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1.
Molecules ; 28(20)2023 Oct 10.
Article in English | MEDLINE | ID: mdl-37894488

ABSTRACT

Due to the low capacity, low working potential, and lithium coating at fast charging rates of graphite material as an anode for Li-ion batteries (LIBs), it is necessary to develop novel anode materials for LIBs with higher capacity, excellent electrochemical stability, and good safety. Among different transition-metal oxides, AB2O4 spinel oxides are promising anode materials for LIBs due to their high theoretical capacities, environmental friendliness, high abundance, and low cost. In this work, a novel, porous Zn0.5Mg0.5FeMnO4 spinel oxide was successfully prepared via the sol-gel method and then studied as an anode material for Li-ion batteries (LIBs). Its crystal structure, morphology, and electrochemical properties were, respectively, analyzed through X-ray diffraction, high-resolution scanning electron microscopy, and cyclic voltammetry/galvanostatic discharge/charge measurements. From the X-ray diffraction, Zn0.5Mg0.5FeMnO4 spinel oxide was found to crystallize in the cubic structure with Fd3¯m symmetry. However, the Zn0.5Mg0.5FeMnO4 spinel oxide exhibited a porous morphology formed by interconnected 3D nanoparticles. The porous Zn0.5Mg0.5FeMnO4 anode showed good cycling stability in its capacity during the initial 40 cycles with a retention capacity of 484.1 mAh g-1 after 40 cycles at a current density of 150 mA g-1, followed by a gradual decrease in the range of 40-80 cycles, which led to reaching a specific capacity close to 300.0 mAh g-1 after 80 cycles. The electrochemical reactions of the lithiation/delithiation processes and the lithium-ion storage mechanism are discussed and extracted from the cyclic voltammetry curves.

2.
Heliyon ; 10(10): e31219, 2024 May 30.
Article in English | MEDLINE | ID: mdl-38807897

ABSTRACT

New calcium borovanadate glass containing manganese ions within the system x Mn2O3-(30-x) V2O5-50 B2O3-20 CaO has been elaborated* in this work using melt quench process. The primary objective of this research is to examine the influence of introducing Mn2O3 upon the various properties of the elaborated glass specimens including physical, thermal, structural, optical and magnetic properties. X-ray diffraction indicated that the samples prepared were amorphous. The variation in density and molar volume revealed that the structure of the glass matrix cross-links and becomes more compact with increasing Mn2O3 content, which is confirmed when the glass transition temperature is increased. Furthermore, in order to check the group constitution of our glasses, a structural study was carried out using infrared (FTIR) and Raman spectroscopy. The optical characteristics of our vitreous materials were analyzed by UV solid, and the results of the band gap energy and refractive index values revealed an enhancement of non-bridging oxygen atoms (NBOs) with rising Mn2O3 concentration, also suggests that manganese acts as a structure modifier. The low Urbach energy values are an indication that the structure of our glasses is stable and uniform. The magnetic investigation highlighted the presence of the predominant antiferromagnetic order in the glass samples studied, which becomes stronger with the incorporation of more manganese ions into the structure.

3.
Dalton Trans ; 53(4): 1630-1639, 2024 Jan 23.
Article in English | MEDLINE | ID: mdl-38167910

ABSTRACT

A novel phosphate containing barium, cobalt, and iron was synthesized in single-crystal and polycrystalline forms. Single crystal-based X-ray measurements revealed that it crystallizes in the monoclinic system with the P21/c space group. The structure is made up of linkages between FeO6 octahedra, CoO4 square planar units, CoO5 square pyramidal units, and PO4 tetrahedra through edges and/or vertices. The interconnection of these polyhedra leads to a three-dimensional framework with tunnels along the a-axis where the Ba2+ cations are located. The polycrystalline form was prepared via the sol-gel method and its XRD pattern was refined by the Le Bail method. Morphological and elemental mapping analyses of this phosphate were performed by scanning electron microscopy. In addition, infrared and Raman spectroscopy provided more insights into chemical bonding. The magnetic behavior was antiferromagnetic below TN ∼ 20 K. Optical measurements revealed a direct bandgap with an energy Eg of 2.83 eV.

4.
Materials (Basel) ; 17(8)2024 Apr 12.
Article in English | MEDLINE | ID: mdl-38673140

ABSTRACT

The beneficial effects of lanthanide incorporation into 0.94Na0.5Bi0.5TiO3-0.06BaTiO3 (BNT-BT) matrix on its functional properties were investigated. The conventional solid-state method was used for synthesizing samples. The structural refinement revealed that all samples crystallized in R3c rhombohedral symmetry. Raman spectroscopy study was carried out using green laser excitation and revealed that no clear perceptible variation in frequency is observed. Dielectric measurements unveiled that the introduction of rare earth obstructed the depolarization temperature promoted in BNT-BT, the diffusive phase transition decreasing with increasing lanthanide size. Only dysprosium addition showed comparable diffusion constant and dielectric behavior as the unmodified composition. Further, the comparison of the obtained ferroelectric hysteresis and strain-electric field loops revealed that only Dy-phase exhibited interesting properties comparing parent composition. In addition, the incorporation of lanthanides Ln3+ into the BNT-BT matrix led to the development of luminescence characteristics in the visible and near infrared regions, depending on the excitation wavelengths. The simultaneous occurrence of photoluminescence and ferroelectric/piezoelectric properties opens up possibilities for BNT-BT-Ln to exhibit multifunctionality in a wide range of applications.

5.
Lancet Reg Health Eur ; 39: 100870, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38361749

ABSTRACT

Background: The burden of psychiatric symptoms in Parkinson's disease includes depression, anxiety, apathy, psychosis, and impulse control disorders. However, the relationship between psychiatric comorbidities and subsequent prognosis and neurological outcomes is not yet well understood. In this systematic review and meta-analysis, in individuals with Parkinson's disease, we aimed to characterise the association between specific psychiatric comorbidities and subsequent prognosis and neurological outcomes: cognitive impairment, death, disability, disease progression, falls or fractures and care home admission. Methods: We searched MEDLINE, Embase, PsycINFO and AMED up to 13th November 2023 for longitudinal observational studies which measured disease outcomes in people with Parkinson's disease, with and without specific psychiatric comorbidities, and a minimum of two authors extracted summary data. Studies of individuals with other parkinsonian conditions and those with outcome measures that had high overlap with psychiatric symptoms were excluded to ensure face validity. For each exposure-outcome pair, a random-effects meta-analysis was conducted based on standardised mean difference, using adjusted effect sizes-where available-in preference to unadjusted effect sizes. Study quality was assessed using the Newcastle-Ottawa Scale. Between-study heterogeneity was assessed using the I2 statistic and publication bias was assessed using funnel plots. PROSPERO Study registration number: CRD42022373072. Findings: There were 55 eligible studies for inclusion in meta-analysis (n = 165,828). Data on participants' sex was available for 164,514, of whom 99,182 (60.3%) were male and 65,460 (39.7%) female. Study quality was mostly high (84%). Significant positive associations were found between psychosis and cognitive impairment (standardised mean difference [SMD] 0.44, [95% confidence interval [CI] 0.23-0.66], I2 30.9), psychosis and disease progression (SMD 0.46, [95% CI 0.12-0.80], I2 70.3%), depression and cognitive impairment (SMD 0.37 [95% CI 0.10-0.65], I2 27.1%), depression and disease progression (SMD 0.46 [95% CI 0.18-0.74], I2 52.2), depression and disability (SMD 0.42 [95% CI 0.25-0.60], I2 7.9%), and apathy and cognitive impairment (SMD 0.60 [95% CI 0.02-1.19], I2 27.9%). Between-study heterogeneity was moderately high. Interpretation: Psychosis, depression, and apathy in Parkinson's disease are all associated with at least one adverse outcome, including cognitive impairment, disease progression and disability. Whether this relationship is causal is not clear, but the mechanisms underlying these associations require exploration. Clinicians should consider these psychiatric comorbidities to be markers of a poorer prognosis in people with Parkinson's disease. Future studies should investigate the underlying mechanisms and which treatments for these comorbidities may affect Parkinson's disease outcomes. Funding: Wellcome Trust, UK National Institute for Health Research (NIHR), National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at University College London Hospitals NHS Foundation Trust, National Brain Appeal.

6.
Radiol Case Rep ; 18(11): 3984-3987, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37680657

ABSTRACT

We report a case of a 40-year-old Italian man presenting with an intramuscular schwannoma in his left thigh, which coincided with the area where he habitually stored his smartphone (front left trouser pocket). An ultrasound examination revealed a well-defined, encapsulated, hypoechoic lesion (41 × 15 × 28 mm) within the muscle, showing multiple small foci of vascularity on color Doppler. Elastographic analysis indicated a deformability score of 2, with some areas of stiffness. Magnetic resonance imaging confirmed the presence of a spindle-shaped mass in the tensor fasciae latae muscle, with varying enhancement after contrast administration. Notably, the location of the intramuscular mass closely corresponded to the placement of the phone's SIM card. While we cannot establish a definitive causal relationship between the patient's smartphone storage habit and the development of the intramuscular schwannoma, we speculate that the habitual storage location may have potentially acted as a risk or predisposing factor. This case underscores the need for further research on the potential health risks associated with smartphone storage habits, considering their widespread prevalence in today's society.

7.
Am J Case Rep ; 24: e939179, 2023 Jun 14.
Article in English | MEDLINE | ID: mdl-37312435

ABSTRACT

BACKGROUND Synchronous tumors occur when 2 separate primary tumors are diagnosed within 6 months. They can originate from the same site or different locations. For example, synchronous primary tumors of uterine and ovarian origin are a common type. Diagnosis can be challenging, however is critical to determine whether a patient has multiple primary tumors or a single tumor with metastasis to guide effective treatment. Compared with endometrial cancer that has spread to the ovary, synchronous primary tumors of the uterus and ovaries typically require less aggressive treatment. CASE REPORT A 45-year-old woman with nonspecific symptoms of headache and confusion had imaging studies that revealed a neoplasm in her brain, which was likely causing her symptoms. The masses were metastatic lesions, and the primary cancer was determined to be synchronous endometrial ovarian cancer (SEOC). She underwent bilateral frontal craniotomy for tumor resection and diagnostic tests. She had an exploratory laparotomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. She was stable during hospitalization but lost to follow-up after discharge. CONCLUSIONS Regular gynecologic examinations, including bimanual palpation of the ovaries during cervical cancer screenings, are essential for detecting cancer early and improving chances of recovery. This case also highlights the indolent growth and high risk of metastasis associated with SEOC. Although this type of cancer is rare, patients with it can be at increased risk of developing metastatic lesions in other parts of their bodies. To manage synchronous tumors effectively, a multidisciplinary approach and close collaboration between medical professionals are necessary to ensure best patient outcomes.


Subject(s)
Carcinoma, Endometrioid , Endometrial Neoplasms , Neoplasms, Multiple Primary , Female , Humans , Middle Aged , Uterus , Neoplasms, Multiple Primary/surgery , Hysterectomy
8.
J Prim Care Community Health ; 14: 21501319221148635, 2023.
Article in English | MEDLINE | ID: mdl-36688423

ABSTRACT

Elevated lipid panels are associated with an increased risk of cardiovascular disease. Management of heart disease with lipid lowering agents play a vital role in medicine. Statins are one group of medications that are widely utilized in the medical field to decrease the risk of atherosclerotic disease. Statins work by inhibiting the hepatic enzyme 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR). Although statins are one of the most effective drugs for secondary and primary prevention of heart disease, they are not without risks and side effects such as hepatotoxicity and myopathy. We present a case of a male patient who developed progressively worsening muscle weakness and elevated muscle enzyme markers upon initiation of a statin. His symptoms persisted despite a trial of an alternative statin and subsequent discontinuation of all statin medications. A multitude of possible etiologies were considered and ranged from infectious, autoimmune, cancerous, to congenital in nature. Environmental factors, such as exposure to medications or toxins, were also considered as one of the possible precipitating factors. The association between his statin consumption and muscle weakness were not easily apparent at first. He required further workup including physical examination, electromyography, panel of myositis antibodies, and muscle biopsy. After clinical suspicion and elevated antibodies to HMGCR beyond the normal limit, he was discovered to have statin-associated autoimmune myopathy. The patient improved with the treatment of immunosuppressive agent's prednisone and methotrexate.


Subject(s)
Autoimmune Diseases , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Muscular Diseases , Male , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Autoantibodies/therapeutic use , Muscle, Skeletal/pathology , Autoimmune Diseases/chemically induced , Autoimmune Diseases/drug therapy , Muscular Diseases/chemically induced , Muscular Diseases/drug therapy , Muscle Weakness/chemically induced , Muscle Weakness/pathology , Lipids
9.
Materials (Basel) ; 16(6)2023 Mar 09.
Article in English | MEDLINE | ID: mdl-36984077

ABSTRACT

Rare earth element-doped Bi0.5Na0.5TiO3-BaTiO3 (BNT-BT-RE) polycrystalline thin films were processed on a platinized substrate by chemical solution deposition. The microstructure, dielectric, and ferroelectric properties were investigated for all prepared films. It was found that the incorporation of rare earth elements into the BNT-BT matrix increases both the dielectric constant and the breakdown strength while maintaining low dielectric losses, leading to an enhancement of the energy storage density to Wrec = 12 and 16 J/cm3 under an effective field of E = 2500 kV/cm, for Nd- and Dy-based films, respectively. The optical properties of films containing the lanthanide element were investigated and the obtained results bear interest for luminescence applications. The simultaneous appearance of ferroelectric and optical properties in the system under investigation is very promising for advanced optoelectronic devices.

10.
Materials (Basel) ; 16(23)2023 Nov 28.
Article in English | MEDLINE | ID: mdl-38068136

ABSTRACT

The effect of ferromagnetic CaMnO3 (CMO) addition to structural, magnetic, dielectric, and ferroelectric properties of BiFeO3 is presented. X-ray diffraction and Raman investigation allowed the identification of a single pseudocubic perovskite structure. The magnetic measurement showed that the prepared films exhibit a ferromagnetic behavior at a low temperature with both coercive field and remnant magnetization increased with increasing CMO content. However, a deterioration of magnetization was observed at room temperature. Ferroelectric study revealed an antiferroelectric-like behavior with a pinched P-E hysteresis loop for 5% CMO doping BFO, resulting in low remnant polarization and double hysteresis loops. Whereas, high remnant polarization and coercive field with a likely square hysteresis loop are obtained for 10% CMO addition. Furthermore, a bipolar resistive switching behavior with a threshold voltage of about 1.8 V is observed for high doped film that can be linked to the ferroelectric polarization switching.

11.
Neuro Endocrinol Lett ; 44(7): 439-443, 2023 Oct 23.
Article in English | MEDLINE | ID: mdl-37874553

ABSTRACT

BACKGROUND: Neurotrophins (NTs) encompass a group of closely associated proteins regulating various aspects of neuronal growth and survival. The potential association between work-related factors and the levels of circulating NTs has not been extensively examined. In this preliminary investigation, we evaluated plasma concentrations of brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), neurotrophin-3 (NT-3), and neurotrophin-4 (NT-4) in a cohort of healthy individuals from three distinct professional categories, each with unique work environments and lifestyle factors. METHODS: The study involved 60 men from three professional fields: airline pilots, construction laborers, and fitness trainers (20 participants per category) recruited during routine occupational health appointments. Plasma levels of NTs were measured using commercially available immunoassays and compared in the three professional groups. RESULTS: Among the professions studied, fitness instructors displayed the highest concentrations of BDNF and NGF, with airline pilots ranking second, and construction workers showing the lowest levels. Significantly decreased NT-3 levels were observed in airline pilots compared to fitness instructors and construction workers, but no differences were found between the latter two occupations. NT-4 levels were similar across all three occupational groups. CONCLUSIONS: Our pilot results suggest that plasma concentrations of NTs, which are involved in various aspects of neuronal and cognitive functioning, may display significant differences among healthy individuals depending on their occupation. These observations warrant additional research to explore potential implications for the field of occupational medicine.


Subject(s)
Brain-Derived Neurotrophic Factor , Construction Industry , Male , Humans , Brain-Derived Neurotrophic Factor/metabolism , Nerve Growth Factor/metabolism , Neurotrophin 3 , Neurons/metabolism , Occupations
12.
Micromachines (Basel) ; 14(10)2023 Sep 27.
Article in English | MEDLINE | ID: mdl-37893278

ABSTRACT

The purpose of this research work was to synthesis bioderived nanocomposite films by incorporating Na0.5Bi0.5TiO3 (NBTO) nanoparticles into a chitosan matrix. The NBTO nanoparticles were synthesized using a traditional solid-state technique. Then, through a solution-casting approach, flexible composite films were fabricated using chitosan polymer. The study presents a range of compelling findings. For structural and morphological insights, scanning electron microscopy (SEM) reveals a fascinating morphology where NBTO nanoparticles are uniformly dispersed and interlocked with other particles, forming interconnected grains with significant interspaces within the chitosan matrix. For the optical properties, the spectral response within the 300-800 nm range is primarily governed by light scattering attributed to NBTO particles with diameter sizes ranging from 100 to 400 nm, as well as the distinctive bandgap exhibited by the NBTO phase. The investigation of dielectric properties demonstrates that composite films exhibit markedly higher dielectric values in comparison to pure chitosan films. It is noteworthy that an increase in the NBTO content results in a corresponding increase in dielectric values, enhancing the versatility of these materials. Local piezoelectric measurements utilizing piezoresponse force microscopy confirm the expected piezoelectric and ferroelectric behavior of NBTO particles when dispersed within the chitosan matrix. This research introduces a novel class of biocompatible nanocomposite materials, combining impressive structural attributes, enhanced dielectric properties, and piezoelectric capabilities. The outcomes of this study hold substantial promise for advanced applications in opto- and piezoelectric technologies, marking a significant advancement in biologically sourced materials with multifunctional properties.

13.
Eur Urol Focus ; 9(4): 631-636, 2023 07.
Article in English | MEDLINE | ID: mdl-36710211

ABSTRACT

CONTEXT: Patients undergoing radical cystectomy frequently suffer from infectious complications, including urinary tract infections (UTIs) and surgical site infections (SSIs) leading to emergency department visits, hospital readmission, and added cost. OBJECTIVE: To summarize the literature regarding perioperative antibiotic prophylaxis, ureteric stent usage, and prevalence of infectious complications after cystectomy. EVIDENCE ACQUISITION: A systematic review of PubMed/Medline, EMBASE, Cochrane Library, and reference lists was conducted. EVIDENCE SYNTHESIS: We identified 20 reports including a total of 55 306 patients. The median rates of any infection, UTIs, SSIs, and bacteremia were 40%, 20%, 11%, and 6%, respectively. Perioperative antibiotic prophylaxis differed substantially between reports. Perioperative antibiotics were used only during surgery in one study but were continued over several days after surgery in all other studies. Empirical use of antibiotics for 1-3 d after surgery was described in 12 studies, 3-10 d in two studies, and >10 d in four studies. Time to stent removal ranged from 4 to 25 d after cystectomy. Prophylactic antibiotics were used before stent removal in nine of 20 studies; two of these studies used targeted antibiotics based on urine cultures from the ureteric stents, and the other seven studies used a single shot or 2 d of empirical antibiotics. Studies with any prophylactic antibiotic before stent removal found a lower median percentage of positive blood cultures after stent removal than studies without prophylactic antibiotics before stent removal (2% vs 9%). CONCLUSIONS: We confirmed a high proportion of infectious complications after cystectomy, and a heterogeneous pattern of choice and duration of antibiotics during and after surgery or stent removal. These findings highlight a need for further studies and support quality prospective trials. PATIENT SUMMARY: In this review, we observed wide variability in the use of antibiotics before or after surgical removal of the bladder.


Subject(s)
Antibiotic Prophylaxis , Urinary Tract Infections , Humans , Antibiotic Prophylaxis/adverse effects , Cystectomy/adverse effects , Prospective Studies , Anti-Bacterial Agents/therapeutic use , Surgical Wound Infection/epidemiology , Surgical Wound Infection/prevention & control , Urinary Tract Infections/epidemiology , Urinary Tract Infections/prevention & control , Urinary Tract Infections/etiology , Stents/adverse effects
14.
Cureus ; 14(4): e24596, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35651442

ABSTRACT

Family medicine practitioners can manage a wide range of health problems, either directly or through referral to other specialists, thereby optimizing the cost-effectiveness of the healthcare system. For most health problems, family medicine practitioners serve as an entry point for individualized healthcare. Providing comprehensive care for most specialties for all ages is the hallmark of family medicine. It is recognized as a distinct specialty in many developed countries, and training is provided through organized residency programs. Family medicine has been incorporated in the foundation course of Bachelor of Medicine, Bachelor of Surgery (MBBS) and is planned to be adopted in all medical institutes in India; however, the MBBS syllabus includes no mention of it. In medical schools in India, fully functioning family medicine departments should be established on an urgent scale. It is necessary to take the required measures to introduce the subject into the undergraduate MBBS program and to generalize it across India. It is recommended that the number of medical schools offering postgraduate residency training in family medicine be increased to meet current community health needs.

15.
Cureus ; 14(3): e23486, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35475060

ABSTRACT

Bradycardia, renal failure, atrioventricular (AV) blockade, shock, and hyperkalemia (BRASH) syndrome is an uncommon and relatively new entity that results from synergy between AV nodal blockade and renal failure leading to a vicious cycle of hypotension, profound bradycardia, and hyperkalemia. Classically, this syndrome is seen in a patient taking AV nodal blocking agents and underlying renal insufficiency. We are presenting a case of a 76-year-old female with a medical history of essential hypertension and non-insulin-dependent type 2 diabetes mellitus presented to the emergency room with a chief complaint of dizziness and generalized weakness. The patient was taking metoprolol tartrate 200 mg twice a day, amlodipine 10 mg once daily, clonidine 0.1 mg twice daily, enalapril 20 mg twice daily, and Metformin 750 mg twice daily. On presentation, the patient had symptomatic bradycardia resistant to atropine with heart rate in 30s and hypotension resistant to volume expansion. The laboratory results showed that the patient also had acute kidney injury and severe resistant hyperkalemia. The whole presentation raised the suspicion of BRASH syndrome. The patient was started on peripheral dopamine infusion for bradycardia and symptomatic hypotension. Nephrology was consulted, and the patient was started on urgent dialysis for resistant hyperkalemia. The patient was admitted to the cardiovascular intensive care unit, and all antihypertensive medication, including beta-blockers, were stopped. The patient clinically improved on the next day, the dopamine infusion was stopped, and the patient remained vitally stable. The patient was eventually discharged home with cardiology and nephrology follow-up. The purpose of this case report is to help with the early diagnosis of this under-recognized and new clinical condition and to discuss the pathophysiology and management.

16.
Cureus ; 14(3): e23198, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35444907

ABSTRACT

Aortitis is the inflammation of the aorta secondary to either infectious or non-infectious etiologies. Infectious aortitis is a rare but potentially life-threatening condition. It is more common among older patients with preexisting pathology. Clinical presentation is variable, therefore, a high index of suspicion is required for timely diagnosis and management. We report a case of aortitis which was complicated with the development of a saccular abdominal aortic aneurysm. A 76-year-old male presented to the Emergency Department with two days of right lower quadrant abdominal pain. Clinical evaluation and imaging studies revealed abdominal aortitis, which progressed to a saccular abdominal aortic aneurysm. We highlight a unique presentation of infectious aortitis to raise awareness among physicians. We also reviewed the available literature on infectious aortitis to illustrate the importance of early diagnosis and appropriate treatment to improve the patients' outcomes.

17.
Cureus ; 14(3): e22805, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35399456

ABSTRACT

Serotonin syndrome (SS) is a condition that occurs following the administration of serotonergic drugs. The syndrome is classically associated with the simultaneous administration of two serotonergic agents. Herein, we present a unique case of SS precipitated by cocaine and fentanyl in conjunction with previously prescribed oxycodone/paracetamol, trazodone, and mirtazapine. The patient was brought to the hospital with chief complaints of altered mental status, abdominal pain, nausea, and vomiting. The patient used her friend's fentanyl patch, and her urine drug screen was positive for cocaine. She was intubated and admitted to the intensive care unit for a low Glasgow Coma Scale score of 6 and autonomic instability. All the inciting agents were stopped, supportive treatment was given, and the patient was sedated with benzodiazepines and propofol. She received cyproheptadine, and the patient was extubated and clinically improved over the next 24 hours. Cocaine and fentanyl are not classically associated with SS. We did not encounter any cases where SS was precipitated by the combined use of cocaine and fentanyl in patients taking psychotropic medications during our literature review. This case report underlines the association of SS with cocaine and fentanyl. SS should be suspected in patients using cocaine and fentanyl or any other substance of abuse along with psychotropic agents.

18.
Cureus ; 14(4): e24351, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35607589

ABSTRACT

The cannonball pulmonary appearance is hematogenous dissemination of various primary tumors but rarely a Hodgkin's lymphoma, a disease that most commonly manifests with lymphadenopathy, often affecting the mediastinum and supraclavicular or cervical lymph nodes. To date, to the best of our knowledge, no case has been reported where the investigation of a cannonball pulmonary appearance led to the diagnosis of Hodgkin's lymphoma. Hence, in our case report, we attempt to highlight the uncommon presentation of this disease in a 14-year-old girl who initially presented with dyspnea before her chest x-ray revealed a cannonball pulmonary appearance, which was later linked with Hodgkin's lymphoma after performing a biopsy of her axillary node.

19.
Cureus ; 14(3): e23602, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35505697

ABSTRACT

Myocardial infarction with non-obstructive coronary arteries (MINOCA) refers to acute myocardial infarction with normal or near-normal coronary arteries. The MINOCA is a heterogeneous group of conditions, and possible etiologies are coronary artery spasm, spontaneous coronary artery dissection, coronary thromboembolism, coronary plaque disruption, coronary microvascular dysfunction, supply and demand mismatch. It is more common in young adults, with women having a higher chance of getting MINOCA than men. Considering MINOCA as a clinically dynamic working diagnostic that needs further investigation rather than a "true" diagnosis is proposed. Optical coherence tomography (OCT), intravenous ultrasound (IVUS), cardiac MRI may be required to stratify the underlying mechanism. Due to the lack of evidence-based literature and prospective randomized controlled studies, therapeutic management is limited. Consequently, the strategy is patient-specific. The prognosis of MINOCA patients remains unclear and depends upon the underlying etiology. This article aims to review the literature about various aspects of MINOCA, including pathophysiology, diagnosis, prognosis, and treatment.

20.
Cureus ; 14(7): e27049, 2022 Jul.
Article in English | MEDLINE | ID: mdl-36000096

ABSTRACT

Malignant rhabdoid tumor of the kidney (MRTK) is a rare aggressive malignant rhabdoid tumor that mainly affects children. At the onset of the disease, the usual clinical manifestations are gross hematuria, abdominal pain, and abdominal distension. The prognosis remains poor. Patients with rhabdoid tumors (RT) are treated according to institutional preferences that combine surgery, radiation therapy, and chemotherapy. The authors present the rare case of a child with xeroderma pigmentosum (XP) who presented with an abdominal mass accompanied by hematuria and abdominal pain. The radiological and histological results were congruent with the MRTK. The patient received preoperative chemotherapy but unfortunately died of septic shock. This case highlights the importance of being aware of MRTK and its fatal complications, as well as the increased risk of kidney tumors in patients with XP.

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