Perforated small intestine in a patient with T-cell lymphoma; a rare cause of peritonitis

The nontraumatic perforations of the small intestine are pathological entities with particular aspects in respect to diagnosis and treatment. These peculiarities derive from the nonspecific clinical expression of the peritonitis syndrome, and from the multitude of causes that might be the primary sources of the perforation: foreign bodies, inflammatory diseases, tumors, infectious diseases, etc. Accordingly, in most cases intestinal perforation is discovered only by laparotomy and the definitive diagnosis is available only after histopathologic examination. Small bowel malignancies are rare; among them, lymphomas rank third in frequency, being mostly B-cell non Hodgkin lymphomas. Only 10% of non-Hodgkin lymphomas are with T-cell. We report the case of a 57 years’ old woman with intestinal T-cell lymphoma, whose first clinical symptomatology was related to a complication represented by perforation of the small intestine. Laparotomy performed in emergency identified an ulcerative lesion with perforation in the jejunum, which required segmental enterectomy with anastomosis. The nonspecific clinical manifestations of intestinal lymphomas make from diagnosis a difficult procedure. Due to the fact that surgery does not have a definite place in the treatment of the small intestinal lymphomas (for cases complicated with perforation), and beyond the morbidity associated with the surgery performed in emergency conditions, prognosis of these patients is finally given by the possibility to control the systemic disease through adjuvant therapy

Appendicular mass – a rare form of tuberculosis

Tuberculosis is in the top 10 causes of death worldwide, being one of the most deadly infectious diseases. It is estimated that one of three people from the entire earth population has a latent infection with M tuberculosis. This aerobic bacterium possesses the ability to persist in host tissues for years and to begin replication once immunity declines. The lungs are most frequent site of infection as the Mycobacterium tuberculosis is carried by aerosol droplets and is commonly transmitted by respiratory route. The second way of transmission is by contaminated food. Intestinal contamination coexists with pulmonary tuberculosis and only 10% represent primitive enteric diseases. The ileocecal region is involved most frequently. Even in this context isolated appendicular involvement remains rare. We report the case of appendicular tuberculosis in a 17-year-old woman with no evidence of other location of disease elsewhere in the body

Androgenic alopecia; the risk–benefit ratio of Finasteride

Finasteride is currently approved and largely used as a therapeutic option for androgenetic alopecia. Apparently a safe drug and effective at the onset of its application, several concerns have since appeared over the years regarding the frequency and magnitude of finasteride adverse effects, which in some cases appear irreversible even after drug termination. This paper discusses the use of finasteride for androgenic alopecia from two distinct perspectives. On the one hand, androgenic alopecia is a condition that especially affects a person’s self-image and esteem, aspects that are subjectively-constructed and thus relative and changeable. On the other hand, this condition involves a multifactorial etiology, with androgens being only partly responsible. Because androgens have important and unique physiological roles within the body, any procedure that results in androgenic suppression should be advised with caution. Furthermore, adverse effects induced by finasteride are neither fully documented nor easily treated. Finally, as alternative therapeutic approaches (such as topical finasteride) become available, the oral administration of finasteride for androgenic alopecia should, in our opinion, be reevaluated. Due to such concerns, a detailed and informed discussion should take place with patients considering therapy with finasteride for androgenic alopecia

HPTLC assay of nicotine and cotinine in biological samples

This study presents the development of a simple high-performance thin layer chromatography (HPTLC) method for the determination of nicotine and its metabolite cotinine in human plasma and urine. The following mobile phases: methanol: ammonia (100:1.5, v:v), chloroform: acetone: ammonia (48.75: 48.75: 2.5, v:v:v), methanol: chloroform: ammonia (48.75: 48.75: 0.5, v:v:v) and glass plates precoated with silicagel 60 F254 (20x20) as a stationary phase were used. Densitometric scanning was performed at 263 nm. Two different extraction procedures have been applied: liquid-liquid extraction using dichloromethane at alkaline pH and solid-phase extraction using C18 cartridges. Preliminary tests in order to establish the system of solvents for development, as well as the range of linearity, were conducted. The best separation of nicotine and cotinine was obtained by using methanol: chloroform: ammonia (48.75: 48.75: 0.5, v:v:v) as the mobile phase. The liquid-liquid extraction technique led to better results than solid phase extraction. The regression curves were linear (with a corresponding correlation coefficient higher than 0.99) in the quantities range of 200 ng–1000 ng/spot for both nicotine and cotinine. The UV spectra confirm the identification of nicotine and cotinine both in the standards and in the extracts after liquid-liquid extraction. The proposed method can be applied for the simultaneous evaluation of nicotine and cotinine in biological samples at toxic/lethal levels. Thus, the method may be applicable in lethal nicotine intoxication cases in forensic toxicological analysis

On the ill/well-posedness and nonlinear instability of the magneto-geostrophic equations

We consider an active scalar equation that is motivated by a model for magneto-geostrophic dynamics and the geodynamo. We prove that the non-diffusive equation is ill-posed in the sense of Hadamard in Sobolev spaces. In contrast, the critically diffusive equation is well-posed. In this case we give an example of a steady state that is nonlinearly unstable, and hence produces a dynamo effect in the sense of an exponentially growing magnetic field.Comment: We have modified the definition of Lipschitz well-posedness, in order to allow for a possible loss in regularity of the solution ma

Xanthogranulomatous pyelonephritis: presentation and management

Xanthogranulomatous pyelonephritis (XGP) is characterized by the presence of lipid-laden foamy macrophages with both acute and chronic phase inflammatory cells. The aim of the study is to present our experience about patients with Xanthogranulomatous pyelonephritis. 29 patients were evaluated through a complete anamnesis and the preoperative management included routine blood and biochemical tests, urine culture and renal ultrasound, intravenous urography and computed tomography (CT). All patients underwent open nephrectomy followed by the pathological exam. The main symptoms of these patients were fever and flank pain. Preoperative laboratory tests revealed anemia, leukocytosis and increasing levels of blood urea nitrogen (BUN) and creatinine. Kidney failure was noticed in almost half of the cases. This study succeeded to evaluate the demographic, clinical, biological, surgical and histological characteristics. A pathological diagnosis is mandatory mainly for the evaluation of its coexistence with renal carcinoma

The postfinasteride syndrome; an overview

As a 5-α reductase inhibitor, Finasteride has proven effective in ameliorating two conditions documented to be androgen dependent, namely male androgenic alopecia and benign prostatic hyperplasia. Therapeutic results are maintained as long as the drug is administered, with treatment cessation generally leading to the return of symptomatology for each condition. In addition, during the therapeutic phase, several adverse effects have been reported, some of which persist long or indefinitely after treatment cessation, known as “post-finasteride syndrome.” Herein we present and discuss the most common finasteride side effects, along with a psycho-neuroendocrine rationale that could explain the persistence of many adverse effects after treatment cessation. Moreover, we argue that finasteride adverse effects occurring during finasteride administration should be delineated from postfinasteride side effects (encountered after treatment cessation), suggesting the need to be addressed separately within a therapeutic perspective. Until a tailored therapeutic approach of postfinasteride syndrome becomes available, we have noted that hand preference and sexual orientation seem to be useful as possible predicting factors for finasteride side effects and postfinasteride syndrome. Finally, even though finasteride administration is considered relatively safe, literature data urges prudence. Specifically, recent studies report that some subjects receiving finasteride develop severe depressive episodes including suicidal thoughts, in part due to persistent sexual side effects

Therapeutic Considerations Related to Finasteride Administration in Male Androgenic Alopecia and Benign Prostatic Hyperplasia

Finasteride has been used extensively until now as a relative efficient therapeutic option for male androgenic alopecia and benign prostatic hyperplasia. Unfortunately, over time several concerns appeared regarding the frequency and magnitude of adverse effects, which in some cases have been even irreversible. Herein we review the recent literature on this topic, trying to clarify the current safety profile of Finasteride for these two therapeutic indications. We concluded that Finasteride could be retained as a therapeutic approach for male androgenic alopecia, based on two important reasons. First, a synergistic action between a partial inhibitor of 5α-reductase (Finasteride) and another compound (like Minoxidil) are preferable to a complete suppression of 5α-reductase (see Dutasteride), in order to preserve the important physiological roles of dihydrotestosterone. Second, Finasteride side effects can currently be addressed in part prior to the onset of the therapy, by using information about the patient such as hand preference and sexual orientation to predict the risk of adverse effects

Global well-posedness for a slightly supercritical surface quasi-geostrophic equation

We use a nonlocal maximum principle to prove the global existence of smooth solutions for a slightly supercritical surface quasi-geostrophic equation. By this we mean that the velocity field $u$ is obtained from the active scalar $\theta$ by a Fourier multiplier with symbol $i k^\perp |k|^{-1} m(k|)$, where $m$ is a smooth increasing function that grows slower than $\log \log |k|$ as $|k|\rightarrow \infty$.Comment: 11 pages, second version with slightly stronger resul

HPTLC assay of nicotine and cotinine in biological samples

This study presents the development of a simple high-performance thin layer chromatography (HPTLC) method for the determination of nicotine and its metabolite cotinine in human plasma and urine. The following mobile phases: methanol: ammonia (100:1.5, v:v), chloroform: acetone: ammonia (48.75: 48.75: 2.5, v:v:v), methanol: chloroform: ammonia (48.75: 48.75: 0.5, v:v:v) and glass plates precoated with silicagel 60 F254 (20x20) as a stationary phase were used. Densitometric scanning was performed at 263 nm. Two different extraction procedures have been applied: liquid-liquid extraction using dichloromethane at alkaline pH and solid-phase extraction using C18 cartridges. Preliminary tests in order to establish the system of solvents for development, as well as the range of linearity, were conducted. The best separation of nicotine and cotinine was obtained by using methanol: chloroform: ammonia (48.75: 48.75: 0.5, v:v:v) as the mobile phase. The liquid-liquid extraction technique led to better results than solid phase extraction. The regression curves were linear (with a corresponding correlation coefficient higher than 0.99) in the quantities range of 200 ng–1000 ng/spot for both nicotine and cotinine. The UV spectra confirm the identification of nicotine and cotinine both in the standards and in the extracts after liquid-liquid extraction. The proposed method can be applied for the simultaneous evaluation of nicotine and cotinine in biological samples at toxic/lethal levels. Thus, the method may be applicable in lethal nicotine intoxication cases in forensic toxicological analysis