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Acute Paraparesis after Epidural Corticosteroid Injection Revealing Spinal Dural Arteriovenous Fistula in a HIV Patient
Get PDFSpinal dural arteriovenous fistulas (SDAVFs) are often misdiagnosed as their symptoms are non-specific, leading to treatment delay and a poor outcome. We describe the case of a 53-year-old man with a history of progressive paraparesis that worsened abruptly after an epidural corticosteroid injection. We highlight here the need for high diagnostic suspicion for an SDAVF in patients deteriorating after an epidural injection and an indication of repeated spine imaging in such cases. Finally, this is the first reported case of an SDAVF in a HIV-positive patient and it emphasizes the need for a broad differential diagnosis
A Phantom Opacity on Chest Radiograph
Get PDFThe authors present a case of phantom tumour of the lung. This is a type of pleural effusion where fluids accumulate in the interlobar fissures, typically in the transverse fissure. Its prompt recognition avoids additional, unnecessary or expensive examination and treatment mistakes
Rare Presentation of Toxoplasma Pneumonitis in the Absence of Neurological Symptoms in an AIDS Patient and Use of Next-Generation Sequencing for Diagnosis
Get PDFToxoplasma gondii is a known cause of encephalitis in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients. Toxoplasma pneumonitis is a manifestation of extracerebral toxoplasmosis and can be clinically indistinguishable from other opportunistic infections including Pneumocystis jirovecii pneumonia (PJP) and miliary tuberculosis. In this case report, Toxoplasmapneumonitis and disseminated toxoplasmosis was diagnosed using next-generation sequencing (NGS) and polymerase chain reaction (PCR) assessment. NGS can detect microbial cell-free DNA (cfDNA) circulating in the plasma of over 1,000 pathogens. This case is a rare presentation of Toxoplasma pneumonitis in the absence of neurological symptoms and we discuss the use of NGS of microbial cfDNA and PCR tests that may be utilized for the timely diagnosis of such challenging cases
Severe Symptomatic Hypophosphataemia as a Complication of Parenteral Iron Replacement
Get PDFParental iron replacement is given to patients with severe iron deficiency or intolerance to oral iron. Hypophosphataemia has been reported to occur as a complication of parental iron replacement, and is postulated to be related to the carbohydrate moieties used in the parenteral preparations. Hypophosphataemia is under-diagnosed as symptoms such as fatigue, muscle weakness and poor effort tolerance mimic anaemia. Severe hypophosphataemia (<0.32 mmol/l) can result in significant complications such as confusion, rhabdomyolysis and arrhythmias. We report a patient with recurrent admissions for non-specific symptoms attributed to iron deficiency anaemia who received multiple doses of parenteral ferric carboxymaltose (FCM). He was found to have severe hypophosphataemia, with further evaluation showing increased renal phosphate wasting and elevated serum levels of fibroblast-growth-factor 23 (FGF23). FCM was stopped and he was given high-dose oral iron supplementation, with no further episodes of hypophosphataemia
A Rare Case of Haemoptysis Revealing Aortic Coarctation in an Adult
Get PDFHaemoptysis is a frequently occurring but sometimes life-threatening condition. Congenital cardiovascular abnormalities are rare causes of haemoptysis. We report a case of a 33-year-old man without any past medical history complaining of haemoptysis with no other associated clinical manifestations. A contrast-enhanced chest computed tomography scan revealed aortic coarctation with dilation of the internal mammary, intercostal and bronchial arteries. He underwent stent placement after balloon angioplasty with favourable outcomes
Dengue Fever and COVID-19 Co-Infection at the Emergency Department of a Tertiary Care Hospital in Jeddah, Saudi Arabia
Get PDFIntroduction: Co-infection with COVID-19 and other viral or bacterial infections has been described in many studies. Most cases of dengue fever in Saudi Arabia have been reported in Jeddah city and mainly during the summer season. Method and results: We describe four patients who presented to the emergency department with febrile illness accompanied by symptoms and blood tests suggestive of dengue fever. They also had radiological findings suggestive of COVID-19 chest infection and positive PCR tests. Three of the patients required hospital admission, and all had a good outcome.Conclusion: In areas with a high rate of dengue fever, serological screening for dengue fever should be considered as part of COVID-19 investigation, especially if symptoms or a full blood count are suggestive
Epstein–Barr Virus-induced Meningitis-Retention Syndrome
Get PDFMeningitis-retention syndrome (MRS) is a rare disorder where aseptic meningitis is accompanied by urinary retention, which can be easily misdiagnosed as urinary tract infection. We present the case of a 55-year-old man with fever and dysuria. At the time of hospitalization, the patient had no symptoms of meningitis, but signs of meningeal irritation appeared later during the course of the disease. Investigation revealed that this was a case of MRS due to Epstein–Barr virus. We have to consider MRS when examining patients with fever and urinary retention, as dysuria may precede meningitis symptoms
Piano di Lavoro Nazionale Raccolta Dati Alieutici 2017-2019. Relazione tecnica periodo Gennaio-Giugno 2020
Get PDFCampionamento biologico delle specie demersali e dei piccoli pelagici (GSA16
Consumo di sostanze nei giovani
Get PDFLa comunità scientifica testimonia di come sia in aumento l’utilizzo di sostanze in fasce d'età sempre più giovani. Gli stili di consumo di sostanze e, conseguentemente, le forme del consumo giovanile sono mutati nel tempo; atteggiamenti diversi hanno condotto anche a differenti interventi e strategie di prevenzione in base all'epoca in cui questi erano e sono inseriti. Negli ultimi anni sono oggetto di studio i modelli di consumo giovanile di sostanze a scopo ricreazionale.
Tali cambiamenti richiedono efficaci strategie validate e innovativi programmi di prevenzione e contrasto, dove diviene fondamentale intercettare precocemente quei comportamenti a rischio in cui il giovane si avvia ad un uso problematico della sostanza, con il rischio legato allo sviluppo di una dipendenza, ma anche il rischio di problemi sanitari rilevanti
The Effectiveness of Durian Peel as a Multi-Mycotoxin Adsorbent
Get PDFDurian peel (DP) is an agricultural waste that is widely used in dyes and for organic and inorganic pollutant adsorption. In this study, durian peel was acid-treated to enhance its mycotoxin adsorption efficacy. The acid-treated durian peel (ATDP) was assessed for simultaneous adsorption of aflatoxin B1 (AFB1), ochratoxin A (OTA), zearalenone (ZEA), deoxynivalenol (DON), and fumonisin B1 (FB1). The structure of the ATDP was also characterized by SEM–EDS, FT–IR, a zetasizer, and a surface-area analyzer. The results indicated that ATDP exhibited the highest mycotoxin adsorption towards AFB1 (98.4%), ZEA (98.4%), and OTA (97.3%), followed by FB1 (86.1%) and DON (2.0%). The pH significantly affected OTA and FB1 adsorption, whereas AFB1 and ZEA adsorption was not affected. Toxin adsorption by ATDP was dose-dependent and increased exponentially as the ATDP dosage increased. The maximum adsorption capacity (Qmax), determined at pH 3 and pH 7, was 40.7 and 41.6 mmol kg−1 for AFB1, 15.4 and 17.3 mmol kg−1 for ZEA, 46.6 and 0.6 mmol kg−1 for OTA, and 28.9 and 0.1 mmol kg−1 for FB1, respectively. Interestingly, ATDP reduced the bioaccessibility of these mycotoxins after gastrointestinal digestion using an in vitro, validated, static model. The ATDP showed a more porous structure, with a larger surface area and a surface charge modification. These structural changes following acid treatment may explain the higher efficacy of ATDP in adsorbing mycotoxins. Hence, ATDP can be considered as a promising waste material for mycotoxin biosorptio