Sapountzi Evdoxia*, Staberna Alexandra, Davidhi Andjoli, Rafailidis Vasileios, Pras-sopoulos Panos, Stamou Maria and Galli-Tsinopoulou Assimina
DOI: 10.37421/2684-4915.2023.7.285
Introduction: Systemic Lupus Erythematosus (SLE) is a complex autoimmune disorder with a wide spectrum of clinical manifestations. Though Antiphospholipid Antibodies (APAs) in SLE increase thrombotic risks, renal artery thrombosis is uncommon, especially in younger patients.
Case report: A 15-year-old presented with fever, chest pain, arthritis, and discoloured skin scars. During his hospitalization, he suddenly developed severe acute abdominal pain. Imaging findings revealed renal artery thrombosis at the site of an anatomical variation involving the bifurcating right renal artery. Clinical manifestations and laboratory tests ultimately led to the diagnosis of APA-positive Systemic Lupus Erythematosus (SLE). Treatment with Low-Molecular-Weight Heparin (LMWH), intravenous methylprednisolone at a dosage of 30 mg/Kg/d for three consecutive days, followed by oral prednisolone at a dosage of 1mg/Kg/d, hydroxychloroquine, and methotrexate, resulting in significant improvement. However, arterial hypertension emerged in the seventh week, requiring lisinopril. Six months later, the patient remains in remission with stable blood pressure.
Conclusion: To our knowledge, this is the first documented case of renal artery thrombosis initiating paediatric-onset APA-positive SLE. Thrombotic events should prompt consideration of systemic vasculitis.
Hitokazu Tsukao*, Riki Matsukawa, Tsubasa Ueda, Yuya Fujii, Wataru Yamaguchi, Junya Nakaya and Toru Kojima
DOI: 10.37421/2684-4915.2024.8.286
Certain skin conditions, like atopic dermatitis, pose a risk for the development of skin infections and, in more advanced stages of bacteremia. Consequently, it is hypothesized that skin diseases could play a role in the onset of Infectious Endocarditis (IE). We present a 21-years-old Japanese female with a history of acne vulgaris. Shingles appeared on the patient’s right trunk, thus she consulted a local dermatologist after 9 days, and her condition improved after receiving an antiviral drug. However, 32 days after she developed shingles, she experienced fever and vomiting that did not improve, and presented to a nearby clinic on day 36. She was referred to the hospital on the same day. A medical work-up revealed Staphylococcus aureus in two sets of blood cultures taken upon admission. Transesophageal echocardiography unveiled a 1.7 cm vegetation near the septum of the right ventricular outflow tract, leading to her diagnosis of Infectious Endocarditis (IE), attributed to S. aureus. Chest imaging displayed multiple nodular opacities within her lung fields, interpreted as a complication associated with a septic pulmonary embolism resulting from IE. Empirical treatment with Ceftriaxone (CTRX) + Sulbactam/Ampicillin (SBT/ABPC) was initiated. CTRX+SBT/ABPC was changed to cefazolin monotherapy after identifying the causative organism, and the patient’s condition gradually improved. Our case is a rare as skin disease is not previously regarded as a risk factor that triggers the onset of IE.
DOI: 10.37421/2684-4915.2024.8.287
Background and objectives: The Neodymium-Doped Yttrium-Aluminum-Garnet (ND: YAG) laser has proven effective in the treatment of leg telangiectasias, yet the literature lacks consensus on the optimal settings. This study aims to assess the efficacy of the 1064nm Nd:YAG laser for the treatment of leg telangiectasias in a safety focused setting.
Materials and methods: Records of 42 patients with lower leg telangiectasia who underwent laser treatment between December 2019 and March 2023 were assessed. Laser parameters have been adjusted to prioritize overall safety. Two months after the treatment Global Aesthetic Improvement Score (GAIS) and the extent of vessel clearance were evaluated on a scale ranging between 0% and 100%. Patients rated their satisfaction on an 11-point Likert scale and their perception of pain during the treatment on a 6-point scale. Narratives of all adverse events were examined.
Results: The mean patient satisfaction was 8.4 ± 0.7 (mean ± SD). The mean GAIS score was 81.4% ± 0.8% (mean ± SD). Vessel clearance of 60% and greater was achieved in 52% of patients. Mean patient satisfaction was 8.4 ± 0.7 (mean ± SD). Both GAIS score and vessel clearance were positively correlated with patient satisfaction (correlation coefficient 0.8 and 0.6, respectively). All patients experienced mild crusting at the site of the treatment which resolved spontaneously within up to two weeks. Two instances of hyperpigmentation self-resolved within six and seventeen weeks.
Conclusion: The treatment of leg telangiectasias with the 1064 nm Nd:YAG laser has proven to be safe and effective. The results achieved through a cautious approach in laser settings appear to be comparable to or better than, previous research in a variety of settings.
Xin Yu, Yahui Huang, Yin Zhang, Xianglong Cai, Liangliang Liu, Na Zhang, Jingzhi Zhu, Xiaotong Xi, Ran Ding and Guoqiang Li*
DOI: 10.37421/2684-4915.2024.8.288
Introduction: To investigate the clinical and chest imaging features of acute military tuberculosis with diffuse ground-glass opacities.
Methods: A case of acute military tuberculosis with diffuse ground-glass opacities was reported.
Results: The patient, a 52-year-old male, was hospitalized for 10 days with fever, and his body temperature fluctuated between 37.8° C and 40° C. The patient had a medical history of nephrotic syndrome for 20 years, lymph node tuberculosis for 10 years and viral hepatitis C for 3 years. There were no findings with Chest CT, and all 5 times of blood culture were negative during the first 12 days of the disease course. Metagenomic Next-Generation Sequencing (mNGS) was employed, revealing the detection of 13 specific reads belonging to M. tuberculosis complex, indicating the drug treatment on day 13. After receiving treatment with isoniazid, rifampicin, pyrazinamide and ethambutol, the highest body temperature of the patient decreased to 38.5° C on day 17. A follow-up chest CT scan showed diffuse ground-glass opacities, and mNGS data analysis revealed 27 specific reads of M. tuberculosis complex in Bronchoalveolar Lavage Fluid (BALF) on day 17. The highest body temperature of the patient decreased to 38° C on day 20. On day 33 of the disease course, a follow-up chest CT scan demonstrated typical imaging changes of miliary tuberculosis, and the body temperature of the patient returned to normal.
Conclusion: The imaging features of immunocompromised patients with acute miliary tuberculosis may manifest as diffuse ground glass opacities. mNGS with high sensitivity is valuable for early and accurate diagnosis, particularly in immunocompromised patients presenting with diffuse ground-glass opacities indicative of acute miliary tuberculosis.
DOI: 10.37421/2684-4915.2024.8.296
Infectious diseases pose significant global health challenges, with ongoing threats from emerging pathogens, antimicrobial resistance, and the reemergence of previously controlled infections. The field of infectious diseases is dynamic and constantly evolving, driven by advances in diagnostics, therapeutics, and preventive strategies. Clinicians play a crucial role in the management of infectious diseases, requiring a comprehensive understanding of the latest clinical perspectives and emerging treatments. This paper aims to provide an overview of advancements in infectious diseases from a clinical perspective, highlighting emerging treatments and strategies for managing infectious diseases effectively. By synthesizing insights from recent research and clinical practice, this review seeks to offer healthcare professionals valuable perspectives on navigating the complexities of infectious diseases and optimizing patient care
DOI: 10.37421/2684-4915.2024.8.297
Healthcare innovation has been a driving force in improving patient care, enhancing outcomes, and advancing the healthcare industry as a whole. Recent years have seen a surge in emerging healthcare innovations that hold the promise of revolutionizing how healthcare is delivered and experienced. This paper aims to explore these innovations, drawing insights from recent reports, to provide a comprehensive overview of the transformative potential they hold. By examining key trends, challenges, and opportunities, this study seeks to offer valuable insights into the future of healthcare delivery and the impact of emerging innovations on patient care and healthcare systems.
DOI: 10.37421/2684-4915.2024.8.298
This paper assesses global progress in healthcare equity and access by synthesizing insights from comprehensive reports. Through a thorough examination of literature and healthcare reports, key indicators of healthcare equity and access are analyzed across different regions and countries. This study aims to identify trends, challenges, and innovations in promoting healthcare equity and access, with a focus on addressing disparities and improving health outcomes for all populations. Access to equitable healthcare is not only a fundamental human right but also a critical determinant of overall well-being and societal development. Despite significant advancements in healthcare delivery, disparities in access to quality care persist across the globe, disproportionately affecting marginalized and underserved populations. Understanding the current state of healthcare equity and access requires a comprehensive examination of global progress, challenges, and opportunities.
DOI: 10.37421/2684-4915.2024.8.301
DOI: 10.37421/2684-4915.2024.8.291
DOI: 10.37421/2684-4915.2024.8.293
DOI: 10.37421/2684-4915.2024.8.302
Alzheimer's Disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and memory loss. Early detection is crucial for effective intervention and management. This review examines the advances in imaging modalities for the early detection of Alzheimer's disease, focusing on the clinical evidence supporting their use. We discuss the capabilities and limitations of various imaging techniques, including magnetic resonance imaging (MRI), Positron Emission Tomography (PET), and emerging technologies like Functional MRI (fMRI) and amyloid PET imaging. The review highlights the potential of these modalities in identifying early biomarkers of AD and improving diagnostic accuracy, thereby facilitating timely therapeutic interventions.
DOI: 10.37421/2684-4915.2024.8.303
Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and hyperglycemia, leading to severe complications if not managed early. Early diagnosis and prognosis are crucial for effective intervention and management. This review evaluates recent advancements in novel biomarkers for the early diagnosis and prognosis of T2DM. We focus on genetic, proteomic, and metabolomic biomarkers, discussing their potential roles and the clinical evidence supporting their use. The review highlights the promise of these biomarkers in improving diagnostic accuracy, predicting disease progression, and enabling personalized treatment strategies.
DOI: 10.37421/2684-4915.2024.8.304
Telemedicine has emerged as a pivotal tool in the management of chronic conditions, offering remote monitoring, consultations, and intervention strategies. This systematic review evaluates the effectiveness, benefits, and challenges of telemedicine in managing chronic conditions such as diabetes, hypertension, and heart disease. By analyzing recent studies, we aim to provide a comprehensive understanding of how telemedicine impacts patient outcomes, adherence to treatment, and overall healthcare delivery. The review highlights the potential of telemedicine to improve access to care, patient engagement, and cost-effectiveness, while also addressing concerns related to technology adoption, privacy, and the digital divide.
DOI: 10.37421/2684-4915.2024.8.305
DOI: 10.37421/2684-4915.2024.8.306
The development of novel antidepressants has revolutionized the treatment of depressive disorders, offering new hope to patients unresponsive to traditional therapies. This review explores the mechanisms of action of these new antidepressant agents from clinical and neurobiological perspectives. We discuss the latest pharmacological targets, including the modulation of neurotransmitter systems, neuroplasticity, and inflammation pathways. By synthesizing clinical trial data and preclinical research, this review aims to provide a comprehensive understanding of how these novel agents function and their potential implications for future treatment strategies.
DOI: 10.37421/2684-4915.2024.8.307
DOI: 10.37421/2684-4915.2024.8.308
DOI: 10.37421/2684-4915.2024.8.309
DOI: 10.37421/2684-4915.2024.8.310
DOI: 10.37421/2684-4915.2024.8.311
Evdoxia Sapountzi*, Andreas Giannopoulos, Styliani Fidani, Maria Trachana, Fragiskos Bersimis, Spiros Gerou and Assimina Galli-Tsinopoulou
DOI: 10.37421/2684-4915.2023.7.265
Kawasaki disease, an acute inflammatory vasculitis, affects children <5 years old. Coronary artery aneurysms constitute a serious complication of the disease. Both genetic factors and hematological parameters (e.g., mean platelet volume-to-lymphocyte ratio) have been implicated in the development of Kawasaki disease and coronary artery aneurysms. We explored the role of rs13017968, a single nucleotide polymorphism in SLC8A1, and of the mean platelet volume-to-lymphocyte ratio in Kawasaki disease and coronary artery aneurysms.
This single-center, case-control study included children with Kawasaki disease treated in our clinic and healthy children registered in the emergency unit. All patients received intravenous immunoglobulin upon diagnosis. Primary outcomes included rs13017968 frequency and the mean platelet volume-to-lymphocyte ratio in patients (with/without coronary artery aneurysms) and healthy children. Secondary outcomes included the mean platelet volume-to-lymphocyte ratio before and after intravenous immunoglobulin in patients (with/without coronary aneurysms) and correlation of the mean platelet volume-to-lymphocyte ratio with inflammation markers, age, and sex.
Overall, 107 healthy children and 59 patients (mean age: 139.38 months vs 37.36 months) were analyzed. Coronary aneurysms developed in 33.9% of the patients. No statistically significant association was detected between rs13017968 and occurrence of Kawasaki disease or coronary aneurysms. The mean platelet volume-to-lymphocyte ratio was significantly lower in patients than in healthy children and significantly decreased after therapy. No significant interaction was found between the mean platelet volume-to-lymphocyte ratio and coronary aneurysms. The only significant associations were between occurrence of coronary aneurysms and sex and between age and the mean platelet volume-to-lymphocyte ratio (before and after therapy) in patients.
Although our results do not support an association of rs13017968 with Kawasaki disease or coronary aneurysms, the relatively small sample size should be considered. The mean platelet volume-to-lymphocyte ratio, age, and sex appear as significant factors in Kawasaki disease and coronary artery aneurysms. Therefore, larger scale studies are warranted.
Ahmed Salah Ali* and Ahmed Soliman
DOI: 10.37421/2684-4915.2023.7.268
Tumour Regressive Grade (TRG), margins and histopathology grade are the way to reach a strategy for addition of adjuvant chemotherapy or not, however lack of solid date about the exact benefit of the sole adjuvant therapy makes it very challenging, so the patients' decisions are very considerable in such cases, especially with high risk features; high TRG, positive margins and poor performance status, as the benefits of pre surgical chemotherapy may not be so clear. High TRG score and borderline performance status may be factors behind a decision to stop treatment after the surgery.
Emelyn Modesto de Sá*, Americo Mota, Aquino Santana, Rafael Valois and Thiago Augusto
DOI: 10.37421/2684-4915.2023.7.267
Vestibular schwannoma or acoustic neuroma is a benign, slow-growing tumor that originates in the Schwann cells, where it eventually compresses the nerve and enlarges the internal acoustic meatus. The present case report presents a patient that arrives at the otorhinolaryngology service with complaints of tinnitus, with no other evident alterations and the imaging exam revealed a voluminous lesion in the left point-cerebellar angle. The methodology used for the research was a case study, with the objective of condensing the case and bringing up its most common radiological findings, based on bibliographic studies. Magnetic resonance imaging is of utmost importance for the treatment and proper diagnosis of the patient with suspected vestibular schwannoma.
Zhi-Ping Liu, Si-Han Liu, He Zhao, Fangying Ruan, Bai Xu* and Da-Xin
DOI: 10.37421/2684-4915.2023.7.258
Advanced cervical cancer has a poor prognosis and few effective therapy options. However, immunotherapy has been approved by the FDA and has shown promising results for patients with cervical cancer. In this report, we present the case of a patient with stage IIIC1 cervical cancer who exhibited a positive response to a combination of Camrelizumab and Apatinib after radio-chemotherapy. Our findings suggest that the combination of Camrelizumab and Apatinib may provide a valuable therapeutic option for advanced cervical cancer patients who do not respond to radiochemotherapy alone.
DOI: 10.37421/2684-4915.2023.7.270
DOI: 10.37421/2684-4915.2023.7.274
DOI: 10.37421/2684-4915.2023.7.271
DOI: 10.37421/2684-4915.2023.7.272
DOI: 10.37421/2684-4915.2023.7.273
DOI: 10.37421/2684-4915.2023.7.269
Abdallah Eltoum Ali*, Mohamed Fathy Seyyed Ahmed, Somia Mohammed Suliman, Ibrahim Ahamed Ali Karti and Haidar Eltayeb Saleh
DOI: 10.37421/2684-4915.2023.7.261
Francis Basimbe*, Ronald Olum, Ignatius Kakande and Hakim Din Iman
DOI: 10.37421/2684-4915.2023.7.270
Juvenile polyps are common benign mucosal lesions in the gastrointestinal tract, with the colon being a frequently affected site. This case series examined three pediatric patients who underwent endoscopic polypectomy for juvenile polyps in a tertiary hospital. The objective was to analyze their presentation, management and outcomes. The patients in this series all presented with rectal bleeding, which aligns with previous studies highlighting rectal bleeding as the most common symptom in juvenile polyps. Interestingly, none of the patients experienced associated abdominal pain, consistent with findings from studies conducted in Asia. Notably, all the children in this series presented more than a year after the onset of rectal bleeding, indicating a longer duration compared to studies from Asia, where the average was 7.6 months. Endoscopic polypectomy, explicitly using the cold snare technique, was successfully performed in all cases without any reported complications. This procedure involves the removal of polyps during an endoscopic examination, followed by a histopathological examination to assess the risk of malignancy. The findings from this examination guide further surveillance or treatment. In this case series, all the juvenile polyps presented with Rectal bleeding with no associated abdominal pain and all were left-sided and presented after over a year of rectal bleeding and cold snare. Endoscopic polypectomy was used safely in their management with no reported complications in our setting.
Samaresh Das*, Nilay Chatterjee, Ahmed Tolba and Sumit Bajaj
DOI: 10.37421/2684-4915.2023.6.277
Clavipectoral Fascial Plane Block (CPB) is an attractive method of providing perioperative analgesia in patients with fractured clavicles. It is safe, easy to perform, and provides satisfactory analgesia with minimum complication risk. This report describes CPB in a 67-year-old woman with multiple comorbidities who underwent successful clavicle fracture fixation either as a stand-alone anaesthetic technique or combined with general anaesthesia. Correctly performed CPB could effectively reduce perioperative analgesic use, particularly in patients unsuitable for commonly used analgesics, while providing adequate analgesia for a prolonged duration.
DOI: 10.37421/2684-4915.2023.7.284
DOI: 10.37421/2684-4915.2023.7.283
DOI: 10.37421/2684-4915.2023.7.282
DOI: 10.37421/2684-4915.2023.7.281
DOI: 10.37421/2684-4915.2023.7.280
DOI: 10.37421/2684-4915.2023.7.279
DOI: 10.37421/2684-4915.2023.7.278
Evdoxia Sapountzi*, Alexandra Staberna, Styliani Fidani, Anastasia Keivanidou, Andreas Giannopoulos and Assimina Galli-Tsinopoulou
DOI: 10.37421/2684-4915.2023.7.276
Marfan syndrome is a rare multi-systemic genetic disorder primarily affecting connective tissue. It manifests prominently in musculoskeletal, orbital and cardiovascular systems. Neonatal Marfan syndrome (nMFS) is distinguished by the occurrence of premature death resulting from rapidly progressive congestive heart failure. This case report presents the clinical presentation of a newborn girl exhibiting dysmorphic features, bilateral myopia and severe cardiac involvement. Genetic analysis revealed a previously unidentified mutation at nucleotide 3964 (c.3346G > A) within intron 26 of the fibrillin-1 gene. This mutation is located in the neonatal region encompassing fibrillin-1 exon 24 to 32. The patient was initially treated with atenolol, followed by a combination of atenolol and irbesartan, which potentially contributed to a reduction in the rate of aortic root dilation. While medical management can delay the progression of cardiac dysfunction, surgical intervention should be reserved as a last option.
Clinical and Medical Case Reports received 40 citations as per Google Scholar report
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