Assuntos
Flagelos , Malária Vivax/parasitologia , Plasmodium vivax/citologia , Humanos , Masculino , Adulto JovemRESUMO
The Swiss Ticino regional pulmonary embolism response team (PERT) features direct access to various pharmacomechanical PE management options within a hub/spoke system, by integrating evidence, guidelines' recommendations and personal experiences. This system involves a collaborative management of patients among the hospitals distributed throughout the region, which refer selected intermediate-high or high PE patients to a second-level hub center, located in Lugano at Cardiocentro Ticino, belonging to the Ente Ospedaliero Cantonale (EOC). The hub provides 24/7 catheterization laboratory activation for catheter-based intervention (CBI), surgical embolectomy and/or a mechanical support system such as extracorporeal membrane oxygenation (ECMO). The hub hosts PE patients after percutaneous or surgical intervention in two intensive care units, one specialized in cardiovascular anesthesiology, to be preferred for patients without relevant comorbidities or with hemodynamic instability and one specialized in post-surgical care, to be preferred for PE patients after trauma or surgery or with relevant comorbidities, such as cancer. From April 2022 to December 2023, a total of 65 patients were referred to the hub for CBI, including ultrasound-assisted catheter-directed thrombolysis (USAT) or large-bore aspiration intervention. No patient received ECMO or underwent surgical embolectomy.
Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/efeitos adversos , Retardo do Crescimento Fetal/induzido quimicamente , Losartan/efeitos adversos , Oligo-Hidrâmnio/induzido quimicamente , Sistema Renina-Angiotensina/efeitos dos fármacos , Automedicação/efeitos adversos , Antagonistas Adrenérgicos beta/uso terapêutico , Adulto , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Antimaláricos/uso terapêutico , Cesárea , Feminino , Retardo do Crescimento Fetal/diagnóstico , Humanos , Hidroxicloroquina/uso terapêutico , Recém-Nascido , Rim/diagnóstico por imagem , Rim/efeitos dos fármacos , Losartan/uso terapêutico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Masculino , Metoprolol/uso terapêutico , Oligo-Hidrâmnio/diagnóstico , Gravidez , UltrassonografiaRESUMO
We report about an 80-year-old patient, who underwent the extraction of an upper molar tooth because of facial pain. In the course of time the patient developed a maxillary sinusitis in presence of an ectopic tooth. Given that the patient got fever, neck pain and -stiffness, a purulent meningitis was first suspected. The liquor analysis was normal and the CT-scan showed a calcification around the dens axis. We finally diagnosed a "Crowned Dens"-syndrome.