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Recurrent Pneumothorax in an Adult Male With Bilateral COVID-19 Pneumonia.

Cureus 2021 Aug 9;13(8):e17025. Epub 2021 Aug 9.

Internal Medicine, Dhulikhel Hospital, Dhulikhel, NPL.

Pneumothorax is defined as the condition in which air is collected between the visceral and parietal pleura. Pneumothorax as a complication of coronavirus disease 2019 (COVID-19) infection has been reported in relatively few cases and recurrent pneumothorax is even rarer. We present a case of a 50-year-old critically ill patient who required mechanical ventilation for 55 days and developed recurrent bilateral pneumothorax. Read More

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Fecal Microbiota Transplantation and Medical Therapy for Clostridium difficile Infection: Meta-analysis of Randomized Controlled Trials.

J Clin Gastroenterol 2021 Sep 9. Epub 2021 Sep 9.

Departments of Medicine Gastroenterology and Hepatology Library Services, Cleveland Clinic Foundation Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH Department of Medicine, UPMC, Pittsburgh, PA Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL Department of Medicine, Asante Rogue Regional Medical Center, Medford, OR Baba Farid University of Health Sciences, Faridkot, Punjab, India.

Goals: The aim was to assess the effectiveness of fecal microbiota transplantation (FMT) against medical therapy (MT).

Background: FMT has shown good outcomes in the treatment of Clostridium difficile infection (CDI). We aimed to conduct a systematic review and meta-analysis to compare the effectiveness of FMT versus MT for CDI. Read More

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September 2021

Recurrent reactive infectious mucocutaneous eruption (RIME) in two adolescents triggered by several distinct pathogens including SARS-CoV-2 and influenza A.

Pediatr Dermatol 2021 Sep 13. Epub 2021 Sep 13.

University of Minnesota Department of Dermatology, Minneapolis, MN, USA.

Reactive infectious mucocutaneous eruption (RIME) was proposed as new terminology to encompass postinfectious mucocutaneous eruptions. The term includes all postinfectious mucocutaneous eruptions such as the widely reported Mycoplasma pneumoniae-induced rash and mucositis (MIRM). Very few reports in the literature regarding recurrent RIME are found. Read More

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September 2021

Predictors and outcomes of recurrent diabetic ketoacidosis in Israeli adults.

Diabetes Metab Syndr 2021 Sep 3;15(5):102276. Epub 2021 Sep 3.

Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel.

Aims: To identify risk factors for recurrent episodes of DKA that may allow the development of an effective prevention strategies.

Methods: Retrospective analysis of admissions for DKA in adult patients between 2004, and 2017 in a tertiary hospital. The clinical characteristics and outcomes of DKA of patients were stratified into an isolated episode of DKA (group 1) and recurrent episodes (group 2). Read More

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September 2021

Febrile Seizure in Children Attending a Tertiary Care Centre in Western Nepal: A Descriptive Cross-sectional Study.

JNMA J Nepal Med Assoc 2021 Apr 30;59(236):331-335. Epub 2021 Apr 30.

Department of Community Medicine, Gandaki Medical College and Teaching Hospital, Pokhara, Nepal.

Introduction: Understanding a child with any episode of febrile seizure is important so that special attention could be given. The objective of this study was to find the prevalence of febrile seizure in children attending a tertiary centre in western Nepal.

Methods: A descriptive cross-sectional study was performed in a tertiary care centre at the department of Pediatrics after taking approval from the Institutional Review Committee. Read More

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Antiphospholipid Syndrome: A Seronegative Case at Ho Teaching Hospital, Ghana.

West Afr J Med 2021 08;38(8):807-810

Department of Internal Medicine and Therapeutics. University of Health and Allied Sciences, School of Medicine. Ho Teaching Hospital, Ghana.

Antiphospholipid syndrome is a systemic autoimmune disease characterized by thrombosis and/or pregnancy morbidity in the presence of persistently positive antiphospholipid antibodies. The finding of individuals who present a clinical picture highly suggestive of antiphospholipid syndrome, but who are persistently negative for "criteria" of antiphospholipid antibodies has led physicians to refer to this patient population as having "seronegative" Antiphospholipid syndrome. We present a case of a 35-years old patient with strong clinical suspicion of antiphospholipid syndrome, with a history of recurrent pregnancy loss and one episode of deep vein thrombosis, but serologically negative, who was admitted and successfully managed and discharged. Read More

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Lessons of the month 2: Meningococcal epiglottitis and connective tissue disease associated with C2 deficiency.

Clin Med (Lond) 2021 Sep;21(5):e539-e540

John Radcliffe Hospital, Oxford, UK

Case Presentation: A 68-year-old woman was referred for immunological investigation following an episode of meningococcal epiglottitis with associated septicaemia. Several years previously, she had been diagnosed with undifferentiated connective tissue disease. On investigation, alternative pathway complement function was normal; however, classical pathway complement activation was reduced. Read More

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September 2021

A Multicenter Cohort Study of Indian Centers on Reoccurring SARS-CoV-2 Infections in Kidney Transplant Recipients.

Exp Clin Transplant 2021 Sep 8. Epub 2021 Sep 8.

From the Department of Nephrology, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, India.

Objectives: There is scarcity of data on reoccurrence of SARS-CoV-2 infections in kidney transplant recipients.

Materials And Methods: We conducted a retrospective multicenter cohort study and identified 13 kidney transplant recipients (10 living and 3 deceased donors) with recurrent COVID-19, and here we report demographics, immunosuppression regimens, clinical profiles, treatments, and outcomes.

Results: COVID-19 second infection rate was 0. Read More

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September 2021

Rumination Syndrome in Children and Adolescents: A Mini Review.

Front Pediatr 2021 19;9:709326. Epub 2021 Aug 19.

Division of Gastroenteology, Hepatology, and Nutrition, Children's Mercy Kansas City, Kansas City, MO, United States.

Rumination syndrome involves recurrent regurgitation of food and is believed to be underdiagnosed with patients experiencing long delays in diagnosis. It can be associated with significant social consequences, high rates of school absenteeism, and medical complications such as weight loss. The primary aims of the current review are to assess the literature regarding prevalence, pathophysiology, and treatment outcomes with a focus on neurotypical children and adolescents. Read More

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A 24-Year-Old Man With Hemoptysis Found to Have a Chest Mass and Contralateral Axillary Lymphadenopathy.

Chest 2021 09;160(3):e289-e293

Department of Pulmonary, Critical Care, and Sleep Medicine, Naval Medical Center San Diego, San Diego, CA.

Case Presentation: A 24-year-old man, never smoker, with no medical or surgical history, not currently on medications, presented to the ED with a second episode of gross hemoptysis, 4 months after an initial episode that had not previously been evaluated. He described the current episode of hemoptysis as "enough to fill the sink"; however, he did not further quantify. He has no history of recurrent epistaxis, hematemesis, or other evidence of clotting disorder. Read More

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September 2021

Estimating the risk of recurrent invasive pneumococcal disease in Australia, 1991-2016.

Vaccine 2021 Sep 2. Epub 2021 Sep 2.

Centre for Children's Health Research, The University of Queensland, South Brisbane, Queensland, Australia; National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia. Electronic address:

Background: Individuals who experience an initial episode of invasive pneumococcal disease (IPD) are at increased risk of recurrent episodes. However, the magnitude of risk has not been well-quantified in the pneumococcal conjugate vaccine era. Individuals with a previous episode of IPD are not commonly identified as a high-risk group in vaccination guidelines. Read More

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September 2021

Cross sectional study to identify prevalence of and factors associated with laminitis in UK donkeys.

Equine Vet J 2021 Sep 3. Epub 2021 Sep 3.

The Donkey Sanctuary, Sidmouth, Devon, UK.

Background: Laminitis causes lameness in donkeys, but its prevalence and factors associated with disease remain uncertain.

Objectives: To determine the prevalence of and identify factors associated with laminitis in donkeys.

Study Design: Retrospective cross-sectional study. Read More

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September 2021

Thiamine deficiency and recovery: impact of recurrent episodes and beneficial effect of treatment with Trolox and dimethyl sulfoxide.

Naunyn Schmiedebergs Arch Pharmacol 2021 Sep 1. Epub 2021 Sep 1.

Programa de Pós-Graduação em Sanidade Animal e Saúde Pública nos Trópicos , Universidade Federal do Tocantins, BR-153, km 112, Araguaína, TO, 77804-970, Brazil.

At present, thiamine deficiency (TD) is managed with administration of high doses of thiamine. Even so, severe and permanent neurological disorders can occur in recurrent episodes of TD. In this study, we used a murine model to assess the efficacy of TD recovery treatments using thiamine with or without additional administration of the antioxidant Trolox or the anti-inflammatory dimethyl sulfoxide (DMSO) after a single or recurrent episode of TD. Read More

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September 2021

Contradiction between genetic analysis and diuretic loading test in type I Bartter syndrome: a case report.

BMC Nephrol 2021 Aug 30;22(1):295. Epub 2021 Aug 30.

Department of Nephrology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.

Background: In typical cases of Bartter syndrome (BS), assessing response to diuretics (furosemide and thiazide), hereinafter referred to as diuretic loading test, may be used to diagnose the type by detecting which part of the kidney tubule is not functioning correctly. However, the diuretic loading test may not always agree with the results of genetic analyses.

Case Presentation: A 5-year-old boy was admitted due to lower extremity weakness and abnormal gait. Read More

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[Mental disorders in type 2 diabetes].

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(7):22-30

Association for the Improvement of Mental Health Programmes, Geneva, Switzerland.

Objective: To assess the prevalence of mental disorders in patients with type 2 diabetes mellitus (DM2) and their relationship with laboratory findings, somatic comorbidities and psychosocial consequences.

Material And Methods: In the frames of the INTERPRET-DD multicenter 200 T2DM patients from primary care (47 men and 153 women) from the Russian sample were studied. The psychometric assessment included MINI-6, HAMD-17, PHQ-9, PAID, WHO-5. Read More

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September 2021

COVID-19 infection triggering hrombotic thrombocytopenic purpura.

IDCases 2021 24;26:e01256. Epub 2021 Aug 24.

Division of Infectious Diseases, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

We present a 62-year-old gentleman with history of Crohn's disease, G6PD deficiency, who presented with immune-mediated thrombotic thrombocytopenia purpura (iTTP) one week after the diagnosis of COVID-19 infection. He was admitted with worsening dyspnea, acute renal failure, and profound thrombocytopenia with marked schistocytosis on peripheral smear. ADAMTS13 level was severely deficient. Read More

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Complete withdrawal of glucocorticoids after dupilumab therapy in allergic bronchopulmonary aspergillosis: A case report.

World J Clin Cases 2021 Aug;9(23):6922-6928

Department of Pulmonary Medicine, Mie Chuo Medical Center, Tsu 514-1101, Mie, Japan.

Background: Allergic bronchopulmonary aspergillosis (ABPA) is an allergic reaction to species that aggravates bronchial asthma. Previous studies demonstrated the glucocorticoid-sparing effect of dupilumab in patients with ABPA. There is no report of complete withdrawal of glucocorticoids after dupilumab. Read More

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Prognostic Value of Cardiac Troponin and Risk Assessment in Pediatric Supraventricular Tachycardia.

J Clin Med 2021 Aug 17;10(16). Epub 2021 Aug 17.

Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City 333, Taiwan.

Cardiac troponin I (cTnI) elevation is common in an acute episode of supraventricular tachycardia (SVT). However, there is limited evidence regarding the prognostic value of cTnI and the predictors of SVT recurrence in pediatric patients. We screened the electronic medical records of all pediatric patients presenting to the emergency departments at five Taiwanese hospitals from 1 January 2010 to 31 May 2021. Read More

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A case of COVID-19 re-infection in Libya.

Afr J Thorac Crit Care Med 2021 23;27(2). Epub 2021 Jun 23.

Zliten Isolation Unit, Zliten Medical Center, Zliten, Libya.

Re-infection with SARS-CoV-2 is an active area of research and studying. Here, we present the first documented case of SARS-CoV-2 re-infection in Libya. The patient was a 24-year-old healthy man who initially presented with mild symptoms of generalised fatigue and intermittent episodes of fever for 3 days. Read More

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NBAS deficiency due to biallelic c.2809C > G variant presenting with recurrent acute liver failure with severe hyperammonemia, acquired microcephaly and progressive brain atrophy.

Metab Brain Dis 2021 Oct 24;36(7):2169-2172. Epub 2021 Aug 24.

Department of Pediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, al. Dzieci Polskich 20, 04-730, Warsaw, Poland.

Biallelic pathogenic variants in the neuroblastoma amplified sequence (NBAS) gene were firstly (2015) identified as a cause of fever-triggered recurrent acute liver failure (RALF). Since then, some patients with NBAS deficiency presenting with neurologic features, including a motor delay, intellectual disability, muscular hypotonia and a mild brain atrophy, have been reported. Here, we describe a case of pediatric patient diagnosed with NBAS deficiency due to a homozygous c. Read More

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October 2021

Deficient DNA mismatch repair and persistence of SARS-CoV-2 RNA shedding: a case report of hereditary nonpolyposis colorectal cancer with COVID-19 infection.

BMC Infect Dis 2021 Aug 21;21(1):854. Epub 2021 Aug 21.

Hull University Teaching Hospital NHS Trust, Castle Road, Cottingham, Hull, HU16 5JQ, UK.

Background: Several independent risk factors have been reported to influence viral shedding following COVID-19 infection, but the influence of host-related molecular factors has not yet been described. We report a case of a cancer patient with Lynch syndrome (hereditary nonpolyposis colorectal cancer, HNPCC) who manifested SARS-CoV-2 PCR (polymerase chain reaction) positivity for at least 54 days after contracting mild COVID-19 illness. We propose that deficient mismatch repair (MMR) may play a role in the prolonged SARS-CoV-2 RNA shedding. Read More

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Disease and Economic Burden Associated with Recurrent Pericarditis in a Privately Insured United States Population.

Adv Ther 2021 Aug 21. Epub 2021 Aug 21.

Kiniksa Pharmaceuticals Corp., Lexington, MA, USA.

Introduction: Approximately 30% of patients with a first acute pericarditis episode experience a recurrence ≤ 18 months; ~ 15% experience multiple recurrences. This study assessed the recurrence and economic burden among patients with multiple recurrences.

Methods: Adults with idiopathic pericarditis were identified in the OptumHealth Care Solutions, Inc. Read More

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[Family history of affective disorders, the gender factor and clinical characteristics of depression].

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(5. Vyp. 2):75-83

Bekhterev National Medical Research Center For Psychiatry And Neurology, St Petersburg, Russia.

Objective: Analysis of clinical features of development and course of depression in patients with FH of mood disorders taking into account sex differences.

Material And Methods: This multicenter cross-sectional study included patients over 18 years of age with depressive episode/recurrent depressive disorder. Clinical characteristics of depression, presence of comorbid mental illness and family history (FH) information were obtained in a structured clinical interview. Read More

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[First depressive episode in the dynamics of personality disorders in adolescence].

Authors:
E S Krylova

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(5. Vyp. 2):35-40

Mental Health Research Center, Moscow, Russia.

Objective: To determine clinical and psychopathological specifics of the first depressive episode (DE) in the context of formation of personality anomalies and their dynamics in adolescence.

Material And Methods: Two hundred and thirty-seven patients (180 male, 57 female), aged 16 to 25 years, with the first DE and comorbid personality disorder (PD) were clinically observed and psychopathologically evaluated. Later 149 patients from this group participated in the follow-up study. Read More

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[Clinical characteristics and risk factors of deaths in patients with Wiskott-Aldrich syndrome].

Zhonghua Er Ke Za Zhi 2021 Jul;59(7):576-581

Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Child Infection and Immunity,Chongqing 400014, China.

To explore the clinical characteristics and risk factors of pediatric patients with Wiskott-Aldrich syndrome (WAS). This was a case-control study. Clinical data of 165 cases of pediatric patients with WAS, who visited the Department of Rheumatology, Children's Hospital of Chongqing Medical University between January 2007 and August 2020 were retrospectively analyzed and divided into death group and survival group (control group) according to the prognosis in the follow-up. Read More

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Pregnancy outcomes in patients treated with belimumab: Report from real-world experience.

Semin Arthritis Rheum 2021 Jun 24;51(5):963-968. Epub 2021 Jun 24.

Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, Taiwan. Electronic address:

Objective: To investigate the neonatal and maternal outcomes of patients treated with belimumab during pregnancy.

Materials And Methods: We retrospectively collected patients who were treated with belimumab during pregnancy from January 2018 to October 2020 in a tertiary referral hospital in Taiwan. All patients had clinical and serological features of systemic lupus erythematosus or antiphospholipid syndrome and had been treated accordingly. Read More

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Long-term Implications of Persistent Diverticulitis: A Retrospective Cohort Study of 915 Patients.

Dis Colon Rectum 2021 Sep;64(9):1112-1119

Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada.

Background: Persistent (or ongoing) diverticulitis is a well-recognized outcome after treatment for acute sigmoid diverticulitis; however, its definition, incidence, and risk factors, as well as its long-term implications, remain poorly described.

Objective: The purpose of this study was to assess the incidence, risk factors, and long-term outcomes of persistent diverticulitis.

Design: This was a retrospective cohort study. Read More

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September 2021

Liver involvement in neuroblastoma amplified sequence gene deficiency is not limited to acute injury: Fibrosis silently continues.

Liver Int 2021 Aug 16. Epub 2021 Aug 16.

Research Center for Translational Medicine (KUTTAM), Koc University, Istanbul, Turkey.

Biallelic mutations in neuroblastoma amplified sequence gene (NBAS) is a rare disease which is characterized by recurrent liver failure (RALF). We reported the novel mutations, clinical characteristics and long-term outcomes of 5 patients with novel biallelic NBAS variants. Four patients (80%) had acute, episodic liver crises (LC) triggered by fever, with a median age of onset of 8. Read More

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Extra-skeletal manifestations in axial spondyloarthritis are associated with worse clinical outcome despite the use of TNF blocking therapy.

J Rheumatol 2021 Aug 15. Epub 2021 Aug 15.

Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, the Netherlands; Rheumatology, Medical Center Leeuwarden, the Netherlands.

Objective: To investigate the prevalence and 4-year incidence of acute anterior uveitis (AAU), inflammatory bowel disease (IBD) and psoriasis, and to explore associations of newly developed extra-skeletal manifestations (ESMs) with clinical disease outcome in a large cohort of axial spondyloarthritis (SpA) patients.

Methods: All consecutive patients included in the Groningen Leeuwarden Axial SpA (GLAS) cohort between 2004 and 2011 were analysed. History of ESMs at baseline and newly developed ESMs during 4-year follow-up were only recorded when diagnosis by an ophthalmologist, gastroenterologist or dermatologist was present. Read More

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