Three cases of severely disseminated Staphylococcus aureus infection in patients treated with tocilizumab

These cases illustrate a number of important points of relevance to acute and general medical physicians as well as in specialties such as Rheumatology. Firstly, patients who are on anti-IL-6 medications may present in a different and less florid way when infected systemically with Staphylococcus aureus than immunocompetent patients. Secondly, they provide a reminder to […]

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Hypertrophic Pulmonary Osteoarthropathy and Congenital Heart Disease

Secondary Hypertrophic osteoarthropathy in cyanotic congenital heart disease is a well known complication but its awareness is coming down. Though its prevalence may have come down thanks to total correction and better palliation during childhood it has not totally disappeared. Awareness about its presentation and x-ray findings is must for a timely diagnosis and management […]

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Failure of anti-TNF therapy to reactivate previously septic prosthetic joints

There are many problems and alarms arising from anti-TNF therapy employed by biological drugs and infections. On the other hand, the medical behavior on this issue is usually personal and medical decisions are made on a case-by-case.  In this case, the elapsed time from the previous infections is really considerable and it is also reasonable […]

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Bilateral cataracts and insulin oedema in a child with type 1 diabetes mellitus

Well written case report of insulin edema and cataract following intense insulin. The only similar case is by Juliusson[1] but in this latter case cataract was present initially and insulin edema followed insulin therapy. The current case report offers good discussion allowing students to learn about the pathophysiology of cataract and insulin edema. This unique […]

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Germany adopts rare disease strategy

Following a three year consultation the German plan Measures to Improve the Health Situation of Persons with Rare Diseases in Germany has been published. “[it] contains 52 distinct proposals for action. Nationally recognised centres of excellence for diseases or groups of diseases that collaborate nationally and internationally are a cornerstone of the German plan in […]

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Unusual foreign bodies

Interesting case of a bronchial obstruction from a germinating pea has resurfaced. Only in America: Pea plant grows inside man’s lung (Hospital Doctor) … but the case is an old one from 2010. Pea plant grows inside man’s lung (BBC Health) Doctor finds plant growing inside man’s lung (WHDH News) Pea sprout plucked from Cape […]

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Vulvar adenocarcinoma: the visual resemblance with a vulvar abscess

Though vulvar cancer is not very common, the misdiagnosis of malignancy as an abscess by practising gynaecologists is a mistake, which can prove costly to the patient. This article focuses attention on this aspect. Reviewer Ranganath Ratnagiri Yashoda Cancer Institute Vulvar adenocarcinoma: the visual resemblance with a vulvar abscess […]

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A very unique cyclist

Cyclist Tom Staniford from Exeter has a particularly rare form of Type 2 diabetes associated with absent subcutaneous fat and hearing loss. “Although he was born a normal weight, he lost all the fat around his face and limbs during his childhood, and yet his body still thinks he is obese, meaning he has type […]

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