scholarly journals Central Hyperthermia Treated with Baclofen in a Patient with Epidural Hematoma

2016 ◽  
Vol 13 (2) ◽  
pp. 102-104
Author(s):  
Manoj Bohara ◽  
Prasanna K Bohara ◽  
Lalit Chaudhary ◽  
Basant Pant

Central hyperthermia is characterized by a rapid-onset elevated temperature, marked temperature fluctuation, and poor response to antipyretics and antibiotics. It is caused by impairment of the central thermoregulatory pathways and is associated with high morbidity and mortality. We report on a case of 31-year old male who sustained fall injury with massive epidural hematoma and a high-grade fever of 40°C on presentation. Following cranio to my and evacuation of hematoma, antipyretics and antibiotics were used for high-grade fever but were not effective. Baclofen was orally administered which effectively controlled the fever. Here, we also discuss the possible central mechanisms for this effect of baclofen and show that baclofen may be an effective treatment in central hyperthermia. Nepal Journal of Neuroscience. Vol. 13, No. 2, 2016, Page: 102-104

2020 ◽  
Vol 99 (5) ◽  
pp. 200-206

Oesophagectomy is being used in treatment of several oesophageal diseases, most commonly in treatment of oesophageal cancer. It is a major surgical procedure that may result in various complications. One of the most severe complications is anastomotic dehiscence between the gastric conduit and the oesophageal remnant. Anastomotic dehiscence after esophagectomy is directly linked to high morbidity and mortality. We propose a therapeutic algorithm of this complication based on published literature and our experience by retrospective evaluationof 164 patients who underwent oesophagectomy for oesophageal cancer. Anastomotic dehiscence was present in 29 cases.


2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Che-Fang Ho ◽  
Yuan-Yun Tam ◽  
Chia-Chen Wu

Objective. Pneumocephalus is a rare complication that often occurs after traumatic skull base injury, leading to morbidity and mortality. Material and Method. We present the case of a 42-year-old healthy man who injured himself when he stuck a metal stick into his left nasal cavity to relieve prolonged nasal obstruction. Immediate cerebrospinal fluid rhinorrhea and subsequent meningitis and pneumocephalus occurred later. He was presented at our hospital with fever and meningeal signs. Result. Computed tomography scans revealed left rhinosinusitis and air collection in the subarachnoid space. The patient received the conservative treatment of bed rest, intravenous hydration, head elevation, and broad-spectrum intravenous antibiotics. Pneumocephalus and meningitis resolved without any surgery, and he experienced no other sequela or complication. Conclusion. Pneumocephalus is a rare incidence and can lead to high morbidity and mortality. Prompt diagnosis and adequate treatment of pneumocephalus and meningitis proved beneficial for our patient who recovered without any complication or surgery.


2021 ◽  
Vol 14 (3) ◽  
pp. e239304
Author(s):  
Syed Muhammad Zubair ◽  
Muhammad Zaid Hamid Hussain ◽  
Ali Bin Sarwar Zubairi

Eosinophilic lung diseases are a rare group of lung disorders with multiple known and unknown aetiologies and the diagnosis is often challenging. We present a case of a young man who was admitted with pneumonia due to methicillin-sensitive Staphylococcus aureus and was discharged on antibiotics. He presented to the emergency department approximately 2 weeks after discharge with high-grade fever, cough and shortness of breath associated with serum and bronchoalveolar lavage eosinophilia. He was then treated with steroids with complete resolution of disease process.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11527-11527
Author(s):  
Emanuela Palmerini ◽  
Catalina Marquez ◽  
Cristina Meazza ◽  
Angela Tamburini ◽  
Gianni Bisogno ◽  
...  

11527 Background: Overexpression of ABCB1/P-glycoprotein (Pgp) predicts poor outcome in retrospective osteosarcoma series.Two prospective trials with Pgp expression and post-induction histologic response as stratification factors were activated in Italy (ISG/OS-2) and Spain (GEIS-33). Methods: Patients ≤ 40 years with extremity non-metastatic high-grade osteosarcoma were eligible. Analysisi of Pgp expression from diagnostic biopsy was centralized. Preoperatively, all patients received methotrexate, adriamycin, cisplatinum (MAP). Surgery was performed at week 8. All patients received a dose of adriamycin following surgery. In case of Pgp overexpression (Pgp+), mifamurtide (2 mg/m2 twice/week for 3 months then weekly for 6 months) was added after surgery, with 4 consecutive cycles of ifosfamide 3 gr/m2/day, day 1-5 (HDIFO) in case of poor histologic response (necrosis < 90%) to MAP. Patients without overexpression of Pgp (Pgp-) received MAP postoperatively, regardless the pathological response. From March 2013, an amendment increased high dose methotrexate cumulative dose from 60 g/m2 (5 cycles) to 120 mg/m2 (10 cycles). The post-amendment regimen was adopted in the observational prospective study by GEIS. Here we present the merged analysis of ISG/OS-2 patients treated post-amendment and GEIS-33. Results: From March 2013 to April 2018, 274 patients were included. Median age was 14 years (range 4-38), male/female: 163/111; 90 were Pgp-, 164 were Pgp+, 20 not evaluable. With a median follow-up of 48 months (1.3-78.5 months), the 3-year EFS and OS were 71.9% (95%CI 66-76.9) and 88% (95%CI: 83.2-91.5) respectively, with no inferior survival for Pgp positive patients and improved survival for good responders (Table). Conclusions: In this prospective uncontrolled study with a risk-adapted strategy for non-metastatic osteosarcoma, survival is superior to that of all ISG/GEIS previous series. The 3-year EFS of 71.9% compares favorably with other reports. Pgp+ patients performed well in this study, in which mifamurtide and HDIFO were added after a poor response to MAP. Clinical trial information: NCT01459484; NCT04383288. [Table: see text]


2017 ◽  
Vol 52 (2) ◽  
pp. 68-81 ◽  
Author(s):  
Maria Smyrli ◽  
Athanasios Prapas ◽  
George Rigos ◽  
Constantina Kokkari ◽  
Michail Pavlidis ◽  
...  

HPB Surgery ◽  
2000 ◽  
Vol 11 (5) ◽  
pp. 285-297 ◽  
Author(s):  
M. A. J. Moser ◽  
N. M. Kneteman ◽  
G. Y. Minuk

Despite recent advances in hepatic surgery, resection of the cirrhotic liver continues to be fraught with high morbidity and mortality rates. As a result, for many patients requiring resection of HCC the postoperative course is complicated and the probability of cure is diminished by coexisting cirrhosis. In this review, we discuss the characteristics of the cirrhotic liver which make it poorly tolerant of resection and the most common complications that follow such surgery. The main purpose of this paper is to review recent attempts to identify interventions that might be beneficial to cirrhotic patients undergoing resection. These interventions include assessment of liver reserve, advances in surgical technique, and improvement in liver function and regeneration.


2017 ◽  
Vol 45 (3) ◽  
pp. 1175-1180 ◽  
Author(s):  
Mir Sadat-Ali ◽  
Moaad Alfaraidy ◽  
Abdulaziz AlHawas ◽  
Ahmed Abdallah Al-Othman ◽  
Dakheel A Al-Dakheel ◽  
...  

Objective To determine the functional morbidity and mortality after fragility hip fracture and compare the mortality with three other common diseases. Methods Data were collected from patients admitted to King Fahd Hospital of the University, AlKhobar from January 2010 to December 2014. Demographic data included the preoperative American Society of Anesthesiologists (ASA) score as assessed by the anesthetist and the type of surgery. Personal and telephone interviews were performed, and data were entered into a database and analyzed. Results We identified 203 patients with fragility proximal femoral fractures, and the data of 189 patients (109 male, 80 female; average age, 66.90 ± 13.43 years) were available for analysis. The overall mortality rate was 26.98% (51 patients). The mortality rate was significantly higher among patients with an ASA score of 4 (36.36%) than 1 (20.45%). With respect to morbidity, only 48.23% of patients were able to return to their pre-fracture status; 32.35% of those who required assisted walking and 83.4% of those who required a wheelchair became bedridden. Conclusions Our data demonstrate that patients with fragility hip fractures have high morbidity and a mortality rate approaching 30%. Age and the ASA score significantly influence this high mortality rate.


2014 ◽  
Vol 10 (1) ◽  
pp. 57-60
Author(s):  
Rabindra B Timala ◽  
Jyotindra Sharma ◽  
Siddhartha Pradhan ◽  
Navin Chandra Gautam

Penetrating atherosclerotic ulcer is one of the acute aortic conditions, associated with high morbidity and mortality. Management option is often debated between conservative vs. surgical, with different data supporting each of the option. Here we present two case reports, managed conservatively. Nepalese Heart Journal | Volume 10 | No.1 | November 2013| Pages 57-60 DOI: http://dx.doi.org/10.3126/njh.v10i1.9748


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