C. González-Martín, Pilar Bolsa-Col, A. Mosquera-Fernandez, V. Balboa-Barreiro, Daniel Gulias-Soidan
1Clinical Epidemiology Research Group, Health Sciences Department, Faculty of Nursing and Podiatry, Universidade da Coruña (UDC) Campus de Ferrol, España, Spain 2Degree in Podology. University of A Coruña, Spain 3Research Group of Clinical Epidemiology and Biostatistics, Biomedical Research Institute of A Coruña (INIBIC), University Hospital Complex of A Coruña (CHUAC), Spain 4Department of Radiology, University Hospital Complex of A Coruña (CHUAC), Spain
{"title":"Simple bone cyst in the calcaneus. About a case","authors":"C. González-Martín, Pilar Bolsa-Col, A. Mosquera-Fernandez, V. Balboa-Barreiro, Daniel Gulias-Soidan","doi":"10.15761/ccsr.1000134","DOIUrl":"https://doi.org/10.15761/ccsr.1000134","url":null,"abstract":"1Clinical Epidemiology Research Group, Health Sciences Department, Faculty of Nursing and Podiatry, Universidade da Coruña (UDC) Campus de Ferrol, España, Spain 2Degree in Podology. University of A Coruña, Spain 3Research Group of Clinical Epidemiology and Biostatistics, Biomedical Research Institute of A Coruña (INIBIC), University Hospital Complex of A Coruña (CHUAC), Spain 4Department of Radiology, University Hospital Complex of A Coruña (CHUAC), Spain","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74645395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Kandoria, S. Rao, P. Negi, R. Bhardwaj, K. Mahajan, N. Gaur
Heparin‐induced thrombocytopenia (HIT) is an immune mediated adverse drug reaction caused by the emergence of antibodies that activate platelets in the presence of heparin. Despite thrombocytopenia, bleeding is rare. HIT is strongly associated with thromboembolic complications involving both the arterial and venous systems. A number of laboratory tests are available to confirm the diagnosis; however, when HIT is clinically suspected, treatment should not be withheld pending the result. Fortunately, therapeutic strategies have been refined, and new and effective therapeutic agents are available. We present a case of HIT Type II. A review of HIT is presented, examining the important clinical symptoms and diagnostic indicators. The treatment of HIT is then discussed, with an emphasis on current therapies. An extensive literature review has been performed to present a comprehensive review of the causes, pathophysiology and treatment of HIT. *Correspondence to: Somendra Rao, MD Senior Resident, Department of Cardiology Indira Gandhi Medical College, Shimla, India, E-mail: sureshdev. rao@gmail.com Received: March 07, 2019; Accepted: March 26, 2019; Published: March 28, 2019 Introduction There are two types of HIT described. Type I is a non-immune, mediated, asymptomatic, transient drop in platelet count that occurs in some heparin treated patients. It is typically characterized by a lesser fall in platelet count within the first two days after heparin initiation and often returns to normal with continued heparin administration [1,2]. Type II (HIT-II) is an immune-mediated disorder characterized by the formation of antibodies against heparin-platelet factor 4 complexes. Since The frequency of HIT varies from 0.5% to 5%, depending on the patient population studied [3]. A meta-analysis noted an incidence of 2.6 percent [4]. It has recently been proposed that the term “HIT type I” be changed to “non‐immune heparin associated thrombocytopenia” and that the term “HIT type II” be changed to “HIT” to avoid confusion between the two syndromes
{"title":"Heparin induced thrombocytopenia: A case-based re-appraisal","authors":"A. Kandoria, S. Rao, P. Negi, R. Bhardwaj, K. Mahajan, N. Gaur","doi":"10.15761/ccsr.1000120","DOIUrl":"https://doi.org/10.15761/ccsr.1000120","url":null,"abstract":"Heparin‐induced thrombocytopenia (HIT) is an immune mediated adverse drug reaction caused by the emergence of antibodies that activate platelets in the presence of heparin. Despite thrombocytopenia, bleeding is rare. HIT is strongly associated with thromboembolic complications involving both the arterial and venous systems. A number of laboratory tests are available to confirm the diagnosis; however, when HIT is clinically suspected, treatment should not be withheld pending the result. Fortunately, therapeutic strategies have been refined, and new and effective therapeutic agents are available. We present a case of HIT Type II. A review of HIT is presented, examining the important clinical symptoms and diagnostic indicators. The treatment of HIT is then discussed, with an emphasis on current therapies. An extensive literature review has been performed to present a comprehensive review of the causes, pathophysiology and treatment of HIT. *Correspondence to: Somendra Rao, MD Senior Resident, Department of Cardiology Indira Gandhi Medical College, Shimla, India, E-mail: sureshdev. rao@gmail.com Received: March 07, 2019; Accepted: March 26, 2019; Published: March 28, 2019 Introduction There are two types of HIT described. Type I is a non-immune, mediated, asymptomatic, transient drop in platelet count that occurs in some heparin treated patients. It is typically characterized by a lesser fall in platelet count within the first two days after heparin initiation and often returns to normal with continued heparin administration [1,2]. Type II (HIT-II) is an immune-mediated disorder characterized by the formation of antibodies against heparin-platelet factor 4 complexes. Since The frequency of HIT varies from 0.5% to 5%, depending on the patient population studied [3]. A meta-analysis noted an incidence of 2.6 percent [4]. It has recently been proposed that the term “HIT type I” be changed to “non‐immune heparin associated thrombocytopenia” and that the term “HIT type II” be changed to “HIT” to avoid confusion between the two syndromes","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73915183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Interscalene catheters have known to migrate leading to failure or even more dangerous complications like intravascular injection related toxicity. We present a case of ipsilateral facial blanching and contralateral facial flushing (Harlequin-like syndrome) immediately after bolus injection of local anesthetics into interscalene catheter. Reviewing the ultrasound image, the incident was most likely triggered by migrated interscalene catheter with intravascular local anesthesia injection. This case emphasizes the importance of vigilance in monitoring regional catheters and illustrates value for ultrasonography in investigating unexpected clinical presentations. *Correspondence to: Ching-Rong Cheng, Department of Anesthesiology, University of California San Diego, USA, E-mail: crcheng@ucsd.edu
{"title":"Harlequin-like syndrome after migrated interscalene catheter bolus injection","authors":"Ching-Rong Cheng, Navreet Sandhu","doi":"10.15761/CCSR.1000116","DOIUrl":"https://doi.org/10.15761/CCSR.1000116","url":null,"abstract":"Interscalene catheters have known to migrate leading to failure or even more dangerous complications like intravascular injection related toxicity. We present a case of ipsilateral facial blanching and contralateral facial flushing (Harlequin-like syndrome) immediately after bolus injection of local anesthetics into interscalene catheter. Reviewing the ultrasound image, the incident was most likely triggered by migrated interscalene catheter with intravascular local anesthesia injection. This case emphasizes the importance of vigilance in monitoring regional catheters and illustrates value for ultrasonography in investigating unexpected clinical presentations. *Correspondence to: Ching-Rong Cheng, Department of Anesthesiology, University of California San Diego, USA, E-mail: crcheng@ucsd.edu","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81180626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Kaya, I. Balkan, S. Kaya, B. Altun, M. Yemisen, B. Mete, N. Saltoğlu, Y. Tunalı, G. Aygün, R. Ozturk
Carbapenem-resistant Klebsiella pneumoniae (CR-KP) strains have been increasingly seen as agents in the nosocomial infections in recent years. Many drugs, especially colistin are mostly used in the treatment of these pathogens [1]. As a natural result, we encountered colistinresistant strains in the hospital outbreak and infections. This challenge provide very limited treatment options for us and it shows that not only carbapenem but also colistin need to be used appropriately because of possibility of resistance [2]. Antibiotic resistance is seen due to unnecessarily and inappropriately using and not implementing hospital infection control procedures. Herein, we presented a patient who was administered intravenous (IV) + intrathecal colistin therapy due to recurrent ventriculitis associated with ventriculoperitoneal (VP) shunt. But the condition of the patient worsened under this treatment and then colistin-resistant Klebsiella pneumoniae (CoR-KP) was isolated from cerebrospinal fluid (CSF) culture. Finally, she could be successfully treated with intravenous and intrathecal amikacin use.
{"title":"A case of recurrent ventriculitis associated with Colistin-Resistant Klebsiella pneumoniae in patient with ventriculoperitoneal shunt treated with intrathecal amikacin","authors":"A. Kaya, I. Balkan, S. Kaya, B. Altun, M. Yemisen, B. Mete, N. Saltoğlu, Y. Tunalı, G. Aygün, R. Ozturk","doi":"10.15761/ccsr.1000132","DOIUrl":"https://doi.org/10.15761/ccsr.1000132","url":null,"abstract":"Carbapenem-resistant Klebsiella pneumoniae (CR-KP) strains have been increasingly seen as agents in the nosocomial infections in recent years. Many drugs, especially colistin are mostly used in the treatment of these pathogens [1]. As a natural result, we encountered colistinresistant strains in the hospital outbreak and infections. This challenge provide very limited treatment options for us and it shows that not only carbapenem but also colistin need to be used appropriately because of possibility of resistance [2]. Antibiotic resistance is seen due to unnecessarily and inappropriately using and not implementing hospital infection control procedures. Herein, we presented a patient who was administered intravenous (IV) + intrathecal colistin therapy due to recurrent ventriculitis associated with ventriculoperitoneal (VP) shunt. But the condition of the patient worsened under this treatment and then colistin-resistant Klebsiella pneumoniae (CoR-KP) was isolated from cerebrospinal fluid (CSF) culture. Finally, she could be successfully treated with intravenous and intrathecal amikacin use.","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89215485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Overlooked chronic constipation in adolescent: Hirschsprung Disease","authors":"Semire Serin Ezer","doi":"10.15761/ccsr.1000115","DOIUrl":"https://doi.org/10.15761/ccsr.1000115","url":null,"abstract":"","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88648346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Donor selection in pre-sensitized patients for renal transplant","authors":"S. Kankonkar","doi":"10.15761/CCSR.1000118","DOIUrl":"https://doi.org/10.15761/CCSR.1000118","url":null,"abstract":"","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79979673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Brescini, L. Weimer, O. Cirioni, G. Morroni, A. Giacometti
{"title":"Eleven years of Maraviroc experience and limited side effects in a HIV-1 experienced patient. Long term antiretroviral observation","authors":"L. Brescini, L. Weimer, O. Cirioni, G. Morroni, A. Giacometti","doi":"10.15761/CCSR.1000117","DOIUrl":"https://doi.org/10.15761/CCSR.1000117","url":null,"abstract":"","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82265044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 23-year-old male was admitted to the emergency department with complaint of worsening lower limbs pain since a few hours ago. No history of recent trauma was noted. He was healthy overall, and his past medical history was unremarkable. On examination the patient was agitated because of pain and mildly dehydrated. His blood pressure was 115/65 mm Hg, pulse rate 106/min, respiratory rate 24/min, and temperature 37.1°C. Evaluation of lower limbs revealed only mild tender and tense calves. No difference between temperature and size of legs was detected. Sensory and motor exam of four limbs was normal.
一名23岁男性，因几小时前下肢疼痛加重而被送往急诊科。无近期外伤史。他整体健康，既往病史无异常。检查时，病人因疼痛而烦躁不安，并伴有轻度脱水。血压115/65 mm Hg，脉率106/min，呼吸率24/min，体温37.1℃。下肢评估显示只有轻微的疼痛和紧张的小腿。没有检测到温度和腿的大小之间的差异。四肢感觉及运动检查正常。
{"title":"Rhabdomyolysis and acute renal failure after intense physical activity","authors":"S. Nikpour, N. Zamani, F. Fahim, M. Farnia","doi":"10.15761/ccsr.1000133","DOIUrl":"https://doi.org/10.15761/ccsr.1000133","url":null,"abstract":"A 23-year-old male was admitted to the emergency department with complaint of worsening lower limbs pain since a few hours ago. No history of recent trauma was noted. He was healthy overall, and his past medical history was unremarkable. On examination the patient was agitated because of pain and mildly dehydrated. His blood pressure was 115/65 mm Hg, pulse rate 106/min, respiratory rate 24/min, and temperature 37.1°C. Evaluation of lower limbs revealed only mild tender and tense calves. No difference between temperature and size of legs was detected. Sensory and motor exam of four limbs was normal.","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"148 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86118820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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