Pernicious anemia presenting with dysphagia and melanoderma: a confusing manifestation.

Vitamin B12 deficiency is widely recognized as a common cause of anemia. However, symptoms such as dysphagia, melanoderma, and pancytopenia, although less frequent, can also be associated with this deficiency. We report the case of a 47-year-old Caucasian man presented with dysphagia to solids associated to high heart rate, dyspnea and melanoderma. He was diagnosed with severe anemia (hemoglobin 4 g/dl) in association with pancytopenia. Further investigation confirmed that the underlying cause was severe vitamin B12 deficiency secondary to pernicious anemia. Subsequent treatment with vitamin B12 supplements led to a significant improvement in all symptoms. A review of the existing literature corroborated the rarity of severe anemia occurring in conjunction with dysphagia and melanoderma due to B12 deficiency.

Anemia is a condition where your body does not have enough healthy red blood cells. We report the case of a 47-year-old man who presented with difficulty swallowing solid food (dysphagia), a fast heart rate, difficulty breathing (dyspnea), and changes in skin color (melanoderma). After some tests, we diagnosed the patient with severe anemia and low counts of different types of blood cells (pancytopenia). The underlying cause was a severe lack of Vitamin B12, and the specific type of anemia was called pernicious anemia. Subsequent treatment with Vitamin B12 supplements led to significant improvement. Physicians should be aware of uncommon presentations of pernicious anemia to diagnose it early, avoid unnecessary investigations and to initiate rapidly simple and efficient treatment.

Metallo-dithiaporphyrin pigments for bulk-heterojunction solar cell applications: ab initio investigation of structural and optoelectronic properties.

Metallo-dithiaporphyrin small molecules have been designed by substituting Ru(ii) with various transition metals at the same oxidation state (M = Mn, Fe, Ni, Cu) as donor materials for Bulk Heterojunction Organic Solar Cells (BHJ-OSCs). Density functional theory (DFT) and time-dependent DFT (TD-DFT) have been used to study the optoelectronic properties of metallo-dithiaporphyrin at various functionals and basis sets. We discovered that the open-circuit voltage (VOC) value increases when Ru(ii) in Ru(S2TTP)Cl2 (S2TTP = tetra-p-tolyldithiaporphyrin) is substituted. In addition, the light harvesting efficiency (LHE) of nickel, manganese, and iron complexes was found to be similar to that of ruthenium, and the iron complex furthermore presented a comparable charge transfer in the excited state corresponding to the Q-band, compared to Ru(S2TTP)Cl2. Hence M(S2TTP)Cl2 (M = Mn, Fe, Ni) appear to be potential low cost candidate donor molecules within a bulk heterojunction solar cell. We further propose suitable engineered acceptor pigments, fitted to provide a good overall solar cell efficiency.

Regio- and stereoselectivity of the [3+2] cycloaddition of nitrones with methyl-acetophenone: A DFT investigation.

A theoretical study of the regio- and stereoselectivities of the [3 + 2] cycloaddition reactions of nitrones with substituted alkene (methyl acetophenone) is investigated using density functional theory (DFT) and carried out at B3LYP/6-311+G(d,p) level. The reactivity of these cycloadditions is rationalized by FMO model, activation energy calculations, and philicity indexes. The electronic populations have been calculated from natural orbital, which based on charges by using NBO analysis, MK and CHelpG electrostatic population. The four possible pathways, fused and bridged regioisomeric modes, and the two stereoisomeric approaches endo and exo for the cycloaddition reactions are analyzed and discussed. Analysis of TS geometries and bond lengths demonstrate that these reactions follow a one-step mechanism with asynchronous transition states. The activation energy indicated a favored endo approach along the four reaction pathways.

A gastric collision tumor composed of adenocarcinoma and gastrinoma: case report.

BACKGROUND: Collision tumors of the stomach are exceedingly rare, with only six previous reported instance in which adenocarcinoma of the stomach were found in association with carcinoid tumor. Only in one case the adenocarcinoma was associated with a gastrinoma. AIM: we report the second case of Collision tumor between adenocarcinoma and gastrinoma. OBSERVATION: A 55 years old man was admitted in our department for an exploration of gastric pain with rapid weight loss. Physical examination showed an epigastric mass. Upper endoscopy showed in the fundic region of the stomach an exophytic process wildly ulcerative in his center associated with the presence of a multiple polypoid tumors. The pathologic examination of the biopsy specimen of the process revealed an adenocarcinoma and of the polypoid tumors showed a carcinoid type tumor. There was no merged appearance between both tumors suggesting collision tumor. The biopsies of the non tumoral gastric mucosa were normal. The Zollinger Ellison syndrome was then suspected. The serum gastrin level showed a rate raised at 8676pg/ml. The diagnosis of collision type tumors between adenocarcinoma and gastrinoma was retained. The assessment of extension revealed the presence of hepatic and ganglion nodes. The patient was treated by chemotherapy but he died three months after initiation of chemotherapy because of tumoral progression. CONCLUSION: Through this observation and with a review of literature, the coexistence of adenocarcinoma and carcinoid tumor of the stomach is discussed.

[Eosinophilic gastroenteritis with ascites: a case report]. / La gastroenterite avec ascite a eosinophile: a propos d'un cas.

BACKGROUND: Eosinophilic gastroenteritis is a rare pathology, of undetermined etiology which incidence is in increase. It is characterized by eosinophilic infiltration of the wall of the gastrointestinal tract. Clinical manifestations are very variable and the severity of the clinical picture depends on the site involved and the wall layers infiltrated. AIM: We point out the clinical, evolutionary and therapeutic characteristics of this rare affection. CASE REPORT: We report the case of a 65 years old man, with the history of allergic asthma. He was admitted for diarrhea associated with vomiting and slimming quantified to 3 kg in 3 weeks. Physical examination noted an edematous-ascitic syndrome. Biology showed the presence of high peripheral eosinophilia. Paracentesis disclosed exudative effusion with high level of eosinophil. The morphological assessment highlighted a segmental parietal thickening of the small intestine and a dense eosinophilic infiltration of the mucosal duodenal layer. The patient was treated by corticotherapy with a favorable evolution. CONCLUSION: Despite its rarity, the diagnosis of gastroenteritis with ascites should be evoked even when the etiologic assessment is negative.