scholarly journals PERCUTANEOUS CYSTOLITHOLAPAXY AS AN ALTERNATIVE APPROACH FOR GIANT BLADDER STONES: A CASE SERIES OF PATIENTS WITH SIGNIFICANT COMORBIDITIES

2022 ◽  
Vol 29 (1) ◽  
Author(s):  
Kharisma Prasetya Adhyatma ◽  
Fauriski Febrian Prapiska
Keyword(s):  
Mental Illness ◽  
Spinal Anesthesia ◽  
Case Series ◽  
Indwelling Catheter ◽  
Bladder Stones ◽  
Renal Functions ◽  
Stone Fragmentation ◽  
Alternative Approach ◽  
Male Patients ◽  
Mentally Impaired

Objective: We reported two giant bladder stones cases, with significant comorbidities and mentally impaired patients, treated with PCCL. Case(s) Presentation: We report two cases of giant cystolithiasis (sized 8.8 cm x 7.2 cm and 7.0 cm x 5.8 cm) in male patients with impaired renal functions and mental illness. We performed PCCL on both patients with cystoscopy-guided bladder puncture and dilation, under spinal anesthesia. Stone fragmentation through transurethral (pneumatic) and percutaneous (suprapubic amplatz ultrasound) lithotriptors was performed simultaneously. Discussion: Stone fragments were evacuated through the nephroscope. These fluoroscopy-free procedures were performed under one hour. The patients were discharged on day three post-operatively without indwelling catheter. Conclusion: We performed PCCL with simultaneous transurethral fragmentation in giant bladder stone cases presenting with impaired renal functions and mental illness. We faced no significant post-operative issue. This technique, or its modified approach, is safe and applicable

scholarly journals Management challenges in patients with comorbid COVID-19 associated delirium and serious mental illness – A case series

2021 ◽  
pp. 009121742098597
Author(s):  
Saba Syed ◽  
Michael Couse ◽  
Rashi Ojha
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Healthcare Providers ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Active Management ◽  
The Novel ◽  
Psychiatric Facility ◽  
Medical Teams ◽  
Novel Coronavirus

Background There is still a lot unknown about the novel Coronavirus Disease 19 (COVID-19) and its effects in humans. This pandemic has posed several challenging clinical situations to healthcare providers. Objective We hope to highlight the distinctive challenges that COVID-19 presents in patients with serious mental illness and what steps primary medical teams can take to co-manage these patients with the psychiatry consultants. Methods We present a retrospective chart review of four patients who were on psychotropic polypharmacy and admitted to our hospital from the same long-term psychiatric facility with COVID-19 delirium and other associated medical complications. Results We illustrate how the primary medical teams and psychiatrists collaborated in clinical diagnosis, treatment, and management. Conclusions Patients with serious mental illness and COVID-19 infection require active collaboration between primary medical teams and psychiatrists for diagnostic clarification, reduction of psychotropic polypharmacy to avoid adverse effects and drug-drug interactions, prevention of psychiatric decompensation, and active management of agitation while balancing staff and patient safety concerns.

scholarly journals Open Appendicectomy under Spinal Anesthesia—A Valuable Alternative during COVID-19

2021 ◽  
Vol 07 (02) ◽  
pp. e69-e72
Author(s):  
Dinh Van Chi Mai ◽  
Alex Sagar ◽  
Oliver Claydon ◽  
Ji Young Park ◽  
Niteen Tapuria ◽  
...  
Keyword(s):  
United Kingdom ◽  
Patient Satisfaction ◽  
Spinal Anesthesia ◽  
Stated Preference ◽  
Case Series ◽  
District General Hospital ◽  
Complication Rates ◽  
Open Appendicectomy ◽  
Surgical Department ◽  
The United Kingdom

Abstract Introduction Concerns relating to coronavirus disease 2019 (COVID-19) and general anesthesia (GA) prompted our department to consider that open appendicectomy under spinal anesthesia (SA) avoids aerosolization from intubation and laparoscopy. While common in developing nations, it is unusual in the United Kingdom. We present the first United Kingdom case series and discuss its potential role during and after this pandemic. Methods We prospectively studied patients with appendicitis at a British district general hospital who were unsuitable for conservative management and consequently underwent open appendicectomy under SA. We also reviewed patient satisfaction after 30 days. This ran for 5 weeks from March 25th, 2020 until the surgical department reverted to the laparoscopic appendicectomy as the standard of care. Main outcomes were 30-day complication rates and patient satisfaction. Results None of the included seven patients were COVID positive. The majority (four-sevenths) had complicated appendicitis. There were no major adverse (Clavien-Dindo grade III to V) postoperative events. Two patients suffered minor postoperative complications. Two experienced intraoperative pain. Mean operative time was 44 minutes. Median length of stay and return to activity was 1 and 14 days, respectively. Although four stated preference in hindsight for GA, the majority (five-sevenths) were satisfied with the operative experience under SA. Discussion Although contraindications, risk of pain, and specific complications may be limiting, our series demonstrates open appendicectomy under SA to be safe and feasible in the United Kingdom. The technique could be a valuable contingency for COVID-suspected cases and patients with high-risk respiratory disease.

Implementation of a spinal anesthesia and sedation protocol that reliably prolongs infant spinal anesthesia: Case series of 102 infants who received spinal anesthesia for urologic surgery

2020 ◽  
Vol 30 (12) ◽  
pp. 1355-1362
Author(s):  
Kathryn Handlogten ◽  
Lindsay Warner ◽  
Candace Granberg ◽  
Patricio Gargollo ◽  
Leanne Thalji ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Case Series ◽  
Urologic Surgery ◽  
Sedation Protocol

Patients with mental illness as victims of homicide: a national consecutive case series

2014 ◽  
Vol 1 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Cathryn Rodway ◽  
Sandra Flynn ◽  
David While ◽  
Mohammed S Rahman ◽  
Navneet Kapur ◽  
...  
Keyword(s):  
Mental Illness ◽  
Case Series ◽  
Consecutive Case

Gabapentin in the Treatment of Mental Illness: The Echo Chamber of the Case Series

2008 ◽  
Vol 14 ◽  
pp. 15-27 ◽  
Author(s):  
TIMOTHY S. CAREY ◽  
JOHN W. WILLIAMS ◽  
JOHN M. OLDHAM ◽  
FRANCINE GOODMAN ◽  
LEAH M. RANNEY ◽  
...  
Keyword(s):  
Mental Illness ◽  
Case Series ◽  
Echo Chamber

scholarly journals An Alternative Approach to Atopic Dermatitis: Part I—Case-Series Presentation

2004 ◽  
Vol 1 (1) ◽  
pp. 49-62 ◽  
Author(s):  
Hiromi Kobayashi ◽  
Kuniaki Takahashi ◽  
Nobuyuki Mizuno ◽  
Haruo Kutsuna ◽  
Masamitsu Ishii
Keyword(s):  
Atopic Dermatitis ◽  
Herbal Medicine ◽  
Conventional Therapy ◽  
Complex Disease ◽  
Case Series ◽  
Line Treatment ◽  
Second Line ◽  
Substantial Portion ◽  
Alternative Approach ◽  
Evidential Basis

Atopic dermatitis (AD) is a complex disease of obscure pathogenesis. A substantial portion of AD patients treated with conventional therapy become intractable after several cycles of recurrence. Over the last 20 years we have developed an alternative approach to treat many of these patients by diet and Kampo herbal medicine. However, as our approach is highly individualized and the Kampo formulae sometimes complicated, it is not easy to provide evidence to establish usefulness of this approach. In this Review, to demonstrate the effectiveness of the method of individualized Kampo therapy, results are presented for a series of patients who had failed with conventional therapy but were treated afterwards in our institution. Based on these data, we contend that there exist a definite subgroup of AD patients in whom conventional therapy fails, but the ‘Diet and Kampo’ approach succeeds, to heal. Therefore, this approach should be considered seriously as a second-line treatment for AD patients. In the Discussion, we review the evidential status of the current conventional strategies for AD treatment in general, and then specifically discuss the possibility of integrating Kampo regimens into it, taking our case-series presented here as evidential basis. We emphasize that Kampo therapy for AD is more ‘art’ than technology, for which expertise is an essential pre-requisite.

scholarly journals GYNAECOMASTIA

2010 ◽  
Vol 17 (02) ◽  
pp. 205-210
Author(s):  
ASIYA SHABBIR ◽  
TARIQ MAHMOOD REHAN ◽  
SHAHID Hussain Jaffery ◽  
Muhammad Ubaidullah Baig
Keyword(s):  
Benign Lesion ◽  
Case Series ◽  
Spontaneous Resolution ◽  
Subcutaneous Mastectomy ◽  
Appropriate Treatment ◽  
Case Series Study ◽  
Causative Factors ◽  
Male Patients ◽  
Series Study ◽  
Surgical Unit

Objectives: To determine the causative factors and management of Gynaecomastia. Study Design: Observational case series study. Place and Duration of Study: Surgical Unit-1 Bahawal Victoria Hospital Bahawalpur, from 1st January 200 till 31st December 2007. Patient and Methods: Thirty male patients having breast swelling were included in this study. Relevant history was obtained. Appropriate physical examination was performed. Necessary investigations were done and after making a diagnosis appropriate treatment was done. A total of 30 patients were studied in the study period of 18 months. Those male patients who were having breast lesion other than benign enlargement (e.g. Ca. Breast, Breast/Abscess) were not included in the study. Necessary investigations were done. Subcutaneous Mastectomy was performed. Results: The most common age group developing gynaecomastia was of 20-30 years (60%). Bilateral gynaecomastia was observed in 76.66% and unilateral gynaecomastia in 23.33%. Idiopathic gynaecomastia was observed in 73.33% cases. Medical treatment was given with tamoxifen 10mg twice a day for the period of three months in 6 case (20%) and this remained effective in 5 case (83.33%). Subcutaneous mastectomy was performed in 17 cases (56.66%). Post-operative complications were seen in 4 cases (23.52%), the most common complication being wound hematoma in 2 cases (11.76%). Most of the patients (88.9%) were fully satisfied with the results of subcutaneous mastectomy. Conclusion: Gynaecomastia is the most common benign lesion of the male breast. As far as physiological gynaecomastia is concerned, patients should be observed for at least 2 years from the onset of their condition. In most of the cases spontaneous resolution occurs. Surgical treatment should be planned in whom spontaneous resolution does not occur. Surgery remains the mainstay of therapy and is frequently indicated for psychological and cosmetic reasons. 

scholarly journals New genome editing technologies in the treatment of X-linked adrenoleukodystrophy

2020 ◽  
Vol 65 (2) ◽  
pp. 104-107
Author(s):  
V. Yu. Voinova ◽  
M. А. Shkolnikova ◽  
E. A. Nikolaeva
Keyword(s):  
Lentiviral Vector ◽  
Allogeneic Transplantation ◽  
Graft Versus Host Reaction ◽  
Gene Encoding ◽  
Graft Versus Host ◽  
Alternative Approach ◽  
Cd34 Cells ◽  
Male Patients ◽  
Genomic Editing ◽  
Type Sequence

X-linked adrenoleukodystrophy is a severe progressive neurological disease that is predominantly found in male patients and caused by mutations in the X-linked ABCD1 gene encoding peroxisome transport protein. The disease is clinically characterized by two main phenotypes: the most severe infant cerebral form and adrenomyeloneuropathy. The disease is treated by allogeneic transplantation of hematopoietic cells from a healthy donor to stop progression, and gene therapy with a self-activating lentiviral vector, the carrier of the functional gene ABCD1. Each method has its own limitations. The authors present and theoretically substantiate an alternative approach to the treatment of adrenoleukodystrophy; they propose to modify the autologous CD34+ cells from the patient using genomic editing, in order to replace the mutant DNA sequence of ABCD1 gene with a wild-type sequence, while replacing the mutant protein in the edited cells. The edited autologous CD34+ cells can be introduced by their transplantation into the bone marrow or by a series of repeated intravenous infusions. This method will allow avoiding both the search for a donor and the graft-versus-host reaction

Sign in / Sign up

Export Citation Format

Share Document