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International Journal of Surgery Case... Nov 2023Hemifacial microsomia (HFM) is a complex congenital facial anomaly characterized by a wide spectrum of clinical features, which encompass the facial skeleton and other...
INTRODUCTION AND IMPORTANCE
Hemifacial microsomia (HFM) is a complex congenital facial anomaly characterized by a wide spectrum of clinical features, which encompass the facial skeleton and other organ systems. Currently, there is no evidence to suggest an association between Hemifacial Microsomia and vascular malformations, whether of the vertebral or any other kind.
CASE PRESENTATION
Reporting a case of a 12-year-old male diagnosed with Hemifacial Microsomia (HFM) and left Microtia. The patient had previously undergone left auricle reconstruction; however, unfortunately, the flap resulted in necrosis. In our next step, we intend to proceed with further reconstruction. Before this, we plan to perform CT angiography to identify viable flap options for effectively closing the auricular defect. During this evaluation, we identified an anomaly structure in the vertebral vascularization.
CLINICAL DISCUSSION
During the CT angiography, we found a vascular malformation in the vertebral region. This anomaly manifested as tortuosity in the left vertebral vein, with the diameter on the left side being larger than that on the right. Additionally, the diameter of the left internal jugular artery was found to be smaller than its counterpart on the right. The maxillary artery of the left side was larger than the right. Notably, there was an absence of a submental artery on the left side, and a hypoplasia of the left angularis artery was observed.
CONCLUSION
Hemifacial microsomia could be associated with other malformations. Despite the fact that vertebral artery anomaly is not considered common anomaly in HFM, it is mandatory to perform CT angiography before reconstructive surgery, considering the possibility of massive bleeding during the operation.
PubMed: 37837667
DOI: 10.1016/j.ijscr.2023.108906 -
Case Reports in Ophthalmological... 2023Vaccines have been approved worldwide to control the coronavirus disease-19 (COVID-19). However, the postvaccination side effects remain controversial. Here, we describe...
BACKGROUND
Vaccines have been approved worldwide to control the coronavirus disease-19 (COVID-19). However, the postvaccination side effects remain controversial. Here, we describe three Japanese cases of arteritic anterior ischaemic optic neuropathy (AAION) following COVID-19 vaccination. . The first case involved an 87-year-old woman who presented with vision loss in the right eye 2 months after her second COVID-19 vaccine and in the left eye 2 days later. The second case involved an 88-year-old woman who presented with vision loss in both eyes 3 months after receiving a second vaccine. The third case involved an 80-year-old man who presented with vision loss in the right eye 5 months after receiving a second vaccine. The C-reactive protein level and erythrocyte sedimentation rate were elevated in all patients. Biopsy of the temporal artery or auricular cartilage showed arteritic occlusion in case 2 and polychondritis in case 3. These patients were referred to a local Japanese hospital in 2021 over a period of no longer than 3 months.
CONCLUSION
We observed three cases of AAION after the affected individuals received their second COVID-19 vaccine. Further long-term investigations of ophthalmological events after COVID-19 vaccination are warranted.
PubMed: 37727533
DOI: 10.1155/2023/8845850 -
International Journal of Surgery Case... Oct 2023Maggot debridement therapy (MDT) is a treatment for chronic ulcers that involves using live larvae to debride the wound.
INTRODUCTION AND IMPORTANCE
Maggot debridement therapy (MDT) is a treatment for chronic ulcers that involves using live larvae to debride the wound.
CASE PRESENTATION
We report a case of serious arterial bleeding in the cervical region in a 52-year-old woman who was hospitalized in Iran for a malignant ulcer of the retro-auricular area. The patient was brought to the hospital by Emergency medical service due to severe hemorrhagic shock.
CLINICAL DISCUSSION
Debridement is a commonly used method for wound management, aimed at reducing the risk of infection and removing ulcer debridement. Several techniques are available for debridement of chronic wounds, including mechanical, surgical, autolytic, and enzymatic methods, each with its own advantages and disadvantages.
CONCLUSION
Maggot debridement therapy (MDT) is one of these methods that seem to be relatively safer. In this method, some larvae are used for debriding wounds in patients. It is usually used as a last resort treatment but in this case, it was used as a third line after surgery and chemoradiotherapy.
PubMed: 37722309
DOI: 10.1016/j.ijscr.2023.108844 -
Journal of Nanobiotechnology Aug 2023The excellent physicochemical and biomedical properties make silk fibroin (SF) suitable for the development of biomedical materials. In this research, the silk fibroin...
BACKGROUND
The excellent physicochemical and biomedical properties make silk fibroin (SF) suitable for the development of biomedical materials. In this research, the silk fibroin microspheres (SFMS) were customized in two size ranges, and then carried gold nanoparticles or doxorubicin to evaluate the performance of drug loading and releasing. Embolization efficiency was evaluated in rat caudal artery and rabbit auricular artery, and the in vivo distribution of iodinated SFMS (I/I-SFMS) after embolization of rat hepatic artery was dynamically recorded by SPECT. Transhepatic arterial radioembolization (TARE) with I-SFMS was performed on rat models with liver cancer. The whole procedure of selective internal radiation was recorded with SPECT/CT, and the therapeutic effects were evaluated with F-FDG PET/CT. Lastly, the enzymatic degradation was recorded and followed with the evaluation of particle size on clearance of sub-micron silk fibroin.
RESULTS
SFMS were of smooth surface and regular shape with pervasive pores on the surface and inside the microspheres, and of suitable size range for TAE. Drug-loading functionalized SFMS with chemotherapy or radio-sensitization, and the enhanced therapeutic effects were proved in treating HUH-7 cells as lasting doxorubicin release or more lethal radiation. For artery embolization, SFMS effectively blocked the blood supply; when I-SFMS serving as the embolic agent, the good labeling stability and embolization performance guaranteed the favorable therapeutic effects in treating in situ liver tumor. At the 5th day post TARE with 37 MBq/3 mg I-SFMS per mice, tumor activity was quickly inhibited to a comparable glucose metabolism level with surrounding normal liver. More importantly, for the fragments of biodegradable SFMS, smaller sized SF (< 800 nm) metabolized in gastrointestinal tract and excreted by the urinary system, while SF (> 800 nm) entered the liver within 72 h for further metabolism.
CONCLUSION
The feasibility of SFMS as degradable TARE agent for liver cancer was primarily proved as providing multiple therapeutic potentials.
Topics: Animals; Mice; Rabbits; Rats; Fibroins; Gold; Positron Emission Tomography Computed Tomography; Metal Nanoparticles; Arteries; Doxorubicin
PubMed: 37598140
DOI: 10.1186/s12951-023-02032-9 -
Journal of Neuroendovascular Therapy 2023A few cases of postsurgical iatrogenic arteriovenous shunts have been reported, with the arterial blood flow directly entering the pial veins. Herein, we reported a...
OBJECTIVE
A few cases of postsurgical iatrogenic arteriovenous shunts have been reported, with the arterial blood flow directly entering the pial veins. Herein, we reported a patient with a dural artery-pial vein shunt found 1 year after aneurysmal clipping.
CASE PRESENTATION
A 64-year-old male presented with generalized convulsion 1 year after cerebral aneurysmal clipping. A CT showed intracerebral hemorrhage in the temporo-occipital cortex and a dural artery-pial vein shunt in proximity to the previous craniotomy center. The arterial blood flow from the deep temporal artery, the middle meningeal artery, and the anterior auricular branch of the superficial temporal artery shunted into the superficial middle cerebral vein, with evident cortical venous reflux. Embolization was performed with n-butyl-2-cyanoacrylate and completely occluded the shunt. The patient was discharged without neurological deficits.
CONCLUSION
Endovascular liquid embolization may be an effective treatment for iatrogenic dural artery-pial vein shunt.
PubMed: 37502352
DOI: 10.5797/jnet.cr.2022-0058 -
Frontiers in Veterinary Science 2023Measurement of arterial blood pressure is recommended in anaesthetized animals to guide perioperative treatment. Invasive blood pressure measurement is considered the...
BACKGROUND
Measurement of arterial blood pressure is recommended in anaesthetized animals to guide perioperative treatment. Invasive blood pressure measurement is considered the gold standard, however it is also technically challenging, requires specialised equipment and carries certain risks. For these reasons, non-invasive blood pressure measurement devices are commonly used and are expected to provide accurate and reliable results. This requirement is particularly true for rabbits, in whom peri-anaesthetic hypotension is commonly observed and in whom perioperative mortality remains disproportionally high. Several authors have compared different non-invasive devices with invasive measurements in rabbits and have reported contrasting results. However, to date no comparison between invasive measurements and the PetMAP device, that has been designed specifically for veterinary medicine, has been reported.
AIM AND HYPOTHESIS
The aim of the study was the comparison of invasive blood pressure measurement with PetMAP in rabbits. We hypothesised that PetMAP would show acceptable agreement with the invasive measurements according to the American College of Veterinary Internal Medicine guidelines.
MATERIALS AND METHODS
Sixteen client-owned rabbits presenting for various surgical interventions were included in the study. Invasive measurements were performed by cannulation of an auricular artery. The PetMAP cuff was applied distal to the elbow according to the manufacturer's guidelines. For each measurement with PetMAP, three invasive blood pressure values were recorded. The mean of the three invasive values was compared with one value measured with PetMAP.
RESULTS
Data collected from 16 rabbits were used for statistical analysis. In the clinical setting, the PetMAP device showed significant overestimation of systolic, diastolic and mean arterial pressure, which were measured in the auricular artery. In addition, the bias was not constant, implying that the device poorly predicted changes in blood pressure.
CONCLUSION
The PetMAP device did not meet any of the American College of Veterinary Internal Medicine recommendations.
PubMed: 37492435
DOI: 10.3389/fvets.2023.1141480 -
Revista Portuguesa de Cardiologia :... Jan 2024The field of Cardio-Oncology has grown significantly, especially during the last decade. While awareness of cardiotoxicity due to cancer disease and/or therapies has...
Interventional cardiology in cancer patients: A position paper from the Portuguese Cardiovascular Intervention Association and the Portuguese Cardio-Oncology Study Group of the Portuguese Society of Cardiology.
The field of Cardio-Oncology has grown significantly, especially during the last decade. While awareness of cardiotoxicity due to cancer disease and/or therapies has greatly increased, much of the attention has focused on myocardial systolic disfunction and heart failure. However, coronary and structural heart disease are also a common issue in cancer patients and encompass the full spectrum of cardiotoxicity. While invasive percutaneous or surgical intervention, either is often needed or considered in cancer patients, limited evidence or guidelines are available for dealing with coronary or structural heart disease. The Society for Cardiovascular Angiography and Interventions consensus document published in 2016 is the most comprehensive document regarding this particular issue, but relevant evidence has emerged since, which render some of its considerations outdated. In addition to that, the recent 2022 ESC Guidelines on Cardio-Oncology only briefly discuss this topic. As a result, the Portuguese Association of Cardiovascular Intervention and the Cardio-Oncology Study Group of the Portuguese Society of Cardiology have partnered to produce a position paper to address the issue of cardiac intervention in cancer patients, focusing on percutaneous techniques. A brief review of available evidence is provided, followed by practical considerations. These are based both on the literature as well as accumulated experience with these types of patients, as the authors are either interventional cardiologists, cardiologists with experience in the field of Cardio-Oncology, or both.
Topics: Humans; Cardio-Oncology; Portugal; Cardiotoxicity; Heart Diseases; Cardiology; Percutaneous Coronary Intervention; Neoplasms
PubMed: 37482119
DOI: 10.1016/j.repc.2023.04.013