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@#Lues maligna, also known as malignant syphilis, is an uncommon variant of syphilis at the secondary stage – more commonly reported in immunocompromised patients or those with concomitant human immunodeficiency virus (HIV) infection. In this report, we present a case of a 28‑year‑old HIV‑negative male with a 9‑month history of multiple, well‑defined, irregularly‑shaped, erythematous papules, and small plaques evolving to ulcerated plaques and nodules with crusts, associated with pain, pruritus, and episodes of fever, arthralgia, and weight loss. Positive treponemal and nontreponemal tests, aided by histopathologic findings consistent with syphilis led to the diagnosis of lues maligna. Significant improvement of lesions was noted with 3 weekly doses of 2.4 million units of benzathine penicillin G. For patients presenting with painful and pruritic erythematous ulcerated plaques with crusts associated with systemic symptoms, and with a significant sexual history despite testing negative for HIV infection, a high index of suspicion for uncommon presentations of other sexually transmitted infections such as syphilis could aid in early diagnosis and subsequent treatment.

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PURPOSE: To study prevalence of targeted therapy (TT)-related adverse events requiring ICU admission in solid tumor patients. METHODS: Retrospective multicenter study from the Nine-i research group. Adult patients who received TT for solid tumor within 3 months prior to ICU admission were included. Patients admitted for TT-related adverse event were compared to those admitted for other reasons. RESULTS: In total, 140 patients, median age of 63 (52-69) years were included. Primary cancer site was mostly digestive (n=27, 19%), kidney (n=27, 19%), breast (n=24, 17%), and lung (n=20, 14%). Targeted therapy was anti-VEGF/VEGFR for 27% (n=38) patients, anti-EGFR for 22% (n=31) patients, anti-HER2 for 14% (n=20) patients and anti-BRAF for 9% (n=5) patients. ICU admission was related to TT adverse events for 30 (21%) patients. The most frequent complications were interstitial pneumonia (n=7), cardiac failure (n=5), anaphylaxis (n=4) and bleeding (n=4). At ICU admission, no significant difference was found between patients admitted for a TT-related adverse event and the other patients. One-month survival rate was higher in patients admitted for TT adverse event (OR=5.733 [2.031-16.182] P<0.001). CONCLUSIONS: Adverse events related to targeted therapy accounted for 20% of ICU admission in our population and carried a 16% one-month mortality. Outcome was associated with admission for TT related to adverse event, breast cancer and good performance status.

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BACKGROUND: Declining Helicobacter pylori (H. pylori) eradication rates have prompted a switch in first-line therapy from standard triple (PPI, clarithromycin, and amoxicillin) to bismuth-based quadruple therapy. A caveat of the ACG 2017 H. pylori treatment guidelines was a paucity of recent US eradication data. AIM: To determine Rhode Island H. pylori eradication data, in the largest US study from the last two decades. METHODS: Electronic records were queried for patients with H. pylori infection diagnosed by pathology, urea breath test, or stool antigen from 2015 to 2017. Demographics, diagnostic test, treatment regimen, and test of cure were extracted. Eradication rates were calculated, and treatment regimens were compared. RESULTS: A total of 1710 patients were identified (64% female): 825 (46%) diagnosed by breath test, 755 (42%) by biopsy, and 191 (12%) by stool antigen. Full data were obtained on 1101 patients. Seven regimens were used: quadruple (64%), triple (25%), doxycycline quadruple (5%), and miscellaneous (6%). Quadruple was superior to triple: (85% vs. 75%, P = 0.002), quadruple 14 days versus triple 14 days (87% vs. 79%, P = 0.0052), quadruple 10 days versus triple 10 days (77% vs. 67%, P = 0.33). Increased therapy length improved eradication (quadruple 14 days  vs. 10 days, 87% vs. 77%, P = 0.002; triple 14 days  versus 10 days 79% vs. 67%, P = 0.13). Finally, substituting doxycycline for tetracycline yielded lower eradication (85% vs. 67%, P = 0.006). CONCLUSION: Quadruple therapy is superior to triple therapy within the Rhode Island population. Fourteen-day therapy achieves superior eradication compared to 10-day therapy, and doxycycline is inferior to tetracycline for quadruple therapy. Our findings support adherence to ACG and international guidelines advising 14-day quadruple therapy.

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Accumulating preclinical evidence suggests the use of amnion as a source of stem cells for investigations of basic science concepts related to developmental cell biology, but also for stem cells' therapeutic applications in treating human disorders. We previously reported isolation of viable rat amniotic fluid-derived stem (AFS) cells. Subsequently, we recently reported the therapeutic benefits of intravenous transplantation of AFS cells in a rodent model of ischemic stroke. Parallel lines of investigations have provided safety and efficacy of stem cell therapy for treating stroke and other neurological disorders. This review article highlights the need for investigations of mechanisms underlying AFS cells' therapeutic benefits and discusses lab-to-clinic translational gating items in an effort to optimize the clinical application of the cell transplantation for stroke.

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We report the clinical, biochemical and molecular findings on the first documented patient with 4-hydroxybutyric aciduria (4-HBA, McKusick 271980) from Uruguay. The patient displayed a severe picture and turned out to be homozygous for a mutation (c.1226G < A) previously shown to be associated with null enzyme activity.

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Neste artigo, analisa-se a olorização, fenômeno parapsíquico de efeito físico caracterizado pela percepção de olores ou perfumes formados através da exteriorização de ectoplasma. Busca-se ampliar a compreensão sobre o assunto e, gradativamente, facilitar o autodiagnóstico dos possíveis momentos nos quais já se passou pela experiência. São descritos e detalhados 14 aspectos fundamentais para o estudo da olorização, listados 7 critérios importantes que permitem a correta identificação e, ao final, são expostos 6 casos extraídos de bibliografia específica e das vivências parapsíquicas do autor(AU)