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Imaging as a first step for Cultural Heritage and archaeology analyses
Get PDFImaging systems are the basic tools of the trade for art historians, conservators, and archaeologists, when they are called to document the results of their work. However, photo cameras and imaging systems are also powerful research tools. These systems, in fact, are inherently portable and give the possibility of acquiring high-resolution, spectrally resolved digital images that can be elaborated exploiting the most advanced algorithms of information science. In this contribution, we will outline the many possibilities opened by the available instrumentation and techniques, to suggest the use of image analysis as the first step of the diagnostic process in Cultural Heritage conservation and study
Gitelman Syndrome: A Rare Case of Hypokalaemia and a Novel Mutation
Get PDFGitelman syndrome (GS) is a hereditary renal tubulopathy caused by mutations in the SLC12A3 gene which encodes the thiazide-sensitive apical sodium-chloride cotransporter. GS is characterized by hypokalaemia, hypomagnesaemia and metabolic alkalosis. Treatment is based on potassium and magnesium replacement ad eternum. We present the case of a young man with palpitations and persistent hypokalaemia, who was diagnosed with GS. Genetic testing revealed 2 mutations in the gene SLC12A3 of combined heterozygosity, both considered pathological. Interestingly, 1 of these mutations was not yet described in the literature or in the reviewed databases. We also discuss the clinical approach and the specificities of managing this rare hereditary renal tubulopathy.
The Deceptive Mushroom: Accidental Amanita muscaria Poisoning
Get PDFAmanita muscaria is considered to be one of the most remarkable and beautiful mushrooms. It has a red or orange cap covered with small white plaques and its distinctive appearance makes accidental and severe intoxication very rare. Its consumption is sometimes used as a means of suicide or it can be consumed for its psychedelic effects, and in some cases, it can be mistaken for edible species. In this paper, we will discuss a patient who fell into a coma after accidental Amanita muscaria poisoning. Rapid identification of the mushroom allowed the regression of symptoms and discharge from the hospital on the fourth day after consumption
Granulomatosis with Polyangiitis: Recurrence or Treatment Consequences?
Get PDFGranulomatosis with polyangiitis (GPA) is the most common antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). We describe the case of a 38-year-old woman with relapsing GPA who presented with intracranial hypertension, followed by the appearance of cavitated lung nodules despite treatment with azathioprine. Clinical improvement and ANCA titre reduction were observed after rituximab treatment. We report a rare form of GPA relapse and highlight the challenge of following-up patients with GPA, in whom can be hard to distinguish relapse from the consequences of long-term immunosuppression
After All, It was Not Lung Cancer: When The Evidence is Misleading
Get PDFThe aetiology of pulmonary nodules is varied, with malignant lesions being the most important and requiring rapid diagnosis and treatment. However, although clinical presentation and imaging may suggest a specific diagnosis, it should be kept in mind that some benign pathologies mimic more serious disease. A 50-year-old man presented with left pleuritic chest pain. A CT scan showed an ipsilateral pulmonary spiculated nodule. Pneumonia was assumed and the patient was started on antibiotic therapy. In the absence of improvement, positron emission tomography and a transthoracic aspiration biopsy were performed. Lung cancer was diagnosed and the patient underwent an upper lobectomy. However, examination of the surgical specimen showed no malignancy
Transplant-associated Thrombotic Microangiopathy Treated with Eculizumab and Romiplostim
Get PDFTransplant-associated thrombotic microangiopathy (TA-TMA) can occur after solid organ transplantation. It results in thrombocytopenia, haemolytic anaemia and microvascular occlusion. TA-TMA is not fully understood and treatment has not been clearly established. However, there is increasing evidence to suggest an immune-complement mediated component to its development. Eculizumab is a monoclonal antibody that inhibits the cleavage of C5 into pro-inflammatory, prothrombotic terminal complement elements and has been utilized in the treatment of atypical haemolytic uremic syndrome. We report a case of TA-TMA successfully treated with eculizumab and romiplostim. This case adds to the evidence that TA-TMA is triggered by complement dysregulation and suggests possible interventions for refractory cases
Kounis Syndrome: Dexketoprofen-Associated ST-Elevation Myocardial Infarction
Get PDFAllergic angina and allergic myocardial infarction are common diseases associated with acute coronary syndromes and encompass a wide spectrum of mast cell activation disorders termed "Kounis Syndrome". We present here a patient with Kounis syndrome presenting with sudden cardiac arrest after intravenous infusion of dexketoprofen in the emergency room
Streptococcus oralis Meningitis
Get PDFStreptococcus oralis is part of the normal flora of the oropharyngeal, nasal, gastrointestinal and genitourinary tracts. Classically, it shows low pathogenicity and virulence, but can very rarely cause meningitis in patients who have undergone dental procedures and have poor oral
hygiene. The purpose of this report is to highlight the importance of considering S. oralis as a cause of meningitis in patients with poor oral hygiene. A 53-year-old man was admitted to the emergency department with high fever (39.4°C), headache and drowsiness. His mouth was unhygienic. He was diagnosed with meningitis and empiric antibiotics (ceftriaxone plus ampicillin) and dexamethasone were started. S. oralis was isolated from cerebrospinal fluid. Ampicillin and dexamethasone were stopped, while ceftriaxone was continued with full recovery of the patient
Paecilomyces Pneumonia Despite Voriconazole Prophylaxis: A Case Report and Literature Review
Get PDFPaecilomyces species are a rare cause of fungal pulmonary infections in immunocompromised hosts.
Paecilomyces variotii and Paecilomyces lilacinus are the two most common species of clinical significance. Both species differ in their susceptibility to antifungal agents. We present a rare case of a 47-year-old immunocompromised woman who developed Paecilomyces pneumonia despite being on voriconazole prophylaxis. We also present a review of the literature on other reported cases
COVID-19 mRNA Vaccine and Myocarditis
Get PDFCoronavirus disease 2019 (COVID-19) is believed to have originated in the Hua nan South China Seafood Market in Wuhan and can present with a spectrum of clinical manifestations. We report the case of 24-year-old male patient who developed chest pain after administration of the second dose of the Pfizer-BioNTech mRNA COVID-19 vaccine and who was diagnosed with myocarditis on work-up