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Cystinuria is an inherited disease, and the defective reabsorption of cysteine causes often requires operations for large urinary stones from childhood. It is rare to be diagnosed only with bladder stones and essential to select an operative procedure according to the age of the patient and the size of the stone. We report the case of a 2-year-old boy with cystinuria diagnosed with a large bladder stone and investigate the efficacy of transurethral cystolithotripsy assisted by percutaneous evacuation. Additional genetic analysis for the entire family revealed benefit for the life-span treatment of cystinuria.Mycosis fungoides with penile involvement is extremely rare. Previous reports have shown successful treatment with imiquimod or a combination of beam radiation and chemotherapy. We present a patient with mycosis fungoides and penile involvement. The penile lesions were initially treated with topical imiquimod; however, he developed worsening glandular lesions and discharge. Therefore the treatment was discontinued. Subsequent treatment with brentuximab (anti-CD30) targeted therapy resulted in complete resolution of the penile lesions. To our knowledge, this represents the first case of a complete penile mycosis fungoides response to brentuximab therapy. check details Brentuximab may be considered for refractory penile mycoses fungoides.Pelviureteric junction obstruction can be attributed to intrinsic and extrinsic pathologies. We report an unusual cause of pelviureteric junction obstruction due to a large parapelvic cyst in a malrotated kidney. The patient presented with intermittent flank pain. The diagnosis was arrived at following imaging. The cyst was managed by open surgery.We report the case of a 4 year old female with severe traumatic brain injury who developed bilateral obstructing ureteral stones after hypertonic saline treatment. She developed calcium phosphate stones after two weeks of hypertonic saline therapy, and was successfully treated with ureteral stents and ureteroscopy. She has remained stone-free since that time. We postulate that an incomplete type 1 renal tubular acidosis made her intolerant to the acid and sodium load of the saline, and discuss other lithogenic factors of her presentation.Non-tuberculous mycobacterias (NTM) are important pathogens responsible for a broad spectrum of diseases in humans. Although exposure is widespread since they are distributed in the environment, the development of the disease is rare. It will depend on the specific species, their virulence (only 50 have been found to cause disease), and the host's immune response. M Mycobacterium Malmoense is a NTM first reported in 1977 at Malmö, Sweden, based on four cases of lung infections. After these, other infections have been reported mainly involving the respiratory tract. Extrapulmonary infections are limited to cervical adenitis, and rarely to tenosynovitis and disseminated disease. We are hence reporting, to our knowledge, the first case of M. malmoense as the cause of bacterial endocarditis in the world.We present a case of Mycobacterium fortuitum ventriculoperitoneal shunt infection in a 26-year-old immunocompromised woman. The patient was treated with revision and replacement of her peritoneal shunt and prolonged combination antimicrobial therapy. There are no established guidelines for the treatment of VP shunt infections due to M. fortuitum. We review the literature and provide treatment recommendations.Motor neuron disease (MND) have an incidence of 2 in 100 000 persons, resulting in the death of 1 in every 500 people affected. The most common disease in MND spectrum is amyotrophic lateral sclerosis (ALS). We describe the case of an ALS-like syndrome in a HIV patient. This case report presents a 38 years old male from Peru with HIV who after 2 months of combined antiretroviral treatment (cART) initiation was admitted to the hospital for spastic paraplegia. On his first admission, rapid plasma reagent (RPR) was positive and he was treated for neurosyphilis and discharged. Nevertheless, one month after, he was admitted for the second time because paraplegia persisted. Laboratory tests, electromyography and imaging were performed, and ALS was diagnosed. Normally, HIV treated patient with ALS tend to have a better prognosis, however this was not the case. In this case report, we discuss possible association between ALS and immune reconstitution inflammatory syndrome in HIV patients.

is one of the most pathogenic and drug-resistant opportunistic microorganisms among the nontuberculous mycobacteria (NTM) involved in skin and soft tissue infections (SSTI) associated with cosmetic surgical procedures. However, NTM infection is often wrongly diagnosed initially causing prolonged suffering. Here is described the author's experience working with patients who developed

SSTI after cosmetic procedures.

Patients who developed NTM infection after undergoing cosmetic procedures, and who presented at the Hospital Metropolitano and Hospital Vozandes (Quito, Ecuador) between

. A review of patient medical records was performed.

Five patients with culture proven

subspecies

SSTI after cosmetic surgeries were identified. All patients were treated with aggressive surgical debridement and antibiotics.

A rapidly spreading wound infection presenting two or more weeks after a cosmetic procedure that fails to respond to standard antimicrobial therapy should raise suspicion for NTM infection. Samples for acid-fast bacilli smear, cultures, and PCR from infected tissue should be taken. Surgical drainage and debridement are recommended along with a long course of antibiotics. In the absence of clinical trials, a combination of amikacin, imipenem, and clarithromycin may be an adequate initial treatment for

subspecies

SSTI in immunocompetent patients.

A rapidly spreading wound infection presenting two or more weeks after a cosmetic procedure that fails to respond to standard antimicrobial therapy should raise suspicion for NTM infection. Samples for acid-fast bacilli smear, cultures, and PCR from infected tissue should be taken. Surgical drainage and debridement are recommended along with a long course of antibiotics. In the absence of clinical trials, a combination of amikacin, imipenem, and clarithromycin may be an adequate initial treatment for M. abscessus subspecies abscessus SSTI in immunocompetent patients.

is an innocuous inhabitant of the normal human epithelial and mucosal surfaces. The



s thogenic potential is increasingly recognized in our time.

We present a rare case of CRBSI by

in a 57-yr-old male patient. The patient suffered from many basic diseases and was admitted to hospital of shock.

The patient finally died of septic shock caused by CRBSI due to multidrug-resistant

which responded neither to empiric nor to targeted treatment.

can cause CRBSI in immunocompromised patients when they were treated by intravenous catheters.

C. striatum can cause CRBSI in immunocompromised patients when they were treated by intravenous catheters.Central nervous system infection caused by Herpes simplex virus 1 remains a significant cause of morbidity and mortality in transplant patients. Additionally, the clinical implications of the recently discovered Human herpesvirus 6A are still under investigation. Hereby, we report a clinical case of an immunosuppressed patient following kidney transplantation and with chromosomally integrated human herpesvirus-6A (CIHHV-6A) that developed rhombencephalitis due to herpes virus simplex 1. This case highlights the importance of investigating the CIHHV-6 status in the differential diagnosis whenever a human herpesvirus is detected in the cerebrospinal fluid.Multispectral Optoacoustic Tomography (MSOT) resolves oxy- (HbO2) and deoxy-hemoglobin (Hb) to perform vascular imaging. MSOT suffers from gradual signal attenuation with depth due to light-tissue interactions an effect that hinders the precise manual segmentation of vessels. Furthermore, vascular assessment requires functional tests, which last several minutes and result in recording thousands of images. Here, we introduce a deep learning approach with a sparse-UNET (S-UNET) for automatic vascular segmentation in MSOT images to avoid the rigorous and time-consuming manual segmentation. We evaluated the S-UNET on a test-set of 33 images, achieving a median DICE score of 0.88. Apart from high segmentation performance, our method based its decision on two wavelengths with physical meaning for the task-at-hand 850 nm (peak absorption of oxy-hemoglobin) and 810 nm (isosbestic point of oxy-and deoxy-hemoglobin). Thus, our approach achieves precise data-driven vascular segmentation for automated vascular assessment and may boost MSOT further towards its clinical translation.The COVID-19 pandemic and lockdown situation have shown both positive and negative effects on the environmental aspects. With an unprecedented rate the different types of waste volume have up surged along with the COVID-19 contamination rate. As the situation has mandated people as well as the most infected persons to stay at home, the amount of generated hazardous waste is 3.40 kg that can be expected daily from each infected person. China and other countries have seen a massive increment in the hazardous waste generation (about 600 % increase in Hubei province) amount. While dealing with this sudden increase in waste amount, the conventional incineration facilities have been outstripped and waste management industry is facing an immense pressure over handling hazardous waste generated from COVID-19 infected patients. Alongside with the hazardous waste volume, single-use plastic items and personal protective equipment (PPEs) have induced a new type of "PPE pollution" in the land and aquatic environment. The current review provides a countrywide waste generation amount, estimated using the infected number of cases for some selected countries. In contrast with the poor waste management noticed during this pandemic, some suggested approaches towards a better waste management service and future implications of waste management are discussed with viable consideration for the waste workers.[This corrects the article DOI 10.1016/j.ijppaw.2020.04.011.].Myelodysplastic/myeloproliferative neoplasm, unclassifiable (MDS/MPN-U) is a rare but heterogeneous subtype of MDS/MPN, with no specific genetic alterations and standard treatments. ASXL1, SRSF2, TET2, JAK2 and NRAS are commonly mutated in MDS/MPN-U. Double gene mutations could be detected in MDS/MPN-U, however, co-mutations of 3 and more genes in this disease entity are very rare. Here, we present a case of MDS/MPN-U with triple mutations involving JAK2, SF3B1, and TP53. After failure of traditional therapy including hydroxyurea and interferon-α, the patient received ruxolitinib monotherapy and achieved hematological response quickly. Though mutations in TP53 implied a poor prognosis in myeloid malignancies, this patient has maintained no AML transformation for 26 months since diagnosis. Further research on complex mutations in the pathogenesis and prognosis of MDS/MPN-U is warranted.Oral cancer is one of the common cancers in the world causing high morbidity. Development of cancer is preceded by certain asymptomatic clinical lesions and conditions all together known as 'oral potentially malignant disorders'. Histologically they are represented by the term 'oral epithelial dysplasia'. The degree of severity of dysplasia is determined in the form of 'grade'. Despite the existence of several grading systems proposed by various scholars, it is still a challenging task for the Pathologists to grade dysplasia accurately for the proper diagnosis of the disease and to follow preferable treatment plans. This review aims to focus on the current challenges and the diagnostic pitfalls in the grading of oral epithelial dysplasia in various oral potentially malignant disorders.

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