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تکامل و مدیریت سرپایی در covid-19
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نشریه نفس باد صبا اولین مجله علمی پژوهشی فارسی زبانی است که بصورت تخصصی به بيماريهای دستگاه تنفس انسان و علوم وابسته به آن مي پردازد. اين فصلنامه توسط مرکز آموزشی پژوهشی و درمانی سل و بيماريهای ريوی بيمارستان دکتر مسيح دانشوری، وابسته به دانشگاه علوم پزشکی شهيد بهشتی انتشار می يابد. مخاطب اين نشريه كليه پرسنل خدمات آموزشي، پژوهشي، درماني و بهداشتي، بويژه متخصصين و فوق متخصصين رشته هاي تنفس و علوم مربوط به آن مي باشند.
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بیست و هفتمین وبینار سالیانه مرکز تحقیقات روماتولورژی با عنوان واسکولیت ها
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گرامیداشت روز جهانی جراحی اعصاب در اتاق عمل بیمارستان عرفان نیایش
برخی از مقالات توسط آقای دکتر اردا کیانی در سال های اخیر 2020-2021
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وبینار آموزشی بررسی کلینیکی و رادیولوژیک بیماران ترومای مغزی /
گرداننده : جناب آقای دکتر گیو شریفی
تومور مغزی در دو دسته قابل تقسیماند: تومورهایی که از خود مغز منشأ میگیرند (تومورهای اولیه) و تومورهایی که از سایر ارگانها نظیر ریه و سینه منشأ گرفته و در اثر متاستاز به مغز میرسند (تومورهای ثانویه). علایمی از قبیل سردرد ، سرگیجه ، تهوع و استفراغ ، تشنج و ضعف اندامها از علایم شایع تومورها ی مغزی هستند.
غده هیپوفیز در قاعده جمجمه قرار داشته و به علت عملکرد خاص و محل قرار گیری، از حساسیت بسزایی برخوردار می باشد. عمل جراحی تومور آدنوم شایع ترین عمل جراحی غده هیپوفیز بوده که با پیشرفت های اخیر، تکنیک های بروز، در اکثر موارد به روش آندوسکوپی و کم تهاجمی از راه بینی عمل می شود.
ما با تجربه حدود 2500 مورد جراحی آندوسکوپی موفق لازم دانستیم تا مواردی را برای آمادگی و مراقبت قبل و بعد از عمل ذکر کنیم.
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Indications and results of sternal allograft transplantation: learning from a worldwide experience
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Reconstruction of the anterior chest wall defect after sternectomy is a challenge for cardiothoracic surgeons. In 2010 the Padua group published the first case of cadaveric sternum transplantation after sternectomy. This multi-center study reports the clinical indications, early and long-term results of sternal chondral allograft transplantation.
This is a retrospective multicentre-study from seven Academic-Centres. Demographic data, surgical indications, technical details, early postoperative results were collected. The complications, long-term stability and tolerance of the allografts were also analysed.
Between January 2008 and December 2019 58-patients underwent sternectomy followed by reconstruction using cadaveric-cryopreserved sterno-chondral allografts. Thirty-two patients were males, with a median age of 63.5 years(IQR50-72). Indications for sternectomy were secondary sternal tumors(n=13), primary sternal tumors(n=15) and non-neoplastic disease(30). Thirty patients underwent total sternectomy, 16 lower-body sternectomy and 12 upper-body-manubrium resection. The 30-days mortality was 5%. The overall morbidity was 31%. Six early reoperations were necessary because of bleeding(n=1), titanium-plates dislocation(n=1) and re-suture of the skin in the lower part of the incision(n=4). Overall, the 5-year survival was 74%. The surviving patient’s reconstructions are stable and free from mechanical or infective complications.
The main indications for sternal allograft implantation were complex post sternotomy dehiscence followed by primary or secondary tumor involvement of the sternum. The collected results demonstrate that sterno-chondral allograft transplantation is a safe and effective method in reconstructing the anterior chest wall after sternectomy. Further studies to demonstrate the integration of the bone grafts into the patient’s sternal wall will be made.
Abstract Background Since the outbreak of the novel coronavirus disease-2019 (COVID-19) in December 2019, limited studies have investigated the histopathologic findings of patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Material and methods This study was conducted on 31 deceased patients who were hospitalized for COVID-19 in a tertiary hospital in Tehran, Iran. A total of 52 postmortem tissue biopsy samples were obtained from the lungs and liver of decedents. Clinical characteristics, laboratory data, and microscopic features were evaluated. Reverse transcription polymerase chain reaction (RTa b c, 1 d, 1 b, 1 d, 1 b, 1 e f b Previous Next PCR) assay for SARS-CoV-2 was performed on specimens obtained from nasopharyngeal swabs and tissue biopsies. Results The median age of deceased patients was 66 years (range, 30–87 years) and 25 decedents (81 %) were male. The average interval from symptom onset to death was 13 days (range, 6–34 days). On histopathologic examination of the lung specimens, diffuse alveolar damage and thrombotic microangiopathy were the most common findings (80 % and 60 %, respectively). Liver specimens mainly showed macrovesicular steatosis, portal lymphoplasmacytic inflammation and passive congestion. No definitive viral inclusions were observed in any of the specimens. In addition, 92 % of lung tissue samples tested positive for SARS-CoV-2 by RTPCR. Conclusions Further studies are needed to investigate whether SARS-CoV-2 causes direct cytopathic changes in various organs of the human body.
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Arachnoid prolapse in endoscopic transsphenoidal surgery of pituitary adenoma, technical note Guive Sharifi, Nader Akbari Dilmaghani, Seyed Mousa Sadrhosseini & Shima Arastou To cite this article: Guive Sharifi, Nader Akbari Dilmaghani, Seyed Mousa Sadrhosseini & Shima Arastou (2020): Arachnoid prolapse in endoscopic transsphenoidal surgery of pituitary adenoma, technical note, British Journal of Neurosurgery, DOI: 10.1080/02688697.2020.1779178 To link to this article:
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Purpose: Glioma cell infiltration, in which the glioma tumor cells spread long distances from the primary location using white matter (WM) or blood vessels, is known as a significant challenge for surgery or localized chemotherapy and radiation therapy. Following the World Health Organization (WHO), the glioma grading system ranges from stages I to IV, in which lower-grade gliomas represent benign tumors, and higher grade gliomas are considered the most malignant.
Materials and Methods: We gathered magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) data for seven patients with right precentral gyrus-located tumors and six age- and sex-matched healthy subjects for analysis. Tract-Based Spatial Statistics (TBSS) was utilized to evaluate whole-brain WM implication due to probable tumor infiltration. Also, along-tract statistics were used in order to trace the implicated WM tracts. Finally, for cortical evaluation of probable tumor cell migration, voxel-based morphometry (VBM) was utilized, which allowed us to do whole-brain cortical estimation.
Results: The TBSS results revealed significantly higher fractional anisotropy (FA) and lower mean diffusivity (MD) in the left side superior corona radiata. Also, higher FA was observed in the right corticostriatal tract. Along-tract statistics were also compiled on the corpus callosum (CC), which is anatomically known as a hub between hemispheres. The body of the CC, which connected with the superior corona radiata anatomically, showed significantly higher FA values relative to healthy subjects, which are in line with the TBSS results. Consistent with these results, whole-brain gray matter changes were analyzed via VBM, which showed significant hypertrophy of both sides of the brainstem.
Conclusion: In future investigations, focusing on the genetic basis of the glioma patients in line with imaging studies on a larger sample size, which is known as genetics imaging, would be a suitable approach for tracing this process.
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Frontiers | Glioma Migration Through the Corpus Callosum and the Brainstem Detected by Diffusion and Magnetic Resonance Imaging: Initial Findings | Human Neuroscience (frontiersin.org)
International Journal of Mycobacteriology
Year : 2021 | Volume : 9 | Issue : 5 | Page : 22
The evaluation of interleukin-4 and interleukin-13 in the serum of pulmonary sarcoidosis and tuberculosis patients
Colloid cyst is a gelatin-containing cyst in the brain almost always found in the third ventricle. The specific shape and location of these cysts, a round well-delineated mass in the rostral part of the third ventricle adjacent to the foramen of Monro, on imaging are the main findings for diagnosis. Several masses of the third ventricle masquerading colloid cysts on images have been reported yet. Based on different surgical approach, pre-operative misdiagnosis of colloid cyst may have great impact on prognosis. Methods: We report two cases that presented with severe headache and hydrocephalus and their pre-operative images were highly indicative of a colloid cyst. Results: Histopathological investigations following tumor resection showed pilocystic asterosytoma of fornix in both cases. Conclusion: 15 cases of colloid cyst misdiagnosis with other masses have been reported thus far, among them two cases were of pilocytic asterocytoma. In this study we report two other cases. Furthermore, we discussed on additional clues helping to differentiate pilocytic asterocytoma from a colloid cyst on images.
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Congenital Absence of the Posterior Element of C1, C2 and C3 Along with Bilateral Absence of C4 Pedicles, Case Report and Review of the Literature
Introduction Development of vertebras is a complex process involving both specific gene expressions and morphogenetic movements, particularly in the craniocervical junction (1). The atlas has three distinct ossification centers; a central and paired neural. The central ossification center can also be divided into two symmetrical areas. Although the anterior arch of the atlas is usually cartilaginous at birth, 20% of newborns have an ossification center for that location, as well (2). The axis is characterized by four primary ossification centers: two neural centers, one or two for the body, and a separate center for the odontoid process (3). In addition, cervical vertebras may have four supplementary secondary ossification centers: one for body center, one for the tip of each transverse process and one at the ending of the spinous process. Posterior spinal element anomalies may be caused by fusion impairment between the primary ossification centers lying at the base of the articular facet. These malformations have been suggested to be a result of dysregulated genes expression, incorrect tissue interactions, cellular migration and proliferation (1, 4). Abnormalities of the posterior arch of vertebras are rare conditions that may incidentally be found on neck radiographs. They may be from a partial cleft to a very rare total agenesis of the posterior arch, with reported prevalence of 0.15% (2, 5-8). Although most of the patients are asymptomatic and are incidentally diagnosed, some patients complain about neck pain or neurologic deficits after traumatic injury. Hadley was the first one who reported disconnected lesions of the cervical spine in 1946 as a unilateral absent pedicle (9). Years later, Perlman described a defect that allowed bilateral spondylolysis of the superior vertebra (10). The common developmental anomalies of the axis are anomalies of the odontoid process like total absence, partial absence, non-fusion of the odontoid process, and segmentation failure of the second and third cervical vertebrae. Isolated anomalies of the posterior elements of the axis are extremely rare (11-13). Rarity of absent cervical spine pedicle besides the fact that it usually happen asymptomatic, its association with other abnormalities and non-characteristic radiologic manifestations make the diagnosis of cervical spine pedicle abnormalities difficult. In this line, CT scan may help to diagnose the abnormalities of posterior elements more accurately (14-16). We report a case of congenital absence of the posterior element of the first three vertebras and concomitant absence of the C4 pedicles. We also review the literature, summarizing various studies on posterior arch abnormalities.
Brain tuberculoma is a rare manifestation of tuberculosis especially in immunosuppressed patients. The definite diagnosis may be difficult due to mimicking the brain tumors and the absence of the common presentation. Bacille Calmette-Guérin (BCG) vaccine is used for protection against tuberculous meningitis and miliary disease, more in the children and also for the treatment of bladder cancer.
The following case of brain tuberculoma is a 6 month-old boy who was presented to our hospital with poor feeding, nausea and vomiting and confusion since 1 month ago. A brain MRI show large mass lesion in pineal region with generalized hydrocephaly that Polymerase chain reaction assays of the tissue was positive for Mycobacterium bovis and had a good response to antituberculosis drugs and surgery
Central nervous system (CNS) is threatening infection that can present in the brain and nerves system as meningitis, tuberculoma, infarction or miliary parenchymal disease (1, 2). A tuberculoma is a clinical presentation that can present solitary or multiple and are associated with neurological deficit, increased intracranial pressure and seizure(3). The large lesions can be misdiagnosed with a brain tumor(4). Mycobacterium tuberculosis is a usual cause but other species rarely found in these lesions(5). The BCG vaccine contains weekend form of Mycobacterium bovis and has protection against tuberculous meningitis and miliary disease(6). Central nervous system (CNS) infections as a complication of BCG vaccine is very rare. In this paper, we report a case of a 6 month-old boy who was presented to our institution with brain tuberculoma and increased intracranial pressure after BCG vaccination.
وبینار رایگان Point of Care Ultrasound in Covid-19 در تاریخ پنجشنبه مورخ 1399.10.18 در ساعت 18:00
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