scholarly journals Many faces of acute bowel ischemia: overview of radiologic staging

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Amir H. Davarpanah ◽  
Afshar Ghamari Khameneh ◽  
Bardia Khosravi ◽  
Ali Mir ◽  
Hiva Saffar ◽  
...  
Keyword(s):  
Wide Spectrum ◽  
Bowel Ischemia ◽  
Management Approach ◽  
Final Decision ◽  
Imaging Findings ◽  
Life Threatening ◽  
Imaging Signs ◽  
Late Stages ◽  
Underlying Pathophysiology ◽  
Made In

AbstractAcute bowel ischemia (ABI) can be life threatening with high mortality rate. In spite of the advances made in diagnosis and treatment of ABI, no significant change has occurred in the mortality over the past decade. ABI is potentially reversible with prompt diagnosis. The radiologist plays a central role in the initial diagnosis and preventing progression to irreversible intestinal ischemic injury or bowel necrosis. The most single imaging findings described in the literature are either non-specific or only present in the late stages of ABI, urging the use of a constellation of features to reach a more confident diagnosis. While ABI has been traditionally categorized based on the etiology with a wide spectrum of imaging findings overlapped with each other, the final decision for patient’s management is usually made on the stage of the ABI with respect to the underlying pathophysiology. In this review, we first discuss the pathologic stages of ischemia and then summarize the various imaging signs and causes of ABI. We also emphasize on the correlation of imaging findings and pathological staging of the disease. Finally, a management approach is proposed using combined clinical and radiological findings to determine whether the patient may benefit from surgery or not.

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.

A Review on the Use of Reversal Agents of Direct Oral Anticogulant Drugs in Case of Gastrointestinal Bleeding

2020 ◽  
Vol 15 ◽  
Author(s):  
Veronica Ojetti ◽  
Angela Saviano ◽  
Mattia Brigida ◽  
Luisa Saviano ◽  
Alessio Migneco ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Major Bleeding ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Medical Emergency ◽  
Management Approach ◽  
Emergency Setting ◽  
Reversal Agents ◽  
Life Threatening ◽  
Andexanet Alfa

Background : Major bleeding is a life-threatening condition and a medical emergency with high mortality risk. It is often the complication of anticoagulant’s intake. Anticoagulants are commonly used for the prevention and the treatment of thrombotic events. The standard therapy with vitamin K antagonist (warfarin) has been frequently replaced by direct oral anticoagulants (DOACs). The latter agents (rivaroxaban, apixaban, edoxaban, dabigatran, betrixaban) showed a better efficacy and safety compared to standard warfarin treatment and they are recommended for the reduction of ischemic stroke. Literature data reported a high risk of gastrointestinal bleeding with DOACs, in particular with dabigatran and rivaroxaban. In case of life-threatening gastrointestinal bleeding, these patients could benefit from the use of reversal agents. Methods: We performed an electronic search on PUBMED of the literature concerning reversal agents for DOACs and gastrointestinal bleeding in the Emergency Department from 2004 to 2020. AIM: This review summarizes the current evidences about three reversal agents idarucizumab, andexanet alfa and ciraparantag, and the use of the first two in the emergency setting in patients with an active major bleeding or who need urgent surgery to offer physicians indications for a better management approach in order to increase patient’s safety. Conclusion: Although these agents have been marketed for five years (idarucizumab) and two years (andexanet alfa) respectively, and despite guidelines considering antidotes as first-line agents in treating life-threatening hemorrhage when available, these antidotes seem to gain access very slowly in the clinical practice. Cost, logistical aspects and need for plasma level determination of DOAC for an accurate therapeutic use probably have an impact on this phenomenon.. An expert multidisciplinary bleeding team should be established so as to implement international guidelines based on local resources and organization.

Hernia interna estrangulada por plastrón en el tercio distal del apéndice cecal

2019 ◽  
Vol 62 (6) ◽  
pp. 24-27
Author(s):  
Leslie M. Leyva Sotelo ◽  
José E. Telich Tarriba ◽  
Daniel Ángeles Gaspar ◽  
Osvaldo I. Guevara Valmaña ◽  
André Víctor Baldín ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Early Diagnosis ◽  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Internal Hernia ◽  
Wide Spectrum ◽  
Internal Hernias ◽  
Mild Abdominal Pain ◽  
Made In

Internal hernias are an infrequent cause of intestinal obstruction with an incidence of 0.2-0.9%, therefore their early diagnosis represents a challenge. The most frequently herniated organ is the small bowel, which results in a wide spectrum of symptoms, varying from mild abdominal pain to acute abdomen. We present the case of an eight-year old patient with nonspecific digestive symptoms, a transoperative diagnosis was made in which an internal hernia was found strangulated by plastron in the distal third of the appendix. Appendectomy was performed and four days later the patient was discharged without complications.

scholarly journals Polymeric Nanocarriers: A Transformation in Doxorubicin Therapies

Materials ◽  
2021 ◽  
Vol 14 (9) ◽  
pp. 2135
Author(s):  
Kamila Butowska ◽  
Anna Woziwodzka ◽  
Agnieszka Borowik ◽  
Jacek Piosik
Keyword(s):  
Drug Delivery ◽  
Wide Spectrum ◽  
Stimuli Responsive ◽  
First Line ◽  
Medical Expenses ◽  
Polymeric Nanocarriers ◽  
Essential Properties ◽  
Life Threatening ◽  
History Of ◽  
Cancerous Cells

Doxorubicin, a member of the anthracycline family, is a common anticancer agent often used as a first line treatment for the wide spectrum of cancers. Doxorubicin-based chemotherapy, although effective, is associated with serious side effects, such as irreversible cardiotoxicity or nephrotoxicity. Those often life-threatening adverse risks, responsible for the elongation of the patients’ recuperation period and increasing medical expenses, have prompted the need for creating novel and safer drug delivery systems. Among many proposed concepts, polymeric nanocarriers are shown to be a promising approach, allowing for controlled and selective drug delivery, simultaneously enhancing its activity towards cancerous cells and reducing toxic effects on healthy tissues. This article is a chronological examination of the history of the work progress on polymeric nanostructures, designed as efficient doxorubicin nanocarriers, with the emphasis on the main achievements of 2010–2020. Numerous publications have been reviewed to provide an essential summation of the nanopolymer types and their essential properties, mechanisms towards efficient drug delivery, as well as active targeting stimuli-responsive strategies that are currently utilized in the doxorubicin transportation field.

scholarly journals Peripheral Arteriovenous Malformations: Imaging and Endovascular Management Strategies

2021 ◽  
Author(s):  
Virender Malik ◽  
Harshith Kramadhari ◽  
Jawahar Rathod ◽  
Yadav W. Munde ◽  
Uday Bhanu Kovilapu
Keyword(s):  
Arteriovenous Malformation ◽  
Vascular Malformation ◽  
Management Strategies ◽  
Treatment Strategies ◽  
Vascular Anomaly ◽  
Classification Systems ◽  
Vascular Anomalies ◽  
Final Decision ◽  
Life Threatening

AbstractThe peripheral high-flow vascular malformation (HFVM) comprises arteriovenous malformation (AVM) and fistula (AVF), shows varied clinical presentation (ranging from subtle skin lesion to life-threatening congestive heart failure), and frequently poses diagnostic and therapeutic challenges. Importance of assigning a specific diagnosis to the vascular malformation cannot be overstated, as the treatment strategy is based on the type of vascular anomaly. Although the International Society for the Study of Vascular Anomalies (ISSVA) classification system is the most commonly accepted system for classifying congenital vascular anomalies in clinical practice, the Cho–Do et al classification is of utmost help in guiding optimal mode of treatment in peripheral AVM. Although transarterial approach remains the most commonly employed route for peripheral AVM embolization, the role of transvenous and direct percutaneous approach is ever increasing and the final decision on the approach depends on angioarchitecture of the AVM. In this article, we review various commonly employed classification systems for congenital vascular anomalies, and describe clinical features, imaging and treatment strategies for peripheral arteriovenous malformation (PAVM).

Lessons learned in intellectual capital management in Germany between 2000 and 2020 – History, applications, outlook

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Manfred Bornemann ◽  
Kay Alwert ◽  
Markus Will
Keyword(s):  
Development Strategy ◽  
Intellectual Capital ◽  
Business Models ◽  
Business Processes ◽  
Lessons Learned ◽  
Strategy Development ◽  
Management Approach ◽  
Content Type ◽  
Over Time ◽  
Made In

PurposeThis article reports on the background, the conceptual ideas and the lessons learned from over more than 20 years of IC Statements and Management with a country focus on Germany and some international developments. It calls for an integrated management approach for IC and offers case study evidence on how to accomplish this quest.Design/methodology/approachReport on the German initiative “Intellectual Capital Statement made in Germany” (ICS m.i.G.). A brief review of the literature describes the background and theoretical foundation of the German IC method. A short description of the method is followed by four detailed case studies to illustrate long-term impact of IC management in very different organizations. A discussion of Lessons Learned from more than 200 implementations and an outlook on current and future developments finalizes the article.FindingsIC Statements made in Germany (ICS m.i.G.) was successful in providing a framework to systematically identify IC, evaluate the status quo of IC relative to the strategic requirements, visualize interdependencies of IC, business processes and business results as well as to connect IC reporting with internal management routines and external communication. However, ICS is not an insulated method but delivers the maximum benefit when integrated with strategy development, strategy implementation, business process optimization accompanied by change management routines. Strong ties to human resource management, information technology departments, quality management, research and development teams as well as business operations as the core of an organization help to yield the most for ICS m.i.G. Over time, the focus of managing IC changes and maturity leads to deutero learning.Practical implicationsICS m.i.G. proved easy to apply, cost efficient for SMEs, larger corporations and networks. It helps to better accomplish their objectives and to adjust their business models. The guidelines in German and English as well as a software application released were downloaded more than 100,000 times. A certification process based on a three-tier training module is available and was successfully completed by more than 400 practitioners. ICS m.i.G. is supporting current standards of knowledge management, such as ISO 9001, ISO 30401 or DIN SPEC PAS 91443 and therefore will most likely have a continuing impact on knowledge-based value creation.Originality/valueThis paper reports lessons learned from the country-wide IC initiative in Germany over the last 20 years initiated and supported by the authors. Several elements of the method have been published over time, but so far no comprehensive view on Lessons Learned had been published.

scholarly journals Chronic granulomatous ‘Aspergillus lung mass’

2020 ◽  
Vol 90 (3) ◽  
Author(s):  
Kavitha Venkatnarayan ◽  
Uma Devaraj ◽  
Uma Maheswari Krishnaswamy ◽  
Priya Ramachandran ◽  
Sreekar Balasundaram ◽  
...  
Keyword(s):  
Immune Response ◽  
Lung Disease ◽  
Respiratory Symptoms ◽  
Clinical Presentation ◽  
Wide Spectrum ◽  
Lung Mass ◽  
Pulmonary Aspergillosis ◽  
Histological Picture ◽  
Life Threatening ◽  
Disseminated Disease

The diverse clinicopathological spectrum of pulmonary aspergillosis is a consequence of varying levels of invasiveness of this ubiquitous fungus, which largely depends on the host immune response and pre-existing lung disease. The clinical presentation of pulmonary aspergillosis spans a wide spectrum from hypersensitivity to life threatening angio-invasive and disseminated disease. We report the case of a young immunocompetent male with no underlying lung disease, who presented with an incidentally detected ‘infective mass’ lesion in the lung associated with minimal respiratory symptoms. The diagnostic challenges posed by the unusual clinical, radiological and histological picture as well as the therapeutic dilemmas faced are discussed in this report.

scholarly journals Recent advances in the prevention and management of infections in children undergoing treatment for cancer

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1910
Author(s):  
Bob Phillips
Keyword(s):  
Major Consequence ◽  
Recent Advances ◽  
Life Threatening ◽  
Made In

A major consequence of the intensive multi-modal chemotherapy commonly used to treat malignancies in childhood is life-threatening infection, frequently during periods of profound neutropenia. Recent advances have been made in all areas of management, from trying to prevent infection to getting patients off antimicrobials and home again in the shortest, safest way. Potential avenues of further research are outlined for readers to be aware of in the next few years.

CT and MR Imaging Findings of Bowel Ischemia from Various Primary Causes

Radiographics ◽  
2000 ◽  
Vol 20 (1) ◽  
pp. 29-42 ◽  
Author(s):  
Sung E. Rha ◽  
Hyun K. Ha ◽  
Soo-Hyun Lee ◽  
Ji-Hoon Kim ◽  
Jeong-Kon Kim ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Bowel Ischemia ◽  
Imaging Findings

scholarly journals Magnetic resonance imaging findings in a patient with cryopyrin-associated periodic syndrome: A rare hereditary multi-system inflammatory disorder

2019 ◽  
Vol 32 (6) ◽  
pp. 420-425
Author(s):  
Jessica Behringer ◽  
Maura Ryan ◽  
Michael Miller ◽  
Alok Jaju
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Wide Spectrum ◽  
Cauda Equina ◽  
Inflammatory Disorder ◽  
Periodic Syndrome ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Nlrp3 Gene ◽  
Organ Systems

Cryopyrin-associated periodic syndrome is a hereditary inflammatory disorder encompassing a wide spectrum of clinical phenotypes. This disorder has been associated with mutation of the NLRP3 gene coding for cryopyrin, which leads to overproduction of interleukin-1. The condition causes relapsing bouts of inflammation involving multiple organ systems, including the central nervous system, and, if untreated, can lead to long-term debilitating effects. A literature review revealed only a few brief descriptions of magnetic resonance imaging findings in cryopyrin-associated periodic syndrome patients. We describe serial magnetic resonance imaging findings in an 11-year-old female with clinically diagnosed cryopyrin-associated periodic syndrome who presented with intermittent headaches, progressive sensorineural hearing loss, fevers, and abdominal pain. The magnetic resonance imaging showed progressively worsening low T2 signal in the cochlea, cochlear enhancement, and leptomeningeal enhancement. We also describe some previously unreported findings in this syndrome, including cranial nerve and cauda equina enhancement.

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