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Frontotemporal dementia is a rare form of dementia and around 2% of people with dementia have frontotemporal dementia ( Warren et al, 2013 ). This article explains the pathophysiology and clinical features of frontotemporal dementia and how it is diagnosed, treated and managed.

Polycystic liver disease (PLD) is a rare hereditary disease that independently exists in isolated PLD, or as an accompanying symptom of autosomal dominant polycystic kidney disease and autosomal recessive polycystic kidney disease with complicated mechanisms. PLD currently lacks a unified diagnostic standard. The diagnosis of PLD is usually made when the number of hepatic cysts is more than 20. Gigot classification and Schnelldorfer classification are now commonly used to define severity in PLD. Most PLD patients have no clinical symptoms, and minority with severe complications need treatments. Somatostatin analogues, mammalian target of rapamycin inhibitor, ursodeoxycholic acid and vasopressin-2 receptor antagonist are the potentially effective medical therapies, while cyst aspiration and sclerosis, transcatheter arterial embolization, fenestration, hepatic resection and liver transplantation are the options of invasion therapies. However, the effectiveness of these therapies except liver transplantation are still uncertain. Furthermore, there is no unified strategy to treat PLD between medical centers at present. In order to better understand recent study progresses on PLD for clinical practice and obtain potential directions for future researches, this review mainly focuses on the recent progress in PLD classification, clinical manifestation, diagnosis and treatment. For information, we also provided medical treatment processes of PLD in our medical center.

Introduction. Kidney damage can vary from mild to severe and occurs in 50% -70% of patients with systemic lupus erythematosus (SLE) [4], more often develops during 2-3 years [2]. Lupus nephritis (LN) has various morphological manifestations with different clinical signs and consequences. Percutaneous kidney biopsy is the gold standard for the diagnosis of LN according to the WHO classification since 1974 [1]. The purpose. This review reveals the importance of kidney biopsy for diagnosis and prognosis. Material and methods. Review of contemporary and foreign literary sources; techniques – description, analysis, abstracting. Results. There are many reports of clinical using of the renal biopsy classification of LN, but the number of studies evaluating its validity is not yet sufficient. Renal biopsy of LN provides vague data, which raises serious doubts about validity and clinical use, because it can lead to serious errors during diagnosis, treatment and prognosis. Conclusions. The molecular analysis of the bioptate will be the key to a personalized approach to drug selection in LN. The molecular characteristics of kidney damage available with LN will provide the necessary supplements to more accurately classify the disease, predict outcomes, and further use of new therapeutics.

Bruises are blood-stained areas of the skin that impair its aesthetic appearance. Bruises often occur in everyday life, when accidental falls, when hitting hard objects, when performing sports exercises and competitions, when performing medical procedures, and also often occur in the elderly and when using drugs that thin the blood. The skin in the area of bruises first has a reddish color, then successively acquires a blue, green and yellow color. Usually bruises persist for up to a week, and then go away on their own and without a trace. Bruising is not recognized by official medicine as an independent disease. Official medicine does not have medicines designed for urgent discoloration of the skin and the area of bruises. However, in recent years, drugs have been discovered that can discolor the skin in the area of bruises in a few minutes. This group of medicines was called oxygen-alkaline bleachers. Their main ingredients are Hydrogen peroxide and Sodium hydrocarbonate. The prescription of medicines is given. Keywords: Bruise, Haematoma, Haemorrhage, Injury, Trauma, Damage, Hydrogen peroxide, Sodium hydrocarbonate, Oxygen-alkaline bleachers

Dimorphic endemic fungi exist as mold and yeast forms at room and body temperature within the host, respectively. Primary infection can arise from new environmental exposure and less frequently through organ transplantation. Reactivation of latent infection can occur when immunosuppression is introduced or intensified. Transplant and immunocompromised hosts (ICH) represent important populations at risk for complicated and disseminated forms of endemic mycoses (EM). Diagnosis is challenging as immunosuppression contributes to insidious clinical presentations resulting in diagnostic and treatment delays. Herein, we present updated diagnosis and prevention strategies for EM in the potential organ donor, transplant candidate and recipient, and ICH. Several EM have previously been considered as restricted to a limited geographical area; however, factors such as global warming, changing precipitation patterns, and increased travel are actively expanding the geographical distribution of endemic fungi. Serological testing, often used in the immunocompetent host, has significant limitations in transplant recipients and ICH. Fungal molecular methods have emerged as an important complementary diagnostic strategy for EM but would benefit from greater standardization and wider availability. High clinical suspicion and a multipronged diagnostic approach are recommended for timely diagnosis and prevention of complications. In ICH, combining diagnostic methods increases diagnostic yield for EM. Immunosuppression-specific risk assessment, laboratory monitoring, and targeted antifungal prophylaxis are pivotal to reduce EM burden. The use of molecular methods for early diagnosis and the role of newer azoles and immunomodulation in the management of EM require further investigation.

Objectives Leishmaniosis is a vector-borne disease and in European countries is caused by Leishmania infantum. Cats are considered secondary reservoirs of the infection in endemic areas. The objective of this retrospective study is to describe the clinical findings, diagnosis, treatment and outcome of feline leishmaniosis (FeL) in 16 cats in Spain. Methods Medical records of cats diagnosed with leishmaniosis were retrospectively reviewed for cases that met the following inclusion criteria: identification of Leishmania organisms and/or DNA on cytological and/or histological specimens and/or a high anti- Leishmania antibody titre, compatible clinical findings and pathological abnormalities. Results Sixteen cats met the inclusion criteria, all of which were living in areas endemic for canine leishmaniosis. Systemic signs were present in 11 cases (68.8%). The most common clinical signs on presentation included cutaneous lesions in 12 cats (75%), ocular disease in six cats (37.5%) and anorexia in six cats (37.5%). A polyclonal gammopathy was noted in 12 cats (85.7%). Non-regenerative anaemia and renal abnormalities were present in six (37.5%) and five patients (31.3%), respectively. In nine cats (56.3%), immunosuppressive conditions/comorbidities were identified. The diagnosis was made in eight of the cats (50%) by cytology, but a combination of diagnostic tests was needed for definitive diagnosis in the remaining patients. Twelve cats (75%) were treated specifically for leishmaniosis. Five of the 12 cats (41.7%) did not improve with treatment. The median survival time in the group of patients treated specifically for leishmaniosis was 17 months. Median survival of patients treated with concomitant diseases was 13 months vs 41 months in those without, although this was not statistically significant ( P = 0.557). Conclusions and relevance Presentation of FeL appears to be similar to canine leishmaniosis but with some specific features: ulcerative and nodular skin lesions are the predominant cutaneous signs; cats with immunosuppressive conditions or coexisting diseases were more commonly present than typically seen in dogs (mainly feline immunodeficiency virus). A combination of diagnostic tests may be needed for definitive diagnosis.

Alcohol misuse is often a hidden problem and alcohol-related brain damage is thought to account for around 10% of cases of dementia ( Gupta and Warner, 2008 ; Brust, 2010 ). In England, an estimated 589 101 adults are alcohol-dependent and 24% of adults in England and Scotland regularly drink more than Department of Health and Social Care (DHSC) guidelines ( Burton et al, 2016 ). Alcohol misuse can affect many aspects of health and can lead to alcohol-related brain damage (ARBD). This article explains about the pathophysiology and clinical features of ARBD, and how it is diagnosed, treated and managed.

Frontotemporal dementia is a rare form of dementia and around 2% of people with dementia have frontotemporal dementia ( Warren et al, 2013 ). This article, the sixth in a series, explains about the pathophysiology and clinical features of frontotemporal dementia and how it is diagnosed, treated and managed.

Globally, more than billion people suffer from fungal infections each year. The early diagnosis of aspergillosis is mandatory for successful treatment outcome. As careful testing takes time, epidemiological surveillance is crucial to guide individual patient therapy and to promote a high standard of health care. In this paper, we first present current trends in the epidemiology and antifungal susceptibility patterns of Aspergillus spp. in Middle Eastern and North African (MENA) countries in order to support infectious disease specialists and health workforces in this geographic area to treat adequately patients with aspergillosis. Then we discuss the existing literature data regarding the available diagnostic tools and antifungal resistance mechanisms of Aspergillus spp. Although a limited number of studies were reviewed here, the currently available data show that Aspergillus infections are not negligible in the MENA region, and that the emergence of antifungal resistance is a growing health issue, especially among immunocompromised patients. Keywords: Aspergillus spp., Epidemiology, Antifungal resistance, Molecular mechanisms, MENA region

Hand eczema is a common condition associated with significantly impaired quality of life and high social and occupational costs. Managing hand eczema is particularly challenging for primary care and occupational health physicians as the condition has varying causes and both disease progression and response to treatment are difficult to predict. Early diagnosis and appropriate protective measures are essential to prevent progression to chronic eczema, which is much more difficult to treat. Appropriate referral to a specialist and opportune evaluation of the need for sick leave are crucial to the good management of these patients. These guidelines cover the diagnosis, prevention, and treatment of chronic hand eczema and highlight the role that primary care and occupational health physicians can play in the early management of this disease.

The purpose — to study of the features of chronic neuropathic facial pain associated with cranial nerve damage. Material and methods. We studied the modern works on the features of the clinic, diagnosis and treatment of chronic orofacial pain caused the cranial nerves damage. Special attention was paid to the methods of diagnosing neuropathic facial pain of various etiologies, and identifying clinical variants of their course. Results. The best known and most common variant of neuropathic orofacial pain is trigeminal neuralgia. There are classic trigeminal neuralgia that occurs as a result of vaso-neural conflict, secondary trigeminal neuralgia (in multiple sclerosis, voluminous brain neoplasm, etc.), and idiopathic trigeminal neuralgia. Patients have short-term (from fractions of a second to 2 minutes) unilateral paroxysmal facial pain in classic trigeminal neuralgia. In case of secondary trigeminal neuralgia, mainly bilateral neuropathic pain is detected. Painful trigeminal neuropathy (trigeminal neuropathic pain other than trigeminal neuralgia) is caused by trauma and herpes zoster with acute neuropathic pain. After 3 months, painful manifestations after the herpes zoster are qualified as trigeminal postherpetic neuralgia. Post-traumatic neuropathic trigeminal pain is the result of external trauma or iatrogenic damage resulting from dental treatment or neuroablation procedures. Both classical and secondary, idiopathic neuralgia of the glossopharyngeal nerve is characterized by unilateral short-term stabbing pain in the ear, base of the tongue, tonsil region, posterior part of the pharynx; it is less common, in contrast to trigeminal neuralgia. Intermediate nerve neuralgia was first described in 1907 by Hunt; it is rare, manifests itself as unilateral, shooting, paroxysmal pain in the ear canal and temporal areas. Painful neuropathy of the intermediate nerve (Ramsey — Hunt syndrome) with herpes zoster is characterized by dull, persistent pain that occurs inside the ear canal, auricle or mastoid. Rarely, tumors of the face can be the cause of Ramsey — Hunt syndrome. Conclusion. Thus, chronic neuropathic facial pain associated with facial nerves damage has a varied etiology, which requires careful differential diagnosis and selection of adequate treatment tactics.

Introduction. Chronic subdural hematoma has become an important entity in radiological, neurological and neurosurgery practice. Classification. The classification of chronic subdural hematoma is most often done in relation to the time of the disease onset (acute, subacute and chronic), whereas the second classification is based on hematoma density using computed tomography. Clinical presentation. The clinical presentation may mimic a spectrum of various diseases and chronic subdural hematoma can be easily overlooked without radiological verification. Diagnosis. The diagnosis of chronic subdural hematoma is partly clinical and partly radiological. In most cases, computed tomography is the initial diagnostic method for detection of this disease. Many studies point to different management strategies in the diagnosis and treatment of the disease. Therapy. The therapy of chronic subdural hematoma depends on the patient?s neurological deficit, but generally it is divided into conservative and surgical treatment. Conclusion. The aim of this paper is to review chronic subdural hematomas with reference to their clinical and radiological characteristics for better understanding of these phenomena.

Alcohol misuse is often a hidden problem and alcohol-related brain damage is thought to account for around 10% of cases of dementia ( Brust, 2010 ; Gupta and Warner, 2008 ). In England, an estimated 589 101 adults are alcohol-dependent and 24% of adults in England and Scotland regularly drink more than Department of Health and Social Care (DHSC) guidelines ( Burton et al, 2016 ). Alcohol misuse can affect many aspects of health and can lead to alcohol-related brain damage (ARBD). This article, the fifth in a series on dementia, explains about the pathophysiology and clinical features of ARBD, and how it is diagnosed, treated and managed.

The purpose of the research is to analyze the literature in the Hypodermа bovis morphology and biology, as well as clinical features and advanced techniques for diagnostics, prevention and treatment of hypodermatosis. Results and discussion. Recent studies have allowed for broadening and supplementing current ideas on the hypodermatosis prevention and treatment. Measures implemented in Russia and abroad against hypodermatosis can reduce the incidence and damage from this disease to low rates. Currently, the development of means to control hypodermatosis and a search for advanced diagnostic techniques has been continuing. Hypodectin is now one of the effective and quite safe medicines to treat animals’ skin in case of hypodermatosis. Injection drugs are also effective, particularly, Dermacin, Avermectin, Abamectin, Ivermectin, Novomec and Aversectin.

The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of renal cell carcinoma was published in 2019 with an update planned for 2021. It was therefore decided by both the ESMO and the Singapore Society of Oncology (SSO) to convene a special, virtual guidelines meeting in May 2021 to adapt the ESMO 2019 guidelines to take into account the ethnic differences associated with the treatment of renal cell carcinomas in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with renal cell carcinoma representing the oncological societies of China (CSCO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of the current treatment practices and drug access restrictions in the different Asian countries. The latter were discussed when appropriate., Highlights • This article provides ESMO expert recommendations adapted for the treatment of renal cell carcinomas in Asian patients. • The aim was to provide guidance for the optimisation of the management of such patients across Asia. • The availability and applicability of certain procedures as they relate to certain of the recommendations are discussed.

Introduction: Novel coronavirus (COVID-19) and tuberculosis (TB) are the newest and one of the oldest global threats, respectively. In the COVID-19 era, due to the health system's focus on the COVID-19 epidemic, the national TB control program received less attention, leading to a worsening of the global TB epidemic. In this study, we will review the characteristics of TB patients coinfected with COVID-19.Material and Methods: Using Scopus, PubMed/Medline, Embase, and Web of Science databases, a systematic search was performed. Case reports and case series on TB/COVID-19 coinfection published from January 1, 2019 to February 24, 2021 were collected. There were no limitations regarding publication language.Results: Eleven case series and 20 case reports were identified from 18 countries, with the majority them being from India (N = 6) and China (N = 4). Overall, 146 patients (114 men and 32 women) coinfected with TB and COVID-19 enrolled. Smoking (15.1%), diabetes (14.4%), and hypertension (8.9%) were the most frequent comorbidities among these patients. The COVID-19 patients with TB mainly suffered fever (78.8%), cough (63.7%), and respiratory distress (22.6%). Hydroxychloroquine (64.0%) and lopinavir/ritonavir (39.5%) were the most common treatments for them. The mortality rate was 13.0% and the rate of discharged patients was 87.0%.Conclusion: Global prevalence of COVID-19-related deaths is 6.6%. Our results showed that 13.0% of patients with TB/COVID-19 died. Thus, this study indicated that coinfection of TB and COVID-19 can increase the mortality. The respiratory symptoms of TB and COVID-19 are very similar, and this causes them to be misdiagnosed. In addition, TB is sometimes diagnosed later than COVID-19 and the severity of the disease worsens, especially in patients with underlying conditions. Therefore, patients with TB should be screened regularly in the COVID-19 era to prevent the spread of the TB/COVID-19 coinfection.

Bladder cancer (BC) is an increasingly frequent cancer worldwide, being currently the sixth most frequent tumor and the thirteenth leading cause of cancer death. Among all BC cases, pathologists have identified several histomorphologies different from the conventional urothelial carcinoma. Although rare, these histologic variants have a distinct growth pattern, an altered cell differentiation and an unusual clinical behavior, especially concerning clinical presentation at diagnosis, response to the standard treatment and prognosis. Therefore, an updated review of this topic should be useful to aid clinicians in a better evidence-based decision-making. This chapter aims to summarize the current literature on the most common histologic variants regarding their epidemiology, clinical presentation at diagnosis, treatment options and prognosis. This includes both non-muscle invasive BC and muscle invasive BC as well as metastatic disease. A special focus will be placed on the role of neoadjuvant chemotherapy and early cystectomy and its prognostic implications.

A range of factors, including social, demographic and economic transformation and human-induced environmental changes, are influencing the emergence or re-emergence of zoonoses, posing new challenges in how we detect, treat and prevent such diseases [...]

The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of squamous cell carcinoma (SCC) of the oral cavity, larynx, oropharynx and hypopharynx was published in 2020. It was therefore decided by both the ESMO and the Korean Society of Medical Oncology (KSMO) to convene a special, virtual guidelines meeting in July 2021 to adapt the ESMO 2020 guidelines to consider the potential ethnic differences associated with the treatment of SCCs of the head and neck (SCCHN) in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with SCCHN (excluding nasopharyngeal carcinomas) representing the oncological societies of Korea (KSMO), China (CSCO), India (ISMPO), Japan (JSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of the current treatment practices and drug access restrictions in the different Asian countries. The latter was discussed when appropriate. This manuscript provides a series of expert recommendations (Clinical Practice Guidelines) which can be used to provide guidance to health care providers and clinicians for the optimisation of the diagnosis, treatment and management of patients with SCC of the oral cavity, larynx, oropharynx and hypopharynx across Asia., Highlights • This article provides ESMO expert recommendations adapted for the treatment of SCCHN (excluding nasopharyngeal carcinomas) in Asian patients. • The aim was to provide guidance for the optimisation of the management of such patients across Asia. • The availability and applicability of certain procedures as they relate to certain of the recommendations are discussed.

Glomus tumours are uncommon neoplasms that are usually benign, solitary and most often found in the skin and soft tissue of distal extremities. Primary gastric glomus tumors are rare, but well described. Fewer than 15 cases of gastric glomus tumour have been reported to have malignant behaviour with distant metastases. Although surgical resection is effective if feasible, recurrence can occur and there is a paucity of evidence on medical treatment options. Here we present the case of a 69-year-old male with a gastric glomus tumour with metastases to abdominal viscera requiring multidisciplinary care for diagnosis, surgical resection, and multiple lines of systemic/radiation therapy guided by available evidence. Genomic analysis revealed a NOTCH2 rearrangement, described in only two prior works and highlighting future possibilities for targeted therapy.

Functional intestinal diseases (FID) in children and young adults are one of the frequent pathologies of the digestive tract. Signs of irritable bowel syndrome are detected in 36 % of children over 4 years of age, abdominal migraine is reported in 19 %, functional constipation — in 17 %, cyclic vomiting syndrome — in 8 % and functional abdominal pain syndrome (non-organ speci­fic) — in 7 %, aerophagy — in 7 % and functional dyspepsia — in 7 % of children. The pathogenesis of FID is multifaceted at different ages. This literature review presents contemporary views on the problem of FID in adolescents and young adults (18–25 years old). These age groups are studied because the manifestation of FID occurs mainly in adolescence and the clinical picture is observed at the age of 18–25 years. Currently, FID are defined as microinflammation in the intestinal mucosa, especially in post-infectious development of functional pathology. An altered microbiota, which affects Toll-like receptors of the intestinal epithelium, is also involved in the development of these pathologies. Polymorphism in the gene encoding Toll-like receptors influences the development of clinical symptoms in patients. The high prevalence of functional intestinal pathology among the population, in adolescents and young adults, calls for a more detailed study of mechanisms of FID development in order to optimize treatment, which will lead to an improvement in the quality of life of patients with this pathology., Функциональные заболевания кишечника (ФЗК) у детей и молодых взрослых являются одной из распространенных патологий пищеварительного тракта. У 36 % детей старше 4 лет диагностируются признаки синдрома раздраженного кишечника, у 19 % — абдоминальной мигрени, у 17 % — функционального запора, у 8 % — синдрома циклической рвоты, у 7 % — синдрома функциональной абдоминальной боли (органонеспецифической), у 7 % — аэрофагии и у 7 % — функциональной диспепсии. Патогенез ФЗК многогранен в различном возрасте. В данном обзоре литературы представлены современные взгляды на проблему ФЗК у подростков и молодых взрослых (18–25 лет). Данные возрастные группы рассматриваются в связи с тем, что манифестация ФЗК происходит преимущественно в подростковом возрасте и клиническая картина наблюдается в возрасте 18–25 лет. В настоящее время ФЗК определяются как микровоспаление в слизистой оболочке кишечника, особенно при постинфекционном варианте развития функциональной патологии. В развитии данной патологии принимает участие измененная микробиота, которая оказывает воздействие на Toll-рецепторы (TLR) кишечного эпителия. Полиморфизм генов, кодирующих TLR, влияет на развитие клинической симптоматики у больных. Высокая распространенность функциональной патологии кишечника среди населения, у подростков и молодых взрослых, вызывает необходимость в более детальном изучении механизмов развития ФЗК с целью оптимизации лечения, что приведет к улучшению качества жизни пациентов с данной патологией., Функціональні захворювання кишечника (ФЗК) у дітей і молодих дорослих є однією з поширених патологій травного тракту. У 36 % дітей старше 4 років діагностуються ознаки синдрому подразненого кишечника, у 19 % — абдомінальної мігрені, у 17 % — функціонального запору, у 8 % — синдрому циклічного блювання, у 7 % — синдрому функціонального абдомінального болю (органонеспецифічного), у 7 % — аерофагії та у 7 % — функціональної диспепсії. Патогенез ФЗК є багатогранним у різному віці. В даному огляді літератури подані сучасні погляди на проблему ФЗК у підлітків і молодих дорослих (18–25 років). Дані вікові групи розглядаються у зв’язку з тим, що маніфестація ФЗК відбувається переважно в підлітковому віці і клінічна картина спостерігається у віці 18–25 років. Сьогодні ФЗК визначаються як мікрозапалення у слизовій оболонці кишечника, особливо при постінфекційних варіантах розвитку функціональної патології. У розвитку даних патологій бере участь змінена мікробіота, що впливає на Toll-рецептори (TLR) кишкового епітелію. Поліморфізм генів, що кодують TLR, впливає на розвиток клінічної симптоматики у хворих. Висока поширеність функціональної патології кишечника серед населення, у підлітків і молодих дорослих, викликає необхідність у більш детальному вивченні механізмів розвитку ФЗК з метою оптимізації лікування, що призведе до поліпшення якості життя пацієнтів з даною патологією.

International audience; Purpose of review. The aim of this study was to highlight the diagnostic and management challenges of primary vitreoretinal lymphoma (PVRL) through a review of the literature and a European survey on real-life practices for PVRL.Recent findings. The care of PVRL patients is heterogeneous between specialists and countries. Upfront systemic treatment based on highdose methotrexate chemotherapy, with or without local treatment, might reduce or delay the risk of brain relapse. Ibrutinib, lenalidomide with or without rituximab, and temozolomide are effective for patients with relapsed/refractory PVRL and should be tested as first-line treatments.Summary. The prognosis of PVRL remains dismal. No firm conclusion regarding optimal treatment can yet be drawn. The risk of brain relapse remains high. Diagnostic procedures and assessment of therapeutic responses need to be homogenized. Collaboration between specialists involved in PVRL and multicentric prospective therapeutic studies are strongly needed. The recommendations of the French group for primary oculocerebral lymphoma (LOC network) are provided, as a basis for further European collaborative work.

Bei verminderter zellularer Immunitat verursacht das zuvor latente Varizella-Zoster-Virus (VZV) das charakteristische klinische Bild eines gurtelformigen blaschenbildenden Exanthems des Herpes zoster. Die klinischen Prodromi eines Herpes zoster sind oft unspezifisch und fuhren nicht selten zu initialen Fehldiagnosen. Die weitaus haufigste Komplikation des Herpes zoster stellt die postherpetische Neuralgie (PHN) dar, eine erneute hamatogene Dissemination wird jedoch nur selten beobachtet. Neben allgemeinen Faktoren wie hoheres Alter und weibliches Geschlecht stellen besonders entzundlich rheumatische Erkrankungen und deren immunsuppressive Therapien wichtige Risikofaktoren fur das Auftreten eines Herpes zoster dar. Eine in den ersten 72 h nach Beginn des Exanthems eingeleitete antivirale Therapie reduziert akute Symptome und das Risiko fur Komplikationen. Der seit 2018 zur Verfugung stehende Subunit-Totimpfstoff weist eine hohe Effektivitat und relativ gute Vertraglichkeit auf, randomisierte kontrollierte Studien bei Patienten mit medikamentoser Immunsuppression bei entzundlich rheumatischen Erkrankungen stehen derzeit aber noch aus.

Background: The development of sepsis, the low efficacy of antibiotics used, long-term antibiotic use, and the development of resistance to antibiotics are significant problems in patients in intensive care units. The use of biological markers is promising for the diagnosis and treatment of sepsis. In this study, proinflammatory cytokines, procalcitonin and four miRNA expressions were analyzed in a time-dependent manner in a patient group and control group, and the correlations between them were examined.Material and Method: The study included 30 patients in the intensive care unit who were diagnosed with sepsis and applied with SOFA and APACHE-2 scoring and 30 control subjects. Serum samples were taken at 24 hours, 72 hours, and on the 7th day. Analyses according to time were made of interleukin-1 beta, interleukin-6, interleukin-10, TNF-alpha, procalcitonin and four miRNAs (miR-122, miR-146a, miR-150, and miR-223) in the collected samples and comparisons were made between the patients and the control group. Results: At 24 hours, a decrease was observed in the miRNA-146a, miRNA-150, and miRNA-122 values and an increase in the miRNA-223 values in the sepsis group compared to the control group. At 72 hours, a decrease was observed in the miRNA-146a, miRNA-150, miRNA-122, and miRNA-223 values in the sepsis group compared to the control group.Conclusion: When procalcitonin and inflammatory cytokines were compared with selected miRNAs in the diagnosis, treatment follow-up, and prognosis of sepsis in the intensive care unit, a correlation between procalcitonin levels, proinflammatory cytokines and miRNA-150, miRNA-146a, and miRNA-223 was found.

Malignant histiocytic neoplasm with histiocytic sarcoma phenotype is a rare malignant neoplasm, distinguished by malignant cells with phenotypic characteristics of mature tissue histiocytes. Histiocytic sarcoma typically presents as a primary malignancy, although can also present as a secondary malignancy, and is rarely seen in the pediatric population. Due to the rarity of this condition, diagnosis of histiocytic sarcoma is difficult and considered a diagnosis of exclusion. We describe a unique case of a chronic upper eyelid lesion with biopsy findings of a highly atypical histiocytic neoplasm initially concerning for histiocytic sarcoma; however, after integration of clinical findings, non-progressive and quiescent molecular profile, concluded to be an atypical juvenile xanthogranuloma in a child treated with excision and observation alone. This report highlights the importance of an integrated team approach to diagnosis of unusual histiocytic neoplasms.

Introduction Ameloblastoma is a rare tumor, benign but rapidly extensive and prone to recurrence. Its management remains difficult and its treatment relies mainly on surgery. For giant ameloblastoma or in people with an advanced stage the gesture remains very mutilating. Presentation of case This is a 22 year old patient, the onset of the symptomatology dates back to 2 years ago with the appearance of a mandibular swelling that increased in size with dental mobility. this motivated the patient to consult a CT scan and a panoramic radiograph as well as a biopsy that objectified an ameloblastoma. He benefited from a surgical excision with reconstruction. Discussion It is a rare tumor that mainly affects young people and especially males. It can be discovered by chance or generally in front of a mandibular swelling. Radiological examination is essential as well as biopsy to confirm the diagnosis. The treatment is surgical, which consists of an exeresis with safety margins. Reconstruction should be discussed especially for young healthy subjects. Conclusion Although ameloblastoma remains a benign tumor, it is a tumor that evolves rapidly and recurs a lot, which is why it is necessary to take care of it quickly with a radical treatment and a regular follow-up with the patients., Highlights • Ameloblastoma is a rare benign but locally aggressive tumor that recurs frequently. • Ameloblastoma remains a benign tumor whose management must be rapid to avoid significant loss of substance because the choice of reconstruction remains difficult. • The maxillofacial surgeon must choose between different treatments with a regular follow-up of the patient.

Background Neuroendocrine tumors of the ovary are uncommon malignant carcinomas with a poor prognosis. There are no standardized management guidelines because of lack of knowledge about these tumors. The objective of this study is to analyze the clinical manifestations, diagnosis and treatment of ovarian neuroendocrine tumors (ONETs). Results Median age at diagnosis was 38.4 years (range 20–58). The main clinical presentations were abdominal pain or a pelvic mass. Two patients underwent fertility-sparing surgery and the others underwent cytoreductive surgery. The finial diagnosis depended on postoperative histopathology. According to the staging standard of the International Federation of Gynecology and Obstetrics (FIGO), three patients had stage I disease, one stage II, and six patients had stage III disease. Eight patients received chemotherapy alone postoperatively, one was maintained with Olaparib after chemotherapy, and one received chemotherapy followed by radiotherapy. The follow-up time for patients raged from 10 to 48 months. One patient died, while the other 9 patients were in follow-up. Seven patients experienced tumor recurrence. Conclusion Ovarian neuroendocrine tumors are characterized by high malignancy, low incidence and poor prognosis. Histopathological analysis is considered the gold standard for diagnosis. Surgical resection may be the first choice of therapy, and adjuvant chemotherapy and possible radiotherapy may prolong the survival of some patients.

The incidence of inflammatory bowel disease (IBD) with a poor prognosis is increasing, and a single field is not capable of fully diagnosing and comprehensively treating IBD. The purpose of the current study was to explore the role of a multidisciplinary team (MDT) in the diagnosis and treatment of IBD. Subjects were 55 patients with IBD who underwent surgery at this hospital before the establishment of a MDT (before June 2016) and 276 patients who were discussed by a MDT; 72 of the latter patients underwent surgery. The preoperative rate of diagnosis, preoperative basic nutritional status, frequency of emergency surgery, and surgical complications in the two groups were compared to determine whether the MDT significantly affected the diagnosis and treatment of IBD and to explore trends in the types of patients with IBD and treatment decision-making since the establishment of MDT. Results revealed that the MDT significantly improved preoperative diagnostic accuracy for patients with IBD who underwent surgery (p < 0.005), and the frequency of elective surgery decreased significantly (p < 0.005). There were significant differences in the rate of clinical recurrence (p < 0.005) and the rate of additional surgery (p < 0.01) between the two groups, with higher rates in the control group. In terms of preoperative nutritional status, the proportion of decreased serum albumin and hemoglobin in the experimental group was significantly lower than that in the control group (p < 0.05). MDT plays a positive role in accurate preoperative diagnosis, improvement of preoperative preparations, and a reduction in postoperative adverse events for patients with IBD undergoing surgery.

The global pandemic produced by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first appeared in Wuhan, China, in December 2019 and which then spread rapidly, made it difficult to find or develop effective medications for its prevention and treatment. Therefore, the first stage is necessitating the use of a precise and quick diagnostic method to detect SARS-CoV-2 infected patient followed by effective patient isolation and the commencement of early treatment, which can range from supportive therapy to specialised medications such corticosteroids, antiviral medications, antibiotics, and the recently introduced convalescent plasma. Despite the extraordinary developments in advanced medicinal system, no confirmed viable medicines exist at this time. Rapid research on SARS CoV-2 epidemiology has led to the discovery of certain new targets for prospective therapeutic treatments. Many therapeutic options have been evaluated, and clinical studies are proceeding at a breakneck speed. However, there is a lot of room for more study into finding cost-effective and safer medicines, vaccinations, and measures to ensuring that COVID-19 preventive and treatment programmes are available to everyone. The goal of this study is to compile all of the current advancements in the worldwide medical system in the fight against COVID-19.

Anomalous origin of a branch pulmonary artery from the aorta is a rare malformation, accounting for 0.12% of all congenital heart defects. We present the case of a 43-year-old man with an anomalous origin of the right pulmonary artery (AORPA) from the ascending aorta. Reimplantation of the right pulmonary artery was carried out successfully, with favourable evolution in the medium-term follow-up. It is the first described case that receives corrective treatment in adulthood with a favourable evolution.

We question the reliability of the vague symptoms that most commonly define catheter-associated urinary tract infection (CAUTI) and encourage further examination of whether the current CAUTI definition reflects a true infection. While diagnosing CAUTI using the current surveillance definition, physicians may be missing a number of nonurinary etiologies for fever, prematurely diagnosing urinary tract infection, and prescribing unnecessary antibiotics. We believe it is time to reconsider the quality metric of CAUTI. By doing so, we can improve antibiotic use and quality of patient care.

Corona virus is one of the fiercest viruses that infect the upper respiratory tract and lead to death. Coronavirus infection severity ranges from the common cold to pneumonia. Corona virus spread recently, as it was in the past transmitted from animal to animal, then the virus evolved to transfer from animal to animal, and recently the virus moved from human to human.