scholarly journals Segmental Posthetomy in a Four Stallions Case Series

Animals ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 1145
Author(s):  
Adriana Palozzo ◽  
Gianluca Celani ◽  
Giulia Guerri ◽  
Paola Straticò ◽  
Vincenzo Varasano ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Single Case ◽  
Case Series ◽  
Scar Tissue ◽  
Successful Outcome ◽  
First Case ◽  
Degloving Injury ◽  
End To End ◽  
Circumferential Segment

Segmental posthetomy, also referred to as circumcision, reefing or posthioplasty, consists of removing a circumferential segment of the internal preputial lamina (internal preputial fold) followed by end-to-end anastomosis of skin edges. The purpose of this case series is to describe the successful outcome of segmental posthetomy for treating different diseases involving the internal or/and external preputial fold, while restoring the normal telescopic function. In this paper, we report the first case of complete degloving injury of the equine penis in the literature (case 1) and describe three different common lesions of the equine prepuce/penis (preputial scar tissue in case 2, preputial sarcoid in case 3 and penile/preputial wound in case 4). The amount of prepuce (safe minimums) that can be removed from a stallion without disrupting the proper telescopic function of the internal/external preputial fold and normal copulatory ability, has not been established. In this case series, all Equidae stallions maintained the telescopic function after preputial surgical resection. However, the surgeon must carefully evaluate every single case, especially when performing the Adam’s procedure.

scholarly journals Treating Penile Cancer in the Immunotherapy and Targeted Therapy Era

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Gavin Hui ◽  
Sanaz N. Ghafouri ◽  
John Shen ◽  
Sandy Liu ◽  
Alexandra Drakaki
Keyword(s):  
Surgical Resection ◽  
Penile Cancer ◽  
Case Series ◽  
Standard Chemotherapy ◽  
Second Line Therapy ◽  
Adjuvant Chemoradiation ◽  
Line Therapy ◽  
First Case ◽  
Novel Approach ◽  
Progression Of Disease

While localized penile cancers are typically treated surgically and metastatic penile cancers benefit from standard chemotherapy, there have been studies on the horizon demonstrating immunotherapy as a novel approach to metastatic penile cancers that have failed standard chemotherapy. We report a case series of two patients who improved on immunotherapy after progressing with standard chemotherapy regimens. The first case describes a 64-year-old male with a penile mass and significant lymphadenopathy who had surgical resection and adjuvant chemotherapy prior to continued disease progression. He was started on anti-EGFR treatment and improved initially, but he eventually had progression of disease. The second case describes a 79-year-old male with a penile mass who was treated with surgical resection and started on adjuvant chemoradiation, but he developed recurrence and nodal involvement. Therefore, second-line therapy of the PD-L1 inhibitor was started in this patient. There were no available clinical trials for penile cancer patients who progressed beyond the standard surgical therapy and chemotherapy.

scholarly journals Nontraumatic Anterior Thigh Pain in a NCAA Lacrosse Athlete: A Case Report and Description of a Rectus Femoris Degloving Injury

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Paul A. Krebs ◽  
James R. Borchers ◽  
Patrick Brayfield
Keyword(s):  
Conservative Therapy ◽  
Case Series ◽  
Rectus Femoris ◽  
Thigh Pain ◽  
Rare Injury ◽  
Anterior Thigh ◽  
First Case ◽  
Degloving Injury ◽  
Closed Degloving Injury ◽  
Closed Degloving

A 21-year-old female lacrosse player complained of anterior thigh pain with no known mechanism of injury and failed to improve with conservative therapy. An MRI was obtained showing a closed degloving injury of the rectus femoris, an injury only previously reported in a small case series of soccer players. After a brief period of rest, she was progressed conservatively through therapy and did well, with progression back to the level of competition at 56 days. This case highlights a rare injury not previously described in sports outside of soccer and is the first case described in a female athlete. In addition, the discussion of this case focuses on the unique anatomy of the rectus femoris.

Case Series: Cystic Brain Metastases Managed With Reservoir Placement and Stereotactic Radiosurgery

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
David J Park ◽  
Prashin Unadkat ◽  
Anuj Goenka ◽  
Michael Schulder
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Surgical Resection ◽  
Case Series ◽  
Treatment Method ◽  
Volume Reduction ◽  
Successful Outcome ◽  
Tumor Control ◽  
Cystic Component ◽  
Alternative Treatment Option

Abstract BACKGROUND Stereotactic radiosurgery (SRS) has become one of the mainstays of treatment for patients with metastatic brain tumors. However, metastatic tumors with a large cystic component often exceed the size limit for safe and effective SRS. In such cases, surgical resection may not be the preferred first method of treatment, due to tumor location, patient co-morbidities, and patient preference. In these patients, volume reduction by cyst aspiration (CA) followed by SRS may be a viable alternative treatment option. OBJECTIVE To present the treatment of patients with cystic metastases using reservoir placement followed by SRS. METHODS Nine patients were treated with this method. We performed reservoir insertion for the aspiration of cystic component in each patient and followed that with outpatient SRS. RESULTS Mean overall volume reduction from this treatment method was 78.5%. Mean volume reduction from the CA alone was 59.8%, and after SRS, a further 66.6%, accounting for some cyst reaccumulation between the time of surgery and SRS. Repeat reservoir aspiration was done a total of 10 times in 5 patients. Our study showed local tumor control in 7 of 9 patients (77.8%), while 2 patients required later surgical resection of their tumors. CONCLUSION CA with reservoir placement followed by SRS is a good option for patients with large cystic brain metastases. The reservoir allows for repeat aspiration if needed. Catheter placement at the center of the cyst, and SRS within 2 to 3 wk of surgery, can maximize the likelihood of a successful outcome.

Anesthesia in Carvajal syndrome; the first case report

2020 ◽  
Vol 24 (1) ◽  
pp. 105-107
Author(s):  
Sedighe Shahhosseini ◽  
Reza Aminnejad ◽  
Amir Shafa ◽  
Mehrdad Memarzade
Keyword(s):  
Intensive Care ◽  
Case Report ◽  
Surgical Resection ◽  
Genetic Disorder ◽  
Anesthetic Technique ◽  
Close Monitoring ◽  
Anesthesia Management ◽  
Rare Genetic Disorder ◽  
First Case ◽  
Anesthetic Considerations

Carvajal syndrome is a rare genetic disorder. Patients reporting for surgery pose some difficulties in anesthesia management. In this case report we present the case of a 12-year-old boy, who was a known case of Carvajal syndrome, referred for surgical resection of perianal condyloma. Close monitoring of hemodynamic status is the mainstay of anesthetic considerations in such patients. As in any other challenging scenario, it should be kept in mind that ‘there is no safest anesthetic agent, nor the safest anesthetic technique; there is only the safest anesthesiologist’. Citation: Shahhosseini S, Aminnejad R, Shafa A, Memarzadeh M. Anesthesia in Carvajal syndrome; the first case report. Anaesth pain intensive care 2020;24(1):___ DOI: https://doi.org/10.35975/apic.v24i1.

scholarly journals Sodium-Glucose Cotransporter-2 Inhibitors in Patients with Hereditary Podocytopathies, Alport Syndrome, and FSGS: A Case Series to Better Plan a Large-Scale Study

Cells ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1815
Author(s):  
Jan Boeckhaus ◽  
Oliver Gross
Keyword(s):  
Glomerular Filtration ◽  
Alport Syndrome ◽  
Large Scale ◽  
Case Series ◽  
Hereditary Diseases ◽  
Glomerular Filtration Barrier ◽  
Early Effect ◽  
Filtration Barrier ◽  
First Case ◽  
Sodium Glucose Cotransporter

Hereditary diseases of the glomerular filtration barrier are characterized by a more vulnerable glomerular basement membrane and dysfunctional podocytes. Recent clinical trials have demonstrated the nephroprotective effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in chronic kidney disease (CKD). SGLT2-mediated afferent arteriole vasoconstriction is hypothesized to correct the hemodynamic overload of the glomerular filtration barrier in hereditary podocytopathies. To test this hypothesis, we report data in a case series of patients with Alport syndrome and focal segmental glomerulosclerosis (FSGS) with respect of the early effect of SGLT2i on the kidney function. Mean duration of treatment was 4.5 (±2.9) months. Mean serum creatinine before and after SGLT-2i initiation was 1.46 (±0.42) and 1.58 (±0.55) mg/dL, respectively, with a median estimated glomerular filtration rate of 64 (±27) before and 64 (±32) mL/min/1.73 m2 after initiation of SGLT2i. Mean urinary albumin-creatinine ratio in mg/g creatinine before SGLT-2i initiation was 1827 (±1560) and decreased by almost 40% to 1127 (±854) after SGLT2i initiation. To our knowledge, this is the first case series on the effect and safety of SGLT2i in patients with hereditary podocytopathies. Specific large-scale trials in podocytopathies are needed to confirm our findings in this population with a tremendous unmet medical need for more effective, early on, and safe nephroprotective therapies.

scholarly journals Post-Infectious Guillain–Barré Syndrome Related to SARS-CoV-2 Infection: A Systematic Review

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 167
Author(s):  
Pasquale Sansone ◽  
Luca Gregorio Giaccari ◽  
Caterina Aurilio ◽  
Francesco Coppolino ◽  
Valentina Esposito ◽  
...  
Keyword(s):  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Guillain Barre Syndrome ◽  
Response To Treatment ◽  
Comprehensive Overview ◽  
Fisher Syndrome ◽  
Immunomodulating Therapy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Background. Guillain-Barré syndrome (GBS) is the most common cause of flaccid paralysis, with about 100,000 people developing the disorder every year worldwide. Recently, the incidence of GBS has increased during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemics. We reviewed the literature to give a comprehensive overview of the demographic characteristics, clinical features, diagnostic investigations, and outcome of SARS-CoV-2-related GBS patients. Methods. Embase, MEDLINE, Google Scholar, and Cochrane Central Trials Register were systematically searched on 24 September 2020 for studies reporting on GBS secondary to COVID-19. Results. We identified 63 articles; we included 32 studies in our review. A total of 41 GBS cases with a confirmed or probable COVID-19 infection were reported: 26 of them were single case reports and 6 case series. Published studies on SARS-CoV-2-related GBS typically report a classic sensorimotor type of GBS often with a demyelinating electrophysiological subtype. Miller Fisher syndrome was reported in a quarter of the cases. In 78.1% of the cases, the response to immunomodulating therapy is favourable. The disease course is frequently severe and about one-third of the patients with SARS-CoV-2-associated GBS requires mechanical ventilation and Intensive Care Unit (ICU) admission. Rarely the outcome is poor or even fatal (10.8% of the cases). Conclusion. Clinical presentation, course, response to treatment, and outcome are similar in SARS-CoV-2-associated GBS and GBS due to other triggers.

Analysis of Clinical, Imaging, and Pathologic Features of 36 Patients with Primary Intraspinal Primitive Neuroectodermal Tumors: A Case Series and Literature Review

2021 ◽  
Author(s):  
Xuefeng Wei ◽  
Xu Zhang ◽  
Zimu Song ◽  
Feng Wang
Keyword(s):  
Literature Review ◽  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Subtotal Resection ◽  
Study Cohort ◽  
Primitive Neuroectodermal Tumors ◽  
Pathologic Features ◽  
Neuroectodermal Tumors ◽  
The Mean

Abstract Background and Study Aims Primary intraspinal primitive neuroectodermal tumors (PNETs) account for ∼0.4% of all intraspinal tumors, but information about these tumors in the medical literature is limited to single case reports. We report four cases of primary intraspinal PNETs and present a systematic literature review of the reported cases. Materials and Methods We retrospectively reviewed and analyzed the clinical data of 4 patients with primary intraspinal PNETs who underwent neurosurgical treatment at our clinic between January 2013 and January 2020, and of 32 cases reported in the literature. Results The female-to-male ratio was 2.6:1. The mean patient age was 21.42 ± 15.76 years (range: 1–60 years), and patients <36 years of age accounted for 83.30% of the study cohort. Progressive limb weakness and numbness were the chief symptoms (accounting for ∼55.6%). The mean complaint duration was 0.89 ± 0.66 months for males and 2.72 ± 3.82 months for females (p = 0.028). Epidural (41.7%) was the most common site, and thoracic (47.3%) was the most frequent location. Most PNETs were peripheral, and magnetic resonance imaging (MRI) appearance was isointense or mildly hypointense on T1-weighted images and hyperintense on T2-weighted images. Homogeneous contrast enhancement was observed. The 1-year survival rate of patients who underwent chemoradiation after total or subtotal lesion resection was better compared with patients who did not undergo chemotherapy, radiotherapy, or total or subtotal resection. The modality of treatment was associated with survival time (p = 0.007). Conclusion Primary intraspinal PNETs mainly occur in young people with a female preponderance. In patients with a rapid loss of lower limb muscle strength and large intraspinal lesions on MRI, PNETs should be considered. Surgical resection and adjuvant radio chemotherapy are key prognostic factors.

scholarly journals Histopathology of Microvascular Anastomosis—Comparison of Patent and Nonpatent Anastomosis: An Experimental Study

2021 ◽  
Author(s):  
Dhaval Gohil ◽  
Nasser Mohammed ◽  
Anita Mahadevan ◽  
Nupur Pruthi
Keyword(s):  
Femoral Artery ◽  
Classical Method ◽  
Single Case ◽  
Microvascular Anastomosis ◽  
Sprague Dawley ◽  
Tunica Media ◽  
Skills Laboratory ◽  
The Mean ◽  
End To End ◽  
The Right

Abstract Objective To compare the histopathology of patent and nonpatent microvascular anastomosis using rat femoral artery end-to-end anastomosis model. Materials and Methods In 15 Sprague–Dawley rats, end-to-end anastomosis was performed on the right femoral artery. The classical method was used in four cases and one-way up method in 11 cases. The animals were sacrificed after 2 weeks and the anastomosis was subjected to histopathology. The pathological changes in patent and nonpatent cases were compared. Results The immediate patency rate and delayed patency (after 2 weeks) rate was 86.7% and 66.7%, respectively. The mean follow-up was 3 months. At sacrifice, 5/15 anastomosis were not patent. Marked subintimal thickening was noted in ⅘ (80%) of the nonpatent group, which was absent in the patent group. Severe loss or fibrosis of tunica media and marked adventitial inflammation were noted in all nonpatent cases (5/5, 100%). As much as ⅘ of the nonpatent cases had poor or indeterminate apposition; in contrast, good apposition was seen in 6/10 (60%) of the patent group. The mean clamp time and mean suturing time were significantly longer in the nonpatent group (69.2 minutes and 53.8 minutes, respectively) as compared with the patent group (48.8 minutes and 31.8 minutes, respectively). A single case that was initially nonpatent was found to have recanalized at 6 months. Conclusion Minimal intimal injury and reaction, minimal thinning of tunica media, mild-to-moderate adventitial changes, good apposition, and equidistant sutures were associated with a successful microvascular anastomosis. Short duration of vessel clamping time and suturing comes with experience and dedicated practice in a skills laboratory.

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