Transition from secukinumab to adalimumab in COVID-19-Induced psoriasis flare-up treatment: a case reportAbstract: Coronavirus disease 2019 (COVID-19) is known to trigger systemic inflammation and elicit immune responses, which may disrupt the delicate balance of cytokines involved in psoriatic regulation. Compared to other therapies in dermatology, biologics used for immune-mediated dermatological diseases have been more extensively studied during the COVID-19 pandemic. Herein, we report a case of flare-up of previously well-controlled psoriasis shortly after infection with COVID-19, with treatment transition from secukinumab to adalimumab.Keywords: COVID-19; psoriasis; flare-up; adalimumab; secukinumab

A woman with single coronary.She underwent aortic valve replacement.But aortic annulus abscess occurred 2 years later. We performed aortic root replacement and coronary artery bypass grafting using the Freestyle valve and saphenous vein graft. The patient was discharged and has visited us as an outpatient without relapse of infection.

Introduction:Pericardial syndromes are not uncommon manifestations in clinical practice [1]. About 5% of all patients admitted to the emergency department with the chief complaint of chest pain, are diagnosed with acute pericarditis [2]. Cardiac involvement is a common presentation of different autoimmune rheumatic diseases. Systemic lupus erythematous (SLE) is a chronic autoimmune rheumatic disease with multiorgan involvement. Cardiac involvement has been reported in about 50% of SLE patients; in some cases, as their first presentation of SLE [3]. The most common type of cardiac involvement in SLE patients is pericarditis [4]. While it is classically known that SLE like most of other autoimmune diseases are more prevalent in women, cardiac involvement as pericarditis in SLE is more prevalent in male patients [2]. Although being a common manifestation of SLE, it is uncommon for acute fibrinous pericarditis with constrictive features to be the first presentation of SLE in patients with severe manifestations and in need for hospital admission [5].

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IntroductionCoronavirus belongs to RNA viruses that cause respiratory, neurologic, enteric, and hepatic diseases distributed among mammals, including humans and birds (1). A novel coronavirus discovered in late 2019 in China caused Coronavirus Disease 2019 (COVID-19). It is associated with complications like severe viral pneumonia, ARDS, AKI, cardiac injury, liver dysfunction, spontaneous pneumothorax, lung cavitation, pleural effusion, pericardial effusion, along with other minor ailments like fever, loss of smell, myalgia, dry cough, lymphadenopathy (2) (3).Pneumothorax due to COVID-19 pneumonia is very rare, and few cases are reported with bronchopleural fistula-associated persistent pneumothorax while recovering from COVID-19 pneumonia (4) (5) (6).

To report on a patient who developed multiple perivalvular leak (PVL) after a mechanical mitral valve replacement, and how clinicians successfully used real-time three-dimensional transesophageal echocardiography combined with 3D printing to complete transapical perivalvular closure. Additionally, we reviewed the literature to explore the advantages and disadvantages of multimodal imaging for perivalvular

Introduction: Vancomycin-resistant enterococcus is rare in Japan. However, as there is a risk of in-hospital outbreak, this infectious disease is clinically important. Case presentation: The patient was a 49-year-old Japanese female living in the United States. At her previous hospital in the United States, total pelvic exenteration for cervical carcinoma, Miami pouch

IntroductionSystemic lupus erythematosus (SLE) is a protean disease. The classification criteria have been evolving to increase the sensitivity and specificity of SLE diagnosis. The American College of Rheumatology (ACR) criteria (1982 version 1and 1997 revised version2 have high specificity, but limited sensitivity. The Systemic Lupus International Collaborating Clinics (SLICC) 2012 criteria have increased sensitivity, but decreased specificity3. The 2019 EULAR/ACR SLE classification criteria have both high sensitivity and specificity, and advocated positive ANA (ever) as an entry criterion4, 5. Therefore, for patients with persistent ANA negative, it is difficult to diagnosis for SLE. Our report describes a young woman who presented an ANA negative and lack of typical clinical symptoms of SLE patient, but with severe lupus-like manifestations. At present, this is unique case report about severe lupus with ANA continued negative.

IntroductionEctopic pancreas tissue (EPT) or pancreatic heterotopia is a rarely observed congenital abnormality defined as the presence of pancreatic tissue in another organ without any anatomical or vascular connection to the pancreas. The term consists of the two Greek words ”hetero-” which means ”other” and ”-topia” which means ”site”, pointing out the unique location of pancreatic cells. EPT’s favored sites are the stomach, duodenum, colon, jejunum, and Meckel’s diverticula (1). The gallbladder is a highly infrequent location for EPT (2). Almost all cases are detected incidentally during the histopathological examination after cholecystectomy for other pathologies. The prevalence of EPT in the gastrointestinal tract varies from 0.6% to 13.7% in autopsy series and 0.2% in laparotomies (3, 4). Although the malignant transformation of this tissue is not frequently expected, pathologists must be aware of it to ensure no malignant pathology is present and prevent further misdiagnosis. In this study, we present a case of EPT that we found incidentally during the histopathological examination of the specimen from the gallbladder in a patient who underwent cholecystectomy due to acute cholecystitis.Case HistoryA 40-year-old male was referred to the emergency department for acute pain in the right upper quadrant of the abdomen. The pain was constant and initiated hours before and intensified when he had dinner. He also reported fever, anorexia, nausea, and one involuntary vomiting episode containing only stomach contents. Besides intellectual disability and epilepsy, patient’s medical history was unremarkable otherwise. He was on Valproate(200mg/D), Risperidone(1mg/BD) and Clonazepam(1mg/HS). He denied smoking and any recreational drug use. No allergies were reported. During the clinical examination, his vitals were slightly above normal ranges (Blood pressure: 115/70mmHg; Heart rate: 108bpm; Respiratory rate: 19 breaths/min; Temperature: 37.9°C; Oxygen saturation: 99% without supplemental oxygen). The palpation of the abdomen revealed tenderness in the right upper quadrant and a positive Murphy sign with no rebound tenderness or guarding. The laboratory evaluation was within normal range except for a WBC count of 10300, ESR of 32, and a 2+ CRP. Additionally, he underwent an ultrasonographic evaluation of the upper abdomen, reporting a thickened wall gallbladder containing multiple stones (measuring up to 8x10mm). The patient was scheduled for emergency laparoscopic cholecystectomy under the diagnosis of acute calculous cholecystitis. During surgery, the gallbladder was found to be gangrenous. The patient had a complicated postoperative period due to surgical wound infections and was hospitalized for a week to receive intravenous antibiotics; however, he did not report any delayed complications or symptoms after discharge.

A document by Somee Rauniyar. Click on the document to view its contents.

Metastatic Prostatic Adenocarcinoma Presenting as Generalized Lymphadenopathy Unmasked by a COVID Booster Vaccine

A document by Ibrahim Nourwali. Click on the document to view its contents.

A document by Nishan Shrestha. Click on the document to view its contents.

A document by Marina Božan. Click on the document to view its contents.

Monoallelic deleterious MUTYH mutations generate colorectal cancer：a case report

Case Report: Treatment of Hypoglycemia due to a Rare Pathogenic Variant in AKT2 with Waxy Maize Heat-Modified Starch

INTRODUCTIONAs a subtype of biliary tumors, gallbladder cancer is rare yet highly malignant1. Characterized by its ease of metastasis and poor prognosis, its common sites of metastasis include lymph nodes and the liver. However, it can also spread to other organs and tissues such as the lungs, bones, and peritoneum2. It’s critical to note that the incidence of lung metastasis in gallbladder carcinoma hovers around 10-30%, with a dismal 5-year survival rate of around 5-10%3-4. Unusually, when gallbladder carcinoma metastasizes to the lungs, it can sometimes present as pulmonary cavitary lesions, although this manifestation is not commonly observed. In this light, we present a case of gallbladder carcinoma with pulmonary manifestations of cavitary lesions.

PEDIATRIC PRIMARY INTRAVENTRICULAR HEMORRHAGE: A CASE REPORT OF ISOLATED 4TH VENTRICLE HEMORRHAGE IN A 10-YEAR-OLD BOY