scholarly journals Management of Severe Epistaxis during Pregnancy: A Case Report and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Maria Grazia Piccioni ◽  
Martina Derme ◽  
Laura Salerno ◽  
Elisa Morrocchi ◽  
Francesco Pecorini ◽  
...  
Keyword(s):  
Pregnant Patient ◽  
Emergency Caesarean Section ◽  
Severe Anemia ◽  
Review Of The Literature ◽  
First Line ◽  
Management Options ◽  
Normal Ranges ◽  
Severe Epistaxis ◽  
Nasal Bleeding ◽  
Clinical Worsening

Background. Epistaxis is a common problem during pregnancy. Few cases of severe epistaxis, not associated with nasal lesions or clotting disorders, were described in the literature. We reported a case of severe epistaxis in a pregnant patient, exploring all the different possible management options.Case. A 33-year-old primigravida, who was 38 weeks pregnant, presented with spontaneous severe left-sided epistaxis. Her blood pressure was into normal ranges. Clotting disorders and nasal lesions were excluded. The patient clinical worsening, due to severe anemia, and the failure of conservative treatment have imposed an emergency caesarean section, with an immediate resolution of the nasal bleeding.Conclusion. Treatment of severe epistaxis must always consider conservative measures first-line with early recourse to otolaryngologist. In general, delivery of the fetus is considered curative.

Social Representations and Commitment

2018 ◽  
Vol 23 (3) ◽  
pp. 233-249 ◽  
Author(s):  
Eric Bonetto ◽  
Fabien Girandola ◽  
Grégory Lo Monaco
Keyword(s):  
Social Representations ◽  
Social Representation ◽  
Second Line ◽  
Review Of The Literature ◽  
First Line ◽  
Research Perspectives ◽  
The Social ◽  
Bibliographic Search ◽  
English Articles

Abstract. This contribution consists of a critical review of the literature about the articulation of two traditionally separated theoretical fields: social representations and commitment. Besides consulting various works and communications, a bibliographic search was carried out (between February and December, 2016) on various databases using the keywords “commitment” and “social representation,” in the singular and in the plural, in French and in English. Articles published in English or in French, that explicitly made reference to both terms, were included. The relations between commitment and social representations are approached according to two approaches or complementary lines. The first line follows the role of commitment in the representational dynamics: how can commitment transform the representations? This articulation gathers most of the work on the topic. The second line envisages the social representations as determinants of commitment procedures: how can these representations influence the effects of commitment procedures? This literature review will identify unexploited tracks, as well as research perspectives for both areas of research.

Isotretinoin induced nail fold pyogenic granuloma resolution with combination therapy: A case report and review of the literature

2019 ◽  
Vol 3 (4) ◽  
pp. 275-278
Author(s):  
Jonathan Bellew ◽  
Chad Taylor ◽  
Jaldeep Daulat ◽  
Vernon Mackey
Keyword(s):  
Pyogenic Granuloma ◽  
Causative Factor ◽  
Adolescent Male ◽  
Review Of The Literature ◽  
First Line ◽  
Healthy Adolescent ◽  
Therapeutic Modalities ◽  
Children And Young Adults ◽  
Intralesional Steroids ◽  
Isotretinoin Therapy

Pyogenic granulomas are vascular hyperplasias presenting as red papules, polyps, or nodules on the gingiva, fingers, lips, face and tongue of children and young adults.  Most commonly they are associated with trauma, but systemic retinoids have rarely been implicated as a causative factor in their appearance.  We present a case of spontaneous eruption of multiple pyogenic granulomas of the bilateral periungal fingers in an otherwise healthy adolescent male undergoing isotretinoin therapy for severe nodulocystic acne. These pyogenic granulomas did not resolve spontaneously with discontinuation of isotretinoin, or first line therapeutic modalities. Their resolution did occur with administration of intralesional steroids and ablation with silver nitrate.

Delayed leukoencephalopathy from suspected polymer embolism after neuroendovascular procedures

2021 ◽  
pp. 197140092110291
Author(s):  
Thomas Mellemkjær ◽  
Ronil V Chandra ◽  
Lasse Speiser ◽  
Benedicte P Ulhøi ◽  
Claus Z Simonsen
Keyword(s):  
Polymer Material ◽  
Endovascular Procedures ◽  
Rare Complication ◽  
Diagnostic Process ◽  
Line Treatment ◽  
Review Of The Literature ◽  
First Line ◽  
Stroke Treatment ◽  
Oral Glucocorticoids ◽  
First Line Treatment

As the neurointervention field grows, a new side effect emerges. Delayed leukoencephalopathy (DL) is believed to be an inflammatory or allergic reaction to polymer material that is shed from catheters during endovascular procedures. We present four cases of DL after aneurysm treatment in two patients, endovascular stroke treatment and diagnostic arteriography. We present our diagnostic process, including biopsy results in two patients, our anti-inflammatory treatment and outcomes together with a review of the literature. In our series, prognosis was variable with ongoing seizures in two patients. Our literature review reveals that asymptomatic shedding of polymer material is common, occurring in a third of endovascular stroke procedures, whereas symptomatic DL occurs in <0.5% of therapeutic neuroendovascular procedures. Clinicians should be aware of this rare complication, and oral glucocorticoids seem to be a reasonable first-line treatment strategy.

scholarly journals Impact of COVID-19 on management of urogynaecology patients: a rapid review of the literature

2021 ◽  
Author(s):  
Jemina Loganathan ◽  
◽  
Stergios K. Doumouchtsis
Keyword(s):  
Evidence Synthesis ◽  
Horizontal Transmission ◽  
Rapid Review ◽  
Review Of The Literature ◽  
First Line ◽  
Face To Face ◽  
Manual Search ◽  
Guidance Documents ◽  
Management Recommendations

Abstract Introduction and hypothesis The coronavirus (COVID-19) pandemic has impacted health systems worldwide. There is a continuing need for clinicians to adapt practice to facilitate timely provision of medical care, whilst minimising horizontal transmission. Guidance and recommendations are increasingly available, and this rapid review aimed to provide a timely evidence synthesis on the current recommendations surrounding urogynaecological care. Methods We performed a literature review using PubMed/Medline, Embase and Cochrane and a manual search of national and international societies for management recommendations for urogynaecological patients during the COVID-19 pandemic. Results Nine guidance documents and 17 articles, including 10 reviews, were included. Virtual clinics are recommended for new and follow-up patients, to assess and initiate treatment, as well as triage patients who require face-to-face appointments. Outpatient investigations such as urodynamics and cystoscopy for benign indications can be deferred. Prolapse and continence surgery should be suspended, except in specific circumstances such as procidentia with upper tract complications and failed pessaries. There is no evidence to support a particular route of surgery, but recommendations are made to minimise COVID-19 transmission. Conclusions Urogynaecological patients face particular challenges owing to inherent vulnerabilities of these populations. Behavioural and medical therapies should be recommended as first line options and initiated via virtual or remote clinics, which are integral to management during the COVID-19 pandemic. Expanding the availability and accessibility of technology will be increasingly required. The majority of outpatient and inpatient procedures can be deferred, but the longer-term effects of such practices are unclear.

The FHM1 Mutation S218L: A Severe Clinical Phenotype? A Case Report and Review of the Literature

Cephalalgia ◽  
2009 ◽  
Vol 29 (12) ◽  
pp. 1337-1339 ◽  
Author(s):  
S Debiais ◽  
C Hommet ◽  
I Bonnaud ◽  
MA Barthez ◽  
S Rimbaux ◽  
...  
Keyword(s):  
Autosomal Dominant ◽  
Cerebral Oedema ◽  
Clinical Phenotype ◽  
Pregnant Patient ◽  
Familial Hemiplegic Migraine ◽  
Review Of The Literature ◽  
Severe Phenotype ◽  
Hemiplegic Migraine ◽  
Motor Weakness ◽  
Cacna1a Gene

Familial hemiplegic migraine (FHM) is a rare autosomal dominant subtype of migraine with aura that is characterized by motor weakness during attacks. FHM1 is associated with mutations in the CACNA1A gene located on chromosome 19. We report a severe, prolonged HM attack in a young pregnant patient who had the S218L FHM1. This CACNA1A mutation has been associated with HM, delayed cerebral oedema and coma following minor head trauma. The case history we report suggests a specific, severe phenotype and the co-occurrence of HM and epilepsy related to the S218L FHM1 mutation.

Migraine in a Pregnant Patient

2021 ◽  
pp. 179-186
Author(s):  
Sara C. LaHue ◽  
Morris Levin
Keyword(s):  
Pregnant Patient ◽  
Management Options ◽  
Good Management

The pregnant migraineur is often frustrated by the lack of safe therapies. Fortunately there are actually a number of good management options.

scholarly journals Parvovirus B19‐induced severe anemia in heart transplant recipients: Case report and review of the literature

2019 ◽  
Vol 33 (4) ◽  
pp. e13498 ◽  
Author(s):  
Natalia C. Pinto ◽  
Clarissa Newman ◽  
Carlos A. Gomez ◽  
Kiran K. Khush ◽  
Yasbanoo Moayedi ◽  
...  
Keyword(s):  
Case Report ◽  
Heart Transplant ◽  
Parvovirus B19 ◽  
Severe Anemia ◽  
Transplant Recipients ◽  
Review Of The Literature ◽  
Heart Transplant Recipients

scholarly journals Medical Cannabis Certification in a Large Pediatric Oncology Center

Children ◽  
2019 ◽  
Vol 6 (6) ◽  
pp. 79 ◽  
Author(s):  
Mary M. Skrypek ◽  
Bruce C. Bostrom ◽  
Anne E. Bendel
Keyword(s):  
Young Adult ◽  
Cancer Cachexia ◽  
Demographic Data ◽  
Review Of The Literature ◽  
Medical Cannabis ◽  
First Line ◽  
Young Adult Cancer ◽  
Young Adult Oncology ◽  
Age Range ◽  
Oncology Center

In Minnesota, medical cannabis was approved for use in 2014. From July 2015 to February 2019, our center certified 103 pediatric and young adult patients for the use of medical cannabis under the qualifying conditions of cancer and treatment-related symptoms. Here, we provide a review of the literature on medical cannabis use in pediatric and young adult cancer patients. We also provide demographic data on our patients certified for medical cannabis. The most common diagnoses were leukemia/lymphoma (36%), brain tumors (37%), and malignant solid tumors (26%). The most common indications were chemotherapy-related nausea, pain, and cancer cachexia. The age range at certification was 1.4–28.7 years (median 15.3 years). The time from cancer diagnosis to certification ranged from 0.5–197 months (median 8.9 months). The majority (94%) were certified during their first line of treatment. In the 32 patients who died from recurrent or progressive cancer, the time from certification to death was 1.3–30.3 months (median 4.4 years). Despite requesting certification, a subset (24%) never had medical cannabis dispensed. In our experience, pediatric and young adult oncology patients are interested in medical cannabis to help manage treatment-related symptoms. Ongoing analysis of this data will identify the therapeutic efficacy of medical cannabis.

scholarly journals Role of Carbamazepine in the Symptomatic Treatment of Subacute Sclerosing Panencephalitis: A Case Report and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Sandhya Ravikumar ◽  
John Ross Crawford
Keyword(s):  
Clinical Presentation ◽  
Vegetative State ◽  
Subacute Sclerosing Panencephalitis ◽  
Symptomatic Treatment ◽  
The United States ◽  
Review Of The Literature ◽  
First Line ◽  
Epileptiform Discharges ◽  
The Subject

We describe the clinical presentation and clinical course of subacute sclerosing panencephalitis in a 13-year-old previously healthy boy who recently immigrated to the United States from Iraq. He presented with macular retinopathy, followed by progressive myoclonus and encephalopathy. After extensive workup, a diagnosis of subacute sclerosing panencephalitis was suspected by the presence of period epileptiform discharges on electroencephalogram and confirmed by elevated measles titers in the cerebrospinal fluid. Combination immunomodulatory therapy with isoprinosine, ribavirin, and intra-Ommaya interferon alpha did not result in clinical improvement. Within days following the administration of carbamazepine, there was remarkable improvement in the myoclonus and he was able to ambulate independently for a period of 4 months at which time he unfortunately progressed to a vegetative state. This case highlights the importance of carbamazepine as a potential first line symptomatic treatment of subacute sclerosing panencephalitis and provides a review of the literature on the subject.

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