Clinical Medical Reviews and Case Reports最新文献

{"title":"Superficial Temporal Artery Aneurysm","authors":"Daly Hafedh, Mnassri Cyrine, Chalbi Farhat, Horchani Amira","doi":"10.23937/2378-3656/1410393","DOIUrl":"https://doi.org/10.23937/2378-3656/1410393","url":null,"abstract":"The superficial temporal artery aneurysm is a rare pathology. We report the case of a 7-year-old child who consulted for a beating mass on the left forehead. The doppler ultrasound and The CT angiography confirmed the diagnosis of a superficial temporal artery aneurysm. The treatment was surgical and the postoperative course was simple.","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88164683","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":"Risk of Pulmonary Toxicity and Benefits of Bleomycin Containing Regimen in Early-Stage Hodgkin's Lymphoma - A Case Report and Insights from Literature Review","authors":"Adetiloye Adebola, Alladin Farhana, Ghosh Kuldeep, Valencia-Manrique Julio, A. Rasha, Victoria Ana Maria, Cosico John, Popescu-Martinez Andrea","doi":"10.23937/2378-3656/1410390","DOIUrl":"https://doi.org/10.23937/2378-3656/1410390","url":null,"abstract":"Background: Bleomycin is chemotherapeutic agent that has been used for cancer treatment for several years. However, potentially life-threatening lung toxicity is a major concern limiting its use. Case report: This is a case of a 64-year-old male presenting sub acutely with gradual onset of exertional shortness of breath and cough after completing 4 cycles of ABVD regimen for Stage 2b Hodgkin’s lymphoma. CT scan showed extensive bibasilar reticular opacities with honey combing suggestive of pulmonary fibrosis with Usual interstitial pneumonia pattern. Based on temporal relations to bleomycin chemotherapy, a diagnosis of bleomycin induced lung fibrosis was made. Bleomycin was subsequently discontinued with some improvement of symptoms. Conclusion: Pulmonary toxicity with irreversible lung fibrosis is a life threatening and menacing adverse effects in patients receiving Bleomycin therapy. The probability of developing lung toxicity from Bleomycin is increased in older patients receiving multiple cycles of chemotherapy, with risk potentially outweighing benefits in select patients with early-stage lymphoma and favorable prognosis. and malignant pleural effusion [1]. It is produced by Streptomyces verticillus and was first isolated by Umezawa, et al. in 1966 [2]. Its mechanism of action involves breakdown of DNA double helix by the production of free radicals, which is dependent on oxygen and iron [2]. Although dermatological adverse effects are the most observed, Bleomycin induced lung toxicity crop up in up to 10% patients which can be life menacing if not diagnosed early with mortality rate of up to 20% [1,3]. Bleomycin induced lung injury encompasses several clinical syndromes including hypersensitivity, bronchiolitis obliterans with organizing pneumonia, hypersensitivity pneumonitis which may progress to pulmonary fibrosis [3]. Several factors including older age and cumulative drug dose have been shown to increase the risk of developing pulmonary toxicity from Bleomycin [4]. The following is a case of pulmonary fibrosis following chemotherapy with Bleomycin for Stage 2B Hodgkin’s Lymphoma (HL). This case emphasizes the need for careful selection of chemotherapy regimen in older patients with Hodgkin’s lymphoma who are risk for bleomycin pulmonary toxicity and the necessity for diligent surveillance in patients with increased baseline risks for toxicity. Introduction Bleomycin is an anti-tumor antibiotic indicated in the treatment of lymphomas, germ cell tumors ISSN: 2378-3656 DOI: 10.23937/2378-3656/1410390 Adetiloye et al. Clin Med Rev Case Rep 2022, 9:390 • Page 2 of 6 • residual mass or metabolic uptake in the neck and mediastinum (Figure 1). Initial evaluation, revealed blood pressure of 127/82 mmHg, heart rate of 104 beats per minute, respiratory rate of 22 breaths per minute, SpO2 90% on room air and Temperature was 97.8 F. He had inspiratory rales bilaterally and use of accessory muscles of respiration on examination. Pertinent negatives ","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73999586","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":"Prolonged Recovery of Neuromuscular Transmission during General Anaesthesia after Mivacurium Administration - Case Report","authors":"Radkowski Paweł, Podhorodecka Katarzyna, Kęska Mariusz","doi":"10.23937/2378-3656/1410389","DOIUrl":"https://doi.org/10.23937/2378-3656/1410389","url":null,"abstract":"Introduction: Mivacurium is the shortest-acting nondepolarizing relaxant, used for brief procedures, such as those performed in the ambulatory setting. The recommended intubating dose of 0.2 mg/kg usually provides a clinically effective neuromuscular block for approximately 15 to 20 minutes and spontaneous recovery is 95% complete within about 25 to 30 minutes. Case presentation: 71-years-old woman was admitted for an elective laparotomy surgery with an intraoperative examination. Standard monitoring and TOF Scan (both the adductor pollicis muscle and the orbicularis oculi) were used. 8 mg dexamethasone, 0.1 mg fentanyl, 150 mg propofol, and 18 mg mivacurium were administered for induction. At the end of the procedure, there was no response from TOF. The return of neuromuscular transmission was achieved only after 75 minutes from the induction. Discussion: Mivacurium as a short-acting non-depolarizing muscle relaxant is well suited for short-term operations and operations of unpredictable duration. However, previous studies have shown that an extended neuromuscular block is likely in patients with significantly reduced plasma cholinesterase activity (especially in patients who are homozygous for the atypical plasma cholinesterase gene) as well as when administering some drugs and during other clinical situations. Conclusions: Extensively prolonged apnoea during general anaesthesia is a dangerous incident. Therefore, we still need systematic reviews to determine the prevalence of incidents of extended neuromuscular block after mivacurium. In case of prolonged muscle relaxation, we should think about possible reversible causes of this phenomenon since it is not always related to genetic causes. Furthermore, mechanical ventilation and close clinical monitoring are required during administering mivacurium. All of this to achieve the best possible patient outcomes.","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75205580","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 Associated Pulmonary Thromboembolic Events in Anti-Coagulated Patients: Case Series from a Tertiary Facility in Ghana","authors":"Hardy O. Yasmine, Ofori Emmanuel, Danso Gyasi Kwaku, Amoah-Dankwah James, Larsen-Reindorf Rita","doi":"10.33425/2768-6647.1017","DOIUrl":"https://doi.org/10.33425/2768-6647.1017","url":null,"abstract":"Severe/critical Coronavirus Virus Disease 2019 (COVID-19) patients face increased risk of pulmonary embolism (PE) and other thromboembolic events. This risk exists even in patients who are on prophylactic and therapeutic doses of anticoagulant. We present three cases of Severe/critical COVID-19 patients who developed PE despite being placed on prophylactic doses of anticoagulants. Clinicians should be keenly aware of this and urgently institute appropriate diagnostic measures if PE is suspected","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84115183","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 Ischaemic Stroke in A Young Man with Mitral Valve Prolapse","authors":"Isaac Ogyefo, P. Adjei, Y. Adu‐Boakye, S. Gyabaah, Jeffery Kudiabor, Harriet Danso, Faustina Abena Nti-Boakye","doi":"10.33425/2768-6647.1013","DOIUrl":"https://doi.org/10.33425/2768-6647.1013","url":null,"abstract":"Mitral valve prolapse is a common valvular abnormality. It affects 2-3% of the general population. It often runs a benign course and the majority of patients are asymptomatic. Cardiac sources of thrombi account for about 20% of ischaemic strokes. There is lingering uncertainty regarding the causal link between mitral valve prolapse and ischaemic stroke. It has been suggested that changes on the surface of the valvular leaflets trigger platelet adherence and aggregation, leading to formation of platelet-fibrin thrombus which can embolize to the cerebral arteries, causing an ischaemic stroke. We herein report a case of a 25 year old young man who presented with sudden onset of left-sided weakness. Cardiac auscultation was notable for a late systolic murmur preceded by a midsystolic click at the apex. Transthoracic echocardiography showed an elongated and thickened anterior mitral valve leaflet which prolapsed into the left atrium during systole. Computed tomography scan of the brain revealed infarcts in the right frontal lobe and the right insular cortex. A diagnosis of myxomatous mitral valve prolapse complicated by ischaemic stroke was made and the patient was accordingly started on anticoagulant therapy with warfarin.","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76504576","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 Spontaneous Tracheal Breach and a Pneumomediastinum in an 18-Month-Old Child: An Extremely Rare Case Report","authors":"Benhoummad Othmane, R. Sara, Sarda Zineb, Rochdi Youssef, Raji Abdelaziz","doi":"10.23937/2378-3656/1410387","DOIUrl":"https://doi.org/10.23937/2378-3656/1410387","url":null,"abstract":"Spontaneous pneumomediastinum (SPM) in children was first defined by Hamman in 1939, Its Association to a posterior tracheal tear is even more uncommon. We report the case of an 18-month-child that presented a SPM associated to a posterior tracheal tear. The patient had no medical history and presented two days before her admission a dry cough and a shortness of breath. The radiological investigation showed a pneumomediastinum with an extensive subcutaneous emphysema and a posterior tear in the trachea. A conservative approach was adopted with a monitoring and surveillance of the regression of the emphysema, that showed a good evolution of the patient. The rare cases published in the literature make it hard to understand the features of this presentation, but the conservative approach has shown great results in patients as the prognosis is still favorable.","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72633784","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":"Termination of Pregnancy After Prenatal Diagnosis of Anencephaly: Case Study and Literature Review","authors":"Youssouf N, S. Z, W. O, Said H, J. M, L. A, F. K, B. S","doi":"10.33425/2768-6647.1016","DOIUrl":"https://doi.org/10.33425/2768-6647.1016","url":null,"abstract":"Anencephaly is a form of neural tube defect, which develops when the cranial neuropore is unable to close. It is one of the fatal neural tube defects. Although most causes of anencephaly are unknown, multiple risk factors are associated with this defect. The purpose of this article is to study the main risk factors and possible means of prevention of this common malformation through a clinical case and a literature review.","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78053896","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 Double-Edged Sword - Multiorgan Dysfunction as a Rare Complication of Dual Checkpoint Immunotherapy","authors":"Boykow Matthew, Patel Ami K, Sondhi Neil, M. Asif, I. Devarajan, Wercberger Eli","doi":"10.23937/2378-3656/1410388","DOIUrl":"https://doi.org/10.23937/2378-3656/1410388","url":null,"abstract":"against the tumor. This disruption in the functioning of immune checkpoint molecules can lead to imbalances in immunologic tolerance that results in an unchecked immune response. This may clinically manifest with autoimmune-like/inflammatory side-effects, which cause collateral damage to normal organ systems and tissues. Such adverse events, termed ‘immunerelated adverse events’ (irAEs), are also thought to be principally T-cell mediated, however other immune cells may play a role in the development of irAEs, including B cells that secrete antibodies which mediate toxicity, as well as granulocytes that secrete inflammatory mediators and cytokines [1]. Of note, the incidence of cardiac toxicity owing to ICIs is rare (occur-ring in < 1% of patients) but can be fulminant and potentially fatal. Neurologic complications are also rare and when all neurological irAEs are pooled, an incidence of 3.8% for CTLA-4 inhibitors, 6% for PD-1 inhibitors and 12% for combination therapy has been reported in one review of 59 clinical trials, and encephalitis has been reported in 0.3% of patients taking ICIs. Lastly, an overall incidence of 2.2% was reported for acute kidney injury (0.6% for grades 3 and 4 renal events) in one systematic review of randomized controlled trials including 3,695 patients treated with ICIs [4]. Here we present a unique case that highlights the impact Opdivo and Yervoy induced irAEs had on our patient and explore this unique case of these monoclonal antibodies causing simultaneous damage to the central nervous system via immune checkpoint inhibitor induced encephalitis, cardiovascular system via acute decompensated left ventricular heart failure Introduction","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73285761","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":"Prevention of Surgical Site Infection in Neurosurgical Practice: A Review of Efficacy of Use 10% Povidone Iodine with or without 4% Chlorhexidine Solutions","authors":"Ashafa Isa Birnin-Gwari, A. Koko","doi":"10.33425/2768-6647.1015","DOIUrl":"https://doi.org/10.33425/2768-6647.1015","url":null,"abstract":"Background: Surgical site infections following Neurosurgical procedures are often associated with significant morbidity and mortality; constitute added economic burden and affect the patient’s quality of life negatively. The primary source of pathogenic microorganisms is the patient’s skin flora, making preoperative skin antisepsis a primary focus for preventive strategies. Objective: To review literature on various antiseptic agents used in neurosurgical practice and find out the most appropriate and effective agent(s) in preventing surgical site infections. Methods: A search in PubMed and Google scholar was made and various published articles on the use of antiseptic agents in preventing SSI in neurosurgery were reviewed. Results: Reviewed literature revealed that sequential use of 4% chlorhexidine and 10% povidone iodine is associated with significant reduction in both transient and resident’s pathogens, as well as surgical site infections. Conclusion: A review of relevant scientific literature supports sequential use of 4% chlorhexidine and 10% povidone iodine in prevention of surgical site infections in neurosurgery","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81178162","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":"Ovarian Ectopic Pregnancy (About A Case)","authors":"Youssouf N, S. Z, Gourja Y, J. M, Lamrissi N, F. K, B. S","doi":"10.33425/2768-6647.1014","DOIUrl":"https://doi.org/10.33425/2768-6647.1014","url":null,"abstract":"Ovarian pregnancy is a rare entity among ectopic pregnancies where the ovary is the seat of implantation. The risk factors are different from those for tubal pregnancy. Its diagnosis is difficult to establish with certainty. Treatment is usually surgical. We report the case of an ovarian pregnancy diagnose in Our department. The aim is to support the clinical and therapeutic features of ovarian pregnancy.","PeriodicalId":10450,"journal":{"name":"Clinical Medical Reviews and Case Reports","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85505842","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}