The superficial temporal artery aneurysm is a rare pathology. We report the case of a 7-year-old child who consulted for a beating mass on the left forehead. The doppler ultrasound and The CT angiography confirmed the diagnosis of a superficial temporal artery aneurysm. The treatment was surgical and the postoperative course was simple.
{"title":"Superficial Temporal Artery Aneurysm","authors":"Daly Hafedh, Mnassri Cyrine, Chalbi Farhat, Horchani Amira","doi":"10.23937/2378-3656/1410393","DOIUrl":"https://doi.org/10.23937/2378-3656/1410393","url":null,"abstract":"The superficial temporal artery aneurysm is a rare pathology. We report the case of a 7-year-old child who consulted for a beating mass on the left forehead. The doppler ultrasound and The CT angiography confirmed the diagnosis of a superficial temporal artery aneurysm. The treatment was surgical and the postoperative course was simple.","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88164683","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}
Pub Date : 2022-04-30DOI: 10.23937/2378-3656/1410390
Adetiloye Adebola, Alladin Farhana, Ghosh Kuldeep, Valencia-Manrique Julio, A. Rasha, Victoria Ana Maria, Cosico John, Popescu-Martinez Andrea
Background: Bleomycin is chemotherapeutic agent that has been used for cancer treatment for several years. However, potentially life-threatening lung toxicity is a major concern limiting its use. Case report: This is a case of a 64-year-old male presenting sub acutely with gradual onset of exertional shortness of breath and cough after completing 4 cycles of ABVD regimen for Stage 2b Hodgkin’s lymphoma. CT scan showed extensive bibasilar reticular opacities with honey combing suggestive of pulmonary fibrosis with Usual interstitial pneumonia pattern. Based on temporal relations to bleomycin chemotherapy, a diagnosis of bleomycin induced lung fibrosis was made. Bleomycin was subsequently discontinued with some improvement of symptoms. Conclusion: Pulmonary toxicity with irreversible lung fibrosis is a life threatening and menacing adverse effects in patients receiving Bleomycin therapy. The probability of developing lung toxicity from Bleomycin is increased in older patients receiving multiple cycles of chemotherapy, with risk potentially outweighing benefits in select patients with early-stage lymphoma and favorable prognosis. and malignant pleural effusion [1]. It is produced by Streptomyces verticillus and was first isolated by Umezawa, et al. in 1966 [2]. Its mechanism of action involves breakdown of DNA double helix by the production of free radicals, which is dependent on oxygen and iron [2]. Although dermatological adverse effects are the most observed, Bleomycin induced lung toxicity crop up in up to 10% patients which can be life menacing if not diagnosed early with mortality rate of up to 20% [1,3]. Bleomycin induced lung injury encompasses several clinical syndromes including hypersensitivity, bronchiolitis obliterans with organizing pneumonia, hypersensitivity pneumonitis which may progress to pulmonary fibrosis [3]. Several factors including older age and cumulative drug dose have been shown to increase the risk of developing pulmonary toxicity from Bleomycin [4]. The following is a case of pulmonary fibrosis following chemotherapy with Bleomycin for Stage 2B Hodgkin’s Lymphoma (HL). This case emphasizes the need for careful selection of chemotherapy regimen in older patients with Hodgkin’s lymphoma who are risk for bleomycin pulmonary toxicity and the necessity for diligent surveillance in patients with increased baseline risks for toxicity. Introduction Bleomycin is an anti-tumor antibiotic indicated in the treatment of lymphomas, germ cell tumors ISSN: 2378-3656 DOI: 10.23937/2378-3656/1410390 Adetiloye et al. Clin Med Rev Case Rep 2022, 9:390 • Page 2 of 6 • residual mass or metabolic uptake in the neck and mediastinum (Figure 1). Initial evaluation, revealed blood pressure of 127/82 mmHg, heart rate of 104 beats per minute, respiratory rate of 22 breaths per minute, SpO2 90% on room air and Temperature was 97.8 F. He had inspiratory rales bilaterally and use of accessory muscles of respiration on examination. Pertinent negatives
背景:博来霉素是一种用于癌症治疗多年的化疗药物。然而，潜在的危及生命的肺毒性是限制其使用的主要问题。病例报告:这是一个64岁的男性病例，在完成4个周期的ABVD治疗2b期霍奇金淋巴瘤后，表现为亚急性，逐渐出现劳力性呼吸短促和咳嗽。CT示广泛双基底网状混浊伴蜂蜜混浊，提示肺纤维化伴间质性肺炎。根据与博来霉素化疗的时间关系，诊断为博来霉素所致肺纤维化。博莱霉素随后停药，症状有所改善。结论:肺毒性伴不可逆肺纤维化是博莱霉素治疗患者的致命不良反应。在接受多周期化疗的老年患者中，博莱霉素产生肺毒性的可能性增加，在某些早期淋巴瘤和预后良好的患者中，风险可能超过益处。恶性胸腔积液。它是由轮状链霉菌产生的，由Umezawa等人于1966年首次分离出来。它的作用机制包括通过产生自由基来破坏DNA双螺旋结构，而自由基的产生依赖于氧和铁。虽然皮肤方面的不良反应最为明显，但博莱霉素引起的肺毒性在高达10%的患者中出现，如果不及早诊断，可能危及生命，死亡率高达20%[1,3]。博莱霉素引起的肺损伤包括几种临床综合征，包括过敏性、闭塞性细支气管炎伴组织性肺炎、可发展为肺纤维化的过敏性肺炎。包括年龄和累积药物剂量在内的几个因素已被证明会增加博莱霉素bbb产生肺毒性的风险。以下是一例2B期霍奇金淋巴瘤(HL)用博来霉素化疗后出现肺纤维化的病例。本病例强调，对于有博来霉素肺毒性风险的老年霍奇金淋巴瘤患者，需要谨慎选择化疗方案，对于基线毒性风险增加的患者，需要认真监测。博莱霉素是一种抗肿瘤抗生素，适用于治疗淋巴瘤、生殖细胞肿瘤ISSN: 2378-3656 DOI: 10.23937/2378-3656/1410390 Adetiloye等。Clin Med Rev Case Rep 2022, 9:90•第2页6•颈部和纵隔残留质量或代谢摄取(图1)。初步评估显示血压127/82 mmHg，心率每分钟104次，呼吸频率每分钟22次，室内空气SpO2 90%，温度97.8华氏度。检查时双侧有吸气音，呼吸副肌使用。相关阴性检查为无腹水、腿部肿胀、颈部静脉扩张、颈部肿块、啰音、喘息或喘鸣。全血细胞计数、基本代谢组、降钙素原、亲BNP和肌钙蛋白T值无显著差异。胸部x线显示双侧肺基底间质性疾病。颈部和胸部CT血管造影显示双侧胸膜下中度增厚，伴有一些磨玻璃影和肺底部广泛的蜂窝状突起，提示通常的间质型(UIP)(图2)。CT扫描未见肺栓塞、肿块、纵隔、肺门或腋窝腺病。超声心动图无明显异常，左、右心室功能正常。痰培养及结缔组织疾病和血管病变标志物均为阴性。根据CT表现及与博来霉素化疗和阴性感染的时间关系，诊断为博来霉素引起的肺炎和肺纤维化。患者被送进医务室，开始以每天1mg /kg的剂量服用强的松龙，持续4周，随后逐渐减少剂量。他还接受了甲氧苄磺胺甲恶唑预防肺囊虫，同时服用类固醇。类固醇治疗可改善呼吸短促。然而，在6分钟的步行测试中，他的SpO2饱和度降至80低。一周后，他出院回家，在运动中补充氧气。基于活动性霍奇金淋巴瘤的PET和CT阴性结果，患者停止化疗。此外，患者未收到病例报告。一名来自孟加拉国的64岁男性，因逐渐出现劳累性呼吸短促1周，并逐渐恶化为休息时呼吸短促而就诊于急诊科。患者有干咳1个月病史，否认有发热、寒战、胸膜炎性胸痛、咯血、直咳、阵发性夜间呼吸困难或腿部肿胀。 5个月前，患者以体重减轻、低烧和颈部肿块就诊血液科和肿瘤科，被诊断为HL 2B期结节性硬化症亚型。当时颈部及胸部CT示颈部右侧大坏死肿块，颈部多发强化淋巴结，邻近气管、隆突及食道旁区;ESR升高至120 mm/hr，颈部肿块活检证实诊断。患者开始ABVD方案治疗，阿霉素(阿霉素)42.25 mg (25 mg/m2)，博来霉素17单位(10单位/m2)，长春碱10 mg (6 mg/m2)，达卡巴嗪634 mg (375 mg/m2)，每4周每周期第1天和第15天，完成6个周期的治疗，聚非格拉西汀每周期第2天和第16天。患者在出现用力性呼吸困难前已完成4个周期的化疗。在被诊断为霍奇金淋巴瘤之前，他没有明显的病史，并否认有吸烟史。化疗开始前进行基线肺功能检查，肺容量正常，FEV1和FVC分别为预测值的82%和80%，一氧化碳弥散能力轻度降低。在劳累性呼吸困难发作时和到急诊科就诊前一周进行的PET扫描显示肺周围高代谢活动(无图1):PET扫描显示肺周围高代谢活动增加。ISSN: 2378-3656 DOI: 10.23937/2378-3656/1410390 Adetiloye等。clinin Med Rev Case Rep 202,9:390•第3页6•美国。结节硬化霍奇金淋巴瘤(NSHL)是经典HL中最常见的亚型，占病例总数的65% ~ 75%。不幸的是，关于如何在不影响治疗效果的情况下最好地预防并发症，从潜在的致命肺炎扩展到不可逆的和使人衰弱的肺纤维化并发症，仍然存在相互矛盾的数据。这部分是由于不同的试验设计和治疗终点。化疗药物和放疗的进步改善了患者的预后;然而，在确定最佳护理标准时，需要仔细的分期、风险分层和考虑潜在的治疗相关不良事件。预后和治疗方式的选择是基于霍奇金淋巴瘤早期有利、早期不利和晚期的分类。早期霍奇金淋巴瘤是指安娜堡I期或II期疾病。根据研究小组(欧洲癌症研究和治疗组织(EORTC)和德国霍奇金研究组)，早期霍奇金淋巴瘤被划分为高风险(不利)组，定义如下:大纵隔肿块(最大胸径的三分之一)，最大尺寸≥10cm的任何肿块，结外疾病，3个或更多的结区，无症状患者的血凝率>为50mm /hr, B症状患者的血凝率>为30mm /hr，年龄大于50岁，腹内疾病[8]。广泛肺纤维化的巩固放疗。不幸的是，在5个月的随访中，患者继续经历由于运动性呼吸困难(改良医学研究委员会分级3级)而导致的运动限制。此时重复肺功能检查显示限制性肺型，FEV1和FVC分别为预测值的40%和34%(表1)。
{"title":"Risk of Pulmonary Toxicity and Benefits of Bleomycin Containing Regimen in Early-Stage Hodgkin's Lymphoma - A Case Report and Insights from Literature Review","authors":"Adetiloye Adebola, Alladin Farhana, Ghosh Kuldeep, Valencia-Manrique Julio, A. Rasha, Victoria Ana Maria, Cosico John, Popescu-Martinez Andrea","doi":"10.23937/2378-3656/1410390","DOIUrl":"https://doi.org/10.23937/2378-3656/1410390","url":null,"abstract":"Background: Bleomycin is chemotherapeutic agent that has been used for cancer treatment for several years. However, potentially life-threatening lung toxicity is a major concern limiting its use. Case report: This is a case of a 64-year-old male presenting sub acutely with gradual onset of exertional shortness of breath and cough after completing 4 cycles of ABVD regimen for Stage 2b Hodgkin’s lymphoma. CT scan showed extensive bibasilar reticular opacities with honey combing suggestive of pulmonary fibrosis with Usual interstitial pneumonia pattern. Based on temporal relations to bleomycin chemotherapy, a diagnosis of bleomycin induced lung fibrosis was made. Bleomycin was subsequently discontinued with some improvement of symptoms. Conclusion: Pulmonary toxicity with irreversible lung fibrosis is a life threatening and menacing adverse effects in patients receiving Bleomycin therapy. The probability of developing lung toxicity from Bleomycin is increased in older patients receiving multiple cycles of chemotherapy, with risk potentially outweighing benefits in select patients with early-stage lymphoma and favorable prognosis. and malignant pleural effusion [1]. It is produced by Streptomyces verticillus and was first isolated by Umezawa, et al. in 1966 [2]. Its mechanism of action involves breakdown of DNA double helix by the production of free radicals, which is dependent on oxygen and iron [2]. Although dermatological adverse effects are the most observed, Bleomycin induced lung toxicity crop up in up to 10% patients which can be life menacing if not diagnosed early with mortality rate of up to 20% [1,3]. Bleomycin induced lung injury encompasses several clinical syndromes including hypersensitivity, bronchiolitis obliterans with organizing pneumonia, hypersensitivity pneumonitis which may progress to pulmonary fibrosis [3]. Several factors including older age and cumulative drug dose have been shown to increase the risk of developing pulmonary toxicity from Bleomycin [4]. The following is a case of pulmonary fibrosis following chemotherapy with Bleomycin for Stage 2B Hodgkin’s Lymphoma (HL). This case emphasizes the need for careful selection of chemotherapy regimen in older patients with Hodgkin’s lymphoma who are risk for bleomycin pulmonary toxicity and the necessity for diligent surveillance in patients with increased baseline risks for toxicity. Introduction Bleomycin is an anti-tumor antibiotic indicated in the treatment of lymphomas, germ cell tumors ISSN: 2378-3656 DOI: 10.23937/2378-3656/1410390 Adetiloye et al. Clin Med Rev Case Rep 2022, 9:390 • Page 2 of 6 • residual mass or metabolic uptake in the neck and mediastinum (Figure 1). Initial evaluation, revealed blood pressure of 127/82 mmHg, heart rate of 104 beats per minute, respiratory rate of 22 breaths per minute, SpO2 90% on room air and Temperature was 97.8 F. He had inspiratory rales bilaterally and use of accessory muscles of respiration on examination. Pertinent negatives ","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73999586","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}
Introduction: Mivacurium is the shortest-acting nondepolarizing relaxant, used for brief procedures, such as those performed in the ambulatory setting. The recommended intubating dose of 0.2 mg/kg usually provides a clinically effective neuromuscular block for approximately 15 to 20 minutes and spontaneous recovery is 95% complete within about 25 to 30 minutes. Case presentation: 71-years-old woman was admitted for an elective laparotomy surgery with an intraoperative examination. Standard monitoring and TOF Scan (both the adductor pollicis muscle and the orbicularis oculi) were used. 8 mg dexamethasone, 0.1 mg fentanyl, 150 mg propofol, and 18 mg mivacurium were administered for induction. At the end of the procedure, there was no response from TOF. The return of neuromuscular transmission was achieved only after 75 minutes from the induction. Discussion: Mivacurium as a short-acting non-depolarizing muscle relaxant is well suited for short-term operations and operations of unpredictable duration. However, previous studies have shown that an extended neuromuscular block is likely in patients with significantly reduced plasma cholinesterase activity (especially in patients who are homozygous for the atypical plasma cholinesterase gene) as well as when administering some drugs and during other clinical situations. Conclusions: Extensively prolonged apnoea during general anaesthesia is a dangerous incident. Therefore, we still need systematic reviews to determine the prevalence of incidents of extended neuromuscular block after mivacurium. In case of prolonged muscle relaxation, we should think about possible reversible causes of this phenomenon since it is not always related to genetic causes. Furthermore, mechanical ventilation and close clinical monitoring are required during administering mivacurium. All of this to achieve the best possible patient outcomes.
{"title":"Prolonged Recovery of Neuromuscular Transmission during General Anaesthesia after Mivacurium Administration - Case Report","authors":"Radkowski Paweł, Podhorodecka Katarzyna, Kęska Mariusz","doi":"10.23937/2378-3656/1410389","DOIUrl":"https://doi.org/10.23937/2378-3656/1410389","url":null,"abstract":"Introduction: Mivacurium is the shortest-acting nondepolarizing relaxant, used for brief procedures, such as those performed in the ambulatory setting. The recommended intubating dose of 0.2 mg/kg usually provides a clinically effective neuromuscular block for approximately 15 to 20 minutes and spontaneous recovery is 95% complete within about 25 to 30 minutes. Case presentation: 71-years-old woman was admitted for an elective laparotomy surgery with an intraoperative examination. Standard monitoring and TOF Scan (both the adductor pollicis muscle and the orbicularis oculi) were used. 8 mg dexamethasone, 0.1 mg fentanyl, 150 mg propofol, and 18 mg mivacurium were administered for induction. At the end of the procedure, there was no response from TOF. The return of neuromuscular transmission was achieved only after 75 minutes from the induction. Discussion: Mivacurium as a short-acting non-depolarizing muscle relaxant is well suited for short-term operations and operations of unpredictable duration. However, previous studies have shown that an extended neuromuscular block is likely in patients with significantly reduced plasma cholinesterase activity (especially in patients who are homozygous for the atypical plasma cholinesterase gene) as well as when administering some drugs and during other clinical situations. Conclusions: Extensively prolonged apnoea during general anaesthesia is a dangerous incident. Therefore, we still need systematic reviews to determine the prevalence of incidents of extended neuromuscular block after mivacurium. In case of prolonged muscle relaxation, we should think about possible reversible causes of this phenomenon since it is not always related to genetic causes. Furthermore, mechanical ventilation and close clinical monitoring are required during administering mivacurium. All of this to achieve the best possible patient outcomes.","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75205580","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}
Severe/critical Coronavirus Virus Disease 2019 (COVID-19) patients face increased risk of pulmonary embolism (PE) and other thromboembolic events. This risk exists even in patients who are on prophylactic and therapeutic doses of anticoagulant. We present three cases of Severe/critical COVID-19 patients who developed PE despite being placed on prophylactic doses of anticoagulants. Clinicians should be keenly aware of this and urgently institute appropriate diagnostic measures if PE is suspected
{"title":"COVID-19 Associated Pulmonary Thromboembolic Events in Anti-Coagulated Patients: Case Series from a Tertiary Facility in Ghana","authors":"Hardy O. Yasmine, Ofori Emmanuel, Danso Gyasi Kwaku, Amoah-Dankwah James, Larsen-Reindorf Rita","doi":"10.33425/2768-6647.1017","DOIUrl":"https://doi.org/10.33425/2768-6647.1017","url":null,"abstract":"Severe/critical Coronavirus Virus Disease 2019 (COVID-19) patients face increased risk of pulmonary embolism (PE) and other thromboembolic events. This risk exists even in patients who are on prophylactic and therapeutic doses of anticoagulant. We present three cases of Severe/critical COVID-19 patients who developed PE despite being placed on prophylactic doses of anticoagulants. Clinicians should be keenly aware of this and urgently institute appropriate diagnostic measures if PE is suspected","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84115183","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}
Isaac Ogyefo, P. Adjei, Y. Adu‐Boakye, S. Gyabaah, Jeffery Kudiabor, Harriet Danso, Faustina Abena Nti-Boakye
Mitral valve prolapse is a common valvular abnormality. It affects 2-3% of the general population. It often runs a benign course and the majority of patients are asymptomatic. Cardiac sources of thrombi account for about 20% of ischaemic strokes. There is lingering uncertainty regarding the causal link between mitral valve prolapse and ischaemic stroke. It has been suggested that changes on the surface of the valvular leaflets trigger platelet adherence and aggregation, leading to formation of platelet-fibrin thrombus which can embolize to the cerebral arteries, causing an ischaemic stroke. We herein report a case of a 25 year old young man who presented with sudden onset of left-sided weakness. Cardiac auscultation was notable for a late systolic murmur preceded by a midsystolic click at the apex. Transthoracic echocardiography showed an elongated and thickened anterior mitral valve leaflet which prolapsed into the left atrium during systole. Computed tomography scan of the brain revealed infarcts in the right frontal lobe and the right insular cortex. A diagnosis of myxomatous mitral valve prolapse complicated by ischaemic stroke was made and the patient was accordingly started on anticoagulant therapy with warfarin.
{"title":"A Rare Case of Ischaemic Stroke in A Young Man with Mitral Valve Prolapse","authors":"Isaac Ogyefo, P. Adjei, Y. Adu‐Boakye, S. Gyabaah, Jeffery Kudiabor, Harriet Danso, Faustina Abena Nti-Boakye","doi":"10.33425/2768-6647.1013","DOIUrl":"https://doi.org/10.33425/2768-6647.1013","url":null,"abstract":"Mitral valve prolapse is a common valvular abnormality. It affects 2-3% of the general population. It often runs a benign course and the majority of patients are asymptomatic. Cardiac sources of thrombi account for about 20% of ischaemic strokes. There is lingering uncertainty regarding the causal link between mitral valve prolapse and ischaemic stroke. It has been suggested that changes on the surface of the valvular leaflets trigger platelet adherence and aggregation, leading to formation of platelet-fibrin thrombus which can embolize to the cerebral arteries, causing an ischaemic stroke. We herein report a case of a 25 year old young man who presented with sudden onset of left-sided weakness. Cardiac auscultation was notable for a late systolic murmur preceded by a midsystolic click at the apex. Transthoracic echocardiography showed an elongated and thickened anterior mitral valve leaflet which prolapsed into the left atrium during systole. Computed tomography scan of the brain revealed infarcts in the right frontal lobe and the right insular cortex. A diagnosis of myxomatous mitral valve prolapse complicated by ischaemic stroke was made and the patient was accordingly started on anticoagulant therapy with warfarin.","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76504576","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}
Pub Date : 2022-03-31DOI: 10.23937/2378-3656/1410387
Benhoummad Othmane, R. Sara, Sarda Zineb, Rochdi Youssef, Raji Abdelaziz
Spontaneous pneumomediastinum (SPM) in children was first defined by Hamman in 1939, Its Association to a posterior tracheal tear is even more uncommon. We report the case of an 18-month-child that presented a SPM associated to a posterior tracheal tear. The patient had no medical history and presented two days before her admission a dry cough and a shortness of breath. The radiological investigation showed a pneumomediastinum with an extensive subcutaneous emphysema and a posterior tear in the trachea. A conservative approach was adopted with a monitoring and surveillance of the regression of the emphysema, that showed a good evolution of the patient. The rare cases published in the literature make it hard to understand the features of this presentation, but the conservative approach has shown great results in patients as the prognosis is still favorable.
{"title":"A Spontaneous Tracheal Breach and a Pneumomediastinum in an 18-Month-Old Child: An Extremely Rare Case Report","authors":"Benhoummad Othmane, R. Sara, Sarda Zineb, Rochdi Youssef, Raji Abdelaziz","doi":"10.23937/2378-3656/1410387","DOIUrl":"https://doi.org/10.23937/2378-3656/1410387","url":null,"abstract":"Spontaneous pneumomediastinum (SPM) in children was first defined by Hamman in 1939, Its Association to a posterior tracheal tear is even more uncommon. We report the case of an 18-month-child that presented a SPM associated to a posterior tracheal tear. The patient had no medical history and presented two days before her admission a dry cough and a shortness of breath. The radiological investigation showed a pneumomediastinum with an extensive subcutaneous emphysema and a posterior tear in the trachea. A conservative approach was adopted with a monitoring and surveillance of the regression of the emphysema, that showed a good evolution of the patient. The rare cases published in the literature make it hard to understand the features of this presentation, but the conservative approach has shown great results in patients as the prognosis is still favorable.","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72633784","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}
Youssouf N, S. Z, W. O, Said H, J. M, L. A, F. K, B. S
Anencephaly is a form of neural tube defect, which develops when the cranial neuropore is unable to close. It is one of the fatal neural tube defects. Although most causes of anencephaly are unknown, multiple risk factors are associated with this defect. The purpose of this article is to study the main risk factors and possible means of prevention of this common malformation through a clinical case and a literature review.
{"title":"Termination of Pregnancy After Prenatal Diagnosis of Anencephaly: Case Study and Literature Review","authors":"Youssouf N, S. Z, W. O, Said H, J. M, L. A, F. K, B. S","doi":"10.33425/2768-6647.1016","DOIUrl":"https://doi.org/10.33425/2768-6647.1016","url":null,"abstract":"Anencephaly is a form of neural tube defect, which develops when the cranial neuropore is unable to close. It is one of the fatal neural tube defects. Although most causes of anencephaly are unknown, multiple risk factors are associated with this defect. The purpose of this article is to study the main risk factors and possible means of prevention of this common malformation through a clinical case and a literature review.","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78053896","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}
Pub Date : 2022-03-31DOI: 10.23937/2378-3656/1410388
Boykow Matthew, Patel Ami K, Sondhi Neil, M. Asif, I. Devarajan, Wercberger Eli
against the tumor. This disruption in the functioning of immune checkpoint molecules can lead to imbalances in immunologic tolerance that results in an unchecked immune response. This may clinically manifest with autoimmune-like/inflammatory side-effects, which cause collateral damage to normal organ systems and tissues. Such adverse events, termed ‘immunerelated adverse events’ (irAEs), are also thought to be principally T-cell mediated, however other immune cells may play a role in the development of irAEs, including B cells that secrete antibodies which mediate toxicity, as well as granulocytes that secrete inflammatory mediators and cytokines [1]. Of note, the incidence of cardiac toxicity owing to ICIs is rare (occur-ring in < 1% of patients) but can be fulminant and potentially fatal. Neurologic complications are also rare and when all neurological irAEs are pooled, an incidence of 3.8% for CTLA-4 inhibitors, 6% for PD-1 inhibitors and 12% for combination therapy has been reported in one review of 59 clinical trials, and encephalitis has been reported in 0.3% of patients taking ICIs. Lastly, an overall incidence of 2.2% was reported for acute kidney injury (0.6% for grades 3 and 4 renal events) in one systematic review of randomized controlled trials including 3,695 patients treated with ICIs [4]. Here we present a unique case that highlights the impact Opdivo and Yervoy induced irAEs had on our patient and explore this unique case of these monoclonal antibodies causing simultaneous damage to the central nervous system via immune checkpoint inhibitor induced encephalitis, cardiovascular system via acute decompensated left ventricular heart failure Introduction
{"title":"A Double-Edged Sword - Multiorgan Dysfunction as a Rare Complication of Dual Checkpoint Immunotherapy","authors":"Boykow Matthew, Patel Ami K, Sondhi Neil, M. Asif, I. Devarajan, Wercberger Eli","doi":"10.23937/2378-3656/1410388","DOIUrl":"https://doi.org/10.23937/2378-3656/1410388","url":null,"abstract":"against the tumor. This disruption in the functioning of immune checkpoint molecules can lead to imbalances in immunologic tolerance that results in an unchecked immune response. This may clinically manifest with autoimmune-like/inflammatory side-effects, which cause collateral damage to normal organ systems and tissues. Such adverse events, termed ‘immunerelated adverse events’ (irAEs), are also thought to be principally T-cell mediated, however other immune cells may play a role in the development of irAEs, including B cells that secrete antibodies which mediate toxicity, as well as granulocytes that secrete inflammatory mediators and cytokines [1]. Of note, the incidence of cardiac toxicity owing to ICIs is rare (occur-ring in < 1% of patients) but can be fulminant and potentially fatal. Neurologic complications are also rare and when all neurological irAEs are pooled, an incidence of 3.8% for CTLA-4 inhibitors, 6% for PD-1 inhibitors and 12% for combination therapy has been reported in one review of 59 clinical trials, and encephalitis has been reported in 0.3% of patients taking ICIs. Lastly, an overall incidence of 2.2% was reported for acute kidney injury (0.6% for grades 3 and 4 renal events) in one systematic review of randomized controlled trials including 3,695 patients treated with ICIs [4]. Here we present a unique case that highlights the impact Opdivo and Yervoy induced irAEs had on our patient and explore this unique case of these monoclonal antibodies causing simultaneous damage to the central nervous system via immune checkpoint inhibitor induced encephalitis, cardiovascular system via acute decompensated left ventricular heart failure Introduction","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73285761","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}
Background: Surgical site infections following Neurosurgical procedures are often associated with significant morbidity and mortality; constitute added economic burden and affect the patient’s quality of life negatively. The primary source of pathogenic microorganisms is the patient’s skin flora, making preoperative skin antisepsis a primary focus for preventive strategies. Objective: To review literature on various antiseptic agents used in neurosurgical practice and find out the most appropriate and effective agent(s) in preventing surgical site infections. Methods: A search in PubMed and Google scholar was made and various published articles on the use of antiseptic agents in preventing SSI in neurosurgery were reviewed. Results: Reviewed literature revealed that sequential use of 4% chlorhexidine and 10% povidone iodine is associated with significant reduction in both transient and resident’s pathogens, as well as surgical site infections. Conclusion: A review of relevant scientific literature supports sequential use of 4% chlorhexidine and 10% povidone iodine in prevention of surgical site infections in neurosurgery
{"title":"Prevention of Surgical Site Infection in Neurosurgical Practice: A Review of Efficacy of Use 10% Povidone Iodine with or without 4% Chlorhexidine Solutions","authors":"Ashafa Isa Birnin-Gwari, A. Koko","doi":"10.33425/2768-6647.1015","DOIUrl":"https://doi.org/10.33425/2768-6647.1015","url":null,"abstract":"Background: Surgical site infections following Neurosurgical procedures are often associated with significant morbidity and mortality; constitute added economic burden and affect the patient’s quality of life negatively. The primary source of pathogenic microorganisms is the patient’s skin flora, making preoperative skin antisepsis a primary focus for preventive strategies. Objective: To review literature on various antiseptic agents used in neurosurgical practice and find out the most appropriate and effective agent(s) in preventing surgical site infections. Methods: A search in PubMed and Google scholar was made and various published articles on the use of antiseptic agents in preventing SSI in neurosurgery were reviewed. Results: Reviewed literature revealed that sequential use of 4% chlorhexidine and 10% povidone iodine is associated with significant reduction in both transient and resident’s pathogens, as well as surgical site infections. Conclusion: A review of relevant scientific literature supports sequential use of 4% chlorhexidine and 10% povidone iodine in prevention of surgical site infections in neurosurgery","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81178162","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}
Youssouf N, S. Z, Gourja Y, J. M, Lamrissi N, F. K, B. S
Ovarian pregnancy is a rare entity among ectopic pregnancies where the ovary is the seat of implantation. The risk factors are different from those for tubal pregnancy. Its diagnosis is difficult to establish with certainty. Treatment is usually surgical. We report the case of an ovarian pregnancy diagnose in Our department. The aim is to support the clinical and therapeutic features of ovarian pregnancy.
{"title":"Ovarian Ectopic Pregnancy (About A Case)","authors":"Youssouf N, S. Z, Gourja Y, J. M, Lamrissi N, F. K, B. S","doi":"10.33425/2768-6647.1014","DOIUrl":"https://doi.org/10.33425/2768-6647.1014","url":null,"abstract":"Ovarian pregnancy is a rare entity among ectopic pregnancies where the ovary is the seat of implantation. The risk factors are different from those for tubal pregnancy. Its diagnosis is difficult to establish with certainty. Treatment is usually surgical. We report the case of an ovarian pregnancy diagnose in Our department. The aim is to support the clinical and therapeutic features of ovarian pregnancy.","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85505842","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：