Myelomeningocele in one neonate from a fraternal triplet birth: Two case reports on neurosurgical and multidisciplinary treatment during the perinatal period

ALTHOUGH the association between hydramnios and congenital anomalies of the alimentary tract of the fetus has been recognized for more than 75 years, little emphasis has been placed upon this prenatal maternal abnormality as an aid to the earlier diagnosis of obstructive disease in the newborn. With the exception of isolated case reports which were summarized by Taussig in 1927 and the more recent observations of Mengert and Bourland, Castanier et al., and Clatworthy and Lloyd, the diagnostic significance of this relationship has not received proper recognition. Fortunately, today, the majority of anatomic abnormalities of the alimentary tract which are encountered in the neonate can be surgically corrected, if the diagnosis can be established and the treatment instituted before the infant has deteriorated irreversibly. A more general appreciation of the importance of hydramnios as a diagnostic sign of obstructive disease by physicians responsible for the care of the infant during the perinatal period should improve infant salvage. Recent surveys of our experience at the Columbus Children's Hospital with neonates having obstructing lesions of the esophagus or intestine attracted our attention to the fact that many of these infants were delivered of mothers who suffered from acute or chronic hydramnios. In an effort to determine the significance of the interrelationship between hydramnios in the mother and congenital obstruction of the alimentary tract in the fetus, a study was undertaken which included not only a survey of all infants admitted to the Children's Hospital with alimentary tract obstruction but also an analysis of a series of obstetric cases at the University Hospital in women with pregnancy complicated by hydramnios.

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Perinatal Mental Health Care for Women With Severe Mental Illness During the COVID-19 Pandemic in India—Challenges and Potential Solutions Based on Two Case Reports

Frontiers in Global Women's Health ◽

10.3389/fgwh.2021.648429 ◽

2021 ◽

Vol 2 ◽

Author(s):

Sachin Nagendrappa ◽

Pratibha Vinod ◽

Naveen Manohar Pai ◽

Sundarnag Ganjekar ◽

Geetha Desai ◽

...

Keyword(s):

Mental Illness ◽

Traumatic Event ◽

Case Reports ◽

Perinatal Period ◽

Mental Illnesses ◽

Traumatic Experiences ◽

Psychotic Episode ◽

Outpatient Services ◽

Middle Income ◽

Travel Restrictions

The ongoing COVID-19 pandemic in India has created several challenges in the care of women with perinatal mental illness. Access to healthcare has been disrupted by lockdowns, travel restrictions, and the unavailability of outpatient services. This report aims to discuss the challenges faced by women with severe mental illnesses during the perinatal period with the help of two case reports. Accordingly, we have highlighted the role of COVID-19 infection as a traumatic event during childbirth and its role in triggering a psychotic episode in women with vulnerabilities; difficulties faced by women with postpartum psychosis in accessing perinatal psychiatry services; and the challenges of admission into an inpatient Mother-Baby Unit (MBU). Further, we have discussed potential solutions from the perspectives of Lower and Middle-income (LAMI) countries that need to be extended beyond the pandemic. They include offering video consultations, reviewing hospital policies, and evolving strategies to mitigate traumatic experiences for pregnant and postpartum women with severe mental illnesses in both obstetric and psychiatric care.

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Multidisciplinary treatment of pain caused by bone metastases in cancer patients: two case reports

Nowotwory Journal of Oncology ◽

10.5603/njo.2017.0023 ◽

2017 ◽

Vol 67 (2) ◽

pp. 142-145 ◽

Cited By ~ 1

Author(s):

Natalia Cichowska-Cwalińska ◽

Renata Zaucha

Keyword(s):

Bone Metastases ◽

Cancer Patients ◽

Case Reports ◽

Multidisciplinary Treatment

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Caudal Duplication Syndrome Systematic Review—A Need for Better Multidisciplinary Surgical Approach and Follow-Up

Medicina ◽

10.3390/medicina56120650 ◽

2020 ◽

Vol 56 (12) ◽

pp. 650

Author(s):

Spătaru Radu-Iulian ◽

Avino Adelaida ◽

Iozsa Dan-Alexandru ◽

Ivanov Monica ◽

Serban Dragos ◽

...

Keyword(s):

Renal Scarring ◽

Case Reports ◽

Multidisciplinary Treatment ◽

Multidisciplinary Care ◽

Colon Anastomosis ◽

Strong Impact ◽

Surgical Interventions ◽

Caudal Duplication ◽

Duplication Syndrome

Background and Objectives: Caudal duplication syndrome is a rare association of anatomical anomalies describing duplication of the hindgut, spine, and uro-genital structures, leading to varied clinical presentations. The current literature focuses on case reports which describe the embryological etiology and anatomical spectrum of the condition giving little attention to the surgical preparation, the need for a well-structured follow-up program, or the transition into adult healthcare of these complex patients. No reviews have been published regarding this complex pathology. Materials and Methods: A review of caudal duplication syndrome cases was done to assess the range of the clinical malformations, timing, and types of surgical interventions. Inconsistencies in multidisciplinary care, follow-up, and risk events were described. Results: Hindgut duplication always involved the anorectal region. Anorectal malformations were evenly distributed as unilateral and bilateral. Colon duplication extended from the anal region to the transverse colon or ascending colon in most of the cases and less to terminal. In females, genital duplication was present in all cases. The follow-up period varied between 3 months and 12 years. In all adult females, the motive of presentation was related to pregnancy (complications after successful delivery, fertility evaluation) or late complications (fecalith obstruction of the end-to-side colon anastomosis, repeated UTIs with renal scarring). Conclusions: Complex malformations affecting multiple caudal organs may have a strong impact in many aspects of the long-term quality of life; therefore, patients with caudal duplication syndrome need increased awareness and joined multidisciplinary treatment.

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Case Report: Prune perineum syndrome: a rare case with an unfavourable outcome

F1000Research ◽

10.12688/f1000research.8246.2 ◽

2016 ◽

Vol 5 ◽

pp. 363

Author(s):

Roberto I. Lopes ◽

Francisco T. Dénes ◽

Gustavo B. Messi ◽

Marcos G. Machado

Keyword(s):

Urinary Diversion ◽

Social Acceptance ◽

Case Reports ◽

Vena Cava ◽

Perinatal Period ◽

Anterior Wall ◽

Initial Result ◽

First Case ◽

Bilateral Cryptorchidism ◽

Staged Reconstruction

Prune perineum syndrome (PPS) is a rare anomaly, with only two previous case reports, both dying in the perinatal period. We report the first case of PPS that reached childhood. The patient presented with a hypoplastic genitalia and bilateral cryptorchidism. There was no evidence of an anal orifice. A significant prune-like mass was observed, extending from the perineum to both gluteal regions and to a cephalic mid-line bony prominence, with a 1cm central orifice that discharged urine. MRI confirmed the previous findings and revealed a right crossed ectopic kidney, intestinal malrotation, a hypoplastic infrarenal inferior vena cava and a hypoplastic right iliac artery. Endoscopic evaluation through the orifice revealed a cavity lined by urothelial mucosa, with a small communication to the anterior urethra in its anterior wall. A staged reconstruction was planned, with a first-step urinary diversion through a continent abdominal reservoir associated to bilateral orchiopexy. He was discharged from the hospital three weeks later under intermittent catheterization. The next surgical step would be the resection of the perineal mass and its cavity associated to the removal of the prominent sacrococcygeal bones. Unfortunately, four months after the first surgery the patient developed an acute abdomen and was submitted to a laparotomy that revealed a necrotic ileal segment secondary to obstructive adherences. He developed severe malabsorption followed by septic shock, dying five weeks after the procedure. Due to the lack of literature, there is no consensus for the management of these cases. The wish of the family for a better quality of life and social acceptance, compelled us to perform a urinary diversion, to be followed by a plastic and orthopedic reconstruction. Despite the successful initial result, the patient developed a late abdominal obstruction that was misdiagnosed, precipitating his untimely death five months after the first procedure.

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Management of brain metastasis from eccrine porocarcinoma: illustrative case

Journal of Neurosurgery: Case Lessons ◽

10.3171/case21242 ◽

2021 ◽

Vol 1 (26) ◽

Author(s):

Ryuichi Noda ◽

Tomohiro Inoue ◽

Sho Tsunoda ◽

Masafumi Segawa ◽

Yoshio Masuda ◽

...

Keyword(s):

Brain Metastasis ◽

Clinical Course ◽

Case Reports ◽

Multidisciplinary Treatment ◽

Brain Lesion ◽

Gamma Knife Radiosurgery ◽

Skin Tumor ◽

Illustrative Case ◽

Malignant Skin ◽

Eccrine Porocarcinoma

BACKGROUND Eccrine porocarcinoma (EP) is a rare malignant skin neoplasm, and there are still many unknowns regarding its natural history and treatment. Due to its scarcity, associated brain metastasis is a far rarer condition. OBSERVATIONS A 71-year-old-woman with a history of EP was diagnosed with brain metastasis. In her clinical course, the patient underwent tumor removal surgery twice and Gamma Knife radiosurgery (GKRS) four times. The tumor showed a good response to radiotherapy. The histopathological findings of the brain tumor were consistent with those of the primary skin tumor. LESSONS There are only a few case reports referring to the detailed treatment, especially with GKRS, of brain metastasis from EP. Few reports have presented a detailed histopathological comparison between the primary skin lesion and the metastatic brain lesion. Herein, the authors have described the clinical course, histological features, and results of multidisciplinary treatment for brain metastasis of EP.

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Five-to-five clear aligner therapy: predictable orthodontic movement for general dentist to achieve minimally invasive dentistry

BMC Oral Health ◽

10.1186/s12903-021-02034-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tommaso Weinstein ◽

Giuseppe Marano ◽

Raman Aulakh

Keyword(s):

Minimally Invasive ◽

Dental Treatment ◽

Case Reports ◽

Treatment Plan ◽

Multidisciplinary Treatment ◽

Clinical Results ◽

Invasive Treatment ◽

Minimally Invasive Dentistry ◽

Ethics Assessment ◽

Clear Aligner

Abstract Background Esthetic dentistry has become a very important aspect of every dental treatment from the patient perspective, whether it is orthodontics or implant therapy. The aim of this article is to describe the advantages of a newly developed branch of five-to-five clear aligner therapy (CAT) (Invisalign Go, Align Technology, San Jose, Calif) in interdisciplinary treatments especially in terms of minimally invasive interventions. Case presentation Two case reports are presented together with a comprehensive analysis using the SAFE (Safety, Assessment, Function, Ethics) assessment. This paper aims to introduce a new systematic in CAT. Invisalign Go (Align Technology, Santa Clara, California, USA) allows orthodontic treatment from second premolar and second premolar in both arches. It is specially designed for general practitioners devoted to restorative dentistry for a better planning of a multidisciplinary and mini-invasive treatment plan. Discussion and conclusion The clinical results demonstrate how CAT is extremely useful in multidisciplinary treatment plan in order to straighten teeth especially in a pre-restorative phase to allow minimally invasive and adhesive restorations.

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Preterm neonate delivered to COVID-19 positive mother on ECMO support

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-210845 ◽

2021 ◽

pp. 1-4

Author(s):

P. Balasundaram ◽

S. Louis ◽

A. Thompson-Branch

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Pregnant Women ◽

Distress Syndrome ◽

Preterm Neonate ◽

Case Reports ◽

Perinatal Period ◽

Ecmo Support ◽

Extra Corporeal Membrane Oxygenation ◽

Ongoing Research ◽

Birth Weight Neonate

Despite ongoing research and recent discoveries, there remains a paucity of data regarding COVID-19 and its implications for pregnant women, particularly its effects on the developing fetus. To date, there are a limited number of articles available regarding the utility of Extra Corporeal Membrane Oxygenation (ECMO) for cardio-respiratory support of pregnant women during the perinatal period. Additionally, there are only a few case reports detailing the delivery management of a baby born to a mother on ECMO support. Here, we report a case of a premature, low birth weight neonate delivered by a 32-year-old woman while on ECMO due to severe acute respiratory distress syndrome resulting from COVID-19 infection.

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Endovascular treatment of superior vena cava syndrome does not preclude continued use of indwelling hemodialysis and chemotherapy lines

American Journal of Interventional Radiology ◽

10.25259/ajir_37_2021 ◽

2021 ◽

Vol 5 ◽

pp. 22

Author(s):

Molly Casey ◽

Sagar Desai ◽

Vinit Khanna

Keyword(s):

Case Reports ◽

Superior Vena ◽

Multidisciplinary Treatment ◽

Vena Cava ◽

Interdisciplinary Treatment ◽

Endovascular Stenting ◽

Common Cause ◽

Lung Malignancies ◽

Treatment Plans ◽

Continued Use

Obstruction of the Super Vena Cava (SVC) can result in symptoms, such as facial plethora and swelling, and be due to a variety of underlying causes besides lung malignancies, the rates of which have changed over time; the underlying etiology is used to determine the best management strategy. This case report aims to discuss the role of etiology in determining the best initial treatment for SVC syndrome (SVCS) and outlines the unique management for a patient that represents the changing demographics of SVCS causes. A 73-year-old male with end-stage renal disease and metastatic carcinoma of the colon presented with swelling of the jaw, neck, and tongue. Computed tomography (CT) scan showed chronic thrombosis of the SVC and bilateral brachiocephalic veins. He had been receiving hemodialysis and chemotherapy through central venous catheters (CVCs) that traversed the SVC and terminated in the right atrium. Treatment involved double-barrel stent reconstruction of the SVC with a snare technique to temporarily reposition the chemotherapy port catheter and exchange of the hemodialysis catheter. After this single procedure, he experienced relief of symptoms without disrupting the use of his CVCs for further hemodialysis or chemotherapy appointments. For cases of SVCS due to underlying lung malignancies, which has been and remains the most common cause, endovascular stenting is reserved as a palliative measure when treatment of a refractory malignancy fails to resolve the obstruction and for when symptoms are severe because most cases are not life-threatening. However, increased use of CVCs has caused a rise in SVCS due to thrombosis, for which stenting is the first-line treatment. Of the few previously published case reports that depict using a snare technique to temporarily reposition a CVC, they all describe cases due to lung malignancies. Outlining this case presentation can increase awareness of thrombotic stenosis as an increasingly common cause of SVCS, which may occur in patients with a broader range of underlying conditions, ages, and life expectancies and require a wider array of physicians to be knowledgeable of management strategies. Furthermore, detailing this unique technique can provide therapeutic alternatives that show how endovascular interventions do not disrupt interdisciplinary treatment plans or preclude continued use of CVCs. While stenting technology has improved dramatically since its inception, follow-up on stent patency will help determine if expanding treatment for lower acuity cases is beneficial. Endovascular stenting is the treatment of choice for thrombotic causes of SVCS, which is becoming more common due to the increased use of CVCs. Techniques to temporarily reposition CVCs intra-procedurally allow for limited disruption in multidisciplinary treatment plans for patients with complex underlying conditions.

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Mallory–Weiss syndrome complicated by severe aspiration pneumonitis in an infant

Oxford Medical Case Reports ◽

10.1093/omcr/omab094 ◽

2021 ◽

Vol 2021 (10) ◽

Author(s):

Yukako Ebara ◽

Akihiko Shimizu ◽

Shigeru Nomura ◽

Akira Nishi ◽

Yoshiyuki Yamada

Keyword(s):

Gastrointestinal Endoscopy ◽

Upper Gastrointestinal Bleeding ◽

Case Reports ◽

Multidisciplinary Treatment ◽

Aspiration Pneumonitis ◽

Upper Gastrointestinal Endoscopy ◽

Pediatric Case ◽

Respiratory Condition ◽

Linear Scar ◽

Upper Gastrointestinal

ABSTRACT A 1-month-old girl presented with hematemesis and dyspnea. A large amount of blood was aspirated through a nasogastric tube, and chest computed tomography showed bilateral centrilobular opacified lesions, which suggested aspiration pneumonitis due to upper gastrointestinal bleeding. Her respiratory condition exacerbated, and we initiated nitric oxide (NO) therapy. Bleeding stopped with conservative treatment. She was weaned off mechanical ventilation and extubated on Day 6 after admission. Afterward, upper gastrointestinal endoscopy showed a longitudinal linear scar indicative of Mallory–Weiss syndrome (MWS). MWS is rarely reported in early infancy since many of the risk factors are absent in infants. Patients with aspiration pneumonitis usually recover respiratory function within 24 h and severe respiratory failure is rare in aspiration pneumonitis. There are no pediatric case reports describing MWS with severe aspiration pneumonitis. Although MWS is a rare cause of neonatal hematemesis, patients can become severely ill and require multidisciplinary treatment.

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