Spontaneous ruptured splenic artery aneurysm: a case report

Splenic artery aneurysms are rare. We discuss a case of a 58-year-old gentleman presenting with collapse and shock secondary to spontaneous splenic artery aneurysm rupture. Patient underwent laparotomy and splenectomy then discharged home within a week of presentation

Chronic breast abscess due to Mycobacterium fortuitum: a case report

<p>Abstract</p> <p>Introduction</p> <p><it>Mycobacterium fortuitum </it>is a rapidly growing group of nontuberculous mycobacteria more common in patients with genetic or acquired causes of immune deficiency. There have been few published reports of <it>Mycobacterium fortuitum </it>associated with breast infections mainly associated with breast implant and reconstructive surgery.</p> <p>Case presentation</p> <p>We report a case of a 51-year-old Caucasian woman who presented to our one-stop breast clinic with a two-week history of left breast swelling and tenderness. Following triple assessment and subsequent incision and drainage of a breast abscess, the patient was diagnosed with <it>Mycobacterium fortuitum </it>and treated with antibiotic therapy and surgical debridement.</p> <p>Conclusion</p> <p>This is a rare case of a spontaneous breast abscess secondary to <it>Mycobacterium fortuitum </it>infection. Recommended treatment is long-term antibacterial therapy and surgical debridement for extensive infection or when implants are involved.</p

Monophasic synovial sarcoma of the pharynx: a case report

Synovial sarcomas are a rare form of soft tissue sarcomas. We present a case of a 62 year-old male presenting with a left thyroid lump initially though to be a thyroid adenoma but subsequently diagnosed as a monophasic synovial sarcoma of the pharynx. We discuss the diagnosis and treatment of this case

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

Parenting for a Digital Future – one year on

It’s been an eventful year in many ways, and a tough one for most people. Children’s lives became digital by default. Education went remote. Screen time hit the roof. Researchers had to do their research via Zoom. And parents? There’s never one answer to that question: parents are as diverse as society, and their experiences of the pandemic have surely varied hugely. For www.parenting.digital, Prof Sonia Livingstone talks about how digital parenting has changed during the past year

Enormous brachio-cephalic arteriovenous fistula aneurysm after renal transplantation: Case report and review of the literature

Creation of arteriovenous fistulae provides readily available vascular access for haemodialysis in patients with end-stage renal disease. However, it is associated with various potentially serious complications if left unattended.We report a case of a 73-year-old male presenting with an enormous brachio-cephalic fistula aneurysm measuring 70-5.4 cm 20 years after successful renal transplantation. Despite attending regular renal outpatient clinic follow-up, this was only noticed as an incidental finding when the patient attended the emergency department after a fall that severely bruised his access. The patient subsequently underwent ligation with complete removal of the aneurismal fistula and discharged to a rehabilitation unit 3 days post-operatively.Systematic closure of an arteriovenous fistula should be considered in all patients after successful renal transplantation to avoid potentially catastrophic complications of an arteriovenous fistula. In patients in whom the closure of vascular access is contraindicated, it is crucial to regularly assess the status of any arteriovenous fistula when following up patients after renal transplantation.Link_to_subscribed_fulltex