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Determining factors these days discovery and advanced-stage proper diagnosis of breast cancer inside Nigeria.
Our results show the importance and the maintenance of natural species-specific behaviours and habits, and they underline the relevance of data collection about reproductive performance in endangered species kept in captivity to improve breeding management in conservation programmes.In Ethiopia, only limited data are available regarding the prevalence of enteric bacterial pathogens and enteroparasites in human immunodeficiency virus (HIV) -infected individuals with diarrhoea. Hence, this study aims to assess the prevalence of enteric bacteria and enteroparasites, and also the antibiotic susceptibility patterns of bacteria in them. An institution-based cross-sectional study was performed in HIV patients with diarrhoea, who visited the Anti-Retroviral Therapy Clinic of the Arba Minch General Hospital between 1 March and 31 August 2019. Data pertaining to sociodemographic characteristics and other factors were collected using a structured questionnaire. Stool culture is of utmost importance in the case of HIV-infected individuals with diarrhoea. Stool samples were collected and examined for bacterial and parasitic pathogens following standard procedures. The antibiotic susceptibility test was performed as per the Kirby-Bauer disc diffusion technique. Data were analysed using SPSS software. ater sources, hand washing habits after toilet and the presence of domestic animals were significantly associated with the prevalence of enteric pathogens.Coronavirus disease 2019 (COVID-19) may present as acute abdomen, although the pathophysiology remains obscure. We report the case of a 45-year-old-man with severe COVID-19 pneumonia with associated pulmonary embolism who presented with acute abdomen. He underwent emergency laparotomy and resection of an ischaemic area of the jejunum. Postoperatively, he had septic shock, acute respiratory distress syndrome and acute kidney injury necessitating continuous renal replacement therapy. We administered antibiotics and therapeutic anticoagulation along with two sessions of haemoadsorption by CytoSorb filter, in conjunction with continuous renal replacement therapy. The patient survived. Bowel ischaemia due to thromboembolic disease should be promptly treated. Extracorporeal blood purification may be useful in managing sepsis in severe COVID-19.The Danish Government announced the culling of 17 million minks in rearing after the report of mink-specific mutations of severe acute respiratory syndrome coronavirus 2 in humans. The rationale behind this decision is that these mutations might negatively impact the deployment of anti-coronavirus disease 2019 vaccines. Is it a precautionary attitude or a panic-driven overreaction?Atezolizumab is an immune checkpoint inhibitor (ICI) that is often associated with the development of several immune-related adverse events, including fulminant type 1 diabetes mellitus (F1DM). Here, we present the case of a 73-year-old woman who was diagnosed with lung adenocarcinoma after surgical lung lobectomy. Two years later, she developed pulmonary metastasis, and atezolizumab treatment was initiated after seven years. However, she only completed two cycles of atezolizumab treatment because of disease progression. Four months after the interruption of atezolizumab treatment, she presented to the emergency department with fatigue and vomiting. On admission, she had a serum glucose level of 962 mg/dL, metabolic acidosis, and elevated ketone body levels. She was diagnosed with diabetic ketoacidosis induced by atezolizumab treatment. Her symptoms improved by insulin therapy. When ICIs are administered, care should be taken regarding the development of F1DM.Immune checkpoint inhibitors are used in the treatment of different types of tumors including melanoma and non-small cell lung carcinoma. The use of these inhibitors is associated with a broad spectrum of immune-related adverse effects. Here we report a case of a patient admitted to the intensive care unit with multiple organ failure due to catastrophic antiphospholipid syndrome following treatment with pembrolizumab, an immune checkpoint inhibitor, because of metastatic melanoma. The presented patient had multiple organ failure of lung, gastro-intestinal, renal, and the liver. Vascular thrombosis was confirmed by both imaging (pulmonary embolism on computed tomography-thorax) and histopathological examination of the intestines. In combination with the presence of IgA anti-cardiolipin antibodies and initially IgM anti-cardiolipin antibodies, catastrophic antiphospholipid syndrome was suspected. Despite treatment with plasmapheresis and corticosteroids, the patient died due to multiple organ failure. Catastrophic antiphospholipid syndrome is difficult to recognize and has high mortality rates despite supportive treatment. In this case report, discussion is provided regarding the possible immunological mechanism behind catastrophic antiphospholipid syndrome during or after treatment with immune checkpoint inhibitors. It is important to realize that in modern intensive care unit, more patients with immune-related adverse effects of the treatment with immune checkpoint inhibitors will be admitted, because of an increase in the number of patients treated with these checkpoint inhibitors. buy CHR-2845 When these patients are admitted on the intensive care unit, multi-disciplinary consultation is important because of the difficulty of early recognition and optimal treatment of these possible lethal side effects.Aortic mural thrombi of the ascending aorta are rare. If an aortic mural thrombus is dislodged, it can cause various embolic complications, which can sometimes be fatal. Although contrast-enhanced computed tomography (CT) and transesophageal echography are useful for diagnosing aortic mural thrombi, four-dimensional CT (4D-CT) is one of the most useful modalities for both diagnosis and treatment selection in such cases. 4D-CT can be used to evaluate the morphology and mobility of thrombi. Furthermore, it is minimally invasive. To the best of our knowledge, there have not been any reports about 4D-CT being used to depict an asymptomatic ascending aortic thrombus. We report a very unusual case, involving an aortic mural thrombus of the ascending aorta.
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