Background An outbreak of Marburg hemorrhagic fever was first observed in a gold-mining village in northeastern Democratic Republic of the Congo in October 1998.

This study describes the chest radiographs of 50 adult patients with histologically verified histiocytosis X, proposes a radiological classification, and examines the role of radiology in assessing the prognosis of the disease. Radiologically the lesions predominate in the middle and lower lung fields, usually sparing the costophrenic angles, and are typically micronodular, reticular, or cystic. These features are especially suggestive of histiocytosis X if lung volume is normal or increased, there is an associated pneumothorax, they occur in a young male and there are no other intrathoracic changes (pleural or mediastinal). The three evolutionary patterns of improvement, stabilisation, and worsening are analysed with respect to the initial radiological features; one which carries a good prognosis is sparing of both costophrenic angles.Pulmonary histiocytosis X (HX) is a chronic interstitial disease characterised by the presence of multiple specific granulomas which contain many Langerhans cells.The radiological features of this disease comprise nodular, reticulonodular, or honeycomb patterns which classically appear "predominantly in the upper lung fields".' However, in our experience the radiographic findings often depart from the classic description.The aims of this study, therefore, were: (1) to use a defined group of adults with HX to describe the chest radiological features of the disease; (2) to develop a qualitative method of analysing the chest radiographs; and (3) Follow-up information extending from one to 12 years was available for 37 patients; 26 of these were followed for over three years (mean = 5 4 years). RADIOGRAPHIC STUDYOnly posteroanterior chest radiographs were considered; tomography was not included. In assessing prognosis, special attention was paid to the earliest and latest films.

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Background and Aims: Sugammadex is a novel agent for reversal of steroidal neuromuscular blocking agents (NMBAs) with potential advantages over acetylcholinesterase inhibitors. In preclinical trials, there have been rare instances of bradycardia with progression to cardiac arrest. To better define this issue, its incidence and mitigating factors, we prospectively evaluated the incidence of bradycardia after sugammadex administration in adults. Material and Methods: Patients ≥ 18 years of age who received sugammadex were included in this prospective, open label trial. After administration, heart rate (HR) was continuously monitored. HR was recorded every minute for 15 minutes and then every five minutes for the next 15 minutes or until patient was transferred out of the operating room. Bradycardia was defined as HR less than 60 beats/minute (bpm) or decrease in HR by ≥ 10 beats per minute (bpm) if the baseline HR was <70 bpm. Results: The study cohort included 200 patients. Bradycardia was observed in 13 cases (7%; 95% confidence interval: 4, 11), occurring a median of 4 minutes after sugammadex administration (IQR: 4, 9, range: 2-25). Among patients developing bradycardia, two (15%) had cardiac comorbid conditions. One patient received treatment for bradycardia with ephedrine. No clinically significant blood pressure changes were noted. On bivariate analysis, patients receiving a higher initial sugammadex dose were more likely to develop bradycardia. On multivariable logistic regression, initial sugammadex dose was not associated with the risk of bradycardia. Conclusion: The incidence of bradycardia after administration of sugammadex in our study was low and not associated with significant hemodynamic changes.

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