No abstract

No abstract

Blastomycosis is a chronic granulomatous and suppurative mycoses caused by Blastomyces dermatitidis. The majority of cases show a primary pulmonary disease. We report a 65-year-old male patient with two painless, violaceous nodules over the left chest wall and right inner thigh. Initially, differential diagnoses of disseminated Blastomycosis, Pneumonia, and Diffuse large B-cell lymphoma made based on past and present clinical history and presentation. The final diag-nosis of disseminated with secondary cutaneous Blastomycosis in a followup case of Diffuse large B-cell lymphoma made based on skin biopsy, broncho-alveolar lavage, and bronchial brushing showing budding yeasts of Blastomyces. The patient responded well to therapy with Amphotericin B and Itraconazole along with intravenous methylprednisolone.

Introduction Case studies and retrospective chart reviews of health system data have demonstrated an increased risk of nephrotoxicity in patients receiving immune checkpoint inhibitors compared to clinical trials. This study investigated the frequency, causes, and risk factors for acute kidney injury in a real-world, rural setting. Methods This was a retrospective cohort study of patients who received at least one dose of a checkpoint inhibitor at a rural health system from May 2013 to February 2020 and who received at least one dose of a checkpoint inhibitor. Electronic and manual chart review helped to determine the incidence of, risk factors for, and renal outcomes and management strategies of checkpoint inhibitor-related acute kidney injury. Multivariable Fine and Gray subdistribution hazard models were used to assess the impact of patient characteristics on the incidence of sustained acute kidney injury and checkpoint inhibitor-induced acute kidney injury. Results After exclusion criteria, 906 patients who received at least one dose of a checkpoint inhibitor at Marshfield Clinic Health System during the study period were included. The incidence of acute kidney injury of any duration and due to any cause was 36.1%, while sustained acute kidney injury occurred in 28.7% of patients. Checkpoint inhibitor-related acute kidney injury was thought to have occurred in 2.7% of patients. Baseline estimated glomerular filtration rate < 60 was the sole predictor of checkpoint inhibitors-related acute kidney injury. Most patients with suspected checkpoint inhibitor-related acute kidney injury were managed with corticosteroids, and 62.5% experienced complete renal recovery. Conclusions Ours is the first retrospective cohort study to test whether baseline Eastern Cooperative Oncology Group score and checkpoint inhibitor place in therapy were associated with checkpoint inhibitor-related acute kidney injury, and neither of these data points were found to be predictive. Even after expanding the parameters and methodologies of our study as compared to other retrospective cohort studies, we found only three baseline characteristics to be predictive of sustained acute kidney injury: Baseline eGFR, loop diuretic, and spironolactone use. For checkpoint inhibitor-related baseline, eGFR alone was predictive.

Since December 2019, people around the world have been affected by a pandemic disease caused by a novel type of betacoronavirus. It can lead to severe contagious respiratory illness. The experts are concerned about the effects of this novel virus on both the mother and their fetuses. This review is to identify strategies for the obstetric management of women diagnosed with COVID-19 and the best neonatal care for their newborns. We conducted a comprehensive literature search using PubMed, ELSEVIER and CDC web page and included the articles published from December 2019 through July 2020. Inclusion criteria were original articles published between December 2019 and July 2020 and Meta-Analysis, Reviews and, Systematic Reviews. Regarding vertical transmission, several studies concluded that there is no evidence for intrauterine vertical transmission of COVID-19 from infected mothers to their babies. Pregnant women with COVID-19 might develop more severe respiratory complications. After delivery, women with COVID-19 can transmit the virus to their babies through respiratory droplets during breastfeeding or care, so experts recommend to adopt hygienic measures. The current information shows that COVID-19 infection apparently is not associated with greater severity of the disease in pregnant women than in the general population. However, the data is minimal, and that represents a challenge for the obstetric care providers.