Metabolic Malady Coming from Molecular Systems for you to Fresh Solutions

A 77-year-old man with arterial hypertension and dyslipidaemia, treated with olmesartan/hydrochlorothiazide and simvastatin, was admitted with a 3-week history of anorexia, nausea, vomiting, profuse diarrhoea and weight loss. He was dehydrated and blood tests showed acute kidney injury. The aetiological study was inconclusive. The patient had a favourable clinical evolution during hospitalization and was discharged. However, after about 10 days at home, he was re-admitted to hospital with the same clinical presentation. It was noticed that olmesartan had not been prescribed during the previous admission but had been restarted on an outpatient basis. Biopsy examination showed duodenal mucosa with villous atrophy and polymorphic inflammatory infiltrate. Antibody testing for coeliac disease was negative. Based on these facts, it was hypothesized that the patient had olmesartan-induced enteropathy, which was subsequently confirmed.
Drug-induced sprue-like enteropathy must be considered in the differential diagnosis of patients with diarrhoea, weight loss, and villous atrophy of the duodenal mucosa of unknow origin.Olmesartan has been associated with the development of enteropathy.Olmesartan-induced enteropathy can happen years after drug initiation.
Drug-induced sprue-like enteropathy must be considered in the differential diagnosis of patients with diarrhoea, weight loss, and villous atrophy of the duodenal mucosa of unknow origin.Olmesartan has been associated with the development of enteropathy.Olmesartan-induced enteropathy can happen years after drug initiation.Obstructive sleep apnoea (OSA) is a common condition usually treated with continuous positive airway pressure (CPAP). No reports have linked it to an acute subdural haematoma. A 54-year-old white man who had hypertension well controlled with an angiotensin II receptor blocker, presented with a 2-week history of occipital headache with no other focal neurological symptoms. The headache began 12 days after he had started using CPAP for OSA. A brain MRI performed 2 weeks later showed bilateral subdural haematomas which were chronic on the left and sub-acute/acute on the right. Since the patient was clinically stable with no focal neurological deficits, he received prednisone for 3 weeks and was followed up with consecutive CT scans demonstrating gradual regression of the haematomas. This is the first report showing that subdural haematomas could be linked to CPAP use.
Primary care physicians, pulmonologists and neurologists should be alert for unexplained headache in a patient on continuous positive airway pressure (CPAP).Subdural haematoma may be a rare reported side effect of CPAP use.Subdural haematoma in a stable patient with no focal neurological deficits can be treated conservatively with close monitoring and follow-up.
Primary care physicians, pulmonologists and neurologists should be alert for unexplained headache in a patient on continuous positive airway pressure (CPAP).Subdural haematoma may be a rare reported side effect of CPAP use.Subdural haematoma in a stable patient with no focal neurological deficits can be treated conservatively with close monitoring and follow-up.
This is the first case report of iatrogenic Takotsubo syndrome (TS) due to a combination of lisdexamfetamine and phentermine.
TS is characterized by transient acute ballooning of the left ventricular wall. Typically, it occurs in extremely stressed post-menopausal women, however a few iatrogenic causes have been described recently.
A 55-year old woman prescribed lisdexamfetamine and phentermine, presented with acute substernal chest pain. Acute coronary syndrome was excluded. The echocardiogram was diagnostic of TS, and she recovered spontaneously, with supportive care.
Caution with the use of sympathomimetic medications in post-menopausal women appears warranted.
This is the first case report in the published English literature of medication-induced Takotsubo cardiomyopathy due to combination use of lisdexamfetamine and phentermine.This provides new information about iatrogenic causes of Takotsubo cardiomyopathy.Caution is indicated in the use of such medications, particularly in post-menopausal women, who are at higher risk.
This is the first case report in the published English literature of medication-induced Takotsubo cardiomyopathy due to combination use of lisdexamfetamine and phentermine.This provides new information about iatrogenic causes of Takotsubo cardiomyopathy.Caution is indicated in the use of such medications, particularly in post-menopausal women, who are at higher risk.While functional decline is a common syndrome in geriatric medicine, the diagnosis of the underlying disease can be complex. We present a case of very late-onset systemic lupus erythematosus with fever, arthritis, lymphadenopathy, sicca syndrome, pleurisy, renal impairment and reversible functional and cognitive impairments. Prompt improvement was observed on prednisolone and hydroxychloroquine.
Systemic lupus erythematosus (SLE) rarely occurs in octogenarian patients.In such oldest old patients, SLE may predominantly present with subacute cognitive and functional impairments.Low-dose treatment (prednisolone 7.5 mg/day and hydroxychloroquine 5 mg/kg/day) can reverse all SLE manifestations within 1 month.
Systemic lupus erythematosus (SLE) rarely occurs in octogenarian patients.In such oldest old patients, SLE may predominantly present with subacute cognitive and functional impairments.Low-dose treatment (prednisolone 7.5 mg/day and hydroxychloroquine 5 mg/kg/day) can reverse all SLE manifestations within 1 month.
We describe a case of systemic sclerosis (SS) with acro-osteolysis associated with cutaneous mucinosis, usually characterized by mucin deposition in the skin. The main differential diagnosis was multicentric reticulohistiocytosis due to the presentation of papulonodular skin lesions.
A physical examination, imaging studies and laboratory tests were performed.
Distal bone resorption was evident on plain radiographs, and skin biopsy confirmed mucinosis. The SS diagnosis was based on the clinical features, high levels of antinucleolar antibodies and typical nailfold capillaroscopy findings.
To the best of our knowledge, this is the first description of cutaneous mucinosis accompanying SS with acro-osteolysis.
Cutaneous mucinosis is rarely associated with systemic sclerosis.Systemic sclerosis with cutaneous mucinosis may resemble multicentric reticulohistiocytosis.
Cutaneous mucinosis is rarely associated with systemic sclerosis.Systemic sclerosis with cutaneous mucinosis may resemble multicentric reticulohistiocytosis.Ogilvie's syndrome is a non-mechanical, acute pseudo-obstruction of the colon, causing massive colonic dilation. Medical or surgical conditions can predispose patients to Ogilvie's syndrome; however, the pathogenesis and clinical findings are still not well understood. Here, we present a case of a 48-year-old male patient who presented to the Emergency Department with intermittent self-resolved left-sided lower chest pain on a background of ischaemic heart disease and positive risk factors for acute coronary syndrome. Troponin testing was negative and an electrocardiogram showed no acute changes. Chest radiography showed a dilated bowel under the left hemidiaphragm and a computed tomography (CT) scan of the abdomen-pelvis confirmed the diagnosis of Ogilvie's syndrome. The patient was treated conservatively with a short period of nil by mouth and intravenous fluids.
Non-cardiac causes of chest pain should be always considered even in patients with previous cardiac history, especially those patients for whom there is no evidence to support recurrent cardiac ischaemia.Acute colonic pseudo-obstruction (Ogilvie's syndrome) can be presented as chest pain that mimics angina pectoris.Chest radiography is of great value in cases of acute chest pain; a dilated bowel segment can be the only finding of Ogilvie's syndrome in the initial assessment.
Non-cardiac causes of chest pain should be always considered even in patients with previous cardiac history, especially those patients for whom there is no evidence to support recurrent cardiac ischaemia.Acute colonic pseudo-obstruction (Ogilvie's syndrome) can be presented as chest pain that mimics angina pectoris.Chest radiography is of great value in cases of acute chest pain; a dilated bowel segment can be the only finding of Ogilvie's syndrome in the initial assessment.In the present report, we describe our experience with a 44-year-old male with abnormal retroperitoneal primitive neuroectodermal tumours (PNETs) in our hospital, who was operated on with a spindle cell neoplasm diagnosis.
Appropriate treatment is a crucial challenge in patients with PNETs due to late referral.The differential diagnoses were malignant pheochromocytoma, paraganglioma and retroperitoneal sarcoma.Physicians should keep in mind that the patient could be simultaneously suffering from sarcoma and a retroperitoneal PNET.
Appropriate treatment is a crucial challenge in patients with PNETs due to late referral.The differential diagnoses were malignant pheochromocytoma, paraganglioma and retroperitoneal sarcoma.Physicians should keep in mind that the patient could be simultaneously suffering from sarcoma and a retroperitoneal PNET.
Pet ownership is increasing rapidly and as growing numbers of dogs in household, clinicians are facing more allergic patients and so as in young children.
This study aims to profile the IgE recognition patterns to aeroallergen components in young children sensitized to dogs.
Through retrospective chart reviews, we evaluated the clinical, environmental, and laboratory findings of patients sensitized to dogs in early life. We further evaluated specific IgE to dog component allergens (Can f 1, Can f 2, and Can f 3) and other aeroallergens using a microarray.
The median age of 28 patients sensitized to dogs (dog-specific IgE ≥ 0.35 kU/L; 0.38-101 kU/L) was 61 months and underlying diseases included doctor diagnosed atopic dermatitis (n = 17), asthma (n = 7), and allergic rhinitis (n = 5). Twenty patients (71.4%) had experienced self-reported dog allergy and 70.0% of them were symptomatic after exposed to dogs from others. Component-resolved diagnosis was performed on 18 patients. Can f 1 positivity was the most common (77.8%) but had no value in symptom prediction. The most common cosensitized aeroallergen was house dust mites (44.5%). The symptomatic group tended to be poly-sensitized to Can f 1, Can f 2, and Can f 3.
Can f 1 was dominantly detected and poly-sensitized to Can f 2 and/or Can f 3 simultaneously tend to develop hypersensitivity to dogs in young children. Most of them were exposed to dogs not living with.
Can f 1 was dominantly detected and poly-sensitized to Can f 2 and/or Can f 3 simultaneously tend to develop hypersensitivity to dogs in young children. Most of them were exposed to dogs not living with.
Anaphylaxis is a serious allergic reaction that needs early administration of intramuscular epinephrine for treatment. Currently, structured education on epinephrine prefilled syringe usage for anaphylaxis does not exist.
This study aimed to examine the effectiveness of the epinephrine prefilled syringe usage video, compared with routine teaching method.
This was a randomized controlled trial. A total of 129 medical students were assigned either to the routine teaching group or the video teaching group. The main outcome is the total number of medical students who passed (>70%) the test. Stenoparib solubility dmso The pre-, posttest, and objective structured clinical examination (OSCE) were used to evaluate the students.
At the 2-week follow-up, the individual scores increased significantly after both interventions (
< 0.001). The percentages of medical students who passed the exam in the pre-, posttests, and OSCE were not significantly different between the groups. In the routine teaching group and video teaching group, the percentages of students who passed increased from 32.