On rare occasions, skin lesions are the first local of metastatic manifestation of internal malignancies. In case of no previous diagnosis of these tumors, the approach of suspicious skin lesions becomes a challenge, especially in differentiating cutaneous metastases and adnexal primary neoplasms. Currently, besides epidemiologic, dermoscopic and histopathologic aspects, the evaluation also int...

Duodenal lipomas are rare benign tumors and pose a diagnostic challenge as their symptoms are non-specific. In this article, we reported a case of duodenal lipoma presenting as upper gastrointestinal obstruction and reviewed the literature on relevant clinical manifestation, diagnosis and treatment. Our review of literature indicated that multiple duodenal lipomas as a cause of upper gastrointe...

Diagnosis and management of blood culture-negative endocarditis constitute a formidable clinical challenge and a systemic approach is necessary for a successful outcome. Blood cultures are negative in endocarditis due mainly to preceding antibiotic administration or to fastidious slow-growing organisms. Less so, non-infective endocarditis is a paraneoplastic manifestation or may occur in associ...

Variability in systemic lupus erythematosus (SLE) disease manifestations is well recognized. Lupus disease activity can range from mild to severe. Fever is a common manifestation of SLE and occurs in 36%-86% of patients. In the Modified Systemic Lupus Erythematosus Disease Activity Index (M-SLEDAI), fever is taken into account as disease activity scoring. Assessment of lupus patients with fever...

Introduction Mevalonate kinase deficiency (MKD) has a wide spectrum and severity of clinical manifestation. Patients with mutations in MVK gene leading to complete lack of the enzyme, suffer from the most severe form of disease, also known as mevalonic acydosis, whereas defects with preserved, but insufficient enzyme activity present with autoinflammatory syndrome , also known as hiperIgD syndr...

.................................................................................................. 1 Zusammenfassung ..................................................................................... 2 2. West Nile Virus Introduction ............................................................... 4 1.1. Virology ...................................................................................

Infants, one to 56-weeks-old, presenting with persistent diarrhoea were placed on a diet free of cow's milk protein which improved their clinical condition. Six weeks later, 67 infants were challenged with a low-lactose cow's milk formula and jejunal biopsy was taken before and 24-hours after challenge. On the basis ofhistological changes in the intestinal mucosa and development of clinical sym...

The development of acute myocarditis in the postoperative period of cardiac surgery is a challenge for the doctor who treats this type of patient. In most cases, myocarditis can be only a consequence of procedural-related inflammation. However, differential diagnoses must be observed. Among them, rheumatic fever must be considered as an important mechanism. Although its cardiac manifestation is...

Over the past few years, many studies on the association between celiac disease and inflammatory bowel disease have been reported. The genetic origin of this association has prompted research that searches for a common link for the concomitant manifestation of these pathologies. Clinical studies aim not only to demonstrate this relation, but also to establish the epidemiological frequencies amo...

The definition of IND-CCA disallows an adversary from querying the challenge ciphertext to its decryption oracle. We point out that there are several ways to formalize this. We show that, surprisingly, for public-key encryption the resulting notions are not all equivalent. We then consider the same question for key-encapsulation mechanisms (KEMs) and show that in this case the four notions are ...