scholarly journals HEV-Associated Neuralgic Amyotrophy: A Multicentric Case Series

Pathogens ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 672
Author(s):  
Johannes H. Bannasch ◽  
Benjamin Berger ◽  
Claus-Peter Schwartkopp ◽  
Marco Berning ◽  
Oliver Goetze ◽  
...  
Keyword(s):  
Case Series ◽  
Hepatitis E ◽  
Intravenous Immunoglobulins ◽  
Large Variability ◽  
Neuralgic Amyotrophy ◽  
Therapeutic Procedures ◽  
Duration Of Hospitalization ◽  
The Common ◽  
Initiation Of Therapy ◽  
Side Dominance

Background: Neuralgic amyotrophy (NA) has been described as a possible extrahepatic manifestation of hepatitis E virus (HEV) infection. Usually, HEV-associated NA occurs bilaterally. The clinical characteristics determining the course of HEV-associated NA have still not been defined. Methods: In this retrospective multicentric case series, 16 patients with HEV-associated NA were studied and compared to 176 HEV patients without NA in terms of their age, sex, and ALT levels. Results: Neither gender distribution (75% vs. 67% male) nor age (47 vs. 48 years median) differed significantly between the NA patients and controls. Eight NA patients (50%) presented with bilateral involvement—seven of these had right-side dominance and one had left-side dominance. Thirteen cases (81%) were hospitalized. Eight of these patients stayed in hospital for five to seven days, and five patients stayed for up to two weeks. The time from the onset of NA to the HEV diagnosis, as well as the diagnostic and therapeutic proceedings, showed a large variability. In total, 13 (81%) patients received treatment: 1/13 (8%) received intravenous immunoglobulins, 8/13 (62%) received glucocorticoids, 3/13 (23%) received ribavirin, and 6/13 (46%) received pregabalin/gabapentin. Patients with ages above the median (47 years) were more likely to be treated (p = 0.001). Conclusion: HEV-associated NA causes a relevant morbidity. In our case series neither the type of treatment nor the time of initiation of therapy had a significant effect on the duration of hospitalization or the course of the disease. The clinical presentation, the common diagnostic and therapeutic procedures, and the patients’ characteristics showed large variability, demonstrating the necessity of standardized protocols for this rare but relevant disease.

scholarly journals Autoimmune Hemolytic Anemia as a Complication of Congenital Anemias. A Case Series and Review of the Literature

2021 ◽  
Vol 10 (15) ◽  
pp. 3439
Author(s):  
Irene Motta ◽  
Juri Giannotta ◽  
Marta Ferraresi ◽  
Kordelia Barbullushi ◽  
Nicoletta Revelli ◽  
...  
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Case Series ◽  
Intravenous Immunoglobulins ◽  
Point Of View ◽  
First Line ◽  
Human Erythropoietin ◽  
Immune Mediated ◽  
Hemolytic Crisis ◽  
Life Threatening

Congenital anemias may be complicated by immune-mediated hemolytic crisis. Alloantibodies are usually seen in chronically transfused patients, and autoantibodies have also been described, although they are rarely associated with overt autoimmune hemolytic anemia (AIHA), a serious and potentially life-threatening complication. Given the lack of data on the AIHA diagnosis and management in congenital anemias, we retrospectively evaluated all clinically relevant AIHA cases occurring at a referral center for AIHA, hemoglobinopathies, and chronic hemolytic anemias, focusing on clinical management and outcome. In our cohort, AIHA had a prevalence of 1% (14/1410 patients). The majority were warm AIHA. Possible triggers were recent transfusion, infection, pregnancy, and surgery. All the patients received steroid therapy as the first line, and about 25% required further treatment, including rituximab, azathioprine, intravenous immunoglobulins, and cyclophosphamide. Transfusion support was required in 57% of the patients with non-transfusion-dependent anemia, and recombinant human erythropoietin was safely administered in one third of the patients. AIHA in congenital anemias may be challenging both from a diagnostic and a therapeutic point of view. A proper evaluation of hemolytic markers, bone marrow compensation, and assessment of the direct antiglobulin test is mandatory.

Epidemiology of fulminant hepatitis E cases in Vienna - an informative case series

2020 ◽  
Vol 73 ◽  
pp. S853-S854
Author(s):  
David JM Bauer ◽  
Stephan Aberle ◽  
Anna Farthofer ◽  
David Chromy ◽  
Benedikt Simbrunner ◽  
...  
Keyword(s):  
Fulminant Hepatitis ◽  
Case Series ◽  
Hepatitis E ◽  
Informative Case

THE EVALUATION OF RACEMIC EPINEPHRINE IN THE TREATMENT OF INFECTIOUS CROUP

PEDIATRICS ◽  
1973 ◽  
Vol 52 (1) ◽  
pp. 52-55
Author(s):  
H. Garry Gardner ◽  
Keith R. Powell ◽  
Vernon J. Roden ◽  
James D. Cherry
Keyword(s):  
Clinical Improvement ◽  
Direct Effect ◽  
Retrospective Review ◽  
Therapeutic Regimen ◽  
Controlled Study ◽  
Double Blind ◽  
Therapeutic Procedures ◽  
Duration Of Hospitalization

The effectiveness of racemic epinephrine in the treatment of croup was evaluated by a retrospective review, a prospective protocol, and a controlled study. Although the majority of children who were treated with racemic epinephrine and evaluated prospectively had significant immediate clinical improvement, the therapeutic regimen did not seem to affect the overall duration of hospitalization or the incidence of tracheotomy during the study period. Ten of the 20 children who participated in the double-blind controlled study had significant improvement; five received racemic epinephrine and five received the placebo. These findings suggest that the apparent effectiveness of racemic epinephrine might be due to the nebulization of moisture rather than a direct effect of the drug. The present study points out the critical need for controlled studies in the evaluation of therapeutic procedures in the treatment of croup.

scholarly journals Carotid surgical cut-down technique for neuroendovascular therapy

2018 ◽  
Vol 25 (3) ◽  
pp. 348-352
Author(s):  
Issei Takano ◽  
Yoshiyuki Matsumoto ◽  
Yoshiko Fujii ◽  
Yuki Inoue ◽  
Yoshiki Sugiura ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Carotid Artery ◽  
Thoracic Aortic Aneurysm ◽  
Case Series ◽  
Aortic Arch Anomaly ◽  
Anticoagulation Agents ◽  
Abdominal Aortic ◽  
Major Vessel ◽  
The Common ◽  
Intracranial Circulation

Background Neuroendovascular therapy is typically performed via the femoral artery, but there are rare cases in which a tortuous upstream angioarchitecture makes it difficult to access the intracranial circulation via this route. Methods In this case series, we describe six cases treated by surgical cut-down in the neck, with puncture of the carotid artery. Antiplatelet and anticoagulation agents were used in all cases. The indications for the technique were postsurgical thoracic aortic aneurysm (two cases), postsurgical abdominal aortic aneurysm (one case), major vessel tortuosity of the common carotid artery (two cases) and aortic arch anomaly (one case). Results The surgical cut-down technique permitted successful neuroendovascular therapy. Although one patient had a small cervical haematoma, he was treated without surgical evacuation. Conclusion Overall, our findings indicate that the surgical cut-down technique is safe and useful for patients in whom the femoral approach is unsuitable.

scholarly journals 1402 Impact of COVID-19 on Nasal Fracture Presentation and Epidemiology: A Retrospective Comparative Case-series Study

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Hassane ◽  
S Palaniappan ◽  
M Szostok ◽  
M Shakeel
Keyword(s):  
Local Anaesthetic ◽  
Older Patients ◽  
Nasal Congestion ◽  
Case Series ◽  
Nasal Fracture ◽  
Case Series Study ◽  
The Common ◽  
The Difference ◽  
Nasal Fractures ◽  
Series Study

Abstract Aim Nasal fractures (NF) are the most common ENT presentation and commonly managed in the clinic or A&E. With the recent COVID pandemic, this study aims to assess the difference in demographics, incidence and aetiology in NF since the start of the first lockdown (16/03/2020) as well as management of nasal fractures. Method Retrospectively, data collection on demographics, history and management over 5 years (2015-2020) for all patients presenting with symptoms of nasal fracture. Data was collected on password-protected Excel spreadsheet and subsequent statistical analysis performed using IBM SPSS Statistics. Results A total of 346 patients were identified of which 36 were diagnosed during the lockdown. Seventy-one percent were ≤40 years old and common aetiology recorded was assault (n = 85), sports (n = 85) and falls (n = 77). Mechanical fall was the common aetiology in older patients. Across gender, falls was the most common aetiology in females (37/94) and assault for males (72/246). Epistaxis (57%) and nasal congestion (31.8%) were most commonly reported symptoms. Before lockdown, Fifty-six percent of the cohort underwent manipulation of NF under local anaesthetic and no intervention needed in 39% while 58% underwent no intervention during the lockdown. No patients were readmitted in 30 days who were treated conservatively or with local anaesthetic during the lockdown. Conclusions This study showed that the most common cause of NF was sports and assault while during the lockdown, falls was the leading cause. More patients were managed conservatively during the lockdown with no 30-readmission showing that conservative management was as effective as management under local anaesthetic.

scholarly journals A psychoacoustical study to investigate the perceived unpleasantness of infrasound combined with audio-frequency sound

Acta Acustica ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. 20
Author(s):  
Elisa Burke ◽  
Stefan Uppenkamp ◽  
Christian Koch
Keyword(s):  
Auditory Perception ◽  
Detection Threshold ◽  
Pairwise Comparison ◽  
Audio Frequency ◽  
Frequency Range ◽  
Comparison Task ◽  
Simultaneous Exposure ◽  
Large Variability ◽  
Numerical Scale ◽  
The Common

At many immission sites of infrasound (frequency f < 20 Hz), humans are exposed to a mixture of infrasound and sound in the common audio-frequency range (audio sound, 20 Hz < f < 20 kHz). Therefore, the purpose of this study was to examine the auditory perception of infrasound and audio sound not only in isolation but also in combination. This laboratory study aims to investigate the perceived unpleasantness of infrasound (sinusoid at 12 Hz) and audio sound (sinusoid at 1000 Hz, pink-noise 250–4000 Hz), presented alone or in combination with each other. A pairwise comparison task and a rating task using a numerical scale were conducted with 19 normal hearing listeners. In addition, individual detection thresholds were determined for the infrasound stimulus. Combinations of infrasound and audio sound were rated as equally or more unpleasant than either sound presented alone. Inter-individual differences in unpleasantness ratings using the numerical scale were particularly high for stimuli containing infrasound. This can only in part be related to the large variability in infrasound thresholds. These findings suggest that simultaneous exposure to infrasound and audio sound can increase the perceived unpleasantness when both are presented at a sufficient level above the detection threshold.

scholarly journals Neuralgic amyotrophy complicating acute hepatitis E infection: a rare association

2015 ◽  
Vol 2015 (mar04 1) ◽  
pp. bcr2014207669-bcr2014207669 ◽  
Author(s):  
E. Theochari ◽  
L. Vincent-Smith ◽  
C. Ellis
Keyword(s):  
Acute Hepatitis ◽  
Hepatitis E ◽  
Neuralgic Amyotrophy ◽  
Rare Association ◽  
Acute Hepatitis E

Acute stroke management and late referrals-Clinician and community unawareness, A one month case series from Tumbi regional referral hospital Pwani, Tanzania

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Adam M Gembe ◽  
◽  
Erhad Bilaro ◽  
Keyword(s):  
Emergency Department ◽  
Acute Stroke ◽  
Developing World ◽  
Case Series ◽  
Referral Hospital ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Stroke Management ◽  
Regional Referral Hospital ◽  
The Common

Stroke is among the common emergency department presentations in Tanzania at large. In the developing world, still there are challenges in diagnosis, management and monitoring of these cases hence high morbidity and mortality. A one month case series is presented here, from Pwani region Tanzania, to demonstrate the encountered challenges. Keywords: Acute stroke management clinician; Community unawareness.

Positive Intraoperative Cholangiography during Laparoscopic Cholecystectomy: Is Laparoscopic Common Bile Duct Exploration Necessary?

2005 ◽  
Vol 71 (9) ◽  
pp. 750-753
Author(s):  
Gabriel Akopian ◽  
James Blitz ◽  
Thomas Vander Laan
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Case Series ◽  
Common Bile Duct Stones ◽  
Common Bile Duct Exploration ◽  
Bile Duct Stones ◽  
Endoscopic Retrograde ◽  
Technical Problems ◽  
The Common

The treatment of choledocholithiasis discovered incidentally during laparoscopic cholecystectomy is not yet standardized. Options include laparoscopic common bile duct exploration (LCBDE), postoperative endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy (ERCP-ES), and no intervention. We undertook a review of our case series to determine whether LCBDE is obligatory and which LCBDE method is unsuccessful. During the 6-year study period, 91 patients with choledocholithiasis were identified. Fifty-six patients (62%) underwent LCBDE. Thirteen (23%) of these 56 patients subsequently required ERCP. Balloon sweeping of the common bile duct failed in 10 of 21 patients (48% failure) compared to any other combination of techniques with a failure rate of 1/33 (3%; P < 0.001). Two patients did not undergo complete duct exploration because of technical problems. Thirty-five patients (38%) did not undergo LCBDE. Nine of these patients (26%) did not have ERCP-ES. None of the patients who underwent postoperative ERCP-ES required additional procedures or surgery. LCBDE can successfully treat common bile duct stones, with minimal to no morbidity, but is not mandatory for safely treating choledocholithiasis. Additionally, advanced techniques for clearing the common bile duct are more successful. Surgeons should be proficient at performing these techniques.

Intravascular Ultrasound in Carotid Web

2019 ◽  
Vol 12 (5) ◽  
pp. 531-534 ◽  
Author(s):  
Sara Hassani ◽  
Raul G Nogueira ◽  
Alhamza R Al-Bayati ◽  
Rajesh Sachdeva ◽  
Michael McDaniel ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Fibromuscular Dysplasia ◽  
Case Series ◽  
Filling Defect ◽  
Vessel Occlusion ◽  
Posterior Aspect ◽  
Guide Catheter ◽  
Carotid Bulb ◽  
The Common ◽  
Clear Differentiation

BackgroundCarotid web (CaW) is a shelf-like linear filling defect in the posterior aspect of the internal carotid bulb, representing an intimal variant of fibromuscular dysplasia. The diagnosis of CaW is traditionally restricted to digital subtraction angiography (DSA), CT/MR angiography (CTA/MRA), and Duplex ultrasonography. In this series of patients with acute ischemic stroke, we evaluated the potential utility of intravascular ultrasound (IVUS) in further characterizing suspected CaWs.MethodsThis is a case series of three patients with suspected CaW who underwent DSA for treatment or investigation of large vessel occlusion strokes. In all cases the stroke investigation failed to identify an alternative cause, and the stroke etiology was attributed to a symptomatic CaW. The procedure consisted of positioning a guide catheter in the common carotid artery, navigating the IVUS probe distal to the carotid bulb, and then retracting the probe with a manual pullback. The acquired images were then reviewed in an independent workstationResultsIn two of the three cases, IVUS showed an isoechoic-to-hyperechoic focal eccentric area at the posterior carotid bulb, consistent with CaW. The endoluminal protrusion was inconspicuous on IVUS due to the low resolution of ultrasound not allowing a clear differentiation between fibrosis, thrombosis, and atherosclerosis. No abnormalities commonly associated with atherosclerotic disease or dissections were noted. The CaW could not be depicted in the third patient.ConclusionThe use of IVUS in the diagnosis of CaW may have limited relevance. Continued investigation of other imaging modalities for accurate CaW diagnosis is recommended.

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