Farmerharmon8074
However, Life-threatening complication scarcely inaugurate crohn's disease like in our patient. Free perforation of the small intestine in crohn's disease occurs rarely, which makes its statistical study difficult. Risk factors for perforation are still poorly identified. Patients diagnosed with crohn's disease have a higher risk of thromboembolic complications. read more Indeed, there is an association between the activity of the disease and thromboembolic events. In our case, the severity of the clinical presentation as well as its inaugural character are unique.
The management of inaugural two uncommon acute conditions in Crohn's disease is challenging.
The management of inaugural two uncommon acute conditions in Crohn's disease is challenging.Penile strangulation by metallic ring is an emergency situation which requires urgent management. Strangulation of the penis usually performed in order to increase sexual performance or because underlying mental disorder or paraphilia. It is an uncommon urological emergency, if not treated as soon as possible it can lead to complications such as gangrene and amputation of the penis. There is no standard of care that has been found to be superior, with each case managed individually according to its clinical findings and operative settings. In this study, we present four cases of penile strangulation in last two years in a tertiary care hospital.
A gallbladder volvulus is a rare medical condition requiring emergency surgery. There are 500 cases reported in the literature, and only 10 % have ever been diagnosed preoperatively. Gallbladder volvulus occurs when the gallbladder torts around the cystic duct and cystic artery resulting in occlusion of both structures and consequently, ischemia of the gallbladder. The diagnosis is challenging because the symptoms mimic cholecystitis without distinct radiological features specific for a volvulus.
In this article, we report the case of a 77-year-old female who underwent ultrasonography (US), computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), and cholescintigraphy, which all reported features of cholecystitis. She underwent a cholecystectomy on admission day 5 because of refractory pain despite treatment with intravenous antibiotics. Intraoperatively, she was discovered to have complete gallbladder torsion with gangrene. Post-operatively, she had immediate and complete resolution of pain, and made a rapid recovery.
We review the available literature to determine radiological characteristics specific to a gallbladder volvulus. Patients without cholelithiasis and incomplete filling of the gallbladder in a nuclear medicine scan should be evaluated for gallbladder volvulus.
Through this report, we suggest a high index of suspicion for gallbladder volvulus in elderly female patients with signs and symptoms of acalculous cholecystitis that have no resolution in symptoms with conservative management.
Through this report, we suggest a high index of suspicion for gallbladder volvulus in elderly female patients with signs and symptoms of acalculous cholecystitis that have no resolution in symptoms with conservative management.
Ischemic heart disease is the most common cause of sudden cardiac death. By autopsy, there may be no histologic evidence of acute myocardial damage few hours after death. The use of cardiac troponins in the postmortem diagnosis of sudden cardiac death is well known in the forensic setting. However, high-sensitivity cardiac troponin T (Hs-TnT) assay in cadaver fluids was tested in few studies. The aim of this study is to assess the diagnostic value of postmortem dosage of Hs-TnT in the diagnosis of sudden cardiac death.
Our study is prospective, dealing with cadavers autopsied at the Department of Forensic Medicine of the University Hospital Habib Bourguiba of Sfax-Tunisia from December 2016 to April 2018. Were excluded from the study resuscitated cases, severely traumatized victims and cadavers that were examined more than 36h after death. Levels of Hs-TnT were measured in pericardial fluid, cardiac blood and peripheral blood.
A total of 80 cases were identified with an average age of 44.5±19 years. Hs-TnT levels in pericardial fluid and heart blood were correlated significantly between cardiac and non-cardiac groups with a p-value respectively at 0.14 and 0.04. Receiver-operator characteristic curves analysis showed that the pericardial fluid had the best sensibility (75%) and specificity (64%) with a cut-off level at 17.72ng/ml and an area under the curve at 0.747. We found also a significant correlation between postmortem interval and Hs-TnT levels in pericardial fluid, cardiac and peripheral blood.
Our data indicate that determination of cardiac troponin T by a highly sensitive assay in pericardial fluid may be a powerful aid in the postmortem diagnosis of sudden cardiac death.
Our data indicate that determination of cardiac troponin T by a highly sensitive assay in pericardial fluid may be a powerful aid in the postmortem diagnosis of sudden cardiac death.In 2014, Buysse published a novel definition of sleep health, raising awareness for the importance of this construct for individuals, populations, clinical care, and research. However, the original definition focused on adults, with the recommendation that it should be adapted for children and adolescents. As children live within a complex and dynamic system, and may not always have control over their own sleep, this theoretical review will examine and apply Buysse's five dimensions of sleep health within the context of pediatrics. In addition, using examples from the pediatric sleep literature we introduce a modified definition that takes into consideration the influence of the socio-ecological system within which children live, and the sleep-related behaviors that are critical in supporting or hindering sleep health. Finally, we discuss how the proposed theoretical framework, Peds B-SATED, can be applied to clinical practice, research, and training in the field of pediatric sleep.Based on biology and pre-clinical data, bromodomain and extra-terminal (BET) inhibitors have at least three potential roles in paediatric malignancies NUT (nuclear protein in testis) carcinomas, MYC/MYCN-driven cancers and fusion-driven malignancies. However, there are now at least 10 BET inhibitors in development, with a limited relevant paediatric population in which to evaluate these medicinal products. Therefore, a meeting was convened with the specific aim to develop a consensus among relevant biopharmaceutical companies, academic researchers, as well as patient and family advocates, about the development of BET inhibitors, including prioritisation and their specific roles in children. Although BET inhibitors have been in clinical trials in adults since 2012, the first-in-child study (BMS-986158) only opened in 2019. In the future, when there is strong mechanistic rationale or pre-clinical activity of a class of medicinal product in paediatrics, early clinical evaluation with embedded correlative studies of a member of the class should be prioritised and rapidly executed in paediatric populations.
