scholarly journals Progressive Dilatation as a Successful Treatment for Y duplication of Urethra

2021 ◽  
Author(s):  
Akash Pati ◽  
Subrat K Sahoo ◽  
Bikasha B Tripathy
Keyword(s):  
Congenital Anomaly ◽  
Case Reports ◽  
Case Series ◽  
Urethral Duplication ◽  
Rare Congenital Anomaly ◽  
Standardized Treatment ◽  
Rectourinary Fistula ◽  
Lost To Follow Up ◽  
Multiple Stages

Duplication of urethra is a rare congenital anomaly that has been reported in case reports and case series. A Y-shaped urethral duplication is the rarest variant as per the classification suggested and hence lacks a standardized treatment option. We report a case of Y-duplication of urethra diagnosed during neonatal age and presented to us at nine years of age. The patient had undegone a vesicostomy at seventh day of life for passing urine per anus and was lost to follow up thereafter. An attempt at disconnection of the duplicated urethral tract to anus after colostomy, at eight years of age had failed. The patient was managed successfully by progressive dilatation of the orthotopic urethra, which required multiple stages, followed by separation of the urethra from the rectum. At three years follow up the patient is continent and asymptomatic. Keywords: Y duplication of the urethra; PADUA technique; Rectourinary fistula; Urethral duplication.

Mechanical thrombectomy in pediatric stroke: systematic review, individual patient data meta-analysis, and case series

2019 ◽  
Vol 24 (5) ◽  
pp. 558-571 ◽  
Author(s):  
Kartik Bhatia ◽  
Hans Kortman ◽  
Christopher Blair ◽  
Geoffrey Parker ◽  
David Brunacci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Neurological Outcomes

OBJECTIVEThe role of mechanical thrombectomy in pediatric acute ischemic stroke is uncertain, despite extensive evidence of benefit in adults. The existing literature consists of several recent small single-arm cohort studies, as well as multiple prior small case series and case reports. Published reports of pediatric cases have increased markedly since 2015, after the publication of the positive trials in adults. The recent AHA/ASA Scientific Statement on this issue was informed predominantly by pre-2015 case reports and identified several knowledge gaps, including how young a child may undergo thrombectomy. A repeat systematic review and meta-analysis is warranted to help guide therapeutic decisions and address gaps in knowledge.METHODSUsing PRISMA-IPD guidelines, the authors performed a systematic review of the literature from 1999 to April 2019 and individual patient data meta-analysis, with 2 independent reviewers. An additional series of 3 cases in adolescent males from one of the authors’ centers was also included. The primary outcomes were the rate of good long-term (mRS score 0–2 at final follow-up) and short-term (reduction in NIHSS score by ≥ 8 points or NIHSS score 0–1 at up to 24 hours post-thrombectomy) neurological outcomes following mechanical thrombectomy for acute ischemic stroke in patients < 18 years of age. The secondary outcome was the rate of successful angiographic recanalization (mTICI score 2b/3).RESULTSThe authors’ review yielded 113 cases of mechanical thrombectomy in 110 pediatric patients. Although complete follow-up data are not available for all patients, 87 of 96 (90.6%) had good long-term neurological outcomes (mRS score 0–2), 55 of 79 (69.6%) had good short-term neurological outcomes, and 86 of 98 (87.8%) had successful angiographic recanalization (mTICI score 2b/3). Death occurred in 2 patients and symptomatic intracranial hemorrhage in 1 patient. Sixteen published thrombectomy cases were identified in children < 5 years of age.CONCLUSIONSMechanical thrombectomy may be considered for acute ischemic stroke due to large vessel occlusion (ICA terminus, M1, basilar artery) in patients aged 1–18 years (Level C evidence; Class IIb recommendation). The existing evidence base is likely affected by selection and publication bias. A prospective multinational registry is recommended as the next investigative step.

scholarly journals Salvage therapy of bleeding esophageal tumor by fully covered self-expandable metallic stent: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199719
Author(s):  
Sundus Bilal ◽  
Saad Muhammad Saeed ◽  
Muhammad Zeeshan Siddique ◽  
Muhammad Saqib ◽  
Shafqat Mehmood ◽  
...  
Keyword(s):  
Case Reports ◽  
Esophageal Tumor ◽  
Metallic Stent ◽  
Diverse Group ◽  
Expandable Metallic Stent ◽  
Lost To Follow Up ◽  
Expandable Metallic Stents ◽  
Tamponade Effect

The role of self-expandable metallic stents is gradually evolving for a diverse group of benign and malignant gastrointestinal tract problems, with luminal obstruction being by far the most common. Although its role in refractory variceal bleeding is well established, it has rarely been tried for tumor-related bleeding, with only a few case reports in this regard. We share our experience of successfully controlling esophageal tumor–related bleeding with the use of a fully covered self-expandable metallic stent. A 58-year-old woman with irresectable distal esophageal cancer, presented with hematemesis. Esophago-gastro-duodenoscopy revealed an obstructing esophageal tumor with diffuse oozing of blood. This was unamenable to local injection of adrenaline and hemospray; therefore, a temporary self-expandable metallic stent was parked to create a tamponade effect. This successfully stopped bleeding and the patient remained asymptomatic till discharge. However, she was lost to follow-up, and therefore, the stent was removed after a period of 5 months instead of 2 weeks.

scholarly journals Challenges in Evaluation and Management of Children with Myocardial Bridging

Cardiology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Nurdan Erol
Keyword(s):  
Congenital Anomaly ◽  
Coronary Artery ◽  
Case Reports ◽  
Case Series ◽  
Diagnosis And Treatment ◽  
Myocardial Bridging ◽  
Small Case Series ◽  
Adults And Children ◽  
Artery Branch

Myocardial bridging (MB) is a congenital anomaly where a coronary artery branch or group of branches extends inside a tunnel consisting of myocardium. Although it is mostly considered “benign,” it is reported that MB may lead to significant cardiac problems and sudden cardiac deaths. While it is a congenital anomaly, its symptoms usually arise at further ages rather than childhood. The literature on MB in children is in the form of case reports or small case series. This is why pediatric cases are assessed in the light of information obtained from adults. This review compiled the literature on MB in adults and children and compared it, as well as discussing questions arising regarding the clinic, diagnosis, and treatment of MB.

Long-Term Follow-Up after Radiotherapy of Hidradenitis Suppurativa

Dermatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Jurr Boer
Keyword(s):  
Total Dose ◽  
Hidradenitis Suppurativa ◽  
Early Stage ◽  
Case Reports ◽  
Case Series ◽  
Postal Survey ◽  
Long Term Follow Up ◽  
Late Treatment

<b><i>Background:</i></b> Patients with hidradenitis suppurativa (HS) are still often disappointed with the current treatments offered and there is a clear demand for more effective options. Since the late 1990s there has been a revival in the use of radiotherapy (RT) for different benign diseases, including HS. During the past 20 years one case series and some scattered case reports have described promising results of RT. <b><i>Objectives:</i></b> To evaluate the long-term efficacy of RT in early-stage HS. <b><i>Methods:</i></b> A postal survey-based long-term follow-up with simple factual questions of partly retrospective and partly contemporary characteristics was performed. Sixty-four patients (96 axillae), diagnosed with mild to moderate HS were irradiated with a orthovoltage unit with 100 kV, 3 mm Al or 200 kV, 0.5 Cu filtering, respectively. Four to six biweekly fractional doses ranging from 0.75 to 1 Gy up to a total dose of 6 Gy in one series, and in chronic cases followed by four daily fractions of 2 Gy up to a total dose of 14 Gy, were given. Late treatment toxicity and the rate of remission of the disease were evaluated. <b><i>Results:</i></b> The overall response rate of the survey was 64.1% with 40.6% (26/64) valid, complete questionnaires. In total, 40 axillae were irradiated in these 26 patients. After a median follow-up of 40 years (range 32–52) complete remission of the lesions occurred in 34 of the 40 sites (85%). None of the 26 patients with 40 irradiated sites reported adverse effects at the time of the survey. <b><i>Conclusions:</i></b> RT appears to be an effective treatment for early and mild HS in the majority of patients. In this case series, no side effects were reported after a median follow-up period of 40 years.

Malignant thyroid teratoma: an integrated analysis of case series and case reports

2021 ◽  
Author(s):  
Huy Gia Vuong ◽  
Truong P.x. Nguyen ◽  
Hanh T.t. Ngo ◽  
Lewis Hassell ◽  
Kennichi Kakudo
Keyword(s):  
Clinical Course ◽  
Case Reports ◽  
Case Series ◽  
Seer Program ◽  
Integrated Analysis ◽  
Continuous Variables ◽  
Chi Square ◽  
Large Tumor ◽  
Exact Test

Malignant thyroid teratoma (MTT) is a very rare thyroid malignancy. These neoplasms have been reported only in case reports and small-sized case series so far. In this study, we searched for MTTs in the Surveillance, Epidemiology, and End Result (SEER) program during 1975-2016. Subsequently, we incorporated the SEER data with published MTT cases in the literature to analyze the characteristics and prognostic factors of MTTs. Integrated data were analyzed using Chi-square or Fisher’s exact test for categorical covariates, and t-test or Mann-Whitney test for continuous variables. We included 28 studies with 36 MTT cases and found additional 8 cases from the SEER program for final analyses. Our results showed that MTT is typically seen in adult females. These neoplasms were associated with an aggressive clinical course with high rates of extrathyroidal extension (80%) and nodal involvement (62%). During follow-up, the development of recurrence and metastases were common (42% and 46%, respectively), and one-third of patients died at the last follow-up. Large tumor size (p = 0.022) and the presence of metastases during follow-up (p = 0.008) were associated with a higher mortality rate. In conclusion, our study demonstrated the characteristic features of MTT patients and outlined some parameters associated with a negative outcome which could help clinicians better predict the clinical course of these neoplasms.

scholarly journals A rare case of metachronous neuroendocrine tumor after a colorectal adenocarcinoma: qualitative critical review of synchronous and metachronous gastrointestinal NET

2020 ◽  
Author(s):  
Francesco Lancellotti ◽  
Luigi Solinas ◽  
Davide Telesco ◽  
Andrea Sagnotta ◽  
Augusto Belardi ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Colorectal Adenocarcinoma ◽  
Retrospective Studies ◽  
Case Reports ◽  
English Literature ◽  
Case Series ◽  
Population Based ◽  
Review Articles ◽  
Gastrointestinal Neuroendocrine Tumor

Abstract Gastrointestinal neuroendocrine tumor (NET) associated with a metachronous intestinal adenocarcinoma is rare. We report the case of a 71-year-old man with an ileal NET. Patient has previously undergone a left colectomy for sigmoid cancer. We report a complete review both of the metachronous and synchronous NET. A comprehensive systematic literature search in PubMed, EMBASE, and MEDLINE identified a total of 35 relevant studies. This study includes an analysis of review articles, case reports, case series, retrospective studies and population-based studies. In the English literature to date, there are 21 case reports (19 synchronous cases and 2 metachronous cases), 3 case series and 3 review articles, and less than 10 retrospective studies or population-based studies. A total of 31 patients in 24 articles were included in the study: 28 patients with a synchronous gastrointestinal NET and colorectal adenocarcinoma and 3 patients with metachronous gastrointestinal NET and colorectal adenocarcinoma. The incidence of synchronous cancer (particularly for colorectal and gastric cancer) with a gastrointestinal NET ranges from 10 to 50%, while for the metachronous ones it is still unclear. This is the third metachronous case report and the first descriptive case of gastrointestinal NET diagnosed 2 years after a colorectal adenocarcinoma. An endoscopic follow-up program for gastrointestinal NET patients and/or for first-degree relatives of NET patients appears recommendable.

scholarly journals Rare presentation of incomplete male urethral duplication: A case report and review of literature

2021 ◽  
Vol 9 (1) ◽  
pp. 292-296
Author(s):  
Orgeness J Mbwambo ◽  
Alex Mremi ◽  
Mohamed Mbarouk ◽  
Jasper Mbwambo ◽  
Frank Bright ◽  
...  
Keyword(s):  
Congenital Anomaly ◽  
Case Report ◽  
Postoperative Period ◽  
Surgical Removal ◽  
Urethral Duplication ◽  
Review Of Literature ◽  
Rare Presentation ◽  
Rare Congenital Anomaly ◽  
Accessory Urethra

Urethral duplication is a rare congenital anomaly affecting mainly males. Here, we report a case of urethral duplication in a 19 years old male presented as a scrotal sinus discharging pus for 1 year. Surgical removal of accessory urethra was done and postoperative period was uneventful.

scholarly journals Multiple Victims of Carbon Monoxide Poisoning in the Aftermath of a Wildfire: A Case Series

2018 ◽  
Vol 31 (3) ◽  
pp. 146 ◽  
Author(s):  
Luís Ramos dos Santos ◽  
Magna Alves-Correia ◽  
Margarida Câmara ◽  
Manuela Lélis ◽  
Carmo Caldeira ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Hyperbaric Oxygen ◽  
Clinical Symptoms ◽  
Carbon Monoxide Poisoning ◽  
Case Series ◽  
Neurological Syndrome ◽  
High Flow Oxygen ◽  
Lost To Follow Up ◽  
Mean Time

Introduction: Carbon monoxide poisoning may occur in several contexts.Material and Methods: Retrospective of 37 carbon monoxide poisoning cases that underwent hyperbaric oxygen during wildfires in Funchal in August 2016.Results: The studied sample included 37 patients, mean age of 38 years, 78% males. Ten were firefighters, four children and two pregnant victims. Neurological symptoms were the most reported. Median carboxyhemoglobin level was 3.7% (IQR 2.7). All received high-flow oxygen from admission to delivery of hyperbaric oxygen. Persistence of symptoms was the main indication for hyperbaric oxygen. Median time to hyperbaric oxygen was 4.8 hours (IQR 9.5), at 2.5 ATA for 90 minutes, without major complications. Discharge in less than 24 hours occurred in 92% of the cases. Thirty days follow-up: five patients presented clinical symptoms of late neurological syndrome; twelve patients were lost to follow-up. Carboxyhemoglobin levels on admission and mean time to hyperbaric oxygen were no different between those who did and did not develop the syndrome at 30 days (p = 0.44 and p = 0.58, respectively).Discussion: Late neurological syndrome at 30 days occurred in 20% and no new cases were reported at 12 months.Conclusion: Use of hyperbaric oxygen appears to have reduced the incidence of the syndrome. This seems to be the first Portuguese series reporting use of hyperbaric oxygen in carbon monoxide poisoning due to wildfires. The authors intend to alert to the importance of referral of these patients because the indications and benefits of this treatment are well documented. This is especially important given the ever-growing issue of wildfires in Portugal.

scholarly journals Application of flow diverters in the treatment of aneurysms in the internal carotid artery bifurcation region

2020 ◽  
Vol 33 (4) ◽  
pp. 297-305
Author(s):  
Mostafa Mahmoud ◽  
Ahmed Farag ◽  
Mostafa Farid ◽  
Ahmed Elserwi ◽  
Amr Abdelsamad ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Case Reports ◽  
Therapeutic Option ◽  
Case Series ◽  
Flow Diversion ◽  
Occlusion Rate ◽  
Flow Diverters

Introduction The treatment of aneurysms in the internal carotid bifurcation region (ICABR), including aneurysms of the true internal carotid artery (ICA) terminus, those inclined on the proximal A1 or M1 segments or at the most distal pre-bifurcation (ICA) segment, is often challenging in microsurgical clipping and endovascular surgery. Few reports had discussed flow diversion as a therapeutic option for this group. Methods This was a retrospective study analysing flow diversion in treating ICABR aneurysms. Seven patients harbouring eight aneurysms in the ICABR were treated with flow diversion. Five aneurysms were inclined on the proximal A1 segment, and three were located at the most distal pre-bifurcation segment. Patients’ demographics, presentation, procedure technical description, angiographic and clinical follow-up were recorded. PubMed and Ovid MEDLINE were also reviewed for articles published in English, including case series or case reports, for ICABR aneurysms treated with flow diverters. Results All patients except one underwent angiographic follow-up. The Karman–Byrne occlusion scale was used to determine the occlusion rate. All six patients with documented angiographic follow-up had a class IV occlusion score. No permanent or transient neurological or non-neurological complications were encountered in this study. Conclusion Treating ICABR aneurysms using flow diversion is feasible, with a promising angiographic occlusion rate. Further studies are needed to analyse long-term clinical and angiographic results.

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