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Oedema management

Joseph Fogarty, Clodagh Loughrey
Hyponatraemia is common and often a source of confusion for junior doctors. It is infrequently dangerous, but when it is, is a medical emergency and requires urgent treatment to avoid life-threatening cerebral oedema. Treatment of acute hyponatraemia is also potentially hazardous; it is therefore important to be able to recognise when urgent management is not indicated, and to investigate appropriately. This paper focuses on these issues, which are most likely to be the cause of consternation for the junior doctor...
May 2017: Ulster Medical Journal
Abhishek De, Sudip Das, Aarti Sarda, Dayamay Pal, Projna Biswas
Acute generalised exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction and is attributed to drugs in more than 90% of cases. It is a rare disease, with an estimated incidence of 1-5 patients per million per year. The clinical manifestations characterised by the rapid development of sterile pustular lesions, fever and leucocytosis. Number of drugs has been reported to be associated with AGEP, most common being the antibiotics. Histopathologically there is intraepidermal pustules and papillary dermal oedema with neutrophilic and eosinophilic infiltrations...
January 2018: Indian Journal of Dermatology
Francesco D'Andrea, Luca D'Andrea, Ercole Manzi
BACKGROUND: Post-operative oedema and ecchymosis represent early post-operative complications, impacting negatively on the final aesthetic outcome of each surgical procedure. In particular, such complications are very frustrating for patients and-sometimes-are difficult to be managed by surgeons. Several strategies are available for managing oedema, although some side effects have been reported. A new promising compound for the management of oedema is Venoplant, and this study aims to assess its effectiveness in decreasing post-operative oedema...
March 5, 2018: Aesthetic Plastic Surgery
Victoria Rizzo, Yousuf Salmasi, Michael Hunter, Pushpinder Sidhu
Sternal osteomyelitis secondary to mycobacterium tuberculosis (TB) is rare, with <1% of musculoskeletal TB cases reported. The recurrent scenario is unresolving infection and delayed diagnosis. A 75-year-old woman presented with a persistently discharging sternal wound 10 months after coronary artery bypass grafting. Multiple antibiotics, wound debridement and removal of sternal wires was attempted; however, progression to local osteomyelitis and sternoclavicular joint destruction occurred. Tissue biopsies were finally sent for mycobacterial culture testing positive for Mycobacterium tuberculosis High index of suspicion is necessary for diagnosis of sternal tuberculosis, confirmed through timely microbiological investigations...
March 5, 2018: BMJ Case Reports
Faith Jelagat Lelei-Mailu, Charles Muriuki Mariara
This case report is of a 32-year-old woman of African descent on follow-up for pregnancy in the background of portal hypertension due to liver cirrhosis. She had initially been treated for chronic hepatitis B infection with lamivudine and tenofovir, complicated by portal hypertension and variceal bleeding that thrice required banding. Her pregnancy was uneventful until 31 weeks gestation when she presented with dyspnoea. On examination and investigation, she had oedema, bilateral pleural effusions and ascites...
March 5, 2018: BMJ Case Reports
Helen Y L Chan, Anthony Cheng, Susana Cheung, Wai-Wah Pang, Wai-Yiu Ma, Long-Chau Mok, Wai-Kuen Wong, Diana T F Lee
AIM AND OBJECTIVES: This study aimed to examine the prevalence of dehydration upon hospital admission and its association with postoperative complications in older persons undergoing orthopaedic surgery. BACKGROUND: Ageing-related physiological and pathological changes, as well as suboptimal care quality, can render older persons vulnerable to dehydration. However, few empirical studies have been conducted to examine the association between dehydration and care outcomes in this population...
March 1, 2018: Journal of Clinical Nursing
Mohammadreza Soltaninejad, Guang Yang, Tryphon Lambrou, Nigel Allinson, Timothy L Jones, Thomas R Barrick, Franklyn A Howe, Xujiong Ye
BACKGROUND: Accurate segmentation of brain tumour in magnetic resonance images (MRI) is a difficult task due to various tumour types. Using information and features from multimodal MRI including structural MRI and isotropic (p) and anisotropic (q) components derived from the diffusion tensor imaging (DTI) may result in a more accurate analysis of brain images. METHODS: We propose a novel 3D supervoxel based learning method for segmentation of tumour in multimodal MRI brain images (conventional MRI and DTI)...
April 2018: Computer Methods and Programs in Biomedicine
I Temblador-Barba, E M Delgado-Alonso, M Toribio-García, L Martínez-Campillo, I Molina-Leyva, M Martínez-Jiménez
CASE REPORT: Here we report a 19-year-old female patient who presented a vasoproliferative tumour. It caused complications, such as epiretinal membrane, macular oedema, vitreous haemorrhage, and exudative retinal detachment. The patient was treated with 3 injections of intravitreal bevacizumab, an intravitreal dexamethasone implant, tocilizumab, and double freeze-thaw cryotherapy. DISCUSSION: Therapeutic options are: observation, if it is small, if it is a peripheral lesion, and if there seems to be no threat to vision...
February 16, 2018: Archivos de la Sociedad Española de Oftalmología
Marie Todd
Marie Todd, Lymphoedema Clinical Nurse Specialist, Specialist Lymphoedema Service, Glasgow, discusses the difficulties of caring for people with compounding conditions.
February 22, 2018: British Journal of Nursing: BJN
Nabin Lageju, Bibhu Pradhan, Narmaya Thapa
INTRODUCTION: Sinonasal polyposis is one of the commonest causes of nasal obstruction. Surgical management is treatment of choice. Microdebrider offers more advantage to conventional instruments. We aimed to find out outcome using microdebrider versus conventional instruments in endoscopic sinus surgery of sinonasal polyposis. METHODS: The cross sectional descriptive study carried out in patients aged 13 years and above with diagnosis of sinonasal polyposis. Total of 51 patients were operated on the right side with microdebrider and left side with conventional instruments...
October 2017: JNMA; Journal of the Nepal Medical Association
Deepak Menon, Ramshekhar N Menon, Chandrasekharan Kesavadas, Anita Mahadevan, Ashalatha Radhakrishnan, Sudheeran Kannoth, Pradeep P Nair, Mathew Abraham, Bejoy Thomas, Sanjeev V Thomas
New-onset refractory focal epilepsy poses significant challenges to the clinician in the absence of specific diagnostic biomarkers. Differential diagnoses based on imaging may be expanded by a veritable spectrum of peri-ictal imaging findings that may mask the underlying substrate. We report a 13-year-old girl who presented with refractory focal seizures of left parieto-occipital origin with cytotoxic gyral oedema noted over the same region on imaging. Despite an initial negative autoantibody profile, the patient was treated with immunosuppression, followed by serial relapses requiring immune-modulation...
February 1, 2018: Epileptic Disorders: International Epilepsy Journal with Videotape
Ji Zhang, Ke Sai, Zheng-Quan Zhu, Fu Hua Lin, Zi-Feng Wang, Yong-Ming Chen, Chun-Yu Huang, Yun-Lin Ye, Xiao-Li Wang, You-Ping Li, Shu-Xin Sun, Wei-Ying Zhong, Jian-Bin Chen, Yun-Qiang Yang
Objectives: Meningioma recurrence remains a significant issue. No study has described the relationship between the clinical features and prognosis of communicating meningioma that primarily originates from the olfactory groove. The aim of the study was to identify prognostic factors of communicating olfactory groove meningiomas that could be stratified according to their risk of recurrence. Results: A Simpson grade one or two resection was achieved. Complications with cerebrospinal rhinorrhoea occurred in two patients: one required reoperation, and the other was managed successfully with external drainage of lumbar cistern...
January 12, 2018: Oncotarget
Gaokun Zhang, Shuang Liu, Lieying Yang, Yanqing Li
The aim of the present study is to determine the efficacy of dexamethasone (DEX) vs. indomethacin (IND) and ciprofloxacin (CIP) in modulating immediate inflammation following cataract surgery. A total of 644 patients with cataract were recruited and inflammation was investigated during the perioperative period. The management protocol was similar in both groups. Each drug was given four times a day for 30 days starting 7 days prior to surgery. The primary efficacy criteria for evaluation were the reduction in anterior chamber (AC) flare and AC inflammation score, in addition, a different secondary efficacy and safety evaluation criteria were maintained...
February 2018: Experimental and Therapeutic Medicine
Adrien Joseph, Stephanie Harel, Marion Venot, Sandrine Valade, Eric Mariotte, Claire Pichereau, Akli Chermak, Lara Zafrani, Elie Azoulay, Emmanuel Canet
Background: Despite substantial improvements in the management of multiple myeloma, renal failure remains an important burden that tremendously impairs prognosis. The purpose of this study was to describe the characteristics and to establish prognostic factors of renal recovery in myeloma patients admitted to the intensive care unit (ICU) for acute kidney injury (AKI) Stage 3 treated with renal replacement therapy (RRT). Methods: A retrospective single-centre cohort study was performed, including consecutive myeloma patients admitted to one medical ICU between 1 January 2007 and 1 September 2015 and treated with RRT...
February 2018: Clinical Kidney Journal
L Brazionis, A Jenkins, A Keech, C Ryan, A Brown, J Boffa, S Bursell
AIM: To determine diabetic retinopathy prevalence and severity among remote Indigenous Australians. METHODS: A cross-sectional diabetic retinopathy screening study of Indigenous adults with Type 2 diabetes was conducted by locally trained non-ophthalmic retinal imagers in a remote Aboriginal community-controlled primary healthcare clinic in Central Australia and certified non-ophthalmic graders in a retinal grading centre in Melbourne, Australia. The main outcome measure was prevalence of any diabetic retinopathy and sight-threatening diabetic retinopathy...
February 6, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Abhishek Dattani, Laura Au, Kok Hoon Tay, Patrick Davey
Contrast-induced encephalopathy (CIE) following coronary angiography (CAG) is a very rare complication. Radiological signs such as cerebral oedema and cortical enhancement are of great importance in the diagnosis. We report a case of probable CIE in a 76-year-old gentleman following a normal diagnostic CAG that involved 120 mL of the iodinated contrast agent iohexol (Omnipaque 300). At 90 min postprocedure he became acutely confused with a normal non-contrast CT of the head. After 9 days of conservative treatment, the patient recovered spontaneously with no neurological deficits...
February 2, 2018: Cardiology
T Pretorius, G van Rensburg, R A Dyer, B M Biccard
BACKGROUND: The optimal fluid management strategy to ensure best outcomes in preeclamptic patients remains a controversial issue, with little evidence to support any one approach. OBJECTIVE: The aim of this systematic review was to investigate the effect of various fluid management strategies on clinical outcomes, haemodynamic indices and biochemical markers in preeclamptic women and their babies. Primary outcome measures were the occurrence of pulmonary oedema and/or the development of renal impairment...
December 20, 2017: International Journal of Obstetric Anesthesia
Sasikala Thineshkumar, Daniel Nyborg, Peter Ruhlmann, Jakob Grauslund
Artificial iris implants were originally developed for therapeutic purposes but have recently been used for cosmetic alteration of the eye colour. A 21-year-old woman presented with bilateral eye redness, visual loss, raised intraocular pressure, corneal oedema and hyphaema following implantation of artificial irises in Tunisia. Combined medical and surgical management led to improvements, but reduced vision and photophobia persisted. Cosmetic iris implantation can lead to persistently sight-threatening eye complications, and we strongly advise against its use...
January 22, 2018: Ugeskrift for Laeger
Diane Jehu, Linda Jenkins, Karen Morgan, Melanie J Thomas
This case study demonstrates the benefits of early intervention and a proactive approach for a patient with chronic oedema living in the community. These benefited the patient and also supported value-based healthcare in the NHS. The patient's health and wellbeing significantly improved with an assessment of his chronic oedema and a management plan consisting of skincare, an exercise and movement programme and the introduction of a class 1 British standard compression garment.
February 2, 2018: British Journal of Community Nursing
Abdullah Algin, Mehmet Ozgur Erdogan, Kaan Yusufoglu, Huseyin Avni Findikli, Hakan Aydin
Femoral artery pseudoaneurysms are commonly iatrogenic due to increasing use of the artery for arterial interventions. Other reasons of pseudoaneurysm formation are intravenous drug use and penetrating trauma. Here, we have discussed the management strategy of a femoral artery pseuodoaneursym and the modalities for preventing the misdiagnoses of the pseudoaneurysm in the emergency department. A 50-year-old male patient was referred to our emergency department (ED) with claudication and severe local swelling...
January 2018: JPMA. the Journal of the Pakistan Medical Association
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