Kounis syndrome: Correct diagnosis leads to correct treatment approach

2021 ◽  
Vol 345 ◽  
pp. 28
Author(s):  
I.M. Amran ◽  
M.H. Umar ◽  
L. Balakrishnan ◽  
L.C. Wong ◽  
S. Kuppan ◽  
...  
Keyword(s):  
Treatment Approach ◽  
Correct Diagnosis ◽  
Kounis Syndrome ◽  
Correct Treatment

scholarly journals MI with Non-obstructive Coronary Artery Presenting with STEMI: A Review of Incidence, Aetiology, Assessment and Treatment

2020 ◽  
Vol 15 ◽  
Author(s):  
Ying X Gue ◽  
Rahim Kanji ◽  
Sabiha Gati ◽  
Diana A Gorog
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Correct Diagnosis ◽  
Correct Treatment ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Plaque Disruption ◽  
Methodical Approach ◽  
St Segment ◽  
Assessment And Treatment

MI with non-obstructive coronary artery (MINOCA) is a condition previously thought to be benign that has recently been shown to have comparable mortality to that of acute coronary syndrome with obstructive coronary disease. The heterogeneity of the underlying aetiology makes the assessment, investigation and treatment of patients with MINOCA challenging. The majority of patients with MINOCA presenting with ST-segment elevation MI generally have an underlying coronary or myocardial cause, predominantly plaque disruption or myocarditis. In order to make the correct diagnosis, in addition to the cause of the presentation, a meticulous and methodical approach is required, with targeted investigations. Stratification of patients to guide investigations that are more likely to provide the diagnosis will allow the correct treatment to be initiated promptly. In this article, the authors review the contemporary incidence, aetiology, recommended assessment and treatment of patients with MINOCA presenting with ST-segment elevation MI.

scholarly journals A Single Institution Experience in Hypertrofic Pyloric Stenosis

2020 ◽  
Vol 25 (4) ◽  
pp. 47-49
Author(s):  
Tamas Toth ◽  
Ana-Maria Prişcă ◽  
Angela Borda ◽  
Horea Gozar ◽  
Radu-Alexandru Prişcă
Keyword(s):  
Pyloric Stenosis ◽  
Gold Standard ◽  
Imaging Technique ◽  
Correct Diagnosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Muscle Thickness ◽  
Single Institution ◽  
Correct Treatment ◽  
Experienced Radiologist ◽  
Common Causes

Abstract The most common causes of non-bilious vomiting in infants are hypertrophic pyloric stenosis and pylorospasm. Differential diagnosis between the pathologies establishes the correct treatment. The aim of our study is to present the management of the pathologies cured in our department. The longer the duration of vomiting symptoms the higher muscle thickness was shown. Dehydration and lethargy was associated with higher muscle thickness. There were no intraoperative or postoperative complications recorded in our cases. Ultrasonography is the gold standard in imaging technique but it requires an experienced radiologist. In case of negative physical examination and ultrasonography, but high suspicion of the diagnosis a fluoroscopy may be required. The correct diagnosis avoids unnecessary surgery combined with general anesthesia.

scholarly journals Kounis syndrome after almonds ingestion: From the diagnostic approach to new therapeutic options

2021 ◽  
Vol 17 (3) ◽  
Author(s):  
Giorgio Fiore ◽  
Carlo Gaspardone ◽  
Silvana Di Maio ◽  
Michele Oppizzi ◽  
Alberto Margonato
Keyword(s):  
Acute Coronary Syndrome ◽  
Emergency Physician ◽  
Acute Coronary Syndromes ◽  
Correct Diagnosis ◽  
Kounis Syndrome ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
Anaphylactoid Reactions ◽  
Patient Prognosis ◽  
Diagnostic Work

Acute coronary syndromes can develop with an unusual and challenging presentation. Kounis syndrome is a mostly overlooked Acute Coronary Syndrome (ACS) in the setting of anaphylactic or anaphylactoid reactions in response to an allergic insult that can lead to severe complications including cardiac arrest. A 52-yearold- man presented to the emergency department of our hospital because of acute transient loss of consciousness that developed some minutes after almonds ingestion. The complex diagnostic workup led to the diagnosis of vasospastic Kounis syndrome, an infrequent type of acute coronary syndrome, mostly overlooked, with challenging diagnostic and therapeutic features. Peculiarities on clinical presentation, the approach adopted by the emergency physician and the consultant cardiologist to achieve the correct diagnosis and our proposed management with a brief revision of the literature will be reported. Unusual clinical presentations of acute coronary syndromes represent part of the pitfalls that an emergency physician can face during the everyday practice. Prompt identification of these conditions is always struggling but of crucial importance to improve patient prognosis with a correct diagnostic work-up and therapeutic management.

scholarly journals A Four-Year Follow-Up Case Report of Hypomineralized Primary Second Molars Rehabilitated with Stainless Steel Crowns

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 923
Author(s):  
Luísa Bandeira Lopes ◽  
Vanessa Machado ◽  
João Botelho
Keyword(s):  
Stainless Steel ◽  
Case Report ◽  
General Anesthesia ◽  
Treatment Approach ◽  
Primary Molars ◽  
Second Primary ◽  
Correct Treatment ◽  
Permanent Molars ◽  
First Permanent Molars

Hypomineralized primary second molars (HPSM) are characterized by enamel opacities accompanied by hypersensitivity and atypical caries lesion, on one to four primary second molars. The correct treatment and follow-ups of those teeth have an important impact on a correct eruption of the first permanent molars and future occlusion. Hence, this report aims to describes a case of a severe HPSM in all second molars of a four-year-old girl and subsequent four-year follow-ups. The rehabilitation involved the placement of four stainless steel crowns on all four second primary molars under general anesthesia. Concerning the available literature and the case severity of HPSM, the treatment approach proposed for the case provided good functional outcome.

scholarly journals Salivary Gland Disorders in Children and Adolescents: A 15-year Experience

2020 ◽  
Vol 24 (01) ◽  
pp. e31-e37
Author(s):  
Donata Gellrich ◽  
Moritz Bichler ◽  
Christoph A. Reichel ◽  
Florian Schrötzlmair ◽  
Pamela Zengel
Keyword(s):  
Salivary Gland ◽  
Children And Adolescents ◽  
Correct Diagnosis ◽  
Retrospective Chart Review ◽  
Diagnostic Procedures ◽  
Correct Treatment ◽  
Salivary Gland Diseases ◽  
Juvenile Recurrent Parotitis ◽  
Long Term Follow Up ◽  
First Occurrence

Abstract Introduction Diseases of the salivary glands are rare in children and adolescents, with the exception of viral-induced infections. Objective To determine the clinical course of the disease, the diagnostic procedures, the treatment and the outcome of all children and adolescents affected with salivary gland diseases at our clinic over a period of 15 years. Methods A retrospective chart review including a long-term follow-up was conducted among 146 children and adolescents treated for salivary gland disorders from 2002 to 2016. Results Diagnosing acute sialadenitis was easily managed by all doctors regardless of their specialty. The diagnosis of sialolithiasis was rapidly made only by otorhinolaryngologists, whereas diagnosing juvenile recurrent parotitis imposed difficulties to doctors of all specialties – resulting in a significant delay between the first occurrence of symptoms and the correct diagnosis. The severity-adjusted treatment yielded improvements in all cases, and a full recovery of 75% of the cases of sialolithiasis, 73% of the cases of juvenile recurrent parotitis, and 100% of the cases of acute sialadenitis. Conclusions Due to their low prevalence and the lack of pathognomonic symptoms, salivary gland diseases in children and adolescents are often misdiagnosed, resulting in an unnecessarily long period of suffering despite a favorable outcome following the correct treatment.

scholarly journals Clinician-Patient Dialogue About Preventive Chronic Migraine Treatment

2020 ◽  
Vol 11 ◽  
pp. 215013272095993
Author(s):  
Andrew M. Blumenfeld
Keyword(s):  
Chronic Migraine ◽  
Treatment Approach ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Severe Form ◽  
Migraine Treatment ◽  
Appropriate Treatment ◽  
The Individual ◽  
Practical Recommendations

Many new medications for the treatment of migraine are now available on the market. In the current evolving migraine treatment landscape, an individualized treatment approach is needed. This review provides practical recommendations on how to obtain a correct diagnosis and then engage in a long-term partnership with patients with the most severe form of migraine: chronic migraine (CM). Given the need to effectively treat this complex neurological disease, clinicians in primary care, general neurologists, and headache specialists are at the forefront to ease the burden of this disease for their patients. This manuscript will review how to discuss the currently available treatment options to help control migraine attacks, manage expectations, and, together with the patient, determine the most effective and appropriate treatment. The goal is to create an environment where the clinician partners with the patient in shared decision-making to choose the most effective appropriate treatment for the individual patient.

scholarly journals Plasma Cell Rich Osteomyelitis: A Rare Entity

2020 ◽  
Author(s):  
Prakhar Maheshwari ◽  
Rajesh Kumar Maheshwari ◽  
Anuradha Kusum ◽  
Digvijay Agarwal
Keyword(s):  
Clinical Features ◽  
Plasma Cell ◽  
Pathological Fracture ◽  
Plasma Cells ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Left Shoulder ◽  
Correct Treatment ◽  
Cortical Irregularity ◽  
Post Traumatic

Plasma cell rich osteomyelitis is a rare finding characterised by a plethora of plasma cells localised in the affected bone without the typical clinical features of infection. It usually affects the metaphysis of long bones with a radiological appearance as a dense thickening of bone without sequestrum formation. We present an atypical case of plasma cell osteomyelitis with a lesion in the metaphysis as well as the diaphysis of the humerus without sclerosis but with sequestrum formation. An 11-year-old girl was brought to OutPatient Department (OPD) with complaints of post-traumatic pain and swelling at left shoulder and proximal arm since one and a half months with aggravation of symptoms since last 10 days. Patient had also been treated for Urinary Tract Infection (UTI) by a paediatrician who prescribed antibiotics and antipyretics because of which fever subsided but the pain persisted. The x-ray of left shoulder with arm revealed a fracture of surgical neck of humerus with cortical irregularity noted in the mid-shaft of humerus along with lamellated periosteal reaction suggestive of post-traumatic osteomyelitis with a pathological fracture. Clinicoradiologic diagnosis of pathological fracture of left neck of humerus was made with an underlying neoplastic or infective aetiology. An open biopsy was taken from left proximal humerus. Histopathological examination showed plasma cells in sheets having abundant basophilic cytoplasm, round to eccentric nuclei and perinuclear hoff along with lymphocytes and few polymorphs with surrounding area showing fibrosis, oedema and hyperemia. A diagnosis of chronic plasma cell osteomyelitis was rendered, which is an uncommon condition without specific clinical findings and an ambigious cause. Histopathology is the definitive tool for obtaining an accurate diagnosis and we strongly recommend a meticulous histopathological examination correlated with clinico-radiological description for a correct diagnosis in order to avoid an increased frequency of diagnosis of neoplastic plasma cell lesion as well as for advocating the correct treatment. This case is discussed for presentation of plasma cell osteomyelitis and also to report a case of chronic primary plasma cell rich osteomyelitis with atypical clinical features.

Instrumental Diagnosis Methods for ENT Diseases

2020 ◽  
pp. 17-23
Author(s):  
Petr Arkadiyevich Ilyin
Keyword(s):  
Correct Diagnosis ◽  
Pathological Process ◽  
Functional Tests ◽  
Correct Treatment ◽  
X Ray ◽  
Investigation Methods ◽  
Acoustic Resistance ◽  
Hearing Assessment ◽  
Paranasal Sinuses Ct ◽  
Ct And Mri

As with any other clinical discipline, otorhinolaryngology uses both simple investigation methods including external examination of ENT organs with an otoscope, rhinoscope and laryngoscope, and more complex ones requiring the use of special devices and equipment. The latter include X-ray examination, US diagnostics, endomicroscopy of the nose and paranasal sinuses, CT and MRI (in case the study of soft tissue formations is needed). To study the auditory analyser functions and the labyrinth state, a number of functional tests are performed including stabilometry or postulography. Audiometry is performed with electroacoustic instruments and can be subjective and objective. Impedancometry, a method of objective hearing assessment, based on measuring the acoustic resistance of a soundconducting device, is used to determine the location and nature of the auditory system disorders. All these methods help establish the correct diagnosis, clarify the localisation of the pathological process and prescribe the correct treatment.

IMPROVEMENT OF INFORMATIVITY OF COMBINED DIFFERENT-RANGE IMAGES IN MEDICAL DIAGNOSTICS

2021 ◽  
pp. 36-42
Author(s):  
А.Н. Ветров ◽  
А.Ю. Потлов
Keyword(s):  
Correct Diagnosis ◽  
Medical Diagnostics ◽  
Range Images ◽  
Infrared Images ◽  
Correct Treatment ◽  
Near Surface ◽  
Video Cameras ◽  
Thermal Imagers ◽  
Oncological Diseases ◽  
Spatial Parameters

Задача повышения качества результатов медицинской диагностики и удобства их интерпретации является актуальной на современном этапе развития биомедицинской инженерии. Особый интерес представляют методы визуализации, применимые при диагностике онкологических заболеваний. Повышать достоверность медицинской диагностики таких патологических состояний предлагается посредством совмещения разнодиапазонных изображений, в частности сканов в инфракрасном и видимом диапазонах длин волн. Предлагается методика, в которой два изображения конкретного биообъекта, полученные от датчиков, работающих в разных частотных диапазонах, имеющие одинаковые пространственные параметры и сформированные с общего ракурса, сводятся в общее изображение чересстрочно. Новизна предлагаемой методики заключается в том, что после совмещения изображений производится взаимная передача заданных частей каждого пикселя соседним пикселям по вертикали. В полученном изображении каждый пиксель содержит информацию оптического и инфракрасного изображений в заданных пропорциях. Показано, что предлагаемая методика обеспечивает увеличение информативности в полученном изображении в шесть раз относительно исходных изображений. Предлагаемая методика совмещения разнодиапазонных изображений может быть применена в различных прикладных областях In the medical diagnostics of diseases, it is necessary to obtain the most reliable information in order to obtain the correct diagnosis and, as a result, the correct treatment for the patient. One of the methods of diagnostic studies of oncological diseases of a near-surface nature is to obtain infrared images. It is possible to increase the reliability of information by combining images obtained from thermal imagers, as well as from television video cameras. In this paper, we propose a technique in which two images of a particular object obtained from sensors operating in different frequency ranges, having the same spatial parameters, and formed from the same angle, are interlaced into a common image. The novelty of the proposed method lies in the fact that after combining the images, the specified parts of each pixel are mutually transmitted to the neighboring pixels vertically. In the resulting image, each pixel contains information of optical and infrared images in appropriate proportions. It is shown that the proposed method provides an increase in information content in the resulting image six times relative to the original image. The proposed technique for combining multi-range images can be applied in various areas

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