Invasive Cytomegalovirus (CMV) Sinusitis in an Acquired Immunodeficiency Syndrome (AIDS) Patient.

A patient with acquired immunodeficiency syndrome presented with findings concerning for acute invasive fungal sinusitis, which is typically associated with Mucorales. However, debridement and pathological analysis revealed Cytomegalovirus, a pathology rarely encountered. Laryngoscope, 134:92-96, 2024.

Otolaryngology consultations for COVID-19 patients: A retrospective cohort study of indications, interventions, and considerations.

OBJECTIVE: To identify differences in inpatient otolaryngology consultations and interventions for patients based on COVID-19. METHODS: Records were reviewed for all patients for whom otolaryngology was consulted at a high-volume tertiary care hospital from April 30, 2020 to October 1, 2020. Demographic information, length of stay, COVID-19 status, indication for consultation, and otolaryngology interventions were recorded. Statistical analysis was performed using R software. RESULTS: Bleeding composed a significantly higher proportion of otolaryngology consults in COVID-19 positive patients (28% vs. 8.4%, p<0.0001). Management of bleeding was the most common procedure performed in positive patients (n=37, 35%), and they had a higher median number of interventions performed when compared to bleeding patients who tested negative (1, IQR 1-2 vs. 1, IQR 0-1, p=0.04). COVID-19 positive patients with bleeding were more likely to expire than those with other indications for otolaryngology consultation (50% vs. 7%, p<0.001). CONCLUSION: Bleeding and associated interventions comprised the predominant discrepancy between COVID-19 positive and negative patients in our cohort. We encourage routine use of simple and cost-effective methods to decrease risk of bleeding.

Evaluation of Susceptibility Testing Methods for Aztreonam and Ceftazidime-Avibactam Combination Therapy on Extensively Drug-Resistant Gram-Negative Organisms.

Carbapenem-resistant Enterobacterales (CRE) and Pseudomonas aeruginosa (CR-PA) producing metallo-ß-lactamases (MBLs) cause severe nosocomial infections with no defined treatment. The combination of aztreonam (ATM) with ceftazidime-avibactam (CZA) is a potential therapeutic option, but there is no approved, feasible testing method for use in clinical laboratories to assess the activity of two antimicrobials in combination. Here, we evaluate the performance of four ATM-CZA combination testing methods, as follows: broth disk elution (DE), disk stacking (DS), strip stacking (SS), and strip crossing (SX). We used 10 clinical, representative Enterobacterales and 6 P. aeruginosa isolates harboring MBL, Guiana extended-spectrum beta-lactamase (GES), or non-MBL enzymes. Four of these isolates were from clinical cases treated by ATM-CZA. All CRE producing NDM and CR-PA producing GES that were resistant to ATM and CZA alone were susceptible to the ATM-CZA combination. P. aeruginosa generating NDM or VIM remained resistant to ATM-CZA, likely due to non-ß-lactamase mechanisms, and all other isolates were susceptible to ATM or CZA alone. The most accurate, precise, and reproducible methods of low complexity were disc elution and both strip methods (SX and SS) using MIC test strips (MTS) , all with 100% sensitivity and specificity, followed by Etest with SX (95.83% sensitivity, 100% specificity) and SS (87.5% sensitivity, 100% specificity). DS had the lowest performance. DE is particularly valuable in low-resource settings that routinely use disks. MTS yielded higher categorical agreements by SX (94%) and SS (84%), relative to Etest by SX (90%) and SS (82%). P. aeruginosa results yielded the majority of the errors. These methods may allow laboratories to inform clinical decision making like combination therapy for severe infections caused by extensively drug-resistant Enterobacterales.

Medical Students' Participation in Longitudinal Community Service During Preclerkship Years: A Qualitative Study on Experiences and Perceived Outcomes.

The aim of this study was to qualitatively evaluate medical students perspectives of the benefits of a longitudinal volunteering experience compared with a 1-day community service experience. Fifteen medical students participated in 2 types of community service: (1) longitudinal, weekly volunteering from February to April of 2019 and (2) a single day of community service in March of 2019. Semistructured interviews were conducted to identify medical students perspectives of the impact of volunteering. Interview data was analyzed thematically based on the common ideas expressed by the participants. Four themes emerged: development of communication and interpersonal skills; understanding how to teach; ability to understand community issues in a low socioeconomic status (SES) neighborhood and the improvement of overall well-being. Medical students' participation in a longitudinal nutrition education volunteer program was perceived as being an effective way to develop communication, interpersonal, and teaching skills. Medical students were able to interact with a diverse and vulnerable community located in a low SES neighborhood, to help them understand current community issues and risk factors.

Cd(II)- and Pb(II)-Induced Self-Assembly of Peripheral Membrane Domains from Protein Kinase C.

Cd2+ and Pb2+ are xenobiotic heavy metal ions that use ionic mimicry to interfere with the cellular function of biomacromolecules. Using a combination of SAXS, electron microscopy, FRET, and solution NMR spectroscopy, we demonstrate that treatment with Cd2+ and Pb2+ causes self-assembly of protein kinase C regulatory domains that peripherally associate with membranes. The self-assembly process successfully competes with ionic mimicry and is mediated by conserved protein regions that are distinct from the canonical Ca2+-binding motifs of protein kinase C. The ability of protein oligomers to interact with anionic membranes is enhanced compared to the monomeric species. Our findings suggest that metal-ion-dependent peripheral membrane domains can be utilized for generating protein-metal-ion nanoclusters and serve as biotemplates for the design of sequestration agents.

Complete Genome Sequence of Klebsiella pneumoniae Siphophage Sugarland.

Klebsiella pneumoniae is a Gram-negative bacterium associated with the gastrointestinal tract and is a significant nosocomial pathogen due to its antibiotic resistance. Phage therapy against K. pneumoniae may prove useful in treating infections caused by this bacterium. This announcement describes the genome of the T5-like K. pneumoniae siphophage Sugarland.