Mixed-dust Pneumoconiosis in a Dental Technician: A Multidisciplinary Diagnosis

2021 ◽  
Author(s):  
Luigi Di Lorenzo ◽  
Antonella Pipoli ◽  
Nicola Mariano Manghisi ◽  
Filippo Cassano ◽  
Eugenio Maiorano ◽  
...  
Keyword(s):  
Crystalline Silica ◽  
Silica Sand ◽  
Case Presentation ◽  
Mineral Particles ◽  
Dental Technician ◽  
Mineral Dusts ◽  
Ambient Concentrations ◽  
Chest X Ray ◽  
First Time ◽  
Small Airway Obstruction

Abstract BackgroundExposure to crystalline silica in dental laboratories can occur during procedures that generate suspended mineral dusts, e.g. dispersion of mixing powders, removal of castings from moulds grinding and polishing castings and porcelain, and use of silica sand for blasting. Case presentationWe report a 55-year-old male dental technician who, after about 15 years of work, began to suffer from a dry cough and dyspnoea on exertion. The operations included in his job resulted in the generation of crystalline silica, aluminium, chromium, titanium dust. The worker did not regularly wear personal protective equipment and some of the above operations were not carried out in closed circuit systems.The Chest X-ray showed diffuse micronodulation in the lung interstitium in the upper-middle lobes bilaterally and a modest left basal pleural effusion, simple spirometry showed initial small airway obstruction, High Resolution Computerized Tomography of the chest showed bilateral micronodulation of a miliariform type, with greater profusion in the upper lobes, also present in the visceral pleura, bilaterally. Histological examination showed aggregates of pigment-laden macrophages forming perivascular macules or arranged in a radial pattern around a core of sclerohyalinosis. Scanning Electron Microscopy and Energy Dispersive Spectrometry revealed several mineral particles, whose composition is characterised by the presence of aggregates of crystalline silica and metals. The ambient concentrations of total dust and its respirable fraction were all lower than the relative TLV-TWA - ACGIH, but did not negligible. ConclusionsThe above findings and a multidisciplinary assessment led to the diagnosis of mixed dust pneumoconiosis s/q with 2/2 profusion of occupational origin. This diagnosis in a dental technician was supported by environmental exposure analysis for the first time in the literature.

scholarly journals A case of pleuroperitoneal communication in which establishing a laparoscopic pneumoperitoneum was useful for the detection of a fistula

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takehiko Manabe ◽  
Kenji Ono ◽  
Soichi Oka ◽  
Yuichiro Kawamura ◽  
Toshihiro Osaki
Keyword(s):  
Thoracic Surgery ◽  
Surgical Repair ◽  
Abdominal Cavity ◽  
Case Presentation ◽  
X Ray ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Pleuroperitoneal Communication ◽  
Small Pore ◽  
Chest X Ray

Abstract Background Pleuroperitoneal communication (PPC) is rarely observed, accounting for 1.6% of all patients who undergo continuous ambulatory peritoneal dialysis (CAPD). Although there have been several reports concerning the management of this condition, we have encountered several cases in which control failed. We herein report a valuable case of PPC in which laparoscopic pneumoperitoneum with video-assisted thoracic surgery (VATS) was useful for supporting the diagnosis and treatment. Case presentation The patient was a 58-year-old woman with chronic renal failure due to chronic renal inflammation who was referred to a nephrologist in our hospital to undergo an operation for the induction of CAPD. Post-operatively, she had respiratory failure, and chest X-ray and computed tomography (CT) showed right-sided hydrothorax that decreased when the injection of peritoneal dialysate was interrupted. Therefore, PPC was suspected, and she was referred to our department for surgical repair. We planned surgical treatment via video-assisted thoracic surgery. During the surgery, we failed to detect any lesions with thoracoscopy alone; we therefore added a laparoscopic port at her right-sided abdomen near the navel and infused CO2 gas into the abdominal cavity. On thoracoscopy, bubbles were observed emanating from a small pore at the central tendon of the diaphragm, which was considered to be the lesion responsible for the PPC. We closed it by suturing directly. Conclusions VATS with laparoscopic pneumoperitoneum should be considered as an effective method for inspecting tiny pores of the diaphragm, especially when the lesions responsible for PPC are difficult to detect.

Obstetrical history of a family with combined oxidative phosphorylation deficiency 3 and methylenetetrahydrofolate reductase polymorphisms

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Murat Cagan ◽  
Canan Unal ◽  
Gizem Urel Demir ◽  
Erdem Fadiloglu ◽  
Riza Koksal Ozgul ◽  
...  
Keyword(s):  
Oxidative Phosphorylation ◽  
Methylenetetrahydrofolate Reductase ◽  
Care Program ◽  
Oocyte Donation ◽  
Mthfr Polymorphisms ◽  
Healthy Baby ◽  
Case Presentation ◽  
Optimal Outcomes ◽  
History Of ◽  
First Time

Abstract Objectives Recurrent pregnancy loss (RPL) is a devastating complication of pregnancy with various etiologic backgrounds. Case presentation We present a case of combined oxidative phosphorylation deficiency 3 (COXPD3) carrier pregnant woman with Methylenetetrahydrofolate reductase (MTHFR) polymorphisms. She had five pregnancy losses and a postpartum death due to COXPD3. The patient was admitted to our clinic for the first time at her seventh pregnancy with oocyte donation. The patient was registered in a special antenatal care program and delivered a healthy baby at term. Her eighth pregnancy was terminated due to COXPD3 which was prenatally diagnosed. Conclusions Comprehensive and individualized approaches are necessary in RPL cases to obtain optimal outcomes.

scholarly journals Central precocious puberty in a girl with LEGIUS syndrome: an accidental association?

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Valentina Orlandi ◽  
Paolo Cavarzere ◽  
Laura Palma ◽  
Rossella Gaudino ◽  
Franco Antoniazzi
Keyword(s):  
Genetic Analysis ◽  
Precocious Puberty ◽  
Central Precocious Puberty ◽  
Neurofibromatosis Type ◽  
Case Presentation ◽  
New Variant ◽  
Legius Syndrome ◽  
Timing Of Puberty ◽  
First Time

Abstract Background Central precocious puberty is a condition characterized by precocious activation of the hypothalamic-pituitary-gonadal axis. It may be idiopathic or secondary to organic causes, including syndromes such as Neurofibromatosis type 1 (NF1). Case presentation We presented a girl of 6 years and 10 months with almost 11 café-au-lait skin macules, without other clinical or radiological signs typical of NF1, and with a central precocious puberty. Genetic analysis evidenced the new variant NM-152594.2:c.304delAp. (Thr102Argfs*19) in SPRED1 gene, which allowed to diagnose Legius syndrome. Conclusions We report for the first time a case of central precocious puberty in a girl with Legius syndrome. The presence of central precocious puberty in a child with characteristic café-au-lait macules should suggest pediatricians to perform genetic analysis in order to reach a definitive diagnosis. Further studies on timing of puberty in patients with RASopathies are needed to better elucidate if this clinical association is casual or secondary to their clinical condition.

scholarly journals Incidental whole-body MRI evidence of COVID-19 in an asymptomatic patient in a high prevalence region

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Valentina Angelini ◽  
Alberta Villanacci ◽  
Angelo Belotti ◽  
Francesca Castagnoli ◽  
Barbara Frittoli ◽  
...  
Keyword(s):  
Asymptomatic Patient ◽  
Whole Body ◽  
Diagnostic Tools ◽  
Historical Period ◽  
Case Presentation ◽  
Whole Body Mri ◽  
High Prevalence ◽  
Chest X Ray ◽  
Full Knowledge ◽  
Polymerase Chain

Abstract Background The purpose of this case report is to emphasize the importance of curing any clinical radiological elements in this historical period, especially in the area of endemic to coronavirus disease 19 (COVID-19) such as Lombardy and to stress the importance of the management of the asymptomatic patient, their crucial role in the spread of contagion. Case presentation We reported the case of incidental diagnosis of interstitial pneumonia by first finding on whole-body MR (WB-MR) in the patient affected by multiple myeloma (MM), with a negative respiratory symptoms at the time and with previous (1 month before) negative chest X-ray. The patient was promptly subjected to chest CT, which confirmed the suspicion of interstitial COVID-19 pneumonia and, in hospitalization, performed nasopharyngeal swabs for real-time polymerase chain reaction (RNA-PCR), with a doubtful outcome. Once the bacterial nature of the alterations was serologically and radiologically excluded, the patient was definitively diagnosed with COVID-19 and appropriately treated in hospitalization. Conclusion The clinical choices must, therefore, to make use of all the diagnostic tools available and full knowledge of the limitation of each of them.

Report from the European Society of Gynaecological Oncology (ESGO) 2020 State-of-the-Art Virtual Meeting

2021 ◽  
Vol 31 (5) ◽  
pp. 658-669
Author(s):  
Zoia Razumova ◽  
Nicolò Bizzarri ◽  
Joanna Kacperczyk-Bartnik ◽  
Andrei Pletnev ◽  
Antonio Gonzalez Martin ◽  
...  
Keyword(s):  
European Society ◽  
State Of The Art ◽  
Opinion Leaders ◽  
European Network ◽  
Case Presentation ◽  
Gynaecological Oncology ◽  
Virtual Meeting ◽  
Different Types ◽  
Cancer Guidelines ◽  
First Time

This is a report from the European Society of Gynaecological Oncology State-of-the-Art Virtual Meeting held December 14–16, 2020. The unique 3-day conference offered comprehensive state-of-the-art summaries on the major advances in the treatment of different types of gynecological cancers. Sessions opened with a case presentation followed by a keynote lecture and interactive debates with opinion leaders in the field. The speakers also presented scientific reviews on the clinical trial landscape in collaboration with the European Network of Gynecological Oncological Trial (ENGOT) groups. In addition, the new ESGO-ESRTO-ESP endometrial cancer guidelines were officially presented in public. This paper describes the key information and latest studies that were presented for the first time at the conference.

scholarly journals Hoarseness of Voice as a Rare Presentation of Tuberculosis: A Case Report Study

2019 ◽  
Vol 7 (19) ◽  
pp. 3262-3264
Author(s):  
Taher Felemban ◽  
Abdullah Ashi ◽  
Abdullah Sindi ◽  
Mohannad Rajab ◽  
Zuhair Al Jehani
Keyword(s):  
Laryngeal Carcinoma ◽  
Incidental Finding ◽  
Chain Reaction ◽  
Rare Presentation ◽  
Case Presentation ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Laryngeal Tuberculosis

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.

Abstract P134: ASSOCIATION OF HYPERTENSION WITH MORTALITY RISK IN PATIENTS WITH COVID 19 PNEUMONIA IN A HOSPITAL IN MEXICO CITY

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
José Martín Alanís Naranjo ◽  
Gabriela Olguín Contreras ◽  
Cristo Raymundo Ibarra Jaimes
Keyword(s):  
Severe Pneumonia ◽  
Ground Glass Opacity ◽  
Cross Sectional Study ◽  
Community Acquired Pneumonia ◽  
P Value ◽  
Cross Sectional ◽  
Risk Of Mortality ◽  
Chest X Ray ◽  
Time Of Admission ◽  
First Time

Introduction: The world is currently suffering from the outbreak of a pandemic caused by the SARS-CoV-2 coronavirus, which causes the disease called COVID-19. This disease was reported for the first time in Wuhan, Hubei Province, China, on December 31, 2019. Hypertension, diabetes and cardiovascular disease are common among patients with COVID-19. In Mexico, information on the association between COVID-19 and hypertension is scarce. Methods: This investigation was a descriptive, observational and cross-sectional study that included patients over 18 years of age who had been hospitalized with laboratory-confirmed COVID-19 between April 6, 2020, and May 6, 2020, and exhibited chest X-ray abnormalities (ground-glass opacity, interstitial alterations and/or multilobar infiltrate). Severity of pneumonia (severe vs. nonsevere) at the time of admission was defined using the community-acquired pneumonia guidelines of the American Thoracic Society (ATS). Results: Information was collected from 89 patients with COVID-19 pneumonia, 34 of whom (38.2%) were hypertensive. When studying risk factors in hypertensive patients and their degree of statistical association with risk of mortality, only the severity of pneumonia stood out. The association between severe pneumonia and mortality was statistically significant (OR: 10.9, CI 1.19-99.6, p value = 0.034). Conclusions: Severity of pneumonia upon admission can be regarded as a marker of adverse clinical outcome in hypertensive COVID-19 patients. Among hypertensive COVID-19 patients, in-hospital mortality was high (68%); such mortality was higher in our study than has been reported in other series worldwide.

scholarly journals Propionibacterium acnes-associated sarcoidosis complicated by acute bird-related hypersensitivity pneumonitis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Michiru Sawahata ◽  
Noritaka Sakamoto ◽  
Hideaki Yamasawa ◽  
Yuki Iijima ◽  
Hirotoshi Kawata ◽  
...  
Keyword(s):  
Lung Biopsy ◽  
Hypersensitivity Pneumonitis ◽  
Propionibacterium Acnes ◽  
Lipoteichoic Acid ◽  
Specific Monoclonal Antibody ◽  
Past Medical History ◽  
Case Presentation ◽  
Different Types ◽  
History Of ◽  
First Time

Abstract Background The number of reports on sarcoidosis complicated by hypersensitivity pneumonitis (HP) is limited, and most describe cases complicated by chronic bird-related HP. Here, we present for the first time a case with Propionibacterium acnes-associated sarcoidosis complicated by acute bird-related HP. Case presentation A 62-year-old man with a past medical history of sarcoidosis was admitted to our department, and chest computed tomography showed diffuse ground-glass opacities, which appeared as he rapidly increased the number of pigeons he kept for a competition. Random transbronchial lung biopsy revealed well-formed non-caseating epithelioid granulomas, which contained positively stained substances on immunohistochemistry using the PAB antibody, a specific monoclonal antibody against P. acnes lipoteichoic acid. Poorly formed non-caseating granulomas without positively stained substances were also detected. Conclusion We describe the successful identification of this exceptionally rare case of sarcoidosis complicated by acute bird-related HP in which two morphologically and immunohistologically different types of granulomas were present in the same lung.

scholarly journals Spontaneous rupture of enormous renal angiomyolipoma in a pregnant tuberous sclerosis patient: a rare case

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Zechuan Liu ◽  
Yinghua Zou ◽  
Tianshi Lv ◽  
Haitao Guan ◽  
Zeyang Fan
Keyword(s):  
Tuberous Sclerosis ◽  
Rare Complication ◽  
Arterial Embolization ◽  
Renal Angiomyolipoma ◽  
Case Presentation ◽  
Selective Arterial Embolization ◽  
Medical Termination ◽  
The Status ◽  
First Time

Abstract Background Renal angiomyolipoma (RAML) is a rare benign kidney tumour comprised of adipose tissue, smooth muscle, and blood vessels. It can cause fatal complications if it ruptures. Although there have been reports of RAMLs rupturing, it is unusual to see RAMLs rupture during pregnancy, especially in pregnant women with tuberous sclerosis (TSC). Moreover, we reported a rare complication after selective arterial embolization (SAE) for the first time, which called aseptic liquefaction necrosis. Case presentation The case is a 16-week-pregnant woman with TSC who presented with severe flank pain, which was secondary to the rupture of a large, previously unknown RAML. This was confirmed by emergency computed tomography and successfully treated with selective arterial embolization after the patient received counselling and provided prior informed written consent for medical termination of pregnancy (MTP). The patient underwent abortion 3 weeks after the SAE. The patient required drainage 2 months after the SAE because of aseptic liquefaction necrosis. During follow-up, the patient’s lesion remained stable. Conclusion RAML rupture is a rare but rather serious complication in pregnant tuberous sclerosis patients. Selective arterial embolization (SAE) should be performed immediately, and the status of the pregnancy needs to be assessed by a multidisciplinary team. We also report for the first time the rare complication of aseptic liquefaction necrosis after SAE of RAML, for which percutaneous drainage is effective.

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