scholarly journals Classifying Hydroceles of the Pelvis and Groin: An Overview of Etiology, Secondary Complications, Evaluation, and Management

2016 ◽  
Vol 10 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Gautam Dagur ◽  
Jason Gandhi ◽  
Yiji Suh ◽  
Steven Weissbart ◽  
Yefim R. Sheynkin ◽  
...  
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Diagnostic Techniques ◽  
Current Treatment ◽  
Serous Fluid ◽  
Secondary Complications ◽  
Appropriate Treatment ◽  
Iatrogenic Trauma ◽  
Life Threatening

Introduction: A hydrocele is defined as the pathological buildup of serous fluid in the pelvis and groin due to various etiologies such as diseases or trauma. It has distinct clinical manifestations, particularly discomfort and psychosocial distress. Understanding the anatomy, embryology, and physiology associated with hydrocele formation is crucial to understand its onset and progression. Materials and Methods: A MEDLINE® search was conducted using keywords for the relevant classification of hydrocele and its etiology, complications, sexual barriers, evaluation, and management. Results: Appropriately classifying the hydrocele as primary, secondary communicating, secondary noncommunicating, microbe-induced, inflammatory, iatrogenic, trauma-induced, tumor-induced, canal of Nuck, congenital, and giant is important for identifying the underlying etiology. Often this process is overlooked when the classification or etiology is too rare. A focused evaluation is important for this, so that timely management can be provided. We comprehensively review the classifications, etiology, and secondary complications of hydrocele. Pitfalls of current diagnostic techniques are explored along with recommended methods for accurate diagnosis and current treatment options. Conclusion: Due to the range of classifications and etiologies of hydrocele in the pelvis and groin, a deliberate differential diagnosis is essential to avoiding imminent life-threatening complications as well as providing the appropriate treatment.

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

scholarly journals Palmoplantar psoriasis: a comparative therapeutic study

2019 ◽  
Vol 5 (4) ◽  
pp. 779
Author(s):  
Sathya Narayanan Rajendran ◽  
Sukanya Mathupal Gurusamy
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Simple Random Sampling ◽  
Inflammatory Dermatosis ◽  
Duration Of Illness ◽  
Erythrodermic Psoriasis ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
Therapeutic Study

<p class="abstract"><strong>Background:</strong> Psoriasis is an immunologically mediated inflammatory dermatosis presenting with extremely variable clinical manifestations ranging from indolent lesions to life threatening forms of pustular and erythrodermic psoriasis. Palmoplantar psoriasis present as hyperkeratotic scaly plaques with fissures and can be managed with different treatment forms. This study was done to compare the efficacy between topical and systemic treatment options.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in a tertiary level teaching hospital after ethical committee clearance. Fifty patients with palmoplantar psoriasis were allocated into the two groups using simple random sampling. PPPASI scoring was calculated to assess the extent of involvement. Patients in Group A were prescribed calcipotriol with clobetasol propionate ointment. Group B patients were given tablet methotrexate.<strong></strong></p><p class="abstract"><strong>Results:</strong> Twenty eight patients were males M: F of 1.27: 1. Mean age was 36. Mean duration of illness was eleven months. Most of these patients were manual laborers. 32 patients had lesions over both palms and soles, 9 over palms alone and 9 involving soles alone. Mean PASI reduction at 16 weeks was seen maximum with methotrexate. Compliance was comparatively good with methotrexate than topical. Though mean PASI reduction and compliance was good, relapse rates were higher with methotrexate in our study.</p><p class="abstract"><strong>Conclusions:</strong> There was no significant change in clinico-epidemiology and presentation of palmoplantar psoriasis. Methotrexate was observed to be the more efficacious modality in treating palmoplantar psoriasis.</p>

scholarly journals Current Treatment Options for Patients with Myotonic Dystrophy Type 2

2021 ◽  
Vol 23 (9) ◽  
Author(s):  
Federica Montagnese
Keyword(s):  
Myotonic Dystrophy ◽  
Treatment Options ◽  
Current Treatment ◽  
Standards Of Care ◽  
Myotonic Dystrophy Type ◽  
Myotonic Dystrophy Type 2 ◽  
Appropriate Treatment ◽  
Symptomatic Management ◽  
The Moment

Abstract Purpose of the review Myotonic dystrophy types 1 and 2 are frequent forms of muscular dystrophies in adulthood. Their clinical differences need to be taken into account for the most appropriate treatment of patients. The aim of this article is to provide an overview on the current and upcoming therapeutic options for patients with myotonic dystrophy type 2 (DM2). Recent findings At the moment, no disease-modifying therapies are available for DM2; next-generation therapies may however be available in the near future. In the meanwhile, the symptomatic management of patients has greatly improved, thank to the production of consensus-based standards of care and the growing evidence of efficacy of anti-myotonic drugs, promising employment of cannabinoids for symptom’s relief, regular monitoring, and early detection of treatable extra-muscular manifestations. Summary The treatment of DM2 is currently symptomatic and relies on the coordinated intervention of a multidisciplinary team. It remains to be determined whether upcoming causal therapies for myotonic dystrophy type 1 will be applicable also in DM2.

scholarly journals The Intrinsic Differences Between Immune Checkpoint Inhibitor Induced Myocarditis: A Retrospective Analysis of Real-World Data

2022 ◽  
Author(s):  
Yanna Lei ◽  
Xiufeng Zheng ◽  
Qian Huang ◽  
Xiaoying Li ◽  
Meng Qiu ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Medical Records ◽  
Immune Checkpoint Inhibitor ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Real World Data ◽  
West China Hospital ◽  
West China ◽  
Life Threatening ◽  
The Relationship

Abstract Immune-related myocarditis is a severe and even life-threatening immune-related adverse event (irAE) which may also be under-estimated due to the challenge in diagnosis. There have been few reports about the intrinsic difference between patients with immune-associated myocarditis. A retrospective analysis was conducted between March 2019 to June 2020 in West China Hospital and 18 patients with immune-related myocarditis were studied. Cases were classified as mild (n=12) or severe myocarditis (n=6) according to the clinical manifestations and haemodynamic complications. Covariates extracted from medical records were compared in different groups, and factors associated with severe myocarditis were identified. In this retrospective analysis, the median age of the 18 patients was 60 years old. Most cases occur early and approximately after the first or second ICI infusion. The severity of myocarditis may be correlated with lactate dehydrogenase (LDH) (P=0.04) and troponin (P=0.0057). The relationship between troponin and myocarditis was further confirmed in another cohort which including 30 patients. In addition, patients are more likely to develop multi-irAEs, and myositis was the most common second irAE. Those who experience multi-irAEs had significantly higher LDH (P=0.02) as well as myoglobin levels (P=0.02) than did not experience. All patients were treated with steroids timely and the mortality rate was 5.6% in our study. In this study, we explore risk factors for severe myocarditis and we emphasized the importance of a multidisciplinary team in assisting diagnosis and treatment options. It is critical to initiate corticosteroid therapy, regardless of the severity of the myocarditis.

Hypersensitivity Reactions and Anaphylaxis

2020 ◽  
Author(s):  
Kristopher K. Ford ◽  
Timothy M. Loftus ◽  
Joseph J. Moellman
Keyword(s):  
Mast Cells ◽  
Clinical Manifestations ◽  
Allergic Reactions ◽  
Hypersensitivity Reactions ◽  
Life Threatening ◽  
Vasopressor Agents ◽  
Ige Mediated ◽  
Criteria For Diagnosis ◽  
Key Words Allergy

Allergic reactions vary in intensity from mild rash or allergic rhinitis to devastating anaphylactic shock. Anaphylaxis, often underrecognized and undertreated, can be a life-threatening syndrome leading to multiorgan dysfunction. This review covers the etiology, pathophysiology, and treatment of severe allergic reactions and anaphylaxis. It is precipitated by exposure to particular allergens—commonly food, medications, insect stings, and environmental exposures—in a previously sensitized individual. Symptoms develop from an IgE-mediated immune response leading to degranulation of mast cells and basophils and the release of preformed mediators, lipid-derived metabolites, and inflammatory cytokines. First-line treatment for anaphylaxis involves epinephrine. Secondary treatments are antihistamines and corticosteroids. Further treatments for patients refractory to standard therapies involve vasopressor agents, nebulized albuterol, and glucagon. Frequency and duration of biphasic reactions are variable, limiting the development of consensus guidelines for monitoring of anaphylactic reactions. Figures show the immune activity and inflammatory pathways in allergic responses, mast cell degranulation, and a depiction of common organs involved and corresponding clinical manifestations. Tables list the criteria for diagnosis of anaphylaxis, classification of hypersensitivity reactions, common clinical manifestations, and etiology and mediators of anaphylaxis.  This review contains 4 highly rendered figures, 11 tables, and 43 references. Key words: allergy, anaphylaxis, antihistamine, corticosteroid, epinephrine, mast cells

scholarly journals Treatment of Diffuse Alveolar Hemorrhage: Controlling Inflammation and Obtaining Rapid and Effective Hemostasis

2021 ◽  
Vol 22 (2) ◽  
pp. 793
Author(s):  
Jeong A. Park
Keyword(s):  
Diffuse Alveolar Damage ◽  
Treatment Options ◽  
Hematologic Malignancies ◽  
Current Treatment ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Factor Vii ◽  
Controlled Study ◽  
High Dose ◽  
Life Threatening

Diffuse alveolar hemorrhage (DAH) is a life-threatening pulmonary complication in patients with hematologic malignancies or systemic autoimmune disorders. Pathologic findings show pulmonary capillaritis, bland hemorrhage, diffuse alveolar damage, and hemosiderin-laden macrophages, but in the majority of cases, pathogenesis remains unclear. Despite the severity and high mortality, the current treatment options for DAH remain empirical. Systemic treatment to control inflammatory activity including high-dose corticosteroids, cyclophosphamide, and rituximab and supportive care have been applied, but largely unsuccessful in critical cases. Activated recombinant factor VII (FVIIa) can achieve rapid local hemostasis and has been administered either systemically or intrapulmonary for the treatment of DAH. However, there is no randomized controlled study to evaluate the efficacy and safety, and the use of FVIIa for DAH remains open to debate. This review discusses the pathogenesis, diverse etiologies causing DAH, diagnosis, and treatments focusing on hemostasis using FVIIa. In addition, the risks and benefits of the off-label use of FVIIa in pediatric patients will be discussed in detail.

scholarly journals ECMO Rescues Patients With Acute Respiratory Failure Related to GPA

2021 ◽  
Vol 8 ◽  
Author(s):  
Rongjun Wan ◽  
Wenzhe Yang ◽  
Xinhua Ma ◽  
Wei Yang ◽  
Pinhua Pan ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Granulomatosis With Polyangiitis ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Systemic Involvement ◽  
Online Databases ◽  
Appropriate Treatment ◽  
Wide Range ◽  
Life Threatening

Granulomatosis with polyangiitis (GPA) is a subtype of anti-neutrophil cytoplasmic antibody-associated vasculitis with a wide range of clinical symptoms related to the systemic involvement of small blood vessels. The respiratory system is one of the most frequently involved, and life-threatening acute respiratory failure could occur due to diffusive alveolar hemorrhage and tracheal stenosis. When maximum mechanical ventilation is unable to maintain oxygenation, extracorporeal membrane oxygenation (ECMO) should be considered as the final respiratory supportive method, if available. Here we present a 32-year-old male patient with acute respiratory failure (ARF) related to GPA, who was rescued by winning time for accurate diagnosis and appropriate treatment. Additionally, we reviewed more than 60 GPA-related ARF cases on multiple online databases, summarized the clinical manifestations of these patients, and concluded that ECMO plays an important role in further respiratory support for ARF patients with GPA and assists in accurate and timely diagnosis and appropriate treatment, thus helping them recuperate.

Endovascular Abdominal Aortic Stent Grafting in Unrecognized Salmonella Aortitis

2012 ◽  
Vol 46 (5) ◽  
pp. 431-434 ◽  
Author(s):  
K. Kommaraju ◽  
Derek R. Brinster
Keyword(s):  
Endovascular Repair ◽  
Treatment Options ◽  
Graft Infection ◽  
Current Treatment ◽  
Stent Grafting ◽  
Endovascular Graft ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Life Threatening Complication

Abdominal endovascular graft infection is a rare but life-threatening complication of endovascular repair that can be challenging to manage. This report delineates the progression of a unique set of events leading to Salmonella graft infection and investigates current treatment options.

scholarly journals Pyogenic brain abscess

2008 ◽  
Vol 24 (6) ◽  
pp. E2 ◽  
Author(s):  
Ersin Erdoğan ◽  
Tufan Cansever
Keyword(s):  
Treatment Options ◽  
Neurological Status ◽  
Diagnostic Techniques ◽  
Diagnosis And Treatment ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Brain Abscesses ◽  
Lower Morbidity

✓ Brain abscesses have been one of the most challenging lesions, both for surgeons and internists. From the beginning of the computed tomography (CT) era, the diagnosis and treatment of these entities have become easier and less invasive. The outcomes have become better with the improvement of diagnostic techniques, neurosurgery, and broad-spectrum antibiotics. Atypical bacterial abscesses are more often due to chemotherapy usage in oncology, long life expectancy in patients with human immunodeficiency virus (HIV) infection, and immunosuppression in conjunction with organ transplantation. Surgical treatment options showed no significant difference with respect to mortality levels, but lower morbidity rates were achieved with stereotactically guided aspiration. Decompression with stereotactically guided aspiration, antibiotic therapy based on results of pus culture, and repeated aspirations if indicated from results of periodic CT follow-up scans seem to be the most appropriate treatment modality for brain abscesses. Immunosuppression and comorbidities, initial neurological status, and intraventricular rupture were significant factors influencing the outcomes of patients. The pitfalls and evolution in the diagnosis and treatment of brain abscesses are discussed in this study.

Diabetic neuropathies: clinical manifestations and current treatment options

2006 ◽  
Vol 2 (5) ◽  
pp. 269-281 ◽  
Author(s):  
Aaron Vinik ◽  
Jagdeesh Ullal ◽  
Henri K Parson ◽  
Carolina M Casellini
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Current Treatment ◽  
Diabetic Neuropathies
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