Observations straight into Cyanobacterial Alkane Biosynthesis

Background Chest radiography is commonly used for diagnosing community-acquired pneumonia (CAP). Computed tomography (CT) is not routinely recommended for initial assessment of CAP patients but is more sensitive and more specific than chest radiography. Objectives To investigate characteristics of pneumonia with negative chest radiography in cases confirmed by CT. Methods We included patients diagnosed with CAP in the emergency department, and chest radiography and CT were performed and sputum cultures were collected. The CR- group was defined as patients for whom infiltration of pneumonia was detected only on CT. The CR+ group was defined as patients for whom infiltration was detected on both chest radiography and CT. Data were collected retrospectively from medical records. Results A total of 138 patients were included, with 58 patients in the CR- group and 80 patients in the CR+ group. Mean age was higher in the CR- group than in the CR+ group, and white blood cell counts and C-reactive protein (CRP) levels were lower in the CR- group than in the CR+ group (8.4 × 103/μL vs 12.4 × 103/μL, p = 0.01; 4.7 mg/dL vs 15.6 mg/dL, p less then 0.001, respectively). Laterality of the infiltrated lungs differed between groups (rightleftbilateral = 143014 vs 482012, p = 0.006). Multivariate logistic analysis identified leukocytosis, elevated CRP levels (odds ratio (OR) 3.57, p = 0.003), laterality (OR 2.16, p = 0.006) as predictors of pneumonia in the CR- group. Conclusion In pneumonia with negative chest radiography in cases confirmed by CT, milder inflammation and infiltration in the left lung tended to be seen. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.Background ACE angioedema has not been characterized in comparison with angioedema from other causes in acute hospitalized patients. Methods We retrospectively compared ACE-angioedema and non-ACE angioedema patients from January 2013 to May 2017. Results Of 855 cases screened, 575 met the inclusion criteria of angioedema diagnosis and an electronic medical record. Of these, 297 (51.7%) had ACE angioedema and 278 had angioedema from other causes, of these 31 who were taking an ACE inhibitor that was not considered to be the cause of angioedema (ACE other cause). At least 80% of cases in all groups were African American. Epinephrine was prescribed in 21% of ACE angioedema cases. One-third of patients in all groups were admitted to the ICU, and about 25% required intubation. Previous history of ACE inhibitor-induced angioedema was found in 63 of 278 non-ACE cause angioedema patients (23%) and in 23 (8%) in the ACE cause group. Conclusion ACE angioedema was the cause of half of angioedema admissions over a 4.5-year period. Mortality, morbidity, and treatment did not differ between the groups. Patients on ACE inhibitors were often treated with medications known not to be effective for ACE angioedema. Over one-fourth of patients not taking an ACE inhibitor had a previous history of ACE angioedema, and 31 patients taking ACE inhibitors were diagnosed with non-ACE angioedema. Regardless of the etiology of angioedema, 25% of patients required airway protection in the form of intubation. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.Background Chronic insomnia is characterized by disturbed sleep that occurs despite adequate opportunity and circumstances to sleep. Selleck LY2874455 Many patients with chronic insomnia have comorbid mental illnesses or medical illnesses that contribute and precipitate insomnia. Hallmark of chronic insomnia treatment includes non-pharmacological measures such as Cognitive Behavioral Therapy for Insomnia (CBT-I). Pharmacologic treatment (sedative or hypnotic agents) has been disappointing because of poor efficacy and numerous undesirable side effects. Other new therapies including meditation have been proven to be effective. Objective This study investigates the effectiveness of Heartfulness meditation coupled with sleep hygiene to treat chronic insomnia. Methods In this prospective pre-post design cohort study, 32 adult patients with chronic primary insomnia engaged in Heartfulness meditation along with appropriate sleep hygiene for eight weeks. Insomnia Severity Index (ISI) scores, usage of sedative or hypnotic agents were measured at baseline and at the end of the eight-week period. Results There was a significant decrease in the mean ISI scores from 20.9 to 10.4 (p  less then  0.001) after eight weeks of Heartfulness meditation. Twenty four of 32 patients were initially on sedative or hypnotic medications. At week eight, 21 of 24 patients (87.5%) were off these medications or the dosage was reduced (p  less then  0.001). Conclusion This study demonstrated statistical improvements in the measures of ISI in patients undergoing a Heartfulness meditation program. Heartfulness meditation may facilitate the taper and eventual cessation of sedative hypnotics in patients suffering from chronic insomnia. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.Background Morning report is an important conventional teaching activity of residency programs worldwide. Objectives We aimed at creating a shared digital folder of the morning report/Harrison Club presentations for the training year of 2018-2019. Our primary objective was to assess the residents' satisfaction regarding its accessibility, as well as to estimate the percentage of residents who felt improvement in confidence levels in their management skills and their preparation for the monthly exams and for the American Board of Internal Medicine (ABIM). Methods This study is a cross-sectional study comparing the three different Post-Graduate Year residents. An anonymous questionnaire was distributed to 44 participating residents, and a multivariate analysis test was conducted. Results Most of the residents thought the morning report/Harrison Club folder was easily accessible. 86.7%, 82.4% and 83.3% found it valuable to improve their confidence in management; 80%, 70.6% and 83.3% found it valuable to improve their confidence in preparation for the monthly exams; and 86.