Background: Although it is the general consensus that sarcoidosis patients who present with sarcoidosis-related symptoms have a worse outcome than patients whose disease is detected incidentally without symptoms, this premise has not been rigorously examined. Methods: Consecutive patients followed longitudinally at one US university sarcoidosis clinic were questioned concerning the onset and description of sarcoidosisrelated symptoms at disease presentation. The patients were classified into those with no sarcoidosis-related symptoms at presentation (NSP group) and those with symptoms at presentation (SP group). The following outcomes were examined in the NSP and SP groups: most recent spirometry, organ involvement, need for sarcoidosis therapy, most recent health related quality of life (HRQOL) as measured by the Sarcoidosis Assessment Tool (SAT), most recent chest imaging Scadding stage results. Results: 660 sarcoidosis patients were analyzed, with 175 in the NSP group and 485 in the SP group. Compared to the NSP group, the SP group had a more frequent requirement for any sarcoidosis treatment, corticosteroid treatment, and non-corticosteroid treatment at some time and within the most recent year of follow up (at least 50% more than the NP group with strong statistical differences with p values all 0.01 or less). In addition, the SP group had significantly more organ involvement (p < 0.001) and several worse SAT domains (p < 0.022) than the NP group. There were no differences between the groups in terms of final spirometry or development of Scadding stage 4 chest radiographs. These findings held even after adjusting for age, sex, race, and time between presentation and the most recent follow-up visit using a multivariable logistic regression framework. Conclusions: In our sarcoidosis cohort, compared to the absence of symptoms at presentation, the presence of symptoms was associated with a greater need for treatment, more organ involvement, and worse HRQOL.

Although in previous studies we have shown an increased incidence of antibody-mediated rejection in patients with pretransplant DSA, neither the presence of HLA antibodies nor DSA translated to an increased risk of allograft dysfunction or death if prospective crossmatch testing was negative. Prospective studies are needed to define the impact of pretransplant sensitization on lung transplant recipients.

A urinary tract infection (UTI) in humans is one of the most common ailments in developing countries. The treatment of UTI is becoming difficult because of the increasing drug resistance against the common bacteria associated with UTI. This research aimed to determine the bacteria, and their antimicrobial drug resistance, associated with UTI in the Grenada population. A retrospective study of data (2015 through 2017) from the microbiology laboratory of the Grenada General Hospital was analyzed. Bacteria were isolated from 1289 (33.3%) urine cultures of 3867 UTI suspected urine samples. Both Gram-positive (Staphylococcus aureus 5.0%; Enterococci group D 43.2%) and Gram-negative bacteria (Escherichia coli 51%; Klebsiella pneumoniae20.0%; Proteus mirabilis 10.0%; Acinetobacter spp. 20.0%) were isolated. Bacterial isolates were tested for their resistance to nine antibacterial drugs (ampicillin, gentamicin, norfloxacin, cefuroxime, ceftazidime, Bactrim, imipenem, augmentin, and ciprofloxacin). Gram-negative bacteria showed higher antimicrobial drug resistance.

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