scholarly journals An Atypical Presentation of Sinonasal Tract Alveolar Rhabdomyosarcoma in a Young Male Patient Submitted to Multimodality Treatment

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Wilber E. Bernaola-Paredes ◽  
Sergio Leonardo Favareto ◽  
Valdener Bella Filho ◽  
Eloah Pascuotte Filippetti ◽  
Walkiria Pantoja Bellotto ◽  
...  
Keyword(s):  
Side Effects ◽  
Young Male ◽  
Multimodality Treatment ◽  
Sinonasal Tract ◽  
Locoregional Control ◽  
Histopathological Analysis ◽  
Atypical Presentation ◽  
Local Conditions ◽  
Early Management ◽  
Management Of Complications

Rhabdomyosarcoma (RMS), a malignant tumor derived from the neoplastic proliferation of striated skeletal muscle cells, is the most common pediatric soft tissue sarcoma. Its treatment is mainly based on neoadjuvant chemotherapy (QT+), surgical resection, and adjuvant radiotherapy (RT+). RT+ has shown satisfactory results for locoregional control of the disease, in spite of promoting local side effects. The present case report was aimed at describing the clinical and therapeutic characteristics and the management of complications resulting from multimodal therapy in a patient with an atypical presentation of RMS in the sinonasal tract. A 20-year-old Afro-descendant man complained of an expansive tumor lesion, with left eye proptosis that reduced visual acuity and caused severe regional pain. Imaging analysis showed an extensive and infiltrative lesion in the periorbital region, sinonasal tract, left maxilla, and orbital roof. According to the histopathological analysis, the diagnosis was established corresponding to parameningeal alveolar RMS that was unresectable. Treatment was initiated with three cycles of QT+ which showed partial response and later RT+. After completing half of the RT+ sessions, the patient showed a complete response with reduction in tumor volume and improvement in pain and local conditions. Side effects such as alopecia and dermatological changes induced by radiation were observed. Moreover, painful erythematous areas were observed in the region of the hard and soft palate, uvula, and oropharynx, compatible with Grade 2 mucositis lesions. After the cytological swab test, some of them were diagnosed as herpes simplex lesions; thickening and decrease in salivary flow were also found. A local drug therapy approach was instituted, and photobiomodulation was performed to manage oral complications. RT+ was shown to be effective in locoregional control of the disease; however, the early management of its undesirable effects on the surrounding tissues was required.

scholarly journals Lipoma in Penis : A Rare Case Report

2013 ◽  
Vol 3 (1) ◽  
pp. 24-25
Author(s):  
T Ahmed ◽  
MA Kalam ◽  
II Mannan ◽  
MA Simi
Keyword(s):  
Case Report ◽  
Plastic Surgery ◽  
Male Patient ◽  
Rare Case ◽  
Young Male ◽  
Histopathological Analysis ◽  
Review Of The Literature ◽  
Ventral Aspect ◽  
Rare Case Report ◽  
Pedunculated Tumor

In this article we report one case of lipoma of the penis in a twenty three years old young male. This site of lipoma is rare. A case of a young male patient who consulted for removal of a penile lump is presented. The small, regular, wellcircumscribed pedunculated tumor localized on the ventral aspect of the penis was excised. The histopathological analysis showed a benign lipoma. A review of the literature showed lipoma of the penis to be very uncommon. For this reason, we were prompted to report this case.DOI: http://dx.doi.org/10.3329/bdjps.v3i1.15003 Bangladesh Journal of Plastic Surgery 2012, 3(1): 24-25

A phase II trial of induction epirubicin, oxaliplatin, and flourouracil, surgery and post-operative concurrent cisplatin and fluorouracil chemoradiotherapy (CRT) in patients (pts) with loco-regionally advanced (LRA) adenocarcinoma (ACA) of the esophagus (E) and gastroesophageal junction (GEJ).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4087-4087
Author(s):  
Michael J. McNamara ◽  
Thomas W. Rice ◽  
Lisa A. Rybicki ◽  
Cristina P. Rodriguez ◽  
Gregory M. M. Videtic ◽  
...  
Keyword(s):  
Induction Chemotherapy ◽  
Phase Ii ◽  
Clinical Stage ◽  
Gastroesophageal Junction ◽  
Multimodality Treatment ◽  
Locoregional Control ◽  
Distant Failure ◽  
Viable Tumor ◽  
Kaplan Meier ◽  
Additional Chemotherapy

4087 Background: In pts with LRA ACA of the E/GEJ, CRT and surgery results in excellent locoregional control. Distant failure remains common, however, suggesting potential benefit from additional chemotherapy. This single arm phase II study investigated the addition of induction chemotherapy to surgery and post-operative CRT. Methods: Pts with an ultrasound-based clinical stage of T3, N1 or M1a (AJCC 6th) ACA of the E/GEJ were eligible. Induction chemotherapy with epirubicin 50mg/m2 d1, oxaliplatin 130mg/m2 d1, and flourouracil 200mg/m2/day continuous infusion for 3 weeks, was given every 21 days for 3 courses and was followed by surgical resection. Adjuvant CRT consisted of 50-55Gy at 1.8-2.0 Gy/d and 2 courses of cisplatin (20mg/m2/d) and flourouracil (1000mg/m2/d) given as 96 hour infusions during weeks 1 and 4 of radiotherapy. Results: Between 2/08 and 1/12, 60 evaluable pts enrolled; 95% male, 97% white and 78% with GEJ tumors. Resection was accomplished in 54 pts (90%) and adjuvant CRT in 48 (80%). Toxicity included 1 death during induction (2%), and 2 post-operative deaths (4%). Unplanned hospitalization was required in 18% of pts during induction and 19% during adjuvant CRT. Induction chemotherapy produced a symptomatic response in 79% of pts, a clinical (ultrasound) response in 48% and a pathologic response in 41% (5% complete). With a median follow-up of 31 months, the Kaplan-Meier 3-year projected locoregional control (LRC) is 84%, distant metastatic control (DMC) 44%, relapse-free survival (RFS) 39%, and overall survival (OS) 42%. Symptomatic response to induction and the percentage of remaining viable tumor at surgery proved the strongest predictors of DMC, RFS, and OS. Conclusions: Induction chemotherapy, surgery and adjuvant CRT is feasible and produces outcomes similar to other multimodality treatment schedules in LRA E/GEJ ACA. Despite excellent LRC, projected DMC and OS remain poor. A symptomatic response to induction and less residual viable tumor at surgery are associated with improved outcomes. Clinical trial information: NCT00601705.

scholarly journals Dermatological manifestations in PLHIV visiting link ART centre at rural medical college hospital in Western Tamilnadu, India

2017 ◽  
Vol 5 (3) ◽  
pp. 901
Author(s):  
Mohankumar Vedhanayagam ◽  
Rajesh Rajagopalan ◽  
Srinivasahan Karatupalyam Govindan ◽  
Balamurgan Bhavani Rajendran
Keyword(s):  
Side Effects ◽  
Highly Active Antiretroviral Therapy ◽  
Skin Diseases ◽  
Medical College Hospital ◽  
People Living With Hiv ◽  
College Hospital ◽  
Early Management ◽  
Medical College ◽  
Wide Range

Background: Ever since the early reports of human immuno deficiency infection, it presented as wide range of infectious and non-infectious dermatoses which correlate with the degree of immunodeficiency. Skin assessment remains a vital tool in the diagnosis and management of HIV infection due to relative easiness of examination. Most of skin diseases are amenable to diagnosis by inspection and biopsy. In this descriptive study, we have enumerated in detail the dermatological manifestations of Link ART centre clients.Methods: To analyze the dermatological manifestations in people living with HIV, we undertook a prospective observational study of all PLHIV on ART visiting IRT Perundurai Medical College Hospital link anti- retroviral therapy centre (LAC) during July 2015 to August 2016 with focus to skin manifestations.Results: Among the 140 clients, 22 in 2010, 12 in 2011, 6 in 2012, 51 in 2013, 36 in 2014, and 9 in 2015, 3 up to June 2016 enrolled for follow up. 31 were transferred to nearby ART, Link ART centres during this period as per their request, 4 lost for follow up and 6 deceased after enrolment, finally ninety-nine (39 male; 60 female) were utilizing our centre during the study period. Majority of participants were on ZLN (zidovudine, lamivudine, and nevirapine) regimen, hailing from rural zones, belonged to low or low middle income group, were undertaking farming, cattle rearing. CD4 counts of the asymptomatic clients in the ZLN group noted increase and decrease in the ZLE (zidovudine, lamivudine, and efavirenz), TLN (tenofovir, lamivudine, and nevirapine) group.  In the symptomatic clients, decline in the individual and the mean counts except in female ZLN subset. 70% were clinically asymptomatic and 30 % were having some dermatological manifestations. Multiple manifestations were seen in 5 clients during the study period. Dermatological manifestations observed commonly were fungal and viral infections, xerosis/ichthyoses, adverse drug reactions like lipodystrophy, and discoloration of nails.Conclusions: Skin manifestations observed in this study were due to aging and long term cosmetic side effects of highly active antiretroviral therapy  (HAART). Lipodystrophy posed significant aesthetic distress in HAART clients. Hence, early management would decrease the most offending cosmetolgical side effects of the disease and drugs. Therapy yields the declining trend in the inflammatory, infectious dermatoses.

scholarly journals Acute Small Gut Obstruction as an Atypical Presentation of Acute Appendicitis without Rupture or Perforation of the Appendix

2021 ◽  
Vol 39 (4) ◽  
pp. 261-265
Author(s):  
ABM Moniruddin ◽  
Salma Chowdhury ◽  
Tanvirul Hasan ◽  
Kazi Muhammad Mahmudul Hasan ◽  
- RounakJahan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Young Male ◽  
Recurrent Abdominal Pain ◽  
Acute Intestinal Obstruction ◽  
Atypical Presentation ◽  
Radiological Evaluation ◽  
Post Operative Period ◽  
History Of ◽  
Operative Findings

Acute appendicitis is a very common surgical emergency. It has got diverse presentations and various complications. Here, we report case history of a young male patient with a 2- year history of recurrent abdominal pain, who presented to our center with a 4-day history of increasing abdominal pain, constipation and vomiting. Clinical and radiological evaluation revealed it as a case of acute intestinal obstruction preoperatively. Per-operative findings suggested acute appendicitis without perforation, small gut obstruction by adhesions, appendicular lump or internal herniation. Appendicectomy was done along with other necessary procedures. His post-operative period was uneventful. This case is reported here to highlight that acute appendicitis may present with atypical features like acute small gut obstruction. J Bangladesh Coll Phys Surg 2021; 39: 261-265

scholarly journals Antipsychotic-induced extrapyramidal side effects: A systematic review and meta-analysis of observational studies

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257129
Author(s):  
Tilahun Ali ◽  
Mekonnen Sisay ◽  
Mandaras Tariku ◽  
Abraham Nigussie Mekuria ◽  
Assefa Desalew
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Tardive Dyskinesia ◽  
Publication Bias ◽  
Psychotic Disorders ◽  
Meta Analysis ◽  
Extrapyramidal Side Effects ◽  
Bias Analysis ◽  
Pharmacological Management ◽  
Early Management

Background Antipsychotic agents are the basis for the pharmacological management of acute and chronic schizophrenia, bipolar disorders, mood disorders with psychotic feature, and other psychotic disorders. Antipsychotic medication use is frequently associated with unfavorable adverse effects such as extrapyramidal side effects (EPSEs). Hence, this systematic review and meta-analysis was aimed to determine the magnitude of antipsychotic-induced EPSEs. Method A literature search was conducted using legitimate databases, indexing services, and directories including PubMed/MEDLINE (Ovid®), EMBASE (Ovid®), google scholar and WorldCat to retrieve studies. Following screening and eligibility, the relevant data were extracted from the included studies using an Excel sheet and exported to STATA 15.0 software for analyses. The Random effects pooling model was used to analyze outcome measures at a 95% confidence interval. Besides, publication bias analysis was conducted. The protocol has been registered on PROSPERO with ID: CRD42020175168. Result In total, 15 original articles were included for the systematic review and meta-analysis. The pooled prevalence of antipsychotic-induced EPSEs among patient taking antipsychotic medications was 37% (95% CI: 18–55%, before sensitivity) and 31% (95% CI: 19–44%, after sensitivity). The prevalence of antipsychotic-induced parkinsonism, akathisia, and tardive dyskinesia was 20% (95% CI: 11–28%), 11% (95% CI: 6–17%), and 7% (95% CI: 4–9%), respectively. To confirm a small-study effect, Egger’s regression test accompanied by funnel plot asymmetry demonstrated that there was a sort of publication bias in studies reporting akathisia and tardive dyskinesia. Conclusion The prevalence of antipsychotic-induced EPSEs was considerably high. One in five and more than one in ten patients experienced parkinsonism and akathisia, respectively. Appropriate prevention and early management of these effects can enhance the net benefits of antipsychotics.

scholarly journals An Atypical Presentation of Lichen Planus-Like Reaction from Pembrolizumab

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Matthew Lee ◽  
Nagashree Seetharamu
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Side Effects ◽  
Lichen Planus ◽  
Lung Cancer Patient ◽  
Topical Steroids ◽  
Atypical Presentation ◽  
Cutaneous Side Effects ◽  
Organ Systems ◽  
Prognostic Implications

Introduction. With the advent of immunotherapy, a new subtype of side effects called IRAEs or immune related adverse effects have become more common. They may present in various organ systems as colitis, pneumonitis, hypophysitis, and thyroiditis and commonly as dermatological reactions. Case. This is a case report of a lung cancer patient that was started on Pembrolizumab and developed shortly after what appeared to be clinically at first pustular psoriasis but on biopsy was confirmed to be lichen planus. She was discontinued on the Pembrolizumab and treated with both systemic and topical steroids and improved. Conclusion. This case highlights a cutaneous reaction from Pembrolizumab and the subsequent management that helped resolve her condition but also weighing the benefits against the risk of treatments and potential prognostic implications of having cutaneous side effects.

scholarly journals Three primary testicular tumours: Trials and tribulations of testicular preservation

2013 ◽  
Vol 7 (9-10) ◽  
pp. 630 ◽  
Author(s):  
Connor M Forbes ◽  
Charles Metcalfe ◽  
Nevin Murray ◽  
Peter C Black
Keyword(s):  
Side Effects ◽  
Male Patient ◽  
Patient Preference ◽  
Young Male ◽  
Recurrence Risk ◽  
Testicular Neoplasms ◽  
Testis Cancer ◽  
Testicular Tumours ◽  
Radical Orchiectomy ◽  
Partial Orchiectomy

Balancing recurrence risk, side effects and patient preference in the treatment of multiple metachronous testicular tumours can be challenging. We present the case of a young male patient who developed 3 different primary testicular neoplasms over an 8-year period, each associated with retroperitoneal lymphadenopathy requiring chemotherapy. The first tumour at age 19 was managed with radical orchiectomy. Four years later, a partial orchiectomy was performed to remove 2 small lesions. Another 4 years later, a complete orchiectomy was required for an additional tumour. This case highlights the caveats of testis-sparing surgery for testis cancer and the need for careful surveillance in these patients.

Assessment of the effectiveness of a prechemotherapy teaching session: A Brown University Oncology Group study.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 260-260
Author(s):  
Nathan Connell ◽  
Anthony E. Mega ◽  
Jorge J. Castillo ◽  
Mary Anne Fenton ◽  
Carolyn Bartley ◽  
...  
Keyword(s):  
Side Effects ◽  
Rating Scale ◽  
Patient Knowledge ◽  
Treatment Schedule ◽  
Teaching Session ◽  
Patient Anxiety ◽  
Schedule Management ◽  
Oncology Nurse ◽  
Management Of Complications ◽  
Clinically Significant

260 Background: Pre-chemotherapy teaching sessions, often coordinated by nursing personnel, are an opportunity to educate patients on treatment side effects, schedule, medications for toxicities such as nausea, and how to contact the oncology team if adverse events develop. Our institution provides a structured 60-minute nurse-coordinated pre-chemotherapy teaching session. The aims of this study were to evaluate whether pre-chemotherapy teaching sessions improve patient knowledge, preparedness, and anxiety in relation to chemotherapy. Methods: Patients were offered the opportunity to participate in the study after their medical oncologist had reviewed their treatment regimen. After informed consent was obtained, participants were administered a 10-question survey assessing knowledge of treatment adverse effects, treatment schedule, management of complications, accessing their medical team, and patient anxiety. Subjects then participated in a pre-chemotherapy teaching session with an oncology nurse. The survey was readministered when patients returned on day 1, cycle 1 of treatment and on day 1, cycle 2. The questionnaire used a 1 to 4 rating scale (1=no knowledge, 2= minimally informed, 3= reasonably informed, 4= well informed). A pre-defined mean change of 1 on the rating scale was considered to be clinically significant. Paired one-sided t-tests were performed to evaluate the mean change in groups between each of the three surveys. p values <0.05 were considered statistically significant. Results: At the time of analysis, 78 patients had completed a pre-chemotherapy teaching session and all three surveys. After participating in a teaching session, there was an increase in patient’s perceived knowledge of side effects (mean score 2.3 vs. 3.5, p<0.001), knowledge of the treatment schedule (mean score 2.4 vs. 3.5, p<0.001) and medications to prevent nausea (mean score of 1.4 vs. 3.1, p <0.001). There was also a statistically significant reduction in patient anxiety in relation to treatment, p< 0.001. Conclusions: These results show that a nurse-coordinated, pre-chemotherapy teaching session increases patient knowledge and reduces anxiety regarding their upcoming treatment.

Syphilis

2019 ◽  
pp. 117-136
Keyword(s):  
Side Effects ◽  
20Th Century ◽  
Sexually Transmitted Infection ◽  
Partner Notification ◽  
Treponema Pallidum ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Treatment Side Effects ◽  
Management Of Complications ◽  
Women And Children

Treponema pallidum is the bacterial spirochaete responsible for the sexually transmitted infection syphilis. Syphilis has been recognized as an STI since at least the mid-1500s. Rates declined in the second half of the 20th century, but in the past 20 years have risen >20-fold with >4000 cases per year since 2014. This chapter discusses epidemiology, clinical features of the different stages of syphilis, and management of adults, pregnant women, and children diagnosed with syphilis. The management of complications of syphilis are also explained, including neurosyphilis. Treatment side effects, partner notification, and epidemiological treatment is also covered

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