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Unusual Presentation of COVID-19 Disease Leading to Respiratory Distress and Coma
Get PDFMultiple neurological complications including Guillain-Barré syndrome (GBS) have been associated with COVID-19. We describe a case of GBS related to SARS-CoV-2 infection with an unusual presentation beginning with mobilization problems at home without previous classic respiratory or general manifestations. Asymptomatic infection with COVID-19 can lead to critical situations with respiratory insufficiency because of neurological complications such as GBS
Prostate Cancer and Reactive Haemophagocytic Lymphohistiocytosis
Get PDFWe report the case of a 76-year-old man presenting with reactive haemophagocytic lymphohistiocytosis (rHLH) in the setting of disseminated prostate cancer. This often fatal syndrome must be diagnosed early in order to maximize survival. Treatment should be initiated whenever the clinical diagnosis is suspected, even if the HLH-2004 criteria are not met. The HScore is a useful diagnostic tool for rHLH. In case of neurological symptoms, an extensive assessment must be performed. The goal of this case report is to raise awareness of this rare syndrome among oncologists
Missed Diagnosis of Subarachnoid Haemorrhage
Get PDFA 79-year-old woman presented with left retro-orbital pain, headache and blurred vision. Based on negative radiological tests, life-threatening conditions like subarachnoid haemorrhage (SAH) were ruled out and outpatient follow-up was planned. However, the patient returned to the hospital that night because of progressively declining consciousness and was diagnosed with SAH by head computed tomography. The diagnosis of SAH is often challenging, especially in cases with negative radiological results. We describe some strategies, other than radiological examination, for ruling out SAH, such as performing a lumbar puncture and repeating tests to take account of disease progression, and describe biases which can affect clinical decision-making
Cardiac Abnormalities in COVID-19 Patients: Should a Cardiac Echocardiogram be Routine?
Get PDFCurrent scientific evidence shows that SARS-CoV-2 infection is associated with an increased risk of thromboembolic events. In patients with ischaemic heart disease and heart failure, thrombi of the left ventricle can increase patient mortality, mainly due to the risk of systemic
embolization. Given the hypercoagulable state associated with COVID-19, such events may be more likely. We describe a patient hospitalized for congestive heart failure and SARS-CoV-2 infection who was diagnosed with a thrombus in the left ventricle. After the thrombus was identified on echocardiography and treated with anticoagulation, it completely resolved and cardiac function improve
Invasive Mediastinal Mucormycosis with Pulmonary and Cardiac Involvement in an Adult with Chronic Granulomatous Disease: Case Report and Review of the Literature
Get PDFMucormycosis is a rare fungal infection that often causes rhinocerebral disease. However, there have been rare cases of mediastinal involvement. These patients remain a therapeutic challenge and mortality in this group is very high. We report a case of mediastinal
mucormycosis with invasion of the heart and right lung in a patient with chronic granulomatous disease (CGD) and also review the available literature on mediastinal mucormycosis
Misoprostol-induced Coronary Vasospasm Complicated by Takotsubo Cardiomyopathy and Cardiac Arrest
Get PDFMisoprostol is a synthetic E1 prostaglandin commonly used to induce abortion in the United States and elsewhere. There is limited literature on the cardiovascular adverse effects of misoprostol, and, to the best of our knowledge, very few such events have been reported. We describe the case of 52-year-old woman who was given misoprostol for cervical softening before endometrial ablation and experienced a cardiac arrest due to coronary vasospasm. She was successfully resuscitated and echocardiography showed features consistent with
Takotsubo cardiomyopathy. Coronary angiography revealed coronary artery spasm which responded to nitroglycerin. Our case adds to the limited literature on this life-threatening adverse event of misoprostol
Cardiac Tamponade in Adrenoleukodystrophy with Addison’s Disease
Get PDFCardiac tamponade is a life-threatening medical emergency and can arise in many clinical situations.We present the case of a 59-year-old man with adrenoleukodystrophy and Addison’s disease who was admitted to the emergency department with severe abdominal pain that turned out to be cardiac tamponade of unknown aetiology. An association between cardiac tamponade and Addison’s disease has been reported in the literature, so this aetiology should be considered in the differential diagnosis for patients presenting with unexplained cardiac tamponad
Nabiximols in Multiple Sclerosis-Related Spasticity
Get PDFMultiple sclerosis (MS) is a chronic, autoimmune disease caused by inflammation and neurodegeneration, which is associated with a wide spectrum of central nervous system symptoms. Spasticity, defined as abnormally increased muscular tone, is 1 of the most common disabling symptoms in MS, occurring in up to 80% of MS patients and showing increased severity as the disease progresses over time. The approval of nabiximols for the management of MS spasticity opened up a new treatment opportunity to many patients. Here, we report a case of a 43-year-old man with a primary progressive MS diagnosis and spasticity-associated symptoms. Nabiximols had significant benefits with respect to spasticity symptoms
Combined Management of Multiple Sclerosis-Related Spasticity
Get PDFSpasticity is one of the most frequently occurring symptoms associated with multiple sclerosis (MS). Pharmacological therapy and interventional procedures are the main approaches to treatment of MS spasticity. Nabiximols is an oromucosal spray used as an add-on treatment for unresponsive spasticity in patients with MS. The COVID-19 pandemic has had a major impact on the management of patients with chronic neurodegenerative conditions. During this period, many people have had difficulty accessing hospitals or rehabilitation facilities. We report a case that shows the efficacy and tolerability of the combination of pharmacological treatment and neurorehabilitation in the treatment of MS-related spasticity
Realizzazione di un generatore di segnale Random PWM a frequenza variabile secondo la logica pseudo casuale di Fibonacci, tramite la scheda a microcontrollore STM32 NUCLEO F411RE ®
Get PDFLa tecnica di modulazione Pulse Width Modulation (PWM), usata per
la generazione dei segnali di controllo nei convertitori switching, genera armoniche con una frequenza fondamentale pari a quella del segnale portante.
Un modo per diminuire la potenza associata a ciascuna armonica per rendere i convertitori elettromagneticamente compatibili consiste nel variare la frequenza portante in modo random, in tal caso compariranno più armoniche nello spettro ma con una potenza inferiore.
questo documento descrive un sistema per la generazione di segnali PWM basato su un circuito analogico pilotato da una scheda a micro controllore. Tale sistema è in grado di generare il segnale di pilotaggio per un gate di un dispositivo switching di potenza