scholarly journals The spectrum of fibroelastolytic papulosis: a retrospective case series.

2018 ◽  
Vol 76 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Nélia Cunha ◽  
Joana Cabete ◽  
Alexandre João ◽  
André Lencastre
Keyword(s):  
Case Series ◽  
Pseudoxanthoma Elasticum ◽  
Time Frame ◽  
Elastic Fibers ◽  
Retrospective Case ◽  
Common Term ◽  
Dermal Collagen ◽  
The Common ◽  
Epidermal Atrophy ◽  
Clinical And Pathological Features

Introduction: There is an overlap between clinical and pathological features of the entities known as pseudoxanthoma elasticum-like papillary dermal elastolysis (PXE-PDE) and white fibrous papulosis of the neck (WFPN). Although the term fibroelastolytic papulosis has been used to encompass both entities as spectrum variants of a one and only disease, many authors still differentiate the two.Methods: Cases of fibroelastolytic papulosis confirmed by histopathologic examination were retrospectively reviewed within a time frame of 2.5 years.Results: Five cases of fibroelastolytic papulosis were identified. All patients were females aged between 63 and 78 years, presenting with an asymptomatic eruption of isolated or coalescing white to yellow papules on the neck. Two of the patients also had involvement of other anatomical areas. In all cases histology demonstrated a significantly decreased or absent papillary dermal elastic plexus, a mild superficial perivascular lymphocytic infiltrate and sparse melanophages in the papillary dermis, without interface changes. A decrease in upper reticular dermal elastic fibers was noted in four cases and thickening of dermal collagen bundles in three cases. Dilated superficial dermal vessels were present in 3 cases and mild epidermal atrophy in one case.Conclusion: We find the differentiation of PXE-PDE and WFPN to be somewhat theoretical, often confusing, and based on non-significant subtle histological and clinical differences. In our opinion, we should not continue to use these terms, but favor the common term of fibroelastolytic papulosis.

scholarly journals Acute bacterial nephritis. A descriptive study of an underdiagnosed entity

2020 ◽  
Vol 80 (3) ◽  
pp. 1-10
Author(s):  
Pedro Antonio Madero-Morales ◽  
Rigoberto Pallares-Méndez ◽  
Rodrigo Romero-Mata ◽  
Guillermo Vizcarra-Mata ◽  
Andrés Guillén-Lozoya
Keyword(s):  
Acute Pyelonephritis ◽  
Clinical Characteristics ◽  
Clinical Course ◽  
Case Series ◽  
Therapy Response ◽  
Time Frame ◽  
Clinical Findings ◽  
Imaging Features ◽  
Imaging Studies ◽  
Retrospective Case

Background: Acute bacterial nephritis is an infectious process diagnosed through imaging studies. The clinical course of the disease has been shown to be more aggressive than acute pyelonephritis. It continues to be underdiagnosed, thus there are few studies on the entity in the literature. Objective: To describe the clinical characteristics and imaging features of acute bacterial nephritis, as well as its clinical course. Design: A descriptive, retrospective case series was conducted. Materials and methods: Thirty-two cases of acute bacterial nephritis in patients admitted to the hospital within the time frame of 2009 to 2016 were reviewed. The patients’ clinical characteristics upon admission were registered, as well as inpatient clinical progression, culture results, and antibiotic therapy response. The imaging studies were re-evaluated and the diagnostic consistency with either the focal or multifocal disease presentation was confirmed. Results: Cases predominated in women (n=29, 90.62%) and the most frequently associated comorbidities were diabetes (n=16, 50%) and obesity (n=9, 28.25%). The most important clinical findings upon admission were fever (n=15, 46.87%) and leukocytosis (n=27, 84.38%). Escherichia coli was the most commonly isolated bacterium (63.63%). Both acute focal bacterial nephritis and acute multifocal bacterial nephritis were observed in 46.87% (n=15) and 53.13% (n=17) of the patients, respectively. Imaging studies were required for all diagnoses. Conclusion: Fever and leukocytosis are the main findings in acute bacterial nephritis. Imaging studies are necessary for making the diagnosis, given that acute pyelonephritis and acute bacterial nephritis cannot be clinically differentiated.

scholarly journals Prevalence of Symptomatic Venous Thrombo-Embolism in Patients with Total Contact Cast for Diabetic foot Complications; A Retrospective Case Series

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Roland King ◽  
Simon Platt ◽  
Gillian Jackson
Keyword(s):  
Retrospective Review ◽  
Diabetic Foot ◽  
Case Series ◽  
Time Frame ◽  
High Rate ◽  
Diabetic Patients ◽  
Retrospective Case ◽  
Total Contact Cast ◽  
Prolonged Contact ◽  
Total Contact Casting

Category: Ankle, Diabetes, Midfoot/Forefoot Introduction/Purpose: Venous thrombo-embolism (VTE) is a costly and potentially life threatening complication of limb immobilisation in a plaster of Paris cast. It is now generally recommended that patients undergoing limb immobilisation in cast are given LMWH therapy. The gold standard of treatment for diabetic patients with Charcot feet is total contact casting (TCC). TCC is also employed in the management of diabetic foot ulceration (DFI). Such casting is often prolonged with a time frame greater than 6 weeks. In general diabetic patients with established complication, (Charcot, DFI) often have comorbidities which increase the risk of VTE when the limb is immobilised. One would anticipate these patients to have a high rate of VTE given the immobile limb and comorbidities contributing to higher risk. Methods: A retrospective review was undertaken. A search on patients’ records up to April 2015 was undertaken to identify patients placed into total contact casting. These patients all had DFI or Charcot treated with a TCC. The patient’s electronic and paper records were reviewed for any documentation of VTE, as well as other co-morbidities. Results: 18 patients aged between 43 and 78 (mean 60) were identified. These patients were casted between one week to 3 months. None of these 18 patients sustained a documented VTE. None of them were on prophylactic anti-coagulation for the time they were in cast. All of the patients had a documented significant cardiovascular history (as well as Diabetes Mellitus), with HbA1c values ranging from 45 to 122 (median 74). Body mass index values for all of the patients were unavailable. Conclusion: Despite high risk for the developing a VTE, none of the patients in our series suffered a documented symptomatic PE or DVT. We recognise the limitations of our study; small numbers with retrospective review. Nonetheless, we hypothesised that with prolonged contact casting in patients with significant comorbidity the prevalence of VTE would be higher than that observed. We believe that this is the first study looking for VTE in a TCC and diabetic population.

scholarly journals Can pleural packing be an effective solution for uncontrollable intra or post-operative hemorrhage

2020 ◽  
Vol 7 (7) ◽  
pp. 2087
Author(s):  
Hazem Zribi ◽  
Abderrahmen Ammar ◽  
Amina Abdelkbir ◽  
Imen Bouacida ◽  
Sarra Maazaoui ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Invasive Pulmonary Aspergillosis ◽  
Case Series ◽  
Good Alternative ◽  
Common Point ◽  
Retrospective Case ◽  
Case Series Study ◽  
History Of ◽  
The Common ◽  
The Mean

Background: Uncontrollable bleeding during thoracic surgery has been a challenging problem faced by surgeons. The aim of this study was to clarify the usefulness of pleural packing as a good alternative to control hemorrhage and to deduce the common point between those patients.Methods: This was a retrospective case series study of eight patients who underwent thoracic surgery with uncontrollable intrathoracic haemorrhage and shock which required intrathoracic packing from January 2014 to December 2019.Results: During the study period, eight patients underwent thoracic surgery with uncontrollable intrathoracic haemorrhage and needed packing.  Successful hemostasis was achieved in all cases after pleural packing. The mean age was 58.5 years and six patients were males. The common point was the history of pulmonary tuberculosis which was with invasive pulmonary aspergillosis for two patients. Incision was a posterolateral thoracotomy in all cases and six patients required pulmonary resection (five lobectomy and one bilobectomy), one patient required decortication, and one had tumorectomy of a paragonglioma located in the Barety’s space. The unpacking took place right after 48 hours. An arrest of the bleeding was noticed in all the remaining patients. The mean time of the mechanical ventilation was 11 days. Complications included atelectasis and infectious pneumonitis. We noted one case of death.Conclusions: Intrathoracic packing may be an effective and feasible technique in managing uncontrollable post-operative hemorrhage when the life of patients is in danger. This technique should always be considered for patients with tuberculosis history.

scholarly journals 2255. The Use of Dalbavancin for Staphylococcus aureus Bacteremia in Persons Who Inject Drugs (PWID)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S772-S772
Author(s):  
Nicholas W Van Hise ◽  
Michael Anderson ◽  
David McKinsey ◽  
Joel McKinsey ◽  
Brian Harting ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Case Series ◽  
Time Frame ◽  
High Morbidity ◽  
Retrospective Case ◽  
Persons Who Inject Drugs ◽  
Staphylococcus Aureus Bacteremia ◽  
Intravenous Antibiotics

Abstract Background Staphylococcus aureus is a significant cause of bacteremia and is associated with high morbidity and mortality rates. In patients with S. aureus bacteremia, studies have proven that intravenous antibiotics are needed for the entire course of therapy. For some groups of patients, specifically in persons who inject drugs (PWID), the long-term use of IV antibiotics is not safe or feasible. In this population, the current options would be obtaining intravenous access daily for antibiotic infusions, oral antibiotics, or being admitted to a facility that can monitor the patient. Data concerning the utilization of dalbavancin for the treatment of S. aureus bacteremia are limited. Methods This was a multicenter, retrospective case series of patients treated with four to six weekly doses of dalbavancin at 5 infusion centers in 3 states under the care of Metro Infectious Disease Consultant (MIDC) physicians between January 1 and December 31, 2018. All patients received intravenous therapy through a peripherally inserted catheter that was removed immediately after the infusion was completed. All patients were evaluated by an MIDC physician at the time of the initial dalbavancin dose, and weekly through their course of therapy. Cure was defined as negative blood cultures and no clinical evidence of persistent or relapsing infection. All patients completed their prescribed dosing and had phone follow-up to assess treatment efficacy at weeks 4, 8, 12, and 24. Results Twenty-one patients were included in the analysis. All patients began therapy for S. aureus bacteremia as inpatients and were transitioned to dalbavancin as outpatients. All patients received dalbavancin 1 g followed by 500 mg doses for at least 3 more weeks with an average of 4 weeks of therapy. Of the 21 patients, 16 were able to be contacted post therapy. Of the 16 patients, 2 patients were readmitted within the 6 month time frame for recurrent bacteremia related to intravenous drug usage. The remaining 14 patients remained disease free at the 6 month interval. No patients experienced a line related issue or C. difficile infection during the course of therapy. Conclusion Use of dalbavancin to treat S. aureus bacteremia infections resulted in clinical cure and markedly decreased healthcare costs. Disclosures All authors: No reported disclosures.

scholarly journals Pituitary Adenoma Surgery: Retrospective Analysis of My Personal Experience

2016 ◽  
Vol 13 (2) ◽  
pp. 63-67
Author(s):  
Prabin Shrestha ◽  
Anjana Rajbhandari
Keyword(s):  
Pituitary Adenoma ◽  
Analytical Study ◽  
Case Series ◽  
Postoperative Mortality ◽  
Pituitary Tumors ◽  
Csf Leak ◽  
Retrospective Case ◽  
The Common ◽  
Hormonal Evaluation

Pituitary tumors are one of the common brain tumors after gliomas, meningieomas and acoustic schwaanomas. It is commonly encountered in Nepal also as in other countries. Retrospective case series analytical study was done. The cases of pituitary adenoma from 2009 till 2015 were included. Types of pituitary adenoma, surgical technique, postoperative morbidities, mortalities and outcome were analyzed. Total 21 cases of pituitary adenoma were operated. All the cases were diagnosed by MRI, plain and contrast. In addition, thorough hormonal evaluation was done. All the cases were operated via transnasal transsphenoidal (TSS) approach. Microscope was used in all the cases whereas endoscope was used in selected cases. Preoperative lumbar puncture and CSF drain was not done in any case. Postoperative transient nasal CSF leak and diabetes insipidus were the most common surgery related morbidities in almost 50% cases which were totally cured with time. All the patients became asymptomatic and got better after surgery. Postoperative mortality and long term morbidity were nil. Recurrence was noted in one case after 3 years of surgery. Pituitary tumor surgery is safe and rewarding provided it is done carefully with skilled hands. TSS is a good approach with minimal postoperative complications. Better to have both microscope and endoscope for TSS.Nepal Journal of Neuroscience. Vol. 13, No. 2, 2016, Page:63-67

Cannabis-associated arteritis

VASA ◽  
2010 ◽  
Vol 39 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Grotenhermen
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Cardiovascular Effects ◽  
Causative Factor ◽  
Cannabis Use ◽  
Thromboangiitis Obliterans ◽  
Pathological Features ◽  
Scientific Support ◽  
Clinical And Pathological Features

Background: To investigate the hypothesis that cases of arteritis similar to thromboangiitis obliterans (TAO) and associated with the use of cannabis were caused by cannabis or THC (dronabinol), or that cannabis use is a co-factor of TAO. Patients and methods: A systematic review on case reports and the literature on so-called cannabis arteritis, TAO, and cardiovascular effects of cannabinoids was conducted. Results: Fifteen reports with 57 cases of an arteritis associated with the use of cannabis and two additional case series of TAO, in which some patients also used cannabis, were identified. Clinical and pathological features of cannabis-associated arteritis do not differ from TAO and the major risk factor of TAO, tobacco use, was present in most, if not in all of these cases. The proposed pathophysiological mechanisms for the development of an arteritis by cannabis use are not substantiated. Conclusions: The hypothesis of cannabis being a causative factor or co-factor of TAO or an arteritis similar to TAO is not supported by the available evidence. The use of the term “cannabis arteritis” should be avoided until or unless more convincing scientific support is forthcoming.

Management of isoniazid-monoresistant tuberculosis (Hr-TB) in Queensland, Australia: a retrospective case series

2020 ◽  
Vol 173 ◽  
pp. 106163
Author(s):  
Malcolm Wilson ◽  
Bridget O'Connor ◽  
Nicholas Matigian ◽  
Geoffrey Eather
Keyword(s):  
Case Series ◽  
Retrospective Case ◽  
Retrospective Case Series

scholarly journals Peripartum hysterectomy: a five year review at a tertiary care centre

2017 ◽  
Vol 6 (8) ◽  
pp. 3590
Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Case Fatality ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
College Hospital ◽  
Peripartum Hysterectomy ◽  
Medical College ◽  
Obstetric Haemorrhage ◽  
Suboptimal Care

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally. 

Sign in / Sign up

Export Citation Format

Share Document