Priapism in an otherwise healthy man with SARS-COV-2: case report and literature review

COVID-19 disease causes acute respiratory infection – pneumonia. It is associated with an increased risk of complications such as hypercoagulopathy, which leads to thromboses. We present a case of a young man presenting with typical SARS-CoV-2 symptoms (fever, cough, fatigue, and dyspnea), who experienced ischemic priapism, most probably due to thrombosis of penile vessels caused by the novel coronavirus infection. After prompt treatment of the priapism with punctures and irrigation, lasting penile detumescence was achieved. However, despite younger age, lack of serious comorbidities and administration of anticoagulants, priapism was followed by a fatal pulmonary embolism some days later

Management of children with mild traumatic brain injury and intracranial hemorrhage

BACKGROUND: Traumatic brain injury (TBI) is a significant public health problem affecting tens of thousands of children each year, and an important subset of these patients sustains intracranial hemorrhage (ICH). The purpose of this study was to test the hypothesis that we could identify a subset of children with traumatic ICH who could be monitored on a general neurosurgery ward with a low risk of clinical deterioration. METHODS: We performed a retrospective review of pediatric patients 18 years or younger with mild TBI (Glasgow Coma Scale [GCS] score 14Y15) and traumatic ICH admitted to Saint Louis Children's Hospital between 2006 and 2011. We excluded patients with injuries unrelated to the TBI that would require intensive care unit (ICU) admission and those with penetrating intracranial injuries. RESULTS: We identified 118 patients meeting inclusion criteria. Repeat neuroimaging was obtained in 69 (58%) of 118 patients. Radiologic progression was noted in 6 (8.7%) of 69 patients, with a trend toward more frequent progression in patients with epidural hematoma (EDH) versus other ICH (3 [20%] of 15 vs. 3 [5.6%] of 54; p = 0.11). Of 118 patients, 8 (6.8%) experienced clinically important neurologic decline (CIND) and 6 (5.1%) required neurosurgical intervention. Both CIND and the need for neurosurgical intervention were significantly higher in patients with EDH (21% each) compared with those with other types of ICH (4% and 2%, respectively) (p = 0.02, p G 0.01). Based on these results, we developed a preliminary management framework to assist in determining which patients can be safely observed on a neurosurgery ward without an ICU admission. Specifically, those patients without EDH, intraventricular hemorrhage, coagulopathy, or concern for a high-risk neurosurgical lesion (e.g., arteriovenous malformation) may be safely observed on the ward. CONCLUSIONS: These results demonstrate that few children with mild TBI and ICH experience CIND and the preliminary framework we developed assists in identifying which patients can safely avoid ICU admission. This framework should be validated prospectively and externally. (J Trauma Acute Care Surg. 2014;76: 1089Y1095

Posttraumatic Parinaud’s syndrome as a contrecoup injury in a case of closed head trauma

The purpose of the study was to present a rare case of post-traumatic Parinaud’s syndrome with a history of closed head injury. The clinical characteristics, examination, and management are presented in a 12-year-old boy who was a victim of physical violence at the hands of a young boy who punched him in his chin with his fists, with associated paralysis of the upward gaze of the left eyeball, and convergence nystagmus with pupillary involvement. CT examination indicated posttraumatic lesions in the dorsal midbrain and in the cavity of third ventricle, suggestive of acute hemorrhages. Posttraumatic Parinaud’s syndrome is a rare phenomenon that can occur in a case of closed head trauma as contrecoup injury

Renal abnormalities associated with Mayer-Rokitansky-Küster-Hauser syndrome

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare congenital disorder affecting female reproductive system (agenesis of uterus and upper part of vagina) alone (type 1), or associated with abnormalities of other organs and systems (type 2). We report a case of a 21-year-old woman diagnosed with MRKH due to primary amenorrhea during puberty and operated for formation of neovagina. She was admitted to the Department of Urology with abdominal pain and oligoanuria, where the physical examination and imaging studies revealed a malformation of the upper urinary tract: a solitary dystopia of kidney in the pelvis with stenosis of ureteropelvic junction and hydronephrosis. After initial desobstruction with a DJ stent, a pyeloplasty was performed. Females with primary amenorrhea are often delayed with the diagnosis of potential MRKH syndrome, and those diagnosed with the syndrome should undergo detailed examination to exclude concomitant urinary abnormalities

Ultrafast laser and amplifier sources

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42152/1/340-65-2-161_70650161.pd

Experimental mycotoxic nephropathy in pigs provoked by a mouldy diet containing ochratoxin A and fumonisin B1.

Mycotoxic nephropathy was induced in eighteen young pigs by mouldy diets containing 0.5ppm ochratoxin A (OTA) and/or 10ppm fumonisin B1 (FB1) for three months. While the most obvious damages provoked by OTA were seen in the kidneys as expressed by the strong degenerative changes in proximal tubules and fibrosis in kidneys, FB1 was found to induce an increase in permeability of vessels mainly in lung, brain, cerebellum or kidneys and slight to moderate degenerative changes in kidneys. Pathomorphological damages in pigs exposed to both mycotoxins simultaneously present a combination of the main lesions provoked by each mycotoxin alone being stronger in their expression. Biochemical investigations as expressed by the increase of serum creatinine, urea and enzyme activity of ASAT/ALAT and by the decrease of serum cholesterol, total protein, albumin and glucose were strongest in pigs exposed to both mycotoxins simultaneously as can be anticipated form the strongest lesions in the kidneys. Both mycotoxins and their combination were found to disturb powerfully humoral immune response in all experimental pigs as expressed by the strong decrease in antibody titer against Morbus Aujesky at days 21 and 35 after vaccination. Having in mind that the feed levels of the both mycotoxins as well as the exposure time and the pathological findings corresponded to those in some spontaneous cases of porcine nephropathy in Bulgaria and South Africa, it can be concluded that the same mycotoxins are involved in the observed field cases of that nephropathy

Committee V.4: Offshore Renewable Energy

Concern for load analysis and structural design of offshore renewable energy devices. Attention shall be given to the interaction between the load and structural response of fixed and floating installations taking due consideration of the stochastic nature of the ocean environment. Aspects related to prototype testing, certification, marine operations and total cost of energy shall be considered

Committee V.4: Offshore Renewable Energy

Concern for load analysis and structural design of offshore renewable energy devices. Attention shall be given to the interaction between the load and structural response of fixed and floating installations taking due consideration of the stochastic nature of the ocean environment. Aspects related to prototype testing, certification, marine operations and total cost of energy shall be considered

Committee V.4: Offshore Renewable Energy

Concern for load analysis and structural design of offshore renewable energy devices. Attention shall be given to the interaction between the load and structural response of fixed and floating installations taking due consideration of the stochastic nature of the ocean environment. Aspects related to prototype testing, certification, marine operations and total cost of energy shall be considered.publishedVersio