Transischiorectal fossa approach for resection of pudendal nerve schwannoma: case report

An outsider to the Held of surgery would probably take it for granted that surgeons have a highly developed rationale for choosing a laparoscopic approach to Crohns disease. After all, an increasing number of surgeons are performing laparoscopic surgery for Crohn's disease as witnessed by several articles published in the 1990s (Table)1-19. In fact this is not quite true. Most papers are case reports or series without controls, capable only of suggesting feasibility. Furthermore, comparison studies often feature selection flaws, and therefore beg the question of whether laparoscopic surgery should or not be considered as standard care. An attempt is made herein to give readers a concise insight of the evidence available in the English language literature. It does not pretend to offer a comprehensive review of the topic rather, it highlights some relevant issues, and then outlines what role, if any, laparoscopic surgery should play in Crohn's disease. There are at least 6 categories for discussion.

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Ovarian Mature Cystic Teratoma: Challenges of Surgical Management

Obstetrics and Gynecology International ◽

10.1155/2016/2390178 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Abha Sinha ◽

Ayman A. A. Ewies

Keyword(s):

Surgical Management ◽

English Language ◽

Cystic Teratoma ◽

Laparoscopic Approach ◽

Premenopausal Women ◽

Ovarian Teratoma ◽

Surgical Approaches ◽

Younger Women ◽

Standard Operation ◽

Chemical Peritonitis

Although ovarian mature cystic teratomas are the commonest adnexal masses occurring in premenopausal women, there are many challenges faced by gynecologists on deciding upon the best surgical management. There is uncertainty, lack of consensus, and variation in surgical practices. This paper critically analyzes various surgical approaches and techniques used to treat these cysts in an attempt to outline a unified guidance. MEDLINE and EMBASE databases were searched in January 2015 with no date limit using the key words “ovarian teratoma” and “ovarian dermoid.” The search was limited to articles in English language, humans, and female. The two authors conducted the search independently. The laparoscopic approach is generally considered to be the gold standard for the management. Oophorectomy should be the standard operation except in younger women with a single small cyst. The risk of chemical peritonitis after contents spillage is extremely rare and can certainly be overcome with thorough peritoneal lavage using warmed fluid. There is a place for surveillance in some selected cases.

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Congenital Zika Virus Infection Paradigm: What is in the Wardrobe? A Narrative Review

East Africa Science ◽

10.24248/easci.v1i1.4 ◽

2019 ◽

Vol 1 (1) ◽

pp. 49-56

Author(s):

Mariam M. Mirambo ◽

Lucas Matemba ◽

Mtebe Majigo ◽

Stephen E. Mshana

Keyword(s):

Virus Infection ◽

Neural Tube ◽

Zika Virus ◽

English Language ◽

Case Reports ◽

Case Series ◽

Epidemiological Studies ◽

Ocular Manifestations ◽

Zika Virus Infection ◽

N 93

Background: Zika virus infection during pregnancy has been recently associated with congenital microcephaly and other severe neural tube defects. However, the magnitude of confirmed cases and the scope of these anomalies have not been extensively documented. This review focuses on the magnitude of laboratory-confirmed congenital Zika virus cases among probable cases and describing the patterns of congenital anomalies allegedly caused by the Zika virus, information which will inform further research in this area. Methods: We conducted a literature search for English-language articles about congenital Zika virus infection using online electronic databases (PubMed/MEDLINE, POPLINE, Embase, Google Scholar, and Web of Knowledge). The search terms used were, “zika”, “pregnancy”, [year], “microcephaly”, “infants”, “children”, “neonates”, “foetuses”, “neural tube defect”, and “CNS manifestations” in different combinations. All articles reporting cases or case series between January 2015 and December 2016 were included. Data were entered into a Microsoft Excel database and analysed to obtain proportions of the confirmed cases and patterns of anomalies. Results: A total of 24 articles (11 case series, 9 case reports, and 4 others) were found to be eligible and included in this review. These articles reported 919 cases, with or without microcephaly, presumed to have congenital Zika virus infection. Of these cases, 884 (96.2%) had microcephaly. Of the 884 cases of microcephaly, 783 (88.6%) were tested for Zika virus infection, and 216 (27.6%; 95% confidence interval, 24.5% to 30.8%) were confirmed to be Zika virus-positive. In addition to microcephaly, other common abnormalities reported – out of 442 cases investigated – were calcifications of brain tissue (n=240, 54.3%), ventriculomegaly (n=93, 20.8%), cerebellar hypoplasia (n=52, 11.7%), and ocular manifestations (n=46, 10.4%). Conclusion: Based on the available literature, Zika virus infection during pregnancy might lead to a wide array of outcomes other than microcephaly. There is a need for more epidemiological studies in Zika-endemic areas, particularly in Africa, to ascertain the role of Zika virus in causing congenital neurological defects.

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Congenital Zika Virus Infection Paradigm: What is in the Wardrobe? A Narrative Review

East Africa Science ◽

10.24248/easci.v1.iss1.4 ◽

2019 ◽

Vol 1 (1) ◽

pp. 49-56

Author(s):

Mariam M. Mirambo ◽

Lucas Matemba ◽

Mtebe Majigo ◽

Stephen E. Mshana

Keyword(s):

Virus Infection ◽

Neural Tube ◽

Zika Virus ◽

English Language ◽

Case Reports ◽

Case Series ◽

Epidemiological Studies ◽

Ocular Manifestations ◽

Zika Virus Infection ◽

N 93

Background: Zika virus infection during pregnancy has been recently associated with congenital microcephaly and other severe neural tube defects. However, the magnitude of confirmed cases and the scope of these anomalies have not been extensively documented. This review focuses on the magnitude of laboratory-confirmed congenital Zika virus cases among probable cases and describing the patterns of congenital anomalies allegedly caused by the Zika virus, information which will inform further research in this area. Methods: We conducted a literature search for English-language articles about congenital Zika virus infection using online electronic databases (PubMed/MEDLINE, POPLINE, Embase, Google Scholar, and Web of Knowledge). The search terms used were, “zika”, “pregnancy”, [year], “microcephaly”, “infants”, “children”, “neonates”, “foetuses”, “neural tube defect”, and “CNS manifestations” in different combinations. All articles reporting cases or case series between January 2015 and December 2016 were included. Data were entered into a Microsoft Excel database and analysed to obtain proportions of the confirmed cases and patterns of anomalies. Results: A total of 24 articles (11 case series, 9 case reports, and 4 others) were found to be eligible and included in this review. These articles reported 919 cases, with or without microcephaly, presumed to have congenital Zika virus infection. Of these cases, 884 (96.2%) had microcephaly. Of the 884 cases of microcephaly, 783 (88.6%) were tested for Zika virus infection, and 216 (27.6%; 95% confidence interval, 24.5% to 30.8%) were confirmed to be Zika virus-positive. In addition to microcephaly, other common abnormalities reported – out of 442 cases investigated – were calcifications of brain tissue (n=240, 54.3%), ventriculomegaly (n=93, 20.8%), cerebellar hypoplasia (n=52, 11.7%), and ocular manifestations (n=46, 10.4%). Conclusion: Based on the available literature, Zika virus infection during pregnancy might lead to a wide array of outcomes other than microcephaly. There is a need for more epidemiological studies in Zika-endemic areas, particularly in Africa, to ascertain the role of Zika virus in causing congenital neurological defects.

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Novel Therapeutic Approaches and Targets for Treatment of Chronic Urticaria: New Insights and Promising Targets for a Challenging Disease

Current Pharmaceutical Biotechnology ◽

10.2174/1389201021666200630140137 ◽

2020 ◽

Vol 22 (1) ◽

pp. 32-45

Author(s):

Emanuela Martina ◽

Federico Diotallevi ◽

Tommaso Bianchelli ◽

Matteo Paolinelli ◽

Annamaria Offidani

Keyword(s):

English Language ◽

Life Experience ◽

Case Reports ◽

Immunosuppressive Agents ◽

Real Life ◽

Chronic Spontaneous Urticaria ◽

New Targets ◽

Current State ◽

Pubmed Database ◽

Novel Drugs

Background: Chronic Spontaneous Urticaria (CSU) is a disease characterized by the onset of wheals and/or angioedema over 6 weeks. The pathophysiology for CSU is very complex, involving mast cells and basophils with a multitude of inflammatory mediators. For many years the treatment of CSU has been based on the use of antihistamines, steroids and immunosuppressive agents with inconstant and frustrating results. The introduction of omalizumab, the only licensed biologic for antihistamine- refractory CSU, has changed the management of the disease. Objective: The aim of this article is to review the current state of the art of CSU, the real-life experience with omalizumab and the promising drugs that are under development. Methods:: An electronic search was performed to identify studies, case reports, guidelines and reviews focused on the new targets for the treatment of chronic spontaneous urticaria, both approved or under investigation. The search was limited to articles published in peer-reviewed journals in the English Language in the PubMed database and trials registered in Clinicaltrials.gov. Results:: Since the advent of omalizumab, the search for new therapies for chronic spontaneous urticaria has had a new impulse. Anti-IgE drugs will probably still be the cornerstone of therapy, but new targets may prove effective in syndromic urticaria or refractory cases. Conclusion:: Although omalizumab has been a breakthrough in the treatment of CSU, many patients do not completely get benefit and even require more effective treatments. Novel drugs are under investigation with promising results.

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Reticular erythematous mucinosis: Literature review and case report of a 24-year-old patient with systemic erythematosus lupus

Lupus ◽

10.1177/0961203320965702 ◽

2020 ◽

pp. 096120332096570

Author(s):

Juliana P Ocanha-Xavier ◽

Camila O Cola-Senra ◽

Jose Candido C Xavier-Junior

Keyword(s):

Systematic Review ◽

Case Report ◽

Literature Review ◽

English Language ◽

Case Reports ◽

Histopathological Diagnosis ◽

Skin Disorders ◽

Histopathological Findings ◽

Inflammatory Skin

Reticular erythematous mucinosis (REM) was first described 50 years ago, but only around 100 case reports in English have been published. Its relation with other inflammatory skin disorders is still being debated. We report a case of REM, including the clinical and histopathological findings. Also, a systematic review of 94 English-language reported cases is provided. The described criteria for clinical and histopathological diagnosis are highlighted in order to REM can be confidently diagnosed.

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Challenges in Treating Chlamydia trachomatis, Including Rectal Infections: Is It Time to Go Back to Doxycycline?

Annals of Pharmacotherapy ◽

10.1177/10600280211029945 ◽

2021 ◽

pp. 106002802110299

Author(s):

S. Lena Kang-Birken

Keyword(s):

Chlamydia Trachomatis ◽

Treatment Failure ◽

English Language ◽

Treatment Guidelines ◽

Case Reports ◽

Controlled Trial ◽

Absolute Difference ◽

Cochrane Library ◽

Increased Risk ◽

Meta Analyses

Objective: To evaluate recent publications on efficacy of single-dose azithromycin and 7-day doxycycline when treating Chlamydia trachomatis. Data Sources: A literature search of MEDLINE, EMBASE, PubMed, and Cochrane library was conducted (1990 to June 13, 2021) using the terms: Chlamydia trachomatis, genital chlamydia, rectal chlamydia, extragenital chlamydia, azithromycin, doxycycline, and treatment guidelines. ClinicalTrials.gov was searched to identify ongoing trials. Study Selection and Data Extraction: English language studies, including controlled studies, retrospective analyses, systematic reviews, meta-analyses, and case reports, reporting microbiological or clinical outcomes in adolescents and adults were considered. Data Synthesis: Systemic reviews and meta-analyses of randomized trials reported azithromycin efficacy of 96% to 97% in genital chlamydia. However, reports of treatment failure have emerged, especially among symptomatic males, with an increased risk of microbiological failure after azithromycin than doxycycline (relative risk = 2.45; 95% CI = 1.36-4.41). Retrospective analyses and prospective observational cohort studies reported lower efficacy range following azithromycin than doxycycline (74%-87% vs 92%-100%, respectively) in rectal chlamydia. First randomized controlled trial comparing azithromycin and doxycycline reported significantly higher microbiological cure following doxycycline, with absolute difference of 26% (95% CI = 16%-36%; P < 0.001). The proposed 2021 Centers for Disease Control and Prevention treatment guidelines designate doxycycline as the preferred agent for treatment at any site. Relevance to Patient Care and Clinical Practice: A growing body of evidence for treatment failure following azithromycin, especially in rectal chlamydia supports updating current practice. Conclusions: Doxycycline continues to achieve high efficacy in genital and rectal chlamydia. Clinicians should consider efficacy with convenience of dosing regimen, medication compliance, and sexual behavior risks when treating chlamydia infections.

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Drug-Induced Restless Legs Syndrome

Annals of Pharmacotherapy ◽

10.1177/1060028018760296 ◽

2018 ◽

Vol 52 (7) ◽

pp. 662-672 ◽

Cited By ~ 9

Author(s):

Edna Patatanian ◽

Melanie K. Claborn

Keyword(s):

Restless Legs Syndrome ◽

English Language ◽

Case Reports ◽

Data Extraction ◽

Case Series ◽

Predisposing Factors ◽

Drug Induced ◽

Restless Legs ◽

Drug Classes ◽

Study Selection

Objective: To review the literature on drug-induced restless legs syndrome (DI-RLS). Data Sources: The review included a search for English-language literature from 1966 to December 2017 in the MEDLINE, PubMed, and Ovid databases using the following search terms: restless legs syndrome (RLS), periodic limb movement, adverse effects, and drug-induced. In addition, background articles on the pathophysiology, etiology, and epidemiology of RLS were retrieved. Bibliographies of relevant articles were reviewed for additional citations. Study Selection and Data Extraction: All case reports, case series, and review articles of DI-RLS were identified and analyzed. There were only a small number of controlled clinical trials, and most data were from case reports and case series. Results: Several drugs and drug classes have been implicated in DI-RLS, with antidepressants, antipsychotics, and antiepileptics having the most evidence. In addition, RLS may be linked with a number of disorders or underlying predisposing factors as well. Conclusions: The prevalence of RLS is variable and ranges from 3% to 19% in the general population. There are many predisposing factors to RLS, but an emerging body of evidence suggests that there is an association between numerous drugs and RLS.

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Irresectable tumours of the temporal bone

The Journal of Laryngology & Otology ◽

10.1017/s0022215100101951 ◽

1987 ◽

Vol 101 (5) ◽

pp. 432-442 ◽

Cited By ~ 1

Author(s):

R. E. Quiney ◽

L. M. Flood

Keyword(s):

Temporal Bone ◽

Case Reports ◽

Sporadic Case ◽

Petrous Apex ◽

Surgical Approaches ◽

Total Removal ◽

Inaccessible Area ◽

History Of ◽

Petrous Temporal Bone

AbstractSporadic case reports and the few published series of expanding lesions of the deep petrous temporal bone propose a variety of surgical approaches to ensure excision. All such surgery represents a compromise between exposure adequate for total removal and avoidance of further neurological deficit. Unfortunately pathology in the petrous apex evolves relatively silently and diagnosis is delayed. In many cases total excision is impossible. We present a series of patients presenting with advanced tumours of the deep petrous temporal bone in order to illustrate the spectrum of disease encountered, the limited role of surgery and the natural history of irresectable pathology in this remote and inaccessible area.

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