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Severe Oleander Poisoning Presenting with Hyperkalaemia and Unusual Electrocardiographic Changes
Get PDFBackground: Hyperkalaemia in oleander (Nerium oleander) poisoning has been associated with a poor prognosis. Different electrocardiographic (ECG) presentations are possible because of vagotonia and hyperkalaemia. Methods/Results: We report a series of three cases of oleander poisoning in which ECG showed unusual hyperkalaemia features, such as bradyarrhythmia, sinoatrial block, atrioventricular block and junctional rhythm. Conclusions: If arterial blood gas analysis or laboratory values indicate hyperkalaemia in oleander poisoning, the hyperkalaemia should be treated immediately, even if the ECG does not show typical hyperkalaemia features
Thymoma and Tuberculoma: Unexpected Coexistence
Get PDFMediastinal tumours can be incidental findings on chest x-ray or present with systemic symptoms and/or direct effect of the mediastinal mass. We report the case of a woman with symptomatic thymoma B1 and simultaneous thymus tuberculosis
A Rare Case of Serrated Polyposis Syndrome with the MSH6 and SMARCA4 variants
Get PDFSerrated polyposis syndrome (SPS) is the most common form of polyposis syndrome and has been shown to increase the risk of colorectal cancer (CRC). The genetic pathway of CRC in SPS is different from the classic adenomatous polyposis coli (APC) pathway, which accounts for 70–80% of cases of CRC. Most commonly, SPS mutations include BRAF and KRAS, with activation of the RAS-RAF-MAP kinase pathway involved in the pathogenesis of serrated lesions. We present a rare case of SPS in a 32-year-old woman with MSH6 and SMARCA4 variants, which have not previously been reported in the literatur
Strongyloides Hyper-Infection Syndrome and Ciliocytophthoria Mimicking Balantidium coli
Get PDFCiliocytophthoria is a phenomenon where degenerated cells in infections or malignancy can present as ciliated cells on microscopy and so may be confused with ciliated parasitic infection. We present an interesting case of recurrent shortness of breath, misdiagnosed as chronic obstructive pulmonary disease exacerbations leading to unnecessary exposure to antimicrobials and steroids. The case was diagnosed as Strongyloides hyper-infection syndrome. Another finding worth mentioning was that ciliated cells noted on broncho-alveolar lavage were thought to be a co-infection with Balantidium coli but were later confirmed as ciliocytophthoria
Purulent Pericarditis: Is It Really a Disease of the Past?
Get PDFThe authors present a case of purulent pericarditis probably secondary to respiratory infection, a rare entity in the antibiotic era. Pericardial fluid analysis identified streptococci and oral anaerobes as the causative agents. A prolonged and complicated diagnostic and therapeutic course, which included a long stay in the intensive care unit, is described, and a review of purulent pericarditis provided. Pericardial effusion, particularly in the setting of concomitant respiratory infection and immunocompromise or other risk factors, should raise the suspicion of bacterial pericarditis and prompt its timely diagnosis and treatment. Purulent pericarditis can be lethal and has potentially severe complications, so adequate antimicrobial therapy and source control are key
More than Valley Fever: Pulmonary Actinomycosis and Coccidioidomycosis Co-infection in a Patient
Get PDFPulmonary coccidioidomycosis and pulmonary actinomycosis are unheard of as co-pathogens. Infection with these organisms on their own can mimic lung cancer, thus presenting a diagnostic challenge. We present the case of a 75-year-old woman presenting with haemoptysis with a chest CT chest finding of a lung mass suggestive of lung cancer. A diagnosis of concomitant infection by Coccidioides posadasii/immitis and Actinomyces odontolyticus was made based on culture and histopathology results. The patient was successfully treated with a combination of antifungal and antibacterial therapy. This is the first reported case of co-infection by these two microorganism
Multiple Sclerosis and Nabiximols at the times of COVID-19
Get PDFThis publication was made possible thanks to the unrestricted educational grant from Admiral
An Effective Treatment for Multiple Sclerosis Urinary Disorders Through a Formulationof Delta-9-Tetrahydrocannabinol and Cannabidiol
Get PDFSpasticity represents an important cause of disability for patients with multiple sclerosis. Even more, dysfunction of the bladder greatly aggravates the patient’s burden and is responsible for their poor quality of life. Here, the case of a 35-year-old woman suffering from relapsing-remitting multiple sclerosis, with a slight spastic paraparesis associated with significant urinary urge incontinence, is reported. First-line antispastic treatments, physiotherapy and symptomatic drugs for urinary disorders did not bring any benefit, for ineffectiveness or side effects. However, nabiximols relieved the urinary symptoms, improving the patient’s sleep and quality of life without side effect
Effectiveness of Cannabinoids in Treating Symptoms of Bladder Dysfunction Associatedwith Spasticity in Multiple Sclerosis
Get PDFNabiximols is an approved add-on therapy for multiple sclerosis (MS)-related spasticity for patients non-responsive to common therapies. It is also more effective in treating bladder dysfunction with more moderate side effects compared with conventional drugs. We present the case of a 48-year-old woman with secondary progressive MS who was treated with nabiximols and who showed significant improvement in bladder complaints. This case focuses on the possibility of prescribing this treatment to patients with symptoms other than spasticity. In addition, it highlights the crucial role of bladder dysfunction improvement in controlling the physiopathological mechanisms related to urinary tract infections frequently reported by patients with M
Giovani e pandemia COVID-19: risvolti psico-sociali
Get PDFA causa del lockdown, non pochi giovani sono stati “confinati”, in situazioni famigliari già connotate da modalità relazionali disfunzionali. Condizioni domestiche di estrema prossimità che, a volte, hanno impattato significativamente sulla salute psicologica di bambini e adolescenti, specialmente in quei contesti dove la limitazione di movimento e la restrizione degli spazi sono diventati presupposti per aggressività e violenza. Pur consapevoli che un evento dalla portata tanto ampia non sia comprensibile nella sua interezza osservandolo “in media res”, si è cercato di analizzare in quale misura la pandemia sia da ritenere unica responsabile dei disagi e/o comportamenti disfunzionali dai giovani. Nel presente articolo, dal punto di vista metodologico, l’attenzione è stata focalizzata su fonti e dati provenienti dalla realtà italiana, con uno sguardo a fonti estere di rilievo