scholarly journals Management of Venous Malformations

2021 ◽  
Vol 38 (02) ◽  
pp. 215-225
Author(s):  
Michael Acord ◽  
Abhay Srinivasan
Keyword(s):  
Adverse Events ◽  
Multidisciplinary Approach ◽  
Clinical Presentation ◽  
Vascular Anomaly ◽  
Mass Effect ◽  
Slow Flow ◽  
Venous Malformations ◽  
Patient Assessment ◽  
Interventional Radiologist ◽  
Expected Outcomes

AbstractVenous malformations (VMs) are slow-flow, congenital vascular anomalies that are a result of vascular dysgenesis. Clinical presentation and morbidity depend on size, location, and association with other syndromes. VMs are the most common symptomatic vascular anomaly referred for intervention, usually due to thrombosis, swelling, mass effect, functional compromise, or cosmetic concerns. Treatment for larger lesions can be challenging and a multidisciplinary approach involving medical, interventional, and surgical input is critical for comprehensive care. This article will assist the interventional radiologist in patient assessment and will discuss current techniques for treatment, means to minimize adverse events, and expected outcomes.

scholarly journals Rheumatic Immune-Related Adverse Events—A Consequence of Immune Checkpoint Inhibitor Therapy

Biology ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 561
Author(s):  
Anca Bobircă ◽  
Florin Bobircă ◽  
Ioan Ancuta ◽  
Alesandra Florescu ◽  
Vlad Pădureanu ◽  
...  
Keyword(s):  
Immune System ◽  
Adverse Events ◽  
Immune Checkpoint ◽  
Multidisciplinary Approach ◽  
Malignant Tumors ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Cancer Cell Growth ◽  
Inhibitory Mechanisms ◽  
Checkpoint Inhibitor Therapy

The advent of immunotherapy has changed the management and therapeutic methods for a variety of malignant tumors in the last decade. Unlike traditional cytotoxic chemotherapy, which works by interfering with cancer cell growth via various pathways and stages of the cell cycle, cancer immunotherapy uses the immune system to reduce malignant cells’ ability to escape the immune system and combat cell proliferation. The widespread use of immune checkpoint inhibitors (ICIs) over the past 10 years has presented valuable information on the profiles of toxic adverse effects. The attenuation of T-lymphocyte inhibitory mechanisms by ICIs results in immune system hyperactivation, which, as expected, is associated with various adverse events defined by inflammation. These adverse events, known as immune-related adverse events (ir-AEs), may affect any type of tissue throughout the human body, which includes the digestive tract, endocrine glands, liver and skin, with reports of cardiovascular, pulmonary and rheumatic ir-AEs as well. The adverse events that arise from ICI therapy are both novel and unique compared to those of the conventional treatment options. Thus, they require a multidisciplinary approach and continuous updates on the diagnostic approach and management.

scholarly journals Complex-Compound Odontoma: A Rare Clinical Presentation

2018 ◽  
pp. 39-44
Author(s):  
Damla Torul DDS, PhD ◽  
Metehan Keskin DDS ◽  
Seda Gun DDS, PhD ◽  
Didem Odabasi DDS, PhD
Keyword(s):  
Early Detection ◽  
Complex Compound ◽  
Rare Case ◽  
Multidisciplinary Approach ◽  
Clinical Presentation ◽  
Odontogenic Tumor ◽  
Compound Odontoma

Odontomas can be detected as complex or compound variants and they rarely show the histologic characteristics of both types together. The tumor commonly associated with malocclusion, eruption disturbances and pathological anomalies, but they seldom cause bony expansion. Early detection and management of odontoma with multidisciplinary approach pose an important role to prevent disturbances associated with this common odontogenic tumor. Here we report a rare case of an odontoma which show the features of both complex and compound types and also cause bony expansion, eruption failure in an 8-year-old boy.

scholarly journals Orofacial manifestations of mucocutaneous leishmaniasis: a case series from Brazil

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 756
Author(s):  
Gleicy Gabriela Vitória Spinola Carneiro Falcão ◽  
Liliane Lins-Kusterer ◽  
Patricia Miranda Leite-Ribeiro ◽  
Viviane Almeida Sarmento
Keyword(s):  
Multidisciplinary Approach ◽  
Clinical Presentation ◽  
Case Series ◽  
Treatment Delay ◽  
Great Variability ◽  
Psychological Consequences ◽  
Facial Deformity ◽  
Mucocutaneous Leishmaniasis ◽  
Risk Of Disease ◽  
Delays In Diagnosis

Dentists play a fundamental role in the early diagnosis of oral leishmaniasis. Although these lesions are rare at oral mucosa, this is one of the manifestations sites of the disease This study reports seven clinical cases of orofacial mucocutaneous leishmaniasis. All had leishmaniasis diagnosis confirmed by laboratory tests, with orofacial involvement. Five out of the seven cases were males, and in four cases, patients had associated comorbidities. Late diagnosis was observed, resulting in treatment delay and increased hospitalization stay. One patient had severe psychological consequences due to facial deformity. The lack of differential diagnosis due the great variability of clinical presentation of the lesions and frequent unspecific histopathology represent a challenge for the dentist. In two reported cases, there were unspecific biopsy results. This series of cases highlights the importance of a multidisciplinary approach in the diagnosis and treatment of oral and perioral leishmaniasis. Patients with atypical lesions, originating from or living in endemic regions, should be investigated for leishmaniasis. These procedures could avoid delays in diagnosis and decrease the risk of disease dissemination.

Xanthogranulomatous pyelonephritis: an overview and management guide for clinicians

2021 ◽  
Vol 82 (2) ◽  
pp. 1-8
Author(s):  
Patrick Jones ◽  
Darko Lazic ◽  
Bhaskar K Somani ◽  
Amr Hawary
Keyword(s):  
Kidney Stone ◽  
Associated Factors ◽  
Multidisciplinary Approach ◽  
Clinical Presentation ◽  
Signs And Symptoms ◽  
Female Gender ◽  
Stone Disease ◽  
Flank Pain ◽  
Xanthogranulomatous Pyelonephritis ◽  
Neoplastic Process

Xanthogranulomatous pyelonephritis is a rare and chronic form of pyelonephritis. Patients can present with an array of signs and symptoms including flank pain, fever and weight loss. The insidious nature of its clinical presentation means that it can mimic a neoplastic process. Kidney stone disease, diabetes and female gender are the most common associated factors. Early diagnosis can be difficult, but is vital to avoid sequelae such as abscess formation and involvement of surrounding structures. Management requires a multidisciplinary approach. Definitive resolution can only be achieved through nephrectomy. This article provides an overview and guide to diagnosis, investigation and management.

scholarly journals Carcinomatous encephalitis as clinical presentation of occult lung adenocarcinoma: case report

2007 ◽  
Vol 65 (3b) ◽  
pp. 841-844 ◽  
Author(s):  
Henrique Barbosa Ribeiro ◽  
Tadeu Ferreira de Paiva Jr ◽  
Gustavo Pignatari Rosas Mamprin ◽  
Milton Luiz Gorzoni ◽  
Antônio José da Rocha ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Mass Effect ◽  
Pulmonary Adenocarcinoma ◽  
Rare Entity ◽  
Resonance Imaging ◽  
Clinical Imaging ◽  
Magnetic Resonance Imaging Mri

Carcinomatous encephalitis is a rare entity, originally described by Madow and Alpers in 1951, which is characterized by tumoral spreading perivascular, without mass effect. Clinical manifestations such as hemiparesis, seizures, ataxia, speech difficulties, cerebrospinal fluid findings as well as computed tomography are nonspecific. This leads the physician to pursue more frequent diseases that could explain those manifestations - toxic, metabolic, and/or infectious encephalopathy. A magnetic resonance imaging (MRI) with gadolinium, the method of choice, presumes the diagnosis. Previous reports of this unusual form of metastatic disease have described patients with prior diagnosis of pulmonary adenocarcinoma. We present the case of carcinomatous encephalitis in a 76-years-old woman as the primary manifestation of occult pulmonary adenocarcinoma with its clinical, imaging, and anatomopathological findings.

Conscious Sedation in Dentistry: Selecting the Right Patient

Dental Update ◽  
2020 ◽  
Vol 47 (4) ◽  
pp. 353-359
Author(s):  
Roya Hazara
Keyword(s):  
Adverse Events ◽  
Physical Examination ◽  
Staff Training ◽  
Clinical Relevance ◽  
Conscious Sedation ◽  
Oral Route ◽  
Patient Assessment ◽  
History Play ◽  
Guidelines And Standards ◽  
The Right

In recent years, conscious sedation has grown in popularity as an alternative to general anaesthesia in a primary setting due to its safety and efficiency. It is imperative to carry out a full patient assessment prior to treatment under conscious sedation. Conscious sedation is provided intravenously, by inhalation or oral route. Clinical and physical examination as well as medical, social and mental history play a fundamental role in selecting the right patient. In addition, to optimize safety of patients, it is necessary to follow available guidelines and standards, provide an appropriate environment and adequate staff training. CPD/Clinical Relevance: This article highlights the importance of pre-assessment prior to treatment under conscious sedation. The vast majority of adverse events during sedation occur as a result of inadequate pre-assessment and preparation.

scholarly journals Patient Assessment: Clinical Presentation, Imaging Diagnosis, Risk Stratification, and the Role of Pulmonary Embolism Response Team

2018 ◽  
Vol 35 (02) ◽  
pp. 116-121 ◽  
Author(s):  
Tamir Friedman ◽  
Keith Quencer ◽  
David Madoff ◽  
Ronald Winokur
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Presentation ◽  
Treatment Guidelines ◽  
The United States ◽  
Imaging Diagnosis ◽  
Patient Assessment ◽  
Timely Manner ◽  
Response Team ◽  
Hospital Deaths

AbstractPulmonary embolism (PE) is currently the third leading cause of death and moreover is likely underdiagnosed. PE remains the most common preventable cause of hospital deaths in the United States, which may be attributable to its diagnostic challenges. Although difficult to diagnose, patient mortality rates are time-dependent, and thus, the suspicion and diagnosis of PE in a timely manner is imperative. Diagnosis based on several criteria which may dictate imaging workup as well as laboratory tests and clinical parameters are discussed. The evolution of treatment guidelines via various clinical trials and recommendations is outlined, setting the stage for the use of fibrinolytics, whether systemic or catheter directed. Treatment, including fibrinolytics, is predicated on patient triage into three large categories—massive, submassive, or low-risk PE. Additionally, a relatively new concept of a multidisciplinary team composed of several subspecialty experts known as the PE response team (PERT) is discussed. PERT's timely and unified recommendations have been shown to optimize care and decrease mortality while tailoring treatment to each individual afflicted by PE.

Pediatric Neurosurgery

2019 ◽  
Keyword(s):  
Decision Making ◽  
Clinical Presentation ◽  
Pediatric Neurosurgery ◽  
Accurate Diagnosis ◽  
Complication Management ◽  
Medical Evidence ◽  
Pediatric Practice ◽  
Planning Decision ◽  
Neurological Surgery ◽  
Expected Outcomes

Part of the Neurosurgery by Example series, this volume on pediatric neurosurgery presents exemplary cases in which renowned authors guide readers through the assessment and planning, decision making, surgical procedure, aftercare, and complication management of common and uncommon disorders. As pediatric neurosurgery approximates the anatomical and pathophysiological breadth of all specialty areas of adult neurosurgery, the cases provided are particularly relevant to and more frequently encountered in pediatric practice. They also reflect aspects of clinical presentation and management that are notably distinct in pediatric compared to adult neurosurgery. Each chapter also contains “pivot points” that illuminate changes required to manage patients in alternate or atypical situations, and “pearls” for accurate diagnosis, successful treatment, and effective complication management. Containing a focused review of medical evidence and expected outcomes, Pediatric Neurosurgery is appropriate for neurosurgeons who wish to learn more about this subspecialty and those preparing for the American Board of Neurological Surgery oral examination.

Adrenocortical cancer

2017 ◽  
Author(s):  
Steve Ball ◽  
Sajid Kalathil
Keyword(s):  
Adjuvant Radiotherapy ◽  
Multidisciplinary Approach ◽  
Clinical Presentation ◽  
Advanced Disease ◽  
Radiological Finding ◽  
Complete Resection ◽  
Overall Survival Rate ◽  
Adrenocortical Cancer ◽  
First Line ◽  
Symptoms And Signs

Adrenocortical cancer (ACC) is rare and associated with poor prognosis. The incidence is estimated at 0.7–2 cases per one million. Overall survival rate at five years for ACC is 37–47%. While the pathogenesis of ACC is incompletely understood, inherited predisposition syndromes are common in childhood ACC. Clinical presentation can be with symptoms and signs of hormone excess (functional tumours), mass effects, or as an incidental radiological finding. A multidisciplinary approach combining radiology, biochemistry, and tissue-based pathology is needed to establish a diagnosis to guide a surgical approach aimed at complete resection of the tumour where possible. At present, recommended first-line therapies for advanced disease are mitotane monotherapy or etopiside, doxorubicin, and cisplatin plus mitotane. Metronomic capecitabine and gemcitabine have been used as alternatives. Adjuvant radiotherapy to the tumour bed should be considered for patients considered to be at high risk of recurrence.

scholarly journals Peripheral Vascular Anomalies – Essentials in Periinterventional Imaging

2019 ◽  
Vol 192 (02) ◽  
pp. 150-162 ◽  
Author(s):  
Maliha Sadick ◽  
Daniel Overhoff ◽  
Bettina Baessler ◽  
Naema von Spangenberg ◽  
Lena Krebs ◽  
...  
Keyword(s):  
Therapeutic Approach ◽  
Vascular Malformations ◽  
Vascular Anomaly ◽  
Flow Dynamics ◽  
Vascular Anomalies ◽  
Vascular Tumors ◽  
Slow Flow ◽  
Peripheral Vascular ◽  
Fast Flow ◽  
Selection Of

Background Peripheral vascular anomalies represent a rare disease with an underlying congenital mesenchymal and angiogenetic disorder. Vascular anomalies are subdivided into vascular tumors and vascular malformations. Both entities include characteristic features and flow dynamics. Symptoms can occur in infancy and adulthood. Vascular anomalies may be accompanied by characteristic clinical findings which facilitate disease classification. The role of periinterventional imaging is to confirm the clinically suspected diagnosis, taking into account the extent and location of the vascular anomaly for the purpose of treatment planning. Method In accordance with the International Society for the Study of Vascular Anomalies (ISSVA), vascular anomalies are mainly categorized as slow-flow and fast-flow lesions. Based on the diagnosis and flow dynamics of the vascular anomaly, the recommended periinterventional imaging is described, ranging from ultrasonography and plain radiography to dedicated ultrafast CT and MRI protocols, percutaneous phlebography and transcatheter angiography. Each vascular anomaly requires dedicated imaging. Differentiation between slow-flow and fast-flow vascular anomalies facilitates selection of the appropriate imaging modality or a combination of diagnostic tools. Results Slow-flow congenital vascular anomalies mainly include venous and lymphatic or combined malformations. Ultrasound and MRI and especially MR-venography are essential for periinterventional imaging. Arteriovenous malformations are fast-flow vascular anomalies. They should be imaged with dedicated MR protocols, especially when extensive. CT with 4D perfusion imaging as well as time-resolved 3D MR-A allow multiplanar perfusion-based assessment of the multiple arterial inflow and venous drainage vessels of arterio-venous malformations. These imaging tools should be subject to intervention planning, as they can reduce procedure time significantly. Fast-flow vascular tumors like hemangiomas should be worked up with ultrasound, including color-coded duplex sonography, MRI and transcatheter angiography in case of a therapeutic approach. In combined malformation syndromes, radiological imaging has to be adapted according to the dominant underlying vessels and their flow dynamics. Conclusion Guide to evaluation of flow dynamics in peripheral vascular anomalies, involving vascular malformations and vascular tumors with the intention to facilitate selection of periinterventional imaging modalities and diagnostic and therapeutic approach to vascular anomalies. Key Points:  Citation Format

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