Diagnostic workflow for small intestine diverticulitis: case series and systematic review.

2020 ◽  
Vol 1 (3) ◽  
pp. 1-17
Author(s):  
Andrés Márquez-Acosta ◽  
◽  
Alberto N. Peón ◽  
Kristopher Suárez-Bautista ◽  
Celia Nashielli Florez-Sánchez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Small Intestine ◽  
Acute Abdomen ◽  
Imaging Technique ◽  
Case Series ◽  
Signs And Symptoms ◽  
The Other ◽  
Scientific Databases ◽  
Keywords Imaging ◽  
Enhanced Computed Tomography

Objective: to assess new strategies in order to promptly diagnose small intestine diverticulitis. Methods: we thoroughly analyzed a case series of small intestine diverticulitis in order to describe three of the typical presentations of such disease (intestinal perforation, intestinal obstruction and obstruction developing perforation). A systematic review of the literature was then conducted in five different scientific databases using six different keywords. Imaging technique's sensitivity for small intestine diverticulitis was assessed, as well as the frequency of signs and symptoms of such pathology. A complete description of the signs and symptoms of acute abdomen-type pathologies was also investigated in order to provide differential traits to distinguish small intestine diverticulitis. Results: No pathognomonic signs or symptoms were detected for the pathology, although we found that all the other pathologies in the “acute abdomen” type of diseases have distinguishing traits that could be used to perform a differential diagnosis of small intestine diverticulitis. Moreover, contrast-enhanced computed tomography is the best imaging technique for the confirmation of such disease, when guided by an initial suspicion. Conclusion: Small intestine diverticulitis cannot be diagnosed by clinical exploration only, but patients that have acute abdomen characteristics, and are negative to signs and symptoms that are characteristic of the other diseases in its type should be suspected for such disease. The aforementioned suspicion may guide a better imaging technique selection and exploration through it.

Signs and symptoms associated with synthetic cannabinoid toxicity: systematic review

2016 ◽  
Vol 24 (6) ◽  
pp. 598-601 ◽  
Author(s):  
Julie Courts ◽  
Virginia Maskill ◽  
Andrew Gray ◽  
Paul Glue
Keyword(s):  
Systematic Review ◽  
Emergency Services ◽  
Case Reports ◽  
Synthetic Cannabinoids ◽  
Case Series ◽  
Signs And Symptoms ◽  
Synthetic Cannabinoid ◽  
Symptom Reporting ◽  
Presenting Symptoms ◽  
Study Population

Aims: Use of synthetic cannabinoids is associated with significant physical and psychological harms. This research quantified reported toxicities from published reports and assessed the influence of size of the reported study population on rates of symptom reporting. Methods: Systematic review of published case reports and case series of toxicity associated with use of synthetic cannabinoids. Results: Symptoms associated with synthetic cannabinoid toxicity were reported for 3695 individuals, predominantly young males. Symptoms included physiological (e.g. tachycardia, hypertension, nausea/vomiting), emotional (e.g. agitation, irritability, paranoia), behavioural (e.g. drowsiness, aggression) and perceptual (e.g. hallucinations) domains. Most common symptoms were tachycardia (30.2% of cases), agitation (13.5%), drowsiness (12.3%), nausea/vomiting (8.2%) and hallucinations (7.6%). Death or serious medical complications were uncommon (e.g. death 0.2%, stroke 0.1%, myocardial infarction 0.09%). Case reports/smaller case series ( n<10) reported statistically significantly higher rates for 29/34 symptoms than larger case series ( n≥10), which could represent selection bias. Conclusions: Symptoms of synthetic cannabinoid toxicity are variable and cover a number of physical and psychological domains. Symptom reporting varies by study population size. Due to the variable presenting symptoms of synthetic cannabinoid toxicity, clinicians in emergency services should consider synthetic cannabinoid toxicity when evaluating young adult male patients presenting with unexplained agitation or cardiovascular symptoms.

scholarly journals 675. Crimean-Congo Hemorrhagic Fever Beyond Ribavirin: A Systematic Review

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S439-S440
Author(s):  
Stephanie P Fabara ◽  
Raghavendra Tirupathi ◽  
Juan Fernando Ortiz ◽  
Urvish Patel ◽  
Sashwath Srikanth ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Acute Infection ◽  
Case Series ◽  
Case Fatality ◽  
Hemorrhagic Fever ◽  
The Other ◽  
Duration Of Symptoms ◽  
Crimean Congo Hemorrhagic Fever ◽  
Significant Difference

Abstract Background The Crimean-Congo Hemorrhagic Fever (CCHF) is a tick-borne virus infection that has been reported in about 30 countries worldwide. Clinical presentation is divided into three phases: pre-hemorrhagic, hemorrhagic, and convalescence. Ribavirin is standard of care treatment for acute infection and prophylaxis. However, the use of other treatments beyond ribavirin is largely unknown. Methods We conducted a systematic review using MOOSE protocol. The inclusion and exclusion criteria are seen in the Prisma diagram. For Bias Analysis we use a Robin-1 tool. Literature review algorithm Results We gathered a total of 10 studies, which included 4 therapeutic plasma exchange (TPE), 2 corticosteroids, 2 IVIG, and 1 with convalescent plasma (CP). TPE in one study showed decreased mortality rate and increased efficacy in patients with severe CCHF. While the other study reported pulmonary embolism related to the use of TPE. Nevertheless, the patients had good outcome in the end. Two case reports used TPE plus ribavirin and supportive measures. Both were discharged home and recovered without sequela. Corticosteroids were found to be beneficial in one study were the case fatality rate was lower with the addition of corticosteroids to ribavirin in severely ill patients (p=0.0014). In a case series of six patients, who received the combination in early stages of the disease had good clinical outcomes with improved survival. IVIG was shown to increase platelet counts in two studies. In the first study, platelet count increased above 150,000/mL in 8.5 +/- 2.5 days. While in the other study the normalization of platelets was seen in 4 - 4.8 days, with no significant difference (P = 0.49). In addition, there was a decrease in the duration of symptoms but there was no statistically significant difference in mortality rates (P = 0.171). CP treatment showed a survival rate of 86% in treated patients. CP was more useful in high-risk patients, defined as having a viral load of 108 copies/mL or more. The main limitations of the studies were the sample size and heterogenicity among the outcomes of the studies. Conclusion TPE, CP, IVIG, and corticosteroids were effective in improving the clinical outcomes of the patients. The use of these treatments beyond ribavirin should be explored in future studies. Disclosures All Authors: No reported disclosures

scholarly journals CLINICAL EVALUATION OF VAITARANA BASTI ALONG WITH DHANWANTARA TAILA MATRA BASTI IN AMAVATA: A CASE SERIES

2020 ◽  
Vol 11 (6) ◽  
pp. 12-15
Author(s):  
Sheetal G Lodha ◽  
Ruchika S Karade
Keyword(s):  
Rheumatoid Arthritis ◽  
Connective Tissue ◽  
Rheumatoid Factor ◽  
Morning Stiffness ◽  
Dominant Role ◽  
Case Series ◽  
Signs And Symptoms ◽  
The Other ◽  
Knee Joints ◽  
The Common

Amavata is one of the common and most crippling joint disorders. It is a chronic, degenerative disease of the connective tissue mainly involving the joints. The clinical features of Amavata such as pain, swelling and stiffness of joints, fever and general disability are very much close to the Rheumatological disorder called rheumatoid arthritis. Ama associated with aggravated vata plays a dominant role in the pathogenesis of Amavata. According to its pathophysiology, one should treat the morbid doshas involve in are kapha and vata simultaneously. In the present study, four clinically diagnosed cases of Amavata with swelling of knee joints and morning stiffness , pain in multiple joints, raised rheumatoid factor and anti CCP factor are treated with Vaitarana basti along with Dhanwantara taila Matra basti on same day and changes are observed in subjective and objective criteria. Significant improvement is observed in reducing signs and symptoms of Amavata and in rheumatoid arthritis factor and anti CCP. Vaitarana basti eradicate Ama and kapha dosha as the drugs of Vaitarana basti having Ama pachaka, vatakapha shamaka and Anulomaka properties. On the other hand, Matra basti of Dhanwantara taila pacifies the vatadosha and reduced the pain and swelling. It also acts as neuroprotective, analgesic, anti-inflammatory, anti-arthritic and anti-paralytic. The combination of Vaitarana basti and Dhanwantara taila Matra basti can be an effective treatment for Amavata.

Medically important trombiculids: a systematic review of the global distribution and clinical consequences of their bites

2021 ◽  
Vol 5 (2) ◽  
pp. 67-76
Author(s):  
Julián F. Porras-Villamil ◽  
Mario Javier-Olivera
Keyword(s):  
Systematic Review ◽  
Human Health ◽  
Case Reports ◽  
Clinical Signs ◽  
Case Series ◽  
Clinical Importance ◽  
Signs And Symptoms ◽  
Publication Date ◽  
Rickettsial Infections ◽  
Clinical Consequences

Background: Mites are among the smallest arthropods that can be seen without magnification, were the use of dermatoscopy is an invaluable tool. They are a cosmopolitan pest, and at the moment more than 250 species have been shown to produce problems for humans and animals alike. These mites are capable of producing a wide array of clinical signs and symptoms, from local to systemic, from mild to severe, as well as transmitting pathogens. This study aimed to provide an update to the clinical impact on human health, the distribution and species involved in the clinical conditions produced by trombiculids through a systematic review. Background: Mites are among the smallest arthropods that can be seen without magnification, were the use of dermatoscopy is an invaluable tool. They are a cosmopolitan pest, and at the moment more than 250 species have been shown to produce problems for humans and animals alike. These mites are capable of producing a wide array of clinical signs and symptoms, from local to systemic, from mild to severe, as well as transmitting pathogens. This study aimed to provide an update to the clinical impact on human health, the distribution and species involved in the clinical conditions produced by trombiculids through a systematic review. Methods: A systematic literature review was conducted in Medline, Lilacs, Redalyc, Scopus, SciELO and Google Scholar, were we use as a threshold of publication date the year 2008. We limited the search strategy to articles published in Portuguese, French, English and Spanish. Eligible studies were case reports and case series that reported outcomes in humans caused by trombiculid bites. Patient-level and study-level information was extracted. Results: The literature search yielded 832 studies; 13 were case reports, 4 case series and 2 descriptive studies reporting a total of 49 cases. Most patients were male, and the median age was 33.7±6.4 years old. The most frequently reported symptoms were local erythema, pruritus and papules. No deaths were documented. Trombiculids from the genera Trombicula, Eutrombicula and Leptotrombidium appear to be the most commonly reported. Discussion: Trombiculiasis is an infestation caused by the larval stage of various types of mites, known as chiggers, they belong to the class Arachnida and the family Trombiculidae. This systematic review provides an overview of the trombiculids of clinical importance, their distribution and effects of the bite on human health. Our results show that there are different species of mites that can have important consequences for human health. No fatal cases owere registered.Even so, the transmission of scrub typhus is important and remains one of the most life-threatening rickettsial infections in some regions of Asia. Conclusions: The bite of different species of trombiculids around the world can cause a wide array of clinical consequences to human health. Even as mortality appear to be nonexistent, trombiculid bites must be adequately diagnosed and treated properly: A systematic literature review was conducted in Medline, Lilacs, Redalyc, Scopus, SciELO and Google Scholar, were we use as a threshold of publication date the year 2008. We limited the search strategy to articles published in Portuguese, French, English and Spanish. Eligible studies were case reports and case series that reported outcomes in humans caused by trombiculid bites. Patient-level and study-level information was extracted. Results: The literature search yielded 832 studies; 13 were case reports, 4 case series and 2 descriptive studies reporting a total of 49 cases. Most patients were male, and the median age was 33.7±6.4 years old. The most frequently reported symptoms were local erythema, pruritus and papules. No deaths were documented. Trombiculids from the genera Trombicula, Eutrombicula and Leptotrombidium appear to be the most commonly reported. Discussion: Trombiculiasis is an infestation caused by the larval stage of various types of mites, known as chiggers, they belong to the class Arachnida and the family Trombiculidae. This systematic review provides an overview of the trombiculids of clinical importance, their distribution and effects of the bite on human health. Our results show that there are different species of mites that can have important consequences for human health. No fatal cases owere registered.Even so, the transmission of scrub typhus is important and remains one of the most life-threatening rickettsial infections in some regions of Asia. Conclusions: The bite of different species of trombiculids around the world can cause a wide array of clinical consequences to human health. Even as mortality appear to be nonexistent, trombiculid bites must be adequately diagnosed and treated properly.

Uneventful delivery of two pregnancies in a woman with severe factor XII deficiency: case report and systematic review

2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Stamatios Petousis ◽  
George Karavas ◽  
Chrysoula Margioula-Siarkou ◽  
Themistoklis Dagklis ◽  
Paraskevi Karapavlidou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Signs And Symptoms ◽  
Factor Xii ◽  
Case Presentation ◽  
Severe Deficiency ◽  
Pubmed Database ◽  
Increased Risk

Abstract Background Deficiency of factor XII (FXII) is widely considered to have a detrimental effect on pregnancy. Several reports underline the increased risk for antenatal complications with few published case reports of uncomplicated deliveries. The main objective of our article is to perform a systematic review to highlight pregnancies with severe deficiency of FXII that have been delivered uneventfully, along with presenting our relative case of a woman with severe deficiency of FXII. Materials and methods A systematic review was performed in the Pubmed database. Inclusion criteria were considered to be case reports and case series presenting delivery of uncomplicated pregnancies in women with severe FXII deficiency. Medical records of our patient were also reviewed in terms of signs and symptoms, laboratory and imaging examinations and neonatal outcomes. Results There were 62 abstracts derived while 44 were assessed for eligibility. There were finally three case reports of women with FXII deficiency delivering live newborns and one case series of 12 women with a final outcome of 19 deliveries. Regarding our case presentation, the woman with FXII levels <12%, after a neonatal death because of extreme prematurity (24 weeks + 4 days), was set in regular follow-up and treatment with bemiparin natriate, 3.5 mg/kg and acetylsalicylic acid, 100 mg/day. She finally managed to have her second pregnancy delivered at 38 weeks + 3 days, her third pregnancy ended up as a miscarriage and her fourth pregnancy was also delivered at 37 weeks + 4 days. Conclusion Despite the increased risk for antenatal complications, appropriate follow-up of pregnancies with severe FXII pregnancy may finally lead to an uneventful delivery.

scholarly journals Comparison of the cardiovascular presentations, complications and outcomes following different coronaviruses’ infection: A systematic review

2021 ◽  
Vol 13 (2) ◽  
pp. 92-101
Author(s):  
Mohammad Mostafa Ansari Ramandi ◽  
Hossein Yarmohammadi ◽  
Somayeh Beikmohammadi ◽  
Behzad Hassan Hosseiny Fahimi ◽  
Farbod Hatami ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Studies ◽  
Systematic Reviews ◽  
Case Reports ◽  
Cardiac Injury ◽  
Laboratory Data ◽  
Case Series ◽  
Signs And Symptoms ◽  
Mesh Terms ◽  
Thrombotic Complications

Manifestations caused by coronavirus family have presented it in many ways during the previous years. The aim of this systematic review was to gather all possible cardiovascular manifestations of the coronavirus family in the literature. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Scopus, Web of Science, Cochrane and ProQuest which were updated on May 1, 2020 for the last time. Regarding to the novelty and speed of publications on COVID-19, we searched Google Scholar and also references of included studies and review articles in the systematic search results were searched manually. The searched keywords were the combination of the following MeSH terms: "COVID-19", "SARS", "MERS" and "cardiovascular presentation". The systematic review was registered with ID CRD42020180736 in International Prospective Register of Systematic Reviews (PROSPERO). After screening, 28 original articles and ten case studies (five case reports and five case series) were included. Most of the studies were focused on COVID-19 (20 original articles and four case studies) while the only studies about Middle East Respiratory Syndrome (MERS) were a case report and a case series. Almost all the cardiovascular presentations and complications including acute cardiac injury, arrhythmias and the thrombotic complications were more prevalent in COVID-19 than severe acute respiratory syndrome (SARS) and MERS. The cardiac injury was the most common cardiovascular presentation and complication in COVID-19 whereas thrombotic complications were commonly reported in SARS. The cardiac injury was the predictor of disease severity and mortality in both COVID-19 and SARS.Coronavirus 2019 may present with cardiovascular manifestations and complications in signs and symptoms, laboratory data and other paraclinical findings. Also, cardiovascular complications in the course of COVID-19 may result in worse outcomes.

scholarly journals MRI, CT and FDG-PET/CT findings of Wolffian tumor: four-case series

2021 ◽  
Author(s):  
Hisataka Ito ◽  
Takashi Koyama ◽  
Yuichiro Kanie ◽  
Kozue Morioka ◽  
Moto Nakaya ◽  
...  
Keyword(s):  
Acute Abdomen ◽  
Fdg Pet ◽  
Case Series ◽  
The Other ◽  
Diffusion Weighted Images ◽  
Ct Findings ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Fdg Accumulation

Abstarct Purpose The purpose of this study is to describe the characteristic MRI, CT, and 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) findings of Wolffian tumor. Methods We reviewed preoperative images in four surgical cases of Wolffian tumor. MRI was available for review in all cases with additional diffusion-weighted images (DWI) in three, and contrast-enhanced images in two. CT was available in three. FDG-PET/CT was obtained in two. Results Two patients were asymptomatic, while the other two presented with acute abdomen. On MRI, all tumors were well-defined masses of increased signals on T2WI. Three tumors were solid, whereas the other was solid and cystic. The normal ipsilateral ovary was identified in two patients of reproductive ages, but not in two postmenopausal patients. Tumors in two patients presented with acute abdomen were complicated by hemorrhage. All three tumors evaluated on DWI showed high intensities. Contrast-enhanced images of MRI and CT showed homogeneous enhancement as the same degree as the myometrium. On CT, one tumor contained punctate calcifications. FDG-PET/CT showed moderate FDG accumulation. Conclusion Wolffian tumors may be typically solid extraovarian tumors occasionally associated with cysts and calcifications. Although they are benign, they mimic malignancy due to high intensities on DWI and increased FDG accumulation.

scholarly journals The First Report of an Intraperitoneal Free-Floating Mass (an Autoamputated Ovary) Causing an Acute Abdomen in a Child

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Ibrahim Uygun ◽  
Bahattin Aydogdu ◽  
Mehmet Hanifi Okur ◽  
Selcuk Otcu
Keyword(s):  
Small Intestine ◽  
Acute Abdomen ◽  
Terminal Ileum ◽  
Signs And Symptoms ◽  
Pathological Examination ◽  
Necrotic Tissue ◽  
First Case ◽  
The Right ◽  
Almost All ◽  
Thin Band

A free-floating intraperitoneal mass is extremely rare, and almost all originate from an ovary. Here, we present the first case with an intraperitoneal free-floating autoamputated ovary that caused an acute abdomen in a child and also review the literature. A 4-year-old girl was admitted with signs and symptoms of acute abdomen. At surgery, the patient had no right ovary and the right tube ended in a thin band that pressed on the terminal ileum causing partial small intestine obstruction and acute abdomen. A calcified mass was found floating in the abdomen and was removed. The pathological examination showed necrotic tissue debris with calcifications. An autoamputated ovary is thought to result from ovarian torsion and is usually detected incidentally. However, it can cause an acute abdomen.

scholarly journals Tubular Duplication of the Midgut Presenting with Acute Abdomen and Hematochezia: A Case Report from Northern Tanzania

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Ayesiga M. Herman ◽  
David Msuya ◽  
Mwemezi Kaino ◽  
Hilary Shilanaiman ◽  
Joachim Magoma ◽  
...  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Gastrointestinal Tract ◽  
Acute Abdomen ◽  
The Other ◽  
Internal Drainage ◽  
Management Options ◽  
Total Resection ◽  
Northern Tanzania ◽  
Enteric Duplication

Enteric duplication is one of the rare malformations affecting the small intestine more than the other parts of the gastrointestinal tract. It poses a challenge in diagnosis due to nonspecific symptoms that may mimic other pathologies. Furthermore, the management options including total resection, mucosal striping, and internal drainage of the duplicate depend on the presentation of the patient, site, and length of the involved bowel. We present the first documented case of enteric duplication in Tanzania, a 3-year-old male, who was found to have a 90 cm long jejunoileal duplicate. We discuss the presentation and management offered.

scholarly journals Diversity of Feeding in Anthozoa (Cnidaria): A Systematic Review

2020 ◽  
Author(s):  
Thaís Barbosa Santos ◽  
James D. Reimer ◽  
Fabián H. Acuña ◽  
Sérgio N. Stampar
Keyword(s):  
Systematic Review ◽  
Scientific Literature ◽  
The Other ◽  
Google Scholar ◽  
Scientific Databases ◽  
Scientific Papers

In this study, we performed a bibliographical review examining the scientific literature on &ldquo;feeding in Anthozoa&rdquo; theme for the period from 1890 to 2019, using scientific databases (Google Scholar) supplemented with additional literature. This study categorized published scientific papers on this topic by decade of publication, target taxa, variability of species studied in each order and main themes studied. As a result, 153 studies were found, and based on their content, it was observed that within Anthozoa, there has been a concentration of feeding studies on species in the orders Actiniaria (Hexacorallia), Scleractinia (Hexacorallia), and Alcyonacea (Octocorallia). This indicates that the other remaining orders of the group have been comparatively neglected with regards to their feeding aspects. Therefore, as data on feeding in some groups of Anthozoa are scarce, studies need to be carried out to fill the gaps that permeate this important benthic group, in order to better understand their ecology.

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