Acta clinica Croatica
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The purpose of this study was to present and analyze patients with audiovestibular post COVID-19 syndrome, and highlight the most characteristic and most common findings. We analyzed 87 patients aged between 20 and 86 years who presented to the Audiology Division between February 1, 2021 and July 1, 2021 after having been isolated due to the SARS-CoV-2 infection. Study patients presented with complaints of persistent hearing loss, tinnitus, and vertigo, lasting for more than 3 months. ⋯ Vertigo occurred in 9 patients, all of which were new-onset. A conclusion of our research is that audiovestibular post-COVID syndrome does exist. Further research with more patients and over a longer period is needed to obtain a better and longer effect on the audiovestibular system and audiovestibular complications, as well as an insight into possible recovery.
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Acta clinica Croatica · Apr 2023
Case ReportsSIMULTANEOUS METASTASES OF PAPILLARY THYROID CARCINOMA AND NEUROENDOCRINE TUMOR OF THE CECUM TO CERVICAL LYMPH NODES: A CASE REPORT.
We present a case of a patient with simultaneous cervical lymph node metastasis of papillary thyroid cancer (PTC) and cecum neuroendocrine tumor (NET). A 45-year-old male patient with the diagnosis of metastatic NET of the cecum underwent fine needle aspiration (FNA) of a positron emission tomography with 18F-fluorodeoxyglucose (18F-FDG PET) positive nodule in the left thyroid lobe. Due to FNA finding suspect of PTC, the patient underwent total thyroidectomy with central neck dissection. ⋯ Postoperative serum Tg value was 17.75 µg/L and the patient underwent 5550 MBq iodine-131 (I-131) therapy. A year after I-131 therapy, follow-up neck US demonstrated complete cure of PTC cervical lymph node metastasis in the region III and stable in size NET cervical lymph node metastasis in the region IV. To our knowledge, this is the first report of simultaneous occurrence of cervical lymph node metastases of PTC and NET of the cecum.
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Acta clinica Croatica · Apr 2023
Case ReportsWHOLE RANGE OF RESPIRATORY SUPPORT IN A PREGNANT WOMAN WITH A SEVERE FORM OF COVID-19 INFECTION: A CASE REPORT.
Acute respiratory syndrome caused by a novel coronavirus (SARS-CoV-2) in pregnant women can progress to a critical condition. In this paper, we present a case of a woman in the 28th week of gestation hospitalized due to respiratory insufficiency caused by COVID-19 infection and consequent bilateral pneumonia with development of severe acute respiratory distress syndrome. Noninvasive ventilation through a face mask was started but due to progression of respiratory insufficiency with high FiO2 and positive end expiratory pressure (PEEP), we decided to intubate the patient, after which obstetricians agreed to complete pregnancy by cesarean section. ⋯ Due to inadequate mechanical ventilation, the patient was transferred to Dr. Fran Mihaljević University Hospital for Infectious Diseases in order to perform extracorporeal membrane oxygenation (ECMO). Owing to all of the measures taken, recovery followed after 13 days on ECMO.
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Acta clinica Croatica · Apr 2023
Case ReportsEMERGENCY TRACHEOTOMY IN TRACHEAL STENOSIS - A CASE REPORT.
Airway management in an emergency department is the first step in critical care of an urgent patient. When orotracheal intubation is not possible due to upper airway obstruction, such an emergency is known as a 'cannot intubate - cannot ventilate' situation. Then, emergency tracheotomy is indicated. ⋯ Early postoperative care was complicated by incipient right-sided pneumonia, which may have provoked narrowing of the existing subglottic stenosis in the first place. Tracheal stenosis is an important differential diagnosis of airway obstruction in patients with previous malignant diseases of the upper respiratory system. Emergency physicians should promptly recognize these situations based on clinical examination to secure appropriate airway management.
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Acta clinica Croatica · Apr 2023
Case ReportsNECK HEMATOMA AFTER CENTRAL VENOUS CATHETERIZATION AND AWAKE INTUBATION AS RESCUE AIRWAY MANAGEMENT TECHNIQUE: A CASE REPORT.
Central venous catheterization (CVC) of the internal jugular vein is an invasive procedure commonly performed in anesthesiology practice. Usually it is an uneventful procedure but complications such as bleeding, infection, and potential damage to the surrounding structures can occur. One of the complications is neck hematoma, which can distort airway anatomy and cause upper airway obstruction. ⋯ Awake tracheal intubation (ATI) with video laryngoscopy was the technique of choice for reintubation because of the neck swelling and compression onto laryngeal structures. In this case, rushed extubation put the patient at risk. Video laryngoscopy ATI with appropriate preparation and titrated sedation can enable quick and safe rescue airway management in patients with rapidly developing neck hematoma, along with definitive evacuation and treatment.