Archive of clinical cases最新文献_第10页

An atypical presentation of type 1 diabetes. 1型糖尿病的不典型表现。

Archive of clinical cases Pub Date : 2021-12-29 eCollection Date: 2021-01-01 DOI: 10.22551/2021.32.0803.10185

Brandon W Knopp, Parvathi Perumareddi

{"title":"An atypical presentation of type 1 diabetes.","authors":"Brandon W Knopp, Parvathi Perumareddi","doi":"10.22551/2021.32.0803.10185","DOIUrl":"https://doi.org/10.22551/2021.32.0803.10185","url":null,"abstract":"Type 1 and type 2 diabetes have been described historically as occurring in distinct patient populations; however, atypical demographics are becoming more frequent as the prevalence of diabetes increases, crossing boundaries of ages. Some of these cases can be challenging to diagnose clinically as the patient symptomatology and progression can differ from the standard features of type 1 and 2 diabetes. Our case is an example of a patient whose type 1 diabetes presented atypically with characteristics often associated with type 2 diabetes. Patient presentations such as this are uncommon, with our patient having presented with the \"textbook\" characteristics of type 2 diabetes. When first diagnosed with diabetes mellitus type 2, the patient was 60 years old, had a BMI around 30 and experienced a gradual onset of symptoms over the course of several months. At the age of 64, the patient tested positive for GAD65 autoantibodies following a year of declining glycemic control and was re-evaluated and classified as a type 1 diabetes patient. Subsequent insulin injections resolved his diabetes-related complications which included polyuria, weakness and weight loss and improved his glycemic control. This case provides an example of an unusual clinical presentation of type 1 diabetes and serves to raise awareness for atypical presentations of diabetes to improve accurate classifications at earlier stages.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"8 3","pages":"46-49"},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/0a/acc-08-03-46.PMC8717001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39646278","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}

引用次数: 0

What to do when nothing else is left to be done - metastatic non-HPV vulvar squamous cell carcinoma with multiple lines of chemotherapy. 当没有别的办法时该怎么做-转移性非hpv外阴鳞状细胞癌与多线化疗。

Archive of clinical cases Pub Date : 2021-12-29 eCollection Date: 2021-01-01 DOI: 10.22551/2021.32.0803.10186

Mihaela Mărioara Stana, Sandra Deac, Călin Cainap, Patriciu Achimaș-Cadariu, Mădălina Bota, Liliana Resiga, Dan Ștefan Luchian, Ovidiu Vasile Bochiș

{"title":"What to do when nothing else is left to be done - metastatic non-HPV vulvar squamous cell carcinoma with multiple lines of chemotherapy.","authors":"Mihaela Mărioara Stana, Sandra Deac, Călin Cainap, Patriciu Achimaș-Cadariu, Mădălina Bota, Liliana Resiga, Dan Ștefan Luchian, Ovidiu Vasile Bochiș","doi":"10.22551/2021.32.0803.10186","DOIUrl":"https://doi.org/10.22551/2021.32.0803.10186","url":null,"abstract":"Recurrent vulvar squamous cell carcinoma with multiple site metastases is a rare entity - (up to 14.2% of the total number of recurrences), with a poor prognosis (only 15% of the patients alive at 5 years). Due to its \"hard to find\" character, there are no standardized guidelines available and the treatment is extrapolated from advanced cervical carcinoma, anal carcinoma and other squamous cell carcinomas. Immunotherapy has shown some positive results in vulvar carcinoma with PD-L1 positive, high TMB, high MSI or with MMR deficiency. An alternative for selected cases without therapeutic resources could be the HPV vaccine. We present the case of a 64-year-old woman diagnosed in 2014 with vulvar squamous cell carcinoma stage II for which she underwent radical vulvectomy with bilateral inguinal lymphadenectomy followed by external radiotherapy. In 2019 she developed local recurrence associated with lung, pleural, lymph nodes and subcutaneous metastasis, treated with three lines of chemotherapy: paclitaxel/carboplatin followed by cisplatin/5-fluorouracil and carboplatin/gemcitabine. The patient's general health status altered progressively, and she died after the 4th cycle of carboplatin/gemcitabine. This case's management could be a starting point for the vulvar carcinoma cases where the standard therapeutical options do not represent a choice anymore, providing the necessary example on how to approach it.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"8 3","pages":"50-55"},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/ea/acc-08-03-50.PMC8716999.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39646279","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}

引用次数: 0

A rare etiology of persistent jaundice in type 1 autoimmune hepatitis. 1型自身免疫性肝炎持续性黄疸的罕见病因。

Archive of clinical cases Pub Date : 2021-12-29 eCollection Date: 2021-01-01 DOI: 10.22551/2021.32.0803.10183

Budumuri Gautam V Kumar, Purna Ch Sethy, Rohit Gupta

引用次数: 0

Total occlusion of abdominal aorta: still a deadly event in the very elderly. 腹主动脉完全闭塞:在老年人中仍然是一个致命的事件。

Archive of clinical cases Pub Date : 2021-12-29 eCollection Date: 2021-01-01 DOI: 10.22551/2021.32.0803.10184

Gonçalo José Pereira Carneiro, Carla Martins

{"title":"Total occlusion of abdominal aorta: still a deadly event in the very elderly.","authors":"Gonçalo José Pereira Carneiro, Carla Martins","doi":"10.22551/2021.32.0803.10184","DOIUrl":"https://doi.org/10.22551/2021.32.0803.10184","url":null,"abstract":"Total occlusion of the abdominal aorta is an uncommon but potentially devastating event. Clinical symptoms are usually sudden and may vary depending on the level of the aortic occlusion. Associated morbidity and mortality remain substantial with high rates of limb loss, acute renal failure, rhabdomyolysis, and death. We report a case of a bedridden 91-year-old woman with history of hypertension, hyperlipidemia, anemia and dementia, carried to the emergency department because of bilateral lower limb pallor. She had been at the same department the week before because of the same problems and high blood pressure (BP), but had been discharged after administration of hypotensive drugs and a short period of observation. No attention was paid to those perfusion alterations, or the global picture at all. The physical examination revealed cooling of the lower limbs and significant BP differential between upper and lower limbs (ankle-brachial index of 0.173), leading to the suspicion of bilateral acute limb ischemia. Abdominal, pelvic and lower limb CT was conducted, revealing calcification and important atheromatosis of the thoracic-abdominal aorta and a mural thrombus beginning above the origin of the celiac trunk, with complete occlusion below the origin of the renal arteries. After discussion with Vascular Surgery Department, given the advanced age, known co-morbidities and the timing of diagnosis, the patient was considered not eligible for revascularization surgery and comfort measures were honored. This case highlights the importance of stablishing a timely and correct diagnosis, even in the very elderly, emphasizing that they too benefit from secondary and tertiary prophylaxis, in order to prevent devastating outcomes as this.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"8 3","pages":"42-45"},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/12/acc-08-03-42.PMC8717000.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39646277","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}

引用次数: 0

A rare case of NXP-2 positive dermatomyositis. 恩智浦-2阳性皮肌炎1例。

Archive of clinical cases Pub Date : 2021-10-27 eCollection Date: 2020-01-01 DOI: 10.22551/2020.29.0704.10176

Nariman Khan, Zehra Hasan Kazmi, Rahaf Alkhateb

引用次数: 0

Lower lateral crural turnover flap combined with alar batten graft for the long-term result of the treatment of alar convexities. 下外侧足部翻转皮瓣联合鼻翼板条移植治疗鼻翼凸出的远期效果。

Archive of clinical cases Pub Date : 2021-10-27 eCollection Date: 2019-01-01 DOI: 10.22551/2019.22.0601.10147

Philippine Merlin, Amanda Fanous, Jean-Paul Marie, Nicolas Bon Mardion, Nadia Benmoussa

{"title":"Lower lateral crural turnover flap combined with alar batten graft for the long-term result of the treatment of alar convexities.","authors":"Philippine Merlin, Amanda Fanous, Jean-Paul Marie, Nicolas Bon Mardion, Nadia Benmoussa","doi":"10.22551/2019.22.0601.10147","DOIUrl":"https://doi.org/10.22551/2019.22.0601.10147","url":null,"abstract":"Introduction: Concave lower lateral cartilages not only cause an esthetic defect but can also lead to external nasal valve insufficiency. The objective of this article is to analyze the combination of two well-known surgical techniques: turning over the alar cartilages as well as the addition of grafts in order to obtain satisfying esthetic and functional long term results.Materials and methods: From August 2016 to July 2018, 62 rhinoplasties, a combination of both primary and revision cases, were performed at the Rouen University Hospital in France. Six of these involved the correction of concave alar cartilages. The turnover technique alone or in combination with Batten grafts was performed.Results: Immediate and 3-months post-operative esthetic results using the turnover flap technique were satisfactory. Alar batten grafts were occasionally employed in order to maintain the newly positioned alar cartilages and avoid long-term contour depressions.Conclusion: The combination of these two techniques seems to be an interesting solution to maintain long-term esthetic results.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"6 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2021-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/86/acc-06-01-1.PMC8565695.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39605220","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}

引用次数: 1

Cephalic undifferentiated carcinoma with osteoclast-like giant cells arising from the main pancreatic duct: case report and literature review. 源自主胰管的头侧未分化癌伴破骨细胞样巨细胞:1例报告及文献复习。

Archive of clinical cases Pub Date : 2021-10-27 eCollection Date: 2019-01-01 DOI: 10.22551/2019.22.0601.10148

Andreea Rusu, Simona Eliza Giuşcă, Delia Gabriela Ciobanu Apostol, Lidia Ionescu, Irina-Draga Căruntu

{"title":"Cephalic undifferentiated carcinoma with osteoclast-like giant cells arising from the main pancreatic duct: case report and literature review.","authors":"Andreea Rusu, Simona Eliza Giuşcă, Delia Gabriela Ciobanu Apostol, Lidia Ionescu, Irina-Draga Căruntu","doi":"10.22551/2019.22.0601.10148","DOIUrl":"https://doi.org/10.22551/2019.22.0601.10148","url":null,"abstract":"Undifferentiated carcinoma with osteoclast-like giant cell (UCOGC) is a ductal carcinoma variant with a recently reported more protracted survival and pathognomonic histology comprising two cell populations: the mononuclear tumoral cells and nontumoral multinucleated giant cells. It usually presents as a large heterogenic tumor with mixed solid-cystic components. The tumor develops from the ductal epithelium but the sequence of epithelial changes is often not identified due to the rapid tumoral growth and associated necrotic changes. We report a case of a 76-year-old patient diagnosed with cephalic UCOGC originating in the epithelium of the main pancreatic duct with endoluminal growth and foci of other ductal neoplasms (high-grade pancreatic intraepithelial neoplasia (PanIN) and conventional ductal carcinoma). The particularity of our case consists in the identification of the columnar epithelium conversion, through high-grade PanIN, into UCOGC specific malignant features, in a large size tumor - aspect usually reported in small tumors. Alongside our case we also present a brief literature review of cephalic UCOGC case reports and case series.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"6 1","pages":"6-21"},"PeriodicalIF":0.0,"publicationDate":"2021-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/f2/acc-06-01-6.PMC8565694.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39605674","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}

引用次数: 0

Cerebral vein thrombosis associated with MTHFR A1289C mutation gene in a young postpartum woman. 年轻产后妇女脑静脉血栓与MTHFR A1289C突变基因相关

Archive of clinical cases Pub Date : 2021-10-27 eCollection Date: 2019-01-01 DOI: 10.22551/2019.22.0601.10150

Alexandru Bostan, Laura Cătălina Țăpoi, Marian Nicolae Barcan, Laura Florea

引用次数: 1

Porocarcinoma: a rare cause of lateral cervical tumor. 宫颈癌:一种罕见的宫颈侧部肿瘤。

Archive of clinical cases Pub Date : 2021-10-27 eCollection Date: 2019-01-01 DOI: 10.22551/2019.23.0602.10154

Gabriela Maria Aniţei, Nicolae Şerban Ioanid, Geanina Bandol, Elena Rodica Gafton, Ana Maria Patraşcu, Dan Ferariu, Angelica Slătineanu, Gema Bugean, Viorel Scripcariu

{"title":"Porocarcinoma: a rare cause of lateral cervical tumor.","authors":"Gabriela Maria Aniţei, Nicolae Şerban Ioanid, Geanina Bandol, Elena Rodica Gafton, Ana Maria Patraşcu, Dan Ferariu, Angelica Slătineanu, Gema Bugean, Viorel Scripcariu","doi":"10.22551/2019.23.0602.10154","DOIUrl":"https://doi.org/10.22551/2019.23.0602.10154","url":null,"abstract":"Porocarcinoma is a rare tumor of the eccrine sweat glands that usually disseminates to the regional lymph nodes, but it can also develop distant metastasis. Case presentation: We report the case of a 67 year-old female patient who underwent wide surgical resection of a left cervical cutaneous tumor in a primary care center, for which the histology exam of the specimen was mixed basal cell and squamous cell carcinoma. She was referred to our hospital's oncology clinic and histologic re-evaluation changed the diagnosis to eccrine porocarcinoma (EPC). Computer-tomography (CT) revealed cervical lymphadenopathies for which the patient underwent 4 cycles of chemotherapy, without regression. She subsequently underwent a left upper anterior jugular lymphadenectomy (group IIa) with all nodes being negative and, three months later, she developed a unique adenopathy under the parotid gland that was excised and confirmed to be metastatic. Postoperative external radiotherapy was administered with a good outcome on CT scan. Nine months after her last surgery, the patient did not show any sign of recurrence or distant metastasis. Conclusion: EPC is a challenge, both diagnostically and therapeutically. In the absence of consensus regarding the indications and extent of lymphadenectomy and adjuvant therapy, patients with EPC should be referred to an experienced multidisciplinary team in a tertiary center.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"6 2","pages":"53-58"},"PeriodicalIF":0.0,"publicationDate":"2021-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/5c/acc-06-02-53.PMC8565700.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39858438","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}

引用次数: 2

Bilateral re-expansion pulmonary edema: an uncommon complication of the pneumothorax drainage. 双侧再扩张性肺水肿:气胸引流术中一种罕见的并发症。

Archive of clinical cases Pub Date : 2021-10-27 eCollection Date: 2020-01-01 DOI: 10.22551/2020.26.0701.10166

Axel Benhamed, Karim Tazarourte

引用次数: 2