Archives of clinical and medical case reports最新文献

{"title":"Regenerative Medicine May Mitigate the Need for Amputation in the Setting of a High Society for Vascular Surgery – Wound, Ischemia, Foot Infection (SVS-Wifi) Score","authors":"Dana M Poloni, Christina M Monaco, Maeghan L Ciampa, Elizabeth Marie Oliver Coffin, Joy N Liang, Eric D Martin.","doi":"10.26502/acmcr.96550556","DOIUrl":"https://doi.org/10.26502/acmcr.96550556","url":null,"abstract":"","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344231","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":"Watch and Wait Strategies in NET Patients: More than Expected.","authors":"Sebastian Krug,&nbsp;Anja Rinke,&nbsp;Marianne Pavel","doi":"10.26502/acmcr.96550511","DOIUrl":"https://doi.org/10.26502/acmcr.96550511","url":null,"abstract":"Neuroendocrine tumors of the gastroenteropancreatic (GEP-NET) system include sporadic and hereditary diseases which have been increasing in incidence recently [1]. In patients with resectable low grade well-differentiated neuroendocrine tumors (NET) surgery is the mainstay of therapy. However, the majority of patients present with unresectable disease, most frequently with liver metastases. In patients with low grade NET G1 (Ki67<2%) a watch-andwait (W&W) strategy can be recommended in patients with loco-regional lymph node metastases or in patients with liver metastases if the liver tumor burden is low. The current German and European guidelines consider the use of W&W as a safe approach in this patient population [2, 3]. However, absence of symptoms and radiological tumor progression are essential requirements, along with a welldifferentiated morphology and low grade as well as limited metastasis. The clearest evidence for an W&W approach in GEP-NET derives from the CLARINET trial, where a median progression-free survival (mPFS) of 18 months was achieved in the placebo group with tumor stability within 3-6 months prior to start of lanreotide [4]. Out of 103 patients in the placebo arm 60 patients experienced progression within 24 months. However, 43 patients demonstrated stable disease even after 2 years which confirms that a subgroup of patients has no need for therapy even in the long-term. Data on the current prevalence of patients with a W&W strategy are not available. In 2021, we surveyed NET patients in Germany, Austria and Switzerland to assess the medical care under the COVID-19 pandemic. The online survey (constructed by LimeSurvey software) was distributed via personal contact and by the patient organization NETZwerk NET e.V. In this process, 542 out of 684 NET patients completely answered all questions [5]. Of these, 68 (12.5%) patients indicated that they were followed by a W&W strategy. About half were between 41-60 years of age (n=36, 53.0%), 30 affected people were between 61-80 years (n=30, 44.1%). Most participants had a small bowel or pancreatic primary tumor with 25.0% (n=17) and 23.5% (n=16), respectively. 25% of the W&W group (n=17) self-reported a functional-active disease and 66.2% (n=45) displayed symptoms at the time of the survey. In most cases, the diagnosis required more than 12 months (n=30, 44.1%) and almost half of the participants have been living with the disease for more than 5 years (n=33, 48.5%). Present comorbidities were specified as follows: hypertension (44.5%, n=30), diabetes (19.1%, n=13), asthma/COPD (16.2%, n=11), chronic renal failure (13.2%, n=9), heart insufficiency (8.8%, n=6). Only one participant mentioned a chronic infection. Liver cirrhosis as comorbidity was not reported. All clinically available characteristics of the participants are listed in Table 1.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"6 4","pages":"534-536"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9401089/pdf/nihms-1825890.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33437655","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":"Lingual Mucosal Lesions for Starting the Secondary Stage of Syphilis: A Case Report","authors":"Min Zhao","doi":"10.26502/acmcr.96550490","DOIUrl":"https://doi.org/10.26502/acmcr.96550490","url":null,"abstract":"Background: Recent years syphilis has the increased case rates among men who have sex with men and remains a continuing public health challenge globally. Owing to its varied manifestations of oral mucosa in syphilis that can mimic other infections, it should be distinguished from oral ulcer, candidiasis, oral lichen planus, oral leukoplakia and so on. Case Presentation: This case report describes the patient with white plaques of the lingual mucosa for the secondary stage of syphilis in a 23-year-old male. It was a rare case that oral mucosal lesions as the only manifestations of secondary syphilis. And the differential diagnosis, treatment, follow-up visits and attentions were discussed. Conclusions: The clinicians need to distinguish the oral clinical presentations of syphilis from other oral diseases for suspected syphilis patients and to achieve early diagnosis and treatment. As well do a good job in relevant self-protection, instrument disinfection and management of nosocomial infection.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69343492","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":"Transcatheter Closure of a Ragged Post-Myocardial Infarction Ventricular Septal Defect Using an Off-Label ASD Occluder","authors":"C. Quast, S. Afzal, P. Leuders, M. Masyuk, K. Klein, M. Kelm, A. Polzin, T. Zeus","doi":"10.26502/acmcr.96550452","DOIUrl":"https://doi.org/10.26502/acmcr.96550452","url":null,"abstract":"Post-myocardial infarction ventricular septal defect has become a rare event following ST Elevation Myocardial Infarction (STEMI) but is still a life-threatening complication with high mortality. Transcatheter closure of post-myocardial infarction ventricular septal defects has emerged as an alternative therapeutic approach but often requires individual strategies due to complex morphology. We report a case of a 62-year-old man who was admitted to our hospital after STEMI of the inferior wall with pulmonary congestion due to a post-myocardial infarction VSD for interdisciplinary evaluation and therapy. The patient was characterized by estimated high perioperative risk and underwent interventional closure of the VSD according to heart team decision. Because of ragged nature of the VSD closure with a conventional Occlutech VSD occluder was not possible. Therefore, we decided to close the defect using an off-lable device for ASD closure which Arch Clin Med Case Rep 2022; 6 (1): 66-71 DOI: 10.26502/acmcr.96550452 Archives of Clinical and Medical Case Reports 67 was successfully implanted without relevant residual shunt.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69343582","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 Case Report on Bronchial Asthma with Myopathy","authors":"SM. Shahidul Islam, Rehana Akter Lima","doi":"10.26502/acmcr.96550453","DOIUrl":"https://doi.org/10.26502/acmcr.96550453","url":null,"abstract":"Muscle disease is referred to as myopathy. As a result, the muscles are less efficient than they might be. When muscles don't grow correctly, are injured, or are missing vital components, this might happen. Muscle atrophy is common in patients who have had Bronchial Asthma with Myopathy for a long time. Muscles lose mass and strength as a result of this fading away. We recently treated a patient who was experiencing some of the same issues. We suggested a Brain MRI and total spine screening to the patient which indicated hypoplasticity in the left transverse sinus. An X-Ray of the chest indicated that the left inferior nasal turbinate had expanded. Traditional therapies like acupuncture and massage, as well as modern techniques like multipurpose equipment and physiotherapy, were chosen to treat our patients. Our patient had wonderful success with these strategies. The procedure for the patient’s treatment has been completed. At the end of the 12th day of chest treatment, the patient was completely free of breathlessness. On the 10th day of acupuncture, the patient’s low back discomfort began to improve. At the end of the 20th day of therapy, the patient's headache begins to improve. Moreover, the authors believe that it is the first successful reported case in Bangladesh using these techniques. Arch Clin Med Case Rep 2022; 6 (1): 72-77 DOI: 10.26502/acmcr.96550453 Archives of Clinical and Medical Case Reports 73","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69343588","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":"Bilateral Approach with Botulinum Toxin Type A Injections in Patients with One-Sided Facial Hyperkinetic Movements","authors":"C. Karapantzou, Joao Pedro Vale, Frank Joachim Haubner, Konstantinos Zagoridis, Konstantinos Agas, Konstantinos Karagogos, Nikoleta Zagoridou, M. Canis","doi":"10.26502/acmcr.96550462","DOIUrl":"https://doi.org/10.26502/acmcr.96550462","url":null,"abstract":"Background: Main subject of our investigation was to clarify, if a bilateral approach with Botulinum toxin type A injections is more efficient from cosmetic and functional aspect, compared to unilateral injections, in patients with one-sided facial hyperkinetic movements, like synkinesis and hemi facial spasm. Methods: Our patient cohort included 30 patients suffering from unilateral hyperkinetic facial contractions. We performed a total of 60 injections, 30 of them only on the Arch Clin Med Case Rep 2022; 6 (2): 149-172 DOI: 10.26502/acmcr.96550462 Archives of Clinical and Medical Case Reports 150 affected side and 30 on both facial sides. All participants underwent 2 botulinum toxin sessions, with a 4 months period lying between the injections. Our statistical analysis was divided into 4 hypothesis testing sub-groups, based on the results of the subjective satisfaction rates our patients delivered 2 months and 6 months after the initial botulinum toxin session. Furthermore 2 doctors evaluated the results based on pre-and after photographs on a Quartile Grading Scale for objective evaluation for the same time periods. Each one of the observers received one patient group, either with bilateral or with ipsilateral treatments, without knowing which group they received. Results: Summarizing the statistical results we analyzed from both sources (patients and doc-tors-observers), we found statistically significant differences in satisfaction rate between the two groups (p=.004) and a better objective evaluation on patients who underwent combined treatments. Conclusions: Our work confirmed the initial assumption that patients with facial asymmetry of different etiology benefit from a bilateral therapeutic approach with botulinum toxin injections, instead of one-sided injections into the hyperkinetic or dyskinesia facial side.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69343676","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":"Diagnosis and Treatment of an Infected Supraorbital Ethmoid Cell Cyst","authors":"K. Koda, K. Yasuhara","doi":"10.26502/acmcr.96550467","DOIUrl":"https://doi.org/10.26502/acmcr.96550467","url":null,"abstract":"1. Case Report A 79-year-old woman with no significant medical history visited an emergency room with a complaint of diplopia. Ocular motility disorder was noted, and a central lesion was suspected. Contrast-enhanced computed tomography (CT) revealed a cystic lesion, and cyst infection was suspected based on the rim enhancement. Coronal images (Figure 1) suggested a frontal sinus cyst, but horizontal (Figure 2) and sagittal (Figure 3) sections revealed a Supraorbital Ethmoid-Cell (SOEC) cyst extending into the orbit. Diplopia disappeared immediately after endoscopic surgery for cyst enucleation. Anatomically, SOECs are associated with the anterior ethmoidal artery (AEA), which runs within or in continuity with the posterior border of the SOEC opening [1] (Figure 4). Therefore, in endoscopic surgery, the risk of AEA damage increases with a posterior approach, and an approach from the front is recommended. If an axillary flap [2] is not created and the nasal ridge is not sufficiently excised, it is difficult to operate using an endoscope.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69343746","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":"Peracute Onset Pediatric Myelin Oligodendrocyte Glycoprotein Antibody Associated Focal Cortical Encephalitis: A Case Report","authors":"Johanna Sophie Pohl, F. Leypoldt, Naomi Larsen, A. van Baalen, K. Wandinger, K. Rostásy, H. Muhle","doi":"10.26502/acmcr.96550522","DOIUrl":"https://doi.org/10.26502/acmcr.96550522","url":null,"abstract":"Recently, several case series have described pediatric patients presenting with new onset focal seizures together with relapsing fever and cortical T2/FLAIR hyperintensities in association with myelin oligodendrocyte glycoprotein (MOG) antibodies, in adults known as unilateral cortical fluid-attenuated inversion recovery (FLAIR) hyperintense lesions in anti-MOG-associated encephalitis with seizures (FLAMES). A previously healthy 12-year-old girl first arrived to the emergency department with stroke-like symptoms, including hemiparesis, facial palsy, and severe headache. Heparin therapy was initiated; seizures were successfully treated with valproate. Due to persistent cortical edema in brain magnetic resonance imaging (MRI), anti-inflammatory treatment with high dose dexamethasone was initiated and led to prompt recovery. One month later, the patient displayed fever and headache of unknown origin. Brain MRI showed cortical FLAIR hyperintensities and leptomeningeal contrast enhancement. Cerebrospinal fluid (CSF) analyses including autoimmune diagnostics revealed a lymphocytic pleocytosis, elevated protein, and positive oligoclonal bands. MOG antibodies in serum and CSF were positive. Intravenous methylprednisolone (IVMP), followed by oral tapering, led to complete recovery, yet one relapse occurred and intravenous immunoglobulins (IVIG) were added, given monthly to date. Our patient remained relapse-free for eight months when moderate but persisting headache and paraesthesia reoccurred. Methylprednisolone therapy was given, but outstanding MOG antibodies in serum and CSF were negative. Therefore, maintenance therapy was not extended. Single focal seizures led to adjustment of antiseizure medication. In summary, this is the first case report of a pediatric patient with MOG encephalitis, first presenting stroke-like symptoms, reminiscent of the newly described FLAMES syndrome.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69343857","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":"CADASIL or MS? Consider “Red Flags” but Avoid a Misdiagnosis: Case Series of a Concomitant Diagnosis","authors":"Morena Emanuele, Lucchi Matteo, Romano Carmela, Petrucci Simona, Tartaglia Matteo, Morosetti Roberta, Conte Antonella, Buscarinu Maria Chiara, Romano Silvia, Salvetti Marco, Mirabella Massimiliano, Ristori Giovanni","doi":"10.26502/acmcr.96550530","DOIUrl":"https://doi.org/10.26502/acmcr.96550530","url":null,"abstract":"Affiliation: 1Centre for Experimental Neurological Therapies (CENTERS), Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy 2Fondazione Policlinico Universitario \"A. Gemelli\" IRCCS, Istituto di Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy 3Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy 4Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy 5Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy 6Neuroimmunology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Santa Lucia, Rome, Italy","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69343964","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":"Unexpected Elevation of Infection Parameters in a Heart Transplanted Patient with Chronic Kidney Disease: A Case Report","authors":"Kurzhagen Jt, Roeder Ss, M. J","doi":"10.26502/acmcr.96550558","DOIUrl":"https://doi.org/10.26502/acmcr.96550558","url":null,"abstract":"Patients with end-stage kidney disease are under an increased risk for morbidity and mortality due to cardiovascular reasons. Yet, patients might show only atypical symptoms during cardiac events and routinely performed pre-transplant diagnostic measures are discussed controversially. A heart transplanted 50-year-old male with end-stage kidney disease was assessed for kidney transplantation. Myocardial scintigraphy, chest x-ray, pulmonary function test, urological and gastrointestinal assessment showed normal results. A routinely performed blood test revealed elevated procalcitonin, C-reactive protein and leucocytes. Measured vital parameters and physical examination revealed no pathologies. Coughing, shortness of breath or chest pain were denied. CT-scan showed no signs of infection but lack of contrast media enhancement in the heart. Myocardial infarction was confirmed in electrocardiogram and transthoracic echocardiogram demonstrated an impaired ejection fraction of 20%. Treatment with anti-platelet medication and anticoagulation was followed by invasive heart catheterization, which revealed no acute stenosis but a dissolved in-stent thrombosis. Since kidney failure was progressing the patient required dialysis treatment. Microbiological analyses of blood and urine samples stayed negative. Chronic kidney disease patients are at increased cardiovascular risk. However, invasiveness of cardiac diagnostics for potential kidney transplant is debated controversially. KDIGO guideline 2020 advises non-invasive screening for coronary artery disease for asymptomatic patients at high risk. However, there is no specific guideline for previously heart transplanted candidates for kidney transplant and patients with high pretest probability benefit from invasive diagnostics. A risk stratification for cardiac complications and pre-kidney transplant evaluation should be executed in clinical practice.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344274","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}