scholarly journals A Case of Chronic Invasive Actinomycosis in the Nasal Cavity

2020 ◽  
Vol 27 (1) ◽  
pp. 58-62
Author(s):  
Dong Hyun Kim ◽  
Tae Kyu Kang ◽  
Seon Tae Kim
Keyword(s):  
Sphenoid Sinus ◽  
Nasal Congestion ◽  
Organ Damage ◽  
Multiple Organ ◽  
Tissue Removal ◽  
Orbital Tissue ◽  
The Right ◽  
Incision Drainage ◽  
Chronic Invasive ◽  
Ct And Mri

A 57-year-old male patient with nasal congestion and nasal congestion, which occurred 1 month prior to the hospital visited. PNS CT and MRI was performed and revealed right orbital cellulitis, sinusitis and brain abcess. Surgical drainage was determined by rhinology, ophthalmology and neurosurgery. The right sphenoid sinus was identified as an open mucosal mucosa, and blackish mucosa was found on the right sphenoid sinus. Eucleation was performed. Infected orbital tissue removal and orbital abscess drainage were performed. Neurosurgery performed dura incision, drainage and removal of a large amount of abscess pattern, and duroplasty with artificial dura. Actinomyces odontolyti was identified by pus culture, and postoperative antibiotic treatment and dressing were performed, but infection aggravation persisted, resulting in deterioration of general condition, multiple organ damage, and cerebral infarction.

scholarly journals A Case of Sphenoidal Meningoencephalocele Masquerading as an Isolated Sphenoid Mucocele

2021 ◽  
Vol 64 (9) ◽  
pp. 680-683
Author(s):  
Young-Chan Kim ◽  
Jiwon Kwak ◽  
Hyeongeun Kim ◽  
Sang Hag Lee
Keyword(s):  
Sphenoid Sinus ◽  
Surgical Complication ◽  
Inferior Turbinate ◽  
Mri Findings ◽  
Sinus Disease ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Sinus Wall ◽  
Leakage Site ◽  
The Right ◽  
Ct And Mri

Isolated sphenoid sinus disease is often misdiagnosed because of its rarity and varing clinical presentation. A 51-year-old male visited the hospital with abnormal brain CT findings which showed homogenous opacification associated with sinus wall expansion on the right sphenoid sinus. Under the impression of isolated sphenoid mucocele, the fenestration of sphenoid sinus was conducted without surgical complication. But, cerebrospinal fluid rhinorrhea spontaneously developed 3 days after fenestration operation and then stopped by sealing the suspicious leakage site with free graft of inferior turbinate mucosa. Based on the pathological findings, paranasal sinus CT and MRI findings, this case is reported to be meningoencephalocele developed in sphenoid sinus.

scholarly journals 949. Use of Optical Coherence Tomography Angiography to Assess Microvascular Health Among Persons with HIV: Employing the Retina as a Convenient Window

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S507-S507
Author(s):  
Lauren F Collins ◽  
Jessica G Shantha ◽  
Peter L Nesper ◽  
Anandi N Sheth ◽  
Amani A Fawzi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Vasculitis ◽  
Organ Damage ◽  
Screening Tools ◽  
Foveal Avascular Zone ◽  
Invasive Technique ◽  
Optical Coherence ◽  
Hiv Diagnosis ◽  
The Right

Abstract Background Mechanisms underlying the rising burden of non-AIDS comorbidities (NACM) among persons with HIV (PWH) remain unclear. Microvasculopathy may link HIV-related chronic inflammation and premature multimorbidity, similar to diabetes and other conditions characterized by inflammatory end-organ damage. We used a novel retinovascular imaging tool, optical coherence tomography angiography (OCTA), to evaluate the retina as a convenient assessment of microvascular health among PWH. Methods Data from 4 PWH who underwent OCTA (Zeiss CIRRUSTM HD-OCT 5000) at the Emory Eye Center from 2018-2020 were analyzed. Demographics, HIV-specific indices and NACM were summarized at the time of OCTA. Images were reviewed qualitatively and metrics of microvascular health – the foveal avascular zone (FAZ) area and vessel density (VD) from the superficial capillary plexus (SCP) – were calculated by ImageJ. Results The median age was 39 years, 100% were male, 100% were black, 25% had ever smoked, and median body mass index was 25.4 kg/m2. Median time since HIV diagnosis was 19 years, all patients had a history of clinical AIDS, including 2 with prior cytomegalovirus retinitis. Median current CD4 count was 84 cells/mm3, 100% were prescribed antiretroviral therapy and 50% had HIV viral suppression. Prevalent NACM included (each n=1): hypertension, dyslipidemia, diabetes, chronic kidney disease and asthma. Qualitatively, all 7 of the eyes evaluated by OCTA had evidence of microvascular pathology: 2 eyes demonstrated diffuse capillary nonperfusion, while the remaining 5 eyes had focal areas of nonperfusion around the FAZ. Mean FAZ area was 0.31 (SD±0.10) mm2 and mean VD of the SCP was 43.9% (SD±10.9%). Retinovascular pathology identified by fundoscopy and OCTA is shown in the figure. Figure. Retinal imaging of a PWH with bilateral retinal vasculitis. Fundus photos of the right (A) and left (C) eyes show retinal vasculitis highlighted by the red arrows. OCTA of the right (B) and left (D) maculae (3X3 scan Zeiss AngioplexTM) show the FAZ areas outlined in yellow, both of irregular contour. OCTA of the left macula demonstrates areas of significant flow voids marked by the asterisks and the FAZ area is enlarged. Conclusion Among patients with longstanding HIV, OCTA identified microvascular abnormalities in all retinae examined. Retinovascular evaluation by OCTA is a feasible, non-invasive technique for assessing microvascular health and findings support additional study in a larger, more diverse group of PWH. Screening tools targeting microvasculopathy among PWH may aid in earlier detection of those at greatest risk of NACM and allow for aggressive risk-modification strategies. Disclosures All Authors: No reported disclosures

scholarly journals Role of combining anticoagulant and antiplatelet agents in COVID-19 treatment: a rapid review

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001628
Author(s):  
Kamal Matli ◽  
Raymond Farah ◽  
Mario Maalouf ◽  
Nibal Chamoun ◽  
Christy Costanian ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Anticoagulation Therapy ◽  
Antiplatelet Agents ◽  
Organ Damage ◽  
Multiple Organ ◽  
Rapid Review ◽  
Thromboembolic Events ◽  
Antithrombotic Agent ◽  
Heparin Resistance

Although primarily affecting the respiratory system, COVID-19 causes multiple organ damage. One of its grave consequences is a prothrombotic state that manifests as thrombotic, microthrombotic and thromboembolic events. Therefore, understanding the effect of antiplatelet and anticoagulation therapy in the context of COVID-19 treatment is important. The aim of this rapid review was to highlight the role of thrombosis in COVID-19 and to provide new insights on the use of antithrombotic therapy in its management. A rapid systematic review was performed using preferred reporting items for systematic reviews. Papers published in English on antithrombotic agent use and COVID-19 complications were eligible. Results showed that the use of anticoagulants increased survival and reduced thromboembolic events in patients. However, despite the use of anticoagulants, patients still suffered thrombotic events likely due to heparin resistance. Data on antiplatelet use in combination with anticoagulants in the setting of COVID-19 are quite scarce. Current side effects of anticoagulation therapy emphasise the need to update treatment guidelines. In this rapid review, we address a possible modulatory role of antiplatelet and anticoagulant combination against COVID-19 pathogenesis. This combination may be an effective form of adjuvant therapy against COVID-19 infection. However, further studies are needed to elucidate potential risks and benefits associated with this combination.

scholarly journals Endovascular plug for internal carotid artery occlusion in the management of a cavernous pseudoaneurysm with bifrontal subdural empyema: technical note

2017 ◽  
Vol 20 (3) ◽  
pp. 239-246
Author(s):  
Sunil Manjila ◽  
Gagandeep Singh ◽  
Obinna Ndubuizu ◽  
Zoe Jones ◽  
Daniel P. Hsu ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Sphenoid Sinus ◽  
Internal Carotid ◽  
Balloon Catheter ◽  
Arterial Injury ◽  
Technical Note ◽  
Subdural Empyema ◽  
Artery Pseudoaneurysm ◽  
The Right

The authors demonstrate the use of an endovascular plug in securing a carotid artery pseudoaneurysm in an emergent setting requiring craniotomy for a concurrent subdural empyema.They describe the case of a 14-year-old boy with sinusitis and bifrontal subdural empyema who underwent transsphenoidal exploration at an outside hospital. An injury to the right cavernous segment of the ICA caused torrential epistaxis. Bleeding was successfully controlled by inflating a Foley balloon catheter within the sphenoid sinus, and the patient was transferred to the authors’ institution. Emergent angiography showed a dissection of the right cavernous carotid artery, with a large pseudoaneurysm projecting into the sphenoid sinus at the site of arterial injury. The right internal carotid artery was obliterated using pushable coils distally and an endovascular plug proximally. The endovascular plug enabled the authors to successfully exclude the pseudoaneurysm from the circulation. The patient subsequently underwent an emergent bifrontal craniotomy for evacuation of a left frontotemporal subdural empyema and exenteration of both frontal sinuses. He made a complete neurological recovery.Endovascular large-vessel sacrifice, obviating the need for numerous coils and antiplatelet therapy, has a role in the setting of selected acute neurosurgical emergencies necessitating craniotomy. The endovascular plug is a useful adjunct in such circumstances as the device can be deployed rapidly, safely, and effectively.

Cancer and COVID-19: A proposed mechanism with therapeutic interventions.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3135-3135
Author(s):  
Yan Leyfman ◽  
Nancy Emmanuel ◽  
Aleksey Tentler ◽  
Jared Cappelli ◽  
Timothy K Erick ◽  
...  
Keyword(s):  
Respiratory Illness ◽  
Organ Damage ◽  
Multiple Organ ◽  
Therapeutic Interventions ◽  
Actual Number ◽  
Data Registry ◽  
Number Of Patients ◽  
Increased Risk ◽  
Life Threatening ◽  
Active Cancer

3135 Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel betacoronavirus that causes the respiratory illness coronavirus disease 2019 (COVID-19). COVID-19 ranges in severity from an asymptomatic viral infection to life-threatening cases of pneumonia, acute respiratory distress syndrome (ARDS), multi-organ damage and sepsis. Cancer patients are at an increased risk of severe SARS-CoV-2 infection due to their immunocompromised status. We propose a mechanism by which SARS-CoV-2 infection causes multiple organ damage through IL-6-mediated inflammation and hypoxia-induced cellular metabolic alterations leading to cell death. Hypoxia is also induced by malignancy due to alterations in metabolism, resulting in greater IL-6 secretion. Methods: To highlight the possible effect of active cancer on the likelihood of hypoxia in COVID-19, we analyzed the correlation between cancer status and the severity of COVID-19 from the COVID-19 and Cancer Consortium data registry. For cancer status, we looked at progressive cancer and remission of cancer only -- those being the two extremes of presence and absence of uncontrolled cancer. Similar to prior studies, the severity of COVID-19 was used as an indication of hypoxia. Results: We observed a 24% positive deviation between expected and actual number of patients with actively progressing cancer who had hypoxic COVID-19 (moderate to severe), and a 26.9% negative deviation between expected and actual number of patients with active cancer who had no hypoxia with COVID-19 (p<0.0001). Conversely, for patients with cancer in remission, there was only a +5.8% and -5.1% deviation between expected and actual number of patients who did not have hypoxia and who had hypoxia, respectively. Conclusions: These results suggest that in the presence of poorly controlled malignancy, there is an increased likelihood of hypoxia in patients with COVID-19, thereby exacerbating downstream cytokine release syndrome and contributing to prolonged systemic inflammatory injury. Appreciating this pathway, future therapies can be developed to target the pathogenesis of both diseases and prevent progression, as seen with mesenchymal stem cells, which demonstrated a 91% overall survival and 100% survival in patients younger than 85 years old at one month after a single treatment.[Table: see text]

Pregnancy After Simultaneous Pancreas-Kidney Transplantation in Treatment of End-Stage Diabetes Mellitus: a Review

2021 ◽  
Author(s):  
Zana Stanic ◽  
Marko Vulic ◽  
Zlatko Hrgovic ◽  
Rajko Fureš ◽  
Milvija Plazibat ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Transplantation ◽  
Graft Function ◽  
Insulin Dependent Diabetes Mellitus ◽  
Organ Damage ◽  
Multiple Organ ◽  
Dependent Diabetes Mellitus ◽  
Increased Risk ◽  
Simultaneous Pancreas Kidney ◽  
The Impact

AbstractThe majority of patients with simultaneous pancreas and kidney transplant (SPKT) required transplantation owing to a long-standing history of insulin-dependent diabetes mellitus (IDDM). The disease causes multiple organ damage, impairs fertility, and affects quality of life. A successful kidney and pancreas transplant can improve health, ameliorate the consequences of pre-existent diabetes, and restore fertility. Good graft function, without any sign of rejection, and stable doses of immunosuppressant drugs are of utmost importance prior to the planned pregnancy. SPKT recipients who become pregnant may be at an increased risk for an adverse outcome and require meticulous multidisciplinary surveillance. We present experiences with SPKT pregnancies, traditional approaches, and recent considerations. In light of complex interactions between new anatomic relations and the impact of developing pregnancy and immunosuppressive medications, special stress is put on the risk of graft rejection, development of pregnancy complications, and potential harmful effects on fetal development. Recent recommendations in management of SPKT recipients who wish to commence pregnancy are presented as well. Key words: transplantation, pregnancy, pancreas, kidney, simultaneous pancreas and kidney transplantation (SPKT)

Hemangiopericytoma of the Sphenoid Sinus

1981 ◽  
Vol 89 (5) ◽  
pp. 713-716 ◽  
Author(s):  
Charles P. Kimmelman
Keyword(s):  
Radiation Therapy ◽  
Sphenoid Sinus ◽  
Vascular Tumor ◽  
External Beam Radiation ◽  
Orbital Apex ◽  
Tumor Nodule ◽  
Beam Radiation ◽  
The Right ◽  
Sinus Ostium ◽  
Ethmoid Labyrinth

A 51-year-old woman complained of intermittent nasal obstruction and rhinorrhea. Sinus roentgenograms and polytomograms revealed a small mucocele of the right sphenoid sinus. There was no encroachment of the orbital apex or intracranial contents. The mucocele was marsupialized via an external ethmoidectomy, and the scant tissue present inside the sinus was examined histologically. The pathologic diagnosis was hemangiopericytoma. The small tumor had apparently originated at the sinus ostium, thus creating the mucocele. Several months postoperatively, a small, vascular tumor nodule was noted in the incision. No recurrence was evident intranasally. A course of 5,040 rads of external beam radiation therapy was given to the right ethmoid labyrinth and right sphenoid. Since completing her radiation therapy, there has been no recurrence. This case is of interest because the tumor occurred as a mucocele of the sphenoid sinus.

scholarly journals Systemic inflammatory response syndrome and multiple-organ damage / dysfunction in complicated canine babesiosis

2001 ◽  
Vol 72 (3) ◽  
Author(s):  
C. Welzl ◽  
A.L. Leisewitz ◽  
L.S. Jacobson ◽  
T. Vaughan-Scott ◽  
E. Myburgh
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Renal Involvement ◽  
Organ Damage ◽  
Multiple Organ ◽  
Systemic Inflammatory Response ◽  
The Body ◽  
Increased Risk

This study was designed to document the systemic inflammatory response syndrome (SIRS) and multiple-organ dysfunction syndrome (MODS) in dogs with complicated babesiosis, and to assess their impact on outcome. Ninety-one cases were evaluated retro-spectively for SIRS and 56 for MODS. The liver, kidneys, lungs, central nervous system and musculature were assessed. Eighty-seven percent of cases were SIRS-positive. Fifty-two percent of the cases assessed for organ damage had single-organ damage and 48 % had MODS. Outcome was not significantly affected by either SIRS or MODS, but involvement of specific organs had a profound effect. Central nervous system involvement resulted in a 57 times greater chance of death and renal involvement in a 5-fold increased risk compared to all other complications. Lung involvement could not be statistically evaluated owing to co-linearity with other organs, but was associated with high mortality. Liver and muscle damage were common, but did not significantly affect outcome. There are manysimilarities between the observations in this study and previous human and animal studies in related fields, lending additional support to the body of evidence for shared underlying pathophysiological mechanisms in systemic inflammatory states.

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