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Acute Kidney Injury and Associated Factors in Intensive Care Units at a Tertiary Hospital in Northern Tanzania.

Can J Kidney Health Dis 2021 8;8:20543581211027971. Epub 2021 Jul 8.

Kilimanjaro Christian Medical University College, Moshi, Tanzania.

Background: Acute kidney injury (AKI) is a recognized complication in critically ill patients. The epidemiology of AKI varies worldwide, depending on the diagnostic criteria used and the setting. The International Society of Nephrology has called for a reduction in preventable deaths from AKI to zero by the year 2025. Read More

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Prophylactic subcutaneous retention sutures in the prevention of superficial wound separation of midline laparotomy.

Int J Gynecol Cancer 2021 Jul 21. Epub 2021 Jul 21.

Department of Gynecology and Obstetrics, Antalya Training and Research Hospital, Antalya, Turkey.

Objectives: This prospective study aimed to determine the effectiveness of prophylactic subcutaneous retention sutures in the prevention of superficial wound separation in women with a confirmed or suspected cancer who had gynecological surgery by midline laparotomy.

Methods: This was a non-randomized, controlled intervention study including patients who underwent cancer surgery between May 2018 and August 2019. Patients who underwent midline laparotomy with confirmed or suspected cancer were included and patients who had an early post-operative complication or who underwent surgery again before the removal of stitches were excluded. Read More

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Electroencephalography Patterns of Subacute Sclerosing Panencephalitis.

Cureus 2021 Jun 17;13(6):e15728. Epub 2021 Jun 17.

Internal Medicine, Khyber Teaching Hospital, Peshawar, PAK.

Introduction And Background: This article explores the electroencephalography (EEG) pattern in patients of suspected subacute sclerosing panencephalitis (SSPE) visiting Lady Reading Hospital, Peshawar. Pakistan has a huge deficit of research culture, and limited studies are done on this topic. This study concluded that a typical pattern is the most common EEG pattern, although atypical and normal EEG patterns were also observed. Read More

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Clinical Characteristics and Predictive Factors of Invasive Fungal Disease in Pediatric Oncology Patients with Febrile Neutropenia in a Country with Limited Resources.

Pediatric Health Med Ther 2021 12;12:335-345. Epub 2021 Jul 12.

Division of Hematology/Oncology, Department of Pediatrics, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand.

Background: The most common complication among pediatric oncology patients is febrile neutropenia (FN). Invasive fungal disease (IFD) is suspected when fever persists >4-7 days after empirical antibiotics. Its clinical characteristics and predictive factors associated with IFD among pediatric oncology patients with FN were thus explored. Read More

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Clopidogrel-Induced Interstitial Lung Disease: A Case Report.

Ther Clin Risk Manag 2021 12;17:711-715. Epub 2021 Jul 12.

Department of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.

In patients, with cerebral infarction resulting from intracranial arterial stenosis, the combined administration of clopidogrel and aspirin may be needed for to prevent subsequent ischemic attacks. Clopidogrel has an inevitable adverse effect profile, and the most common complications are related to hemorrhagic propensity. A 79-year-old female patient had used aspirin (100 mg/day) for cerebral infarction and then a dual antiplatelet regimen of aspirin and clopidogrel (75 mg/day) because of severe stenosis in both anterior cerebral arteries. Read More

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Frozen Shoulder Related to Influenza Vaccine Administration.

Clin J Sport Med 2021 Jul 16. Epub 2021 Jul 16.

Lehigh Valley Hospital/Coordinated Health, Allentown, Pennsylvania.

Abstract: Shoulder pain is often a transient physical finding after vaccination. We present the case of a 46-year-old woman who presented clinically with frozen shoulder that was progressively worse and temporally related to her yearly influenza vaccination. The patient failed conservative management, and 7 months postvaccination, the patient underwent shoulder manipulation under anesthesia with good results. Read More

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A rare brainstem hemorrhage due to incomplete transvenous embolization of the cavernous sinus dural arteriovenous fistula: A case report.

Radiol Case Rep 2021 Sep 5;16(9):2526-2529. Epub 2021 Jul 5.

Department of Neurosurgery, International Medical Center, Saitama Medical University, 350-1298, Japan.

Endovascular embolization is generally thought to be safe and effective for the cavernous sinus dural arteriovenous fistula (CS DAVF); however, some complications have been reported. We report an extremely rare brainstem hemorrhage associated with transvenous embolization (TVE) of CS DAVF. A 66-year-old man presented with right-sided conjunctival chemosis and exophthalmos. Read More

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September 2021

Complications of renal interventions: a pictorial review of CT findings.

Insights Imaging 2021 Jul 18;12(1):102. Epub 2021 Jul 18.

Medical Imaging Department, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia.

A number of potential vascular and non-vascular complications can arise from surgical, extracorporeal shock wave lithotripsy, radiotherapy and radiological renal interventions, including percutaneous image-guided biopsy and drainage. Computed tomography scan is usually one of the first and most important diagnostic imaging examinations requested when a potential complication is suspected. There are a wide range of common and uncommon potential complications from renal interventions. Read More

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Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study.

Lancet 2021 07;398(10296):223-237

Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.

Background: COVID-19 is a multisystem disease and patients who survive might have in-hospital complications. These complications are likely to have important short-term and long-term consequences for patients, health-care utilisation, health-care system preparedness, and society amidst the ongoing COVID-19 pandemic. Our aim was to characterise the extent and effect of COVID-19 complications, particularly in those who survive, using the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK. Read More

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Fibroblast Activation Protein specific PET/CT imaging in fibrotic interstitial lung diseases and lung cancer: a translational exploratory study.

J Nucl Med 2021 Jul 16. Epub 2021 Jul 16.

University Hospital Heidelberg, Germany.

Interstitial lung diseases (ILD) comprise over 200 parenchymal lung disorders. Among them, fibrosing ILDs, especially idiopathic pulmonary fibrosis (IPF) in particular are associated with a poor prognosis, while some others ILDs like sarcoidosis have a much better prognosis. A high proportion of ILD manifests as fibrotic ILD (fILD). Read More

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Fluid Overload.

Bernie Hansen

Front Vet Sci 2021 29;8:668688. Epub 2021 Jun 29.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States.

Fluid overload (FO) is characterized by hypervolemia, edema, or both. In clinical practice it is usually suspected when a patient shows evidence of pulmonary edema, peripheral edema, or body cavity effusion. FO may be a consequence of spontaneous disease, or may be a complication of intravenous fluid therapy. Read More

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Strategies to Offer Uninterrupted Neurosurgical Care at a Tertiary Center in Makka amid COVID-19 Pandemic.

Mohammed A Azab

Asian J Neurosurg 2021 Apr-Jun;16(2):271-275. Epub 2021 May 28.

Department of Neurosurgery, King Abdullah Medical City, Makka, KSA.

Background: Globally, there is a shooting pandemic that affected many healthcare systems. Healthcare facilities had to set up logistics to avoid being drained while facing a catastrophic health problem. There are currently no available vaccines or perfect therapies and also no certified immunity against that disease. Read More

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Suture granuloma mimicking local recurrence of colon cancer after open right hemicolectomy: a case report.

Surg Case Rep 2021 Jul 14;7(1):164. Epub 2021 Jul 14.

Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.

Background: Foreign body granuloma is a rare surgery-related complication that can masquerade as cancer recurrence during postoperative surveillance. It may therefore deceive clinicians and lead to unnecessary interventions. The case presented herein demonstrates how a foreign body granuloma can be misleading in preoperative radiological studies and why this condition should not be ignored in differential diagnoses during surveillance of patients with previous history of abdominal surgery of any kind. Read More

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Post-tracheostomy tracheoinnominate fistula: endovascular treatment.

Rev Paul Pediatr 2021 7;40:e2020229. Epub 2021 Jul 7.

aHospital Federal dos Servidores do Estado, Ministry of Health, Rio de Janeiro, RJ, Brazil.

Objective: Tracheoinnominate fistula (TIF) is a rare and frequently lethal complication of tracheostomies. Immediate bleeding control and surgical treatment are essential to avoid death. This report describes the successful endovascular treatment of TIF in a preschooler and reviews the literature concerning epidemiology, diagnosis, prophylaxis, and treatment of TIF in pediatric patients. Read More

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Back somersault-induced atrioventricular nodal reentrant tachycardia - A case of a 15-year-old promising gymnast.

J Cardiol Cases 2021 Jul 26;24(1):14-19. Epub 2020 Dec 26.

Cardiology, Nephrology, Pulmonology and Neurology Division, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.

A male 15-year-old promising gymnast suffered palpitations, which emerged only after landing a round-off back somersault. The performance induced an attack of regular narrow QRS complex tachycardia that was highly reproducible. Not a single element of the performance, but a whole sequence of round-off back somersault was required to induce the attack. Read More

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Severe Chemosis: Initial Misdiagnosis of an Emergent Complication of Acute Rhinosinusitis.

J Emerg Med 2021 Jul 10. Epub 2021 Jul 10.

Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

Background: Orbital findings such as cellulitis, ophthalmoplegia, and proptosis are possible complications of sinusitis. Acute sinusitis can also cause a conjunctival cyst-like lesion induced by severe chemosis; however, it is an uncommon complication.

Case Report: We report the case of a 53-year-old man who presented to our facility's emergency department. Read More

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Optimizing diagnostic and staging pathways for suspected lung cancer: a decision analysis.

Chest 2021 Jul 10. Epub 2021 Jul 10.

Professor, Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address:

Background: The optimal diagnostic and staging strategy for patients with suspected lung cancer is not known.

Research Question: What diagnostic and staging strategies are most cost-effective for lung cancer?

Study Design And Methods: A decision model was developed using a hypothetical patient with a high probability of lung cancer. Sixteen unique permutations of bronchoscopy with fluoroscopy, radial endobronchial ultrasound (rEBUS), electromagnetic navigation, convex EBUS (cEBUS) with or without rapid-onsite evaluation (ROSE), computed tomography guided biopsy (CTBx) and surgery were evaluated. Read More

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Usefulness of digestive biopsy in the diagnosis of graft-versus-host disease.

Cir Pediatr 2021 Jul 1;34(3):125-129. Epub 2021 Jul 1.

Pediatric Surgery Department. La Fe Polytechnic and University Hospital. Valencia (Spain).

Introduction: Graft-versus-host disease (GVHD) is a frequent complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT), with high morbidity and mortality rates. Intestinal clinical signs are unspecific, which means differential diagnosis with infections and drug-related etiology should be carried out. Even though intestinal biopsy is widely considered as the gold standard technique, there is no consensus as to which sampling method is best. Read More

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Laparoscopic Appendectomy: A Safe and Definitive Solution for Suspected Appendicitis.

Visc Med 2021 Jun 5;37(3):180-188. Epub 2020 Oct 5.

Department of Anesthesiology, Bethlehem Gesundheitszentrum Stolberg (Rhld.), Stolberg, Germany.

Introduction: Since conservative antibiotic treatment in uncomplicated appendicitis might not solve the clinical problem definitively, it has to compete with the results of today's laparoscopic appendectomy.

Methods: In a county hospital, accommodating also a pediatric department, all cases of appendectomy for suspected appendicitis over 15 years were analyzed retrospectively for the following items: beginning of symptoms, time from admission to surgery, surgical technique as "open," "laparoscopic" or "converted," if perforated at operation and histological confirmation of acute inflammation. Surgical morbidity was detected in distinct categories. Read More

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Spontaneous Bilateral Tubal Ectopic Pregnancy in a Low-Risk Patient: A Case Report with Implications for Preoperative Patient Counseling.

Case Rep Obstet Gynecol 2021 19;2021:5588869. Epub 2021 Jun 19.

Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York, USA.

Bilateral tubal ectopic pregnancies (BTP) are the rarest form of ectopic pregnancy. They are difficult to diagnose preoperatively, and an evidence-based guideline for management does not exist. In this report, we discuss a 35-year-old patient who presented with suspected right tubal ectopic pregnancy. Read More

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A Case of Massive Lower Gastrointestinal Bleed from a Cystic Artery Pseudoaneurysm Bleeding through a Cholecystocolic Fistula.

Am J Case Rep 2021 Jul 11;22:e931921. Epub 2021 Jul 11.

Atlanta Gastroenterology Associates, Athens, GA, USA.

BACKGROUND Acute lower gastrointestinal bleeding (GIB) is often associated with favorable outcomes. It is readily diagnosed and managed with colonoscopy, or may resolve spontaneously. Rarely, extra-colonic sources of bleeding may masquerade as lower GIB, posing a diagnostic challenge and potentially lead to harm if there are therapeutic delays. Read More

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Peritoneal lesions caused by suspected to be metastases of ovarian malignancy.

BMJ Case Rep 2021 Jul 8;14(7). Epub 2021 Jul 8.

Microbiology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.

, also known as pinworm, is a helminth that commonly causes intestinal parasitic infestation. can also cause extraintestinal infestations. We report a case of lower abdominal pain and intermittent vaginal bleeding in a 45-year-old woman who was referred to our gynaecology department. Read More

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Acquired Gerbode Defect in a Patient With Infective Endocarditis of Bicuspid Aortic Valve.

Cureus 2021 May 31;13(5):e15352. Epub 2021 May 31.

Cardiovascular Disease, Mount Sinai Hospital, New York, USA.

Aortic valve abscess is a fatal complication of infective endocarditis. Transthoracic echocardiography is the initial imaging obtained in suspected infective endocarditis. However, its accuracy in detecting cardiac complications remains low, thus should be followed by transesophageal echocardiography if the clinical situation permits. Read More

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Subarachnoid-pleural fistula: To drain or not to drain.

Respir Med Res 2020 Aug 26;80:100786. Epub 2020 Aug 26.

Service de pneumologie et de soins intensifs, hôpital Européen Georges-Pompidou, AP-HP, Paris, France; Université de Paris, Paris, France; Inserm UMRS 11400, Paris, France. Electronic address:

Subarachnoid-pleural fistula (SPF) is a rare complication of spine surgery with a transthoracic approach. The outcome of such an injury is affected by not only the pulmonary status due to the pleural effusion but also the neurological one, secondary to the intracranial hypotension. After reviewing the few published cases of SPF, the journey to diagnosis seams heterogenous and the management plan non-uniform. Read More

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Late presentation of extrauterine adenomyomas after laparoscopic morcellation at hysterectomy: a case report.

BMC Womens Health 2021 07 7;21(1):269. Epub 2021 Jul 7.

College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Building 14, 505055, Dubai, United Arab Emirates.

Background: An adenomyoma is a well circumscribed form of adenomyosis and can be located within the myometrium, in the endometrium as a polyp, or extrauterine with the last being the rarest presentation amongst the three. With the ongoing advancement in gynecological surgery, the use of electromechanical morcellators have made the removal of large and dense specimens possible with minimally invasive techniques. However, it has also caused an increase in complications which were previously rare. Read More

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Neurological Complications After Electrochemotherapy Treatment in the Head and Neck Area.

Anticancer Res 2021 Jul;41(7):3519-3522

Örebro University, Örebro, Sweden.

Background/aim: Electrochemotherapy (ECT) is a predominately palliative treatment for cutaneous metastases where an electric field is used to increase the intracellular accumulation of a chemotherapeutic drug (bleomycin or cisplatin). ECT induces a strong anti-vascular effect and endothelial cells seem especially vulnerable. To date, almost no neurological and/or cerebrovascular complications after ECT treatment have been published. Read More

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Delayed leukoencephalopathy from suspected polymer embolism after neuroendovascular procedures.

Neuroradiol J 2021 Jul 5:19714009211029172. Epub 2021 Jul 5.

Department of Neurology, 11297Aarhus University Hospital, Aarhus University Hospital, Denmark.

As the neurointervention field grows, a new side effect emerges. Delayed leukoencephalopathy (DL) is believed to be an inflammatory or allergic reaction to polymer material that is shed from catheters during endovascular procedures. We present four cases of DL after aneurysm treatment in two patients, endovascular stroke treatment and diagnostic arteriography. Read More

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Elderly woman with a bleb leak.

Am J Ophthalmol Case Rep 2021 Sep 18;23:101126. Epub 2021 Jun 18.

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.

Purpose: To describe a unique incidence of inadvertent filtering bleb creation after intravitreal injections.

Observations: An 84-year-old woman with a history of wet age-related macular degeneration requiring intravitreal injections presented with a Seidel-positive conjunctival cyst. The cyst was in an area where she had received multiple injections and was suspected to be an inadvertent filtering bleb secondary to a full-thickness scleral hole created by these injections. Read More

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September 2021

Thyroidectomy-related Swallowing Difficulties: Review of the Literature.

Acta Clin Croat 2020 Jun;59(Suppl 1):38-49

1Clinical Department for ENT and Head and Neck Surgery, Zagreb University Hospital Centre, 2Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Croatia, 3School of Medicine, Zagreb University, Croatia, 4Faculty of Education and Rehabilitation Sciences University of Zagreb, Croatia.

This study aims to provide insight into the etiology and frequency of swallowing complications that arise after thyroidectomy and to outline the available diagnostic procedures by revising the existing literature on this topic. We conducted a bibliographic search using the electronic database MEDLINE/PubMed to identify all relevant articles and 44 studies were included in the review out of a total of 218 published articles. Dysphagia after thyroid surgery is a common postoperative complication which, in the short- or long-term, significantly affects patient life quality. Read More

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Traumatic perforations are associated with previous tympanostomy tube placement.

Int J Pediatr Otorhinolaryngol 2021 Jun 26;148:110812. Epub 2021 Jun 26.

Department of Otolaryngology - Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, USA.

Introduction: Recognized late complications of tympanostomy tube placement include persistent tympanic perforation, tympanosclerosis, and focal atrophy. Based on clinical experience, we suspected that atrophy at healed tympanostomy tube sites might predispose to re-perforation following trauma.

Methods: Computerized record review of children seen in an academic pediatric otolaryngology practice from January 2001 to December 2020. Read More

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