scholarly journals Sustaining viability in a pre-gangrenous bowel with midgut volvulus

2021 ◽  
Vol 8 (7) ◽  
pp. 1300
Author(s):  
Fatima Al Zahra ◽  
Nadeem Akhtar ◽  
Sana Khan ◽  
Mohammed Abdulmomen Abdullah Saif ◽  
Muhammad Umair Butt ◽  
...  
Keyword(s):  
Watchful Waiting ◽  
Signs And Symptoms ◽  
Midgut Volvulus ◽  
Total Resection ◽  
Sick Neonate ◽  
Intestinal Transplant ◽  
Radiological Procedures ◽  
Gangrenous Bowel ◽  
Fair Chance ◽  
Made In

Midgut volvulus is a condition peculiar to neonates having acute abdomen. The condition is anticipated in any neonate having bilious vomitus and inability to pass stools. This being a surgical emergency does not sanction any time-consuming radiological procedures, thus, history and the clinical picture are sufficient to warrant surgical exploration. A sick neonate in the 2nd week of life presented with all signs and symptoms of midgut volvulus for which he was explored. Exploration gave the outlook of a necrotic midgut along its entire length. No haste was made in resection as it had a fatal prognosis for survival, instead, watchful waiting opted after necessary measures were taken to allow for the resumption of perfusion. Not only the baby survived to undergo a relook laparotomy showing marked improvement but also showed improvement in lab values and started passing stool and tolerating orally after a wait of three weeks post 1st laparotomy. Midgut volvulus leading to seemingly necrotic intestine should be given due consideration by relook surgery. The alternative would be total resection followed by short bowel syndrome, need for an intestinal transplant while being on TPN. This approach gives an immense advantage by giving the gut a fair chance to restore its perfusion by gut rest after de-twisting.  

scholarly journals Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing syndrome secondary to an epidermoid tumor in the cerebellopontine angle

2013 ◽  
Vol 34 (3) ◽  
pp. E1 ◽  
Author(s):  
Shaun D. Rodgers ◽  
Bryan J. Marascalchi ◽  
Russell G. Strom ◽  
Paul P. Huang
Keyword(s):  
Medical Treatment ◽  
Trigeminal Nerve ◽  
Cerebellopontine Angle ◽  
Signs And Symptoms ◽  
Definitive Treatment ◽  
Trigeminal Autonomic Cephalalgias ◽  
Conjunctival Injection ◽  
Total Resection ◽  
Sunct Syndrome ◽  
Epidermoid Tumor

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome is classified under trigeminal autonomic cephalalgias. This rare headache syndrome is infrequently associated with secondary pathologies. In this paper the authors report on a patient with paroxysmal left retroorbital pain with associated autonomic symptoms of ipsilateral conjunctival injection and lacrimation, suggestive of SUNCT syndrome. After failed medical treatment an MRI sequence was obtained in this patient, demonstrating an epidermoid tumor in the left cerebellopontine angle. The patient's symptoms completely resolved after a gross-total resection of the tumor. This case demonstrates the effectiveness of resection as definitive treatment for SUNCT syndrome associated with tumoral compression of the trigeminal nerve. Early MRI studies should be considered in all patients with SUNCT, especially those with atypical signs and symptoms.

Extravascular Masses Masquerading as Deep Venous Thrombosis

1993 ◽  
Vol 8 (4) ◽  
pp. 158-161 ◽  
Author(s):  
O. Thulesius ◽  
A. Thurin
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Duplex Ultrasound ◽  
Signs And Symptoms ◽  
Clinical Physiology ◽  
Characteristic Appearance ◽  
Non Invasive ◽  
The Right ◽  
Symptoms And Signs ◽  
Made In

Objective: To determine the incidence and characteristics of extravascular masses (EVM) giving rise to symptoms and signs of deep venous thrombosis (DVT). Design and technique: Routine ultrasound colour duplex scanning during a 6-month period. Patients: Three hundred and two inpatients and outpatients investigated on suspicion of DVT. Setting: Department of Clinical Physiology, which is the central non-invasive diagnostic unit of the county. Results: A diagnostis of DVT was made in 33%. EVM were detected in 14 patients (5%). In most cases the characteristic appearance on scanning was spindle-shaped (like a ‘mouse’) and mostly confined to the upper calf. These EVM were regarded as intramuscular haematoma or ruptured popliteal cysts. Conclusion: EVM of the leg are (1) a frequent cause of ‘pseudothrombosis' and can positively be identified by duplex ultrasound scanning: (2) most frequently found in the medial aspect of the right calf; and (3) often detected in patients with rheumatoid arthritis or patients on anticoagulant therapy and may give rise to signs and symptoms identical to DVT.

scholarly journals Antipsychotic drugs for psychosis and agitation in dementia: efficacy, safety, and a possible noradrenergic mechanism of action

2014 ◽  
Vol 26 (6) ◽  
pp. 879-883 ◽  
Author(s):  
Murray A. Raskind ◽  
Lucy Y. Wang
Keyword(s):  
Mechanism Of Action ◽  
Behavioral Problems ◽  
Antipsychotic Drugs ◽  
Drug Class ◽  
Work Group ◽  
Signs And Symptoms ◽  
Dementia Patients ◽  
Pharmacologic Treatments ◽  
Made In ◽  
Noradrenergic Mechanism

The first patient described by Alzheimer in 1907 had both progressive cognitive deterioration and prominent comorbid signs and symptoms of psychosis and agitation (Alzheimer, 1907, 1987). In this editorial, we use “psychosis” to denote delusions and hallucinations and “agitation” to denote irritability, aggression, pressured motor activity, and active resistance to necessary care. Although advances have been made in the treatment of these non-cognitive symptoms, these psychosis and agitation symptoms continued to be burdensome and costly for dementia patients, caregivers, and society. Among the pharmacologic treatments available for psychosis and agitation, antipsychotic drugs are the drug class most consistently demonstrated effective for psychosis and agitation in dementia (Lyketsos et al., 2006; APA Work Group on Alzheimer's Disease and Other Dementias et al., 2007). These are widely prescribed for these behavioral problems, but their use remains controversial and their mechanism of action unclear.

Differential diagnosis between ventriculitis and fourth ventricle cyst in neurocysticercosis

1983 ◽  
Vol 59 (4) ◽  
pp. 660-663 ◽  
Author(s):  
Abelardo Salazar ◽  
Julio Sotelo ◽  
Hector Martinez ◽  
Francisco Escobedo
Keyword(s):  
Differential Diagnosis ◽  
Fourth Ventricle ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Large Cyst ◽  
Content Type ◽  
Surgical Exploration ◽  
Precise Diagnosis ◽  
The Central Nervous System ◽  
Radiological Procedures

✓ The fourth ventricle is frequently affected in patients with cysticercosis of the central nervous system, due either to a large cyst occluding the cavity or to granular ependymitis (ventriculitis) as a consequence of diffuse inflammation within the intraventricular and subarachnoid spaces. In some cases, the differential diagnosis between these two forms of neurocysticercosis is difficult to make, even after special radiological procedures. It is important to establish the correct diagnosis, since a surgical approach is beneficial only when the fourth ventricle is obstructed by a large cyst. In this paper, the clinical differences between fourth ventricle cysts and ventriculitis are presented in 16 patients with neurocysticercosis who were subjected to surgical exploration of the posterior fossa. Patients with a large cyst occluding the fourth ventricle had a short evolution of signs and symptoms, Bruns' syndrome, and discrete or no inflammatory reaction in the cerebrospinal fluid (CSF). Patients with ventriculitis generally had a longer duration of signs and symptoms, Parinaud's syndrome, a consistently positive complement fixation test to cysticerci, and more cells and proteins in the CSF. The clinical picture and ancillary studies can give the precise diagnosis in most patients before surgical exploration is performed.

scholarly journals Amyotrophic Lateral Sclerosis: The Most Common And Lethal Form Of Motor Neuron Disease-a Case Report From Middle East

2019 ◽  
Vol 09 (02) ◽  
pp. 156-158
Author(s):  
Waseem Mehmood Nizamani ◽  
Ameet Jesrani ◽  
Mujtaba Khan ◽  
Kalthoum Tlili ◽  
Nader Al Khuraish ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Motor Neuron ◽  
Motor Neurons ◽  
Clinical Presentation ◽  
Neurodegenerative Disorder ◽  
Signs And Symptoms ◽  
Corticospinal Tracts ◽  
Familial Form ◽  
Lateral Sclerosis ◽  
Made In

A neurodegenerative disorder which is fatal, rapidly progressive and has no effective treatment till date is amyotrophic lateral sclerosis. Almost 90% of all cases occur in the sporadic form, with the rest occurring in the familial form. It is a devastating disease leading to death within 3-5 years in most cases. The diagnosis of AML is difficult to made in spite of acknowledgment for 140 years. It is diagnosed by clinical presentation which is a combination of upper and lower motor neuron signs and electro diagnostic studies which gives information about diffuse motor axonal injury. This neurodegenerative disorder results in degeneration of corticospinal tracts and anterior horn cells and involving motor neurons of the cerebral cortex, brainstem, and spinal cord. There are a variable signs and symptoms of this disease, so the diagnosis is very important for the management and better outcome of the patients. Cause of death in these patients is usually respiratory failure

ROENTGENOGRAPHIC EVIDENCE OF GANGRENOUS BOWEL IN MIDGUT VOLVULUS WITH OBSERVATIONS IN EXPERIMENTAL VOLVULUS

1972 ◽  
Vol 114 (2) ◽  
pp. 394-401 ◽  
Author(s):  
THOMAS R. FRYE ◽  
CHONGGI L. MAH ◽  
MEDAD SCHILLER
Keyword(s):  
Midgut Volvulus ◽  
Gangrenous Bowel

Osteomyelitis: Early Scintigraphic Detection in Children

PEDIATRICS ◽  
1976 ◽  
Vol 57 (2) ◽  
pp. 173-186
Author(s):  
S. Treves ◽  
Jayant Khettry ◽  
Frederik H. Broker ◽  
Robert H. Wilkinson ◽  
Hugh Watts
Keyword(s):  
Soft Tissue ◽  
Bone Biopsy ◽  
Signs And Symptoms ◽  
Subperiosteal Abscess ◽  
Local Bone ◽  
Subacute Osteomyelitis ◽  
Tissue Changes ◽  
Bone Scintigram ◽  
Soft Tissue Changes ◽  
Made In

The value of scintigraphy in the early detection of osteomyelitis is demonstrated in children who had signs and symptoms suggestive of bone infection. Nine patients between 2 and 13 years of age were evaluated with technetium Tc 99m diphosphonate bone scintigrams and roentgenograms. Blood cultures were performed in all patients, and bone biopsy or drainage was obtained in six patients. The diagnosis of osteomyelitis was made in seven patients; one patient had a subperiosteal abscess surrounded by osteomyelitis, and one patient had cellulitis. The seven children with osteomyelitis had focal increase of radiopharmaceutical uptake in the bone. The child with the subperiosteal abscess had an area of decreased uptake in the center of the abscess surrounded by a zone of increased uptake of the radioactive bone-seeker. The patient with cellulitis had soft tissue changes by X-ray and a normal bone scintigram. In the seven patients with osteomyelitis, the bone scintigram was performed during the early phase of the disease and no bony changes were present on the roentgenogram. In one patient with subacute osteomyelitis, soft tissue changes were seen radiologically. Only three of the seven children with osteomyelitis developed radiological bony changes. Since bone scintigraphy can detect early local bone derangement, it is recommended in the initial evaluation of children in whom osteomyelitis is suspected.

scholarly journals Neonate Born to a Mother with a Diagnosis of Suspected Intra-Amniotic Infection versus COVID-19 or Both

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Rishi Lumba ◽  
Juan Remon ◽  
Moi Louie ◽  
Michelle Quan ◽  
Sourabh Verma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Horizontal Transmission ◽  
Healthcare Providers ◽  
Signs And Symptoms ◽  
Shortness Of Breath ◽  
Clinical Criteria ◽  
Sputum Production ◽  
Low Threshold ◽  
Fetal Tachycardia ◽  
Made In

A diagnosis of intra-amniotic infection is typically made based on clinical criteria, including maternal intrapartum fever and one or more of the following: maternal leukocytosis, purulent cervical drainage, or fetal tachycardia. The diagnosis can also be made in patients with an isolated fever of 39°C, or greater, without any other clinical risk factors present. Coronavirus disease 2019 (COVID-19), caused by the virus SARS-CoV-2, has been noted to have varying signs and symptoms over the course of the disease including fever, cough, fatigue, anorexia, shortness of breath, sputum production, and myalgia. In this report, we detail a case of a newborn born to a mother with a clinical diagnosis of intra-amniotic infection with maternal fever and fetal tachycardia, who was then found to be SARS-CoV-2 positive on testing. Due to the varying presentation of COVID-19, this case illustrates the low threshold needed to test mothers for SARS-CoV-2 in order to prevent horizontal transmission to neonates and to healthcare providers.

scholarly journals False Myths versus Medical Facts: Ten Common Misconceptions Related to Dry Eye Disease

Biomedicines ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. 172
Author(s):  
Giuseppe Giannaccare ◽  
Vincenzo Scorcia
Keyword(s):  
Dry Eye ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
The Past ◽  
Ocular Surface Diseases ◽  
Medical Fact ◽  
The Common ◽  
Definition Of ◽  
Common Misconceptions ◽  
Made In

Since the first definition of dry eye, rapid progress has been made in this field over the past decades that has guided profound changes in the definition, classification, diagnosis and management of the disease. Although dry eye is one of the most frequently encountered ocular conditions, various “old” misconceptions persist, in particular among comprehensive ophthalmologists not specialized in ocular surface diseases. These misconceptions hamper the correct diagnosis and the proper management of dry eye in the routine clinical practice. In the present review, we described the 10 most common misconceptions related to dry eye and provided an evidence-based guide for reconsidering them using the format “false myth versus medical fact”. These misconceptions concern the dry eye definition and classification (#1, #2, #3), disease physiopathology (#4), diagnosis (#5), symptoms (#6, #7) and treatment (#8, #9, #10). Nowadays, dry eye is still an under-recognized and evolving disease that poses significant clinical challenges to ophthalmologists. The two major reasons behind these challenges include the heterogeneity of the conditions that fall under the umbrella term of dry eye and the common discrepancy between signs and symptoms.

scholarly journals Anatomical and MRI relations of the cerebral aqueduct to the adjacent parts of the brain and calvaria

2017 ◽  
Vol 145 (7-8) ◽  
pp. 357-363
Author(s):  
Gordana Stankovic ◽  
Biljana Vitosevic ◽  
Dorentina Bexheti ◽  
Kristina Davidovic ◽  
Aleksandra Dozic ◽  
...  
Keyword(s):  
Internal Surface ◽  
Numerical Data ◽  
Signs And Symptoms ◽  
Optic Chiasm ◽  
Detailed Examination ◽  
Cerebral Aqueduct ◽  
The Brain ◽  
Practical Implications ◽  
Made In

Introducton/Objective. Insufficiency of relevant anatomic data and great neurological and neurosurgical significance were the reasons for this study with scientific and practical implications. The purpose was to determine, at the transverse in situ section of the head, the position and relations of the sylvian aqueduct of the mesencephalon by measuring its distances from particular brain and calvaria structures. Also, the aim was to determine the same distances according to axial sections by using MRI. Methods. The material consisted of twenty autopsy human heads. The section of the head was made at the level of the tentorial hiatus and the midbrain. After that, we measured the distances between the cerebral aqueduct and a) posterior border of the optic chiasm, b) upper border of the dorsum sellae, c) terminal bifurcation of the basilar artery, d) beginning of the straight sinus, e) internal occipital protuberance, f) tentorial edge (lateral from the aqueduct), and g) internal surface of the calvaria (lateral to the aqueduct). We determined the same distances by the MRI system. The measurements were made in 37 subjects. Results. The numerical data obtained by this study will be of benefit to neurosurgeons in choosing a surgical approach to the contents of the incisural space, and to neurologists for the exact localization of the lesion and interpretation of certain signs and symptoms. Conclusion. The results of a detailed examination of the sylvian aqueduct position and relations have shown that the use of MRI is the morphometric method of choice, because it is more precise for all the parameters monitored than in situ measurements.

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