scholarly journals Leprosy in Refugees and Migrants in Italy and a Literature Review of Cases Reported in Europe between 2009 and 2018

2020 ◽  
Vol 8 (8) ◽  
pp. 1113
Author(s):  
Anna Beltrame ◽  
Gianfranco Barabino ◽  
Yiran Wei ◽  
Andrea Clapasson ◽  
Pierantonio Orza ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Wide Spectrum ◽  
Case Reports ◽  
Case Series ◽  
Skin Lesions ◽  
Clinical Suspicion ◽  
High Risk Population ◽  
European Guidelines ◽  
Eye Involvement ◽  
Multibacillary Leprosy

Leprosy is a chronic neglected infectious disease that affects over 200,000 people each year and causes disabilities in more than four million people in Asia, Africa, and Latin America. The disease can appear with a wide spectrum of clinical forms, and therefore the clinical suspicion is often difficult. Refugees and migrants from endemic countries affected by leprosy can remain undiagnosed in Europe due to the unpreparedness of clinicians. We retrospectively describe the characteristics of 55 refugees/migrants with a diagnosis of leprosy established in Italy from 2009 to 2018. Continents of origin were Africa (42%), Asia (40%), and South and Central America (18%). The symptoms reported were skin lesions (91%), neuropathy (71%), edema (7%), eye involvement (6%), fever (6%), arthritis (4%), and lymphadenopathy (4%). Seven patients (13%) had irreversible complications. Overall, 35% were relapses and 66% multibacillary leprosy. Furthermore, we conducted a review of 17 case reports or case series and five nationwide reports, published in the same decade, describing 280 migrant patients with leprosy in Europe. In Europe, leprosy is a rare chronic infectious disease, but it has not completely disappeared. Diagnosis and treatment of leprosy in refugees and migrants from endemic countries are a challenge. European guidelines for this neglected disease in this high-risk population would be beneficial.

scholarly journals Characterization of a case series of Mastocytosis in a health care center in Cali, Colombia

2021 ◽  
Author(s):  
Daniela Marulanda Sandoval ◽  
Oscar Felipe Borja Montes ◽  
Jose Leonel Zambrano Urbano ◽  
Rigoberto Gomez Gutierrez
Keyword(s):  
World Literature ◽  
Case Reports ◽  
Care Center ◽  
Clinical Manifestations ◽  
Case Series ◽  
Poor Response ◽  
Skin Lesions ◽  
Serum Tryptase ◽  
Health Care Center

Abstract Mastocytosis is a group of rare diseases, which correspond to neoplasms of the myeloid lineage. In Colombia there are only case reports and so far there are no studies of greater extension. We conducted a case series in which an active search was made for patients with a diagnosis of mastocytosis, either cutaneous (CM) or systemic (SM), from the total number of consultations between June 2004 and June 2019 in the reference hemato-oncologic center ("mastocytosis"). A total of 4 cases of CM and 3 cases of SM were identified. The most frequent clinical manifestations were skin lesions, which were present in 100% of patients; of these hyperpigmented macules were the most frequent findings. Serum tryptase (TS) levels were found to be elevated in 67% (2/3) of patients with DM. Both TS levels and mean absolute eosinophils were higher in patients with MS. In this case series we found a higher frequency of extracutaneous involvement, and in general a very poor response to the management. The findings of this series are comparable to those reported in world literature.

scholarly journals Atypical Presentation of PKDL due toLeishmania infantumin an HIV-Infected Patient with Relapsing Visceral Leishmaniasis

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Benedetto Maurizio Celesia ◽  
Bruno Cacopardo ◽  
Daniela Massimino ◽  
Maria Gussio ◽  
Salvatore Tosto ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Hiv Infection ◽  
Leishmania Infantum ◽  
Plasma Cells ◽  
Case Reports ◽  
Case Series ◽  
Skin Lesions ◽  
Secondary Prophylaxis ◽  
Complete Disappearance ◽  
Cutaneous Lesions

We describe the case of an Italian patient with HIV infection who developed an atypical rash resembling post-kala-azar dermal leishmaniasis (PKDL) when receiving liposomal Amphotericin B (L-AMB) for secondary prophylaxis of visceral leishmaniasis (VL). At the time of PKDL appearance, the patient was virologically suppressed but had failed to restore an adequate CD4+ T-cell count. Histology of skin lesions revealed the presence of a granulomatous infiltrate, with lymphocytes, plasma cells, and macrophages, most of which containedLeishmaniaamastigotes. Restriction fragment length polymorphism-polymerase chain reaction was positive forLeishmania infantum. Paradoxically, cutaneous lesions markedly improved when a new relapse of VL occurred. The patient received meglumine antimoniate, with a rapid clinical response and complete disappearance of cutaneous rash. Unfortunately, the patient had several relapses of VL over the following years, though the interval between them has become wider after restarting maintenance therapy with L-AMB 4 mg/kg/day once a month. Even if rare, PKDL due toLeishmania infantummay occur in Western countries and represents a diagnostic and therapeutic challenge for physicians. The therapeutic management of both PKDL and VL in HIV infection is challenging, because relapses are frequent and evidence is often limited to small case series and case reports.

scholarly journals Homeopathic Treatment for COVID-19-Related Symptoms: A Case Series

2021 ◽  
pp. 1-6
Author(s):  
Ramzi Kurd ◽  
Yakov Freed ◽  
Amir Jarjoui ◽  
Gabriel Izbicki ◽  
Philip Levin ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Case Reports ◽  
Case Series ◽  
Therapeutic Agents ◽  
Time Span ◽  
Homeopathic Treatment ◽  
Short Time Span ◽  
Respiratory Tract Illness ◽  
Coronavirus Infection ◽  
Short Time

<b><i>Background:</i></b> Severe acute respiratory syndrome due to coronavirus 2 (SARS CoV-2) is a novel infectious disease, which has quickly developed into a pandemic. The spectrum of COVID-19 symptoms is broad, ranging from a mild, self-limiting respiratory tract illness to severe progressive pneumonia, multi-organ failure and possible death. Despite much effort and multiple clinical trials, there are, to date, no specific therapeutic agents to treat or cure the coronavirus infection. <b><i>Case Reports:</i></b> The present paper presents 5 cases of patients with moderate to severe COVID-19 infections, 2 of them hospitalized in the intensive care unit, who were successfully treated with homeopathy. <b><i>Results:</i></b> All 5 patients responded to homeopathic treatment in an unexpectedly short time span, improving both physically and mentally. <b><i>Conclusion:</i></b> The present case series emphasizes the rapidity of response among moderate to severely ill patients to homeopathic treatment, when conventional medical options have been unable to relieve or shorten the disease. The observations described should encourage use of homeopathy in treating patients with COVID-19 during the acute phase of the disease.

scholarly journals Spectrum of cutaneous manifestations in lupus erythematous -a dermatologist perspective

1970 ◽  
Vol 10 (1) ◽  
pp. 8-11 ◽  
Author(s):  
S Bhattarai ◽  
S Agrawal ◽  
A Rijal ◽  
SK Sharma ◽  
SS Dhakal
Keyword(s):  
Skin Lesion ◽  
Lupus Erythematosus ◽  
Skin Disease ◽  
Case Series ◽  
Skin Lesions ◽  
Cutaneous Manifestations ◽  
Malar Rash ◽  
Skin Changes ◽  
Nail Changes ◽  
Eye Involvement

Background: The cutaneous manifestations of lupus erythematosus (LE) specific skin disease consists of acute cutaneous LE (ACLE), Subacute cutaneous (SCLE) and Chronic cutaneous (CCLE). Objective: To evaluate the spectrum of cutaneous manifestation in patients of LE. Methods: A case series of 41 clinically diagnosed cases of LE attending the outpatient department of Dermatology, BPKIHS were evaluated for the specific and non-specific skin changes. Results: All the patients enrolled in the study were female,with the age ranging from 14-64 years. ACLE was detected in 22/41(78.04%). Malar rash was the frequent skin lesion. CCLE was seen in 6/41 (14.63%) patients with classical discoid lesions (localized and generalized) in 4/6(66.66%) and 2/6(33.33%) respectively. Non specific skin lesions were found in 30/ 41(73.17%) of patients. Mucosal ulcers were seen in 23/41(56.09%), Facial telangiectasias 20/41(48.78%), Raynaunds phenomena 22/41(53.65%), Chronic urticaria 9/41(21.95%), Nail changes 12/41(29.26%) and non scarring alopecia was seen in 6/41(14.63%) patients. Eye involvement was seen in 3/41(7.3%), cutaneous vasculitis in 5/41(12.19%) and scaring alopecia in 3/41(7.3%) patients. Conclusion: The cutaneous manifestations of patients with lupus erythematosus (LE) are very frequent, show a great variety and can occur at any stage of the disease. DOI: http://dx.doi.org/10.3126/hren.v10i1.5999 HREN 2012; 10(1): 8-11

scholarly journals Treatment of COVID-19 in Patients With Sarcoidosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Shreya Kondle ◽  
Titus Hou ◽  
Michael Manansala ◽  
Christian Ascoli ◽  
Richard M. Novak ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Case Reports ◽  
Case Series ◽  
Review Article ◽  
Hospitalization Rate ◽  
Treatment Modalities ◽  
Tnf Alpha ◽  
Disease Course ◽  
Improve Treatment ◽  
Management Algorithm

Recent case reports and studies on treating COVID-19 in patients with chronic sarcoidosis describe different treatment modalities ranging from glucocorticoids to biologic medications. This review article summarizes seven case series and reports totaling 46 patients. While one case report suggested that sarcoidosis medications such as glucocorticoids may lengthen the COVID-19 disease course, another study with a larger registry suggests they do not. More studies are needed to elucidate an improvement in outcomes. It is possible that addition of TNF-alpha inhibitors at COVID-19 diagnosis decreases hospitalization rate. Overall, it is difficult to make firm conclusions regarding treatment given the heterogeneity of treatment modalities in the current literature. Our summarized findings are outlined with the opinions of sarcoidosis, pulmonary, and infectious disease experts in a flow chart that provides clinicians with our proposed management algorithm for sarcoidosis patients who develop COVID-19. We emphasize a need for exchange of information regarding management of COVID-19 in the setting of sarcoidosis to further improve treatment in this vulnerable population of patients.

scholarly journals Acquired White Oral Lesions with Specific Patterns: Oral Lichen Planus and Lupus Erythematosus

2021 ◽  
pp. 2021074
Author(s):  
Marco Manfredini ◽  
Gioia Pedroni ◽  
Laura Bigi ◽  
Roberto Apponi ◽  
Alberto Murri dello Iago ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Current Knowledge ◽  
Wide Spectrum ◽  
Case Reports ◽  
Case Series ◽  
Specific Pattern ◽  
Special Pattern ◽  
Lichenoid Reactions ◽  
Immunomodulatory Therapies ◽  
Oral Lichen

Background: Diagnosis of oral white lesions might be challenging. These lesions represent a wide spectrum of diseases with different etiology and prognosis. Oral white lesions can be categorized into two major groups, congenital and acquired, according to their development, and in four subgroups: lesions which can be scraped off or not and lesions with special pattern or not. Objectives: The aim of this manuscript is to review, from diagnosis to treatment, the current knowledge on oral white lesions with specific pattern. Methods: A review on oral white lesions with specific pattern was conducted on PubMed and Scopus from inception to January 2021. Results: Among acquired lesions with specific pattern two clinical entities are mostly represented: Oral lichenoid reactions and Lupus erythematosus. The etiology of both diseases is still not known but their pathogenesis is mainly immunological. At present the mucoscopic features of those disease have been described only in few case reports or case series. Immunomodulatory therapies are often the agents of choice for their treatment. Conclusions: The collaboration of dermatologists and dentists as a team is important for early diagnoses and effective treatments. Mucoscopy is a promising technique which may reveal important features for the differentiation of OLP and LE oral white lesions.

Underrepresentation of genitourinary cancers in studies of venous thromboembolism (VTE) prophylaxis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17115-e17115
Author(s):  
Max S Perlmutt ◽  
Tracy L Rose ◽  
Vaibhav Kumar ◽  
Matthew I. Milowsky
Keyword(s):  
High Risk ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Best Supportive Care ◽  
Bleeding Complications ◽  
High Risk Population ◽  
Vte Prophylaxis ◽  
Full Text Review ◽  
Diagnosis Of Cancer

e17115 Background: Significant advances in the management of VTE in cancer have led to a recent ASCO clinical practice update for VTE prophylaxis and treatment in patients with cancer. Genitourinary (GU) cancers (including bladder, kidney, prostate, testicular) have a high incidence of VTE, but also frequent bleeding complications, and it is not clear if patients with GU cancers are adequately represented in studies of VTE prophylaxis. We sought to determine the frequency of inclusion of patients with GU cancers in prospective studies of VTE prophylaxis. Methods: A systematic review of the literature using MEDLINE (inception to January 2020) was conducted. We included randomized controlled trials that compared thromboprophylaxis to placebo or best supportive care in patients with an established diagnosis of cancer. Observational studies, case series, and case reports were excluded. The primary outcome was proportion of patients with GU malignancies included within the trials. Results: A total of 137 articles were identified under the original search and 7 underwent full text review. A total of 6066 patients were included in 7 thromboprophylaxis trials, of which only 119 (2.0%) had a defined GU malignancy (Table). Given the heterogeneity of the GU cancers represented in each study, and the small numbers of patients included with GU cancers, a patient-level meta-analysis among GU patients in this population was not performed. Conclusions: In spite of the high risk for VTE in GU cancers, in particular bladder and testicular cancer, GU cancers are underrepresented in prospective randomized trials investigating VTE prophylaxis. To ensure appropriate decision making for each individual patient, future prospective trials must ensure adequate representation of patients with GU cancers to better understand the potential role for VTE prophylaxis in this high-risk population.[Table: see text]

scholarly journals Variable Presentations of Tuberculosis during COVID-19 Pandemic- A Case Series

2021 ◽  
Vol 22 (1) ◽  
pp. 60-66
Author(s):  
Mahbub Mayukh Rishad ◽  
Sumaiya Akter ◽  
Arfa Rahman ◽  
Homayra Tahseen ◽  
HAM Nazmul Ahasan ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Clinical Features ◽  
Broad Spectrum ◽  
Private Hospital ◽  
Tertiary Care ◽  
Case Series ◽  
Clinical Suspicion ◽  
The Body ◽  
Delay In Diagnosis

Tuberculosis is an ancient infectious disease, which can involve almost any organ of the body and can have broad spectrum of presentations. The objective of this case series presentation is to highlight the importance of considering Tuberculosis as a diagnosis even in this COVID pandemic time. It presents with wide variety of clinical features involving different organs and often potentially fatal. Mortality from tuberculosis is most often due to delay in diagnosis & thus starting treatment. Thus, treatment should be initiated immediately based on strong clinical suspicion. Here we have presented six different cases of TB where each case presented differently in a tertiary care private hospital of Dhaka. J MEDICINE JAN 2021; 22 (1) : 60-66

scholarly journals Impact of the COVID-19 pandemic on publication dynamics and non-COVID-19 research production

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marc Raynaud ◽  
Valentin Goutaudier ◽  
Kevin Louis ◽  
Solaf Al-Awadhi ◽  
Quentin Dubourg ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Case Reports ◽  
Case Series ◽  
Median Number ◽  
Scientific Production ◽  
High Impact ◽  
Publication Type ◽  
Number Of Patients ◽  
Number Of Publications ◽  
Number Of Authors

Abstract Background The COVID-19 pandemic has severely affected health systems and medical research worldwide but its impact on the global publication dynamics and non-COVID-19 research has not been measured. We hypothesized that the COVID-19 pandemic may have impacted the scientific production of non-COVID-19 research. Methods We conducted a comprehensive meta-research on studies (original articles, research letters and case reports) published between 01/01/2019 and 01/01/2021 in 10 high-impact medical and infectious disease journals (New England Journal of Medicine, Lancet, Journal of the American Medical Association, Nature Medicine, British Medical Journal, Annals of Internal Medicine, Lancet Global Health, Lancet Public Health, Lancet Infectious Disease and Clinical Infectious Disease). For each publication, we recorded publication date, publication type, number of authors, whether the publication was related to COVID-19, whether the publication was based on a case series, and the number of patients included in the study if the publication was based on a case report or a case series. We estimated the publication dynamics with a locally estimated scatterplot smoothing method. A Natural Language Processing algorithm was designed to calculate the number of authors for each publication. We simulated the number of non-COVID-19 studies that could have been published during the pandemic by extrapolating the publication dynamics of 2019 to 2020, and comparing the expected number to the observed number of studies. Results Among the 22,525 studies assessed, 6319 met the inclusion criteria, of which 1022 (16.2%) were related to COVID-19 research. A dramatic increase in the number of publications in general journals was observed from February to April 2020 from a weekly median number of publications of 4.0 (IQR: 2.8–5.5) to 19.5 (IQR: 15.8–24.8) (p < 0.001), followed afterwards by a pattern of stability with a weekly median number of publications of 10.0 (IQR: 6.0–14.0) until December 2020 (p = 0.045 in comparison with April). Two prototypical editorial strategies were found: 1) journals that maintained the volume of non-COVID-19 publications while integrating COVID-19 research and thus increased their overall scientific production, and 2) journals that decreased the volume of non-COVID-19 publications while integrating COVID-19 publications. We estimated using simulation models that the COVID pandemic was associated with a 18% decrease in the production of non-COVID-19 research. We also found a significant change of the publication type in COVID-19 research as compared with non-COVID-19 research illustrated by a decrease in the number of original articles, (47.9% in COVID-19 publications vs 71.3% in non-COVID-19 publications, p < 0.001). Last, COVID-19 publications showed a higher number of authors, especially for case reports with a median of 9.0 authors (IQR: 6.0–13.0) in COVID-19 publications, compared to a median of 4.0 authors (IQR: 3.0–6.0) in non-COVID-19 publications (p < 0.001). Conclusion In this meta-research gathering publications from high-impact medical journals, we have shown that the dramatic rise in COVID-19 publications was accompanied by a substantial decrease of non-COVID-19 research. Meta-research registration https://osf.io/9vtzp/.

Management of external jugular vein aneurysm: a systematic review

Vascular ◽  
2021 ◽  
pp. 170853812110139
Author(s):  
Petroula Nana ◽  
Eleni Gkrinia ◽  
Chara Maiou ◽  
Ourania Karyda ◽  
Christos Korais ◽  
...  
Keyword(s):  
Systematic Review ◽  
Jugular Vein ◽  
Valsalva Maneuver ◽  
Case Reports ◽  
Case Series ◽  
External Jugular Vein ◽  
Clinical Suspicion ◽  
Histological Evaluation ◽  
Primary Indication ◽  
High Clinical Suspicion

Introduction Aneurysms of the jugular vein system are rare and high clinical suspicion is needed for diagnosis. External jugular vein aneurysms (EJVA) are considered innocent lesions that need treatment mainly for aesthetic reasons. The aim of this systematic review was to present current literature regarding diagnosis and management of EJVAs. Methods A literature review was conducted through the Pubmed/Medline and Scopus regarding articles referring on EJVA from 2000 to 2020. Using the PRISMA guidelines (Preferred Reporting Items for Systematic reviews and Meta-Analyses), 30 articles were identified, according to inclusion criteria. Demographics, clinical characteristics, etiology, diagnostic imaging, complications, treatment, and histopathological findings were recorded and analyzed. Results Twenty-seven case reports and one case series were identified, including 30 patients and 31 EJVAs. One-third of patients (30.3%) were < 18 years old (mean age 32 years, range 1–72 years) and 54% of them were females. In 51% of the cases, the lesion was characterized as a true aneurysm after histological evaluation. The presence of a soft cervical mass was the most common clinical symptom, while Valsalva maneuver pointed out the presence of an EJVA in 66.7% of patients. Diagnosis was achieved using ultrasonography, computed tomography, or magnetic resonance imaging. Forty-three percent of the patients underwent more than one radiological examination. Twenty patients underwent surgical management. The primary indication of surgical treatment was aesthetic reasons (11/20, 55%). Thrombosis was the most common EJVA complication (11/30, 36.3%). Conclusions Differential diagnosis of neck mass should include EJVA. High clinical suspicion and adequate imaging are important for diagnosis. Open surgical approach is the more commonly applied therapeutic strategy.

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