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Soo Buem Cho, Sung Eun Park, Chang Min Lee, Ji-Ho Park, Hye Jin Baek, Kyeong Hwa Ryu, Jin Il Moon, Bo Hwa Choi, Ji Young Ha, Sangmin Lee
RATIONALE: Splenic artery pseudoaneurysm induced by benign gastric ulcer is extremely rare and can lead to a fatal clinical situation. To the best of our knowledge, there are only five cases in the literature review. Therefore, it can be a diagnostic challenge for radiologists and clinicians because of rare incidence. PATIENT CONCERNS: The patient visited our hospital due to melena and dizziness. DIAGNOSES: The patient showed a huge ulcer and an exposed vessel in the posterior wall of the gastric high body during endoscopy...
July 2018: Medicine (Baltimore)
Zikai Song, Haidi Wu, Hongyan Cao, Minglong Tang, Shuo Yang, Ling Qin
INTRODUCTION: Pulmonary embolism (PE) is often misdiagnosed, or the diagnosis is delayed because of its diverse clinical manifestations, it may even remain asymptomatic until sudden death. Most risk factors are not associated with young people, and there is a paucity of literature regarding PE in children and young adults. CASE PRESENTATION: Patient 1 who died was diagnosed with nephrotic syndrome more than 10 years before. He presented to a clinic with gradually worsening dyspnea, which was initially misdiagnosed as myocarditis...
July 2018: Medicine (Baltimore)
Chiara Palermo, Angelo Sanfiorenzo, Alessia Testo Giaquinta, Carla Virgilo, Massimiliano Veroux, Pierfrancesco Veroux
RATIONALE: Central venous catheter (CVC) placement, particularly in emergency setting, may be associated with significant morbidity and mortality. PATIENT CONCERNS: A 33-year old woman with suspected pulmonary embolism, developed a pseudoaneurysm of the neck three days after a CVC placement in the right internal jugular vein, determining compression to adjacent neck structures. DIAGNOSES: Computed tomography angiography and selective angiography demonstrated the presence of the pseudoaneurysm originating from the thyro-cervical trunk...
July 2018: Medicine (Baltimore)
Gökhan Yırgın, İhsan Ateş, Bilal Katipoğlu, Burak Furkan Demir, Nisbet Yılmaz
A 29-year-old male patient was treated and followed up for a pulmonary embolism. The patient had no relevant medical history, other than the fact that he had smoked bonzai, a synthetic cannabinoid derivative, for 2 years. Hypercoagulability tests were normal. The use of synthetic cannabinoids is increasing in the young population and should be kept in mind among the causes of pulmonary embolism.
July 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Samuel R Brown, Carlos Fernandez, Robert Bertellotti, Juan Antonio Asensio
A 53-year-old man was admitted to our trauma center after sustaining thoracoabdominal injuries, secondary to a rear-end motor vehicle collision. As he stepped out of his vehicle, he was struck by a tractor trailer at 55 mph. The following were the initial vital signs on his arrival: heart rate 140 beats/min, blood pressure 142/80 mm Hg, respiratory rate 28 breaths/min, temperature 36.8°C, and oxygen saturation 93%. The Glasgow Coma Scale score was 15 and the Injury Severity Score was 59. He was evaluated and resuscitated per the advanced trauma life support protocols...
2018: Trauma surgery & acute care open
Desiree Raygor, James Cunningham, Joseph Costa, Marie Crandall, David Skarupa
A 69-year-old obese man was involved in a high-speed head-on motor vehicle collision. He was tachycardic and normotensive on arrival. He subsequently developed hemodynamic instability requiring blood transfusion. On examination he had bilateral pneumothoraces, an anterior-posterior compression (APC) pelvic fracture, an open wound at the left groin, and gross hematuria after Foley catheter placement.CT imaging revealed hemoperitoneum, right hepatic lobe grade II lacerations, splenic laceration, mesenteric root injury with extravasated contrast, intraperitoneal and extraperitoneal bladder rupture, bilateral ureteral injuries at the level of the pelvic inlet (see figure 1), APC pelvic fracture, bilateral rib fractures, pneumothoraces, and pulmonary contusions...
2018: Trauma surgery & acute care open
Edward D Foley, Mohamed Ben Omran, Vaibhav Bora, Manuel R Castresana
Abiotrophia defectiva , also known as nutritionally variant streptococcus, is part of the normal flora of the oral cavity and urogenital and intestinal tracts and is a rare cause of infective endocarditis. It is fastidious or difficult to culture and associated with high rates of septic embolization, treatment failure and mortality. We describe an unusual presentation of infective endocarditis with severe mitral valve regurgitation due to Abiotrophia defectiva in an immunocompetent patient. After a complicated hospital course, surgical replacement of both the mitral and aortic valves was performed...
2018: SAGE Open Medical Case Reports
Antonio Meštrović, Ivan Žaja, Žarko Ardalić, Pavle Vrebalov-Cindro, Ivan Šustić, Marko Puljiz, Andre Bratanić, Damir Bonacin
Crohn's disease and ulcerative colitis (UC) patients have an increased risk for thromboembolic complications, the most common of them are deep venous thrombosis and pulmonary embolism. Other locations and genetic mutations of coagulation factors are not so common in these patients. Here we present a case of a young woman with exacerbation of previously diagnosed mild UC complicated by multiple thrombotic incidents due to MTHFR gene mutation.
May 2018: Case Reports in Gastroenterology
Weilin Chen, Zhibo Zhang, Xinyan Liu
Purpose: In a tertiary hospital, patients facing delayed treatment with placental remnants were common. The aim of this study was to assess the clinical efficacy and long-term pregnancy outcomes of the delayed surgical/non-surgical treatment for placental remnants. Patients and methods: The records of referral patients with placental remnants after second/third-trimester delivery/termination of pregnancy were retrospectively analyzed. A long-term follow-up was made by phone to inquire about the future pregnancy outcomes...
2018: Therapeutics and Clinical Risk Management
Kristy Yuan, Scott Eric Kasner
The patent foramen ovale (PFO), given its high prevalence in the general population and especially in patients with cryptogenic stroke, has long generated investigation and debate on its propensity for stroke by paradoxical embolism and its management for stroke prevention. The pendulum has swung for percutaneous PFO closure for secondary stroke prevention in cryptogenic stroke. Based on a review of current evidence, the benefit from PFO closure relies on careful patient selection: those under the age of 60 years with few to no vascular risk factors and embolic-appearing stroke deemed cryptogenic after thorough evaluation...
June 2018: Stroke and Vascular Neurology
J David Spence
Historically, because of the difficulty of using warfarin safely and effectively, many patients with cardioembolic stroke who should have been anticoagulated were instead given ineffective antiplatelet therapy (or no antithrombotic therapy). With the arrival of new oral anticoagulants that are not significantly more likely than aspirin to cause severe haemorrhage, everything has changed. Because antiplatelet agents are much less effective in preventing cardioembolic stroke, it is now more prudent to anticoagulate patients in whom cardioembolic stroke is strongly suspected...
June 2018: Stroke and Vascular Neurology
Kosmas I Paraskevas, Frank J Veith, J David Spence
Offering routine carotid endarterectomy (CEA) or carotid artery stenting (CAS) to patients with asymptomatic carotid artery stenosis (ACS) is no longer considered as the optimal management of these patients. Equally suboptimal, however, is the policy of offering only best medical treatment (BMT) to all patients with ACS and not considering any of them for prophylactic CEA. In the last few years, there have been many studies aiming to identify reliable predictors of future cerebrovascular events that would allow the identification of patients with high-risk ACS and offer a prophylactic carotid intervention only to these patients to prevent them from becoming symptomatic...
June 2018: Stroke and Vascular Neurology
Koichi Inukai, Shuhei Uehara, Yoshiteru Furuta, Masanao Miura
PURPOSE: The success rate of nonoperative management (NOM) of traumatic liver injury is approximately 90%. Although NOM has become the standard treatment when patients' vital signs are stable, open surgical hemostasis is often selected when these signs are unstable. At our hospital, we extensively use NOM along with transcatheter arterial embolization (TAE) to treat patients with severe abdominal trauma, as per our original protocol. We also apply NOM for severe liver injury with unstable hemodynamics...
July 19, 2018: Emergency Radiology
Makiko So, Yoshiro Itatani, Kazutaka Obama, Shigeru Tsunoda, Shigeo Hisamori, Kyoichi Hashimoto, Yoshiharu Sakai
BACKGROUND: Arteriovenous malformations (AVM) developed in the small intestine are rare, and it is sometimes difficult to identify and treat bleeding from small intestinal AVMs endoscopically because of their localization. We present a case of a jejunal AVM successfully treated with the combination of metallic coil embolization and laparoscopic surgery. CASE PRESENTATION: A 50-year-old woman with a history of repetitive gastrointestinal bleeding was admitted to the hospital...
July 18, 2018: Surgical Case Reports
Vafa Alakbarzade, Anthony C Pereira
Catheter-based angiography is an important but invasive procedure in vascular neurology. It is used mainly for diagnosis and for planning treatment in patients with a suspected underlying vascular abnormality. It is often performed as a semiurgent, planned investigation or linked to an interventional procedure. Cerebral angiography provides high-resolution, three-dimensional, pathoanatomical data about the cerebral vasculature and also allows real-time analysis of blood flow. Contrast injections can be repeated to identify subtleties...
July 18, 2018: Practical Neurology
Juan J Gonzalez, Ebrahim Abdelrazzak, Kavitha Kesari
No abstract text is available yet for this article.
July 18, 2018: BMJ Case Reports
Qiang Su, Xiangwei Lv, Yuhan Sun, Huafeng Yang, Ziliang Ye, Lang Li
OBJECTIVE: Coronary microembolization (CME) is a common complication in percutaneous coronary intervention (PCI). Local myocardial inflammation caused by CME is the major cause of progressive cardiac dysfunction. High mobility group A1 (HMGA1)/nuclear factor-kappa B (NF-κB) signaling plays an important role in the development and progression of inflammation, but its role in CME remains unclear. This study evaluated the effect of HMGA1/NF-κB signaling on CME-induced myocardial inflammation and cardiac dysfunction...
September 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Farhan Shahid, Nur A Rahmat, Gregory Y H Lip, Eduard Shantsila
BACKGROUND AND OBJECTIVES: High monocyte counts are related to adverse outcomes in cardiovascular disease. Their role in prognostication in patients with atrial fibrillation (AF) is unknown. We investigated whether monocyte counts are useful as a marker of prognosis in patients with AF. METHODS: Monocyte counts were obtained from blood samples in 881 AF patients. Study outcomes were (i) all-cause death; (ii) major adverse cardiovascular events; (iii) stroke, TIA or other systemic embolism (SSE); and (iv) major bleeding...
2018: PloS One
Craig I Coleman, Alexander G G Turpie, Thomas J Bunz, Daniel Eriksson, Nitesh A Sood, William L Baker
Aims: To compare the effectiveness and safety of standard dose rivaroxaban (20 mg once daily) and warfarin in nonvalvular atrial fibrillation (NVAF) patients with a non-sex-related CHA2DS2-VASc score of 1. Methods and Results: Analysis of United States Truven MarketScan claims from 11/2011-12/2016 for anticoagulant-naïve NVAF patients with a single non-sex-related stroke risk factor assigned 1-point in the CHA2DS2-VASc score and ≥12-months of continuous medical/prescription insurance coverage prior to the qualifying oral anticoagulant dispensing...
July 17, 2018: European Heart Journal. Cardiovascular Pharmacotherapy
Sake van der Wall, Stephan Hendriks, Menno Huisman, Erik Klok
PURPOSE OF REVIEW: Historically, because of the necessity of parenteral anticoagulation, patients with acute pulmonary embolism are hospitalized until stable oral anticoagulation is achieved. Despite improvements in prognostic risk stratification and the introduction of the direct oral anticoagulants, home treatment is still not widely applied. Main advantages of home treatment involve improvement of quality of life and significant healthcare cost reduction. In this review, we summarized recent published data on home treatment of patients with acute pulmonary embolism...
July 16, 2018: Current Opinion in Pulmonary Medicine
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