Fluid Analysis Research Articles

Flow characteristics and factors affecting flow pulsation of external meshing herringbone gear pump

To enhance the outlet flow stability of the external herringbone gear pump, an analysis was conducted on the main influencing factors, key geometric parameters were identified, and a numerical model was developed for fluid analysis. A numerical model was then established for fluid analysis. The accuracy of the numerical model was verified by comparing it with experimental results, with simulation errors of displacement and volumetric efficiency being < 5%, ensuring the simulation's accuracy. The simulation results indicated that the pump's head (49.7808 m) and outlet pressure (4.9285 bar) remained stable. At 700 rev/min, the simulated volumetric efficiency was 82.94%. Subsequently, the impact of helix angle, changes in center distance, and tip clearance on outlet flow stability were analyzed. The analysis revealed that increasing the helix angle from 27° to 30° could reduce flow pulsation. A slight reduction in center distance from 180.3 (δ = +0.3 mm) to 179.9 mm (δ = −0.1 mm) effectively decreased mass flow difference and outlet pressure pulsation, enhancing outlet output stability. Reducing tip clearance from 0.25 to 0.12 mm, while meeting design requirements, resulted in more stable pressure and lift output. These results ensured smooth pump operation, improved outlet output stability, and met low-flow pulsation requirements. This study offered valuable insights into the design and production of the external meshing herringbone gear pump.

Construction of Kinetic Model of Vacuum Arc Magnetic Fluid Under External Magnetic Field

The external magnetic field is an important control method of vacuum arc at present. Because of its high efficiency and economy, it has become an important method to study the kinetic model of vacuum arc magnetic fluid. Therefore, the kinetic model of vacuum arc magnetic fluid under the external magnetic field is constructed. Firstly, the mass conservation equation, radial momentum conservation equation, axial momentum conservation equation, energy conservation equation, electromagnetic equations are analyzed. The boundary conditions of the dynamic model are cathode boundary, anode boundary and fluid wall boundary. The fluid dynamics calculation software FLUENT is used as the calculation platform, and its secondary development is carried out. Combining VC++self-programming and self-defined macro functions, according to the boundary conditions, the kinetic model of vacuum arc magnetic fluid under external magnetic field is solved, and the kinetic model analysis of vacuum arc magnetic fluid under external magnetic field is realized. Experimental analysis shows under the action of longitudinal magnetic field, the intensity of longitudinal magnetic field increases, the maximum point of ion rotation speed in the magnetic fluid of vacuum arc moves outward along the edge of vacuum arc, the number density of electrons gradually moves from the central axis to the radial direction, and the high density area increases first and then decreases; Under the action of transverse magnetic field, the intensity of transverse magnetic field increases, the ion pressure in vacuum arc magnetic fluid gradually shifts and increases, and the ion number density also increases.

Patterns of Microbial Infections in Post-Infective Hydrocephalus and Treatment Methods at Bugando Medical Center

Background: Post Infective Hydrocephalus is among the complicated types of hydrocephalus and poses a challenge in management of these patients, globally. Antibiotics susceptibility patterns of common bacteria implicating in pyogenic ventriculitis complicated with hydrocephalus were not clearly known at our setting. Therefore, we determined antibiotics susceptibility patterns of common bacteria implicating in pyogenic ventriculitis complicated with hydrocephalus to recommend empirical therapy while waiting for culture and sensitivity results at Bugando Medical Centre (BMC) in Mwanza, Tanzania. Methods: Thirty-five patients with hydrocephalus who had undergone cerebrospinal fluid (CSF) tapping and analysis were selected randomly retrospectively and their bacteriological culture and sensitivity results were analyzed to determine the common microbial patterns. Patients were rationally prescribed antibiotics depending on laboratory results for 7 days and were later done control CSF cultures until negative cultures were achieved. Results: A total of 35 patients with median (interquartile range [IQR]) age was 5.5 [2-8] months were reviewed. The majority of participants were males, 62.9% (22/35). 20% (7/35) and 37.1% (13/35) had turbid CSF-shunt sample and first culture positive results, respectively, whereas one patient had culture positive with two pathogens resulting to 14 isolates. Gram positive bacteria were predominantly isolated (66.7%, 8/14), whereby S. aureus was frequently encountered (35.7%, 5/14). Overall, gram positive and negative bacteria exhibited least resistance against tetracycline (16.7% and 25%) and ciprofloxacin (16.7% and 25%) respectively. Three (8.6%) patients died from respiratory complications. Conclusion: Post infective hydrocephalus is a clinically challenging but treatable form of hydrocephalus and Staphylococcus aurous is the most common cause. This study found that the use of a seven-day regimen as cost effective and associated with a shorter hospital stay with the focus on CSF analysis with subsequent microbial targeted antibiotic therapy to achieve sterile CSF culture. Treatment strategy should be multidisciplinary approach with collaboration from microbiologists, radiologists, pediatricians and neurosurgeons.

Diagnostic Value of Metagenomic next-generation sequencing and X-pert in Bronchoalveolar lavage fluid for pneumonia in HIV-infected and HIV-uninfected patients

BackgroundThe pathogens causing unexplained pneumonia in both HIV-infected or HIV-unfected patients are likely to be complex. This retrospective study aimed to characterize the etiology of pneumonia in HIV-infected and HIV-uninfected patients using bronchoalveolar lavage fluid (BALF) analysis with metagenomic next-generation sequencing (mNGS) and X-pert MTB/RIF. MethodsBetween January 2022 and May2024, 141 HIV-infected and 104 HIV-uninfected patients admitted to Nanjing Second Hospital with pneumonia were included. BALF samples were collected and analyzed using mNGS to detect bacteria, fungi, viruses, tuberculosis (TB) and non-tuberculous mycobacteria (NTM), and X-pert for TB detection. Clinical data including CD4 T-cell counts, comorbidities, and ART status were collected and analyzed. ResultsHIV-uninfected patients were found to be older and exhibited a higher prevalence of comorbidities compared to HIV-infected patients. Despite higher median CD4 T-cell counts in HIV-uninfected individuals (412 cells/μL vs. 31 cells/μL in HIV-infected), TB detection rates using X-pert and mNGS were lower than anticipated, particularly in HIV-infected patients. Mixed-pathogen infections were significantly more prevalent in HIV-infected patients, especially those with lower CD4 T-cell counts. ART use showed variable impacts on pathogen diversity, with longer treatment durations associated with reduced infection complexity but persistent immunodeficiency in some cases.In patients with pneumonia, whether HIV-infected or HIV-uninfected, pathogens often exhibit complexity, underscoring the critical role of timely mNGS and X-pert analysis of BALF for early pathogen detection.

Semi-analytical solutions for dynamic analysis of fluid conveying pipes by a novel hybrid method

Semi-analytical solutions for dynamic analysis of fluid conveying pipes by a novel hybrid method

Different allergen-induced asthma and anaphylaxis show distinctive IgE pathway dependence

BackgroundThe pathogenesis of allergic asthma is classically understood to involve allergens crosslinking Immunoglobulin E (IgE) bound to mast cells, leading to the release of histamine and other inflammatory mediators. ObjectiveThis study aims to explore whether different allergens have distinct IgE-dependent mechanisms in mouse models of both asthma and anaphylaxis. MethodsWild type (WT) and IgE knockout (IgE KO) mice were used to generate asthma mouse models. Lung inflammation was assessed by histological analysis and inflammatory cells in Bronchial Alveolar Lavage Fluids (BALF). Passive Cutaneous Anaphylaxis (PCA) was conducted to quantify IgE, and Toluidine Blue staining was used to visualize mast cell recruitment. ResultsAll allergen-treated mice exhibited significant airway inflammation. Compared to WT mice, HDM-treated IgE KO mice showed an attenuated inflammatory profile, particularly with reduced eosinophils. These mice had lower serum levels of HDM-specific IgE and IgG1 as well as reduced levels of Th2 cytokines interleukin 4 (IL-4) and IL-5 in BALF. CRE-treated IgE KO mice also displayed a reduced inflammation, with significant differences only in eosinophils. Interestingly, no significant differences in airway inflammation were observed between OVA-treated IgE KO mice and WT mice. Furthermore, both HDM and CRE-induced PCA model showed significantly less Evan's blue dye leakage and mast cell recruitment in the ears of IgE KO mice compared to WT mice, with no differences for OVA-induced PCA and mast cell recruitment. ConclusionThe results highlight the variability in IgE pathway dependence among different allergens, emphasizing the need for further research to delineate the underlying mechanisms.

Preliminary findings of a ‘test bundle’ to accelerate the diagnosis of MS and NMOSD following optic neuritis

No study has investigated the length of time it takes to diagnose multiple sclerosis (MS) or neuromyelitis optic spectrum disorder (NMOSD, aquaporin 4 antibody disease or myelin oligodendrocyte glycoprotein antibody disease, MOGAD) following the onset of de novo optic neuritis (ON). Minimizing the time between ON and downstream diagnoses needs urgency since early diagnosis equals early treatment. The time elapsed from ON to a subsequent diagnosis of MS/NMOSD was estimated through analysis of retrospective data collected from the Axon Registry (AR) of the American Academy of Neurology (AAN) and from the University of Kentucky (UK), Lexington. The time to diagnose MS/NMOSD was arbitrarily set as occurring < 6 months (early) or > 6 months (delayed) following ON. Data was collected between 2007 and 2021 (AR) and 2012 to 2022, for UK, respectively.Of the 4015 ON patients from the AR dataset, 1069 (26.6 %) were diagnosed with MS, with 857 (80.2 %) diagnosed < 6 months (early) and 212 (19.8 %) diagnosed after > 6 months (delayed). Secondly, 420/4015 (10.4 %) were diagnosed with NMOSD (either MOGAD or AQP4 antibody disease), of which 340/420 (80.9 %) were diagnosed < 6 months (early) and 80/420 (19 %) diagnosed > 6 months (delayed). In the UK dataset, a total of 90/1464 individuals (6.14 %) were diagnosed with MS; of these, 69 patients (76.7 %) were diagnosed at < 6 months (early) and included a sub-group of 25 (27.8 %) diagnosed < 4 weeks; 21 (23.3 %) were diagnosed > 6 months (delayed) following ON. In either dataset (AR or UK, between 20 % - 23 % of MS diagnoses occurred > 6 months (delayed) after a diagnosis of ON. An accelerated diagnosis (4 weeks or less) of MS/NMOSD following ON in the UK data suggests that it is possible to minimize the time to a downstream diagnosis if a ‘test bundle’ of MRI of orbits, brain, C-spine, cerebrospinal fluid (CSF) analysis, and serum testing for NMOSD is used. Additional studies using prospective, larger datasets are required to confirm our findings.

Adult‐onset neuronal ceroid lipofuscinosis in a smooth‐haired dachshund

AbstractA 5‐year‐old, smooth‐haired miniature dachshund exhibited a progressive history of frequent episodes of aggression towards objects, head pressing, circling and intermittent pelvic limb ataxia over a period of 2 weeks. Visual impairment was also noticed several months prior. Neurolocalisation was consistent with forebrain disease. Blood and urine analysis, magnetic resonance imaging of the brain and cerebrospinal fluid analysis were all unremarkable. The patient was euthanased due to disease progression, and postmortem histopathological analysis and electronic microscopy identified the accumulation of intracellular granular material in a number of neurons, mainly located in the thalamus and hypothalamus. This supported a diagnosis of neuronal ceroid lipofuscinosis. Genetic testing showed no mutations in the causative genes reported for this breed. This case reports the occurrence of a potentially novel subtype of neuronal ceroid lipofuscinosis, due to a currently unidentified genetic mutation, leading to an adult onset of clinical signs in the dachshund.

Lyme neuroborreliosis in adults - epidemiology data and clinical findings

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Introduction. &amp;lt;/strong&amp;gt;Lyme neuroborreliosis (LNB) can manifest during the early and late stages of Lyme disease (LD). The aim of this study is to determine epidemiology and clinical findings in patients with LNB.&amp;amp;nbsp;&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Methods.&amp;lt;/strong&amp;gt; The research was conducted in Banja Luka at the University Clinical Center of Republic of Srpska (UCC RS) during a four-year period from 10/2017 to 10/2021. The research included 51 patients admitted to the hospital with some neurological symptoms that could lead to the LNB diagnosis. Patients had lumbar puncture with cytochemical analysis of cerebrospinal fluid (CSF), ELISA anti-Borrelia IgM/IgG in serum and CSF, Immunoblot anti-Borrelia IgM/IgG in serum, and other documentation about epidemiology and clinical findings in LNB. &amp;amp;nbsp;&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Results.&amp;lt;/strong&amp;gt; A statistically significant (p=0.017) higher proportion of female patients was observed. Most patients were between 50 and 60 years old. Most of them were retirees (31.37%), farmers, medical technicians followed with forestry workers, students etc. Most of examinees did not have information on previous tick bite (64.71%). The largest number (72.55%) did not have data on previous skin changes. The largest number of neurological symptoms at admission related to the feeling of tingling and weakness in the extremities, headache, dizziness and some ophthalmological symptoms. Patients also suffered from consciousness and speech disorder, anxiety, paresis n.VII. The largest number of examinees had some neurological symptoms up to three months prior the admission to the hospital. &amp;amp;nbsp;&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Conclusion. &amp;lt;/strong&amp;gt;Symptoms of LNB can be quite non-specific or possibly even mimic other neurological diseases. Involvement&amp;amp;nbsp;&amp;lt;br /&amp;gt;of peripheral nervous system is dominant in adult patients. It is necessary to work on early diagnosis of LD and it is mandatory to report it to the national epidemiological service.&amp;amp;nbsp;&amp;lt;/p&amp;gt;

Clinical variability of equine asthma phenotypes and analysis of diagnostic steps in phenotype differentiation

BackgroundEquine asthma is a common, non-infectious, chronic lung disease that affects up to 80% of the horse population. Strict phenotyping and identification of subclinically asthmatic horses can be challenging. The aim of this study was to describe equine asthma phenotypes (mild, moderate, and severe asthma) defined by BALF cytology and occurrence of clinical signs in a population of privately owned horses and to identify the variables and examination steps with best discriminative potential. The standardised examination protocol included clinical examinations, blood work, airway endoscopy with bronchoalveolar lavage fluid analysis, arterial blood gas analysis and radiography under clinical conditions performed by one veterinarian.ResultsOut of 26 horses, four were diagnosed with mild (subclinical), seven with moderate, and seven with severe asthma based on clinical examination and BALF cytology. Eight horses served as controls. Cough with history of coughing was the strongest variable in phenotype differentiation. Factor analysis revealed an increasing clinical variability with disease severity and an overlapping of clinical presentations between phenotypes. Elevated mast cell (4/4 horses) and neutrophil counts (3/4 horses) in bronchoalveolar lavage cytology differentiated mild asthmatic horses from healthy horses. Moderate and severe asthmatic horses were characterised by clinical signs and neutrophil counts.ConclusionsThe results indicate that medical history, clinical examination and bronchoalveolar lavage cytology are minimum indispensable steps to diagnose equine asthma and that phenotypes are clinically overlapping. A differentiation of three phenotypes without neutrophil and mast cell counts in bronchoalveolar lavage cytology is not sufficient for clinical diagnostics. A comparably exact diagnosis cannot be achieved by relying on alternative examinations used in this study. Screenings of inconspicuous horses with bronchoalveolar lavage can aid in diagnosing subclinically affected animals, however, group size was small, the procedure is invasive and clinical relevance of slightly elevated cells in bronchoalveolar lavage remains unclear. Clinical relevance could not be clarified in this study, since follow-up examinations or lung function testing were not performed.

Review of voice biomarkers in the screening of neurodegenerative diseases

Abstract Neurodegenerative diseases significantly impact patients and their families, making early identification crucial for improving patients’ quality of life and reducing care burdens. Current screening methods for neurodegenerative diseases, such as dementia and mild cognitive impairment, still rely on subjective assessments or expensive techniques like invasive cerebrospinal fluid analysis and magnetic resonance imaging. These factors make early identification challenging. Voice biomarkers present a promising alternative as convenient, non-invasive, and low-cost screening tools. With the application and development of artificial intelligence and big data, the prediction and screening of neurodegenerative diseases based on voice data have become a research focus. This article reviews the progress in voice biomarkers for neurodegenerative diseases screening and classification. It summarizes relevant studies on both single and multimodal data, identifies existing challenges, and suggests future research directions to enhance the application of voice biomarkers in neurodegenerative disease contexts.

A prospective study of the association between varicoceles and semen quality in men with infertility

BackgroundMale infertility is a global problem, and varicoceles are a common and treatable cause of male infertility. This study prospectively evaluated the effects of varicoceles on the fertility status and potential among Nigerian men. The consequences of the presence, location, and grades of varicoceles on the fertility status of infertile men with varicoceles were determined using a Doppler scrotal ultrasound scan and their seminal fluid parameters.MethodsOne hundred infertile males with clinical varicoceles (study group) and 100 infertile males without varicocele (control group) were recruited. Varicoceles were confirmed/excluded and graded with an ultrasound scan in each subject. They also all had a seminal fluid analysis to measure their fertility potential. The findings were compared and correlated in the two groups.ResultsMost subjects in the study group (67%) had bilateral varicoceles, 31% had isolated left varicoceles, and only 2% had isolated right varicoceles. The majority of the participants (61%) in the study group had secondary infertility, while the majority (63%) in the control group had primary infertility (p = 0.001). There were significant increases in the prevalence of azoospermia (p = 0.008) and oligospermia (p = 0.030) with the higher grades of left varicoceles.ConclusionBilateral varicoceles were significantly present in males with infertility in the study group. Varicoceles were more common in males with secondary infertility, and higher grades of varicoceles were significantly more associated with azoospermia and severe oligospermia. We recommend the routine use of ultrasound scans to diagnose varicoceles for the optimal management of infertile male patients.

Therapeutic diagnosis of atony of the detrusor muscle in a dog – case report

The urinary bladder is composed of layers of smooth muscle, known as the detrusor muscle. Urination occurs through the "detrusor reflex," which causes contraction of the bladder and relaxation of the urethra. Bethanechol, a parasympathomimetic drug, is indicated for dogs with hypocontractility or atonia of this muscle, aiding in bladder emptying. This report presents the case of a 9-year-old, 13.5 kg, spayed mixed-breed female dog, who experienced pollakiuria for three months. Initial supplementary exams revealed no significant alterations, except for a full and firm bladder upon palpation. Cystitis was identified, but the dog still could not urinate properly after the condition was resolved. Bethanechol was then administered as a diagnostic and therapeutic alternative, resulting in significant improvement. Thus, based on the response to the medication and the absence of other findings, it was concluded that the patient had detrusor muscle atonia. However, 23 days after the resolution of the condition, there was a worsening of clinical symptoms, necessitating more in-depth diagnostic evaluation to define the primary cause of the condition. Computed tomography helped exclude potential differential diagnoses related to spinal cord conditions. Nonetheless, more specific supplementary exams, such as magnetic resonance imaging and cerebrospinal fluid (CSF) analysis, would be necessary to reach a definitive diagnosis. This case highlights the importance of a comprehensive and continuous diagnostic approach for complex and recurrent urinary conditions in dogs.

Neuroinflammatory Disorders of the Central Nervous System Associated with Monkeypox Virus Infection: A Systematic Review and Call to Action.

The Monkeypox virus, a zoonotic pathogen of the Orthopoxvirus genus, has shown a marked global spread, resulting in cases of neuroinflammatory disorders. This systematic review aims to summarize the central nervous system manifestations linked to monkeypox virus infection. We conducted a systematic review according to PRISMA guidelines. Databases such as PubMed, EMBASE, Cochrane Library, and Web of Science were searched up to September 2024. Inclusion criteria focused on monkeypox virus-positive patients with confirmed central nervous system inflammatory disorders, including encephalitis, meningitis, myelitis, and related neuroimmune diseases. From 770 screened articles, 38 studies were included. Of the 20 reported monkeypox virus-infected cases with central nervous system involvement, the most common manifestations were encephalitis (40%), encephalomyelitis (30%), and meningoencephalitis (10%). Additional rarer presentations included Guillain-Barré syndrome (5%) and transverse myelitis (5%). The mean age of affected individuals was 27.9±13.69 years, and 75% were male. Fever, fatigue, and myalgia were the predominant systemic symptoms, with neurological complications often appearing within 4.6±2.5 days post-infection. Diagnoses were confirmed by quantitative reverse transcription polymerase chain reaction, magnetic resonance imaging, and cerebrospinal fluid analysis. Treatment strategies varied, with antivirals (e.g., tecovirimat) and immunomodulatory therapies (e.g., methylprednisolone, immunoglobulins, and rituximab) utilized. Monkeypox virus infection is associated with severe neuroinflammatory disorders, with varying outcomes from complete recovery to mortality. Increased awareness, comprehensive diagnostic approaches, and targeted therapeutic interventions are critical in managing these cases. Further research is required to elucidate the mechanisms of neuroinflammation in the monkeypox virus and establish standardized treatment protocols.

A Literature Review of Cutibacterium Acnes: From Skin Commensal to Pathogen in Shoulder Surgery.

Cutibacterium acnes, previously known as Propionibacterium acnes, is a gram-positive rod in the pilosebaceous glands and commonly implicated in acne vulgaris. Its role in prosthetic joint infections, particularly in shoulder surgeries, has recently gained attention due to its prevalence around the shoulder girdle. This review collates evidence on the pathogenic role of C. acnes in shoulder surgeries, discussing preventive measures, risk factors, clinical presentation, investigation, and treatment strategies. C. acnes infections are complex, often presenting with non-specific symptoms and delayed diagnoses. Risk factors include male sex, presence of hair, shoulder steroid injections, and previous shoulder surgeries. Investigations such as inflammatory markers, synovial fluid analysis, diagnostic arthroscopy, tissue cultures, and advanced molecular techniques like next-generation sequencing and multiplex polymerase chain reaction are explored for their effectiveness in detecting C. acnes. Treatment strategies range from prolonged antibiotics and antibiotic spacers to single-stage and two-stage revision surgeries. Studies indicate that single-stage revision may provide better outcomes compared to two-stage revision. Effective management of C. acnes infections requires careful assessment, relevant investigations, and tailored treatment approaches. This review emphasizes the need for further research to address intraoperative contamination and to develop more efficient diagnostic and treatment methods.

Research on the impact of overflow well shut-in on wellbore integrity and safety

If an overflow occurs, the well must be closed immediately. To ensure the safety of the drilling wellbore in ultra-deep wells, it is critical to analyze the transient flow process and pressure fluctuations of the fluid in the annular space of the overflow well shut-in. This paper investigates the pressure fluctuation model of multi-phase fluid in the annular space after overflow occurs during gas well drilling, analyzes the influence factors of multi-phase fluid's pressure wave velocity, and simulates and analyses pressure fluctuation changes in the annular space in light of the impact of overflow well shut-in on wellbore safety. The model's correctness is verified by comparing it to experimental data published in the literature. The model is developed and examined using the example of a genuine gas well in western China. According to the study, as soon as the BOP closes, pressure rapidly increases to a high of 6.09 MPa at 5.89 s before falling to a valley of 4.68 MPa at 35.36 s. When the mild shut-in time lasts 20 s, the wellhead annular pressure reaches a maximum of 5.8 MPa. If the wellhead equipment can withstand the annular space's first pressure wave, a hard shut-in is recommended. To optimize the overflow well shut-in system and ensure wellbore safety, the change in pressure in the wellhead annular space as a result of varied shut-in timings and drilling fluid displacement is studied.

Bronchoalveolar lavage fluid analysis in patients with checkpoint inhibitor pneumonitis

BackgroundCheckpoint inhibitor pneumonitis (CIP) is a relatively uncommon but potentially life-threatening immune-related adverse event (irAE). Lung biopsies have not been commonly performed for CIP patients. Bronchoalveolar lavage fluid (BALF) analysis is a useful diagnostic approach for interstitial lung disease. However, BALF features were inconsistent across different studies.MethodsWe retrospectively reviewed the medical records of 154 patients with pathologically confirmed malignancies and suffering from CIPs between July 2018 and December 2022. Patients who had bronchoalveolar lavage (BAL) data available were enrolled in our study. Patient clinical, laboratory, radiological and follow-up data were reviewed and analyzed.ResultsThe BALF differential cell count and lymphocyte subset analysis were performed for 42 CIP patients. There were 32 males (76.2%). The mean age at diagnosis of CIP was 62.0 ± 10.4 (range: 31–78) years. The median time to onset of CIP was 98.5 days after the start of immunotherapy. There were 18 patients (42.9%) with low-grade CIPs and 24 patients (57.1%) with high-grade CIPs. The mean lymphocyte percentage was 36.7 ± 22.5%. There were 34 (81%) CIP patients with a lymphocytic cellular pattern. The median ratio of CD3+CD4+/CD3+CD8+ lymphocytes was 0.5 (0.3, 1.0). The ratio was less than 1.0 for 31 CIP patients (73.8%). However, there was no significant difference in the BALF features between patients with low-grade CIPs and those with high-grade CIPs.ConclusionsThe CD3+CD8+ lymphocytosis pattern was the main inflammatory profile in the BALF of CIP patients in this cohort. Targeting CD3+CD8+ lymphocytes might be a treatment option for CIPs.

Pathogen-induced diseases of the spinal cord and adjacent structures

Pathogen-induced myelitis is an inflammatory disease of the spinal cord that can be caused by various pathogens including viruses, bacteria, fungi or parasites. The most frequent viral pathogens include herpes and enteroviruses, while bacterial myelitis can be caused by, e.g., Mycobacterium tuberculosis, Borrelia burgdorferi and Treponema pallidum. Fungi such as Candida and Aspergillus and parasites such as Toxoplasma gondii and schistosomes can also cause myelitis. The main symptom is subacute paraplegia with motor, sensory and autonomic deficits to varying degrees, often accompanied by fever and ageneral malaise. Following athorough clinical examination and review of the medical history diagnostic imaging procedures, such as magnetic resonance imaging (MRI) along with cerebrospinal fluid analysis and blood tests that include antibody testing are warranted. The treatment is directed at the cause of the myelitis and mostly with anti-infective agents but for some viral pathogens no specific treatment is available and the only option is asymptomatic treatment. The prognosis is very variable and depends on the etiology and severity of the disease. Afast diagnosis and targeted treatment are crucial to achieve agood outcome.

Bar adsorptive microextraction and liquid chromatography-diode array detection of synthetic cannabinoids in oral fluid

In recent years, synthetic cannabinoids (SCs) have become a major public health issue. For this reason, there is a need for innovative analytical methods that allow its monitoring in biological matrices. In this work, we propose a novel methodology to screen eight SCs (AM-694, cumyl-5F-PINACA, MAM-2201, 5F-UR-144, JWH-018, JWH-122, UR-144 and APINACA) in oral fluids. A bar adsorptive microextraction method followed by microliquid desorption combined with high-performance liquid chromatography with diode array detection (BAµE-µLD/HPLC-DAD) was developed to monitor the target SCs. The main factors affecting the BAµE technology were fully optimized for oral fluid analysis. Under optimized experimental conditions, the proposed methodology showed good linear dynamic ranges from 20.0 to 2000.0 µg L−1 (r2 > 0.99, relative residuals < 15%), limits of detection between 2.0 and 5.0 µg L−1 and suitable average recovery yields (87.9–100.5%) for the eight studied SCs. The intra- and interday accuracies (bias ≤ ± 14.7%) and precisions (RSD ≤ 14.9%) were also evaluated at three spiking levels. The validated methodology was then assayed to oral fluid samples collected from several volunteers. The proposed analytical approach showed remarkable performance and could be an effective alternative for routine monitoring of the target compounds in oral fluid.Graphical

AN OVERLAP OF GUILLAIN-BARRÉ SYNDROME, MILLER-FISHER SYNDROME, AND BICKERSTAFF BRAINSTEM ENCEPHALITIS PRESENTING AS CLINICAL BRAIN DEATH, A CASE SERIES

Guillain-Barré Syndrome (GBS), Miller-Fisher Syndrome (MFS), and Bickerstaff Brainstem Encephalitis (BBE) are neuroinflammatory disorders that share common immunopathogenic mechanisms. Although overlapping presentations of these conditions are rare, they pose significant diagnostic challenges, especially when mimicking clinical brain death. Objective: To present a case series of three patients who demonstrated an overlap of GBS, MFS, and BBE, with all patients exhibiting profound neurological impairments, including clinical signs of brain death. Methods: A retrospective review of three cases admitted to the ICU over the last three years was conducted. Detailed clinical profiles, cerebrospinal fluid (CSF) analysis, nerve conduction studies (NCS), and electromyography (EMG) results were reviewed. All patients were treated with intravenous immunoglobulins (IVIG) and therapeutic plasma exchange (TPE). Results: All three patients had a history of preceding infections and were presented with ophthalmoplegia, ataxia, and altered levels of consciousness, progressing to coma. CSF analysis revealed albuminocytological dissociation, and NCS/EMG indicated severe polyneuropathy. Two patients responded positively to IVIG and plasmapheresis, showing significant neurological recovery, while the third patient demonstrated a delayed but spontaneous recovery. All patients eventually achieved full or near-full neurological recovery. Conclusions: This case series highlights the clinical continuum and diagnostic complexity of overlapping GBS, MFS, and BBE, particularly in presentations mimicking brain death. Early recognition and prompt immunomodulatory therapy are crucial in improving patient outcomes, even in cases with severe neurological deficits. Further research is warranted to elucidate pathophysiology and optimize treatment strategies for overlapping neuroinflammatory syndromes.