Annals of Medicine and Surgery最新文献

{"title":"Corticosteroid-induced bradycardia following high-dose methylprednisolone administration: a case report.","authors":"Jwil Zkib, Raneem Sattout, Sabah Faour, Sultaneh Haddad, Ranim Bassut, Wajd Swed, Shahd Hritani, Milad Mansouer, Mike Ghabally","doi":"10.1097/MS9.0000000000002530","DOIUrl":"10.1097/MS9.0000000000002530","url":null,"abstract":"<p><strong>Introduction: </strong>Besides their wide use in the clinical field due to their anti-inflammatory and immune-modulating effect, corticosteroids still have a lot of adverse effects. The most common adverse effects are hyperglycemia, hypertension, osteoporosis, psychosis, immunosuppression, weight gain, and hyperlipidemia. Another important side effect is cardiac arrhythmias.</p><p><strong>Case presentation: </strong>We report a case of a 43-year-old woman with multiple sclerosis who developed symptomatic bradycardia after 3 days of treatment with a high dose of methylprednisolone. The patient received a dose of atropine and her bradycardia resolved after 36 h of stopping methylprednisolone.</p><p><strong>Discussion: </strong>While tachyarrhythmias are more common, bradyarrhythmias such as bradycardia and premature atrial or ventricular contraction are rare but crucial to be considered.</p><p><strong>Conclusion: </strong>Corticosteroid-induced bradycardia is usually in sinus rhythm and has an unknown etiology, possibly occurring at high and low doses. The majority of cases in the literature were asymptomatic and resolved spontaneously.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364115","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":"Potassium dynamics in sickle cell anemia: clinical implications and pathophysiological insights.","authors":"Emmanuel Ifeanyi Obeagu","doi":"10.1097/MS9.0000000000002551","DOIUrl":"10.1097/MS9.0000000000002551","url":null,"abstract":"<p><p>Potassium dynamics are critical in the pathophysiology of sickle cell anemia (SCA), a genetic disorder characterized by the presence of abnormally shaped red blood cells that lead to various complications such as vaso-occlusive crises and hemolytic anemia. This review focuses on the clinical implications and pathophysiological insights of potassium regulation in SCA, highlighting its impact on disease progression and potential therapeutic strategies. The dysregulation of potassium transport in SCA leads to significant K+ efflux and cellular dehydration, exacerbating the sickling process. Dehydrated sickle cells, due to potassium loss, become more rigid and prone to causing blockages in small blood vessels, leading to painful vaso-occlusive crises and ischemia. Furthermore, chronic hemolysis in SCA, aggravated by potassium imbalance, contributes to severe anemia and systemic complications. These insights underscore the importance of maintaining potassium homeostasis to mitigate disease severity and improve patient outcomes. Therapeutic strategies targeting potassium regulation show promise in managing SCA. Inhibitors of the Gardos channel, such as senicapoc, have demonstrated potential in reducing sickling and hemolysis. Additionally, hydration therapy plays a crucial role in maintaining electrolyte balance and preventing RBC dehydration. A comprehensive approach that includes monitoring and correcting electrolyte imbalances, along with standard treatments like hydroxyurea and blood transfusions, is essential for effective disease management.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142368179","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":"A complex case of PASH syndrome: pyoderma gangrenosum, acne, suppurative hidradenitis, and Crohn's disease in a 36-year-old smoker.","authors":"Noura Abdul Rahman, Aya Jazmati, Bakri Roumi Jamal, Israa Darwish, Doaa Kouja, Silva Ishkhanian","doi":"10.1097/MS9.0000000000002533","DOIUrl":"10.1097/MS9.0000000000002533","url":null,"abstract":"<p><strong>Introduction and importance: </strong>PASH syndrome, is autoinflammatory condition driven by immune system dysfunction, resulting in elevated interleukin 1 levels and subsequent production of proinflammatory cytokines and chemokines. The clinical progression of PASH typically starts with acne conglobate in adolescence, followed by hidradenitis suppurativa, and pyoderma gangrenosum. Diagnosis relies on recognizing these hallmark features, but treatment remains a challenge despite current understanding. Conventional immunosuppressive therapies have shown limited efficacy in managing PASH syndrome.</p><p><strong>Case presentation: </strong>The authors present a 36-year-old man with a complex combination of pyoderma gangrenosum, acne, suppurative hidradenitis, obesity, and Crohn's disease. The patient's symptoms began in adolescence with acne and recurrent furuncles, evolving into painful skin ulcers and fistulas over time. Histological examination confirmed the diagnosis of pyoderma gangrenosum. Despite various treatment modalities, including isotretinoin, cyclosporine, azathioprine, and adalimumab, the patient experienced only partial improvement until receiving Infliximab, which led to remarkable improvement.</p><p><strong>Discussion: </strong>PASH syndrome, a rare neutrophilic dermatosis linked to autoinflammatory conditions like Braun Flaco, is characterized by Pyoderma gangrenosum, acne, and suppurative hidradenitis. This clinical entity presents diagnostic challenges due to its unique features and association with obesity and bowel diseases, such as Crohn's disease. Treatment options, including TNF-α blockers like Infliximab, have shown promising results in controlling cutaneous manifestations. Our case study underscores the complexity of treating PASH syndrome and highlights the importance of personalized therapeutic approaches for optimal outcomes.</p><p><strong>Conclusion: </strong>PASH syndrome presents significant diagnostic and treatment challenges due to its complex symptomatology and associations with conditions like Crohn's disease. The case of a 36-year-old man demonstrates the partial efficacy of conventional therapies and highlights the promising results of infliximab. This underscores the need for personalized treatment strategies and ongoing research to improve outcomes for patients with this rare and intricate syndrome.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364084","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":"Enhancing clarity and methodological rigor in umbrella reviews.","authors":"Abdullah, Humza Saeed, Muhammad Husnain Ahmad","doi":"10.1097/MS9.0000000000002536","DOIUrl":"10.1097/MS9.0000000000002536","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364128","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":"Exploring the need for surgical face masks in operating room: a comprehensive literature review.","authors":"Mortada Abbass, Jana Kotaich, Karl Ziade, Yara Sleiman, Hanine Olleik, Inaam Nasrallah, M Baker Obeid, Mohamad Moussa","doi":"10.1097/MS9.0000000000002542","DOIUrl":"10.1097/MS9.0000000000002542","url":null,"abstract":"<p><p>Surgical face masks (SFM) are pivotal in preventing surgical site infections (SSI) in the operating room (OR). However, there are currently no specific recommendations for their most effective use. SFM effectiveness is influenced by factors such as material, fit, and duration of use, sparking ongoing debates about their benefits and risks in surgery. SFMs act as a protective barrier, but their ability to filter out harmful compounds is questioned. They can also impact communication and create a false sense of security. Nevertheless, SFMs aid in infection prevention and provide psychological comfort. Clear guidelines are needed to ensure their appropriate use in the OR. This paper offers a historical overview of surgical masks, emphasizing their role in infection prevention. It explores SFM effectiveness for both the surgical team and patients during surgery and considers their future in surgical settings. As we navigate the evolving landscape of SFMs, clear and concise guidelines are imperative to ensure their judicious and effective use in the OR. This paper serves as an essential resource for understanding the historical significance, contemporary efficacy, and prospective trajectory of SFMs in surgical practice.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364132","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":"Unanticipated diagnosis of Swyer syndrome: a case report.","authors":"Kanti Prabha Giri, Sumana Thapa, Rohit Rawat, Sangam Rouniyar","doi":"10.1097/MS9.0000000000002535","DOIUrl":"10.1097/MS9.0000000000002535","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Swyer syndrome or complete/pure gonadal dysgenesis, a rare genetic disorder, presents with a female phenotype despite a 46, XY karyotype. The case highlights the importance of early diagnosis and management in XY females to prevent gonadal malignancy and facilitate proper growth of secondary sexual characteristics of the patient by initiating hormone replacement therapy (HRT).</p><p><strong>Case presentation: </strong>A 15-year-old female presented with lower abdominal pain, seeking an investigation, ultrasonography revealed the non-visualization of the uterus. Further examination with MRI revealed a hypoplastic uterus and non-visualization of ovaries. Clinical examination and diagnostic laparoscopy along with karyotype analysis confirmed the diagnosis of Swyer syndrome, prompting bilateral Salpingo-oophorectomy and initiation of HRT after the surgery. Follow-up showed improvement in the growth of the uterus and secondary sexual characteristics.</p><p><strong>Clinical discussion: </strong>Case discussion explores into the unique clinical findings of Swyer syndrome, emphasizing the importance of differentiating it from other disorders of sex development (DSD) like Mayer-Rokitansky-Küster-Hauser syndrome and androgen insensitivity syndrome. Genetic and hormonal aspects of the condition are also explored in relation to the patient's presentation and management.</p><p><strong>Conclusion: </strong>The case highlights the significance of early diagnosis and comprehensive management of Swyer syndrome. It emphasizes the need for multidisciplinary care, including fertility counseling and psychological support, in addressing the complexities of rare genetic disorders like Swyer syndrome. The key message includes the importance of considering Swyer syndrome in cases of primary amenorrhea, the benefits of early surgical intervention, and the necessity of psychological support for patients.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364152","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":"Rare clinical presentation of a ruptured spinal bulbomedullary arteriovenous malformation: a case report.","authors":"Daniel A Vega-Moreno, Rodolfo P Molina-Martínez, Yolanda Aburto-Murrieta, Beatriz Méndez-González, Gervith Reyes-Soto, Mónica Serrano-Murillo, Ulises García-González, Bipin Chaurasia","doi":"10.1097/MS9.0000000000002529","DOIUrl":"10.1097/MS9.0000000000002529","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Spinal arteriovenous malformations (AVMs) are a rare condition that has a high risk of bleeding and complications. The authors present the case of a spinal arteriovenous malformation in an unusual location and presentation.</p><p><strong>Case presentation: </strong>A 67-year-old man with subarachnoid hemorrhage due to a ruptured spinal arteriovenous malformation type IVa, with associated bulbomedullary aneurysm, which was managed conservatively due to the high risk of complications and mortality.</p><p><strong>Clinical discussion: </strong>Spinal AVMs have had different management and treatments over the years, so conservative management remains an option when arterial cannulation is complex and surgery carries a high risk of complications.</p><p><strong>Conclusion: </strong>Due to the high risk of complications of surgery in this location, conservative treatment is an option for the management of such cases with good outcomes.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364137","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":"Enhancing public health through multi-stakeholder collaboration in Africa.","authors":"Chimwemwe Ngoma, William K B Phiri, Robert Chidzaye, Sahan Lungu, Apatsa Matatiyo, Martha Shantel Mwase, Wanangwa Nyimba","doi":"10.1097/MS9.0000000000002532","DOIUrl":"10.1097/MS9.0000000000002532","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364129","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":"A case of hypertensive crisis following administration of nonionic low molecular weight contrast in hemorrhagic stroke patient: a case report.","authors":"Nour Akkash, Mohamad S Alshutaihi","doi":"10.1097/MS9.0000000000002538","DOIUrl":"10.1097/MS9.0000000000002538","url":null,"abstract":"<p><strong>Introduction: </strong>Radiocontrast agents can be iodinated or noniodinated. Iodinated agents are further divided into low and high molecular weights. In recent decades, LOCM has largely replaced the use of HOCM due to safety concerns, but an increasing number of severe side effects cases have been reported.</p><p><strong>Case presentation: </strong>A 62-year-old woman presented with acute right hemiparesis. A CT scan revealed ICH with IVH. A contrasted CTA was ordered, during which Iohexol was administered. Shortly after the injection, she developed a hypertensive crisis. She was transferred to the ICU, intubated, and given labetalol. Repeated CT scan showed increased IVH with posterior edema. Her family declined surgical intervention. Unfortunately, she died.</p><p><strong>Discussion: </strong>This represents a unique adverse effect of a low molecular weight contrast agent that has been rarely reported before, particularly in pheochromocytoma patients. Nevertheless, our patient had subtle hypertension that was revealed during hospital admission but without pheochromcytoma.</p><p><strong>Conclusion: </strong>This case represents an unusual instance of a severe adverse. It suggests that the malignant rise in blood pressure may not be catecholamine-induced.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364073","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":"Overuse of tetanus toxoid vaccine: a common but under-addressed issue in Nepal.","authors":"Suraj Shrestha, Roshan Aryal, Randhir S Yadav, Sujita Baidya, Suman Acharya, Sanjeeb S Bhandari","doi":"10.1097/MS9.0000000000002525","DOIUrl":"10.1097/MS9.0000000000002525","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Tetanus, though potentially fatal, is preventable with proper vaccination, but high tetanus titers from frequent or higher doses can lead to increased adverse events. In countries like Nepal, where tetanus vaccines are readily available over the counter, irrational and frequent dosing, especially in certain occupational groups, is a noted issue.</p><p><strong>Case presentation: </strong>A 28-year-old metal worker presented with a superficial cut on his forearm, managed with standard wound care, and reported a history of frequent tetanus vaccinations. Given his extensive vaccination history, a tetanus toxoid injection was deemed unnecessary, and he was educated on proper vaccination schedules and advised to seek medical attention for future injuries.</p><p><strong>Clinical discussion: </strong>Timely administration of vaccines for pre-exposure and postexposure prophylaxis is crucial for combating tetanus, with booster doses recommended every 10 years or as needed for wound management. High antibody titers from frequent tetanus vaccinations can increase the risk of adverse events, prompting guidelines to avoid administering Td more frequently than every 10 years unless necessary. Local reactions, like pain and swelling at the injection site, are common, while systemic reactions can include fever and peripheral neuropathy. Over-immunization is a concern in some regions, with frequent unnecessary booster doses potentially causing harm and highlighting the need for adherence to vaccination guidelines.</p><p><strong>Conclusion: </strong>Modifying and monitoring adult Td booster vaccination can lead to significant cost savings and fewer adverse events, requiring proper vaccination record-keeping, accurate assessment, and adherence to guidelines by healthcare workers.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364098","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}