Effects of Tocilizumab in COVID-19 patients: a cohort study.

Background: Due to the lack of proven therapies, we evaluated the effects of early administration of tocilizumab for COVID-19. By inhibition of the IL-6 receptor, tocilizumab may help to mitigate the hyperinflammatory response associated with progressive respiratory failure from SARS-CoV-2.

Methods: A retrospective, observational study was conducted on hospitalized adults who received intravenous tocilizumab for COVID-19 between March 23, 2020 and April 10, 2020.

IL-2/CD25: A Long-Acting Fusion Protein That Promotes Immune Tolerance by Selectively Targeting the IL-2 Receptor on Regulatory T Cells.

Low-dose IL-2 represents an immunotherapy to selectively expand regulatory T cells (Tregs) to promote tolerance in patients with autoimmunity. In this article, we show that a fusion protein (FP) of mouse IL-2 and mouse IL-2Rα (CD25), joined by a noncleavable linker, has greater in vivo efficacy than rIL-2 at Treg expansion and control of autoimmunity. Biochemical and functional studies support a model in which IL-2 interacts with CD25 in the context of this FP in to form inactive head-to-tail dimers that slowly dissociate into an active monomer.

A Review of Extrapulmonary Tuberculosis.

Mycobacterium tuberculosis is an aerobic, non-spore-forming, non-motile bacillus that causes tuberculosis of both pulmonary and extrapulmonary sites. Though nationwide 66 percent of reported tuberculosis cases occur in foreign-born individuals, these individuals only contributed to 29 percent of the cases in South Dakota in 2015, whereas most of our cases were found in citizens born in the U.S.

Atypical Presentations of Tularemia.

Francisella tularensis is a gram-negative coccobacillus that causes a condition commonly referred to as tularemia. There has been a dramatic increase in tularemia cases reported in South Dakota, many of which were challenging to diagnose due to atypical clinical manifestations. We describe an interesting case of pneumonic tularemia and summarize six similar cases, several of which presented with lung nodules suggestive of malignancy.

Vaccination and the health care worker.

Historically, health care worker vaccination has been a strategy to protect the health care worker from infectious work related risk. This article will discuss the transition to health care worker vaccination as a key patient safety initiative for hospitals and health care systems. As the case is evolving toward mandatory influenza vaccination of health care workers, we have outlined key success factors for a voluntary program in a rural frontier referral hospital.

H1N1 influenza in elderly nursing home residents.

We offer this brief report to inform other nursing home medical directors and attending physicians of a possible change in the profile of persons susceptible to H1N1 influenza. If a significant number of cases appear in older persons, the recommendations for H1N1 vaccination may need to be changed to include the elderly.

The origin of mean arterial and jugular venous blood pressures in giraffes.

Using a mechanical model of the giraffe neck and head circulation consisting of a rigid, ascending, 'carotid' limb, a 'cranial' circulation that could be rigid or collapsible, and a descending, 'jugular' limb that also could be rigid or collapsible, we have analyzed the origin of the high arterial and venous pressures in giraffe, and whether blood flow is assisted by a siphon. When the tubes were rigid and the 'jugular' limb exit was lower than the 'carotid' limb entrance a siphon operated, 'carotid' hydrostatic pressures became more negative, and flow was 3.3 l min(-1) but ceased when the 'cranial' and 'jugular' limbs were collapsible or when the 'jugular' limb was opened to the atmosphere.