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1.
Cureus ; 16(6): e61556, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38962645

RESUMO

Pulmonary edema is a rare mechanism of death that develops after partial hanging, a potential complication that physicians should consider early in the management of these patients. This case series discusses the presentation, evaluation, and treatment course of three patients who had attempted suicide by hanging and were admitted to the hospital. These patients were admitted to the intensive care unit after being stabilized and supportive treatment was provided. In all the cases, a radiological scan of the chest revealed diffuse infiltrates consistent with pulmonary edema on both sides, features of which were also noted during a diagnostic bronchoscopy. After providing the best intensive care in the hospital, two patients clinically improved, and one patient succumbed to cardiac arrest. As most patients will be brought dead to the hospital following hanging, negative pressure pulmonary edema remains underdiagnosed. Thus, this case series enumerates the possible etiologies of negative pressure pulmonary edema and its contribution to death following suicidal hanging.

2.
Cureus ; 16(5): e60571, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38894795

RESUMO

Adenoid cystic carcinoma (ACC) is a rare type of tumor that usually originates from minor salivary glands in the oral cavity. ACC of the larynx is even rare. This case study describes a 36-year-old non-smoking male farmer who initially presented with dyspnea and was misdiagnosed with bronchial asthma. Spirometry revealed fixed airway obstruction. Further evaluation revealed a pedunculated mass obstructing the airway, which was diagnosed as ACC by histopathological examination of the biopsy specimen. The patient was treated with radiation therapy, resulting in clinical improvement after six weeks. ACC is highly invasive and slow-growing, with perineural extension and a higher risk of recurrence. Metastasis in the lungs is common. Adequate preoperative staging, including imaging with computed tomography (CT) and magnetic resonance imaging, is important for planning treatment. The role of radiation therapy with concurrent chemotherapy is still under trial.

3.
Cureus ; 16(4): e59103, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38803712

RESUMO

Here, we report a case of non-Hodgkin's lymphoma in a 21-year-old man who presented with symptoms of gastric discomfort, hematemesis, breathlessness, dry cough, chest pain, loss of appetite, and weight loss. He had a history of pleural effusion and was previously diagnosed with tuberculosis. Further investigations revealed a mediastinal mass. A biopsy confirmed non-Hodgkin's lymphoma and ruled out thymoma. The patient underwent therapeutic thoracentesis for symptomatic relief and was started on chemotherapy. The prognosis of T-cell lymphoblastic lymphoma (T-LBL) is generally poorer compared to B-cell lymphoblastic lymphoma (B-LBL). T-LBL commonly presents with a mediastinal mass and pleural effusion. Imaging techniques like computed tomography (CT) help evaluate the extent and characteristics of the tumor. Prognostic factors for T-LBL include age, pleural effusion, and extranodal involvement. Molecular characterization is important in determining prognosis and treatment options. 18F-FDG imaging can assist in determining the extent of the tumor, staging, and assessment of response to treatment. Overall, lymphoblastic lymphoma is a rare entity, and T-LBL accounts for a small percentage of all lymphomas. Before the start of definitive chemotherapy, during the evaluation, the patient was started on steroid therapy for symptomatic management, following which regression in the size of the mediastinal tumor was noted.

4.
Cureus ; 16(4): e59324, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38817485

RESUMO

Mechanical ventilation and endotracheal intubation can cause airway damage and inflammation resulting in excessive mucus secretions, thereby increasing the risk of respiratory failure post extubation. An abundance of secretions may result in bronchial obstruction and lung collapse distant from the site of obstruction. If lung collapse is diagnosed, extra support, including oxygen and, rarely, reintubation, can be necessary. The combination of chest wall percussion and vibrations, patient positioning to facilitate mucus drainage, coughing, and breathing exercises was the chest physiotherapy method employed for airway clearance in this study. Since the late 20th century, pulmonary rehabilitation strategies have been a standard aspect of care to prevent lung collapse in postoperative cases. Bronchoscopic aspiration and lavage are the common techniques used to remove retained secretions or mucus plugs. Large-volume saline instillation in aliquots and repeated suctioning are required during the procedure. Thus, the current case series emphasizes the role of bronchoscopy and pulmonary rehabilitation in the management of acute lung atelectasis during the postoperative period.

5.
J Clin Diagn Res ; 8(9): ZC07-10, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25386511

RESUMO

OBJECTIVE: To determine the relationship between the changes of soft and hard tissues after anterior segmental osteotomy and to evaluate these changes using cepahalometric and photometric analyses. MATERIALS AND METHODS: Ten patients aged 18-30 years who underwent anterior segmental osteotomy were included in the study. Preoperative and postoperative records consisted of lateral cephalogram and frontal and lateral photographs. Postoperative measurements were taken six months after surgery. RESULTS: Statistical analysis showed changes in both soft and hard tissue parameters. Changes were not uniform for all the parameters. Upper lip and upper incisor protrusion showed very large effect size whereas nasal tip inclination showed small effect and mentolabial angle showed no effect. CONCLUSION: Skeletal protrusion pose problem to orthodontists as they can't be corrected by orthodontics alone. Anterior segmental osteotomy in association with orthodontia is the choice of treatment. Anterior segmental osteotomy allows for functional and aesthetical correction with good success rate and minimal complication.

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