Fungal endocarditis leading to pulmonary embolism and death

A 38 year-old male was admitted to the emergency room with fever and hemoptysis in the last 3 weeks. His past medical history included previous intravenous drug usage (20 years before), severe acute pancreatitis in the last year, and steroid therapy for the last 10 months due to presumptive diagnosis of bronchiolitis obliterans organizing pneumonia. The episode of pancreatitis required hospital admission, when the patient received total parenteral nutrition and also had an episode of pneumonia treated with antibiotics.

Low-dose aspirin does not affect the renal function of microalbuminuric type 2 Diabetic patients

BACKGROUND: Low-grade inflammation has been implicated in the pathogenesis of diabetic nephropathy, and anti-inflammatory drugs could be potentially useful as a therapeutic tool. The aim of this study was to analyze the effect of low-dose aspirin (300 mg/d) on urinary albumin excretion (UAE) and glomerular filtration rate (GFR) levels of microalbuminuric type 2 DM patients.METHODS: In this randomized, double-blind, crossover, placebo-controlled study, 18 microalbuminuric (UAE=30-300 mg/24 h) type 2 DM patients received aspirin (300 mg/d) or identical placebo for 8 weeks, with a 6-week washout period. The patients were aged 56±9 years, had a diabetes duration of 16±7.5 years; 11 (61%) were female, and they were all using enalapril 10 mg bid. GFR was measured by 51Cr-EDTA single-injection method and UAE by immunoturbidimetry. The sample-size calculation showed that 17 patients were needed to detect a 30% change in UAE (α= 0.05 and β= 0.20).RESULTS: After 8 weeks of treatment, there were no significant differences between placebo and aspirin, respectively, regarding UAE [57.7 (8.9-420.0) vs. 63 (8.2-272.0) mg/24 h; P=0.45] and GFR (108±34 vs. 111±47 ml/min/1.73 m2; P=0.90). C-reactive protein levels [2.72 (0.34-10.3) vs. 2.03 (0.25-10.3) μg/l; P=0.21] were comparable after placebo and aspirin, respectively. There were no period (P=0.41) or carry-over effects (P=0.49).CONCLUSION: Low-dose aspirin did not affect GFR and UAE levels of microalbuminuric type 2 DM. It seems that the putative low-grade inflammation of diabetic nephropathy does not respond to these low doses of the drug

Deep neck infection after third molar extraction: A case report

Deep neck infections are associated with high morbidity rates in dentistry. Early diagnosis and intervention play an essential part in decreasing morbidity rates. The present study aims to report a case of odontogenic deep neck infection after third molar extraction. A 51-year-old male patient underwent extraction of the mandibular right third molar. Seven days later, the patient developed symptoms and signs of progressive infection. Laboratorial and radiologic examinations in association with clinical investigations confirmed deep neck infection. Extraoral drainage was performed under orotracheal intubation. Postoperative laboratory tests and clinical examinations revealed signs of complete remission within a follow-up period of 10 days. Considering the invasive nature of pathogens related to deep neck infections, it is possible to infer that a combination of accurate diagnosis and early intervention plays an essential role in the field of maxillofacial surgery and pathology

Giant thrombus entrapped by a patent foramen ovale in a patient with polycystic kidney disease

Polycystic kidney disease (PKD) is the most common genetic cause of chronic kidney disease (CKD). The most common cause of death in patients with this condition is cardiovascular disease, mainly due to hypertension and its consequences. We report a case of a 42-year-old male patient with polycystic kidney disease who developed a giant thrombus entrapped by a patent foramen ovale after an acute myocardial infarction.Keywords: Acute myocardial infarction; patent foramen ovale; thrombus-in-transi

Fungal endocarditis leading to pulmonary embolism and death

A 38 year-old male was admitted to the emergency room with fever and hemoptysis in the last 3 weeks. His past medical history included previous intravenous drug usage (20 years before), severe acute pancreatitis in the last year, and steroid therapy for the last 10 months due to presumptive diagnosis of bronchiolitis obliterans organizing pneumonia. The episode of pancreatitis required hospital admission, when the patient received total parenteral nutrition and also had an episode of pneumonia treated with antibiotics

Síndrome Coronariana Aguda como apresentação atípica do fenômeno de Roubo Subclávio

Roubo coronariano da subclávia (RCS) é um fenômeno raro que ocorre em pacientes submetidos a cirurgia de revascularização miocárdica com enxerto de artéria torácica interna esquerda (ATIE) e que causa estenose da artéria subclávia ipsilateral e proximal à origem da ATIE. Relatamos o caso de um paciente masculino de 65 anos que apresentou quadro atípico de síndrome do RCS, manifestando-se como síndrome coronariana aguda no pós-operatório de cirurgia vascular.Palavras-chave: Síndrome coronariana aguda; angioplastia; síndrome do roubo coronário-subclávi

Síndrome Coronariana Aguda como apresentação atípica do fenômeno de Roubo Subclávio

Roubo coronariano da subclávia (RCS) é um fenômeno raro que ocorre em pacientes submetidos a cirurgia de revascularização miocárdica com enxerto de artéria torácica interna esquerda (ATIE) e que causa estenose da artéria subclávia ipsilateral e proximal à origem da ATIE. Relatamos o caso de um paciente masculino de 65 anos que apresentou quadro atípico de síndrome do RCS, manifestando-se como síndrome coronariana aguda no pós-operatório de cirurgia vascular. Palavras-chave: Síndrome coronariana aguda; angioplastia; síndrome do roubo coronário-subclávi

Giant thrombus entrapped by a patent foramen ovale in a patient with polycystic kidney disease

Polycystic kidney disease (PKD) is the most common genetic cause of chronic kidney disease (CKD). The most common cause of death in patients with this condition is cardiovascular disease, mainly due to hypertension and its consequences. We report a case of a 42-year-old male patient with polycystic kidney disease who developed a giant thrombus entrapped by a patent foramen ovale after an acute myocardial infarction. Keywords: Acute myocardial infarction; patent foramen ovale; thrombus-in-transi

Electro-optical interfacial effects on a graphene/?-conjugated organic semiconductor hybrid system.

The influence of graphene and retinoic acid (RA) ? a ?-conjugated organic semiconductor ? interface on their hybrid system is investigated. The physical properties of the interface are assessed via scanning probe microscopy, optical spectroscopy (photoluminescence and Raman) and ab initio calculations. The graphene/RA interaction induces the formation of a well-organized ?-conjugated self-assembled monolayer (SAM) at the interface. Such structural organization leads to the high optical emission efficiency of the RA SAM, even at room temperature. Additionally, photo-assisted electrical force microscopy, photo-assisted scanning Kelvin probe microscopy and Raman spectroscopy indicate a RA-induced graphene doping and photo-charge generation. Finally, the optical excitation of the RA monolayer generates surface potential changes on the hybrid system. In summary, interface-induced organized structures atop 2D materials may have an important impact on both design and operation of ?-conjugated nanomaterialbased hybrid systems

GVHD-derived plasma as a priming strategy of mesenchymal stem cells

Background: Mesenchymal stem cell (MSC) therapy is an important alternative for GVHD treatment, but a third of patients fail to respond to such therapy. Therefore, strategies to enhance the immunosuppressive potential of MSCs constitute an active area of investigation. Here, we proposed an innovative priming strategy based on the plasma obtained from GVHD patients and tested whether this approach could enhance the immunosuppressive capacity of MSCs. Methods: We obtained the plasma from healthy as well as acute (aGVHD) and chronic (cGVHD) GVHD donors. Plasma samples were characterized according to the TNF-α, IFN-γ, IL-10, IL-1β, IL-12p40, and IL-15 cytokine levels. The MSCs primed with such plasmas were investigated according to surface markers, morphology, proliferation, mRNA expression, and the capacity to control T cell proliferation and Treg generation. Results: Interestingly, 57% of aGVHD and 33% of cGVHD plasmas significantly enhanced the immunosuppressive potential of MSCs. The most suppressive MSCs presented altered morphology, and those primed with cGHVD displayed a pronounced overexpression of ICAM-1 on their surface. Furthermore, we observed that the ratio of IFN-γ to IL-10 cytokine levels in the plasma used for MSC priming was significantly correlated with higher suppressive potential and Treg generation induction by primed MSCs, regardless of the clinical status of the donor. Conclusions: This work constitutes an important proof of concept which demonstrates that it is possible to prime MSCs with biological material and also that the cytokine levels in the plasma may affect the MSC immunosuppressive potential, serving as the basis for the development of new therapeutic approaches for the treatment of immune diseases