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Challenges about Reorganizing a Hospital to Respond to the Covid-19 Outbreak: Experience from the University Hospital of Naples “Federico II”, Italy” 重组医院应对新冠肺炎疫情的挑战:来自意大利那不勒斯“费德里科二世”大学医院的经验
Pub Date : 2023-01-01 DOI: 10.26502/acmcr.96550591
Montella Emma, Frangiosa Alessandro, Iodice Sabrina, Bellopede Salvatore, Trama Ugo, Triassi Maria
The 2020 pandemic has taken a toll on governments, hospitals and healthcare workers. The newly established Task Force of the University Hospital has sought to answer this huge challenge by applying a Hospital Incident Management System (HIMS). Given the lack of knowledge of this new pandemic, the System was created on the basis of previous organizational and structural models present in the literature and adapted to the Covid-19 pandemic. The response plan has included: -
2020年的大流行给政府、医院和医护人员造成了损失。新成立的大学医院专责小组已尝试应用医院事故管理系统(HIMS)来应对这一巨大挑战。鉴于对这一新的大流行缺乏了解,该系统是在文献中现有的先前组织和结构模型的基础上创建的,并针对Covid-19大流行进行了调整。应对计划包括:-
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引用次数: 0
Spinal Anesthesia in a Healthy Parturient Causing Suspicious Bullous Skin Lesions: A Case Report 健康产妇腰麻引起可疑大疱性皮肤病变1例报告
Pub Date : 2023-01-01 DOI: 10.26502/acmcr.96550608
C. Karam, R. Kaddoum, Nancy Abou Nafeh, C. Zeeni, Fatima Msheik El-Khoury, Amro Khalili
Affiliation: 1Cynthia Karam, MD, Assistant Professor, Department of Anesthesiology and Pain Medicine, American University of Beirut Medical Center, Beirut, Lebanon 2Roland Kaddoum, MD, Associate Professor, Department of Anesthesiology and Pain Medicine, American University of Beirut Medical Center, Beirut, Lebanon 3Nancy Abou Nafeh, MD, Clinical Instructor of Anesthesiology, Department of Anesthesiology and Pain Medicine, American University of Beirut Medical Center, Beirut, Lebanon 4Carine Zeeni, MD, Associate Professor, Department of Anesthesiology and Pain Medicine, American University of Beirut Medical Center, Beirut, Lebanon 5Fatima Msheik El-Khoury, MBA, PhD, Clinical Instructor of Anesthesiology, Department of Anesthesiology and Pain Medicine, American University of Beirut Medical Center, Beirut, Lebanon 6Amro Khalili, MD, Clinical Instructor of Anesthesiology, Department of Anesthesiology and Pain Medicine, American University of Beirut Medical Center, Beirut, Lebanon
联系:1Cynthia Karam医学博士,黎巴嫩贝鲁特美国大学医学中心麻醉科和疼痛医学系助理教授2Roland Kaddoum医学博士,黎巴嫩贝鲁特美国大学医学中心麻醉科和疼痛医学系副教授3Nancy Abou Nafeh医学博士,黎巴嫩贝鲁特美国大学医学中心麻醉科和疼痛医学系麻醉科临床讲师4Carine Zeeni医学博士,黎巴嫩贝鲁特5Fatima Msheik El-Khoury,工商管理硕士,博士,黎巴嫩贝鲁特美国大学医疗中心麻醉与疼痛医学系麻醉学临床讲师。6Amro Khalili,医学博士,黎巴嫩贝鲁特美国大学医疗中心麻醉与疼痛医学系麻醉学临床讲师
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引用次数: 0
Segmental Infarction of the Testis: Report of Three Cases 睾丸节段性梗死3例报告
Pub Date : 2023-01-01 DOI: 10.26502/acmcr.96550620
Anteja Krištić, L. Pažanin, Filip Kučak, Monica Stephany Kirigin, D. Katušin, B. Krušlin
Segmental testicular infarction is a rare cause of acute scrotum and can easily masquerade as a tumor on ultrasonography and color Doppler imaging. The present report of three cases describes three patients with segmental testicular infarction, which were all suspicious for tumor on ultrasonography/color Doppler imaging. All of the cases were finally diagnosed by pathological examination. It is hypothesized that if the arterial flow is impaired because of abnormalities in arteries, excessive intrascrotal movement of testis, torsion and detorsion (which are all risks with the bell-clapper anomaly) or an unobserved interruption of an arterial blood flow during operations, predisposition to a partial infarct will result, mostly in the upper pole of the testis. In this report, first case of infarction was in the center of the testis, second one in the lower pole and third in the upper pole. Third case had a small concurrent seminoma which was discovered microscopically on the permanent HE slides of the intraoperative biopsy. We could not find such a case in the literature. It is debatable if the cause of the infarction in this case is because of an anomaly in some vessel or because of the possible cancer-associated thrombosis of the adjacent seminoma. Diagnosis of segmental testicular infarction is a radiological problem in standard practice and the final diagnosis still belongs to the pathologist. Intraoperative biopsy is a fiducial option for correct diagnosis of the segmental lesion in testis of unsure origin.
节段性睾丸梗死是一种罕见的急性阴囊疾病,在超声和彩色多普勒成像上很容易伪装成肿瘤。本文报告3例节段性睾丸梗死患者,超声/彩色多普勒检查均怀疑为肿瘤。所有病例均经病理检查确诊。假设由于动脉异常、睾丸在腹膜内过度运动、扭转和扭曲(这些都是钟瓣异常的风险)或手术中动脉血流未被观察到的中断而导致动脉血流受损,则易导致部分梗死,主要发生在睾丸上极。本报告中,第一例梗死位于睾丸中心,第二例位于睾丸下极,第三例位于睾丸上极。第三例患者在术中活检的永久HE切片上发现了一个小的并发精原细胞瘤。我们在文献中找不到这样的案例。在这种情况下,梗死的原因是由于某些血管的异常还是由于邻近精原细胞瘤可能的癌症相关血栓形成,这是有争议的。节段性睾丸梗死的诊断在标准实践中是一个放射学问题,最终诊断仍属于病理学家。术中活检是正确诊断来源不明的睾丸节段性病变的基础选择。
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引用次数: 0
Nose Necrosis in Female Shocked Patient: Conservative Treatment with Heparin 女性休克患者鼻坏死:肝素保守治疗
Pub Date : 2023-01-01 DOI: 10.26502/acmcr.96550625
Marco Stabile, L. Rosato, V. Navach
Acute skin failure is an event in which skin and underlying tissue die due to hypoperfusion concurrent with a critical illness [1]. Usually skin hypoperfusion is a late symptom in a shock setting and it is present in patients with an advanced multiorgan failure (MOF) dysfunction. Acute skin damage is mainly present in feet and hands as consequence of distal hypoperfusion due to hypotension or microthrombotic events [2]. Face is less commonly affected. In some cases of purpura fulminas there is anyway an important face skin involvement. Purpura fulminans is usually associated with meningococcal sepsis, varicella, and pneumococcal infections andor coagulation disorders [3-4]. We present the clinical case of a young woman occurring at our hospital with nose skin necrosis as first sing of shock setting.
急性皮肤衰竭是指皮肤和皮下组织因血流灌注不足而死亡,同时伴有危重疾病。通常,皮肤灌注不足是休克后出现的症状,并出现在晚期多器官功能衰竭(MOF)功能障碍患者中。由于低血压或微血栓事件导致远端灌注不足,急性皮肤损伤主要出现在足部和手部。面部较少受到影响。在一些暴发性紫癜的病例中,无论如何都有重要的面部皮肤受累。暴发性紫癜通常与脑膜炎球菌脓毒症、水痘、肺炎球菌感染和凝血功能障碍有关[3-4]。我们提出的临床病例,一个年轻的妇女发生在我们的医院与鼻子皮肤坏死作为休克设置的第一唱。
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引用次数: 1
Implantation of Embryonic Cardiomyocytes in a Post-Infarction Myocardium: A Long-Term Outcome after 25 Years of Follow-Up. 胚胎心肌细胞植入梗死后心肌:25年随访后的长期结果。
Pub Date : 2023-01-01 DOI: 10.26502/acmcr.96550583
Yu L Schevchenko, V G Gudymovich

In this article, we report the first case of embryonic cardiomyocyte implantation in a patient with severe ischemic heart lesions. In 1998, a 58-year-old male underwent coronary artery bypass grafting supplemented by injection of a pre-prepared suspension of human embryonic cardiomyocytes. During the next 24 years, the patient felt well and reported quite satisfactory quality of life. He is currently 82 years old and also feels well. He has no signs of circulatory insufficiency. No complications associated with cell implantation were observed during the entire follow-up period.

在本文中,我们报告了一例胚胎心肌细胞植入严重缺血性心脏病变患者。1998年,一名58岁男性接受冠状动脉旁路移植术,并辅以注射预先制备的人胚胎心肌细胞悬浮液。在接下来的24年里,患者感觉良好,并报告了相当满意的生活质量。他现在已经82岁了,身体也很好。他没有循环功能不全的迹象。在整个随访期间未观察到与细胞植入相关的并发症。
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引用次数: 0
A Severe Case of Invasive Rhino-Orbito-Cerebral Mucormycosis in a Patient with Acute T-Cell Leukemia with Successful Outcome: a Case Report and a Literature Review 急性t细胞白血病患者发生严重侵袭性鼻-眶-脑毛霉菌病1例,预后良好:1例报告并文献复习
Pub Date : 2023-01-01 DOI: 10.26502/acmcr.96550572
Linas Davainis, Dominyka Vasilevska, A. Žučenka, Birutė Davainienė, R. Pileckyte, Laimonas Griskvevicius
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引用次数: 0
A case of EBUS-TBNA in a Total Laryngectomy Patient using High Flow Nasal Oxygen 使用高流量鼻吸氧的全喉切除术患者发生EBUS-TBNA 1例
Pub Date : 2023-01-01 DOI: 10.26502/acmcr.96550575
Ralph Nehme
Endobronchial Ultrasound transbronchial needle aspiration (EBUS-TBNA) is currently considered as the gold standard technique for the assessment of mediastinal, hilar and centrally located lymph nodes and tumours. However, the ideal approach to sedation and oxygen supplementation during the procedure has not been clearly defined especially in particular clinical scenarios like total laryngectomy patients. In the following article we present the case of an EBUS-TBNA in a total laryngectomy patient done under moderate sedation and oxygenation using a heated High Flow Nasal Oxygen canula. The purpose of this case report is to shed light on the feasibility of the procedure under moderate sedation and the utility of the HFNO in special patients as those having a total laryngectomy.
支气管内超声经支气管穿刺(EBUS-TBNA)目前被认为是评估纵隔、肺门和中央位置淋巴结和肿瘤的金标准技术。然而,在手术过程中理想的镇静和氧气补充方法尚未明确定义,特别是在特殊的临床情况下,如全喉切除术患者。在接下来的文章中,我们介绍了一例EBUS-TBNA在全喉切除术患者中使用加热高流量鼻氧管进行中度镇静和氧合的病例。本病例报告的目的是阐明中度镇静下手术的可行性,以及HFNO在特殊患者中作为全喉切除术的效用。
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引用次数: 0
Hyperpigmentation after Full Thickness Skin Grafts–A Case Report 全层皮肤移植后色素沉着1例报告
Pub Date : 2023-01-01 DOI: 10.26502/acmcr.96550618
Staubach R, K. P, Glosse H, L. S
,
,
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引用次数: 0
Surgical Management of Full-Thickness Macular Hole In A Patient with Pachychoroid Spectrum Disease with Atypical Fundus Autofluorescence After Surgery 厚脉络膜谱病伴非典型眼底自身荧光术后全层黄斑裂孔的外科治疗
Pub Date : 2023-01-01 DOI: 10.26502/acmcr.96550594
Rony Carlos Preti, Lívia da Silva Conci, L. P. Cunha, Sérgio Luís Gianotti Pimentel, L. Zacharias, M. L. Ribeiro Monteiro
Purpose : To describe a case of atypical full-thickness macular hole (FTMH) in a patient with pachychoroid spectrum disease. The efficacy of surgical intervention is discussed. Observations: A 64-year-old woman presented with poor vision and metamorphopsia in her left eye (OS). Swept-Source Optical Coherence Tomography (SS-OCT) revealed a grade II FTMH in association with serous macular detachment and indocyanine green angiography (ICGA) showed choroidal hyperpermeability in OS. The patient underwent pars plana vitrectomy (PPV), inner limiting membrane peel, and 20% SF6 gas fill. Macular hole closure was achieved successfully on early postoperative, with opening of FTMH in the right eye in the first posoperative week when patient in positioning. Unusual hyper-autoflurescent peripapillary spots appeared in OS early after PPV with slowly resolution, but followed by RPE mottling. Complete subretinal fluid reabsorption was observed only at 12 months of follow-up. Conclusions and Importance : FTMH with large subretinal detachment can still be closed with standard PPV technique without fluid drainage. Atypical evolution of this case could be explained by the overlapping of two distinct eye conditions (vitreoretinal interface disease and central serous chorioretinopathy). Multimodal imaging was a useful tool for diagnostic and long-term follow-up significantly helping to understand the unusual postoperative evolution of the case.
目的:报告一例厚脉络膜谱疾病患者的非典型全层黄斑裂孔(FTMH)。讨论了手术干预的效果。观察:一名64岁女性,因左眼视力不佳和变形。扫描源光学相干断层扫描(SS-OCT)显示II级FTMH与浆液性黄斑脱离有关,吲胺绿血管造影(ICGA)显示OS的脉络膜高通透性。患者接受了玻璃体切除(PPV)、内限制膜剥离和20% SF6气体填充。术后早期成功关闭黄斑孔,术后第一周患者定位时右眼FTMH开放。PPV术后早期OS出现异常的超自身荧光斑点,消退缓慢,但随后出现RPE斑驳。仅在随访12个月时观察到完全的视网膜下液重吸收。结论及意义:采用标准的PPV技术,不需引流,仍可关闭大面积视网膜下脱离的FTMH。本病例的非典型演变可以解释为两种不同眼病(玻璃体视网膜界面病和中枢性浆液性脉络膜视网膜病)的重叠。多模态成像是诊断和长期随访的有用工具,有助于了解该病例术后不寻常的演变。
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引用次数: 0
Urethral-Sparing Robot-Assisted Simple Prostatectomy: Case Series of the Initial Experience of a Brazilian Surgical Center 保留尿道的机器人辅助简单前列腺切除术:巴西外科中心初步经验的病例系列
Pub Date : 2023-01-01 DOI: 10.26502/acmcr.96550600
J. P. Manzano, João Henrique Sendrete de Pinho, Thainã de Oliveira Azambuja, D. S. Constantin, Vinicius Meneguette Gomes de Souza, Ricardo Luis Vita Nunes, Jaime Comar Filho, Frederico Teixeira Barbosa
Benign prostatic hyperplasia (BPH) is a common condition among older men that causes lower urinary tract symptoms. Although pharmacological treatments are available, surgery is often required. The development of surgical techniques has progressed, with robotic simple prostatectomy (RASP) being one of the minimally invasive techniques for larger prostates. However, ejaculatory dysfunction remains a common postoperative problem of BPH surgery, significantly impacting patients' quality of life. In 1990, Dixon et al. were the first to describe the urethral-sparing approach, which maintained anterograde ejaculation
良性前列腺增生(BPH)是老年男性中引起下尿路症状的常见疾病。虽然药物治疗是可行的,但通常需要手术治疗。随着手术技术的发展,机器人简单前列腺切除术(RASP)已成为治疗较大前列腺的微创技术之一。然而,射精功能障碍仍然是BPH手术后常见的问题,严重影响患者的生活质量。1990年,Dixon等人首次描述了保留尿道的方法,该方法可以保持顺行射精
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引用次数: 0
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Archives of clinical and medical case reports
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