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Burningham KM, Swali RN, Rady PL, Patel AB, Tyring SK. Resolution of painful trichodysplasia spinulosa with topical cidofovir: case report. J DERMATOL TREAT 2024; 35:2328180. [PMID: 38493799 DOI: 10.1080/09546634.2024.2328180] [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: 03/19/2024]
Abstract
Purpose: Trichodysplasia spinulosa (TS) is a rare, disfiguring skin condition which presents with widespread asymptomatic or pruritic, skin-colored papules with white protruding keratin spiculations in immunocompromised individuals. Due to its rarity, there is little data to guide treatment decisions. The purpose of this article is to report a case of TS that completely resolved after treatment with topical cidofovir.Materials and methods: A 19-year-old immunosuppressed female presented with widespread painful, itchy bumps on the nose and face. Upon examination, there were erythematous papules with hyperkeratinized spicules affecting the central face. Biopsy of the lesions was consistent with TS which was confirmed via PCR analysis. The tenderness of this patient's eruption was highly atypical for TS. Once daily topical application of compounded 1% cidofovir cream was prescribed.Results: The patient's symptoms resolved completely after 4 weeks of therapy with topical cidofovir 1% cream, without reduction of immunosuppression.Conclusions: Topical cidofovir 1% cream may be a valuable treatment for this rare disease.
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Affiliation(s)
| | - Ritu N Swali
- Department of Dermatology, The University of Texas Health Science Center at Houston, Bellaire, Texas, USA
- Dermatology and Laser Center, Houston, Texas, USA
| | - Peter L Rady
- Department of Dermatology, The University of Texas Health Science Center at Houston, Bellaire, Texas, USA
| | - Anisha B Patel
- Department of Dermatology, The University of Texas Health Science Center at Houston, Bellaire, Texas, USA
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Stephen K Tyring
- Center for Clinical Studies, LTD, Webster, Texas, USA
- Department of Dermatology, The University of Texas Health Science Center at Houston, Bellaire, Texas, USA
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2
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Beljan A, Blagec V, Bronic A, Pavić M. Hematological investigations in a case of intravascular hemolysis due to Clostridium perfringens infection. Biochem Med (Zagreb) 2024; 34:021001. [PMID: 38665872 PMCID: PMC11042560 DOI: 10.11613/bm.2024.021001] [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: 10/09/2023] [Accepted: 02/16/2024] [Indexed: 04/28/2024] Open
Abstract
A patient presented with fever, severe pain and edematous tight due to hip trauma and was scheduled for urgent fasciotomy. Following physical examination, laboratory analyses were requested, and results revealed anemia and severe infection. As the patient's condition was serious, a new set of samples was sent to the laboratory four hours later. Following centrifugation, severely hemolyzed dark-colored serum and plasma samples were obtained and in vitro hemolysis was suspected. The collection of samples was repeated, but a new set of samples was also hemolyzed with a significant decrease in the hemoglobin value. At that point, in vivo hemolysis was suspected, and samples were processed according to standard laboratory procedures for hemolytic samples. Following confirmation of the gas gangrene diagnosis by clinicians, the cause of hemolysis was attributed to the cytotoxic activity of α-toxin produced by the anaerobic gram-positive bacterium Clostridium perfringens. An insight into the laboratory procedure that could help to narrow down the causes of hemolysis and single out C. perfringens as a cause of intravascular hemolysis was given.
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Affiliation(s)
- Anamarija Beljan
- Clinical Institute of Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Viktorija Blagec
- Clinical Institute of Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Ana Bronic
- Clinical Institute of Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Marina Pavić
- Clinical Institute of Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
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3
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Ishido H, Tajima H, Meguro S, Takada M, Tatsuoka T, Kawasaki K, Ono Y, Ban S, Okuyama T, Yoshitomi H. Primary anastomosing hemangioma as a preoperative diagnostic mimicker of retroperitoneal cavernous hemangioma: A case report. Oncol Lett 2024; 27:254. [PMID: 38646490 PMCID: PMC11027107 DOI: 10.3892/ol.2024.14386] [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: 11/15/2023] [Accepted: 01/30/2024] [Indexed: 04/23/2024] Open
Abstract
Anastomosing hemangioma (AH) is rare and a newly recognized variant of capillary hemangioma that is mostly found in the genitourinary tract. Additionally, AH is sometimes difficult to diagnose without pathological specimens. It is difficult to diagnose preoperatively due to the lack of specific clinical and radiologic appearance. The present report describes the imaging features from a radiological perspective and outlines the clinicopathologic features and treatment options. A 67-year-old woman was referred to Dokkyo Medical University Saitama Medical Center (Koshigaya, Japan) for a retroperitoneal tumor that was identified at a medical checkup 4 years prior. The patient had no symptoms, no abnormal physical signs and no past medical or specific family history. Routine blood tests were all within the normal ranges. A nonenhanced CT scan showed a circular, homogenous, well-circumscribed retroperitoneal tumor that was ~32×23 mm in size, between the abdominal aorta and the inferior vena cava, and just below the left renal vein. On a contrast-enhanced multidetector CT scan, the tumor showed heterogeneous septal enhancement in the arterial phase and persistent enhancement in the portal phase. The tumor was diagnosed as a benign neurogenic tumor or a retroperitoneal cavernous hemangioma at the time, and the patient was intended to be followed up at the outpatient clinic. However, it gradually increased to a maximum diameter of 35 mm over 4 years. Finally, it was completely resected by open laparotomy and pathologically diagnosed as AH. Retroperitoneal hemangioma is extremely rare in adulthood and has been confirmed in only 1-3% of all retroperitoneal tumors. To the best of our knowledge, only 6 cases of para-aortic AH have been reported. The incidence of this variant is very low. However, AH may be included in the differential diagnosis when a slowly progressing heterogeneous mass appears in the para-aortic region that exhibits a CT-enhanced pattern similar to a typical cavernous hemangioma.
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Affiliation(s)
- Hirotaka Ishido
- Department of Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Hidehiro Tajima
- Department of Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Soya Meguro
- Department of Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Musashi Takada
- Department of Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Teppei Tatsuoka
- Department of Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Keishi Kawasaki
- Department of Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Yuko Ono
- Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama 350-8550, Japan
- Department of Diagnostic Pathology, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan
| | - Shinichi Ban
- Department of Pathology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Takashi Okuyama
- Department of Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Hideyuki Yoshitomi
- Department of Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
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4
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Huang H, Jiang H, Yang M, Gao Y, Cao L. Case report: biotin-thiamine-responsive basal ganglia disease with severe subdural hematoma on magnetic resonance imaging. Int J Neurosci 2024; 134:184-192. [PMID: 35775132 DOI: 10.1080/00207454.2022.2097080] [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: 12/20/2021] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
Abstract
Background: Biotin-thiamine-responsive basal ganglia disease (BTBGD) is a rare, treatable autosomal recessive neurometabolic disorder. This condition eventually leads to severe disability and death if not treated correctly. The clinical features of BTBGD, especially those with unusual complications, are not widely known by neurologists or pediatricians.Case presentation: A 4-month-old male infant was admitted to the hospital with a history of cough for the past 7 days and convulsions of 6 h duration. Physical examination showed confusion, bilateral pupillary light reflex delays, hypertonia of limbs, and brisk tendon reflexes of the limbs. Brain magnetic resonance imaging (MRI) showed multiple abnormal signals in the bilateral basal ganglia, lobes, corpus callosum, brainstem, and brain atrophy. However, his condition continued to worsen. Computed tomography performed 3 months later showed severe subdural hematoma and effusion. Subsequently, he underwent puncture drainage; however, his condition did not improve postoperatively. Repeated MRIs showed increasing subdural hematoma and effusion, and brain atrophy. The patient was diagnosed with BTBGD following whole-genome sequencing, which identified a novel compound heterozygous mutation of SLC19A3 gene. He was treated with biotin and thiamine, and the symptoms gradually improved. Subsequent MRIs showed a decrease in the subdural hematoma and effusion and partial improvement in brain atrophy.Conclusion: To the best of our knowledge, this is the first reported case of BTBGD, complicated by severe subdural hematoma. These observations extend our understanding of the clinical features, neuroimaging spectrum, and gene mutation spectrum of BTBGD. The phenotypic spectrum and pathophysiology of BTBGD are not completely understood and need to be studied further.
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Affiliation(s)
- Huasheng Huang
- Department of Neurology, Liuzhou People's Hospital, Liuzhou, China
| | - Hongliang Jiang
- Department of Neurology, The Third People's Hospital of Yiyang City, Yiyang, China
| | - Mingxiu Yang
- Department of Neurology, Liuzhou People's Hospital, Liuzhou, China
| | - Yujuan Gao
- Department of Neurology, Hechi People's Hospital, Hechi, China
| | - Liming Cao
- Department of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
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5
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Mowitz M, Hosseini S, Siemund I, Ulriksdotter J, Svedman C. New device, 'old' allergens. Allergic contact dermatitis caused by the Dexcom G7 glucose sensor. Contact Dermatitis 2024; 90:495-500. [PMID: 38316128 DOI: 10.1111/cod.14514] [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: 12/11/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) has been reported as an adverse effect from the use of several glucose sensors and insulin pumps from different manufacturers. Isobornyl acrylate (IBOA) has been identified as a major culprit sensitizer, but also other acrylates and (modified) colophonium have been reported as causes of ACD. OBJECTIVES To report the two first cases diagnosed with ACD caused by the Dexcom G7 (DG7) glucose sensor. PATIENTS AND METHODS Two children with suspected ACD from DG7 were patch tested with our medical device series with an addition of selected test preparations including two variants of modified colophonium - methyl hydrogenated rosinate (MHR) and glyceryl hydrogenated rosinate (GHR). Both patients were also tested with acetone extracts made from different parts of the DG7 sensor. The extracts were analysed by gas chromatography-mass spectrometry (GC-MS). RESULTS Both patients tested positive to IBOA, hydroabietyl alcohol and GHR. In addition, patient 1 had a positive reaction to MHR and patient 2 had a positive reaction to colophonium. The GC-MS analyses showed the presence of IBOA and colophonium-related substances in the DG7 extracts. CONCLUSIONS Both patients were diagnosed with contact allergy to well-known medical device-related sensitizers. The presence of IBOA and (modified) colophonium in a newly introduced (on the Swedish market in 2023) glucose sensor is remarkable and indicates an inadequate toxicological assessment of the materials used in the sensor.
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Affiliation(s)
- Martin Mowitz
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Sarah Hosseini
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
- Department of Dermatology and Venereology, Ryhov County Hospital, Jönköping, Sweden
| | - Ingrid Siemund
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Josefin Ulriksdotter
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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6
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Ohana E, Samueli B, Shahar M, Ben-Haroush A, Shufaro Y. Tubal superfetation following frozen-thawed single-embryo transfers in two separate cycles: Case report and literature review. Int J Gynaecol Obstet 2024; 165:562-565. [PMID: 37789649 DOI: 10.1002/ijgo.15170] [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: 07/19/2023] [Revised: 09/05/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023]
Abstract
Superfetation is a very rare occurrence. In the context of assisted reproduction, it has been reported only as an intrauterine pregnancy after ovarian stimulation and/or embryo transfer in the presence of an undiagnosed ectopic pregnancy. Here we report a case of a 27-year-old anovulatory patient, gravida 1 para 1, who underwent two frozen-thawed single-blastocyst transfers in separate cycles. The patient reported that 12 days after the first transfer, she had menstrual bleeding and stopped her estradiol and progesterone supplementation without undergoing a blood human chorionic gonadotropin (βhCG) test. At her request, a second cycle was immediately initiated, with endometrial thickness measuring 4 mm. Eleven days after the second transfer, the βhCG value was inappropriately high. A right tubal pregnancy corresponding to 8 gestational weeks was diagnosed. Laparoscopy revealed a prominent right tubal pregnancy in addition to a significantly smaller left tubal pregnancy. The discordant tubal pregnancies were confirmed histologically. To our knowledge, superfetation involving a second ectopic pregnancy coexistent with a first, contralateral ectopic pregnancy consequent to consecutive in vitro fertilization procedures has not previously been described in the medical literature. This case emphasizes the importance of routine βhCG testing after every IVF cycle, even if apparently unsuccessful.
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Affiliation(s)
- Eric Ohana
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Benzion Samueli
- Department of Pathology, Soroka University Medical Center, Beer Sheva, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Moran Shahar
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Avi Ben-Haroush
- Infertility and IVF Unit, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yoel Shufaro
- Infertility and IVF Unit, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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7
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Liu A, Van Uum S, Lee D, Hammond RR, Ezzat S, Clemens KK. A Rare Prolactin-secreting Pituitary Carcinoma With Epidural and Thecal Metastases. JCEM Case Rep 2024; 2:luae047. [PMID: 38660486 PMCID: PMC11040273 DOI: 10.1210/jcemcr/luae047] [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] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Indexed: 04/26/2024]
Abstract
Pituitary carcinomas are rare but associated with significant morbidity and mortality. They remain challenging to diagnose and manage. In this case, we describe a 56-year-old man who presented with erectile dysfunction and binocular vertical diplopia. He had central hypogonadism, secondary adrenal insufficiency, and central hypothyroidism on biochemical testing. His serum prolactin was 1517 mcg/L (1517 ng/mL; reference range 4-15 mcg/L), and his sellar magnetic resonance imaging showed a 2.0 × 2.2 × 3.1 cm pituitary tumor. Pathology revealed a prolactin-secreting carcinoma. Despite treatment with a high-dose dopaminergic, 2 transsphenoidal resections, and 1 course of radiation, prolactin levels continued to rise. He developed metastases to the epidural space and thecal sac from the thoracic to sacral spine, for which he received 12 cycles of temozolomide chemotherapy with initial clinical and biochemical response. This was followed by disease escape and progression. We discuss the clinical and imaging features that warrant a high index of suspicion for pituitary carcinoma and review contemporary treatment.
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Affiliation(s)
- Anna Liu
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada
| | - Stan Van Uum
- Center for Diabetes, Endocrinology and Metabolism, St. Joseph's Health Care London, London, ON N6A 4V2, Canada
- Department of Medicine, Division of Endocrinology and Metabolism, Western University, London, ON N6A 5W9, Canada
| | - Donald Lee
- Department of Medical Imaging, Western University, London, ON N6A 5A5, Canada
| | - Robert R Hammond
- Department of Pathology and Laboratory Medicine and Department of Clinical Neurological Sciences, Western University, London, ON N6A 5A5, Canada
| | - Shereen Ezzat
- Endocrine Oncology Site Group, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada
| | - Kristin K Clemens
- Center for Diabetes, Endocrinology and Metabolism, St. Joseph's Health Care London, London, ON N6A 4V2, Canada
- Department of Medicine, Division of Endocrinology and Metabolism, Western University, London, ON N6A 5W9, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON N6G 2M1, Canada
- Lawson Health Research Institute, London, ON N6C 2R5, Canada
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8
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Ouni NEI, Korbi M, Belhadjali H, Amri F, Othmen Y, Zrig M, Youssef M, Abid A, Zili J. Analysis of patch testing with polyvinylpyrrolidone-iodine: A hospital series of 100 patients. Contact Dermatitis 2024; 90:530-531. [PMID: 38316059 DOI: 10.1111/cod.14509] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/12/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Nour El Imene Ouni
- Department of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Mouna Korbi
- Department of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia
- Research Laboratory LR20SP03A, University of Monastir, Monastir, Tunisia
| | - Hichem Belhadjali
- Department of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia
- Research Laboratory LR20SP03A, University of Monastir, Monastir, Tunisia
| | - Feryel Amri
- Department of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Youssef Othmen
- Department of Orthopedic Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Makrem Zrig
- Department of Orthopedic Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Monia Youssef
- Department of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia
- Research Laboratory LR20SP03A, University of Monastir, Monastir, Tunisia
| | - Abderazzek Abid
- Department of Orthopedic Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Jameleddine Zili
- Department of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia
- Research Laboratory LR20SP03A, University of Monastir, Monastir, Tunisia
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Kanji A, Kapadia S, Wakelin SH. Citalopram-induced DRESS confirmed by patch testing. Contact Dermatitis 2024; 90:522-524. [PMID: 38354423 DOI: 10.1111/cod.14504] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 02/16/2024]
Affiliation(s)
- Alpa Kanji
- Department of Dermatology, Imperial College Healthcare NHS Trust, London, UK
| | | | - Sarah H Wakelin
- Department of Dermatology, Imperial College Healthcare NHS Trust, London, UK
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10
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Edinoff AN, Hathaway DB, Martinez Garza D, Rosen J, Suzuki J. The possible clinical utility of the alcohol biomarker phosphatidylethanol for managing suspected alcohol withdrawal in hospitalized patients: A case report. Am J Addict 2024; 33:351-353. [PMID: 38319035 PMCID: PMC11032224 DOI: 10.1111/ajad.13516] [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: 07/12/2023] [Revised: 11/16/2023] [Accepted: 12/31/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The decision to initiate pharmacotherapy for alcohol withdrawal is typically based on examining self-reported use of alcohol and symptoms of withdrawal. Phosphatidylethanol (PEth) is a biomarker that could aim in clinical decision-making in withdrawal management. METHODS This report describes three cases highlighting the potential clinical utility of PEth in caring for individuals at risk for alcohol withdrawal. RESULTS Two of the cases received phenobarbital when their PEth showed that the risk of withdrawal was low and one case where PEth could have shown this was needed. The results were only available in a delayed fashion, however, could have been useful in informing clinical care. DISCUSSION AND CONCLUSION PEth can be a useful tool if available without delay. PEth can be used to quickly rule out alcohol withdrawal and avoid misdiagnoses and prolonged hospital stays. SCIENTIFIC SIGNIFICANCE This is a clinical case study available looking at PEth and withdrawal in hospitalized patients. It proposes that PEth can be used as a way to quickly rule out alcohol withdrawal to avoid misdiagnoses and the possibility of a prolonged hospital stay.
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Affiliation(s)
- Amber N. Edinoff
- McLean Hospital, Division of Alcohol, Drugs, and Addiction, Belmont, MA
- Harvard Medical School, Department of Psychiatry, Boston, MA
| | - David B. Hathaway
- Harvard Medical School, Department of Psychiatry, Boston, MA
- Brigham and Women’s Hospital, Department of Psychiatry, Boston, MA
| | - David Martinez Garza
- Harvard Medical School, Department of Psychiatry, Boston, MA
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA
| | - Jordan Rosen
- Harvard Medical School, Department of Psychiatry, Boston, MA
- Brigham and Women’s Hospital, Department of Psychiatry, Boston, MA
| | - Joji Suzuki
- Harvard Medical School, Department of Psychiatry, Boston, MA
- Brigham and Women’s Hospital, Department of Psychiatry, Boston, MA
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11
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Pruksaeakanan C, Boonchai W. Contact leukoderma following allergic contact dermatitis to nickel in a patient with a history of alopecia areata. Contact Dermatitis 2024; 90:540-542. [PMID: 38310869 DOI: 10.1111/cod.14518] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/04/2024] [Accepted: 01/26/2024] [Indexed: 02/06/2024]
Affiliation(s)
- Chutipon Pruksaeakanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Waranya Boonchai
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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12
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Kachaner A, Seror R, Aubart FC, Henry J, Lazure T, Emile JF, Mariette X, Bitoun S. Complete remission after a single bisphosphonate infusion in isolated bone Langerhans cell histiocytosis lesion: a case report and a narrative review of the literature. JBMR Plus 2024; 8:ziae043. [PMID: 38644976 PMCID: PMC11032215 DOI: 10.1093/jbmrpl/ziae043] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/12/2024] [Accepted: 02/15/2024] [Indexed: 04/23/2024] Open
Abstract
Langerhans cell histiocytosis (LCH) is a rare disease with limited treatment options. We present a case involving a 57-year-old woman afflicted with an isolated LCH bone osteolytic lesion. A single bisphosphonate infusion significantly alleviated pain, and follow-up scans via CT, PET-CT, and MRI revealed a substantial recalcification of the lesion. Conducting an extensive literature review, we identified 46 cases documenting the efficacy of bisphosphonates in the context of LCH. These findings have raised interest in bisphosphonate infusion as a simple therapeutic alternative in similar situations, with benefits in terms of bone recalcification and pain control for individuals with LCH.
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Affiliation(s)
- Alexandra Kachaner
- Department of Rheumatology, Paris Saclay University, Bicêtre Hospital, AP-HP, FHU Care, Le Kremlin Bicêtre 94270, France
| | - Raphaèle Seror
- Department of Rheumatology, Paris Saclay University, Bicêtre Hospital, AP-HP, FHU Care, Le Kremlin Bicêtre 94270, France
| | - Fleur Cohen Aubart
- Internal Medicine Department 2, French National Referral Center for Rare Systemic Diseases and Histiocytosis, Sorbonne University AP-HP, Pitié-Salpêtrière Hospital, INSERM UMRS-1135 Team 7, Paris 75013, France
| | - Julien Henry
- Department of Rheumatology, Paris Saclay University, Bicêtre Hospital, AP-HP, FHU Care, Le Kremlin Bicêtre 94270, France
| | - Thierry Lazure
- Department of Pathology, Paris Saclay University, Bicêtre Hospital, AP-HP, Le Kremlin Bicêtre 94270, France
| | - Jean François Emile
- Paris-Saclay University, Versailles SQY University, EA4340-BECCOH, Assistance Publique–Hôpitaux de Paris (AP-HP), Ambroise-Paré Hospital, Smart Imaging, Service de Pathologie, Boulogne 92100, France
| | - Xavier Mariette
- Department of Rheumatology, Paris Saclay University, Bicêtre Hospital, AP-HP, FHU Care, Le Kremlin Bicêtre 94270, France
| | - Samuel Bitoun
- Department of Rheumatology, Paris Saclay University, Bicêtre Hospital, AP-HP, FHU Care, Le Kremlin Bicêtre 94270, France
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Fenech G, Fenech A, Bensefa-Colas L, Crepy MN. Three-dimensional printing: A new source of exposure to (meth)acrylates in a dental technician. Contact Dermatitis 2024; 90:534-536. [PMID: 38303406 DOI: 10.1111/cod.14512] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/03/2024]
Affiliation(s)
- Goël Fenech
- Department of Occupational and Environmental Diseases, University Hospital of Centre of Paris, Hotel-Dieu Hospital, AP-HP, Paris, France
| | | | - Lynda Bensefa-Colas
- Department of Occupational and Environmental Diseases, University Hospital of Centre of Paris, Hotel-Dieu Hospital, AP-HP, Paris, France
- Henri Mondor Hospital, Créteil, France
- HERA Team, Université Paris Cité, CRESS-INSERM UMR-1153, Paris, France
| | - Marie-Noëlle Crepy
- Department of Occupational and Environmental Diseases, University Hospital of Centre of Paris, Hotel-Dieu Hospital, AP-HP, Paris, France
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14
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Avilés-Prieto J, Caro-Magdaleno M, Rodríguez-de-la-Rúa-Franch E. Peripheral Ulcerative Keratopathy following Systemic Treatment with Bortezomib: A Case Report. Ocul Immunol Inflamm 2024; 32:470-472. [PMID: 36780594 DOI: 10.1080/09273948.2023.2173241] [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: 03/22/2022] [Revised: 11/01/2022] [Accepted: 01/22/2023] [Indexed: 02/15/2023]
Abstract
A 60-year-old patient was diagnosed with multiple myeloma in November 2020, and started treatment in December 2020 with bortezomib, dexamethasone, and thalidomide. Four months later, he presented to the ophthalmology emergency department with inflammation and pain in the left eye. Examination of the anterior segment revealed severe, mixed anterior squamous blepharitis with significant bilateral palpebral inflammation, dysfunction of the meibomian glands, and several styes on both eyelids bilaterally. A peripheral ulcerative keratopathy was detected while examining the left eye cornea, with an inferior infiltrate and significant thinning, approximately 5 mm in length, at the limbal margin (Figure 1). Tear break-up time was shortened bilaterally. In addition to palpebral hygiene and oral treatment with doxycycline 100 mg every 24 hours, the patient was prescribed the following topical treatment without preservatives: artificial tears with lipid emulsion, netilmicin 0,3% 0,4 ml eye drops every 6 hours and dexamethasone 1 mg/ml every 8 hours.
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Affiliation(s)
- Javier Avilés-Prieto
- Department of Ophthalmology, University Hospital Virgen Macarena, Seville, Spain
| | - Manuel Caro-Magdaleno
- Department of Ophthalmology, University Hospital Virgen Macarena, Seville, Spain
- Members of RETICS OFTARED RD16/0008/0010 and RICORS FISS-21-RD21/0002/0011 (Inflammatory Diseases Network, Ocular Inflammatory Diseases, Ocular Surface Inflammatory Non Infectious Diseases, Instituto de Salud Carlos III)
- Department of Surgery, Ophthalmology Area, University of Seville, Seville, Spain
| | - Enrique Rodríguez-de-la-Rúa-Franch
- Department of Ophthalmology, University Hospital Virgen Macarena, Seville, Spain
- Members of RETICS OFTARED RD16/0008/0010 and RICORS FISS-21-RD21/0002/0011 (Inflammatory Diseases Network, Ocular Inflammatory Diseases, Ocular Surface Inflammatory Non Infectious Diseases, Instituto de Salud Carlos III)
- Department of Surgery, Ophthalmology Area, University of Seville, Seville, Spain
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15
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Wu L, Luo J, Wang X, Zhou P. Extraoral type of intraductal papilloma in sublingual gland: A case report. Clin Hemorheol Microcirc 2024:CH231717. [PMID: 37212087 DOI: 10.3233/ch-231717] [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] [Indexed: 05/23/2023]
Abstract
INTRODUCTION It is rare for intraductal papilloma (IDP), a benign papillary tumor, to occur in the sublingual gland (SLG). CASE SUMMARY A 55-year-old man incidentally found a painless mass in his left submandibular region (SMR). He had a history of two surgeries for bilateral SLG cyst. Contrast enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) were performed. The patient received trans-cervical excision of left residual SLG in combination with excision of left submandibular gland (SMG). The postoperative course was uneventful and no signs of recurrence during 5 months of follow-up. DISCUSSION For a SMR mass, extraoral type of IDP in SLG should be considered in the differential diagnosis.
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Affiliation(s)
- Lilu Wu
- Department of Ultrasound, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jieli Luo
- Department of Ultrasound, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaogang Wang
- Department of Pathology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Panpan Zhou
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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16
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Shingu M, Matsumoto K, Hoshijima M, Kawasaki S, Nishisaki H. A peculiar "tetra-phasic transmitral flow": An unusual case of acute aortic regurgitation accompanied by mid- and late-diastolic mitral regurgitation. Eur Heart J Cardiovasc Imaging 2024:jeae104. [PMID: 38651682 DOI: 10.1093/ehjci/jeae104] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 04/13/2024] [Indexed: 04/25/2024] Open
Affiliation(s)
- Manami Shingu
- Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tamba, Japan
| | - Kensuke Matsumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tamba, Japan
| | - Masahiko Hoshijima
- Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tamba, Japan
| | - Satoru Kawasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tamba, Japan
| | - Hogara Nishisaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tamba, Japan
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17
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Fathi A, Nadian F, Ghorbani M, Razavi P, Mosharraf R, Ebadian B. Enhancing oral function: A case report on mandibular overdenture utilization with custom-made subperiosteal implant. J Prosthodont 2024. [PMID: 38650475 DOI: 10.1111/jopr.13860] [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: 12/19/2023] [Accepted: 04/06/2024] [Indexed: 04/25/2024] Open
Abstract
Subperiosteal implants, previously set aside because of complications, are now emerging again as effective treatments for severe mandibular atrophy, aided by recent improvements in digital dentistry. Traditional dentures in such cases often face challenges with support and retention, necessitating complex regenerative procedures. This paper presents a case report of a 54-year-old male patient with significant mandibular atrophy who received a custom-made subperiosteal implant, showcasing promising results. The implant was precisely designed utilizing computed tomography (CT) scans, a 3D-printed model, the selective laser melting (SLM) technique, and constructed with biocompatible Ti6Al4V material. This innovative approach offered a practical solution, resulting in high patient satisfaction and no complications over a year of use.
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Affiliation(s)
- Amirhossein Fathi
- Department of Prosthodontics, Dental Materials Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farshad Nadian
- Department of Prosthodontics, Dental Materials Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahsa Ghorbani
- School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pouyan Razavi
- Dental School, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Ramin Mosharraf
- Department of Prosthodontics, Dental Materials Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behnaz Ebadian
- Department of Prosthodontics, Dental Materials Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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18
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Madike R, Rana K, Patel S, Selva D. A case of disseminated nocardiosis with orbital apex involvement and endophthalmitis. Orbit 2024:1-4. [PMID: 38647136 DOI: 10.1080/01676830.2024.2343302] [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: 11/23/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
Nocardia is a rare cause of ocular infections and most commonly occurs secondary to trauma. Systemic Nocardiosis may have ocular involvement in rare cases. We report a case of disseminated nocardiosis with orbital apex involvement and endophthalmitis in an immunocompromised patient. The patient presented with respiratory sepsis, and later developed complete ptosis and ophthalmoplegia in the left eye. This was on the background of treatment with high-dose prednisolone. Magnetic resonance imaging showed enhancement of the entire clivus, extending into the left orbital apex and cavernous sinus. The patient was initially treated empirically for CNS tuberculosis. Bronchoscopic cultures returned positive for Nocardia farcinica, and the patient was treated with trimethoprim/sulfamethoxazole and weaned off previous corticosteroids.
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Affiliation(s)
- Reema Madike
- School of Medicine, University of Adelaide, Adelaide, Australia
| | - Khizar Rana
- Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Sandy Patel
- South Australia Medical Imaging, Royal Adelaide Hospital, Adelaide, Australia
| | - Dinesh Selva
- Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
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19
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Barone DG, Kendziora RW, Broski SM, Schembri Wismayer DJ, Spinner RJ. The paraneurium and the tumefactive appearance of peripheral nerve neurolymphomatosis: illustrative case. J Neurosurg Case Lessons 2024; 7:CASE24125. [PMID: 38648674 DOI: 10.3171/case24125] [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] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/15/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Peripheral neurolymphomatosis (NL) is an often-misdiagnosed condition characterized by lymphomatous infiltration within the peripheral nerves. Its rarity and complexity frequently result in delayed diagnosis and suboptimal patient outcomes. This study aims to elucidate the role of the paraneurium (circumneurium) in NL, emphasizing its diagnostic and therapeutic significance. OBSERVATIONS A 72-year-old man presented with lesions on his right lower eyelid. Initial diagnostics were inconclusive until an excisional biopsy confirmed extranodal marginal zone lymphoma. Following a complete metabolic response to rituximab treatment, the patient relapsed 14 months later with progressive lymphoma and bilateral sciatic nerve involvement, as confirmed by positron emission tomography-computed tomography and magnetic resonance imaging. LESSONS This paper underscores the critical role of the paraneurium in NL, enhancing understanding of its pathophysiology. Integrating advanced imaging techniques have proved essential in accurately identifying neurolymphomatous involvement within the paraneurium. This study paves the way for more effective management strategies in NL and similar conditions, focusing on improving patient care and outcomes.
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20
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Deng X, Tang X, Yao H, Wang Y. Severe Venous Calcifications in Phlebosclerotic Colitis and Significantly Decreased Expression in Betaine. Int J Surg Pathol 2024:10668969241246475. [PMID: 38646813 DOI: 10.1177/10668969241246475] [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] [Indexed: 04/23/2024]
Abstract
Phlebosclerotic colitis (PC) is a rare type of chronic ischemic colitis. Its etiology is still unknown, and PC is also known as idiopathic mesenteric phlebosclerosis colitis. Currently, many studies have reported that long-term use of Chinese herbal medicine and drinking history are related to its pathogenesis. In the early stage of the lesion, due to insufficient understanding of PC, it is difficult to distinguish it from inflammatory bowel disease and other nonneoplastic intestinal diseases. We reported a case of severe diffuse total colon calcification with multiple misdiagnosis, summarizing and analyzing the clinical pathological characteristics to increase clinical and pathological physicians' understanding of the disease and reduce misdiagnosis. Moreover, for the first time, we conducted metabolomics sequencing on fresh intestinal specimens of PC, in order to explore the possible mechanism of severe calcification in the patient. We found that betaine was significantly decreased in the intestinal specimens of the patient, which is an amino acid that has been shown to improve vascular risk factors, and may be one of the mechanisms underlying severe calcification in the patient.
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Affiliation(s)
- Xue Deng
- Chongqing Medical University, Chongqing, China
- Department of Pathology, The Chongqing General Hospital, Chongqing, China
| | - Xuefeng Tang
- Chongqing Medical University, Chongqing, China
- Department of Pathology, The Chongqing General Hospital, Chongqing, China
| | - Hui Yao
- Department of Pathology, The Chongqing General Hospital, Chongqing, China
| | - Ying Wang
- Department of Pathology, The Chongqing General Hospital, Chongqing, China
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21
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Jasińska-Nowacka A, Wojciechowski T, Wnuk E, Niemczyk K. Regression of Endolymphatic Hydrops in Patient With Meniere's Disease Treated With Vestibular Neurectomy: A Case Report. Ear Nose Throat J 2024:1455613241238633. [PMID: 38642031 DOI: 10.1177/01455613241238633] [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] [Indexed: 04/22/2024] Open
Abstract
Vestibular neurectomy is an effective method eliminating vertigo attacks in patients suffering from disabling Meniere's disease with no clinical improvement despite conservative and intratympanic therapy. Magnetic resonance imaging allows in vivo evaluation of changes manifesting in the inner ear after treatment; however, downgrading of the endolymphatic hydrops after vestibular neurectomy had not been previously described in the literature. In the present article, a case of a patient with unilateral severe Meniere's disease treated with selective vestibular nerve section from middle fossa approach was described. Clinical symptoms and audiovestibular tests were evaluated before and 13 months after the surgery. Complete resolution of vertigo episodes and hearing preservation was achieved. Magnetic resonance imaging was performed before and after the surgery using a 3 Tesla scanner with dedicated protocol after intravenous administration of gadolinium contrast agent. In the follow-up examination, regression of the cochlear and vestibular endolymphatic hydrops was visualized, which may suggest processes occurring in the labyrinth as a result of the vestibular efferent fibers section.
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Affiliation(s)
- Agnieszka Jasińska-Nowacka
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Warsaw, Warszawa, Mazowieckie, Poland
| | - Tomasz Wojciechowski
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Warsaw, Warszawa, Mazowieckie, Poland
- Department of Clinical and Descriptive Anatomy, Center for Biostructure Research, Medical University of Warsaw, Warszawa, Mazowieckie, Poland
| | - Emilia Wnuk
- Second Department of Clinical Radiology, Medical University of Warsaw, Warszawa, Mazowieckie, Poland
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Warsaw, Warszawa, Mazowieckie, Poland
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22
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Penkl M, Mayr JA, Feichtinger RG, Reilmann R, Debus O, Fobker M, Penkl A, Reunert J, Rust S, Marquardt T. Anaplerotic Therapy Using Triheptanoin in Two Brothers Suffering from Aconitase 2 Deficiency. Metabolites 2024; 14:238. [PMID: 38668366 DOI: 10.3390/metabo14040238] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/01/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Citric acid cycle deficiencies are extremely rare due to their central role in energy metabolism. The ACO2 gene encodes the mitochondrial isoform of aconitase (aconitase 2), the second enzyme of the citric acid cycle. Approximately 100 patients with aconitase 2 deficiency have been reported with a variety of symptoms, including intellectual disability, hypotonia, optic nerve atrophy, cortical atrophy, cerebellar atrophy, and seizures. In this study, a homozygous deletion in the ACO2 gene in two brothers with reduced aconitase 2 activity in fibroblasts has been described with symptoms including truncal hypotonia, optic atrophy, hyperopia, astigmatism, and cerebellar atrophy. In an in vivo trial, triheptanoin was used to bypass the defective aconitase 2 and fill up the citric acid cycle. Motor abilities in both patients improved.
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Affiliation(s)
- Maximilian Penkl
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Münster, Albert-Schweizer-Campus 1, 48149 Muenster, Germany
| | - Johannes A Mayr
- Universitätsklinik für Kinder- und Jugendheilkunde, Salzburger Landeskliniken (SALK) and Paracelsus Medical University (PMU), Müllner Hauptstraße 48, 5020 Salzburg, Austria
| | - René G Feichtinger
- Universitätsklinik für Kinder- und Jugendheilkunde, Salzburger Landeskliniken (SALK) and Paracelsus Medical University (PMU), Müllner Hauptstraße 48, 5020 Salzburg, Austria
| | - Ralf Reilmann
- George-Huntington-Institut, Wilhelm-Schickard-Straße 15, 48149 Muenster, Germany
| | - Otfried Debus
- Clemenshospital Münster, Klinik für Kinder- und Jugendmedizin, Düesbergweg 124, 48153 Muenster, Germany
| | - Manfred Fobker
- Zentrale Einrichtung UKM Labor, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - Anja Penkl
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Münster, Albert-Schweizer-Campus 1, 48149 Muenster, Germany
| | - Janine Reunert
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Münster, Albert-Schweizer-Campus 1, 48149 Muenster, Germany
| | - Stephan Rust
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Münster, Albert-Schweizer-Campus 1, 48149 Muenster, Germany
| | - Thorsten Marquardt
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Münster, Albert-Schweizer-Campus 1, 48149 Muenster, Germany
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Kimura E, Miura M. Giant retinal pigment epithelial tear following photodynamic therapy for the bullous variant of central serous chorioretinopathy: A case report. Medicine (Baltimore) 2024; 103:e37855. [PMID: 38640292 PMCID: PMC11029976 DOI: 10.1097/md.0000000000037855] [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: 12/07/2023] [Revised: 02/28/2024] [Accepted: 03/20/2024] [Indexed: 04/21/2024] Open
Abstract
RATIONALE The bullous variant of central serous chorioretinopathy (CSC) is a severe form of chronic CSC. Patients with the bullous variant of CSC have an increased risk of experiencing multiple pigment epithelial detachments (PEDs) and retinal pigment epithelium (RPE) tears. Photodynamic therapy (PDT) is a treatment for the bullous variant of CSC. RPE tear is a possible postoperative complication of PDT for eyes with PEDs. To our knowledge, no cases of giant RPE tears following PDT for the bullous variant of CSC have been reported previously. This case report presents the first instance of a giant RPE tear after half-time PDT for the bullous variant of CSC, accompanied by a series of images depicting the tear development. PATIENT CONCERNS A 63-year-old male patient presented with rapidly deteriorating vision in his left eye over a 3-month period. He also reported a previous episode of vision loss in his right eye 2 years prior. Best-corrected visual acuity (BCVA) in the left eye was 0.2. DIAGNOSIS The right eye was diagnosed with chronic non-bullous CSC, while the left eye was diagnosed with the bullous variant of CSC with a large PED. INTERVENTIONS Half-time PDT was administered to the left eye. OUTCOMES One month after half-time PDT, a giant RPE tear exceeding 3 clock-hours in size was confirmed in the lower temporal quadrant of the left eye. Three months after the initial half-time PDT, a second half-time PDT was performed owing to recurrent retinal detachment. Two months after the second half-time PDT, the retinal detachment resolved, and BCVA improved to 0.4, 6 months after the second half-time PDT. LESSONS In cases where the bullous variant of CSC is complicated by extensive PED, clinicians should consider the potential development of a giant RPE tear as a treatment complication.
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Affiliation(s)
- Eri Kimura
- Department of Ophthalmology, Tokyo Medical University, Ibaraki Medical Center, Inashiki, Ibaraki, Japan
| | - Masahiro Miura
- Department of Ophthalmology, Tokyo Medical University, Ibaraki Medical Center, Inashiki, Ibaraki, Japan
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Amitani H, Nishi R, Fukumoto T, Hamada K, Kato R, Yamamoto T, Fuku Y, Sagiyama K, Asakawa A. Severe fibromyalgia alleviated by the unique muscle relaxation method of applying low force: A case report. Medicine (Baltimore) 2024; 103:e37929. [PMID: 38640262 PMCID: PMC11030016 DOI: 10.1097/md.0000000000037929] [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: 01/09/2024] [Accepted: 03/28/2024] [Indexed: 04/21/2024] Open
Abstract
RATIONALE Fibromyalgia (FM) is characterized by idiopathic persistent chronic pain in the ligaments or musculoskeletal system, and more than half of the patients with FM might have migraine headaches. Direct musculoskeletal intervention could be a non-pharmacological management to relieve symptoms. However, patients with severe FM often have intense pain from only a soft touch, thereby rendering musculoskeletal intervention challenging. PATIENT CONCERNS A 47-year-old man had progressing intense pain, and this affected his everyday life. There were no abnormal physical findings on laboratory examination such as levels of complement, antinuclear antibodies, and C-reactive protein, which were within normal limits. Magnetic resonance imaging did not indicate abnormalities. DIAGNOSES, INTERVENTIONS, AND OUTCOMES The patient satisfied the American College of Rheumatology criteria. Finally, we made a final diagnosis of fibromyalgia. The therapeutic intervention of Kanshoho, the unique muscle relaxation technique with low force, relieved his pain. LESSONS If Kanshoho is carefully applied in a state of hospitalization under surveillance by an experienced physician, it could be a promising muscle relaxation method. Relaxing the trapezius muscle and reducing its intramuscular pressure might be key in treating patients with severe FM. However, it needs elucidation of its mechanism.
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Affiliation(s)
- Haruka Amitani
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan
| | - Ryusei Nishi
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan
| | - Takamasa Fukumoto
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan
| | - Kazumasa Hamada
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan
| | - Ryuichi Kato
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan
| | - Takako Yamamoto
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan
| | - Yuuki Fuku
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan
| | - Kenichiro Sagiyama
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan
| | - Akihiro Asakawa
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan
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25
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Xiao Y, Yu R, Gu J. Diagnosis and rescue of malignant hyperthermia induced by anesthesia during radical surgery in a cervical cancer patient using the National Remote Emergency System: A case report. Medicine (Baltimore) 2024; 103:e37699. [PMID: 38640306 PMCID: PMC11030021 DOI: 10.1097/md.0000000000037699] [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: 12/27/2023] [Accepted: 03/04/2024] [Indexed: 04/21/2024] Open
Abstract
RATIONALE Malignant hyperthermia (MH) is a rare yet serious medical complication that typically arises following general anesthesia or the administration of specific anesthetics. Due to the infrequency of MH, anesthesiologists often lack sufficient expertise in identifying and managing it, leading to misdiagnosis and inappropriate treatment. There is an urgent need to enhance the diagnosis and management of MH through the utilization of relevant tools. PATIENT CONCERNS In this case, a 52-year-old woman underwent radical cervical cancer surgery under general anesthesia, with no family or significant medical history. She experienced a gradual increase in end-tidal carbon dioxide (ETCO2) to a maximum of 75 mm Hg and a rise in body temperature from 36.5 to 37.5 °C in a very short period, as well as a blood gas analysis showing a pH of 7.217. DIAGNOSIS The anesthesiologist immediately used The WeChat applet-based National Remote Emergency System for Malignant Hyperthermia (MH-NRES), and the score was 40, which indicated that the patient was very likely to have MH. INTERVENTIONS We immediately discontinued sevoflurane and switched total intravenous anesthesia to maintain general anesthesia, with a rapid intravenous infusion of dantrolene sodium. OUTCOMES The ETCO2 and the temperature quickly dropped to normal, followed by successful completion of the surgery, and the patient was discharged 8 days after surgery. LESSONS The experience can provide a basis use of MH-NRES and improve the ability of anesthesiologists to deal with intraoperative MH as well as increase the survival probability of patients.
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Affiliation(s)
- Yang Xiao
- Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Rou Yu
- Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Juan Gu
- Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
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Ho CL, Lee IY, Hsu HY, Kuo LC, Fang JJ. Metacarpophalangeal joint reconstruction using a costal osteochondral graft: A case report. Medicine (Baltimore) 2024; 103:e37868. [PMID: 38640291 PMCID: PMC11029923 DOI: 10.1097/md.0000000000037868] [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: 12/10/2023] [Revised: 03/05/2024] [Accepted: 03/21/2024] [Indexed: 04/21/2024] Open
Abstract
RATIONALE The conventional treatment of giant cell tumors is intralesional curettage with local adjuvant therapy. Because hand tumors have a high local recurrence, the primary goal for treating tumors of the hand is to eradicate the lesion. PATIENT CONCERNS To preserve the metacarpophalangeal (MCP) joint function as well as avoid further recurrence after surgery. DIAGNOSES The giant cell tumor invades the patient's MCP joint in an index proximal phalanx. INTERVENTIONS Using computer-aided design and three-dimensional printing techniques, we reformed the original shapes of the MCP joint and its peripheral bone to replica models. The surgeon then performed an en bloc resection and proximal phalanx with MCP joint reconstruction by fabricating the patient's costal osteochondral graft during the operation. OUTCOMES After 6 months of rehabilitation, the patient's finger functions could pinch and grasp objects naturally. At the 1-year follow-up, the range of motion of the MCP, proximal interphalangeal, and distal interphalangeal joints improved from flexion of 35° to 60°, 75° to 85°, and 60° to 80°, respectively. The hand function achieved the mean performance of non-preferred hands for young females at the postoperative 3-year follow-up. LESSONS The customized prototyping technique has the potential to replica the original patient's bony graft to reach the goal of minimizing the defects at the donor site and maximizing the function of the reconstructed MCP joint.
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Affiliation(s)
- Chien-Liang Ho
- Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University, Tainan, Taiwan
| | - I-Ying Lee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University, Tainan, Taiwan
| | - Hsiu-Yun Hsu
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Chieh Kuo
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
| | - Jing-Jing Fang
- Department of Mechanical Engineering, National Cheng Kung University, Tainan, Taiwan
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Calvo-Asín C, Tous-Romero F, Puig-Buendia J, Cavestany-Rodríguez R, Montero-Menárguez J, Gutiérrez-Collar C, Alejo-Fernández JL, Ortiz-de Frutos J. Occupational allergic contact dermatitis to Dittrichia graveolens in a gardener. Contact Dermatitis 2024. [PMID: 38641882 DOI: 10.1111/cod.14566] [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: 02/23/2024] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/21/2024]
Affiliation(s)
- Carlos Calvo-Asín
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Fátima Tous-Romero
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Jose Puig-Buendia
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Raquel Cavestany-Rodríguez
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Julia Montero-Menárguez
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Christian Gutiérrez-Collar
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - José Luis Alejo-Fernández
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Javier Ortiz-de Frutos
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
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Luo S, Zhang X, Wang Z. Breast mucosa-associated lymphoid tissue lymphoma: A case report and literature review. Medicine (Baltimore) 2024; 103:e37895. [PMID: 38640287 PMCID: PMC11029987 DOI: 10.1097/md.0000000000037895] [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: 01/03/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Mucosa-associated lymphoid tissue (MALT) lymphoma, also known as extranodal marginal zone lymphoma, is more commonly detected in the stomach and rarely in the breast. Our study presented a clinical and pathological examination of a patient diagnosed with breast MALT lymphoma, supplemented with pertinent research, to offer guidance for the diagnosis and treatment of this condition. PEOPLE CONCERNS The occurrence of breast MALT lymphoma has risen in the past decade, but its etiology, progression and treatment response are less well-studied. DIAGNOSIS Breast MALT lymphoma was diagnosed by excisional biopsy and histopathology. INTERVENTIONS Following breast MALT lymphoma diagnosis, the patient was transferred to the hematology department for further treatment, and she made the decision to continue observing. OUTCOMES After 3 months of observation, the patient remained asymptomatic. CONCLUSION Breast MALT lymphoma is an indolent disease with an asymptomatic presentation, There are no standardized treatment guidelines for breast MALT lymphoma, treatment must be tailored to the patient willingness to treat and the severity of the disease. Hence, in order to give patients a better chance of cure, more research is needed to explore its pathogenesis and more clinical trials are needed investigate the treatment of this disease.
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Affiliation(s)
- Siyi Luo
- Department of Breast, Jiujiang NO.1 People’s Hospital, Jiujiang, People’s Republic of China
| | - Xinyue Zhang
- Department of Pathology, Jiujiang NO.1 People’s Hospital, Jiujiang, People’s Republic of China
| | - Zhichun Wang
- Department of Breast, Jiujiang NO.1 People’s Hospital, Jiujiang, People’s Republic of China
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Chu YQ, Tien CT, Ding DC. Early intrauterine pregnancy with an intrauterine device in place and terminated with spontaneous abortion: A case report. Medicine (Baltimore) 2024; 103:e37843. [PMID: 38640319 PMCID: PMC11030003 DOI: 10.1097/md.0000000000037843] [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: 01/03/2024] [Accepted: 03/19/2024] [Indexed: 04/21/2024] Open
Abstract
RATIONALE The overall pregnancy rate in individuals with an intrauterine device (IUD) for contraception is <1%. If pregnancy occurs while an IUD is in place, there is a higher risk of an ectopic pregnancy. We report the case of a woman with an IUD who was 7 weeks pregnant and experienced a spontaneous abortion 1 week later. PATIENT CONCERN A 32-year-old woman presented to our outpatient department with intermittent vaginal staining for several days. DIAGNOSES She was 7 weeks pregnant and had an IUD in place for over 4 years. A vaginal examination revealed no vaginal bleeding and no blood clots; however, a parous cervix was observed. The IUD string was not visible. Transvaginal ultrasonography revealed a gestational sac in the uterine cavity, with a fetal pole and a crown-rump length of 11.4 mm. The fetal heart rate was 159 beats/min. The IUD was located in the retroplacental region. The bilateral adnexa appeared normal (right ovary, 2.9 cm; left ovary, 2.5 cm). The patient was diagnosed with an intrauterine pregnancy with an IUD in place and threatened abortion. INTERVENTIONS Attempts to remove the IUD were abandoned due to its location, and conservative treatment was initiated with Utrogestan (100 mg) administered 3 times a day for 1 week. Bed rest was advised. OUTCOMES Unfortunately, she experienced a complete abortion 1 week later. LESSONS The novelty of this case report lies in the rare occurrence of an intrauterine pregnancy with a long-term IUD in place, the challenges posed by the IUD's specific location, and the complex management of threatened abortion in this context. Our case highlights the diagnostic management approach for intrauterine pregnancy with an IUD in place. Furthermore, it explores the impact of IUD location on pregnancy prognosis.
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Affiliation(s)
- Yu-Qun Chu
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Chin-Tzu Tien
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
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Yang H, Zhu J, Sun J. Management of six episodes of intraoperative cardiac arrests in an infant with traumatic bronchial rupture: A case report. Medicine (Baltimore) 2024; 103:e37891. [PMID: 38640271 PMCID: PMC11029952 DOI: 10.1097/md.0000000000037891] [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: 12/21/2023] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/21/2024] Open
Abstract
RATIONALE Traumatic bronchial rupture in infants usually necessitates surgical intervention, with few reports documenting instances of multiple cardiac arrests occurring during surgery under conditions of severe hypoxemia. PATIENT CONCERNS A 3-year-old boy after trauma presented with severe hypoxemia for 2 days and was urgently transferred to the operating room for surgery, 6 episodes of cardiac arrest happend during surgery. DIAGNOSES The baby was diagnosed with bronchial rupture based on the history of trauma, clinica manifestations, and intraoperative findings. INTERVENTIONS Intrathoracic cardiac compression and intravenous adrenaline were administrated. OUTCOMES The normal sinus rhythm of the heart was successfully restored within 1 minute on each occasion, facilitating the smooth completion of the surgical procedure. By the end of surgery, SpO2 levels had rebounded to 95% and remained stable. LESSONS Inadequate management of bronchial ruptures in infants frequently coincides with severe hypoxemia, necessitating immediate surgical intervention. Prompt identification and management of cardiac arrest by anesthetists during surgery is imperative to reduce mortality.
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Affiliation(s)
- Haikou Yang
- Department of Anesthesiology, Affiliated Hospital of Yang Zhou University Medical College, Huai’an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
| | - Jixiang Zhu
- Department of Anesthesiology, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, Yancheng, Jiangsu, People’s Republic of China
| | - Jian Sun
- Department of Anesthesiology, Affiliated Hospital of Yang Zhou University Medical College, Huai’an Maternal and Child Health Care Center, Huai’an, Jiangsu, People’s Republic of China
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Liu J, Wang X, Huang D, Qi Y, Xu L, Shao Y. A novel ABCD1 gene mutation causes adrenomyeloneuropathy presenting with spastic paraplegia: A case report. Medicine (Baltimore) 2024; 103:e37874. [PMID: 38640304 PMCID: PMC11029984 DOI: 10.1097/md.0000000000037874] [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: 12/13/2023] [Revised: 02/29/2024] [Accepted: 03/21/2024] [Indexed: 04/21/2024] Open
Abstract
RATIONALE X-linked adrenoleukodystrophy (X-ALD) is caused by mutations in the ABCD1 gene leading to very long chain fatty acid (VLCFA) accumulation. The disease demonstrates a spectrum of phenotypes including adrenomyeloneuropathy (AMN). We aimed to identify the genetic basis of disease in a patient presenting with AMN features in order to confirm the diagnosis, expand genetic knowledge of ABCD1 mutations, and elucidate potential genotype-phenotype associations to inform management. PATIENT CONCERNS A 29-year-old male presented with a 4-year history of progressive spastic paraplegia, weakness of lower limbs, fecal incontinence, sexual dysfunction, hyperreflexia, and positive Babinski and Chaddock signs. DIAGNOSES Neuroimaging revealed brain white matter changes and spinal cord thinning. Significantly elevated levels of hexacosanoic acid (C26:0) and tetracosanoic acid (C24:0) suggested very long chain fatty acids (VLCFA) metabolism disruption. Genetic testing identified a novel hemizygous ABCD1 mutation c.249dupC (p.F83fs). These findings confirmed a diagnosis of X-linked ALD with an AMN phenotype. INTERVENTIONS The patient received dietary counseling to limit VLCFA intake. Monitoring for adrenal insufficiency and consideration of Lorenzo's oil were advised. Genetic counseling and testing were offered to at-risk relatives. OUTCOMES At present, the patient continues to experience progressive paraplegia. Adrenal function remains normal thus far without steroid replacement. Family members have undergone predictive testing. LESSONS This case expands the known mutation spectrum of ABCD1-linked X-ALD, providing insight into potential genotype-phenotype correlations. A thoughtful diagnostic approach integrating clinical, biochemical and genetic data facilitated diagnosis. Findings enabled genetic counseling for at-risk relatives regarding this X-linked disorder.
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Affiliation(s)
- Jinxin Liu
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xin Wang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Di Huang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yuna Qi
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Lei Xu
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yankun Shao
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
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Xu G, He K, Ye X, Ning S, Zhang Q. Acupuncture therapy for isolated ischemic oculomotor nerve palsy: A case report. Medicine (Baltimore) 2024; 103:e37850. [PMID: 38640311 PMCID: PMC11029924 DOI: 10.1097/md.0000000000037850] [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: 12/01/2023] [Revised: 02/28/2024] [Accepted: 03/20/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Isolated ischemic oculomotor nerve palsy as a type of ophthalmic disease is rarely observed in clinical practice. Quality of life is frequently impacted by isolated ischemic oculomotor nerve palsy due to its lack of treatment options and long-term visual impairment. We describe an acupuncture-treated instance of isolated ischemic oculomotor paralysis. METHODS Acupoints including Jingming (BL 1), Chengqi (ST 1), Cuanzhu (BL 2), and Sizhukong (TE 23) on the right side, and bilateral Fengchi (GB 20), Waiguan (TE 5), Hegu (LI 4), and Zulinqi (GB 41) were selected for needling. Each treatment lasted for 30 minutes, once every other day. Acupuncture treatment was administered for a total of 11 times. RESULTS Acupuncture is a promising treatment option for isolated ischemic oculomotor nerve palsy. CONCLUSIONS Ischemic oculomotor nerve paralysis can affect the quality of life of patients. Acupuncture intervention can promote the recovery of the disease is a very effective treatment measure.
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Affiliation(s)
- Guan Xu
- Zhejiang Chinese Medical University, Hangzhou, China
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Kelin He
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiao Ye
- Confucius Institute, University of Coimbra, Coimbra, Portugal
| | - Songhao Ning
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Quanai Zhang
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Zhao L, Wang Y, Guo Z. Successful treatment of gastric cancer 10 years after heart transplantation: A case report. Medicine (Baltimore) 2024; 103:e37841. [PMID: 38640302 PMCID: PMC11029957 DOI: 10.1097/md.0000000000037841] [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: 12/27/2023] [Accepted: 03/19/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND While survival rates among cardiac allograft recipients have improved, there has been a rise in post-transplant malignancies, with gastric cancer being less commonly reported. This study presented a successful treatment of gastric cancer in an individual 10 years after undergoing a heart transplant. CASE PRESENTATION A 66-year-old Chinese man presented to the gastrointestinal clinic with a complaint of diagnosis of gastric cancer for 4 months and treated with neoadjuvant therapy for 1 month. He has undergone orthotopic heart transplantation 10 years earlier due to a myocardial infarction. Physical examination and laboratory tests did not reveal any significant abnormalities. Abdominal contrast-enhanced computed tomography (CT) imaging indicated a gastric mass near the greater curvature, with gastroscopy suggesting a carcinoma at the esophagogastric junction, Siewert III. An echocardiogram indicated left atrial enlargement with mild mitral and tricuspid regurgitation. The diagnosis suggested that his gastric cancer at the esophagogastric junction was a consequence of long-term immunosuppressive therapy. A multidisciplinary team (MDT) consultation recommended a proximal radical gastrectomy. Postoperatively, the patient received 4 cycles of adjuvant chemotherapy with XELOX combined with Herceptin, initiated a month after surgery. During the 1-year follow-up, the patient showed commendable recovery, with no signs of tumor recurrence or metastasis. CONCLUSION This case underscores the potential risk of malignancy from immunosuppressive agents in transplant recipients. The successful management of this complex scenario underscores the indispensable role of an MDT approach in treating such unique and challenging cases.
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Affiliation(s)
- Lin Zhao
- Department of Anesthesiology, Peking University, Shougang Hospital, Shijingshan District, Beijing, China
| | - Ye Wang
- Department of Anesthesiology, Peking University, Shougang Hospital, Shijingshan District, Beijing, China
| | - Zhenggang Guo
- Department of Anesthesiology, Peking University, Shougang Hospital, Shijingshan District, Beijing, China
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Xie CM, Zhu D, Wang SZ, Pan XB. Successful treatment of severe primary mitral regurgitation due to rheumatic aetiology using a novel-designed transcatheter edge-to-edge repair system. Catheter Cardiovasc Interv 2024. [PMID: 38639161 DOI: 10.1002/ccd.31058] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/07/2024] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Abstract
The transcatheter edge-to-edge mitral valve repair (TEER) has been recommended as a reliable treatment option for selected patients with severe degenerative and functional mitral regurgitation (MR). Although MR patients with rheumatic etiology were excluded from two significant trials (EVEREST II and COAPT) that established a role for the TEER in degenerative and functional MR. However, it has been reported that the TEER procedure could be safely and effectively performed in carefully selected rheumatic MR patients. Therefore, we share a case report of successfully treating severe rheumatic MR using a novel-designed TEER system (JensClipTM).
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Affiliation(s)
- Chun-Mei Xie
- Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, China
| | - Da Zhu
- Department of Structure Heart Center, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, China
| | - Shou-Zheng Wang
- Department of Structure Heart Center, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, China
- Department of Structure Heart Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiang-Bin Pan
- Department of Structure Heart Center, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, China
- Department of Structure Heart Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Han P, Li D, Guo Q, Lei Y, Liu J, Tian D, Yan W. Over-the-scope clip as a rescue treatment for massive bleeding due to Dieulafoy lesion at the colorectal anastomosis: A case report. Medicine (Baltimore) 2024; 103:e37871. [PMID: 38640308 PMCID: PMC11030013 DOI: 10.1097/md.0000000000037871] [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: 12/12/2023] [Revised: 03/04/2024] [Accepted: 03/21/2024] [Indexed: 04/21/2024] Open
Abstract
RATIONALE The bleeding of Dieulafoy lesion predominantly involves the proximal stomach and leads to severe gastrointestinal bleeding. However, these lesions have also been reported in the whole gastrointestinal tract. Bleeding of Dieulafoy lesions at the anastomosis was seldomly reported and was very easy to be ignored clinically. PATIENT CONCERNS We describe a 72-year-old woman with a past history of surgery for rectal carcinoma hospitalized with chief complaint of massive rectal bleeding. No gross bleeding lesion was found during the first emergency colonoscopy. Despite multiple blood transfusions, her hemoglobin rapidly dropped to 5.8 g/dL. DIAGNOSIS She was diagnosed with Dieulafoy lesion at the colorectal anastomosis during the second emergency colonoscopy. INTERVENTIONS Primary hemostasis was achieved by endoscopic hemostatic clipping. However, she experienced another large volume hematochezia 3 days later, and then received another endoscopic hemostatic clipping. She was improved and discharged. However, this patient underwent hematochezia again 1 month later. Bleeding was arrested successfully after the over-the-scope clip (OTSC) was placed during the fourth emergency colonoscopy. OUTCOMES This patient underwent 4 endoscopic examinations and treatments during 2 hospitalizations. The lesion was overlooked during the first emergency colonoscopy. The second and third endoscopes revealed Dieulafoy lesion at the colorectal anastomosis and performed endoscopic hemostatic clippings, but delayed rebleeding occurred. The bleeding was stopped after the fourth emergency colonoscopy using OTSC. There was no further rebleeding during hospitalization and after 2-year of follow-up. LESSONS As far as we know, there is no reported case of lower gastrointestinal bleeding caused by Dieulafoy lesion at the colorectal anastomosis, OTSC is a safe and effective rescue treatment for Dieulafoy lesions.
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Affiliation(s)
- Ping Han
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Demin Li
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Qiaozhen Guo
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Yu Lei
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Jingmei Liu
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Dean Tian
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Wei Yan
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
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Aydın E, Tokat ÜM, Özgü E, Adibi A, Tutar O, Kurzrock R, Demiray M. Navigating uncharted territory: a case report and literature review on the remarkable response to personalized crizotinib containing combinational therapy in a pazopanib refractory patient with novel alterations. Ther Adv Med Oncol 2024; 16:17588359241247023. [PMID: 38645422 PMCID: PMC11027594 DOI: 10.1177/17588359241247023] [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: 11/14/2023] [Accepted: 03/27/2024] [Indexed: 04/23/2024] Open
Abstract
This paper presents a patient with a novel Ig-like-III domain fibroblast growth factor receptor (FGFR2) alteration (W290_P307>C) along with CDKN2A/B alterations and a cadherin 1 (CDH1) alteration. Initial responsiveness to pazopanib monotherapy was encouraging, yet progression occurred after 7.5 months. Following progression, the molecular tumor board recommended a combination therapy approach comprising pazopanib, crizotinib, and palbociclib to target all of the changed pathways at the same time. Pazopanib was chosen to specifically target the FGFR2 alteration, while crizotinib was selected due to its potential synthetic lethality with the CDH1 alteration. In addition, the CDK4/6 inhibitor palbociclib was administered to address the CDKN2A/B alterations. The patient exhibited a remarkable and sustained response to this innovative combination. This case not only underscores the potential of tyrosine kinase inhibitors, exemplified by pazopanib, as a viable alternative for patients without access to pan-FGFR inhibitors, but it also emphasizes their efficacy beyond commonly detected point mutations and rearrangements. Notably, the outstanding response to combination therapy, including crizotinib, in a patient with a CDH1 alteration, further substantiates the preclinical evidence of synthetic lethality between crizotinib and CDH1 alterations. To our knowledge, this represents the first clinical evidence demonstrating the efficacy of crizotinib in a patient with a CDH1 alteration. Through careful dosage adjustments and consideration of individualized genomic information, this case exemplifies the power of personalized medicine in achieving favorable treatment outcomes.
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Affiliation(s)
- Esranur Aydın
- Demiray Precision Oncology Center, Medicana Health Group, Istanbul, Turkey
| | - Ünal Metin Tokat
- Demiray Precision Oncology Center, Medicana Health Group, Istanbul, Turkey
| | - Eylül Özgü
- Demiray Precision Oncology Center, Medicana Health Group, Istanbul, Turkey
| | - Ashkan Adibi
- Demiray Precision Oncology Center, Medicana Health Group, Istanbul, Turkey
- Division of Cancer Genetics, Department of Basic Oncology, Institute of Oncology, University of Istanbul, Istanbul, Turkey
| | - Onur Tutar
- Cerrahpaşa Faculty of Medicine, Department of Radiology, Istanbul University–Cerrahpasa, Istanbul, Turkey
| | - Razelle Kurzrock
- Department of Medicine, Division of Hematology & Oncology, Medical College of Wisconsin, 9200 W, Wisconsin Ave, Milwaukee, WI 53226, USA
| | - Mutlu Demiray
- Demiray Precision Oncology Center, Medicana Health Group, Küçükbakkalköy, Vedat Günyol Cd. No. 24, Ataşehir, Istanbul 34750, Turkey
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Liu Y, Shu S, Shi J, Li J. Multimodal ultrasound diagnosis of epididymo-orchitis with secondary testicular infarction: A case report. J Clin Ultrasound 2024. [PMID: 38624174 DOI: 10.1002/jcu.23692] [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] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024]
Abstract
We report a case of a 48-year-old man with testicular infarction caused by epididymo-orchitis (EO). Multimodal ultrasound showed extensive necrosis of the testis, and the patient underwent right orchiectomy. Postoperative pathology confirmed extensive necrosis of the testis. After 3 months of follow-up, the examination of scrotal ultrasound showed that the left testis and epididymis had no obvious abnormality.
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Affiliation(s)
- Yuexia Liu
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Hospital of Chinese Medicine, Guangzhou, China
| | - Shengchun Shu
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Hospital of Chinese Medicine, Guangzhou, China
| | - Jiayao Shi
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Hospital of Chinese Medicine, Guangzhou, China
| | - Jinbing Li
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Hospital of Chinese Medicine, Guangzhou, China
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Abbas N, Chehade L, Shamseddine A. Personalized treatment with PARP inhibitors in advanced urothelial carcinoma: a case report and literature review. Ther Adv Med Oncol 2024; 16:17588359241245283. [PMID: 38638285 PMCID: PMC11025443 DOI: 10.1177/17588359241245283] [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: 12/10/2023] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Bladder cancer (BC) poses a significant health challenge, particularly in metastatic cases, where the prognosis is unfavorable and therapeutic options are limited. Poly ADP-ribose polymerase (PARP) inhibitors have gained approval for use in various cancer types, but their application in BC remains controversial, despite the notable prevalence of DNA damage response alterations in advanced or metastatic urothelial carcinomas. In this report, we describe a 66-year-old heavy-smoking female diagnosed with muscle-invasive BC. She underwent multiple rounds of chemotherapy and radiation, yet her disease remained poorly controlled, leading to metastasis in the left obturator internus muscle. Comprehensive genomic profiling through FoundationOne® Liquid CDx, examining a 324-gene panel using circulating tumor DNA from blood samples, revealed a pathogenic ATM gene alteration (p.Q654fs*10, c.1960delC), suggesting potential eligibility for PARP inhibitor therapy. Remarkably, the patient achieved a complete response to talazoparib, prompting an optimal investigation into BC candidates for this promising therapy.
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Affiliation(s)
- Noura Abbas
- Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Laudy Chehade
- Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Shamseddine
- Naef K. Basile Cancer Institute, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El-Solh, Beirut 1107 2020, Lebanon
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Al-Mutawa M, Schroeder HWS. Arachnoid bands in hemifacial spasm: an overlooked etiology? Illustrative case. J Neurosurg Case Lessons 2024; 7:CASE24164. [PMID: 38621308 PMCID: PMC11023010 DOI: 10.3171/case24164] [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] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Primary hemifacial spasm (HFS) is usually caused by arterial compression of the facial nerve at the root exit zone at the brainstem. Rarely, a purely venous compression is seen. However, arachnoid bands strangulating the facial nerve have not been recognized as a cause of hemifacial spasm. OBSERVATIONS The authors present a case of a 24-year-old female who had experienced HFS for 9 years. Endoscopic inspection of the root exit zone revealed no vascular compression but an arachnoid band strangulating the facial nerve. After cutting the band, the lateral spread response disappeared, and the patient was immediately spasm free after the surgery. Two years later, she was still doing well without any spasms. LESSONS This is the third patient in the authors' series of 535 patients who had no vascular conflict but rather a strangulation of the nerve by arachnoid bands. All patients have remained spasm free. To the authors' knowledge, no other group has reported arachnoid bands as an etiological factor of HFS so far.
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Lei S, Tian S, Lu S, Qing Z, Long J, Li L, Yang D. Primary Pulmonary Lymphoepithelioma-like Carcinoma: A Case Report Utilizing Camrelizumab and Anlotinib for Prolonged Survival. Anticancer Agents Med Chem 2024; 24:ACAMC-EPUB-139713. [PMID: 38623978 DOI: 10.2174/0118715206294031240404071838] [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: 12/26/2023] [Revised: 02/29/2024] [Accepted: 03/28/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Primary Pulmonary Lymphoepithelioma-like Carcinoma (PPLELC) is a rare form of cancer for which no standard treatment has been established to date. Patients with advanced-stage PPLELC generally have a poor prognosis with overall survival of 22.7 months. CASE PRESENTATION Here, we report a case of advanced primary pulmonary lymphoepithelioma-like carcinoma. Initially, the patient underwent a first-line (GP) and a second-line (DP) of chemotherapy, which provided temporary relief but resulted in varying degrees of myelosuppression. When the disease progressed again, we administered a third-line treatment consisting of camrelizumab combined with anlotinib. RESULT This resulted in a progression-free survival of over 26 months without significant toxic side effects. CONCLUSION Our findings suggest that combining camrelizumab and anlotinib could lead to a long progressionfree survival in patients with advanced PPLELC.
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Affiliation(s)
- ShuangYi Lei
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing, 400030, China
| | - ShanShan Tian
- The 120 Emergence Department of Chong Qing Emergency Medical Center, China
| | - SongMei Lu
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing, 400030, China
| | - Zhou Qing
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing, 400030, China
| | - JianLin Long
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing, 400030, China
| | - LuChun Li
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing, 400030, China
| | - Dan Yang
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing, 400030, China
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Agur Cohen D, Braun E. Unusual subacute endocarditis following herpes zoster infection. a case report. Fam Pract 2024; 41:214-218. [PMID: 38069742 DOI: 10.1093/fampra/cmad113] [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] [Indexed: 04/16/2024] Open
Abstract
OBJECTIVE This paper presents a rare case of subacute bacterial endocarditis (SBE) following a herpes zoster (HZ) episode, with no prior records found in the existing literature. PATIENT INFORMATION Specifically, we describe a case of a 76-year-old female whose diagnosis of SBE was hindered by the concurrent manifestation of HZ symptoms, which had emerged 3 weeks before the onset of SBE indicators. FOLLOW-UP AND OUTCOMES This delay in diagnosis resulted in profound complications, including a cerebrovascular accident and significant mitral valve destruction. DISCUSSION HZ episodes have not conventionally been linked in the medical literature to the occurrence of SBE. Nonetheless, it is noteworthy that HZ infections have been associated with the development of other consequential bacterial infections, such as pneumonia and necrotizing fasciitis.This case underscores the necessity for medical practitioners to recognize the possibility of HZ symptoms obscuring indications of critical underlying conditions and infections. The implications of this report highlight the significance of maintaining heightened vigilance for signs of other severe infections when managing patients presenting with HZ symptoms.
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Affiliation(s)
- Dikla Agur Cohen
- The Rappaport Faculty of Medicine, Technion, Haifa, Israel
- Family Physician Department, Haifa and West Galilee District, Clalit Health Service, Haifa, Israel
| | - Eyal Braun
- The Rappaport Faculty of Medicine, Technion, Haifa, Israel
- Division of Internal Medicine, Rambam Health Care Campus, Haifa, Israel
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Halloran PJ, Chiocca EA, Santos A. Phantom limb pain, traumatic neuroma, or nerve sheath tumor? Illustrative case. J Neurosurg Case Lessons 2024; 7:CASE247. [PMID: 38621303 PMCID: PMC11023014 DOI: 10.3171/case247] [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] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/29/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Phantom limb pain and traumatic neuromas are not commonly seen in neurosurgical practice. These conditions can present with similar symptoms; however, management of traumatic neuroma is often surgical, whereas phantom limb pain is treated with conservative measures. OBSERVATIONS A 77-year-old female patient with a long-standing history of an above-the-knee amputation experienced severe pain in her right posterior buttocks area for several years' duration, attributed to phantom limb pain, which radiated down the stump of her leg and was treated with a variety of conservative measures. A recent exacerbation of her pain led to a prolonged hospitalization with magnetic resonance imaging of her leg stump, revealing a mass in the sciatic notch, at a relative distance from the stump. The anatomical location of the mass on the sciatic nerve in the notch led to a presumed radiological diagnosis of nerve sheath tumor, for which she underwent excision. At surgery, a neuroma of the proximal portion of the transected sciatic nerve that had retracted from the amputated stump to the notch was diagnosed. LESSONS Traumatic neuromas of transected major nerves after limb amputation should be considered in the differential diagnosis of phantom limb pain.
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Affiliation(s)
- Patrick J Halloran
- University of Connecticut School of Medicine, Farmington, Connecticut; and Departments of
| | | | - Andres Santos
- Pathology, Brigham and Women’s Hospital, Boston, Massachusetts
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Heyne S, Steininger J, Bauer A. Occupational allergic contact dermatitis to marijuana. Contact Dermatitis 2024. [PMID: 38616499 DOI: 10.1111/cod.14567] [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: 01/18/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/16/2024]
Affiliation(s)
- S Heyne
- Department of Dermatology, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - J Steininger
- Department of Dermatology, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - A Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
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Hua W, Jin Y, Yao X, Zhang X, Li L, Zhang W, Zhao Y, Liu H. Allergic contact dermatitis to in-ear headphones occurring in the external ear. Contact Dermatitis 2024. [PMID: 38613244 DOI: 10.1111/cod.14556] [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: 01/23/2024] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024]
Affiliation(s)
- Wei Hua
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
- Cosmetic Safety and Efficacy Evaluation Center of West China Hospital, Sichuan University, Chengdu, China
| | - Youyou Jin
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
- Department of Hearing & Speech Rehabilitation, West China School of Clinical Medicine, Sichuan University, Chengdu, China
| | - Xinyi Yao
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
- Department of Hearing & Speech Rehabilitation, West China School of Clinical Medicine, Sichuan University, Chengdu, China
| | - Xiangling Zhang
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
- Department of Hearing & Speech Rehabilitation, West China School of Clinical Medicine, Sichuan University, Chengdu, China
| | - Li Li
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
- Cosmetic Safety and Efficacy Evaluation Center of West China Hospital, Sichuan University, Chengdu, China
| | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Zhao
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
- Department of Hearing & Speech Rehabilitation, West China School of Clinical Medicine, Sichuan University, Chengdu, China
| | - Haotian Liu
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
- Department of Hearing & Speech Rehabilitation, West China School of Clinical Medicine, Sichuan University, Chengdu, China
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
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Fetzer K, Forchhammer S, Silber T, Volc S. A rare case of acute generalized exanthematous pustulosis induced by gadobutrol. Contact Dermatitis 2024. [PMID: 38613226 DOI: 10.1111/cod.14562] [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: 01/04/2024] [Revised: 03/30/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Affiliation(s)
- Katharina Fetzer
- Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | | | - Toni Silber
- Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Sebastian Volc
- Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
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Sanchez-Holgado M, Bravo MC, Alvarez-Garcia P, Lopez-Ortego P, Criado Camargo S, Pellicer A. Severe pulmonary hypertension and circulatory failure associated with Congenital syphilis. Case report. J Neonatal Perinatal Med 2024:NPM230133. [PMID: 38640174 DOI: 10.3233/npm-230133] [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] [Indexed: 04/21/2024]
Abstract
BACKGROUND Congenital syphilis is a vertical infection caused by Treponema pallidum. Despite the implementation of preventive strategies during pregnancy, its incidence is increasing, and it constitutes an important public health problem. Most patients with congenital syphilis are asymptomatic; however, a small group may develop severe disease at birth with the need of advanced resuscitation in the delivery room, acute hypoxemic respiratory failure, and hemodynamic instability. Therefore, awareness is needed. METHODS AND RESULTS This series describes the clinical course of two late preterm infants with congenital syphilis who developed acute hypoxemic respiratory failure, pulmonary hypertension, and circulatory collapse early after birth. Integrated hemodynamic evaluation with neonatologist-performed echocardiography (NPE) and therapeutic management is provided. CONCLUSIONS A comprehensive hemodynamic evaluation including early and serial functional echocardiography in these patients is needed to address the underlying complex pathophysiology and to help to establish accurate treatment.
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Affiliation(s)
- M Sanchez-Holgado
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | - M C Bravo
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | - P Alvarez-Garcia
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | - P Lopez-Ortego
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | - S Criado Camargo
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | - A Pellicer
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
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Qiao Y, Zhao J, Wu J, Cao L, Song G, Mao J. Clinical and genetic analysis of a case of Gitelman syndrome accompanied with Graves disease and adrenocortical adenoma: A case report. Medicine (Baltimore) 2024; 103:e37770. [PMID: 38608089 PMCID: PMC11018201 DOI: 10.1097/md.0000000000037770] [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: 01/04/2024] [Accepted: 03/11/2024] [Indexed: 04/14/2024] Open
Abstract
RATIONALE Gitelman syndrome (GS), also known as familial hypokalemia and hypomagnesemia, is a rare autosomal recessive inherited disease caused by primary renal desalinization caused by impaired reabsorption of sodium and chloride ions in the distal renal tubules. We report a case of clinical and genetic characteristics of GS accompanied with Graves disease and adrenocorticotrophic hormone (ACTH)-independent adrenocortical adenoma. PATIENT CONCERNS The patient is a 45 year old female, was admitted to our hospital, due to a left adrenal gland occupying lesion as the chief complaint. DIAGNOSIS The patient was finally diagnosed as GS with Graves disease and adrenocortical adenoma. INTERVENTIONS Potassium magnesium aspartate (1788 mg/d, taken orally 3 times a day (supplement a few times a day, intake method, treatment duration). Contains 217.2 mg of potassium and 70.8 mg of magnesium, and potassium chloride (4.5 g/d, taken orally 3 times a day (supplement a few times a day, intake method, and treatment duration); Potassium 2356 mg), spironolactone (20 mg/d, taken orally once a day (supplement a few times a day, intake method, treatment duration). After 3 months of treatment, the patient's blood potassium fluctuated between 3.3-3.6 mmol/L, and blood magnesium fluctuated between 0.5-0.7 mmol/L, indicating a relief of fatigue symptoms. OUTCOMES On the day 6 of hospitalization, the symptoms of dizziness, limb fatigue, fatigue and pain were completely relieved on patient. In the follow-up of the following year, no recurrence of the condition was found. LESSONS The novel c.1444-10(IVS11)G > A variation may be a splicing mutation. The compound heterozygous mutations of the SLC12A3 gene may be the pathogenic cause of this GS pedigree.
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Affiliation(s)
- Yan Qiao
- Department of Endocrinology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College, Nanchong, China
| | - Jinghong Zhao
- Department of Endocrinology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College, Nanchong, China
| | - Ji Wu
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College, Nanchong, China
| | - Lewei Cao
- Department of Endocrinology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College, Nanchong, China
| | - Guiqin Song
- Institute of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, China
| | - Jingxin Mao
- Chongqing Medical and Pharmaceutical College, Chongqing, China
- College of Pharmaceutical Sciences, Southwest University, Chongqing, China
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Kaabi HH. Smokeless tobacco keratosis in oral mucosa with epithelial dysplasia: A case report. Medicine (Baltimore) 2024; 103:e37771. [PMID: 38608125 PMCID: PMC11018213 DOI: 10.1097/md.0000000000037771] [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: 01/04/2024] [Accepted: 03/11/2024] [Indexed: 04/14/2024] Open
Abstract
RATIONALE Smokeless tobacco use is a risk factor for the development of various oral lesions, among which is smokeless tobacco keratosis (STK). This condition is caused by constant frictional irritation of smokeless tobacco products against the oral mucosa and appears as a White-to-gray plaque with wrinkling. PATIENT CONCERNS A 50-year-old man who had been using smokeless tobacco for 24 years visited our clinic complaining of changes in the lower right sulcus of the oral cavity for 10 days. Clinical examination revealed a unilateral, nonhomogeneous White lesion in the area of the complaint. Histopathological examination showed hyperkeratosis, areas of keratin plugging, and mild dysplastic epithelial changes. DIAGNOSIS The clinico-histopathological correlation suggested a diagnosis of STK with focal mild epithelial dysplasia. INTERVENTION AND OUTCOME A comprehensive management plan included maintaining oral hygiene, education on the detrimental effects of smokeless tobacco, advice to cease smoking, and regular follow-up to monitor the potential for malignant transformation. The patient was referred to a tobacco cessation society for tailored advice and counseling. On follow-up visits, there was an improvement in the lesion after habitual cessation. LESSONS The diagnosis of tobacco-related oral lesions is often delayed, which may result in malignant transformation. This illustrates the need to train healthcare professionals to identify tobacco-related conditions at an early stage and to educate patients regarding the harmful effects of tobacco use.
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Affiliation(s)
- Hassan Hamed Kaabi
- Assistant Professor, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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49
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Sugaya K, Misawa T, Onodera M, Iseki K. Serotonin syndrome treated with cyproheptadine using NPi from a digital pupillometer as a therapeutic indicator: A case report. Medicine (Baltimore) 2024; 103:e37852. [PMID: 38608060 PMCID: PMC11018211 DOI: 10.1097/md.0000000000037852] [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: 12/04/2023] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
RATIONALE Serotonin syndrome is a potentially life-threatening condition resulting from the use of antidepressants, their interactions with other serotonergic medications, or poisoning. It presents with a triad of psychiatric, dysautonomic, and neurological symptoms and is sometimes fatal. While cyproheptadine is a specific treatment option, the optimal duration of its administration remains unclear. The purpose of this report is to quantitatively assess the endpoints of serotonin syndrome treatment. Based on the hypothesis that neurological pupil index (NPi) on a digital pupil recorder would correlate with the severity of the serotonin syndrome, we administered cyproheptadine using NPi as an indicator. PATIENT CONCERNS A patient with a history of depression was brought to our hospital after he overdosed on 251 tablets of serotonin and noradrenaline reuptake inhibitors. DIAGNOSES On day 3, the patient was diagnosed with serotonin syndrome. INTERVENTIONS Cyproheptadine syrup was administered at 4 mg every 4 hours. The NPi of the automated pupillometer was simultaneously measured. On day 5, the NPi exceeded 3.0 cyproheptadine was discontinued. OUTCOMES The patient was discharged on day 7. LESSONS The lack of considerable improvement during the treatment period suggests that the patient may have improved on his own. In this case, the relationship between NPi and the severity of serotonin syndrome could not be determined.
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Affiliation(s)
- Kazuki Sugaya
- Department of Emergency Medicine, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Tomotaka Misawa
- Department of Emergency Medicine, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Makoto Onodera
- Department of Regional Emergency Medicine, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Ken Iseki
- Department of Emergency Medicine, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
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Li Y, Ma D. Bilateral sinonasal inverted papillomas originating from both sides of the frontal sinus and the left lamina papyracea: A case report. Medicine (Baltimore) 2024; 103:e37703. [PMID: 38608083 PMCID: PMC11018199 DOI: 10.1097/md.0000000000037703] [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: 12/16/2023] [Accepted: 03/04/2024] [Indexed: 04/14/2024] Open
Abstract
RATIONALE The present investigation documented a case of bilateral sinonasal inverted papilloma (SNIP) that arose from both sides of the frontal sinus and ethmoid sinus. The occurrence of bilateral involvement of the nasal cavities and frontal sinus is rather infrequent. PATIENT CONCERNS Informed consent was obtained from the patient. DIAGNOSIS Bilateral SNIP. INTERVENTIONS The tumor was completely removed by Draf III endoscopic resection complemented by an external eyebrow arch approach, and the postoperative recovery was uneventful. OUTCOMES The purpose of this paper is to present a comprehensive reference for the management of bilateral SNIP that affects the frontal sinuses. LESSONS This study addresses the staging and surgical management of bilateral SNIP, along with a review of the factors contributing to its recurrence. The recommended treatment method involves applying the Draf III technique combined with an external nasal approach.
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Affiliation(s)
- Yang Li
- School of Clinical Medicine, Jining Medical University, Shandong, Jining, China
| | - Dengdian Ma
- Department of ENT, Affiliated Hospital of Jining Medical University, Shandong, Jining, China
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