Short Supply-Driven Modifications to Blood Culture Practice and Their Clinical Impact: A Single-Center Time-Series Study.

Introduction: Blood cultures are essential for identifying bloodstream infections and guiding treatment. A global BD BACTEC™ bottle (BD, Franklin Lakes, NJ, US) shortage disrupted diagnostics, including at the Saitama Medical Center. During the shortage period, clinicians were instructed to prioritize cultures based on clinical necessity and infection focus, often opting for single-set submissions or deferring testing.

Disseminated gonococcal infection developing two days after initial eculizumab administration in a patient with neuromyelitis optica spectrum disorder: A case report and literature review.

Disseminated gonococcal infection (DGI) is a rare complication of Neisseria gonorrhoeae infection. Eculizumab, a complement C5 inhibitor used in conditions such as paroxysmal nocturnal hemoglobinuria, increases the risk of invasive Neisseria spp. infections.

Impact of hippocampal α-synuclein oligomers on cognitive trajectory in patients with dementia with Lewy bodies.

Introduction: Increasing evidence indicates that α-synuclein (αSYN) oligomers are toxic. We sought to determine whether αSYN oligomers were associated with faster cognitive decline in prospectively-followed patients with dementia with Lewy bodies (DLB).

Methods: Eight autopsy-confirmed patients with DLB were selected based on rapid or slow cognitive decline determined by the rate of change of Mini-Mental State Examination (MMSE) scores.

Early Subtypes and Progressions of Progressive Supranuclear Palsy: A Data-Driven Brain Bank Study.

Background: Progressive supranuclear palsy (PSP) is typically characterized by vertical supranuclear gaze palsy and early falls, referred to as Richardson's syndrome (PSP-RS). Other presentations include postural instability (PSP-PI), parkinsonism (PSP-P), speech/language impairment (PSP-SL), frontal presentation (PSP-F), ocular motor dysfunction (PSP-OM), and corticobasal syndrome (PSP-CBS). Differences across the early presentations and in their subsequent progression have yet to be elucidated.

Substantia Nigra Iron Deposition in Lewy Body Disease: A Magnetic Resonance Imaging and Neuropathology Study.

Objective: To compare iron deposition in the substantia nigra (SN) as measured with quantitative susceptibility mapping (QSM) on antemortem magnetic resonance imaging (MRI) between individuals with and without Lewy-related pathology at autopsy.

Methods: We performed a retrospective cohort study including 54 participants who underwent autopsy and antemortem MRI with QSM. Cases were classified as Lewy body disease (LBD)-present (n = 13) if they had Lewy-related pathology and LBD-absent (n = 41) if they did not have Lewy-related pathology.

Cefiderocol "under siege"? Understanding the rise of NDM-mediated resistance to novel agents.

The global spread of antimicrobial resistance (AMR) underscores the critical need for the rapid development of new drugs. Particularly alarming is the surge in metallo-β-lactamases (MBLs) - broad spectrum enzymes able to inactivate penicillins, cephalosporins, and carbapenems. Cefiderocol (FDC), a siderophore-containing cephalosporin, was initially reported as resistant to MBL hydrolysis.

A case of infectious endocarditis and vertebral discitis caused by Streptococcus pneumoniae serotype 23A.

Streptococcus pneumoniae, is a Gram-positive diplococcus, causes various community-acquired infections. Although pneumococcal vaccination has reduced the incidence of invasive pneumococcal disease, relative incidence of non-vaccine serotype-associated infections has increased. Herein, we report a case of pneumococcal infectious endocarditis and vertebral discitis diagnosed concurrently.

A Case of Differential Lung Ventilation Using a Double-Lumen Endotracheal Tube via Tracheostomy in a Patient With Acquired Laryngeal Web Undergoing Lobectomy.

Acquired laryngeal web is associated with difficult airway management during anesthesia induction or extubation. We experienced a case of lung resection under general anesthesia in a patient who was preoperatively diagnosed with a laryngeal web. The patient was a 78-year-old female (height: 153 cm, weight: 59 kg, BMI: 25.

Impact of Immunosuppression on Immune Cell Dynamics in COVID-19: A Serial Comparison of Leukocyte Data in Healthy and Immunocompromised Patients Before and After Infection.

: The significance of cell population data (CPD) and leukocyte scattergrams in COVID-19 has not been fully established, partly due to the absence of serial leukocyte monitoring before and after SARS-CoV-2 infection. This study first examined changes in these parameters in non-immunosuppressed subjects over the course of infection. Subsequently, these findings were compared with those observed in patients who were immunosuppressed to assess the impact of immunosuppression.

Meningitis caused by triggered by malignant otitis externa: A case report.

A previously healthy 58-year-old male initially presented to a healthcare facility with otorrhea in his left ear, accompanied by a scab in both the auricle and ear canal, with a lesion protruding from the left cavity and oozing discharge (day 0). The following day, the patient was transferred to our facility with fever and altered consciousness. Imaging studies, including computed tomography and magnetic resonance imaging, revealed a soft tissue mass in the left maxillary, ethmoid and sphenoid sinuses, and diffuse pus within the subdural space over the bilateral frontoparietal regions.

A case of pleuritis and continuous ambulatory peritoneal dialysis-related peritonitis diagnosed by simultaneous-onset bacteremia.

A 42-year-old man undergoing peritoneal dialysis due to a chronic kidney disease of unknown etiology complained of fever and chills. Oral levofloxacin was started, but the symptoms did not improve. He was admitted, and the levofloxacin was switched to intravenous ciprofloxacin.

Refining Muscle Morphometry Through Machine Learning and Spatial Analysis.

Aims: Muscle morphology provides important information in differentiating disease aetiology, but its measurement remains challenging because of the lack of an efficient and objective method. This study aimed to quantitatively refine the morphological features of muscle fibres in neuromuscular diseases using machine learning.

Methods: In this retrospective study, we analysed muscle biopsy specimens on haematoxylin and eosin-staining.

Genome-wide association study of neuropathological features in Lewy body disease.

Studies assessing genetic associations with neuropathological features in Lewy body disease (LBD) have been limited to candidate gene investigations, and therefore, information is lacking regarding the genetic architecture of the neuropathology of LBD. In the current study, we examined a large series of neuropathologically confirmed LBD cases (n = 980 in the discovery series, n = 503 in the replication series) and performed genome-wide association studies of 11 different neuropathological outcome measures. The 11 neuropathological outcomes included Braak neurofibrillary tangle (NFT) stage, Thal amyloid phase, LBD subtype, Lewy body (LB) counts in five different brain regions, dorsolateral and ventromedial putaminal tyrosine hydroxylase immunoreactivity and neuronal loss in the ventrolateral part of the substantia nigra.

Parkinsonism in Alzheimer's disease without Lewy bodies in association with nigral neuron loss: A data-driven clinicopathologic study.

Introduction: Parkinsonism in patients with Alzheimer's disease (AD) is often attributed to Lewy-related pathology, given its high comorbidity. In the era of anti-amyloid therapy, recognizing parkinsonism caused by AD pathology is needed to optimize the treatment.

Methods: This study aimed to quantitatively characterize parkinsonism and nigral neuropathology in AD without Lewy bodies (LB).

Mycoplasma hominis Intracranial Abscess Diagnosed by Characteristic Colonies Obtained Through Extended Culture: Case Report and Literature Review.

causes genitourinary infections and pregnancy-related complications. Reports of intracranial abscesses due to infection are rare. Here, we report a intracranial abscess case following a traffic accident who was admitted to our hospital (day 0).

Chemogenetic activation of astrocytes modulates sleep-wakefulness states in a brain region-dependent manner.

Study Objectives: Astrocytes change their intracellular calcium (Ca) concentration during sleep/wakefulness states in mice. Furthermore, the Ca dynamics in astrocytes vary depending on the brain region. However, it remains unclear whether alterations in astrocyte activity can affect sleep-wake states and cortical oscillations in a brain region-dependent manner.

A Pilot Study of Urine Oxytocin as an Objective Biomarker for Chronic Pain.

Measuring pain objectively or quantitatively is difficult. Since urine oxytocin (OXT) concentration has been reported to be potentially associated with chronic pain. We conducted a pilot study to evaluate the relationship between changes in numerical rating scale (NRS) score following nerve block and urine OXT concentration in patients with chronic pain.

Cryptogenic New-onset Refractory Status Epilepticus with Hyperintensity of T1-weighted Magnetic Resonance Imaging in the Bilateral Basal Ganglia: An Autopsy Report.

We present a 76-year-old man with cryptogenic new-onset refractory status epilepticus (C-NORSE) with an initial abnormal signal in the nucleus accumbens and a remarkable hyperintense signal on T1-weighted magnetic resonance imaging in the bilateral basal ganglia (BG). His status epilepticus did not respond to most anti-epileptic therapies or immunotherapies, and he died of sepsis. An autopsy revealed severe neuronal loss and hypertrophic astrocytes in the BG and limbic system, with no signs of inflammation or malignancy.

[A case of left posterior cortical atrophy presenting with kana-predominant reading impairment].

The patient was an 85-year-old man with a one-year history of difficulty reading kana. Neuropsychological evaluation revealed kana (phonogram)-selective reading impairment and kanji (ideogram)-dominant writing impairment. MRI revealed significant cerebral atrophy in the left occipital cortex, leading to the clinical diagnosis of posterior cortical atrophy (PCA).

Glutamatergic signaling from melanin-concentrating hormone-producing neurons: A requirement for memory regulation, but not for metabolism control.

Melanin-concentrating hormone-producing neurons (MCH neurons), found mainly in the lateral hypothalamus and surrounding areas, play essential roles in various brain functions, including sleep and wakefulness, reward, metabolism, learning, and memory. These neurons coexpress several neurotransmitters and act as glutamatergic neurons. The contribution of glutamate from MCH neurons to memory- and metabolism-related functions has not been fully investigated.

The interaction of the azetidine thiazole side chain with the active site loop (ASL) 3 drives the evolution of IMP metallo-β-lactamase against tebipenem.

Imipenemase (IMP) metallo-β-lactamases (MBLs) hydrolyze almost all available β-lactams including carbapenems and are not inhibited by any commercially available β-lactamase inhibitor. Tebipenem (TP) pivoxil is the first orally available carbapenem and possesses a unique bicyclic azetidine thiazole moiety located at the R2 position. TP has potent activity against producing extended-spectrum and/or AmpC β-lactamases.