Sneaky Sarcoidosis or a Metastatic Masquerade? - A case of nodular sarcoidosis.

Sarcoidosis is a multisystem disease of unclear pathogenesis that peaks between ages 20 to 39. Sarcoidosis is more common in women and affects blacks three times more frequently than whites. Nodular sarcoidosis is a rare variant of sarcoid that occurs in 1-4 percent of patients. It presents in female smokers with cough and shortness of breath. Nodular sarcoidosis often also presents as multifocal bilateral ill-defined nodules mimicking airspace disease or malignancy on imaging. Patients generally have a favorable prognosis, with complete resolution of the masses with steroid treatment. Herein, we present a case of nodular sarcoidosis in a female smoker who presented with cough, weight loss, and fever. Imaging revealed multiple pulmonary nodules, a dominant lung mass, and lymphadenopathy suggestive of malignancy. Ultimately, the patient underwent bronchoscopy and was diagnosed with nodular sarcoidosis; there was no evidence of malignancy or infectious process. Resolution of her symptoms ensued with steroid treatment.

Turicella otitidis hypoglossal nerve stimulator device associated infection.

71-year-old male with history of obstructive sleep apnea presented with persistent drainage from the surgical incision site over the recently implanted hypoglossal nerve stimulator. Wound cultures from device pocket identified the pathogen as Turicella otitidis. Clinical course included treatment with broad-spectrum intravenous antibiotics and device explantation. This case is the first known T. otitidis device associated infection.

West nile virus RNA not detected in urine of 40 people tested 6 years after acute West Nile virus disease.

West Nile virus (WNV) causes an acute infection that is usually cleared by an effective immune response after several days of viremia. However, a recent study detected WNV RNA in the urine of 5 of 25 persons (20%) tested several years after their initial acute WNV disease. We evaluated an established cohort of 40 persons >6 years after initial infection with WNV. Urine collected from all participants tested negative for WNV RNA by reverse-transcription polymerase chain reaction and transcription-mediated amplification. Prospective studies are needed to determine if and for how long WNV persists in urine following WNV disease.

Clusters of nontuberculous mycobacteria linked to water sources at three Veterans Affairs medical centers.

OBJECTIVE: To characterize nontuberculous mycobacteria (NTM) associated with case clusters at 3 medical facilities. DESIGN: Retrospective cohort study using molecular typing of patient and water isolates. SETTING: Veterans Affairs Medical Centers (VAMCs). METHODS: Isolation and identification of NTM from clinical and water samples using culture, MALDI-TOF, and gene population sequencing to determine species and genetic relatedness. Clinical data were abstracted from electronic health records. RESULTS: An identical strain of Mycobacterium conceptionense was isolated from 41 patients at VA Medical Centers (VAMCs A, B, and D), and from VAMC A's ICU ice machine. Isolates were initially identified as other NTM species within the M. fortuitum clade. Sequencing analyses revealed that they were identical M. conceptionense strains. Overall, 7 patients (17%) met the criteria for pulmonary or nonpulmonary infection with NTM, and 13 of 41 (32%) were treated with effective antimicrobials regardless of infection or colonization status. Separately, a M. mucogenicum patient strain from VAMC A matched a strain isolated from a VAMC B ICU ice machine. VAMC C, in a different state, had a 4-patient cluster with Mycobacterium porcinum. Strains were identical to those isolated from sink-water samples at this facility. CONCLUSION: NTM from hospital water systems are found in hospitalized patients, often during workup for other infections, making attribution of NTM infection problematic. Variable NTM identification methods and changing taxonomy create challenges for epidemiologic investigation and linkage to environmental sources.

Synthesis, characterization, electronic structure and catalytic performance of bimetallic and trimetallic nanoparticles containing tin.

When anchored on a high-area, siliceous supports, nanoparticle catalysts, consisting of two or three different metals, but totaling no more than twenty atoms in all, exhibit exceptional activities and selectivities in solvent-free, one-step hydrogenation reactions at low temperatures (< 420 K) and much lower pressures (e.g. 30 bar) than those required in current industrial manufacture. The two selective hydrogenations illustrated here are the conversion of (a) cyclododecatriene (CDT) to cyclododecene (CD) and (b) dimethyl terephthalate (DMT) to cyclohexane dimethanol (CHDM); each of these products is extensively used in the polymer industry. All our mixed-metal nanoparticles are derived from an appropriately chosen parent (precursor) mixed-metal carbonyl having phenyl-containing tin ligands, e.g. Ru4(mu4-SnPh)2(CO)12. Various techniques are used to characterize the denuded, anchored cluster catalysts; and it is expected that aberration-corrected high-resolution electron microscopy (and other techniques, which are outlined) will be invaluable in such characterization. Density functional theory has provided important insights into the structures and electronic properties of our catalysts and their precursors.

Multiple additions of phenylgermanium ligands to tetraruthenium and tetraosmium carbonyl cluster complexes.

Three new compounds, Ru4(mu4-GePh)2(mu-GePh2)2(mu-CO)2(CO)8 (11), Ru4(mu4-GePh)2(mu-GePh2)3(mu-CO)(CO)8 (12), and Ru4(mu4-GePh)2(mu-GePh2)4(CO)8 (13), were obtained from the reaction of H(4)Ru(4)(CO)12 with excess Ph(3)GeH in octane (11 and 12) or decane (13) reflux. Compound 11 was converted to compound 13 by reaction with Ph(3)GeH by heating solutions in nonane solvent to reflux. Compounds 11-13 each contain a square-type arrangement of four Ru atoms capped on each side by a quadruply bridging GePh ligand to form an octahedral geometry for the Ru(4)Ge(2) group. Compound 11 also contains two edge-bridging GePh(2) groups on opposite sides of the cluster and two bridging carbonyl ligands. Compound 12 contains three edge-bridging GePh(2) groups and one bridging carbonyl ligand. Compound 13 contains four bridging GePh(2) groups, one on each edge of the Ru4 square. The reaction of H(4)Os(4)(CO)12 with excess Ph(3)GeH in decane at reflux yielded two new tetraosmium cluster complexes, Os4(mu4-GePh)2(mu-GePh2)3(mu-CO)(CO)8 (14) and Os4(mu4-GePh)2(mu-GePh(2))4(CO)8 (15). These compounds are structurally similar to compounds 12 and 13, respectively.