Human dirofilariasis

Introduction. Dirofilariasis is a zoonosis caused by nematodes from the genus Dirofilaria, which is a parasite in dogs and other canids, and humans get infected by a mosquito bite. In Europe, the number of patients outside the endemic area is increasing. So far, more than 2,850 cases of human dirofilariasis have been reported worldwide. In the last 20 years, we have had only two confirmed cases in our institution. The disease is manifested in a cutaneous, visceral, and ocular form. From the initial infection, the first symptoms can take several years to manifest. The diagnosis can be confirmed histologically, morphologically, and/or by molecular techniques. The treatment includes surgical removal of the parasite and antiparasitic therapy. Case outline. The paper presents two cases of Dirophilaria repens infection. The first patient had a migratory nodular facial skin change for several years. After the skin induration incision in the zygomatic region, a 7-cm-long worm was extracted, later identified as Dirophilaria repens. The pathohistological finding of the extirpated change showed that it was a granuloma inflammation. The second case was a patient with a persistent cough and hemoptysis, with a morphologically verified nodular change in the pulmonary parenchyma. The pathohistological finding of the extirpated change showed a chronic granulomatous inflammation and the presence of parasites. The treatment of both patients resulted in a complete recovery without complications. Conclusion. In case of subcutaneous nodules or unclear lung changes, dirofilariasis should be considered. Video-assisted thoracoscopic surgery is the leading diagnostic surgical procedure concerning dirofilariasis, and a significant therapeutic modality.

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Spontaneous pneumothorax in cocaine users

QJM ◽

10.1093/qjmed/hcz070 ◽

2019 ◽

Vol 112 (7) ◽

pp. 519-522 ◽

Cited By ~ 2

Author(s):

P Ciriaco ◽

F Rossetti ◽

A Carretta ◽

M Sant’Angelo ◽

G Arrigoni ◽

...

Keyword(s):

Surgical Treatment ◽

Foreign Body ◽

Ct Scan ◽

Spontaneous Pneumothorax ◽

Thoracoscopic Surgery ◽

Granulomatous Inflammation ◽

Visceral Pleura ◽

Long Term Follow Up ◽

Pulmonary Parenchyma

Abstract Background Pneumothorax is one of the respiratory toxic effects of cocaine inhalation. The literature counts several cases, some associated to other respiratory conditions such as pneumomediastinum, haemoptysis and others not requiring surgical treatment. Aim We present a series of nonHIV cocaine-inhaler subjects who underwent video-assisted thoracoscopic surgery (VATS) for isolated spontaneous pneumothorax. Design Nine subjects, with a mean age of 24 ± 4 years, admitting cocaine inhalation, developed spontaneous pneumothorax and underwent 10 surgical treatments by means of VATS, at our Institution. Results Previous pneumothorax occurred in six cases episodes ranged from 0 to 5 (mean 1.6 ± 1.6). Chest computed tomography (CT) scan showed abnormalities in seven cases. All subjects underwent lung apicectomy, apical pleurectomy and mechanical pleurodesis. Seven subjects had also bullectomy. In all cases the visceral pleura was partially covered by fibrinous exudate. Histology of the lung showed small foreign body granulomatous inflammation in fibrotic and/or emphysematous pulmonary parenchyma. Relapse of pneumothorax occurred in one subject at 60 days and it was surgically treated. Mean follow-up was 150 ± 38 months (range 120–239). All subjects are now well, with no evidence of pneumothorax. Conclusions Spontaneous pneumothorax in cocaine-inhaler subjects is a reality of which physicians need to be aware. Chest CT scan might not reveal abnormalities. Macroscopically the lung might presents bullae and/or peculiar visceral pleura. Foreign body granulomas observed in the specimens suggest that the particulate component of inhaled substances can injure the lung. Surgical treatment of the bullous disease and mechanical pleurodesis can provide a long-term follow-up without relapse of pneumothorax.

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Nanogel-Facilitated In-Situ Delivery of a Cataract Inhibitor

Biomolecules ◽

10.3390/biom11081150 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1150

Author(s):

Dixa Gautam ◽

Michelle G. Pedler ◽

Devatha P. Nair ◽

Jonathan Mark Petrash

Keyword(s):

Cataract Surgery ◽

Vision Loss ◽

Effective Means ◽

Lens Capsule ◽

Posterior Capsular Opacification ◽

Surgical Removal ◽

Visual Disability ◽

Visual Axis ◽

Number Of Patients ◽

Subsequent Degradation

Cataracts are a leading cause of blindness worldwide. Surgical removal of cataracts is a safe and effective procedure to restore vision. However, a large number of patients later develop vision loss due to regrowth of lens cells and subsequent degradation of the visual axis leading to visual disability. This postsurgical complication, known as posterior capsular opacification (PCO), occurs in up to 30% of cataract patients and has no clinically proven pharmacological means of prevention. Despite the availability of many compounds capable of preventing early steps in PCO development, there is currently no effective means to deliver such therapies into the eye for a suitable duration. To model a solution to this unmet medical need, we fabricated acrylic substrates as intraocular lens (IOL) mimics scaled to place into the capsular bag of the mouse lens following a mock-cataract surgery. Substrates were coated with a hydrophilic crosslinked acrylate nanogel designed to elute Sorbinil, an aldose reductase inhibitor previously shown to suppress PCO. Insertion of the Sorbinil-eluting device into the lens capsule at the time of cataract surgery resulted in substantial prevention of cellular changes associated with PCO development. This model demonstrates that a cataract inhibitor can be delivered into the postsurgical lens capsule at therapeutic levels.

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Patterns of skull base meningioma progression after failed radiosurgery

Journal of Neurosurgery ◽

10.3171/jns.2007.106.1.30 ◽

2007 ◽

Vol 106 (1) ◽

pp. 30-35 ◽

Cited By ~ 45

Author(s):

William T. Couldwell ◽

Chad D. Cole ◽

Ossama Al-Mefty

Keyword(s):

Skull Base ◽

Stereotactic Radiosurgery ◽

Growth Patterns ◽

World Health ◽

Benign Tumors ◽

Subtotal Resection ◽

Surgical Removal ◽

Skull Base Meningioma ◽

Number Of Patients ◽

Health Organization

Object Stereotactic radiosurgery has been reported to be an effective alternative to surgical removal of small to medium benign meningiomas as well as an adjuvant treatment modality to reduce the risk of tumor progression after subtotal resection. Its efficacy has been proved by excellent short-term radiosurgically demonstrated control rates, which have been reported to approach or exceed 90% in many contemporary studies involving the use of either linear accelerator–based systems or the Gamma Knife. Little is known, however, regarding the growth patterns of meningiomas that fail to stabilize after radiosurgery. Methods The authors report 13 cases of benign skull base meningiomas (World Health Organization Grade I) that demonstrated progression after radiosurgical treatment as a primary or an adjuvant therapy. Several tumors demonstrated rapid growth immediately after radiosurgical treatment, whereas other lesions progressed in a very delayed manner in some patients (up to 14 years after treatment). Regardless of the interval after which it occurs, tumor growth can be quite aggressive once it has begun. Conclusions Skull base meningioma growth can be aggressive after failed radiosurgery in some patients, and treatment failure can occur at long intervals following treatment. Special attention must be devoted to such significant occurrences given the increasing number of patients undergoing stereotactic radiosurgery for benign tumors, and careful extended (> 10 years) follow up must be undertaken in all patients after radiosurgery.

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Early ultrasonographic follow up in neonatal pneumatocele. Two case reports

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2017-0063 ◽

2018 ◽

Vol 7 (2) ◽

Author(s):

Eugenia Maranella ◽

Arianna Mareri ◽

Marialuisa Tataranno ◽

Luisa Di Luca ◽

Alessandra Marciano ◽

...

Keyword(s):

Neonatal Intensive Care ◽

Case Reports ◽

Central Area ◽

Neonatal Intensive Care Units ◽

Promising Technique ◽

Progressive Reduction ◽

Number Of Patients ◽

Chest X Ray ◽

Pulmonary Parenchyma

Abstract Pulmonary pneumatocele is a thin-walled, air-filled cyst originating spontaneously within the lungs’ parenchyma, generally after infections or prolonged mechanical respiratory support. The diagnosis of pneumatocele is usually made using both chest X-ray (CXR) and computed tomography (CT) scan. Lung ultrasonography (LUS) is a promising technique used to investigate neonatal pulmonary diseases. We hereby present two cases of pneumatocele in newborns with respiratory distress syndrome (RDS) in which CXR and LUS were used to evaluate pulmonary parenchyma. LUS showed a multilobed cyst with a thin hyperechoic wall and a hypoechoic central area. Repeated LUS demonstrated a progressive reduction of the cyst’s size. After a few weeks, the small lesions were no longer detectable by ultrasound, therefore CXR was used, for follow-up, in the following months, until complete resolution. No data are available in the literature regarding ultrasonographic follow-up of neonatal pneumatocele. A larger number of patients are required to confirm our results and increase the use of LUS in the neonatal intensive care units (NICUs) to reduce neonatal radiations exposure.

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Safety and efficacy of mini doppler in recurrent pituitary tumours

Romanian Neurosurgery ◽

10.33962/roneuro-2020-051 ◽

2020 ◽

pp. 336-342

Author(s):

Moshiur Rahman ◽

Ezequiel Garcia-Ballestas ◽

Luis Rafael Moscote-Salazar

Keyword(s):

Cavernous Sinus ◽

Surgical Excision ◽

Pituitary Surgery ◽

Pituitary Tumour ◽

Csf Leak ◽

Surgical Removal ◽

Pituitary Tumours ◽

Female Ratio ◽

Cavernous Sinus Invasion ◽

Number Of Patients

Background: Pituitary surgery is the most common surgery used to remove pituitary tumours. The use of mini doppler in surgical removal of an endonasal pituitary tumour has shown good short-term clinical outcomes and few complications in patients. Cavernous sinus invasion limits the surgical excision and still a challenge of gross total resection. Objective: The main objective of this study is to evaluate the outcome of surgical removal of an endonasal pituitary tumour using mini doppler. Method: A total of 12 patients were studied retrospectively from 2012 to 2018 in a single institution (Private hospital) in Dhaka, Bangladesh. The male and female ratio was 7:5. Results: 92% of cases of the total number of patients had satisfactory removal/ neurological improvement/hormonal improvement. Among 12 cases, 8 cases had transient diabetes insipidus and one patient had CSF leak. Conclusion: The intraoperative Doppler is a useful tool to localize the carotids, which provides safer resection of endonasal pituitary tumours. Thus, it is very safe and effective for laterosellar resection of recurrent pituitary tumours and for cavernous sinus invasions.

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Visual Outcome after Microsurgical removal of Craniopharyngioma via Pterional Craniotomy

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2020.10.1.288 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Adnan Khaliq ◽

Farooq Azam ◽

Mumtaz Ali ◽

Asadullah , ◽

Akramullah , ◽

...

Keyword(s):

Benign Tumor ◽

Case Series ◽

Visual Outcome ◽

Bimodal Distribution ◽

Visual Disturbance ◽

Surgical Removal ◽

Paired Data ◽

Chi Square ◽

Female Ratio ◽

Number Of Patients

Background: Craniopharyngioma is a benign tumor of sellar & Suprasellar area with bimodal distribution. Visual disturbance isone of the common clinical presentation. Early surgical intervention results in favourable results.Objective: To analyze visual outcome after surgical removal of craniopharyngioma via pterional craniotomy.Material and Methods: This observational descriptive case series was conducted at department of neurosurgery,LRH/Peshawar. Duration of study was 18 months from Jan 2017 to June 2018. The study included patients withcraniopharyngioma, who underwent surgery in elective setup, newly diagnosed cases and patients operated via pterionalapproach. All those patients who presented in crisis like acute hydrocephalus, operated via other approaches and recurrent caseswere excluded from this study. The changes of visual function (visual acuity and field) of the patients were assessed preoperativelyand postoperatively, documented by a predesigned proforma and paired data of this change were compared. Visual assessmentwas done on follow up visits on 2 weeks,1 month,3 months and 6 months. Chi square test was applied as statistical test. Data wasanalysed through SPSS version 17.Results: Total number of patients were (30) with Male to female ratio was 1.5:1.Age of patients were Ranging from 4 year to 62years (mean 35 years).There were 23 Children (76.6%) and 7 Adults (23.3%).Out of 30 patients, 21 patients(70%) presented withvisual disturbance and 9 patients (30%) had non opthalmogical symptoms. Optic atrophy was seen in 6 patients (20%) preoperatively.Per operatively tumor was found in suprasellar area in 24 patients(80%) and in both supra+infrasellar area in 6patients(20%). Tumor size was less than 3cm in 19 patients(63.3%) and more than 3cm in 11 patients(36.6%). Morphology peroperatively was cystic in 19 patients(63.3%), solid in 5 patients(16.6%) and both solid and cystic in 6 patients(20%). Calcification intumor was seen in 16 patients(53.3%). Gross total resection(GTR) of tumor was done in only 21 patients(70%). Post-operativefollow up assessment of visual status showed that (50%) of patients improved.Conclusion: Craniopharyngioma is a benign tumor with malignant behaviour so timely intervention give favourable results.

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Surgical site infection in Laparoscopic versus Open appendicectomy

Journal of Nobel Medical College ◽

10.3126/jonmc.v7i2.22306 ◽

2018 ◽

Vol 7 (2) ◽

pp. 39-43

Author(s):

Ashok Koirala ◽

Dipendra Thakur ◽

Sunit Agrawal ◽

Bhuwan Lal Chaudhary ◽

Sagar Poudel

Keyword(s):

Acute Appendicitis ◽

Surgical Site Infection ◽

Age Groups ◽

Laparoscopic Appendicectomy ◽

Surgical Removal ◽

Age Group ◽

Site Infection ◽

Open Appendicectomy ◽

Number Of Patients ◽

The Mean

Background: Acute appendicitis is very common surgical cause of acute abdomen and needs surgical removal either by laparoscopic or open appendicectomy. The aim of this study is to compare frequency of surgical site infection (SSI) in patients undergoing laparoscopic and open appendicectomy. Materials and Methods: The study was prospective study conducted in NMCTH, Biratnagar. Total 200 patients with diagnosis of acute appendicitis admitted through the emergency department of our hospital were included in the study. The patients were randomly allocated in two groups: Laparoscopic appendicectomy group (LA) and Open appendicectomy group (OA). Both groups underwent successful emergency appendicectomy. Wound infections in terms of surgical site infection (SSI) if present were recorded. All age groups and both sexes were included. Results: Two hundred patients underwent appendicectomy, one hundred Laparoscopic appendicectomy (LA) and another hundred open appendicectomy (OA). The mean age of patients with acute appendicitis was 30.63±16.14 years with minimum of 6 years and maximum of 77 years. The highest number of patients were in age group of 10 to 20 years (29.5%). In LA group SSI noted in 3 patients (3%) whereas in OA group it was found in 12 patients (12%). Conclusion: Laparoscopic appendicectomy is better and offers great advantages in terms of SSI as compared to Open appendicectomy.

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ACT-22 CLINICAL RESULT AND CONSIDERATION OF 70 CASES OF INSULAR GLIOMA

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz039.068 ◽

2019 ◽

Vol 1 (Supplement_2) ◽

pp. ii15-ii15

Author(s):

Takashi Maruyama ◽

Yoshihiro Muragaki ◽

Taiishi Sato ◽

Masayuki Nitta ◽

Shunsuke Tsuzuki ◽

...

Keyword(s):

Removal Rate ◽

Point Of View ◽

Surgical Removal ◽

Tumor Extension ◽

Policy Effect ◽

Number Of Patients ◽

First Onset ◽

Invasion Pattern ◽

Temporal Stem ◽

Grade 3

Abstract Our policy for insular glioma has achieved more than 90% removal. The policy influence grade 2 to postpone farther treatment and grade 3 to extend prognosis. In this study, we analyzed our clinical data to be sure how this policy effect to insular glioma. First-onset tumor since 2006 to 2015 were collected and following parameters were analyzed retrospectively, such as the tumor, extension, surgical removal rate, complications, pathological and genomic diagnosis. Of all 70 cases, the average age was 41 years old (24–76). The pathological diagnosis and number of patients were DAmt 20, DAwt 1, AAmt 8, AAwt 5, AO 5, O 18. PFS of each pathological grade(2,3,4) were 55,5m, 42,6m and 4,7m, OS were nr, nr, 32,8 months. 57 cases of IDHmt showed 60,2m of PFS and n.r of OS. 10 cases of IDHwt showed 19,9m PFS and 35,8m OS. The average and median removal rate were 91.4% and 95%. The number of complication case were mild 9 and moderate 2 at 3 months after surgery. The invasion pattern from temporal stem showed that frontal base invasion cases was resulted as poor prognosis comparing with temporal or parietal extension. Number of patients with IDHwt, Oligodedroglial tumor and GBM were relatively low. Surgical complications are mainly caused in the first half of the proficiency process, 15% had paralysis due to LSA infarction. Most of grade 2 cases were treated without post-operative treatment and the prognosis was almost same as grade 3 cases which were treated by chemo and radiation therapy such as 55m, 43m of PFS and n.r of OS. AA wt and GBM showed almost same OS of 32m.We have reconsidered a new classification based on temporal stem extension from surgical point of view. Insular glioma is somewhat different from the other location glioma.

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Periocular Cutaneous Mucormycosis Caused by Saksenaea erythrospora

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0037-1608888 ◽

2017 ◽

Vol 14 (04) ◽

pp. 209-212

Author(s):

Bunyada Putthirangsiwong ◽

Pornchai Mahaisavariya ◽

Weerawan Chokthaweesak ◽

Dinesh Selva

Keyword(s):

Complete Recovery ◽

Molecular Techniques ◽

First Case ◽

Chronic Dacryocystitis ◽

Oral Itraconazole ◽

Periocular Region ◽

Cutaneous Mucormycosis ◽

The Right

Abstract Saksenaea erythrospora is a rare pathogen in humans. Ten adult cases have been previously reported, eight manifested with cutaneous infection, and two presented with invasive rhinosinusitis infection. The authors present a 16-month-old boy with progressive painful mass at the right medial canthus and upper cheek that was unresponsive to broad-spectrum antibiotics. He underwent an anterior orbitotomy and biopsy. Histopathology revealed broad nonseptate sterile hyphae and grew S. erythrospora, which was confirmed by molecular techniques. The patient was treated with intravenous liposomal amphotericin B and oral itraconazole combined with aggressive surgical debridement. The patient made a complete recovery without long-term complications at 4 months of follow-up. Primary cutaneous mucormycosis caused by S. erythrospora may rarely involve the periocular region and mimic chronic dacryocystitis. We report the first case of pediatric periocular cutaneous mucormycosis caused by S. erythrospora.

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Microsurgical Resection of an Intramedullary Spinal Cord Hemangioblastoma Through an Anterior Cervical Approach: 2-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opaa314 ◽

2020 ◽

Author(s):

Kyle Lindsey McCormick ◽

Nikita Alexiades ◽

Paul C McCormick

Keyword(s):

Spinal Cord ◽

Tumor Resection ◽

Residual Tumor ◽

Complete Recovery ◽

Surgical Removal ◽

Intramedullary Spinal Cord ◽

Dural Closure ◽

Cervical Approach ◽

Anterior Cervical Approach ◽

Microsurgical Resection

Abstract This video demonstrates the microsurgical removal of an intramedullary spinal cord hemangioblastoma through an anterior cervical approach. While most spinal hemangioblastomas arise from the dorsal or dorsolateral pial surface and can be safely resected through a posterior approach,1,2 ventral tumors can present a significant challenge to safe surgical removal.3-5 This patient presented with a progressively symptomatic ventral pial based hemangioblastoma at the C5-6 level with large polar cysts extending from C3 to T1. The tumor was approached through a standard anterior cervical exposure with a C5 and C6 corpectomy. Following midline durotomy, the tumor was identified and complete microsurgical resection was achieved. The principles and techniques of tumor resection are illustrated and described in the video. Following tumor resection and dural closure, a fibular allograft was inserted into the corpectomy defect and a C4-C7 fixation plate was placed. The patient was maintained in a supine position for 36 h. He was discharged home on postoperative day 3 in a cervical collar. The patient did well with near-complete recovery of neurological function. Postoperative magnetic resonance imaging at 6 wk showed a substantial resolution of the polar cysts and no evidence of residual tumor. The patient featured in this video consented to the procedure.

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