scholarly journals Management of Calcium Channel Antagonist Overdose with Hyperinsulinemia-Euglycemia Therapy: Case Series and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Shiwan K. Shah ◽  
Sanjeev Kumar Goswami ◽  
Rajesh V. Babu ◽  
Gulshan Sharma ◽  
Alexander G. Duarte
Keyword(s):  
Literature Review ◽  
Supportive Care ◽  
Calcium Channel ◽  
Fluid Resuscitation ◽  
Calcium Channel Antagonist ◽  
Case Series ◽  
Review Of The Literature ◽  
Calcium Channel Antagonists ◽  
Drug Overdoses ◽  
Potential Use

Calcium channel antagonists (CCAs) are commonly involved in drug overdoses. Standard approaches to the management of CCA overdoses, including fluid resuscitation, gut decontamination, administration of calcium, glucagon, and atropine, as well as supportive care, are often ineffective. We report on two patients who improved after addition of hyperinsulinemia-euglycemia (HIE) therapy. We conclude with a literature review on hyperinsulinemia-euglycemia therapy with an exploration of the physiology behind its potential use.

scholarly journals Prontosan® soluzione e Prontosan® Debridement Pad nel trattamento di diversi tipi di ferite cutanee: dichiarazioni basate su opinioni di esperti, serie di casi e revisione della letteratura/Prontosan® solution and Prontosan® Debridement Pad in the treatment of different types of cutaneous wounds: expert-based statements, case series and review of the literature

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Angela Peghetti ◽  
Diletta Olivari ◽  
Silvia Tedesco ◽  
Andrea Bellingeri ◽  
Marino Ciliberti ◽  
...  
Keyword(s):  
Literature Review ◽  
Chronic Wounds ◽  
Wound Care ◽  
Evidence Synthesis ◽  
New Technology ◽  
Case Series ◽  
Sono State ◽  
Review Of The Literature ◽  
Combined System ◽  
New Device

Prontosan® Debridement Pad (PDP; B. Braun) è un nuovo presidio disegnato per migliorare il processo di debridement meccanico. In questo lavoro riportiamo i risultati di un complesso progetto condotto al fine di sviluppare consenso tra gli esperti sul migliore modo di impiegare questa nuova tecnologia nella pratica clinica. Il progetto si è articolato in tre fasi. Nella prima è stata condotta una estesa revisione della letteratura che ha condotto ad identificare, analizzare criticamente e a riassumere in formato strutturato 27 studi clinici pertinenti. Nella seconda fase le evidenze disponibili sono state discusse in modo sistematico con un pannello di 10 esperti, i quali hanno formulato 12 raccomandazioni per l'impiego clinico del PDP. Queste raccomandazioni sono state quindi sottoposte a votazione formale attraverso il metodo GRADE. Infine, nei mesi successivi, 13 casi clinici provenienti dalla pratica clinica routinaria e trattati in accordo con le raccomandazioni stabilite sono stati raccolti e vengono qui presentati. Nel complesso, i dati disponibili in letteratura e quelli raccolti dalla pratica clinica confermano l'efficacia del PDP come strumento per il debridement meccanico, offrendo vantaggi significativi per una ottimale Wound Bed Preparation e per il controllo del dolore. Il nostro progetto può inoltre essere utile per ottimizzare l'impiego pratico di questo nuovo promettente dispositivo. Prontosan® Debridement Pad (PDP; B. Braun) is a new device designed for mechanical debridement. This paper summarizes the results of a complex initiative aimed to develop consensus among a panel of wound care experts about the optimal use of this new technology. An extensive review of the literature found 27 pertinent papers, which underwent a formal process of critical appraisal and evidence extraction by two independent methodologists. Results are displayed in an evidence report. 12 practical recommendations, concerning management of acute and chronic wounds, have been developed and approved. Main point of strength of this project is the use of a systematic approach to literature review, evidence synthesis and presentation, development and measurement of expert consensus. Moreover, expert panel provided further clinical data, through the reporting of 13 clinical cases managed according to abovementioned recommendations, with a particular focus on burns and chronic ulcers treatment, both in adult and pediatric patients. Overall, results from literature review and from clinical experience confirm that the combined system Prontosan® Solution and PDP is a promising tool useful in the critical phase of debridement in acute and chronic wounds treatment. Efficacy in debris removal and pain reduction are the main points of strength. Our project may contribute to optimize clinical use of this innovative device.

scholarly journals Long-term outcomes of acromegaly treated with fractionated stereotactic radiation: case series and literature review

2017 ◽  
Vol 4 (4) ◽  
pp. 255-262
Author(s):  
Ryan Rhome ◽  
Isabelle M Germano ◽  
Ren-Dih Sheu ◽  
Sheryl Green
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Case Series ◽  
Tumor Control ◽  
Pituitary Neoplasms ◽  
Review Of The Literature ◽  
Biochemical Control ◽  
Low Incidence

Abstract Background Growth hormone (GH)-secreting pituitary adenomas represent an uncommon subset of pituitary neoplasms. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) have been used as primary or adjuvant treatment. The purpose of this study is to report the long-term tumor control and toxicity from our institution and to perform a systematic literature review of acromegaly patients treated with FSRT. Methods We retrospectively reviewed all patients treated with FSRT (median dose 50.4 Gray [Gy], range 50.4–54 Gy) between 2005 and 2012 who had: 1) GH-secreting adenoma with persistently elevated insulin growth factor-1 (IGF-1) despite medical therapy and 2) clinical follow up >3 years after FSRT. Patients were treated with modern FSRT planning techniques. Biochemical control was defined as IGF-1 normalization. Systematic review of the literature was performed for FSRT in acromegaly. Results With a median follow-up of 80 months, radiographic control was achieved in all 11 patients and overall survival was 100%. Long-term biochemical control was achieved in 10 patients (90.9%) with either FSRT alone (36.4%) or FSRT with continued medical management (45.5%). No patient experienced new hypopituitarism, cranial nerve dysfunctions, or visual deficits. Our systematic review found published rates of biochemical control and hypopituitarism vary, with uniformly good radiographic control and low incidence of visual changes. Conclusions Adjuvant FSRT offered effective long-term biochemical control and radiographic control, and there was a lower rate of complications in this current series. Review of the literature shows variations in published rates of biochemical control after FSRT for acromegaly, but low incidence of serious toxicities.

scholarly journals Hereditary haemorrhagic telangiectasia and pregnancy: a review of the literature

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Olivier Dupuis ◽  
Laura Delagrange ◽  
Sophie Dupuis-Girod
Keyword(s):  
Heart Failure ◽  
Literature Review ◽  
Arteriovenous Malformations ◽  
Case Reports ◽  
Case Series ◽  
Main Body ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Review Of The Literature ◽  
Management Decisions ◽  
Recurrent Epistaxis

Abstract Background Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited genetic vascular disorder that has prevalence of 1:5000 to 1:8000, and which is characterised by recurrent epistaxis, cutaneous telangiectasia, and arteriovenous malformations (AVMs) that affect many organs including the lungs, gastrointestinal tract, liver, and central nervous system. The aim here was to carry out a review of the literature on HHT complications during pregnancy in order to guide management decisions. Main body A literature review was carried out to analyse all publications on complications that occurred during pregnancy in women with HHT. The PubMed/Medline and Scopus databases were searched. The complications observed in HHT women during pregnancy were then described. The authors identified 5 case series and 31 case reports that describe the evolution of 1577 pregnancies in 630 women with HHT. The overall maternal death rate described in the case series was estimated at 1.0% of pregnancies in the case series and 2 maternal deaths occurred in 31 pregnancy case reports. Severe maternal complications occurred in 2.7 to 6.8% of pregnancies in the case series. Severe complications occurred mostly in the second and third trimester in non-diagnosed and non-screened HHT patients. Severe complications were related to visceral involvement. The most frequent complications were related to pulmonary arteriovenous malformations (PAVMs) (haemothorax (n = 10), haemoptysis (n = 4), and severe hypoxaemia (n = 3)). Neurological complications were related to PAVMs in one case (right to left shunt) and to cerebral arteriovenous malformations (CAVM) and intracranial haemorrhage in 2 cases. Complications were related to hepatic arteriovenous malformations (HAVMs) in 8 cases (acutely decompensated heart failure due to hepatic involvement (n = 1), dyspnoea related to heart failure (n = 5), and hepatobiliary necrosis (n = 2)). Conclusion Based on the literature review, most pregnancies in HHT women occur normally. However, these pregnancies should be considered high-risk, given the potential life-threatening events related to AVM rupture. Furthermore, there is currently no international consensus regarding the medical follow-up of pregnancy in women with HHT and the aim here was to carry out a review of the literature in order to guide screening and management decisions for this rare disease.

scholarly journals Multi-Modal Treatment Approach to Painful Rib Syndrome: Case Series and Review of the Literature

2016 ◽  
Vol 3;19 (3;3) ◽  
pp. E465-E471 ◽  
Author(s):  
Andrew Germanovich
Keyword(s):  
Literature Review ◽  
Chest Wall ◽  
Treatment Plan ◽  
Case Series ◽  
Intercostal Nerve ◽  
Pain Clinic ◽  
Review Of The Literature ◽  
Presenting Symptoms ◽  
Modal Treatment ◽  
Manual Manipulation

Background: Mechanical chest wall pain is a common presenting complaint in the primary care office, emergency room, and specialty clinic. Diagnostic testing is often expensive due to similar presenting symptoms that may involve the heart or lungs. Since the chest wall biomechanics are poorly understood by many clinicians, few effective treatments are offered to patients with rib-related acute pain, which may lead to chronic pain. Objective: This case series and literature review illustrates biomechanics involved in the pathogenesis of rib-related chest wall pain and suggests an effective multi-modal treatment plan using interventional techniques with emphasis on manual manipulative techniques. Study Design: Case series and literature review. Setting: Pain clinic in an academic medical center. Results: This is a case series of 3 patients diagnosed with painful rib syndrome using osteopathic palpatory physical examination techniques. Ultrasound-guided intercostal nerve blocks were followed by manual manipulation of mechanically displaced ribs as a part of our multi-modal treatment plan. A review of the literature was undertaken to clarify nomenclature used in the description of rib-related pain, to describe the biomechanics involved in the pathogenesis of mechanical rib pain, and to illustrate the use of effective manual manipulation techniques. Limitation: This review is introductory and not a complete review of all manual or interventional pain management techniques applicable to the treatment of mechanical ribrelated pain. Conclusions: Manual diagnostic and therapeutic skills can be learned by physicians to treat biomechanically complex rib-related chest wall pain in combination with interventional imageguided techniques. Pain physicians should learn certain basic manual manipulation skills both for diagnostic and therapeutic purposes.: Key words: Chest wall pain, rib pain, intercostal neuralgia, slipping rib syndrome, chest pain, intercostal nerve block, chest trauma

scholarly journals Systematic review of the beneficial effects of thrombin and vitamin K inhibitors on migraine treatment

2019 ◽  
pp. 5-9
Author(s):  
Eduardo de Almeida Guimaraes Nogueira ◽  
Angela dos Anjos Couto ◽  
Beatriz Moraes Grossi ◽  
Gabriela Dias Nunes ◽  
Taliê Zanchetta B. Hanada ◽  
...  
Keyword(s):  
Systematic Review ◽  
Calcium Channel ◽  
Vitamin K ◽  
Beta Blockers ◽  
Case Series ◽  
Thrombin Inhibitors ◽  
Migraine Treatment ◽  
Calcium Channel Antagonists ◽  
Beneficial Effects ◽  
Patients With Epilepsy

Background: Prophylactic migraine therapy includes beta-blockers, anticonvulsants, tricyclic antidepressants and calcium channel modulators. These drugs have been serendipitously identified as agents capable of migraine control. In order to reduce drug intake, interactions and potential adverse events, patients who have high blood pressure and migraine are often prescribed beta-blockers or calcium channel antagonists. Patients with epilepsy and migraine can use anticonvulsants, those with depression and migraine can be treat with antidepressants, and those with heart arrhythmia or recurrent vertigo and concomitant migraine can benefit from use of calcium channel antagonists. The beneficial effects of vitamin K or thrombin inhibitors on migraine attacks were first described decades ago, and there may be a place for these drugs in migraine prophylaxis. Objective: To investigate the potential beneficial effects of this class of anticoagulants regarding prevention of migraine attacks. Method: Systematic review of the literature including papers with patients’ results. Results: A search of the literature yielded 16 papers with data on patients using inhibitors of vitamin K or thrombin for thromboembolic conditions. Articles typically reported on single cases or small case series. In all but one of these reports, the effect of the drug was remarkable in decreasing migraine severity. Conclusion: Although the level of recommendation is low due to the lack of proper clinical trials, vitamin K or thrombin inhibitors may be useful for migraine management in patients who also require anticoagulation. For these individuals, use of this class of anticoagulants could avoid adding extra drugs for migraine management.

Immunosuppression as efficient therapy for Eosinophilic cholangitis: A case series and review of the literature

2018 ◽  
Vol 56 (01) ◽  
pp. E2-E89
Author(s):  
D Reher ◽  
C Schramm ◽  
F Brinkert ◽  
A Lohse ◽  
C Weiler-Normann
Keyword(s):  
Case Series ◽  
Review Of The Literature ◽  
Eosinophilic Cholangitis

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

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