New Horizons in Clinical Case Reports最新文献

{"title":"Tracheoesophageal fistula in sibilings - A rare occurence","authors":"Hind Zaidan *,&nbsp;Hussein Hamdy,&nbsp;Martin Corbally","doi":"10.1016/j.nhccr.2017.06.153","DOIUrl":"10.1016/j.nhccr.2017.06.153","url":null,"abstract":"<div><h3>Introduction</h3><p>Esophageal atresia is one of the most common congenital malformations occurring in 1 in every 2000-4000 live births. Previously considered to be a fatal condition, it has now become an eminently treatable condition with survival limited only by the presence or absence of major cardiac malformations. For the majority of families, the condition is unique to one child which in itself is challenging. It is extremely rare to affect more than one sibling in any family. The risk of recurrence is 0.5-2% and rises to 20% if another sibling is affected.</p></div><div><h3>Case description</h3><p>We report on two siblings, born two years apart with Type C TOF who were treated at King Hamad University Hospital, Bahrain. The first sibling was born with a short gap esophageal atresia with a distal fistula and repaired shortly after birth in another institution. The second sibling was born with a more challenging long gap esophageal atresia also with a distal fistula. The fistula was ligated on the second day of life and a gastrostomy tube put in place for feeding; repair of the atresia took place 2 months later. Both patients underwent serial dilatations to overcome strictures but are both tolerating oral diets. The third sibling in the family was unaffected with TOF or any VACTREL association.</p></div><div><h3>Conclusion</h3><p>The etiology of TOF is multifactorial with genetic, environmental and unknown components. There were no known environmental factors which could have contributed to this rare occurrence, but the only factor of significance is consanguinity of the parents who are first cousins. On the other hand, genetic factors are responsible for 12% of cases, these are classified as Chromosomal mutations, Syndromic or Isolated. These siblings do not fall into any of the mentioned categories and it is therefore speculated that this occurrence is due to a sporadic mutation.</p></div><div><h3>Take-home message</h3><p>Esophageal atresia with or without fistula is a fairly common condition encountered by paediatric surgeons on a daily basis. Despite increased experience and advancements in management of complex cases, the etiology remains a mystery. Future research should focus on more in-depth genetic studies on the impact of co-sanguinity on sibling TOFs.</p></div>","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 ","pages":"Page 8"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nhccr.2017.06.153","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81999887","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":"Post-infarction left ventricular pseudoaneurysm","authors":"Rienzi Diaz *","doi":"10.1016/j.nhccr.2017.06.194","DOIUrl":"https://doi.org/10.1016/j.nhccr.2017.06.194","url":null,"abstract":"<div><h3>Introduction</h3><p>Pseudoaneurysm of the left ventricle is a severe complication of myocardial infarction that results from a free cardiac wall rupture that is contained by the pericardium, thrombus, or adhesions. Most patients with a cardiac pseudoaneurysm will display symptoms of dyspnea or chest pain, but 10% of patients can be asymptomatic. Transthoracic Doppler color flow imaging is a suitable starting diagnostic method for diagnosing a pseudoaneurysm of the left ventricle. Cardiac magnetic resonance is an excellent complementary method for identifying this cardiac entity.</p></div><div><h3>Case description</h3><p>A patient in heart failure was admitted to receive intensive care therapy. An electrocardiogram showed anterolateral ST elevation and two-dimensional echocardiogram [2DE] posterolateral akinesis of the left ventricle. After a satisfactory in-hospital course he was discharged without any apparent complication. Six months later he was referred for new evaluation due to heart failure symptoms. A 2DE revealed a pseudoaneurysm along the left ventricular lateral wall. A cardiac magnetic resonance confirmed a pseudoaneurysm contained by the pericardium. Late gadolinium-enhanced imaging demonstrated a transmural lateral myocardial infarction with marked delayed enhancement of the pericardium that forms the wall of the pseudoaneurysm.</p></div><div><h3>Results and conclusions</h3><p>Early surgical intervention is recommended for a pseudoaneurysm of the left ventricle because of its tendency to rupture. Most patients do well after surgical repair, except for that requiring concomitant mitral valve replacement. However, the long-term outcomes of patients with a pseudoaneurysm not treated with surgery appear to be relatively benign, with a very low risk of fatal rupture. Therefore, a conservative approach may be considered in these patients that should include chronic anticoagulation therapy because of a high risk of ischemic stroke.</p></div><div><h3>Take-home message</h3><p>Transthoracic echocardiography is an acceptable starting diagnostic method in patients having a pseudoaneurysm. Cardiac magnetic resonance has been increasingly used as a non-invasive diagnostic method.</p></div>","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 ","pages":"Page 26"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nhccr.2017.06.194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91723072","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":"Neurocysticercosis presenting with psychosis","authors":"Aml ElemamaliI *,&nbsp;Shafa Talyb,&nbsp;Abobaker Awad","doi":"10.1016/j.nhccr.2017.06.188","DOIUrl":"https://doi.org/10.1016/j.nhccr.2017.06.188","url":null,"abstract":"<div><h3>Introduction</h3><p>Neurocysticercosis, the infection caused by the larval form of the tape worm Taenia Solium is the most common parasitic disease of the central nervous system. The disease presents it with spectrum of clinical manifestations like seizure, headache, neurological deficit and psychiatric symptoms such as psychosis. Even though most commonly patients present with seizure, rarely it may produce symptoms of neuropsychiatric disorder such as psychosis.</p></div><div><h3>Case description</h3><p>Here we are going to report a case of a patient 31-year-old Nepali male who presented to our emergency department with features of acute psychosis. Later on with diagnostic imaging like CT head and MRI brain was discovered to have multiple neurosysticercosis one in the right frontal region and the other in the right inferior cerebellar region. Patient was admitted to the inpatient and was managed with anthelminthic, antipsychotic and steroids.</p></div><div><h3>Results and conclusions</h3><p>Patient condition improved and he is on regular follow up in psychiatry and neurology clinic.</p></div><div><h3>Take-home message</h3><p>Although it is rare for neurocysticercosis to present with psychosis, always keep a high index of suspicion especially in patients from endemic areas.</p></div>","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 ","pages":"Page 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.2017.06.188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91723178","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":"One center experience of pneumatosis cystoides intestinalis","authors":"V. Mokricka, Polina Zalizko, M. Pavărs, A. Āboliņš, A. Puķītis","doi":"10.1016/J.NHCCR.2017.06.195","DOIUrl":"https://doi.org/10.1016/J.NHCCR.2017.06.195","url":null,"abstract":"","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"24 1","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88372918","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":"Reduced GO/NOGO ACC-sensitive Activity in A Case of Parkinson's Disease with Impulse Control Disorders","authors":"S. Palermo, R. Morese, M. Zibetti, Francesca Dematteis, Maria ConsueloValentini, L. Lopiano","doi":"10.1016/J.NHCCR.2017.06.155","DOIUrl":"https://doi.org/10.1016/J.NHCCR.2017.06.155","url":null,"abstract":"","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 1","pages":"9-9"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80236431","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":"Diffuse colon polyposis unexpected, total regression due to combined treatment on liver metastasis","authors":"Zsanett Bíró, A. Papp, Ö. Horváth, A. Vereczkei","doi":"10.1016/j.nhccr.2017.06.196","DOIUrl":"https://doi.org/10.1016/j.nhccr.2017.06.196","url":null,"abstract":"","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"824 1","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78905649","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":"Partial Priapisim: A rare presentation of sickle cell anemia","authors":"M. Malallah, Hussain Al Rashed, Abdullatif Al Terki, Tariq Al Shaiji","doi":"10.1016/J.NHCCR.2017.06.156","DOIUrl":"https://doi.org/10.1016/J.NHCCR.2017.06.156","url":null,"abstract":"","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 1","pages":"9-10"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87779140","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 renal failure and severe lactic acidosis due to metformin","authors":"Sirmpilantze Tamta * ,&nbsp;Kordali Christina ,&nbsp;Poulas Andreas ,&nbsp;Charalambous Natasa ,&nbsp;Lambas Vaggelis ,&nbsp;Rozi Fotini ,&nbsp;Mavras Georgios ,&nbsp;Lampropoulos E Christos","doi":"10.1016/j.nhccr.2017.06.167","DOIUrl":"https://doi.org/10.1016/j.nhccr.2017.06.167","url":null,"abstract":"<div><h3>Introduction</h3><p>Metformin may rarely cause lactic acidosis in patients with predisposing factors of acidosis or tissue hypoxia, like acute renal or heart failure, liver failure, dehydration, alcohol consumption or serious infection. Mortality may approach 50% in these cases.</p></div><div><h3>Case description</h3><p>A 70-year-old lady came to the emergency unit because of vomits and diffuse abdominal pain. Five days ago, she had visited our hospital for the same reason, with normal findings on physical and laboratory examination. Her medical history included diabetes mellitus under metformin/vildagliptin and dementia. The patient was confused and disoriented, afebrile, oliguric, with tachypnea and diffuse abdominal tenderness. Pressure was 130/70mmHg. Blood gases revealed severe lactic acidosis (lactate&gt;15mmol/L), pH=6.84, PCO₂=7mmHg, pO2=133mmHg, glucose=57mg/dL, HCO3&lt;3mmol/L. Abnormal laboratory tests included creatinine=5.3mg/dL, urea=152mg/dL, WBC=17000/µL, hemoglobin=12.3gr/dL, sodium=133mmol/L, potassium=4.4mmol/L, ESR=43mm/h. Chest x-ray, abdominal ultrasound (to exclude obstructive nephropathy) and echocardiography were normal.</p></div><div><h3>Results and conclusions</h3><p>The patient received 400mL bicarbonate 4.8%, aggressive hydration, dopamine (diuretic dose) and 160mg furosemide. Because of clinical deterioration she underwent hemodialysis. She was treated, according to guidelines, as for severe sepsis with meropenem. Blood and urine cultures were negative. On 1^st day, ECG showed ischemic lesions, which resolved with nitrates. Abdominal CT was normal. She remained afebrile after the 1^st day (low grade fever). Overall, the patient underwent three hemodialysis sessions (resistant severe lactic acidosis, low bicarbonates). On 2^nd day, she was well oriented. She was discharged 8 days later with urea=59mg/dL and creatinine=1.6mg/dL. After 20 days, creatinine was 1mg/dL.</p></div><div><h3>Take-home message</h3><p>Metformin may be a cause of severe lactic acidosis, disproportionate to the degree of renal failure, in patients with previous normal renal function and acute dysregulation. Hemodialysis is a lifesaving therapeutic intervention in these patients.</p></div>","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 ","pages":"Page 15"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nhccr.2017.06.167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91723666","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":"Gastrointestinal metastases from breast cancer: A case report","authors":"Begoña Peinado,&nbsp;Estibaliz Álvarez,&nbsp;Isabel Pascual,&nbsp;Ines Rubio,&nbsp;Mario Alvarez,&nbsp;Jose Luis Marijuan,&nbsp;Joaquin Diaz","doi":"10.1016/j.nhccr.2017.06.199","DOIUrl":"https://doi.org/10.1016/j.nhccr.2017.06.199","url":null,"abstract":"<div><h3>Background</h3><p>Breast cancer is the most common type of cancer in women nowadays. According to published major studies, the most common sites of metastases of breast cancer are bone, lung, liver and brain. However, it can also metastasize rarely to the gastrointestinal tract. Among the different subtypes of breast cancer, gastrointestinal spread has been associated to infiltrating lobular carcinoma. We present a case of perforated acute diverticulitis that underwent surgery, in which the pathological exam informed of colonic metastasis of lobular breast carcinoma.</p></div><div><h3>Case report</h3><p>A 78-year-old woman, with medical history of high blood pressure, diabetes and left mastectomy performed 14 years ago for infiltrating lobular carcinoma (Stage T2N2M0), with positive estrogenic receptors. Oncological controls showed pleural and bone progression in the last year, so hormonal therapy was indicated. She was admitted to the emergency department due to 72 hours of left lower-quadrant abdominal pain associated with constipation and nausea. On examination she presented tenderness and a palpable mass in the left lower quadrant. Blood tests showed an increased leukocyte count of 13.5x103/µL with neutrophilia, a CRP of 356mg/L and high lactate levels (4.5mmol/L). An abdominal computed tomography (CT) scan showed a left inguinal abscess (6x8x7cm) communicating with an inflammatory mass involving the sigmoid colon, as well as extensive bone metastases, not visualized in previous CTs. An emergency Hartmann's procedure was performed. The postoperative period was uneventful. The pathological report of the surgical specimen informed of infiltration in multiple diverticula by a carcinoma, with morphological pattern and immunohistochemistry compatible with a lobular breast carcinoma. The patient was derived to the Department of Oncology to continue follow-up and hormonal therapy.</p></div><div><h3>Conclusions</h3><p>Gastrointestinal breast metastases are uncommon, however, we should consider this diagnosis in patients with tumoral progression presenting with abdominal symptoms. Metastatic patients should receive medical treatment, reserving surgery for complications like obstruction or perforation, as in the case presented.</p></div>","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 ","pages":"Pages 27-28"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nhccr.2017.06.199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91723181","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":"Dasatinib related pericardial effusion requiring pericardial drainage","authors":"Kyriacos Mouyis *,&nbsp;Sofia Metaxa,&nbsp;Constantinos Missouris","doi":"10.1016/j.nhccr.2017.06.179","DOIUrl":"https://doi.org/10.1016/j.nhccr.2017.06.179","url":null,"abstract":"<div><h3>Introduction</h3><p>Dasatinib is an oral Bcr-Abl and Src family tyrosine kinase inhibitor approved for use in patients with chronic myelogenous leukaemia (CML) and Philadelphia chromosome positive acute lymphoblastic leukaemia (ALL). Its common side effects include myelosuppression, oedema, diarrhea and nausea. It has also been associated with the formation of pleural and pericardial effusions. As a result, Dasatinib is to be avoided in patients with pre-existing effusions or predisposition to respiratory or cardiovascular disease.</p></div><div><h3>Case description</h3><p>A fit 62-year-old pilot with no relevant medical history was diagnosed with CML in 2014, and commenced on Dasatinib therapy (100mg OD). A subsequent trans-thoracic echocardiogram (TTE) revealed normal ventricles and cardiac valves. There was however a mild to moderate global pericardial effusion, without haemodynamic compromise. This was regularly monitored with TTEs and remained stable until May 2016, where it measured 2.1cm posteriorly around the LV and 1.0 cm around the RV. Due restrictions imposed by the Civil Aviation Authority in the UK, the patient was referred for pericardial window procedure, prior to being considered fit for flying.</p></div><div><h3>Conclusions</h3><p>Dasatinib is known to cause pleural and pericardial effusions. This has been reported in patients without any predisposing factors.(1) The link with pericardial effusions has been proven with robust statistical analysis.(2) No specific mechanism has been proposed but an immune mediated reaction or off target inhibition of growth factors may be involved.(3) Management includes dose interruption or reduction, and/or treatment with steroids.(3) Our case report re-enforces that Dasatinib is an important cause of pericardial effusion and TTE is the modality of choice for follow-up. Pericardial window and drainage may be needed in patients where this prohibits them from undertaking employment.</p></div><div><h3>Take-home message</h3><p>Dasatinib related pericardial effusions are a documented side effect of therapy. One should be vigilant in monitoring patients on the drug as effusions may progress over time and require intervention. TTE is the monitoring modality of choice. As far as we are aware this is the first case report for surgical intervention in a patient with Dasatinib induced pericardial effusion.</p></div>","PeriodicalId":100954,"journal":{"name":"New Horizons in Clinical Case Reports","volume":"1 ","pages":"Pages 19-20"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nhccr.2017.06.179","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91723660","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}