Pub Date : 2024-02-06DOI: 10.36502/2024/asjbccr.6335
Bo Xu, Rurong Wang
Background: Aspiration of gastric contents during the induction of general anesthesia remains a significant cause of mortality and morbidity in anesthesia. We report an 18-year-old patient with a closed atrial septal defect who developed gastric content reflux aspiration and severe aspiration pneumonia despite abstaining from drinking and fasting for more than 12 hours. Case Presentation: An 18-year-old female patient with congenital heart disease (atrial septal defect) had no previous history of gastroesophageal reflux. After fully abstaining from drinking and fasting (more than 12h), conventional anesthesia was induced, and after the patient’s spontaneous breathing and consciousness disappeared, the patient was assisted with mandibular support with both hands and mask pressure. The induction process was smooth. When preparing for intubation, a large amount of yellow fluid was found in the patient’s mouth. Intubation was performed immediately after suction. Aspiration pneumonia still occurs after the operation even if the patient is treated promptly. Conclusions: As the incidence of perioperative pulmonary aspiration is relatively low, precautions to prevent aspiration tend to be overlooked. We should be alert to the complications of gastric contents regurgitation aspiration in patients with sufficient abstention and fasting during general anesthesia intubation.
{"title":"A Case of Gastric Contents Reflux Aspiration during General Anesthesia Induction in A Patient with Femoral Vein Atrial Septal Defect Closure","authors":"Bo Xu, Rurong Wang","doi":"10.36502/2024/asjbccr.6335","DOIUrl":"https://doi.org/10.36502/2024/asjbccr.6335","url":null,"abstract":"Background: Aspiration of gastric contents during the induction of general anesthesia remains a significant cause of mortality and morbidity in anesthesia. We report an 18-year-old patient with a closed atrial septal defect who developed gastric content reflux aspiration and severe aspiration pneumonia despite abstaining from drinking and fasting for more than 12 hours.\u0000Case Presentation: An 18-year-old female patient with congenital heart disease (atrial septal defect) had no previous history of gastroesophageal reflux. After fully abstaining from drinking and fasting (more than 12h), conventional anesthesia was induced, and after the patient’s spontaneous breathing and consciousness disappeared, the patient was assisted with mandibular support with both hands and mask pressure. The induction process was smooth. When preparing for intubation, a large amount of yellow fluid was found in the patient’s mouth. Intubation was performed immediately after suction. Aspiration pneumonia still occurs after the operation even if the patient is treated promptly.\u0000Conclusions: As the incidence of perioperative pulmonary aspiration is relatively low, precautions to prevent aspiration tend to be overlooked. We should be alert to the complications of gastric contents regurgitation aspiration in patients with sufficient abstention and fasting during general anesthesia intubation.","PeriodicalId":93523,"journal":{"name":"Asploro journal of biomedical and clinical case reports","volume":"47 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139860478","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 : 2024-01-22DOI: 10.36502/2023/asjbccr.6333
M. Jaffer, Kibe John Ng’ang’a
Background: Common modalities for breast cancer screening include regular clinical breast exams (73%), annual breast sonograms (73%) for high-risk groups, and mammograms (71.5%) recommended every 3 years for high-risk groups. Despite a higher sensitivity of 89.4%, MRI is underutilized, especially among high-risk groups with the means for the test. Kenyan guidelines recommend mammography for normal-risk populations, omitting MRI for routine screening in average-risk populations. This study explores an intriguing case of a 60-year-old post-menopausal lady, with no hormone replacement history, three parities, and a smoking habit. She presented with a left-sided benign cyst but revealed an ominous, undetected lesion on the right breast, emphasizing the limitations of conventional screening modalities. Method: The patient was admitted for abdominal pain due to gastroenteritis and a breast lump on the left breast for 3 months with a strong family history of breast cancer, so she requested screening for the same. In the process, we found axillary and mediastinal lymph nodes, but the left breast showed a simple harmless cystic lesion. The right breast confirmed a lesion with irregular borders that looked suspicious, and a biopsy confirmed ductal carcinoma of the right breast. Results: The right breast that had no symptoms or signs, and no abnormality on mammogram, ultrasound, or CT scan, had a grade 3a Ductal Cancer in its initial stage that was seen on a simultaneous MRI. Conclusion: MRI could be a better choice for screening early breast cancer in high-risk groups and in those who can afford the test.
背景：乳腺癌筛查的常见方式包括定期临床乳房检查（73%）、每年为高危人群进行乳房超声波检查（73%），以及建议高危人群每 3 年进行一次乳房 X 光检查（71.5%）。尽管核磁共振成像的灵敏度较高，达到 89.4%，但其利用率并不高，尤其是在有能力进行该检查的高危人群中。肯尼亚的指南建议正常风险人群进行乳房 X 线照相术，而忽略了对普通风险人群进行核磁共振成像常规筛查。本研究探讨了一个有趣的病例：一位 60 岁的绝经后妇女，无激素替代史，三次生育，有吸烟习惯。她的左侧乳房有良性囊肿，但右侧乳房却有一个未被发现的不祥病灶，这凸显了传统筛查方法的局限性：该患者因肠胃炎导致腹痛和左侧乳房肿块入院 3 个月，有较强的乳腺癌家族史，因此要求进行乳腺癌筛查。在检查过程中，我们发现了腋窝和纵隔淋巴结，但左侧乳房显示为简单无害的囊性病变。右侧乳房的病变边界不规则，看起来很可疑，活检证实为右侧乳腺导管癌：结果：右侧乳房没有任何症状或体征，乳房 X 光检查、超声波检查或 CT 扫描均未发现异常，但同时进行的核磁共振成像检查却显示其为 3a 级乳腺导管癌。结论核磁共振成像是筛查高危人群和有经济能力者早期乳腺癌的更好选择。
{"title":"Case Presentation where MRI shows Superiority as A Modality for Breast Cancer Screening","authors":"M. Jaffer, Kibe John Ng’ang’a","doi":"10.36502/2023/asjbccr.6333","DOIUrl":"https://doi.org/10.36502/2023/asjbccr.6333","url":null,"abstract":"Background: Common modalities for breast cancer screening include regular clinical breast exams (73%), annual breast sonograms (73%) for high-risk groups, and mammograms (71.5%) recommended every 3 years for high-risk groups. Despite a higher sensitivity of 89.4%, MRI is underutilized, especially among high-risk groups with the means for the test. Kenyan guidelines recommend mammography for normal-risk populations, omitting MRI for routine screening in average-risk populations. This study explores an intriguing case of a 60-year-old post-menopausal lady, with no hormone replacement history, three parities, and a smoking habit. She presented with a left-sided benign cyst but revealed an ominous, undetected lesion on the right breast, emphasizing the limitations of conventional screening modalities.\u0000Method: The patient was admitted for abdominal pain due to gastroenteritis and a breast lump on the left breast for 3 months with a strong family history of breast cancer, so she requested screening for the same. In the process, we found axillary and mediastinal lymph nodes, but the left breast showed a simple harmless cystic lesion. The right breast confirmed a lesion with irregular borders that looked suspicious, and a biopsy confirmed ductal carcinoma of the right breast.\u0000Results: The right breast that had no symptoms or signs, and no abnormality on mammogram, ultrasound, or CT scan, had a grade 3a Ductal Cancer in its initial stage that was seen on a simultaneous MRI. Conclusion: MRI could be a better choice for screening early breast cancer in high-risk groups and in those who can afford the test.","PeriodicalId":93523,"journal":{"name":"Asploro journal of biomedical and clinical case reports","volume":"36 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139607662","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 : 2024-01-20DOI: 10.36502/2023/asjbccr.6332
Xuewei Liu
Thoracoscopy, as a minimally invasive surgical technique in the field of thoracic surgery, has been widely utilized due to its minimally invasive nature, cost-effectiveness, and short hospital stay. Most thoracoscopic surgeries involve intraoperative single-lung ventilation, aiming to maintain intraoperative oxygen saturation (SPO2) above 93% by increasing the respiratory rate and administering a high concentration of oxygen. However, the high concentration of oxygen administered during surgery and postoperative pain in thoracic surgery often result in decreased ventilation and hypoxia in patients. This case report details a patient who underwent bilateral thoracoscopic surgery with single-lung ventilation on both sides, subsequently developing oxygen-associated hypercapnia in the post-anesthesia care unit (PACU) and necessitating reintubation.
{"title":"Oxygen-Associated Hypercapnia after both side Video-Assisted Thoracoscopic Surgery – A Case Report","authors":"Xuewei Liu","doi":"10.36502/2023/asjbccr.6332","DOIUrl":"https://doi.org/10.36502/2023/asjbccr.6332","url":null,"abstract":"Thoracoscopy, as a minimally invasive surgical technique in the field of thoracic surgery, has been widely utilized due to its minimally invasive nature, cost-effectiveness, and short hospital stay. Most thoracoscopic surgeries involve intraoperative single-lung ventilation, aiming to maintain intraoperative oxygen saturation (SPO2) above 93% by increasing the respiratory rate and administering a high concentration of oxygen. However, the high concentration of oxygen administered during surgery and postoperative pain in thoracic surgery often result in decreased ventilation and hypoxia in patients. This case report details a patient who underwent bilateral thoracoscopic surgery with single-lung ventilation on both sides, subsequently developing oxygen-associated hypercapnia in the post-anesthesia care unit (PACU) and necessitating reintubation.","PeriodicalId":93523,"journal":{"name":"Asploro journal of biomedical and clinical case reports","volume":"25 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139610820","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 : 2024-01-20DOI: 10.36502/2023/asjbccr.6331
Takafumi Kawata, Hiroshi Bando, Y. Kato, H. Yamashita, Y. Kato, K. Ogura
The patient is a 55-year-old male with type 2 diabetes (T2D). In his 20s, 30s, and 50s, his body weight was 80 kg, 95 kg, and 90 kg, respectively. HbA1c was 10.9% in March 2023, and he was prescribed imeglimin (Twymeeg) as an oral hypoglycemic agent (OHA). HbA1c decreased to 9.3%, 7.2%, and 6.8% within just 3 months. His body weight also decreased from 86 kg to 82 kg during this period. Liver function tests showed improvement between March and May 2023, with AST decreasing from 54 to 24 U/L, ALT from 121 to 28 U/L, and GGT from 45 to 18 U/L, respectively. This suggests an improvement in fatty liver.
{"title":"Improvement of HbA1c, Weight and Fatty Liver by Short Treatment of Imeglimin (Twymeeg)","authors":"Takafumi Kawata, Hiroshi Bando, Y. Kato, H. Yamashita, Y. Kato, K. Ogura","doi":"10.36502/2023/asjbccr.6331","DOIUrl":"https://doi.org/10.36502/2023/asjbccr.6331","url":null,"abstract":"The patient is a 55-year-old male with type 2 diabetes (T2D). In his 20s, 30s, and 50s, his body weight was 80 kg, 95 kg, and 90 kg, respectively. HbA1c was 10.9% in March 2023, and he was prescribed imeglimin (Twymeeg) as an oral hypoglycemic agent (OHA). HbA1c decreased to 9.3%, 7.2%, and 6.8% within just 3 months. His body weight also decreased from 86 kg to 82 kg during this period. Liver function tests showed improvement between March and May 2023, with AST decreasing from 54 to 24 U/L, ALT from 121 to 28 U/L, and GGT from 45 to 18 U/L, respectively. This suggests an improvement in fatty liver.","PeriodicalId":93523,"journal":{"name":"Asploro journal of biomedical and clinical case reports","volume":"118 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140501756","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 : 2023-12-26DOI: 10.36502/2023/asjbccr.6330
Liu Qian, Haibei Liu, Yujun Zhang
Background: Acute aortic dissection poses a life-threatening condition that typically necessitates immediate surgical intervention, such as total arch replacement. However, hypoxemia is a severe complication in such surgeries, potentially resulting in organ dysfunction, prolonged hospital stays, and even mortality. Hypoxemia presents significant challenges to anesthesiologists. Through this case, we can enhance our comprehension of anesthetic management for total arch replacement. Case presentation: A 43-year-old man with acute type A aortic dissection underwent total arch replacement. After a smooth surgery, severe hypoxemia occurred during weaning off cardiopulmonary bypass. Initial interventions, including airway suction and recruitment maneuvers, failed to improve oxygenation. Further investigations found left lung atelectasis and pleural effusion on transesophageal echocardiography, with minimal improvement after drainage. Fiberoptic bronchoscopy revealed extensive tenacious secretions occluding the airways. Conventional suctioning was ineffective due to high sputum viscosity. Ultimately, techniques including pulmonary lavage, bronchoscopic suctioning, and repeated lung recruitment controlled the refractory hypoxemia. The patient recovered after treatment in the intensive care unit. Conclusions: It is worth noting that our case highlights the challenges posed by severe hypoxemia during total arch replacement surgery. The successful management of this complication underscores the importance of a multidisciplinary approach and close monitoring during the perioperative period. Individualized anesthetic management plays a critical role in addressing severe hypoxemia during total arch replacement surgery.
背景：急性主动脉夹层是一种危及生命的疾病，通常需要立即进行手术干预，如全弓置换术。然而，低氧血症是此类手术的严重并发症，可能导致器官功能障碍、住院时间延长甚至死亡。低氧血症给麻醉医生带来了巨大挑战。通过本病例，我们可以加深对全牙弓置换术麻醉管理的理解。病例介绍：一名患有急性 A 型主动脉夹层的 43 岁男子接受了全弓置换术。手术顺利进行后，心肺旁路断流时出现了严重的低氧血症。最初的干预措施，包括气道抽吸和吸气操作，都未能改善氧合状况。进一步检查发现，经食道超声心动图检查发现左肺无气道和胸腔积液，引流后改善甚微。纤维支气管镜检查发现大量顽固分泌物堵塞气道。由于痰液粘稠度高，常规抽吸无效。最终，包括肺灌洗、支气管镜吸痰和反复肺招引在内的技术控制了难治性低氧血症。患者在重症监护室接受治疗后康复。结论值得注意的是，我们的病例凸显了全弓置换手术中严重低氧血症带来的挑战。这一并发症的成功处理强调了多学科方法和围手术期密切监测的重要性。个性化的麻醉管理在应对全牙弓置换手术中的严重低氧血症方面发挥着至关重要的作用。
{"title":"Anesthesia Management of Severe Hypoxemia During Total Arch Replacement for Acute Aortic Dissection: A Case Report","authors":"Liu Qian, Haibei Liu, Yujun Zhang","doi":"10.36502/2023/asjbccr.6330","DOIUrl":"https://doi.org/10.36502/2023/asjbccr.6330","url":null,"abstract":"Background: Acute aortic dissection poses a life-threatening condition that typically necessitates immediate surgical intervention, such as total arch replacement. However, hypoxemia is a severe complication in such surgeries, potentially resulting in organ dysfunction, prolonged hospital stays, and even mortality. Hypoxemia presents significant challenges to anesthesiologists. Through this case, we can enhance our comprehension of anesthetic management for total arch replacement. Case presentation: A 43-year-old man with acute type A aortic dissection underwent total arch replacement. After a smooth surgery, severe hypoxemia occurred during weaning off cardiopulmonary bypass. Initial interventions, including airway suction and recruitment maneuvers, failed to improve oxygenation. Further investigations found left lung atelectasis and pleural effusion on transesophageal echocardiography, with minimal improvement after drainage. Fiberoptic bronchoscopy revealed extensive tenacious secretions occluding the airways. Conventional suctioning was ineffective due to high sputum viscosity. Ultimately, techniques including pulmonary lavage, bronchoscopic suctioning, and repeated lung recruitment controlled the refractory hypoxemia. The patient recovered after treatment in the intensive care unit. Conclusions: It is worth noting that our case highlights the challenges posed by severe hypoxemia during total arch replacement surgery. The successful management of this complication underscores the importance of a multidisciplinary approach and close monitoring during the perioperative period. Individualized anesthetic management plays a critical role in addressing severe hypoxemia during total arch replacement surgery.","PeriodicalId":93523,"journal":{"name":"Asploro journal of biomedical and clinical case reports","volume":"13 34","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139156414","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 : 2023-12-18DOI: 10.36502/2023/asjbccr.6329
Siying Wang, Peng Liang
Background: Acute pulmonary edema following cardiopulmonary bypass (CPB) is a serious complication, the etiology of which could be classified into two groups: cardiogenic and noncardiogenic. Case presentation: We present a 42-year-old male with multiple pulmonary bullae scheduled for mitral valve and aortic valve replacement. Acute pulmonary edema occurred approximately 1 hour after weaning from CPB. The diagnosis of non-cardiogenic pulmonary edema was established with changes in pathophysiology and findings on ultrasound. The patient was promptly treated and transferred to the ICU uneventfully. Conclusions: This case report highlights the changes in pathophysiology combined with ultrasound findings to establish a diagnosis in the operating room. We also emphasize the perioperative management of noncardiogenic pulmonary edema.
{"title":"Acute Pulmonary Edema Following Cardiopulmonary Bypass: A Case Report","authors":"Siying Wang, Peng Liang","doi":"10.36502/2023/asjbccr.6329","DOIUrl":"https://doi.org/10.36502/2023/asjbccr.6329","url":null,"abstract":"Background: Acute pulmonary edema following cardiopulmonary bypass (CPB) is a serious complication, the etiology of which could be classified into two groups: cardiogenic and noncardiogenic.\u0000Case presentation: We present a 42-year-old male with multiple pulmonary bullae scheduled for mitral valve and aortic valve replacement. Acute pulmonary edema occurred approximately 1 hour after weaning from CPB. The diagnosis of non-cardiogenic pulmonary edema was established with changes in pathophysiology and findings on ultrasound. The patient was promptly treated and transferred to the ICU uneventfully.\u0000Conclusions: This case report highlights the changes in pathophysiology combined with ultrasound findings to establish a diagnosis in the operating room. We also emphasize the perioperative management of noncardiogenic pulmonary edema.","PeriodicalId":93523,"journal":{"name":"Asploro journal of biomedical and clinical case reports","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138964434","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 : 2023-11-30DOI: 10.36502/2023/asjbccr.6327
An-Phuc Ta, Megan Hsu, Satori Iwamoto
Sporadic or inherited deficiencies in the production or activity of the tumor suppressor P53 lead to Li-Fraumeni Syndrome (LFS), a multi-organ tumorigenic condition. Glioblastoma multiforme (GBM), a tumor that commonly presents with a median age of 64, has a higher chance of appearing in much younger patients who have LFS [9]. Since the implementation of the 2016 Toronto Protocol to increase cancer surveillance in LFS patients, three cases of LFS-GBM have been discussed [11-13]. Here, we report a case of LFS in an 18-year-old male who had a seizure due to a GBM that had evaded a full-body MRI six months prior. Furthermore, we discuss the potential quality of life (QOL) benefits of providing patients with a shorter brain MRI screening interval: better survival outcomes and peace of mind. Though there may be a rise in the financial cost with an increase in the number of MRI scans, the prevalence of aggressive tumors that must be treated early for a better prognosis warrants more frequent screening. Furthermore, we address the importance of expanding clinical knowledge on GBM in the LFS setting as well as addressing the benefits of the protocol through statistical studies.
{"title":"Li-Fraumeni Syndrome Cancer Surveillance Strategy Considerations for Glioblastoma Multiforme","authors":"An-Phuc Ta, Megan Hsu, Satori Iwamoto","doi":"10.36502/2023/asjbccr.6327","DOIUrl":"https://doi.org/10.36502/2023/asjbccr.6327","url":null,"abstract":"Sporadic or inherited deficiencies in the production or activity of the tumor suppressor P53 lead to Li-Fraumeni Syndrome (LFS), a multi-organ tumorigenic condition. Glioblastoma multiforme (GBM), a tumor that commonly presents with a median age of 64, has a higher chance of appearing in much younger patients who have LFS [9]. Since the implementation of the 2016 Toronto Protocol to increase cancer surveillance in LFS patients, three cases of LFS-GBM have been discussed [11-13]. Here, we report a case of LFS in an 18-year-old male who had a seizure due to a GBM that had evaded a full-body MRI six months prior. Furthermore, we discuss the potential quality of life (QOL) benefits of providing patients with a shorter brain MRI screening interval: better survival outcomes and peace of mind. Though there may be a rise in the financial cost with an increase in the number of MRI scans, the prevalence of aggressive tumors that must be treated early for a better prognosis warrants more frequent screening. Furthermore, we address the importance of expanding clinical knowledge on GBM in the LFS setting as well as addressing the benefits of the protocol through statistical studies.","PeriodicalId":93523,"journal":{"name":"Asploro journal of biomedical and clinical case reports","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139205954","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 : 2023-11-14DOI: 10.36502/2023/asjbccr.6328
Hongqiang Tu, Xiao Wang
Background: Prostatectomy offers the greatest potential for a definitive cure for localized prostate cancer. Closure devices for secundum atrial septal defects have a good safety and efficacy profile. Simultaneous operation of the two types of surgery has not been reported to date. Case Presentation: A 65-year-old man was admitted to receive laparoscopic radical prostatectomy for prostate cancer under general anesthesia. The chest CT imaging unexpectedly showed that the heart and the pulmonary artery were obviously enlarged. Subsequently, a secundum atrial septal defect (ASD) with left-to-right shunt measuring 27*23mm was observed on transthoracic echocardiography (TTE). After a multi-disciplinary team (MDT) consisting of departments of urology, cardiac surgery, and anesthesiology was assembled to discuss the surgical procedure, an atrial septal defect closure device was scheduled to be implanted, followed by laparoscopic radical prostatectomy. The patient underwent both surgeries and was successfully discharged from the hospital. Conclusions: Adequate perioperative assessment and management are crucial for patients. We should pay more attention to patients with cardiac disease undergoing both cardiac and non-cardiac surgery.
{"title":"A Patient Undergoing Laparoscopic Radical Prostatectomy and Atrial Defect Closure Simultaneously: A Case Report","authors":"Hongqiang Tu, Xiao Wang","doi":"10.36502/2023/asjbccr.6328","DOIUrl":"https://doi.org/10.36502/2023/asjbccr.6328","url":null,"abstract":"Background: Prostatectomy offers the greatest potential for a definitive cure for localized prostate cancer. Closure devices for secundum atrial septal defects have a good safety and efficacy profile. Simultaneous operation of the two types of surgery has not been reported to date. Case Presentation: A 65-year-old man was admitted to receive laparoscopic radical prostatectomy for prostate cancer under general anesthesia. The chest CT imaging unexpectedly showed that the heart and the pulmonary artery were obviously enlarged. Subsequently, a secundum atrial septal defect (ASD) with left-to-right shunt measuring 27*23mm was observed on transthoracic echocardiography (TTE). After a multi-disciplinary team (MDT) consisting of departments of urology, cardiac surgery, and anesthesiology was assembled to discuss the surgical procedure, an atrial septal defect closure device was scheduled to be implanted, followed by laparoscopic radical prostatectomy. The patient underwent both surgeries and was successfully discharged from the hospital. Conclusions: Adequate perioperative assessment and management are crucial for patients. We should pay more attention to patients with cardiac disease undergoing both cardiac and non-cardiac surgery.","PeriodicalId":93523,"journal":{"name":"Asploro journal of biomedical and clinical case reports","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139276303","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 : 2023-11-14DOI: 10.36502/2023/asjbccr.6326
Vince Thomas, Meraj Alam, Zohaer Muttalib, Nalin Ranasinghe, Leonard Ranasinghe
Spontaneous Pneumothorax is a potentially life-threatening condition that is brought on when air makes its way into the pleural spaces resulting in decreased negative pressure between the pleural membranes without trauma or injury occurring. Spontaneous pneumothorax was reported as an adverse complication of severe acute respiratory syndrome brought on by SARS-COV-2. It is thought spontaneous pneumothorax may be a consequence of the breakdown of elastic fibers within the lung tissue. This breakdown is believed to be caused by the body’s own immune response in particular by innate lymphoid cells (ILCs) which have been shown to be elevated in response to intracellular pathogens like viruses, but additional research is needed to clearly state a causal relationship between SARS-CoV-2 and the immune-mediated formation of pneumothorax. Limited studies look at the link between the pathophysiology of Pneumothorax and COVID-19, which is why the patient from this case is of interest. We present a unique case of a 27-year-old male presenting to the Emergency Department complaining of difficulty breathing, chest pain, and fatigue who had prior tested positive for COVID-19. A diagnosis of pneumothorax was made by chest x-ray. In this report, we discuss the pathophysiology, imaging, and management related to pneumothorax and its connection to COVID-19.
{"title":"Case Study of Pneumothorax in a 27-year-old Male as a Possible Post- COVID 19 Infection Complication","authors":"Vince Thomas, Meraj Alam, Zohaer Muttalib, Nalin Ranasinghe, Leonard Ranasinghe","doi":"10.36502/2023/asjbccr.6326","DOIUrl":"https://doi.org/10.36502/2023/asjbccr.6326","url":null,"abstract":"Spontaneous Pneumothorax is a potentially life-threatening condition that is brought on when air makes its way into the pleural spaces resulting in decreased negative pressure between the pleural membranes without trauma or injury occurring. Spontaneous pneumothorax was reported as an adverse complication of severe acute respiratory syndrome brought on by SARS-COV-2. It is thought spontaneous pneumothorax may be a consequence of the breakdown of elastic fibers within the lung tissue. This breakdown is believed to be caused by the body’s own immune response in particular by innate lymphoid cells (ILCs) which have been shown to be elevated in response to intracellular pathogens like viruses, but additional research is needed to clearly state a causal relationship between SARS-CoV-2 and the immune-mediated formation of pneumothorax. Limited studies look at the link between the pathophysiology of Pneumothorax and COVID-19, which is why the patient from this case is of interest. We present a unique case of a 27-year-old male presenting to the Emergency Department complaining of difficulty breathing, chest pain, and fatigue who had prior tested positive for COVID-19. A diagnosis of pneumothorax was made by chest x-ray. In this report, we discuss the pathophysiology, imaging, and management related to pneumothorax and its connection to COVID-19.","PeriodicalId":93523,"journal":{"name":"Asploro journal of biomedical and clinical case reports","volume":"85 21","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134900722","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 : 2023-11-04DOI: 10.36502/2023/asjbccr.6325
Hiroshi Bando, Koji Ebe
For type 2 diabetes (T2D), the recommended meal has shifted from calorie restriction (CR) to a low carbohydrate diet (LCD). LCD gained worldwide prevalence through the efforts of Atkins and Bernstein, and we further developed LCD both medically and socially through the Japan LCD Promotion Association (JLCDPA). The beneficial and convenient methods of LCD include petite, standard, and super LCD, which have carbohydrate ratios of 40%, 26%, and 12%, respectively. For these three types, the approximate permitted carbohydrate amounts in each meal appear to be 20g, 30g, and 40g. Some foods with lower carbohydrate content include eggs (0.1g), a piece of cheese (0.2g), chicken meat (180g) (0.4g), and Japanese tofu (300g) (4g).
{"title":"Beneficial and Convenient Method of Low Carbohydrate Diet (LCD) as Petite, Standard and Super LCD","authors":"Hiroshi Bando, Koji Ebe","doi":"10.36502/2023/asjbccr.6325","DOIUrl":"https://doi.org/10.36502/2023/asjbccr.6325","url":null,"abstract":"For type 2 diabetes (T2D), the recommended meal has shifted from calorie restriction (CR) to a low carbohydrate diet (LCD). LCD gained worldwide prevalence through the efforts of Atkins and Bernstein, and we further developed LCD both medically and socially through the Japan LCD Promotion Association (JLCDPA). The beneficial and convenient methods of LCD include petite, standard, and super LCD, which have carbohydrate ratios of 40%, 26%, and 12%, respectively. For these three types, the approximate permitted carbohydrate amounts in each meal appear to be 20g, 30g, and 40g. Some foods with lower carbohydrate content include eggs (0.1g), a piece of cheese (0.2g), chicken meat (180g) (0.4g), and Japanese tofu (300g) (4g).","PeriodicalId":93523,"journal":{"name":"Asploro journal of biomedical and clinical case reports","volume":"256 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135775570","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：