Atypical fibroxanthoma and hemosiderotic dermatofibroma are both dermal tumors that can raise significant challenges for differential diagnosis. The definitive diagnosis is established based on histopathological appearance and immunohistochemistry. The aim of this paper is to present the differential diagnosis challenges encountered in the case of a 67-year-old male patient who developed within a month, following trauma to the lower third of the right thigh, a large asymptomatic tumor with an irregular outline.
Transcatheter valve-in-valve implantation in failing bioprosthesis is an emerging field in cardio-vascular surgery and cardiology. If a valve plasty is not possible, a biological valve is implanted with limited durability. Due to valve degeneration repeated valve exchanges are necessary in some patients. To expand the lifetime of a bioprosthesis in the tricuspid position percutaneous transcatheter valve-in-valve implantation was introduced recently. This is a promising new catheter interventional technology. There are no published outcomes of repeat surgical, but overall early mortality after tricuspid valve replacement (TVR) was 37% in patients undergoing TVR after prior tricuspid valve (TV) repair. The off-label use of transcatheter aortic valve prostheses for tri-cuspid valve– in–valve implantation within dysfunctional surgical tricuspid valve bioprosthesis has been described in small reports but has become of interest nowadays.
Multiple sclerosis (MS) is an autoimmune disease in which the myelin sheath is damaged by the body itself. Because of the symptoms and progressive forms, in most cases, patients experience recurrent depressive disorder or anxious depression disorders. Depression treatment for MS patients stands in two categories, one is psychotherapy and the other is pharmacological. This article presents the research results on customized pharmacological treatment schemes applied to a group of relapsing-remitting multiple sclerosis (RRMS) patients with moderate, or severe, depression. All of them are included in the national treatment program for multiple sclerosis and their health state is continuously monitored. The therapeutic scheme based on four different antidepressants had encouraging results, meaning that any of the antidepressants used is efficient and with the patient's good tolerance. There were no side effects that could determine interruption of the treatment. Further research development would focus on improved therapeutic plans for patients with depression disorders in relapsing-remitting multiple sclerosis.
