This case report presents a 66-year-old man with chest pain and shortness of breath who had a 16 cm × 9 cm × 12-cm anterior mediastinal atypical carcinoid tumor with compression causing severe right ventricular outflow tract obstruction. We were consulted for anesthetic management of surgical resection of this tumor. Thoracic epidural, femoral, and radial arterial catheterizations, and femoral central venous access were performed with sedation. Upon ensuring adequate surgical site analgesia under thoracic epidural, chest incision was performed. Thereafter, induction and intubation were performed without complication. During intubation, fiberoptic bronchoscopy highlighted external compression of the left mainstem bronchus. The procedure was completed, and the patient was extubated in the operating room and transported to the intensive care unit in stable condition without complications.
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http://dx.doi.org/10.7759/cureus.11688 | DOI Listing |
ANZ J Surg
January 2025
Otolaryngology Head and Neck Surgery, Darling Downs Hospital and Health Service, Toowoomba, Queensland, Australia.
Background: Australia has the highest global incidence of keratinocyte cancer. Surgically managing keratinocyte cancers in regional Australia presents geographic and economic challenges, which necessitate cost-effective resource allocation. Previous work has outlined the cost benefit for outpatient day surgical excision of head and neck skin lesions that can be closed primarily.
View Article and Find Full Text PDFJ Clin Med
January 2025
Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126 Parma, Italy.
Sepsis is one of the leading causes of mortality in hospital settings, and early diagnosis is a crucial challenge to improve clinical outcomes. Artificial intelligence (AI) is emerging as a valuable resource to address this challenge, with numerous investigations exploring its application to predict and diagnose sepsis early, as well as personalizing its treatment. Machine learning (ML) models are able to use clinical data collected from hospital Electronic Health Records or continuous monitoring to predict patients at risk of sepsis hours before the onset of symptoms.
View Article and Find Full Text PDFJ Clin Med
January 2025
Faculty of Medicine, "Carol-Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
: Bupropion, an atypical antidepressant and smoking cessation aid, is known for its potential to cause seizures, cardiotoxicity and neurotoxicity in overdose scenarios. However, overdoses may present variably, and muscular and renal complications, such as rhabdomyolysis and acute kidney injury (AKI), can emerge in unexpected ways. Previous reports have shown that severe overdoses can lead to a spectrum of complications, but the precise mechanisms linking bupropion overdose with rhabdomyolysis remain poorly understood.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Hospital Centre Rijeka, 51000 Rijeka, Croatia.
Autoimmune thyroid disease (AITD) is the leading cause of thyroid dysfunction globally, characterized primarily by two distinct clinical manifestations: Hashimoto's thyroiditis (HT) and Graves' disease (GD). The prevalence of AITD is approximately twice as high in women compared to men, with a particularly pronounced risk during the reproductive years. Pregnancy exerts profound effects on thyroid physiology and immune regulation due to hormonal fluctuations and immune adaptations aimed at fostering maternal-fetal tolerance, potentially triggering or exacerbating AITD.
View Article and Find Full Text PDFJ Clin Med
December 2024
Anesthesiology and Operative Intensive Care, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany.
Mediastinal mass syndrome represents a major threat to respiratory and cardiovascular integrity, with difficult evidence-based risk stratification for interdisciplinary management. We conducted a narrative review concerning risk stratification and difficult airway management of patients presenting with a large mediastinal mass. This is supplemented by a case report illustrating our individual approach for a patient presenting with a subtotal tracheal stenosis due to a large cyst of the thyroid gland.
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