scholarly journals Ipilimumab-nivolumab therapy causing STEMI in a melanoma patient: A case report

2017 ◽  
Vol 4 (3) ◽  
pp. 57
Author(s):  
Ahmed Zaid Alkhathlan ◽  
David S. Tofovic ◽  
Claire Sullivan ◽  
Anjan Gupta ◽  
Sanjay Rajagopalan
Keyword(s):  
Combination Therapy ◽  
De Novo ◽  
Thrombus Formation ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Great Promise ◽  
First Case ◽  
Aged Woman ◽  
Arterial Thrombus ◽  
Middle Aged Woman

The combination of ipilimumab and nivolumab has shown great promise in improving survival in patients with advanced melanoma. However, these novel agents are not without side effects, with adverse events occurring in up to 55% of patients on combination therapy. We report a case of ST-elevation myocardial infarction (STEMI) with resultant new severe systolic heart failure and left ventricular thrombus in a middle-aged woman with metastatic melanoma on ipilimumab-nivolumab therapy suspicious for de novo intra-arterial thrombus formation. We hypothesize that this is likely due to an immune-related adverse event, a documented phenomenon in patients on this combination therapy. To the best of our knowledge, this is the first case in patients on ipilimumab-nivolumab therapy to develop STEMI due to intra-arterial thrombus formation.

De novo formation and rupture of an aneurysm

2002 ◽  
Vol 97 (3) ◽  
pp. 697-700 ◽  
Author(s):  
Takao Yasuhara ◽  
Takashi Tamiya ◽  
Kenji Sugiu ◽  
Satoshi Inoue ◽  
Takashi Ohmoto
Keyword(s):  
Internal Carotid ◽  
De Novo ◽  
Short Interval ◽  
Anterior Communicating Artery ◽  
Left Internal Carotid Artery ◽  
Content Type ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
De Novo Aneurysm ◽  
Insight Into

✓ The authors describe a case of de novo formation and rupture of an aneurysm located at the junction of the left internal carotid artery and the superior hypophyseal artery in a middle-aged woman 2 months after another aneurysm, located on the anterior communicating artery, had been clipped. This case is rare because of the short interval between the last angiographic study performed at the first operation and the diagnosis of the de novo aneurysm; in this case the interval was only 47 days, compared with other cases in the literature in which the intervals were 3 to 34 years. Aneurysms can enlarge considerably in 2 to 4 weeks and can rupture at or soon after their formation. This case provides insight into aneurysm formation and rupture.

Left Ventricular Free Wall Rupture in A Middle-Aged Woman

2020 ◽  
Author(s):  
Fernando Fonseca Gonçalves ◽  
João Pedro Monteiro ◽  
Fátima São Neves ◽  
José Ilídio Moreira
Keyword(s):  
Left Ventricular ◽  
Ventricular Free Wall ◽  
Mechanical Complication ◽  
Free Wall ◽  
Rare Presentation ◽  
Free Wall Rupture ◽  
Aged Woman ◽  
Strong Adhesion ◽  
Middle Aged Woman ◽  
Hemodynamic Improvement

Abstract Background: Ventricular free wall rupture is an uncommon but potentially fatal mechanical complication following a myocardial infarction.Case presentation: We report a case of a 51 year-old female admitted in our emergency department in cardiogenic shock, in which echocardiography was fundamental in the diagnosis of a left ventricle free wall rupture with tamponade. In this case, removal of pericardial clots with subsequent hemodynamic improvement and the presence of a strong adhesion between the pericardial layers at the rupture site were sufficient for the short-term surgical treatment. The patient remained stable and was discharged fifteen days later.Conclusions: Although being a rare presentation, this unconventional surgical approach might be useful in this kind of cases.

scholarly journals Case Report: Two cases of rare head injuries from Nepal

F1000Research ◽  
2021 ◽  
Vol 7 ◽  
pp. 1483
Author(s):  
Joe M. Das ◽  
Apar Pokharel ◽  
Rashmi Sapkota ◽  
Manish Mishra ◽  
Ashish Babu Aryal
Keyword(s):  
Head Injury ◽  
Case Reports ◽  
Head Injuries ◽  
Neurological Deficits ◽  
Accidental Injury ◽  
First Case ◽  
Aged Woman ◽  
The Face ◽  
Middle Aged Woman ◽  
The Impact

Background: There are a number of ways in which one can sustain a head injury. Even if you are doing simple household activities or going out for a morning walk, you cannot be sure of what type of injury awaits you. The source of injury may be a pressure cooker whistle acting as a projectile or a hailstone falling from the sky. Such injuries are common in Nepal, considering the socio-demographic and geographic conditions. In this article, we present two such very rare cases of head injury. Case Reports: The first case is a middle-aged woman who sustained an accidental injury to the face associated with fracture of frontal sinus and frontal contusion, following the impact from a high momentum projectile in the form of the pressure regulator of a pressure cooker. She underwent craniotomy and removal of the foreign body. In the second case, an elderly man sustained minor injury to the head following the fall of hail. The abrasions and contusions produced by the hail were managed conservatively. Since he did not have any clinical evidence of head injury, other than multiple abrasions with contusions in the scalp, he did not undergo any imaging studies. He did not have any neurological deficits. The postoperative period was uneventful for the first patient and she was followed up for one month. The second patient was lost to follow-up. Conclusion: Successful management of two very rare cases of head injuries from Nepal are reported. Proper care and maintenance of the house-hold utensils that are constantly used may protect people from head injuries.  Though natural calamities cannot always be avoided, simple measures like using an umbrella while going outdoors may protect individuals from head injuries due to hailstones.

scholarly journals Acute Complication Due to Impella 2.5 Device (Superficial Femoral Artery Thrombosis): Managed Successfully with Novel Aspiration Thrombectomy catheter (pronto V3)

2011 ◽  
Vol 5 ◽  
pp. CMC.S6157 ◽  
Author(s):  
Tariq M. Bhat ◽  
Alain Waked ◽  
Sumaya Teli ◽  
James Lafferty ◽  
Bhavesh Gala
Keyword(s):  
High Risk ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Thrombus Formation ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Vascular Complication ◽  
Aspiration Thrombectomy ◽  
First Case

The Impella recover LP 2.5 is a percutaneous left ventricular assist device (LVAD) recently approved for use in patients undergoing high risk percutaneous coronary intervention (PCI) and also in cases of cardiogenic shock. There is limited evidence available in literature about its safety, especially with regards to the incidence of local vascular complications, their management and long-term implications. We report here the first case of a serious local vascular complication—superficial femoral artery thrombus formation during Impella recover LP 2.5 use in a high risk PCI which was managed successfully with novel aspiration thrombectomy catheter (Pronto V3), which in itself is the first reported use of Pronto V3 in such a vascular complication.

scholarly journals Application of the Monti procedure in Adult Continent Cutaneous Urinary Diversion.

2020 ◽  
Vol 4 (2) ◽  
pp. 679-683
Author(s):  
Gëzim GALIQI ◽  
Luan BAJRI ◽  
Albert PESHA ◽  
Artan KONI ◽  
Bledar SHEGA
Keyword(s):  
Urinary Diversion ◽  
Functional Results ◽  
Small Series ◽  
First Case ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
High Degree ◽  
Difficult Cases ◽  
Vesico Vaginal Fistula ◽  
Continent Cutaneous Urinary Diversion

Introduction; Monti and co. described in 1997 is a continent catheterizable conduit using short segments of the ileum (1). The use of this technique allows us to obtain 2 to 2.5 cm segment of the ileum to achieve a tabularized segment of 7-8 cm. The 15 cm of terminal ileum was not routinely used for this type of procedure. After the reconstruction of a tunnel, anastomosis was performed on the superior part of the posterio-lateral junction of the bladder. Objectives: To report 6 cases using the Monti procedure with ileum for adult continent cutaneous urinary diversion, from different etiologies. Materials and Methods: From 2007 to 2020 we treated 6 patients with different conditions with this procedure. First case was a middle-aged woman with a big vesico-vaginal fistula (fig.3) It was unappropriated to be closed with satisfactory functional results in terms of continence, because a part of the sphincter was destroyed also. The reason of damage was auto mutilation as a result of borderline personality. Discussion: Monti procedure associating Mitrofanoff principle was mainly used in pediatric patients (1,2,3) That’s because of the relatively easy execution of the “Mitrofanoff principle” and the high degree of continence obtained with its use (4). But can we use the same principle to resolve some difficult cases in adult urology also? Conclusion: The Monti tunnel is a valid option for continent intermittent catheterisation. It’s also an alternative to be adjunct with Mitrofanoff procedure when needed. We used it when the appendix was not appropriate to be used as a tunnel or when it was missing. It has a good continent percentage and it can be done rather easily. Of course, ours is a small series of cases to represent more important conclusions.

scholarly journals Case Report: Two cases of rare head injuries from Nepal

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1483
Author(s):  
Joe M. Das ◽  
Apar Pokharel ◽  
Rashmi Sapkota ◽  
Manish Mishra ◽  
Ashish Babu Aryal
Keyword(s):  
Head Injury ◽  
Case Reports ◽  
Head Injuries ◽  
Neurological Deficits ◽  
Accidental Injury ◽  
First Case ◽  
Aged Woman ◽  
The Face ◽  
Middle Aged Woman ◽  
The Impact

Background: There are a number of ways in which one can sustain a head injury. Even if you are doing simple household activities or going out for a morning walk, you cannot be sure of what type of injury awaits you. The source of injury may be a pressure cooker whistle acting as a projectile or a hailstone falling from the sky. Such injuries are common in Nepal, considering the socio-demographic and geographic conditions. In this article, we present two such very rare cases of head injury. Case Reports: The first case is a middle-aged woman who sustained an accidental injury to the face associated with fracture of frontal sinus and frontal contusion, following the impact from a high momentum projectile in the form of the pressure regulator of a pressure cooker. She underwent craniotomy and removal of the foreign body. In the second case, an elderly man sustained minor injury to the head following the fall of hail. The abrasions and contusions produced by the hail were managed conservatively. Since he did not have any clinical evidence of head injury, other than multiple abrasions with contusions in the scalp, he did not undergo any imaging studies. He did not have any neurological deficits. The postoperative period was uneventful for the first patient and she was followed up for one month. The second patient was lost to follow-up. Conclusion: Successful management of two very rare cases of head injuries from Nepal are reported. Proper care and maintenance of the house-hold utensils that are constantly used may protect people from head injuries.  Though natural calamities cannot always be avoided, simple measures like using an umbrella while going outdoors may protect individuals from head injuries due to hailstones.

scholarly journals Anaphylactoid Reaction from IV Contrast Dye Causing Ischemic Colitis with Portal Venous Gas

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Adeleke Adesina ◽  
Adam Colombo ◽  
Rebecca Jeanmonod
Keyword(s):  
Mortality Rate ◽  
Ischemic Colitis ◽  
Anaphylactoid Reaction ◽  
Radiographic Finding ◽  
Bowel Ischemia ◽  
Intravenous Contrast ◽  
Portal Venous Gas ◽  
First Case ◽  
Aged Woman ◽  
Middle Aged Woman

Portal venous gas is a radiographic finding with numerous causes. The most common etiologies include bowel ischemia or other intra-abdominal catastrophes. The finding of portal venous gas carries a high mortality rate. We report the first case of portal venous gas associated with anaphylactoid reaction to intravenous contrast dye in a middle-aged woman. This was likely secondary to anaphylactoid-induced ischemic colitis. This patient was managed conservatively and had a good outcome.

scholarly journals Prolonged Response of a Patient with Relapsed Acute Myeloid Leukemia to a Novel Oral Bromodomain Extraterminal Inhibitor (BETi)

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Meilen Chang Muñoz ◽  
Jennifer A. Murphy ◽  
Johannes E. Wolff ◽  
Brian A. Jonas
Keyword(s):  
Acute Myeloid Leukemia ◽  
Complete Remission ◽  
Combination Therapy ◽  
Myeloid Leukemia ◽  
Therapeutic Potential ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Prolonged Response ◽  
Acute Myeloid ◽  
Count Recovery

Acute myeloid leukemia (AML) is an aggressive clonal bone marrow cancer characterized by high rates of relapse and mortality. A middle-aged woman with AML relapsed twice after achieving complete remission with induction therapy and subsequent salvage therapy. She was then enrolled in a clinical trial with the bromodomain extraterminal inhibitor (BETi) mivebresib and achieved complete remission with incomplete count recovery (CRi) with monotherapy. Subsequently, she relapsed and was transitioned to combination therapy with mivebresib plus venetoclax and achieved CR again. The patient required eltrombopag to decrease platelet dependence in both arms of the trial and exhibited less myelosuppression with the combination therapy. The exceptional response to mivebresib demonstrated by this patient underscores the therapeutic potential of mivebresib.

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