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 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.

Pediatric Bacterial Tracheitis—A Variable Entity: Case Series with Literature Review

2018 ◽  
Vol 160 (3) ◽  
pp. 546-549 ◽  
Author(s):  
Geoffrey Casazza ◽  
M. Elise Graham ◽  
Douglas Nelson ◽  
David Chaulk ◽  
David Sandweiss ◽  
...  
Keyword(s):  
Literature Review ◽  
Case Series ◽  
Pediatric Intensive Care ◽  
Respiratory Arrest ◽  
Prolonged Intubation ◽  
Children's Hospital ◽  
Presenting Symptoms ◽  
Bacterial Tracheitis ◽  
Children’S Hospital ◽  
Viral Illness

Objective To review the presentation and treatment of children diagnosed with bacterial tracheitis at our institution and to review the available literature focusing on key presenting symptoms and clinical outcomes of children diagnosed with bacterial tracheitis. Study Design Case series with literature review. Setting Tertiary children’s hospital and available literature. Subjects and Methods Case series of children with bacterial tracheitis retrospectively reviewed at a tertiary children’s hospital. Those with a tracheostomy or those who developed bacterial tracheitis as a complication of prolonged intubation were excluded. Results Thirty-six children were identified (mean ± SD age, 6.7 ± 4.5 years). The most common presenting symptom was cough (85%), followed by stridor (77%) and voice changes/hoarseness (67%). A concurrent viral illness was found for 55%, and the most common bacteria cultured was methicillin-sensitive Staphylococcus aureus. Pediatric intensive care admission occurred for 69%, and 43% required intubation. No patient required tracheostomy. One patient (2.7%) died secondary to airway obstruction and subsequent respiratory arrest. Four patients had recurrence of bacterial tracheitis 4 to 12 months following their initial presentation. Conclusion Bacterial tracheitis is an uncommon condition with an atypical presentation and variable clinical course but serious consequences if left unrecognized. Staphylococcus is the most common bacteria identified, and many patients will have a prodromal viral illness. Changes in patient epidemiology and presentation may have occurred over time.

Acute Annular Outer Retinopathy: Literature Review and a Report of 2 Cases

2019 ◽  
Vol 3 (3) ◽  
pp. 172-182
Author(s):  
R. Rishi Gupta ◽  
Douglas S.M. Iaboni ◽  
Mark E. Seamone ◽  
Cyril Archambault ◽  
David E. Lederer
Keyword(s):  
Literature Review ◽  
English Literature ◽  
Fundus Autofluorescence ◽  
Case Series ◽  
Complete Recovery ◽  
Visual Field Defects ◽  
Disease Evolution ◽  
Presenting Symptoms ◽  
Uncommon Disease ◽  
Sd Oct

Purpose: Acute annular outer retinopathy (AAOR) is an uncommon disease. We present 2 illustrative cases and demonstrate disease evolution using multimodal imaging. The 18 previously reported cases in the peer-reviewed English literature are also reviewed. Methods: We conducted a case series and literature review. Results: We observed complete structural resolution by spectral-domain optical coherence tomography (SD-OCT) and ultra-widefield fundus autofluorescence in 1 case. In the literature review, 20 cases of AAOR were identified, including the 2 we have presented. Fifteen cases were unilateral and 5 bilateral, resulting in a total of 25 eyes with AAOR. Presenting symptoms included visual field defects (72%), decreased vision (48%), and photopsia (36%). Sixty-eight percent had a final visual acuity better than or equal to 20/40, while a minority (14%) were 20/200 or worse. Clinically, all eyes had a peripapillary annular band of gray-white opacification of the deep retina. Conclusions: We have reviewed and summarized the 18 previously reported cases of AAOR in the English literature and have shown for the first time that AAOR may undergo complete recovery of the external limiting membrane and ellipsoid zone on SD-OCT with resolution of disease. There is still much to be understood regarding the pathogenesis of and optimal management of AAOR.

SUNCT/SUNA: Case series presenting in an orofacial pain clinic

Cephalalgia ◽  
2020 ◽  
pp. 033310242097729
Author(s):  
Beth R Groenke ◽  
Iryna Hryvenko Daline ◽  
Donald R Nixdorf
Keyword(s):  
Orofacial Pain ◽  
Case Series ◽  
Initial Therapy ◽  
Pain Clinic ◽  
Conjunctival Injection ◽  
Inclusion Criteria ◽  
Presenting Symptoms ◽  
Cranial Autonomic Symptoms ◽  
Age Of Diagnosis

Aim Little is known about short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA). We present our experience with SUNCT/SUNA patients to aid identification and management of these disorders. Methods A retrospective review of patient records of one orofacial pain clinic was performed. Inclusion criteria was a diagnosis of SUNCT/SUNA confirmed with at least one follow-up visit. Results Six of the 2464 new patients seen between 2015–2018 met the selection criteria (SUNCT n = 2, SUNA n = 4). Gender distribution was one male to one female and average age of diagnosis was 52 years (range 26–62). Attacks were located in the V1/V2 trigeminal distributions, and five patients reported associated intraoral pain. Pain quality was sharp, shooting, and burning with two patients reporting “numbness”. Pain was moderate-severe in intensity, with daily episodes that typically lasted for seconds. Common autonomic features were lacrimation, conjunctival injection, rhinorrhea, and flushing. Frequent triggers were touching the nose or a specific intraoral area. Lamotrigine and gabapentin were commonly used as initial therapy. Conclusions Differentiating between SUNCT/SUNA does not appear to be clinically relevant. Presenting symptoms were consistent with those published, except 5/6 patients describing intraoral pain and two patients describing paresthesia.

scholarly journals Pediatric Patient with Lemierre Syndrome of the External Jugular Vein: Case Report and Literature Review

2021 ◽  
Author(s):  
Yehuda Schwarz ◽  
Nadeem Habashi ◽  
Noa Rosenfeld-Yehoshua ◽  
Eugene Soikher ◽  
Tal Marom ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Jugular Vein ◽  
Management Strategies ◽  
External Jugular Vein ◽  
Review Of The Literature ◽  
Lemierre Syndrome ◽  
Presenting Symptoms ◽  
Intravenous Antibiotics ◽  
Fever Treatment

Abstract Introduction Lemierre syndrome (LS) involving the external jugular vein (EJV) is rare, and only a few cases have been reported in the literature. Objectives To report a case of LS involving the external jugular vein as well as to make a review of the literature regarding both diagnosis and management strategies. Data Synthesis We describe a case of LS involving the EJV and review the literature of previously published articles to search for additional cases. A PubMed, Embase, Scopus, and Web of science-based search was performed to determine the scope of coverage in well-reported articles in English. Twenty-one papers were retrieved and documented for age, incidence, pathogen, presenting symptoms, imaging, treatment, and outcome, which were noted for each of these cases. In our literature review of 21 papers, there were 16 patients (61%) in their 2nd and 3rd decades of life. Lemierre syndrome was shown to affect females and males equally. The presenting symptoms were a sore throat and fever. Treatment requires intravenous antibiotics, and there is no consensus regarding treatment with anticoagulation. Conclusions The present case report and review of the literature emphasize the importance of history taking as well as physical examination in what seems to be a case of simple tonsillitis.

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.

Secondary malignancies of the penis and epididymis: a case report and review of the literature.

1985 ◽  
Vol 3 (1) ◽  
pp. 110-116 ◽  
Author(s):  
B L Powell ◽  
J B Craig ◽  
H B Muss
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Surgical Excision ◽  
Patient Characteristics ◽  
Secondary Malignancies ◽  
Review Of The Literature ◽  
Carcinoma Of The Colon ◽  
Presenting Symptoms ◽  
Metastatic Lesions ◽  
Major Mode

A patient with carcinoma of the colon developed metastases to the penis and right epididymis. These two organs are rare locations for metastases and the concurrent involvement of both sites has not been previously described. Our patient and the results of a literature review are presented. Two hundred eighteen cases of penile and 37 separate cases of epididymal metastases were identified. The genitourinary and gastrointestinal tracts were the predominant sites of the primary malignancies. Presenting symptoms, the interval between diagnoses of the primary and metastatic lesions, and the therapy of the penile/epididymal deposits varied greatly. Surgical excision is the major mode of therapy; radiotherapy, chemotherapy, or hormonal therapy may be beneficial in selected cases. Survival among these patients is poor due to the presence in most patients of widespread metastases in addition to their genital lesions. However, instances of prolonged survival are noted in both groups. Patient characteristics and possible mechanisms of metastatic spread to the genitals are discussed.

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