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Syncope Caused by a Head and Neck Cancer Controlled by a Permanent Pacemaker
Get PDFSyncope caused by carotid sinus syndrome due to head and neck cancer is rare. We report a case of recurrent syncope as a result of extreme bradycardia requiring pacemaker implantation. The patient began chemotherapy and radiation therapy to treat the underlying cause. When diagnosed early, a positive outcome is expected in these situations
Suppression of CMV Infection with Letermovir in a Kidney Transplant Patient
Get PDFInfection with cytomegalovirus (CMV) with resistance to ganciclovir (GCV) is a therapeutic challenge in kidney transplant patients, because standard treatment options are nephrotoxic. We report the case of a kidney transplant recipient with GCV-resistant CMV disease, in whom letermovir, a novel inhibitor of CMV packaging, was administered off-label and prevented a relapse of disease once the CMV load was decreased by cidofovir. Furthermore, we observed significant drug interactions between letermovir and tacrolimus
Primitive Neuroectodermal Tumour Invading the Inferior Vena Cava
Get PDFn 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
Disseminated Coccidioidomycosis in Africa
Get PDFBackground: Coccidioidomycosis is an endemic disease in the Americas. No cases have been reported in Africa. Patient: A 23-year-old HIV seronegative Ugandan man was referred to Mulago National Referral Hospital in Kampala, Uganda with a 10-month history of haemoptysis and difficulty breathing, and a 6-month history of localized swellings on the extremities. He had associated weight loss and drenching sweats, but no fevers. He had taken anti-tuberculosis medicine for 2 months with no improvement. He had never travelled out of Uganda. On physical examination, he had cystic swellings and ulcerated lesions on the extremities. He had tachypnoea, crackles in the chest and mild hepatomegaly. Bronchoscopic examination showed two masses occluding the right main bronchus. Bronchoscopic biopsy showed findings consistent with coccidioidomycosis. The patient improved with antifungal treatment and was discharged. Conclusion: We report the first case of disseminated coccidioidomycosis with pulmonary and cutaneous manifestations in Africa
Scleroderma with Acro-Osteolysis and Papular Mucinosis Resembling
Get PDFObjectives: 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. Materials and methods: A physical examination, imaging studies and laboratory tests were performed.Results: 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.Conclusion: To the best of our knowledge, this is the first description of cutaneous mucinosis accompanying SS with acro-osteolysi
Non-Bacterial Thrombotic Endocarditis: A Presentation of COVID-19
Get PDFThe SARS-CoV-2 virus is a newly emergent pathogen first identified in Wuhan, China, and responsible for the COVID-19 global pandemic. In this case report we describe a manifestation of non-bacterial thrombotic endocarditis with continuous peripheral embolization in a COVID-19-positive patient. The patient responded well to high-dose LMWH treatment with cessation of the embolic process
Severe Refractory Anaemia and Fever of Unknow Origin: Human Parvovirus B19 Reactivation
Get PDFReactivation of human parvovirus B19 is exceptional and characteristic of immunosuppression, with anaemia being the predominant manifestation although pancytopenia and thrombotic microangiopathy may also occur. We describe a patient with a history of diffuse large B-cell lymphoma with pure erythrocyte aplasia due to reactivation of parvovirus B19, who was treated with corticosteroids and immunoglobulins
Transcranial Direct Current Stimulation in the Treatment of Subacute Post-Stroke Thalamic Aphasia
Get PDFBackground: Although many studies have demonstrated the effectiveness of transcranial direct current stimulation (tDCS) in improving speech recovery in post-stroke aphasia, as far as we know patients affected by thalamic aphasia have never been investigated.Patient and method: A 65-year-old man with severe non-fluent aphasia due to a left thalamic haemorrhagic stroke underwent intensive daily speech therapy combined with tDCS. Results: The patient showed progressive improvement with almost complete recovery of his speech disorder, behavioural disinhibition and apathy. Conclusions: Our findings suggest that tDCS with concurrent speech therapy can be useful in patients with subcortical stroke lesions
Reversible Cerebral Vasoconstriction Syndrome Associated with Infundibular Dilation
Get PDFBackground: Reversible cerebral vasoconstriction syndrome (RCVS) is defined as a clinical and radiological syndrome that comprises a group of disorders characterized by sudden-onset severe headache and segmental vasoconstriction of the cerebral arteries with resolution within 3 months.Case presentation: A 51-year-old female patient with a 2-week history of sudden-onset severe headache, visual disturbances and cerebellum; no relevant imaging findings, except for an infundibular dilation at the origin of the posterior communicating artery, and so, angiography was performed. When symptoms persisted, a new imaging study was carried out with findings of RCVS as the cause of the symptoms from the beginning.Conclusions: Findings of RCVS can be obtained in various vasculopathies of the nervous system and vasculitis, being misdiagnosed, and so, clinical suspicion is essential; if vasoconstriction is not demonstrated on the initial image and other diagnoses have been excluded, the patient should be managed as having possible or probable RCVS
Tempo orizzontale e tempo verticale nei social network
Get PDFI social network non sono altro che luoghi digitali che tutti noi abitiamo e frequentiamo con maggiore o minore intensità a seconda dell’età, degli interessi e delle fasi della vita. Come ogni luogo fisico, anche i social network hanno le proprie regole, scritte e non scritte. “Social NetWorld” vuole essere un viaggio in esplorazione di questi luoghi digitali e dei loro abitanti. In questa tappa esploreremo insieme i differenti tempi attraverso gli utenti sono chiamati a muoversi all’interno di tre diverse piattaforme: Facebook, Instagram e TikTok. C’è un tempo verticale, che è quello che dal presente va verso il passato e ci permette di fare memoria, anche sul social network. Il tempo orizzontale, invece, è il tempo dell’effimero nel vero senso del termine, cioè che dura un solo giorno, e dopo 24 ore si cancella senza lasciare traccia. C’è poi una sorta di eterno presente, un tempo fisso e cristallizzato che al tempo stesso non scorre e passa subito