scholarly journals A Case Series of Spontaneous Secondary Pneumothorax in Post Covid Period: A Clinical Insight

2018 ◽  
Vol 3 (1) ◽  
pp. 013-017
Author(s):  
Sayani Banerjee ◽  
Sujoy Das Thakur ◽  
Aishwarya Nandy
Keyword(s):  
Rare Complication ◽  
Case Series ◽  
Sudden Onset ◽  
Positive Pressure ◽  
Persistent Inflammation ◽  
Chest Auscultation ◽  
Long Term Prognosis ◽  
Novel Coronavirus ◽  
Mean Time

Introduction: We are in the era of novel coronavirus pandemic. Each wave is teaching us something new about the disease pathology, long term prognosis. Nonetheless, COVID-19 is giving rise to new challenges to the clinicians every day with its new found complications, long haul Covid symptoms. Secondary spontaneous pneumothorax has been reported to be a rare complication, seen in 1%-2% of COVID-19 patients with a mean time occurrence of 24.3 days from the hospital admission during the early phase of intubation. Case discussion: We report a case series of four patients in post COVID period presented with sudden onset respiratory distress and hypoxia, diagnosed with spontaneous secondary pneumothorax. Out of three only one patient received NIV support during his past treatment for COVID-19 and others were treated with oxygen. Therefore, barotrauma secondary to positive pressure ventilation and rupture of cystic bulla cannot be a sole cause of this complication. Persistent chronic inflammatory process and ischemic damage of alveoli are other possible etiologies. Conclusion: We highlight in our case series the importance of clinical examination, especially chest auscultation, which most clinicians circumvent owing to the trepidation of contracting COVID-19. We also proposed large researches to identify causal association with pneumothorax and previous use of steroids to treat COVID-19, persistent inflammation, age, gender, comorbidity etc to prevent it, as it can be debilitating and fatal. A clinician should always keep pneumothorax as a differential in sudden deteriorating breathlessness and hypoxia in post COVID period as it may happen as late as >40 days from primary COVID diagnosis.

scholarly journals Totally implantable catheter embolism: two related cases

2008 ◽  
Vol 126 (6) ◽  
pp. 347-349 ◽  
Author(s):  
Rodrigo Chaves Ribeiro ◽  
Áurea Cristina Ferreira Monteiro ◽  
Quirino Cavalcante Menezes ◽  
Sérgio Tomaz Schettini ◽  
Sonia Maria Rossi Vianna
Keyword(s):  
Wilms Tumor ◽  
Rare Complication ◽  
Case Series ◽  
Stage Iv ◽  
Venous Access ◽  
Endovascular Procedure ◽  
Asymptomatic Patients ◽  
Case Series Study ◽  
Series Study

CONTEXT AND OBJECTIVE: Long-term totally implantable catheters (e.g. Port-a-Cath®) are frequently used for long-term venous access in children with cancer. The use of this type of catheter is associated with complications such as infection, extrusion, extravasation and thrombosis. Embolism of catheter fragments is a rare complication, but has potential for morbidity. The aim here was to report on two cases in which embolism of fragments of a long-term totally implantable catheter occurred. DESIGN AND SETTING: Case series study at Hospital do Servidor Público Estadual, São Paulo. METHODS: Retrospective review of catheter embolism in oncological pediatric patients with long-term totally implantable catheters. RESULTS: The first patient was a 3-year-old girl diagnosed with stage IV Wilms' tumor. Treatment was started with the introduction of a totally implantable catheter through the subclavian vein. At the time of removal, it was realized that the catheter had fractured inside the heart. An endovascular procedure was necessary to remove the fragment. The second case was a boy diagnosed with stage II Wilms' tumor at the age of two years. At the time of removal, it was noticed that the catheter had disconnected from the reservoir and an endovascular procedure was also necessary to remove the embolized catheter. CONCLUSION: Embolism of fragments of totally implantable catheters is a rare complication that needs to be recognized even in asymptomatic patients.

P1836Constrictive pericarditis after open heart surgery: a 20-year case controlled study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A E Moreyra ◽  
Y Yang ◽  
S Zinonos ◽  
N M Cosgrove ◽  
J Cabrera ◽  
...  
Keyword(s):  
Constrictive Pericarditis ◽  
Heart Surgery ◽  
Rare Complication ◽  
Open Heart Surgery ◽  
Controlled Study ◽  
Robert Wood Johnson Foundation ◽  
Open Heart ◽  
Significant Difference ◽  
Long Term Prognosis

Abstract Background Constrictive pericarditis (CoPe) after open-heart surgery (OHS) is a rare complication. Information on the incidence, determinants, and prognosis of this condition has been scarcely reported. Purpose To investigate the long term prognosis of CoPe after OHS. Methods Using the Myocardial Infarction Data Acquisition System database, we analyzed records of 144,902 patients that had OHS in New Jersey hospitals between 1995 and 2015. CoPe was identified in 79 patients after discharge. Differences in proportions were analyzed using chi square. Cases and controls were matched for demographics and comorbidities. Cox proportional hazard models were used to evaluate outcome risks. Log-rank test was used to assess differences in the Kaplan-Meier survival curves. Results Patients with CoPe were more likely to have history of valve disease (HVD) (p<0.0001), atrial fibrillation (AF) (p=0.0006) and chronic kidney disease (CKD) (p=0.012). Significant predictors of CoPe were AF (HR 1.62, 95% CI 1.02–2.59), CKD (HR 2.70, 95% CI 1.53–4.76), diabetes (HR 1.73, 95% CI 1.08–2.80) and HVD (HR 3.11, 95% CI 1.88–5.15). Patients with CoPe compared to matched controls had a higher 10-year mortality (p<0.0001). This became a statistically significant difference at 6 years after surgery (Figure). Survival Curve Conclusion Constrictive pericarditis is a rare complication of OHS and occurs more frequently in patients with AF, CKD, diabetes and HVD. It is associated with an unfavorable long-term prognosis. The data highlight the need for strategies to help prevent this complication. Acknowledgement/Funding Robert Wood Johnson Foundation

scholarly journals Salvage endoscopic resection in patients with esophageal adenocarcinoma after chemoradiotherapy

2018 ◽  
Vol 06 (09) ◽  
pp. E1126-E1129 ◽  
Author(s):  
Irma C. Noordzij ◽  
Wouter L. Curvers ◽  
Clément J. Huysentruyt ◽  
Grard A.P. Nieuwenhuijzen ◽  
Geert-Jan Creemers ◽  
...  
Keyword(s):  
Esophageal Adenocarcinoma ◽  
Endoscopic Resection ◽  
Argon Plasma Coagulation ◽  
Case Series ◽  
Argon Plasma ◽  
Residual Tumor ◽  
Esophageal Resection ◽  
Sustained Remission ◽  
Long Term Prognosis

Abstract Background and study aims For early esophageal adenocarcinoma, endoscopic resection is an accepted curative treatment with an excellent long-term prognosis. Case series from Japan have reported endoscopic resection of residual esophageal squamous cell carcinoma after chemoradiotherapy. This is the first report describing endoscopic resection of residual esophageal adenocarcinoma after chemoradiotherapy. Two patients with advanced esophageal adenocarcinoma had been treated with chemoradiotherapy because comorbidity precluded esophageal resection. When residual tumor was observed endoscopically, complete remission was achieved by salvage endoscopic therapy alone or in combination with argon plasma coagulation (APC). Both patients achieved long-term sustained remission and died of non-tumor-related causes.

scholarly journals RESECTION AND REGENERATION- A HOPE FOR THE HOPELESS

2020 ◽  
pp. 1-5
Author(s):  
Apeksha Annigeri B. ◽  
Rajiv Nidasale Puttaswamaiah ◽  
Avinash Janaki Lingaraju
Keyword(s):  
Alveolar Bone ◽  
Treatment Plan ◽  
Treatment Options ◽  
Case Series ◽  
Cost Effective ◽  
Ridge Preservation ◽  
Tooth Structure ◽  
Implant Placement ◽  
Long Term Prognosis

Preservation of tooth structure has always been the prime aim of dental practice. Teeth with advanced periodontal disease in multirooted teeth often pose a significant challenge to the clinician, complicating the treatment plan and compromising long term prognosis. The outcome of the treatment is determined by proper case selection and surgical, endodontic and prosthetic parameters. Resective and regenerative osseous procedures are often employed to help preserve the tooth structure, alveolar bone involving the retained root of multirooted teeth and are cost effective over the other treatment options like ridge preservation/augmentation followed by implant placement. This case series describes application of resective and regenerative techniques for molars with extensive combined periodontal-endodontic disease.

Parafoveal atrophy after human amniotic membrane graft for macular hole in patients with high myopia

2020 ◽  
pp. bjophthalmol-2019-315603
Author(s):  
Der-Chong Tsai ◽  
Yu-Hsuan Huang ◽  
Shih-Jen Chen
Keyword(s):  
Macular Hole ◽  
Amniotic Membrane ◽  
Axial Length ◽  
High Myopia ◽  
Rare Complication ◽  
Case Series ◽  
Visual Outcome ◽  
Human Amniotic Membrane ◽  
Significant Difference

PurposeTo report the surgical outcome and postoperative hypopigmented change around fovea among patients with high myopia who received human amniotic membrane (hAM) graft transplantation for macular hole (MH).MethodThis retrospective, interventional case series included 10 eyes of 10 consecutive patients (5 (50%) male) with high myopia (axial length over 26.5 mm) who received hAM graft to treat persisted or chronic MH with or without retinal detachment in two hospitals. Postoperative parafoveal atrophy was identified with colour fundus picture and structure optical coherent tomography. Baseline characteristics and short-term visual outcome were analysed.ResultsThe preoperative mean (±SD) axial length and MH diameter were 29.9 (±1.8) mm and 881.8 (±438.5) μm, respectively. After hAM transplantation, seven (70%) eyes had complete MH closure and the mean best-corrected visual acuity (BCVA) improved from 1.26 (±0.48) logarithm of minimal angle of resolution (logMAR) before operation to 1.11 (±0.44) logMAR on the last visit (p=0.074). Patchy atrophy-like depigmentation developed around the MH lesion in four (40.0%) eyes as early as in the first month after surgery. None of them had visual worsening. In terms of demographics, axial length, MH size, ocular history, preoperative BCVA and postoperative BCVA, there was no significant difference between those with and without the parafoveal atrophy. No graft rejection and inflammation happened during the follow-up.ConclusionParafovea atrophy, a rare complication in the conventional MH surgery, was observed in 40% of eyes with highly myopic MH after hAM graft transplantation. The pathogenesis and long-term consequence need further investigations.

scholarly journals COVID-19 Pandemic in the Disguise of Multi System Inflammatory Syndrome in Children: A Case Series

2021 ◽  
Author(s):  
Anahita Sanaei Dashti ◽  
Kamyar Ebrahimi ◽  
Reza Shahriarirad ◽  
Shabnam Hajiani Ghotbabadi ◽  
Shiva Aminnia
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Organ Damage ◽  
The Novel ◽  
Number Of Children ◽  
Public Crisis ◽  
Novel Coronavirus ◽  
Atypical Presentations ◽  
Inflammatory Syndrome

Abstract Although nearly a year has passed since the emerge of the SARS-CoV-2 virus, with it, a serious and novel pediatric condition called children's multisystem inflammatory syndrome (MIS-C) has subsequently emerged. In order to achieve a better understanding and management of the disease, documentation and reporting of atypical cases is justified, particularly with the growing number of children with inflammatory syndrome with clinical features simulating MIS during the ongoing COVID-19 pandemic. Based on similar reports from numerous countries with temporal relation to COVID-19 infection in the community, it is essential for general pediatricians to be on alert for such atypical presentations and early referral to tertiary care should be considered as appropriate. Here we four cases of Multisystem Inflammatory Syndrome (MIS) during the COVID-19 pandemic. Early diagnosis and treatment of patients meeting full or partial criteria for MIS are critical to preventing end-organ damage and other long-term complications, especially during times of public crisis and global health emergencies, such as the novel coronavirus pandemic.

scholarly journals Chronic headache treatment: can we always follow international guidelines?

2019 ◽  
Vol 3 (24) ◽  
pp. 5-9
Author(s):  
N. V. Latysheva
Keyword(s):  
Chronic Headache ◽  
Beta Blockers ◽  
Botulinum Toxin Type A ◽  
Case Series ◽  
Botulinum Toxin Type ◽  
Tension Type Headache ◽  
International Guidelines ◽  
Long Term Prognosis ◽  
Type Headache

International guidelines on the prevention of migraine recommend the use of five main classes of medications: beta-blockers, antiepileptics, antidepressants (amitriptyline and venlafaxine), angiotensin receptor antagonists and botulinum toxin type A. Chronic tension-type headache (CTTH) guidelines are even more limiting and contain only amitriptyline, venlafaxine and mirtazapine. However, long-term intake of these medications is substantially limited by their tolerability issues. Moreover, most recommended medications cannot control the most frequently observed comorbidities, where depression plays the most important role in treatment selection, efficacy and long-term prognosis. This paper reviews the current migraine and CTTH prevention guidelines and complexities that physicians encounter with their use. The paper also includes a case series of treating chronic headache with a new multimodal antidepressant vortioxetine.

scholarly journals Therapy of Pyothorax in Cats via Small-Bore Thoracostomy Tube in Terms of Efficacy, Complications and Outcomes

Animals ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 107
Author(s):  
Evelyn Heier ◽  
Gabriel Wurtinger ◽  
Esther Hassdenteufel ◽  
Matthias Schneider
Keyword(s):  
Case Series ◽  
Comparable Efficacy ◽  
Closed Chest ◽  
Treatment Groups ◽  
First Line Therapy ◽  
Intravenous Antibiotics ◽  
A New Technique ◽  
Long Term Prognosis ◽  
One Year

First-line therapy for cats with pyothorax consists of intravenous antibiotics, drainage of the septic pleural effusion and closed-chest lavage. Large-bore thoracostomy tubes are traditionally used for drainage, but case series indicate a comparable efficacy using small-bore tubes. In this retrospective study, we describe a new technique of sheath-guided small-bore (6 F) thoracostomy tubes in cats with pyothorax and evaluate their efficacy and complications. Additionally, we compare outcomes between two treatment groups. Placement and use of the small-bore thoracostomy tubes described here has a low complication rate of 4% (3/67 tubes), and 53% (24/45) of the cats could be treated with thoracostomy tubes and closed-chest lavage according to the protocol. The success rate is reduced by 18% (8/45) due to deaths caused mainly by sepsis, 16% (7/45) due to structural diseases requiring surgery and a further 14% (6/43) due to lavage failures that could only be cured after additive therapy (thoracotomy or fibrinolysis). The long-term prognosis was very good, with a survival rate one year after discharge of 94% (30/32). We detected no effect on survival by early placement of bilateral thoracostomy tubes or closed-chest lavage with a heparinised solution. In conclusion, therapy of pyothorax with small-bore thoracostomy tubes is as successful as therapy with large- or medium-bore tubes.

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