scholarly journals Photo gallery of onychodystrophies

2020 ◽  
Vol 23 (3) ◽  
pp. 194-196
Author(s):  
Ivan S. Maksimov
Keyword(s):  
Fungal Infection ◽  
Clinical Symptoms ◽  
Everyday Practice ◽  
Common Cause ◽  
Dermatological Diseases ◽  
Nail Changes ◽  
Clinical Pictures

Onychodystrophies are various pathological processes in the nail apparatus of infectious and non-infectious nature, related to changes in its morphology. The most common cause of nail changes is a fungal infection. However, onychodystrophy can be a manifestation of dermatological diseases, trauma, medication, systemic and tumor processes. Since the clinical symptoms of onychodystrophies are unspecific, sometimes it can cause difficulties in making a diagnosis. This photo gallery presents clinical pictures of diseases that a physician may encounter in everyday practice.

scholarly journals Rare Variants in Autophagy and Non-Autophagy Genes in Late-Onset Pompe Disease: Suggestions of Their Disease-Modifying Role in Two Italian Families

2021 ◽  
Vol 22 (7) ◽  
pp. 3625
Author(s):  
Filomena Napolitano ◽  
Giorgia Bruno ◽  
Chiara Terracciano ◽  
Giuseppina Franzese ◽  
Nicole Piera Palomba ◽  
...  
Keyword(s):  
Pompe Disease ◽  
Rare Variants ◽  
Clinical Symptoms ◽  
Late Onset ◽  
Respiratory Muscles ◽  
Autosomal Recessive Disorder ◽  
Compound Heterozygous ◽  
Enzyme Replacement ◽  
Whole Exome ◽  
Clinical Pictures

Pompe disease is an autosomal recessive disorder caused by a deficiency in the enzyme acid alpha-glucosidase. The late-onset form of Pompe disease (LOPD) is characterized by a slowly progressing proximal muscle weakness, often involving respiratory muscles. In LOPD, the levels of GAA enzyme activity and the severity of the clinical pictures may be highly variable among individuals, even in those who harbour the same combination of GAA mutations. The result is an unpredictable genotype–phenotype correlation. The purpose of this study was to identify the genetic factors responsible for the progression, severity and drug response in LOPD. We report here on a detailed clinical, morphological and genetic study, including a whole exome sequencing (WES) analysis of 11 adult LOPD siblings belonging to two Italian families carrying compound heterozygous GAA mutations. We disclosed a heterogeneous pattern of myopathic impairment, associated, among others, with cardiac defects, intracranial vessels abnormality, osteoporosis, vitamin D deficiency, obesity and adverse response to enzyme replacement therapy (ERT). We identified deleterious variants in the genes involved in autophagy, immunity and bone metabolism, which contributed to the severity of the clinical symptoms observed in the LOPD patients. This study emphasizes the multisystem nature of LOPD and highlights the polygenic nature of the complex phenotype disclosed in these patients.

Multiple causes for rhinolithiasis

2014 ◽  
Vol 52 (2) ◽  
pp. 183-186
Author(s):  
T. Send ◽  
M. Jakob ◽  
K.W.G. Eichhorn
Keyword(s):  
Nasal Cavity ◽  
Foreign Bodies ◽  
Clinical Symptoms ◽  
Pathological Findings ◽  
Common Cause ◽  
Clinical Pattern ◽  
Ectopic Tooth ◽  
Low Incidence ◽  
Iatrogenic Origin ◽  
Endotracheal Anesthesia

Background: Rhinoliths are rare affections of the main nasal cavity and the paranasal sinuses. Initially, as a result of their low incidence, they are often incorrectly classified as calcified tumors in clinical examination. Methodology: We have identified three cases in our patient population and evaluated the clinical symptoms as well as the pathological findings and the causes of the disease. Results: Due to their extension and the respective clinical pattern, all masses were surgically removed under endotracheal anesthesia. The histopathological findings comprised an ectopic tooth, a vegetable (most likely a leaf from the garden) as well as a textile foreign body (probably of iatrogenic origin). Conclusion: Undiscovered foreign bodies of the main nasal cavity are a common cause for the formation of rhinoliths. We have also displayed the respective incidence and the therapeutic options.

scholarly journals Difficulties in therapy of aerobic vaginitis and ways to overcome them

2021 ◽  
Vol 4 ◽  
pp. 30-35
Author(s):  
I.V. Kuznetsova
Keyword(s):  
Genital Tract ◽  
Clinical Symptoms ◽  
Wide Spectrum ◽  
Local Therapy ◽  
External Genitalia ◽  
Empirical Therapy ◽  
Aerobic Vaginitis ◽  
Common Cause ◽  
Selective Antimicrobial Activity ◽  
Systemic Agents

Pathological discharge from the genital tract and other signs of discomfort of the external genitalia are a common cause of a visit to the gynecologist. The cause of these disorders in most cases is vulvovaginal infection, accompanied (vaginitis) or not accompanied (vaginosis) by leukocyte reaction. Methods for treating vulvovaginal infection are predominantly local therapy or systemic agents with highly selective antimicrobial activity. Since a significant part of the vaginitis is of mixed polymicrobial origin, treatment should be complex, which determines the possibility of prescribing topical medicines containing several components of a wide spectrum of action. At the same time, the complexity of diagnosis and the time spent on it allow one to talk about the advisability of empirical therapy of vulvovaginitis, accompanied by severe clinical symptoms.

Dermatology

2020 ◽  
pp. 559-616
Author(s):  
Chantal Simon ◽  
Hazel Everitt ◽  
Françoise van Dorp ◽  
Nazia Hussain ◽  
Emma Nash ◽  
...  
Keyword(s):  
General Practice ◽  
Skin Cancer ◽  
Fungal Infection ◽  
Sweat Gland ◽  
Skin Infection ◽  
Skin Tumours ◽  
Nail Changes ◽  
Skin Erythema ◽  
Keratinization Disorders ◽  
Skin Conditions

This chapter in the Oxford Handbook of General Practice explores dermatology in general practice. It covers skin assessment, treatment of skin conditions, changes in skin colour and eruptions, itching and blistering of the skin, erythema, pigmentation disorder, hair and sweat gland problems, nail changes, and atopic and other eczemas. It discusses ulcers, urticaria, angio-oedema, acne, psoriasis, lichen planus, keratinization disorders, pityriasis, and seborrhoeic warts. It examines sunlight and the skin, benign skin tumours, and skin cancer. It also explores bacterial skin infection, viral skin infection, fungal infection, and infestation.

scholarly journals A VIEW ON THE PROBLEM OF INADEQUATE SCREENING OF COLORECTAL CANCER IN UKRAINE

2019 ◽  
pp. 3-5
Author(s):  
Nelya Melnitchouk ◽  
Galyna Shabat
Keyword(s):  
Colorectal Cancer ◽  
Clinical Symptoms ◽  
Screening Program ◽  
Early Stage ◽  
Cancer Death ◽  
Common Cause ◽  
Screening Programs ◽  
Incidence And Mortality ◽  
National Organizations

The incidence of colorectal cancer (CRC) is increasing worldwide and it is the second most common cause of cancer death. There is a lot of investigations and improvement to rise quality of early diagnosis, successful treatment and effective preventions of colorectal cancer. Nowadays available few guidelines of international and national organizations what support effectiveness of screening programs. Colorectal cancer screening is effective way to decrease incidence and mortality with strong evidence confirmed by a lot of investigations of different scientific groups. Currently, Ukraine doesn’t have an established colorectal cancer program, what need to be changed as soon as possible. A lot of patients in Ukraine wait at home till the beginning of clinical symptoms, what often is the representation of later stage of diseases; and of course treatment of patients with later stage of diseases need more costs for treatment and show worst results of morbidity and mortality rate compare with patients treated at the early stage of diseases. We created a simulation Markov model and demonstrated that the implementation of the national screening program for colorectal cancer in Ukraine will be cost saving and will decrease the mortality from colorectal cancer significantly.

scholarly journals A case of intussuscepted and incarcerated Meckel’s diverticulum in to the coecum

2011 ◽  
Vol 58 (4) ◽  
pp. 107-109
Author(s):  
Srdjan Dikic ◽  
Svetlana Dragojevic ◽  
Darko Zdravkovic ◽  
Miroslav Djordjevic ◽  
Vladimir Kovcin ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Ultrasound Examination ◽  
Clinical Symptoms ◽  
Common Cause ◽  
Prior Surgery ◽  
History Of ◽  
Physical Examinations ◽  
Possible Cause

BACKGROUND: Intussusception with the Meckel?s diverticulum is rare cause of small bowel obstruction in the adults. The Meckel diverticulum is the most common cause of intestinal obstruction in children. METHODS (CASE REPORT): We present a case of 18-year-old boy with developing signs of small bowel obstruction The onset of disease was the day before the first examination. There was no history of prior surgery. According to the clinical symptoms, physical examinations as well as radiographic and ultrasound examination, surgical treatment was indicated. Surgical approach was inferior medial laparotomy. Intussusceptions of the Meckel?s diverticulum and into the coecum with incarceration were found. De-sincarceration and simple diverticulectomy was done. CONCLUSION: The Meckels?s diverticulum should be consider as a possible cause of the small bowel obstruction in previously healthy patient.

scholarly journals Utility of serial procalcitonin measurement in management of febrile neutropenia in a resource constrained setting.

2020 ◽  
Author(s):  
Rohan Halder ◽  
Tulika Seth ◽  
Pradeep Chaturvedi ◽  
Manoranjan Mahapatra ◽  
Hara Prasad Pati ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Fungal Infection ◽  
Sensitivity And Specificity ◽  
Febrile Episode ◽  
Common Cause ◽  
Fever Onset ◽  
Diagnostic Work ◽  
Febrile Episodes ◽  
Work Up ◽  
Diagnostic Work Up

Abstract Background: Febrile neutropenia is a common cause in morbidity and mortality during treatment of hematological neoplasms.Methods: Subjects included all cases admitted under hematology department with febrile neutropenia from February to June 2018. Diagnostic work up for each febrile episode was done including Procalcitonin (PCT) was sent at fever onset 0,24,48hour, day 7 and day 14.Results: Data was analyzed for 52 febrile episodes in 50 patients.PCT cut off value at 24 hours of ≤1.2ng/ml had a sensitivity and specificity of 62.5% and 87.5% for discriminating IFI and MDI (p=0.033). PCT had a negative predictive value of 70% for the diagnosis of IFI as compared to MDI. PCT cut-off of 0.4ng/ml on day 7 had a sensitivity and specificity of 60.98% and 100% respectively for discriminating IFI and PUO (p= 0.0001). There was a significant fall in the level of PCT by day 14(median fall in PCT of 10.8) in the group of patients who had both IFI+ MDI when compared to other groups (p=0.047). PCT level at 24 and 48hours can be a predictor of severity of infection.Conclusion: Procalcitonin at 24 hours could discriminate between bacterial and fungal infection and between fever due to fungal infection and disease fever.

scholarly journals Incidentally detected isolated Aspergillus fumigates infection of the renal allograft

2021 ◽  
Vol 7 (1) ◽  
pp. e08-e08
Author(s):  
Kajal N. Patel ◽  
Nitin A. Patel ◽  
Shruti P. Gandhi ◽  
Hargovind L. Trivedi
Keyword(s):  
Renal Transplant ◽  
Fungal Infection ◽  
Renal Allograft ◽  
Clinical Symptoms ◽  
Central Nervous System Involvement ◽  
Radiology Department ◽  
Renal Transplant Recipients ◽  
Aspergillus Infection ◽  
Aspergillus Fumigates ◽  
Allograft Nephrectomy

Fungal infection represents 5% of the infections of post renal transplant recipients. The frequency of invasive Aspergillus ranges from 0.5% to 2.2% with a mortality rate of 88%. In renal transplantation, Aspergillus infection usually affects primarily the lungs with occasional dissemination and the central nervous system. Involvement of a renal allograft in the isolated form is rare. A-35-year-old male post-renal transplant patient presented in our institute for routine follow up examination. Ultrasound and computed tomography (CT) were conducted in our radiology department, suggestive of abscess formation in mid pole of transplanted kidney. The patient did not have any clinical symptoms. His serum creatinine level was also within normal limit. Diagnosis of Aspergillus fumigates was made by aspiration of pus. Treatment started according to culture and sensitivity report. Ultimately graft nephrectomy was performed to control infection. Aspergillus infection of a renal allograft remains a key issue for nephrologists and infection specialists. For diagnosis of fungal infection, a high index of suspicious is necessary. In the present case, the infected allograft nephrectomy and the elimination of immune-compromised state and the prompt administration of antifungal therapy, made recovery possible. However, early diagnosis remains difficult.

scholarly journals Extracellular Vesicles from Aspergillus flavus Induce M1 Polarization In Vitro

mSphere ◽  
2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Verônica S. Brauer ◽  
André M. Pessoni ◽  
Tamires A. Bitencourt ◽  
Renato G. de Paula ◽  
Liliana de Oliveira Rocha ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Extracellular Vesicles ◽  
Aspergillus Flavus ◽  
Crucial Role ◽  
Galleria Mellonella ◽  
Biologically Active ◽  
Common Cause ◽  
Content Type ◽  
M1 Macrophage

ABSTRACT Aspergillus flavus, a ubiquitous and saprophytic fungus, is the second most common cause of aspergillosis worldwide. Several mechanisms contribute to the establishment of the fungal infection. Extracellular vesicles (EVs) have been described as “virulence factor delivery bags” in several fungal species, demonstrating a crucial role during the infection. In this study, we evaluated production of A. flavus EVs and their immunomodulatory functions. We verified that A. flavus EVs induce macrophages to produce inflammatory mediators, such as nitric oxide, tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), and IL-1β. Furthermore, the A. flavus EVs enhance phagocytosis and killing by macrophages and induce M1 macrophage polarization in vitro. In addition, a prior inoculation of A. flavus EVs in Galleria mellonella larvae resulted in a protective effect against the fungal infection. Our findings suggest that A. flavus EVs are biologically active and affect the interaction between A. flavus and host immune cells, priming the innate immune system to eliminate the fungal infection. Collectively, our results suggest that A. flavus EVs play a crucial role in aspergillosis. IMPORTANCE Immunocompromised patients are susceptible to several fungal infections. The genus Aspergillus can cause increased morbidity and mortality. Developing new therapies is essential to understand the fungal biology mechanisms. Fungal EVs carry important virulence factors, thus playing pivotal roles in fungal pathophysiology. No study to date has reported EV production by Aspergillus flavus, a fungus considered to be the second most common cause of aspergillosis and relevant food contaminator found worldwide. In this study, we produced A. flavus EVs and evaluated the in vitro immunomodulatory effects of EVs on bone marrow-derived macrophages (BMDMs) and in vivo effects in a Galleria mellonella model.

Efficacy and Safety of Micafungin as An Empirical Antifungal Therapy for Suspected Fungal Infection in Patients with Hematological Disorders.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1939-1939
Author(s):  
Minoru Yoshida ◽  
Kazuo Tamura ◽  
Masahiro Imamura ◽  
Yoshiro Niitsu ◽  
Takeshi Sasaki ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Antifungal Therapy ◽  
Clinical Symptoms ◽  
Fungal Infections ◽  
Efficacy And Safety ◽  
Hematopoietic Stem ◽  
Persistent Fever ◽  
Hematological Disorders ◽  
Study Results ◽  
Empirical Antifungal Therapy

Abstract Background: Invasive fungal infections (IFIs) are of serious concern in the management of immunocompromised patients (pts) with hematological disorders. Empiric antifungal therapy is recommended for neutropenic pts with persistent fever, because treatment after confirmation of fungal infection often produces poor outcomes. Micafungin (MCFG), one of the echinocandin families, was launched first in Japan in 2002, and has now been approved in more than 11 countries and areas including the USA and the EU. Although the efficacy and safety of MCFG against both Candida and Aspergillus infections has been shown in many clinical trials, there are few clinical study reports on the empiric therapy of a suspected fungal infection. Here, we report the multi-center study results of MCFG for the empiric antifungal therapy, which were conducted from April 2005 to September 2006 in Japan. Objective: This prospective study was performed to clarify the efficacy and safety of MCFG for the empirical antifungal therapy on suspected fungal infection in pts with hematological disorders and neutropenia. Methods: Study design: A multiple-center, open, uncontrolled study. The investigator registered pts with neutropenia (< 1,000/μl) who met the following criteria to the Subject Registration Center. Suspected fungal infections were divided into two categories: possible fungal infection defined by positive clinical symptoms/findings and serological testing (beta-D-glucan or galactomannan) or diagnostic imaging (chest X-ray or CT scan), refractory fever defined by unexplained persistent fever (an axillary temperature higher than 37.5 °C) after the antibacterial treatment over 2 days and by positive clinical symptoms/findings. IFIs categorized as proven or probable were not included in this study. Efficacy evaluation was performed using an algorithm based on each of the evaluation of clinical symptoms/findings, imaging study findings, and serological tests. Results: 388 pts (M:234, F:154, mean age:57.8 years old) were registered. The mean dosage and duration of treatment with MCFG were 154.6±55.3 mg/day and 14.0±6.9 days, respectively. The main underlying hematological disorders were acute leukemia (61.3%), non-Hodgkin’s lymphoma (18.3%) and myelodysplastic syndrome (10.8%). The number of pts with hematopoietic stem cell transplantation (HSCT) was 76 (19.6%). The clinical response rate (CRR), excluding 4 non-evaluable pts was 63.3% (243/384): 60.1% (89/148) for pts with possible fungal infection and 65.3% (154/236) for pts with refractory fever, respectively. Even in persistent neutropenic pts whose neutrophil counts were < 500/μL throughout the treatment with MCFG, the CRR was high enough: 46.9% (61/130). No difference was observed in the CRR among the main underlying hematological disorders. The CRR in pts with HSCT and other conditions were 63.2% (48/76) and 63.3% (195/308), respectively. Drug-related adverse events (DAEs) were observed in 16.8% (65/388). Serious DAEs such as elevation of serum bilirubin and renal dysfunction was observed in 0.52% (2/388). Conclusion: MCFG was confirmed to have high clinical efficacy and be safe for the treatment of suspected fungal infection in pts with hematological disorders and neutropenia.

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