Case report: Typhoid fever complicated by hemophagocytic lymphohistiocytosis and rhabdomyolysis

Hemophagocytic lymphohistiocytosis (HLH) and rhabdomyolysis are rare complications of typhoid fever from Salmonella enterica serovar Typhi. Herein, we describe the clinical features in a 21-year-old female from India who presented to the intensive care unit with fever, severe pancytopenia, and rhabdomyolysis

A Comparative Analysis of Mast Cell Quantification in Five Common Dermatoses: Lichen Simplex Chronicus, Psoriasis, Lichen Planus, Lupus, and Insect Bite/Allergic Contact Dermatitis/Nummular Dermatitis

There is a large body of literature demonstrating an important role of mast cells in adaptive and innate immunity. The distribution of mast cells in the skin varies in different parts of the body. It is well known that mast cells are important for effector functions of classic IgE-associated allergic disorders as well as in host defense against infective agents and influence the manifestation of autoimmune diseases. We aimed to quantify mast cells in five common dermatoses and compare them statistically with respect to the immunostains. We retrieved paraffin-embedded tissue sections from the archives of the Pathology Department at the UF, Jacksonville, for five cases with each of the above diagnosis from the last three years. We performed CD-117 and tolidine blue stains on each one of them. The presence or absence of mast cells was evaluated and quantified. We observed that, in the skin, mast cells are mainly located close to the vessels, smooth muscle cells, hair follicles, and nerve ending. Our study showed that the mast cell distribution pattern is different across the two methods of staining for the five aforesaid dermatoses. The other important observation was the dendritic morphology of the mast cells

Understanding the motions of the cheetah tail using robotics

The cheetah is capable of incredible feats of manoeuvrability. But, what is interesting about these manoeuvres is that they involve rapid swinging of the animal's lengthy tail. Despite this, very little is understood about the cheetah tail and its motion, with the common view being that it is "heavy" and possibly used as a "counter balance" or as a "rudder". In this dissertation, this subject is investigated by exploring the motions of the cheetah tail by means of mathematic al models, feedback control and novel robot platforms. Particularly, the motion in the roll axis is first investigated and it is determined that it assists stability of high speed turns. This is validated by modelling and experimental testing on a novel tailed robot, Dima I. Inspired by cheetah video observations, the tail motion in the pitch axis during rapid acceleration and braking manoeuvres is also investigated. Once again modelling and experimental testing on a tailed robot are performed and the tail is shown to stabilise rapid acceleration manoeuvres. Video observations also indicate the tail movement in the shape of a cone: a combination of pitching and yawing. Understanding this motion is done by setting up an optimization problem. Here, the optimal motion was found to be to a cone which results in a continuous torque on the body during a turn while galloping. A novel two degree of freedom tailed robot, Dima II, was then developed to experimentally validate the effect of this motion. Lastly, measurement of the cheetah tail inertia was performed during a routine necropsy where it was found to have lower inertia than assumed. However, the tail has thick, long fur that was tested in a wind tunnel. Here it was found that the furry tail is capable of producing significant drag forces without a weight penalty. Subsequently, mathematical models incorporating the aerodynamics of the tail were developed and these were used to demonstrate its effectiveness during manoeuvres

Basal cell carcinoma with intravascular invasion

Summary: We report the case of a 59-year-old Caucasian male with a primary infiltrative basal cell carcinoma (BCC) with vascular invasion on the right temple. An excision biopsy was taken and histology confirmed a BCC, 2.5mm thick, invading into the reticular dermis. The patient underwent a scar excision which demonstrated no further malignancy. The patient showed no clinical signs of recurrence 2 years after diagnosis. Relevance: BCC is the most common human malignancy and its incidence is increasing. Less than 1% of BCCs metastasize and very few cases of intravascular invasion by a primary BCC have been reported. This report discusses the clinical features of a BCC, the population at risk and summarises all known cases of BCC with vascular invasion in the literature. Take Home Messages: Due to the rarity of BCC with vascular invasion, there is a poor understanding of the disease process and the metastatic potential, resulting in uncertainty for clinician and patient regarding appropriate management

Unusual Etiology of Chronic Cough and Syncope as Chiari Malformation Type 1

Chronic cough is a common chief complaint in ambulatory clinics. Unlike most cases that are caused by upper airway cough syndrome, gastroesophageal reflux disease, asthma, and non-asthmatic eosinophilic bronchitis, chronic cough can also be the presenting feature of a Chiari malformation. Our case is that of a 39-year-old female who had a chronic cough associated with shortness of breath, and when severe, associated with loss of consciousness. Her cough was refractory to conventional management. Further workup including pulmonary functions tests (PFT), laryngoscopy, high-resolution CT of the chest, an upper GI series, and esophageal pH manometry study were all normal. An MRI of her brain was obtained due to her syncopal episodes and revealed findings concerning a type 1 Chiari malformation. She subsequently underwent a Chiari decompression with patchy duraplasty and tonsilloplasty with cervical vertebrae 1 and 2 (C1-C2) laminectomy with a resolution of her symptoms. Chiari malformations are sometimes inherited but are often sporadic in nature, and, thus, appropriate diagnosis is key. Our patient is unique in that she presented at an older age, suggesting that atypical etiologies of a chronic cough refractory to conventional treatments must be considered