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Posso-Nuñez JA, Álvarez-Ortega AC, Bautista-Rincón DF, García-González CA, Cujiño-Álvarez IF, Sánchez-Ortiz ÁI, Velásquez-Galvis M. Surgical stabilization of rib fractures under extracorporeal membrane oxygenation: A case report. Trauma Case Rep 2024; 51:101019. [PMID: 38638329 PMCID: PMC11024646 DOI: 10.1016/j.tcr.2024.101019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2024] [Indexed: 04/20/2024] Open
Abstract
A 47-year-old male patient was referred to a level 1 trauma center with refractory acute respiratory distress syndrome, bilateral lung contusions, and flail chest after initial management for injuries sustained 5 days prior from an 8-m fall from a tower crane. Surgical stabilization of the rib fractures was achieved under extracorporeal membrane oxygenation support, with successful decannulation 4 days after surgery. The patient was discharged after 42 days and following multidisciplinary interventions. Use of extracorporeal membrane oxygenation support in blunt chest trauma patients presents a valuable opportunity as it may enable earlier surgical intervention and reduce in-hospital complications.
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Affiliation(s)
| | | | | | | | | | - Álvaro Ignacio Sánchez-Ortiz
- Fundación Valle del Lili, Department of General Surgery, Division of General Thoracic Surgery, Kra 98 No. 18-49, Cali 760032, Colombia
| | - Mauricio Velásquez-Galvis
- Fundación Valle del Lili, Department of General Surgery, Division of General Thoracic Surgery, Kra 98 No. 18-49, Cali 760032, Colombia
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Hariri O, Al Laham O, Ibrahim Basha Z, Ghannam E, Ghannam M, Mohammad A. Multiple Hereditary Exostoses instigating a popliteal pseudoaneurysm in a young Middle Eastern male: A case report and literature review. Int J Surg Case Rep 2024; 118:109633. [PMID: 38626641 PMCID: PMC11035074 DOI: 10.1016/j.ijscr.2024.109633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/09/2024] [Indexed: 04/18/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Multiple Hereditary Exostoses is a rare autosomal dominant bone disorder that predominantly affects males at an incidence of (1:50,000 to 1:100,000) in Western populations. The etiology is owed to mutations in the EXT gene group, specifically EXT1 and EXT2 which cause the formation of Osteochondromas. Diagnosis is typically established in childhood. Nevertheless, vascular complications are extremely rare while being potentially fatal. Therefore, timely diagnosis and treatment are vital for such patients. CASE PRESENTATION We present the case of a 37-year-old Middle Eastern male with Multiple Hereditary Exostoses who experienced sudden-onset left lower limb pain persisting for a month prior to admission. It was associated with coldness and paresthesia of the ipsilateral lower limb. The presurgical radiological workup uncovered a popliteal pseudoaneurysm subsequent to Multiple Hereditary Exostoses. CLINICAL DISCUSSION Through open surgery, the vascular perfusion was successfully restored, and a subsequent supra- to infra-geniculate popliteal artery anastomosis via saphenous vein grafting was done. Furthermore, the Osteochondroma was utterly resected to limit recurrence of another vascular injury. The following histopathological analysis confirmed the diagnosis of an Osteochondroma as a result of MHE. CONCLUSION Multiple Hereditary Exostoses is a rare occurrence leading to pseudoaneurysms. This event underscores the need for further documentation to aid in establishing a prompt diagnosis and carrying out suitable interventions. Considering this pathology in a multidisciplinary approach ensures proper treatment. Following a comprehensive literature review, our case stands as the first case in the published literature from our country which emphasizes its value and rarity.
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Affiliation(s)
- Omar Hariri
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.
| | - Omar Al Laham
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.
| | - Zein Ibrahim Basha
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic; Department of Pathology, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic.
| | - Eman Ghannam
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.
| | - Mohammad Ghannam
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic; Department of Vascular and Endovascular Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic.
| | - Ammar Mohammad
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic; Department of Vascular and Endovascular Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic.
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Cadena-Piñeros E, Correa-Marin J, Romero-Rojas A. Thyroid Leiomyoma: Case Report. Indian J Otolaryngol Head Neck Surg 2024; 76:1998-2002. [PMID: 38566633 PMCID: PMC10982239 DOI: 10.1007/s12070-023-04356-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/12/2023] [Indexed: 04/04/2024] Open
Abstract
37-year-old Colombian male with mass in the anterior region of the neck. Initial ultrasonography and computed tomography (CT) scan showed a large solid mass (67 × 20.7 mm), dependent on the thyroid isthmus. Total thyroidectomy (TT) was performed. The latest pathological and immunohistochemical findings showed a mesenchymal neoplasm compatible with primary thyroid leiomyoma. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-04356-2.
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Affiliation(s)
- Enrique Cadena-Piñeros
- Department of Otorhinolaryngology, Clínica de Marly, Bogotá D.C, Colombia
- Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Bogotá D.C, Colombia
- Department of Otorhinolaryngology, Universidad Nacional de Colombia and Hospital, Universitario Nacional de Colombia, Bogotá D.C, Colombia
| | - Jessica Correa-Marin
- Department of Head and Neck Surgery, Hospital Universitario del Valle, Cali, Colombia
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Grün P, Pfaffeneder-Mantai F, Schneider B, Meier M, Bytyqi D, Bandura P, Turhani D. Can jaw bone healed from chronic sclerosing osteomyelitis be considered healthy when planning dental implants? Case report with 20-year follow-up. Ann Med Surg (Lond) 2024; 86:2266-2276. [PMID: 38576989 PMCID: PMC10990345 DOI: 10.1097/ms9.0000000000001826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/02/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction and importance Extraction of mandibular third molars can lead to complications such as chronic sclerosing osteomyelitis (CSO), an inflammatory bone marrow disease that tends to progress. CSO involves the cortical plates and often the periosteal tissues and is caused by a variety of microorganisms, including Corynebacterium spp. The treatment of chronic osteomyelitis (CO) and CSO remains challenging, as there is no universal treatment protocol. This case report investigated whether jaw bone that has healed from chronic sclerosing osteomyelitis can be considered healthy bone when planning dental implants. Case presentation A 21-year-old Caucasian woman developed CO and CSO after third molar surgery. Clinical discussion A combination of alveolar ridge bone resection, extraction of teeth 47-32, and long-term specific antibiotic therapy against Corynebacterium spp. was administered. An attempt at preprosthetic alveolar ridge reconstruction with an anterior superior iliac crest bone graft resulted in graft failure and the patient refused further harvesting procedures. Implantation in the intraforaminal zone also resulted in the loss of two implants after loading. Finally, inferior alveolar nerve transposition resulted in the successful reimplantation of two implants, which were fully functional almost 11 years later. Conclusion This case report presents the treatment history of this patient. With a longitudinal observation period of greater than 20 years, the results of this case demonstrate the successful treatment of bone with CO, CSO, and Corynebacterium spp. infection. Following the removal of infected bone, radical debridement, and long-term antibiotic therapy, bone health was restored.
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Affiliation(s)
- Pascal Grün
- Center for Oral and Maxillofacial Surgery, Department of Dentistry
| | - Florian Pfaffeneder-Mantai
- Center for Oral and Maxillofacial Surgery, Department of Dentistry
- Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | | | - Marius Meier
- Center for Oral and Maxillofacial Surgery, Department of Dentistry
| | - Ditjon Bytyqi
- Center for Oral and Maxillofacial Surgery, Department of Dentistry
| | - Patrick Bandura
- Center for Oral and Maxillofacial Surgery, Department of Dentistry
| | - Dritan Turhani
- Center for Oral and Maxillofacial Surgery, Department of Dentistry
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Mohamed FS, Lokman FL, Mansoor WNBW, Shakri NBM, Hussain RI, Abdullah A. Recurrent Cholesteatoma: Why it occurs? Int Tinnitus J 2024; 27:242-246. [PMID: 38512871 DOI: 10.5935/0946-5448.20230037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
A cholesteatoma is an expansion of keratinizing squamous epithelium that enters the middle ear cleft from the outer layer of the tympanic membrane or ear canal. Choleatomas are always treated surgically. Recurrence of the illness presents another challenge for the patient and the surgeon, though. There have been reports of recurrence rates as high as 30% in adults and as high as 70% in children. Here, we describe a case of persistent recurrent otorrhea following revision surgery, along with acquired recurrent cholesteatoma following canal wall down surgery. A 38-year -male with underlying Diabetes Mellitus and Hypertension presented with left scanty and foul-smelling ear discharge for 2 years and left reduced hearing. He was diagnosed with left chronic active otitis media with cholesteatoma for which he underwent left modified radical mastoidectomy, meatoplasty and tympanoplasty in 2017. Five months post operatively, he presented with left otorrhea. However, he defaulted followed up and presented in April 2018 for similar complaints. Otoscopy examination revealed left tympanic membrane perforation at poster superior quadrant of pars tensa and bluish discoloration behind pars flacida. He was diagnosed as recurrent left cholesteatoma and subsequently he underwent left mastoid exploration under general anesthesia in June 2018. Postsurgery, he developed recurrent ear discharge which was treated with topical antibiotics and ear toileting. We report a case of recurrent Cholesteatoma despite canal wall down procedure requiring a second redo procedure and with persistent recurrent otorrhea after the redo procedure.However, this case demonstrates the need for regular follow ups even after a canal wall down procedure for detecting recurrence of disease. Moreover, this case denotes some of the patient factors and surgeon factors involved in disease recurrence. Furthermore, importance of opting for an imaging study in case of high suspicion of the disease.
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Affiliation(s)
- Fathmath Shana Mohamed
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan, Malaysia, Kuala Lumpur
| | - Farah Liana Lokman
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan, Malaysia, Kuala Lumpur
| | - Wan Nabila Binti Wan Mansoor
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan, Malaysia, Kuala Lumpur
| | - Nadhirah Binti Mohd Shakri
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan, Malaysia, Kuala Lumpur
| | - Rizuana Iqbal Hussain
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan, Malaysia, Kuala Lumpur
| | - Asma Abdullah
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan, Malaysia, Kuala Lumpur
- Centre of Hearing and Speech (Pusat-HEARS), Universiti Kebangsaan, Malaysia, Kuala Lumpur
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Alfadhel M, Albarakati R. First successful outcomes of pegvaliase (PALYNZIQ) in children. BMC Med Genomics 2024; 17:76. [PMID: 38515136 PMCID: PMC10958957 DOI: 10.1186/s12920-024-01847-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND PKU is an autosomal recessive hereditary inborn error of metabolism caused by a lack of phenylalanine hydroxylase enzyme activity. Pegvaliase (PALYNZIQ®) treatment has been approved to reduce blood Phe concentrations in adult phenylketonuria patients with uncontrolled blood Phe concentrations greater than 600 micromol/L on current management. However, data regarding individuals under the age of 16 is still unavailable. CASE REPORT We report a 12-year-old Saudi girl who underwent pegvaliase therapy and was closely monitored for one year. Remarkably, a positive therapeutic response became apparent six months after commencing pegvaliase treatment. Phenylalanine (Phe) levels showed significant improvement, stabilising within the < 5 to 14 µmol/L range on a regular diet without any restriction. At her current age of 12, the patient maintains an unrestricted dietary regimen, consuming a diverse selection of foods, including poultry, meat, and protein sources, all while consistently maintaining normal Phe levels with no change in mental status after treatment. The parents gave their written, informed consent in allowing the research study to be carried out and clinical data to be published. CONCLUSIONS This report addresses the potential broader applications of Pegvaliase in children, as well as its safety and tolerability in this age group. However, larger sample sizes and robust methodologies are required to validate such findings.
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Affiliation(s)
- Majid Alfadhel
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia.
- Genetics and Precision Medicine Department (GPM), King Abdullah Specialized Children Hospital (KASCH), King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia.
- Medical Genomic Research Department, King Abdullah International Medical Research Center (KAIMRC), Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia.
| | - Rayyan Albarakati
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia
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Naqvi WM, Mishra G, Pashine AA, Arora SP, Gupta S, Goyal C, Varma AR, Quazi Z, Muthukrishnan R, Kumar Kandakurti P, Umate L. A protocol for the development of PhyCaRe: An extension of the CARE guideline for physiotherapy using the Delphi method. F1000Res 2024; 12:838. [PMID: 37655118 PMCID: PMC10465994 DOI: 10.12688/f1000research.138599.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 09/02/2023] Open
Abstract
Background Case reports are one of the important forms of documentation and publication of clinical physiotherapy presenting the first line of evidence in scientific literature. In order to provide a systematic and precise structure for reporting and presenting cases, the CARE guidelines were established in 2013. However, these guidelines present limitations as while reporting require items of specific specialties following the checklist. Authors from different specialities have developed CARE extensions specifying the characteristic features of corresponding fields, however, an extension dealing with physiotherapy assessment and line of management in the CARE guidelines is proposed as PhyCaRe. Method After consulting with the advisors, a draft will be prepared of the specific elements that should be included in the PhyCaRe using web Delphi methodology considering CARE statement as the source and SurveyMonkey will be used to undertake the web Delphi questionnaire. The web Delphi methodology will be assumed for three rounds and will be open to physiotherapists and others with substantial experience in reviewing case reports. Subsequently, an online consensus meeting, pilot testing, and submission of the CARE extension for physiotherapy will be conducted for publication. Dissemination The 2010 "Guidance for Developers of Health Research Reporting" and instructions from the EQUATOR Network will be followed in the preparation of PhyCaRe guidelines. The guidelines will be propagated at different platforms and journals will be requested to adopt the guidelines. Registration The reporting guideline under development is prospectively registered on the EQUATOR Network website on PhyCaRe - Reporting guideline for physiotherapy case reports.
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Affiliation(s)
- Waqar M. Naqvi
- Physiotherapy, Gulf Medical University, Ajman, United Arab Emirates
- Datta Meghe Institute of Higher Education and Research, Wardha, India
| | - Gaurav Mishra
- Datta Meghe Institute of Higher Education and Research, Wardha, India
| | | | - Sakshi P. Arora
- Datta Meghe Institute of Higher Education and Research, Wardha, India
| | - Sonia Gupta
- VSPM College of Physiotherapy, Nagpur, India
| | | | - Ashish R. Varma
- Datta Meghe Institute of Higher Education and Research, Wardha, India
| | - Zahiruddin Quazi
- Datta Meghe Institute of Higher Education and Research, Wardha, India
| | | | | | - Laxmikant Umate
- Datta Meghe Institute of Higher Education and Research, Wardha, India
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Rustemov D, Bilal R, Tukinov R, Nekessov A, Dzhenalaev D, Ermeshev E, Mukhamedov Z, Mustafinov D, Utebaliev R, Sakuov Z, Kaliev B. Case Report: Unique management strategy for rare case of esophageal foreign body. Front Surg 2024; 11:1370876. [PMID: 38505410 PMCID: PMC10948502 DOI: 10.3389/fsurg.2024.1370876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/20/2024] [Indexed: 03/21/2024] Open
Abstract
Background Foreign bodies that enter the esophagus can cause serious complications that may require extensive surgical intervention, including open surgery. The treatment method depends on the location, size, configuration, and number of foreign bodies in the esophagus, but to date, the best method to remove foreign bodies from the esophagus remains uncertain. Foreign bodies which can damage the walls of esophagus varies from bones and bone fragments, to metallic objects and batteries. In this article, we present a rare case of a "fish bone" penetrating through the esophagus walls and directly punctured the aorta, forming a post-traumatic saccular pseudoaneurysm of the descending thoracic aorta, which was successfully treated with endovascular stent placement to the aorta and with endoscopic foreign body removal. Case summary We reported a case of a 16-year-old male with a 6-day history of chest pain after consuming fish. As result of immediate test in regional hospital using oral flexible esophagogastroduodenoscopy abnormalities were not reported. Due to persistence of beforementioned symptoms, a fiberoptic esophagogastroduodenoscopy was performed 3 days later, revealing a 1.5-2.0 cm long altered area with contact bleeding 33.0 cm from the incisors, but no visualization of any foreign body. Computed tomography revealed a fish bone that had completely passed through walls of the esophagus and punctured the aortic wall, forming an aneurysm. Patient was urgently hospitalized by air ambulance to our hospital for high-specialized medical intervention after 6 days. After the endovascular placement of a stent graft, the fish bone was successfully removed by endoscopic intervention. 12 months follow up showed no abnormalities. Conclusion Endoscopic removal of foreign bodies in the esophagus and extracting a foreign body after thoracic endovascular aortic stent may be a feasible option for some cases.
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Affiliation(s)
- Dastan Rustemov
- Clinical Academic Department of Pediatric Surgery, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Ruslan Bilal
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Ruslan Tukinov
- Clinical Academic Department of Radiology and Nuclear Medicine, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Adilzhan Nekessov
- Clinical Academic Department of Pediatric Surgery, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Damir Dzhenalaev
- Clinical Academic Department of Pediatric Surgery, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Erbulat Ermeshev
- Clinical Academic Department of Radiology and Nuclear Medicine, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Zarip Mukhamedov
- Clinical Academic Department of Pediatric Surgery, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Dulat Mustafinov
- Clinical Academic Department of Pediatric Surgery, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Ruslan Utebaliev
- Resuscitation and Intensive Care Unit, Clinical Academic Department Pediatric Anesthesiology, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Zhenis Sakuov
- Resuscitation and Intensive Care Unit, Clinical Academic Department Pediatric Anesthesiology, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Baurzhan Kaliev
- Clinical Academic Department of Radiology and Nuclear Medicine, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
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Wen J, Li Z, Chi Y, Chen B, Hong T, Liu Z, Yu N, Wang X. Vulvar migration of injected polyacrylamide hydrogel following breast augmentation: a case report and literature review. BMC Womens Health 2024; 24:152. [PMID: 38431590 PMCID: PMC10909281 DOI: 10.1186/s12905-024-02998-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 02/26/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Vulvar migration is a rare complication of filler injection for breast augmentation, generally presenting as repeated pain and fever. We will report a case of woman with polyacrylamide hydrogel breast injection develops vulvar abscess. CASE PRESENTATION A woman with a history of polyacrylamide hydrogel breast injection was noted to have vulvar abscess due to migration of filler materials. Filler removal surgery and vacuum sealing drainage was performed for this patient. The patient was discharged from the hospital with no further complications. After a review of pertinent literature, only four previous case reports are found. Local inflammatory response, infection, large volume injections, inframammary fold destruction, hematogenous or lymphatic migrate, trauma, gravity and external pressure could play essential parts in the migration of injected filler. CONCLUSION Polyacrylamide hydrogel migration poses a worldwide challenge, necessitating personalized solutions. Our case study underscores the importance of comprehensive examinations for individuals with a history of filler breast injection when suspecting vulvar filler migration.
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Affiliation(s)
- Junxian Wen
- Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Zhijin Li
- Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yarong Chi
- Peking Union Medical College (PUMC), PUMC & Chinese Academy of Medical Sciences, Beijing, China
| | - Bo Chen
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Tao Hong
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- Department of International Medical Service, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Zhifei Liu
- Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Nanze Yu
- Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
- Department of International Medical Service, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
| | - Xiaojun Wang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
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Al Laham O, Abdul Khalek G, Alboushi H, Abazid E, Darwish A, Hamza A. An incidentally diagnosed primary pancreatic body hydatid cyst: A case report and literature review. Int J Surg Case Rep 2024; 116:109392. [PMID: 38367420 PMCID: PMC10943930 DOI: 10.1016/j.ijscr.2024.109392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Primary pancreatic hydatid cysts are exceptionally rare as they have an incidence rate ranging from 0.14 % to 2 %. Due to their extreme rarity, the patient's clinical manifestations are nonspecific. This leads to misdiagnosis and delay in treatment. Therefore, a multidisciplinary approach is necessary for the proper treatment of this pathology. CASE PRESENTATION Herewith, we present the rare case of a 46-year-old Middle Eastern female who sought medical attention at our surgical clinic complaining of an acute on-top-of chronic epigastric pain that radiated to the back. It was associated with a reported dark and pale discoloration of the urine and stool, respectively. The preoperative investigative radiological analysis identified a primary pancreatic body mass formation. CLINICAL DISCUSSION A meticulous surgical resection of the pancreatic body, tail, and the spleen was performed. Subsequent histopathological analysis of the excised specimens decisively established the diagnosis of a primary pancreatic body hydatid cyst. CONCLUSION Primary pancreatic hydatid cysts are profoundly rare, and their occurrence in the pancreatic body is even rarer. The profound scarcity of published literature on primary pancreatic body hydatid cysts highlights the imperative need for documentation, epidemiological studies, and the development of crucial interventional protocols. After a meticulous review of the published literature, we deduced that ours is the third documented case from our country of a primary pancreatic body hydatid cyst. Furthermore, no other cases beyond these three have been published from our country involving primary pancreatic hydatid cysts.
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Affiliation(s)
- Omar Al Laham
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Gheed Abdul Khalek
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al-Mouwasat University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Hazar Alboushi
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Pathology, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Eias Abazid
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al-Mouwasat University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Abdo Darwish
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al-Mouwasat University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Ali Hamza
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
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Rossignon P, Morra S, de Hemptinne Q, de Cannière D, Unger P. Papillary muscle rupture without severe mitral regurgitation following percutaneous balloon mitral commissurotomy: a case report. Eur Heart J Case Rep 2024; 8:ytae114. [PMID: 38487589 PMCID: PMC10939169 DOI: 10.1093/ehjcr/ytae114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 03/17/2024]
Abstract
Background Percutaneous transvenous mitral commissurotomy (PTMC) is the first-line therapy of clinically significant rheumatic mitral stenosis. While the procedure is generally safe, new onset or aggravation of mitral regurgitation (MR) may occur, mainly due to commissural splitting and, less frequently, to leaflet tear and chordal rupture. Papillary muscle rupture (PMR) is exceedingly rare in this setting. Case summary A 74-year-old woman with a history of aortic valve replacement and prior rheumatic mitral commissurotomy presented for worsening exercise intolerance and exertional dyspnoea. Transthoracic echocardiography showed a mean pressure gradient of 10 mmHg and a mitral valve area of 1.0 cm², consistent with clinically significant mitral stenosis. Subsequent PTMC was complicated by anterolateral PMR. However, the resulting MR was unexpectedly only of mild-to-moderate severity. Because of residual mitral stenosis and persisting symptoms, surgical mechanical mitral valve replacement and tricuspid annuloplasty were performed 6 weeks after PTMC. Papillary muscle rupture was confirmed during surgery. Discussion We herein describe the occurrence of PMR induced by PTMC; the resulting MR was unexpectedly of mild-to-moderate severity, as a result of extensive rheumatic lesions limiting valve mobility. This case challenges the dogma according to which PMR invariably leads to severe MR. This might not be necessarily the case when it occurs following PTMC.
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Affiliation(s)
- Pierre Rossignon
- Department of Cardiology, CHU Saint-Pierre, Université Libre de Bruxelles, Rue aux Laines 105, 1000 Brussels, Belgium
| | - Sofia Morra
- Department of Cardiology, CHU Saint-Pierre, Université Libre de Bruxelles, Rue aux Laines 105, 1000 Brussels, Belgium
| | - Quentin de Hemptinne
- Department of Cardiology, CHU Saint-Pierre, Université Libre de Bruxelles, Rue aux Laines 105, 1000 Brussels, Belgium
| | - Didier de Cannière
- Department of Cardiac Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Philippe Unger
- Department of Cardiology, CHU Saint-Pierre, Université Libre de Bruxelles, Rue aux Laines 105, 1000 Brussels, Belgium
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12
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Akhila G, Sahoo I, Priyadarshini D, Dash M. Intravenous Insulin in Hypertriglyceridemic Pancreatitis. Indian J Pediatr 2024; 91:297-299. [PMID: 36952110 DOI: 10.1007/s12098-023-04558-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/06/2023] [Indexed: 03/24/2023]
Abstract
Hypertriglyceridemia is a rare but significant cause of pancreatitis in children. Hypertriglyceridemic pancreatitis is often correlated with more severity and complications like pancreatic necrosis. Therefore, proper management and prevention of further episodes is essential. The authors report a case of a child with hypertriglyceridemic pancreatitis who was managed with intravenous insulin. According to various case reports and case series, intravenous insulin has been found to be effective in hypertriglyceridemic pancreatitis in adults. Few case reports in children also have mentioned use of intravenous insulin in diabetic ketoacidosis with hypertriglyceridemia. The authors found intravenous insulin to be highly effective in management of pancreatitis due to severe hypertriglyceridemia in the present child.
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Affiliation(s)
- Goolla Akhila
- Department of Pediatrics, IMS & SUM Hospital, Bhubaneswar, Odisha, 751003, India
| | - Ipsita Sahoo
- Department of Pediatrics, IMS & SUM Hospital, Bhubaneswar, Odisha, 751003, India.
| | | | - Mrutunjay Dash
- Department of Pediatrics, IMS & SUM Hospital, Bhubaneswar, Odisha, 751003, India
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13
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Jyoti AS, Kamrul-Hasan A, Rahman M, Hasan MJ. Acute hypothermia in a patient with COVID-19: a case report and summary of the evidence. Ann Med Surg (Lond) 2024; 86:1691-1694. [PMID: 38463048 PMCID: PMC10923324 DOI: 10.1097/ms9.0000000000001709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/29/2023] [Indexed: 03/12/2024] Open
Abstract
Introduction and importance SARS-COV-2 has many presenting signs including a number of typical and atypical symptoms. However, having the enormous capacity of mutation, the virus is changing its genetic pattern continuously, giving rise to newer and rarer manifestations. Here, the authors report a case of adult COVID-19 along with features of hypothermia which is relatively rare and has future implications in clinical perspective. Case presentation The patient presented with hypothermia and indicative symptoms of COVID-19 during admission. Comorbidities were assessed, potential differentials were ruled out thorough appropriate clinical examination and investigations. Insulation with a blanket and room heater was used to stabilize the normal body temperature (98.6°F) in the hospital setting, during this period vitals (Blood pressure, Pulse rate and oxygen saturation) were assessed regularly. On the sixth day of hospital admission, he was discharged from the hospital with advice. Clinical discussion COVID-19 virus can enter into brain through olfactory tract and may cause dysfunction in the medial preoptic area of the hypothalamus containing warm sensitive neurons directly or via cytokine-induced release of prostaglandin E2 from endothelial cells, which acts through a paracrine mechanism that may provoke hypothermia in our case. Conclusions This case highlights a rare presentation of COVID-19 infection that has not been thoroughly explored. The authors believe the case report holds particular importance especially in dealing with COVID-19 cases in both clinical and home settings.
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Affiliation(s)
| | - A.B.M Kamrul-Hasan
- Department of Endocrinology, Mymensingh Medical College, Mymensingh, Bangladesh
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14
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Lee KE, Woo OH, Kim CY, Cho KR, Seo BK. Unusual US Findings of Diffuse Large B-Cell Lymphoma of the Breast: A Case Report. J Korean Soc Radiol 2024; 85:415-420. [PMID: 38617862 PMCID: PMC11009123 DOI: 10.3348/jksr.2022.0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 07/10/2023] [Accepted: 09/03/2023] [Indexed: 04/16/2024]
Abstract
Lymphoma is an uncommon type of breast malignancy, with low prevalence. The ultrasonographic findings of breast lymphoma have been described as nonspecific. Breast lymphoma most commonly appears as a solitary hypoechoic mass on US, and usually shows hypervascularity on color Doppler US. Herein, we report an unusual case of breast lymphoma that presented as multiple bilateral hyperechoic nodules on US.
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15
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Zribi A, Nagy A, Riyami MA, Burney IA. Successful Treatment of a Case of Crescentic Glomerulonephritis in a Patient with Primary Peritoneal Carcinoma: A case report. Sultan Qaboos Univ Med J 2024; 24:119-122. [PMID: 38434475 PMCID: PMC10906771 DOI: 10.18295/squmj.1.2023.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 12/14/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
Crescentic glomerulonephritis has been associated with several solid tumour malignancies. Only a few cases of nephropathy have been reported in association with tubo-ovarian/peritoneal malignancies. We report a 55-year-old female patient who presented to a tertiary care centre, Muscat, Oman, in 2022. She developed combined immune complex-mediated glomerulonephritis and pauci-immune necrotising crescentic vasculitis simultaneously with the diagnosis of tubo-ovarian/peritoneal cancer. The baseline estimated glomerular filtration rate (eGFR) was 13 mL/min. The patient received two doses of rituximab and three doses of pulse corticosteroids, leading to significant improvement in renal function and the disappearance of her proteinuria. The eGFR improved to >60mL/min; her proteinuria gradually resolved after 10 weeks of treatment. She was then given a combination chemotherapy treatment for tubo-ovarian/peritoneal cancer leading to a normalisation of her CA-125 after three months of therapy.
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Affiliation(s)
| | - Amro Nagy
- Department of Medicine, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman
| | - Marwa Al Riyami
- Department of Pathology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
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16
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Mansour LT, Candy N, Nowicki J, Jukes A, Chryssidis S, Harding M. An infratentorial dural arteriovenous fistula mimicking cervical myelopathy: A case report. Clin Neurol Neurosurg 2024; 237:108149. [PMID: 38350172 DOI: 10.1016/j.clineuro.2024.108149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 02/15/2024]
Abstract
Dural arteriovenous fistulas may have insidious clinical presentations and are often challenging to diagnose. A small number of cases have been associated with perimedullary venous congestion and cord oedema, mimicking common pathologies, such as cervical myelopathy. We describe a case report of a patient presenting with a constellation of symptoms and radiological signs mimicking C5/6 cervical myelopathy secondary to disc herniation. The patient was managed with anterior cervical discectomy and fusion, with postoperative neurological deterioration unresponsive to steroid therapy. This prompted further investigation of other pathologies. An infratentorial Cognard 5 and Borden type 3 dural arteriovenous fistula was diagnosed on 6-vessel DSA and managed with onyx embolization. Marked improvement of neurological symptoms, notably bilateral lower limb weakness, was achieved postoperatively. In summary, this case demonstrates the importance of considering alternative, less common pathologies that involve the cervical spinal cord when neurological improvement is not achieved following decompressive surgery for cervical myelopathy.
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Affiliation(s)
- Laure Taher Mansour
- Department of Neurosurgery, Flinders Medical Center, Bedford Park 5042 South Australia, Australia; Department of Surgery, The University of Adelaide, Adelaide 5000, South Australia, Australia.
| | - Nicholas Candy
- Department of Neurosurgery, Flinders Medical Center, Bedford Park 5042 South Australia, Australia; Department of Surgery - Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Research, Woodville South, Adelaide, Australia
| | - Jake Nowicki
- Department of Neurosurgery, Flinders Medical Center, Bedford Park 5042 South Australia, Australia
| | - Alistair Jukes
- Department of Radiology, Flinders Medical Center, Bedford Park 5042 South Australia, Australia
| | - Steve Chryssidis
- Department of Radiology, Flinders Medical Center, Bedford Park 5042 South Australia, Australia
| | - Marguerite Harding
- Department of Neurosurgery, Flinders Medical Center, Bedford Park 5042 South Australia, Australia
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Aburayya BI, Obeidat LR, Kitana FI, Al Khatib O, Romman S, Hamed OH. Complete Common Bile Duct Injury after Laparoscopic Cholecystectomy in Situs Inversus Totalis: A Case Report, Review of the Literature and Illustrative Case Video. Int J Surg Case Rep 2024; 115:109265. [PMID: 38244377 PMCID: PMC10831892 DOI: 10.1016/j.ijscr.2024.109265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/22/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Situs Inversus Totalis (SIT) is a rare condition characterized by the transposition of internal organs. Given the anatomical variations in SIT, surgeons must exercise extreme caution when performing laparoscopic cholecystectomy to avoid iatrogenic bile duct injury. Despite the high difficulty index associated with laparoscopic cholecystectomy in SIT, there is only one case report of common bile duct (CBD) injury in the English-language literature. CASE PRESENTATION A 41-year-old female patient, known to have Kartagener syndrome, underwent laparoscopic cholecystectomy for acute cholecystitis and was discharged home on post-operative day one. However, on post-operative day five, the patient presented to the emergency room with abdominal pain, fever, and jaundice. Laboratory tests revealed leukocytosis and hyperbilirubinemia. Radiological images revealed complete occlusion of the CBD. A delayed approach was chosen, and six weeks after her initial operation, a hepaticojejunostomy was performed. CLINICAL DISCUSSION Laparoscopic cholecystectomy is the standard operative procedure for gallbladder disease. The unique anatomy of SIT increases the risk of CBD injury during laparoscopic cholecystectomy. Surgeons are required to perform a mirror-image procedure and adhere to the basic principles of safe laparoscopic cholecystectomy in SIT. This is only the second reported case of CBD injury in SIT patients. CONCLUSION Laparoscopic cholecystectomy in SIT presents a significant challenge. In patients with SIT, preventing CBD injury is the best approach, and referral to an experienced hepato-pancreato-biliary (HPB) surgeon is recommended. A delayed approach to CBD injuries in SIT allows thorough planning and understanding of the complex anatomical variations in these patients.
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Affiliation(s)
- Bahaa I Aburayya
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan.
| | | | | | | | - Saleh Romman
- Specialty Hospital, Jaber Ibn Hayyan St, Amman, Jordan
| | - Osama H Hamed
- Arab Medical Center, Jabal Amman, 5th Circle, Amman 11181, Jordan.
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18
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Khalili AA, Maciagowski E, Nguyen K, Watters KA. Trichodysplasia Spinulosa. Sultan Qaboos Univ Med J 2024; 24:131-134. [PMID: 38434466 PMCID: PMC10906767 DOI: 10.18295/squmj.5.2023.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/26/2023] [Accepted: 03/28/2023] [Indexed: 03/05/2024] Open
Abstract
Trichodysplasia spinulosa (TS) is a unique, rare clinical and histological dermatologic entity described mainly in a setting of immunosuppression. It is caused by a novel human polymoavirus, TS-associated polyomavirus. Reduction of immunosuppression and/or anti-viral therapy is the main therapeutic strategies used to treat such cases. We report a biopsy-proven case of TS in a male renal transplant patient who presented to a dermatology outpatient clinic in Montreal, Canada, in 2015. He was managed with valgancyclovir with no obvious response. Subsequently, a trial of topical imiquimod was commenced. Awareness of TS can prompt early diagnosis and management to prevent possible complications.
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Affiliation(s)
- Ayida Al Khalili
- Dermatology Unit, Department of Family Medicine and Public Health, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Elsa Maciagowski
- Department of Dermatology, McGill University Health Center, Montreal, Canada
| | - Khue Nguyen
- Department of Dermatology, McGill University Health Center, Montreal, Canada
| | - Kevin A. Watters
- Department of Pathology, McGill University Health Center, Montreal, Canada
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19
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Al Laham O, Sharaf Aldeen R, Ibrahim Basha Z, Ali A, Alhanwt A. Dual unifocal primary Epithelioid Angiosarcoma: A case report and review of the literature unveiling a rare genre of neoplasia. Int J Surg Case Rep 2024; 115:109310. [PMID: 38281378 PMCID: PMC10839256 DOI: 10.1016/j.ijscr.2024.109310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 01/30/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Angiosarcomas are an exceedingly rare and malignant form of soft tissue sarcoma that are derived from endothelial cells. Overall, they comprise <1 % of the total number of soft tissue sarcomas. Due to nonspecific and misleading symptoms, the subsequent clinical presentations can easily result in misdiagnosis. This leads to life-threatening complications for patients. Contemplating this tumor as a differential diagnosis during the preoperative phase allows for essential time-sensitive therapeutic interventions to be accomplished. CASE PRESENTATION Herein, we present the seldom precedented case of a 66-year-old Middle Eastern male who came to our surgical clinic chiefly complaining of an exacerbation of chronic left hypochondriac pain accompanied by gradual inexplicable abdominal distention. Our diagnostic radiological evaluation demonstrated two isolated abdominal mass formations. CLINICAL DISCUSSION Sheer excision of the neoplastic masses with safety margins was successfully executed via open surgery. The stemming histopathological examination through Hematoxylin and Eosin and immunohistochemical staining established the definitive diagnosis of an Epithelioid Angiosarcoma. CONCLUSION Epithelioid Angiosarcomas belong to the category of profoundly rare tumors. The available published literature conveys this rarity through the scarcity of epidemiological parameters and studies. It necessitates being borne in mind when facing similar clinical scenarios so that apt therapeutic interventions can be achieved. Structured diagnostic methods, timely surgical interventions and proper techniques, and comprehensive follow-up patient surveillance protocols are, therefore, merited. After thorough review of the published literature, we reckon herewith that ours is the first documented case from our country of an Epithelioid Angiosarcoma.
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Affiliation(s)
- Omar Al Laham
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Rahaf Sharaf Aldeen
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al-Mouwasat University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Zein Ibrahim Basha
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Pathology, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Amad Ali
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al-Mouwasat University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
| | - Alaa Alhanwt
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic.; Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic..
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Tribovane DC, Tortajada Bustelo JC, Cañellas ÁR. Sodium Hypochlorite-induced Facial Hematoma Following Root Canal Treatment. Iran Endod J 2024; 19:46-49. [PMID: 38223834 PMCID: PMC10787179 DOI: 10.22037/iej.v19i1.43306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/04/2023] [Accepted: 11/13/2023] [Indexed: 01/16/2024]
Abstract
This case report highlights a rare complication of root canal treatment involving the inadvertent extrusion of sodium hypochlorite solution, resulting in a sodium hypochlorite-induced facial hematoma. A 44-year-old female patient presented significant right hemifacial swelling and ecchymosis following root canal therapy. Computed tomography imaging confirmed a hematoma involving the facial region without active signs of bleeding. Sodium hypochlorite, a potent cytotoxic agent commonly used in root canal procedures, was identified as the causative agent. Treatment consisted of prednisone, antibiotics, and NSAIDs, resulting in gradual improvement over a month. The cytotoxic properties of sodium hypochlorite, its variable concentrations, and risk factors associated with facial hematomas are discussed. It is essential to emphasize the rarity of such hematomas and highlight the need for precise technique, vigilant monitoring, and interdisciplinary collaboration to mitigate risks and prioritize patient safety.
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Affiliation(s)
| | | | - Álex Rovira Cañellas
- Department of Neuroradiology, Hospital Universitari Vall d´Hebron, Barcelona, Spain
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21
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Aleksashina A, Rachina S, Kiyakbaev G, Hewathanthirige G, Cherdantseva Y. A Case of Acute Neurologic Deficit and Hypoglycemia in the Setting of Thyroid Storm and Diabetic Ketoacidosis: A New Clinical Scenario. Korean J Fam Med 2024; 45:51-55. [PMID: 38272451 PMCID: PMC10822729 DOI: 10.4082/kjfm.23.0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 01/27/2024] Open
Abstract
The simultaneous development of diabetic ketoacidosis (DKA) and thyroid storm (TS) is a rare but potentially lifethreatening condition that requires immediate and targeted treatment. However, their combined diagnosis poses a serious challenge because of the similarities between their clinical manifestations. To date, only a few dozen cases have been described; most of which have been linked to the progression of thyrotoxicosis or uncontrolled hyperglycemia as contributing factors. We present the case of a 37-year-old woman with type 1 diabetes mellitus and Graves' disease who presented with both TS and DKA. She was initially admitted to the emergency department as a suspected case of stroke. Severe hypoglycemia significantly lowered her alertness to TS and probably provoked a sharp hyperthyroid decompensation, thereby leading to subsequent DKA development.
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Affiliation(s)
- Alena Aleksashina
- City Clinical Hospital Named after S.S. Yudin, Moscow, Russian Federation
| | - Svetlana Rachina
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Gayrat Kiyakbaev
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | | | - Yulia Cherdantseva
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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22
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Beheshti Fard S, Afzal S, Barzegar M, Mortazavi SMJ. Single-stage bilateral conversion arthroplasty for hip fusion via direct anterior approach in a patient with severe ankylosing spondylitis and kyphoscoliosis: a case report. J Med Case Rep 2023; 17:508. [PMID: 38072934 PMCID: PMC10712173 DOI: 10.1186/s13256-023-04251-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Severe ankylosing spondylitis (AS) frequently involves hip joints and, occasionally, presents with concurrent spinal deformities, such as kyphoscoliosis, creating complex challenges for surgical management. CASE PRESENTATION We present a 26-year-old Persian male with a history of AS and severe kyphoscoliosis, leading to bilateral hip fusion and immobility. Following spinal deformity correction, a one-stage bilateral conversion to total hip arthroplasty (THA) was conducted through the direct anterior approach. CONCLUSION Primary correction of spinal deformities allows for extended surgical procedures under general anesthesia. Single stage bilateral hip conversion arthroplasty via the direct anterior approach enhances postoperative mobilization, reduce the risk of re-ankylosis, and improve the overall quality of life for AS patients with this unique presentation.
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Affiliation(s)
| | - Sina Afzal
- Department of Orthopedic Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Barzegar
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
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23
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Kimberley TJ, Prudente CN, Engineer ND, Dickie DA, Bisson TA, Van de Winckel A. Vagus Nerve Stimulation Paired With Mobility Training in Chronic Ischemic Stroke: A Case Report. Phys Ther 2023; 103:pzad097. [PMID: 37669130 DOI: 10.1093/ptj/pzad097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/28/2023] [Accepted: 07/02/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVE The purpose of this case report is to describe pairing vagus nerve stimulation (VNS) with mobility training in an individual after stroke. METHODS A 53-year-old man with left hemiparesis 14.2 months after an ischemic stroke participated in a pilot study investigating the safety and feasibility of VNS paired with upper limb rehabilitation. In addition to upper limb impairment, the participant had impaired gait and wanted to improve his mobility. A single-subject design investigation of VNS paired with self-directed mobility training was conducted. Following the conclusion of the pilot study, the participant was instructed to complete daily sessions of self-activated VNS paired with walking or stationary biking. The 10-Meter Walk Test and timed distance (6-Minute Walk Test) were assessed at 4 baseline points and at 3 to 41 months after mobility training. RESULTS The participant had stable baseline values and was classified as a household ambulator with a quad cane. After VNS-paired mobility training, statistically significant improvements were observed in all measures, with the greatest improvements at 9 months exceeding the minimal detectable change: self-selected gait speed from 0.34 (standard deviation [SD] = 0.01) to 0.60 meters/second, fast gait speed from 0.37 (SD = 0.03) to 0.79 meters/second, and 6-Minute Walk Test distance from 106.91 (SD = 6.38) to 179.83 meters. The participant reported increased confidence and balance when walking. No falls or adverse events were reported. CONCLUSION The participant demonstrated improved gait speed and timed distance after VNS-paired mobility training. Randomized, blinded trials are needed to determine treatment efficacy. IMPACT This is the first documented case of VNS-paired mobility training in an individual with chronic poststroke gait impairments. VNS paired with mobility training may improve poststroke gait impairments.
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Affiliation(s)
- Teresa J Kimberley
- Division of Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
- Departments of Physical Therapy and Rehabilitation Science, Rehabilitation Science PhD Program, School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Cecília N Prudente
- Division of Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
- MicroTransponder Inc, Austin, Texas, USA
| | | | - David Alexander Dickie
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, UK
| | - Teresa A Bisson
- Division of Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ann Van de Winckel
- Division of Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
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24
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Pereira SM, Lima RV, Muniz MCR, Araújo MBF, de Moraes Ferreira Júnior L, de Queiroz Sales Martins JT, Luz CFC, Cid DAC, da Rocha Lucena D. Congenital herpes simplex with ophthalmic and multisystem features: a case report. BMC Pediatr 2023; 23:611. [PMID: 38044450 PMCID: PMC10694881 DOI: 10.1186/s12887-023-04423-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 11/14/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Neonatal herpes simplex virus (HSV) infection is rare and has significant morbimortality rates. Approximately 85% of newborns are infected intrapartum, and risk factors for mother-to-child transmission include vaginal delivery, primary maternal infection, and prolonged rupture of membranes. Neonatal HSV can manifest with isolated mucocutaneous lesions, neurological involvement, or disseminated disease. In general, herpetic infection can cause blepharoconjunctivitis or keratitis. We report a rare case of congenital herpes with ophthalmologic manifestations and multisystemic involvement. CASE PRESENTATION A preterm infant, born at 32 weeks and 2 days, with presumed neonatal infection developed intestinal and respiratory complications, as well as hyperemic lesions on the left nostril and oral mucosa. An ophthalmological assessment was requested and brought up the suspicion of HSV infection, indicating empirical treatment with endovenous acyclovir. Later, a new ocular examination was suggestive of panuveitis. Afterward, serum IgM antibodies to HSV-1 and HSV-2 were positive. Proper antiviral therapy led to an improvement in the condition. DISCUSSION Neonatal herpes is associated with a high risk of persistent skin lesions, long-term neurological disability and other lasting sequelae. It is essential to consider HSV infection in cases of neonatal conjunctivitis, especially in patients with an epithelial defect and no improvement after initial treatment with topical or systemic antibiotics. CONCLUSIONS In the management of neonatal HSV, early diagnosis is essential for the timely initiation of antiviral therapy. Our report highlights that ocular assessment can be crucial in the correct diagnostic investigation of this condition.
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Arora V, Yadav V, Aggarwal M, Mandal G, Chakraborty A, Dewan AK, Kamboj M. Collision Tumour of Combined Neuroendocrine and Squamous Cell Carcinoma of Nasal Cavity and Paranasal Sinus- Case Report and Review of Literature. Indian J Otolaryngol Head Neck Surg 2023; 75:3765-3769. [PMID: 37974826 PMCID: PMC10646142 DOI: 10.1007/s12070-023-04101-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 11/19/2023] Open
Abstract
Background There have been many disputes about the definition, diagnosis, therapy, and prognosis of collision tumours. Case Summary We describe a rare patient with a collision tumour consisting of high-grade neuroendocrine carcinoma (NEC) and squamous cell carcinoma (SCC) in the right nasal cavity and paranasal sinus. She received surgery, concurrent chemoradiotherapy, and then two cycles of palliative chemotherapy. Follow-up at 26 months after diagnosis showed that this patient experienced a complete response with no signs of recurrence or metastasis. A literature review of previous 27 cases diagnosed with collision tumour of NEC and SCC in the head and neck was also undertaken. Conclusion It is highly challenging to manage collision tumours because these are two morphologically and etiologically distinct tumours. Well-designed multimodality therapy including surgery and chemoradiotherapy might lead to a long survival in these patients.
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Affiliation(s)
- Vikas Arora
- Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Vishal Yadav
- Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Manisha Aggarwal
- Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Ghanashyam Mandal
- Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Arnab Chakraborty
- Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - A K Dewan
- Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Meenakshi Kamboj
- Department of Patho Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
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Kharawala A, Chen YY, Christian T, Thachil R. Confounding clinical picture in the diagnosis of left ventricular and valvular masses: a case report. Eur Heart J Case Rep 2023; 7:ytad606. [PMID: 38130862 PMCID: PMC10734628 DOI: 10.1093/ehjcr/ytad606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 11/19/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023]
Abstract
Background Masses in the heart and valves have a broad differential diagnosis including infective and rheumatic causes as well as primary or metastatic tumours. Diagnosis involves delineating the location, shape, and origin of the mass/masses and considering the clinical context. This case outlines the work-up and approach to diagnosing a cardiac mass along with imaging findings of a unique secondary metastatic mass in the left ventricle (LV). Case summary A 69-year-old female with past medical history of metastatic lung cancer treated with radiotherapy and breast cancer treated with mastectomy presented with dyspnoea and fever. Due to concern for infective endocarditis, transthoracic echocardiogram (TTE) was performed revealing 2 cm × 0.72 cm finger-like, echo-lucent, mobile mass, appearing to originate from LV lateral wall, protruding into the LV cavity, along with valvular masses on mitral and tricuspid valves. Initial differential diagnosis included benign pathologies, but due to the clinical suspicion of malignancy, cardiac MRI was performed which revealed a broad-based mass with invasion into the LV lateral wall and delayed gadolinium enhancement, suggestive of metastatic tumour. The patient was given Aspirin to prevent embolization and eventually underwent hospice care. Discussion Atypical appearing cardiac masses can be seen on TTE. Cardiac magnetic resonance imaging (MRI) should be used for definite diagnosis in cases where clinical features do not match the echocardiographic findings.
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Affiliation(s)
- Amrin Kharawala
- Department of Medicine, NewYork City Health+Hospitals/Jacobi, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yi-Yun Chen
- Department of Medicine, NewYork City Health+Hospitals/Jacobi, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Timothy Christian
- Department of Cardiology, NewYork City Health+Hospitals/Jacobi, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Rosy Thachil
- Division of Cardiology, NewYork City Health+Hospitals/Elmhurst, Mount Sinai School of Medicine, Queens, NY, USA
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d'Arienzo PD, Cunningham N, O’Sullivan H, Grieco C, Patel V, Popat S. Salvage Therapy With Selpercatinib for RET-Rearranged NSCLC With Pralsetinib-Related Pneumonitis and Leptomeningeal Disease: A Case Report. JTO Clin Res Rep 2023; 4:100581. [PMID: 38034820 PMCID: PMC10687334 DOI: 10.1016/j.jtocrr.2023.100581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/18/2023] [Accepted: 09/26/2023] [Indexed: 12/02/2023] Open
Abstract
Selpercatinib and pralsetinib are RET inhibitors with substantial activity in advanced RET-rearranged NSCLC. We present a case of pralsetinib-related pneumonitis and leptomeningeal and brain metastases progression during treatment suspension for pneumonitis. During recovery, selpercatinib administration led to rapid neurologic response and complete intracranial response and allowed pneumonitis resolution. This case supports the safety of selpercatinib in patients with pneumonitis on pralsetinib and highlights its marked efficacy in leptomeningeal disease.
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Affiliation(s)
| | | | | | | | - Virjen Patel
- Clinical Radiology Department, Royal Marsden Hospital, London, United Kingdom
| | - Sanjay Popat
- Lung Unit, Royal Marsden Hospital, London, United Kingdom
- Division of Clinical Studies, Institute of Cancer Research, London, United Kingdom
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Sakhrekar R, Ha JS, Han HD, Kim DH, Kim CW, Kulkarni S. Unilateral Biportal Endoscopic Approach for Symptomatic Adjacent Segment Disease: Case Report and Technical Note. J Orthop Case Rep 2023; 13:172-177. [PMID: 38162358 PMCID: PMC10753676 DOI: 10.13107/jocr.2023.v13.i12.4122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/19/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Recently, lumbar degenerative disease has been treated using unilateral biportal endoscopic (UBE) lumbar interbody fusion. However, the use of the UBE approach for symptomatic ASD following lumbar interbody fusion surgery isn't illustrated widely in the literature. This case report and technical note describe the use of the UBE approach for symptomatic ASD. Case Report A 72-year-old female who underwent conventional fusion surgery elsewhere twelve years ago at the L5-S1 level presented with severe back pain (VAS 8/10) and radicular pain in both legs (left > right) (left VAS 7/10, right VAS 7/10) for 1 year with an ODI score of 70%. Preoperative X-ray and MRI showed dynamic instability with spondylolisthesis at L4-5. We performed an upper-level extension using UBE FES techniques to resolve ASD. The operative time was 132 minutes, blood loss was 40 ml. After surgery, the patient was followed up at 1 week, 6 weeks, 3 months, 6 months, 12 months, and 2 years. The pain and tingling sensation in the legs got better at the 1-week follow-up itself with a VAS score of 0/10 and an ODI score of 10% at the 2-year follow-up. Patient satisfaction was surveyed using Odom's criteria at each follow-up visit (at 1 week, 6 weeks,3 months, 6 months, and 2 years) and found to be excellent. Postoperative imaging showed a good reduction and canal decompression at L4-5. Conclusion The UBE fusion extension technique for ASD is a safe, less invasive, and effective treatment option for lumbar interbody fusion extension and posterior pedicle screw revision with less morbidity and early recovery.
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Affiliation(s)
| | - Ji Soo Ha
- Department of Spine Surgery, Yonsei Okay Hospital, Seoul, South Korea
| | - Hee-Don Han
- Department of Spine Surgery, Yonsei Okay Hospital, Seoul, South Korea
| | - Do-Hyoung Kim
- Department of Spine Surgery, Yonsei Okay Hospital, Seoul, South Korea
| | - Chang Wook Kim
- Department of Spine Surgery, Yonsei Okay Hospital, Seoul, South Korea
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Maddali MM, Munasinghe TD, Al Aamri I, Al-Abri IA, Al-Adawi S. Propofol and Kearns-Sayre Syndrome: An idiographic approach. Sultan Qaboos Univ Med J 2023; 23:63-67. [PMID: 38161763 PMCID: PMC10754313 DOI: 10.18295/squmj.12.2023.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/30/2023] [Accepted: 05/23/2023] [Indexed: 01/03/2024] Open
Abstract
With the focus on an idiographic approach whereby the observations incorporated the various dimensions of individual functioning 'top-down' to 'bottom-up', this case report describes the successful management of a 14-year-old girl with Kearns-Sayre syndrome and Dyggve-Melchior-Clausen disease requiring a transvenous permanent pacemaker implantation for complete heart block. The patient presented to a tertiary care centre in Muscat, Oman, in 2023 seeking consultation. The current idiographic approach appears to have a heuristic value for 2 interrelated reasons. Firstly, it is unlikely that even tertiary care units can accrue such rare presentations and scrutinise them under nomothetic approach. Secondly, by employing the idiographic approach that is capable of examining each case in-depth, the aspiration for good health and well-being may come to the forefront. To the best of the authors' knowledge this is the first published idiographic report in anaesthesia care.
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Affiliation(s)
| | | | | | - Ismail A. Al-Abri
- Pediatric Cardiology, National Heart Center, Royal Hospital, Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioral Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
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Evangelisti TM, Platoff RM, Khrizman P, Morrison JC, Joneja U, Allen AA, Giugliano DN, Kwiatt ME, McClane SJ. Small Cell Carcinoma of the Rectum-An Unexpected Diagnosis: Current Treatment Options for a Rare and Aggressive Entity. Am Surg 2023; 89:6359-6361. [PMID: 37203324 DOI: 10.1177/00031348231175116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Rectal small cell carcinoma is a rare and aggressive cancer subtype for which a consensus of optimal treatment has not yet been reached. This cancer presents a difficult surgical problem, and thus, the mainstay of treatment tends to mirror that of small cell carcinoma of the lung (chemotherapy, radiation therapy, and immune modulators). This brief report highlights current treatment options available for this rare and difficult entity. There is a significant need for large-center clinical trials and prospective studies to help determine the best treatment regimen to effectively care for patients with small cell carcinoma of the rectum.
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Affiliation(s)
| | | | - Polina Khrizman
- Cooper University Hospital, Department of Hematology and Medical Oncology, Camden, NJ, USA
| | - Jamin C Morrison
- Cooper University Hospital, Department of Hematology and Medical Oncology, Camden, NJ, USA
| | - Upasana Joneja
- Cooper University Hospital, Department of Pathology, Camden, NJ, USA
| | - Ashleigh A Allen
- Cooper University Hospital, Department of Pathology, Camden, NJ, USA
| | | | - Michael E Kwiatt
- Cooper University Hospital, Department of Surgery, Camden, NJ, USA
| | - Steven J McClane
- Cooper University Hospital, Department of Surgery, Camden, NJ, USA
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Maddali MM, Al-Abri IA, Patel MH, Abokwafa AM, Zacharias S. Troubleshooting During Temporary Epicardial Lead Implantation in a Child with an Erosive Twiddler's Syndrome and Multiple Sternotomies: A case report. Sultan Qaboos Univ Med J 2023; 23:55-58. [PMID: 38161755 PMCID: PMC10754304 DOI: 10.18295/squmj.12.2023.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/04/2023] [Accepted: 03/28/2023] [Indexed: 01/03/2024] Open
Abstract
Temporary epicardial cardiac pacing in patients with bradyarrhythmias may be used as a bridge to implantation of a permanent pacemaker. The temporary epicardial lead placement may sometimes necessitate a sternotomy that may pose a challenge in patients who have had multiple earlier sternotomies. The difficulty in accessing the epicardium for urgent implantation of temporary epicardial pacing leads depends on the extent of adhesions in such patients. We report an 8-year-8-month-old girl with a pacemaker with an extruded pulse generator and difficult myocardial access due to 5 prior transsternal procedures. The child presented to a tertiary care hospital in Muscat, Oman, in 2021. A trouble-shooting technique was adopted to achieve temporary epicardial pacing to provide time for a course of antibiotic therapy administration. A permanent transvenous pulse generator system was implanted after 7 days of temporary pacing.
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Affiliation(s)
| | | | | | - Amr M. Abokwafa
- Cardiothoracic Surgery, National Heart Center, The Royal Hospital, Muscat, Oman
| | - Sunny Zacharias
- Cardiothoracic Surgery, National Heart Center, The Royal Hospital, Muscat, Oman
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Ugalde-Abiega B, Stanescu S, Belanger A, Martinez-Pardo M, Arrieta F. New challenges in management of phenylketonuria in pregnancy: a case report. J Med Case Rep 2023; 17:465. [PMID: 37941064 PMCID: PMC10633903 DOI: 10.1186/s13256-023-04209-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/10/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Phenylketonuria (PKU) is an autosomal recessive disease that belongs to a group of disorders resulting from inborn errors of protein metabolism. It was the first disease included in neonatal screening. Neonatal screening has allowed an early diagnosis and treatment of the disease. As a result, an increasing number of women diagnosed with phenylketonuria have reached the reproductive phase of life in good health, and management of pregnancy in women with PKU is becoming more frequent. CASE PRESENTATION In this study, we report the case of a 28-year-old Caucasian patient being followed up for phenylketonuria at Ramón y Cajal Hospital's Metabolic Diseases Unit. We describe the patient's gestation, impacted by her and her partner's diagnosis of PKU, classic and mild phenotypes, respectively, resulting in the fetus affectation. CONCLUSIONS The description of PKU management-diagnosis, follow-up, and treatment-for both that of patient and that of the gestation with fetus affectation covers a wide sample scenario that shows the effectiveness of pregnancy planning and monitoring of females with PKU and questions the need to carry out a genetic study of gene PKU in the study of fertility.
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Affiliation(s)
- Beatriz Ugalde-Abiega
- Unidad de Enfermedades Metabólicas, Hospital Universitario Ramón y Cajal, IRYCIS, Crta de Colmenar Viejo, km 9,100, 28034, Madrid, Spain.
| | - Sinziana Stanescu
- Unidad de Enfermedades Metabólicas, Hospital Universitario Ramón y Cajal, IRYCIS, Crta de Colmenar Viejo, km 9,100, 28034, Madrid, Spain
| | - Amaya Belanger
- Unidad de Enfermedades Metabólicas, Hospital Universitario Ramón y Cajal, IRYCIS, Crta de Colmenar Viejo, km 9,100, 28034, Madrid, Spain
| | - Mercedes Martinez-Pardo
- Unidad de Enfermedades Metabólicas, Hospital Universitario Ramón y Cajal, IRYCIS, Crta de Colmenar Viejo, km 9,100, 28034, Madrid, Spain
| | - Francisco Arrieta
- Unidad de Enfermedades Metabólicas, Hospital Universitario Ramón y Cajal, IRYCIS, Crta de Colmenar Viejo, km 9,100, 28034, Madrid, Spain
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Yunchun CH, Yao L, Zhengmin Z, Xuning H, Changying K, Chongnan L. Study on The Pedigrees of Three Cases of Whole-Arm Translocation in Hainan China and Literature Review: A Retrospective Study. Int J Fertil Steril 2023; 18:81-86. [PMID: 38041464 PMCID: PMC10692743 DOI: 10.22074/ijfs.2023.548275.1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 06/03/2023] [Accepted: 06/18/2023] [Indexed: 12/03/2023]
Abstract
In this study, in order to promote chromosome abnormality carriers eugenics, three patients with adverse pregnancy histories were examined by cytogenetics and their pedigrees further analyzed. In this retrospective study, approximately anticoagulant peripheral venous blood from the patients was collected for peripheral blood cell culture and chromosome analysis. Karyotypes were analyzed in the BEIONMED karyotype analysis system. The karyotypes of the three probands were all whole-arm translocations (WATs): case 1 (DatabaseNo.3591): 46, XY, t (7; 13) (p10; p10) dn, two years of marriage in which the spouse did not have pregnancy, with azoospermia; case 2 (Database No.3809): 46, XY, t(12; 17) (p10; q10), three spontaneous abortions within three years of marriage; case 3 (Database No.4914) 46, XX, t(2;6) (p10; q10) mat, 21ps+pat, a year of marriage without pregnancy. When the parents are carriers of WAT, the family should be considered to have a high reproductive risk, increasing the risk of producing offspring with chromosomal abnormalities. Three kinds of human chromosomal aberration karyotypes were reported for the first time providing an important basis for studying the occurrence and clinical consultation of chromosomal diseases.
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Affiliation(s)
- C Hen Yunchun
- Department of Laboratory Medicine, Haikou Hospital of Traditional Chinese Medicine, Haikou, China
| | - Lin Yao
- Pediatrics, The Third People's Hospital of Haikou City, Haikou, China
| | - Zhao Zhengmin
- Department of Laboratory Medicine, Haikou Hospital of Traditional Chinese Medicine, Haikou, China
| | - Huang Xuning
- Department of Ultrasound Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Kong Changying
- Department of Ultrasound Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Liang Chongnan
- Department of Laboratory Medicine, Haikou Hospital of Traditional Chinese Medicine, Haikou, China.
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Upadhya P, Bai M, Gunasekaran V, Dwivedi DP, Shahana M. Nil Intervention is at Times the Best Intervention: Benign emptying of pneumonectomy space. Sultan Qaboos Univ Med J 2023; 23:539-542. [PMID: 38090251 PMCID: PMC10712387 DOI: 10.18295/squmj.12.2022.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/01/2022] [Accepted: 08/31/2022] [Indexed: 12/18/2023] Open
Abstract
A sudden drop of air-fluid level in the pneumonectomy space in the absence of a bronchopleural fistula and pleural infection is termed benign emptying of the pneumonectomy space (BEPS). We report a 28-year-old female patient who presented to a tertiary care referral centre, in Pondicherry, India in 2020 with multiple episodes of vomiting. Subsequent to a left-sided pneumonectomy due to tuberculosis, she was diagnosed with BEPS. Generally, patients with BEPS are clinically stable, afebrile with no fluid expectoration and have a normal white blood cell count. Bronchoscopy reveals an intact bronchial stump and pleural fluid cultures are often sterile. In terms of management, close monitoring and early detection of a bronchopleural fistula are the key points. BEPS should be a differential diagnosis in case of a drop in the air-fluid level of the post-pneumonectomy space. Awareness of this entity is crucial as it helps prevent unnecessary and morbid surgical interventions.
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Affiliation(s)
- Pratap Upadhya
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Muniza Bai
- Department of Pulmonary Medicine, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | | | - Dharm P. Dwivedi
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - M.P. Shahana
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Papamichail S, Karlafti E, Malliou P, Zatagias A, Ioannidis A, Netta S, Panidis S, Paramythiotis D. A Rare Case of a Direct Incarcerated Inguinal Hernia Containing an Epiploic Appendage and a Literature Review. Sultan Qaboos Univ Med J 2023; 23:547-550. [PMID: 38090244 PMCID: PMC10712395 DOI: 10.18295/squmj.12.2022.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/07/2022] [Accepted: 10/24/2022] [Indexed: 12/18/2023] Open
Abstract
Inguinal hernias are a widespread condition, responsible for a large number of acute abdomen cases. Typically, indirect, rather than direct, hernias lead to complications, as a consequence of their narrower hernial defect. We report a 71-year-old male patient with a rather rare incidence of a direct incarcerated hernia who presented with acute pain in the left inguinal area at a university general hospital in Thessaloniki, Greece, in 2017. Upon clinical examination, an irreducible inguinal mass was palpated. Therefore, the existence of a complicated hernia was suspected. The patient underwent an emergency repair, during which it was established that the hernia was direct and incarcerated and that its sac contained an ischaemic epiploic appendage. The hernia was successfully repaired with mesh, the patient recovered uneventfully and was discharged five days later. Despite the rarity of complicated direct inguinal hernias, they should always be included in the differential diagnosis of irreducible groin masses as they can increase severe complications.
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Affiliation(s)
- Stella Papamichail
- 1st Propaedeutic Surgical Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Karlafti
- Emergency Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Petra Malliou
- 1st Propaedeutic Surgical Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Zatagias
- 1st Propaedeutic Surgical Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aristeidis Ioannidis
- 1st Propaedeutic Surgical Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Smaro Netta
- 1st Propaedeutic Surgical Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Panidis
- 1st Propaedeutic Surgical Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Daniel Paramythiotis
- 1st Propaedeutic Surgical Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Upadhya P, Arpitha A, Sivaselvi C, Papa D, Vignesh K. A Rare Case of Lung Hypoplasia, Cardiac Anomalies and Ovarian Tumour in a Patient with Mayer-Rokitansky-Küster-Hauser Syndrome. Sultan Qaboos Univ Med J 2023; 23:556-559. [PMID: 38090232 PMCID: PMC10712378 DOI: 10.18295/squmj.1.2023.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/14/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Hypoplasia of the lung is an uncommon congenital abnormality of the respiratory system in contrast to pulmonary agenesis. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is the congenital absence of the upper two-thirds of the vagina and uterus with normal secondary sexual characteristics, ovary and normal karyotype. We report a 31-year-old female patient who presented in 2022 with cough with expectoration, left-side chest pain and breathlessness for 4 years to tertiary hospital, Puducherry, India. She was evaluated for amenorrhoea and diagnosed as MRKH syndrome and the patient underwent right-side oophorectomy for right ovarian torsion with a tumour. Computed tomography pulmonary angiogram and fiberoptic endoscopy were suggestive of left lung hypoplasia and the patient was advised symptomatic treatment for lung hypoplasia and planned for vaginoplasty for which she refused.
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Affiliation(s)
- Pratap Upadhya
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - A. Arpitha
- Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - C. Sivaselvi
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - Dasari Papa
- Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - K. Vignesh
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
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Al-Johani WM. Macroamylasemia as a Rare Cause of Hyperamylasemia: A Case Report. Korean J Fam Med 2023; 44:347-349. [PMID: 37989276 PMCID: PMC10667079 DOI: 10.4082/kjfm.23.0195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 11/23/2023] Open
Abstract
Macroamylasemia is a rare condition characterized by the formation of an amylase-globulin complex that is too large to be readily excreted by the kidneys and leads to elevated serum amylase levels. It is a benign condition lacking severe signs and symptoms that does not require treatment. This paper presents a case of a middle-aged man with unexplained elevated serum amylase levels. Despite an initially elevated triglyceride level, clinical findings, laboratory test results, and radiological findings were not suggestive of pancreatitis. The ratio of renal amylase clearance to creatinine clearance was calculated at <1%, consistent with macroamylasemia. No specific treatment was given, and he was monitored periodically. Nevertheless, macroamylasemia is a diagnostic challenge because of the need to differentiate it from other causes of hyperamylasemia to avoid unnecessary tests and treatments.
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Affiliation(s)
- Wejdan M. Al-Johani
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Al Housni S, Al-Thihli K, Rahmatalla D, Wali Y, Al Rawahi Y. Severe Neonatal Presentation of Progressive Familial Intrahepatic Cholestasis Type 4 in an Omani Infant. Sultan Qaboos Univ Med J 2023; 23:543-546. [PMID: 38090248 PMCID: PMC10712380 DOI: 10.18295/squmj.8.2022.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/20/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Progressive familial intrahepatic cholestasis type 4 (PFIC4) is a relatively newly described autosomal recessive disorder caused by biallelic mutations in the gene encoding tight junction protein 2 (TJP2) which is located in chromosome 9q21. PFIC4 is characterised by cholestasis with or without other extrahepatic manifestations. Bleeding tendency due to vitamin k deficiency is a well-known complication of cholestasis. We present a neonate who presented to the Emergency Department at a tertiary care hospital in 2021 with cholestasis and multiple intracranial bleeds. He was found to have severe coagulopathy and his genetic work up revealed a homozygous variant mutation in TJP2 gene causing PFIC4. He had persistent cholestasis that necessitated an internal biliary diversion with some clinical improvement.
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Affiliation(s)
- Samira Al Housni
- Pediatric Department, Oman Medical Specialty Board, Muscat, Oman
| | - Khalid Al-Thihli
- Department of Genetics, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Dafalla Rahmatalla
- Department of Child Health, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Yasser Wali
- Department of Child Health, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Yusriya Al Rawahi
- Department of Child Health, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
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Sattout GIA, Wardeh AM, Alhassoun A, Zain Aldain RN, Alshraikey AM. Idiopathic bilateral occlusion of Foramen of Monro treated by septostomy with unilateral foraminoplasty: a rare case report. Ann Med Surg (Lond) 2023; 85:5816-5819. [PMID: 37915630 PMCID: PMC10617907 DOI: 10.1097/ms9.0000000000001391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction Idiopathic occlusion of the Foramen of Monro is extremely rare in adults. The occlusion is classified into four types, with the first being the most infrequent. This condition induces noncommunicating hydrocephalus with the ensuing increased intracranial pressure symptoms. Headache is usually the chief complaint. Presentation of the case The authors present a case of a 28-year-old female who presented with a chronic headache that was unresponsive to analgesics. No other neurological deficits were present. Fundoscopic examination revealed the presence of bilateral papillary edema. Computed tomography scan results showed bilateral enlargement of the lateral ventricles of the brain. A subsequent MRI scan ruled out secondary causes of occlusion, such as colloid cysts, meningiomas, or choroid plexus tumors, which entailed an idiopathic etiology.Treatment options include ventriculoperitoneal shunt insertion and septostomy with foraminoplasty. The former option is currently the treatment of choice, yet it is notorious for its ramifications, including foreign body reaction, breakage, and mechanical problems. The latter option is free of these risks; however, it requires meticulousness and precision to avoid damaging the fornix, which leads to impaired memory function. Conclusion Septostomy with unilateral foraminoplasty could yield better outcomes if it is performed fastidiously.
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Fazelnia F, Hasani S, Zamani F, Shabanian R. COVID-19-Associated Acute Necrotizing Encephalopathy: A Case Report. Iran J Child Neurol 2023; 17:163-169. [PMID: 38074930 PMCID: PMC10704296 DOI: 10.22037/ijcn.v17i4.38029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 11/16/2022] [Indexed: 01/03/2024]
Abstract
COVID-19 is a pandemic disease in which most patients have pulmonary symptoms. However, several cases of CNS involvement associated with COVID-19 have been reported. Acute necrotizing encephalopathy of childhood (ANEC) is a rare CNS complication of viral infections such as influenza, herpes virus, and COVID-19, leading to high mortality and morbidity rates. Several cases of COVID-19-associated acute necrotizing encephalopathy (ANE) have been reported since March 2020 in adults, with just a few cases in pediatrics. This article reports a 5-month-old child who presented with seizures, with the final diagnosis of ANE as a complication of COVID-19. MRI findings of ANEC, as reported in most COVID-19-associated ANEC case reports, involve bilateral, symmetric, multifocal lesions in the central thalami. Moreover, the brainstem, cerebral white matter, and cerebellum could be affected. The prognosis of COVID-19-associated ANE is poor, leading to neurologic dysfunction or mortality. COVID-19-associated ANE cases must be reported, especially in pediatrics, with detailed clinical history, laboratory data, and radiologic findings to introduce diagnostic criteria, prognosis, and a management protocol.
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Affiliation(s)
- Faezeh Fazelnia
- Department of Radiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Hasani
- Department of Radiology, Rafsanjan University of Medical Sciences, Rafsanjan , Iran
| | - Fatemeh Zamani
- Department of Radiology, Children Medical Center of excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shabanian
- Department of Pediatric Cardiology, Children's Medical Center, Tehran University of Medical Sciences
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Saeki S. Internet Technology to Promote Academic Writing among Students and Trainees. JMA J 2023; 6:567-568. [PMID: 37941714 PMCID: PMC10627938 DOI: 10.31662/jmaj.2023-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 11/10/2023] Open
Affiliation(s)
- Soichiro Saeki
- Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
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Mardani P, Kamran H, Ghaderpanah R, Geramizadeh B, Fouladi D, Shahriarirad R, Amirian A. A massive immature mediastinal teratoma treated with chemotherapy and surgical resection: a case report. J Cardiothorac Surg 2023; 18:294. [PMID: 37845684 PMCID: PMC10580578 DOI: 10.1186/s13019-023-02389-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 09/30/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Teratoma is a type of germ cell tumor consisting of one or multiple tissues derived from germinal layers. The location and size of the tumor can cause various presentations. Here we report one of the largest ever cases of immature cystic teratoma. CASE PRESENTATION In this report, we presented a 24-year-old patient with dyspnea, chest pain, nausea, and anorexia. A computed tomography scan revealed a giant, right-sided mass measuring about 190 × 150 × 140 mm. Chemotherapy was initiated for the patient, followed by thoracotomy. Histopathological evaluation revealed the nature of the mass to be an immature mediastinal teratoma. CONCLUSION the incidence of immature mediastinal teratoma is uncommon, and due to its rarity, the diagnosis needs more profound evaluation studies such as radiological and pathological assessments. Immature teratomas are optimally treated by a combination of chemotherapy and complete resection.
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Affiliation(s)
- Parviz Mardani
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
| | - Hooman Kamran
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
- Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rezvan Ghaderpanah
- Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bita Geramizadeh
- Shiraz Transplant Research Center (STRC), Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Damoun Fouladi
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
- Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran.
- Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Armin Amirian
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
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Yang SY, Zhang J, Yang ZQ, Duan JJ, Zhang Y, Li MK, Wang L, Ye CM, Nie JY. Advanced hormone receptor-positive/human epidermal growth factor receptor 2-positive invasive ductal carcinoma with cecal metastasis: A case report. Sci Prog 2023; 106:368504231201043. [PMID: 37828835 PMCID: PMC10576924 DOI: 10.1177/00368504231201043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
The incidence of gastrointestinal metastases from breast cancer (BC) is low. We report a special case of Luminal B (Hormone Receptor positive [HR+]/Human Epidermal Growth Factor receptor 2-positive [HER-2+]) BC. The patient presented with asymptomatic brain metastases two years after radical surgery for modified breast cancer and developed right lower abdominal pain during relief therapy. Electronic gastroenteroscopy revealed inflammatory changes in the cecal mucosa. These changes were confirmed on pathology to be cecal metastasis from BC. The patient's condition was stabilised after treatment with an antibody-drug conjugate (ADC). For patients with BC who develop appendicitis-like symptoms after treatment for invasive ductal carcinoma of the breast, clinicians should be fully aware that the possibility of cecal metastasis needs to be considered, despite the very low probability of occurrence.
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Affiliation(s)
- Si-Yuan Yang
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
- Kunming Medical University, Kunming, China
| | - Ji Zhang
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Zhuang-Qing Yang
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
- Kunming Medical University, Kunming, China
| | - Jia-Jun Duan
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Ying Zhang
- Department of Thyroid and Breast Surgery, The Third People's Hospital of Yunnan Province, Kunming, China
| | - Ming-Ke Li
- Department of Digestive Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lei Wang
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Chun-mei Ye
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Jian-Yun Nie
- The Third Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
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Xie B, Zhu G, Shen G, Tang J, Cui J, Ren H, Jiang X. Endoscopic Resection and Decompression for Lateral Displacement of Cage after Oblique Lumbar Interbody Fusion: A Case Report from a Single Center. Orthop Surg 2023; 15:2730-2735. [PMID: 37435856 PMCID: PMC10549870 DOI: 10.1111/os.13808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/27/2023] [Accepted: 05/31/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Lateral displacement of cage is a rarely seen complication of oblique lumbar interbody fusion (OLIF). To the best of our knowledge, this complication has always been revised with posterior open surgery. However, open surgery often associates with large trauma and long period of recovery. CASE PRESENTATION In the case presented, a 64-year-old male patient with lateral displacement of cage which consequently caused neurological symptoms after OLIF, was reported and surgically revised with an endoscopic resection and decompression technique. The surgery was performed through a posterolateral approach which was similar to transforaminal approach, with estimated blood loss of 45mL and whole operation time of 70 min. Neurological symptoms were disappeared after operation immediately and the patient was discharged 2 days later. He reported no symptoms other than mild weakness of the lower back at the last follow-up of 12 months. CONCLUSION Endoscopic decompression technique may be an effective alternative to surgically treat lateral displacement of cage after OLIF with advantages of minimal invasion and quick recovery.
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Affiliation(s)
- Bin Xie
- First Clinical Medical CollegeGuangzhou University of Chinese MedicineGuangzhouChina
| | - Guangye Zhu
- First Clinical Medical CollegeGuangzhou University of Chinese MedicineGuangzhouChina
- Department of Orthopaedic SurgerySuzhou TCM Hospital Affiliated to Nanjing University of Chinese MedicineSuzhouChina
| | - Gengyang Shen
- Department of Spinal SurgeryThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Jingjing Tang
- Department of Spinal SurgeryThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Jianchao Cui
- Department of Spinal SurgeryThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Hui Ren
- Department of Spinal SurgeryThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Xiaobing Jiang
- Department of Spinal SurgeryThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
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Choi Y, Byun JS, Choi HS, Choi JK, Kim S. Asymptomatic Common Carotid Artery Occlusion and Occipital-Vertebral Artery Anastomosis: A Case Report and Literature Review. J Korean Soc Radiol 2023; 84:1152-1157. [PMID: 37869126 PMCID: PMC10585084 DOI: 10.3348/jksr.2022.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/24/2022] [Accepted: 01/20/2023] [Indexed: 10/24/2023]
Abstract
Common carotid artery occlusion (CCAO) is a very rare disorder that has rarely been studied. CCAO causes several neurological symptoms but can sometimes be asymptomatic due to the development of various anastomoses. Herein, we report the case of a 70-year-old male patient diagnosed with asymptomatic CCAO due to anastomotic flow. The patient underwent transfemoral cerebral angiography (TFCA) and was found to have CCAO with two collateral pathways, including an occipital artery-vertebral artery anastomosis. We emphasize the importance of TFCA when CCAO is suspected and review the types and anastomotic pathways of CCAO.
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Hatampour K, Zamani A, Asil RS, Ebrahimian M. Amyand's hernia in an elective inguinal hernia repair: A case report. Int J Surg Case Rep 2023; 110:108699. [PMID: 37603916 PMCID: PMC10445443 DOI: 10.1016/j.ijscr.2023.108699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Amyand's hernia is a rare condition in which the appendix is situated inside an inguinal hernia sac. It occurs in less than 1 % of all inguinal hernias, and preoperative diagnosis is often challenging, even with the aid of ultrasonography or computed tomography. The course of treatment depends on the degree of inflammation of the appendix. In this report, we present a case of Amyand's hernia that was discovered during elective inguinal hernia repair. CASE PRESENTATION We are presenting a case of a 65-year-old man who complained of right inguinal swelling and pain for one week. Upon clinical examination, a nontender and reducible mass was discovered in his right inguinal region. Further ultrasound examination suggested the presence of a right inguinal hernia, without any additional notable findings. During the surgery, the appendix was found to be present inside the indirect inguinal hernia sac, and due to its normal condition, the hernia was reduced, and a prosthetic mesh was placed. CLINICAL DISCUSSION Amyand's hernia is a rare form of inguinal hernia, predominantly found in men, with the appendix being trapped within the inguinal canal. The clinical presentation and treatment depend on the appendix's inflammation, and while ultrasonography is commonly used for diagnosis, preoperative detection of Amyand's hernia is often challenging. CONCLUSION Amyand's hernia is a rare but potentially life-threatening condition. A high index of suspicion is required to make the diagnosis. Surgical intervention is the treatment of choice, and In the absence of complications, the prognosis is favorable.
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Affiliation(s)
- Kasra Hatampour
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Zamani
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roozbeh Shadidi Asil
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Manoochehr Ebrahimian
- Department of General Surgery, 22 Bahman Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran..
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Wakeford W, Ioannidis D. Nasal obstruction in a 14 year old girl caused by a huge middle turbinate mucocele appearing radiologically as an inverted papilloma. J Radiol Case Rep 2023; 17:29-33. [PMID: 38098962 PMCID: PMC10718309 DOI: 10.3941/jrcr.v17i8.4774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Introduction We present a case of a fourteen year old girl who presented with a large intra-nasal mass to the ENT team at a district general hospital in the UK. Presentation of case The girl presented predominantly with nasal obstruction and some symptoms of allergic rhinitis. Imaging revealed a large lesion abutting the skull base and causing bony remodelling with marked septal deviation. Based both on CT and MRI imaging, the reporting (non-head and neck) radiologist suggested inverted papilloma as a differential diagnosis. Intra-operative exploration in fact revealed a very large left middle turbinate mucocele extending to the left frontal sinus. The mass was excised endoscopically without complications. Discussion Although concha bullosa of the middle turbinate of the nose are common, development of a mucocele within them is far less common and for such a mucocele to develop to this size in a child is extremely rare. The egg shell lining of the lesion can be a tell-tale sign of their aetiology when taken alongside other radiological factors. This case highlights challenges in radiological diagnosis of intra-nasal masses in children, which can lead to delays and increased anxiety. Conclusion When assessing nasal masses in children it is important to keep a wide differential due to the challenges of diagnosis. A close conversation should be had with local head and neck radiologists and, of course, where there is a unilateral nasal mass tissue sampling is essential and may be taken as part of a full excision where clinically indicated.
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Affiliation(s)
- William Wakeford
- ENT Specialty Registrar, ENT Department, Colchester Hospital, East and North Essex NHS Foundation Trust, Colchester, UK
| | - Dimitrios Ioannidis
- Consultant ENT Surgeon, ENT Department, Colchester Hospital, East and North Essex NHS Foundation Trust, Colchester, UK
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Seo JH, Cho SY, Park JH, Seo JY, Lee HY, Kim DJ. Intraoperative sudden arrhythmias in cervical spine surgery adjacent to the stellate ganglion: A case report. World J Clin Cases 2023; 11:5789-5796. [PMID: 37727714 PMCID: PMC10505998 DOI: 10.12998/wjcc.v11.i24.5789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/07/2023] [Accepted: 08/02/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Atrial arrhythmias such as paroxysmal supraventricular tachycardia (PSVT) and atrial flutter (AF) are common in the perioperative setting. They commonly resolve spontaneously. However, occasionally, they may continually progress to fatal arrhythmias or cause complications. Therefore, prompt and appropriate management is important. CASE SUMMARY A 46-year-old female patient diagnosed with cervical C6-7 radiculopathy characterized by decreased sensation in the right third, fourth and fifth fingers underwent C6-7 anterior cervical disc fusion surgery. Electrocardiography showed PSVT and ventricular tachycardia during C6-7 disc retraction. However, the patient remained stable. Initial treatment with esmolol and lidocaine for ventricular tachycardia was ineffective. Carotid massage and Valsalva maneuver were attempted but PSVT did not resolve. The surgery was paused, and the patient's fraction of inspired oxygen was set to 100%. Adenosine was administered for pharmacological management of PSVT. The arrhythmia temporarily resolved. However, it then transformed into AF. Diltiazem was administered, which briefly decreased blood pressure, which immediately recovered. Surgery resumed while the patient was in normal sinus rhythm. She was discharged safely on postoperative day 6 without complications or abnormalities. Currently, she is living a healthy life without arrhythmia recurrence. CONCLUSION Ganglia associated with cardiac arrhythmias in the surgical site should be identified during cervical spine surgery.
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Affiliation(s)
- Jong-Hun Seo
- Department of Neurosurgery, Chosun University Hospital, Gwangju 61453, South Korea
| | - Su-Yeon Cho
- Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju 61453, South Korea
| | - Ji-Hwan Park
- Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju 61453, South Korea
| | - Jin-Young Seo
- Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju 61453, South Korea
| | - Hyun-Young Lee
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chosun University, Gwangju 61453, South Korea
| | - Dong-Joon Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chosun University, Gwangju 61453, South Korea
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de Souza Timoteo AR, Pinheiro de Almeida IC, Yurchenko AA, de Miranda Henriques SR, de Souza Segundo P, Rajabi F, Nikolaev S, Petta TB. Brazilian XP-E siblings carrying a novel DDB2 variant developed early-onset melanoma: a case report. BMC Med Genomics 2023; 16:186. [PMID: 37573316 PMCID: PMC10422713 DOI: 10.1186/s12920-023-01622-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 07/31/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Xeroderma pigmentosum group E (XP-E) is one of the least common forms of XP, a rare syndrome where patients are prone to develop skin cancer in exposed sunlight areas. XP-E patients are generally not diagnosed until they are adults due to the mild phenotype. CASE PRESENTATION two XP-E siblings, female, 23 years, and male, 25 years, from a Brazilian consanguineous family carrying the novel missense pathogenic variant in DDB2 gene, NM_000107.3:c.1027G > C, associated with skin cancer early-onset and severe phenotype, as nodular melanoma in the cornea and in the ear. CONCLUSION The assessment of genomic variant pathogenicity was a challenge since this family belongs to an underrepresented population in genomic databases. Given the scarcity of literature documenting XP-E cases and the challenges encountered in achieving an early diagnosis, this report emphasizes the imperative of sun protection measures in XP-E patients. Additionally, it highlights the detrimental impact of the COVID-19 pandemic on cancer diagnosis, leading to the manifestation of a severe phenotype in affected individuals.
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Affiliation(s)
- Ana Rafaela de Souza Timoteo
- Departamento de Biologia Celular e Genética, Universidade Federal do Rio Grande do Norte, Av. Senador Salgado Filho, s/n, Natal, 59078-970, RN, Brazil
| | | | - Andrey A Yurchenko
- Cancer Genomics Lab, B2M, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, 94805, France
| | | | - Paulo de Souza Segundo
- Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, Av. Nilo Peçanha, 620, 59012-300, RN, Natal, Brazil
| | - Fatemeh Rajabi
- Cancer Genomics Lab, B2M, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, 94805, France
| | - Sergey Nikolaev
- Cancer Genomics Lab, B2M, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, 94805, France
| | - Tirzah Braz Petta
- Departamento de Biologia Celular e Genética, Universidade Federal do Rio Grande do Norte, Av. Senador Salgado Filho, s/n, Natal, 59078-970, RN, Brazil.
- Keck School of Medicine, Department of Pathology, University of Southern California, HMR 315, 2011, Zonal Avenue, Los Angeles, CA, 90089-9092, USA.
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Kučinskaite G, Lutz T, Frey S, Wetterkamp M, Schulte TL, Lukas C. Diagnosis behind the mask: A rare case of infected Charcot's spine. Radiol Case Rep 2023; 18:2800-2805. [PMID: 37324554 PMCID: PMC10267433 DOI: 10.1016/j.radcr.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 06/17/2023] Open
Abstract
Charcot's spine is a very uncommon long-term complication of spinal cord injury. Infection of the spine is a common pathology, but infection of a Charcot's spine is rare and is challenging to diagnose, especially in differentiating between the Charcot defect and the osteomyelitis defect. Surgical reconstruction has to be extremely individualized. A 65-year-old man with a history of thoracic spinal cord injury with paraplegia 49 years ago was admitted to our hospital with high fever and aphasia. After a thorough diagnostic process, destructive Charcot's spine and secondary infection were diagnosed. This report additionally reviews the surgical management of secondary infected destructive lumbar Charcot's spine and follows the patient's recovery and postoperative quality of life.
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Affiliation(s)
- Giedre Kučinskaite
- Department of Diagnostic and Interventional Radiology, St. Josef Hospital, Ruhr University of Bochum, Gudrunstrasse 56, Bochum, 44791, Germany
| | - Theodor Lutz
- Department of Diagnostic and Interventional Radiology, St. Marien Hospital Hamm, Germany
| | - Sönke Frey
- Department of Orthopedics and Trauma Surgery, St. Josef Hospital, Ruhr University of Bochum, Bochum, Germany
| | - Mark Wetterkamp
- Department of Orthopedics and Trauma Surgery, St. Josef Hospital, Ruhr University of Bochum, Bochum, Germany
| | - Tobias L. Schulte
- Department of Orthopedics, Emergency Surgery and Hand Surgery, Florence Nightingale Hospital, Dusseldorf, Germany
| | - Carsten Lukas
- Institute of Neuroradiology, St. Josef Hospital, Ruhr University of Bochum, Bochum, Germany
- Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Bochum, Germany
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