Masseter hypertrophy (MH) is an uncommon natural condition that affects the facial contour. The etiology is debatable, and complaints are usually cosmetic in nature. The diagnosis is essentially clinical and aided by imaging tests. Treatment is still controversial. The literature is relatively scarce in relation to information on MH, particularly in the evaluation of outcomes. Through questionnaires, the progress was observed in the evaluation of the outcomes of aesthetic procedures. Thus, the purpose of this paper is to apply a Facelift Outcome Evaluation (FOE) questionnaire to evaluate the outcomes of surgical treatment in a case of MH. A 23-year-old male presented to the clinic complaining of bullying due to his facial aesthetics. Clinical and imaging evaluation was performed, with the creation of surgical guides. The patient answered the FOE questionnaire pre- and postoperatively, with results of 12.5 and 100.00 respectively. This subjectively shows the success of the treatment. We suggest that a questionnaire applied exclusively to masseter hypertrophy should be developed, as well as studies for the development of muscle volume measurement protocols, aiming at a more specific evaluation of the surgical outcomes.
- MeSH
- ambulantní zařízení * MeSH
- dospělí MeSH
- estetika MeSH
- hypertrofie chirurgie MeSH
- lidé MeSH
- mladý dospělý MeSH
- šikana * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Al-Ghorab procedure is known as open distal shunt for the treatment of ischemic priapism. In the literature, no information in terms of complications is available in three of fourteen studies. In the remaining eleven studies, complications occurred in five studies only. Here we present a case report describing successful treatment of detachment of the incision after Al-Ghorab procedure.
- MeSH
- chirurgická rána * MeSH
- lidé MeSH
- priapismus * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
Neonatal osteomyelitis (OM), although exceptionally rare, has been linked to detrimental sequel, as diagnosis in the early stages is challenging and any delay in treatment can lead to disturbance in skeletal growth. In pediatric OM the most commonly grown bacteria is Staphylococcus aureus followed by group A Streptococcus (GAS). Notwithstanding, sepsis-induced coagulopathy is a well-known entity in children and adults, still sepsis-associated thrombosis is sparsely observed. we present a case of a newborn with GAS associated OM and thrombosis. A term neonate on the 11th day of life was referred to our NICU due to right (R) lower limb edema, cyanosis and core temperature up to 39 °C. Late onset sepsis was suspected and started on vancomycin and amikacin. A colour Doppler scan showed thrombosis of the R common femoral vein. The neonate started on iv unfractionated heparin. Ampicillin was added given positive for GAS blood culture. An MRI on the 5th day of admission, showed evidence of thrombosis resolution. On the 14th day of admission, a bone Tc99 scan showed evidence of OM of R femur. Antibiotic treatment switched to amoxicillin per os. The management was restricted to anticoagulant therapy with low molecular weight heparin for 3 months and antibiotic therapy for 6 months without surgery intervention and the patient recovered and discharged at 42 days of age. Early diagnosis and treatment of neonatal osteomyelitis can prevent bone destruction. Sepsis-associated thrombosis is barely observed during osteomyelitis, yet it should be considered as an emerged case requiring prompt treatment.
- MeSH
- amoxicilin MeSH
- dítě MeSH
- dospělí MeSH
- heparin MeSH
- lidé MeSH
- novorozenec MeSH
- osteomyelitida * komplikace diagnóza MeSH
- Streptococcus pyogenes MeSH
- streptokokové infekce * komplikace diagnóza farmakoterapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Acute eosinophilic pneumonia (AEP) is a rare cause of respiratory failure. It is primarily a disease of smokers, either a new smoker or an existing one with a recent increase in cigarette consumption. Other risk factors include toxic gas exposure, inhalational illicit drugs, and smoking marijuana. AEP has also been reported in patients with e-cigarette or vaping associated lung injury (EVALI). We present the case of a 20-year-old male who presented to the hospital with acute respiratory failure. The patient has been vaping heavily for the past three months and started smoking three days before presenting to the emergency department. He was hypertensive, tachycardic, tachypneic, and required high-flow nasal cannula to maintain SpO2 > 92%. His condition deteriorated in the first 24 hours following hospitalization requiring noninvasive positive pressure ventilation. Bronchoalveolar lavage revealed an eosinophil count of 36%. Bronchoalveolar lavage (BAL) cytology revealed lipid-laden macrophages. He was diagnosed with AEP due to EVALI, and the patient was treated with high dose corticosteroid with subsequent improvement. Before the bronchoscopic evaluation, the clinical and radiologic findings were consistent with COVID-19, and the patient was tested twice for SARS-CoV-2 PCR. In the appropriate clinical setting, AEP should be considered in the differential diagnoses of community-acquired pneumonia, acute respiratory distress syndrome (ARDS), and COVID-19, especially in this pandemic era.
- MeSH
- COVID-19 * MeSH
- dimerkaprol MeSH
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- plicní eozinofilie * chemicky indukované diagnóza MeSH
- poškození plic * MeSH
- SARS-CoV-2 MeSH
- systémy dodávající nikotin elektronicky * MeSH
- vaping * škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Optimal rehabilitation of asymmetric dentofacial deformity secondary to unilateral temporomandibular joint (TMJ) ankylosis is often a challenge. The purpose of this case series is to present an insight into esthetic, occlusal and functional rehabilitation of two patients with varying degree of asymmetric Class II dentofacial deformities secondary to long-standing unilateral TMJ ankylosis. The patients were treated with one-stage surgical protocol employing simultaneous dual distraction technique along with interpositional arthroplasty. Dual distraction technique entailed the simultaneous use of two distractors which allowed for proper control of proximal condylar segment during the course of distraction and lowering the risk of ankylosis recurrence. Thereafter, comprehensive fixed orthodontic mechanotherapy involving the use of temporary anchorage devices was instituted to align and level the compensated dentition. Post-treatment records showed significant improvements in skeletal disharmony and functional stability with good functional occlusion. At the three-year follow-up, the morphological and functionally acceptable results were reasonably well-maintained, with no signs of relapse. Through the two cases reported here, we would like to highlight that one-stage concurrent arthroplasty and dual distraction technique is a safe, stable, and reliable approach for surgical and functional rehabilitation of an adult asymmetric dentofacial deformity secondary to unilateral TMJ ankylosis. Meticulously executed comprehensive orthodontic manipulations involving use of acrylic bite-blocks, elastic traction, and temporary skeletal anchorage device play a crucial role in enhancing the final occlusal outcomes.
- MeSH
- ankylóza * etiologie chirurgie MeSH
- dentofaciální deformity * MeSH
- dospělí MeSH
- lidé MeSH
- následné studie MeSH
- ortodoncie * MeSH
- temporomandibulární kloub chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The acute scrotum (AS) in the pediatric population is a medical emergency. AS is usually caused by testicular torsion (TT) and torsion of the appendix testis (TAT). The current study explored which demographic and clinical characteristics can help distinguish between TT and TAT. We analyzed all children ≤16 years who underwent surgical exploration for AS. The patients were divided into Group 1/TT and Group 2/TAT. Ninety patients were included in the study (24 with TT and 66 with TAT). The peak incidence of TT was significantly higher than in the TAT group (p<0.001). Scrotal pain was more prevalent in the TAT group (p=0.02), whereas systemic signs (nausea/vomiting and abdominal pain) affected more frequently the TT patients (p=0.003 and p<0.001, respectively). The duration of symptoms was significantly longer in the TAT group (p<0.001). The duration of symptoms in the TT cohort significantly impacted the testicular salvage (p=0.008). Color Doppler ultrasound (CDUS) findings of absent/decreased testicular blood flow in the affected testis strongly favored the diagnosis of TT (p<0.001). The older age, shorter duration of symptoms, systemic signs, and CDUS findings can help distinguish between the two most common acute scrotum causes.
- MeSH
- apendix * MeSH
- demografie MeSH
- dítě MeSH
- lidé MeSH
- retrospektivní studie MeSH
- testis diagnostické zobrazování MeSH
- torze semenného provazce * diagnóza chirurgie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Patients with chronic kidney disease (CKD) have high cardiovascular risk (CVR), which is often underestimated by conventional tools. The coronary artery calcium score (CACS) significantly improves CVR stratification by conventional tools, but it is often not available in low-resources settings. Aldosterone may be a cheaper alternative to CACS for CVR assessment in CKD patients. The aim was to assess the ability of serum aldosterone level to predict CACS in patients with CKD in comparison to standard predictors. This single-center study included 57 patients aged 40 to 67 years with CKD (estimated glomerular filtration rate [eGFR] ≥45 ml/min) and arterial hypertension. Serum aldosterone, sex, age, body mass index, blood pressure, total cholesterol, eGFR, and proteinuria were used for prediction of CACS>0 Agatston units (AU) and CACS>100 AU. The area under the curve (AUC) with 95% confidence intervals (CI) and the mean Brier scores were examined for predictors of CACS. Aldosterone predicted a CACS>100 AU (AUC = 0.72, 95% CI: 0.56-0.88), but not a CACS>0 AU. Age predicted a CACS>100 AU (AUC = 0.80, 95% CI: 0.67-0.93) and a CACS>0 AU (AUC = 0.75, 95% CI: 0.62-0.89). The addition of aldosterone to age for prediction of a CACS>100 AU improved the mean Brier score, compared to the model with age alone, from 0.16 to 0.14, but not the AUC (0.83, 95% CI: 0.70-0.95). Aldosterone was a significant predictor of a CACS>100 AU in patients with CKD, but aldosterone was not a better predictor than age alone.
- MeSH
- aldosteron MeSH
- chronická renální insuficience * diagnóza MeSH
- koronární cévy MeSH
- lidé MeSH
- plocha pod křivkou MeSH
- vápník * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The use of convalescent plasma (CP) appeared to be a promising, easily available and safe way of treatment of severe COVID-19 at the onset of the pandemic in early 2020. Conducted in 2020 and 2021, our study of 52 severely to critically ill COVID-19 patients who received CP plasma as a treatment and of 97 controls found no difference in 30-day or 90-day mortality rates. A significant viral load drop in most patients (4.7 log10 [p<0.001] copies/ml) was observed following CP administration. Retrospective analysis of selected inflammatory markers and immunoglobulins showed higher C-reactive protein levels among the study group, and their decrease on Day 7.
- MeSH
- COVID-19 * terapie MeSH
- lidé MeSH
- pasivní imunizace MeSH
- retrospektivní studie MeSH
- sérologická léčba covidu-19 MeSH
- virová nálož MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Cannabidiol (CBD) is the second most abundant component of the plant Cannabis sativa. Currently, CBD is approved for Lennox-Gastaut and Dravet syndrome and newly for tuberous sclerosis complex. However, based on the available data, CBD migth have a broad spectrum of potential therapeutic uses. Therefore, the aim of this review was to summarize the evidence on the effects of CBD on pain and inflammation of various causes. PubMed and Web of Science databases were searched until January 2023. The medical keyword term "cannabidiol" was combined with "pain", "arthritis", and "inflammation". Based on the initial search for these terms, 9, 5, and 5 relevant publications have been selected. Based on the available data, it is not possible to draw a clear conclusion about the effect of CBD to releave pain, because each study used a different route of administration or treatment regimen. The studies also differed in etiopathogenesis of pain (chronic, neuropathic, and possibly inflammatory pain), and in general included only small number of subjects. In case of anti-inflammatory qualities of CBD, its effect on the intestinal system is negligible. On the other hand, positive treatment results were observed in all publications dealing with the effect of CBD on arthritis.
- MeSH
- artritida * MeSH
- bolest farmakoterapie etiologie MeSH
- epilepsie myoklonické * farmakoterapie MeSH
- kanabidiol * terapeutické užití MeSH
- lidé MeSH
- zánět farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Targeted therapy with protein kinase inhibitors (PKIs) represents one of the important treatment options for non-small cell lung cancer (NSCLC). It has contributed to improve patients' survival and quality of life significantly. These anticancer drugs are administrated orally in flat-fixed doses despite the well-known large interpatient pharmacokinetic variability and the possible need for dose individualization. To optimize and individualize dosing of PKIs, and thereby increasing the effectiveness and safety of the treatment, therapeutic drug monitoring (TDM) is the most frequently mentioned method. Unlike other areas of medicine, TDM has been rather exceptional in oncological practise since there is a little evidence or no data for concentration-effect relationships of PKIs. Therefore, the aim of this review is to summarize the pharmacokinetic characteristics of PKIs and provide the evidence supporting the use of TDM for personalised treatment of patients with NSCLC.
