scholarly journals An Uncommon Cause of Dysphagia: Postpneumonectomy Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Erica Rego ◽  
Ahmed Abdelmeguid ◽  
Yuqi (Kevin) Wang ◽  
Karuna Dewan
Keyword(s):  
Voice Therapy ◽  
Stage Iiia ◽  
External Compression ◽  
Severe Dysphagia ◽  
Adenocarcinoma Of The Lung ◽  
Mediastinal Shift ◽  
History Of ◽  
High Degree ◽  
Chest Ct Scan ◽  
Left Pneumonectomy

Objective. Dysphagia after pneumonectomy is uncommon but concerning. The purpose of this paper is to present a case of dysphonia secondary to postpneumonectomy syndrome. Case Report. A 66-year-old female with stage IIIa adenocarcinoma of the lung was treated with a left pneumonectomy. Three years later, she presented with severe dysphagia, dyspnea, and dysphonia. Esophagram demonstrated severely deviated esophagus to the left of midline, attributed to prior left-sided pneumonectomy, without clear evidence of any external compression. Chest CT scan showed associated leftward mediastinal shift. This patient was treated with voice therapy and an exclusion diet, as the patient elected not to have surgery. Conclusion. This is the first reported case of dysphonia accompanying severe dysphagia following left pneumonectomy. While postpneumonectomy syndrome is rare, a high degree of clinical suspicion is recommended when treating patients with history of pneumonectomy.

Left Anterior Thoracotomy Minimally Invasive Aortic Valve Replacement Following Left Pneumonectomy

2020 ◽  
Vol 15 (5) ◽  
pp. 484-486
Author(s):  
James E. Mace ◽  
Panos N. Vardas ◽  
Clifton T. Lewis ◽  
Kyle W. Eudailey
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Aortic Insufficiency ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Mediastinal Shift ◽  
History Of ◽  
Left Pneumonectomy

We report the case of a 59-year-old man referred for aortic valve replacement for severe, symptomatic aortic insufficiency who underwent a minimally invasive left anterior thoracotomy aortic valve replacement. This approach was facilitated by his history of a left pneumonectomy for lung cancer 7 years prior to presentation, which resulted in a significant left mediastinal shift. The cannulation strategy and exposure were analogous to what would be expected from a standard right anterior thoracotomy minimally invasive aortic valve replacement. The minimally invasive approach allowed for early extubation and mobilization in a patient with moderate baseline pulmonary dysfunction.

THE R.J. CHAMBERS COLLECTION: AN “ARCHIVIST'S” REVELATIONS OF 20th CENTURY ACCOUNTING THOUGHT AND PRACTICE

2006 ◽  
Vol 33 (1) ◽  
pp. 145-166 ◽  
Author(s):  
Graeme W. Dean ◽  
Peter W. Wolnizer ◽  
Frank L. Clarke
Keyword(s):  
Prima Facie ◽  
Accounting Education ◽  
Hard Copy ◽  
Accounting History ◽  
Research Areas ◽  
Archival Source ◽  
Inflation Accounting ◽  
History Of ◽  
High Degree ◽  
Accounting Standard Setting

A major, unique accounting archival source, the R.J. Chambers Collection comprises both hard copy and, utilizing cutting-edge search technology, internet accessible materials. From his academic beginnings, Chambers was an orderly person, an archivist of the extensive and varied evidence that underpinned his proposals for accounting reform. Opening research areas for accounting biography, the development of accounting thought, the history of accounting institutions, prosopography, public sector accounting history, and comparative international accounting history are foremost amongst the myriad justifications for seeking to unravel the accounting history “lodes” in archives such as the Goldberg, Chambers, and Briloff Collections [Potter, 2003]. The archiving of the meticulously kept Chambers papers from 1947–1999 provides an opportunity for unfolding the background to events previously withheld from accounting history scholars. Professional episodes in relation to inflation accounting, standard setting, proposals to reform accounting education, and the like that appeared prima facie to be worth investigating are now open to scrutiny from a different angle, with a different type of evidence available in this Collection. This Collection provides a high degree of archival provenance. In particular, it represents an orderly retention of past documentation of what Chambers wrote, and perhaps uniquely for accounting historians, received; thus, providing an extensive window from which to examine the disorderly present environment of acounting.

scholarly journals Euglycemic Diabetic Ketoacidosis after a Single Dose of Empagliflozin in a Patient with Pancreatitis

2021 ◽  
Vol 11 (2) ◽  
pp. 216-218
Author(s):  
Marta Brandão Calçada ◽  
Luís Fernandes ◽  
Rita Soares Costa ◽  
Sara Montezinho ◽  
Filipa Martins Duarte ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Drug Class ◽  
Clinical Suspicion ◽  
Laboratory Findings ◽  
Sodium Glucose Cotransporter ◽  
History Of ◽  
High Degree ◽  
Euglycemic Diabetic Ketoacidosis

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the most recently approved drug class for the treatment of type 2 diabetes mellitus (T2D). Although they are largely well-tolerated, their intake has been associated with euglycemic diabetic ketoacidosis (DKA) in some rare cases. We report the case of a 70-year-old male with type 2 diabetes and no history of DKA, who started therapy with empagliflozin one day before presenting with acute pancreatitis and laboratory findings consistent with euglycemic DKA. SGLT2i can induce euglycemic DKA from the first dose. Given the atypical presentation, a high degree of clinical suspicion is required to recognize this complication.

929 Not Another Abscess - A Case of Streptococcal Myositis Misdiagnosed as a Right Axillary Abscess

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
O Oyende ◽  
J Jackman
Keyword(s):  
White Cell Count ◽  
General Surgeon ◽  
High Dose ◽  
General Anaesthetic ◽  
Microbiological Analysis ◽  
Reactive Protein ◽  
Affected Tissue ◽  
Life Threatening ◽  
History Of ◽  
High Degree

Abstract Introduction Streptococcal myositis is a rare form of infectious myositis caused by Lansfield A beta-haemolytic streptococci. It is characterised by rapidly spreading inflammation that can result in severe systemic toxicity and necrosis of the affected tissue if not diagnosed and aggressively treated. Presentation We report a case of a 42-year-old male who presented with a one-week history of worsening right axillary swelling that progressed to painful swelling of his arm. Inflammatory markers were significantly elevated with a white cell count of 17 ×109/L and C-reactive protein of 212 mg/L. On examination, a fluctuant axillary swelling was appreciated, and a decision was made for incision and drainage under general anaesthetic. Intraoperative aspiration of his arm revealed copious purulent fluid prompting intraoperative orthopaedic consult and exploration of the anterior compartment in which there was extensive involvement of the biceps muscle. The microbiological analysis revealed gram-positive cocci in chains, and microbiology advice sought for tailoring of antibiotic regimen. He has recovered well. Discussion Though uncommon, the emergency general surgeon should have a high degree of suspicion when evaluating soft tissue infections to avert potentially disastrous outcomes. Conclusion Early diagnosis, aggressive management with high-dose intravenous antibiotics, and surgical debridement are principles to treat this rare, life-threatening infection.

scholarly journals The Return of National Self-Sufficiency? Excavating Autarkic Thought in a De-Globalizing Era

2021 ◽  
Author(s):  
Eric Helleiner
Keyword(s):  
Intellectual History ◽  
International Political Economy ◽  
Economic Thought ◽  
John Maynard Keynes ◽  
New Politics ◽  
Self Sufficiency ◽  
National Economic ◽  
History Of ◽  
High Degree ◽  
Rich History

Abstract As the global crisis triggered by the COVID-19 virus unfolded, The Economist magazine published a cover in May 2020 titled “Goodbye globalization: the dangerous lure of self-sufficiency.” The title summed up well the new political interest in the ideology of national economic self-sufficiency in the pandemic context. Unfortunately, contemporary textbooks in the field of international political economy (IPE) say little about this kind of “autarkic” thought. No survey of the history of autarkic thought exists even within specialist IPE literature or in the fields of intellectual history and the history of economic thought. Filling this gap in existing scholarship, this article highlights a rich history of autarkic thought that includes the ideas of famous thinkers such as Jean-Jacques Rousseau, Johann Fichte, Mohandas Gandhi, and John Maynard Keynes. Three core rationales for a high degree of national self-sufficiency have been advanced in the past: (1) insulation from foreign economic influence, (2) insulation from foreign political and/or cultural influence, and (3) the promotion of international peace. At the same time, considerable disagreements have existed among autarkists about some of these rationales and their relative importance, as well as about the precise meaning of national self-sufficiency. These disagreements stemmed not just from differences in their specific goals but also from the different conditions across time and space in which autarkic thought was developed. In addition to improving understanding of the autarkic ideological tradition, this article contributes to emerging scholarship attempting to overcome Western-centrism in IPE scholarship as well as literature exploring the new politics of de-globalization in the current era.

scholarly journals Multi-Locus Selection and the Structure of Variation at the white Gene of Drosophila melanogaster

Genetics ◽  
1996 ◽  
Vol 144 (2) ◽  
pp. 635-645 ◽  
Author(s):  
David A Kirby ◽  
Wolfgang Stephan
Keyword(s):  
Drosophila Melanogaster ◽  
White Gene ◽  
Transcriptional Unit ◽  
North American Population ◽  
Evolutionary Mechanisms ◽  
Locus Selection ◽  
Neutral Equilibrium ◽  
History Of ◽  
High Degree ◽  
Very High

Abstract We surveyed sequence variation and divergence for the entire 5972-bp transcriptional unit of the white gene in 15 lines of Drosophila melanogaster and one line of D. simulans. We found a very high degree of haplotypic structuring for the polymorphisms in the 3′ half of the gene, as opposed to the polymorphisms in the 5′ half. To determine the evolutionary mechanisms responsible for this pattern, we sequenced a 1612-bp segment of the white gene from an additional 33 lines of D. melanogaster from a European and a North American population. This 1612-bp segment encompasses an 834bp region of the white gene in which the polymorphisms form high frequency haplotypes that cannot be explained by a neutral equilibrium model of molecular evolution. The small number of recombinants in the 834bp region suggests epistatic selection as the cause of the haplotypic structuring, while an investigation of nucleotide diversity supports a directional selection hypothesis. A multi-locus selection model that combines features from both-hypotheses and takes the recent history of D. melanogaster into account may be the best explanation for these data.

scholarly journals Tuberculosis presenting as dacryoadenitis in the USA

2019 ◽  
Vol 12 (11) ◽  
pp. e231694 ◽  
Author(s):  
Harry Ross Powers ◽  
Mark Anthony Diaz ◽  
Julio C Mendez
Keyword(s):  
Correct Diagnosis ◽  
Developed Countries ◽  
Histopathological Analysis ◽  
Orbital Mass ◽  
Antituberculosis Therapy ◽  
The Usa ◽  
History Of ◽  
Patient’S History ◽  
High Degree ◽  
Filipino Woman

A 25-year-old Filipino woman living in the USA was evaluated for a 5-month history of left eye pain and a subsequent orbital mass. Histopathological analysis of the lacrimal mass showed a mixed inflammatory process with necrotising granulomas and positive cultures for Mycobacterium tuberculosis. She was treated with antituberculosis therapy, with resolution of symptoms. Tuberculosis dacryoadenitis is extremely rare in the USA and other developed countries. It requires a high degree of clinical suspicion with special attention to the patient’s history to make the correct diagnosis. It can be treated successfully with antituberculosis therapy.

scholarly journals Modelling the COVID-19 pandemic in context: an international participatory approach

2020 ◽  
Vol 5 (12) ◽  
pp. e003126
Author(s):  
Ricardo Aguas ◽  
Lisa White ◽  
Nathaniel Hupert ◽  
Rima Shretta ◽  
Wirichada Pan-Ngum ◽  
...  
Keyword(s):  
Mathematical Models ◽  
Low Income ◽  
Scientific Evidence ◽  
Participatory Approach ◽  
Middle Income ◽  
Middle Income Countries ◽  
Containment Measures ◽  
History Of ◽  
High Degree ◽  
The Mathematical Model

The SARS-CoV-2 pandemic has had an unprecedented impact on multiple levels of society. Not only has the pandemic completely overwhelmed some health systems but it has also changed how scientific evidence is shared and increased the pace at which such evidence is published and consumed, by scientists, policymakers and the wider public. More significantly, the pandemic has created tremendous challenges for decision-makers, who have had to implement highly disruptive containment measures with very little empirical scientific evidence to support their decision-making process. Given this lack of data, predictive mathematical models have played an increasingly prominent role. In high-income countries, there is a long-standing history of established research groups advising policymakers, whereas a general lack of translational capacity has meant that mathematical models frequently remain inaccessible to policymakers in low-income and middle-income countries. Here, we describe a participatory approach to modelling that aims to circumvent this gap. Our approach involved the creation of an international group of infectious disease modellers and other public health experts, which culminated in the establishment of the COVID-19 Modelling (CoMo) Consortium. Here, we describe how the consortium was formed, the way it functions, the mathematical model used and, crucially, the high degree of engagement fostered between CoMo Consortium members and their respective local policymakers and ministries of health.

scholarly journals Post-COVID-19 Kawasaki-Like Syndrome

2021 ◽  
pp. 014556132110060
Author(s):  
Jérôme R. Lechien ◽  
Rémi Hervochon ◽  
Stéphane Hans
Keyword(s):  
Abdominal Pain ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Hepatitis A ◽  
Clinical Presentation ◽  
Multiple Organ ◽  
Mild Form ◽  
Severe Dysphagia ◽  
History Of ◽  
Inflammatory Syndrome

A 42-year-old man was referred for a week history of severe dysphagia, odynophagia, fever (39 °C), fatigue, abdominal pain, pharyngeal swelling, and multiple neck lymphadenopathies. The medical history reported a mild form of COVID-19 one month ago. The biology reported an unspecified inflammatory syndrome. The patient developed peritonitis, myocarditis, and hepatitis. A myocardium biopsy was performed. A diagnosis of Kawasaki-like disease (KLD) was performed. The occurrence of KLD in adults is rare but has to be known by otolaryngologists regarding the otolaryngological clinical presentation that may precede the multiple organ failure.

Myeloid Sarcoma of the Head and Neck Region

2013 ◽  
Vol 137 (11) ◽  
pp. 1560-1568 ◽  
Author(s):  
Jane Zhou ◽  
Diana Bell ◽  
L. Jeffrey Medeiros
Keyword(s):  
Head And Neck ◽  
Low Frequency ◽  
Neck Region ◽  
Immunohistochemical Analysis ◽  
Myeloid Sarcoma ◽  
Head And Neck Region ◽  
Bone Marrow Disease ◽  
Highly Sensitive ◽  
History Of ◽  
High Degree

Context.—Myeloid sarcoma of the head and neck region can pose diagnostic challenges because of the low frequency of myeloid sarcoma and the potential for tumors of almost any lineage to occur in the head and neck. Objective.—To study the clinicopathologic and immunohistochemical characteristics of myeloid sarcoma in the head and neck region and to review the differential diagnosis. Design.—We searched for cases of myeloid sarcoma involving the head and neck region for a 24-year period at our institution. The medical records and pathology slides were reviewed. Additional immunohistochemical stains were performed. Results.—We identified 17 patients, age 17 to 85 years. Most tumors involved the oral cavity. Myeloid sarcoma was the initial diagnosis in 9 patients (53%); the remaining 8 patients (47%) had a history of bone marrow disease. Immunohistochemical analysis using antibodies specific for lysozyme, CD43, and CD68 were highly sensitive for diagnosis but were not specific. By contrast, assessment for myeloperoxidase in this study was less sensitive but more specific. We also used antibodies specific for CD11c and CD33 in a subset of cases, and these reagents seem helpful as well. Conclusions.—The clinical presentation of myeloid sarcoma involving the head and neck, particularly the mouth, is often nonspecific, and a high degree of suspicion for the possibility of myeloid sarcoma is needed. Immunohistochemistry is very helpful for establishing the diagnosis.

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