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Ophthalmology and Therapy Dec 2021To describe a simple technique of diamond burr-assisted superficial keratectomy for the treatment of peripheral corneal edema.
PURPOSE
To describe a simple technique of diamond burr-assisted superficial keratectomy for the treatment of peripheral corneal edema.
CASES PRESENTATION
Two patients with persistent symptomatic peripheral corneal edema underwent superficial keratectomy with the use of a diamond ophthalmic burr. The efficacy of the treatment was evaluated clinically as well as with anterior segment optical coherence tomography. During the postoperative follow-up period, no adverse events were observed and corneal edema reduced significantly. The patients were asymptomatic, no epithelial cysts could be identified clinically, and visual acuity remained unchanged.
CONCLUSION
Peripheral superficial keratectomy could be an effective alternative for the treatment of peripheral, symptomatic corneal edema.
PubMed: 34283411
DOI: 10.1007/s40123-021-00370-1 -
Medicina 2023The complex, heterogeneous, and dynamic interaction between the interstitial and intravascular fluid compartments is one of the main reasons for the wide variability in...
The complex, heterogeneous, and dynamic interaction between the interstitial and intravascular fluid compartments is one of the main reasons for the wide variability in the distribution and severity of congestion among patients with acute heart failure. The "hemodynamic congestion" often goes undetected clinically; as opposed to "clinical congestion", which occurs later and is evidenced by dyspnea and orthopnea, rales, peripheral edema, and jugular venous distension. Clinical signs, chest X-ray, brain natriuretic peptide (BNP) or N-terminal-proBNP (NT-proBNP), central venous pressure (CVP), echocardiogram, inferior vena cava (IVC) diameter, and pulmonary wedge pressure are the most commonly used elements to assess congestion. Other alternatives are pulmonary and visceral ultrasound (VEXUS), CA 125 and other markers, and recently, the CardioMems system.
Topics: Humans; Heart Failure; Natriuretic Peptide, Brain; Edema; Ultrasonography; Echocardiography; Dyspnea; Peptide Fragments
PubMed: 38117713
DOI: No ID Found -
BMJ Case Reports Mar 2021A 59-year-old man presented with exertional dyspnoea and pretibial oedema that had lasted 6 months. He was referred to our hospital with suspected constrictive...
A 59-year-old man presented with exertional dyspnoea and pretibial oedema that had lasted 6 months. He was referred to our hospital with suspected constrictive pericarditis (CP). Several examinations, including CT, echocardiography and cardiac catheterisation, indicated heart failure associated with CP that had been induced by trauma 13 years prior. The CP and heart failure were unresponsive to medical treatment, therefore, a surgical pericardiectomy was performed, which is considered the only definitive treatment. Pathological examination of the resected pericardium revealed a fatty texture and dense fibrous connective tissues, which are associated with old haemorrhage and focal calcification. The patient's symptoms were improved to New York Heart Association Class I, and his peripheral oedema disappeared 6 months after leaving hospital.
Topics: Echocardiography; Heart Failure; Humans; Male; Middle Aged; Pericardiectomy; Pericarditis, Constrictive; Pericardium
PubMed: 33727294
DOI: 10.1136/bcr-2020-240235 -
Journal of Thrombosis and Haemostasis :... Jan 2019Essentials Phlebitis is one of the most frequent complications related to short peripheral catheters (SPC). A new SPC design, aimed for minimizing mechanical phlebitis,...
Essentials Phlebitis is one of the most frequent complications related to short peripheral catheters (SPC). A new SPC design, aimed for minimizing mechanical phlebitis, was tested in vivo in swine. MRI analysis revealed 40% less inflammation with the new SPC design compared to commercial SPC. The results confirm that our SPC biomechanical design approach can minimize phlebitis rates. SUMMARY: Background Short peripheral catheters (SPCs) are the most common intravenous device in today's medical practice. Short peripheral catheter thrombophlebitis (SPCT) occurs in up to 80% of hospitalized patients. Symptoms appear on average 3 days after catheter insertion and can lead to extended hospitalization and increased related costs. Here we introduce a novel SPC, named very short peripheral catheter (VSPC), that was designed to minimize biomechanical irritation and improve blood flow. Objective The goal was to test the performance of the novel catheter in vivo for reduction of thrombophlebitis. Methods Very short peripheral catheter prototypes were inserted into swine ear veins (n = 12). Verification of the catheter conformation in situ and blood perfusion was performed using Echo-Doppler. The SPCT development rate was measured using magnetic resonance imaging (MRI), 4 and 12 days after catheter insertion, and analyzed by means of edema and inflammation intensities. Blind histopathology analysis was performed on the veins postmortem. Clinically available SPC was used as a reference. Results Operation of the VSPC devices did not require any special skills over those used for the clinically available SPC. Echo-Doppler imaging confirmed that in contrast to the traditional SPC, the VSPC avoided contact with the vein wall and allowed better blood perfusion. The MRI analysis revealed 2-fold inflammation and edema rates (~80%) in the veins cannulated with the commercial SPC, whereas rates of only ~40% were seen with the novel VSPC. A similar trend was noticed in the histopathology analysis. Conclusions The results indicate that the novel catheter design significantly reduced SPCT rates and demonstrated proof of concept for our biomechanical approach.
Topics: Animals; Catheterization, Peripheral; Ear; Edema; Equipment Design; Female; Magnetic Resonance Angiography; Materials Testing; Models, Animal; Punctures; Sus scrofa; Thrombophlebitis; Time Factors; Ultrasonography, Doppler; Vascular Access Devices; Veins
PubMed: 30506866
DOI: 10.1111/jth.14350 -
Medicine Sep 2022To elucidate the relationship between peripheral edema and programmed cell death-1/programmed cell death ligand 1 (PD-1/PD-L1) inhibitors, the meta-analysis was... (Meta-Analysis)
Meta-Analysis
PURPOSE
To elucidate the relationship between peripheral edema and programmed cell death-1/programmed cell death ligand 1 (PD-1/PD-L1) inhibitors, the meta-analysis was performed.
METHOD
Following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analyses, all-grade and grade 3-5 of peripheral edema data extracted from clinical trials were taken into account for the final comprehensive assessments.
RESULTS
Twenty-seven PD-1/PD-L1-related clinical trials with peripheral edema data were collected. Compared with chemotherapy (PD-1/PD-L1 vs chemotherapy), the risk of developing peripheral edema for all-grade was much lower (odds ratio [OR] = 0.36, 95% confidence interval [CI]: [0.23, 0.56], Z = 4.55 [P < .00001]). When PD-1/PD-L1 plus chemotherapy were compared with chemotherapy, no significant analysis results for all-grade was found (OR = 1.15, 95% CI:[0.93, 1.44], I2 = 25%, Z = 1.27 [P = .20]). Similar risk trends could also be found when the incidence risk of peripheral edema for grade 3-5 was evaluated. No obvious publication bias was identified throughout the total analysis process.
CONCLUSION
The effect of PD-1/PD-L1 inhibitor on the risk of developing peripheral edema was weaker than that of chemotherapy, and the combination with chemotherapy slightly increased the incidence risk of developing peripheral edema without statistical significance.
Topics: B7-H1 Antigen; Edema; Humans; Immune Checkpoint Inhibitors; Incidence; Neoplasms; Programmed Cell Death 1 Receptor
PubMed: 36086680
DOI: 10.1097/MD.0000000000030151 -
Targeted Oncology Sep 2022Small molecule mesenchymal-epithelial transition (MET) inhibitors, such as crizotinib, capmatinib, and tepotinib, are treatment options for metastatic non-small cell...
Small molecule mesenchymal-epithelial transition (MET) inhibitors, such as crizotinib, capmatinib, and tepotinib, are treatment options for metastatic non-small cell lung cancer (NSCLC) in adult patients whose tumors have a mutation that leads to MET exon 14 skipping. In clinical trials, these MET inhibitors were associated with a high incidence of peripheral edema, although this was generally mild-to-moderate in severity. There is limited information about the mechanism involved in MET inhibitor-induced peripheral edema. Perturbation of hepatocyte growth factor (HGF)/MET signaling may disrupt the permeability balance in the vascular endothelium and thus promote edema development. Another potential mechanism is through effects on renal function, although this is unlikely to be the primary mechanism. Because edema is common in cancer patients and may not necessarily be caused by the cancer treatment, or other conditions that have similar symptoms to peripheral edema, a thorough assessment is required to ascertain the underlying cause. Before starting MET-inhibitor therapy, patients should be educated about the possibility of developing peripheral edema. Patient limb volume should be measured before initiating treatment, to aid assessment if symptoms develop. Since the exact mechanism of MET inhibitor-induced edema is unknown, management is empiric, with common approaches including compression stockings, specific exercises, massage, limb elevation, and/or diuretic treatment. Although not usually required, discontinuation of MET inhibitor treatment generally resolves peripheral edema. Early diagnosis and management, as well as patient information and education, are vital to decrease the clinical burden associated with edema, and to reinforce capmatinib treatment adherence.
Topics: Adult; Benzamides; Carcinoma, Non-Small-Cell Lung; Crizotinib; Diuretics; Edema; Exons; Hepatocyte Growth Factor; Humans; Imidazoles; Lung Neoplasms; Mutation; Protein Kinase Inhibitors; Proto-Oncogene Proteins c-met; Triazines
PubMed: 36087188
DOI: 10.1007/s11523-022-00912-y -
Lakartidningen Jun 2020We here describe the current knowledge about the radiologic and histologic pulmonary features of covid-19, caused by SARS-CoV-2, and present lung histology from a case...
We here describe the current knowledge about the radiologic and histologic pulmonary features of covid-19, caused by SARS-CoV-2, and present lung histology from a case with fatal disease. Initial findings on computed tomography (CT) typically include peripheral multifocal bilateral ground-glass opacities, and correspondingly microscopic alveolar edema. This is followed by peripheral consolidations with air bronchogram and perilobular pattern on CT, signs of organizing pneumonia, corresponding to loose (potentially reversible) fibrosis. The posterior parts of the lungs and the lower lobes are typically more markedly affected. In severe disease with acute respiratory distress syndrome, thickened interlobular septa and crazy paving pattern appear on CT, which corresponds to histologic diffuse alveolar damage with, depending on the stage of the disease, features such as edema, hyaline membranes, reactive epithelium, inflammation, and fibrosis.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Pandemics; Pneumonia, Viral; SARS-CoV-2; Tomography, X-Ray Computed
PubMed: 32484232
DOI: No ID Found -
Annals of Medicine and Surgery (2012) Jan 2022and importance: Brucellosis is a common infection in Mediterranean region that manifests with various symptoms. Brucellosis should be considered as a possible cause of...
INTRODUCTION
and importance: Brucellosis is a common infection in Mediterranean region that manifests with various symptoms. Brucellosis should be considered as a possible cause of recurrent fever even if the symptoms are not suggestive of brucellosis.
CASE PRESENTATION
We report a case of 10-year-old child with no significant past medical history who presented with a 4-day period peripheral edema and ascites without fever, arthralgia or abdominal pain.
CLINICAL DISCUSSION
Proper investigations showed normal cardiac and renal functions; ultrasonography showed no portal vein hypertension. Albumin and total protein were also within normal. Complete blood count revealed pancytopenia; bone marrow aspiration and biopsy revealed hypercellularity that could be attributed to hypersplenism as a possible cause. Liver biopsy revealed non-specific inflammatory findings and also did not lead to a definite diagnosis. While broadening the scope of deferential diagnosis in order to reach a final diagnosis, Wright serum agglutination was tested positive (1/640) and we diagnosed a brucellosis infection. A proper management with Antibiotics ensued; the patient had uneventful recovery on treatment until complete clinical and imaging resolution of signs and symptoms.
CONCLUSION
Although brucellosis is considered a multi-systemic disease with atypical presentations, early diagnosis of brucellosis with management causes rapid recovery and favorable prognosis. We report a case of ascites and edema in context of Brucella infection which was completely resolved after treatment. This condition is rare especially in previously healthy child and after excluding other possible causes. We aim to share our case to keep brucellosis in mind as a differential diagnosis when dealing with infectious diseases with non-specific symptoms.
PubMed: 35003727
DOI: 10.1016/j.amsu.2021.103196 -
Acta Ophthalmologica Feb 2023
Topics: Humans; Diabetic Retinopathy; Macular Edema; Retina; Tomography, Optical Coherence; Diabetes Mellitus
PubMed: 35900071
DOI: 10.1111/aos.15221