Scrotal calcinosis due to resorption of cyst walls: a case report

<p>Abstract</p> <p>Introduction</p> <p>Scrotal calcinosis is a rare benign entity defined as the presence of multiple calcified nodules within the scrotal skin. There are controversies about the origin of this entity. In fact, it is still debatable whether scrotal calcinosis is an idiopathic growth or dystrophic calcification of dartoic muscles. It is also unclear whether scrotal calcinosis originates from inflammation of epidermal cysts affected by mild to moderate inflammation of mononuclear cells, from foreign body granuloma formation followed by resorption of cyst walls or from eccrine epithelial cysts.</p> <p>Case presentation</p> <p>We report a 41-year-old male Turkish patient presenting with a 10-year history of scrotal tumours increasing slowly in size and number. Histopathologically, there was no epithelial lining around the calcified nodules, but there was fibrosis adjacent to atrophic stratified squamous epithelium.</p> <p>Conclusion</p> <p>Results of histopathological examinations suggested that scrotal calcinosis might have been due to resorption of cyst walls. Surgery remains the key for this problem. In cases of non-massive scrotal calcinosis, like the case presented here, excision of the nodules from the affected part of the scrotal wall and repairing the defect with horizontal stitches offer good cosmetic results without relapse.</p

Post-Covid-19 Irritable Bowel Syndrome

Objectives The long-term consequences of COVID-19 infection on the gastrointestinal tract remain unclear. Here, we aimed to evaluate the prevalence of gastrointestinal symptoms and post-COVID-19 disorders of gut-brain interaction after hospitalisation for SARS-CoV-2 infection. Design GI-COVID-19 is a prospective, multicentre, controlled study. Patients with and without COVID-19 diagnosis were evaluated on hospital admission and after 1, 6 and 12 months post hospitalisation. Gastrointestinal symptoms, anxiety and depression were assessed using validated questionnaires. Results The study included 2183 hospitalised patients. The primary analysis included a total of 883 patients (614 patients with COVID-19 and 269 controls) due to the exclusion of patients with pre-existing gastrointestinal symptoms and/or surgery. At enrolment, gastrointestinal symptoms were more frequent among patients with COVID-19 than in the control group (59.3% vs 39.7%, p < 0.001). At the 12-month follow-up, constipation and hard stools were significantly more prevalent in controls than in patients with COVID-19 (16% vs 9.6%, p=0.019 and 17.7% vs 10.9%, p=0.011, respectively). Compared with controls, patients with COVID-19 reported higher rates of irritable bowel syndrome (IBS) according to Rome IV criteria: 0.5% versus 3.2%, p=0.045. Factors significantly associated with IBS diagnosis included history of allergies, chronic intake of proton pump inhibitors and presence of dyspnoea. At the 6-month follow-up, the rate of patients with COVID-19 fulfilling the criteria for depression was higher than among controls. Conclusion Compared with controls, hospitalised patients with COVID-19 had fewer problems of constipation and hard stools at 12 months after acute infection. Patients with COVID-19 had significantly higher rates of IBS than controls

The Large Hadron-Electron Collider at the HL-LHC

The Large Hadron-Electron Collider (LHeC) is designed to move the field of deep inelastic scattering (DIS) to the energy and intensity frontier of particle physics. Exploiting energy-recovery technology, it collides a novel, intense electron beam with a proton or ion beam from the High-Luminosity Large Hadron Collider (HL-LHC). The accelerator and interaction region are designed for concurrent electron-proton and proton-proton operations. This report represents an update to the LHeC's conceptual design report (CDR), published in 2012. It comprises new results on the parton structure of the proton and heavier nuclei, QCD dynamics, and electroweak and top-quark physics. It is shown how the LHeC will open a new chapter of nuclear particle physics by extending the accessible kinematic range of lepton-nucleus scattering by several orders of magnitude. Due to its enhanced luminosity and large energy and the cleanliness of the final hadronic states, the LHeC has a strong Higgs physics programme and its own discovery potential for new physics. Building on the 2012 CDR, this report contains a detailed updated design for the energy-recovery electron linac (ERL), including a new lattice, magnet and superconducting radio-frequency technology, and further components. Challenges of energy recovery are described, and the lower-energy, high-current, three-turn ERL facility, PERLE at Orsay, is presented, which uses the LHeC characteristics serving as a development facility for the design and operation of the LHeC. An updated detector design is presented corresponding to the acceptance, resolution, and calibration goals that arise from the Higgs and parton-density-function physics programmes. This paper also presents novel results for the Future Circular Collider in electron-hadron (FCC-eh) mode, which utilises the same ERL technology to further extend the reach of DIS to even higher centre-of-mass energies.Peer reviewe

A Novel Biomarker for Post-Transplant Recurrent IgA Nephropathy.

Background. The serum levels of galactose-deficient immunoglobulin (Ig)A1 (Gd-IgA1)represent the most promising candidate biomarker for IgA nephropathy (IgAN). The aimof this study was to evaluate the serum levels of Gd-IgA1 as a novel noninvasive biomarkerfor post-transplant IgAN recurrence.Methods. Serum Gd-IgA1 levels of 18 patients with recurrent IgAN were compared withcontrol renal transplant recipients (n ¼ 23) with non-recurrent IgAN and control nontransplantIgAN patients (n ¼ 44) and healthy relatives (n ¼ 11). Serum Gd-IgA1 levelsof patients were measured with the use of KM55 enzyme-linked immunosorbent assay(ELISA). The effects of serum Gd-IgA1 concentrations on IgAN recurrence, posttransplantevents, and graft survival were evaluated.Results. All recurrent IgAN patients presented with renal dysfunction (mean serumcreatinine, 1.62 0.39 mg/dL) and detectable proteinuria at the time of diagnosis. SerumGd-IgA1 levels of recurrent IgAN patients (8735 10854 ng/mL [log10: 3.71 0.45]) weresignificantly higher than those of non-recurrent IgAN patients (4790 6089 ng/mL [log10:3.31 0.64]) (P ¼ .027). Serum Gd-IgA1 levels of non-transplant IgAN patients weresignificantly higher (8791 8700 ng/mL [log10: 3.79 0.36]) than those of nonrecurrentIgAN patients (4790 6089 ng/mL [log10: 3.31 0.64]) and healthy relatives(2615 1611 ng/mL [log10: 3.34 0.27]) (P &lt; .001 and P ¼ .021, respectively).Receiver-operating characteristic curve analysis revealed that the area under the curvefor recurrence of IgAN was 0.69 (0.53e0.85) for serum Gd-IgA1 (P ¼ .038). Biopsyconfirmedallograft rejection rates were similar in the recurrent IgAN group [3 (17%)]compared with the non-recurrent IgAN [6 (26%)] group (P ¼ .47). Graft failure ratewas not also significantly different in the recurrent IgAN group [4 (22.2%)] comparedwith the non-recurrent IgAN group [2 (8.7%)] (P ¼ .224).Conclusions. This novel lectin-independent Gd-IgA1 ELISA that can detect serum Gd-IgA1 in patients with recurrent IgAN can be used as a biomarker for diagnosis and activityassessment of post-transplant recurrent IgAN

Effects of Rituximab on Atherosclerotic Biomarkers in Kidney Transplant Recipients

Introduction. Cardiovascular disease is the leading cause of mortality in kidney transplantrecipients. Rituximab is widely used in kidney transplantation for a variety of situations,and rituximab may inhibit some cytokines and antibodies that may play an active role in theatherosclerotic process. The aim of the study was to evaluate the efficacy of rituximab onatherosclerosis biomarkers in kidney transplant recipients.Methods. All patients, 18 years of age and older, who underwent kidney transplantationand received at least 1 dose of 375 mg/m2 rituximab were considered for participation inthis study. The primary study endpoint was the development of cardiovascular diseasesafter rituximab therapy. The secondary endpoint was the onset of cytomegalovirus (CMV)disease or biopsy-confirmed BK virus nephropathy. In addition, comparison ofatherosclerosis biomarkers was performed between study and control groups.Results. There were no cardiovascular events observed during follow up. Only 8 patientsin the study group suffered from CMV disease during follow up. Serum interleukin 10levels were significantly higher in the rituximab group compared with the control group,although antieoxidized low-density lipoprotein levels were lower in the rituximab groupcompared with the control group, though this did not achieve statistical significance.Discussion. Rituximab treatment may increase the risk of CMV reactivation anddecrease lymphocyte counts and interleukin 10 levels; however, significant decreases in allatherosclerotic-related biomarkers have not been shown in our study

Prevalence of Gastrointestinal Symptoms in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Results of the Prospective Controlled Multinational GI-COVID-19 Study,

Gastrointestinal (GI) symptoms in coronavirus-19 disease (COVID-19) have been reported with great variability and without standardization. In hospitalized patients, we aimed to evaluate the prevalence of GI symptoms, factors associated with their occurrence, and variation at 1 month. METHODS: The GI-COVID-19 is a prospective, multicenter, controlled study. Patients with and without COVID-19 diagnosis were recruited at hospital admission and asked for GI symptoms at admission and after 1 month, using the validated Gastrointestinal Symptom Rating Scale questionnaire. RESULTS: The study included 2036 hospitalized patients. A total of 871 patients (575 COVID+ and 296 COVID−) were included for the primary analysis. GI symptoms occurred more frequently in patients with COVID-19 (59.7%; 343/575 patients) than in the control group (43.2%; 128/296 patients) (P &lt; 0.001). Patients with COVID-19 complained of higher presence or intensity of nausea, diarrhea, loose stools, and urgency as compared with controls. At a 1-month follow-up, a reduction in the presence or intensity of GI symptoms was found in COVID-19 patients with GI symptoms at hospital admission. Nausea remained increased over controls. Factors significantly associated with nausea persistence in COVID-19 were female sex, high body mass index, the presence of dyspnea, and increased C-reactive protein levels. DISCUSSION: The prevalence of GI symptoms in hospitalized patients with COVID-19 is higher than previously reported. Systemic and respiratory symptoms are often associated with GI complaints. Nausea may persist after the resolution of COVID-19 infection