Clinical Case Studies and Reports最新文献

{"title":"SARS-CoV-2 infection presenting as sustained atrial flutter and advanced ventricular dysfunction","authors":"J. Su, M. Weisert, M. Silka, Y. Bar-Cohen, J. Menteer","doi":"10.15761/ccsr.1000155","DOIUrl":"https://doi.org/10.15761/ccsr.1000155","url":null,"abstract":"Viral infections may affect the cardiovascular system in various ways. A number of viruses are known to cause myocarditis and pericarditis, which may result in severe impairment of ventricular function leading to decompensated heart failure [1]. Viral infections may also cause systemic inflammatory response syndrome and septic shock from exaggerated immune inflammatory response [2]. Certain viruses have also been linked to development of cardiac arrhythmias [3,4]. In these cases, evidence of myocardial inflammation is often found. However, arrhythmias are sometimes the only indicator of cardiac involvement in viral infections. Additionally, myocardial failure of any cause can raise atrial and ventricular filling pressures, resulting in increased myocardial fiber stress, potentially inducing arrhythmias or triggering arrhythmias.","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89101084","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":"A rare case of foetal endocardial fibroelastosis diagnosed on prenatal sonography","authors":"Sundeep Nvk, M. Venkatesh","doi":"10.15761/ccsr.1000139","DOIUrl":"https://doi.org/10.15761/ccsr.1000139","url":null,"abstract":"Foetal Endocardial Fibroelastosis (EFE) is a rare cardiac disorder, characterised by echogenic thickening of the endocardium and decreased ventricular contractility, secondary to proliferation of elastic and collagen fibres. In this case report we present a case of endocardial fibroelastosis with review of literature regarding etiopathogenesis, classical features and prognosis.","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81309481","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":"Perioperative considerations of an extended forequarter amputation for recurrent high-grade radiation-induced sarcoma: A case report","authors":"Alexander Stoker, Jeff Mueller, Christopher A. Thunberg, K. Goulding, S. Beamer, M. Hinni, A. Rebecca, C. Beauchamp, Andrew W. Gorlin","doi":"10.15761/ccsr.1000149","DOIUrl":"https://doi.org/10.15761/ccsr.1000149","url":null,"abstract":"Forequarter amputation is a radical surgical procedure involving removal of the entire upper extremity and shoulder girdle and is most commonly performed in the management of aggressive upper extremity malignancies. A number of perioperative challenges can arise during extended resections including postoperative respiratory compromise due to altered chest wall mechanics, potential need for lung isolation, selecting appropriate sites for vascular access, complex fluid and hemodynamic resuscitation, optimizing conditions for free flap viability, and managing pain and the psychological impact of such a significant operation. Here we present a case of an extended forequarter amputation with a multidisciplinary team for the management of a recurrent high-grade radiation-induced sarcoma. lateral decubitus position and the right arm, chest wall and were prepped and draped. The plastic surgery began by preparing the forearm for a free fillet flap, but delaying the anastomosis until the extremity was removed. The surgical teams then performed a right forequarter amputation with neck dissection and lymphadenectomy, costotransversectomy from C7 to T2, and chest wall resection. The brachial plexus, external jugular vessels and internal jugular vein were divided. Left lung isolation was required during the chest wall resection involving the first through fifth ribs, sternoclavicular joint, a portion of the manubrium, right upper lobectomy, and total lung pulmonary decortication. The right upper extremity was then removed from the body, leaving a 17 x 25 centimeter defect. The plastic surgery team then removed the free fillet flap from the extremity on a sterile back table, and inset the free forearm fillet flap, anastomosing the brachial artery and vein of the free fillet flap to the lingual artery and anterior cervical vein, respectively. Then 2000 units of heparin were administered intravenously. Reconstruction of the chest wall was performed with a 15 x 18 cm Goretex mesh, and the flap was inset and incisions reapproximated. The surgical time of the procedure was 10 hours and 21 minutes.","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"127 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75839602","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":"Intra-myometrial pregnancy-A rare site of ectopic pregnancy","authors":"M. Venkatesh, Sindhuja Kln, Sundeep Nvk","doi":"10.15761/ccsr.1000137","DOIUrl":"https://doi.org/10.15761/ccsr.1000137","url":null,"abstract":"A 35-year-old G2 P1 L1 lady presented with amenorrhea of 7 weeks and mild lower abdominal pain. No prior history of abortion or dilatation and curettage. Urine pregnancy test was positive and early antenatal ultrasound was advised. Transvaginal sonography was performed which revealed a gestational sac in the myometrium close to serosa (Figure 1A). Fetal pole was seen within the sac with good fetal cardiac activity (Figure 1B). MRI pelvis was done for better delineation of the sac. MRI (Figure 2A and 2C) showed gestational sac with hypointense fetal pole in the anterior myometrium as revealed on USG. MRI (Figure 2B) revealed additional finding of T2 curvilinear hyperintense tract which was seen extending from the endometrial cavity to gestational sac. Bilateral adnexa were normal and there was no free fluid in pelvis. USG and MRI features were suggestive of intramyometrial pregnancy. In view of location of gestational sac in the myometrium close to serosa with high risk of rupture, wedge resection of myometrium was performed (Figure 2D). Patient was discharged on 5th post-operative day with no complications. Abstract","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"97 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79224228","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":"Electroencephalographic evidence of organic alteration in a patient with SARS-CoV2 induced delirium","authors":"J. Pastor, L. Vega-Zelaya, E. Parada, J. L. Mateos","doi":"10.15761/ccsr.1000152","DOIUrl":"https://doi.org/10.15761/ccsr.1000152","url":null,"abstract":"Neurological complications in COVID-19 infected patients have been extensively reported. CNS affections include encephalitis, toxic encephalopathy, ageusia and anosmia, headache or acute cerebrovascular disease and delirium [1-5]. The mechanisms of CNS infection by CoV2 are still debated and it has been proposed a direct invasion through blood-brain barrier, a neuronal pathway, hypoxia damage, immune-response mediated injury or angiotensin-converter enzyme 2, among others [2,6,7].","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73967761","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":"Penetrating excimer Laser-assisted keratoplasty for corneal epithelial downgrowth in childhood","authors":"Barbora Majkutova, F. Flockerzi, M. BertholdSeitz, Celestina Schober, A. Viestenz","doi":"10.15761/ccsr.1000143","DOIUrl":"https://doi.org/10.15761/ccsr.1000143","url":null,"abstract":"A 5-year-old boy was presented in our department one month after corneal injury caused by metal stick, complaining of pain in his right eye and pronounced photosensitivity. The primary removal of corneal foreign body took place in an external clinic. BCVA was 0.6 OD and 1.0 OS. The slit-lamp biomicroscopy examination revealed a corneal intrastromal whitish membranous structure in the right eye spreading over the visual axis (Figure 1).","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80579465","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":"Old causes still alive - A case report","authors":"J. Berg","doi":"10.15761/ccsr.1000140","DOIUrl":"https://doi.org/10.15761/ccsr.1000140","url":null,"abstract":"Prevalence patterns for infectious diseases change over time and the testing of their presence at referral to hospitals may be reduced when the incidence rates are low. A case is presented, where a suspicion of syphilis as the maybe reason for a stabbing in a train, firstly came during the forensic psychiatric interview. This underscores the need for taking rare causes into consideration and for the use of psychiatrists, not only psychologists at forensic examination of mental illness.","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73079414","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":"COVID-19 infection presenting as massive, multi-organ thromboembolism","authors":"M. Bongiovanni, F. Bini, B. Bodini, G. Xhepa, A. Marra, G. D. Angelis","doi":"10.15761/ccsr.1000154","DOIUrl":"https://doi.org/10.15761/ccsr.1000154","url":null,"abstract":"The emergence of Coronavirus disease 2019 (COVID-19) has presented an unprecedented challenge for the healthcare community across the world. Based on the rapid increase in the rate of human infection, the World Health Organization (WHO) has classified the COVID-19 outbreak as a pandemic [1-3]. Respiratory involvement, presenting as mild flu-like illness to potentially lethal acute respiratory distress syndrome or fulminant pneumonia, is the dominant clinical manifestation of COVID-19 [4]. However, pre-existing cardiovascular disease (CVD) and CV risk factors may enhance vulnerability to COVID-19; further, COVID-19 can worsen underlying CVD and even precipitate new cardiac complications, due to possible endothelial dysfunction [5-6]. Furthermore, patients with COVID-19 pneumonia exhibit a number of coagulation abnormalities that have been associated with a higher mortality rate [7-8]; in particular, severe lung inflammation and impaired pulmonary gas exchange in COVID‐19 infected individuals has been suggested to be due to the up-regulation of pro‐inflammatory cytokines [9]. Further, it has been demonstrated that the activation of the coagulation system is relevant in the pathogenesis of acute respiratory distress syndrome (ARDS), one of the most common complications of COVID‐19 infection [10]. As a consequence, COVID-19 infection may predispose to both venous and arterial thromboembolic disease due to excessive inflammation, hypoxia, immobilization and diffuse intravascular coagulation (DIC).","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87601110","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":"Transient hypoxia following nitrogen spray cryotherapy for Barrett’s Esophagus: A case report","authors":"atthew L Ritz, A. Murray, Andrew W. Gorlin","doi":"10.15761/ccsr.1000148","DOIUrl":"https://doi.org/10.15761/ccsr.1000148","url":null,"abstract":"The patient was a 70-year-old male with a past medical history significant for gastro esophageal reflux disease, Barrett’s Esophagus, and Class III obesity with a body mass index greater than 40. The patient had undergone previous radio frequency ablation for treatment of Barrett’s Esophagus. The patient presented for a surveillance endoscopy and nitrogen cryotherapy. A nasal cannula was placed with side stream capnography, and intravenous induction of anesthesia was performed with propofol and lidocaine. A propofol infusion was used for maintenance of anesthesia and titrated appropriately to maintain depth of anesthesia, the patient was breathing spontaneously for the duration of the case. The endoscope was introduced without complication. Nitrogen spray cryotherapy was performed for twenty seconds for two cycles at each treatment site. A total of four different sites were ablated. Ventilation tubing was inserted adjacent to the endoscope and suction aided ventilation of gases was performed through the ventilation tubing during, and for 20 seconds after the ablation procedure. The patient developed hypoxia with desaturation into the 80s by pulse oximetry during each ablation. The hypoxia resolved each time ablation was completed. The procedure was ultimately completed successfully and the patient was taken to the PACU with a nasal cannula in place which was ultimately discontinued, he was discharged without further episodes of hypoxia.","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80928313","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":"The Use of I-gel laryngeal mask with selective endobronchial blocker for uniportal video assisted thoracic surgery","authors":"G. D. Gregorio, N. Sella, A. Pangoni, D. Pittarello, P. Navalesi, F. Rea, A. Dell’Amore","doi":"10.15761/ccsr.1000153","DOIUrl":"https://doi.org/10.15761/ccsr.1000153","url":null,"abstract":"The development of video-assisted thoracoscopic surgery has led to a rising interest in decreasing the invasiveness not only of the surgical procedures, but also of the anaesthetic management. We report our preliminary experience using a supraglottic device and a bronchial blocker without neuromuscular blockade during uniportal video assisted thoracic surgery.","PeriodicalId":10345,"journal":{"name":"Clinical Case Studies and Reports","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77676221","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}