Does miliary sarcoidosis really exist? A case report and review of the literature.

BACKGROUND: Miliary sarcoidosis is a rare form of sarcoidosis characterized by numerous miliary-like micronodules dispersed throughout the lungs. It has been documented in less than 1% of all sarcoidosis cases. We first described a rare case of miliary sarcoidosis and then conducted a literature review on the subject. CASE PRESENTATION: A 51-year-old male complained about a progressive loss of appetite, significant weight loss, occasional night sweats, and fatigue. After a thorough clinical exploration, a differential diagnosis of miliary lung disease was suspected - miliary tuberculosis, fungal infection, metastatic pulmonary carcinoma, or sarcoidosis. High-resolution chest computed tomography revealed bilateral diffuse micronodules with mediastinal lymphadenopathy. Histopathological analysis of transbronchial bioptic tissue identified non-caseating epithelioid granulomas, while no malignant cells were found. Lung tuberculosis and fungal infections were excluded. The levels of angiotensin-converting enzyme in the blood, as well as serum's and 24-hour urine calcium levels, were elevated. After a multidisciplinary discussion, the diagnosis of miliary pulmonary sarcoidosis was established. The patient was treated with prednisone for a total of 9 months, with full clinical and radiological recovery. Using PubMed, we also conducted a review of the literature on this topic and discovered only a few case reports of patients with miliary sarcoidosis, with just one systematic review accessible. The key findings of studies investigating patients diagnosed with miliary sarcoidosis are tabularly displayed. CONCLUSIONS: Miliary sarcoidosis is an uncommon type of pulmonary sarcoidosis that can mimic several entities that manifest as miliary nodules. Most patients require treatment since it can have a significant impact on lung function.

Measuring pharmacovigilance knowledge and attitudes among healthcare sciences students: development and validation of a universal questionnaire.

OBJECTIVE: Pharmacovigilance education and reporting of adverse drug reactions (ADRs) are important competencies that healthcare sciences students should develop before completing their studies and entering clinical practice. Since students frequently lack adequate knowledge in this area and fail to recognize the importance of ADRs monitoring and reporting, the aim of this study was to develop and validate a unique and reliable instrument for assessing health sciences students' knowledge and attitudes toward pharmacovigilance and ADRs reporting. SUBJECTS AND METHODS: A cross-sectional observational study was conducted from February to July 2021 to examine students' knowledge and attitudes toward pharmacovigilance activities. Students of medicine, dentistry, pharmacy, and nursing science of three faculties in the Autonomous Province of Vojvodina, Serbia were examined. A total of 211 of them completed the specially designed, three-section questionnaire (Demographic data section, Pharmacovigilance Knowledge test, PVKT, and Pharmacovigilance Attitude Questionnaire, PVAQ). The questionnaire was posted on the Google Forms platform, and the link was distributed to respondents via the official websites and social networks of all three faculties. RESULTS: Findings demonstrated good psychometric properties and reliability of the questionnaire. Six questions were removed from the PVKT after item analyses. After excluding these items, the calculated ordinal alpha of the final version of the PVKT, which included 14 items, was good (αord = 0.83), as were other statistical indicators. PVAQ reliability testing also revealed great performance of this questionnaire-calculated ordinal alpha for two PVAQ subscales was excellent (αord = 0.91, for both scales). CONCLUSIONS: This questionnaire has favorable validity and reliability in assessing healthcare sciences students' knowledge and attitudes toward pharmacovigilance and ADRs reporting.

Precipitation composition and wet deposition temporal pattern in Central Serbia for the period from 1998 to 2004.

Bulk samples collected on a daily basis at three principal meteorological stations in central Serbia were analyzed on chloride (Cl(-)), nitrate (NO(3)(-)), sulfate (SO(4)(2-)), sodium (Na(+)), ammonium (NH(4)(+)), potassium (K(+)), calcium (Ca(2+)), and magnesium (Mg(2+)) in addition to precipitation amount, pH and conductivity measurements over the period 1998-2004. The data were subjected to variety of analyses (linear regression, principal component analysis, time series analysis) to characterize precipitation chemistry in the study area. The most abundant ion was SO(2-)(4) with annual volume weighted mean concentration of 242 microeq L(-1). Neutralization of precipitation acidity occurs both as a result of the dissolution of alkaline compounds containing Ca(2+), Mg(2+), and K(+) as well as the absorption of ammonia. The ratio of SO(4)(2-)/NO(3)(-) was above 5, which indicated that the combustion process of low-grade domestic lignite for electricity generation from coal-fired thermal power plants was the main source of pollution in the investigated area. A considerable mean annual bulk wet deposition of SO(4)-S determined by precipitation amount and concentrations of sulfate in the precipitation was calculated to be 12-35 kg ha(-1).

A WBAN System for Ambulatory Monitoring of Physical Activity and Health Status: Applications and Challenges.

Recent technological advances in sensors, low-power integrated circuits, and wireless communications have enabled the design of low-cost, miniature, lightweight, intelligent physiological sensor platforms that can be seamlessly integrated into a body area network for health monitoring. Wireless body area networks (WBANs) promise unobtrusive ambulatory health monitoring for extended periods of time and near real-time updates of patients' medical records through the Internet. A number of innovative systems for health monitoring have recently been proposed. However, they typically rely on custom communication protocols and hardware designs, lacking generality and flexibility. The lack of standard platforms, system software support, and standards makes these systems expensive. Bulky sensors, high price, and frequent battery changes are all likely to limit user compliance. To address some of these challenges, we prototyped a WBAN utilizing a common off-the-shelf wireless sensor platform with a ZigBee-compliant radio interface and an ultra low-power microcontroller. The standard platform interfaces to custom sensor boards that are equipped with accelerometers for motion monitoring and a bioamplifier for electrocardiogram or electromyogram monitoring. Software modules for on-board processing, communication, and network synchronization have been developed using the TinyOS operating system. Although the initial WBAN prototype targets ambulatory monitoring of user activity, the developed sensors can easily be adapted to monitor other physiological parameters. In this paper, we discuss initial results, implementation challenges, and the need for standardization in this dynamic and promising research field.

Reconfigurable intelligent sensors for health monitoring: a case study of pulse oximeter sensor.

Design of low-cost, miniature, lightweight, ultra low-power, intelligent sensors capable of customization and seamless integration into a body area network for health monitoring applications presents one of the most challenging tasks for system designers. To answer this challenge we propose a reconfigurable intelligent sensor platform featuring a low-power microcontroller, a low-power programmable logic device, a communication interface, and a signal conditioning circuit. The proposed solution promises a cost-effective, flexible platform that allows easy customization, run-time reconfiguration, and energy-efficient computation and communication. The development of a common platform for multiple physical sensors and a repository of both software procedures and soft intellectual property cores for hardware acceleration will increase reuse and alleviate costs of transition to a new generation of sensors. As a case study, we present an implementation of a reconfigurable pulse oximeter sensor.

[Mycobacteriosis]. / Mikobakterioze.

Classification of atypical mycobacteria, problems related to their identification, epidemiological, clinical, radiological and pathohistological presentation of mycobacteriosis are given. Up-to-date alternatives for treatment of these patients are also given. Finally, three cases treated at the VII Clinical Ward of the Institute of Pulmonary Diseases and TBC in the course of 1990 are presented. In two of them Mycobacterium avium was isolated. In all three cases the same strains were isolated and identified repeatedly.

[Obytin in the treatment of superficial skin mycoses]. / Obytin u lecenju povrsnih mikoza koze.

Obytin (1% Cyclopyroxolamine) in the form of cream, a preparation of the firm Jugoremedija/Hoechst, was applied in the treatment of 33 patients with dermatophytic skin infections. The diseases were most frequently located in the intertriginous areas 19 (57%), somewhat less frequently on nude places of the skin 9 (27%), and on the hands and feet 5 (16%). The cream was applied twice daily for 28 days. Acute clinical symptoms of the disease disappeared rapidly under the influence of the preparation and disappeared completely after three weeks of treatment in 32 patients (97%); and four weeks after start of therapy mycology tests were negative in the same number of cases. Only 3% of patients had no evident changes during therapy. Obytin is one of the new topical antifungal agents with a wide spectrum of action and it can be used in all types of superficial dermatomycoses as well as in some bacterial infections. It is characterized by rapid onset of action. Side effects of local or systemic nature (irritative, alergic or toxic) had not been registered.

Isolation of the glycoprotein of vesicular stomatitis virus and its binding to cell surfaces.

The glycoprotein (G) of vesicular stomatitis virus (VSV) was radiolabelled, extracted and purified so that its potential interaction with host cell surfaces could be studied. When BHK-21 cells were incubated with the radiolabelled virus glycoprotein, the virus component rapidly attached to the cell surface. The attachment was shown to be temperature-dependent adn saturated at approx. 3 X 10(5) molecules/cell. The omission of Mg2+ or Ca2+ from the incubation medium had little effect on the glycoprotein binding. Treating the isolated G protein and intact virions with neuraminidase did not significantly decrease their binding to BHK-21 cells. Pre-incubating cells with trypsin did not decrease the attachment of VSV virions nor the binding of purified G protein. Treating cells with phospholipase A or phospholipase C suggested that the binding of the glycoprotein and the intact virion might have been dissimilar. Unlabelled glycoprotein competitively inhibited binding of the labelled molecules although the presence of intact virions did not inhibit attachment of the G protein. Likewise, saturating amounts of the glycoprotein did not decrease binding of VSV to BHK-21 cells. These observations suggested that either the isolated glycoprotein bound to cell surface components that were distinct from the virion receptor or that the manner of the purified glycoprotein attachment differed from the G protein still associated with the intact virion. Chemical crosslinking and diagonal two-dimensional gel electrophoresis were used to identify and to compare the cell surface components responsible for glycoprotein and virion attachment.

The relationship between glycosylation and glycoprotein metabolism of mouse neuroblastoma N18 cells.

Two inhibitors of glycosylation, glucosamine and tunicamycin, were utilized to examine the effect of glycosylation inhibition in mouse neuroblastoma N18 cells on the degradation of membrane glycoproteins synthesized before addition of the inhibitor. Treatment with 10 mM-glucosamine resulted in inhibition of glycosylation after 2h, as measured by [3H]fucose incorporation into acid-insoluble macromolecules, and in a decreased rate of glycoprotein degradation. However, these results were difficult to interpret since glucosamine also significantly inhibited protein synthesis, which in itself could cause the alteration in glycoprotein degradation [Hudson & Johnson (1977) Biochim. Biophys. Acta 497, 567-577]. N18 cells treated with 5 microgram of tunicamycin/ml, a more specific inhibitor of glycosylation, showed a small decrease in protein synthesis relative to its effect on glycosylation, which was inhibited by 85%. Tunicamycin-treated cells also showed a marked decrease in glycoprotein degradation in experiments with intact cells. The inhibition of glycoprotein degradation by tunicamycin was shown to be independent of alterations in cyclic AMP concentration. Polyacrylamide-gel electrophoresis of isolated membranes from N18 cells, double-labelled with [14C]fucose and [3H]fucose, revealed heterogeneous turnover rates for specific plasma-membrane glycoproteins. Comparisons of polyacrylamide gels of isolated plasma membranes from [3H]fucose-labelled control cells and [14C]fucose-labelled tunicamycin-treated cells revealed that both rapidly and slowly metabolized, although not all, membrane glycoproteins became resistant to degradation after glycosylation inhibition.

Characterization of cell-surface glycopeptides from mouse cerebral cortex that inhibit cell growth and protein synthesis.

Glycopeptides were isolated from the cell surfaces of mouse brain cortical tissue that inhibited both cell division and protein synthesis by cells in culture. The protein-synthesis inhibition appeared to affect most cells exposed and was equally effective against glycoprotein and protein synthesis. The inhibition of protein metabolism was independent of mRNA synthesis and uptake of labelled precursors into intracellular pools, indicating that it was directed at intracellular translational events. Fractionation of chloroform/methanol-extracted preparations of this brain cell-surface substance on Bio-Gel P-100 revealed the material to be quite heterogenous, although inhibitory activity was found only in fractions of mol.wt. 25000--30000 and 6000--10000. Biochemical analysis of these fractions demonstrated that they were 6% carbohydrate and 94% amino acid by weight. The 25000--30000-mol.wt. glycopeptides were shown to inhibit cell growth at concentrations of 2 microgram/ml in cultured cells and to inhibit protein synthesis by 50% at concentrations of 3 microgram/ml. The 25000--30000-mol.wt. brain-cell-surface-substance glycopeptides were further purified by ultrafiltration and affinity chromatography with Ulex europaeus agglutinin, resulting in a 400-fold increase in specific biological activity. The inhibitor was not lethal to cells and was not species- or tissue-specific.

Growth and metabolism of fucosylated plasma-membrane glycoproteins in mouse neuroblastoma N2a cells.

The presence of 1.0mm-dibutyryl cyclic AMP (N(6),O(2')-dibutyryladenosine 3':5'-cyclic monophosphate) and 1.5mm-theophylline completely inhibits the growth of mouse neuroblastoma N2a cells by 24-36h. When compared with N2a cultures without inhibitors (controls), the proportion of cells in S phase, measured by radioautography with [(3)H]-thymidine, was decreased from 55 to 12%. In addition, the presence of the inhibitors decreased apparent [(3)H]fucose incorporation into glycoproteins by 50%, and removing the inhibitors resulted in a rapid recovery of both DNA synthesis and glycoprotein metabolism. Measurement of intracellular acid-soluble radioactive fucose revealed that decreased fucose uptake could account for the apparent change in incorporation. Removing dibutyryl cyclic AMP and theophylline from the medium resulted in a rapid uptake of radioactive fucose to within control values, which illustrated that the inhibitors decreased transport of the carbohydrate, although the cells remained viable. Treatment with dibutyryl cyclic AMP and theophylline also reversibly inhibited glycoprotein degradation. Plasma membranes isolated from growing cells and from growth-inhibited cells labelled with [(14)C]fucose and [(3)H]fucose respectively were co-electrophoresed on sodium dodecyl sulphate/polyacrylamide gels. These displayed no apparent differences in synthesis of specific membrane glycoproteins. Electrophoresis of plasma membranes isolated from cultures pulse-chased with [(14)C]fucose and [(3)H]fucose was used to discern turnover patterns of specific plasma-membrane glycoproteins. High-molecular-weight glycoproteins exhibited rapid rates of turnover in membranes from growing cells, but moderate turnover rates in growth-inhibited cells and cells reversed from growth inhibition. These data indicate that growth arrest of N2a cells results in alterations in the metabolic turnover of plasma-membrane glycoproteins.