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A Case of Wellens Syndrome Combined with De Winter Syndrome
Zhixiong Zhong,
JueTong Chen,
Ning Xu,
Zhichao Qiu,
Jianyong Zhang,
Guibin Liu,
Fanchao Zeng
Issue:
Volume 11, Issue 3, May 2022
Pages:
36-41
Received:
3 April 2022
Accepted:
6 May 2022
Published:
12 May 2022
Abstract: This paper reports a typical case of Wellens syndrome combined with De Winter syndrome. The male patient was admitted with "one day chest pain". He is 64 years old. He had chest pain without obvious inducement. Preliminary diagnosis: coronary heart disease unstable angina pectoris. The Electrocardiogram of this case is typical of Wellens syndrome. The patient's Electrocardiogram pseudonormalized during the onset of chest pain, and no significant ST-T changes were observed. After being admitted to hospital, chest pain was relieved. In the case of this case, when the chest pain occurred again, the electrocardiogram of the patient showed a 1-3mm depression of J point in lead V2-V6, followed by symmetrical high tip of T wave and normal ECG changes in QRS wave. Which was in line with the characteristics of electrocardiogram changes in De Winter syndrome. Coronary angiography results: right dominant type, no stenosis in LM, LCX and RCA, and 90%-95% stenosis in the middle part of LAD. The Electrocardiogram of the patient showed dynamic evolution of ST-T. Wellens syndrome and De Winter syndrome successively appeared. It suggests that severe proximal stenosis of the anterior descending artery is accompanied by coronary spasm and the possibility of spontaneous remission. Which will lead to changes of electrocardiograph in ST-T. For these patients, it is necessary to observe the changes of the condition closely and monitor the changes of electrocardiogram dynamically. It is likely to progress to acute extensive anterior wall myocardial infarction without further treatment. So it is necessary perform coronary intervention in time.
Abstract: This paper reports a typical case of Wellens syndrome combined with De Winter syndrome. The male patient was admitted with "one day chest pain". He is 64 years old. He had chest pain without obvious inducement. Preliminary diagnosis: coronary heart disease unstable angina pectoris. The Electrocardiogram of this case is typical of Wellens syndrome. ...
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Limiting Factors Analysis in Validation of a CryoShipper & a CryoExtra Freezer for Cryo-samples Related to the Abu Dhabi Bone Marrow Transplantation Program
Rene Antonio Rivero-Jimenez,
Zain Asif,
Muhammad Touseef Haider,
Yandy Marx Castillo-Aleman,
Yendry Ventura-Carmenate,
Carlos Agustin Villegas-Valverde,
Antonio Alfonso Bencomo-Hernandez
Issue:
Volume 11, Issue 3, May 2022
Pages:
42-47
Received:
25 April 2022
Accepted:
9 May 2022
Published:
31 May 2022
Abstract: Introduction: CryoShipper and CryoFreezer tanks were designed to safely transport and store biological material at cryogenic temperatures. An adverse warming event may occur if the CryoShipper is tilted during transit if temperature and proper levels of liquid nitrogen (LN2) vapors are not maintained. Storing cryogenic hematopoietic stem cell samples for a short or long time requires validating all pieces of equipment employed in a bone marrow transplant program. Objective: To determine the limitations of the MVE CryoShipper CX and the Thermo Fisher CryoExtra™ Cryogenic tank for the Abu Dhabi Bone Marrow Transplantation Program. Methods: The MVE CryoShipper CX was weighted and primed with LN2, and the excess was removed. After stabilizing the temperature, the shipper was tilted onto its side for 24, 72, and 96 hours. The temperature was monitored and recorded at 15 minutes intervals using a Datalogger. After returning to the correct upright position, the dry shipper temperature was also observed for five days after refilling with LN2 to evaluate the secure timing of a shipment. For an LN2 filled CryoExtra tank, dual control of the LN2 level and the temperature was done using manual measurement and automatic display. Later, vials and a bag from three healthy donors’ frozen white blood cell buffy coat samples were kept inside and defrosted daily to measure total mononuclear cell counts CD45+/7AAD cells viability by flow cytometry for five days. Results: The CryoShipper maintained cryogenic temperatures below -150°C for the entire duration of each analysis. A maximum temperature of -182.7°C was reached during the 24-hour tilt experiment from the temperature probe. The CryoExtra 0140 freezer temperature was always between -184°C / -194.2°C, and LN2 levels coincided in both measuring methods during the time slot. Stored and defrosted cells keep their % of viability and absolute number over the expected reference range and compare mean+/-standard deviation (SD) between them without assessing the statistical difference with p≥0.05. The defrosted cells’ mean viability of 83.12%, SD±9.04, and a mean of 1,781 cell/µL, SD±1,215. Conclusion: Our modern dry shipper controls much of the vapor within the shipper. The CryoShipper can withstand being tilted during transit for 96 hours without risks of an adverse warming event. The CryoExtra 0140 tank its performance was under the established parameters. Both types of cryogenic devices can be used for the safe cryopreservation of cell samples keeping all the security measures and controls as advised.
Abstract: Introduction: CryoShipper and CryoFreezer tanks were designed to safely transport and store biological material at cryogenic temperatures. An adverse warming event may occur if the CryoShipper is tilted during transit if temperature and proper levels of liquid nitrogen (LN2) vapors are not maintained. Storing cryogenic hematopoietic stem cell sampl...
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Diagnostic Pitfalls: A Case Series of 5 Patients with Lacrimal Gland Mass
Renu Bansal,
Viji Rangarajan,
Radhakrishnan Shanthi,
Kavitha
Issue:
Volume 11, Issue 3, May 2022
Pages:
48-52
Received:
14 October 2021
Accepted:
14 December 2021
Published:
8 June 2022
Abstract: Background: The orbit is infamous to harbor various mass lesions, out of which lacrimal gland tumors contribute to about 10% of all tumors. The peak incidence is in the middle-aged adults who present with upper eyelid mass. These tumors have a high morbidity and mortality rate due to their misdiagnosis. The diagnosis is still a dilemma on clinical examination and even its very difficult to get a specific diagnosis after imaging. Thus, biopsy can be an important tool to help in diagnosis and their suitable treatment. Objective: To provide specific, accurate and definitive diagnosis by correlating clinico-radiological findings with pathological examination to optimize management. Methods: We present a case series of 5 patients who presented with lacrimal gland mass with or without proptosis, defective vision, diplopia or restricted motility. These were evaluated radiologically which provide differential diagnosis that leads to a diagnostic challenge and their further management. So to reach a definitive diagnosis they were then correlated with histopathology with or without immunohistochemical stains by taking biopsy from the mass. Result and Conclusion: In our case series, we concluded that to make a confirmative diagnosis of the lacrimal gland tumors, the clinical and radiological findings should be correlated with the histopathological examination with or without immunohistochemical stains by biopsy and thus helps in rationalizing their further treatment.
Abstract: Background: The orbit is infamous to harbor various mass lesions, out of which lacrimal gland tumors contribute to about 10% of all tumors. The peak incidence is in the middle-aged adults who present with upper eyelid mass. These tumors have a high morbidity and mortality rate due to their misdiagnosis. The diagnosis is still a dilemma on clinical ...
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Clinical and Pathogenic Analysis in 1393 Cases of Superficial Fungal Diseases in Shanghai
Issue:
Volume 11, Issue 3, May 2022
Pages:
53-69
Received:
15 April 2022
Accepted:
20 May 2022
Published:
14 June 2022
Abstract: Fungi are a kind of eukaryotic cell organisms widely distributed in nature and are considered as independent branches in existing organisms. There are 1 million to 1.5 million fungi in the world, most of which are beneficial to humans and only a few are harmful to humans. Mycosis is an infectious disease caused by fungi that infect humans and animals. The fungus that infects humans is mainly from the external environment. The route of infection can be contact, inhalation or ingestion. A few fungi can be directly pathogenic, and most fungi are conditional pathogens that require certain conditions to cause disease. Based on the depth of fungal invading tissue, fungal infectious diseases are clinically classified into superficial fungal diseases and deep fungal diseases. Superficial mycosis refers to fungal infections in superficial tissues such as epidermis, hair and nails (toenails). It is a common fungal disease in dermatology clinics and the prevalence rate can reach 20%-50%. According to the different types of pathogenic fungi, superficial fungal diseases can be divided into dermatophytosis, cutaneous candidiasis and Malassezia disease. Among them, dermatophytosis is the most common superficial fungal disease. The pathogenic fungi are dermatophytes, including Trichophyton, Microsporum and Epidermophyton, and Trichophyton rubrum in Trichophyton occupy the first place; Candida is a common human conditional pathogenic fungus, can cause skin candidiasis, the incidence has gradually increased in recent years, still dominated by Candida albicans, but Candida tropicalis, Candida glabrata, Candida krusei with the increase in the detection rate, there are also increasing trends year by year; Malassezia is also a conditional pathogen that easily accumulates in areas rich in sebaceous glands, has lipid dependence, and often causes pityriasis versicolor and Malassezia folliculitis in clinical practice. Malassezia disease is prone to recurrence. With the development of research and improvement of detection techniques, it has been found that Malassezia infection is associated with more and more diseases.
Abstract: Fungi are a kind of eukaryotic cell organisms widely distributed in nature and are considered as independent branches in existing organisms. There are 1 million to 1.5 million fungi in the world, most of which are beneficial to humans and only a few are harmful to humans. Mycosis is an infectious disease caused by fungi that infect humans and anima...
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Tinea Faciei in Children: A Case Series at the Instituto Nacional de Salud del Niño-Breña (Lima-Peru)
Medina_Flores Juan,
Gonzales_Saravia Carlos
Issue:
Volume 11, Issue 3, May 2022
Pages:
70-73
Received:
10 February 2022
Accepted:
11 March 2022
Published:
14 June 2022
Abstract: The objective of this study is to report the epidemiology, clinical and microbiological characteristics, and treatment of pediatric patients diagnosed with tinea faciei. 30 cases have been identified in which the infectious agent was isolated, the data was collected in statistical tables that were evaluated. In this series of cases, it is evidenced that tinea faciei affects more frequently the female sex in 73.3% and children under 5 years old in 66.6%. They attended with a time of disease greater than 30 days. 40% had previous treatment, 53.3% with polyvalent, topical corticoid and antibiotics. The presence of cats, dogs and rabbits was reported in 46% of cases, 76.7% had the genian region compromised. Trichophyton tonsurans was identified in 80% of cases and good response to topical treatment with terbinafine or sertaconazole in 100% of cases. The isolated etiological agents differ according to the geographical area where the study is carried out and new agents are reported that must be known given the wide interconnectivity between different geographical areas as well as the predisposing factors in the pediatric population that to date have not been clearly defined. These data must be proved with larger studies that allow to recognize patients that come to their medical appointment with this pathology. Tinea facie should have a CID-10 that identifies it, in order to have information from different geographical areas, since the isolation of new agents whose sensitivity to antifungals in use is necessary to know is reported. Finally, it is necessary to beware to new forms of clinical presentation due to the use of masks by COVID-19.
Abstract: The objective of this study is to report the epidemiology, clinical and microbiological characteristics, and treatment of pediatric patients diagnosed with tinea faciei. 30 cases have been identified in which the infectious agent was isolated, the data was collected in statistical tables that were evaluated. In this series of cases, it is evidenced...
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Efficacy and Safety of Dalbavancin Monotherapy as Salvage Treatment for Bone and Joint Infection
Hajnal-Gabriela Illes,
Anca Lupu,
Bouchra Loutfi,
Catherine Hoskovec,
Jean-Marc Rogero,
Laurent Delbast,
Mohamed Acra,
Damien Mondon
Issue:
Volume 11, Issue 3, May 2022
Pages:
74-80
Received:
18 May 2022
Accepted:
6 June 2022
Published:
14 June 2022
Abstract: Bone and joint infection (BJI) treatment is challenging with significant morbidity and mortality. Dalbavancin is a semi-synthetic lipoglycopeptide analogue of the teicoplanin class that exhibits bactericidal activity and a long half-life. The use of dalbavancin may be an option in cases of gram-positive BJI. From November 2017 to April 2019, dalbavancin was used in monotherapy as a salvage option for BJI, as follows: 1500 mg, 1st (D1) and 8th (D8) days, repeated if needed. The follow-up period was of 6 months for osteomyelitis and 1 year for prosthetic joint infections (PJIs). The demographics of the 16 patients showed that 75% were men (n=12), with a mean age of 77.8 years [64-90]. The BJI characteristics: 5 cases of vertebral osteomyelitis; 12 cases of lower limb BJI {8 joint infections, among which were 6 PJIs (4 knees, 2 hips) and 4 cases of foot osteomyelitis)}; 2 cases of shoulder PJI. The debridement, antibiotics, irrigation, and implant retention (DAIR) procedure was performed in 83.4% (5/6) of cases. Monobacterial biopsy was obtained in 75% (n=12) of patients with majority of staphylococcus (15/25) dalbavancin susceptible micro-organismes): 14 Staphylococcus aureus (10/14 methicillin susceptible). Twelve patients received 2 doses of dalbavancin. The mean duration of the 1st antibiotherapy was 18.3 days [0-49]. The clinical success rate was 75% at the end of follow-up with no major side effects of dalbavancin. This report highlights the potential role and efficiency of dalbavancin in treating fragile patients who require long-term antimicrobial therapy with excellent tolerance profiles.
Abstract: Bone and joint infection (BJI) treatment is challenging with significant morbidity and mortality. Dalbavancin is a semi-synthetic lipoglycopeptide analogue of the teicoplanin class that exhibits bactericidal activity and a long half-life. The use of dalbavancin may be an option in cases of gram-positive BJI. From November 2017 to April 2019, dalbav...
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Opportunity Development Association (ODA) Center for Advanced Vision Care: A Structured Approach Towards Remediation of Visual Dysfunction
Issue:
Volume 11, Issue 3, May 2022
Pages:
81-87
Received:
26 August 2021
Accepted:
27 January 2022
Published:
20 June 2022
Abstract: This paper presents the development and the on-going mission of The Center for Advanced Vision Care, a Vision Therapy Center established within ODA (Opportunity Development Association) Primary Health Care Network. The Center is designed to remediate visual dysfunction with an emphasis on therapeutic lenses, prisms and vision therapy. A structured approach towards Vision Therapy will be introduced highlighting the way in which remediation of visual dysfunction can occur without regression. The Center for Advanced Vision Care was founded with the primary goal of improving vision care for the children of Williamsburg, NY and the surrounding areas. The providers at this Center utilize therapeutic lenses and prisms in conjunction with vision therapy in order to achieve remediation of visual dysfunction, without regression. This unique program provides an opportunity for children to attain a higher level of self-esteem, thereby enabling them to reach their fullest potential. Working alongside other professionals comprising ODA’s exceptional multidisciplinary therapy service, ODA’s Vision Center is redefining the standard for which pediatric behavioral vision care is rendered. A Vision Therapy program, as part of a distinct multidiscipline therapy center, will be presented as a unique facility utilizing therapeutic lenses and prisms, in conjunction with vision therapy, in a way that serves to remediate visual dysfunction, as part of an interdisciplinary approach.
Abstract: This paper presents the development and the on-going mission of The Center for Advanced Vision Care, a Vision Therapy Center established within ODA (Opportunity Development Association) Primary Health Care Network. The Center is designed to remediate visual dysfunction with an emphasis on therapeutic lenses, prisms and vision therapy. A structured ...
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Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case
Avenamar Mora Zúñiga,
Jair Eder Hernández Carrillo,
Juan Daniel Cruz Munguía,
Flavio Cárdenas Arellano
Issue:
Volume 11, Issue 3, May 2022
Pages:
88-91
Received:
24 May 2022
Accepted:
8 June 2022
Published:
20 June 2022
Abstract: Background: Chronic osteomyelitis is a disease usually of infectious origin. The main cause is post-traumatic, it affects the bone tissue and surrounding tissue, the most frequent causative agent is Staphylococcus aureus. The most affected bone is the tibia. Case description: A 42-year-old male with a diagnosis of chronic tibia osteomyelitis, with sequelae of previous surgical interventions, multiple antibiotic treatments, and type IV B classification by Cierny-Mader. Methods: Two-stage surgical management was chosen. Firstly, extensive bone and soft tissue debridement, placement of cement beads medicated with amikacin in the medullary cavity and osteoclast system for irrigation with vancomycin. In the second stage, free fibular bone grafting, fixation and stabilization with screws, bioactive glass placement in areas of interface between stabilized fibula and posterior tibial cortex. Results: Before a multitratada chronic osteomyelitis it is necessary to individualize and evaluate treatment alternatives, in this case the surgical management in two time, the use of medication beads, bone graft and the use of bioactive glass, achieved a complete eradication of the infection and favorable clinical evolution with optimal functional recovery of affected limb.
Abstract: Background: Chronic osteomyelitis is a disease usually of infectious origin. The main cause is post-traumatic, it affects the bone tissue and surrounding tissue, the most frequent causative agent is Staphylococcus aureus. The most affected bone is the tibia. Case description: A 42-year-old male with a diagnosis of chronic tibia osteomyelitis, with ...
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