Asploro Journal of Biomedical and Clinical Case Reports [ISSN: 2582-0370]

Anaplastic multiple myeloma (AMM) is a very rare but distinct subtype of multiple myeloma (MM) with an extremely poor prognosis. Due to its rarity, AMM lacks detailed descriptions and clear definitions. Moreover, there is no consensus on the treatment and evidence suggests that AMM responds poorly to several novel therapies. We conducted a literature review and retrospective case series to determine clinical characteristics, pathological features, and outcomes of AMM.

An increased risk of testicular cancer in men with infertility and poor semen quality has been reported. We aim to present a patient who was being studied for infertility and incidentally found a testicular nodule, discuss management and prevalence of small testicular masses.

Cerebral Vein Thrombosis associated with preeclampsia is a rare phenomenon that is not fully understood and presents a potentially challenging situation for treatment and future management. This case presents a 25-year old female with a history of gestational diabetes and hypertriglyceridemia presenting three days post-partum for an eclamptic seizure complicated by cerebral vein thrombosis and HELLP syndrome. The patient’s presenting symptoms were alleviated by eclampsia procedure, anti-anxiety medication, and two different types of anticoagulation. Thrombectomy was not indicated, as imaging did not suggest any large vein clotting. Future check-ins, as well as careful considerations in the event of future pregnancies, should be pursued by the physicians. Testing and gaining a better understanding of the pathophysiology behind cerebral vein thrombosis proves to be difficult as the occurrence is rare, but looking to previous literature to further an understanding of eclampsia and how it progresses in the body may help to provide a greater insight into similar cases and the approach that should be used in said cases.

A febrile seizure is a seizure that occurs in children with a temperature of 38 ºC or more, common in pediatric patients between the ages of 6 to 60 months without intracranial infections, metabolic disorder, or a history of seizures without fever. In 50% of children the first febrile seizure occurs at 2 years and in 90% before 3 years, anemia is also a frequent pathology in pediatric patients, in fact, the figures of the World Health Organization (WHO), point out that iron deficiency anemia attacks children under five years of age, occurring worldwide around 799 million, an average, in the last 10 years, of 42%. And in Latin America, the figure is 23%. Iron deficiency anemia can predispose to the development of febrile seizures because iron plays a crucial role in the transport of oxygen to all tissues, its deficiency also produces a dysfunction of myelination, tyrosine, and tryptophan synthesis hydroxylase, which are necessary for the release of neurotransmitters, therefore, if said neurotransmitters are not released, the brain synapse can be altered and lead to a seizure. Therefore, it is important and relevant to recognize these concepts and the intimate relationship between them, in addition to the risk factors that can trigger them, in order to promote the reduction of the risk of presenting these diseases in vulnerable groups such as pediatric patients.

As an oral hypoglycaemic agent (OHA), imeglimin (Twymeeg) has been recently introduced to clinical practice for patients with type 2 diabetes mellitus (T2DM) as Twymeeg. It has beneficial pharmacological mechanisms, which are improving insulin secretion, increasing insulin sensitivity, and decreasing insulin resistance.

As recommended pharmacological agents for type 2 diabetes mellitus (T2DM), Glucagon-Like Peptide 1 receptor agonist (GLP-1Ra) is highly evaluated for its various beneficial effects. Among them, semaglutide (Rybelsus) has been in focus for useful oral formation with useful oral hypoglycemic agent (OHA). Administration per os is possible due to the developed technique of absorption enhancer sodium N-(8-[2-hydroxybenzoyl] amino) caprylate. Clinical efficacy was shown by a series of Peptide Innovation for Early Diabetes Treatment (PIONEER) with enough weight reduction and decreased HbA1c. From the results of several PIONEER programs, oral semaglutide 14 mg/day had reduced HbA1c values by approximately 1.0-1.4%.

Tetanus is commonly seen in the emergency department with a puncture wound. This is an unusual presentation of tetanus without an open wound.
A 59 year old male with a past history of hypertension, hepatitis C, prior injection drug use, and homeless presented to the emergency department with altered mental status and hyperthermia with fever of 105 F on a hot July afternoon.
Patient was found in his car sleeping. Initially, the patient declined medical care, but was later found unresponsive with a methadone bottle next to him. Given Narcan on field with improvement of mental status.

ACE-inhibitor induced angioedema is a rare, potentially life-threatening phenomenon with unpredictable symptoms. With advanced angioedema, orotracheal intubation may not be possible necessitating nasotracheal intubation or cricothyroidotomy. This case describes a 76-year-old male with a history of hypertension controlled with lisinopril-hydrochlorothiazide who developed sudden-onset angioedema. Additionally, this case was complicated by the patient’s anticoagulation after recent abdominal aortic aneurysm repair. The patient’s acute respiratory distress was managed with nasotracheal intubation because of severe edema of the oral cavity including at the base of the tongue without improvement with epinephrine, a corticosteroid, or an antihistamine. He was extubated the following day, but mild edema of the oral cavity and left side of face persisted at discharge 4 days after presentation. When presenting to the emergency room with angioedema mediated via ACE-inhibitor use, time is of the essence to avoid cardiopulmonary arrest secondary to hypoxemia. Rapid identification and management of this condition is key to improve outcomes. After acute management, patients should be advised to avoid all ACE-inhibitors in the future.

Objective: Obesity is a worldwide endemic disease with limited options for treatment. Studies have indicated that the probiotic Bacillus subtilis can reduce weight gain and serum lipid levels in animal models. However, there are no publications showing positive results on the anti-obesity effect in humans. Here, we investigated the anti-obesity effect of the probiotic B. subtilis DG101 (i.e., reductions in weight, corporal fat content, and BMI) on overweight/obese subjects and the management of their HbA1c and insulin values.
Design: A randomized, double-blinded, placebo-controlled study.
Methods: A total of 294 subjects were divided into two groups according to sex. The subjects were randomly assigned to receive a daily dose of the probiotic B. subtilis DG101 or pure water (placebo) in all cases combined with a low-caloric/low-fat diet for 12 weeks. Weight, fat percentage, and BMI were measured, as well as HbA1c and insulin levels before and after the intervention.
Results: The probiotic B. subtilis DG101 significantly reduced weight, fat percentage, and BMI after 12 weeks of the intervention compared to the placebo (p<0.05). There was a significant reduction of HbA1c and insulin levels between the groups (p<0.05). Conclusions: Ingestion of the probiotic B. subtilis DG101 as an adjuvant in the anti-obesity therapy compared with placebo for 12 weeks significantly reduce obesity related parameters. Our finding of lower HbA1c and insulin levels in pre-diabetic and diabetic patients during ingestion of the probiotic B. subtilis DG101 validated one of our previous reports.