Reports

6 pages, 580 KiB

Open AccessCase Report

Social Isolation as a Precipitating Factor for Charles Bonnet Syndrome in a Patient with Mild Visual Deterioration

by Shriya Prakash Bhat, Abeezar Shipchandler and Chris Tokunaga

Reports 2024, 7(3), 65; https://doi.org/10.3390/reports7030065 (registering DOI) - 2 Aug 2024

Charles Bonnet Syndrome (CBS) is characterized by complex visual hallucinations in individuals with acute vision loss, typically affecting older adults. Most CBS cases are observed in patients with sudden severe visual impairment; however, there are limited reports of CBS occurring in individuals with [...] Read more.

Charles Bonnet Syndrome (CBS) is characterized by complex visual hallucinations in individuals with acute vision loss, typically affecting older adults. Most CBS cases are observed in patients with sudden severe visual impairment; however, there are limited reports of CBS occurring in individuals with mild visual deterioration, particularly when confounded by sensory deprivation and social isolation. Here, we report a case of CBS in a female in her early 80s, who experienced vivid visual hallucinations during a period of prolonged social isolation following a hip surgery. Although symptomatology initially presented as delirium and psychosis, the diagnosis of CBS was confirmed after a neuropsychiatric evaluation and ophthalmologic exam, which showed mild deterioration in the patient’s macular degeneration, combined with a social history of reduced independence and increased isolation. The case highlights the lesser-known role of sudden lifestyle changes and reduced cognitive engagement in CBS development in cases of mild visual impairment. It also suggests that cognitive and social stimulation may play a crucial role in CBS management, which has limited reports in the current literature. Full article

(This article belongs to the Section Mental Health)

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11 pages, 1381 KiB

Open AccessArticle

Is It Necessary to Add the Feedback Insufflation Time in Manikins? A Simulation Pilot Study

by Luis Castro-Alonso, Eloy Carracedo-Rodríguez, Martín Otero-Agra, Sheila Vázquez-Álvarez, Roberto Barcala-Furelos and María Fernández-Méndez

Reports 2024, 7(3), 64; https://doi.org/10.3390/reports7030064 - 1 Aug 2024

Abstract

(1) Objective: This study aimed to assess the evolution of the quality of ventilations of a group of rescuers after two training sessions by taking into account inspiration times. (2) Materials and Methods: A pilot simulation study was carried out with a sample [...] Read more.

(1) Objective: This study aimed to assess the evolution of the quality of ventilations of a group of rescuers after two training sessions by taking into account inspiration times. (2) Materials and Methods: A pilot simulation study was carried out with a sample of 10 lifeguard students. Two training sessions were held three weeks apart, in which CPR skills were trained by means of feedback tools. Participants performed three tests in pairs on a ResusciAnne QCPR^® manikin connected to SkillReporter QCPR software, namely one pre-training test and one test after each training session. CPR was performed in pairs for two minutes and began with five rescue breaths. (3) Results: One training session was enough to improve chest compression quality (T0: 48%; IQR 17–77/T1: 83%; IQR 59–88; p = 0.022/T2: 79%; IQR 64–92; p = 0.002). The quality of the ventilations increased progressively in each training session without reaching high-quality results (T0: 0%; IQR 0–0/T2: 15%; IQR 8–27; p = 0.011). (4) Conclusion: A two-session training program focused on inspiratory times achieved significant improvements in the quality of bag-mask ventilations performed by lifeguard students. Training focused on the insufflation time of ventilations and not only on the volume seems to be an important factor in improving the quality of ventilations. Full article

(This article belongs to the Section Critical Care/Emergency Medicine/Pulmonary)

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6 pages, 2340 KiB

Open AccessCase Report

Multimodal Management of a Descending Aorta Injury with Penetrating Chest Trauma: A Case Report

by Giuseppe Sena, Paolo Perri, Paolo Piro, Francesco Zinno, Daniela Mazzuca, Davide Costa and Raffaele Serra

Reports 2024, 7(3), 63; https://doi.org/10.3390/reports7030063 - 1 Aug 2024

Abstract

A penetrating thoracic aorta injury (PTAI) is a life-threatening condition with significant morbidity and mortality, often resulting from several traumatic mechanisms. Among these, gunshot wounds leading to aortic injury are exceedingly rare and pose unique challenges in terms of diagnosis, management, and surgical [...] Read more.

A penetrating thoracic aorta injury (PTAI) is a life-threatening condition with significant morbidity and mortality, often resulting from several traumatic mechanisms. Among these, gunshot wounds leading to aortic injury are exceedingly rare and pose unique challenges in terms of diagnosis, management, and surgical intervention. We present a case of a 47-year-old male victim of a gunshot wound resulting in penetrating chest trauma and a descending thoracic aorta injury. This report outlines the sequential management involving thoracic endovascular aortic repair (TEVAR), followed by surgical intervention for hematoma drainage and foreign body removal, highlighting the interdisciplinary approach required in managing complex cardiothoracic injuries. Full article

(This article belongs to the Section Critical Care/Emergency Medicine/Pulmonary)

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10 pages, 30058 KiB

Open AccessCase Report

Optimization of Collagen Scaffold with Cultured Autologous Chondrocytes for Osteochondritis Dissecans of the Knee: A Case Report

by Nicolas Valladares, Gibran J. Jacobo-Jimenez, Nathaniel Lara-Palazuelos and Maria G. Zavala-Cerna

Reports 2024, 7(3), 62; https://doi.org/10.3390/reports7030062 - 30 Jul 2024

Abstract

The treatment of osteochondritis dissecans of the knee has always been a challenge for orthopedic surgeons. We present a case report of a 38-year-old male with severe right knee pain after suffering from an indirect trauma and axial rotation of the knee, limiting [...] Read more.

The treatment of osteochondritis dissecans of the knee has always been a challenge for orthopedic surgeons. We present a case report of a 38-year-old male with severe right knee pain after suffering from an indirect trauma and axial rotation of the knee, limiting knee functionality and impeding his ability to walk, with a diagnosis of osteochondritis dissecans in the trochlea of the knee, who underwent arthroscopic treatment with matrix-induced autologous chondrocyte implantation (MACI). After the surgery, a physical therapy protocol for MACI was implemented, and magnetic resonance images with cartilage mapping were used to evaluate the recovery of the lesion. A total recovery was observed and evaluated with the modified Cincinnati knee rating system (mCKRS). A discussion is provided with evidence and general recommendations for the use of MACI in the treatment of adult OCD of the knee as a possible alternative to conventional treatments. Our case shows a rapid improvement in pain and functionality 2 months after surgery that progressed to full recovery within 6 months. Full article

(This article belongs to the Special Issue Orthopedic and Trauma Surgery: Clinical Research and Case Reports)

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11 pages, 958 KiB

Open AccessArticle

Association of SARS-CoV-2 Seropositivity with Persistent Immune Activation in HIV/Tuberculosis Co-Infected Patients

by Ashwini Shete, Manisha Ghate, Hiroko Iwasaki-Hozumi, Sandip Patil, Pallavi Shidhaye, Takashi Matsuba, Gaowa Bai, Pratiksha Pharande and Toshio Hattori

Reports 2024, 7(3), 61; https://doi.org/10.3390/reports7030061 - 29 Jul 2024

Abstract

We asked if SARS-CoV-2 seropositivity in HIV/TB co-infected patients plays a role in precipitating active tuberculosis in HIV-infected individuals and alters inflammatory status. A prospective study was conducted on HIV/TB co-infected patients presenting with pulmonary (n = 20) or extrapulmonary (n [...] Read more.

We asked if SARS-CoV-2 seropositivity in HIV/TB co-infected patients plays a role in precipitating active tuberculosis in HIV-infected individuals and alters inflammatory status. A prospective study was conducted on HIV/TB co-infected patients presenting with pulmonary (n = 20) or extrapulmonary (n = 12) tuberculosis. Abbott SARS-CoV-2 IgG kits assessed the presence of anti-nucleoprotein antibodies. Inflammatory markers viz. osteopontin, total and full-length galectin-9, and C-reactive protein were tested at baseline and the end of antituberculosis treatment. The inflammatory score (INS) was assessed based on the percentage of reduction in the inflammatory markers’ levels at the end of the treatment. Anti-SARS-CoV-2 antibodies were detected in five male patients diagnosed with pulmonary (n = 2) and extrapulmonary (n = 3) TB. None of them reported symptomatic COVID-19. Inflammatory marker levels did not differ significantly at baseline compared to those in seronegative patients. However, the INS correlated negatively with SARS-CoV-2 seropositivity (r = −0.386, p = 0.039), indicating persistently raised inflammatory markers in these patients at the end of the treatment compared to seronegative individuals. Among the four markers studied, total galectin-9 levels failed to decrease significantly in these patients (p = 0.030). The majority of HIV/TB co-infected patients enrolled in our study (84.5%) were SARS-CoV-2-seronegative, indicating that SARS-CoV-2 infection might not have played a role in precipitating TB reactivation. Full article

(This article belongs to the Special Issue Acute and Persistent Viral Infection Diseases)

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12 pages, 1819 KiB

Open AccessArticle

Diagnosis of Relapse of Colorectal Adenocarcinoma through CEA Fluctuation

by Zsolt Fekete, Patricia Ignat, Laura Gligor, Nicolae Todor, Alina-Simona Muntean, Alexandra Gherman and Dan Eniu

Reports 2024, 7(3), 60; https://doi.org/10.3390/reports7030060 - 27 Jul 2024

Abstract

Carcinoembryonic antigen(CEA) is a routine marker employed for follow-up of colorectal tumors. We aimed to determine whether a CEA increase within the normal range can be linked to a risk of recurrence. From the period of 2006–2013 we selected 78 consecutive patients with [...] Read more.

Carcinoembryonic antigen(CEA) is a routine marker employed for follow-up of colorectal tumors. We aimed to determine whether a CEA increase within the normal range can be linked to a risk of recurrence. From the period of 2006–2013 we selected 78 consecutive patients with colorectal cancer, who underwent curative surgery with or without neo-/adjuvant chemo- or radiotherapy and had proper follow-up procedures. For analyzing CEA fluctuation, we used the smallest value of the CEA during follow-up as the reference. With the aid of a Chi-squared test, we have chosen the value of 1.1 ng/mL for significant CEA fluctuation. A total of 43.6% of patients had fluctuations in CEA of at least 1.1 ng/mL, with or without increases above 5 ng/mL. From these, in 79.4% of patients, the increases in CEA were explained either by recurrence (44.1%), adjuvant chemotherapy (20.6%) or benign pathology (14.7%). In 23% of the recurrences, a CEA increase of at least 1.1 ng/mL, but below 5 ng/mL, preceded the clinical relapse by a median of 8 months. Our conclusion is that an increase in CEA levels by at least 1.1 ng/mL within the normal range after curative treatment for colorectal cancer may serve as an early indicator of relapse or could be associated with other pathological conditions. Full article

(This article belongs to the Collection Clinical Research in Oncology)

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4 pages, 1505 KiB

Open AccessCase Report

Popliteal Arteriovenous Fistula Diagnosed Eight Years after Total Knee Arthroplasty. Endovascular Treatment with Viabahn^® Endoprosthesis and Five-Year Follow-Up

by Francisco Santiago Lozano-Sánchez, Jesús García-Alonso, Roberto Salvador-Calvo, Luis Velasco-Pelayo and María Begoña García-Cenador

Reports 2024, 7(3), 59; https://doi.org/10.3390/reports7030059 - 25 Jul 2024

Abstract

Background: Orthopedic surgery, while it rarely cause iatrogenic vascular lesions, leads to significant clinical, social, and economic consequences when it does. The knee is particularly susceptible to these injuries. Case Description: This case study presents the clinical case of a 71-year-old woman with [...] Read more.

Background: Orthopedic surgery, while it rarely cause iatrogenic vascular lesions, leads to significant clinical, social, and economic consequences when it does. The knee is particularly susceptible to these injuries. Case Description: This case study presents the clinical case of a 71-year-old woman with a history of left total knee replacement. Eight years after the initial procedure, a popliteal—popliteal arteriovenous fistula was identified in the same knee. Given the location and caliber of the fistula, and despite the absence of symptoms, an endovascular prosthesis (Viabahn^®) was deployed in the popliteal artery to cover the fistula. The prosthesis remained intact for the remainder of the patient’s life, who succumbed to metastatic cancer five years later. Additionally, a review of the literature was conducted. Conclusion: This brief report describes an exceptional case of popliteal arteriovenous fistula, diagnosed eight years after a TKA, treated endovascularly and followed up over five years. Both pseudoaneurysms and arteriovenous fistulae should also be considered for early detection. Full article

(This article belongs to the Section Cardiology/Cardiovascular Medicine)

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7 pages, 3171 KiB

Open AccessCase Report

Myxolipoma of the Popliteal Fossa: A Rare Tumor Case Report

by Yuchen You, Jessica Cao, Brandon Nguyen, Melanie Gero and Karim Jreije

Reports 2024, 7(3), 58; https://doi.org/10.3390/reports7030058 - 25 Jul 2024

Abstract

Myxolipomas are rare variants of lipomas characterized by abundant myxoid changes resulting from an abundant mucoid component. While myxolipomas have been reported in various anatomical locations, their occurrence in the popliteal fossa is exceptionally rare, with the last published case dating back to [...] Read more.

Myxolipomas are rare variants of lipomas characterized by abundant myxoid changes resulting from an abundant mucoid component. While myxolipomas have been reported in various anatomical locations, their occurrence in the popliteal fossa is exceptionally rare, with the last published case dating back to 1914. We present a case of a 64-year-old male with a large myxolipoma in the popliteal region. The patient underwent successful surgical excision, and a histopathological examination confirmed the diagnosis of myxolipoma. This case report highlights the clinical features, differential diagnosis, and diagnostic challenges associated with myxolipomas in the popliteal fossa. Full article

(This article belongs to the Section Oncology)

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10 pages, 1207 KiB

Open AccessCase Report

The Effects of Hybrid Tele Airway Clearance in Bronchiectasis Patients: A Case Series

by Aung Aung Nwe, Nimit Kosura, Chatchai Phimphasak, Pornthip Barnludech, Si Thu Aung, Worawat Chumpangern and Chulee Ubolsakka-Jones

Reports 2024, 7(3), 57; https://doi.org/10.3390/reports7030057 - 19 Jul 2024

Abstract

This study aims to evaluate the preliminary effects of a hybrid tele-supervised airway clearance protocol on secretion clearance, health-related quality of life, and patient satisfaction in bronchiectasis patients. A single-arm experimental pilot case series with three participants was conducted, involving six ACT sessions [...] Read more.

This study aims to evaluate the preliminary effects of a hybrid tele-supervised airway clearance protocol on secretion clearance, health-related quality of life, and patient satisfaction in bronchiectasis patients. A single-arm experimental pilot case series with three participants was conducted, involving six ACT sessions over three days, including one onsite supervised session and five tele-supervised sessions. Assessment measures comprised sputum expectoration, COPD assessment test (CAT), and participant satisfaction ratings. The results showed increased sputum expectoration rates during each ACT session, alongside notable improvements in CAT scores (reductions of 16, 8, and 8 points for each participant). Participants expressed high satisfaction with tele-supervised sessions and reported increased confidence in independent ACT performance post-program. The findings suggest that the hybrid ACT program may be a promising avenue for enhancing bronchiectasis management. However, further research with larger sample sizes and rigorous control groups is necessary to validate its efficacy and broader applicability. Full article

(This article belongs to the Section Orthopaedics/Rehabilitation/Physical Therapy)

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5 pages, 865 KiB

Open AccessCase Report

Intradural Melanotic Schwannoma of the Sacral Spine: An Illustrated Case Report of Diagnostic Conundrum

by Jiunn-Kai Chong, Navneet Kumar Dubey and Wen-Cheng Lo

Reports 2024, 7(3), 56; https://doi.org/10.3390/reports7030056 - 16 Jul 2024

Abstract

Schwannomas are benign and slow-growing peripheral nerve sheath neoplasms of Schwann cells. These are generally encountered in the neck, head, and flexor areas of the extremities. Even though many schwannomas are easily diagnosable, their variable morphology can occasionally create difficulty in diagnosis. In [...] Read more.

Schwannomas are benign and slow-growing peripheral nerve sheath neoplasms of Schwann cells. These are generally encountered in the neck, head, and flexor areas of the extremities. Even though many schwannomas are easily diagnosable, their variable morphology can occasionally create difficulty in diagnosis. In this study, we present a rare case of melanotic schwannoma of the sacrum, emphasizing the need for routine biopsy to understand the etiology. A 46-year-old man presented to the Department of Neurosurgery, Taipei Medical University Hospital, with buttock pain in the sacrum area for 1 year, which worsened in the last 1–2 months. The patient had no known history of trauma or malignancy. We evidenced an intradural extramedullary neurogenic tumor at the caudal end from S1 to S3. Histologic analysis revealed melanin deposition in the tumor cells. Round to oval tumor cells were positive for HMB-45 and S-100 proteins, suggestive of melanotic Schwannoma, which were removed by laminectomy. After 1 month, the tumor recurred and was further removed surgically. Conclusively, we observed the sacrum as an unusual anatomic site for the possible occurrence of melanotic schwannoma, especially in patients with no known history of trauma and malignancy. The possibility of melanotic schwannoma is very high. We hypothesize that melanotic schwannoma was possible because it occurred in the intradural and extramedullary regions of the spine. Hence, a routine biopsy should be performed to corroborate the exact cause and prevent incorrect presumptions. Full article

(This article belongs to the Section Neurology)

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7 pages, 5123 KiB

Open AccessCase Report

Concurrent Onset of Central Retinal Vein Occlusion and Inflammation of a Large Maxillary Odontogenic Cyst: Case Report and Analysis

by Vlatko Kopić, Andrijana Kopić, Mihael Mišir and Sanjin Petrović

Reports 2024, 7(3), 55; https://doi.org/10.3390/reports7030055 - 14 Jul 2024

Abstract

Central retinal vein occlusion typically manifests in older individuals with underlying systemic pathology, leading to a spectrum of symptoms ranging from blurred vision to complete vision loss. While odontogenic infections are recognized for causing complications affecting the eye and vision, their potential role [...] Read more.

Central retinal vein occlusion typically manifests in older individuals with underlying systemic pathology, leading to a spectrum of symptoms ranging from blurred vision to complete vision loss. While odontogenic infections are recognized for causing complications affecting the eye and vision, their potential role as an etiological factor in cases of sudden vision impairment merits consideration. This article presents a case involving central retinal vein thrombosis, wherein resolution was achieved through a combination of ophthalmic therapy and the surgical removal of a concurrently existing large inflamed odontogenic cyst located in the ipsilateral hemimaxilla. This case underscores the importance of recognizing odontogenic factors in the assessment of sudden vision impairment and the efficacy of a multidisciplinary therapeutic approach. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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7 pages, 207 KiB

Open AccessCase Report

Anisometropic Patient and Current Bioelectrical Activity in the Masticatory and Cervical Muscles

by Grzegorz Zieliński, Anna Woźniak, Michał Ginszt, Jacek Szkutnik, Nicola Marchili, Marcin G. Prost, Piotr Gawda and Robert Rejdak

Reports 2024, 7(3), 54; https://doi.org/10.3390/reports7030054 - 10 Jul 2024

Abstract

(1) Background: This study aims to analyze the bioelectrical activity of the masticatory and cervical muscles in a subject with anisometropia. (2) Methods: A female patient aged 23 years with a best-corrected visual acuity of 1.0 in the right eye and 0.1 in [...] Read more.

(1) Background: This study aims to analyze the bioelectrical activity of the masticatory and cervical muscles in a subject with anisometropia. (2) Methods: A female patient aged 23 years with a best-corrected visual acuity of 1.0 in the right eye and 0.1 in the left eye, a refractive error of −2.25 Dsph in the right eye and +4.25 Dsph in the left eye, and astigmatism of −1.75 Dcyl axis 24° was examined. A comprehensive ophthalmological examination and the study of the bioelectrical activity of the muscles were carried out. During the ophthalmological examination, best-corrected visual acuity was determined, refractive error (spherical equivalent) was assessed, and additionally, retinal thickness, choroidal thickness, axial length, and intraocular pressure were measured. (3) Results: It was demonstrated that higher tension in the resting mandibular position and pain-free maximum unassisted opening were observed on the right side (myopia). Conversely, higher tension during maximum voluntary clenching in the intercuspal position and maximum voluntary clenching on dental cotton rolls in the intercuspal position was observed on the left side (hyperopia and astigmatism). (4) Conclusions: In the case study, muscle asymmetry was demonstrated, which is likely associated with anisometropia. This phenomenon requires further investigation. Full article

(This article belongs to the Section Ophthalmology)

8 pages, 2852 KiB

Open AccessCase Report

ADEM as an Initial Presentation of SLE: A Case Report

by Yousuf Sherwani, Ayham Alsaab and Mohan Sengodan

Reports 2024, 7(3), 53; https://doi.org/10.3390/reports7030053 - 5 Jul 2024

Abstract

Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder of the white matter. The pathophysiology is thought to be immune-mediated as in most cases the condition follows an infection or triggering incident. More recent literature has demonstrated that there may be a link [...] Read more.

Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder of the white matter. The pathophysiology is thought to be immune-mediated as in most cases the condition follows an infection or triggering incident. More recent literature has demonstrated that there may be a link between autoimmune conditions and ADEM. Here we present a case of ADEM in a middle-aged woman with systemic lupus erythematosus that recovered well after treatment with corticosteroids and rituximab. Full article

(This article belongs to the Section Allergy/Immunology)

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11 pages, 1142 KiB

Open AccessArticle

Factors Influencing Abdominal Compliance during CO₂ Insufflation in Patients Undergoing Laparoscopic Abdominal Surgery

by Ezgi Yıldırım, K. Sanem Cakar Turhan, Aysegul Güven, Derya Gökmen and Menekse Özcelik

Reports 2024, 7(3), 52; https://doi.org/10.3390/reports7030052 - 28 Jun 2024

Abstract

The aim of this study was to investigate the effect of patient demographic and anatomical characteristics on abdominal compliance (AC), which represents the slope of the pressure–volume (P–V) curve of the abdominal cavity and is a measure of the ease of abdominal dilatation. [...] Read more.

The aim of this study was to investigate the effect of patient demographic and anatomical characteristics on abdominal compliance (AC), which represents the slope of the pressure–volume (P–V) curve of the abdominal cavity and is a measure of the ease of abdominal dilatation. The study included 90 patients undergoing laparoscopic abdominal surgery. Subcutaneous adipose tissue and abdominal muscle thickness were measured using ultrasonography. The mean AC was calculated during insufflation using the formula (ΔV/ΔP). The relationship between demographic and anatomical variables and AC was investigated. The results demonstrated that AC was higher in men, the elderly, and women with a history of pregnancy, and lower in patients with a history of abdominal surgery. No significant correlation was found between AC and BMI, abdominal muscle thickness, and subcutaneous adipose tissue thickness. These findings suggest that morbid obesity, a common comorbidity in laparoscopic surgery, and well-developed abdominal muscles are not indicators of low AC. However, gender, age, pregnancy history, and previous abdominal surgery affect AC during laparoscopic surgery. By taking these factors into account during preoperative evaluation, it may be possible to predict patients with low AC, which could improve perioperative outcomes through the application of individualized intra-abdominal pressure (IAP) during pneumoperitoneum. Full article

(This article belongs to the Section Surgery)

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6 pages, 3804 KiB

Open AccessInteresting Images

Gingival Cyst of the Adult: A Case Description with a Relevant Literature Analysis

by Marta Forte, Antonio d’Amati, Alfonso Manfuso, Massimiliano Vittoli, Giorgia Girone, Eliano Cascardi and Saverio Capodiferro

Reports 2024, 7(3), 51; https://doi.org/10.3390/reports7030051 - 24 Jun 2024

Abstract

Gingival cysts of the adult are rare and benign odontogenic lesions of the oral cavity, accounting for almost 0.3% of all odontogenic cysts. Their differential diagnosis is still challenging for surgeons as it includes other gingival inflammatory or non-inflammatory lesions and peripheral odontogenic [...] Read more.

Gingival cysts of the adult are rare and benign odontogenic lesions of the oral cavity, accounting for almost 0.3% of all odontogenic cysts. Their differential diagnosis is still challenging for surgeons as it includes other gingival inflammatory or non-inflammatory lesions and peripheral odontogenic tumors. The aim of this paper is to report a new case occurring in an adult, analyzing the clinical, radiographic, and histopathological features as guidelines for a differential diagnosis. We report a 49-year-old patient complaining of a small, pigmented lesion localized on the attached gingiva with no history of trauma, which was surgically excised and histologically diagnosed as a gingival cyst. A differential diagnosis may be challenging for clinicians it includes a wide spectrum of inflammatory and non-inflammatory lesions, so a correct diagnostical–therapeutical approach is needed to avoid possible overtreatment and minimize the recurrence rate. Full article

(This article belongs to the Special Issue Clinical Research on Oral Diseases)

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6 pages, 2178 KiB

Open AccessCase Report

Facial Cellulitis of Unusual Odontogenic Origin

by Alexandre Perez, Valerio Cimini, Vincent Lenoir and Tommaso Lombardi

Reports 2024, 7(3), 50; https://doi.org/10.3390/reports7030050 - 21 Jun 2024

Abstract

A healthy man in his 40s was referred to the Oral Surgery and Implantology Unit of Geneva University Hospital for diagnosis and management of facial swelling affecting the right side of his lower jaw. The patient’s history revealed that the patient had been [...] Read more.

A healthy man in his 40s was referred to the Oral Surgery and Implantology Unit of Geneva University Hospital for diagnosis and management of facial swelling affecting the right side of his lower jaw. The patient’s history revealed that the patient had been hit by several punches to the face a few months earlier. To investigate the swelling, an intra-oral radiograph, an orthopantomographic radiograph, and computed tomography were performed, which revealed no fracture of the lower jaw but the presence of a partly impacted fractured wisdom tooth (third molar). This finding, together with the clinical status, indicated cellulitis most likely related to the presence of a fractured wisdom tooth. The decision was made to proceed with tooth extraction, and follow-up at 3 weeks showed good healing and complete resolution of facial swelling. This case highlights that odontogenic infection can also occur as a result of necrosis following the fracture of an impacted wisdom tooth. Full article

(This article belongs to the Section Dentistry/Oral Medicine)

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10 pages, 5256 KiB

Open AccessCase Report

Primary Melanoma of the Pineal Gland Case Report and Review of the Literature

by Daniel Rotariu, Bogdan F. Iliescu, Gabriela Dumitrescu, Antonia Nita and Bogdan Costachescu

Reports 2024, 7(2), 49; https://doi.org/10.3390/reports7020049 - 20 Jun 2024

Abstract

Pineal-region tumors are a histologically heterogeneous group of tumors and represent a rare occurrence, accounting for less than 1% of all adult intracranial tumors. Among these, primary pineal malignant melanomas (PPM) represent an even rarer entity, with only twenty-five cases being reported in [...] Read more.

Pineal-region tumors are a histologically heterogeneous group of tumors and represent a rare occurrence, accounting for less than 1% of all adult intracranial tumors. Among these, primary pineal malignant melanomas (PPM) represent an even rarer entity, with only twenty-five cases being reported in the literature to date. We present the case of a 65-year-old patient who presented in our department for progressive headache, gait disturbance and memory impairment. Magnetic resonance imaging (MRI) of the brain revealed a solid mass in pineal region, measuring 2.2 × 1.2 × 2.0 cm and causing obstructive hydrocephalus. He underwent a third ventriculostomy, but we failed to obtain a sample for diagnostic purposes. The intraoperative surprise was the presence, at the level of the third ventricle, of multiple melanin deposits, which were not picked up by the MRI. Although the biopsy could not be performed and had to be obtained by stereotactic biopsy in a second intervention, the endoscopy findings allowed for the correct staging of the intracranial disease and appropriate treatment management. Full article

(This article belongs to the Section Oncology)

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6 pages, 6409 KiB

Open AccessCase Report

Complete Left-Sided Pericardial Congenital Absence

by Petar Kalaydzhiev, Anelia Partenova, Radostina Ilieva, Kamelia Genova and Elena Kinova

Reports 2024, 7(2), 48; https://doi.org/10.3390/reports7020048 - 20 Jun 2024

Abstract

Background: Congenital absence of pericardium is a rare cardiac disorder with a reported incidence of less than 1 in 10,000. Although most of the cases are of little clinical significance, some of them are associated with serious complications, including risk of herniation and [...] Read more.

Background: Congenital absence of pericardium is a rare cardiac disorder with a reported incidence of less than 1 in 10,000. Although most of the cases are of little clinical significance, some of them are associated with serious complications, including risk of herniation and strangulation or coronary artery compression. Detailed Case Description: We report a case of a 36-year-old male referred for routine cardiovascular examination. He had a medical history of a heart murmur since childhood. Electrocardiogram (ECG) revealed sinus rhythm, normal axis, poor R-wave progression in the precordial leads and repolarization abnormalities with negative T waves in leads V1–V4. On 2D transthoracic echocardiography (TTE), an unusual heart position was noted with poor image quality from the standard acoustic windows. The parasternal long axis view gave the impression of right ventricular dilatation. The findings raised the suspicion of left to right shunt and possible atrial septal defect. For further evaluation, the patient was referred for cardiac magnetic resonance which demonstrated complete left-sided absence of the pericardium. Discussion: Due to indistinct and atypical symptoms and lack of clinical awareness, pericardial congenital absence is frequently misdiagnosed. Patients may complain of atypical chest pain. Patient’s history and physical examination are often nonspecific. In cases with complete pericardial absence, ECG findings may include right axis deviation, right bundle block and sinus bradycardia. Echocardiography findings are also not characteristic, but some may raise the clinical suspicion of this diagnosis. The imaging modalities of choice are computed tomography and cardiac magnetic resonance. Treatment depends on the type of defect and clinical symptoms. Full article

(This article belongs to the Section Cardiology/Cardiovascular Medicine)

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6 pages, 194 KiB

Open AccessCase Report

Successfully Anticipated Difficult Airway Management of a “Can Ventilate, but Cannot Intubate” Situation for Urgent Laparoscopic Appendectomy in a Patient with Duchenne Muscular Dystrophy

by Fabian P. Brunner, Philippe Neth and Alexander Kaserer

Reports 2024, 7(2), 47; https://doi.org/10.3390/reports7020047 - 14 Jun 2024

Abstract

Background: Airway management in Duchenne patients can be challenging. We present a case of an anticipated difficult airway in a 24-year-old Duchenne patient that was managed by planning different suitable strategies based on the unanticipated difficult airway algorithm of the Difficult Airway Society [...] Read more.

Background: Airway management in Duchenne patients can be challenging. We present a case of an anticipated difficult airway in a 24-year-old Duchenne patient that was managed by planning different suitable strategies based on the unanticipated difficult airway algorithm of the Difficult Airway Society (DAS). Case presentation: The patient initially presented with appendicitis, requiring a laparoscopic appendectomy within 6 h. Due to the underlying condition and a known difficult airway, we anticipated potential airway problems and successfully managed the “can ventilate but cannot intubate” situation using the algorithm. The difficult airway was attributed to reduced mandibular mobility, limited inclination or reclination, a large tongue, prominent incisors, and a posteriorly positioned epiglottis. Despite thorough preparation and team briefing, we experienced three failed intubation attempts. Considering limited nighttime resources, the urgency of the surgery, the need for a tube for laparoscopy, and the risk of exacerbating airway issues, we made the decision to awaken the patient and wait for a second attempt after the epiglottis swelling had subsided. We used reversible, short-acting agents for induction, enabling us to continue with the algorithm within the allotted timeframe. In a second stage, we successfully performed fiberoptic-guided intubation via a supraglottic airway device using the Aintree intubation catheter, utilizing more favorable resources. Conclusions: For a patient with Duchenne muscular dystrophy and a difficult airway, advanced expertise is critical. Detailed anesthesia planning, clear team communication, and the use of reversible, short-acting agents are crucial. Adherence to the Difficult Airway Society guidelines is essential for safe airway management. Full article

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