scholarly journals Rare cause of emergency in the first week of life: congenital hepatoblastoma (case report)

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Gloria Ha Young Yoo ◽  
Veronica Mugarab-Samedi ◽  
Gregory Hansen ◽  
Grant Miller ◽  
Laurence Givelichian ◽  
...  
Keyword(s):  
Case Report ◽  
Organ Dysfunction ◽  
Metabolic Disorders ◽  
Causative Factor ◽  
Hemodynamic Instability ◽  
Term Infant ◽  
Sick Newborn ◽  
Cardiac Lesions ◽  
Rule Out

Abstract During the first week of life, a sudden deterioration in a newborn commonly includes investigations to rule out infections, lung pathologies, cardiac lesions, neurological insults, metabolic disorders or gastrointestinal emergencies. It is unusual, however, to consider malignancy as the primary causative factor. In this case report, we describe a rare and unusual presentation of congenital hepatoblastoma, its complications and management in a neonate with multi-organ dysfunction. A term infant presented with sudden deterioration, hemodynamic instability and an acute abdomen on his 4th day of life. Surgical exploration revealed a ruptured neoplasm that pathology diagnosed as a congenital hepatoblastoma. After the patient was stabilized, chemotherapy was initiated. At present, the patient is 8 months old and under continuous follow-up of oncology service. This case highlights the importance of considering rare diagnoses including congenital malignancy when investigating and managing a sick newborn with multi-organ dysfunction.

scholarly journals Asystole in an older patient with recurrent falls. Case report

Case reports ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 77-83
Author(s):  
William Fernando Bautista-Vargas
Keyword(s):  
Case Report ◽  
Older Patients ◽  
Implantable Devices ◽  
Loop Recorder ◽  
General Terms ◽  
Recurrent Falls ◽  
History Of ◽  
Rule Out

Introduction: Recurrent falls are a usual problema in older patients. It is therefore important to learn how to differentiate a pathological or syncopal episode from a simple stumbling fall, especially in patients who have limitations for communicating clearly and are poorly understood, in general terms, during the medical consultation. Implantable loop recorders (ILR) have been used as an investigation tool in selected cases of recurrent falls in older patients. Consequently, this case report aims to describe its usefulness in this type of patients.Case presentation: An 87-year-old female patient, hypertensive, with a history of recent stroke and frequent falls —referred to as stumbling—, received an implantable loop recorder due to atrial fibrillation. During one follow-up appointment, a 36-second pause related to a fall was documented, so a bicameral pacemaker was implanted.Conclusions: Evaluating repeated falls in older patients is complex; it must be done in detail to rule out syncopal episodes. Implantable devices to diagnose arrhythmic causes are useful and allow achieving accurate diagnoses and establish specific behaviors aimed at improving the quality of life of patients.

scholarly journals Abdominal Viscera Migration Performing Hemodynamic Instability after Esophagectomy: A Case Report

2021 ◽  
pp. 1-6
Author(s):  
Ian Torres de Lima ◽  
Edno Tales Bianchi ◽  
Gabriel Lunardi Aranha ◽  
Beatriz Camargo Azevedo ◽  
Guilherme Naccache Namur ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Case Report ◽  
Minimally Invasive ◽  
Surgical Techniques ◽  
Rare Condition ◽  
Hemodynamic Instability ◽  
Minimally Invasive Surgical ◽  
Late Postoperative Period ◽  
Made In

Hiatal hernia is a rare postoperative complication of esophagectomy in the treatment of esophageal cancer. Although rare, its incidence increased after the establishment of minimally invasive surgical techniques. The patient is usually oligosymptomatic, and the diagnosis is made in the late postoperative period, during outpatient follow-up. The initial presentation of hiatus hernia with hemodynamic instability is a rare condition that has never been described in the literature before. In the following report, we address the clinical picture, diagnosis, and treatment for this condition, discussing the main nuances of the literature.

Neonatal Enterovirus: A Case Report in a Term Infant Requiring Air Evacuation

2020 ◽  
Vol 39 (4) ◽  
pp. 215-221
Author(s):  
Morgan S. Shaff ◽  
C. Scott Love ◽  
Elizabeth V. Schulz
Keyword(s):  
Case Report ◽  
Clinical Symptoms ◽  
Response Times ◽  
Rapid Diagnosis ◽  
Term Infant ◽  
Clinical Complications ◽  
Life Threatening ◽  
Initial Hospital ◽  
Polymerase Chain ◽  
Rule Out

Enterovirus infections in neonates have the potential to cause a cascade of devastating clinical complications that can lead to death. Because of vague maternal symptom presentations, the diagnosis may not be obvious to antepartum adult providers. Clinicians evaluating infants in the newborn nursery and following initial hospital discharge must be alert for this potential infection. Common newborn issues, such as hyperbilirubinemia and weight loss, may be early signs of a more life-threatening diagnosis. Enterovirus infections may be responsible for a continuum of critical diagnoses in the neonate. Utilization of viral panels during the initial rule-out sepsis evaluation may provide rapid diagnosis and, ultimately, earlier response times to devastating clinical symptoms. Antepartum history and presenting features of enteroviral infections warrant rapid diagnosis with viral polymerase chain reaction detection panels to potentially reduce antibiotic usage and inpatient length of stay. The purpose of this case report is to review risk factors, presentation, and management of neonatal enterovirus infections. As this infant was born in a remote setting and required air evacuation, the logistics of this transport are also discussed.

scholarly journals Brazilian National Anthem presenting as musical hallucination: A case report with 9-year follow-up

2016 ◽  
Vol 10 (3) ◽  
pp. 247-250
Author(s):  
José Eduardo Martinelli ◽  
Juliana Francisca Cecato ◽  
Ivan Aprahamian
Keyword(s):  
Hearing Loss ◽  
Cognitive Impairment ◽  
Case Report ◽  
Metabolic Disorders ◽  
Auditory Hallucination ◽  
Sensory Deprivation ◽  
Neurologic Diseases ◽  
National Anthem ◽  
Musical Hallucination

ABSTRACT Musical hallucination is a type of complex auditory hallucination. Possible etiologies are deafness, psychiatric disorders such as schizophrenia, major depression, use of medication and stress, besides neurologic diseases including epilepsy, stroke and cancer. Uncommon etiologies encompass infectious diseases, metabolic disorders, and sensory deprivation. Although musical hallucinations have a major impact on patients' lives, they have been undervalued and understudied in the literature. We report a case of a 79-year-old woman with musical hallucination (hearing a sung National anthem) without cognitive impairment or hearing loss. The patient had preserved insight of her complaint and responded well to neuroleptics.

scholarly journals Spinal Tuberculosis with Paraplegia in Pregnancy: a Case Report with Management of Spinal TB in Pregnancy

2015 ◽  
Vol 53 (198) ◽  
pp. 123-125
Author(s):  
Sushruti Kaushal ◽  
Santosh Kumar Dora ◽  
Sunil Thakur
Keyword(s):  
Case Report ◽  
Surgical Intervention ◽  
Spinal Tuberculosis ◽  
Neurological Status ◽  
Term Infant ◽  
Therapeutic Challenge ◽  
Healthy Term Infant ◽  
Mother And Child ◽  
In Pregnancy

Spinal tuberculosis leading to paraplegia is uncommon in pregnancy and is a diagnostic and therapeutic challenge. We report a case of tubercular paraplegia presenting at 35 weeks of gestation. She was managed with Anti-tubercular drugs and did not require surgical intervention. Her neurological status improved and she was allowed to go in labour. She delivered a healthy term infant by cesarean. At three months follow-up, both mother and child are doing well.  Keywords: paraplegia; pregnancy; spinal tuberculosis.

scholarly journals Tuberculosis of the Left Calcaneum and Collapsed Right Femoral Head: A Case Report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Joël Bizimanasharale Bikoroti ◽  
Alex Mathias Buteera ◽  
Felix Manirakiza ◽  
Louise Munezero ◽  
Josué Nzarora ◽  
...  
Keyword(s):  
Case Report ◽  
Staining Technique ◽  
University Teaching ◽  
Common Diagnosis ◽  
High Incidence ◽  
Clinical Conditions ◽  
Work Up ◽  
Suspicion Index ◽  
Rule Out

Introduction: Tuberculosis (TB), one of the oldest diseases known to affect humans, is caused by the bacteria Mycobacterium tuberculosis. The disease usually affects the lungs, although, in up to one-third of cases, other organs are involved. TB of the bone mimics other clinical conditions such as chronic osteomyelitis, Madura mycosis and actinomycosis. Case Report: A fifth child and last-born girl, in a family of living four children, aged 9 years, consulted Kigali University Teaching Hospital (CHUK) on December 7, 2017, from Kibuye Referral Hospital (Western of Rwanda) for ulcerated, infected left heel with swollen foot 4 months before our consultation. Physical examination revealed a patient with swollen and tender foot discharging serous bloody fluids accompanied by inability to stand with a painful right hip. Small left inguinal lymph nodes were present. Blood work-up, computed tomography scan of the left foot, and an incisional biopsy at the level of the left calcaneus were performed and revealed extrapulmonary TB. The histopathological features for TB were scanty, but the high index suspicion of possible extrapulmonary TB led to the confirmation of the diagnosis using auramine-rhodamine special stain. Anti-TB therapy for 12 months course was initiated and the monthly follow-up for 11 months was done. Conclusion: Although calcaneal TB is very rare, in countries with high incidence of TB, clinicians must have a high suspicion index and skeletal TB must be included in differential diagnosis of bone masses whenever possible bone mass biopsy and special staining technique in addition to most common diagnosis means should be done to rule out the possibility of bone TB. Keywords: Calcaneus, tuberculosis, Rwanda.

Ectopia Cordis Sternal Cleft Repair With Mandibular Distractors: A Follow-Up Case Report

2021 ◽  
pp. 215013512097895
Author(s):  
Bharadwaj Sandeep ◽  
Frank A. Vicari ◽  
Carl L. Backer ◽  
Osama Eltayeb
Keyword(s):  
Case Report ◽  
Hemodynamic Instability ◽  
Ectopia Cordis ◽  
Sternal Closure ◽  
Sternal Cleft ◽  
Novel Approach

A neonate with thoracic ectopia cordis presented following an uncomplicated delivery. A mandibular distractor was placed to bridge the sternal cleft and retracted (reverse distractor activation) over 24 days to facilitate sternal closure. Follow-up at five years postoperatively demonstrated a well-healed sternum. This novel approach to ectopia cordis repair facilitates slow, steady physiologic accommodation of the heart without hemodynamic instability or long-term complications.

Intensive Stuttering Therapy With Telepractice Follow-up: A Case Study

2011 ◽  
Vol 21 (1) ◽  
pp. 11-21 ◽  
Author(s):  
Farzan Irani ◽  
Rodney Gabel
Keyword(s):  
Case Report ◽  
Therapeutic Intervention ◽  
Intensive Therapy ◽  
Positive Outcome ◽  
Eclectic Approach

This case report describes the positive outcome of a therapeutic intervention that integrated an intensive, residential component with follow-up telepractice for a 21 year old male who stutters. This therapy utilized an eclectic approach to intensive therapy in conjunction with a 12-month follow-up via video telepractice. The results indicated that the client benefited from the program as demonstrated by a reduction in percent stuttered syllables, a reduction in stuttering severity, and a change in attitudes and feelings related to stuttering and speaking.

Immunologic Studies of Antithrombin III Heparin Cofactor in the Newborn

1978 ◽  
Vol 39 (03) ◽  
pp. 624-630 ◽  
Author(s):  
W E Hathaway ◽  
L L Neumann ◽  
C A Borden ◽  
L J Jacobson
Keyword(s):  
Gestational Age ◽  
Antithrombin Iii ◽  
Newborn Infants ◽  
Term Infant ◽  
Sick Newborn ◽  
At Iii ◽  
Thrombotic Complications ◽  
Low Levels ◽  
Collection Methods ◽  
Made In

SummarySerial quantitative immunoelectrophoretic (IE) measurements of antithrombin III heparin cofactor (AT III) were made in groups of well and sick newborn infants classified by gestational age. Collection methods (venous vs. capillary) did not influence the results; serum IE measurements were comparable to AT III activity by a clotting method. AT III is gestational age-dependent, increasing from 28.7% of normal adult values at 28-32 weeks to 50.9% at 37-40 weeks, and shows a gradual increase to term infant levels (57.4%) by 3-4 weeks of age. Infants with the respiratory distress syndrome (RDS) show lower levels of AT III in the 33-36 week group, 22% vs. 44% and in the 37-40 week group, 33.6% vs. 50.9%, than prematures without RDS. Infants of 28-32 week gestational age had only slight differences, RDS = 24%, non-RDS = 28.7%. The lowest levels of AT III were seen in patients with RDS complicated by disseminated intravascular coagulation and those with necrotizing enterocolitis. Crossed IE on representative infants displayed a consistent pattern which was identical to adult controls except for appropriate decreases in the amplitude of the peaks. The thrombotic complications seen in the sick preterm infant may be related to the low levels of AT III.

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