Bratisl Med J
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Diffuse alveolar haemorrhage (DAH) is a serious pulmonary complication seen in patients with autoimmune disorders and patients treated with chemotherapy or after hematopoietic stem cell transplantation. The clinical management of DAH is complex and the condition has a high mortality rate. During inflammation, tissue factor is expressed in the lung alveoli and therefore pulmonary administration of human recombinant activated factor VIIa (rFVIIa) could be a rational treatment option (4.1). ⋯ Symptomatic therapy--intrapulmonary administration of one dose of rFVIIa was found to have an excellent haemostatic effect in the patient with DAH. The intrapulmonary administration of rFVIIa seemed to have a high benefit-to-risk ratio. These findings warrant further exploration (Ref. 12).
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Portomesenteric vein gas and pneumatosis intestinalis is most commonly caused by mesenteric ischemia and bowel necrosis but may have a variety of other causes. The etiology is multifactorial and the clinical presentation is variable. ⋯ The finding of hepatic portal venous gas alone is not an indication for emergent exploration. We report portomesenteric venous gas as a rare complication after neoadjuvant radiochemotherapy of the oesophageal cancer (Fig. 3, Ref. 12).
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The goal of this project was to determine if mechanical stimulation to the posterolateral oropharynx would elicit the urge-to-cough and/or cough. ⋯ Oropharyngeal mechanical stimulation elicits urge-to-cough and cough in healthy young adults. Like other methods to elicit coughing, the motor and sensory thresholds are different using the oropharyngeal air-puff stimuli. Further, it appears there is a sensitization to the air puff stimuli with later trials associated with stronger urge-to-cough and higher likelihood of coughing versus the first and second trial (Tab. 1, Fig. 5, Ref. 21).
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The authors present two cases of spontaneous intraperitoneal perforation of urinary bladder. The first case was a 56-year old female patient with history of urothelial cancer with partial urinary bladder resection and subsequent radiotherapy six years ago. The diagnostic laparoscopy was indicated because of the clinical signs of peritonitis. ⋯ It is important to consider this diagnosis in case of acute abdomen. The treatment of urinary bladder perforation is based on the identification of the defect, lavage of the peritoneal cavity, excision of the defect, reconstruction of the bladder with intact blood supply, bladder drainage supporting the defect healing, and exclusion of malignancy. The laparoscopic treatment of spontaneous perforation according to literature is not common, however very effective (Fig. 1, Ref. 41).
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The authors describe a case of 33 year old Caucasian married man with an irregular 6 cm penile mass associated with multiple penile ulcers. He reluctantly admitted that 10 years ago he had multiple mineral oil (Vaseline) self injections into the penis, for penile enlargement purposes. The patient had a surgical intervention 10 years ago, but he has recurrent ulcers on his penis. ⋯ The term paraffinoma describes a distinct histopathological finding that results from the injection of foreign oily substances into the skin. Although such procedure may be considered rare, they are still performed in some countries. The major point we want emphasis is following: a lot of people seek penile augmentations, it is necessary to remind physicians and the public that nonscientific and inadequate procedure such as Vaseline may lead to debilitating and destructive consequences (Tab. 1, Ref. 12).