Norepinephrine-Induced Peripheral Ischemia Leading to Gangrene: A Case Series

2021 ◽  
Vol 34 (5) ◽  
pp. 273-277
Author(s):  
Michael Wilson ◽  
Kristin Schafer ◽  
Eric Goldschmidt ◽  
Benita Wu ◽  
Richard Simman
Keyword(s):  
Case Series ◽  
Peripheral Ischemia

Retinal Manifestations of Incontinentia Pigmenti: A Case Series of 14 Patients Highlighting the Importance of Intravenous Fluorescein Angiography and the Benefits of Early Laser Photocoagulation

2020 ◽  
pp. 247412642096264
Author(s):  
Jaimie Bryan ◽  
Reda Issa ◽  
Benjamin Bakall ◽  
Matthew Welch ◽  
J. Shepard Bryan
Keyword(s):  
Fluorescein Angiography ◽  
Laser Photocoagulation ◽  
Vision Loss ◽  
Case Series ◽  
Vitreoretinal Surgery ◽  
Vitreous Hemorrhage ◽  
Fundus Photography ◽  
Incontinentia Pigmenti ◽  
Peripheral Ischemia ◽  
Fundus Photographs

Purpose: This case series describes the nature and frequency of retinal manifestations in patients with incontinentia pigmenti (IP). Methods: This is a retrospective single-center case series of all known patients with IP who presented to Associated Retina Consultants (Phoenix, AZ) between May 2016 and April 2019. Twenty-eight eyes of 14 patients with a dermatologic diagnosis of IP were included (n = 28). Most patients underwent examination under anesthesia with fundus photographs and intravenous fluorescein angiography (IVFA). Results: Of the 28 eyes, 8 (28.6%) had abnormal retinal findings on fundus examination. Of the 26 eyes that had IVFA, 10 (38.5%) had abnormal findings: Seven eyes (26.9%) had peripheral ischemia, 2 (7.7%) had previous peripheral laser scarring, and 2 (7.7%) had active peripheral neovascularization. Three eyes with normal examination results were found to have mild ischemia by IVFA. Patients with ischemia confirmed by IVFA were treated with laser photocoagulation. During follow-up, 4 previously treated eyes received additional laser photocoagulation. No patients showed vision loss, vitreous hemorrhage, retinal detachment, or adverse effects of treatment. No patients required vitreoretinal surgery. Conclusions: IP is a potentially blinding disease. Our case series demonstrates the efficacy of early treatment and the importance of ancillary testing with IVFA and fundus photography.

Palliative Use of Nitroglycerin to Improve Microvascular Circulation

2019 ◽  
Vol 35 (2) ◽  
pp. 75-77
Author(s):  
Rose K. McGahan ◽  
Ellin F. Gafford ◽  
Bryan A. Whitson ◽  
Thomas J. Papadimos ◽  
Ravi S. Tripathi
Keyword(s):  
Case Series ◽  
Intravenous Nitroglycerin ◽  
Comfort Care ◽  
Case Presentation ◽  
Grieving Process ◽  
Peripheral Ischemia ◽  
Digital Ischemia ◽  
Physical Interactions ◽  
Physical Changes ◽  
Vasopressor Use

Background: In the setting of critical illness, life preservation may come at the expense of limb as increasing concentration of vasopressors causes peripheral ischemia. When goals of care specify comfort measures, clinicians are faced with the difficult task of mitigating already present distal malperfusion while abiding to wishes of patient and patients’ families. Physical changes post vasopressor use, such as mottling of appendages or cooling of skin, can limit meaningful physical interactions with grieving family members. Case Presentation: We describe a case series of successful utilization of intravenous nitroglycerin to improve postvasopressor digital ischemia for comfort care measures to assist patient’s families in the grieving process. Conclusion: Following decision for comfort care measures, management for patient care goes beyond the realm of pain control. Dignified dying is an active process that requires clinicians to navigate care for both patient and patients’ families. By reversing the digital ischemia associated with vasopressors, patients’ families have the opportunity to give meaningful touch in setting of which it may be needed most.

Conserved regression patterns of retinopathy of prematurity after intravitreal ranibizumab: A class effect

2020 ◽  
pp. 112067212094510
Author(s):  
Marco H Ji ◽  
Darius M Moshfeghi ◽  
Ryan A Shields ◽  
Zachary Bodnar ◽  
Cassie A Ludwig ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Case Series ◽  
Intravitreal Bevacizumab ◽  
Class Effect ◽  
Intravitreal Ranibizumab ◽  
Retrospective Case ◽  
Avascular Area ◽  
Peripheral Ischemia ◽  
Stage Disease ◽  
Postmenstrual Age

Purpose: To determine if fluorescein angiographic (FA) findings after intravitreal ranibizumab (IVR) for retinopathy of prematurity (ROP) conform to a class effect previously described with bevacizumab. Methods: Single-center retrospective case series of all infants treated with 0.2 mg (0.02 mL) IVR for Type 1 ROP from July 2016 to November 2018. FA were obtained at 40, 52, 62, and 72 weeks of postmenstrual age (PMA) using wide-angle photography. FA images were analyzed and the peripheral avascular areas measured with ImageJ using a reference disc diameter (DD). Based on the extent of the avascular area and tortuosity of the retinal vessels all eyes were classified into four categories: complete vascular maturity (vascularization within 2 DD of the ora serrata), VAA (avascular area >2 DD of the ora serrata), VAT (avascular area >2 DD of the ora serrata and posterior tortuosity), and reactivation (recurrence of stage disease). Results: About 13 infants were enrolled and 24 eyes were available in this study. None of the eyes reached complete vascular maturity at an average PMA of 60 weeks, 7 (29%) eyes presented with VAA, 8 (33%) with VAT, and 9 (37.5%) reactivated. The reactivated eyes presented with the largest area of peripheral ischemia, followed by the VAT and then the VAA groups ( p = 0.02). Conclusion: IVR conforms to the previously described regression patterns following intravitreal bevacizumab for ROP indicative of a class effect. Follow-up using FA might help to optimize the management of these infants after injection of the drug.

Abstract #856 A Case Series Review of Clinical and Biochemical Characteristics of Pituitary Abcess in Mexican Patients

2018 ◽  
Vol 24 ◽  
pp. 202-203
Author(s):  
Mireya Perez-Guzman ◽  
Alfredo Nava de la Vega ◽  
Arturo Pena Velarde ◽  
Tania Raisha Torres Victoria ◽  
Froylan Martinez-Sanchez ◽  
...  
Keyword(s):  
Case Series ◽  
Biochemical Characteristics ◽  
Mexican Patients

Cannabis-associated arteritis

VASA ◽  
2010 ◽  
Vol 39 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Grotenhermen
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Cardiovascular Effects ◽  
Causative Factor ◽  
Cannabis Use ◽  
Thromboangiitis Obliterans ◽  
Pathological Features ◽  
Scientific Support ◽  
Clinical And Pathological Features

Background: To investigate the hypothesis that cases of arteritis similar to thromboangiitis obliterans (TAO) and associated with the use of cannabis were caused by cannabis or THC (dronabinol), or that cannabis use is a co-factor of TAO. Patients and methods: A systematic review on case reports and the literature on so-called cannabis arteritis, TAO, and cardiovascular effects of cannabinoids was conducted. Results: Fifteen reports with 57 cases of an arteritis associated with the use of cannabis and two additional case series of TAO, in which some patients also used cannabis, were identified. Clinical and pathological features of cannabis-associated arteritis do not differ from TAO and the major risk factor of TAO, tobacco use, was present in most, if not in all of these cases. The proposed pathophysiological mechanisms for the development of an arteritis by cannabis use are not substantiated. Conclusions: The hypothesis of cannabis being a causative factor or co-factor of TAO or an arteritis similar to TAO is not supported by the available evidence. The use of the term “cannabis arteritis” should be avoided until or unless more convincing scientific support is forthcoming.

Propranolol Weakens Trauma-Related Psychophysiological Arousal: A Case Series

2009 ◽  
Author(s):  
Emilie Thomas ◽  
Joaquin Poundja ◽  
Alain Brunet ◽  
Jacques Tremblay
Keyword(s):  
Case Series ◽  
Psychophysiological Arousal
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