Total hip replacement infected with Mycobacterium tuberculosis complicated by Addison disease and psoas muscle abscess: a case report

Abstract Introduction Prosthetic joint infection due to Mycobacterium tuberculosis is occasionally encountered in clinical practice. To the best of our knowledge, this is the first report of a prosthetic joint infection due to Mycobacterium tuberculosis complicated by psoas abscesses and secondary Addison disease. Case presentation A 67-year-old immunocompetent Caucasian woman underwent total left hip arthroplasty because of osteoarthritis. After 18 months, she underwent arthroplasty revision for a possible prosthetic infection. Periprosthetic tissue specimens for bacteria were negative, and empirical antibiotic therapy was unsuccessful. She was then admitted to our department because of complications arising 22 months after arthroplasty. A physical examination revealed a sinus tract overlying her left hip and skin and mucosal pigmentation. Her levels of C-reactive protein, basal cortisol, adrenocorticotropic hormone, and sodium were out of normal range. Results of the tuberculin skin test and QuantiFERON-TB Gold test were positive. Computed tomography revealed a periprosthetic abscess and the inclusion of the left psoas muscle. Results of microbiological tests were negative, but polymerase chain reaction of a specimen taken from the hip fistula was positive for Mycobacterium tuberculosis. Our patient's condition was diagnosed as prosthetic joint infection and muscle psoas abscess due to Mycobacterium tuberculosis and secondary Addison disease. She underwent standard treatment with rifampicin, ethambutol, isoniazid, and pyrazinamide associated with hydrocortisone and fludrocortisone. At 15 months from the beginning of therapy, she was in good clinical condition and free of symptoms. Conclusions Prosthetic joint infection with Mycobacterium tuberculosis is uncommon. A differential diagnosis of tuberculosis should be considered when dealing with prosthetic joint infection, especially when repeated smears and histology examination from infected joints are negative. Clinical outcomes of prosthetic joint infection by Mycobacterium tuberculosis are unpredictable, especially given the limited literature in this field and the uncertainty of whether medical treatment alone can eradicate the infection without prosthesis removal. Furthermore, this case report raises interesting issues such as the necessity of a follow-up evaluation after treatment based on clinical conditions, the utility of a more standardized length of treatment for periprosthetic tuberculous infection, and the importance of a high diffusion capacity of anti-mycobacterial agents in order to eradicate the infection.</p

Picosecond Spin Orbit Torque Switching

Reducing energy dissipation while increasing speed in computation and memory is a long-standing challenge for spintronics research. In the last 20 years, femtosecond lasers have emerged as a tool to control the magnetization in specific magnetic materials at the picosecond timescale. However, the use of ultrafast optics in integrated circuits and memories would require a major paradigm shift. An ultrafast electrical control of the magnetization is far preferable for integrated systems. Here we demonstrate reliable and deterministic control of the out-of-plane magnetization of a 1 nm-thick Co layer with single 6 ps-wide electrical pulses that induce spin-orbit torques on the magnetization. We can monitor the ultrafast magnetization dynamics due to the spin-orbit torques on sub-picosecond timescales, thus far accessible only by numerical simulations. Due to the short duration of our pulses, we enter a counter-intuitive regime of switching where heat dissipation assists the reversal. Moreover, we estimate a low energy cost to switch the magnetization, projecting to below 1fJ for a (20 nm)^3 cell. These experiments prove that spintronic phenomena can be exploited on picosecond time-scales for full magnetic control and should launch a new regime of ultrafast spin torque studies and applications.Comment: Includes article + supplementary information. Latest version uses full name of the first author. Nature Electronics (2020

Stress, psychological disease, psychological well-being and personality in Italian firefighters compared to other working categories

This study analyzed the differences between firefighters and other working categories (urban policemen, employees in the service industry) in psychological well-being, anxiety, depression, personality and stress. Much research has evidenced that people who have to deal with emergencies are more subjected to psychological diseases. Our results showed that firefighters have lower levels of anxiety, depression, emotional instability and negative emotions in relation to urban policemen and employees. In addition, there are no significant differences in psychological well-being. Further research is necessary to define the specific psychological attitudes or traits which allow firefighters to deal with psychological disease and stress

Influence of Congested Match Schedules, Pre-Match Well-Being and Level of Opponents on Match Loads during World Rugby Women’s Sevens Series

This study aimed at assessing (1) the effect of congested match schedules on match loads and well-being as well as (2) pre-match well-being and level of opponents on match loads in elite women’s rugby sevens. Eleven players of the Brazilian women’s rugby sevens national team were investigated across three 2019-20 HSVC World Rugby Women’s Seven Series tournaments to assess: (1) within-tournament match-to-match changes in various external and internal match load measures; (2) daily changes in players’ well-being collected before the commencement of a tournament (day one) and during or post-tournament (day two to day four); and (3) the effect of pre-match well-being and level of opponents (high vs. low level) on match loads. Results revealed no between-match significant differences (p &gt; 0.05) in most of the investigated match load measures. A congested match schedule negatively affected perceived fatigue (p &lt; 0.001), muscle soreness (p = 0.004) and overall wellness (p &lt; 0.001), with post hoc analyses showing decreased values on day four compared to previous days (small-to-moderate effect sizes). Finally, pre-match well-being and level of opponents did not affect match loads (p &gt; 0.05). These results highlighted the necessity to embrace a multidimensional approach when adopting monitoring systems in elite women’s rugby sevens during tournaments and to consider various contextual factors possibly affecting match loads, besides those investigated.</jats:p

Influence of congested match schedules, pre-match well-being and level of opponents on match loads during World Rugby Women's Sevens series

This study aimed at assessing (1) the effect of congested match schedules on match loads and well-being as well as (2) pre-match well-being and level of opponents on match loads in elite women's rugby sevens. Eleven players of the Brazilian women's rugby sevens national team were investigated across three 2019-20 HSVC World Rugby Women's Seven Series tournaments to assess: (1) within-tournament match-to-match changes in various external and internal match load measures; (2) daily changes in players' well-being collected before the commencement of a tournament (day one) and during or post-tournament (day two to day four); and (3) the effect of pre-match well-being and level of opponents (high vs. low level) on match loads. Results revealed no between-match significant differences (p > 0.05) in most of the investigated match load measures. A congested match schedule negatively affected perceived fatigue (p 0.05). These results highlighted the necessity to embrace a multidimensional approach when adopting monitoring systems in elite women's rugby sevens during tournaments and to consider various contextual factors possibly affecting match loads, besides those investigated

Assessing the Relationship Between External and Internal Match Loads in Elite Women’s Rugby Sevens

Purpose: To assess the relationship between external and internal load during official women’s rugby seven matches. Methods: Six backs (age = 24.2 [3.2] y; height = 161.5 [7.3] cm; body mass = 59.5 [5.0] kg; playing experience = 5.3 [1.5] y) and 8 forwards (age = 22.4 [2.7] y; height = 167.0 [4.8] cm; body mass = 70.6 [5.6] kg; playing experience = 5.0 [1.5] y) belonging to the women’s rugby seven Brazilian national team were monitored across 3 international tournaments during the 2019–20 season, with 2 players excluded from the analysis since they did not participate in any investigated match. Total distance (TD), distance during high-intensity running 18.1 to 20.0 km·h−1 and &gt;20 km·h−1 (sprinting), number of accelerations &gt;1.8 m·s−2 (ACC), and of decelerations &lt;1.8 m·s−2 were used as match load volume measures, while their relative values (TD per minute, high-intensity running per minute, sprinting per minute, ACC per minute, and decelerations per minute) were used as external load match intensity measures. Internal load intensity and volume were assessed using the session rating of perceived exertion (sRPE) and its value multiplied by match duration (sRPE-ML), respectively. Spearman correlations and linear mixed models were used to assess the relationships between internal and external load measures. Results: A very large relationship (ρ = .830, P &lt; .001) was found between sRPE-ML and TD, with linear mixed models showing that TD statistically affected sRPE-ML (P &lt; .001). Linear mixed models analysis showed that ACC per minute was also affecting the sRPE-ML (P = .017), while sprinting (P = .007) and ACC per minute (P = .005) were the only 2 measures statistically affecting sRPE. However, weak relationships (trivial to large) were found for these and all other measures. Conclusions: These results highlight that TD is the main external load measure able to anticipate the internal load responses measured via sRPE-ML in elite women’s rugby sevens.</jats:p

In Valtellina : chiaroscuri /

University of Illinois Library bookplate "From the library of Conte Antonio Cavagna Sangiuliani di Gualdana Lazelada di Bereguardo, purchased 1921" on the inside front cover.Includes errata.Mode of access: Internet