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BMJ Case Rep 2021 Jun 14;14(6). Epub 2021 Jun 14.

Interventional Cardiology, Cardiology, Carle Foundation Hospital, Urbana, Illinois, USA.

Drug-induced immune thrombocytopaenia (DITP) is a type of thrombocytopaenia caused by medications. It is one of the common causes of unexplained thrombocytopaenia. It is caused by the formation of autoantibodies against a particular drug and is commonly observed with medications like heparin and beta-lactam antibiotics. Read More

Can Fam Physician 2021 Jun;67(6):427-429

Question: A child came to my clinic complaining of recurrent epistaxis with several episodes occurring every year since he was a toddler. The nosebleeds affect both nostrils, often lasting for an extended period of time and occurring in no apparent seasonal pattern. What interventions are safe and effective for recurrent epistaxis in children, and which patients warrant hematologic testing?

Answer: Epistaxis affects more than half of children by the time they are 10 years old, with 9% of children reported to have recurrent episodes. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2021 Jun 11. Epub 2021 Jun 11.

Otolaryngology Head and Neck Surgery department, CHU de Caen, France; Unicaen, UFR de médecine Caen, France.

Pan Afr Med J 2021 18;38:285. Epub 2021 Mar 18.

Department of Respiratory Diseases, Hospital 20 Août 1953, University of Hassan II, University Hospital Center Ibn Rochd, Casablanca, Morocco.

Granulomatosis with polyangiitis (GPA) is a rare vasculitis among adolescents. Its pulmonary manifestations may mimic tuberculosis. We report the case of a 16-years-old female patient with multiple excavated lung nodules revealed by a chronic cough, hemoptysis, epistaxis and weight loss. Read More

Gastroenterology 2021 Jun 8. Epub 2021 Jun 8.

Department of Radiology, the Third Xiangya Hospital, Central South University, Changsha 410013, Hunan Province, China. Electronic address:

J Vet Diagn Invest 2021 Jun 10:10406387211022864. Epub 2021 Jun 10.

Departments of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.

A 7-y-old, intact male Alaskan Malamute was presented with a 3-mo history of stertor and epistaxis. Computed tomography of the skull revealed generalized loss of gas throughout both nasal passages with replacement by a soft tissue mass that traversed the cribriform plate. Histopathology revealed neoplastic neuroblast cells arranged in anastomosing cords, as well as separately located aggregates of ganglion cells. Read More

J Adv Pract Oncol 2021 Mar 1;12(2):211-215. Epub 2021 Mar 1.

Rush University Medical Center, Chicago, Illinois.

Acute thrombotic thrombocytopenic purpura (aTTP) is a rare microangiopathic hemolytic anemia. Standard of care currently includes plasma exchange and immunosuppressive agents, including glucocorticoids, vincristine, and rituximab. Even with these therapies, relapse occurs in 36% of patients, and mortality ranges from 10% to 20%. Read More

Eur Heart J Case Rep 2021 Jun 5;5(6):ytab206. Epub 2021 Jun 5.

Service d'hématologie biologique, Hôpital Lariboisière, 2rue Ambroise Pare ´,75010 Paris, Université de Paris, Paris, France.

Background: Severe acute respiratory syndrome coronavirus 2 disease is strongly associated with a high incidence of thrombotic events. Anticoagulation could be a cornerstone in successfully managing severe forms of coronavirus disease 2019 (COVID-19). However, optimal anticoagulant dosing in elderly patients is challenging because of high risk of both thrombosis and bleeding. Read More

Cureus 2021 May 4;13(5):e14832. Epub 2021 May 4.

Australian Resuscitation Council, Australian and New Zealand Committee on Resuscitation (ANZCOR) Evidence Reviewer, East Melbourne, AUS.

Epistaxis, or nosebleed, is bleeding from the nostril(s), nasal cavity, or nasopharynx. Anterior nasal bleeding is the most common location for spontaneous nontraumatic epistaxis and is commonly treated with manual compression to the nasal alae. Cryotherapy is also routinely recommended in conjunction with manual compression in the first aid and ED setting. Read More

Pan Afr Med J 2021 8;38:248. Epub 2021 Mar 8.

CHU de la Référence, N´Djamena, Tchad.

Yellow fever (YF) is a viral haemorrhagic fever caused by yellow fever virus transmitted by Aedes mosquitoes. Since 2013, in Chad, four cases of yellow fever have been detected and confirmed as part of the national fever surveillance program. We here report the last clinical case confirmed in the health district of Lai. Read More

J Am Coll Emerg Physicians Open 2021 Jun 29;2(3):e12456. Epub 2021 May 29.

Department of Pharmacy Practice and Science University of Kentucky College of Pharmacy Lexington Kentucky USA.

Tranexamic acid (TXA) is an antifibrinolytic commonly used to reduce blood loss due to surgical procedures, heavy menstruation, trauma, bleeding disorders, among other uses. Possible adverse reactions associated with TXA include abdominal pain, headache, fatigue, cerebral thrombosis, dizziness, retinal artery occlusion, chromatopsia, and more. We present a case of acute color vision disturbance developed soon after initiation of oral TXA for epistaxis prophylaxis in the setting of factor VII deficiency. Read More

Surg Neurol Int 2021 26;12:191. Epub 2021 Apr 26.

Department of Radiology and Interventional Neuroradiology, University of Patras, Patra, Achaia, Greece.

Background: Intracranial infectious aneurysms are cerebral aneurysms caused by pathogen-induced inflammation undermining the arterial wall. We present a rare case of inflammatory pseudoaneurysm of cavernous internal carotid artery (ICA).

Case Description: A 51-year-old female with a recent diagnosis of acute lymphoblastic leukemia developed maxillofacial infection with and after chemotherapy onset. Read More

Saudi J Med Med Sci 2021 May-Aug;9(2):178-189. Epub 2021 Apr 29.

Adult Hematology/Bone Marrow Transplantation Section, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired hematopoietic stem cell disorder, and eculizumab and ravulizumab are its two approved therapies. Only few case series/reports have reported the outcomes of pregnancies in patients with PNH despite the increased risk of thrombosis. Similarly, there is limited knowledge regarding the effect of the approved treatments on conception and pregnancy outcomes. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2021 May 31. Epub 2021 May 31.

Service d'ORL et de Chirurgie Cervico Faciale, Institut Arthur Vernes, 36, rue d'Assas, 75006 Paris, France.

Objectives: The main objective of this study was to determine the rate of outpatient management in a population of patients undergoing bilateral ethmoidectomy. The secondary objectives were to evaluate the quality of outpatient management (rate of unscheduled overnight admission, readmission rate, complications) and to compare inpatient and outpatient groups to determine which elements of the phenotype and care pathway favored outpatient management.

Materials And Methods: A single-center observational study included 204 patients operated on for bilateral ethmoidectomy. Read More

BMC Neurol 2021 Jun 3;21(1):215. Epub 2021 Jun 3.

Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.

Background: Chronic inflamed tissue in nasal cavity is a rare complication of transsphenoidal approach (TSA). Inflamed tissue is rich in blood vessels, which can lead to frequent nosebleeds. In addition, chronic inflammation can cause pseudoaneurysm, whose rupture results in massive epistaxis. Read More

Stroke 2021 Jun 4:STROKEAHA120032073. Epub 2021 Jun 4.

University of Connecticut, Storrs (S. D.P., M.J.A.).

Background And Purpose: Pulmonary arteriovenous fistulas (PAVFs) are a treatable cause of acute ischemic stroke (AIS), not mentioned in current American Heart/Stroke Association guidelines. PAVFs are recognized as an important complication of hereditary hemorrhagic telangiectasia.

Methods: The prevalence of PAVF and hereditary hemorrhagic telangiectasia among patients admitted with AIS in the United States (2005-2014) was retrospectively studied, utilizing the Nationwide Inpatient Sample database. Read More

J Clin Med 2021 May 25;10(11). Epub 2021 May 25.

Multidisciplinary Gemelli Group for HHT, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

Background: Hereditary hemorrhagic telangiectasia (HHT) needs high-quality care and multidisciplinary management. During the COVID-19 pandemic, most non-urgent clinical activities for HHT outpatients were suspended. We conducted an analytical observational cohort study to evaluate whether medical and psychological support, provided through remote consultation during the COVID-19 pandemic, could reduce the complications of HHT. Read More

Diseases 2021 May 14;9(2). Epub 2021 May 14.

BioGeneticks and Other Vector Diseases Lab., Tulancingo, Hidalgo 43660, Mexico.

Human granulocytic Anaplasmosis (HGA), is a tick-borne infectious disease transmitted by ticks, resulting in acute feverish episodes. The etiological agent is the bacteria ; which is spread by ticks of the genus . to complete its life cycle. Read More

Pol Arch Intern Med 2021 May 31. Epub 2021 May 31.

Cureus 2021 Apr 27;13(4):e14718. Epub 2021 Apr 27.

Medical Oncology, Tata Main Hospital, Jamshedpur, IND.

Metastases of malignant tumors to the nasal cavity and paranasal sinuses are very rare. Metastases to these locations are usually solitary and produce similar symptoms to those of a primary sinonasal tumor. Pain, nasal obstruction, and epistaxis are the most common symptoms. Read More

J Paediatr Child Health 2021 May 28. Epub 2021 May 28.

A. Clinic, Kolkata, India.

Pituitary 2021 May 27. Epub 2021 May 27.

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Purpose: Rathke cleft cysts (RCC) are a target for transsphenoidal surgery when symptomatic; however, the surgical techniques and outcomes continue to be of interest. Our goal is to highlight nuances in diagnosis, surgical philosophy and techniques, and outcomes.

Methods: We retrospectively reviewed a single surgeon experience in a contemporary series of RCC from April 2008 through December 2019. Read More

J Family Med Prim Care 2021 Feb 27;10(2):826-830. Epub 2021 Feb 27.

Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.

Bleeding tendency is a common medical problem that is usually caused by either coagulation factors abnormalities, platelets disorders, or vasculopathy. Detection of patients with high bleeding risk through history taking and accurate diagnosis followed by appropriate management will help decreasing chances of significant complications.

Methodology: A cross-sectional survey of a random sample of adolescent students in the preparatory year at Taibah University in Almadinah Almunawwarah, Saudi Arabia were interviewed using a validated semi-structured condensed bleeding tendency questionnaire generated from Molecular and Clinical Markers for the Diagnosis and Management of (MCMDM-1). Read More

Postgrad Med J 2021 May 26. Epub 2021 May 26.

Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

Background: During flexible fibreoptic bronchoscopy through the nasal route, anaesthesia of the nasal passage is achieved by lignocaine gel application by a slip-tip syringe or with the help of a cotton tip swab. No studies in existing literature have compared the two techniques in terms of efficacy.

Methods: 137 consecutive patients undergoing bronchoalveolar lavage (BAL) were recruited over a 2-year period. Read More

Emerg Microbes Infect 2021 Dec;10(1):1116-1128

Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.

The World Health Organization (WHO) introduced the new dengue classification in 2009. We aimed to assess the association of clinical signs and symptoms with WHO severe dengue classification in clinical practice. A systematic literature search was performed using the databases of PubMed, Embase, and Scopus between 2009 and 2018 according to PRISMA guideline. Read More

Arch Argent Pediatr 2021 06;119(3):e261-e263

Residencia de Otorrinolaringología Infantil. Hospital General de Niños "Pedro de Elizalde", Ciudad Autónoma de Buenos Aires, Argentina.

Hematomas and septal abscesses are an emergency in rhinology and require early surgical treatment due to the risk of infectious, functional, and aesthetic complications. They generally occur as a consequence of nasal trauma, although they have also been described in relation to other triggers. Accumulation of blood or pus between the mucoperichondrium and septal cartilage, causes avascular necrosis injury to the cartilage with cartilage destruction. Read More

J Neurol Surg B Skull Base 2021 Jun 21;82(3):295-302. Epub 2019 Oct 21.

Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, Australia.

 Despite multidisciplinary care being commonly recommended, there remains limited evidence supporting its benefits in pituitary disease management. This study aimed to assess the impact of multidisciplinary care in pituitary surgery.  A retrospective cohort study was performed comparing pituitary surgery outcomes among consecutive patients within a quaternary referral center in 5 years before and after introduction of a multidisciplinary team (MDT). Read More

Chest 2021 Apr 6;159(4):e225-e230. Epub 2021 Apr 6.

Divisions of Pulmonary, Critical Care and Sleep Medicine, University of Texas Health-McGovern Medical School, Houston, TX.

Clinical Presentation: A 52-year-old man presented with hemoptysis of 2 weeks' duration. He had been experiencing hoarseness, right-sided pleuritic chest pain, subjective fevers, chills, night sweats, and 10 pounds weight loss for the previous 2 months. He additionally reported severe frontal headaches, nasal congestion, and intermittent epistaxis, which had been present for a year before his current presentation. Read More

BMJ Case Rep 2021 May 19;14(5). Epub 2021 May 19.

Ophthalmology, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-In-Ashfield, UK.

This case report describes a significant complication of a routine COVID-19 swab in a previously fit and well young patient who developed preseptal cellulitis and an infraorbital abscess as a consequence of the mentioned nasal swabbing. Other authors have previously reported various complications in connection with the use of nasal swabs, including retained swab fragments, epistaxis and cerebrospinal fluid leakage. To our knowledge, to date, this is the first reported case of an abscess as a consequence of COVID-19 swabbing. Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 May;56(5):436-441

Department of Otorhinolaryngology Head and Neck Surgery, the First Clinical Center of Chinese People's Liberation Army General Hospital, Beijing 100853, China Allergy Department, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.

To observe the clinical effects of bevacizumab in the treatment of familial epistaxis caused by hereditary hemorrhagic telangiectasia (HHT). The data of 27 patients with familial epistaxis caused by HHT who were treated with bevacizumab intravenously from Beijing Anzhen Hospital, the First Clinical Center of Chinese People's Liberation Army General Hospital and Binzhou Central Hospital between December 2016 and December 2019 were retrospectively analyzed. There were 14 males and 13 females, aged (55. Read More