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A Case of Binocular Vertical Diplopia after Intratympanic Gentamicin Therapy
Get PDFIntratympanic gentamicin therapy is a useful alternative treatment for refractory Meniere's disease and is generally well tolerated. Visual
disturbances as side effects of this treatment are rarely reported in the literature. In this report we describe the case of a 52-year-old woman
with refractory Meniere's disease who developed binocular vertical diplopia following intratympanic gentamicin therapy. Spontaneous
resolution of diplopia occurred within 2 weeks. The development of diplopia should be discussed as a potential complication with patients
undergoing intratympanic gentamicin therapy
Hyponatremic Coma after Bowel Preparation
Get PDFIntroduction: Colonoscopy is a useful tool in modern medicine and is increasingly employed for both diagnostic and treatment purposes.
However, bowel preparations can cause electrolyte imbalance, with the risk apparently related to the type of bowel cleansing solution used,
the age of the patient and their comorbidities. Symptomatic hyponatremia, especially coma, is a rare complication of oral bowel preparation
for colonoscopy and is thought to result from excessive antidiuretic hormone secretion.
Case description: The authors report the case of a 48-year-old man who developed symptomatic hyponatremia (coma) after bowel
preparation with sodium picosulfate/magnesium oxide/citric acid prior to a colonoscopy. The patient was admitted to an intensive care unit
where other causes of coma were excluded. The symptoms of hyponatremia rapidly resolved after sodium level correction with intravenous
administration of hypertonic saline.
Discussion: Hyponatremic coma is an uncommon but serious complication of colonoscopy bowel preparation. Patients at risk (>65 years old,
chronic kidney disease, heart failure, history of electrolyte problems, or taking thiazide diuretics, angiotensin-converting-enzyme inhibitors
or antidepressants) should be closely monitored during bowel cleansing and macrogol-based solutions should preferably be used
Pneumothorax as a Presentation of Tuberous Sclerosis-Associated Lymphangioleiomyomatosis
Get PDFTuberous sclerosis complex (TSC) is a rare, autosomal dominant disorder with a recognized phenotypic variability with clinical manifestations developing continuously throughout life. The follow-up of TSC patients is challenging. The authors present a case with a definite diagnosis of TSC with known skin, renal, hepatic and neuropsychiatric involvement, whose diagnosis of TSC-associated lymphangioleiomyomatosis was establish at a late stage after the patient had presented with recurrent pneumothorax. Notwithstanding, mammalian target of rapamycin inhibition therapy was initiated
Pulmonary Arteriovenous Malformation can be Associated with Embolic Stroke of Undetermined Source (ESUS)
Get PDFPulmonary arteriovenous malformations (PAVMs) are rare vascular anomalies. Alternative designations are pulmonary arteriovenous fistulae or aneurysms. Although mostly asymptomatic, PAVMs can cause respiratory symptoms due to right-to-left shunt. The central nervous system is a potential target for complications, including stroke, as a result of paradoxical embolism. In this report, the authors describe an unusual case of cerebral emboli caused by paradoxical embolism through a PAVM, presenting with a broad pathology including orthodeoxia, central cyanosis and digital clubbing, which should be kept in mind since misdiagnosis may cause severe morbidity in young adults
Acute Heart Failure in a Healthy Young Patient after Severe Carbon Monoxide Poisoning
Get PDFIntroduction: Carbon monoxide (CO) poisoning may cause severe cellular hypoxia.
Materials and methods: A 28-year-old male presented reduced levels of consciousness and dyspnoea after CO exposure. Clinical examination revealed tachypnoea, bilateral rales, dilated jugular veins and confusion. Troponin I, lactate and carboxyhaemoglobin levels were increased. Thoracic X-ray depicted pulmonary oedema and an echocardiogram, severe heart failure (HF; EF<25%). He was intubated due to clinical deterioration.
Results: He remained intubated for 5 days with excellent improvement of left ventricular function (EF>55%). He was discharged 1 week later with full recovery.
Discussion: Acute HF is a rare serious complication of CO poisoning, even in healthy young individuals
Pseudoxanthoma Elasticum and Cardiorenal Disease: A Case Report
Get PDFPseudoxanthoma elasticum (PXE) is a rare genetic disorder characterized by calcification of elastic fibres, skin lesions, fundus lesions and systemic vascular complications. PXE affects approximately 1 in 160,000 people, typically appearing as a formation of yellow papules containing abnormally calcified elastic fibres. The renal involvement of PXE has been reported. Several factors are known to promote soft tissue and accelerated arterial calcification in chronic kidney disease, including systemic inflammation, altered calcium and phosphate homeostasis, hypertension and a deficiency of endogenous calcification inhibitors. Given the impact of this disease, nephrologists may seek additional supportive features to improve and avoid the risk of complications. Moreover, PXE per se represents an interesting model to evaluate vascular disease in the early stages of renal disease
Palmoplantar Pustulosis-like Eruption Induced by Baricitinib for Treatment of Rheumatoid Arthritis
Get PDFObjectives: Baricitinib is an orally active Janus kinase (JAK) inhibitor used in the treatment of moderate to severe rheumatoid arthritis (RA).
Materials and methods: Here, we report the case of a 56-year-old Caucasian male diagnosed with RA who developed palmoplantar pustulosis (PPP) while being treated with baricitinib.
Results: The patient’s PPP resolved after discontinuation of baricitinib and recurred when this was restarted. Based on causality assessment, it was considered a drug-induced PPP. Conclusion: To the authors’ knowledge, this is the first case of baricitinib-induced PPP
Preliminary results of the PASTA project
Get PDF67Cu, 186Re and 47Sc are theranostic radionuclides in the spot-light of the scientific community: the insufficient availability is limiting their use in clinical and pre-clinical studies. The aim of this work is the analysis of 47Sc production by using high-energy and high-intensity cyclotrons, as the one installed at INFN-LNL in the framework of SPES project, by exploring promising nuclear reactions induced by proton-beams
QCD+QED lattice calculation of hadronic decay rates
Get PDFIsospin is an almost exact symmetry of strong interactions and the corrections to the isosymmetric limit are, in general, at the percent level. For several hadronic quantities relevant for flavour physics phenomenology, such as pseudoscalar meson masses or the kaon leptonic and semileptonic decay rates, these effects are of the same order of magnitude of the uncertainties quoted in current large-scale QCD simulations on the lattice and cannot be neglected anymore. In this contribution I discuss some recent results for the leptonic decay rates of light pseudoscalar mesons obtained by the Soton-RM123 Collaboration including the leading-order electromagnetic and strong isospin-breaking corrections in first-principles lattice simulations. The adopted strategy is within the reach of the present lattice technologies and it allows to determine electromagnetic corrections to physical observables for which delicate cancellations of infrared divergences occur in the intermediate steps of the
calculation. The application of the developed method to the study of heavy-light meson and semileptonic decay rates is currently underwa
Search for heavy mass diboson resonances in the ATLAS experiment
Get PDFSearches for high mass resonances decaying in a couple of vectorial bosons (Z or W) are presented. The results refer to an integrated luminosity of 36.1 fb−1 recorded with the ATLAS detector in 2015–2016 at √s = 13 TeV at the Large Hadron Collider. Final states in which one boson decays in leptons and the other one decays in hadrons are considered. Also fully hadronic final states are considered. These results are interpreted within the context of Standard Model extensions with additional Higgs bosons, a heavy vector triplet or warped extra dimensions