Coexistence of psoriasis and cutaneous T-cell lymphoma.

It has been reported that individuals with psoriasis are at an increased risk of developing cutaneous T-cell lymphoma (CTCL). However, the increased risk of lymphoma in these patients has been questioned because CTCL in its early stages may be incorrectly labelled as psoriasis, thus introducing potential for misclassification bias. We retrospectively reviewed patients with a confirmed diagnosis of CTCL seen in a tertiary cutaneous lymphoma clinic (n = 115) over a 5-year period and found that 6 (5.2%) patients had clinical evidence of coexisting psoriasis. This demonstrates that there is a small cohort of individuals who develop both psoriasis and CTCL.

V˙O2peak, Body Composition, and Neck Strength of Elite Motor Racing Drivers.

PURPOSE: Automobile racing is widely known to be physically demanding; however, there is no published information comparing the physical fitness variables of elite-level race car drivers across various competitive championships. METHODS: We documented the body composition, peak oxygen consumption (V˙O2peak), and isometric neck strength in a sample of elite race car drivers currently competing in Formula 1, IndyCar, NASCAR, and International Motor Sports Association sports car racing (IMSA GTD), to determine current human performance benchmarks and establish goals for drivers wishing to compete in these series. RESULTS: Percent body fat was significantly (P < 0.001) lower in Formula 1 drivers (8.1% ± 1.7%) as compared with the other series, with IndyCar (17.4% ± 1.7%) and NASCAR (17.3% ± 4.6%) being less than IMSA GTD (24.9% ± 1.8%). Percent lean mass followed the same trend as percent body fat. IMSA GTD had not only the highest percent body fat but also the lowest (P = 0.001) V˙O2peak (45.2 ± 2.1 mL·kg·mL) compared with Formula 1 (62.0 ± 6.0 mL·kg·mL), IndyCar (58.05 ± 6.40 mL·kg·mL), and NASCAR (53.2 ± 4.1 mL·kg·mL). Isometric neck strength was the highest in Formula 1 and IndyCar drivers as compared with IMSA GTD and NASCAR drivers. CONCLUSION: These results support the hypothesis that the varying physical demands of each competition series require different physical fitness levels of drivers. These benchmarks can be used by exercise professionals to better prepare athletes for competition.

An unusual presentation of pulmonary embolism leading to infarction, cavitation, abscess formation and bronchopleural fistulation.

We report an unusual presentation of pulmonary embolism (PE) where a 58-year-old man first developed symptoms of community-acquired pneumonia. Despite antibiotic therapy, he remained unwell with rising inflammatory markers, general malaise and persistent cough. He developed stony dull percussion and absent breath sounds to his left mid to lower zones. Serial chest x-rays showed progression from lobar consolidation to a large loculated left-sided pleural collection. CT chest showed left-sided lung abscess, empyema and bronchopleural fistulation. Incidentally, the scan revealed acute left-sided PE and its distribution corresponded with the location of the left lung abscess and empyema. The sequence of events likely started with PE leading to infarction, cavitation, abscess formation and bronchopleural fistulation. This patient was managed with a 6-month course of rivaroxaban. After completing 2 weeks of intravenous meropenem, he was converted to 4-week course of oral co-amoxiclav and metronidazole and attained full recovery.

A 68-year-old with cranial nerve neuropathies and a troponin rise.

In this case study, we summarise the inpatient investigations and management of a 68-year-old woman with Takotsubo cardiomyopathy secondary to a Varicella zoster encephalitis and the difficulties inherent with making this diagnosis. She presented with evolving cranial nerve neuropathies, which started with a vagal nerve mononeuritis and eventually included left-sided sensorineural hearing loss and a facial nerve palsy. These symptoms were concomitant with a variety of cardiac abnormalities, including fast atrial fibrillation and electrocardiographic changes. We summarise some of the current understanding of Takotsubo cardiomyopathy and the criteria for its diagnosis. Although left ventricular apical ballooning has been described in association with severe infections and states of high stress, we have not seen it reported in association with a Varicella zoster encephalitis.

Group 9 bimetallic carbonyl permethylpentalene complexes.

We describe the synthesis, structure and bonding of the first iridium and rhodium permethylpentalene complexes, syn-[M(CO)2]2(µ:η(5):η(5)-Pn*) (M = Rh, Ir). In fact, [Ir(CO)2]2(µ:η(5):η(5)-Pn*) is the first iridium pentalene complex. An interesting preference for the isolation of the sterically more demanding syn-isomer is observed and substantiated by DFT analysis. Upon photolysis, the rhodium analogue yields an unusual tetrameric species Rh4(CO)6(µ:η(3):η(5)-Pn*)2 with bridging carbonyls and Rh-Rh bonds, which has been characterised by single crystal X-ray diffraction and by solution NMR spectroscopy.