Here we present a case of a 56-year-old male with HIV who presented with a pseudoaneurysm rupture that was being repaired and found to be infected with Mycobacterium Avium Complex. The case highlights a rare cause of pseudoaneurysm infection and is the first case of an infrarenal MAC infected pseudoaneurysm and advocates for further study. In addition, it emphasizes the importance of surveillance and management of pseudoaneurysms (especially in immunocompromised patients) to prevent complications.
{"title":"Infrarenal mycotic aortic pseudoaneurysm","authors":"S. Miles, Maher Khazem Ms","doi":"10.15761/ccrr.1000490","DOIUrl":"https://doi.org/10.15761/ccrr.1000490","url":null,"abstract":"Here we present a case of a 56-year-old male with HIV who presented with a pseudoaneurysm rupture that was being repaired and found to be infected with Mycobacterium Avium Complex. The case highlights a rare cause of pseudoaneurysm infection and is the first case of an infrarenal MAC infected pseudoaneurysm and advocates for further study. In addition, it emphasizes the importance of surveillance and management of pseudoaneurysms (especially in immunocompromised patients) to prevent complications.","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448651","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":"Health care suggestions for COVID 19 pandemic crisis","authors":"V. Kamath","doi":"10.15761/ccrr.1000477","DOIUrl":"https://doi.org/10.15761/ccrr.1000477","url":null,"abstract":"","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67447826","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":"Chemical pneumonitis secondary to chlorine dioxide consumption in a patient with severe Covid 19","authors":"Andres Silva","doi":"10.15761/ccrr.1000488","DOIUrl":"https://doi.org/10.15761/ccrr.1000488","url":null,"abstract":"","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448369","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}
Although headaches attributed to masticatory myofascial pain have been reported, to our knowledge, the treatment of headache with occlusal position correcting therapy has not been reported. Occlusal improvement was achieved using the occlusal position correcting therapy in a patient with headache and temporomandibular joint sound. Occlusal analysis was performed by mounting the dental models on an articulator and identifying a premature occlusal contact on the right first premolars and a deviation of the habitual occlusal position from the muscular reference position. Occlusal modification was performed to coincide the habitual occlusal position with the muscular reference position. After the completion of occlusal equilibration, the chronic headache immediately became an episodic headache, and after the fourth month, the headache almost disappeared. The headache was believed to be caused by myofascial pain of the lateral and medial pterygoid muscles produced with the occlusal discrepancy between the habitual occlusal position and the muscular position. The headache was considered a referred pain from both the lateral and medial pterygoid muscles.
{"title":"Occlusal analysis and management of a patient with headache and temporomandibular joint sound: A case report","authors":"Kengo Torii","doi":"10.15761/ccrr.1000481","DOIUrl":"https://doi.org/10.15761/ccrr.1000481","url":null,"abstract":"Although headaches attributed to masticatory myofascial pain have been reported, to our knowledge, the treatment of headache with occlusal position correcting therapy has not been reported. Occlusal improvement was achieved using the occlusal position correcting therapy in a patient with headache and temporomandibular joint sound. Occlusal analysis was performed by mounting the dental models on an articulator and identifying a premature occlusal contact on the right first premolars and a deviation of the habitual occlusal position from the muscular reference position. Occlusal modification was performed to coincide the habitual occlusal position with the muscular reference position. After the completion of occlusal equilibration, the chronic headache immediately became an episodic headache, and after the fourth month, the headache almost disappeared. The headache was believed to be caused by myofascial pain of the lateral and medial pterygoid muscles produced with the occlusal discrepancy between the habitual occlusal position and the muscular position. The headache was considered a referred pain from both the lateral and medial pterygoid muscles.","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448582","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}
Y. Tono, T. Mizuno, H. Oda, M. Ishihara, Kanako Saito, Y. Yamashita, K. Nakase
Hyponatremia is the most common electrolyte disturbance seen in patients receiving anticancer drugs. Several cytotoxic agents, including carboplatin, cisplatin, vincristine, and vinblastine, have been found to cause hyponatremia. Recently, clinically significant hyponatremia has been reported in cancer patients treated with moleculartargeted therapies [1]. Moreover, several studies have suggested that hyponatremia is a poor prognostic factor among cancer patients [2,3].
{"title":"Low-dose cyclophosphamide-induced hyponatremia in primary breast cancer","authors":"Y. Tono, T. Mizuno, H. Oda, M. Ishihara, Kanako Saito, Y. Yamashita, K. Nakase","doi":"10.15761/CCRR.1000491","DOIUrl":"https://doi.org/10.15761/CCRR.1000491","url":null,"abstract":"Hyponatremia is the most common electrolyte disturbance seen in patients receiving anticancer drugs. Several cytotoxic agents, including carboplatin, cisplatin, vincristine, and vinblastine, have been found to cause hyponatremia. Recently, clinically significant hyponatremia has been reported in cancer patients treated with moleculartargeted therapies [1]. Moreover, several studies have suggested that hyponatremia is a poor prognostic factor among cancer patients [2,3].","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448715","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}
Data on 1000 successive ferric carboxymaltose infusions involving 517 different individuals are presented. The infusions were safe and a clinically effective way of reconstituting the depleted iron stores in patients with iron deficiency anemia and with iron deficiency without anemia. The infusion was discontinued due to infusion-related adverse events in less than one percent of patients (5 out of 517). Some 60% of the patients required more than one infusion. Overall, some 80% of the patients achieved an excellent or good response. However, there seems to be no way of predicting the clinical response nor the need for further infusion(s). The median interval between infusions was about six months, but the variation of time between infusions was large. Thus, patients who require iron infusion therapy must be followed up for extended periods.
{"title":"Intravenous iron – personal experience of 1000 consecutive infusions","authors":"E. Soppi","doi":"10.15761/CCRR.1000492","DOIUrl":"https://doi.org/10.15761/CCRR.1000492","url":null,"abstract":"Data on 1000 successive ferric carboxymaltose infusions involving 517 different individuals are presented. The infusions were safe and a clinically effective way of reconstituting the depleted iron stores in patients with iron deficiency anemia and with iron deficiency without anemia. The infusion was discontinued due to infusion-related adverse events in less than one percent of patients (5 out of 517). Some 60% of the patients required more than one infusion. Overall, some 80% of the patients achieved an excellent or good response. However, there seems to be no way of predicting the clinical response nor the need for further infusion(s). The median interval between infusions was about six months, but the variation of time between infusions was large. Thus, patients who require iron infusion therapy must be followed up for extended periods.","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448770","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}
This case of vertical gaze palsy due to mesencephalon hemorrhage represents an unusual presentation of subarachnoid hemorrhage (SAH). A 28-year-old male patient presented with acute onset of headache and vertical diplopia. On admission he had no neurological deficit except for slightly limited vertical eye movements of the left eye. Three hours after onset, he was slightly lethargic; vertical gaze palsy became more prominent; ptosis developed, which was more evident on the left side; and the left pupil became mydriatic. He became unconscious and was taken for an operation for ventricular drainage, but he died. Magnetic resonance imaging (MRI) angiography of the brain showed tortuous vascular structures in the posterior mesencephalon, evaluated as arteriovenous malformation. Conclusion: Spontaneous midbrain hemorrhages are very rare but extremely life-threatening clinical conditions that most frequently present with oculomotor disorders such as ptosis and vertical gaze palsy. In young SAH patients, MRI angiography is considered the gold standard to elucidate the underlying etiology, which is vascular malformation most of the time.
{"title":"A rare presentation of subarachnoid hemorrhage: Vertical gaze palsy – A case report","authors":"Gülşah Ci, D. Seda, Hikmet Sc, C. Yunsur","doi":"10.15761/ccrr.1000487","DOIUrl":"https://doi.org/10.15761/ccrr.1000487","url":null,"abstract":"This case of vertical gaze palsy due to mesencephalon hemorrhage represents an unusual presentation of subarachnoid hemorrhage (SAH). A 28-year-old male patient presented with acute onset of headache and vertical diplopia. On admission he had no neurological deficit except for slightly limited vertical eye movements of the left eye. Three hours after onset, he was slightly lethargic; vertical gaze palsy became more prominent; ptosis developed, which was more evident on the left side; and the left pupil became mydriatic. He became unconscious and was taken for an operation for ventricular drainage, but he died. Magnetic resonance imaging (MRI) angiography of the brain showed tortuous vascular structures in the posterior mesencephalon, evaluated as arteriovenous malformation. Conclusion: Spontaneous midbrain hemorrhages are very rare but extremely life-threatening clinical conditions that most frequently present with oculomotor disorders such as ptosis and vertical gaze palsy. In young SAH patients, MRI angiography is considered the gold standard to elucidate the underlying etiology, which is vascular malformation most of the time.","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448624","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}
J. Ziani, Sara Eloudi, S. Benkirane, H. Baybay, Z. Douhi, F. Mernissi
Perforating annular granuloma represents 5% of patients who have an annular granuloma. It is a rare form that rather affects the back of the hand and fingers, it is sometimes generalized on the trunk and extremities. Some lesions are umbilicated (with a hollow in the center) and sometimes allow thick material to flow. The lesions may leave scars that are sequelae. We report an observation in a 7-year-old child. *Correspondence to: Jihane Ziani, Department of Dermatology, Hassan II Hospital, University, Fez, Morocco, E-mail: dr.zianijihane@gmail.com
{"title":"Perforating granuloma annulare in children: A case report","authors":"J. Ziani, Sara Eloudi, S. Benkirane, H. Baybay, Z. Douhi, F. Mernissi","doi":"10.15761/ccrr.1000474","DOIUrl":"https://doi.org/10.15761/ccrr.1000474","url":null,"abstract":"Perforating annular granuloma represents 5% of patients who have an annular granuloma. It is a rare form that rather affects the back of the hand and fingers, it is sometimes generalized on the trunk and extremities. Some lesions are umbilicated (with a hollow in the center) and sometimes allow thick material to flow. The lesions may leave scars that are sequelae. We report an observation in a 7-year-old child. *Correspondence to: Jihane Ziani, Department of Dermatology, Hassan II Hospital, University, Fez, Morocco, E-mail: dr.zianijihane@gmail.com","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67447817","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}
K. Ho, E. Wang, J. A. Salud, C. Cheung, Ferdinand Syfu, K. Chong
Background: Early and effective treatment of postoperative pain is vital for minimizing pain severity and optimizing patient outcomes and satisfaction. The efficacy and tolerability data of tramadol 75 mg plus dexketoprofen 25 mg fixed-dose combination (TRAM/DKP FDC) are reported in clinical trials but the data on real-world experience in postoperative pain management in the Asian population is limited. Objectives: This series of case studies reviews clinicians’ experience and outcomes of postoperative pain management in Asian patients using a TRAM/DKP FDC in the real-world setting. Methods: Clinicians compiled, shared and discussed case studies of their experience using a TRAM/DKP FDC during two case studies expert meetings. A total of 13 case studies were shared across orthopaedic, soft tissue and laparoscopic surgery. Results: All cases reported well-tolerated postoperative pain management with good pain relief with TRAM/DKP FDC. Conclusions: TRAM/DKP FDC is an effective and well-tolerated option for the management of acute moderate-to-severe postoperative pain in Asian patients.
{"title":"Real-world experience with tramadol plus dexketoprofen fixed-dose combination in postoperative pain management: A series of case studies from Asia","authors":"K. Ho, E. Wang, J. A. Salud, C. Cheung, Ferdinand Syfu, K. Chong","doi":"10.15761/CCRR.1000493","DOIUrl":"https://doi.org/10.15761/CCRR.1000493","url":null,"abstract":"Background: Early and effective treatment of postoperative pain is vital for minimizing pain severity and optimizing patient outcomes and satisfaction. The efficacy and tolerability data of tramadol 75 mg plus dexketoprofen 25 mg fixed-dose combination (TRAM/DKP FDC) are reported in clinical trials but the data on real-world experience in postoperative pain management in the Asian population is limited. Objectives: This series of case studies reviews clinicians’ experience and outcomes of postoperative pain management in Asian patients using a TRAM/DKP FDC in the real-world setting. Methods: Clinicians compiled, shared and discussed case studies of their experience using a TRAM/DKP FDC during two case studies expert meetings. A total of 13 case studies were shared across orthopaedic, soft tissue and laparoscopic surgery. Results: All cases reported well-tolerated postoperative pain management with good pain relief with TRAM/DKP FDC. Conclusions: TRAM/DKP FDC is an effective and well-tolerated option for the management of acute moderate-to-severe postoperative pain in Asian patients.","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67449182","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}
Case study: A 55 y old woman presents with a cT2N0M0 triple negative breast cancer at our breast clinic. The upfront neo-adjuvant chemotherapy had to be interrupted due to clinically important needle tract metastasis (NTM), confirmed on imaging. Surgery was expedited and pathology report confirmed clear tumourload as NTM+. Aim: We conducted a literature study to evaluate the prevalence and prognostic importance for NTM+ after breast cancer diagnosis, treated with NACT. Moreover, the causal relationship between these NTM+ and the differences in puncture techniques was investigated. Conclusion: There seems to be a striking discordance between the (accidental) histopathologic diagnosis of NTM+ after surgery and prognosis. The malignant potential from these accidentally found NTM+ is not known, but seems not quite important, at least, when short interval between surgery and adjuvant radiotherapy is respected as defined in international guidelines. However, less is known about progression of these NTM+ during NACT and the consequences for local relapse and disease control at long term. Biopsy technique as such is reported as less important, but vacuum assisted biopsy seems to reduce the incidence of the described NTM+. relapse and survival. In other words: if these spread cells have any malignant potential?
{"title":"Local progression of needle tract metastases during neo-adjuvant chemotherapy after core biopsy in breast carcinoma: A case report","authors":"Judith Lamberigts, K. Leunen","doi":"10.15761/CCRR.1000494","DOIUrl":"https://doi.org/10.15761/CCRR.1000494","url":null,"abstract":"Case study: A 55 y old woman presents with a cT2N0M0 triple negative breast cancer at our breast clinic. The upfront neo-adjuvant chemotherapy had to be interrupted due to clinically important needle tract metastasis (NTM), confirmed on imaging. Surgery was expedited and pathology report confirmed clear tumourload as NTM+. Aim: We conducted a literature study to evaluate the prevalence and prognostic importance for NTM+ after breast cancer diagnosis, treated with NACT. Moreover, the causal relationship between these NTM+ and the differences in puncture techniques was investigated. Conclusion: There seems to be a striking discordance between the (accidental) histopathologic diagnosis of NTM+ after surgery and prognosis. The malignant potential from these accidentally found NTM+ is not known, but seems not quite important, at least, when short interval between surgery and adjuvant radiotherapy is respected as defined in international guidelines. However, less is known about progression of these NTM+ during NACT and the consequences for local relapse and disease control at long term. Biopsy technique as such is reported as less important, but vacuum assisted biopsy seems to reduce the incidence of the described NTM+. relapse and survival. In other words: if these spread cells have any malignant potential?","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448787","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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