Recurrent Candida-Associated Esophageal Strictures in an Immunocompetent Patient.

Esophageal stricture due to Candida esophagitis is a rare complication reported among immunocompromised patients in only limited case reports. We describe a unique case of a 36-year-old man with chronic mucocutaneous candidiasis without underlying immunocompromise who experienced over 10 years of recurrent dysphagia due to esophageal strictures from candidiasis. His symptoms were initially believed to be due to eosinophilic esophagitis; however, numerous biopsies from the esophagus were negative for eosinophils. Several upper endoscopies, however, did reveal fungal elements consistent with Candida spp. He experienced recurring episodes of dysphagia and persistent esophageal stricture, requiring multiple antifungal courses and endoscopic balloon dilatations.

Author Correction: An open data infrastructure for the study of anthropogenic hazards linked to georesource exploitation.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

An open data infrastructure for the study of anthropogenic hazards linked to georesource exploitation.

Mining, water-reservoir impoundment, underground gas storage, geothermal energy exploitation and hydrocarbon extraction have the potential to cause rock deformation and earthquakes, which may be hazardous for people, infrastructure and the environment. Restricted access to data constitutes a barrier to assessing and mitigating the associated hazards. Thematic Core Service Anthropogenic Hazards (TCS AH) of the European Plate Observing System (EPOS) provides a novel e-research infrastructure. The core of this infrastructure, the IS-EPOS Platform (tcs.ah-epos.eu) connected to international data storage nodes offers open access to large grouped datasets (here termed episodes), comprising geoscientific and associated data from industrial activity along with a large set of embedded applications for their efficient data processing, analysis and visualization. The novel team-working features of the IS-EPOS Platform facilitate collaborative and interdisciplinary scientific research, public understanding of science, citizen science applications, knowledge dissemination, data-informed policy-making and the teaching of anthropogenic hazards related to georesource exploitation. TCS AH is one of 10 thematic core services forming EPOS, a solid earth science European Research Infrastructure Consortium (ERIC) (www.epos-ip.org).

Ultrasound-guided fine needle aspiration diagnosis of supraglottic laryngeal cancer.

BACKGROUND: Although intraoperative laryngoscopic examination and biopsy of patients who present with locally advanced supraglottic carcinomas remains the standard of care, there are occasions when a more expedited biopsy can be helpful. METHODS AND RESULTS: We describe a quick diagnostic technique of ultrasound-guided fine needle aspiration of endolaryngeal advanced supraglottic carcinomas, which can be performed in the clinic without any preparation. Ultrasound scanning is performed through the thyrohyoid membrane. The tumor is visualized as an irregular hypoechoic mass. While continuing to visualize the mass, a 21-gange needle attached to a syringe is passed through the contralateral thyrohyoid membrane into the mass. Suction is applied, and the aspirate is sent for cytologic study. CONCLUSIONS: When formal intraoperative laryngoscopy and biopsy is not feasible or timely, ultrasound-guided fine-needle aspiration biopsy enables a rapid diagnosis and eliminates the cost, side effects, and risks of a direct laryngoscopy.

Geophysical monitoring of simulated clandestine graves using electrical and ground-penetrating radar methods: 0-3 years after burial.

This study provides forensic search teams with systematic geophysical monitoring data over simulated clandestine graves for comparison to active cases. Simulated "wrapped" and "naked" burials were created. Multigeophysical surveys were collected over a 3-year monitoring period. Bulk ground resistivity, electrical resistivity imaging, multifrequency ground-penetrating radar (GPR), and grave and background "soil-water" conductivity data were collected. Resistivity surveys revealed the naked burial had consistently low-resistivity anomalies, whereas the wrapped burial had small, varying high-resistivity anomalies. GPR 110- to 900-MHz frequency surveys showed the wrapped burial could be detected throughout, with the "naked" burial mostly resolved. Two hundred and twenty-five megahertz frequency GPR data were optimal. "Soil-water" analyses showed rapidly increasing (year 1), slowly increasing (year 2), and decreasing (year 3) conductivity values. Results suggest resistivity and GPR surveys should be collected if target "wrapping" is unknown, with winter to spring surveys optimal. Resistivity surveys should be collected in clay-rich soils.

Self-discontinuation of antiepileptic medication in pregnancy: detection by hair analysis.

PURPOSE: Concerns over teratogenicity of antiepileptic drugs (AEDs) during pregnancy must be balanced against the risks of seizures to the mother and developing fetus. Pharmacokinetic changes and vomiting may alter drug levels, but more important may be the patient's decision to stop medication before or during pregnancy. Compliance assessment traditionally relies either on self-reporting or on AED plasma level monitoring; neither provides reliable information on drug-taking behaviour over an extended interval (e.g., before, during, and after pregnancy). METHODS: We have used hair analysis to assess AED-taking behavior in pregnant women compared with nonpregnant female controls. Twenty-six pregnant women [mean age, 27.5 +/- 6.7 (SD) years] and 13 nonpregnant female epilepsy outpatients (mean age, 31.9 +/- 8.3 years) were studied. Carbamazepine (CBZ) or lamotrigine (LTG) concentrations were measured in 1-cm hair segments, and the within-subject variance in segmental hair concentrations of these drugs was calculated for each group. The variances of each group were then compared by using a variance ratio test. RESULTS: The variance of AED concentration in hair differed significantly between the pregnant and nonpregnant groups [variance ratio, 1.59 (p < 0.01)]. Four (15%) of the 26 pregnant patients had little or no AED in their proximal hair segments compared with more distal segments, apparently having discontinued their medication during pregnancy. Only one of these later disclosed having stopped her medication. One pregnant woman whose hair profile was similar to controls died suddenly at 30 weeks of gestation. CONCLUSIONS: This study confirms the perception that pregnant women with epilepsy frequently stop or greatly reduce their prescribed medication, usually without reference or acknowledgement to their clinician.