Scientific Open-access Literature Archive and Repository
Not a member yet
16397 research outputs found
Sort by
Acute Myocardial Infarction Secondary to Paradoxical Embolism
Get PDFIntroduction: Exertional heat illness (EHI) is common in hot weather among young athletes, outdoor manual workers and military personnel. EHI can involve multiple organs of the body, including the muscles, kidneys and brain; however, myocardium involvement is infrequent.Materials and methods: We present the case of a 26-year-old male construction worker who worked outdoors in a hot arid environment. He presented with acute kidney injury and rhabdomyolysis and was diagnosed with EHI. During his hospital stay, he developed complete heart block, and cardiac MRI showed features of myocarditis. Work-up to identify other aetiologies of myocarditis was normal. This case highlights the effects of EHI on the myocardium.Conclusion: It is important to keep in mind the various effects of EHI on the myocardium. Myocarditis due to EHI is rare, and conduction defects resulting from it might persist, necessitating specialist intervention
An Improbable Case of Ascites
Get PDFProstate cancer is the most frequent malignancy seen in males, with about 15% of cases showing metastatic disease at diagnosis, most commonly in bones (vertebrae, ribs, long bones). However, peritoneal metastasis with malignant ascites is extremely rare and may be overlooked by physicians. We report the case of a 77-year-old man presenting with symptoms of abdominal distension, nausea and weight loss. Abdominal ultrasound and computerised tomography confirmed ascites, peritoneal carcinomatosis and an enlarged prostate. Serum and ascitic prostatic-specific antigen were both elevated. Prostate biopsy identified a prostate adenocarcinoma, while biopsy of a peritoneal implant identified a prostate cancer metastasis, which responded well to hormonal therapy
Hyperemesis Gravidarum: A Benign Condition of Pregnancy or a Challenging Metabolic Disorder?
Get PDFHyperemesis gravidarum (HG) is a complication mainly of the first trimester of pregnancy, which sometimes leads to metabolic disorders such as hypovolemia and acute kidney injury (AKI). Herein, we present the case of a 25-year-old woman at week 10 of gestation who exhibited a constellation ofsevere abnormalities, namely AKI (serum creatinine 6.15 mg/dl), transaminasemia (serum aminotransferases >1,000 IU/l), alkalemia (arterial pH7.667), hyponatremia (serum sodium 117 mEq/l), hypochloremia (serum chloride 54 mEq/l),hypokalemia (serum potassium 2.2 mEq/l) and hyperuricemia (serum uric acid 20 mg/dl). Despite a thorough work-up, no other disorder was found apart from HG. All symptoms and metabolic abnormalities resolved with targeted administration of intravenous fluids. The differential diagnosis of these disorders and therapeutic challenges are discussed
Presentation of Severe Rheumatic Mitral Stenosis at the Peak of the COVID-19 Pandemic and the Presumptive Treatment as Severe Coronavirus Illness
Get PDFhis case report describes a young female Caucasian patient with newly presenting severe mitral stenosis at the peak of the coronavirus pandemic in the Republic of Ireland. The initial presumptive diagnosis was of severe coronavirus illness. This case report highlights the importance of keeping an open mind to alternative diagnoses and examines some of the challenges in the diagnosis and management of a rare condition in the pandemic environment. This patient gained 10 kg of weight within 6 weeks of percutaneous balloon mitral valvuloplasty, highlighting the contribution of cardiac cachexia to her low body weight and demonstrating the exceptional benefit that this treatment can offer to patients
Intracranial Neurenteric Cyst in a Patient with Acute Unilateral Thalamic Infarction
Get PDFIntracranial neurenteric cysts are rare congenital lesions that can be mistaken for other lesions. They may contain mucous or serous glands, smooth muscle, lymphoid tissue and components of connective tissue. We report a case of neurenteric cyst which was detected accidentally by diagnostic imaging in the context of a thalamus infarct in a 45-year-old woman. We also discuss the results of a brief literature review and the pathological findings, imaging spectrum, evaluation and management of neurenteric cysts and thalamic infarctions
An Eminent Absence: Agenesis of Inferior Vena Cava Underlying Bilateral Iliac Vein Thrombosis
Get PDFAmong thrombophilic risk factors for deep venous thrombosis (DVT), agenesis of the inferior vena cava (AIVC) is very rare, but it must be considered in specific settings. Here, we present the case of an 18-year-old woman who was admitted to the Emergency Department with swelling and pain of her left leg. Clinical examination and ultrasonography detected extensive proximal DVT of the left leg. After attempted mechanical thrombectomy failed, an abdominal CT scan was obtained, which demonstrated bilateral thrombosis of the iliac-femoral axis in the context of congenital AIVC
The Clot Thickens: Diagnosing Acute Pulmonary Embolism as a Trigger for Chronic Obstructive Pulmonary Disease Exacerbation in the Setting of Anticoagulation Failure
Get PDFChronic obstructive pulmonary disease (COPD) exacerbations are most commonly triggered by infections, but up to 25% of those that require hospitalization are thought to be triggered by acute pulmonary embolism. We present the case of a 71-year-old patient with a history of unprovoked pulmonary embolisms on anticoagulation therapy hospitalized for a COPD exacerbation. The exacerbation was triggered by an acute pulmonary embolism, representing anticoagulation failure
Riflessioni su come limitare il “rischio penale” dei sanitari al tempo del Covid-19
Get PDFLa portata dell’epidemia ha messo sotto grande pressione gli esercenti le professioni sanitarie, imponendo loro scelte drammatiche su chi curare, costringendoli a lavorare
interamente “off label”, secondo moduli organizzativi emergenziali, con scarse risorse a disposizione e,
spesso, a rischio della propria incolumità. Questo scenario eccezionale ha dilatato il “rischio penale” dei professionisti sanitari, del quale l’Autore delinea le principali direttive al tempo dell’emergenza pandemica
La solitudine del morente al tempo del Covid-19
Get PDFL’articolo affronta la questione del consenso alle cure dell’anziano, soffermandosi sul tema della morte al tempo della crisi epidemica dal Covid-19 e sull’opportunità di riconoscere al morente il diritto di operare le scelte ultime
Dal cordoglio alla risoluzione del lutto
Get PDFSebbene i primi modelli teorici e le prime osservazioni descrittive risalgano agli inizi del Novecento, ad oggi il lutto rimane una condizione in fase di studio. In letteratura, il lutto normale è spiegato attraverso vari modelli teorici che si rifanno all’approccio psicoanalitico, a quello biologico, alla teoria della crisi o alla teoria esistenzialista, mentre il lutto complicato continua ad essere inserito nella categoria “condizioni che necessitano di ulteriori studi” del DSM-5 (APA, 2014). Il presente articolo ha lo scopo di fornire una panoramica il più esaustiva possibile sul tema del lutto: dalla definizione e descrizione dei principali modelli teorici alla clinica del lutto, sia nell’adulto che nel bambino - soffermandosi sulla distinzione tra lutto normale e lutto complicato secondo i criteri diagnostici attualmente in uso - ad una panoramica sui principali modelli di trattamento del lutto complicato nell’adulto e nel bambino