Are Oropharyngeal Dysphagia Screening Tests Effective in Preventing Pneumonia?

Oropharyngeal dysphagia, a clinical condition that indicates difficulty in moving food and liquid from the oral cavity to the esophagus, has a markedly high prevalence in the elderly. The number of elderly people with oropharyngeal dysphagia is expected to increase due to the aging of the world’s population. Understanding the current situation of dysphagia screening is crucial when considering future countermeasures. We report findings from a literature review including citations on current objective dysphagia screening tests: the Water Swallowing Test, Mann Assessment of Swallowing Ability, and the Gugging Swallowing Screen. Pneumonia can be predicted using the results of the screening tests discussed in this review, and the response after the screening tests is important for prevention. In addition, although interdisciplinary team approaches prevent and reduce aspiration, optimal treatment is a challenging. Intervention studies with multiple factors focusing on the elderly are needed.

Intravascular leiomyomatosis with cardiac extension: a case report

Background Intravascular leiomyomatosis with intracardiac extension is a rare benign tumor seen exclusively in women, characterized by proliferation of uterine smooth muscle cells through the venous circulation into the inferior vena cava and the right heart chambers. Case summary A 47 years old women with history of previous hysterectomy due to myomatosis, presented with nausea, anorexia and bilateral lower limb swelling over the preceding two months. An outpatient abdominal ultrasound discovered a mass in the Inferior vena cava. Echocardiogram and Computed tomography demonstrated a large intravascular mass extending from the pelvis to the right heart chambers. The tumor was completely removed in a concomitant open-heart surgery and laparotomy. Post operative course was uncomplicated. A month later the patient was feeling well and in good clinical condition. The histological analysis consisted with intravascular leiomyomatosis. Discussion Intracardiac leiomyomatosis is a rare clinical condition which requires high index of suspicion. Multimodality imaging is usually required to establish the preoperative diagnosis, although the final diagnosis is achieved with tissue investigation. Complete surgical resection of the tumor is curative and associated with good long-term prognosis.

The Research and Implications of Organoid Technology

Background: The induction of the formation of organoids derived from induced pluripotent stem cells (iPSC) is a new technology that is being well studied and aims to improve the clinical condition of patients with various diseases and even patients undergoing certain types of procedures. Methods: Systematic review, using the PRISMA protocol. The study period was from 2010 to 2020 and the keywords included “Organoids”, “iPSC”, “Ethic” and “Evidence-Based Medicine”, one at a timeand then combined with the Boolean operator “AND”. Results: 44 registrations were found. Of this total, 15 articles were excluded because they have not approached organoids and stem cells objectively, often attending to other phenomena or details that are not of interest to the review.

Torsion of a Wandering Spleen Treated by Laparoscopic Surgery: A Case Report

The spleen is an organ located in the upper left portion of the abdomen. Wandering spleen is defined as the location of the spleen is the shift to other parts of the abdomen rather than the left upper quadrant. Wandering spleen is a rare clinical condition and can lead to hilar torsion and subsequent infarction requiring emergency surgery. The author presents a case of torsion of a wandering spleen in a 34-year-old female presenting with abdominal pain. The patients underwent emergent laparoscopic splenectomy. She had an uncomplicated postoperative course and recovered well.

New Insights into Pulmonary Hypertension: A Role for Connexin-Mediated Signalling

Pulmonary hypertension is a serious clinical condition characterised by increased pulmonary arterial pressure. This can lead to right ventricular failure which can be fatal. Connexins are gap junction-forming membrane proteins which serve to exchange small molecules of less than 1 kD between cells. Connexins can also form hemi-channels connecting the intracellular and extracellular environments. Hemi-channels can mediate adenosine triphosphate release and are involved in autocrine and paracrine signalling. Recently, our group and others have identified evidence that connexin-mediated signalling may be involved in the pathogenesis of pulmonary hypertension. In this review, we discuss the evidence that dysregulated connexin-mediated signalling is associated with pulmonary hypertension.

Management of intractable chronic cough during awake craniotomy: illustrative case

BACKGROUND Chronic cough is a common but challenging clinical condition that can adversely affect the safety of awake surgical endeavors such as awake craniotomy (AC). This case lesson highlighted a patient with severe refractory chronic cough undergoing AC for resection of a recurrent left frontal, insula, anterior temporal anaplastic ependymoma of the eloquent cortex. OBSERVATIONS The patient was successfully managed using a multifaceted medical treatment regimen combined with preoperative and intraoperative cough suppression therapy with a speech-language pathologist. The patient coughed only once intraoperatively and had a positive outcome. LESSONS Chronic cough is often multifactorial and requires a multifaceted treatment approach. Despite this challenge, select patients can successfully be navigated through AC with appropriate treatment for their condition. A review of neurogenic cough and modern treatments, which were used in this patient and would be helpful to neurologists or neurosurgeons, are also discussed.

Compromiso gastrointestinal inusual en paciente pediátrico con vasculitis asociada a anticuerpos anticitoplasma de neutrófilos. Reporte de un caso

Vasculitis is characterized by presenting inflammation of the wall of blood vessels, one type of these diseases are those associated with anti-neutrophil cytoplasm antibodies. They usually occur in adulthood and are rare in childhood. The disease generally affects the lung, kidney, and skin, with gastrointestinal involvement being rare. Here we describe the case of a pediatric patient with gastrointestinal bleeding secondary to ANCA positive vasculitis. Endoscopy revealed patchy erythematous lesions and wall hematoma at the level of the colon. Although we report a fairly infrequent clinical condition, it is not without complications. We believe it is appropriate to suspect it, first of all, intestinal involvement where the underlying inflammatory process is not clear, even more so when it involves other organs.

Premature graying of hair: A concise review

Authors have attempted to provide a short concise and clinically relevant review on premature graying of hairs with the focus of updated pathogenesis, rational investigations, and treatment options. Premature graying of hairs is a fairly common clinical condition faced by dermatologists, however, very scarce therapeutic options are available for successful management of gray hairs. The role of antioxidants is not yet established firmly in the therapeutic armamentarium of premature graying of hairs. Authors have summarized the currently available therapeutic options for the treatment of premature graying of hairs.