Blunt gastric rupture: a plural clinical presentation and literature review

2021 ◽  
Vol 14 (6) ◽  
pp. e239942
Author(s):  
Bruno Maltese Zuffo ◽  
Pedro Souza Lucarelli-Antunes ◽  
Luca Giovanni Antonio Pivetta ◽  
José Cesar Assef
Keyword(s):  
Clinical Presentation ◽  
Clinical Suspicion ◽  
Medical Community ◽  
Gastric Injury ◽  
Therapeutic Approaches ◽  
Essential Step ◽  
Gastric Rupture ◽  
Rare Lesion ◽  
Low Incidence ◽  
Mechanism Of Trauma

Blunt trauma is still the leading mechanism of trauma found in patients admitted to trauma centres worldwide. In these patients, the gastric injury is a very rare lesion, occurring in less than 2% of all blunt traumas. Besides the low incidence, gastric rupture mortality is high, which makes the diagnosis an essential step. Thus, this study aims to report two blunt gastric injuries, with different clinical features, prompting the discussion about the main features of clinical suspicion and diagnosis, besides the main therapeutic approaches. Therefore, this study can alert the medical community to the quick diagnosis and assertive therapy, saving patients of unwelcome endpoints.

scholarly journals Parotid gland tuberculosis-presentation of 4 case variants

2021 ◽  
Vol 8 (3) ◽  
pp. 984
Author(s):  
Samir Paruthy ◽  
Shivani B. Paruthy
Keyword(s):  
Parotid Gland ◽  
Clinical Presentation ◽  
Pulmonary Involvement ◽  
Clinical Suspicion ◽  
Treatment Modalities ◽  
Residual Deformity ◽  
Diagnostic Dilemma ◽  
Parotid Neoplasm ◽  
Low Incidence ◽  
Anti Tubercular Therapy

Pulmonary tuberculosis is a necrotizing granulomatous disease with diverse presentation. Nevertheless, extra pulmonary involvement although rare even in endemic regions, is associated with diagnostic dilemma for confirmation and treatment modalities. Contextually, parotid gland tuberculosis is a rare surgical presentation because of nonspecific signs, symptoms and allegedly low incidence; it is often misdiagnosed as parotid neoplasm, and therefore remains a diagnostic paradox. However, clinical suspicion alongside pathological evidence and imaging helps in diagnosing indecisive questionable cases. We present 4 cases of parotid tuberculosis each with different clinical presentation along with clinical suspicion and pathological diagnosis. Parotid tuberculosis is a rare clinical entity and completely curable by category-I anti-tubercular therapy. It has no residual deformity if diagnosed timely followed by conservative treatment management.

Alteraciones sistémicas y metabólicas producidas por lesión medular

2019 ◽  
Vol 1 (1) ◽  
pp. 59-75
Author(s):  
Gabriel Guízar Sahagún
Keyword(s):  
Spinal Cord ◽  
Daily Living ◽  
Autonomic Function ◽  
Clinical Presentation ◽  
Scientific Literature ◽  
International Standards ◽  
Therapeutic Approaches ◽  
Cord Injury ◽  
Life Threatening ◽  
The Impact

Besides the well-known loss of motor and sensory capabilities, people with spinal cord injury (SCI) experience a broad range of systemic and metabolic abnormalities including, among others, dysfunction of cardiovascular, respiratory, gastrointestinal, urinary, and endocrine systems. These alterations are a significant challenge for patients with SCI because such disorders severely interfere with their daily living and can be potentially life-threatening. Most of these disorders are associated with impairment of regulation of the autonomic nervous system, arising from disruption of connections between higher brain centers and the spinal cord caudal to the injured zone. Thus, the higher and more complete the lesion, the greater the autonomic dysfunction and the severity of complications.This article summarizes the medical scientific literature on key systemic and metabolic alterations derived of SCI. It provides information primarily focused on the pathophysiology and clinical presentation of these disorders, as well as some guides to prevent and alleviate such complications. Due to the impact of these alterations, this topic must be a priority and diffuse to those involved with the care of people with SCI, including the patient himself/herself. We consider that any collaborative effort should be supported, like the development of international standards, to evaluate autonomic function after SCI, as well as the development of novel therapeutic approaches.

scholarly journals Enucleation of a giant symptomatic gastric lipoma, a safe surgical approach

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Rafaela Parreira ◽  
Tiago Rama ◽  
Teresa Eloi ◽  
Vítor Carneiro ◽  
Maria Inês Leite
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Clinical Presentation ◽  
Pyloric Obstruction ◽  
Asymptomatic Patients ◽  
Recurrent Vomiting ◽  
Low Incidence ◽  
Diagnostic Modalities ◽  
Benign Tumours ◽  
Gastric Lipoma

Abstract Gastric lipomas are rare, representing 2–3% of all benign tumours of the stomach. Most of these stomach neoplasms are small and detected incidentally during endoscopic or radiology evaluations. Computed tomography is highly specific imaging for lipoma diagnosis. Endoscopy and endoscopic ultrasound are other important diagnostic modalities to confirm the diagnosis. Identifying typical features can avoid biopsy or surgery in asymptomatic patients. In patients with larger lesions, usually more than 2 cm, clinical presentation may encompass haemorrhage, abdominal pain, pyloric obstruction and dyspepsia. As a result of its extreme low incidence, treatment is not standardized, though it is widely accepted that a symptomatic tumour mandates resection. Here, we present the case of a 60-year-old female presenting with abdominal pain and recurrent vomiting due to a giant gastric lipoma (80 × 35 × 35 mm). The patient underwent laparotomy and an enucleation was performed.

scholarly journals Chronic Inflammation and Radiation-Induced Cystitis: Molecular Background and Therapeutic Perspectives

Cells ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 21
Author(s):  
Carole Helissey ◽  
Sophie Cavallero ◽  
Clément Brossard ◽  
Marie Dusaud ◽  
Cyrus Chargari ◽  
...  
Keyword(s):  
Stromal Cells ◽  
Therapeutic Strategy ◽  
Randomized Trials ◽  
Clinical Presentation ◽  
Therapeutic Approaches ◽  
Radiation Cystitis ◽  
Fibrotic Process ◽  
Radiation Induced ◽  
Therapeutic Irradiation ◽  
Underlying Pathophysiology

Radiation cystitis is a potential complication following the therapeutic irradiation of pelvic cancers. Its clinical management remains unclear, and few preclinical data are available on its underlying pathophysiology. The therapeutic strategy is difficult to establish because few prospective and randomized trials are available. In this review, we report on the clinical presentation and pathophysiology of radiation cystitis. Then we discuss potential therapeutic approaches, with a focus on the immunopathological processes underlying the onset of radiation cystitis, including the fibrotic process. Potential therapeutic avenues for therapeutic modulation will be highlighted, with a focus on the interaction between mesenchymal stromal cells and macrophages for the prevention and treatment of radiation cystitis.

Schwannomas of the Nose and Paranasal Sinuses

1993 ◽  
Vol 7 (2) ◽  
pp. 59-65 ◽  
Author(s):  
John R. Wanamaker ◽  
Hayes H. Wanamaker ◽  
Bernard Kotton ◽  
Greg D. Akers ◽  
Pierre Lavertu
Keyword(s):  
Paranasal Sinuses ◽  
Clinical Presentation ◽  
Clinical Course ◽  
Diagnostic Techniques ◽  
Therapeutic Approaches ◽  
Management Philosophy ◽  
Nose And Paranasal Sinuses ◽  
Therapeutic Tools ◽  
Diagnostic Work ◽  
Work Up

Schwannomas are benign neoplasms arising from the peripheral nerve sheath. The sinonasal tract is an unusual location for these neoplasms. Because of their rarity, few series have been reported. Five previously unreported cases of schwannomas of the nose and paranasal sinuses are presented that illustrate the spectrum of disease. The clinical presentation, diagnostic work-up, clinical course, and diverse therapeutic approaches will be discussed. A management philosophy based on the diversity of these tumors and their clinical behavior, and incorporating the new diagnostic and therapeutic tools available to the clinician will be presented. The implications of newer diagnostic techniques including sinonasal endoscopy, magnetic resonance imaging, and immuno-chemistry in the diagnosis and treatment of these tumors will be discussed.

Clinical and pharmacological rationale for principles of therapy for bacterial vaginosis

2021 ◽  
Vol 20 (3) ◽  
pp. 134-145
Author(s):  
N.B. Lazareva ◽  
◽  
E.V. Rebrova ◽  
A.Yu. Ryazanova ◽  
E.V. Shikh ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Metabolic Pathways ◽  
Disease Recurrence ◽  
Gardnerella Vaginalis ◽  
Adherence To Treatment ◽  
Therapeutic Approaches ◽  
New Therapeutic Approaches ◽  
Structural Differences ◽  
Single Use ◽  
Low Incidence

Metronidazole and clindamycin have been the main medications for the treatment of bacterial vaginosis (BV) for 60 years. Despite the available arsenal of therapeutic agents, the frequency of disease recurrence remains high, and therefore the search for new therapeutic approaches remains relevant. In 2017, the FDA (Food and Drug Administration, USA) approved the use of secnidazole for the treatment of BV. As a member of the 5-nitroimidazole group, secnidazole differs structurally from metronidazole and tinidazole by radical groups attached to the annular nitrogen next to the nitro group. Structural differences may explain physicochemical and biochemical differences (e.g., tissue distribution, metabolic pathways) between these agents within the same pharmacological class of 5-nitroimidazoles. Secnidazole has the longest half-life compared to other medications in this group, which can significantly increase adherence to treatment, due to the possibility of achieving a clinical effect after a single use and a low incidence of adverse drug reactions, comparable to placebo. Key words: bacterial vaginosis, gardnerella vaginalis, lactobacilli, metronidazole, secnidazole

scholarly journals Treatment of infant leukemias: challenge and promise

Hematology ◽  
2013 ◽  
Vol 2013 (1) ◽  
pp. 596-600 ◽  
Author(s):  
Patrick Brown
Keyword(s):  
High Frequency ◽  
Clinical Presentation ◽  
State Of The Art ◽  
Poor Response ◽  
Cooperative Groups ◽  
Therapeutic Approaches ◽  
Unique Biology ◽  
Current Therapies ◽  
Epidemiologic Features ◽  
Infant Leukemia

Abstract Leukemia in infants is rare but generates tremendous interest due to its aggressive clinical presentation in a uniquely vulnerable host, its poor response to current therapies, and its unique biology that is increasingly pointing the way toward novel therapeutic approaches. This review highlights the key clinical, pathologic, and epidemiologic features of infant leukemia, including the high frequency of mixed lineage leukemia (MLL) gene rearrangements. The state of the art with regard to current approaches to risk stratified treatment of infant leukemia in the major international cooperative groups is discussed. Finally, exciting recent discoveries elucidating the molecular biology of infant leukemia are reviewed and novel targeted therapeutic strategies, including FLT3 inhibition and modulation of aberrant epigenetic programs, are suggested.

scholarly journals Iron metabolismin conditions of infection. Review

2020 ◽  
pp. 90-99
Author(s):  
Yuriy P. Orlov ◽  
N. V Govorova ◽  
V. N Lukach ◽  
G. A Baitugaeva ◽  
A. V Klementyev ◽  
...  
Keyword(s):  
Fungal Pathogens ◽  
Medical Literature ◽  
Bacterial Flora ◽  
Medical Community ◽  
Therapeutic Approaches ◽  
Iron Supply ◽  
Review Analysis ◽  
The Relationship ◽  
Iron Exchange

The purpose of writing the review. Analysis of publications on the role of iron metabolism in the manifestation of the septic process and the dependence of bacterial flora activity on the conditions of their access to iron. Methods. More than 200 publications in pubmed, Medline, EMBASE medical literature databases were analyzed between 2000 and 2018 using the search words: iron and infection, iron and sepsis, iron exchange, iron and bacteria - including and available works in domestic (e-library) literature. Results. The review uses materials from 61 publications that meet the challenges of the search and reflect both the relationship between iron exchange and the development of the septic process and the importance for the medical community of understanding the identified relationships in the search for future therapeutic approaches. Conclusion. The review provides evidence of direct iron involvement in the manifestation of the septic process caused by various bacterial (q/-) and fungal flora. Introduction of iron-hesing agents and ciderophon - conjugate drugs to infected patients today seems to be a biologically acceptable approach as an auxiliary therapy in the treatment of septic process caused by pathogens dependent on iron supply (many bacterial and fungal pathogens), but the problem that is being raised certainly requires further experimental and clinical research.

scholarly journals Clinical presentation, demographics and outcome of Tuberculosis (TB) in a low incidence area: a 4-year study in Geneva, Switzerland

2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Omar Kherad ◽  
François R Herrmann ◽  
Jean-Pierre Zellweger ◽  
Thierry Rochat ◽  
Jean-Paul Janssens
Keyword(s):  
Clinical Presentation ◽  
Low Incidence

scholarly journals Cerebellar Infarction — Review of Recent Experiences

1980 ◽  
Vol 7 (2) ◽  
pp. 97-99 ◽  
Author(s):  
W.B. Woodhurst
Keyword(s):  
Clinical Presentation ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical Syndrome ◽  
Clinical Suspicion ◽  
Cerebellar Infarction ◽  
Tissue Mass ◽  
Clinical Signs And Symptoms ◽  
High Level ◽  
Infarcted Tissue

SUMMARY:Six cases of acute cerebellar infarction seen on a neurosurgery service in a general hospital during a twenty-six month period are reviewed. The clinical presentation, course, and treatment are presented and discussed. This is an important clinical syndrome which requires a high level of clinical suspicion for detection. The diagnosis rests primarily upon the clinical signs and symptoms. The C.T. Scan may provide useful confirmatory evidence and clarifies the differential diagnosis. Surgial treatment by resection of the infarcted tissue — mass lesion is urgently required for those patients who deteriorate progressively.

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