Multidisciplinary management of hepatilithiasis: a case series

Abstract Background Myelomeningocele (MMC) is the most common and severe form of spina bifida and imposes a significant burden on patients and the healthcare system. Recently, the multidisciplinary management of MMC has become popular. Herein, we aimed to review the orthopedic management, outcomes, and complications of the of patients with MMC eyeing a multidisciplinary approach. Methods We searched PubMed and EMBASE to find relevant studies published before August 2020. All studies that included clinical management of MMC patients and published earlier than 2000 were considered for review on the condition that they reported at least one orthopedic intervention and the rate of complications. We excluded review articles, case reports, case series, letters, commentaries, editorials, and conference abstracts. The primary and secondary goals of our review were to report the outcomes and complication rates of multidisciplinary management for MMC patients. Results Twenty-six studies included data for the management of 229,791 patients with MMC and were selected. Sixteen studies reported multidisciplinary management in addition to orthopedic management. From those, 11 (42.31%) included urologic management, 13 (50%) neurosurgical management, 11 (42.31%) neurologic management, and 5 (19.23%) gastrointestinal management. All studies included postnatal operations and related management. No randomized clinical trial was found in our search. Conclusion Orthopedic approaches play a key role in MMC management by alleviating spinal deformities, particularly scoliosis, and hip, foot, and ankle complications. However, the most appropriate management, whether surgical or non-surgical, may vary for different patients, given disease severity and the age of patients. Graphical abstract

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A case series and literature review on patients with rhinological complications secondary to the use of cocaine and levamisole

The Journal of Laryngology & Otology ◽

10.1017/s0022215120000894 ◽

2020 ◽

Vol 134 (5) ◽

pp. 440-446

Author(s):

R J Green ◽

Q Gardiner ◽

K Vinod ◽

R Oparka ◽

P D Ross

Keyword(s):

Literature Review ◽

Management Strategy ◽

Case Series ◽

The Other ◽

Antineutrophil Cytoplasmic Antibodies ◽

Systemic Effects ◽

Proteinase 3 ◽

Multidisciplinary Management ◽

Retrospective Case ◽

Complex Patient

AbstractBackgroundLevamisole is an increasingly common cutting agent used with cocaine. Both cocaine and levamisole can have local and systemic effects on patients.MethodsA retrospective case series was conducted of patients with a cocaine-induced midline destructive lesion or levamisole-induced vasculitis, who presented to a Dundee hospital or the practice of a single surgeon in Paisley, from April 2016 to April 2019. A literature review on the topic was also carried out.ResultsNine patients from the two centres were identified. One patient appeared to have levamisole-induced vasculitis, with raised proteinase 3, perinuclear antineutrophil cytoplasmic antibodies positivity and arthralgia which improved on systemic steroids. The other eight patients had features of a cocaine-induced midline destructive lesion.ConclusionAs the use of cocaine increases, ENT surgeons will see more of the complications associated with it. This paper highlights some of the diagnostic issues and proposes a management strategy as a guide to this complex patient group. Often, multidisciplinary management is needed.

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Adenocarcinomas presenting as abdominal wall masses

BMJ Case Reports ◽

10.1136/bcr-2020-236125 ◽

2020 ◽

Vol 13 (10) ◽

pp. e236125

Author(s):

Ammu Vijayakumar ◽

Valerie Grignol

Keyword(s):

Abdominal Wall ◽

Treatment Planning ◽

Surgical Resection ◽

Metastatic Disease ◽

Case Series ◽

Unknown Primary ◽

Multidisciplinary Management ◽

Malignant Tumours ◽

Primary Origin ◽

Unknown Primary Origin

Patients with abdominal wall masses as primary malignant tumours or metastatic disease are rare. Thorough evaluation with biopsy and imaging is required prior to surgical resection for treatment planning. We present a case series of three patients who presented with abdominal adenocarcinoma of unknown primary origin. All patients ultimately underwent surgical resection and final pathology showed a gynaecological origin for these tumours. Multidisciplinary management is required for these rare and complex tumours.

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