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Author(s):  
Munish Kumar ◽  
Chitra Priyadarshini

Metronidazole is an antibiotic and an antiprotozoal drug, is cost effective treatment of choice in amoebic liver abscess. Cerebellar toxicity is quite rare and serious side effect of metronidazole, which is reversible. The importance of MRI brain in this condition is the typical finding of abnormal T2 as well as FLAIR hyperintensities in dentate nuclei and splenium of corpus callosum. We present a case of liver abscess on prolong metronidazole treatment presented with acute onset cerebellar ataxia.


2021 ◽  
Vol 22 (5) ◽  
pp. 2684
Author(s):  
Knut Brockow ◽  
Katarzyna Plata-Nazar ◽  
Magdalena Lange ◽  
Bogusław Nedoszytko ◽  
Marek Niedoszytko ◽  
...  

Mastocytosis is characterized by the pathological accumulation of mast cells (MC) in various organs. In these patients, MC may degranulate and thereby contribute to clinical symptoms, especially when a concomitant allergy is present. However, MC activation can not only be induced by high-affinity receptors for IgE, but also by anaphylatoxins, neuropeptides, IgG immune complexes, complement-components, drugs, products of bacteria or parasites, as well as physical factors such as heat, cold, vibration, stress, sun, or physical effort. Symptoms due to mediators released by activated MC may develop in adults suffering from systemic mastocytosis, but also evolve in children who usually have cutaneous mastocytosis (CM). Clinically, CM is otherwise characterized by typical brown, maculopapular skin lesions or mastocytoma associated with a positive Darier’s sign. Pruritus and flushing are common and blistering may also be recorded, especially in diffuse CM (DCM). Pediatric patients with mastocytosis may also have gastrointestinal, respiratory, and neurologic complaints. Although anaphylaxis is not a typical finding, pediatric patients with massive skin involvement and high tryptase levels have a relatively high risk to develop anaphylaxis. This paper reviews MC mediator-related symptoms and anaphylaxis in children with mastocytosis, with special emphasis on risk factors, triggers, and management.


2021 ◽  
pp. 1-6

Background: Rett syndrome is a rare X-linked dominant neuro-developmental and pervasive developmental disorder that has no satisfactory or effective treatment. The diagnosis is generally clinical and autistic feature is a typical finding in all patients. We have previously described the short-term treatment of an Iraqi girl with Rett syndrome who was first seen at the age of about three years. The girl was treated with intramuscular cerebrolysin and oral citicoline for 40 days. Treatment was associated with significant improvement with the development of purposeful movement and the ability to hold feeding bottle with assistant of the mother and feed her. She was able to stand and step one step holding furniture. She started babbling and showed some reduction in the autistic features. The aim of this paper is to describe the extended treatment of the girl with Rett syndrome which was treated with a novel therapeutic approach which included intramuscular cerebrolysin, citicoline and piracetam. Patients and methods: After the initial 40 days treatment, the girl received several treatment courses that included intramuscular cerebrolysin, citicoline and piracetam. Results: Several months of treatment resulted in improvements in behavior, autistic features and mobility and she was walking confidently holding a wall or furniture. Treatment was not associated with any side effects. Conclusion: Rett syndrome is a very complex neuro-developmental and pervasive developmental disorder that has no satisfactory or effective treatment. The use of novel therapeutic approach which included intramuscular cerebrolysin, citicoline and piracetam for the treatment of Rett syndrome resulted in within few months a significant improvement that have not been reported without treatment or with any other therapies before.


Author(s):  
Sasaki K ◽  

Candida-associated gastric ulcer occurs not only in debilitated but healthy individuals. Though had been reported to demonstrate nothing but nonspecific endoscopic features, it occasionally exhibits a typical finding I designated a candidarium. The natural history of the disease had not been clarified and the recurrence had not been described. However, I demonstrated that the ulcer not only occurs but also recurs in a different site with a different shape in a non-diabetic, H. pylori-negative patient, who has not taken NSAIDs, antibiotics, antineoplastic agents, or systemic corticosteroids, advocating that, contrary to the prevailing opinion, Candida is no innocuous bystander but an etiologic perpetrator. It has recently been shown to secrete a cytolytic PFT, candidalysin, into a pocket in the epithelium after penetrating into it to activate MAPK/MKP1/ c-Fos pathway, triggering release of damage as well as immune cytokines in OPC and VVC. While candidalysin, exerting an effect even on the adjacent oropharyngeal cells, directly injures the tissue with damage cytokines, immune counterparts activate PMNs to eventually terminate inflammation. Though the epithelial response to the fungus is different from organ to organ, it invades into and induces necrotic cellular damage to the IECs through the toxin to translocate: the action of candidalysin is proven not only on the squamous but on the columnar epithelium. Since, by analogy with intestinal candidiasis, it is never difficult to speculate that the PFT inflicts such damage to the gastric mucosa, a theoretically strong possibility has come up that Candida-associated gastric ulcer is actually Candida-induced.


Author(s):  
Knut Brockow ◽  
Katarzyna Plata-Nazar ◽  
Magdalena Lange ◽  
Bogusław Nedoszytko ◽  
Marek Niedoszytko ◽  
...  

Mastocytosis is characterized by pathological accumulation of mast cells (MC) in various organs. In these patients, MC may degranulate and thereby contribute to clinical symptoms, especially when a concomitant allergy is present. However, MC activation can not only be induced by high-affinity receptors for IgE, but also by anaphylatoxins, neuropeptides, IgG immune complexes, complement-components, drugs, products of bacteria or parasites, as well as physical factors such as heat, cold, vibration, stress, sun, or physical effort. Symptoms due to mediators released by activated MC may develop in adults suffering from systemic mastocytosis, but also evolve in children who usually have cutaneous mastocytosis (CM). Clinically, CM is otherwise characterized by typical brown, maculopapular skin lesions or mastocytoma associated with a positive Darier’s sign. Pruritus and flushing are common and blistering may also be recorded, especially in diffuse CM (DCM). Pediatric patients with mastocytosis may also have gastrointestinal, respiratory, and neurologic complaints. Although anaphylaxis is not a typical finding, pediatric patients with massive skin involvement and high tryptase levels have a relatively high risk to develop anaphylaxis. This paper reviews MC mediator-related symptoms and anaphylaxis in children with mastocytosis, with special emphasis on risk factors, triggers, and management.


2020 ◽  
Author(s):  
Oliver Genschow ◽  
Johanna Groß-Bölting

Past research has shown that merely anticipating a certain action in someone else leads observers to engage in the anticipated action—a phenomenon called anticipated action. In a standard experiment on anticipated action, participants watch video clips of a model engaging in triggering events such as nose wrinkling or hair falling. A typical finding is that when observing nose wrinkling, participants engage in more nose scratching actions than hair stroking actions and vice versa for observing hair falling. While past research suggested that this effect is due to inferring a desire in others to act, an alternative explanation is that observing a triggering event in someone else guides attention towards respective body parts facilitating any action towards this body part. In two experiments we set this explanation to a critical test. The results speak against attention as driving process and in favor of inferring a desire in others to act, because guiding attention to the location of the triggering event did not result in anticipated action effects. This result has important implications for research on anticipative processes and imitative behavior.


2020 ◽  
Vol 185 (9-10) ◽  
pp. e1854-e1856
Author(s):  
Imelda Muller ◽  
Alyson Brinker

Abstract Scabies outbreaks are relatively common worldwide, particularly in communal living settings such as military barracks. The infestation is caused by the parasite Sarcoptes Scabiei and is easily treated once properly diagnosed. Classic symptoms include pruritus around the waist, wrists, and ankles.1 On physical examination, linear burrows visualized in finger web spaces is a typical finding.1 It is not uncommon, however, for scabies to present with a variety of other dermatologic manifestations, which can lead to a delayed or missed diagnosis. This case highlights a delayed diagnosis of scabies, initially presenting as urticaria in a 26-year-old active duty male living in military barracks where multiple previous outbreaks were identified. Providers should be aware of the oftentimes-elusive diagnosis of scabies and the many nonclassic dermatologic manifestations. A thorough skin examination with skin scrapings and examination of the finger web spaces should be considered in those with ambiguous skin rashes who are particularly at risk for scabies infection, such as military recruits, submariners, and other service members living in communal settings. Timely and accurate diagnosis and treatment is crucial to prevent reinfection and spread of scabies throughout these communal living settings.


2020 ◽  
Vol 105 (8) ◽  
pp. 2595-2605
Author(s):  
Sandra Ueberberg ◽  
Michael A Nauck ◽  
Waldemar Uhl ◽  
Chiara Montemurro ◽  
Andrea Tannapfel ◽  
...  

Abstract Background Amyloid deposits are a typical finding in pancreatic islets from patients with type 2 diabetes. Whether this is linked to the pathogenesis of type 2 diabetes is currently unknown. Therefore, we compared the occurrence of islet amyloid in patients with type 2 diabetes, diabetes secondary to pancreatic disorders, and nondiabetic individuals. Patients and methods Pancreatic tissue from 15 nondiabetic patients, 22 patients with type 2 diabetes, and 11 patients with diabetes due to exocrine pancreatic disorders (chronic pancreatitis, pancreatic carcinoma) were stained for insulin, amyloid, and apoptosis. β-cell area, amyloid deposits, and β-cell apoptosis were quantified by morphometric analysis. Results The proportion of islets containing amyloid deposits was significantly higher in both type 2 diabetes and diabetes due to exocrine pancreatic disorders than in healthy subjects. Islets with both amyloid and apoptosis were observed more frequently in type 2 diabetes and significantly more so in diabetes due to exocrine pancreatic disorders. In both diabetic groups, apoptotic ß-cells were found significantly more frequently in islets with more prominent amyloid deposits. Conclusions The occurrence of amyloid deposits in both type 2 diabetes and diabetes secondary to exocrine pancreatic disorders suggests that islet amyloid formation is a common feature of diabetes mellitus of different etiologies and may be associated with a loss of pancreatic ß-cells.


2019 ◽  
Vol 2 (2) ◽  
pp. 125
Author(s):  
Ryan Enast Intan ◽  
Tan Nicko Octora ◽  
Firas Farisi Alkaff ◽  
Dimas Rio Balti

Pericarditis is a common disorder that might present in various settings, including primary-care and emergency department. However, the clinical features in some cases did not match with the written theory, which could lead to a misdiagnosis. A 46-year-old man presented to the emergency room with progressive tightness chest pain, epigastric pain, nausea, and vomiting in the past 2 days. Based on the clinical, electrocardiograph (ECG), and laboratory evaluation, the patient was diagnosed with unstable angina pectoris and treated accordingly but did not showed an improvement. Clinical re-examination and echocardiography evaluation showed a pathognomonic finding of pericarditis feature. Combination therapy of colchicine and ibuprofen was given for 3 weeks. One-month follow-up evaluation showed normal ECG and echocardiography result without any remaining symptoms. Acute pericarditis does not always show typical finding. Therefore, clinician must always aware with other differential diagnosis of chest pain and ECG variation of acute pericarditis.


2019 ◽  
Vol 130 (625) ◽  
pp. 1-23 ◽  
Author(s):  
Revital Bar ◽  
Asaf Zussman

Abstract How does one's identity affect the evaluation of others? To shed light on this question, we analyse the universe of driving tests conducted in Israel between 2006 and 2015, leveraging the effectively random assignment of students and testers to tests. We find strong and robust evidence of both ethnic (Arab/Jewish) in-group bias and gender out-group bias. While the first result is in line with the typical finding in the literature, the second is novel. Analyses of administrative and survey data suggest a utility-based interpretation for the observed patterns: testers seem to reward members of groups whose company they enjoy.


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