A retrospective study of pulse steroid therapy for acute respiratory failure associated with tuberculosis.

BACKGROUND: Tuberculosis can cause acute respiratory failure, which is associated with a high mortality rate, even in patients receiving effective anti-tuberculosis therapy. We retrospectively analyzed patients with acute respiratory failure associated with tuberculosis who underwent pulse steroid therapy to describe the clinical characteristics and effectiveness of pulse steroid therapy in this condition. METHODS: The medical records of patients admitted to our hospital for culture-proven tuberculosis treatment from April 1, 2017, to March 31, 2022, who received pulse steroid therapy for acute respiratory failure associated with tuberculosis were reviewed. RESULTS: In total, 10 patients were included in this study. Chest computed tomography (CT) revealed diffuse ground-glass opacities and consolidation in these patients. Overall, 70% of the patients (7/10) showed an adjudicated response to pulse steroid therapy, with improved respiratory condition and radiological findings. Three patients died without response to pulse steroid therapy. One patient died of pancreatic cancer after recovering from respiratory failure. The remaining six patients were discharged without supplemental oxygen and completed anti-tuberculosis therapy. CONCLUSIONS: Pulse steroid therapy can lead to dramatic improvements in some patients with acute respiratory failure associated with tuberculosis.

Poncet's Disease (Reactive Arthritis Associated with Tuberculosis).

An 82-year-old man with miliary tuberculosis was admitted to our hospital. Approximately six weeks after starting anti-tuberculosis treatment, he complained of pain in the fingers, wrists, and ankles. A histopathological examination of the synovial biopsy revealed nonspecific chronic inflammation with no granulomas. Culture of the biopsy specimen yielded no acid-fast bacilli. Poncet's disease was diagnosed based on the clinical presentation, with no findings suggestive of other diseases. His joint pain rapidly improved with steroid therapy. Tuberculosis can cause arthritis through immune-mediated mechanisms without direct invasion in an entity known as Poncet's disease.

Abatacept for rheumatoid arthritis complicated by disseminated cryptococcosis: a case report.

A 78-year-old man developed disseminated cryptococcosis with central nervous system involvement as encapsulated yeast cells were detected in transbronchial biopsy and skin biopsy specimens, and cerebrospinal fluid. Cryptococcus neoformans was confirmed by culture. He had been treated with low-dose prednisolone and methotrexate for rheumatoid arthritis. He started receiving antifungal therapy with intravenous liposomal amphotericin B followed by oral fluconazole. Methotrexate was discontinued. Approximately 4 months after the course of intravenous liposomal amphotericin B was completed, he complained of pain and swelling of the right wrist, which suggested that rheumatoid arthritis was worsening. Abatacept therapy was initiated along with antifungal therapy, and his symptoms relieved. After 24 months of antifungal therapy, although he was still receiving oral fluconazole, he was doing well and the serum cryptococcal antigen had become negative. Disseminated cryptococcosis is an important opportunistic infection associated with low-dose methotrexate for rheumatoid arthritis. Abatacept therapy may be feasible in strictly selected patients with rheumatoid arthritis complicated with cryptococcosis concomitantly with intensive anti-fungal therapy.

Prediction of the duration needed to achieve culture negativity in patients with active pulmonary tuberculosis using convolutional neural networks and chest radiography.

BACKGROUND: We aimed to predict the duration needed to achieve culture negativity in patients with active pulmonary tuberculosis using convolutional neural networks (CNNs) and chest radiography. METHODS: Medical records were searched for eligible patients with culture-confirmed active pulmonary tuberculosis. The eligible patients were randomly assigned to the training dataset group (N = 180) and the validation dataset group (N = 59). Posteroanterior X-ray radiographs in the standing position were obtained at diagnosis. The image data were augmented by a factor of 10 by randomly shifting and rotating the original image. Thus, 1800 images (112 × 112 pixels, 8-bit grayscale) from 180 patients in the training dataset group were used for training the CNN model. The model performance was evaluated on the validation dataset. RESULTS: The values predicted by the CNN model were significantly associated with the actual values (Pearson's correlation coefficient 0.392, p = 0.002). The mean absolute error was 18.0. The visualization of the layer outputs suggested that the CNN model recognized some of the chest radiographic findings that were useful in predicting the duration needed to achieve culture negativity. CONCLUSIONS: The CNN model was useful for predicting the duration needed to achieve culture negativity in active pulmonary tuberculosis, although the accuracy was unsatisfactory. This study suggests that chest radiography findings are as important as other clinical factors for prediction and could be learned by the machine.

Uniform and controllable preparation of Au-Ag core-shell nanorods using anisotropic silver shell formation on gold nanorods.

Anisotropic and controllable silver shell formation on gold nanorods was realized in a micellar solution of hexadecytrimethylammonium chloride. Uniformity of the anisotropic Au-Ag core-shell particles contributes separation of four extinction bands. The ability to manipulate the shapes and sizes of these nanoparticles offers a wide-range control of the surface extinction from the visible to the near infrared regions (450-800 nm).

Characterization of silver ions adsorbed on gold nanorods: surface analysis by using surface-assisted laser desorption/ionization time-of-flight mass spectrometry.

Surface-assisted laser desorption/ionization time-of-flight mass spectrometry (SALDI-MS) indicated AgBr2-, which adsorbed on gold nanorod surfaces, was a key material to control the anisotropic growth of gold nanorods.

Photochemical reactions of ketones to synthesize gold nanorods.

Photochemical synthesis of gold nanorods (NRs) in a micellar solution of hexadecyltrimethylammonium bromide (CTAB) was triggered by photoreactions of ketones. Photoexcitation of gold ions and silver bromide clusters ((AgBr)n) in the absence of ketones did not produce NRs. The initial products of the photoirradiation were probably ketyl radicals, which then initiated reactions to form NRs. NRs formed in darkness, if the reaction solutions were irradiated by UV light for a few minutes, thus indicating that the photochemical products catalyzed NR-formation.

Rapid synthesis of gold nanorods by the combination of chemical reduction and photoirradiation processes; morphological changes depending on the growing processes.

Combination of chemical reduction of tetrachloroaurate by ascorbic acid and subsequent ultraviolet photoirradiation resulted in the quick generation of gold nanorods quantitatively, with appreciable shape changes as the reaction proceeds.