João Lança Pereira

Aims: To describe an unusual and severe presentation of non-typhoidal salmonellosis involving multiple atypical anatomical sites in an elderly immunocompromised patient, and to highlight the diagnostic and therapeutic challenges associated with this condition. Study Design: Single case report. Place and Duration of Study: The case was managed at a tertiary care hospital. The patient was followed from initial presentation at the emergency department through surgical intervention and outpatient orthopedic follow-up, over a period of approximately four months. Methodology: Clinical data were obtained from the patient's medical records, including laboratory results, microbiological cultures, imaging studies, surgical reports, and outpatient follow-up records. Results: A woman in her 80s, immunocompromised due to prolonged corticosteroid therapy for organizing pneumonia, presented with right inguinal pain and functional limitation of gait, without fever or gastrointestinal symptoms. Blood and urine cultures were positive for non-typhoidal Salmonella group D. Despite targeted antibiotic therapy, inflammatory markers worsened. Advanced imaging revealed right iliopsoas abscesses, septic arthritis, and osteomyelitis of the right proximal femur. Management included an eight-week course of ampicillin combined with proximal femoral osteotomy, surgical joint debridement, and placement of antibiotic-loaded spacers, followed by total right hip arthroplasty. The patient showed favourable clinical and laboratory evolution. Conclusion: This case highlights the potential for non-typhoidal Salmonella to cause severe disseminated infection involving atypical anatomical sites, particularly in immunocompromised patients and even without classic gastrointestinal symptoms. Early microbiological diagnosis, advanced imaging, and a multidisciplinary approach are essential when response to initial antibiotic therapy is inadequate.

Background: Sister Mary Joseph’s nodule (SMJN) is a rare manifestation of intra-abdominal malignancy presenting as a metastatic umbilical lesion. Case report: An 82-year-old woman with no prior medical history presented with a violaceous, ulcerated umbilical lesion. Imaging revealed peritoneal carcinomatosis, pelvic lymphadenopathy, and suspicious endometrial mass. Biopsies of both the cutaneous and endometrial lesions identified a serous endometrial adenocarcinoma with umbilical metastasis, confirmed by immunohistochemical markers (CK7+, PAX8+, CK20-, CDX2-). Given the extent of lymphatic and peritoneal spread, the patient was referred to palliative care. Conclusion: SMJN accounts for approximately 10% of cutaneous metastases and often signifies advanced disease with a poor prognosis. Although rare, it may be the first visible sign of a hidden malignancy. This case highlights the importance of considering SMJN in differential diagnoses of umbilical lesions and underscores the need for prompt investigation to determine the underlying pathology. Early recognition can aid in appropriate management, although treatment is typically palliative due to the advanced stage at diagnosis.

Melamine-formaldehyde is the most common resin used in the production of high-pressure laminates and low-pressure laminates (melamine impregnated paper), due to its properties of durability, good fire, and heat resistance and good moisture resistance. High-pressure laminate is a common choice for horizontal and vertical applications in the construction and furniture industries, thanks to its durability and versatility. The manufacture of such laminates commonly starts with the impregnation of decorative and kraft papers with thermosetting resins and after a drying process, the impregnated paper sheets are bonded together by high pressure and temperature pressing. The aim of this work was to evaluate the influence of the melamine-formaldehyde resins condensation degree after synthesis on high-pressure laminates performance. For that purpose, melamine-formaldehyde resins with different condensation degree were synthetized and characterized. Fourier-transform infrared–attenuated total reflection spectroscopy and dynamic mechanical analysis were used to study the chemical and mechanical cure of melamine-formaldehyde resins. Melamine-formaldehyde condensation degree has shown to have influence on resin pot-life, on characteristic reaction temperatures, on the degree of cross-linking achieved, and finally on the surface quality of high-pressure laminates.