.20 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION APPROPRIATE TECHNOLOGY SMALL GRANTS PROGRAM § 470.20 Dissemination... nature, usage and availability of the energy-related systems and supporting technologies developed...

  5. Cultivating Change: Disseminating Innovation in Higher Education Teaching and Learning

    ERIC Educational Resources Information Center

    Gannaway, Deanne; Hinton, Tilly; Berry, Bianca; Moore, Kaitlin

    2013-01-01

    Effective dissemination is crucial if innovation and development in teaching and learning in higher education are to lead to sustainable changes in practice. In 2003, King used an agricultural metaphor to challenge innovators to understand the purposes behind their dissemination aims. Similar to the way that seed can be spread, one could choose to…

  6. 15 CFR 8a.140 - Dissemination of policy.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false Dissemination of policy. 8a.140 Section 8a.140 Commerce and Foreign Trade Office of the Secretary of Commerce NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 8a.140 Dissemination of policy. (a)...

  7. 43 CFR 41.140 - Dissemination of policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Dissemination of policy. 41.140 Section 41.140 Public Lands: Interior Office of the Secretary of the Interior NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 41.140 Dissemination of policy. (a) Notification...

  8. 10 CFR 5.140 - Dissemination of policy.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Dissemination of policy. 5.140 Section 5.140 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 5.140 Dissemination of policy. (a) Notification of policy. (1) Each recipient shall...

  9. 6 CFR 17.140 - Dissemination of policy.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 6 Domestic Security 1 2014-01-01 2014-01-01 false Dissemination of policy. 17.140 Section 17.140 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 17.140 Dissemination of policy. (a)...

  10. 22 CFR 146.140 - Dissemination of policy.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Dissemination of policy. 146.140 Section 146.140 Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 146.140 Dissemination of policy. (a) Notification of policy. (1)...

  11. 22 CFR 229.140 - Dissemination of policy.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Dissemination of policy. 229.140 Section 229.140 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 229.140 Dissemination of policy. (a) Notification of policy....

  12. 40 CFR 5.140 - Dissemination of policy.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Dissemination of policy. 5.140 Section 5.140 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 5.140 Dissemination of policy. (a) Notification...

  13. 47 CFR 11.53 - Dissemination of Emergency Action Notification.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Dissemination of Emergency Action Notification. 11.53 Section 11.53 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Emergency Operations § 11.53 Dissemination of Emergency Action Notification. Initiation...

  14. 48 CFR 2905.101 - Methods of disseminating information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Methods of disseminating information. 2905.101 Section 2905.101 Federal Acquisition Regulations System DEPARTMENT OF LABOR ACQUISITION... dissemination of information concerning procurement actions. The Division of Acquisition Management...

  15. 36 CFR 1211.140 - Dissemination of policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Dissemination of policy. 1211... FINANCIAL ASSISTANCE Introduction § 1211.140 Dissemination of policy. (a) Notification of policy. (1) Each... prominently include a statement of the policy described in paragraph (a) of this section in each...

  16. 28 CFR 54.140 - Dissemination of policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Dissemination of policy. 54.140 Section... Dissemination of policy. (a) Notification of policy. (1) Each recipient shall implement specific and continuing...) Publications. (1) Each recipient shall prominently include a statement of the policy described in paragraph...

  17. 31 CFR 28.140 - Dissemination of policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Dissemination of policy. 28.140... Introduction § 28.140 Dissemination of policy. (a) Notification of policy. (1) Each recipient shall implement...) Publications. (1) Each recipient shall prominently include a statement of the policy described in paragraph...

  18. 14 CFR 1253.140 - Dissemination of policy.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Dissemination of policy. 1253.140 Section... § 1253.140 Dissemination of policy. (a) Notification of policy. (1) Each recipient shall implement... policy described in paragraph (a) of this section in each announcement, bulletin, catalog, or...

  19. 32 CFR 196.140 - Dissemination of policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Dissemination of policy. 196.140 Section 196.140... FINANCIAL ASSISTANCE Introduction § 196.140 Dissemination of policy. (a) Notification of policy. (1) Each... prominently include a statement of the policy described in paragraph (a) of this section in each...

  20. 44 CFR 19.140 - Dissemination of policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Dissemination of policy. 19... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 19.140 Dissemination of policy. (a) Notification of policy. (1) Each recipient shall implement specific and continuing steps to notify...

  1. 47 CFR 11.53 - Dissemination of Emergency Action Notification.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Dissemination of Emergency Action Notification. 11.53 Section 11.53 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Emergency Operations § 11.53 Dissemination of Emergency Action Notification. Initiation...

  2. 13 CFR 113.140 - Dissemination of policy.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Dissemination of policy. 113.140 Section 113.140 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NONDISCRIMINATION IN... Introduction § 113.140 Dissemination of policy. (a) Notification of policy. (1) Each recipient shall...

  3. 32 CFR 2400.28 - Dissemination of classified information.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... TECHNOLOGY POLICY REGULATIONS TO IMPLEMENT E.O. 12356; OFFICE OF SCIENCE AND TECHNOLOGY POLICY INFORMATION SECURITY PROGRAM Safeguarding § 2400.28 Dissemination of classified information. Heads of OSTP offices... 32 National Defense 6 2010-07-01 2010-07-01 false Dissemination of classified information....

  4. Ultra-stable radio frequency dissemination in free space.

    PubMed

    Miao, J; Wang, B; Gao, C; Bai, Y; Zhu, X; Wang, L J

    2013-10-01

    We demonstrate an ultra-stable radio frequency (RF) dissemination scheme over 80 m free space. The frequency dissemination stability is 3.2 × 10(-13)/s and 4.4 × 10(-17)/day, which can be applied to transfer frequency signal without compromising its stability in a global navigation satellite system (GNSS) or radio astronomy. PMID:24182140

  5. New Jersey Curriculum Management Center: Curriculum Dissemination Services.

    ERIC Educational Resources Information Center

    Law, Gordon F., Jr.

    A description of the curriculum dissemination system of the New Jersey Curriculum Management Center (NJCMC) is provided for the use of educators needing these services and for other states who wish to establish similar curriculum dissemination systems. As a curriculum management center in the National Network for Curriculum Coordination in…

  6. 49 CFR 25.140 - Dissemination of policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Dissemination of policy. 25.140 Section 25.140 Transportation Office of the Secretary of Transportation NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 25.140 Dissemination of policy. (a) Notification of policy. (1)...

  7. 29 CFR 36.140 - Dissemination of policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Dissemination of policy. 36.140 Section 36.140 Labor Office of the Secretary of Labor NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 36.140 Dissemination of policy. (a) Notification of policy. (1) Each recipient shall...

  8. 43 CFR 41.140 - Dissemination of policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Dissemination of policy. 41.140 Section 41.140 Public Lands: Interior Office of the Secretary of the Interior NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 41.140 Dissemination of policy. (a) Notification...

  9. 29 CFR 34.23 - Dissemination of policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Dissemination of policy. 34.23 Section 34.23 Labor Office of the Secretary of Labor IMPLEMENTATION OF THE NONDISCRIMINATION AND EQUAL OPPORTUNITY REQUIREMENTS OF THE JOB TRAINING PARTNERSHIP ACT OF 1982, AS AMENDED (JTPA) Recordkeeping and Other Affirmative Obligations of Recipients § 34.23 Dissemination...

  10. Do Haphazard Reviews Provide Sound Directions for Dissemination Efforts?

    ERIC Educational Resources Information Center

    Gambrill, Eileen; Littell, Julia H.

    2010-01-01

    Comments on The dissemination and implementation of evidence-based psychological treatments: A review of current efforts by Kathryn R. McHugh and David H. Barlow. The lead article in the February-March issue by McHugh and Barlow (2010) emphasized the need for "dissemination and implementation of evidence-based psychological treatments." The…

  11. 40 CFR 56.6 - Dissemination of policy and guidance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 5 2011-07-01 2011-07-01 false Dissemination of policy and guidance. 56.6 Section 56.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) REGIONAL CONSISTENCY § 56.6 Dissemination of policy and guidance. The Assistant Administrators...

  12. 48 CFR 2905.101 - Methods of disseminating information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Methods of disseminating information. 2905.101 Section 2905.101 Federal Acquisition Regulations System DEPARTMENT OF LABOR ACQUISITION PLANNING PUBLICIZING CONTRACT ACTIONS Dissemination of Information 2905.101 Methods of...

  13. 48 CFR 3052.242-71 - Dissemination of contract information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... prescribed in (HSAR) 48 CFR 3042.202-70, insert the following clause: Dissemination of Contract Information... performance of this contract, without the prior written consent of the Contracting Officer. An electronic or... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Dissemination of...

  14. 29 CFR 34.23 - Dissemination of policy.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 1 2013-07-01 2013-07-01 false Dissemination of policy. 34.23 Section 34.23 Labor Office of the Secretary of Labor IMPLEMENTATION OF THE NONDISCRIMINATION AND EQUAL OPPORTUNITY REQUIREMENTS OF THE JOB TRAINING PARTNERSHIP ACT OF 1982, AS AMENDED (JTPA) Recordkeeping and Other Affirmative Obligations of Recipients § 34.23 Dissemination...

  15. Photoletter to the editor: Disseminated histoplasmosis with initial oral manifestations.

    PubMed

    Sinha, Surabhi; Sardana, Kabir; Garg, Vijay K

    2013-03-30

    Histoplasmosis is a systemic fungal disease that may present in a variety of clinical manifestations. Involvment of the oral mucosa is very rare and may occur as part of disseminated histoplasmosis or as isolated involvement. We present a patient with disseminated histoplasmosis, in whom oral lesions were the initial manifestation of the disease. PMID:23580913

  16. A Dissemination Model for New Technical Education Programs. Final Report.

    ERIC Educational Resources Information Center

    Hull, Daniel M.

    The Technical Education Research Center-SW has conceived, tested, and refined a model for disseminating newly developed programs and materials throughout the nation. The model performed successfully in the dissemination of more than 50,000 educational units (modules) of Laser/Electro-Optics Technician (LEOT) materials during a four-year period…

  17. Connecting Network Properties of Rapidly Disseminating Epizoonotics

    PubMed Central

    Rivas, Ariel L.; Fasina, Folorunso O.; Hoogesteyn, Almira L.; Konah, Steven N.; Febles, José L.; Perkins, Douglas J.; Hyman, James M.; Fair, Jeanne M.; Hittner, James B.; Smith, Steven D.

    2012-01-01

    Background To effectively control the geographical dissemination of infectious diseases, their properties need to be determined. To test that rapid microbial dispersal requires not only susceptible hosts but also a pre-existing, connecting network, we explored constructs meant to reveal the network properties associated with disease spread, which included the road structure. Methods Using geo-temporal data collected from epizoonotics in which all hosts were susceptible (mammals infected by Foot-and-mouth disease virus, Uruguay, 2001; birds infected by Avian Influenza virus H5N1, Nigeria, 2006), two models were compared: 1) ‘connectivity’, a model that integrated bio-physical concepts (the agent’s transmission cycle, road topology) into indicators designed to measure networks (‘nodes’ or infected sites with short- and long-range links), and 2) ‘contacts’, which focused on infected individuals but did not assess connectivity. Results The connectivity model showed five network properties: 1) spatial aggregation of cases (disease clusters), 2) links among similar ‘nodes’ (assortativity), 3) simultaneous activation of similar nodes (synchronicity), 4) disease flows moving from highly to poorly connected nodes (directionality), and 5) a few nodes accounting for most cases (a “20∶80″ pattern). In both epizoonotics, 1) not all primary cases were connected but at least one primary case was connected, 2) highly connected, small areas (nodes) accounted for most cases, 3) several classes of nodes were distinguished, and 4) the contact model, which assumed all primary cases were identical, captured half the number of cases identified by the connectivity model. When assessed together, the synchronicity and directionality properties explained when and where an infectious disease spreads. Conclusions Geo-temporal constructs of Network Theory’s nodes and links were retrospectively validated in rapidly disseminating infectious diseases. They distinguished

  18. Evaluating the dissemination of Body & Soul, an evidence-based fruit and vegetable intake intervention: challenges for dissemination and implementation research

    PubMed Central

    Allicock, Marlyn; Campbell, Marci K.; Valle, Carmina G.; Carr, Carol; Resnicow, Ken; Gizlice, Ziya

    2011-01-01

    Objective To evaluate whether the evidence-based Body & Soul program, when disseminated and implemented without researcher or agency involvement and support, would achieve similar results to earlier efficacy and effectiveness trials. Design Prospective group randomized trial. Setting Churches with predominantly African American membership. Participants A total of 1033 members from the fifteen churches completed baseline surveys. Of these, 562 (54.4%) completed the follow-up survey six months later. Intervention Church-based nutrition program for African Americans that included pastoral involvement, educational activities, church environmental changes, and peer counseling. Main Outcome Measure Daily fruit and vegetable (FV) intake was assessed at pre- and post-test. Analysis Mixed-effects linear models. Results At posttest, there was no statistically significant difference in daily servings of FV between the early intervention group participants compared to control group participants (4.7 vs, 4.4, P=0.38). Process evaluation suggested that added resources such as technical assistance could improve program implementation. Conclusions and Implications The disseminated program may not produce improvements in FV intake equal to those in the earlier efficacy and effectiveness trials, primarily due to lack of program implementation. Program dissemination may not achieve public health impact unless support systems are strengthened for adequate implementation at the church level. PMID:22406012

  19. Hawaii Educational Dissemination Diffusion System: An Action Report. Hawaii State Dissemination Conference, Hawaii Department of Education (Honolulu, Hawaii, October 1979).

    ERIC Educational Resources Information Center

    Northwest Regional Educational Lab., Portland, OR.

    The first intensive exposure to organized dissemination at the state, regional, and national level for many of the participants, this 2-day conference consisted of a series of sessions held in Honolulu and neighboring islands. Explanations of how these dissemination efforts are organized and operated were followed by detailed information on the…

  20. Developing Agency Dissemination Policy. Washington State Dissemination Conference, Office of the Superintendent of Public Instruction (Olympia, Washington, January 22, 1980).

    ERIC Educational Resources Information Center

    Northwest Regional Educational Lab., Portland, OR.

    Building upon groundwork established by previous meetings, this session of the Washington Dissemination Task Force focused on the preparation and intensive study of a policy and guidelines on dissemination for the Office of the State Department of Public Instruction (OSPI), and the identification of future responsibilities of the group. Conference…

  1. The problem of dissemination: evidence and ideology.

    PubMed

    Traynor, M

    1999-09-01

    This paper recontextualises research evidence as an example of textually-based social control. It does this by drawing on two areas of theoretical literature; feminist literary theory and the sociology of scientific knowledge. Accounts of literary works as ideological instruments of social control suggest that (at least some kinds of) research literature may fulfil a similar role among a clinical readership. There have also been compelling accounts of scientific writing as expressions of desire on the part of one group to 'act at a distance' upon others. In the light of this literature, it becomes less tenable to see research dissemination as the simple transfer of information, supplemented by organisational work. Research is implicated in the attempt by one group to enrol others in its own project and in the (self-)construction of the identities of the healthcare worker. The accounts that literary theory can provide do not remain focused upon the text, but draw links between the reading process and the experience and place in society, for example the gender, of the writer and reader. As such their explanations create a space for the resisting reader. PMID:10795272

  2. Disseminated intravascular coagulation following administration of sunitinib

    PubMed Central

    OLIVO, ANAËLLE; NOËL, NICOLAS; BESSE, BENJAMIN; TABURET, ANNE-MARIE; LAMBOTTE, OLIVIER

    2016-01-01

    Sunitinib is an increasingly used, orally administered targeted therapy, approved by the European Medicines Agency for the treatment of various types of cancer, including gastrointestinal stromal tumor unresectable or metastatic disease, following disease progression or intolerance to imatinib, and advanced or metastatic renal cell carcinoma, progressive well-differentiated pancreatic neuroendocrine tumors in patients with unresectable, locally advanced or metastatic disease. Sunitinib inhibits several tyrosine kinases, including the vascular endothelial growth factor receptor and the platelet-derived growth factor receptor. Tyrosine kinases inhibitor therapies are generally well-tolerated; nonetheless, they are not void of side effects. The majority of patients reported are grade 1 or 2, and include common and unspecific adverse events, including fatigue, gastrointestinal disorders, skin discoloration, altered taste, cough and dyspnea. Grade 3 or 4 adverse events, including bleeding and hemorrhage, are less frequent. The present study presented the first case of disseminated intravascular coagulation associated with the administration of sunitinib, shortly following the increase of sunitinib dosage. PMID:27330781

  3. User data dissemination concepts for earth resources

    NASA Technical Reports Server (NTRS)

    Davies, R.; Scott, M.; Mitchell, C.; Torbett, A.

    1976-01-01

    Domestic data dissemination networks for earth-resources data in the 1985-1995 time frame were evaluated. The following topics were addressed: (1) earth-resources data sources and expected data volumes, (2) future user demand in terms of data volume and timeliness, (3) space-to-space and earth point-to-point transmission link requirements and implementation, (4) preprocessing requirements and implementation, (5) network costs, and (6) technological development to support this implementation. This study was parametric in that the data input (supply) was varied by a factor of about fifteen while the user request (demand) was varied by a factor of about nineteen. Correspondingly, the time from observation to delivery to the user was varied. This parametric evaluation was performed by a computer simulation that was based on network alternatives and resulted in preliminary transmission and preprocessing requirements. The earth-resource data sources considered were: shuttle sorties, synchronous satellites (e.g., SEOS), aircraft, and satellites in polar orbits.

  4. Disseminated Intravascular Coagulation Syndromes in Obstetrics.

    PubMed

    Cunningham, F Gary; Nelson, David B

    2015-11-01

    Disseminated intravascular coagulation (DIC) is a syndrome that can be initiated by a myriad of medical, surgical, and obstetric disorders. Also known as consumptive coagulopathy, DIC is a common contributor to maternal morbidity and mortality and is associated with up to 25% of maternal deaths. The etiopathogenesis of DIC is complex and currently thought to be initiated by tissue factor or thromboplastin, which is released from trophoblastic or fetal tissue, or maternal decidua or endothelium. Tissue factor activates the coagulation sequence to cause fibrin clotting and its dissolution by the fibrinolysin system. The result of this process can range from mild, clinically insignificant laboratory derangements to marked coagulopathy with bleeding at sites of minimal trauma. Although clinical recognition varies by disease severity, several organizations have attempted to standardize the diagnosis through development of scoring systems. Several important--albeit not necessarily common--obstetric disorders associated with DIC include placental abruption, amniotic fluid embolism, sepsis syndrome, and acute fatty liver of pregnancy. More common disorders include severe preeclampsia, hemolysis, elevated liver enzymes, and low platelet count syndrome, and massive obstetric hemorrhage. Importantly, many of these disorders either cause or are associated with substantive obstetric hemorrhage. Treatment of DIC is centered on two principles. The first is identification and treatment of the underlying disorder. Because many women with consumptive coagulopathy also have massive hemorrhage, the second tenet of treatment is that obstetric complications such as uterine atony or lacerations must be controlled simultaneously with prompt blood and component replacement for a salutary outcome. PMID:26444122

  5. Cacades: A reliable dissemination protocol for data collection sensor network

    USGS Publications Warehouse

    Peng, Y.; Song, W.; Huang, R.; Xu, M.; Shirazi, B.; LaHusen, R.; Pei, G.

    2009-01-01

    In this paper, we propose a fast and reliable data dissemination protocol Cascades to disseminate data from the sink(base station) to all or a subset of nodes in a data collection sensor network. Cascades makes use of the parentmonitor-children analogy to ensure reliable dissemination. Each node monitors whether or not its children have received the broadcast messages through snooping children's rebroadcasts or waiting for explicit ACKs. If a node detects a gap in its message sequences, it can fetch the missing messages from its neighbours reactively. Cascades also considers many practical issues for field deployment, such as dynamic topology, link/node failure, etc.. It therefore guarantees that a disseminated message from the sink will reach all intended receivers and the dissemination is terminated in a short time period. Notice that, all existing dissemination protocols either do not guarantee reliability or do not terminate [1, 2], which does not meet the requirement of real-time command control. We conducted experiment evaluations in both TOSSIM simulator and a sensor network testbed to compare Cascades with those existing dissemination protocols in TinyOS sensor networks, which show that Cascades achieves a higher degree of reliability, lower communication cost, and less delivery delay. ??2009 IEEE.

  6. A Spread Willingness Computing-Based Information Dissemination Model

    PubMed Central

    Cui, Zhiming; Zhang, Shukui

    2014-01-01

    This paper constructs a kind of spread willingness computing based on information dissemination model for social network. The model takes into account the impact of node degree and dissemination mechanism, combined with the complex network theory and dynamics of infectious diseases, and further establishes the dynamical evolution equations. Equations characterize the evolutionary relationship between different types of nodes with time. The spread willingness computing contains three factors which have impact on user's spread behavior: strength of the relationship between the nodes, views identity, and frequency of contact. Simulation results show that different degrees of nodes show the same trend in the network, and even if the degree of node is very small, there is likelihood of a large area of information dissemination. The weaker the relationship between nodes, the higher probability of views selection and the higher the frequency of contact with information so that information spreads rapidly and leads to a wide range of dissemination. As the dissemination probability and immune probability change, the speed of information dissemination is also changing accordingly. The studies meet social networking features and can help to master the behavior of users and understand and analyze characteristics of information dissemination in social network. PMID:25110738

  7. Converting hard copy documents for electronic dissemination

    SciTech Connect

    Hoffman, F.

    1994-12-31

    Since the advent of computer systems, the goal of a paperless office, and even a paperless society, has been pursued. While the normal paper flow in an organization is far from totally automated, particularly for items requiring signatures or authorizations, electronic information dissemination is becoming an almost simple task. The reasons for providing on-line documents are many and include faster and easier access for everyone, elimination of printing costs, reduction of wasted shelf and desk space, and the security of having a centrally-located, always up-to-date document. New computer software even provides the user with the ability to annotate documents and to have bookmarks so that the old scribbled-in and dog-eared manual can be replaced without loosing this `customizability`. Moreover, new hypermedia capabilities mean that documents can be read in a non-linear fashion and can include color figures and photographs, audio, and even animation sequences, capabilities which exceed those of paper. The proliferation of network-based information servers, coupled with the growth of the Internet, has enticed academic, governmental, and even commercial organizations to provide increasing numbers of documents and data bases in electronic form via the network, not just to internal staff, but to the public as well. Much of this information, which includes everything from mundane company procedures to spiffy marketing brochures, was previously published only in hard copy. Converting existing documents to electronic form and producing only electronic versions of new documents poses some interesting challenges to the maintainer or author.

  8. Lymph Node Macrophages Restrict Murine Cytomegalovirus Dissemination

    PubMed Central

    Farrell, Helen E.; Davis-Poynter, Nick; Bruce, Kimberley; Lawler, Clara; Dolken, Lars; Mach, Michael

    2015-01-01

    ABSTRACT Cytomegaloviruses (CMVs) establish chronic infections that spread from a primary entry site to secondary vascular sites, such as the spleen, and then to tertiary shedding sites, such as the salivary glands. Human CMV (HCMV) is difficult to analyze, because its spread precedes clinical presentation. Murine CMV (MCMV) offers a tractable model. It is hypothesized to spread from peripheral sites via vascular endothelial cells and associated monocytes. However, viral luciferase imaging showed footpad-inoculated MCMV first reaching the popliteal lymph nodes (PLN). PLN colonization was rapid and further spread was slow, implying that LN infection can be a significant bottleneck. Most acutely infected PLN cells were CD169+ subcapsular sinus macrophages (SSM). Replication-deficient MCMV also reached them, indicating direct infection. Many SSM expressed viral reporter genes, but few expressed lytic genes. SSM expressed CD11c, and MCMV with a cre-sensitive fluorochrome switch showed switched infected cells in PLN of CD11c-cre mice but yielded little switched virus. SSM depletion with liposomal clodronate or via a CD169-diphtheria toxin receptor transgene shifted infection to ER-TR7+ stromal cells, increased virus production, and accelerated its spread to the spleen. Therefore, MCMV disseminated via LN, and SSM slowed this spread by shielding permissive fibroblasts and poorly supporting viral lytic replication. IMPORTANCE HCMV chronically infects most people, and it can cause congenital disability and harm the immunocompromised. A major goal of vaccination is to prevent systemic infection. How this is established is unclear. Restriction to humans makes HCMV difficult to analyze. We show that peripheral MCMV infection spreads via lymph nodes. Here, MCMV infected filtering macrophages, which supported virus replication poorly. When these macrophages were depleted, MCMV infected susceptible fibroblasts and spread faster. The capacity of filtering macrophages to limit

  9. Disseminated varicella-zoster virus in an immunocompetent adult.

    PubMed

    Petrun, Branden; Williams, Victoria; Brice, Sylvia

    2015-03-01

    Varicella-zoster is the virus that causes varicella (chicken pox), herpes zoster (shingles), and rarely, severe disseminated disease including diffuse rash, encephalitis, hepatitis, and pneumonitis. Disseminated disease is most often seen in immunocompromised patients. We describe a case of disseminated zoster in an immunocompentent patient who had previously been immune to VZV. This case is also unusual in that his clinical presentation was most consistent with varicella while his laboratory data was most consistent with herpes zoster. For the purpose of rapid diagnosis and initiation of appropriate therapy, clinicians should be aware of these more atypical presentations of VZV infection. PMID:25780980

  10. [DISSEMINATED PERITONEAL LEYOMYOMATOSIS AFTER LAPAROSCOPIC MORCELLATION--A CASE REPORT].

    PubMed

    Gincheva, D; Nikolova, M

    2016-01-01

    We presented a case of 41-year-old patient underwent two laparoscopic Myomectomies and current laparotomy regarding suspection of necrotic leiomyoma. Intraoperative finding was suggestive of disseminated malignancy, but gefrir study showed benign smooth muscle tumors. The patient underwent total hysterectomy with right adnesectomy and total omentectomy. After histological and immunohistochemical study of the entire macroscopic material the final diagnosis was disseminated peritoneal leiomyomatosis. This disease is rare, but in recent years, in connection with the widespread introduction of laparoscopic surgery the reports of disseminated peritoneal leiomyomatosis occurring after laparoscopic morcellation, were frequent. PMID:27514144