RESUMO
Endobronchial stents have been used occasionally to treat benign conditions such as tracheobronchomalacia (TBM). This report describes a unique case of a patient with crescentic TBM in whom Dynamic Y stent was placed on 2 separate occasions to control symptoms and resulted in identical posterior wall stent fractures within a year of stent placement, both times. A silicone Y stent was substituted for the dynamic stent, and it has been effective in controlling symptoms for 9 months without complications. A literature review of cases of fractured Dynamic Y stents is made and factors affecting the choice of stent type for crescentic TBM are explored.
Assuntos
Falha de Prótese , Stents/efeitos adversos , Traqueobroncomalácia/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese/efeitos adversos , Fatores de Risco , Silicones/uso terapêutico , Tomografia Computadorizada por Raios X , Traqueobroncomalácia/diagnóstico por imagem , Resultado do TratamentoRESUMO
Oxcarbazepine, a metabolite of carbamazepine, is used as an antiepileptic, analgesic for neuropathic pain and in the treatment of affective disorders. It has been approved by the Food and Drug Administration for partial seizures in adults as both adjunctive and monotherapy, and as adjunctive therapy in children aged from 2 to 16 years (http://www.fda.gov/ohrms/dockets/ac/06/briefing/2006-4254b_07_05_KP%20OxcarbazepineFDAlabel102005.pdf). We present a case of serotonin syndrome, which was precipitated by this medicine in a patient who had been predisposed by long-term treatment with sertraline, a selective serotonin reuptake inhibitor. This is the first reported fatality due to this drug interaction and only the second case of serotonin syndrome reported with oxcarbazepine. Physicians should consider this risk when prescribing the above combination.
Assuntos
Analgésicos/efeitos adversos , Carbamazepina/análogos & derivados , Interações Medicamentosas , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Síndrome da Serotonina/induzido quimicamente , Sertralina/administração & dosagem , Idoso de 80 Anos ou mais , Analgésicos/administração & dosagem , Anti-Hipertensivos/administração & dosagem , Fibrilação Atrial/complicações , Broncodilatadores/administração & dosagem , Carbamazepina/administração & dosagem , Carbamazepina/efeitos adversos , Doença da Artéria Coronariana/complicações , Depressão/complicações , Depressão/tratamento farmacológico , Diabetes Mellitus , Neuropatias Diabéticas/complicações , Evolução Fatal , Humanos , Hipertensão/complicações , Hipoglicemiantes/administração & dosagem , Masculino , Neuralgia/tratamento farmacológico , Oxcarbazepina , Doença Pulmonar Obstrutiva Crônica/complicaçõesRESUMO
Malignant primary tracheal tumors are extremely rare. The most common malignant primary tracheal tumors are squamous cell carcinoma and adenoid cystic carcinomas. In this brief report, we describe a patient who presented with a primary papillary squamous cell carcinoma in-situ at multiple areas in the trachea with a significant airway obstruction. Our case was successfully managed using a combination of electrocautery and argon photocoagulation for endotracheal ablation of the tumor and adjuvant external beam radiotherapy.
