scholarly journals Pneumonia-related pneumatoceles in infants: CT assessment and image-guided treatment

2021 ◽  
Author(s):  
Elisa Mercanzin ◽  
Pietro Andrea Bonaffini ◽  
Antonino Barletta ◽  
Francesco Stanco ◽  
Clarissa Valle ◽  
...  
Keyword(s):  
Percutaneous Drainage ◽  
Potential Role ◽  
Scientific Literature ◽  
Case Series ◽  
Consensus Guidelines ◽  
Successful Management ◽  
Image Guided ◽  
Life Threatening

Lung pneumatoceles represent a potential life-threatening complication of pneumonia in infants, especially when they do not spontaneously reabsorb. In this category of patients, scientific literature lacks and no consensus guidelines for management have been proposed. Imaging plays a key role in the diagnosis, characterization, and follow-up of pneumatoceles. Image-guided percutaneous drainage can be considered a safe and effective treatment in children, although it is not widely recognized in newborns and infants. The aim of this case series review is to describe the main CT features of complicated or persistent pneumatoceles in infants and to highlight the potential role of image-guided percutaneous drainage as an effective approach for their treatment. Successful management of four infants affected by pneumonia-related pneumatoceles with percutaneous drainage is presented.

scholarly journals The “Fountain of Death”: A Case Series on Tracheo-innominate Artery Fistula

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Jason Lo ◽  
Marina Mat Baki ◽  
Yeoh Xing Yi ◽  
Nik Hisyam Amirul ◽  
Zahirrudin Zakaria
Keyword(s):  
Potential Role ◽  
Rare Complication ◽  
Case Series ◽  
Innominate Artery ◽  
Survival Outcomes ◽  
Permissive Hypotension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion

Tracheo-innominate artery fistula (TIF) is a very rare complication related to tracheostomy and has been reported in 0.7% of patients, but certainly is one of the most life-threatening conditions. It is of paramount importance to maintain a high index of suspicion in evaluating patients with TIF and to anticipate occurrence of massive haemorrhage even during simple procedures related to tracheostomy such as tube change. We report 3 cases of TIF, each with a unique and unsuspecting history of the condition and review the emergency protocol in arresting the bleeding. We’ve also highlighted the potential role of permissive hypotension with sedation in improving survival outcomes of patients with TIF.

scholarly journals The Use of Targeted Monoclonal Antibodies in the Treatment of ABPA—A Case Series

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 53
Author(s):  
Aoife O’Reilly ◽  
Eleanor Dunican
Keyword(s):  
Cystic Fibrosis ◽  
Potential Role ◽  
Antifungal Agents ◽  
Case Reports ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Case Series ◽  
Pulmonary Disorder ◽  
The Impact

Allergic bronchopulmonary aspergillosis (ABPA) is a pulmonary disorder occurring in response to Aspergillus fumigatus that can complicate the course of asthma and cystic fibrosis. Here we present a case of acute ABPA without central bronchiectasis, a case of chronic active ABPA with central bronchiectasis, and a case of severe relapsing ABPA with central bronchiectasis. All three were initially treated with corticosteroids and antifungal agents but had an incomplete response. These patients were then treated with anti-IgE therapy with omalizumab before being switched to the anti-IL5R agent benralizumab. They responded well to both agents. These case reports highlight the potential role of omalizumab and benralizumab in the treatment of ABPA, but further studies are required to evaluate the effectiveness of these medications. Longer follow-up periods and objective measurements of the impact of treatment are necessary.

scholarly journals Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuya Kato ◽  
Yoshikazu Ogawa ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Case Series ◽  
Optimal Timing ◽  
Presenting Symptoms ◽  
Pathological Evaluation ◽  
Mother And Child ◽  
Life Threatening ◽  
In Pregnancy

Abstract Background Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy. Case presentation We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34 weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin. Conclusions Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.

scholarly journals A Narrative Review of Early Oral Stepdown Therapy for the Treatment of Uncomplicated Staphylococcus aureus Bacteremia: Yay or Nay?

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Michael Dagher ◽  
Vance G Fowler ◽  
Patty W Wright ◽  
Milner B Staub
Keyword(s):  
Staphylococcus Aureus ◽  
Hospital Readmission ◽  
Potential Role ◽  
Review Article ◽  
Narrative Review ◽  
Oral Antibiotics ◽  
Staphylococcus Aureus Bacteremia ◽  
Complete Treatment

Abstract Historically, intravenous (IV) antibiotics have been the cornerstone of treatment for uncomplicated Staphylococcus aureus bacteremia (SAB). However, IV antibiotics are expensive, increase the rates of hospital readmission, and can be associated with catheter-related complications. As a result, the potential role of oral antibiotics in the treatment of uncomplicated SAB has become a subject of interest. This narrative review article aims to summarize key arguments for and against the use of oral antibiotics to complete treatment of uncomplicated SAB and evaluates the available evidence for specific oral regimens. We conclude that evidence suggests that oral step-down therapy can be an alternative for select patients who meet the criteria for uncomplicated SAB and will comply with medical treatment and outpatient follow-up. Of the currently studied regimens discussed in this article, linezolid has the most support, followed by fluoroquinolone plus rifampin.

Role of Image-Guided Percutaneous Drainage in Pancreatic Collections

2018 ◽  
Vol 02 (02) ◽  
pp. 125-130
Author(s):  
Katayoun Samadi ◽  
Ronald Arellano
Keyword(s):  
United States ◽  
Acute Pancreatitis ◽  
Percutaneous Drainage ◽  
Hospital Admissions ◽  
Disease Process ◽  
The United States ◽  
Morbidity And Mortality ◽  
Image Guided ◽  
Gastrointestinal Conditions

AbstractAcute pancreatitis is one of the major gastrointestinal conditions that lead to around 300,000 hospital admissions per year in the United States. While mild inflammation of the pancreas is often managed conservatively, progression of the disease process to necrosis significantly increases the overall morbidity and mortality and often requires surgical or other interventional techniques for management. The purpose of this review is to describe the role of percutaneous drainage for the management of complicated pancreatitis.

scholarly journals Stent Deployment as an Emergency Alternative Treatment for Acute Stroke. Case Series

2019 ◽  
Vol 29 (3) ◽  
pp. 517-522
Author(s):  
Roberto Crosa ◽  
Alejandro M. Spiotta
Keyword(s):  
Mechanical Thrombectomy ◽  
Case Series ◽  
Large Vessel Occlusion ◽  
Good Clinical Outcome ◽  
Vessel Occlusion ◽  
Stent Deployment ◽  
Small Series ◽  
Treatment Variant

Introduction. Acute ischemic stroke due to large vessel occlusion refractory to aspiration or mechanical thrombectomy is a therapeuticchallenge. Objective. A treatment variant is in order. Methods. In the last three years, we admitted seven patients with refractory largevessel occlusions, for all of whose aspiration and mechanical thrombectomy had failed. A Solitaire AB stent was deployed as a rescuemeasure. Results. Data was retrospectively analyzed. Six out of seven patients had a good clinical outcome as measured by mTICIand mRS twelve months after the procedure. One patient died after the first follow-up visit, one month after endovascular therapy.Conclusion. Results of this small series support the role of stent deployment as a rescue measure for such challenging patients.

scholarly journals Case Report: Clostridium neonatale Bacteremia in a Preterm Neonate With Necrotizing Enterocolitis

2021 ◽  
Vol 9 ◽  
Author(s):  
Nadim Cassir ◽  
Isabelle Grandvuillemin ◽  
Manon Boxberger ◽  
Priscilla Jardot ◽  
Farid Boubred ◽  
...  
Keyword(s):  
Necrotizing Enterocolitis ◽  
Potential Role ◽  
Preterm Neonate ◽  
Gastrointestinal Disorder ◽  
Etiologic Agent ◽  
Preterm Neonates ◽  
Environmental Cleaning ◽  
Life Threatening

Necrotizing enterocolitis is a life-threatening acquired gastrointestinal disorder among preterm neonates and is associated with a high mortality rate and long-term neurodevelopmental morbidity. No etiologic agent has been definitively established; nonetheless, the most implicated bacteria include members of the Clostridium genus. We reported here on a case of Clostridium neonatale bacteremia in a preterm neonate with necrotizing enterocolitis, providing more information regarding the potential role of this bacterium in pathogenesis of necrotizing enterocolitis. We emphasized the sporulating form of C. neonatale that confers resistance to disinfectants usually applied for the hospital environmental cleaning. Further works are needed to establish the causal relationship between the occurrence of NEC and the isolation of C. neonatale, with promising perspectives in terms of diagnostic and therapeutic management.

A Rare Case of Bilateral Spaghetti Injuries in Children due to Assault by Mother and Analysis of Functional Outcome at Three Years

2021 ◽  
Author(s):  
Parag B. Lad ◽  
N. Venkateshwaran ◽  
M. R. Thatte ◽  
Sanket Tanpure
Keyword(s):  
Functional Outcome ◽  
Case Series ◽  
Sensory Loss ◽  
Nerve Reconstruction ◽  
Range Of Movement ◽  
Flexor Tendons ◽  
Tendon Lengthening ◽  
Flexor Tendon Injuries ◽  
Life Threatening

AbstractManagement of child abuse with flexor tendons, neurovascular injuries, and life-threatening conditions is challenging. It needs a multisectoral coordinated and synchronized team effort for successful outcomes. We present a case series of children abused by a parent with a sharp object. The children sustained multiple flexor tendon injuries, neurovascular injuries in upper limbs, and tracheal injury compromising respiration. We performed a tracheostomy to save a child and subsequently repaired numerous flexor tendons, nerves, and arteries. During follow-up, these children required secondary reconstruction (tenolysis, tendon lengthening, nerve reconstruction) for flexor contractures, stiffness, and sensory loss in distal forearms. We measured the range of movements and assessed the children’s functional outcome using the Strickland score at 3-year follow-up. The range of movement and functional outcome was excellent in both children in our series. A timely performance of surgery, aided with efficient intensive care, therapy, and consistent posttraumatic psychosocial rehabilitation, produced excellent results in our series.

Intraperitoneal recombinant alpha-2-interferon alternating with cisplatin as salvage therapy for minimal residual-disease ovarian cancer: a phase II study.

1990 ◽  
Vol 8 (6) ◽  
pp. 1036-1041 ◽  
Author(s):  
M Nardi ◽  
F Cognetti ◽  
C F Pollera ◽  
M D Giulia ◽  
A Lombardi ◽  
...  
Keyword(s):  
Ovarian Carcinoma ◽  
Phase Ii ◽  
Salvage Therapy ◽  
Potential Role ◽  
Residual Disease ◽  
Phase Ii Study ◽  
Positive Cytology ◽  
Chemical Peritonitis

A phase II study was initiated in March 1987 at the Regina Elena National Cancer Institute of Rome to evaluate the efficacy of alternating intraperitoneal (IP) recombinant alpha-2-interferon (r-alpha 2-IFN) and cisplatin (DDP) as salvage therapy for less than or equal to 5 mm residual-disease (RD) ovarian carcinoma. Fourteen assessable patients entered the study. All had received prior chemotherapy (11 with DDP-based regimens); five patients had macroscopic RD (less than or equal to 5 mm), and nine had microscopic RD (histologically positive random biopsies and/or positive cytology and immunocytochemical tests). The response to IP immunochemotherapy was evaluated by laparotomy. Pathologic complete remissions (PCRs) were achieved in seven patients (50%) who have remained free of disease with a median follow-up of 22+ months (range, 11+ to 30+ months). Six patients achieved a stable disease and one presented disease progression. With the exception of chemical peritonitis-induced adhesions, no limiting toxicity was observed. The results obtained in this small, highly selected series demonstrate that a high PCR rate may be obtained with IP immunochemotherapy with DDP and r-alpha 2-IFN as salvage therapy in residual ovarian carcinoma less than or equal to 5 mm after first-line chemotherapy also including intravenous (IV) DDP. Larger comparative studies must be conducted to establish the potential role of IP DDP and r-alpha 2-IFN as compared with either of the single treatments.

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