Summary With a large number of coronavirus disease 2019 (Covid‐19) patients being discharged from hospital with negative test results for SARS‐CoV‐2, it has been reported that several recovered cases tested positive after discharge (re‐positive, RP). This finding has raised several important questions for this novel coronavirus and Covid‐19 disease. In this review, we have discussed several important questions, including: (1) Can the virus re‐infect recovered individuals? (2) What are the possible causes of the re‐positive reverse transcriptase‐polymerase chain reaction (RT‐PCR) test in recovered patients? (3) What are the implications of these re‐positive cases concerning the spread of the virus? Understanding how recovery from Covid‐19 confers immunity to decrease the risk of re‐infection is needed to inform current efforts to safely scale back population‐based interventions, such as physical distancing. We have also described what is currently known about the immune response to Covid‐19, highlighted key gaps in knowledge, and identified opportunities for future research. Overall, the quality of the evidence is poor and we describe the features that should be described for future cases.

The evolving epidemic of type 2 diabetes mellitus has challenged health-care professionals. It stands among the leading causes of mortality in the present world. It warrants new and versatile approaches to improve mortality and the associated huge quality-adjusted life years lost to it once diagnosed. A possible venue to lower the incidence is to assess the safety and efficacy of various diabetes prevention strategies. Diet and exercise have a well-developed role in the prevention of weight gain and, ultimately, diabetes mellitus type II in high-risk individuals. However, high-risk individuals can also benefit from adjunct pharmacotherapy. In light of this information, we decided to conduct a systematic review of randomized controlled trials. This article summarizes the evidence in the literature on the pharmacological prevention of diabetes in high-risk individuals.

Sjogren's syndrome (SS) is a chronic inflammatory disorder of the exocrine glands. It is characterized by a lymphocytic infiltrate in the lacrimal and salivary glands causing keratoconjunctivitis sicca and xerostomia. Extra-glandular involvement may be present in about one-third of patients with primary Sjogren’s syndrome (pSS). The most commonly affected organs are the thyroid, lungs, gastrointestinal tract, kidneys, skin, and nervous system. Cardiac manifestations of Sjogren's syndrome are rare and not well-described in the current literature. Most of the evidence is present in the form of case reports and small case series. However, recent studies have shown that patients with Sjogren's syndrome (SS) seem to have a greater overall risk of cardiovascular (CV) events. Although not conventionally considered a feature of the disease, cardiac manifestations can lead to increased morbidity and mortality in this patient population. In this review article, we study the association between cardiac diseases and primary Sjogren's syndrome.

Anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) is a class of small vessel vasculitis that includes granulomatosis with polyangiitis (GPA), eosinophilic GPA (EGPA), and microscopic polyangiitis (MPA). Despite extensive research, the mechanisms behind AAV etiology remain obscure. The genetics of AAV is a complex area of investigation because of the rarity of familial cases. However, recent multi-center genome-wide association studies (GWAS) have greatly contributed to our understanding of the genetic basis of AAV. In this study, we report a rare occurrence of GPA in two Caucasian family members who presented with similar clinical symptoms and performed a comprehensive review to study the present literature available regarding the heritability of this disease.

In scientific literature, silicone embolization syndrome has been well described and multiple presentations have been delineated. The use of non-medical injections of silicone has become very popular with the public in general, in particular with certain groups that are highly focused on their physical image. Local effects including tissue necrosis, foreign body giant cell reaction, and community-acquired infection have been commonly recorded. Distal effects suggesting an embolic phenomenon can present as regional lymphadenopathy, granulomatous hepatitis, interstitial nephritis, and other acute systemic illnesses. But pulmonary and neurologic sequelae especially warrant emergency attention and can be fatal, if not identified immediately. Pulmonary manifestation can sometimes easily mimic bilateral pneumonia, especially if there is no suspicion for illicit silicone use, which was the case with our patients. The injected subcutaneous silicone migrated rapidly from the interstitial subcutaneous tissue into the general bloodstream resulting in systemic silicone embolization. An analysis of the presented case in conjunction with a review of the pertinent medical literature, including relevant case reports revealed the common clinicopathological manifestations of silicon embolism.