New Horizons in Clinical Case Reports最新文献

{"title":"A true silent compartment syndrome in a competent sensate patient: Case report","authors":"Myrielle Hitz, G. Donner, J. Decking","doi":"10.1016/J.NHCCR.2017.06.158","DOIUrl":"https://doi.org/10.1016/J.NHCCR.2017.06.158","url":null,"abstract":"","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"480 1","pages":"10-11"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76372820","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":"Acute abdomen and septic shock in young lady treated conservatively","authors":"Kaldis Vasileios, Lampropoulos E. Christos, Zarokostas Theodoros, Sirmpilantze Tamta, Charalambous Natasa, K. Christina, Efi Tegonikou","doi":"10.1016/J.NHCCR.2017.06.165","DOIUrl":"https://doi.org/10.1016/J.NHCCR.2017.06.165","url":null,"abstract":"","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"16 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79708456","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":"Osteosarcoma During Pregnancy-Case Report","authors":"M. Stefaniak, B. Kozakiewicz, E. Dmoch-Gajzlerska","doi":"10.1016/J.NHCCR.2017.06.187","DOIUrl":"https://doi.org/10.1016/J.NHCCR.2017.06.187","url":null,"abstract":"","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"9 5-6","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91508858","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":"Rash or infection? An uncommon case of fever with skin lesions","authors":"Gaël Villanueva-Charbonneau *","doi":"10.1016/j.nhccr.2017.06.144","DOIUrl":"10.1016/j.nhccr.2017.06.144","url":null,"abstract":"<div><h3>Introduction</h3><p>Acute generalised exanthematous pustulosis (AGEP) is rare form of late hypersensitivity syndrome that can be sometimes mistaken as a skin infection. The differential diagnosis of infectious pustular lesion is large but it can also appear in the setting of a complete non-infectious estate.</p></div><div><h3>Case description</h3><p>We present a 40-year-old woman from a French-Canadian background who developed pustular lesions all over her body in the setting of fever, weakness and headache. She was previously affected by an Henoch–Schönlein purpura and developed secondary chronic infectious leg skin lesions.</p></div><div><h3>Result and conclusion</h3><p>Two months before the apparition of the pustules, she was treated by many different antibiotics (cephalexin, clindamycin, imipenem, vancomycin) because of the persistence of her chronic cellulitis skin lesions. Her immunosuppressive treatment was also modified and switched from prednisone to azathioprine. The later meticulous listing of her historical pharmacology revealed azathioprine to be the trigger of an AGEP.</p></div><div><h3>Take-home message</h3><p>Late hypersensitivity reactions appear usually one to two weeks after the exposure to a new medication. A scrupulous medical history helps to identify potential causative drugs in most cases. Although AGEP remains to be a rare disease, it has an excellent prognosis if identified and treated correctly by removing the responsible molecule.</p></div>","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 ","pages":"Pages 4-5"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nhccr.2017.06.144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89136827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New friend, old foe: Anti-interleukin-6 agents increase risk of Pneumocystis jirovecii pneumonia","authors":"Raj Palraj * ,&nbsp;Enrique Machare-Delgado ,&nbsp;Ala Dababneh","doi":"10.1016/j.nhccr.2017.06.192","DOIUrl":"https://doi.org/10.1016/j.nhccr.2017.06.192","url":null,"abstract":"<div><h3>Introduction</h3><p>Anti-interleukin-6 agents such as Tocilizumab (Actemra) are increasingly being used in patients with rheumatoid arthritis who did not have good clinical response to TNF (Tumor necrosis factor) inhibitors. Interleukin-6 is a key cytokine in the pathogenesis of several autoimmune disorders. <em>Pneumocystis jirovecii</em> is an opportunistic pathogen that causes pneumonia in immunocompromised patients such as HIV positive individuals with low CD4 count. There is limited data about the risk of pneumocystis pneumonia associated with newer biological agents. We report a rare case of <em>Pneumocystis jirovecii</em> pneumonia in a rheumatoid arthritis patient without HIV, associated with anti-interleukin-6 agent.</p></div><div><h3>Case description</h3><p>A 65-year-old female with rheumatoid arthritis, presented with progressive shortness of breath over a period of 3 weeks. She was receiving methotrexate and a biological interleukin-6 receptor blocker (Tocilizumab). She had a non productive cough and gradually progressing shortness of breath. She did not have fever or rigors. CT Chest angiogram was negative for pulmonary embolism, but did note extensive diffuse ground-glass opacity throughout both lungs, predominantly in the upper lobe. Hemoglobin was 14.9g/dL, White count 13.4X10(9)/L, platelet count 147X10(9)/L, Creatinine 0.83mg/dL, CRP 8.8mg/L.</p></div><div><h3>Results and conclusions</h3><p>Her clinical picture was suggestive of <em>Pneumocystis jirovecii</em> pneumonia. Bronchoalveolar lavage cultures, bacterial, fungal, viral and mycobacterial were negative. <em>Pneumocystis jirovecii</em> PCR was negative. Serum Beta-D-Glucan, a component of cell wall of <em>Pnemocystis jirovecii</em> was high (&gt;500pg/ml) and elevated levels have been reported to have high sensitivity and specificity in its diagnosis. Clinical picture, radiological findings and elevated serum Beta-D-Glucan (Fungitell) supported the diagnosis of Pneumocystis jirovecii. Patient recovered with oral Atovaquone for 21 days and tapering course of oral Prednisone. Repeat imaging showed complete resolution and Serum Beta-D-Glucan level trended down.</p></div><div><h3>Take-home message</h3><p>Interleukin-6 receptor blocker, used in patients with rheumatoid arthritis increase the risk of pneumocystis pneumonia, an opportunistic infection. Serum Beta-D Glucan test can be used as non-invasive testing modality to diagnose pneumocystis pneumonia in non-HIV patients with good sensitivity and specificity. Serial Beta-D Glucan levels may be used to monitor with clinical progress. Molecular methods such as <em>Pneumocystis jirovecii</em> PCR (Polymerase chain reaction) may be falsely negative in non-HIV patient.</p></div>","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 ","pages":"Pages 24-25"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nhccr.2017.06.192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91723185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of buried penis syndrome: The novel therapeutic DJ- SAM (Deepak Jumani-Sesame Arginine Metformin) approach","authors":"Deepak Jumani *","doi":"10.1016/j.nhccr.2017.06.178","DOIUrl":"https://doi.org/10.1016/j.nhccr.2017.06.178","url":null,"abstract":"<div><h3>Objectives</h3><p>Buried penis (hidden penis) is a congenital or acquired condition in which the penis is partially or completely hidden below the surface of the skin. It is an unusual, difficult-to-treat condition that presents a unique clinical challenge. It is an acquired condition in adulthood, most commonly due to predisposing factors such as morbid obesity and diabetes mellitus which are becoming increasingly prevalent, which suggests a potential increase in the incidence of this condition. Although no specific approach is applicable to all patients, a combination of various techniques may be applied. The use of L-arginine gel for erectile dysfunction is well documented, however the use of sesame seed oil applied topically for penile lengthening has not been reported. Both the ingredients are routinely used and have no known side-effects and are being studied for penile lengthening.</p></div><div><h3>Methods</h3><p>24 patients in age group 31-45 years, BMI ≥ 36 were administered Metformin SR 1gm/OD, L Arginine 3gm OD along with Sesame seed oil (food grade) and 5% L arginine for local application on the shaft of the penis for 12 weeks (DJ-SAM regime). The treatment for the comorbid diseases like diabetes, dyslipidaemia, hypertension, Vitamin D deficiency, COPD, UTI continued as per current standard of care.</p></div><div><h3>Results</h3><p>The patients were on low carbohydrate, high protein diet and exercise, but were unable to adhere to the exercise regimen. The patients were motivated and adhered to the DJ-SAM therapeutic regimen. Patients reported an increase of penile length to an extent of 2.5±0.56 inches. The changes in the BMI were statistically insignificant.</p></div><div><h3>Conclusion</h3><p>We postulate that sesame oil along with L-arginine for its topical properties could account for the lengthening of the penis in obese subjects with buried penis. The results of this pilot study as proof in concept highlights the concept of pharmacological modulation in penile lengthening. Metformin in high BMI patients would have a role as a metabolic hormonal regulator which needs further exploration. Although the exact mechanism of action of sesame seed oil for penile lengthening, is still not known, this is the first study that demonstrates the use of sesame seed oil as a therapeutic agent along with L-arginine gel for topical application.</p></div>","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 ","pages":"Page 19"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nhccr.2017.06.178","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91723659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implantation of penile prosthesis (3-piece inflatable) for erectile dysfucntion in a patient with left orchiectomy for left undescended testis: A cosmetic approach","authors":"Ahmad Al-Tawari * ,&nbsp;Said Yaiesh ,&nbsp;Tariq Al-Shaiji","doi":"10.1016/j.nhccr.2017.06.183","DOIUrl":"https://doi.org/10.1016/j.nhccr.2017.06.183","url":null,"abstract":"<div><p>Erectile dysfunction (ED) results from various functional and organic causes. Its management has always been a challenge to urologists and other physicians. After failing to respond to medical and intracorporal injections, patients might resort to surgical penile prosthesis implants to improve their sexual performance. Apart from functional outcome, cosmetic results also concern such patients. Cosmetic is also affected in patients with undescended testis or those who underwent an orchiectomy. We discuss the case of a diabetic 59-year-old gentleman with a left undescended testis who was receiving medical treatment for longstanding ED with unsatisfactory results of recent. The patient was counseled appropriately and his medical conditions were optimized prior to any possible surgical intervention. A planned laparoscopic orchiectomy was followed 5 months later by implantation of a 3-piece penile prosthesis device, with successfully placing the pump in a fashioned dartos pouch in the empty left hemiscrotum, attaining both satisfactory functional and cosmetic results for the patient. The prosthesis and the implantation of the pump in the empty left hemiscrotum helped the patient attain satisfactory sexual function and a cosmetic and textural resemblance of a full left hemiscrotum the likes of having a normal left testis. This approach boosted his self-confidence about his sexual performance and image, as reported by the patient after years of erectile dysfunction and having an undescended left testicle. Attention should be paid when planning and executing any surgery that will impact a patient's sexual function. Allowing for surgical innovation and studying the current setting could result in great results beyond the presenting complaint. The ability to restore a male patient's sexual function with implantable prosthesis along with good cosmetic results of the penis and the hemiscrotums can enhance the patient's final experience and level of satisfaction.</p></div>","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 ","pages":"Pages 21-22"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nhccr.2017.06.183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91759085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buerger's disease","authors":"Matthew Megson *,&nbsp;Michael Collins,&nbsp;Simon Hobbs","doi":"10.1016/j.nhccr.2017.06.186","DOIUrl":"https://doi.org/10.1016/j.nhccr.2017.06.186","url":null,"abstract":"<div><h3>Introduction</h3><p>This case demonstrates some of the features associated with Buerger's disease. This is a disease affecting the distal arteries causing ischaemia to the limb. It is associated with young patients who are heavy smokers.</p></div><div><h3>Case description</h3><p>A 27-year-old gentleman, who smokes heavily was admitted with ulcerated and necrotic toes. An angiogram was done which showed the cockscrew appearance of the more distal arteries classical of thromboanglitis obliterans, this is what causes the ischaemia. He was treated with smoking cessation and a standard five day course of Inoprost with good symptom relief.</p></div><div><h3>Results and conclusions</h3><p>Though Inoprost has good symptomatic relief the disease will continue to progress until the patient has completely stopped smoking as the autoimmune reaction is triggered by a component within the cigarette. If these patients do not stop smoking they are likely to require an amputation of the limb.</p></div><div><h3>Take-home message</h3><p>These patients require smoking cessation assistance. If these patients do continue to smoke, they often require amputation, therefore early counselling with an amputation service/physiotherapists is useful.</p></div>","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 ","pages":"Pages 22-23"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nhccr.2017.06.186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91759130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Kikuchi disease and lupus erythematosus in a schizophrenic patient with extreme anorexia","authors":"Lamia Abu Ghazaleh * ,&nbsp;Ludmila Vysman ,&nbsp;Amir Tanai ,&nbsp;Hedi Orbach","doi":"10.1016/j.nhccr.2017.06.180","DOIUrl":"https://doi.org/10.1016/j.nhccr.2017.06.180","url":null,"abstract":"<div><p>Kikuchi-Fujimoto Disease (KFD) is a rare benign condition of necrotizing histiocytic lymphadenitis. The manifestations include localized lymphadenopathy, fever and weight loss. KFD has been described in association with systemic lupus erythematosus (SLE).</p><p>This case describes a patient whose anorexia and deterioration were first interpreted as a manifestation of her schizophrenia. Diagnosis of a rare organic treatable disease resulted in improvement in her life threatening condition.</p><p>A 36-year-old woman with schizophrenia treated with depot haloperidol experienced a general deterioration, extreme anorexia and fever up to 38°C for few months. On examination she was cachectic weighing 33kg and confined to bed. She had malar rash, cough, fever, and enlarged axillary lymph nodes. Primary laboratory tests revealed pancytopenia and LDH 1254U/L. For suspected atypical pneumonia, therapy with ceftriaxone and azithromycin was started with no improvement. Cotrimoxazole was initiated and appropriate tests ruled out PCP, TB and HIV. Her condition deteriorated further demonstrating neutropenia 600mm³, and coombs positive hemolytic anemia with hemoglobin 8g/L.</p><p>Further lab tests revealed: positive ANA with titer of 1:60, elevated anti-smith, anti-RNP levels more than 200U. Anti-double stranded DNA was negative, C3: 62mg/dL, 24 hour protein urine collection showed 3.8g with no casts in urinary sediment.</p><p>A total body CT scan revealed pleural effusion, enlarged axillary and mediastinal lymph nodes. A biopsy form a right axillary lymph node revealed histiocytic necrotizing lymphadenitis. The diagnosis of KFD associated with SLE was made based on a malar rash, pleural and pericardial effusion, nephrotic range proteinuria, positive ANA, Anti-Smith, Anti-RNP, pancytopenia and a positive coombs test. The pathology result was consistent with KFD.</p><p>A follow up cardiac echocardiogram showed a new large pericardial effusion with right atrial compression and tachycardia. Parallel to high dose IV methylprednisolone treatment, a pericardiocentesis was performed and only 250ml were aspirated because of septations. A sternotomy with a pericardial window was performed. Following this procedure the patient's condition improved. Therapy with azathioprine 75mg/day and Prednisone 40mg/day was started. A second CT scan showed that the previously shown lymph nodes disappeared.</p><p>Physiotherapy was started on admission and continued ongoing. Five months after admission the patient maintains a significant improvement in her daily function and activity. She gained 15kg. There was a decrease in her proteinuria and increase in the C3 level to 93 with a normal blood count.</p><p>To conclude, we describe a case of KFD, a rare disease evolving in a SLE patient. Both diagnoses were made relatively late in the course of a chronic schizophrenic patient, leading to the appropriate therapy and saving her life.</p></div>","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 ","pages":"Page 20"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nhccr.2017.06.180","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91759131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostatic abscess: An unusual presentation","authors":"Latifa Al Mutairi, Abdullatif Al Terki, Tariq Al Shaiji","doi":"10.1016/J.NHCCR.2017.06.171","DOIUrl":"https://doi.org/10.1016/J.NHCCR.2017.06.171","url":null,"abstract":"","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"41 1","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83765563","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}