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Pascal Bilbault - One of the best experts on this subject based on the ideXlab platform.
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Open Access Confusion after spine injury: cerebral fat embolism after traumatic rupture of a Tarlov cyst:
2013Co-Authors: Corina M Duja, Christophe Berna, Stéphane Kremer, Claude Géronimus, Jacques Kopferschmitt, Pascal BilbaultAbstract:Background: Acute low back pain is a very common symptom and reason for many Medical consultations. In some unusual circumstances it could be linked to a rare aetiology. Case presentation: We report a 70-year-old man with an 8-month history of left posterior thigh and leg pain who had sudden confusion after a fall from standing. It was due to cerebral fat embolism suspected by computed tomography scan, later confirmed by brain magnetic resonance imaging (MRI). A spinal MRI scan was then performed and revealed a sacral fracture which drained into an unknown perineurial cyst (Tarlov cyst). Under Medical Observation the patient fully recovered within three weeks. Conclusions: Sacral perineurial cysts are rare, however they remain a potential cause of lumbosacral radiculopathy. Background In Emergency Care, patients admitted for low back pain with or without sciatica are common. Specific aetiology of low back pain is rarely found and does not need routinely imaging exploration [1]. But if physical examination is abnormal or pain unusually persistent, Emergency Physician should explore the lumbar spine with a CT or MRI scan. These imaging techniques can reveal herniated disk, spinal stenosis, early spinal infection or tumour. Nevertheless other rare causes can occur as in our Observation where we report a sacral fracture of an unknown Tarlov cyst complicated with cerebral fat embolism. Case presentation A 70-year-old man with an 8-month history of left posterior thigh and leg pain was admitted to our Emergency Department after a fall during a gym session. He presented with a moderate pelvic and head trauma. A physical examination showed only tenderness upon palpation and percussion of the lumbar and sacral spine
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Confusion after spine injury: cerebral fat embolism after traumatic rupture of a Tarlov cyst: Case report
BMC emergency medicine, 2010Co-Authors: Corina M Duja, Christophe Berna, Stéphane Kremer, Claude Géronimus, Jacques Kopferschmitt, Pascal BilbaultAbstract:Acute low back pain is a very common symptom and reason for many Medical consultations. In some unusual circumstances it could be linked to a rare aetiology. We report a 70-year-old man with an 8-month history of left posterior thigh and leg pain who had sudden confusion after a fall from standing. It was due to cerebral fat embolism suspected by computed tomography scan, later confirmed by brain magnetic resonance imaging (MRI). A spinal MRI scan was then performed and revealed a sacral fracture which drained into an unknown perineurial cyst (Tarlov cyst). Under Medical Observation the patient fully recovered within three weeks. Sacral perineurial cysts are rare, however they remain a potential cause of lumbosacral radiculopathy.
Lais Helena Camacho Navarro - One of the best experts on this subject based on the ideXlab platform.
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Does Spinal Block Through Tattooed Skin Cause Histological Changes in Nervous Tissue and Meninges?: An Experimental Model in Rabbits.
Regional Anesthesia and Pain Medicine, 2015Co-Authors: Isabela Leite Ferraz, Guilherme Antônio Moreira De Barros, Patrícia Gomes Ferreira Neto, Daneshivari Solanki, Mariângela Esther Alencar Marques, Vânia Maria De Vasconcelos Machado, Lucas Wynne Cabral, Rodrigo Moreira E Lima, Pedro Thadeu Galvão Vianna, Lais Helena Camacho NavarroAbstract:Background and Objectives Although there is no documented evidence that tattoo pigments can cause neurological complications, the implications of performing neuraxial anesthesia through tattooed skin are unknown. In this study, we aimed to assess whether spinal puncture performed through tattooed skin of rabbits determines changes over the spinal cord and meninges. In addition, we sought to evaluate the presence of ink fragments entrapped in spinal needles. Methods Thirty-six young male adult rabbits, each weighing between 3400 and 3900 g and having a spine length between 38.5 and 39 cm, were divided by lot into 3 groups as follows: GI, spinal puncture through tattooed skin; GII, spinal puncture through tattooed skin and saline injection; and GIII, spinal puncture through skin free of tattoo and saline injection. After intravenous anesthesia with ketamine and xylazine, the subarachnoid space was punctured at S1-S2 under ultrasound guidance with a 22-gauge 2½ Quincke needle. Animals in GII and GIII received 5 μL/cm of spinal length (0.2 mL) of saline intrathecally. In GI, the needle tip was placed into the yellow ligament, and no solution was injected into the intrathecal space; after tattooed skin puncture, 1 mL of saline was injected through the needle over a histological slide to prepare a smear that was dyed by the Giemsa method to enable tissue identification if present. All animals remained in captivity for 21 days under Medical Observation and were killed by decapitation. The lumbosacral spinal cord portion was removed for histological analysis using hematoxylin-eosin stain. Results None of the animals had impaired motor function or decreased nociception during the period of clinical Observation. None of the animals from the control group (GIII) showed signs of injuries to meninges. In GII, however, 4 animals presented with signs of meningeal injury. The main histological changes observed were focal areas of perivascular lymphoplasmacyte infiltration in the pia mater and arachnoid. There was no signal of injury in neural tissue in any animal of both groups. Tissue coring containing ink pigments was noted in all GI smears from the spinal needles used to puncture the tattooed skin. Conclusions On the basis of the present results, intrathecal injection of saline through a needle inserted through tattooed skin is capable of producing histological changes over the meninges of rabbits. Ink fragments were entrapped inside the spinal needles, despite the presence of a stylet.
Vololontiana, Hanta Marie Danielle - One of the best experts on this subject based on the ideXlab platform.
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Management of systemic disease patients in the service of internal medicine CHU Antananarivo Madagascar “Prise en charge des patients atteints de maladies systémiques dans le service de médecine interne du CHU Antananarivo Madagascar”
Journal of Medical Care Research and Review, 2019Co-Authors: Rahantamalala, Marie Ida, Andrianandrasana, Ny Ony, Ranaivoson, Rotsy Nala, Dinafanomezana Harijaona, Vololontiana, Hanta Marie DanielleAbstract:Résumé : Cette étude a eu pour objectif d’estimer les types de traitement et l’utilisation des différents médicaments chez les patients atteints de maladies systémiques dans le service de Médecine interne du CHU d’Antananarivo à Madagascar. Il s’agissait d’une étude transversale, réalisée à partir de 33 cas de maladies systémiques observés dans le service de médecine interne du CHU d’Antananarivo à Madagascar, durant une période de 16 mois (Avril 2013- 31 Août 2014). Etaient inclus, après Observation des dossiers médicaux respectifs, tout patient présentant des signes cliniques, paracliniques en faveur de: lupus érythémateux systémique, polyarthrite rhumatoïde, uvéite autoimmune, sclérodermie systémique, purpura thrombopénique immunologique, cytopénies autoimmunes, maladie de (Sharp, Behçet, Takayasu, Still, Crohn), arthrite juvénile idiopathique, pseudo polyarthrite rhizomélique. Les patients dont l’Observation médicale ne remplissait pas les paramètres à évaluer étaient exclus. Le lupus érythémateux systémique (27,3%) et la polyarthrite rhumatoide (21,2%) étaient les pathologies les plus fréquentes. Quatre classes pharmacologiques ont été prescrites: corticostéroïdes (93,33%), cytotoxiques (48,48%), antipaludiques de synthèse (24,24%) et immunosuppresseurs (9,09%). Les effets iatrogènes notoires étaient mis en exergue chez les patients sous corticoïdes (n=12), ciclosporine (n=2), cyclophosphamide(n=6), méthotrexate (n=1) et sous antipaludiques de synthèse (n=3). Des mesures non médicamenteuses étaient également préconisées: régime sans résidu (n=1), vaccination antigrippale (n=2). Une chimioprophylaxie par cotrimoxazole forte était faite lors des traitements par cyclophosphamide (n=2). Dans cette étude, les corticoïdes étaient les médicaments les plus utilisés. Les effets notoires du traitement et l’inobservance thérapeutique, ainsi que l’inaccessibilité aux médicaments représentaient les causes probables de l’échec thérapeutique. Mots clés: Maladies systémiques, traitement, corticoids Abstract: The objective of this study was to estimate the types of treatment and use of different drugs in patients with systemic diseases in the Department of Internal Medicine at the University Hospital of Antananarivo in Madagascar. It was about a transversal study realized from 33 cases observed in the service of internal medicine of the CHU from Antananarivo to Madagascar, during a period of 16 months from April 31st, 2013 till August 31st, 2014. All patients with clinical signs of systemic lupus erythematosus, rheumatoid arthritis, autoimmune uveitis, systemic scleroderma, immunological thrombocytopenic purpura, autoimmune cytopenia, (Sharp, Behçet, Takayasu , Still, Crohn), juvenile idiopathic arthritis, pseudo rhizomelic arthritis.The patients excluded from the study were the patients with whom the Medical Observation had not filled the parameters to be estimated. Systemic Lupus erythematous (27,3%) and Rheumatoid Arthritis (21,2%) were the most common pathologies. Four classes of pharmacological drugs were mainly used including corticosteroid (93,33%), cytotoxic (48,48%), antimalarial (24,24%) and immunosuppressive (9,09%). The bad effects have been seen into patients after taking medicines containing corticoid (n=12), methotrexate (n=1), cyclosporine (n=2), cyclophosphamide (n=6), antimalarial (n=3). Non medicinal’s measures were equally recommending: diet without residue (n=1), vaccination against influenza (n=2). A chemoprophylaxis by cotrimoxazole forte was done at the time of treatments by cyclophosphamide (n=2). In this study, corticoids were the most using medicines. The notorious effects of treatement, the therapeutic inobservance, and the inaccessibility to medicine represented the expected causes of therapeutic failure. Key words : Systemic diseases, treatment, corticoid
Athar M Qureshi - One of the best experts on this subject based on the ideXlab platform.
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abstract 20256 clinical presentation management and longitudinal follow up of neonatal and infants with coronary artery fistula a multicenter study from the coronary artery fistula registry
Circulation, 2014Co-Authors: Srinath T Gowda, Shelby Kutty, Asnes Jeremy, Lourdes R Prieto, Zhi Chen, Masaru Miura, Takeda Atsuhito, Athar M QureshiAbstract:Background: Neonatal coronary artery fistula is rare, and data regarding its clinical presentation, treatment, and long term outcome are lacking. Methods: Data in all neonates and infants who underwent evaluation in the catheterization lab for coronary artery fistula (CAF) from Jan 1995 - Jan 2014 were reviewed from the multicenter CAF registry. The CAF were classified as proximal and distal for analysis. Results: A total of 21 patients were included from 12 centers. Results: The median age and BSA was 0.26 yrs and 0.26 m2, respectively. At presentation, heart failure (HF) symptoms were noted in 14 / 21 (61%) pts; 11 had proximal and 10 had distal CAF. The largest and narrowest mean calibers of CAF were 6.9 and 3.3mm. Eleven pts underwent transcatheter closure (TCC), 7 surgical closure (SC), and 3 had Medical Observation only. Procedural success was 100%,; intentional partial closure was performed in 1 patient with large distal fistula. Follow-up with median 2.3 ( 0.3-18 ) years in 90% pts revealed corona...
Corina M Duja - One of the best experts on this subject based on the ideXlab platform.
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Open Access Confusion after spine injury: cerebral fat embolism after traumatic rupture of a Tarlov cyst:
2013Co-Authors: Corina M Duja, Christophe Berna, Stéphane Kremer, Claude Géronimus, Jacques Kopferschmitt, Pascal BilbaultAbstract:Background: Acute low back pain is a very common symptom and reason for many Medical consultations. In some unusual circumstances it could be linked to a rare aetiology. Case presentation: We report a 70-year-old man with an 8-month history of left posterior thigh and leg pain who had sudden confusion after a fall from standing. It was due to cerebral fat embolism suspected by computed tomography scan, later confirmed by brain magnetic resonance imaging (MRI). A spinal MRI scan was then performed and revealed a sacral fracture which drained into an unknown perineurial cyst (Tarlov cyst). Under Medical Observation the patient fully recovered within three weeks. Conclusions: Sacral perineurial cysts are rare, however they remain a potential cause of lumbosacral radiculopathy. Background In Emergency Care, patients admitted for low back pain with or without sciatica are common. Specific aetiology of low back pain is rarely found and does not need routinely imaging exploration [1]. But if physical examination is abnormal or pain unusually persistent, Emergency Physician should explore the lumbar spine with a CT or MRI scan. These imaging techniques can reveal herniated disk, spinal stenosis, early spinal infection or tumour. Nevertheless other rare causes can occur as in our Observation where we report a sacral fracture of an unknown Tarlov cyst complicated with cerebral fat embolism. Case presentation A 70-year-old man with an 8-month history of left posterior thigh and leg pain was admitted to our Emergency Department after a fall during a gym session. He presented with a moderate pelvic and head trauma. A physical examination showed only tenderness upon palpation and percussion of the lumbar and sacral spine
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Confusion after spine injury: cerebral fat embolism after traumatic rupture of a Tarlov cyst: Case report
BMC emergency medicine, 2010Co-Authors: Corina M Duja, Christophe Berna, Stéphane Kremer, Claude Géronimus, Jacques Kopferschmitt, Pascal BilbaultAbstract:Acute low back pain is a very common symptom and reason for many Medical consultations. In some unusual circumstances it could be linked to a rare aetiology. We report a 70-year-old man with an 8-month history of left posterior thigh and leg pain who had sudden confusion after a fall from standing. It was due to cerebral fat embolism suspected by computed tomography scan, later confirmed by brain magnetic resonance imaging (MRI). A spinal MRI scan was then performed and revealed a sacral fracture which drained into an unknown perineurial cyst (Tarlov cyst). Under Medical Observation the patient fully recovered within three weeks. Sacral perineurial cysts are rare, however they remain a potential cause of lumbosacral radiculopathy.