scholarly journals De Quervain’s thyroiditis: current concepts and a report of four cases

2013 ◽  
pp. 49-54
Author(s):  
Roberto Boni ◽  
Pier G. Rabitti
Keyword(s):  
Post Partum ◽  
Rare Complication ◽  
Treatment Options ◽  
Current Treatment ◽  
Subacute Thyroiditis ◽  
Literature Discussion ◽  
Inflammatory Disorder ◽  
Upper Respiratory Tract ◽  
Systemic Symptoms ◽  
End Stage

Introduction: De Quervain’s subacute thyroiditis is a self-limiting granulomatous inflammatory disorder, which is thought to be virally induced in genetically predisposed individuals. It is characterized by thyroid pain and thyrotoxicosis, as well as by systemic symptoms like fever, hepatic cytolysis, and an elevated erythrocyte sedimentation rate. It is often mistaken for an upper respiratory tract infection. Materials and methods: The authors review recent advances in the understanding of the pathogenesis and pathophysiology of De Quervain’s subacute thyroiditis; risk factors for complications, with emphasis on relapses and end-stage hypothyroidism; differential diagnosis and the exclusion of other subtypes of thyroiditis; and current treatment options. Four cases of De Quervain’s thyroiditis are then analyzed and compared with cases in the literature. Discussion: In three of the patients, onset occurred in June and was probably related to a small, seasonal epidemic cluster. These cases were quite different from the fourth one, which occurred in October, suggesting that two distinct viruses might be involved. One of the patients presented a very rare complication, vocal-cord paralysis, which responded well to glucocorticoid therapy. Another presented with an even rarer post-partum form of painful thyroiditis.

scholarly journals Metachromatic Leukodystrophy: Diagnosis and Treatment Challenges

Bionatura ◽  
2021 ◽  
Vol 3 (3) ◽  
pp. 2083-2090
Author(s):  
Nayibe Tatiana Sanchez-Alvarez ◽  
Paula Katherine Bautista-Niño ◽  
Juanita Trejos-Suárez ◽  
Norma Cecilia Serrano-Diaz
Keyword(s):  
Intracellular Signaling ◽  
Metachromatic Leukodystrophy ◽  
Treatment Options ◽  
Current Treatment ◽  
Significant Advance ◽  
Rapid Progression ◽  
Hematopoietic Stem ◽  
Enzyme Replacement ◽  
Bibliographic Search ◽  
Systemic Symptoms

Metachromatic leukodystrophy is a neurological disease of the lysosomal deposit that has a significant impact given the implications for the neurodegenerative deterioration of the patient. Currently, there is no treatment available that reverses the development of characteristic neurological and systemic symptoms. Objective. Carry out an updated bibliographic search on the most critical advances in the treatment and diagnosis for LDM. A retrospective topic review published in English and Spanish in the Orphanet and Pubmed databases. Current treatment options, such as enzyme replacement therapy and hematopoietic stem cell transplantation aimed at decreasing the rapid progression of the disease, improving patient survival; however, these are costly. The pathophysiological events of intracellular signaling related to the deficiency of the enzyme Arylsulfatase A and subsequent accumulation of sulphatides and glycosylated ceramides have not yet been established. Recently, the accumulation of C16 sulphatides has been shown to inhibit glycolysis and insulin secretion in pancreatic cells. The significant advance in technology has allowed timely diagnosis in patients suffering from LDM; however, they still do not have an effective treatment.

scholarly journals Chylous ascites after laparoscopic donor nephrectomy: First case report in Turkey

2021 ◽  
pp. 190-194
Author(s):  
Selçuk Şahin ◽  
Osman Özdemir ◽  
İsmail Evren ◽  
Serdar Karadağ ◽  
Volkan Tuğcu ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Complication ◽  
Treatment Options ◽  
Chylous Ascites ◽  
Donor Nephrectomy ◽  
Free Fluid ◽  
Somatostatin Analogue ◽  
Laparoscopic Donor Nephrectomy ◽  
First Case ◽  
End Stage

Living-donor kidney transplantation is one of the treatment options of end-stage renal failure. In many transplant centers, laparoscopic live-donor transplantation is recognised as the standard pro- cedure. Chylous ascites (CA) is a very rare complication after laparoscopic donor nephrectomy (LDN). We aimed to present the management of the first case report in Turkey. 62-year-old male patient underwent laparoscopic transperitoneal left donor nephrectomy. One month after discharge, he was admitted with abdominal distention and imaging revealed diffuse free fluid in the abdomen. After diagnosis, milky colored chylous fluid was collected by inserting a percutenous drainage cathe- ter. The patient was treated with combination of percutaneous drainage, somatostatin analogue and total parenteral nutrition. Keywords: chylous ascites; laparoscopic donor nephrectomy; complication

scholarly journals Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient

2017 ◽  
Vol 3 (2) ◽  
pp. 55-62 ◽  
Author(s):  
Alexander A. Vitin ◽  
Leonard Azamfirei ◽  
Dana Tomescu ◽  
John D. Lang
Keyword(s):  
Liver Disease ◽  
Lactic Acidosis ◽  
Perioperative Management ◽  
Treatment Options ◽  
Disease Patient ◽  
Lactate Production ◽  
Current Treatment ◽  
Multiple Organ ◽  
End Stage Liver Disease ◽  
End Stage

Abstract Lactic acidosis (LA) in end-stage liver disease (ESLD) patients has been recognized as one of the most complicated clinical problems and is associated with increased morbidity and mortality. Multiple-organ failure, associated with advanced stages of cirrhosis, exacerbates dysfunction of numerous parts of lactate metabolism cycle, which manifests as increased lactate production and impaired clearance, leading to severe LA-induced acidemia. These problems become especially prominent in ESLD patients, that undergo partial hepatectomy and, particularly, liver transplantation. Perioperative management of LA and associated severe acidemia is an inseparable part of anesthesia, post-operative and critical care for this category of patients, presenting a wide variety of challenges. In this review, lactic acidosis applied pathophysiology, clinical implications for ESLD patients, diagnosis, role of intraoperative factors, such as anesthesia- and surgery-related, vasoactive agents impact, and also current treatment options and modalities have been discussed.

scholarly journals Cartilage Perforation in Rhinophyma Treated with Diode Laser A Disastrous Complication

2017 ◽  
Vol 1 (1) ◽  
pp. 22-23
Author(s):  
S. S. Shirol ◽  
Keyword(s):  
Diode Laser ◽  
Rare Complication ◽  
Surgical Excision ◽  
Unusual Complication ◽  
Inflammatory Disorder ◽  
Layer By Layer ◽  
Aesthetic Outcome ◽  
Level Of Evidence ◽  
Acne Rosacea ◽  
End Stage

Rhinophyma is a slowly progressive, disfiguring, inflammatory disorder of nose, which represents the end stage of acne rosacea. Various modalities of treatments like dermabrasion, surgical excision, cryotherapy, electrocautery and lasers. Each modality has some limitations and advantages. Lasers are known for precise excision layer by layer and good aesthetic outcome. However, we present a patient of Rhinophyma treated with diode lasers with an unusual complication of lower lateral cartilage perforation. Level of Evidence: Level V, A report of rare complication. Keywords: Rhinophyma, Diode laser, Cartilage perforation, Complication, Laser.

scholarly journals Recent Treatment Advances and New Trials in Adult Nephrotic Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Eva Königshausen ◽  
Lorenz Sellin
Keyword(s):  
Nephrotic Syndrome ◽  
Treatment Options ◽  
Immunosuppressive Treatment ◽  
Case Series ◽  
Current Treatment ◽  
Primary Glomerulonephritis ◽  
Kdigo Guidelines ◽  
Stage Renal Disease ◽  
End Stage ◽  
Insight Into

The etiology of nephrotic syndrome is complex and ranges from primary glomerulonephritis to secondary forms. Patients with nephrotic syndrome often need immunosuppressive treatment with its side effects and may progress to end stage renal disease. This review focuses on recent advances in the treatment of primary causes of nephrotic syndrome (idiopathic membranous nephropathy (iMN), minimal change disease (MCD), and focal segmental glomerulosclerosis (FSGS)) since the publication of the KDIGO guidelines in 2012. Current treatment recommendations are mostly based on randomized controlled trials (RCTs) in children, small RCTs, or case series in adults. Recently, only a few new RCTs have been published, such as the Gemritux trial evaluating rituximab treatment versus supportive antiproteinuric and antihypertensive therapy in iMN. Many RCTs are ongoing for iMN, MCD, and FSGS that will provide further information on the effectiveness of different treatment options for the causative disease. In addition to reviewing recent clinical studies, we provide insight into potential new targets for the treatment of nephrotic syndrome from recent basic science publications.

Management of osteoarthritis - biological approaches: current concepts

2019 ◽  
Vol 5 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Eric J Cotter ◽  
Rachel M Frank ◽  
Bert Mandelbaum
Keyword(s):  
Biological Treatment ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Current Evidence ◽  
Anti Inflammatory ◽  
End Stage

Osteoarthritis is a major cause of disability and decreased quality of life in millions of patients and costs billions of dollars annually to treat. The current treatment options for osteoarthritis include weight loss, activity modification, anti-inflammatory medications, steroid intra-articular injections, lubricating hyaluronic acid injections and arthroplasty for end-stage cases. There has been interest in recent decades in identifying biological treatment modalities to slow the progression of the disease and preserve native joints. Biologics including platelet-rich plasma, bone marrow aspirate concentrate and adipose-derived mesenchymal stem cells are among the most commonly investigated treatments. Existing literature demonstrates anti-inflammatory properties of orthobiologics, butno treatment has clearly demonstrated significant joint preservation properties, including the ability to reverse progression of osteoarthritis. What is more clear is that these injection treatments have been shown in the majority of studies to be safe. Research is ongoing to identify optimal indications, preparations, compositions, safety profiles and clinical outcomes of biological therapies. This article will review the current evidence of biologics for treatment of osteoarthritis and recent statements made by orthopaedic subspecialty groups on this important topic.

scholarly journals Managing acute pain in patients who report lactose intolerance: the safety of an old excipient re-examined

2018 ◽  
Vol 9 (5) ◽  
pp. 227-235 ◽  
Author(s):  
Deanna Mill ◽  
Jessica Dawson ◽  
Jacinta Lee Johnson
Keyword(s):  
Acute Pain ◽  
Lactose Intolerance ◽  
Treatment Options ◽  
Specific Treatment ◽  
Pharmaceutical Preparations ◽  
Current Treatment ◽  
Individual Variability ◽  
Drug Classes ◽  
Alternative Treatment Strategy ◽  
Systemic Symptoms

Lactose intolerance is exceedingly common, reportedly affecting up to 70% of the world’s population, leading to both abdominal and systemic symptoms. Current treatment focuses predominantly on restricting dietary consumption of lactose. Given lactose is one of the most commonly used excipients in the pharmaceutical industry, consideration must be given to the lactose content and therefore safety of pharmaceutical preparations prescribed for patients with lactose intolerance. This article summarizes the current literature examining the likelihood of inducing adverse effects through the administration of lactose-containing pharmaceutical preparations in patients reporting lactose intolerance, describes how to assess this risk on an individual patient basis and reviews suitable analgesic options for this population. A case study is presented detailing a patient reporting lactose intolerance who insists on treatment with the lactose-free product codeine/ibuprofen (Nurofen Plus) rather than other codeine-free analgesics. It is important to assess the likelihood of lactose as an excipient inducing symptoms in this scenario, as reluctance to cease codeine could suggest codeine dependence, an issue that is becoming increasingly common in countries such as Australia and Canada. Given codeine dependence is associated with serious sequelae including hospitalization and death, the patient must either be reassured the lactose component in their prescribed analgesics will not induce symptoms or an alternative treatment strategy must be confirmed. General recommendations applying theory from the literature to the management of acute pain in lactose-intolerant patients are discussed and specific treatment options are outlined. Although large inter-individual variability is reported, most lactose-intolerant patients can tolerate the small quantities of lactose found in pharmaceutical preparations. Cumulative lactose exposure can be assessed in patients taking multiple medications while also consuming lactose in the diet. In those sensitive to small quantities of lactose, lactase supplements can be trailed. Additionally, for the analgesic drug classes employed for the management of acute pain, lactose-free formulations, including most oral liquids and dispersible tablets and some oral tablets and capsules, are available.

scholarly journals Exploring Body Mass Index Changes in Left Ventricular Assist Device Patients

2019 ◽  
Author(s):  
Raquel E. Thomas ◽  
Corrine Hanson ◽  
Glenda Woscyna ◽  
Brian D. Lowes
Keyword(s):  
Heart Failure ◽  
Weight Gain ◽  
Treatment Options ◽  
Current Treatment ◽  
Left Ventricular ◽  
Weight Changes ◽  
Ventricular Assist ◽  
Weight One ◽  
Mechanical Devices ◽  
End Stage

Background: Current treatment options for end-stage heart failure, such as transplantation, can be limited by obesity guidelines. Mechanical devices such as Left Ventricular Assistive Devices (LVAD) can bridge heart failure patients to transplantation, however, after implantation; some patients may experience weight gain that precludes them from transplantation. Therefore, the objective of this study was to evaluate weight changes after the implantation of an LVAD. Methods: A retrospective review of 130 patients receiving an LVAD were divided into two groups based on BMI at the time of implantation: obese (>30 kg/m2) and non-obese (/m2). Patients were evaluated at three time points post LVAD implantation: 3, 6, and 12 months for changes in weight and BMI. Results: The mean BMI of the overall cohort at the time of LVAD implantation was 30.3 kg/m2. Patients who were not classified as obese at the time of LVAD implementation had a significant increase in BMI (2.1 kg/m2, p<0.001). Conclusion: Weight gain after LVAD implementation is more likely in patients who are non-obese at the time of LVAD evaluation; however, obese subjects remained unlikely to lose weight one year post implantation.

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

EPIDEMIC THYROIDITIS

1964 ◽  
Vol 45 (3) ◽  
pp. 381-401 ◽  
Author(s):  
G. Hintze ◽  
P. Fortelius ◽  
J. Railo
Keyword(s):  
Thyroid Gland ◽  
Distribution Pattern ◽  
Needle Biopsy ◽  
Serum Proteins ◽  
Acute Infection ◽  
Thyroid Tissue ◽  
Subacute Thyroiditis ◽  
Present Observation ◽  
Upper Respiratory Tract ◽  
Endemic Goitre

ABSTRACT A type of subacute thyroiditis occurring epidemically in a factory in Helsinki was observed in 44 cases. In every case the thyroiditis followed an acute infection of the upper respiratory tract. The variation in incidence during one and a half years was in good agreement with that of the acute infection. Since Helsinki is in an endemic goitre region, the fact that the disease was of the migrating type was of great diagnostic importance. In all cases but one, the nodules have persisted. One case of asymptomatic thyroiditis was seen. In the majority of the patients the thyroid gland had been carefully palpated before the thyroiditis occurred, and in all cases the condition was followed up by the same investigator. Special attention was paid to changes in the iodine metabolism, the serum cholesterol, the electrophoretic distribution pattern of the serum proteins, and the circulating thyroid auto-antibodies. In many cases needle biopsy of the thyroid gland was performed. Thyroid function invariably returned to normal with time, although one patient remained in a hypothyroid state for about a year. In no cases were thyroid auto-antibodies found. For the beta-globulin fraction, the electrophoretic distribution pattern of the serum proteins gave values which were still not normalized in any case, and only in two cases was the alpha2-fraction normalized. The needle biopsy, when thyroid tissue was obtained, showed almost the same picture as in endemic goitre, but in some specimens nonspecific inflammatory changes were seen. Prednisolone relieved the symptoms, but did not affect the course of the disease. According to the present observation this type of epidemic thyroiditis would seem to represent a form of nonspecific subacute thyroiditis.

Sign in / Sign up

Export Citation Format

Share Document