scholarly journals Cannabinoid Hyperemesis Syndrome: The Missed Diagnosis

2020 ◽  
Vol 6 (3) ◽  
pp. 127-130
Author(s):  
João B. Fonseca ◽  
Daniela Vilaverde ◽  
Rosa Rodrigues ◽  
Pedro Morgado
Keyword(s):  
Illicit Drug ◽  
Cannabis User ◽  
Cannabinoid Hyperemesis Syndrome ◽  
History Of ◽  
Missed Diagnosis ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up ◽  
Cyclic Vomiting

Cannabis is the most cultivated and abused illicit drug worldwide. Paradoxically to the antiemetic properties attributed to cannabis, a relatively new cannabinoid hyperemesis syndrome (CHS) started to be recognized and is characterized by cyclic vomiting that are interspaced by asymptomatic phases. We present a case of a 36‑year‑old woman who repeatedly presented to the emergency room with cyclic vomiting that alleviated with hot showers. She was a long‑term cannabis user and the diagnosis was only established several years later after the onset of symptoms. The diagnostic work up was unremarkable, and the only effective treatment was cannabis cessation. Hot bathing behavior is a key characteristic of this syndrome. CHS is a new clinical condition that should be considered in a setting of recurrent and intractable vomiting in patients with a history of cannabis use.

Urethral Diverticulum in Women with Neurologic Bladder

1998 ◽  
Vol 65 (4) ◽  
pp. 532-535
Author(s):  
P. Menchinelli ◽  
L De Giovanni ◽  
A. Manca ◽  
J.M. Weir ◽  
G. Ronzoni
Keyword(s):  
Multiple Sclerosis ◽  
Urethral Diverticulum ◽  
Therapeutic Strategies ◽  
Long Term Results ◽  
White Population ◽  
Diagnostic Work ◽  
Work Up ◽  
Female Urethral Diverticulum ◽  
Diagnostic Work Up

Female urethral diverticulum is a rather rare pathology, often ignored, which affects from 1 to 4% of the white population. In this study we report our series, limited to a selected population of women affected by neurologic bladder (6 paraplegic patients; 2 patients with multiple sclerosis) who were referred to our Urosurgical Unit within the space of four years. The diagnostic work-up relevant to these patients is discussed, together with the therapeutic strategies carried out and the long-term results obtained.

The Japanese Operation for Biliary Atresia: Remedy or Mischief?

PEDIATRICS ◽  
1975 ◽  
Vol 55 (1) ◽  
pp. 12-19
Author(s):  
John R. Lilly
Keyword(s):  
Biliary Atresia ◽  
Case Illustration ◽  
Kasai Operation ◽  
Early Results ◽  
Bile Drainage ◽  
Diagnostic Work ◽  
Work Up ◽  
Term Analysis ◽  
Diagnostic Work Up

A case illustration is given of an infant with biliary atresia who had the Kasai operation more than 1½ years ago and is now, by all biochemical and histiological criteria, cured. The early results with this operation in 14 patients are similar to those reported by the Japanese, that is, 25% have had sustained postoperative bile drainage. Success has never been achieved in infants older than 4 months. A long-held notion in this country to withhold operation in infants with jaundice until after 4 months has thus far militated against a critical and impartial evaluation of the Kasai operation. A plea is made to complete diagnostic work-up for jaundice during the first months of life so that the operation, if elected, may have a genuine chance for legitimate long-term analysis.

Gemcitabine associated pseudocellulitis: A missed diagnosis

2017 ◽  
Vol 24 (7) ◽  
pp. 550-552 ◽  
Author(s):  
Dalvir Gill ◽  
Josh Schrader ◽  
Matthew Kelly ◽  
Fidel Martinez ◽  
Wajihuddin Syed ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Platelet Count ◽  
Lower Extremity ◽  
Antibiotic Exposure ◽  
Past Medical History ◽  
Missed Diagnosis ◽  
Basic Metabolic Panel ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

We report a case of a 51-year-old male with past medical history significant for cholangiocarcinoma presented with two weeks of worsening bilateral lower extremity swelling and erythema. Patient has been on active chemotherapy for his cholangiocarcinoma with Gemcitabine weekly infusions. Physical exam was significant for bilaterally petechial rash coalescing into ecchymoses over the dorsum of the feet, sparing soles and toes, which dissipated into thinning petechiae more proximally. On labs he did not have any leukocytosis, his platelet count was 50 × 103/µL and basic metabolic panel was benign. Patient was started on Vancomycin for presumed cellulitis. Lower extremity ultrasound Doppler ruled out deep venous thrombosis. Patient did have biopsies bilaterally on his legs, which showed hypersensitivity reaction consistent with the diagnosis of pseudocellulitis. His Vancomycin was discontinued and his symptoms improved. Our case further supports that pseudocellulitis is underrecognized and underreported, potentially leading to unnecessary antibiotic exposure and unnecessary diagnostic work-up as seen unfortunately in our patient. Unnecessary antibiotic exposure is increasing the risk for clostridium difficile and or antibiotic resistance, therefore awareness of this reaction is critical, as to avoid unnecessary antibiotics, and costly diagnostic workups.

scholarly journals An Overview of Hypoglycemia in Children Including a Comprehensive Practical Diagnostic Flowchart for Clinical Use

2021 ◽  
Vol 12 ◽  
Author(s):  
Alberto Casertano ◽  
Alessandro Rossi ◽  
Simona Fecarotta ◽  
Francesco Maria Rosanio ◽  
Cristina Moracas ◽  
...  
Keyword(s):  
Neurological Complications ◽  
Clinical Use ◽  
Pediatric Age ◽  
Therapeutic Approaches ◽  
Age Related ◽  
Diagnostic Flowchart ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Hypoglycemia is the result of defects/impairment in glucose homeostasis. The main etiological causes are metabolic and/or endocrine and/or other congenital disorders. Despite hypoglycemia is one of the most common emergencies in neonatal age and childhood, no consensus on the definition and diagnostic work-up exists yet. Aims of this review are to present the current age-related definitions of hypoglycemia in neonatal-pediatric age, to offer a concise and practical overview of its main causes and management and to discuss the current diagnostic-therapeutic approaches. Since a systematic and prompt approach to diagnosis and therapy is essential to prevent hypoglycemic brain injury and long-term neurological complications in children, a comprehensive diagnostic flowchart is also proposed.

scholarly journals Vaccine-Induced Thrombotic Thrombocytopenia: Novelty Testing in the Diagnostic Work-up?

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1061-1061
Author(s):  
Rossella Rosari Cacciola ◽  
Veronica Vecchio ◽  
Elio Gentilini Cacciola ◽  
Emma Cacciola
Keyword(s):  
Conflicts Of Interest ◽  
Clot Lysis ◽  
Clotting Time ◽  
Vein Thrombosis ◽  
History Of ◽  
Diagnostic Work ◽  
Deep Vein ◽  
Work Up ◽  
Diagnostic Work Up ◽  
Maximum Clot Firmness

Abstract COVID-19 vaccination campagnies with several vaccines types are currently undeway. Recently, the ASTRA ZENECA vaccine has raised public alarm with concerns regarding the development of thrombotic events known as vaccine-induced thrombotic thrombocytopenia (VITT). Early and limited studies have implicated an antibody-mediated platelet activation as the mechanism of the clotting events. Aim of this study was to investigate the platelet and coagulation activation using specialized tests. In this study we enrolled 60 patients (40 men, 20 women; mean age 55±10 years) without cardiovascular risk factors or a history of thrombosis who reported having poplitea deep vein thrombosis (35/60) and pulmonary embolism (25/60) revealed with lower-limb ultrasonography and computed tomography (CT) angiography, respectively, 7 days after vaccination with ASTRA ZENECA. All patients were evaluated for initial testing such as platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib) and D-dimer (DD). Platelets were measured by automated analyzer, PT and APTT by coagulometric test, Fib using Clauss method, and DD using ELISA. Complete blood hemostasis was studied by platelet function assay (PFA-100) on Collagen/ADP (CT-ADP) and Collagen/Epinephrine (CT-EPI) cartridges and Thromboelastometry method on Clotting Time (CT), Clotting Formation Time (CFT), Maximum Clot Firmness (MCF), and clot lysis at 30 minutes (LY-30). All patients had thrombocytopenia (60±5x109/L), longer PT (28±10 s) and PTT (50±10 s), lower Fib (80±20 mg/dl), higher DD ((550±100 mg/l). All patients had shorter C/ADP and C/EPI (C/ADP, n.v. 68-121 s (42±10 s) and C/EPI n.v. 84-160 s (38±5 s) and shorter CT (CT, unit: s. n.v. 100-240 s) (INTEM 30±20 s, EXTEM 18±10 s), shorter CFT (CFT, unit: s, n.v. 30-160 s (INTEM 11±10 s, EXTEM 19±10 s), longer MCF (MCF, unit: mm, n.v. 50-72 mm (INTEM 128±10 mm, EXTEM 110±10 mm), and lower LY-30 (LY-30, %: v.n. 15% (INTEM 0.8%, EXTEM 0.7%). These interesting findings may be the novelty in the diagnostic work-up of the VITT. If these tests may aid in the diagnosis of VITT deserve to be confirmed and need reproducing in other studies. Disclosures No relevant conflicts of interest to declare.

Diagnosis and management of urethro-cavernosal fistulas

2020 ◽  
Vol 13 (6) ◽  
pp. 398-401
Author(s):  
Jullet Han ◽  
Saum Ghodoussipour ◽  
Evgeniy I Kreydin ◽  
Leo Doumanian
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Surgical Approaches ◽  
Success Rates ◽  
Long Term Outcomes ◽  
Level Of Evidence ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Objective: To present a case series of urethro-cavernosal fistulas evaluating their diagnostic work-up and management. Methods: A literature search was performed using key words including “urethro-cavernosal fistula,” “urethral fistula,” and “cavernosal fistula.” Results: In total 10 case reports were identified and reviewed for information regarding clinical diagnosis, management, and long-term outcomes including success rates and complications. Conclusion: Urethro-cavernosal fistula is a rare urological condition. With few cases reported to date, there is considerable variation in diagnostic work-up and management. Both conservative and surgical approaches can be utilized in the management of urethro-cavernosal fistulas with good long-term outcomes. Level of evidence: Not applicable for this multicentre audit.

scholarly journals Gastrointestinal spindle cell tumor of the rumen with metastasis to the liver in a goat

2018 ◽  
Vol 30 (3) ◽  
pp. 451-454 ◽  
Author(s):  
Michael E. Pesato ◽  
Ashley G. Boyle ◽  
Marie-Eve Fecteau ◽  
Alexander Hamberg ◽  
Billy I. Smith
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
General Health ◽  
Spindle Cell ◽  
Symptomatic Treatment ◽  
Cell Tumor ◽  
Spindle Cell Tumor ◽  
History Of ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Many neoplasms have been reported in goats; however, neoplasia of the rumen is rarely reported. A 9-y-old castrated male pygmy goat was presented with a history of respiratory stertor, fever, and anorexia. A respiratory diagnostic work-up including skull and thorax radiographs and endoscopy revealed minor enlargement of the arytenoids but no other abnormal findings. After a month of little improvement on symptomatic treatment and worsening general health, the goat was euthanized. On autopsy, the forestomachs, liver, spleen, diaphragm, and the ventral and lateral aspects of the cranial third of the walls of the peritoneal cavity were adhered to one another by fibrinous and fibrous adhesions. Numerous firm, white, up to 2 cm diameter nodules were found throughout the liver. A large sessile mass extended from the rumen wall into the lumen. The rumen mass was a gastrointestinal stromal tumor with metastasis to the liver.

Anemia in children: prevalence, causes, diagnostic work-up, and long-term consequences

2017 ◽  
Vol 10 (11) ◽  
pp. 1023-1028 ◽  
Author(s):  
Slimane Allali ◽  
Valentine Brousse ◽  
Anne-Sylvia Sacri ◽  
Martin Chalumeau ◽  
Mariane de Montalembert
Keyword(s):  
Long Term Consequences ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

scholarly journals Multidisciplinary Evaluation of Interstitial Lung Diseases: New Opportunities Linked to Rheumatologist Involvement

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 664 ◽  
Author(s):  
Enrico De Lorenzis ◽  
Silvia Laura Bosello ◽  
Francesco Varone ◽  
Giacomo Sgalla ◽  
Lucio Calandriello ◽  
...  
Keyword(s):  
Gold Standard ◽  
Lung Diseases ◽  
Interstitial Lung Diseases ◽  
Red Flags ◽  
The Third ◽  
Autoimmune Rheumatic Diseases ◽  
History Of ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Multidisciplinary team (MDT) discussion is the gold standard in the management of interstitial lung disease (ILD). The rheumatologist is not routinely involved in MDT, even if up to 20% of ILD are related to systemic autoimmune rheumatic diseases (SARD). The study aims to assess the agreement and its variation over time between rheumatologists and pulmonologists in the screening of SARD and between rheumatologists and an MDT extended to rheumatologists (eMDT) in evaluating the progression of SARD. We computed the agreement between the pulmonologist and rheumatologist in the identification of red flags for SARDs of 81 ILD cases and between the rheumatologist alone and eMDT in the confirmation of 70 suspected SARD-ILD progressions. The agreement between rheumatologists and pulmonologists was moderate for the detection of autoimmunity test positivity (κ = 0.475, p < 0.001) and family history of SARD (κ = 0.491, p < 0.001) and fair for the identification of extrapulmonary symptoms (κ = 0.225, p = 0.064) or routine laboratory abnormalities consistent with SARD. The average agreement between the rheumatologist and eMDT in the identification of ILD progression was moderate (κ = 0.436, p < 0.001). The class of agreement improved from the first to the third semester. The average agreement with the rheumatologist ranged from fair to moderate, suggesting that a shared evaluation of SARD-ILD in eMDT could improve the diagnostic work-up and the evaluation of ILD progression.

Sign in / Sign up

Export Citation Format

Share Document