scholarly journals Egy diagnosztikus kihívás: paraduodenalis pancreatitis. Két eset bemutatása

2019 ◽  
Vol 160 (22) ◽  
pp. 873-879
Author(s):  
Ivett Hegedűs ◽  
Barna Bogner ◽  
Nándor Faluhelyi ◽  
András Macygan ◽  
Anita Illés ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Diagnostic Methods ◽  
Duodenal Wall ◽  
Surgical Specimen ◽  
Dorsal Pancreas ◽  
Minor Papilla ◽  
Pancreatic Fluid ◽  
First Case ◽  
Strong Suspicion

Abstract: The paraduodenal, or groove pancreatitis is a lesser-known type of chronic pancreatitis, often mimicking malignancy, hence resulting in serious differential diagnostic challenges. Herein we report two cases of this entity. Both required analysis of the surgical specimen in order to ensure the diagnosis due to inadequate preoperative histological sampling and a vague clinical presentation. In the first case, strong suspicion of malignancy following imaging, while in the second, severe gastric outlet stenosis indicated the resection. In our report, we give a clinicopathological summary from the literature of this entity, including its epidemiology, clinical presentation and applicable diagnostic methods as well as macroscopic and microscopic pathomorphology. The pathogenesis of this disease is complex. Beside the role of alcohol, anatomic variations of the pancreatic ductal system, pancreatic islets in duodenal wall resulting from incomplete involution of dorsal pancreas, or Brunner gland hyperplasia (often observed as part of the lesion) can all play a role in the disturbance of pancreatic fluid discharge in the minor papilla area, eventually leading to this specific localised inflammation. In addition, recent investigations revealed a susceptible role of genetic polymorphism in the persistent inflammatory disorders of the pancreas. Besides summarizing the differential diagnostic aspects, we also discuss therapeutic possibilities, underlining the conservative methods, which can be used with good efficacy after a successful identification of this entity. Orv Hetil. 2019; 160(22): 873–879.

scholarly journals A Schizophyllum commune fungus ball in a lung cancer cavity: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Naoya Itoh ◽  
Nana Akazawa ◽  
Hiromi Murakami ◽  
Yuichi Ishibana ◽  
Yusuke Takahashi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Internal Transcribed Spacer ◽  
Histopathological Examination ◽  
Schizophyllum Commune ◽  
Diagnostic Methods ◽  
Fungus Ball ◽  
Surgical Specimen ◽  
Fungal Ball ◽  
First Case ◽  
Causative Microorganism

Abstract Background Schizophyllum commune is a basidiomycete that lives in the environment and can cause infections, mainly those of the respiratory system. Although S. commune is increasingly reported as a cause of allergic bronchopulmonary mycosis and sinusitis, cases of fungal ball formation are extremely uncommon. Identification of S. commune is difficult using routine mycological diagnostic methods, and in clinically suspicious cases, internal transcribed spacer sequencing should be used for diagnosis. Here, we report a first case of lung cancer with a fungal ball formation of S. commune, confirmed by analyzing the internal transcribed spacer. Case presentation A 76-year-old man with diabetes and hypertension was admitted to the hospital with a chief complaint of hemosputum, which he had for about 19 months. A computed tomography image of the patient’s chest showed a cavity and internal nodule in the left upper lobe of his lung. A left upper lobectomy was performed, and histopathological examination revealed squamous cell carcinoma of the lung and a fungal ball. The isolate from the surgical specimen was identified as S. commune by analyzing the internal transcribed spacer. The patient had no recurrence of the infection during 5 months of follow-up. Conclusions Only three cases of lung fungal balls caused by S. commune have been previously reported, and this is the first case of lung cancer cavity with a fungal ball formation. In cases of fungal ball formation in the lung, S. commune should be considered a possible causative microorganism.

scholarly journals Role of early surgical intervention in outcome and prognosis of spontaneous cerebellar hemorrhage with intraventricular extension

2021 ◽  
Vol 3 (01) ◽  
pp. 28-32
Author(s):  
Jemesh Singh Maharjan
Keyword(s):  
Clinical Presentation ◽  
Surgical Intervention ◽  
Sudden Onset ◽  
Cerebellar Hemorrhage ◽  
First Case ◽  
Spontaneous Intracranial Hemorrhage ◽  
Poor Outcomes ◽  
The Right ◽  
Early Surgical Intervention

Spontaneous cerebellar hematomas represent 5 to 13% of all cases of spontaneous intracranial hemorrhage. The main controversy involves deciding which cases require surgical evacuation of the hematoma versus other options, such as ventricular drainage only or conservative treatment. Furthermore, because the clinical course is variable in some cases, timing of such treatment should be carefully considered. The duration from the onset of hemorrhage also plays an important role in prognosis and recovery of the patient. Both the clinical presentation and subsequent course vary among cases. Unpredictable rapid deterioration in consciousness levels has been recognized. The majority of patients with such decline in consciousness experience the deterioration primarily within 72 hrs after onset⁠. Acute presentation was observed to be correlated with poor outcomes. In our report, the first case presented with sudden onset of headache in the right frontal region of head with vertigo. He came to hospital within 6 hours of onset. However, the second case had an onset of symptoms around 72 hours before the presentation.

Combination of Adenomyoma and Adenomyomatous Hyperplasia of the Ampullary System: A First Case Report

2018 ◽  
Vol 26 (7) ◽  
pp. 644-648 ◽  
Author(s):  
Eleftherios Gialamas ◽  
Murielle Mormont ◽  
Ilias Bagetakos ◽  
Jean-Louis Frossard ◽  
Philippe Morel ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Malignant Neoplasm ◽  
Duodenal Papilla ◽  
Surgical Specimen ◽  
Minor Papilla ◽  
System A ◽  
Unusual Association ◽  
First Case ◽  
Adenomyomatous Hyperplasia ◽  
Tumor Like Lesions

Adenomyoma and adenomyomatous hyperplasia are benign tumor-like lesions that rarely involve the major or minor duodenal papilla. We report the case of a 73-year-old patient who underwent a cephalic duodenopancreatectomy due to clinical and radiological evidence of underlying malignant neoplasm. The histopathology results revealed the unusual association of a major duodenal papilla adenomyoma and an adenomyomatous hyperplasia of the minor papilla. Because of their resemblance to pancreatic malignancy, the diagnosis of these lesions is particularly challenging. In most cases, it is established postoperatively, after histopathological examination of the surgical specimen.

scholarly journals Role of Coxiella burnetii in the development of fever of unknown origin: А mini review

2019 ◽  
Vol 22 (3) ◽  
pp. 251-265
Author(s):  
P. Genova-Kalou ◽  
S. Ivanova ◽  
A. Pavlova ◽  
K. Simeonov ◽  
D. Pencheva ◽  
...  
Keyword(s):  
Fever Of Unknown Origin ◽  
Clinical Presentation ◽  
Q Fever ◽  
Unknown Origin ◽  
Accurate Diagnosis ◽  
Diagnostic Methods ◽  
Molecular Diagnostic ◽  
Agricultural Systems ◽  
The World

Q fever is a widespread zoonosis throughout the world in the form of numerous natural and agricul-tural outbreaks. C. burnetii infects various hosts, including humans, ruminants and pets and in rare cases, reptiles, birds, and ticks. This bacterium is excreted in urine, milk, faeces, and birth products. In humans Q fever occurs as acute or chronic disease with diverse clinical presentation, as isolated cases and epidemics. It affects various organs and systems, and in pregnant women can cause miscar-riage or premature birth. Untreated Q fever can become chronic with adverse effects on patients. Diversity in the clinical picture in the absence of specific pathological syndrome often hinders accurate diagnosis and proper etiological significance. Therefore, improvement of diagnostic methods and in particular the development and introduction of new molecular diagnostic methods is the basis of effective therapeutic and prophylactic approach. Тhe purpose of the review is to renew the interest to Q fever – on one hand, because of its serious impact on human health and agricultural systems, and on the other, the ability for development and introduction of new molecular diagnostic methods.

Amyand’s hernia, a rare clinical presentation. Diagnostic and therapeutic update on the role of coelioscopy

2020 ◽  
Vol 41 (1) ◽  
pp. 42-45
Author(s):  
S Dobos ◽  
V Thill ◽  
K Mottart ◽  
L Bruyninx ◽  
E Creanga ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Amyand’S Hernia

T2 Gallbladder Cancer—Aggressive Therapy is Warranted

2016 ◽  
Vol 82 (6) ◽  
pp. 518-521 ◽  
Author(s):  
Mohd Raashid Sheikh ◽  
Houssam Osman ◽  
Susannah Cheek ◽  
Shenee Hunter ◽  
Dhiresh Rohan Jeyarajah
Keyword(s):  
Clinical Presentation ◽  
Radical Surgery ◽  
Radical Resection ◽  
Gall Bladder Cancer ◽  
Incidental Diagnosis ◽  
Radical Cholecystectomy ◽  
Node Positive ◽  
Operative Findings ◽  
Worse Prognosis

Treatment of gall bladder cancer (GBC) has traditionally been viewed with pessimism and lymph node positivity has been associated with worse prognosis. The aim of this study is to analyze the role of radical cholecystectomy in T2 tumors. All patients who underwent surgery for GBC between September 2005 and June 2014 were identified retrospectively. Data collected included clinical presentation, operative findings, and histopathological data. Twenty-five patients had incidental GBC diagnosis after cholecystectomy. Ten patients were T2 on initial cholecystectomy pathology and all underwent radical resection. Two patients were N1 on initial cholecystectomy pathology. Four were upstaged to N1 and two patients were upstaged to T3 after further surgery. Overall, 60 per cent patients with T2 disease had node positivity and 60 per cent were upstaged by further surgery. Eleven patients were diagnosed on imaging. Four of these patients were unresectable and six were either stage T3 or higher or node positive. Sixty per cent of T2 GBC was node positive and 60 per cent were upstaged with radical cholecystectomy. This finding supports the call for radical resection in patients with incidental diagnosis of T2 tumor on cholecystectomy. This study also emphasizes the role of radical surgery in accurate T staging.

scholarly journals Depression among health care students in the time of COVID-19: the mediating role of resilience in the hopelessness–depression relationship

2021 ◽  
pp. 008124632199445
Author(s):  
Tammy-lee Pretorius
Keyword(s):  
Health Care ◽  
Traumatic Event ◽  
National Level ◽  
Depression Scale ◽  
Health Care Students ◽  
Mediating Role ◽  
First Case ◽  
Hopelessness Depression ◽  
The World

COVID-19 spread rapidly across the world, and by March 2020, the first case of COVID-19 was identified in South Africa. Lockdown-related measures such as restricted movement and isolation were implemented to contain the virus. Combined with these measures, factors such as economic decline, job losses, and food shortages can cause numerous mental health sequelae such as depression. Feelings of hopelessness and helplessness as well as cases of suicide have been reported around the world due to the pandemic and the associated feelings of anxiety and depression. The aims of this study were to investigate levels of hopelessness and depression in a sample of health care students. A random sample of students ( N = 174) enrolled in a health sciences programme at the University of the Western Cape completed the Beck Hopelessness Scale, the Center for Epidemiological Studies Depression Scale, and a three-item Resilience Scale. The results revealed high levels of hopelessness and depression compared to previously reported normative data for these scales. In addition, the indirect effects of hopelessness on depression were significant, demonstrating the mediating role of resilience in the hopelessness–depression relationship. These results highlight a call for universities to take proactive measures in providing students with free and easily accessible resources to help them cope and manage stress during a traumatic event. More importantly, at a national level, preventive measures should be implemented to strengthen resilience in young adults.

scholarly journals FRI0212 THE ROLE OF AGE ON THE CLINICAL PRESENTATION AND RELAPSE RATES IN A LARGE COHORT OF 720 PATIENTS WITH GIANT CELL ARTERITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 689.1-690
Author(s):  
S. Monti ◽  
L. Dagna ◽  
C. Campochiaro ◽  
A. Tomelleri ◽  
G. Zanframundo ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Relapse Rate ◽  
Clinical Presentation ◽  
Age Groups ◽  
Age At Diagnosis ◽  
First Relapse ◽  
Time To Relapse

Background:Giant cell arteritis (GCA) is the most frequent systemic vasculitis after the age of 50 years old. Recent interest in the processes of immune and vascular aging have been proposed as a disease risk factor. Data on the impact of age at diagnosis of GCA on the clinical course of the disease are scarceObjectives:To assess the role of age at diagnosis of GCA on the risk and time to relapseMethods:Centres participating in the Italian Society of Rheumatology Vasculitis Study Group retrospectively enrolled patients with a diagnosis of GCA until December 2019. The cohort was divided in tertiles according to age at diagnosis (≤ 72; 73-79; > 79 years old). Negative binomial regression was used to assess the relapse rate according to age groups, and Cox regression for time to first relapse.Results:Of 720 patients enrolled in 14 Italian reference centres, 711 had complete follow-up data (female 50%; mean age 75±7). Median follow-up duration was 34 months (IQR 16;70). Patients in the older group at diagnosis (> 79 years) had more frequent visual loss compared to the 73-79 and ≤ 72 age groups (31% vs 20% vs 7%; p<0.001), but lower rates of general symptoms (56% vs 70% vs 77%; p<0.001). Large-vessel (LV)-GCA was less frequent in the older group (18% vs 22% vs 43%; p<0.001). At least one relapse occurred in 47% of patients. Median time to relapse was 12 months (IQR 6;23). Age did not influence the rate of relapses [18 per 100 persons/years (95%CI 15;21) vs 19 (95% CI 17;22) vs 19 (95%CI 17;22)], nor the time to first relapse (Figure 1). LV-GCA, presentation with significantly elevated c-reactive protein (> 50 mg/L) and general symptoms were independent predictors of relapse.Conclusion:Age at diagnosis of GCA influenced the clinical presentation and risk of ischaemic complications, but did not affect the relapse rate during follow-up. LV-GCA occurred more frequently in younger patients and was an independent predictor of relapse risk, highlighting the need for a correct characterization of the clinical subtype at the early stages of disease.Disclosure of Interests:Sara Monti: None declared, Lorenzo Dagna Grant/research support from: Abbvie, BMS, Celgene, Janssen, MSD, Mundipharma Pharmaceuticals, Novartis, Pfizer, Roche, SG, SOBI, Consultant of: Abbvie, Amgen, Biogen, BMS, Celltrion, Novartis, Pfizer, Roche, SG, and SOBI, Corrado Campochiaro Speakers bureau: Novartis, Pfizer, Roche, GSK, SOBI, Alessandro Tomelleri: None declared, Giovanni Zanframundo: None declared, Catherine Klersy: None declared, Francesco Muratore: None declared, Luigi Boiardi: None declared, Roberto Padoan: None declared, Mara Felicetti: None declared, Franco Schiavon: None declared, Milena Bond: None declared, Alvise Berti: None declared, Roberto Bortolotti: None declared, Carlotta Nannini: None declared, Fabrizio Cantini: None declared, Alessandro Giollo: None declared, Edoardo Conticini: None declared, angelica gattamelata: None declared, Roberta Priori: None declared, Luca Quartuccio Consultant of: Abbvie, Bristol, Speakers bureau: Abbvie, Pfizer, Elena Treppo: None declared, Giacomo Emmi: None declared, Martina Finocchi: None declared, Giulia Cassone: None declared, Ariela Hoxha Speakers bureau: Celgene, UCB, Novartis, Sanofi, Werfen, Rosario Foti Consultant of: lilly, sanofi, MSD, Janssen, Abbvie, BMS, celgene, roche, Speakers bureau: lilly, sanofi, MSD, Janssen, Abbvie, BMS, celgene, roche, Michele Colaci: None declared, Roberto Caporali Consultant of: AbbVie; Gilead Sciences, Inc.; Lilly; Merck Sharp & Dohme; Celgene; Bristol-Myers Squibb; Pfizer; UCB, Speakers bureau: Abbvie; Bristol-Myers Squibb; Celgene; Lilly; Gilead Sciences, Inc; MSD; Pfizer; Roche; UCB, Carlo Salvarani: None declared, Carlomaurizio Montecucco: None declared

scholarly journals Endovascular Considerations in Traumatic Injury of the Carotid and Vertebral Arteries

2021 ◽  
Vol 38 (01) ◽  
pp. 053-063
Author(s):  
Ananth K. Vellimana ◽  
Jayson Lavie ◽  
Arindam Rano Chatterjee
Keyword(s):  
Natural History ◽  
Clinical Presentation ◽  
Traumatic Injury ◽  
Classification Systems ◽  
Endovascular Techniques ◽  
Traumatic Injuries ◽  
Cerebrovascular Injury ◽  
Vertebral Arteries ◽  
Carotid And Vertebral Arteries

AbstractCervical carotid and vertebral artery traumatic injuries can have a devastating natural history. This article reviews the epidemiology, mechanisms of injury, clinical presentation, and classification systems pertinent to consideration of endovascular treatment. The growing role of modern endovascular techniques for the treatment of these diseases is presented to equip endovascular surgeons with a framework for critically assessing patients presenting with traumatic cervical cerebrovascular injury.

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