1141

The prevalence of E. coli in faecal sample of apparently healthy and clinical cases of goats was investigated. A total of 150 samples of which 90 from clinical cases and 60 from apparently healthy goat were examined. Among the samples examined, 65(72.22%) and 25(41.67%) were found to be positive for E. coli in clinical and healthy cases respectably. The banding pattern of chromosome of isolated E. coli from goats of apparently healthy and clinical cases was also carried out by Pulsed Field Gel Electrophoresis through which the clonal relation between the isolated E. coli was studied. Chromosomal banding pattern of E. coli from goat of apparently healthy cases from same and different location were found identical which indicates similar clonal origin of E. coli. On the other hand, banding pattern of E. coli chromosome from diseased goat of different location were found dissimilar which may be either due to difference in origin of E. coli clone or phage encoded chromosome which can muted E. coli isolates. Thus it can be concluded that Pulsed Field Gel Electrophoresis profile varies according to severity of the disease.Keywords: Goat; E. coli; Isolation; Molecular CharacterizationDOI: http://dx.doi.org/10.3329/bjm.v27i1.9162BJM 2010; 27(1): 14-17

Multiple introductions and subsequent transmission of multidrug-resistant Candida auris in the USA: a molecular epidemiological survey

Monte Carlo (MC) methods are recognized as the gold-standard for dose calculation, however they have not replaced analytical methods up to now due to their lengthy calculation times. GPU-based applications allow MC dose calculations to be performed on time scales comparable to conventional analytical algorithms. This study focuses on validating our GPU-based MC code for proton dose calculation (gPMC) using an experimentally validated multi-purpose MC code (TOPAS) and compare their performance for clinical patient cases. Clinical cases from five treatment sites were selected covering the full range from very homogeneous patient geometries (liver) to patients with high geometrical complexity (air cavities and density heterogeneities in head-and-neck and lung patients) and from short beam range (breast) to large beam range (prostate). Both gPMC and TOPAS were used to calculate 3D dose distributions for all patients. Comparisons were performed based on target coverage indices (mean dose, V95, D98, D50, D02) and gamma index distributions. Dosimetric indices differed less than 2% between TOPAS and gPMC dose distributions for most cases. Gamma index analysis with 1%/1 mm criterion resulted in a passing rate of more than 94% of all patient voxels receiving more than 10% of the mean target dose, for all patients except for prostate cases. Although clinically insignificant, gPMC resulted in systematic underestimation of target dose for prostate cases by 1–2% compared to TOPAS. Correspondingly the gamma index analysis with 1%/1 mm criterion failed for most beams for this site, while for 2%/1 mm criterion passing rates of more than 94.6% of all patient voxels were observed. For the same initial number of simulated particles, calculation time for a single beam for a typical head and neck patient plan decreased from 4 CPU hours per million particles (2.8–2.9 GHz Intel X5600) for TOPAS to 2.4 s per million particles (NVIDIA TESLA C2075) for gPMC. Excellent agreement was demonstrated between our fast GPU-based MC code (gPMC) and a previously extensively validated multi-purpose MC code (TOPAS) for a comprehensive set of clinical patient cases. This shows that MC dose calculations in proton therapy can be performed on time scales comparable to analytical algorithms with accuracy comparable to state-of-the-art CPU-based MC codes.

Elaboration of a Framework for Assessment of IT-based Interventions in the Field of Autism Disorder

Bovine neonatal pancytopenia (BNP): novel insights into the incidence, vaccination-associated epidemiological factors and a potential genetic predisposition for clinical and subclinical cases

Introduction/Objective Many natural products have biological effects on humans and animals. Poisoning caused by natural products is often found in clinical toxicology cases. Liquid chromatography-high-resolution-mass spectrometry (LC-HRMS) has recently emerged as a powerful analytical tool for large-scale target screening, and the application of LC-HRMS can be expanded to solve the clinical cases of natural product poisoning. Methods The LC-HRMS method is based on a spectral library of 121 natural products. The spectral library was constructed by analyzing standards either in a Q-TOF mass spectrometer (only MS2 spectra acquired) or in an Orbitrap Tribrid mass spectrometer (MS2 and MS3 spectra acquired). Results The LC-HRMS method was verified for the limit of detection (LOD) and matrix effects in both serum and urine matrices. For each compound, the LOD was evaluated from 1.0 ng/ml to 1000 ng/ml for urine samples and from 0.50 ng/ml to 500 ng/ml for serum samples. The matrix effects were determined at three concentration levels andranged from 30.4% to 123.5% for urine samples and from 23.4% to 132.9% for serum samples. The LC-HRMS method was successfully applied to identify the culprits in three clinical cases. In addition, the combined use of MS2 and MS3 spectra enhanced the accuracy of compound identification, in library search reducing the importance of retention time that varies among instruments and consumable lots. In Case 1, the patient presented with paresthesias, arrhythmias, and stiffened arms and legs. The toxic alkaloid aconitine was identified in the serum sample and the extract of herbs that the patient ingested. In Case 2, the patients presented with weakness, dizziness, and vomiting. The symptoms were caused by mistakenly taking Nicotiana glauca leaves and the alkaloid anabasine was identified as the culprit. In Case 3, the patients were suspected of intoxicated by taking too much extract of lupini beans. The culprit alkaloids from lupini beans lupanine and sparteine were found in the serum samples. Conclusion The involvement of a toxicology laboratory with the capability to perform the LC-HRMS method and with experience in the investigation of undifferentiated cases provides a unique diagnostic advantage in cases where exposure to toxic substances is possible.

Cytological examination of the material from the bronchopulmonary system is a highly effective method of diagnosing lung cancer. Cytomorphological criteria for various types of lung tumors, including adenocarcinomas, are well known and described in detail in the literature. However, in some cases, cytologists face difficulties in the differential diagnosis of various types and subtypes of malignant lung lesions, which determines the continuing interest in studying their cytomorphological features. The article presents a clinical and morphological case of lung adenocarcinoma, shows the high efficiency of the traditional (classical) cytological method in its diagnosis, which complements the literature data. Introduction. Lung cancer (LC) occupies a leading place in the structure of the incidence of malignant neoplasms and a leading place in the structure of mortality among cancer patients. Cytological examination of lung material is a highly informative, accessible and minimally invasive method of diagnosing LC. Discussion. The article presents a clinical and morphological case of lung adenocarcinoma in a 62-year-old man. To assess the lesion, a comprehensive diagnosis was carried out using a combined cytological method of examining sputum samples, taking into account clinical and anamnestic data and the results of imaging studies. The data obtained were correlated with the results of histological and immunohistochemical studies. Conclusion. An integrated approach based on the analysis of the morphological features of the cellular material, clinical and anamnestic data, and the results of immunochemical research allows to increase the value of cytological examination of sputum. The results of the combined cytological examination correlate with the data of histological and immunohistochemical studies.

Lipoma of sigmoid

Background The past few years have been a time of rapid development in artificial intelligence (AI) and its implementation across numerous fields. This study aimed to compare the performance of GPT-4o (OpenAI, San Francisco, CA, USA) and DeepSeek-R1 (DeepSeek AI, Zhejiang, China) on the Polish specialty examination in infectious diseases. Materials and methods The study was conducted from April 1 to April 4, 2025, using the Autumn 2024Polish specialty examination in infectious diseases.The examination comprised 120 questions, each presenting five answer options, with only one correct choice. The Center for Medical Education (CEM) in Łódź, Polanddecided to withdraw one question due to the absence of a definitive correct answer and inconsistency with up-to-date clinical guidelines. Furthermore, the questions were classified as either 'clinical cases' or 'other' to enable a more in-depth evaluation of the potential of artificial intelligence in real-world clinical practice.The accuracy of the responses was verified using the official answer key approved by the CEM.To assess the accuracy and confidence level of the responses provided by GPT-4o and DeepSeek-R1, statistical methods were employed, including Pearson's χ2test, and Mann-Whitney U test. Results GPT-4o correctly answered 85 out of 199questions (71.43%) while DeepSeek-R1 answered correctly 88 out of 199 questions (73.85%).A minimum of 72 (60.5%) correct responses is required to pass the examination.No statistically significant difference was observed between responses to 'clinical case' questions and 'other' questions for either AI model.For both AI models, a statistically significant difference was observed in the confidence levels between correct and incorrect answers, with higher confidence reported for correctly answered questions and lower confidence for incorrectly answered ones. Conclusions Both GPT-4o and DeepSeek-R1 demonstrated the ability to pass the Polish specialty examination in infectious diseases, suggesting their potential as educational tools. Additionally, it is noteworthy that DeepSeek-R1 achieved a performance comparable to GPT-4o, despite being a much newer model on the market and, according to available data, having been developed at significantly lower cost.

Proximal 1q21 microduplication is an incomplete penetrance and variable expressivity syndrome. This study reports 28 new cases and summarizes data on phenotype, gender, and parental origin. Data on isolated proximal 1q21.1 microduplications (g. chr1:145,394,956-145,762,959 GRCh37/hg19) was retrieved in postnatal and prenatal "clinical cases" group, and prenatal "control group." The "clinical cases" cases included cases where chromosomal microarray (CMA) was performed due to congenital anomalies, autism spectrum disorder, seizures, and developmental delay/intellectual disability. The "control group" cases consisted of fetal CMA performed upon parental request despite normal nuchal translucency and anatomical second trimester fetal scans. We analyzed a local database of 27,990 cases and another cohort of 80,000 cases (including both indicated and non-indicated cases) for population frequency analysis. A total of 62 heterozygous cases were found, including 28 index cases and 34 family members. Among the index cases, 13 (9 males, 4 females) were identified in the "clinical cases" group, of which 10 had developmental abnormalities. Parental origin was tested in 9/13 cases, and all were found to be maternally inherited. In the "control group," which comprised non-affected cases, of 15 cases (10 males, 5 females), only 5/11 were maternally inherited. Four cases with clinical follow-up showed no reported neurodevelopmental abnormalities. No de-novo cases were detected, and the population frequency in both cohorts was 1:1000. Proximal 1q21.1 microduplication is a recurrent copy number variant, associated with neurodevelopmental abnormalities. It has a greater impact on males inheriting it from their mothers than females from their fathers.

Ewing’s sarcoma is an aggressive tumor rarely found in the head and neck region and extremely rare in the nasal cavity or paranasal sinuses (2-3% of all Ewing’s sarcomas).
 Purpose: The article presents a clinical diagnostic case of nasal cavity Ewing’s sarcoma finally verified only by IHC test.
 Results: The presented clinical case describes Ewing’s sarcoma of the nasal cavity in a 14-year-old girl and presents the clinical picture, the results of MRI and CT examination of the sinuses, histopathological and IHC tests. Adequate diagnostical tools made it possible to establish a diagnosis. Timely determined treatment tactics, taking into account the tumor localization and possible postoperative complications, led to tumor remission. At present, the patient is under dynamic observation.
 Conclusion: The presented clinical case confirms that a primary nasal cavity Ewing’s sarcoma diagnostic largely depends on histopathological examination since visual diagnostic techniques do not provide reliable information on the tumor type.

Comparison of spectra and mean glandular dose (MGD) with tube voltage used in digital mammography for simulated, metrological and clinical cases

Mastitis has been a major challenge in dairy industry incurring heavy loss to dairy farmers. Although targeted antibiotic regime is successful for culturable microbes, the non-culturable and novel microbes are often overlooked. Hence, the present study employed a whole-metagenome profiling to investigate and compare the microbial diversity among the milk samples of healthy and affected buffaloes. 16 Milk samples were collected from Murrah buffaloes and classified into three groups based on the somatic cell count and California Mastitis Test score, i.e., Clinical (3), Sub-clinical (6), and Healthy (7). DNA extraction from milk was followed by Whole Meta-Genome Shotgun (WGS) sequencing to study microbial diversity. The study revealed that Proteobacteria as the most abundant phylum in the clinical mastitis cases, which could be related to the severity of the disease, whereas Firmicutes were strongly associated with the healthy group of buffaloes. The genus Acinetobacter was most abundant in clinical cases (79%) and least in healthy animals (33%). The present study provides important insights into the microbial population and composition in the milk of mastitis-affected buffaloes. The findings will aid in investigating potential therapeutic ways for reducing antibiotic resistance and treatment costs.

Variability in clinical target volume delineation for intensity modulated radiation therapy in 3 challenging cervix cancer scenarios

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and its related disease (COVID-19) continue to represent a challenge for humans. To date, vaccination programs have represented an opportunity to navigate the pandemic. However, the advent of new genetic COVID-19 variants has increased more attention representing a worrying threat not only for not vaccinated but also for vaccinated people as virus infections have been shown also in the last ones. Herein, we report different clinical cases and radiological findings of COVID-19 pneumonia in six fully vaccinated patients. Two patients had a history of Rituximab therapy for follicular lymphoma and with persistent positivity for SARS-CoV-2 on nasopharyngeal/oropharyngeal (NP/OP) swabs and with moderate pneumonia on the chest computed tomography (CT). One patient who resulted to be positive to delta variant 8 days after the second vaccination dose, died shortly after. Two patients were hospitalized due to the worsening of fever and dyspnea in presence of mild pneumonia on CT. In one patient mild pneumonia was found on the chest-CT performed after a lipothymic episode associated with chest pain and positive NP/OP swab tested for SARS-CoV-2. These data suggested that in fully vaccinated people, caution should be preserved, and the use of masks and social distancing should be continued in all closed environments. However, further clinical trials should be done to better understand how various factors can influence vaccine immunogenicity as the presence of virus mutations, age factors, and the presence of an immunocompromised state.