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The thymus plays an integral role in immune system regulation, modulating the development, diversity, and selection of T lymphocytes, a critical feature for the prevention of T cell-mediated autoimmunity. Thymoma is a rare tumor of the thymus. Autoimmune diseases and paraneoplastic syndromes such as myasthenia gravis, pure red blood cell aplasia, and systemic lupus erythematosus, although relatively uncommon, have been described in association with thymomas. Rare cases of post-thymectomy autoimmune related diseases, including systemic lupus erythematosus and pure red cell aplasia, have been reported in the literature. Here, we present the case of a 65-year-old male who developed systemic lupus erythematosus 2 years after thymectomy in the setting of thymoma-associated pure red cell aplasia.

Cellular transplantation using neural stem cells and progenitors is a promising therapeutic strategy that has the potential to replace lost cells, modulate the injury environment, and create a permissive environment for the regeneration of injured host axons. Our research has focused on the use of human glial restricted progenitors (hGRP) and derived astrocytes. In the current study, we examined the morphological and phenotypic properties of hGRP prepared from the fetal central nervous system by clinically-compatible protocols, compared with astrocytes derived from hGRP prepared by treatment with ciliary neurotrophic factor or bone morphogenetic protein 4. These differentiation protocols generated astrocytes that showed morphological differences and could be classified along an immature to mature spectrum, respectively. Despite these differences, the cells retained morphological and phenotypic plasticity upon a challenge with an alternate differentiation protocol. Importantly, when hGRP and derived astrocytes were transplanted acutely into a cervical dorsal column lesion, they survived and promoted regeneration of long ascending host sensory axons into the graft/lesion site, with no differences among the groups. Further, hGRP taken directly from frozen stocks behaved similarly and also supported regeneration of host axons into the lesion. Our results underscore the dynamic and permissive properties of human fetal astrocytes to promote axonal regeneration. They also suggest that a time-consuming process of pre-differentiation may not be necessary for therapeutic efficacy, and that the banking of large quantities of readily available hGRP can be an appropriate source of permissive cells for transplantation.

The use of herbal and dietary supplements has gained an increasing foothold in the United States. While often touted as safer alternatives to more traditional “western” therapeutics, the pharmacology and pharmacokinetics of these substances, their interactions with other medications, their purity, and individual pharmacogenomics, remain unknown. Turmeric is a popular supplement that has been demonstrated to be safe, and even hepatoprotective. Recently, however, there have been several reports of turmeric-induced liver injury. We report a case of drug-induced liver injury due to turmeric that was complicated by acute liver failure and hepatorenal syndrome.

Neurosyphilis is a condition characterized by insidious onset of encephalopathy and delirium. The infrequency with which it is encountered makes neurosyphilis a formidable diagnostic challenge. We present a rare case of a 71-year-old male with ischemic cardiomyopathy, chronic obstructive pulmonary disease (COPD), undifferentiated arthritis and alcohol use disorder who was brought to the emergency department after he was found altered, confused, and paranoid. His hospital stay was eventful for multiple episodes of agitation that were difficult to control despite benzodiazepines and high doses of antipsychotics. After an extensive workup, he was found to have neurosyphilis and his delirium resolved following a brief period of treatment. This case illustrates the importance of early suspicion for neurosyphilis as a cause of delirium, especially in endemic areas and in patients with focal neurologic findings.

Herpes simplex virus (HSV) is well known to cause Central Nervous System (CNS) infections, ranging from more common HSV-2 viral meningitis to the more rare and severe HSV-1 encephalitis. Here we present an atypical case of aseptic meningitis due to HSV-1. Intriguingly, despite the potential severity of HSV-1 infections, the patient had an uncomplicated course with only mild symptoms that resolved with conservative management alone. This case report aims to provide a frame of reference for the non-specific presentation of a patient with uncommon HSV-1 meningitis.

Pioglitazone, a peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist, is used in the treatment of type 2 diabetes mellitus by reducing insulin resistance. While peripheral edema and fluid retention are well-documented adverse effects, isolated pleural effusion in the absence of heart failure is rare. We present the fourth reported case of a woman in her 60s with type 2 diabetes who developed recurrent left-sided pleural effusion after the initiation and dose escalation of pioglitazone. The effusion resolved completely following discontinuation of the drug. This case underscores the importance of early recognition of drug-induced pleural effusion and timely cessation of the offending agent to prevent morbidity.

Dermatofibrosarcoma protuberans (DFSP) is a rare, slow‐growing soft tissue tumor affecting the dermis and subcutaneous tissues, with potential involvement of muscle and fascia. This case report describes a 68‐year‐old Caucasian male with a history of recurrent DFSP on the left cheek, initially excised 36 years ago, with multiple recurrences despite wide local excisions (WLEs), eventually requiring left orbital enucleation, presenting to the clinic with a 10‐year history of a slow‐growing lesion on the left temporal scalp. Examination revealed a 2 cm flesh‐colored, firm nodule, which biopsy confirmed as DFSP. Despite two subsequent WLEs, positive margins persisted. The patient refused further surgical intervention and was referred for imatinib and radiation therapy, which he also declined. MRI revealed additional nodules near the left zygomatic arch and sternocleidomastoid. DFSP is diagnosed via biopsy, often confirmed with CD34 immunohistochemistry. Optimal treatment is Mohs micrographic surgery (MMS), but WLE is also used. The recurrence rate is high, especially in head and neck locations. This case underscores the necessity for multidisciplinary management and highlights the critical role of thorough physical and histopathologic examinations. Close clinical follow‐up is essential due to the high recurrence risk within the first three years post‐treatment. This report emphasizes the importance of early detection and comprehensive care strategies to manage DFSP effectively.

Myroides odoratus is a relatively little-known pathogen despite its ubiquitous presence in the environment. It is an opportunistic gram-negative bacillus commonly found in soil and water. Infection by Myroides species is rare, but the spectrum of illness varies from skin and soft tissue infections, urinary tract infections, pneumonia, and, in severe cases, bacteremia and septic shock. Though infection with Myroides species is uncommon and typically limited to immunocompromised individuals, the wide range of antimicrobial resistance it exhibits makes treatment challenging. In this report, we present the case of a 76-year-old male with compensated cirrhosis who presented with cellulitis complicated by bacteremia secondary to Myroides odoratus and was managed successfully with levofloxacin

Solid pseudopapillary neoplasms (SPNs) are exceedingly rare type of exocrine pancreatic malignancy, representing only 0.9%-2.7% of all exocrine pancreatic malignancies. They predominantly affect young women and unlike other pancreatic malignancies, they have excellent prognoses with 5-year survival following surgical resection approaching 97%. Given the rarity of the disease, little is known about their histopathogenesis as they do not harbor similar genetic mutational abnormalities like other pancreatic tumors. We describe a rare case of SPN in a young female who was found to have the rare diagnosis during the work up for deranged liver function tests.