Attention bias away from threat during life threatening danger predicts PTSD symptoms at one-year follow-up

Abstract Background Mucormycosis is a rare fungal infection occurring chiefly in the lung or the rhino-orbital-cerebral compartment, particularly in patients with immunodeficiency or diabetes mellitus. Among Mucorales fungi, Rhizopus spp. are the most common cause of mucormycosis. Case presentation We report a case of pulmonary mucormycosis caused by Rhizopus microsporus in a young patient with diabetes but no other apparent risk factors. The diagnosis mainly relied on clinical manifestation, positive pulmonary tissue biopsy, and fungal culture. The patient was successfully treated with posaconazole oral suspension and remains asymptomatic at one-year follow-up. Conclusions Pulmonary mucormycosis is a life-threatening condition and posaconazole is an effective treatment for pulmonary mucormycosis caused by Rhizopus microspores.

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Lessons from the "non-critical" patient during a pandemic: developmental-behavioural pediatric populations & COVID-19

International Journal of Whole Person Care ◽

10.26443/ijwpc.v9i1.327 ◽

2022 ◽

Vol 9 (1) ◽

pp. 23-24

Author(s):

Shuvo Ghosh ◽

Andreea Gorgos

Keyword(s):

Clinical Care ◽

Acute Health Care ◽

Life Threatening ◽

Pediatric Populations ◽

One Year ◽

Novel Coronavirus ◽

The Waves ◽

Short Narrative ◽

Acute Crisis

Seemingly overnight, in March 2020, the world was turned upside down by the global SARS-CoV 2 (novel coronavirus) pandemic. As COVID-19 affected all aspects of clinical care, Canadian ambulatory clinics for any service deemed "non-urgent" or "non-critical," were suspended for several months. When outpatient care slowly resumed during the summer and fall of 2020, the backlog of patients in these areas and subsequent requests for follow-up significantly outpaced the number of available appointments. In fact, it became apparent that certain patients' needs had grown in unprecedented ways during the pandemic, even though their issues had previously been given low priority during the acute crisis period. Among these groups were youth with underlying mental health conditions, those with chronic but non-life-threatening illnesses, and the subgroups seen in Developmental-Behavioural Pediatrics. In Montréal, they were among the least likely to have their needs met as the waves of COVID-19 moved through the community, and many still struggle to find relevancy in the discussions about the hidden impacts of the coronavirus pandemic, even one year later. What can the experiences of these marginalised youth teach us about what our system labels less relevant care in the context of an acute health care crisis? A short narrative presentation will demonstrate insights gleaned from 2020 & early 2021 to underscore the often unrecognised challenges faced by these populations and their families.

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Successful Treatment of Pulmonary Mucormycosis Caused by Rhizopus Microsporus With Posaconazole

10.21203/rs.3.rs-302265/v1 ◽

2021 ◽

Author(s):

Fan Yuan ◽

Jun Chen ◽

Fang Liu ◽

Yongchao Dang ◽

Qingtao Kong ◽

...

Keyword(s):

Fungal Culture ◽

Rhizopus Microsporus ◽

Pulmonary Tissue ◽

Case Presentation ◽

Common Cause ◽

Pulmonary Mucormycosis ◽

Threatening Condition ◽

Life Threatening ◽

One Year

Abstract Background: Mucormycosis is a rare fungal infection occurring chiefly in the lung or the rhino-orbital-cerebral compartment, particularly in patients with immunodeficiency or diabetes mellitus. Among Mucorales fungi, Rhizopus spp. are the most common cause of mucormycosis. Case presentation: We report the case of pulmonary mucormycosis caused by Rhizopus microsporus in a young patient with diabetes but no other apparent risk factors. The diagnosis has mainly relied on clinical manifestation, positive pulmonary tissue biopsy, and fungal culture. The patient was successfully treated with posaconazole oral suspension and remains asymptomatic at one-year follow-up.Conclusions: Pulmonary mucormycosis is a life-threatening condition and based on direct microscopy, histopathology, and culture for the diagnosis.

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Treatment of pregnancy-associated oral pyogenic granuloma with life-threatening haemorrhage by transarterial embolisation

The Journal of Laryngology & Otology ◽

10.1017/s0022215115001176 ◽

2015 ◽

Vol 129 (6) ◽

pp. 607-610 ◽

Cited By ~ 4

Author(s):

K-Y Tsai ◽

W-H Wang ◽

G-H Chang ◽

Y H Tsai

Keyword(s):

Case Report ◽

Pregnant Woman ◽

Surgical Excision ◽

Pyogenic Granuloma ◽

Severe Bleeding ◽

Transarterial Embolisation ◽

Wound Pain ◽

Life Threatening ◽

One Year

AbstractBackground:Pregnancy-associated pyogenic granuloma (pregnancy tumour) is not uncommon. However, control of severe bleeding associated with the lesion by transarterial embolisation has never been reported.Case report:We report the case of a 33-year-old pregnant woman (34 weeks gestation) who presented with a pregnancy-associated pyogenic granuloma of the mandibular gingiva with a life-threatening haemorrhage. The bleeding stopped soon after transarterial micro-embolisation and regressed after one month; thus, no further surgical excision was needed. The patient was free of post-operative wound pain and infection, and there was no recurrence after one year of follow up.Conclusion:In general, surgical excision is the first treatment choice for pregnancy tumours. However, it is limited by the risk of marked deformity or incomplete excision when large lesions or difficult surgical areas are encountered. For large tumours, transarterial embolisation may be a safer alternative.

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A Case Report of Infective Endocarditic Aortic Valve Abscess with Perforation in Infant

10.21203/rs.3.rs-58089/v1 ◽

2020 ◽

Author(s):

Yanfeng Yang ◽

Feifei Si ◽

Mei Jin ◽

Sheng Yang

Keyword(s):

Infective Endocarditis ◽

Aortic Valve ◽

Structural Damage ◽

Autologous Pericardial Patch ◽

Life Threatening ◽

One Year ◽

Surgery Department ◽

Short Time ◽

To Receive

Abstract Background: Infective endocarditis (IE) is an uncommon but a potentially life-threatening infectious disease in children. The epidemiology of IE has changed in the past three to four decades and its incidence has been increasing recently. This case with atypical present including culture-negative and no-cardiovascular diseases got cardiovascular structural damage that deteriorate in short time. Case presentation: This case was an infant less than one year old without basic cardiovascular disease,and this case was admitted with Kawasaki disease early. His diagnosis was infective endocarditic aortic valve abscess with perforation. The patient received intravenous injection of cefotaxime for two days and piperacillin sulbactam and cefazolin for six days. On 9 th day, piperacillin sulbactam combining with vancomycin were used. On 10 th day, the patient was sent to cardiac surgery department to receive aortic valve repair. The operation is successful.The abscess cavity of the inferior aortic valve and the vegetations on the aortic valve were completely removed, the left coronary valve was removed, and the left coronary valve was locally widened by autologous pericardial patch. Conclusions: Infective Endocarditis in children may be difficult to diagnosis and manage.and the treatment are becoming a new challenge for conventional antibiotic therapy. Some IE require serial follow-up to determine potential need for subsequent cardiovascular surgery (CVS) intervention despite microbiologic cure with antimicrobial therapy.

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Longitudinal Substance Use following an Emergency Department Visit for Cocaine-Associated Chest Pain

Journal of Drug Issues ◽

10.1177/002204260803800401 ◽

2008 ◽

Vol 38 (4) ◽

pp. 929-956 ◽

Cited By ~ 2

Author(s):

Purushottam B. Thapa ◽

Maureen A. Walton ◽

Rebecca Cunningham ◽

Ronald F. Maio ◽

Xiaotong Han ◽

...

Keyword(s):

Emergency Department ◽

Substance Use ◽

Chest Pain ◽

Brief Interventions ◽

Future Studies ◽

Life Threatening ◽

Potential Impact ◽

One Year ◽

Over Time

Substance abuse is a chronic, relapsing condition, yet some individuals over time seem to cease use for factors that are largely unclear. A life threatening episode of cocaine-associated chest pain requiring an emergency department (ED) visit may influence subsequent use. A consecutive cohort (n = 219) of patients who presented to a large, urban ED with cocaine-associated chest pain was interviewed at baseline, three months, six months, and 12 months to evaluate longitudinal rates of subsequent drug use. Overall, there was a significant decrease in cocaine use over time (baseline = 100.0%, three months = 56.5%, six months = 54.2%, and 12 months = 51.7%, p < .05 for baseline versus each follow-up interval). Findings suggest that substance use declines following an ED visit for cocaine-related chest pain. However, about half of the subjects were still using cocaine one year later. Future studies examining the potential impact of brief interventions or case management to intervene with this not-in-treatment ED population are warranted.

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Hydralazine Induces Myeloperoxidase and Proteinase 3 Anti-Neutrophil Cytoplasmic Antibody Vasculitis and Leads to Pulmonary Renal Syndrome

Case Reports in Nephrology ◽

10.1155/2014/868590 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Gaurav Agarwal ◽

Ghayyath Sultan ◽

Sherry L. Werner ◽

Claudia Hura

Keyword(s):

Systemic Vasculitis ◽

High Titer ◽

Pulmonary Hemorrhage ◽

Kidney Injury ◽

Necrotizing Glomerulonephritis ◽

Threatening Condition ◽

Life Threatening ◽

Pulmonary Renal Syndrome ◽

One Year

We report a case of hydralazine-induced ANCA-associated glomerulonephritis with pulmonary hemorrhage. A 62-year-old Hispanic man with hypertension, who was being treated with hydralazine 100 mg three times a day for four and half years, presented to the hospital with severe anemia. He had acute kidney injury and urinalysis showed proteinuria, dysmorphic RBCs, and rare RBC cast. CT scan of the chest revealed bilateral pulmonary ground-glass infiltrates. Transbronchial biopsy was consistent with pulmonary hemorrhage. Serologic tests showed high titer PR3 ANCA and, to a lesser extent, MPO ANCA. Kidney biopsy revealed focal segmental necrotizing glomerulonephritis with crescents, without evidence of immune complex deposits. Hydralazine was discontinued and the patient was treated with corticosteroids and intravenous cyclophosphamide. At one-year follow-up, he had no symptoms and anemia had resolved. Kidney function improved dramatically. Serology showed undetectable PR3 ANCA and minimally elevated MPO ANCA. To our knowledge, hydralazine-associated PR3 ANCA has not been previously reported. The possibility of ANCA systemic vasculitis should be included in the differential diagnosis of any patient with hydralazine use and pulmonary renal syndrome. This is a potentially life threatening condition requiring prompt cessation of the drug and treatment with glucocorticoids and immunosuppression.

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EMDR for Survivors of Life-Threatening Cardiac Events: Results of a Pilot Study

Journal of EMDR Practice and Research ◽

10.1891/1933-3196.5.1.2 ◽

2011 ◽

Vol 5 (1) ◽

pp. 2-13 ◽

Cited By ~ 24

Author(s):

Emanuele Arabia ◽

Maria Luisa Manca ◽

Roger M. Solomon

Keyword(s):

Pilot Study ◽

Cardiac Event ◽

Anxiety Symptoms ◽

Depression And Anxiety ◽

Ptsd Symptoms ◽

Cardiac Events ◽

Life Threatening ◽

Clinically Significant ◽

Better Than

This pilot study evaluated the effectiveness of eye movement desensitization and reprocessing (EMDR) in treating posttraumatic stress disorder (PTSD) symptoms and concomitant depressive and anxiety symptoms in survivors of life-threatening cardiac events. Forty-two patients undergoing cardiac rehabilitation who (a) qualified for the PTSD criterion “A” in relation to a cardiac event and (b) presented clinically significant PTSD symptoms were randomized to a 4-week treatment of EMDR or imaginal exposure (IE). Data were gathered on PTSD, anxiety, and depressive symptoms at pretreatment, posttreatment, and 6-month follow-up. EMDR was effective in reducing PTSD, depressive, and anxiety symptoms and performed significantly better than IE for all variables. These findings provide preliminary support for EMDR as an effective treatment for the symptoms of PTSD, depression, and anxiety that can follow a life-threatening cardiac event.

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Antithrombotic management and outcomes of patients with atrial fibrillation treated with NOACs early at the time of market introduction: Main results from the PREFER in AF Prolongation Registry

Internal and Emergency Medicine ◽

10.1007/s11739-020-02442-9 ◽

2020 ◽

Author(s):

Giulia Renda ◽

Ladislav Pecen ◽

Giuseppe Patti ◽

Fabrizio Ricci ◽

Dipak Kotecha ◽

...

Keyword(s):

Atrial Fibrillation ◽

Oral Anticoagulants ◽

Thromboembolic Risk ◽

Prevention Of Thromboembolic Events ◽

Life Threatening ◽

Coronary Syndromes ◽

One Year ◽

Antithrombotic Management ◽

European Registry

Abstract The management of patients with atrial fibrillation (AF) has rapidly changed with increasing use of non-vitamin K antagonist oral anticoagulants (NOACs) and changes in the use of rhythm control therapy. The prevention of thromboembolic events European Registry in Atrial Fibrillation Prolongation Registry (PREFER Prolongation) enrolled consecutive patients with AF on NOACs between 2014 and 2016 in a multicentre, prospective, observational study with one-year follow-up, focusing on the time of introduction of NOACs. Overall, 3783 patients were enrolled, with follow-up information available in 3223 (85%). Mean age was 72.2 ± 9.4 years, 40% were women, mean CHA2DS2VASc score was 3.4 ± 1.6, and 2587 (88.6%) had a CHA2DS2VASc score ≥ 2. Rivaroxaban was used in half of patients, and dabigatran and apixaban were used in about a quarter of patients each; edoxaban was not available for use in Europe at the time. Major cardiovascular event rate was low: serious events occurred in 74 patients (84 events, 2%), including 24 strokes (1%), 62 major bleeds (2%), of which 30 were life-threatening (1%) and 3 intracranial (0.1%), and 28 acute coronary syndromes (1%). Mortality was 2%. Antiarrhythmic drugs were used in about 50% of patients, catheter ablation in 5%. Adverse events were low in this contemporary European cohort of unselected AF patients treated with NOACs already at the time of their first introduction, despite high thromboembolic risk.

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Plugging and sealing technique by Onyx to prevent type II endoleak in ruptured abdominal aortic aneurysm

Vascular ◽

10.1177/1708538113478724 ◽

2013 ◽

Vol 21 (2) ◽

pp. 87-91 ◽

Cited By ~ 7

Author(s):

Thomas Larzon ◽

Tal Hörer

Keyword(s):

Endovascular Aneurysm Repair ◽

Emergency Situation ◽

Type Ii ◽

Hypogastric Artery ◽

Type Ii Endoleak ◽

Aortoiliac Aneurysm ◽

Life Threatening ◽

One Year ◽

Threatening Situation

Control of back bleeding from the hypogastric artery into the aneurysm after endovascular aneurysm repair (EVAR) of a ruptured aortoiliac aneurysm may be necessary in order to avoid a type II endoleak. It is an emergency situation and selective catheterization and embolization of the hypogastric artery may be time-consuming and more importantly, it has to be performed before complete exclusion of the aneurysm has been established. We describe a plugging and sealing technique that embolizes the hypogastric artery after the exclusion of a ruptured aortoiliac aneurysm using the embolizing agent Onyx. The mortality rate of the 16 patients treated in our institute with this technique was 25% (4/16) at 30-day and 31% (5/16) at 90-day follow up. One patient had a type II endoleak at one-year follow-up. The EVAR procedure can focus completely on controlling the acute life-threatening situation, with the embolization performed at the end of the procedure.

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