Renal transplantation using kidneys from a donor with high grade cytomegalovirus viraemia: case report and literature review.

Transplanting organs from cytomegalovirus-seropositive donors into cytomegalovirus-seronegative recipients is an accepted practice. However, outcomes following transplantation of organs from donors with active cytomegalovirus disease are unknown. We present a case involving a patient aged 61 years with end-stage renal disease, seropositive for cytomegalovirus, who underwent dual kidney transplant from a donor with high-grade cytomegalovirus viraemia. The donor was on immunosuppressive therapy for systemic lupus erythematosus and interstitial lung disease and had been admitted with respiratory failure. The donor had high-grade cytomegalovirus viraemia with probable cytomegalovirus pneumonitis (cytomegalovirus viral load >100 000 international units [IU]/mL in plasma and 319 000 IU/mL in bronchoalveolar lavage). Renal biopsy at organ procurement showed the absence of cytomegalovirus inclusions. Following transplantation, the recipient had delayed graft function, with renal recovery after 1 week. The patient received basiliximab induction and standard tacrolimus-based maintenance immunosuppression. He received ganciclovir and valganciclovir treatment for 1 month, followed by valganciclovir prophylaxis (or viral load monitoring, when prophylaxis had to be paused) for 2 additional months to prevent donor-derived cytomegalovirus infection. Transient cytomegalovirus viraemia (peaking at 4480 IU/mL) developed at 4 months and resolved with 1 month of valganciclovir treatment. The patient is doing well 1 year after transplantation, with adequate kidney function. This case highlights the successful and safe transplantation of kidneys from a donor with cytomegalovirus disease into a cytomegalovirus-seropositive recipient. Further research is needed to confirm our findings and define post-transplantation management.

The Relationship Between Tumor Budding and Patient's Survival in Breast Cancer.

Introduction: Breast cancer is a severe life-threatening condition in which many women are involved yearly. One factor that has recently been noticed and investigated as a diagnostic predictor of this type of cancer is the number of tumor buds and the relation of this factor with a patient's survival rate. Materials and methods: This study includes 150 female patients over 18 years old with a mean age of 53.99 ± 12.56 years old with breast cancer, which was diagnosed at various medical centers, including Rouhani Hospital itself, and referred to Rouhani Hospital Medical Center, Babol, Iran. The number of intratumoral and peritumoral buds in patients' microscopic slides were archived and evaluated along with tumor microenvironment on hematoxylin and eosin (H&E) slides and compared to other clinicopathological findings. This article precisely investigated the relationship between the number of intratumoral and peritumoral buds with patients' 5-year survival rate. Also, the relationship between age, tumor stage, grade, size, the number of lymph nodes involved, and the presence of metastasis with the number of intratumoral and peritumoral buds was studied. Results and discussion: The result showed a significant statistical association between the number of intratumoral and peritumoral buds with tumor size, tumor stage, presence of metastasis, the number of lymph nodes involved, and 5-year survival rate. On the other hand, there is not a significant statistical association between the number of intratumoral and peritumoral buds with age and tumor grade. Conclusion: Our investigation revealed a significant statistical relationship between the number of tumor buds and patients' survival rate. So, this factor should be considered significant to help those patients increase their survival ratio.

Presentation and treatment of a rare case of metaplastic breast cancer: A case report.

Breast carcinosarcoma, also known as metaplastic breast cancer, is one of the rarest types of breast cancer. It is an aggressive and poor prognostic breast cancer compared to triple-negative breast cancer. Due to the lack of specific and prescribed treatment, it could threaten patients' lives, especially women worldwide. There are various diagnostic methods, such as multiple imaging and pathology methods, to diagnose breast cancers. Still, considering the common appearance characteristic of this type of breast cancer with other types, histopathology is the most definitive way. There is no standard neoadjuvant or adjuvant chemotherapy for this rare type of breast cancer. In this article, we reported the case of a 62-year-old female with a final diagnosis of metaplastic breast carcinoma and her surgical and medical treatment method.

Simultaneous transverse colon and sigmoid volvulus.

Colonic volvulus is one of the most common causes of bowel obstruction. It could occur in different parts of the colon. The sigmoid is the most common part, but it rarely occurs in the transverse colon because of the colon's anatomical features. So, simultaneous sigmoid and transverse colon volvulus is a rare phenomenon that could endanger patients' lives due to its rarity, ischemia, necrosis of the colon wall, and the lack of a definite algorithm to approach this disease. So, it is essential to consider this disease as one of the most important differential diagnoses in patients with abdominal pain and distention. In this article, a 45-year-old male presented to the surgical ward with severe prolonged abdominal pain, diagnosed with simultaneous sigmoid and transverse colon volvulus during laparotomy.

Additively manufactured MAX- and MXene-composite scaffolds for bone regeneration- recent advances and future perspectives.

Human bones can suffer from various injuries, such as fractures, bone cancer, among others, which has initiated research activities towards bone replacement using advanced bio-materials. However, it is still challenging to design bio-scaffolds with bone-inducing agents to regenerate bone defects. In this regard, MAX-phases and MXenes (early transition metal carbides and/or nitrides) have gained notable attention due to their unique hydrophilicity, bio-compatibility, chemical stability, and photothermal properties. They can be used in bone tissue engineering as a suitable replacement or reinforcement for common bio-materials (polymers, bio-glasses, metals, or hydroxyapatite). To fabricate bio-scaffolds, additive manufacturing is prospective due to the possibility of controlling porosity and creating complex shapes with high resolution. Until now, no comprehensive article summarizing the existing state-of-the-art related to bone scaffolds reinforced by MAX-phases and MXenes fabricated by additive manufacturing has been published. Therefore, our article addresses the reasons for using bone scaffolds and the importance of choosing the most suitable material. We critically discuss the recent developments in bone tissue engineering and regenerative medicine using MAX-phases and MXenes with a particular emphasis on manufacturing, mechanical properties, and bio-compatibility. Finally, we discuss the existing challenges and bottlenecks of bio-scaffolds reinforced by MAX-phases and MXenes before deriving their future potential.

A rare case of extremely large mature ovarian cystic teratoma.

Mature ovarian cystic teratoma, also known as the dermoid cyst, is one of the most common benign ovarian neoplasms that can occur in different age groups and could appear in various sizes. Diagnosing this problem as soon as possible is essential due to complications that can coincide, such as torsion, rupture, internal hemorrhage and malignant transformation. In this article, we reported a 66-year-old female patient with a single huge mature ovarian cyst teratoma who presented to the surgical ward with abdominal pain and swelling but did not see any doctor during that period and disregarded her problems for 4 years.

Intermammary breast cancer: A rare case of cancer with origin of breast cells in an unusual location.

The most common type of cancer among the female population is breast cancer. The most common site for the occurrence of breast cancer is the upper outer quadrant; the upper inner quadrant is the second site, and both the lower outer and the lower inner quadrants are in the third place. This problem is rarely seen in the central portion. Intermammary metastasis due to breast cancer is an infrequent finding. This article presents a 62-year-old lady who presented to the surgical ward with intermammary swelling that appeared suddenly 3 months ago. Ultrasound examination showed a hypoechoic micro-lobulated mass with internal vascularity on the chest wall. Although core needle biopsy suspected invasive ductal carcinoma, both right and left axillary lymph nodes were normal and free. The patient was consulted by an oncologist who recommended radiotherapy before surgery and chemotherapy before and after surgery. This study aims to report and discuss a rare case of intermammary cancer with the origin of breast cells without breast and axillary lymph node involvement. Although the intermammary region is an extremely rare location where breast cancer could occur, its management strategy is the same as other breast cancers.

A rare simultaneous occurrence of appendiceal diverticulitis and non-perforated peptic ulcer mimicking abdominal peritonitis symptoms.

Appendiceal diverticulitis is an infrequent disease that can mimic other diseases' symptoms or cause different symptoms because of its various complications. However, one of the most frequent complications of this disease is a perforation that can lead to other serious problems such as peritonitis. This complication can threaten a patient's health condition. In this article, a male patient presented with abdominal pain and was admitted to the surgical ward with suspicion of a perforated peptic ulcer. However, more investigation showed a simultaneous occurrence of peptic ulcer and perforated appendiceal diverticulitis that cause peritonitis symptoms.

Rare case of umbilical urachal sinus mimicking infected umbilical abscess: A case report.

Incomplete obliteration of urachus during the fetal period can lead to urachal abnormalities. One of these abnormalities is the urachal sinus that can be asymptomatic, or it can be symptomatic by becoming infected or being malignant, and it can mimic other diseases' symptoms. Although it is rare in adults, it should be considered a significant differential diagnosis in patients with abdominal pain or umbilical discharge. This article presents a young patient with urachal sinus mimicking umbilical pilonidal sinus symptoms.

A Rare Condition of Simultaneous Occurrence of Sigmoid and Transverse Colon Volvulus.

Volvulus of the colon is the third important reason for colon obstruction, which can occur in different parts of the colon for various reasons and can lead to ischemia and necrosis of the colon wall tissue. In this article, we are going to describe a simultaneous sigmoid and colon volvulus which was operated on with suspicion of sigmoid volvulus. A 72-year-old patient presented with suddenly severe generalized abdominal pain with a past medical history of inflammatory bowel disease (IBD) and prolonged constipation who underwent laparotomy for suspected colonic volvulus. During the operation, it was found that transverse colon volvulus occurred simultaneously with sigmoid colon volvulus with colon necrosis along its length. Therefore, a total colectomy with ileorectal anastomosis was performed. After one week, the patient was discharged from the surgical ward after tolerating feeding and with stable vital signs. The simultaneous transverse colon and sigmoid volvulus is a rare phenomenon, and there are several ways to diagnose and evaluate this situation. However, none of them can help us diagnose this disease. Unfortunately, no specific algorithm has been designed for the approach in this situation, and it all depends on the patient's condition. Simultaneous occurrence of the sigmoid and transverse colon can make a high-risk emergency condition that could threaten the patient's life. Therefore, paying attention to the patient's symptoms and patient's condition and clinical findings, with high accuracy and speed and subsequently selecting the best surgical technique, if surgery is necessary, and according to the finding during surgery, especially the extent of necrotic tissue, the most crucial issue in treating the patient.

A Rare Simultaneous Occurrence of Splenic and Pelvic Cavity Hydatid Cyst.

Hydatid cyst is a significant health-threatening problem that can affect almost all organs, especially the lungs and the liver, but the possibility of its occurrence in organs such as the spleen or pelvic cavity is rare. Thus, simultaneous hydatid cysts in the spleen and pelvic cavity are probably very rare. Nevertheless, since hydatid cysts in different areas can cause various symptoms, it should be considered a significant diagnosis. This article presents a case report of a 21-year-old woman presenting with right lower quadrant abdominal pain mimicking appendicitis but found to have simultaneous hydatid cysts in the spleen and the pelvic cavity.