casestudies-crimson

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Arthrosamid Offers a New Therapeutic Approach in the Treatment of Omarthrosis_Crimson Publishers

Abstract

The successful pain-relieving treatment of highly symptomatic osteoarthritis in a national karate coach with Arthrosamid is described in this case report. This type of treatment had previously only been used in cases of gonarthrosis. The extensive conservative and arthroscopic treatment that had previously been carried out had not resulted in a sustained reduction in pain. A single off-label injection of 3 ml of a 2.5% polyacrylamide hydrogel (Arthrosamid) was administered. The injection was performed under CT guidance. A significant analgesic effect occurred rapidly and was long lasting. A follow-up MRI scan did not reveal any structural changes. If the manufacturer’s instructions are followed, Arthrosamid represents a therapeutic option for the treatment of advanced osteoarthritis. A prerequisite for the therapy is that the joint capsule and the rotator cuff are intact so that Arthrosamid can have an effect in the affected joint. A single course of oral antibiotics is a prophylactic measure immediately prior to injection.

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Stent Embolization_Crimson Publishers

Abstract

Although the number of PCI procedures has significantly increased over the years, the severe complications are rare. Stent embolization is a rare complication of coronary stenting, at a rate of 0.2%. We report on a case with a 64-year-old man admitted to the emergency department with unstable angina and stent embolization during the coronary angiography and successful retrieval of a coronary stent from the left anterior descending (LAD) artery, which migrated to the left popliteal artery. The stent was finally removed surgically.

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Orthorexia-Prevalence and Risk factors, Review of Literature_Crimson Publishers

Abstract

Aim: The main aim of the study was to determine the prevalence and risk factors of orthorexia nervosa based on a review of research papers published in PubMed, Wiley Online Library and Springer Link databases. Material and method: From the available studies, 56 articles were selected for final analysis, containing research papers that used diagnostic questionnaires of orthorexia and analyzed potential risk factors for its occurrence. Results: According to research data from 3,1 to 41,7 %, on average, 20.6% of subjects were found to be at risk of orthorexia nervosa, with the ORTO 15 questionnaire considering a score of 35 as the cutoff point. The highest score of risk was observed in the group of subjects with eating disorders of the nature of anorexia nervosa and bulimia nervosa, those who follow diets, those who are dissatisfied with the appearance of their bodies, those who engage in intense physical exercise, those with maladaptive personality traits, those who use immature defense mechanisms, and those who function poorly socially. Additional risk factors appeared to be health-related studies-especially dietetics, occupational stress (especially medics and musicians performing in orchestras). Conclusion: It should be noted that in the ORTO 15 questionnaires, the cut-off point assumed by the authors of the tool was 40 and its use significantly overestimated the results, so the researchers’ postulation to adopt a score of 35 in clinical practice, as indicating the risk of orthorexia, seems correct. In research opinion for more effective diagnosis, it would be advisable to adopt a cut-off point for orthorexia in the ORTO-15 at the level of 35 points, as postulated by some authors. The 40-point threshold is associated with considerable overdiagnosis of the phenomenon. The analysis as a whole points to the validity of placing ON in the eating disorder group, perhaps as a specific variant of anorexia nervosa. The study showed no correlation of ON with OCD. Whilst this might suggest a substantial crossover between symptoms of ON and eating pathology more generally.

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Prevalence and Characteristics of Orthorexia Nervosa in a Sample of University Students in Poland_Crimson Publishers

Abstract

Aim: The aim of the study was to determine the prevalence of orthorexia nervosa (ON) among young adults from Poland as well as search for factors which enhance the risk of orthorexia nervosa. Material and Method: The study group consisted of 136 subjects (95 females, 3 non-binary and 38 males). The mean age of female participants was 20.21+/-3.27 years, and of male participants–18.93+/-3.67 years. In the study, we used a proprietary questionnaire to collect patient data, as well as following diagnostic questionnaires: ORTO-15 by Donini et al. (score of 35 was considered as cut-off point) and EAT-26 by Garner and Garfinkel. The results were statistically analyzed. Results: Among the overall surveyed respondents, the proportion of those found to be at risk for orthorexia was 26.5% (36 subjects). Eating disorders were found in a total of 15.4% (21) of the respondents. The risk of orthorexia occurred significantly more often in those who had an eating disorder, 71.4% (15), than in those who did not, 18.3% (21). A statistically significant association was found between the presence of an eating disorder and the occurrence of orthorexia risk (chi square=25.790 p <0.001). Depression was present (according to respondents’ self-assessment and evaluation) in 57.3% (78) of respondents or their families. The highest score of risk was observed in the group of students when the respondent experienced depression. A statistically significant association was found between the presence of depression and the occurrence of orthorexia risk (chi square=3.924 p =0.048). There were no statistically significant differences in the risk of orthorexia in groups from big cities and small towns. The studied social factors did not show impact on the risk of orthorexia as well as gender and BMI. Conclusion: The prevalence of orthorexia nervosa (ON) among young adults from Poland was 26%. A statistically significant association was found between the presence of eating disorders and the risk of orthorexia, confirming that ON is most likely a slightly different clinical manifestation of the eating disorder. The respondent’s depressive disorders were the only statistically significant factor increasing the risk of orthorexia.

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Treatment of Supracondylar Fractures of the Humerus in Adults Using a Novel Anatomical Locking Plate on the Anterior Distal Humerus_Crimson Publishers

Abstract

Due to its unique anatomical characteristics, supracondylar fractures of the humerus are often difficult to achieve firm fixation with internal fixation equipment, resulting in delayed functional exercise, often leaving cubitus varus deformity, elbow stiffness, contractures and other complications. Here, we report an adult patient with a supracondylar fracture of the humerus who underwent internal fixation through an anterior median incision in the humerus with our self-developed anterior anatomical locking plate of the distal humerus. During the 16-month follow-up period, the patient’s elbow range of motion was almost completely restored, functional scores were excellent, and there were no minor or major postoperative complications. We assumed this to be caused by our surgical reconstruction strategy for adult patients with supracondylar humeral fractures.

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The Impact of Sars-Covid19 Pandemic on Multidrug Resistant Bacteria Colonization in Stem Cell Transplantation in the Era of New Agents_Crimson Publishers

Abstract

Infections are among the major cause of mortality in patients receiving allogeneic hemopoietic stem cell transplantation (HSCT). In the last decades, the progressive raise of Carbapenemic Resistant Enterobacteriaceae (CRE) infections was associated with a concomitant increase in terms of morbidity and mortality rates. The primary aims of our retrospective analysis were to assess the impact of SARSCOVID19 Pandemic on CRE colonization at our Transplant Program and the efficacy of new antibiotics on the 100 days and 1-yr Transplant Related Mortality in both CRE colonized and non-colonized patients. CRE colonization resulted significantly lower during SARS-COVID19 Pandemic (p<0.0001), related to the COVID-19 associated restrictions adopted at the AORN Cardarelli Hospital, in Naples. However, the outcomes of CRE colonized and non-colonized patients who underwent allogeneic Hematopoietic Stem Cell Transplant procedure were similar in terms of morbidity and mortality (p=ns).

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Allogeneic Chimeric Antigen Receptor T Cells: A Further Potential Weapon for Haematological Malignancies_Crimson Publishers

Autologous (patient-derived) Chimeric Antigen Receptor T (CAR T) cells have widely proven their efficacy to treat certain B-cell haematological malignancies [1-3]. However, autologous CAR-T presented some limitations regarding both the manufacturing process and the use of T cell exhaust due to several therapy lines [4,5]. The possibility to use cells from healthy donors, referred to as “off-the-shelf” allogeneic CAR T or universal CAR T (UCART) could potentially overcome these limitations, as well as making a marked reduction in costs due to the implementation of industrialized manufacturing process. At the same time, the creation of batches allowed the possibility to have a product immediately available also for redosing, if necessary. However, allogeneic approaches are associated with two major issues: the life-threatening Graft Versus Host Disease (GVHD) and the short persistence of allogeneic CAR-T due to host immune recognition. Here, we report the promising results of the main phase-1 clinical trials in haematological malignancies [6].

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Guttate Psoriasis in Images, A Sign of Streptococcal Tonsillopharyngitis_Crimson Publishers

Abstract

This report presents two cases of systemic Kaposi’s sarcoma (KS) in HIV-positive women from Gabon and Equatorial Guinea. KS is caused by Human Herpes Virus 8 (HHV8) and is a common cancer among HIV-infected individuals in Africa. The equatorial form of KS is aggressive and affects individuals of all ages and is commonly found in Central and South Africa, including Gabon. Both patients had multifocal involvement and several localizations and were treated at the Omar Bongo Ondimba Military Hospital in Libreville, Gabon. The coexistence of HIV and HHV8 has contributed to the high prevalence of this disease in both endemic and epidemic areas.

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Severe Tophaceous Gout_Crimson Publishers

Abstract

Tophaceous gout is the osteoarticular and cutaneous expression of chronic hyperuricemia that can occur years after recurrent attacks of acute inflammatory arthropathies. This metabolic complication is increasingly rare. We report the particular observation of a patient with “historical” tophaceous gout severely handicapped by polyarticular involvement and skin tophi.

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HIV-Related Kaposi’s Sarcoma at the Omar Bongo Ondimba Military Hospital in Libreville: Two Clinical Cases_Crimson Publishers

Abstract

This report presents two cases of systemic Kaposi’s sarcoma (KS) in HIV-positive women from Gabon and Equatorial Guinea. KS is caused by Human Herpes Virus 8 (HHV8) and is a common cancer among HIV-infected individuals in Africa. The equatorial form of KS is aggressive and affects individuals of all ages and is commonly found in Central and South Africa, including Gabon. Both patients had multifocal involvement and several localizations and were treated at the Omar Bongo Ondimba Military Hospital in Libreville, Gabon. The coexistence of HIV and HHV8 has contributed to the high prevalence of this disease in both endemic and epidemic areas.

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Peripheral Facial Nerve Paralysis After Real-Time Ultrasound-Guided Percutaneous Biopsy: A Case Report and Literature Review_Crimson Publishers

Abstract

We report a case of a 65-year-old man who developed peripheral facial nerve paralysis after perioperative infiltration of lidocaine and successful biopsy. He was then observed by his daughter to have a crooked smile and slurred speech after going back to in-patients department. The clinical signs of facial paralysis started to regress 1 hour later, and then, the facial nerve paralysis was resolved completely with no neurological sequelae after another 2 hours. We assumed this to be caused by the direct action of the local anesthetic agent on the facial nerve.

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The Effects of Diamagnetic Therapy in a Peripheral Facial Paralysis: A Case Report_Crimson Publishers

Abstract

Peripheral facial paresis, or paralysis, is the most common acute mononeuropathy that affects the face. Also known as Bell’s paralysis and it involves the VII cranial nerve on one side of the face. The clinical resolution is almost always spontaneous, in a few weeks, but the complete recovery usually occurs in about six months; rarely, the pathology continues with long symptoms for life or occurs more than once. Despite the cause is frequently unknown, the therapeutic choice includes corticosteroids or antiviral drugs in force of a possible inflammatory or viral origin. In addition to medical therapy, short electrical stimulation of the facial muscles, low-level facial lasers, facial exercises, and tape feedback have been proposed, but with conflicting results.

We are unaware of the use of Pulsed Electromagnetic Fields in the management of paralysis, although this type of biophysical stimulation has already proven to be effective in neurological diseases, both in the central and peripheral nervous contexts. Based on this rationale, an original technology that employs High-Intensity Magnetic Fields (Diamagnetic therapy) has been proposed as a therapeutic choice in facial palsy given the lengthy response after conventional rehabilitative treatments. The results of the treatment are very encouragin

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Autoimmune Hemolytic Anemia Induced by Anti-D Injection_Crimson Publishers

Anti-D immunoglobulin can cause acute hemolysis when used in the treatment of Rh(D) positive patients with immune thrombocytopenic purpura (ITP). The use of Anti-D immunoglobulin to prevent Rh(D) alloimmunization during pregnancy is quite safe. Although drug induced immune hemolytic anemia have been described during pregnancy, hemolytic anemia was not described as adverse event of Anti-D immunoglobulin administered as a prophylaxis for Rh(D) negative pregnant women. Herein we present an unusual case of warm type autoimmune hemolytic anemia induced by Anti-D immunoglobulin in O Rho(D) negative pregnant women.

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Basal Cell Carcinoma in a Filipino with Oculocutaneous Albinism:A Case Report_Crimson Publishers

Abstract

Background: Oculocutaneous albinism (OCA) is an autosomal recessive disorder characterized by defects in melanin synthesis that affect the skin, eyes, and hair. This melanin deficiency causes albino patients to be at a higher risk for sun-induced skin cancers. Herein, this report highlights the rare occurrence of basal cell carcinoma (BCC) in a Filipino with oculocutaneous albinism. Case: A 25-year-old Filipino female presented with a 1-year history of a keratotic plaque on the neck. She had milky-white skin, silvery hair, and blue eyes at birth that gradually darkened with age with progressive photosensitivity and photophobia. No family history of albinism nor consanguineous marriage was noted. Physical examination revealed a fair-skinned patient with brown hair, gray-tinted irises, marked nystagmus, and decreased visual acuity. Clinical and genetic counseling was done leading to the diagnosis of OCA IB. In addition to this, an erythematous keratotic plaque on the left side of the neck was noted and upon dermoscopy, short fine telangiectasias, ulceration and yellow crusts were seen. Skin biopsy was done that showed tumor islands with atypical basaloid cells and a retraction artifact diagnostic of nodular BCC. She underwent Mohs micrographic surgery for her BCC, was recommended to follow-up regularly for screening, and was advised strict sun protection. Conclusion: The hypopigmented skin of this patient with oculocutaneous albinism predisposed her to severe skin damage that led to the development of basal cell carcinoma. Due to melanin deficiency, it is recommended to closely observe, regularly follow-up, and advise strict sun protection as early as possible to prevent skin cancer in this population.

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Non-genetically Editing Dysbiotic Microbiome Using Probiotic-specific Prebiotics for Treatments of Human Skin Diseases_Crimson publishers

Abstract

External interruption in the balance of microbes in the microbiome can lead to a dysbiotic microbiome which has been linked to a variety of human diseases. Antibiotics have been widely used for treatments of infectious diseases in humans, but they are generally not pathogen specific and run a risk of yielding antibiotic-resistant microbes. Inappropriate use of antibiotics may disrupt the homeostasis of human microbiome, causing dysbiotic microbiome and abolishing natural and self-curative of human body. Here, we review a new approach by using bacterial specific prebiotics to amplify the fermentation activity of probiotic bacteria against pathogens and keep the microbiome balanced for optimal health. The pros and cons of using skin prebiotic as a new modality for improvement of skin health are compared to other treatments including antibiotics, vaccines, bacteriophages, genetically modified/engineering bacteria and live skin probiotic bacteria.

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Aortic Root Abscess Presenting as Syncope and Substernal Chest Pain: Case Report and Literature Review_Crimson Publishers

Abstract

Background: Aortic root abscess (ARA) is a serious complication of infective endocarditis (IE) which requires urgent/emergent surgery. ARA has high intra-operative mortality, estimated to be as high as 12%. ARA does not always have specific symptoms, so a high index of suspicion from clinicians is key for diagnosis.

Case presentation: A 53-year-old male with a past medical history of type A aortic dissection (AD) status post repair one year prior to presentation, chronic foot wound and hypertension presented to the Emergency Department (ED) with substernal chest pain radiating to his back and neck. He also reported an episode of syncope at home. In ED, he was found to be hypoxic. Initial Computed Tomography chest was done without contrast due to elevated creatinine and was negative for pulmonary embolism (PE). Ventilation/perfusion scan showed low probability of PE and blood cultures came back positive for grampositive cocci, eventually specified as methicillin resistant staphylococcus aureus (MRSA). Repeat CT chest with contrast showed fluid collection near the aortic arch and he was diagnosed with an ARA. He was initially treated with drainage of the abscess by interventional radiology (IR) and was transferred to another facility for surgical management.

Conclusion: Although infective endocarditis (IE) is routinely managed with medical therapy alone, ARA is an indication for surgery. Patients with ARA are often critically ill and at risk for many disastrous complications, including acute congestive heart failure (CHF), septic shock, fistula formation, and involvement of the mitral valve. It is integral to promptly diagnose this condition so patients may receive proper treatment and care.

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Clinical Review: Best Medical Therapy Superior to Carotid Endarterectomy in Secondary Stroke Prevention in Symptomatic Extracranial Internal Carotid Artery Stenosis of 50-69%_Crimson Publishers

Abstract

Extracranial internal carotid artery stenosis poses a high risk of recurrent stroke or transient ischemic attack (TIA) after a TIA or minor stroke. Secondary prevention with carotid endarterectomy for highgrade stenosis between 70-99% has been well documented with large scale randomized controlled trials in both Europe and North America. The benefit of intermediate grade stenosis (50-69%) stenosis is not as clear and the present-day standard treatment guidelines do not favor surgery or best medical treatment. When the surgery trials were published in early 1990s, the medical therapy was not as clear or as aggressive. Over the past 20+ years, multimodality medical therapy has been strongly recommended in all stroke guidelines and significantly improved results of secondary prevention of 80-90% is achievable. This review will try to analyze the available data to provide the best treatment recommendation for patients with symptomatic extracranial internal carotid stenosis of 50-69%.

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