Eosinophilia caused by Toxocara canis infection

Eosinophilia is defined as an absolute peripheral blood eosinophil count > 0.5 GL. Most often, its intensity is mild. Eosinophilia usually accompanies other diseases such as allergic, rheumatological, infectious, or oncological. The signs depend on the underlying diseases. After starting treatment of the underlying disease, the eosinophil count returns to the reference range. The diagnosis of eosinophilia starts by excluding the secondary causes. Clonal eosinophilia is a rare disease in which eosinophils are part of a tumor clone. The clonality is confirmed by molecular biology methods. The most common eosinophilic infiltration includes skin, lungs, and heart. The symptoms are not connected with a count of eosinophils in blood or bone marrow. The manifestation can be mild but also severe, life-threatening like venous thromboembolism. This article presents a case of 36-year-old man with eosinophilia caused by Toxocara canis infection manifested by systemic symptoms, erythroderma, and liver failure

The rapid development of thyroid lymphoma - case report

Thyroid lymphoma is a rare malignant neoplasm of the thyroid gland, constituting about 5% of all cases of thyroid cancer. Its incidence is higher in female patients aged 60-70 years. Many affected patients have the history of Hashimoto disease. When the goitre increases and compression symptoms occur, quick diagnosis and treatment are required. The diagnosis is mainly based on histopathological examinations. Further treatment and prognosis depend on the histopathological subtype, progression and size of the tumour. Our case report describes a 70-year-old female patient who presented due to an increasing circumference of the neck and dyspnoea aggravating for three weeks. The course of disease and the patient's condition deteriorated rapidly. Based on clinical observations and histopathological findings, thyroid lymphoma was diagnosed

Transfermoral aortic valve implantation using self-expanding New Valve Technology (NVT) Allegra bioprosthesis: A pilot prospective study

Background: Transcatheter aortic valve implantation (TAVI) has become a standard therapeutic option for patients with severe aortic stenosis (AS) at high cardiac surgical risk. The aim of the NAUTILUS study was to investigate the safety and performance of the New Valve Technology (NVT) Allegra bioprosthesis in high-risk patients undergoing TAVI. Methods: Twenty seven patients with severe, symptomatic AS at high surgical risk were prospectively enrolled, who underwent treatment using the novel self-expanding NVT Allegra bioprosthesis via transfemoral approach (TF-TAVI). The primary end-point was all-cause mortality at 30 days. Results: Patients were elderly (83 years, range 75–89 years), and predominantly female (70.4%, n = 19). All patients were deemed to be at high surgical risk, with a mean logistic EuroSCORE of 12.4% (range, 2.8–31.8%). The bioprosthesis was successfully implanted in 96% of the cases (n = 25). The echocardiographic assessment confirmed good hemodynamic profile after implantation of the NVT Allegra bioprosthesis. Complications included cardiac tamponade (4%, n = 1) and the need for permanent pacemaker implantation (8%, n = 2). The analysis of procedural aspects showed a short learning effect related to the precise placement of the valve. A significant improvement in clinical symptoms were observed, and no patients died in-hospital or within 30 days of post-discharge observation. Conclusions: This prospective observation shows that the NVT Allegra bioprosthesis was associated with a satisfactory safety profile and a remarkable hemodynamic performance after implantation

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Jerónimo Martins SGPS: Portugal retail: under the Polish umbrella… Escaping from the Portuguese problems and securing long term growth.

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Finance from the NOVA – School of Business and Economic