Multiple oral sinus tract and trismus leading to a surprising diagnosis of osteopetrosis: Case report.

AIMS: We report a rare case of late diagnosis of malignant osteopetrosis in a 36-year-old male patient due to multiple intraoral sinus tracts and trismus. CASE REPORT: The patient reported a history of facial scars that could not be attributed to the older external fistulas that were present and various complicated dental extractions since infancy. In addition, the patient had not been previously diagnosed with any other significant diseases other than blindness since infancy. Computed tomography revealed a marble-like sclerotic pattern of all cranial bones, a thickened parietal bone, and a narrowing of the encephalic space and the optic canal. Further laboratory and imaging studies revealed complete sclerosed bone of the chest and pelvis, anemia, reticulocitosis, extramedular hematopoiesis, altered dehydrogenasis lactate, and acid phosphatasis. An interdisciplinary treatment was initiated with medical and dental care monitoring. The patient is still receiving attention after 4 years of follow-up. CONCLUSIONS: The outcome of this case represents the daily challenges faced by interdisciplinary care providers and reveals pearls and pitfalls that can serve as a reference for professional practice in such cases.

Monitoring occurrence of SARS-CoV-2 in school populations: A wastewater-based approach.

Clinical testing of children in schools is challenging, with economic implications limiting its frequent use as a monitoring tool of the risks assumed by children and staff during the COVID-19 pandemic. Here, a wastewater-based epidemiology approach has been used to monitor 16 schools (10 primary, 5 secondary and 1 post-16 and further education) in England. A total of 296 samples over 9 weeks have been analysed for N1 and E genes using qPCR methods. Of the samples returned, 47.3% were positive for one or both genes with a detection frequency in line with the respective local community. WBE offers a low cost, non-invasive approach for supplementing clinical testing and can provide longitudinal insights that are impractical with traditional clinical testing.

Doença de Castleman: relato de caso / Castleman's disease: case report

A doença de Castleman é um distúrbio linfoproliferativo raro. Há três tipos histológicos: hialino-vascular (mais comum), variante de células plasmáticas e forma mista. A forma hialino-vascular é caracterizada tipicamente por apresentar uma evolução clínica benigna e localizada, sem sintomas constitucionais. É geralmente tratada com cirurgia e/ou radioterapia. A doença multicêntrica apresenta sintomas sistêmicos. Ainda não há um consenso sobre qual a melhor abordagem terapêutica. Reportamos o caso da doença em um homem de 47 anos com diagnóstico de doença de Castleman variante hialino-vascular e anemia hemolítica autoimune associada, com presença de CD-20, CD-10, CD3 e Ki67 positivos. Foi tratado com protocolo quimioterápico esquema CHOP e corticoterapia com prednisona, evoluindo com melhora do quadro.

Castleman's disease is a rare lymphoproliferative disorder. There are three histological types: hyaline-vascular (most common), plasma cell variant, and mixed form. The hyaline-vascular form is typically characterized by a benign and localized clinical course without constitutional symptoms. It is usually treated with surgery and/or radiotherapy. The multicentric disease has systemic symptoms. There is still no consensus on the best therapy approach. We report a case of the disease in a 47-year-old man diagnosed with hyaline-vascular variant of Castleman's disease, and associated Autoimmune Hemolytic Anemia, with the presence of CD20-positive, CD10-positive, CD3-positive and Ki67-positive cells. He was treated with chemotherapy protocol of CHOP regimen and corticotherapy with Prednisone, and evolved with improvement.