Infiltrative gallbladder tuberculosis versus locally infiltrating tumour of the gallbladder: a diagnostic dilemma unmasked by histopathology

2021 ◽  
Vol 14 (6) ◽  
pp. e241178
Author(s):  
Asra Tus Saleha Siddiqui ◽  
Om Parkash
Keyword(s):  
Weight Loss ◽  
Granulomatous Inflammation ◽  
Low Grade ◽  
Rare Entity ◽  
Significant Weight Loss ◽  
Diagnostic Dilemma ◽  
Ct Guided ◽  
Clinical Presentations ◽  
The World ◽  
Lesser Curvature

Gallbladder tuberculosis (TB) as an isolated infection and is an extremely rare entity even in parts of the world with endemicity. Though it has myriad ways of presentation, it can be cured successfully. We present a case of a 53-year-old man who presented with epigastric fullness and bloating with on and off low-grade fever for 2 months and significant weight loss. He underwent a CT scan, which showed a soft tissue gallbladder mass causing mural thickening of the antrum and lesser curvature. This was followed by a CT-guided core biopsy and gastric antrum biopsy via gastroscopy. Histopathology revealed chronic granulomatous inflammation in both samples. Various clinical presentations of gallbladder TB have been reported in literature, but to the best of our knowledge, the present case has a unique presentation and has never been reported before.

Artery of percheron infarction: case reports and literature review

2017 ◽  
Vol 5 (10) ◽  
pp. 4629
Author(s):  
Dinkar Kulshreshtha ◽  
Pradeep K. Maurya ◽  
Rohit Chhirolya ◽  
Ajai K. Singh ◽  
Anup K. Thacker ◽  
...  
Keyword(s):  
Case Reports ◽  
Signs And Symptoms ◽  
Rare Entity ◽  
Diagnostic Dilemma ◽  
Mri Brain ◽  
Clinical Presentations ◽  
Artery Of Percheron ◽  
Rare Anatomic Variant ◽  
Midbrain Infarct ◽  
Management Issues

The artery of Percheron is a rare anatomic variant supplying the thalamus and the rostral midbrain. Infarct in this territory results in a wide array of neurological signs and symptoms causing diagnostic dilemma and management issues. We describe the clinical presentations in three cases admitted and evaluated for neurological symptoms and diagnosed as artery of percheron infarct after brain imaging. In one patient, the etiology turned out to be infective while the other two patients had cerebrovascular accident secondary to dilated cardiomyopathy and hyper homcystinimea respectively. Artery of percheron infarction is a rare entity and should be considered in patients with altered sensorium and behavioral manifestations with associated eye abnormalities. MRI brain is the investigation of choice to detect this rare variant of thalamic circulation. 

scholarly journals Infected Scalp Hematoma Presenting With Low-Grade Fever and Significant Weight Loss

2007 ◽  
Vol 15 (1) ◽  
pp. 74
Author(s):  
Amit Agrawal ◽  
Anand Kumar ◽  
Amit Thapa ◽  
Abhishek Sinha
Keyword(s):  
Weight Loss ◽  
Low Grade ◽  
Significant Weight Loss

scholarly journals Visceral leishmaniasis presenting as haemophagocytic lymphohistiocytosis

2019 ◽  
Vol 12 (12) ◽  
pp. e232576
Author(s):  
Lewis Vanhinsbergh ◽  
Aaron Mason ◽  
Andrew Godfrey
Keyword(s):  
Weight Loss ◽  
Fever Of Unknown Origin ◽  
Hospital Admissions ◽  
Unknown Origin ◽  
Low Grade ◽  
Extensive Investigation ◽  
Significant Weight Loss ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Clinical Criteria ◽  
Medical Specialists

A 53-year-old man presented with a number of hospital admissions for investigation of fever of unknown origin. He became gradually weaker with significant weight loss, pancytopenia and progressive splenomegaly over a 6-month period of extensive investigation. This was undertaken at different NHS hospitals with involvement of multiple medical specialists. Clinical criteria for haemophagocytic lymphohistiocytosis were met. Following investigation, this was felt likely secondary to a low-grade lymphoma of the spleen, necessitating splenectomy for diagnostic and therapeutic purposes. Ultimately, this risky surgical procedure was avoided when positive Leishmania serology led to successful treatment with amphotericin B.

Multiple sclerosing pneumocytomas: a review

2020 ◽  
Vol 73 (9) ◽  
pp. 531-534
Author(s):  
Prodipto Pal ◽  
Runjan Chetty
Keyword(s):  
Chest Pain ◽  
East Asian ◽  
Low Grade ◽  
Molecular Pathways ◽  
Rare Entity ◽  
Asian Origin ◽  
X Ray ◽  
Clinical Presentations ◽  
Chest X Ray ◽  
Grade Tumour

Sclerosing pneumocytoma (SP) is a rare benign low-grade tumour of the lung, and typically presents as single discrete coin lesions on imaging. Multiple SP is an exceedingly rare entity and thus reported sparingly. We review the literature on multiple SP, their clinical presentations, histopathology, relevant differential diagnoses and molecular histogenesis of this entity. SP has a predilection for East Asian origin females who have never smoked. Patients are either asymptomatic or have symptoms such as cough, haemoptysis that may be persistent, chest pain if involving the pleura and presents as discrete coin lesion on chest X-ray. Histologically, they are papillary, solid, angiomatoid or sclerotic, or combinations of these four basic patterns. Multiple lesions have the same or slightly different histological patterns. They can be distributed in either lung, in any lobe and can even be bilateral. AKT-1 molecular pathways are pivotal in their molecular pathogenesis. In this review, we further propose a classification based on five types of distribution of multiple SP.

Abstract #615: Hispanic People Achieve Clinically Significant Weight loss with Liraglutide 3.0 Mg for Weight Management

2015 ◽  
Vol 21 ◽  
pp. 121
Author(s):  
Patrick O’Neil ◽  
W. Timothy Garvey ◽  
J. Michael Gonzalez-Campoy ◽  
Pablo Mora ◽  
Rafael Violante Ortiz ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Significant Weight Loss ◽  
Hispanic People ◽  
Clinically Significant

Primary hyperparathyroidism in pregnancy: Uncommon manifestation of significant weight loss

2020 ◽  
Author(s):  
Timea Varga ◽  
Isuri Kurera ◽  
James Clark ◽  
Benjamin Field ◽  
Vidhu Nayyar ◽  
...  
Keyword(s):  
Weight Loss ◽  
Primary Hyperparathyroidism ◽  
Significant Weight Loss ◽  
In Pregnancy

scholarly journals Combining ecological momentary assessment, wrist-based eating detection, and dietary assessment to characterize dietary lapse: A multi-method study protocol

2021 ◽  
Vol 7 ◽  
pp. 205520762098821
Author(s):  
Stephanie P Goldstein ◽  
Adam Hoover ◽  
E Whitney Evans ◽  
J Graham Thomas
Keyword(s):  
Weight Loss ◽  
Eating Behavior ◽  
Ecological Momentary Assessment ◽  
Structured Interview ◽  
Self Report ◽  
Significant Weight Loss ◽  
Clinically Significant ◽  
Ecological Momentary ◽  
Momentary Assessment ◽  
Lapse Behavior

Objectives Behavioral obesity treatment (BOT) produces clinically significant weight loss and health benefits for many individuals with overweight/obesity. Yet, many individuals in BOT do not achieve clinically significant weight loss and/or experience weight regain. Lapses (i.e., eating that deviates from the BOT prescribed diet) could explain poor outcomes, but the behavior is understudied because it can be difficult to assess. We propose to study lapses using a multi-method approach, which allows us to identify objectively-measured characteristics of lapse behavior (e.g., eating rate, duration), examine the association between lapse and weight change, and estimate nutrition composition of lapse. Method We are recruiting participants (n = 40) with overweight/obesity to enroll in a 24-week BOT. Participants complete biweekly 7-day ecological momentary assessment (EMA) to self-report on eating behavior, including dietary lapses. Participants continuously wear the wrist-worn ActiGraph Link to characterize eating behavior. Participants complete 24-hour dietary recalls via structured interview at 6-week intervals to measure the composition of all food and beverages consumed. Results While data collection for this trial is still ongoing, we present data from three pilot participants who completed EMA and wore the ActiGraph to illustrate the feasibility, benefits, and challenges of this work. Conclusion This protocol will be the first multi-method study of dietary lapses in BOT. Upon completion, this will be one of the largest published studies of passive eating detection and EMA-reported lapse. The integration of EMA and passive sensing to characterize eating provides contextually rich data that will ultimately inform a nuanced understanding of lapse behavior and enable novel interventions. Trial registration: Registered clinical trial NCT03739151; URL: https://clinicaltrials.gov/ct2/show/NCT03739151

Synthesis and properties of a benzoxazine monomer containing maleimide and biphenyl groups

2021 ◽  
pp. 095400832199674
Author(s):  
Tao Guo ◽  
Yang Fan ◽  
Chang Bo ◽  
Zhang Qi ◽  
Han Tao ◽  
...  
Keyword(s):  
Weight Loss ◽  
Loss Rate ◽  
Proton Nuclear Magnetic Resonance ◽  
Significant Weight Loss ◽  
Scanning Calorimetry ◽  
Weight Loss Rate ◽  
Reaction Heat ◽  
H Nmr ◽  
Curing Reaction ◽  
Dsc Curves

Benzoxazine resin exhibits excellent properties and is widely used in many fields. Herein, the synthesis of a novel compound, the bis(2,4-dihydro-2 H-3-(4- N-maleimido)phenyl-1,3-benzoxazinyl)biphenyl (BMIPBB), has been reported, which was synthesized by reacting N-(4-aminophenyl)maleimide (APMI), formaldehyde, and 4,4’-dihydroxybiphenyl. 1,3,5-three(4-(maleimido)phenyl)-1,3,5-triazine (TMIPT) was formed as an intermediate during the reaction. The proton nuclear magnetic resonance (1H-NMR) and Fourier transform-infrared (FTIR) spectroscopy experiments were conducted to determine the structure of BMIPBB. BMIPBB was obtained as a reddish-brown solid in 40.1% yield. The thermal properties of BMIPBB were investigated using differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA) techniques. Analysis of the DSC curves revealed that the broad peak representing the release of curing reaction heat appeared in the temperature range of 140–330°C. The peak temperature was 242.59°C and the heat of the reaction was 393.82 J/g, indicating that the rate of the curing reaction was low and the heat of the reaction was high. Analysis of the TGA results revealed that the weight loss rate was 5% at 110°C. The monomer exhibited a significant weight loss in the range of 320–500°C. The compound lost 50% of its weight at a temperature of 427°C.

scholarly journals Fecal Metaproteomics Reveals Reduced Gut Inflammation and Changed Microbial Metabolism Following Lifestyle-Induced Weight Loss

Biomolecules ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 726
Author(s):  
Ronald Biemann ◽  
Enrico Buß ◽  
Dirk Benndorf ◽  
Theresa Lehmann ◽  
Kay Schallert ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Weight Loss ◽  
Gut Microbiome ◽  
Taxonomic Composition ◽  
Low Grade ◽  
Gut Inflammation ◽  
Functional Changes ◽  
Microbiome Composition ◽  
Before And After ◽  
Human Proteins

Gut microbiota-mediated inflammation promotes obesity-associated low-grade inflammation, which represents a hallmark of metabolic syndrome. To investigate if lifestyle-induced weight loss (WL) may modulate the gut microbiome composition and its interaction with the host on a functional level, we analyzed the fecal metaproteome of 33 individuals with metabolic syndrome in a longitudinal study before and after lifestyle-induced WL in a well-defined cohort. The 6-month WL intervention resulted in reduced BMI (−13.7%), improved insulin sensitivity (HOMA-IR, −46.1%), and reduced levels of circulating hsCRP (−39.9%), indicating metabolic syndrome reversal. The metaprotein spectra revealed a decrease of human proteins associated with gut inflammation. Taxonomic analysis revealed only minor changes in the bacterial composition with an increase of the families Desulfovibrionaceae, Leptospiraceae, Syntrophomonadaceae, Thermotogaceae and Verrucomicrobiaceae. Yet we detected an increased abundance of microbial metaprotein spectra that suggest an enhanced hydrolysis of complex carbohydrates. Hence, lifestyle-induced WL was associated with reduced gut inflammation and functional changes of human and microbial enzymes for carbohydrate hydrolysis while the taxonomic composition of the gut microbiome remained almost stable. The metaproteomics workflow has proven to be a suitable method for monitoring inflammatory changes in the fecal metaproteome.

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