Journal Description
Reports
Reports
is an international, peer-reviewed, open access journal about the medical cases, images, and videos in human medicine, published quarterly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within ESCI (Web of Science), FSTA, and other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 20.6 days after submission; acceptance to publication is undertaken in 3.5 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
0.8 (2023)
Latest Articles
Factors Influencing Abdominal Compliance during CO2 Insufflation in Patients Undergoing Laparoscopic Abdominal Surgery
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.
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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.
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(This article belongs to the Section Surgery)
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Gingival Cyst of the Adult: A Case Description with a Relevant Literature Analysis
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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
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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.
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(This article belongs to the Special Issue Clinical Research on Oral Diseases)
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Open AccessCase Report
Facial Cellulitis of Unusual Odontogenic Origin
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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
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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.
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(This article belongs to the Section Dentistry/Oral Medicine)
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Open AccessCase Report
Primary Melanoma of the Pineal Gland Case Report and Review of the Literature
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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
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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.
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(This article belongs to the Section Oncology)
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Complete Left-Sided Pericardial Congenital Absence
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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
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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.
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(This article belongs to the Section Cardiology/Cardiovascular Medicine)
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Successfully Anticipated Difficult Airway Management of a “Can Ventilate, but Cannot Intubate” Situation for Urgent Laparoscopic Appendectomy in a Patient with Duchenne Muscular Dystrophy
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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
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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.
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Open AccessCase Report
Endoscopic Surgical Approach for a Mesiodens in the Nasal Cavity: A Rare Phenomenon
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Enzo Iacomino, Chiara Fratini, Federica Zoccali, Francesca Cambria, Matteo Laudani, Alberto Eibenstein, Christian Barbato, Marco de Vincentiis and Antonio Minni
Reports 2024, 7(2), 46; https://doi.org/10.3390/reports7020046 - 13 Jun 2024
Abstract
The nasal cavity is a sporadic site for mesiodens, and if it is impacted in the lower nasal floor or localized in the nasal septum, it may cause various nasal symptoms such as nasal obstruction, recurrent rhinitis, and epistaxis. Early diagnosis is made
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The nasal cavity is a sporadic site for mesiodens, and if it is impacted in the lower nasal floor or localized in the nasal septum, it may cause various nasal symptoms such as nasal obstruction, recurrent rhinitis, and epistaxis. Early diagnosis is made through clinical findings and a cone-beam computed tomography (CBCT) scan, but a definite treatment plan has not yet been developed. This study aims to present a case of a mesiodens in a 27-year-old male, located in the nasal septum, an unusual and rare site, and its surgical removal using an endoscopic nasal approach with subperiosteal intranasal dissection. The result of the study appears significant because this technique led to fewer postoperative complications, and it appears to be safer and more effective than the traditional palatal or transoral approach. Moreover, the nasal endoscopic approach is more natural to the ear, nose, and throat (ENT) surgeons than the transoral approach.
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(This article belongs to the Special Issue Clinical Research on Oral Diseases)
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Febrile Rash: An Early Diagnostic Clue to Infectious Illness in Travelers Returning from Thailand
by
Hisham Ahmed Imad, Anastasia Putri, Ratchata Charoenwisedsil, Sakarn Charoensakulchai and Eric Caumes
Reports 2024, 7(2), 45; https://doi.org/10.3390/reports7020045 - 7 Jun 2024
Abstract
The eruption of a rash along with spiking fever in travelers returning from the tropics may be suspicious of arboviral diseases, and isolation prevent further transmission in non-endemic countries. The case presented here was seen at the Fever Clinic at the Hospital for
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The eruption of a rash along with spiking fever in travelers returning from the tropics may be suspicious of arboviral diseases, and isolation prevent further transmission in non-endemic countries. The case presented here was seen at the Fever Clinic at the Hospital for Tropical Diseases in Bangkok, Thailand. The presenting complaints were fever, headache, myalgia, and a distinctive erythematous blanching rash. Despite a negative dengue NS1 test on the initial day, anti-dengue IgM and IgG were detectable on day five of illness. Dengue, a leading cause of traveler’s fever with rash, is of particular concern, especially during outbreaks like the one in Thailand in 2023, when the number of cases exceeded one hundred thousand over a nine-month period. The influx of 28 million travelers in 2023, many with naive immunity to many arboviruses, raises fear of transmission to temperate regions, including to countries like France, where Aedes albopictus establishment can lead to autochthonous dengue cases and clusters. Enhanced surveillance is crucial, urging the consideration of dengue as a potential diagnosis in travelers with febrile rash, even prior to lab confirmation. Immediate isolation of patients is essential to prevent autochthonous transmission, reduce outbreak risks, and avert public health crises.
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(This article belongs to the Collection Health Threats of Climate Change)
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Atraumatic Lateral Tibial Plateau Periprosthetic Insufficiency Fracture after Primary Total Knee Arthroplasty: A Case Report
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Ahmed M. Abdelaal and Ahmed A. Khalifa
Reports 2024, 7(2), 44; https://doi.org/10.3390/reports7020044 - 4 Jun 2024
Abstract
Tibial Periprosthetic fractures (PPF) after primary total knee arthroplasty (TKA) are uncommon and mainly occur after trauma. Various management options have been proposed; however, the decision mainly relies on the location of the fracture and the tibial baseplate stability and ranges between conservative
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Tibial Periprosthetic fractures (PPF) after primary total knee arthroplasty (TKA) are uncommon and mainly occur after trauma. Various management options have been proposed; however, the decision mainly relies on the location of the fracture and the tibial baseplate stability and ranges between conservative (non-operative), fracture fixation, and revision TKA. We report a case of a 79-year-old female patient who presented with atraumatic lateral tibial plateau PPF (Felix type ⅠB) with a loose tibial implant after three weeks of having left primary TKA. The patient was treated successfully by revising the tibial component using a stemmed tibial baseplate and reconstructing the tibial bone defect using two metal wedges. The radiological, functional, and PROM outcomes were satisfactory and accepted both early on (eight weeks) and at the last follow-up (six months). Atraumatic insufficiency Felix type ⅠB PPF of the lateral tibial plateau after primary TKA is uncommon. Reconstructing the tibial bone defect, revising the tibial component, and adding a stem to offload the tibial plateau are the treatments of choice that lead to acceptable outcomes.
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(This article belongs to the Special Issue Orthopedic and Trauma Surgery: Clinical Research and Case Reports)
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Guidewire Retention by the Venous Cannula of Veno-Arterial Extracorporeal Membrane Oxygenation
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Sebastian Bratke and Jan A. Graw
Reports 2024, 7(2), 43; https://doi.org/10.3390/reports7020043 - 4 Jun 2024
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While insertion of a central venous catheter (CVC) for intravascular access, diagnosis, and intensive care medical treatment is frequently needed in critically ill patients, retention of the guidewire used for CVC placement with Seldinger’s technique is a very rare complication. In patients treated
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While insertion of a central venous catheter (CVC) for intravascular access, diagnosis, and intensive care medical treatment is frequently needed in critically ill patients, retention of the guidewire used for CVC placement with Seldinger’s technique is a very rare complication. In patients treated with extracorporeal membrane oxygenation (ECMO), significant negative pressures in the thoracal and abdominal venous system are generated by the venous ECMO drainage cannula. Therefore, during CVC placement in patients treated with ECMO, special vigilance is required because the significant negative pressures generated by the venous ECMO drainage cannula facilitate venous suction of an unsecured guidewire.
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Open AccessArticle
Drug–Drug Interactions of Hydroxychloroquine and Chloroquine in Older Patients with COVID-19 during the First Pandemic Waves: The GeroCovid Observational Study
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Caterina Trevisan, Andrea Cignarella, Andrea Grandieri, Giuseppe Sergi, Stefano Fumagalli, Fabio Monzani, Chukwuma Okoye, Giuseppe Bellelli, Alba Malara, Pietro Gareri, Stefano Volpato, Raffaele Antonelli Incalzi and The GeroCovid Acute Ward Working Group
Reports 2024, 7(2), 42; https://doi.org/10.3390/reports7020042 - 23 May 2024
Abstract
Objective: Chloroquine (CQ) and hydroxychloroquine (HCQ) were used as off-label treatments for SARS-CoV-2 infection during the first pandemic waves. The urgency of combatting COVID-19 led to the dissemination of medical recommendations with a scarce awareness of possible drug–drug interactions. This issue primarily concerned
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Objective: Chloroquine (CQ) and hydroxychloroquine (HCQ) were used as off-label treatments for SARS-CoV-2 infection during the first pandemic waves. The urgency of combatting COVID-19 led to the dissemination of medical recommendations with a scarce awareness of possible drug–drug interactions. This issue primarily concerned people already taking multiple medications, such as older individuals. We estimated the prevalence of drug interactions with CQ or HCQ in COVID-19 inpatients during the first pandemic waves and their possible association with hospitalization-related outcomes. Methods: This study considers 487 patients aged ≥60, hospitalized for COVID-19 from March to December 2020, and treated with CQ or HCQ. Data on acute and chronic therapies and hospitalization length and outcomes were derived from medical records. The presence of drugs potentially interacting with CQ and HCQ was identified based on published literature and drug databases. Results: In our sample (mean age 77.1 years, 47.8% females), 255 (52.4%) patients presented with one drug interaction with CQ or HCQ, and 114 (23.4%) had more than two interactions. The most frequent drugs potentially interacting with CQ or HCQ were lopinavir/ritonavir (50.4%), azithromycin (47.2%), tocilizumab (15.4%), levofloxacin (8.7%), clarithromycin (6.0%), amlodipine (3.3%), and trazodone (2.4%). No substantial differences in the duration and outcomes of the hospitalization emerged as a function of the presence of drug–drug interactions. Conclusions: Many older patients prescribed with CQ or HCQ, which have lately proved ineffective against COVID-19, were exposed to the risk of drug–drug interaction. This underlines that medical recommendations should undergo careful peer review before being widely disseminated, even in emergencies like a pandemic.
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(This article belongs to the Special Issue Acute and Persistent Viral Infection Diseases)
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Comparison of the Haas Expander and the Elastodontic Device for the Resolution of Transverse Discrepancies in Growing Patients: A Single-Centre Observational Study
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Eleonora Ortu, Sara Di Nicolantonio, Samuele Cova, Davide Pietropaoli, Lucia De Simone and Annalisa Monaco
Reports 2024, 7(2), 41; https://doi.org/10.3390/reports7020041 - 21 May 2024
Abstract
Background: This study aimed to compare the clinical outcomes of using two different devices to treat upper palatal discrepancies evaluated with a digital intraoral scanner. Methods: A total of 64 patients were enrolled and treated with either an elastodontic expansion device (32 patient
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Background: This study aimed to compare the clinical outcomes of using two different devices to treat upper palatal discrepancies evaluated with a digital intraoral scanner. Methods: A total of 64 patients were enrolled and treated with either an elastodontic expansion device (32 patient test group, 16 females and 16 males, mean age 7.08 ± 0.44) or Haas expander (32 patient control group, 16 females and 16 males, mean age 7.32 ± 0.50). The two groups exhibited similar orthodontic features. The orthodontic criteria were: skeletal class I relationship; molar class I relationship; complete eruption of upper sixths; presence of unilateral or bilateral cross bite. All dental casts were examined and subsequently scanned with an intraoral scanner (I-Tero) pre-treatment (T0) and 12 months after the onset of therapy (T1) to assess the distance between the decidous upper canines (ICW, intercanine width) and the distance between the mesiopalatal cusps of the upper first molars (IMW, intermolar width). For statistical analysis, the t-test for continous variables and the chi-square test for categorical variables were used, respectively. Results: There were no statistically significant differences between the mean and SD of the expansions that resulted from the Haas expander and the elastodontic devices (Haas expander vs. Eptamed: ICW_T1 (Haas) = 42.34 (3.09), ICW_T1 (Eptamed) = 42.69 (2.77); p = 0.743; IMW_T1 (Haas) = 34.22 (2.29), IMW_T1 (Eptamed) = 34.00 (2.56); p = 0.800). The two devices were similarly effective. Conclusions: Elastodontic devices and the Haas expander can successfully help the orthodontist to conduct upper arch expansion treatment. However, elastodontic devices are more comfortable during the resolution of palatal discrepancies compared to palatal expander devices.
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(This article belongs to the Special Issue Clinical Research on Oral Diseases)
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Descending Necrotizing Mediastinitis in Healthy Young Adults: The Fatal Consequence of the Delayed Help
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Petar Uchikov, Maria Kraeva, Krasimir Kraev, Bozhidar Hristov, Dzhevdet Chakarov, Nedzhat Ali, Chavdar Stefanov, Angelina Mollova-Kyosebekirova, Tihomir Tenchev, Snezhanka Dragusheva, Elizabet Dzhambazova and Bistra Dobreva-Yatseva
Reports 2024, 7(2), 40; https://doi.org/10.3390/reports7020040 - 21 May 2024
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Introduction: Descending necrotizing mediastinitis is one of the most lethal forms of acute mediastinitis. It originates from an odontogenic or deep neck infection, which descends to the mediastinum through the fascial planes. It is a rare condition, but mortality rates remain high, especially
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Introduction: Descending necrotizing mediastinitis is one of the most lethal forms of acute mediastinitis. It originates from an odontogenic or deep neck infection, which descends to the mediastinum through the fascial planes. It is a rare condition, but mortality rates remain high, especially in the presence of comorbidities or predisposing factors. Delay in diagnosis has been shown to be one of the most important factors for the disease outcome. Therefore, early diagnosis and treatment by a multidisciplinary team are of utmost importance. Case series: Four healthy young males with descending necrotizing mediastinitis were treated at our institution. None of them had any comorbidities, but all of them waited between 3 and 4 days before seeking medical help. Upon their arrival at the hospital, in addition to the presence of a severe neck infection, the presence of mediastinitis was also found. Despite the timely surgical treatment of both the source of the infection and the mediastinitis, three of the four cases had a fatal outcome. Conclusion: We believe that the time factor is of greater importance for the outcome of acute descending mediastinitis than the factors of age and presence of accompanying diseases. Proper and rapid treatment by a multidisciplinary team is essential, even for young and healthy people.
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Management of Pregnancy in a Patient with Familial Hypercholesterolemia and Previous Myocardial Infarction—Treatment with LDL Apheresis: A Case Report
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Milos Milincic, Jovana Todorovic, Stefan Dugalic, Ivana Novakovic, Maja Macura, Katarina Lalic and Miroslava Gojnic Dugalic
Reports 2024, 7(2), 39; https://doi.org/10.3390/reports7020039 - 19 May 2024
Abstract
Familial hypercholesterolemia, a genetic disorder marked by elevated low-density lipoprotein cholesterol (LDL-C), poses significant risks for premature atherosclerosis and cardiovascular diseases, particularly during pregnancy. One of the safe methods of treating this condition in pregnancy is with the use of LDL apheresis. We
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Familial hypercholesterolemia, a genetic disorder marked by elevated low-density lipoprotein cholesterol (LDL-C), poses significant risks for premature atherosclerosis and cardiovascular diseases, particularly during pregnancy. One of the safe methods of treating this condition in pregnancy is with the use of LDL apheresis. We present a 38-year-old primigravida with homozygous Familial Hypercholesterolemia (HoFH), ischemic cardiomyopathy, and angina pectoris. Two years before conception, extremely elevated lipid levels prompted statin therapy and lifestyle changes. Stent placements followed acute myocardial infarction. When planning pregnancy, statins were discontinued, but lipid levels elevated. LDL apheresis was initiated, achieving a 60% reduction. Throughout pregnancy, 16 LDL apheresis sessions were performed every 14 days, maintaining optimal lipid profiles. A cesarean section was performed in the 38th week of gestation, delivering a healthy infant. The patient resumed statin therapy after 8 months of breastfeeding. The patient maintained cardiovascular health, demonstrating the feasibility of controlled HoFH pregnancies. This case highlights the successful management of HoFH during pregnancy using LDL apheresis, ensuring maternal and fetal well-being. Future research on novel treatments and their safety during pregnancy is essential for refining therapeutic approaches in similar cases.
Full article
(This article belongs to the Special Issue Case Reports in Obstetrics and Gynecology)
Open AccessCase Report
Cost-Effectiveness in Alternative Treatment Options for Pancreatic Pseudocysts
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Nikola Boyanov, Nikol Milinich, Katina Shtereva, Katerina Madzharova, Stoilka Tufkova, Mariana Penkova-Radicheva, Daniela Radicheva and Neno Shopov
Reports 2024, 7(2), 38; https://doi.org/10.3390/reports7020038 - 17 May 2024
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Background and Objectives: Pancreatic pseudocysts often arise as complications of pancreatitis and present unique challenges in clinical management, encompassing considerations for both technical aspects and financial implications. Before the advancements of invasive gastroenterology, pancreatic pseudocysts have been drained surgically for many years.
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Background and Objectives: Pancreatic pseudocysts often arise as complications of pancreatitis and present unique challenges in clinical management, encompassing considerations for both technical aspects and financial implications. Before the advancements of invasive gastroenterology, pancreatic pseudocysts have been drained surgically for many years. Nowadays, we have less invasive techniques with higher efficiency and lower mortality rates, however, they remain cost-challenging for most countries. Materials and Methods: We present four patients (two males and two females) with pancreatic pseudocysts who underwent endoscopic ultrasound-guided transgastric drainage using plastic stents accompanied by a standard lavage protocol using a nasocystic catheter. Results: All four patients had successful outcomes, and a follow-up at 6 months revealed no traces of the pseudocysts or any significant long-term complications. One acute complication (arterial bleeding) and one late complication (stent migration) were observed. As the study aimed to present a cheaper option for draining pancreatic pseudocysts, we investigated and compared costs for the materials we utilized and those associated with lumen-apposing metal stents. Upon compiling the data, a notable advantage was evident in favour of our method. Conclusions: While EUS-guided drainage of pancreatic pseudocysts using lumen-apposing metal stents (LAMSs) represents a high-end strategy for treating pancreatic pseudocysts, our method demonstrates better cost-effectiveness without compromising efficacy.
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Open AccessArticle
Trophoblast Cell Surface Antigen 2 (Trop2) Is Expressed in Cases of EBV-Positive Diffuse Large B-Cell Lymphoma Emerging from Angioimmunoblastic T-Cell Lymphoma
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Susanne Ghandili, Judith Dierlamm, Carsten Bokemeyer, Clara Marie von Bargen, Anne Menz and Sören Alexander Weidemann
Reports 2024, 7(2), 37; https://doi.org/10.3390/reports7020037 - 14 May 2024
Abstract
Although trophoblast cell surface antigen 2 (Trop2)-targeting drugs are already approved or under investigation in various solid tumors, the significance of Trop2 in lymphoma is unknown. Thus, our objective was to investigate the expression of Trop2 in diffuse large B-cell lymphoma (DLBCL) through
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Although trophoblast cell surface antigen 2 (Trop2)-targeting drugs are already approved or under investigation in various solid tumors, the significance of Trop2 in lymphoma is unknown. Thus, our objective was to investigate the expression of Trop2 in diffuse large B-cell lymphoma (DLBCL) through a systemic immunohistochemistry screening. We constructed a tissue microarray comprising tissue from 92 DLBCL patients, each diagnosed at the University Medical Center Hamburg-Eppendorf (2020–2022). Trop2-immunohistochemistry was carried out, and positive staining was deemed a specific membranous positivity. Four samples were derived from Epstein-Barr virus (EBV)-positive DLBCL, with one case of EBV-positive DLBCL following angioimmunoblastic T-cell lymphoma (AITL). Strong Trop2 immunostaining was detectable in 1 of 91 analyzable samples, originating from a patient with a composite EBV-positive DLBCL emerging from AITL. Therefore, we performed an additional database search to identify all cases of composite EBV-positive DLBCL emerging from AITL since 2015. Five additional cases were identified and stained for Trop2, revealing two cases with strong B-blast positivity. Our preliminary data imply that Trop2 appears absent in de novo DLBCL, whereas Trop2 is strongly expressed in cases of a rare variant of EBV-positive DLBCL. Further investigations are needed to confirm our results, particularly on the subset of EBV-positive DLBCL emerging from AITL.
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(This article belongs to the Special Issue Cyto-Histological Correlations in Pathology Diagnostics)
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Postural Orthostatic Tachycardia Syndrome (POTS) as an Adverse Event to the Human Papilloma Virus (HPV) Vaccine and Its Relationship with Ehlers–Danlos Syndrome (EDS)
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Nicole Schipperijn, Megan Wijesinghe, Aisa Romo and Benjamin Brooks
Reports 2024, 7(2), 36; https://doi.org/10.3390/reports7020036 - 12 May 2024
Abstract
Gardasil 4, a human papilloma virus vaccine, has been shown to protect against various cancers, including cervical cancer. Common side effects include injection site pain, fever, headaches, and muscle aches. In some individuals, the severe side effect of postural orthostatic tachycardia syndrome (POTS)
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Gardasil 4, a human papilloma virus vaccine, has been shown to protect against various cancers, including cervical cancer. Common side effects include injection site pain, fever, headaches, and muscle aches. In some individuals, the severe side effect of postural orthostatic tachycardia syndrome (POTS) has been reported. POTS is characterized by the abnormal response of lightheadedness, blurry vision, and dizziness while transitioning to an upright posture. POTS predominately affects women, with more than eighty-five (85) percent of POTS patients being female. POTS, on average, takes five years and eleven months to receive diagnosis. Additionally, a strong association between POTS and Ehlers–Danlos Syndrome Type III (EDS) exists. Eighty (80) percent of patients with EDS have POTS. This severe side effect indicates that providers need to be aware of this strong association of HPV vaccinations and POTS. In this report, we will present a case of a young women with a past medical history significant for EDS type III who was diagnosed with POTS after receiving Gardasil 4 vaccination. This case demonstrates the need for physicians to be aware of the association of POTS with EDS type III and HPV vaccination. Physician awareness of the associations, signs, and symptoms of POTS and earlier testing at the first presentation of signs and symptoms will limit the negative impact on patient’s quality of life.
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Development and Validation of the Bone Tumor Surgery Complexity Score
by
Annika Frei, Georg Schelling, Philip Heesen, Pietro Giovanoli and Bruno Fuchs
Reports 2024, 7(2), 35; https://doi.org/10.3390/reports7020035 - 10 May 2024
Abstract
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Bone tumors often manifest with non-specific symptoms such as pain and swelling, often posing diagnostic challenges. Optimal treatment requires centralized care in specialized centers, emphasizing the need for complete tumor removal and interdisciplinary collaboration. We developed the Bone Tumor Surgery Complexity Score (BT-SCS)
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Bone tumors often manifest with non-specific symptoms such as pain and swelling, often posing diagnostic challenges. Optimal treatment requires centralized care in specialized centers, emphasizing the need for complete tumor removal and interdisciplinary collaboration. We developed the Bone Tumor Surgery Complexity Score (BT-SCS) based on a retrospective study of 501 patients. The BT-SCS, structured around patient demographics, tumor biology, and surgical parameters, categorizes surgical cases into four groups to comprehensively assess complexity. Application of the BT-SCS resulted in scores ranging from 3 to 33, with an average score of 14 ± 7.2. Patients with malignant tumors had higher scores (19.6 ± 5.2) compared to those with benign (10.0 ± 3.8) or intermediate malignant tumors (14.6 ± 7.1). Patients with pelvic tumors registered the highest scores (16.0), followed by extremities/trunk (14.3) and spinal tumors (13.6). The BT-SCS was validated against the Case Mix Index (CMI), using an independent cohort of bone and soft tissue cases. This validation process, utilizing Loess smoothing, illustrated the BT-SCS’s granular differentiation of surgical complexity, particularly in the lower-to-mid-range of case severities. The BT-SCS represents a significant shift from volume-based to complexity-based assessments in surgical care, aligning with evolving healthcare paradigms. It serves as a tool for strategic patient allocation to treatment centers, aiming to improve outcomes and benchmarking in sarcoma care. The score’s development and application in clinical practice align with the focus on patient-centered and value-based healthcare. Future enhancements, including machine learning integration and outcome data, will refine its categorization process, enhancing clinical utility.
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Open AccessCase Report
Waldenstrom Macroglobulinemia Recurrence with Bing–Neel Syndrome Presentation
by
Raffaella Capasso, Miriam Buonincontro, Ferdinando Caranci and Antonio Pinto
Reports 2024, 7(2), 34; https://doi.org/10.3390/reports7020034 - 7 May 2024
Abstract
Bing–Neel syndrome (BNS) is a rare condition that may occur in patients with Waldenstrom macroglobulinemia (WM) and is caused by lymphoplasmacytic infiltration into the central nervous system. BNS is an extramedullary manifestation of WM which may present with various neurological signs and symptoms
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Bing–Neel syndrome (BNS) is a rare condition that may occur in patients with Waldenstrom macroglobulinemia (WM) and is caused by lymphoplasmacytic infiltration into the central nervous system. BNS is an extramedullary manifestation of WM which may present with various neurological signs and symptoms that make the diagnosis difficult to achieve. We present a case of BNS in a 60-year-old patient diagnosed 6 years after recovering from Waldenstrom’s macroglobulinemia. We observed the patient for a secondary generalized focal motor seizure. Unenhanced brain CT revealed slight hyperdensity of left parietal subarachnoid spaces. The MRI of the brain and spinal cord showed leptomeningeal enhancement in both parietal lobes. The presence of monoclonal bands (light chain k and IgM) was found in cerebrospinal fluid, leading to the diagnosis of BNS. The patient started treatment with ibrutinib and remains clinically stable during a 1-year follow-up. However, the MRI showed the appearance of a new subcortical left parietal lesion. BNS is an extremely rare presentation of WM that should be recognized and considered early in the presence of unexplained neurological symptoms in patients with a history of WM, even if the patient appears to have recovered.
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(This article belongs to the Special Issue Case Reports of Precision Medicine in Oncology)
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Open AccessCase Report
Proton Pump Inhibitors Induced Hyponatremia in a Liver Transplanted Patient—The Role of Deprescribing: A Case Report and Literature Review
by
Gianmarco Marcianò, Benedetto Caroleo, Luca Catarisano, Donatella Cocchis, Caterina Palleria, Giovambattista De Sarro and Luca Gallelli
Reports 2024, 7(2), 33; https://doi.org/10.3390/reports7020033 - 6 May 2024
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Liver transplant patients are frail subjects due to lifelong therapy with immunosuppressants. In these patients, comorbidity and polytherapy increase the risk of adverse drug reactions. In this study, we report the development of hyponatremia, probably related to pantoprazole in a liver transplant patient.
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Liver transplant patients are frail subjects due to lifelong therapy with immunosuppressants. In these patients, comorbidity and polytherapy increase the risk of adverse drug reactions. In this study, we report the development of hyponatremia, probably related to pantoprazole in a liver transplant patient. Sertraline dismission and treatment with sodium chloride did not improve clinical symptoms and laboratory levels. Pantoprazole dismission induced an improvement in clinical symptoms and the normalization of sodium levels. A five-month follow-up revealed the absence of clinical symptoms and normal serum sodium levels.
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