Clinical case reports and reviews最新文献

{"title":"Case report: Cardio-renal syndrome with concomitant cardio-hepatic syndrome in a severe aortic stenosis patient","authors":"Hung Manh Pham, Quang Ngoc Nguyen, Hanh Duc VAN","doi":"10.15761/ccrr.1000468","DOIUrl":"https://doi.org/10.15761/ccrr.1000468","url":null,"abstract":"Unstable systemic hemodynamics in acute heart failure causes various detrimental effects on organs. In recent years, the heart-kidney and heart-liver interactions have been investigated under the terms “cardio-renal syndrome (CRS)” and “cardio-hepatic syndrome (CHS)”, respectively [1,2]. Each syndrome is divided into five subtypes based on the combined dysfunction of the heart and the kidney or the heart and the liver. While type 1 CRS is characterized by acute and rapid worsening of the heart leading to acute kidney injury, type 1 CHS describes the relationship between abnormal liver function tests and the the severity of acute heart failure. The main pathophysiological mechanisms of type 1 CRS and CHS are congestion and abnormal reperfusion in the heart, the kidney and the liver. Other compounding effects of type 1 CRS include neurohormonal activation, hypothalamicpituitary stress reaction, inflammation and immune cell signaling, oxidative stress and failure of counter-regulatory mechanisms [3]. Some important mechanisms of CHS have been previously described such as venous congestion, backward failure, decreased hepatic blood flow, decreased arterial saturation and sinusoidal thrombosis [4].","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448220","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":"Management of Total Dyspnea","authors":"Lee Guozhang","doi":"10.15761/ccrr.1000452","DOIUrl":"https://doi.org/10.15761/ccrr.1000452","url":null,"abstract":"Dyspnea, is an unpleasant sensation defined as “a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity” [1]. It is of considerable burden with high prevalence in advanced cancer, heart failure and chronic lung disease that increase towards the end of lif [2,3], lead to significant healthcare utilization [4], and adversely impacts on patients’ quality of life [2].","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67447654","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":"Thyroid Storm Complicated by Multisystem Organ Failure Requiring Plasmapheresis to Bridge to Thyroidectomy: A Case Report and Literature Review","authors":"R. Soomro, N. Campbell, S. Campbell, Christopher Lesniak, M. Sullivan, R. Ong, Jennifer Cheng, M. A. Hossain","doi":"10.15761/ccrr.1000469","DOIUrl":"https://doi.org/10.15761/ccrr.1000469","url":null,"abstract":"Thyroid storm is a rare life-threatening medical emergency. It is associated with high mortality (10 to 30%) [1]. It is characterized by severe thyrotoxicosis and systemic hemodynamic decompensation. There are multiple risk factors but usually patients with Graves’ disease are at a greater risk [1]. Patients can present with diverse signs and symptoms and varying degrees of organ decompensation. Treatment should be initiated promptly by targeting all steps of thyroid hormone synthesis, release and action. Patients who are not responding appropriately to medical therapy should be treated with therapeutic plasma exchange and later thyroidectomy once the patient is stabilized [2]. Here, we report a case of thyroid storm secondary to noncompliance with medication for Graves’ disease which was managed appropriately in an intensive care unit (ICU) setting initially with medical therapy, then plasmapheresis and ultimately thyroidectomy.","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448259","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":"Post-Vaccination Inflammatory Syndrome: a new syndrome","authors":"Giannotta G, Giannotta N","doi":"10.15761/ccrr.1000454","DOIUrl":"https://doi.org/10.15761/ccrr.1000454","url":null,"abstract":"","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448075","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":"Pancreatitis Caused by Tigecycline: A Rare Case Report","authors":"Yinyin Guo, Laiyuan Li, Xia Song, Hui Zhao","doi":"10.15761/ccrr.1000467","DOIUrl":"https://doi.org/10.15761/ccrr.1000467","url":null,"abstract":"Tigecycline was approved on the market in 2005 by the US Food and Drug Administration (FDA). It is a broad-spectrum antibiotic that shows remarkable efficacy against many multiple drug-resistant (MDR) pathogens. The common side effects of tigecycline include nausea and vomiting. With the increasing detection rate of drug-resistant bacteria, the application of tigecycline increased significantly. Therefore, tigecycline-associated adverse reactions are increasing. In this report, we present a patient who was diagnosed with IgA nephropathy and pneumonia and presented with acute pancreatitis after the use of tigecycline.","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448172","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":"Hungry bone syndrome after parathyroidectomy: Incidence and predictive factors","authors":"S. Mezri, S. Sayhi, Hadhemi Ben chikha, R. Ben M'hamed, K. Akkari","doi":"10.15761/ccrr.1000458","DOIUrl":"https://doi.org/10.15761/ccrr.1000458","url":null,"abstract":"The hungry bone syndrome (HBS) is an important complication often under diagnosed that occurs essentially after parathyroidectomy for primary hyperparathyroidism (PHP) or secondary hyperparathyroidism (SHPT). It is defined as a prolonged hypocalcaemia with hypophosphataemia hat exacerbated by suppressed parathyroid hormone (PTH) levels [1,2]. Indeed, intensive bone turnover and excessive greed for calcium is developed during the HBS [3].","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448239","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":"Anastrozole induced irreversible hepatotoxicity: Frailty and adverse drug reactions","authors":"R. Khuwaileh, T. Green, Subramaniam Nagasayi","doi":"10.15761/ccrr.1000471","DOIUrl":"https://doi.org/10.15761/ccrr.1000471","url":null,"abstract":"Laboratory tests showed severe cholestasis: alanine transaminase 33 U/l, alkaline Phosphatase 614 U/l, bilirubin 317 μmol/L, gamma glutamyl transferase 468 U/l, ammonia 90 μmol/L (normal value: <50). CT scan of abdomen confirmed no evidence of hepatic metastases or extra and intrahepatic biliary ductal dilatation. Anastrozole was then discontinued. During the admission, serum alkaline phosphatase and bilirubin continued to worsen despite normal transaminases.","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67448264","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":"Epstein - Barr virus Infection in a Patient with Neuromyelitis Optica Spectrum Disorder and Sjögren's Syndrome: A Case Report and Review of Literature.","authors":"Justin B Levinson,&nbsp;Milena Rodriguez Alvarez,&nbsp;Kristaq Koci,&nbsp;Aleksander Feoktistov,&nbsp;Isabel M McFarlane","doi":"10.15761/CCRR.1000411","DOIUrl":"https://doi.org/10.15761/CCRR.1000411","url":null,"abstract":"<p><strong>Background: </strong>The association of Neuromyelitis Optica Spectrum Disorders (NMOSD) with autoimmune disorders including Sjögren's syndrome (SS), is well recognized. Epstein Barr virus (EBV) has been associated to various neurological entities. We describe a case where EBV infection likely preceded NMOSD in a patient with unrecognized SS. The clinical features, work up and management are described.</p><p><strong>Case presentation: </strong>A 40-year woman with history of stroke and Guillain-Barre Syndrome (GBS) two years prior, presented with progressive lower extremity weakness and pain. Brain MRI revealed hyperintensities in the cerebellar and parietal lobes consistent with old infarcts, high intensity signal in the white matter and enhancing intramedullary lesion at the level of T2 and the conus medullaris. Cerebrospinal fluid (CSF) revealed no oligoclonal bands. Next day, the patient developed right ankle weakness and urinary incontinence. NMOSD was suspected and pulse steroids initiated. Patient's weakness resolved. Antinuclear antibodies (ANA), anti-SSA/SSB and Aquaporin 4 antibodies (AQP4Ab) were positive. CSF was positive for EBV. Parotid gland ultrasound revealed non-homogeneous tissue.Ganciclovir and plasmapheresis were started. The patient's sensation and motor deficits improved and one month after, she had regained motor power and sphincter control. The patient was discharged on oral prednisone and plans for rituximab infusions.On follow-up imaging, Spinal MRI showed areas of myelomalacia and complete resolution at the level of T2 and conus medularis lesions respectively. The patient had no additional flares, but did complain of chronic neuropathic pain.</p><p><strong>Conclusion: </strong>NMOSD commonly coexist with other autoimmune diseases. The association of SS and NMOSD is well recognized. EBV infections can present with neurological manifestations however, EBV has also been linked to the development of autoimmunity. In our case, EBV was detected in CSF and antiviral therapy was initiated in addition to the treatment modalities for NMOSD which led to a full recovery in our patient.</p>","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"4 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10536160","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":"Alternative Strategy for Treating Deep Sternal Wound Infection Following Coronary Artery Bypass Grafting with Retention of the Sternal Plating System, Systemic Antibiotics, and Vacuum Assisted Closure System: A Case Report","authors":"A. F","doi":"10.26420/austincardiocardiovasccaserep.2018.1024","DOIUrl":"https://doi.org/10.26420/austincardiocardiovasccaserep.2018.1024","url":null,"abstract":"Sternal wound infection (SWI) is an uncommon but potentially fatal complication of cardiac surgery following median sternotomy. It has a considerable impact on in-hospital morbidity and mortality, duration of hospital stay, mid-long term survival, and considerable financial concerns. The traditional approach to treating SWI involves removal of all foreign hardware, surgical debridement, and subsequent sternal reconstruction and long-term intravenous antibiotics. The therapy itself is associated with significant complications including chronic concerns for chest wall integrity, morbidity, and occasionally mortality. In this Case, report, we describe an alternative strategy for deep sternal wound infection treatment that maintains sternal integrity by retention of the sternal plating system, soft tissue debridement, use of a vacuum-assisted closure system, and systemic antibiotics. anesthesia. given IV 1500mg of vancomycin and 2g of Cefazolin intra-operatively as part of the antibiotic prophylaxis protocol. Sternotomy was performed which was followed by open harvesting of Left Internal Mammary Artery (LIMA) and endoscopic harvesting of Saphenous Venous Graft (SVG). The aorta and right atrium were cannulated for Cardio Pulmonary Bypass (CPB). A normotensive CPB was initiated and a pump assisted beating heart five-vessel CABG was performed: SVG to Diagonal, Obtuse Marginal-1, Obtuse Marginal-2 and PDA, while LIMA to LAD. Ventilation was resumed and patient was weaned off CPB after a total time of 134 minutes. Trans-esophageal","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69277901","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":"Furious Stem-Cell Technology To Cure Heart Cancer","authors":"Indhu Umapathi","doi":"10.4172/2155-9880-C5-101","DOIUrl":"https://doi.org/10.4172/2155-9880-C5-101","url":null,"abstract":"Pleuropulmonary Blastoma (PPB) is an uncommon crude essential neoplasm of the chest in kids. It might emerge in the pneumonic parenchyma, pleura and/or mediastinum. PPB emerges from the crude mesenchymal cell and is experienced in the initial hardly any long stretches of life. Three subtypes (Type I, II, III) are a continuum from the least to the most harmful sore. A worldwide library (ppbregistry.org) has been built up. Treatment is multimodal (medical procedure and chemotherapy, once in a while radiation treatment) and relies upon the sort and forcefulness of the malady. We report a multi year old youngster gauging, 15 kilograms, who introduced to the pediatrician with history of hack and fever of about fourteen days term. Difference mechanized tomography (CT) output of the chest showed an enormous (100x55x53mm), all around characterized, heterogeneous (80-120HU) mass, involving two-third of the left hemithorax. The mass had a central improving delicate tissue part with slight septae. Lung parenchyma was discovered second rate compared to the mass. Windpipe and fundamental bronchi were ordinary. CT guided biopsy of the mass was accounted for as round cell tumor. The patient experienced medical procedure by means of a left posterolateral thoracotomy through the fourth intercostal space. A heterogeneous (predominately strong with not many cystic zones) mass, 12x14cm was found involving the upper 66% of left hemithorax, follower to chest divider, pericardium and the left flap of thymus . The mass had invaded into the lower flap of lung. The upper projection and Lingula were not recognizable. Three hilar lymph hubs which were 1cm in distance across and firm in consistency were available. Enbloc extraction biopsy was done and tissue sent for histopathological assessment (HPE). The HPE report was PPB type III including the lymph hubs; the bronchial careful edges were liberated from tumor.","PeriodicalId":72607,"journal":{"name":"Clinical case reports and reviews","volume":"44 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70323890","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}