Patients with severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) infection mainly present severe pneumonia associated with complications related to cytokine storm syndrome. So, it was associated with thrombotic incidents like acute limb ischemia and pulmonary embolism.
COVID-19 Associated Large Vessel Thrombosis and Ischemic Stroke: A Case Seriesmahendrareddychirra
The novel severe acute respiratory syndrome coronavirus (SARS-COV-2) affects different people in different ways. Most infected people will develop mild to moderate respiratory flu-like illness and recover without the need for hospitalization.
Thrombophylia and COVID-19. A case report of young man 53 years old whith acu...komalicarol
A 57-year-old male was admitted to our Hospital on March 2020
for SARS-Cov2 related interstitial pneumonia. Chest x-ray showed
a bilateral interstitial-alveolar pneumonia and Blood gas analysis
(BGA) in room air highlighted a severe respiratory failure (pO2 46
mmHg, pH 7.41). Due to clinical and biohumoral worsening (stable CRP at 24 mg/dL), tocilizumab (800mg) was performed after
acquiring patient’s informed consensus. In the evening, after 96
hours of hospitalization, the patient presented a clear hyposthenia
/ hemiparesis of the right hemisome whit hyperreflexia, confusion
and slowed speech
The severe acute respiratory syndrome-coronavirus-2-caused coronavirus disease-2019 (COVID-19) has arisen as a serious worldwide public health adversity. Early in the COVID-19 pandemic, an increased incidence of arterial and venous thrombosis was found, linked to systemic inflammation, immobilization, and a prothrombotic environment. Venous thromboembolism (VTE) can manifest itself in a variety of ways. A 55-year-old man presented to the emergency department with peripheral arterial disease (PAD) history.
Visit Here - https://pubrica.com/services/physician-writing-services/case-report/
Guillain Barre Syndrome & Covid-19: A Case Reportclinicsoncology
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia, headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection.
Guillain Barre Syndrome & Covid-19: A Case Reportpateldrona
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs
Guillain Barre Syndrome & Covid-19: A Case Reportkomalicarol
Besides respiratory symptoms, coronavirus disease 2019
(COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia,
headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection. Guillain barre syndrome (GBS) is a neurological disorder
that usually follows a viral infection, it is possible that COVID-19
infection and GBS are closely related. In this case report, we try to
elucidate the relation between SARS-CoV-2 and GBS.
COVID-19 Associated Large Vessel Thrombosis and Ischemic Stroke: A Case Seriesmahendrareddychirra
The novel severe acute respiratory syndrome coronavirus (SARS-COV-2) affects different people in different ways. Most infected people will develop mild to moderate respiratory flu-like illness and recover without the need for hospitalization.
Thrombophylia and COVID-19. A case report of young man 53 years old whith acu...komalicarol
A 57-year-old male was admitted to our Hospital on March 2020
for SARS-Cov2 related interstitial pneumonia. Chest x-ray showed
a bilateral interstitial-alveolar pneumonia and Blood gas analysis
(BGA) in room air highlighted a severe respiratory failure (pO2 46
mmHg, pH 7.41). Due to clinical and biohumoral worsening (stable CRP at 24 mg/dL), tocilizumab (800mg) was performed after
acquiring patient’s informed consensus. In the evening, after 96
hours of hospitalization, the patient presented a clear hyposthenia
/ hemiparesis of the right hemisome whit hyperreflexia, confusion
and slowed speech
The severe acute respiratory syndrome-coronavirus-2-caused coronavirus disease-2019 (COVID-19) has arisen as a serious worldwide public health adversity. Early in the COVID-19 pandemic, an increased incidence of arterial and venous thrombosis was found, linked to systemic inflammation, immobilization, and a prothrombotic environment. Venous thromboembolism (VTE) can manifest itself in a variety of ways. A 55-year-old man presented to the emergency department with peripheral arterial disease (PAD) history.
Visit Here - https://pubrica.com/services/physician-writing-services/case-report/
Guillain Barre Syndrome & Covid-19: A Case Reportclinicsoncology
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia, headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection.
Guillain Barre Syndrome & Covid-19: A Case Reportpateldrona
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs
Guillain Barre Syndrome & Covid-19: A Case Reportkomalicarol
Besides respiratory symptoms, coronavirus disease 2019
(COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia,
headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection. Guillain barre syndrome (GBS) is a neurological disorder
that usually follows a viral infection, it is possible that COVID-19
infection and GBS are closely related. In this case report, we try to
elucidate the relation between SARS-CoV-2 and GBS.
Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus.
Most people who fall sick with COVID-19 will experience mild to moderate symptoms and recover without special treatment.
COVID-19 Infection Occurring in The Postoperative Period in A Patient Who Und...semualkaira
While the coronavirus-associated Covid-19 infection remains a
risk for people all over the world as a pandemic, it is also a major
catastrophic clinical situation for patients undergoing surgery in
hospitals. If patients encounter this infection picture, especially
after severe operations such as heart surgery, the life-threatening
rates increase gradually.
COVID-19 infection occurring in the postoperative period in a patient who und...semualkaira
While the coronavirus-associated Covid-19 infection remains a risk for people all over the world as a pandemic, it is also a major catastrophic clinical situation for patients undergoing surgery in hospitals. If patients encounter this infection picture, especially after severe operations such as heart surgery, the life-threatening rates increase gradually. In this article, we presented the aortic thrombotic process and lung infection that occurred after a patient undergoing coronary artery surgery was infected with corona virus during clinical follow-up. The patient, who was followed up in the intensive care unit due to lung involvement, did not undergo surgical intervention, since there was no ischemic clinical picture due to peripheral occlusion. However, the patient died due to Covid-19 infection
COVID-19 infection occurring in the postoperative period in a patient who und...semualkaira
While the coronavirus-associated Covid-19 infection remains a risk for people all over the world as a pandemic, it is also a major catastrophic clinical situation for patients undergoing surgery in hospitals. If patients encounter this infection picture, especially after severe operations such as heart surgery, the life-threatening rates increase gradually. In this article, we presented the aortic thrombotic process and lung infection that occurred after a patient undergoing coronary artery surgery was infected with corona virus during clinical follow-up. The patient, who was followed up in the intensive care unit due to lung involvement, did not undergo surgical intervention, since there was no ischemic clinical picture due to peripheral occlusion. However, the patient died due to Covid-19 infection
Ulcerative Colitis with Aseptic Abscesses Controlled by Vedolizumab: A Case R...georgemarini
Aseptic abscesses (AAs) are neutrophilic infiltrative lesions that often coincide with systemic inflammatory disorders such as inflammatory bowel diseases (IBD). According to recent literature, medical therapies in IBD with AAs include corticosteroid, immunosuppressants and anti-TNFα biologics.
Prevalence and Determinants of Distress Among Residents During COVID Crisisgeorgemarini
Residents are predisposed to develop distress, burnout, and depression. With COVID-19, new stressful working conditions were imposed. This study aims to assess the impact of COVID-19 on residents’ wellbeing in France.
A Road from Coronary to Pulmonary: A Rare Imaging Presentationgeorgemarini
Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Its association with Pulmonary Atresia is considered to be the most severe form, the diagnosis of which plays an important role in determination of the treatment protocol. In such cases, systemic vascular channels called Major Aortopulmonary Collateral Arteries (MAPCA’s) develop from aorta and its major branches to supply and maintain the pulmonary circulation. Such patients commonly undergo a Cardiac CT as an imperative pre-operative investigation for detailed information of these collaterals which helps plan further management. Here, we present a Case Report of an adult female patient with Pentalogy of Fallot wherein, a Cardiac CT showed the presence of dilated coronary-to-pulmonary collateral circulation. i.e. CAPA apart from the normally visualized MAPCA’s, an extremely rare occurrence.
Loop –Mediated Isothermal Amplification (LAMP) Based POINT-OF-CARE for Rapid ...georgemarini
Abstract Infectious diseases, including foodborne diseases, to this day remain a major health threat worldwide. Molecular diagnostics, based on nucleic acid (NA) amplification technologies, are in the forefront for the detection of pathogens. Polymerase chain reaction (PCR) is one of the most widely used methods for nucleic acid amplification in pathogen diagnostic.
Wen Dan Tang: A Potential Jing Fang Decoction for Headache Disordersgeorgemarini
Chinese herbal medicine is considered relatively safe, inexpensive, and easily accessible. Furthermore, it is becoming increasingly popular in the western countries. Wen Dan Tang, a Jing Fang ancient classical Chinese herbal formula, with a broad indication profile, has been used for several centuries in China to treat various illnesses.
Abstract Syringoma is a benign eccrine sweat gland tumor affecting mostly females at puberty projected with multiple soft papules usually 1-2 mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter, as a benign eccrine sweat gland tumor. The sites of predilection are lower eyelids, and cheeks. The regions of tendency are cheeks and lower eyelids. Syringoma of the vulvar is a rare disorder few cases of which have been reported in literature.
Rural Healthcare in Light of a Multinational Pandemic: A Global Perspectivegeorgemarini
Abstract Rural healthcare recently came into international spotlight, with recent reported influx of the COVID-19 into rural regions. This article focuses on susceptibilities of the rural population to pandemics and mitigating measures to prevent formation of disease epicentre. Rural Healthcare is by far one of the most neglected areas of medicine. The discrepancies in quality of rural healthcare has been evident for decades, yet no lasting measures have been able to bridge this gap till date. Lessons gleaned from the recent SARS and H1N1 pandemics has once again fallen through the cracks in a futile attempt to curb urban spread. http://dx.doi.org/10.47829/ACMCR.2021.61801
A Mild form of Familial Mediterranean Fever Associated with a Polymorphisms C...georgemarini
Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disease caused bymutation(s) in the Mediterranean fever (MEFV, pyrinmarenostrin) gene. FMF is characterized byrecurrent fever crisis combined with serosal, synovial, or cutìaneous inflammation
Portosystemic Shunt for Treatment of Symptomatic Varices in Polycythemia Vera...georgemarini
Myeloproliferative disorders are commonly associated with portal vein thrombosis, which can lead to extensive and symptomatic variceal disease due to the development of noncirrhotic portal hy- pertension. In severe cases, a decline in liver synthetic function may indicate the need for liver transplantation
A hookah (shisha, waterpipe) use may increase the risk of suffering from serious symptoms due to
COVID-19. Like smoking, hookahs may exacerbate the risk for severe COVID-19 through shared use
and being difficult-to-clean the long pipes and having a cold water reservoir. Social gatherings also
provide an opportunity for the virus to spread.
Can Lung Ultrasound in Patients with Fever of Unknown Origin Detect Early Sig...georgemarini
The increasing interest in Lung Ultrasound (LUS) over the last years led to a great diffusion and better experience in using this technique, which became an essential tool for clinicians. During the current Coronavirus Disease 2019 (COVID-19) pandemic
Postpartum Meningitis by Enterococcus Faecalis Secondary to Neuraxial Anesthesiageorgemarini
Meningitis is an infrequent and serious cause of postpartum fever that requires early diagnosis and treatment to prevent serious complications and to reduce the high mortality rate. Neuraxial anesthesia is a frequently used technique in obstetrics. Meningitis is a very rare complication of neuraxial an- esthesia and enterococcus....
Advanced Esophagogastric Cancer after Bariatric Proceduregeorgemarini
A 74-year-old man, non-smoker or alcoholic, underwent gastric bypass with stapled division of the stomach and Roux-en-Y gastrojejunostomy 20 years ago. A band was used to limit the emptying of the gastric pouch. Follow up was abandoned there are ten years, and, three months ago,
Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus.
Most people who fall sick with COVID-19 will experience mild to moderate symptoms and recover without special treatment.
COVID-19 Infection Occurring in The Postoperative Period in A Patient Who Und...semualkaira
While the coronavirus-associated Covid-19 infection remains a
risk for people all over the world as a pandemic, it is also a major
catastrophic clinical situation for patients undergoing surgery in
hospitals. If patients encounter this infection picture, especially
after severe operations such as heart surgery, the life-threatening
rates increase gradually.
COVID-19 infection occurring in the postoperative period in a patient who und...semualkaira
While the coronavirus-associated Covid-19 infection remains a risk for people all over the world as a pandemic, it is also a major catastrophic clinical situation for patients undergoing surgery in hospitals. If patients encounter this infection picture, especially after severe operations such as heart surgery, the life-threatening rates increase gradually. In this article, we presented the aortic thrombotic process and lung infection that occurred after a patient undergoing coronary artery surgery was infected with corona virus during clinical follow-up. The patient, who was followed up in the intensive care unit due to lung involvement, did not undergo surgical intervention, since there was no ischemic clinical picture due to peripheral occlusion. However, the patient died due to Covid-19 infection
COVID-19 infection occurring in the postoperative period in a patient who und...semualkaira
While the coronavirus-associated Covid-19 infection remains a risk for people all over the world as a pandemic, it is also a major catastrophic clinical situation for patients undergoing surgery in hospitals. If patients encounter this infection picture, especially after severe operations such as heart surgery, the life-threatening rates increase gradually. In this article, we presented the aortic thrombotic process and lung infection that occurred after a patient undergoing coronary artery surgery was infected with corona virus during clinical follow-up. The patient, who was followed up in the intensive care unit due to lung involvement, did not undergo surgical intervention, since there was no ischemic clinical picture due to peripheral occlusion. However, the patient died due to Covid-19 infection
Ulcerative Colitis with Aseptic Abscesses Controlled by Vedolizumab: A Case R...georgemarini
Aseptic abscesses (AAs) are neutrophilic infiltrative lesions that often coincide with systemic inflammatory disorders such as inflammatory bowel diseases (IBD). According to recent literature, medical therapies in IBD with AAs include corticosteroid, immunosuppressants and anti-TNFα biologics.
Prevalence and Determinants of Distress Among Residents During COVID Crisisgeorgemarini
Residents are predisposed to develop distress, burnout, and depression. With COVID-19, new stressful working conditions were imposed. This study aims to assess the impact of COVID-19 on residents’ wellbeing in France.
A Road from Coronary to Pulmonary: A Rare Imaging Presentationgeorgemarini
Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Its association with Pulmonary Atresia is considered to be the most severe form, the diagnosis of which plays an important role in determination of the treatment protocol. In such cases, systemic vascular channels called Major Aortopulmonary Collateral Arteries (MAPCA’s) develop from aorta and its major branches to supply and maintain the pulmonary circulation. Such patients commonly undergo a Cardiac CT as an imperative pre-operative investigation for detailed information of these collaterals which helps plan further management. Here, we present a Case Report of an adult female patient with Pentalogy of Fallot wherein, a Cardiac CT showed the presence of dilated coronary-to-pulmonary collateral circulation. i.e. CAPA apart from the normally visualized MAPCA’s, an extremely rare occurrence.
Loop –Mediated Isothermal Amplification (LAMP) Based POINT-OF-CARE for Rapid ...georgemarini
Abstract Infectious diseases, including foodborne diseases, to this day remain a major health threat worldwide. Molecular diagnostics, based on nucleic acid (NA) amplification technologies, are in the forefront for the detection of pathogens. Polymerase chain reaction (PCR) is one of the most widely used methods for nucleic acid amplification in pathogen diagnostic.
Wen Dan Tang: A Potential Jing Fang Decoction for Headache Disordersgeorgemarini
Chinese herbal medicine is considered relatively safe, inexpensive, and easily accessible. Furthermore, it is becoming increasingly popular in the western countries. Wen Dan Tang, a Jing Fang ancient classical Chinese herbal formula, with a broad indication profile, has been used for several centuries in China to treat various illnesses.
Abstract Syringoma is a benign eccrine sweat gland tumor affecting mostly females at puberty projected with multiple soft papules usually 1-2 mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter, as a benign eccrine sweat gland tumor. The sites of predilection are lower eyelids, and cheeks. The regions of tendency are cheeks and lower eyelids. Syringoma of the vulvar is a rare disorder few cases of which have been reported in literature.
Rural Healthcare in Light of a Multinational Pandemic: A Global Perspectivegeorgemarini
Abstract Rural healthcare recently came into international spotlight, with recent reported influx of the COVID-19 into rural regions. This article focuses on susceptibilities of the rural population to pandemics and mitigating measures to prevent formation of disease epicentre. Rural Healthcare is by far one of the most neglected areas of medicine. The discrepancies in quality of rural healthcare has been evident for decades, yet no lasting measures have been able to bridge this gap till date. Lessons gleaned from the recent SARS and H1N1 pandemics has once again fallen through the cracks in a futile attempt to curb urban spread. http://dx.doi.org/10.47829/ACMCR.2021.61801
A Mild form of Familial Mediterranean Fever Associated with a Polymorphisms C...georgemarini
Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disease caused bymutation(s) in the Mediterranean fever (MEFV, pyrinmarenostrin) gene. FMF is characterized byrecurrent fever crisis combined with serosal, synovial, or cutìaneous inflammation
Portosystemic Shunt for Treatment of Symptomatic Varices in Polycythemia Vera...georgemarini
Myeloproliferative disorders are commonly associated with portal vein thrombosis, which can lead to extensive and symptomatic variceal disease due to the development of noncirrhotic portal hy- pertension. In severe cases, a decline in liver synthetic function may indicate the need for liver transplantation
A hookah (shisha, waterpipe) use may increase the risk of suffering from serious symptoms due to
COVID-19. Like smoking, hookahs may exacerbate the risk for severe COVID-19 through shared use
and being difficult-to-clean the long pipes and having a cold water reservoir. Social gatherings also
provide an opportunity for the virus to spread.
Can Lung Ultrasound in Patients with Fever of Unknown Origin Detect Early Sig...georgemarini
The increasing interest in Lung Ultrasound (LUS) over the last years led to a great diffusion and better experience in using this technique, which became an essential tool for clinicians. During the current Coronavirus Disease 2019 (COVID-19) pandemic
Postpartum Meningitis by Enterococcus Faecalis Secondary to Neuraxial Anesthesiageorgemarini
Meningitis is an infrequent and serious cause of postpartum fever that requires early diagnosis and treatment to prevent serious complications and to reduce the high mortality rate. Neuraxial anesthesia is a frequently used technique in obstetrics. Meningitis is a very rare complication of neuraxial an- esthesia and enterococcus....
Advanced Esophagogastric Cancer after Bariatric Proceduregeorgemarini
A 74-year-old man, non-smoker or alcoholic, underwent gastric bypass with stapled division of the stomach and Roux-en-Y gastrojejunostomy 20 years ago. A band was used to limit the emptying of the gastric pouch. Follow up was abandoned there are ten years, and, three months ago,
Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...georgemarini
Encephalitis caused by Herpes Simplex Virus (HSV) and medulloblastoma are both fairly rare disorders with relatively poor prognoses. We experienced a case of HSV encephalitis (HSE) in which the patient presented 1 year after surgical resection and radiation therapy and 1 month after chemotherapy....
Superior Mesenteric Artery Syndrome Treated by Laparoscopic Duodenojejunostomygeorgemarini
Superior Mesenteric Artery syndrome (SMA Sd) is a very rare disease. It is suspected in the case of intestinal obstruction in severely underweight patients
Colopleural Fistula. A Case Report and Review of Literaturegeorgemarini
The presence of a colopleural fistula is a rare event related to several factors, inadequate placement of drains, poor surgical technique, infection or dehiscence of a GI anastomosis
Atypical Presentation of Post-Kala Azar Dermal Leishmaniasis in Bhutangeorgemarini
This article describes an atypical case of post-kala azar dermal leishmaniasis associated with complications due to delayed diagnosis and poor case management. The grave consequences of the prolonged disease process, which included facial disfigurement
Cutaneous Larva Migrans: A Case Report in a Traveler Childgeorgemarini
Cutaneous Larva Migrans (CLM) is the most common skin disease of tropical origincaused by hookworms larvae, occurring in international travelers. Typical manifestations consist of erythematous, serpiginous slightly elevated linear cutaneous lesions
Since receiving unexplained pneumonia patients at the Jinyintan Hospital in Wu- han, China in December 2019, the new coronavirus (COVID-19) has rapidly spread in Wuhan, China and spread to the entire China and some neighboring countries.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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2. http://www.acmcasereport.com/ 2
Volume 8 Issue 17 -2022 Case Report
mottled and cold. His right popliteal artery and pedal pulse were
not palpable. Computed tomography angiography showed com-
plete occlusion of the right superficial femoral artery extended to
the popliteal artery (figure 1).
He was started on a therapeutic heparin infusion. He underwent an
emergency right lower artery embolectomy Fogarty catheter. But
his foot was cyanosis and his pedal pulse was not palpable. So, the
patient had a mid-leg amputation. Two days after, the amputation
stump was necrotic.
He had a mid-thigh amputation then transferred to intensive care
for respiratory distress and he died a few days later.
5. Case Presentation 3
An A-58-year-old man without medical history presented to the
emergency department complaining of fever, asthenia, and short-
ness of breath.
Vital signs on presentation were: Glasgow scale, 15/15; tem-
perature, 37 C°; heart rate, 99 beats/min; blood pressure, 122/64
mmHg; oxygen saturation, 80% on room air and 96% on supple-
mental oxygen (16 liter/min of oxygen). His nasopharyngeal swap
was positive for COVID-19 infection. The electrocardiography
was normal. On initial laboratory evaluation, we found: hyperleu-
kocytosis, 10700/mm3
; lymphopenia, 510/mm3
; elevated D-dimer
635 ng/mL and elevated C-reactive protein, 195 ng/mL.
The patient has been treated with dexamethasone 12 mg for a day,
LMWH 0,4mg twice for a day, cefotaxime 3 g for a day. He had
received insulin for newly diagnosed diabetes. Two days after, he
had painful lower extremities. On examination, his bilateral ex-
tremities were mottled and cold. His femoral, posterior tibial, and
pedal pulses were not palpable. Computed tomography angiogra-
phy of the aorta and iliofemoral arteries showed complete occlu-
sion of the abdominal aorta with extension to both common iliac
arteries, complete occlusion of the right popliteal artery, the left
anterior tibial artery (figure 2). It showed a splenic infarction. The
patient had received UFH. But he had a distress respiratory and a
cardiac arrest and died.
Figure 1: CT angiography of aorta and iliofemoral arteries: Complete occlusion of the right superficial femoral artery extended to the popliteal artery
Figure 2: CT angiography of the aorta and iliofemoral arteries showed:
- Complete occlusion of the abdominal aorta extension to both common iliac arteries
- Complete occlusion of the right popliteal artery, the left anterior tibial artery
3. http://www.acmcasereport.com/ 3
Volume 8 Issue 17 -2022 Case Report
6. Discussion
COVID-19 significantly impacted healthcare worldwide. It can
present with a variety of clinical manifestations including fever,
cough, myalgia, dyspnea, headache, diarrhea, and vomiting [1].
Although respiratory symptoms predominate, COVID-19 is a
high risk for arterial thromboembolism. Patients with severe
COVID-19 infection can develop intravascular coagulopathy with
endothelial dysfunction [2].
Multiple retrospective analyses have similar incidents from 12
to 31% of thrombotic complications in patients infected with
COVID-19 [2]. A minority of these events are arterial (4%) [1, 3].
The mechanism of thromboembolic complications is multifactori-
al: a direct viral infection of the endothelial cell leading to diffuse
endothelial inflammation increased pro-coagulant factors such
as fibrinogen, factor VIII, and high inflammatory state associat-
ed with the cytokine storm leading to coagulation and fibrinolysis
activation [4]. So, endothelitis and hypercoagulability, together
with prolonged immobilization of critically ill COVID-19 patients
complete the
Virchow’s triad explains the mechanism of arterial thrombosis [3].
Elevated D-dimer was associated with high mortality [5]. The
study of Tang et al showed that abnormal coagulation results,
characterized by markedly elevated D-dimer and fibrin degrada-
tion products
are common in patients who have died of this viral pneumonia [6].
In China, a study of 1099 covid-19 cases showed that 46,4% of
patients had a high level of D-dimer (≥500μg/l), 60% of them had
severe pneumonia [7].
Parminder K et al reported a similar case of a 43-year-old patient
who had a severe form of COVID-19 infection. He had an elevated
D-dimer and fibrinogen. He was found to have a thrombus of the
proximal right superficial femoral artery and two days after admis-
sion, he had a cardiac arrest and died [8].
In a review, Cheruiyot I et al found that most patients with arterial
thrombosis were elderly and had pre-existing co-morbidities [3],
confirming the current evidence that pre-existing chronic disease
increases the incidence and severity of COVID-19 [3, 9]. Pre-ex-
isting cardiac diseases have been known to prejudice vascular in-
flammation which could be exacerbated by the SARS-CoV-2 in-
fection and the enhanced prevalence of arterial thrombosis in these
particularly predisposed individuals [3]. An observation has been
reported in the pediatric population where the presence of congen-
ital cardiovascular disease predisposed affected children to severe
COVID-19 infection and thrombotic complications [10].
We have two elderly patients with preexisting chronic illness in
our cases, but the third case had 58 years, without medical history.
The American Society of Hematology (ASH) recommends that
all hospitalized patients with COVID-19 infection should receive
anticoagulant thromboprophylaxis, in the absence of a contraindi-
cation [11].
The recommendations regarding therapeutic anticoagulation in pa-
tients with limb ischemia and SARS-CoV-2 infection are not well
established yet [12, 13].
Bellosta R et al, in a study on 20 patients who underwent revascu-
larization, showed that the usage of systemic heparin was associ-
ated with increased survival [5]. In this study, all the patients re-
ceived LMWH after revascularization, and none of them required
reintervention, which leads to the possibility that heparinization
prevents recurrent thrombosis and improves the rate of survival
and limb salvage [12].
However, in our case, a patient, treated with therapeutic LMWH
after Fogarty artery embolectomy catheter, had a mid-leg ampu-
tation for a necrotic lower. This may be explained by the patient's
comorbidities and the delay of the revascularization.
7. Conclusion
COVID-19 can be associated with an increased risk of limb isch-
emia. Our cases and review of the literature reveal that health care
providers should be aware of life-threatening thromboembolic
events. So, we should discuss therapeutic anticoagulation and lab-
oratory values such as D-dimer may help with the decision.
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