We designed and built a bespoke device which can translate and rotate patients 360° around a horizontal axis. The device meets all design and safety criteria with early usability tests indicating a high degree of comfort and utility. The system has been installed in a clinical bunker, integrated with a fixed-beam linear accelerator and is currently being commissioned for the purposes of cancer radiotherapy treatment.

Peritonitis of viral etiology is rarely reported in the literature; a prior report described a patient undergoing continuous ambulatory peritoneal dialysis who had the disease. We report a case of primary herpetic peritonitis (the agent of which was typed by polymerase chain reaction as herpes simplex virus biotype 1), which caused intestinal perforation, and we review the current literature and provide possible pathophysiologic mechanisms.

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Varicella-zoster virus and herpes simplex virus types 1 and 2 are neurotropic viruses that can be reactivated after a surgical or stressful intervention. Although such cases are uncommon, consequences can be debilitating, and variable treatment responses merit consideration. We describe a 41-year-old male with a history of varicella-mediated skin eruptions, who presented with continuing right arm pain, burning, and numbness in a C6 dermatomal distribution following a C5-6 anterior cervical discectomy and fusion and epidural steroid injections. The operative course was uncomplicated and he was discharged home on postoperative day 1. Approximately ten days after surgery, the patient presented to the emergency department complaining of severe pain in his right upper extremity and a vesicular rash from his elbow to his second digit. He was started on Acyclovir and discharged home. On outpatient follow-up, his rash had resolved though his pain continued. The patient was started on a neuromodulating agent for chronic pain. This case adds to the limited literature regarding this rare complication, brings attention to the symptoms for proper diagnosis and treatment, and emphasizes the importance of prompt antiviral therapy. We suggest adding a neuromodulating agent to prevent long-term sequelae and resolve acute symptoms.

Q fever endocarditis, caused by Coxiella burnetii, is an uncommon disease that can be difficult to diagnose and often lead to significant morbidity and mortality. We describe a case of a 73-year-old woman with bioprosthetic aortic and mitral valves, who presented with nonspecific symptoms, negative blood cultures, and an unremarkable transthoracic echocardiogram. She was subsequently diagnosed with vasculitis. However, after several months with no improvement with steroid therapy, she was reevaluated and diagnosed with Q fever endocarditis by a positive serology for C. burnetii, along with transesophageal echocardiography, which demonstrated vegetations. In conclusion, this case highlights that Q fever is usually a form of culture-negative endocarditis that should be suspected on the differential diagnosis for patients, especially those with a history of exposure to farm animals and presence of prosthetic valves.