RESUMEN
Cryptogenic organizing pneumonia (COP) is a form of idiopathic interstitial pneumonia that commonly presents with exertional dyspnea. The mainstay diagnostic criterion is with histopathological confirmation alongside excluding secondary causes of interstitial lung disease. The COVID-19 pandemic left many mysteries regarding the long-term sequelae of this disease. We explore a case of post-COVID-19 syndrome organizing pneumonia (PCOP) in a patient presenting with new-onset respiratory symptoms seven weeks after recovery from COVID-19 infection. Upon further review of the literature, there were no published case reports on PCOP in Trinidad and Tobago. We describe a case of PCOP presented at Apley Medical Clinic, Trinidad, and Tobago, West Indies, with the aim of increasing awareness of this condition to allow for early identification and effective management.
RESUMEN
Datura, a wild-growing annual plant, common in the American Southwest and the Caribbean, has many uses, including medicinal or pharmaceutical, ornamental, religious, and social. In the Caribbean, this white trumpet-shaped flower has been used for many cultural aspects and has also been found to be used as a potent psychological stimulant. Despite its many purposes, its inappropriate misuse can result in mild-to-severe toxicity, leading to severe anticholinergic effects and even death in some cases. The purpose of this report is to highlight the toxic effects of this plant when misused and the subsequent management as it relates to the spectrum of anticholinergic poisoning, a common complication of drug overdose. We describe a case of datura poisoning presenting in Trinidad, West Indies, which was not described previously in the literature.
RESUMEN
Abnormal elevation in pulmonary arterial blood pressure without secondary causes is Idiopathic Pulmonary Arterial Hypertension (IPAH). It is imperative to establish this diagnosis because IPAH often progresses to right heart failure (RHF) and death without treatment. Right heart catheterization is the standard gold test for diagnosing pulmonary hypertension (PH); however, echocardiography is a susceptible sensitive test and the best non-invasive test. The overall management of IPAH involves supportive measures, conventional therapy, and, pending availability, PAH-targeted therapy. Upon review of the literature, there were no published case reports on IPAH in Trinidad and Tobago. We describe a case of IPAH presented at Apley Medical Centre Limited, Trinidad and Tobago, in the West Indies, emphasizing contemporary management, including using the Implantable Delivery Systems (IDS) for Remodulin injection.
RESUMEN
Paclitaxel-induced pneumonitis (PIP) is an immune-mediated disease resulting from a delayed hypersensitivity reaction (type IV) to paclitaxel, an anti-microtubule chemotherapeutic drug commonly used to treat breast cancer in both neoadjuvant and adjuvant settings. PIP is diagnosed by exclusion utilizing laboratory work-up, imaging, biopsy studies, and results of antibiotic therapy because there is no single diagnostic test. Ground-glass opacifications on CT, coupled with minimal restrictive disturbance with decreased diffusion on pulmonary function tests (PFTs), negative bronchoalveolar lavage (BAL), and bronchoscopy cultures, may assist physicians in diagnosing paclitaxel-induced pneumonitis. In this report, we describe a case of PIP present in Trinidad, West Indies, which has not been described previously in this region.
RESUMEN
Allergic bronchopulmonary aspergillosis (ABPA) is an immunologically mediated disease resulting from a hypersensitivity reaction to Aspergillus fumigatus. ABPA is identified by bronchial asthma, peripheral eosinophilia, high levels of serum immunoglobulin E, pulmonary infiltration, mucoid impaction, and central bronchiectasis. Diagnosing ABPA is important to consider since there are treatment options that are readily available and response to therapy yields positive results. We describe a case of ABPA present in Trinidad, West Indies, which was not described previously in the literature.
RESUMEN
Cardiac pain is usually manifested as a crushing, squeezing, or sensation of pressure in the center of the chest. The pain can be referred to the left shoulder, neck, jaw, and epigastric region as well as the temporomandibular region, paranasal sinuses, and head in general. Although not well understood, during myocardial ischemia, the process of cardiac referred pain to craniofacial structures can be explained by the convergence of visceral and somatic relays at the trigeminal nucleus in the brain stem. The goal of this article is to review the possible pathways for referred jaw pain due to myocardial ischemia. Clin. Anat. 32:476-479, 2019. © 2019 Wiley Periodicals, Inc.
Asunto(s)
Isquemia Miocárdica/complicaciones , Dolor Referido/etiología , Humanos , Maxilares/inervación , Vías NerviosasRESUMEN
The posterior cerebral artery (PCA) is a branch of the terminal part of the basilar artery and perfuses the temporal lobes, midbrain, thalamus, and the posterior inferior portion of the parietal lobes. It is divided into P1-P4 segments. Variations in the P1 segment of the PCA are important to neurosurgeons when performing surgery, for example, on basilar tip aneurysms. We report bilateral superior cerebellar artery (SCA) arising from the P1 segment of the PCA. Such a configuration appears to be uncommon but should be kept in mind by neurosurgeons, neurointerventionalists, and neuroradiologists.
RESUMEN
The ophthalmic artery arises from the supraclinoid segment of the internal carotid artery (ICA) and enters the orbit through the optic canal. It perfuses the orbit and the orbit apparatus. Ophthalmic artery aneurysms (OAA) account for 0.5% to 11% of all intracerebral aneurysms. Patients are usually asymptomatic but, in some cases, patients can present with ophthalmoplegia and total blindness if these aneurysms rupture. Aneurysms are usually diagnosed using computed tomography (CT) angiography but can also be seen on magnetic resonance imaging (MRI) and four-vessel digital subtraction angiography. Treatment of OAA entails either surgical or endovascular approaches with the mortality rate for surgical treatment as high as 25%, whereas embolization with balloon therapy is deemed safer with mortality rates around 9%. Recent techniques of embolization coiling have had even better results.
RESUMEN
The fabella is a sesamoid bone that is embedded in the lateral head of the gastrocnemius muscle and often articulates directly with the lateral femoral condyle. It is present in 10-30% of the general population with a higher incidence in Asians. The fabella can lead to various pathologies such as fabella pain syndrome and common fibular nerve palsy. Conservative treatment involves physical therapy or injecting local anesthetics or steroids around this bone. However, if symptoms persist, then a fabellectomy can be performed. Physicians should be aware of the fabella bone and the multiple pathologies associated with it in order to provide the best treatment and management for patients.
RESUMEN
The venous drainage of the neck can be characterized into superficial or deep. Superficial drainage refers to the venous drainage of the subcutaneous tissues, which are drained by the anterior and external jugular veins (EJVs). The brain, face, and neck structures are mainly drained by the internal jugular vein (IJV). The superficial veins are found deep to the platysma muscle while the deep veins are found encased in the carotid sheath. The junction of the retromandibular vein and the posterior auricular vein usually form the EJV, which continues along to drain into the subclavian vein. The anterior jugular vein is usually formed by the submandibular veins, travels downward anterior to the sternocleidomastoid muscle (SCM), and drains either into the EJV or the subclavian vein. Other superficial veins of the neck to consider are the superior, middle, and inferior thyroid veins. The superior thyroid and middle thyroid veins drain into the IJV whereas the inferior thyroid vein usually drains into the brachiocephalic veins.