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Sample records for 20-year-old patient case

  1. Paraurethral Leiomyoma in a 20 Year-old Woman: A Case Report

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    Emily Adams-Piper

    2016-01-01

    Full Text Available We present the case of a 20 year-old woman with a vulvar mass, found to be a paraurethral leiomyoma. She subsequently underwent supermedial-approach paraurethral mass excision, distal urethral reconstruction and cystourethroscopy. Paraurethral leiomyoma make up approximately five percent of urethral tumors. This case depicts the presentation and treatment of a paraurethral leiomyoma in one of the youngest women reported in the literature.

  2. Congenital Orbital Lymphangioma in a 20-Years Old Girl – Case Report and Review of Literature

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    Mishra A

    2009-01-01

    Full Text Available We report a case of a 20-year-old girl who presented to the out-patients’ department with congenital, progressive unilateral proptosis and reduced vision. Ultrasound, computed tomography (CT scan and magnetic resonance imaging (MRI were performed. Diagnosis of orbital lymphangioma was made on imaging. Authors highlight the crucial role of imaging in diagnosis and to plan therapeutic approach. This case is reported because of its extreme rarity and unusual presentation.

  3. A rare case of moyamoya disease in a 20-year-old Puerto Rican female U.S. soldier.

    Science.gov (United States)

    Busey, Blake; Berry-Cabán, Cristóbal S; Hoedebecke, Kyle; Barts, Rachel N

    2014-12-01

    Moyamoya disease is a progressive, occlusive pathology involving the cerebral vasculature with particular involvement of the circle of Willis and its tributaries. The cause of moyamoya disease is unknown, but is believed to be hereditary. Females 20 to 39 years old with moyamoya represent 0.5% of all acute cerebral ischemia and infarcts with risk factors including smoking, estrogen-containing birth control use, coagulopathy, neoplasm, and congenital malformation. This case reports on a 20-year-old Puerto Rican female U.S. soldier with a 1-year history of migraine headaches with worsening right retro-orbital pain, blurred vision, and photophobia. The patient had minimal unilateral neurological deficits despite evidence of significant cerebral infarction on non-contrast computed tomography. Other neuroimaging findings were consistent with moyamoya disease with confirmation via cerebral angiography. This case details the process of diagnosis and treatment as well as discussing its incidence, identification, and treatment options.

  4. Treatment of multiple traumatized anterior teeth associated with an alveolar bone fracture in a 20-year-old patient: a 3-year follow up

    OpenAIRE

    2014-01-01

    Intrusive luxation is a type of recognizable luxation injury represented by a deeper axial displacement of the tooth toward the alveolar bone. Treatment strategies include waiting for the tooth to return to its position, immediate surgical repositioning, and repositioning through dental traction by orthodontic devices. The aim of this case report was to present the management of severe dental trauma and later restoration following IADT. A 20-year-old patient was presented after fainting at ho...

  5. Complications of Aortic Stenting in Patients below 20 Years Old: Immediate and Intermediate Follow-Up

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    Akbar Molaei

    2011-12-01

    Full Text Available Background: Optimal timing and mode of treatment for patients with coarctation of the aorta (COA remain controversial, particularly in children. Surgery, balloon dilatation, and stent implantation have all proven effective in the treatment of moderate or severe obstruction. The aim of this study was to investigate the complications of COA stenting angioplasty in pediatric patients. Methods: This retrospective, descriptive study was conducted on patients less than 20 years of age who underwent aortic stenting angioplasty because of congenital COA in the pediatric catheterization laboratory of Rajaie cardiovascular, medical and research Center, Tehran between 2005 and 2010. Results: A total of 26 patients (18 [65.4%] males and 9 [34.6%] females with congenital COA who had undergone aortic stenting angioplasty were recruited. Nineteen (73.1% of these patients had native COA and 7 (26.9% had recurrent COA. Most of the early complications were minor and temporary; only one patient developed early major complications. During the follow-up, whereas none of the native group patients developed late complications, in the re-COA group 28.57% of the patients had re-stenosis and 14.28% had chronic systemic hypertension, requiring drug therapy. Conclusion: Our investigation into post-stenting complications in patients with native COA and re-COA showed that endovascular stenting could be an effective and safe method, even in young patients with native COA.

  6. Computed tomography findings in patients less than 20 years old with lymphoma; Aspectos da tomografia computadorizada no linfoma em pacientes abaixo de 20 anos de idade

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    Borba, Adriana Moreira Viana [Pontificia Universidade Catolica do Rio de Janeiro (PUC-RJ), Rio de Janeiro, RJ (Brazil). Escola de Medicina; Monteiro, Alexandra Maria Vieira; Lucena, Stella Beatriz Goncalves de [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Faculdade de Ciencias Medicas; Lima, Claudio Marcio Amaral de Oliveira; Ribeiro, Erica Barreiros [Hospital Naval Marcilio Dias, Rio de Janeiro, RJ (Brazil)]. E-mail: cmaol@br.inter.net; Skinner, Luis Flavio [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Faculdade de Ciencias Medicas. Hospital Universitario Pedro Ernesto (HUPE)

    2007-03-15

    Objective: To describe the general findings of lymphoma and their histological patterns in patients less than 20 years old. Materials And Methods: Twenty-two cases (16 male and 6 female, mean age 11.5 years) from the digital archive of computed tomography at the Cancer Control Center of Hospital Universitario Pedro Ernesto - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil, were retrospectively analyzed in the period between March 2003 and July 2005. Of these 22 cases, 12 were Hodgkin's and 10 were non-Hodgkin's. Results: Overall, mediastinal lymphadenomegaly was the most frequent finding (59%), with predominance in the Hodgkin's subgroup (75%), followed by hepatosplenomegaly (50%) and cervical and retroperitoneal lymphadenomegaly (27.3%). The Hodgkin's subgroup presented a prevalence of lymphadenopathy, in many lymph node chains, followed by hepatosplenomegaly (50%). One case was found with unilateral tonsillar mass, pulmonary ground-glass opacities, and renal nodules. In the non-Hodgkin's subgroup, the disease was predominantly extranodal, characterized by hepatosplenomegaly (50%), thickening of the intestinal wall (40%), pleural effusion (30%), pulmonary nodule (20%), ascites (10%), pericardial effusion (10%) and mixed bone lesions (10%). Conclusion: Computed tomography is an extremely useful method for detection, staging and follow-up of lymphomas, with alert findings like mediastinal lymphadenopathy, hepatosplenomegaly, unilateral tonsillar mass and thickening of intestinal wall. (author)

  7. Treatment of multiple traumatized anterior teeth associated with an alveolar bone fracture in a 20-year-old patient: A 3-year follow up.

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    Faus-Matoses, Vicente; Martínez-Viñarta, María; Alegre-Domingo, Teresa; Faus-Matoses, Ignacio; Faus-Llácer, Vicente J

    2014-10-01

    Intrusive luxation is a type of recognizable luxation injury represented by a deeper axial displacement of the tooth toward the alveolar bone. Treatment strategies include waiting for the tooth to return to its position, immediate surgical repositioning, and repositioning through dental traction by orthodontic devices. The aim of this case report was to present the management of severe dental trauma and later restoration following IADT. A 20-year-old patient was presented after fainting at home four hours before, resulting in a dento-alveolar trauma. Clinical examinations revealed a traumatic intrusion, in 1.2, 1.1 and 2.1, uncomplicated crown fractures in 1.1 and 2.1 and a complicated crown-root fracture in 2.2. The diagnosis was confirmed with CBCT. Following IADT protocol, the emergency treatment consisted of the surgical repositioning and semi-rigid splinting using orthodontic wire-composite, replacing the buccal bone plate, and postoperative instructions to the patient regarding oral hygiene. After 2 weeks the root canal treated and filled with fiberglass posts in 1.2, 1.1, 2.1 and 2.2. Splint was removed after 4 weeks and the IADT reassessment protocol followed, with revisions at 6-8 weeks, 6 months, a year and annual reviews for 5 years. A year after the treatment, the traumatized teeth were restored with minimally invasive preparations of feldspathic ceramic. Esthetics and function were recorded with a 3-year follow-up period. Key words:Intrusive luxation, dental trauma, crown-root fracture, dento-alveolar trauma, permanent tooth, CBCT.

  8. Aspectos da tomografia computadorizada no linfoma em pacientes abaixo de 20 anos de idade Computed tomography findings in patients less than 20 years old with lymphoma

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    Adriana Moreira Viana Borba

    2007-04-01

    Full Text Available OBJETIVO: Descrever os achados gerais do linfoma em pacientes abaixo de 20 anos de idade e por subtipo histológico. MATERIAIS E MÉTODOS: Estudo retrospectivo do arquivo digital de tomografia computadorizada do Centro de Controle do Câncer do Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro, no período de março de 2003 a julho de 2005. Dos 22 casos - 16 do sexo masculino e 6 do sexo feminino, com média de idade de 11,5 anos -, 12 eram do subtipo Hodgkin e 10 eram não-Hodgkin. RESULTADOS: Dos achados gerais, verificamos as linfonodomegalias mediastinais como o mais freqüente (59%, com predomínio no grupo Hodgkin (75%, seguido por hepatoesplenomegalia (50% e linfonodomegalias cervicais e retroperitoneais (27,3%. No subtipo Hodgkin houve predomínio do acometimento linfonodal, em sucessivas cadeias, seguido pela hepatoesplenomegalia (50%. Verificamos um caso de massa tonsilar unilateral, opacidade pulmonar em "vidro-fosco" e nódulos renais. No subtipo não-Hodgkin houve predomínio extranodal caracterizado por hepatoesplenomegalia (50%, espessamento de alça intestinal (40%, derrame pleural (30%, nódulo pulmonar (20%, ascite (10%, derrame pericárdico (10% e lesões ósseas mistas (10%. CONCLUSÃO: A tomografia computadorizada é de grande valia no diagnóstico, estadiamento e seguimento do linfoma, com achados de alerta como massa linfonodal, notadamente mediastinal, hepatoesplenomegalia, massa unilateral na tonsila e espessamento parietal de alça intestinal.OBJECTIVE: To describe the general findings of lymphoma and their histological patterns in patients less than 20 years old. MATERIALS AND METHODS: Twenty-two cases (16 male and 6 female, mean age 11.5 years from the digital archive of computed tomography at the Cancer Control Center of "Hospital Universitário Pedro Ernesto - Universidade do Estado do Rio de Janeiro", Rio de Janeiro, RJ, Brazil, were retrospectively analyzed in the period between

  9. Acute unstable complex radial head and neck fractures fixed with a mini T-shaped plate in a 20-year-old man: a case report

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    Yu W

    2016-05-01

    Full Text Available Weiguang Yu,1,* Jun Hu,1,* Xinchao Zhang,2 Xingfei Zhu,2 Yinfeng Xu,1 Jianhua Yi,1 Yunjiang Liu1 1Department of Orthopedics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, 2Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Acute unstable complex radial head and neck fractures in adults are seldom reported in the literature. Early recognition and appropriate management are essential to prevent long-term consequences of the loss of elbow function, forearm rotation, and chronic pain. Here, we describe an unusual case of a 20-year-old man who exhibited acute unstable complex fractures of the head and neck of the right radius without other injuries or comorbidity. An open reduction and mini T-shaped plate fixation were performed within 3 hours after injury, and the results were satisfactory. A long plaster fixation was continued for 3 weeks. A gradual mobilization was started after the removal of the plaster under the supervision of a physiotherapist. At the 12-month follow-up, no complications associated with the use of the mini T-shaped plate were noted, and the Mayo Elbow Performance Score was 97 (excellent. To our knowledge, acute unstable complex radial head and neck fractures in adults can be successfully treated with a mini T-shaped plate reconstruction technique. Keywords: unstable complex fractures, mini T-shaped plate, radial head, internal fixation, radial head replacement

  10. A Rare, Recurrent, De Novo 14q32.2q32.31 Microdeletion of 1.1 Mb in a 20-Year-Old Female Patient with a Maternal UPD(14-Like Phenotype and Intellectual Disability

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    Almira Zada

    2014-01-01

    Full Text Available We present a 20-year-old female patient from Indonesia with intellectual disability (ID, proportionate short stature, motor delay, feeding problems, microcephaly, facial dysmorphism, and precocious puberty who was previously screened normal for conventional karyotyping, fragile X testing, and subtelomeric MLPA analysis. Subsequent genome wide array analysis was performed on DNA from blood and revealed a 1.1 Mb deletion in 14q32.2q32.31 (chr14:100,388,343-101,506,214; hg19. Subsequent carrier testing in the parents by array showed that the deletion had occurred de novo in the patient and that her paternal 14q32 allele was deleted. The deleted region encompasses the DLK1/GTL2 imprinted gene cluster which is consistent with the maternal UPD(14-like phenotype of the patient. This rare, recurrent microdeletion was recently shown not to be mediated by low copy repeats, but by expanded TGG repeats, flanking the 14q32.2q32.21 deletion boundaries, a novel mechanism of recurrent genomic rearrangement. This is another example how the application of high resolution genome wide testing provides an accurate genetic diagnosis, thereby improving the care for patients and optimizing the counselling for family.

  11. Colonoscopia em pacientes não pediátricos abaixo de 20 anos de idade traz pouca contribuição nos resultados Colonoscopy in non pediatric patients under 20 years old brings poor contribution in results

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    Antonio Sérgio Brenner

    2007-12-01

    Full Text Available INTRODUÇÃO: A utilização da colonoscopia como método de diagnóstico e prevenção das doenças do cólon e reto é cada ano mais freqüente. Esse aumento na indicação também é observado nos extremos de idade, como pacientes não pediátricos abaixo dos 20 anos. MÉTODO: Entre outubro de 1998 a julho de 2006, 4354 pacientes foram submetidos à colonoscopia na clínica privada de um dos autores. Foram analisados retrospectivamente, os prontuários de 66 pacientes com vinte anos ou menos de idade. O estudo histológico foi obtido nos pacientes com exames alterados. RESULTADOS: A idade variou de 11 a 20 anos (média de 17,96 anos. Trinta e nove pacientes pertenciam ao sexo feminino e 27 ao masculino. O exame foi normal em 40, observou-se apenas hiperplasia de tecido linfóide em 10, divertículos em 2, colite inespecífica em 1 e pólipo hiperplásico em 1 paciente, totalizando 54 (81,81% exames sem alteração específica. Colites foram observadas em 10 e pólipos em 5. Em dois pacientes havia história familiar de doença inflamatória intestinal e em um de câncer de cólon. CONCLUSÃO: A seleção dos pacientes é fundamental para evitar exames colonoscópicos desnecessários em pacientes abaixo de 20 anos de idade.INTRODUCTION: The colonoscopy as a diagnostic and prevention tool has been increasingly used for the prevention and treatment of the colon and rectum diseases. This rise is also seen in non pediatric teenagers under 20 years old. METHOD: Between October 1998 and July 2006, 4354 patients were submitted to colonoscopy scope in one of the author's privet clinic. The files of 66 patients under 20 y/o were retrospectively analyzed. Histology was obtained for patients with abnormal exams. RESULTS: Medium age was 17,96 y/o (range 11 to 20. Thirty nine patients were female and 27 male. The exam was normal in 40, Linfoid hiperplasic tissue was found in 10, diverticulosis in 2, unspecific colitis in 1 and hyperplasic polyps in 1

  12. Primary Hyperparathyroidism with Extensive Brown Tumors and Multiple Fractures in a 20-Year-Old Woman

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    Choi, Ju Hee; Kim, Kyoung Jin; Lee, Ye Jin; Kim, Sun Hwa; Kim, Sin Gon; Jung, Kwang Yoon; Choi, Dong Seop

    2015-01-01

    A brown tumor is a benign fibrotic, erosive bony lesion caused by localized, rapid osteoclastic turnover, resulting from hyperparathyroidism. Although brown tumors are one of the most pathognomonic signs of primary hyperparathyroidism, they are rarely seen in clinical practice. In this report, we present a case of 20-year-old woman with recurrent fractures and bone pain. Plain digital radiographs of the affected bones revealed multiple erosive bone tumors, which were finally diagnosed as brown tumors associated with primary hyperparathyroidism due to a parathyroid adenoma. This case shows that multiple, and clinically severe form of brown tumors can even occur in young patients. PMID:26354493

  13. Primary Hyperparathyroidism with Extensive Brown Tumors and Multiple Fractures in a 20-Year-Old Woman

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    Ju Hee Choi

    2015-12-01

    Full Text Available A brown tumor is a benign fibrotic, erosive bony lesion caused by localized, rapid osteoclastic turnover, resulting from hyperparathyroidism. Although brown tumors are one of the most pathognomonic signs of primary hyperparathyroidism, they are rarely seen in clinical practice. In this report, we present a case of 20-year-old woman with recurrent fractures and bone pain. Plain digital radiographs of the affected bones revealed multiple erosive bone tumors, which were finally diagnosed as brown tumors associated with primary hyperparathyroidism due to a parathyroid adenoma. This case shows that multiple, and clinically severe form of brown tumors can even occur in young patients.

  14. 20 year old lady with a paraspinal mass.

    LENUS (Irish Health Repository)

    O'Toole, Orna

    2010-05-01

    A 20 year old female presented with a 4 month history of right upper limb pain and paraesthesias. She had no systemic symptoms and no prior medical or family history of note. MRI revealed a right-sided intradural extramedullary mass extending from C7-T1 and displacing the spinal cord. While awaiting surgery her symptoms progressed to involve the right lower limb. She was re-imaged and the lesion now extended from C5 to T3 with spinal cord compression at C7-T1. The radiological features and recent rapid growth were felt to be in keeping with a large plexiform neurofibroma. The patient underwent emergency resection of the lesion and pathology revealed Hodgkin\\'s Lymphoma (HL)-mixed cellularity type. A mediastinal mass was identified on further imaging and biopsy confirmed the diagnosis of HL-stage IV. The patient is currently undergoing treatment with ABVD chemotherapy. CNS-HL is extremely rare and may occur de novo or in association with systemic disease. Lesions may be parenchymal or dural based and are usually intracranial with an increased risk of CNS involvement in HL-mixed-cellularity type as in our patient. This is the first report in the literature of CNS-HL radiologically mimicking a paraspinal plexiform neurofibroma.

  15. Factitious aortic dissection leading to thoracotomy in a 20-year-old man.

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    Chambers, Elise; Yager, Joel; Apfeldorf, William; Camps-Romero, Eduardo

    2007-01-01

    A 20-year-old man presented to an emergency department with dramatic, sudden-onset, tearing chest pain. He also claimed to have been previously diagnosed with Ehler-Danlos syndrome and a previous Type I aortic dissection (intimal tear of ascending aorta), rapidly increasing his treating physician's suspicion of an emergent aortic dissection. The patient was quickly transferred to a large university hospital, where he underwent a median sternotomy and thoracotomy, with no aortic pathology found on operation and biopsy. After the patient's postoperative recovery, he was treated at a mental health facility, where he remained ambivalent about his psychiatric condition and did not respond well to treatment. This case report describes a unique case of factitious disorder that led to a serious operative intervention and subsequent psychiatric care and assesses factors that might have contributed to his hospital course.

  16. Radiographic findings on 3rd molars removed in 20-year-old men.

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    Rajasuo, Ari; Peltola, Jaakko; Ventä, Irja; Murtomaa, Heikki

    2003-10-01

    In this study we assess radiographic findings characteristic of mandibular 3rd molars that had required either routine or surgical extraction. X-ray findings relating to acute pericoronitis were also examined. The material was collected by investigating patient records and rotational panoramic radiographs of 20-year-old Finnish male conscripts (n = 738) treated during military service because of 3rd-molar-related problems. The follicle around the crown of mandibular 3rd molars with acute pericoronitis was enlarged in 19% of cases and in 13% of chronic symptom-free pericoronitis cases (not statistically significant difference). Mandibular 3rd molars extracted surgically were more often mesially inclined than those extracted routinely (61% vs. 23%; P pericoronitis [around 27% vs. 39% of the teeth routinely extracted (OR 0.5, 95% CI 0.3-0.8)]. In 86% of cases the space between 2nd molar and ramus of the mandible was narrower than the 3rd molar extracted surgically, whereas this was 62% in routine extraction cases (P < 0.001). We conclude that there are some typical 3rd-molar findings in rotational panoramic radiographs that show a need for surgical extraction.

  17. Dental health state in the 20 year-old population and more in Cienfuegos province.

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    Emma Gil Ojeda

    2007-04-01

    Full Text Available Background: The absence of consice data of some indicators in the stomatological subsystem of our province difficults the knowledge of the real situation of the dental health in our province population. Objetive: to determine some epidemiological indicators related to dental health in the 20 year-old population and more in Cienfuegos province. Method: a descriptive epidemiologcal study. Methods: 253 621 patients in a range of 20 years old and more. All health areas including municipalities were taken into consideration from May to June 2004. Results: The kind of denture more demanded for its rehabilitation by the population was the upper and the lower one. The highest indicators of cavities and exodonties were found in the 35 to 59 year-old group of patient as well as in the rural areas. The anatomic localization of cavity lesions were predominant in the posterior dental sector with a relation between sectors of 1:1,7. The lowest percetange in the covering range of stomatological attention was found in the 35 to 59 year-old group with 5 and 18 % in the majority of the municipalities. Conclusions: Through this investigation the behaviour of proposed indicators were evaluated as well as the necesities of treatment to establish future strategies of work in order to improve the dental health in the population.

  18. At a Crossroads: First Results for the 18 to 20-Year-old Cohort of the Youth in Transition Survey

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    Bowlby, Jeffrey W.; McMullen, Kathryn

    2002-01-01

    This report provides a descriptive overview of the first results from the 2000 Youth in Transition Survey (YITS) for 18-20-year-olds in Canada. These early results draw a picture of where youth stand in terms of both their educational participation and attainment and their labour market participation as of December 1999. Youth at this age are in…

  19. Phaeochromocytoma in a 20-year-old Nigerian, resolving the dilemma of benignity or malignancy

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    Fred O. Ugwumba

    2012-01-01

    Full Text Available Pheochromocytomas are rare tumors that present a diagnostic challenge in developing countries. They occur in the adrenal gland and as paragangliomas along the sympathetic chain. Clinical features are usually those of sustained or paroxysmal hypertension and complications thereof. Surgical extirpation remains the mainstay of treatment and is greatly facilitated by accurate pre-operative tumor localization. Pre-operative medical management with antihypertensive medication has led to significant reductions in peri-operative mortality. Determination of malignancy is difficult in the absence of obvious metastases. We present a case of left adrenal phechromocytoma that was stabilized. Adrenalectomy had a good outcome and the patient has so far been followed up for a year.

  20. Risk of Hyperprolactinemia and Sexual Side Effects in Males 10-20 Years Old Diagnosed with Autism Spectrum Disorders or Disruptive Behavior Disorder and Treated with Risperidone

    NARCIS (Netherlands)

    Roke, Yvette; Buitelaar, Jan K.; Boot, Annemieke M.; Tenback, Diederik; van Harten, Peter N.

    2012-01-01

    Objective: The aim of this study was to investigate the long-term treatment effects of risperidone on prolactin levels and prolactin-related side effects in pubertal boys with autism spectrum disorders (ASD) and disruptive behavior disorders (DBD). Method: Physical healthy 10-20-year-old males with

  1. Recovery and purification of 4.66 TBq(126 Ci) of {sup 137}Cs from a 20-year-old spent sealed source

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    Dash, Ashutosh, E-mail: adash@barc.gov.in [Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Varma, R.N. [Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Sastry, K.V.S.; Patil, B.N. [Board of Radiation and Isotope Technology (BRIT), Engineering Programme, Trombay, Mumbai 400085 (India); Ram, Ramu [Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Nikam, Seema [Board of Radiation and Isotope Technology (BRIT), Engineering Programme, Trombay, Mumbai 400085 (India); Venkatesh, Meera [Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India)

    2009-09-15

    An attempt to recover and purify 4.66 TBq(126 Ci) of {sup 137}Cs as solution from a 20-year-old doubly encapsulated sealed source containing {sup 137}CsCl was made successfully. The primary capsule was first cut open to retrieve the secondary capsule. The top end of the secondary SS capsule was then cut to render it as an open cylinder and the {sup 137}CsCl pellet inside was dissolved in small aliquots of water. Each aliquot of the {sup 137}CsCl solution was dispensed into glass vials, sealed, assayed and stored. Barium formed during the radioactive decay of {sup 137}Cs was removed by carbonate precipitation. Chloride was removed by heating with HNO{sub 3} and evaporation. About 91.8% of the total activity could be recovered and used subsequently for making brachytherapy sources.

  2. A rare case of malignant peripheral nerve sheath tumour

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    Anita Harry, Nirankumar Samuel, Vigil TD

    2014-04-01

    Full Text Available Malignant Peripheral Nerve Sheath Tumours are tumours of ectomesenchymal origin often originating from major nerves or their nerve sheaths, they are commonly found in patients with neurofibromatosis-1 though sporadic cases have been reported. We report a rare sporadic case of MPNST in a 20 year old patient arising from the spinal accessory nerve.

  3. Simultaneous extraarticular fracture of the base of the first metacarpal and dislocation of the metacarpophalangeal joint of the thumb: A case report

    Institute of Scientific and Technical Information of China (English)

    Anani Abalo; Sena Amouzou; Kouami Amakoutou; Assang Dossim

    2015-01-01

    Double fracture-dislocations of the thumb are rare.Only a single case report of a simultaneous extraarticular fracture of the base of the first metacarpal and dislocation of the metacarpophalangeal joint has been previously reported.We report the second case report of this injury in a 20-year-old man.The patient had an excellent outcome after treatment.

  4. Secondary mandibular fibrosarcoma after chemoradiotherapy for undifferentiated nasopharyngeal carcinoma. Report of a case and literature review; Fibrosarcome secondaire de la mandibule apres chimioradiotherapie pour carcinome indifferencie du nasopharynx. A propos d'une observation et revue de la litterature

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    Kochbati, L.; Besbes, M.; Benna, F.; Maalej, M. [Institut Salah Azaiz, Service de Radiotherapie, Tunis (Tunisia); Boussen, H.; Ben Ayed, F. [Institut Salah Azaiz, Service de Medecine, Tunis (Tunisia); Gritli, S.; Ladgham, A. [Institut Salah Azaiz, Service de Chirurgie ORL, Tunis (Tunisia); Saadi, A. [Institut Salah Azaiz, Service de Radiodiagnostic, Tunis (Tunisia); El May, A. [Institut Salah Azaiz, Service d' Anatomopathologie, Tunis (Tunisia)

    2001-06-01

    Secondary mandibular fibrosarcoma after chemoradiotherapy for undifferentiated nasopharyngeal carcinoma. Report of a case and literature review. Secondary tumours to radio- and/or chemotherapy have rarely been reported after treatment for head and neck cancers. We report a case of mandibular fibrosarcoma observed 7 years after chemoradiotherapy for undifferentiated nasopharyngeal carcinoma in a patient treated when 20 years old. (authors)

  5. Bilateral detachment of the macular neuroepithelium in a patient with Klinefelter syndrome.

    NARCIS (Netherlands)

    Haarlem, J. van; Cruysberg, J.R.M.; Deutman, A.F.

    2003-01-01

    PURPOSE: To describe the occurrence of atypical, bilateral detachment of the macular neuroepithelium and Klinefelter syndrome in a young patient. METHODS: Case report. RESULTS: A 20-year-old male of Chinese origin with karyotype 47,XXY presented with bilateral central neurosensory retinal detachment

  6. Unusual Gingival Enlargement: A Rare Case Report

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    Ashutosh Dixit

    2014-01-01

    Full Text Available This is an atypical case report of a 20-year-old male patient who suffered from unusual unilateral, gingival enlargement together with rapidly progressive alveolar bone loss. The enlarged gingiva completely covered his left posterior teeth in both arches. The patient was diagnosed with gingival fibromatosis and aggressive periodontitis based on the clinical, histological, and radiographic findings. The gingival enlargement was treated by conventional gingivectomy under local anaesthesia. The postoperative result was uneventful.

  7. Bilateral combined Monteggia and Galeazzi fractures: a case report.

    Science.gov (United States)

    Jafari, Davod; Taheri, Hamid; Shariatzade, Hooman; Mazhar, Farid Najd; Jalili, Alireza; Ghahramani, Mohamad H

    2012-02-01

    We present an exceedingly rare case of left Monteggia-Galeazzi fracture-dislocation and right Monteggia-distal radius fracture occurring simultaneously in a 20-year old male patient who had fallen 13 meters from a building. The combination of Monteggia and Galeazzi fracture-dislocation in the same forearm is very rare and, to the best of our knowledge, simultaneous bilateral Monteggia and Galeazzi or distal radius fracture in the same patient, have never been reported.

  8. Larva currens in a case of Organophosphorous poisoning

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    Rao D

    2006-01-01

    Full Text Available A 20-year-old healthy farmer consumed organophosphorous poison. On third day he developed diarrhoea and on fourth day linear serpiginous ulcers appeared on both buttocks. Clinically lesions were considered as decubitus ulcers. By stool examination and other laboratory investigations it was diagnosed as cutaneous larva currens due to S trongyloides stercoralis in a case of organophosphorus poisoning. Patient responded very well to a course of albendazole.

  9. Surgical-orthodontic management of bilateral multiple impactions in non-syndromic patient

    OpenAIRE

    Agrawal, Jiwanasha Manish; Agrawal, Manish Suresh; Nanjannawar, Lalita Girish

    2013-01-01

    Several surgical and orthodontic treatment options are available to disimpact the impacted teeth. But the closed eruption technique has the best long-term prognosis. The tooth is surgically exposed, an attachment is bonded to it, flap is resutured over it and an orthodontic extrusive force is delivered to bring the tooth into occlusion. This case report presents a case with multiple impacted teeth in which no syndrome or systemic conditions were detected. A 20-year-old female patient reported...

  10. Endometrioid like yolk sac tumor of the testis with small teratomatous foci: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Prabir Hazarika

    2015-01-01

    Full Text Available I have reported a case of endometrioid like yolk sac tumor of the testis in a 20-year-old boy. Endometrioid like yolk sac tumor is a rare tumor. A few cases have been reported in ovary. In case of male, a case of pure glandular endometrioid like yolk sac tumor is reported in a 43 years male in right undescended testis and another case of abdominal metastasis showing endometrioid pattern from mixed testicular germ cell tumor comprising of teratoma and embryonal carcinoma. My patient was a 20-year-old male presented with painless enlargement of right testis. Grossly the tumor was glistening creamish white with a multicystic appearance. Histopathological examination showed the tumor to be composed of glandular elements resembling early secretory endometrium, foci of keratinized thin squamous epithelium and a single focus of benign cartilage. The glandular elements show immunohistochemical positivity for AFP, cytokeratin 7 (CK7 and epithelial membrane antigen (EMA.

  11. Larva currens in a case of Organophosphorous poisoning

    OpenAIRE

    Rao D; Rao VRS

    2006-01-01

    A 20-year-old healthy farmer consumed organophosphorous poison. On third day he developed diarrhoea and on fourth day linear serpiginous ulcers appeared on both buttocks. Clinically lesions were considered as decubitus ulcers. By stool examination and other laboratory investigations it was diagnosed as cutaneous larva currens due to S trongyloides stercoralis in a case of organophosphorus poisoning. Patient responded very well to a course of albendazole.

  12. A Rare Case of Stroke Secondary to Iron Deficiency Anemia in a Young Female Patient

    Science.gov (United States)

    Gopalratnam, Kavitha; Sena, Kanaga; Gupta, Manisha

    2017-01-01

    Ischemic strokes occur when there is a sudden obstruction of an artery supplying blood flow to an area of the brain, leading to a focal neurological deficit. Strokes can be thrombotic or embolic in etiology and are associated with underlying conditions such as hypertension and atherosclerosis. Possible etiologies of strokes include cardioembolic disease, hematologic disorders, connective tissue disorders, and substance abuse or can be cryptogenic. Most stroke cases are seen in patients over 65 years of age. However, about one-fourth of strokes occur in young adults. Iron deficiency anemia (IDA) has been described as a known cause for strokes in children, but very few case reports describe this association in adults. We describe a 20-year-old female who presented with sudden onset left side weakness. Magnetic Resonance Imaging (MRI) of the brain demonstrated ischemic infarctions. Patient was also found to be severely anemic. Patient had a thorough work-up including Magnetic Resonance Angiography (MRA) of the brain, echocardiogram, and an extensive screen for thrombophilia disorders. This, however, did not demonstrate a clear etiology. As it has been suggested that IDA is a potential cause for stroke, it is possible the stroke in this young patient was attributable to severe IDA. PMID:28348599

  13. 新疆兵团四师77团>20岁人群高血压、糖尿病普查情况分析%Analysis of hypertension, diabetes census prevalence situation of people over 20 years old in Xinjiang regiment four division 77 regiment

    Institute of Scientific and Technical Information of China (English)

    李建梅; 王露; 严翠芳; 王生文

    2015-01-01

    Objective:To survey the hypertension,diabetes epidemiology of people over 20 years old in four division 77 regiment. Methods:The physical examination data of people over 20 years old in whole regiment were given consolidation analysis by using cross sectional study(prevalence rate) and screening method.Results:The prevalence of hypertension increased with age,and the prevalence of diabetes also increased with age.Conclusion:After 60 years old is a high risk factor of hypertension,diabetes.The prevalence rate of minority nationalities is lower than the prevalence of Han nationality.%目的:对四师77团>20岁人群进行高血压、糖尿病的流行病学调查。方法:采用现况研究(患病率调查)与筛检法对全团>20岁人群的健康体检资料进行整理分析。结果:高血压患病情况是随年龄增长而增加,糖尿病患病情况也是随年龄增长而增加。结论:>60岁是高血压、糖尿病高危因素。少数民族患病率低于汉族的患病率。

  14. A Case of Clozapine-Induced Myocarditis in a Young Patient with Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Ronny Cohen

    2015-01-01

    Full Text Available We present a case of drug-induced myocarditis manifesting as acute heart failure in a young patient with bipolar disorder being treated for depression. The case describes a 20-year-old man being treated in the psychiatry ward for worsening depression when he started complaining of chest pain and shortness of breath. His list of medications included clozapine, lithium, lorazepam, and haloperidol. The main findings on physical examination were tachycardia, low-grade fever, crackles in both lung bases on auscultation, and the absence of any notable edema. Abnormal labs included a troponin of 0.9, with a CK of 245 and CK-MB of 3.1. An ECG revealed sinus tachycardia and left anterior fascicular block (LAFB. An echocardiogram revealed global hypokinesis, severe left ventricular dysfunction with an ejection fraction estimated at 20%. The patient had an admitting diagnosis of acute left ventricular systolic dysfunction likely secondary to drug-induced myocarditis (suspect clozapine versus acute coronary syndrome. He was managed conservatively and transferred to another facility for endomyocardial biopsy confirming myocarditis. This case is an example of one of the most typical presentations of suspected drug-induced acute myocarditis and will hopefully prompt the reader to think of this underdiagnosed entity in the right clinical setting.

  15. San Marino-China Friendship Association 20 Years Old

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    <正>San Marino, with a population of less than 30,000, is one of the smallest countries in Europe. In such a small country the San Marino-China Friendship Association (SMCFA) was set up and has exerted

  16. 甘肃省14-20岁学龄青少年网络行为与信息安全意识调查分析%The investigation and analysis of Internet behavior and information security awareness of Gansu school-age adolescents aged 14-20 years old

    Institute of Scientific and Technical Information of China (English)

    童红梅

    2011-01-01

    A sampling survey was conducted on Internet behavior and information security awareness of Gansu school-age adolescents aged 14-20 years old. The paper analyzes the causes of their Internet behavior and information security awareness and proposes corresponding countermeasures to guide teenagers' effective use of Internet resources and set up Internet information security and precaution awareness.%通过对甘肃省14-20岁学龄青少年使用互联网的行为特征与信息安全意识抽样调查,分析了其网络行为及信息安全意识的原因,并提出了相应对策,以正确引导青少年有效利用网络资源,树立网络信息安全与防范意识.

  17. ANAESTHETIC MANAGEMENT OF PERIPARTUM CARDIOMYOPATHY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Prabhu

    2016-02-01

    Full Text Available Anaesthetic management for caesarean section of a patient with peripartum cardiomyopathy (PPCM can be challenging. These patients require analgesia/anaesthesia for normal delivery or caesarean section. In this case report we describe the anaesthetic management of a 20-year-old patient at 37 weeks of gestation, with peripartum cardiomyopathy, heart failure and pulmonary oedema. She was scheduled for emergency caesarean section because of a threat to mother’s life and fetal distress. GA was induced with Etomidate and fentanyl safely. No adverse outcome on mother or new born was observed.

  18. De Toni-Debré-Fanconi syndrome in a patient with Kearns-Sayre syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Mihai Cristina

    2009-11-01

    Full Text Available Abstract Introduction Kearns-Sayre syndrome is a mitochondrial myopathy that demonstrates chronic progressive ophthalmoplegia with onset before the age of 20 and pigmentary degeneration of the retina. Case presentation We report the case of an 18-year-old Romanian man with short stature, external ophthalmoplegia, palpebral ptosis, myopathy, sensorineural hearing impairment, cerebellar ataxia, cardiac conduction defect, diabetes mellitus, hypoparathyroidism and hyperaldosteronism. The patient's evolution showed progressive insufficiency of the renal tubule: hyperphosphaturia, hyperaminoaciduria and, later, glucosuria (de Toni-Debré-Fanconi syndrome, a syndrome, to date, rarely diagnosed in association with complete Kearns-Sayre syndrome. The final diagnosis was delayed for several years and was only established when he developed diabetes mellitus. Southern blot analysis and polymerase chain reaction amplification revealed the presence of a deletion in the mitochondrial DNA. Conclusion Despite the rarity of this syndrome, the diagnosis was easily made due to the presence of the classic triad: external ophthalmoplegia, pigmentary retinopathy and onset in a patient younger than 20 years old. In our opinion, a search for Kearns-Sayre syndrome in all patients with de Toni-Debré-Fanconi syndrome is a valuable medical routine.

  19. Hampton's hump in a patient with endocarditis and septic emboli.

    Science.gov (United States)

    Basso, Mark; Goldstein, Scott

    2016-05-01

    We discuss a case of a 20-year-old woman presenting with chest pain found to have a Hampton's hump on chest x-ray and corresponding wedge infarct on computed tomographic scan. Contrary to our suspicion that this febrile and tachycardic patient had a pulmonary embolism, she was later determined to have a septic embolus secondary to endocarditis. We highlight the difficulties in diagnosing certain cases of endocarditis in the emergency department, as well as the difficulties in distinguishing septic emboli from pulmonary emboli,especially with plain radiographs.

  20. Ambient echolalia in a patient with germinoma around the bilateral ventriculus lateralis: a case report.

    Science.gov (United States)

    Suzuki, Tadashi; Itoh, Shouichi; Arai, Noritoshi; Kouno, Masako; Noguchi, Makoto; Takatsu, Masami; Takeda, Katsuhiko

    2012-01-01

    Ambient echolalia is a rare condition with few reported cases. We report the case of a 20-year-old man with a germinoma around the bilateral ventriculus lateralis who exhibited ambient echolalia. Clinical features included instinctive grasp reaction and compulsive manipulation of tools in his right hand. Speech or mental deterioration has been cited as a cause of ambient echolalia, but neither dementia nor aphasia was present. We propose that ambient echolalia in our case could be interpreted as a disinhibition of pre-existing essentially intact motor subroutines due to damage of the medial frontal lobe.

  1. Renal AA amyloidosis in a patient with hereditary complete complement C4 deficiency

    Directory of Open Access Journals (Sweden)

    Imed Helal

    2011-01-01

    Full Text Available Hereditary complete C4 deficiency has until now been reported in 30 cases only. A disturbed clearance of immune- complexes probably predisposes these individuals to systemic lupus erythematosus, other immune- complex diseases and recurrent microbial infections. We present here a 20- year- old female with hereditary complete C4 deficiency. Renal biopsy demonstrated renal AA amyloidosis. This unique case further substantiates that deficiency of classical pathway components predisposes to the development of recurrent microbial infections and that the patients may develop AA amyloidosis. Furthermore, in clinical practice, the nephrotic syndrome occurring in a patient with hereditary complete complement C4 deficiency should lead to the suspicion of renal AA amyloidosis.

  2. Non-syndromic bilateral condylar aplasia: A rare case

    Directory of Open Access Journals (Sweden)

    Peeyush Shivhare

    2015-01-01

    Full Text Available The temporomandibular joint is one of the most complex joints of the human body. It consists of the mandibular condyle, glenoid fossa and the articular eminence of the temporal bone. Aplasia of the condyle is usually seen as part of a syndrome otherwise it is rare. We report a case of bilateral condylar aplasia in a 20-year-old male not associated with any syndrome. The patient reported to the department with a chief complaint of the underdeveloped lower jaw. Clinical examination, conventional radiographs, and 3D computer tomography images revealed a complete absence of condyle on the right and left sides.

  3. Improved pathologic teeth migration following gingivectomy in a case of idiopathic gingival fibromatosis.

    Science.gov (United States)

    Seki, Keisuke; Sato, Shuichi; Asano, Yukhiro; Akutagawa, Hideyasu; Ito, Koichi

    2010-01-01

    A case is reported of a 20-year-old woman with generalized severe gingival overgrowth covering almost all of the teeth with diastemata, diagnosed as idiopathic gingival fibromatosis. After initial therapy, the patient underwent surgery consisting of a full-mouth internal beveled gingivectomy. Postoperatively, the maxillary anterior teeth spontaneously moved to almost optimal positions. Removing the cause by gingivectomy can lead to spontaneous correction of the pathologic tooth migration. With supportive periodontal treatment, the patient showed no recurrence of gingival enlargement or repositioning of the teeth at the 5-year follow-up.

  4. Tuberculosis of the cervix and infertility: report of a rare case.

    Science.gov (United States)

    Guié, P; Iovenitti, P; N'guessan, K; Tegnan, J; Koffi, K; Carta, G; Anongba, S

    2008-01-01

    Tubercolosis is a frequent bacterial infection in less developed countries. Lung and lymph node localisations are common, while the genital apparatus is less involved. In this work a rare case of cervical tuberculosis followed by some lesions causing infertility in a 20-year-old woman is reported. The diagnosis was confirmed by a histological examination from a biopsy of the cervix. The patient was offered six-month antituberculosis therapy which eliminated the cervical lesions. A few years later she came under our care for infertility due to uterine adhesions diagnosed by hysterosalpingography. Now the patient is being treated for infertility complicated by amenorrhoea.

  5. Hepatic torsion with colonic obstruction - a case report and review of the literature; Torcao hepatica e obstrucao de colon transverso - relato de um caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Grasso Filho, Luiz Eduardo; Albertotti, Flavio; Vieira, Thiago Dieb R.; Carvalho, Claudio Sobral de; Cabral, Jose Eduardo B.; Rosa, Ana Claudia F.; Ogasawara, Aparecida M. Peng Yong Sheng [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Centro de Diagnostico por Imagem; Albertotti, Cezar J. [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Setor de Tomografia Computadorizada; Cerri, Giovanni Guido [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Instituto de Radiologia

    2001-02-01

    The authors report a case of a 20-year-old patient with the following clinical features: complete rotation of the liver into the left upper quadrant; severe hypotension secondary to inferior vena cava compression; congenital malformation of falciform and coronary ligaments; obstruction of the transverse colon due to congenital peritoneal fibrotic bands; massive colonic dilatation in the right upper quadrant. The patient was treated by resection of the pericolonic bands, and during the operation the liver returned to its anatomic position, in the right upper abdomen. This unique condition, and the three other similar cases reported in the world literature are discussed. (author)

  6. Writing of Patient Case History

    Institute of Scientific and Technical Information of China (English)

    Tian Junying

    2016-01-01

    This paper introduces the language features, structure and contents of case history. Good patient case history contributes to correct diagnosis and formulation of a treatment plan, therefore, it is important for physicians to learn how to write case history.

  7. Acquired hemophagocytic syndrome in a patient with synovial sarcoma: a case report

    Science.gov (United States)

    Ciccarese, Chiara; Ferrara, Roberto; Fantinel, Emanuela; Zecchetto, Camilla; Simionato, Francesca; Grego, Elisabetta; Ortolani, Silvia; Caccese, Mario; Bimbatti, Davide; Cingarlini, Sara; Brunelli, Matteo; Andreini, Angelo; Tortora, Giampaolo; Massari, Francesco

    2015-01-01

    Hemophagocytic lymphohistiocytosis (HLH) is a syndrome characterized by severe hyperinflammation due to an overwhelming ineffective immune response to different triggers. Most important symptoms are fever, hepatosplenomegaly and cytopenias. Biochemical signs include elevated ferritin, hypertriglyceridemia and low fibrinogen. Hemophagocytosis in the bone marrow is a hallmark of this syndrome. Based on the pathogenetic mechanism, it can be classified into primary (inherited) or secondary (acquired) HLH. We report, to our knowledge, the first case of acquired hemophagocytic syndrome that arose in a 20-year-old man affected by synovial sarcoma as a complication during chemotherapy. PMID:28031902

  8. Periodontal disease in a patient with Prader-Willi syndrome: a case report

    OpenAIRE

    Kitamura Masahiro; Yamada Satoru; Nozaki Takenori; Kobashi Mariko; Hirano Hiroyuki; Yanagita Manabu; Murakami Shinya

    2011-01-01

    Abstract Introduction Prader-Willi syndrome is a complex genetic disease caused by lack of expression of paternally inherited genes on chromosome 15q11-q13. The prevalence of Prader-Willi syndrome is estimated to be one in 10,000 to 25,000. However, descriptions of the oral and dental phenotype are rare. Case presentation We describe the clinical presentation and periodontal findings in a 20-year-old Japanese man with previously diagnosed Prader-Willi syndrome. Clinical and radiographic findi...

  9. An unusual penetrating craniocerebral injury due to landmine explosion: a case report.

    Science.gov (United States)

    Atabey, Cem; Ersoy, Turgay

    2012-03-01

    Penetrating landmine injuries are the unavoidable consequences of military conflicts. They are potentially life-threatening. The mortality rates in the literature range from 23% to 92% and are considerably higher in patients admitted with poor neurologic state. Penetrating craniocerebral injuries require early surgical management designated to prevent infection and remove foreign objects, necrotic tissue and complicating blood clots, as well as to minimalize post-traumatic sequelae. We report herein an interesting case of penetrating intracerebral injury with giant shrapnel due to landmine in a 20-year-old young man.

  10. Chondroblastoma in a metatarsal treated with autogenous fibular graft: a case report.

    Science.gov (United States)

    Dhatt, Sarvdeep S; Bhagwat, Kishan R; Kumar, Vishal; Dhillon, Mandeep Singh

    2012-01-01

    Chondroblastoma is a relatively rare tumor that mimics giant cell tumor and displays a predilection for long bones. In the present report, we describe the case of a benign chondroblastoma localized to the second metatarsal in a 20-year-old male who presented with a 2-year history of painless left foot swelling. Treatment of the tumor involved excision of the second metatarsal with use of an autologous structural fibular bone graft to stabilize the metatarsus and second toe. After 27 months of follow-up, the patient was ambulating well in regular shoes, with no clinical or radiographic evidence of tumor recurrence.

  11. Periodontal disease in a patient with Prader-Willi syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Kitamura Masahiro

    2011-07-01

    Full Text Available Abstract Introduction Prader-Willi syndrome is a complex genetic disease caused by lack of expression of paternally inherited genes on chromosome 15q11-q13. The prevalence of Prader-Willi syndrome is estimated to be one in 10,000 to 25,000. However, descriptions of the oral and dental phenotype are rare. Case presentation We describe the clinical presentation and periodontal findings in a 20-year-old Japanese man with previously diagnosed Prader-Willi syndrome. Clinical and radiographic findings confirmed the diagnosis of periodontitis. The most striking oral findings were anterior open bite, and crowding and attrition of the lower first molars. Periodontal treatment consisted of tooth-brushing instruction and scaling. Home care involved recommended use of adjunctive chlorhexidine gel for tooth brushing twice a week and chlorhexidine mouthwash twice daily. Gingival swelling improved, but further treatment will be required and our patient's oral hygiene remains poor. The present treatment of tooth-brushing instruction and scaling every three weeks therefore only represents a temporary solution. Conclusions Rather than being a direct result of genetic defects, periodontal diseases in Prader-Willi syndrome may largely result from a loss of cuspid guidance leading to traumatic occlusion, which in turn leads to the development of periodontal diseases and dental plaque because of poor oral hygiene. These could be avoided by early interventions to improve occlusion and regular follow-up to monitor oral hygiene. This report emphasizes the importance of long-term follow-up of oral health care by dental practitioners, especially pediatric dentists, to prevent periodontal disease and dental caries in patients with Prader-Willi syndrome, who appear to have problems maintaining their own oral health.

  12. Cystic lung changes in a thin section CT in an asymptomatic young adult with unilateral pulmonary vein atresia: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Choul; Yi, Jeong Geun; Park, Jeong Hee [Konkuk Univ. Medical Center, Seoul (Korea, Republic of)

    2012-07-15

    Unilateral pulmonary vein atresia is a rare anomaly, usually associated with symptoms of recurrent hemoptysis and pneumonia in early childhood. Only one report of an asymptomatic adult patient can be found in the literature. We present the case of an asymptomatic patient with unilateral right pulmonary vein atresia in a 20 year old man. Chest radiograph and multidetector computed tomography showed not only pulmonary vein atresia, pulmonary artery hypoplasia, but also cystic lung changes on thin section CT, along with septal and bronchovascular bundle thickening, and ground-glass opacity. Unilateral pulmonary vein atresia could be another disease which can show cystic lung changes on thin section chest CT.

  13. Brucellosis - diagnostic dilemma: Case report

    Directory of Open Access Journals (Sweden)

    Bojić Biljana

    2002-01-01

    Full Text Available The authors present a case of a 20-year old student from Belgrade, who was admitted to the Institute of Infectious Diseases with fever, muscle and spine pains, strong headacke and malice. During the clinical examination bilateral sacroileitis was found. Serological analyses confirmed brucellosis. Epidemiological data showed that she lived in Kosovo and Metohia in 1997, where she consumed diary products from domestic animals this might be the reason of the acquired infection. With appropriate antibiotic therapy (aminoglycoside, doxicyclin, rifampicin, symptomatic therapy and rehabilitation the disease had favorable outcome; there was no recidive. The authors point out the importance of specific microbiological examinations of patients with fever of unknown origin, especially if the patient has the symptoms that are compatible with brucellosis. In our case it was sacroileitis, as a characteristic complication. As brucellosis is endemic in some parts of our country, there is always a possibility of brucellosis in general medical practice.

  14. Refractory autoimmune hemolytic anemia in a patient with DiGeorge syndrome treated successfully with plasma exchange: a case report and review of the literature.

    Science.gov (United States)

    Damlaj, Moussab; Séguin, Chantal

    2014-11-01

    Warm antibody autoimmune hemolytic anemia (AIHA) results from targeted antibodies towards the red blood cells (RBCs) and can be either idiopathic or secondary to certain diseases, such as autoimmune disorders or malignancy, drugs, or infection. Patients with DiGeorge syndrome are particularly vulnerable to autoimmune conditions secondary to thymic hypoplasia and dysfunction of the immune system. First-line therapy for AIHA consists of corticosteroids, with most patients showing signs of response. Relapses are not uncommon and are treated with splenectomy or rituximab. There is a paucity of reports in the literature regarding treatment options beyond this stage. Herein, we describe an unusual case of a 20-year-old female affected by DiGeorge syndrome with a history of immune thrombocytopenia (ITP), who presented with life-threatening AIHA. Standard first- and second-line therapeutic modalities were ineffective in controlling her disease and she ultimately underwent plasma exchange therapy with successful resolution of hemolysis. At her last follow-up, one year after her initial presentation, she remains clinically well without signs of hemolysis. We conclude that in refractory cases of warm AIHA, plasma exchange therapy can be a valuable tool in the therapeutic armamentarium.

  15. Ecstacy-induced delayed rhabdomyolysis and neuroleptic malignant syndrome in a patient with a novel variant in the ryanodine receptor type 1 gene.

    Science.gov (United States)

    Russell, T; Riazi, S; Kraeva, N; Steel, A C; Hawryluck, L A

    2012-09-01

    We present the case of a 20-year-old woman who developed rhabdomyolysis, disseminated intravascular coagulopathy and multi-organ failure induced by ecstasy. Following initial improvement, she developed delayed rhabdomyolysis then haloperidol-induced neuroleptic malignant syndrome, which was treated with a total of 50 mg.kg(-1) dantrolene. Subsequent genetic testing revealed a novel potentially pathogenic variant in the ryanodine receptor type 1 gene. However, caffeine-halothane contracture testing of the patient's mother who carried the same gene variant was negative for malignant hyperthermia.

  16. Esophagectomy in Scleroderma: Report of a Case

    Directory of Open Access Journals (Sweden)

    Erdal Yekeler

    2008-12-01

    Full Text Available Scleroderma is a generalized autoimmune disease with variable involvement of the skin and major organs (esophagus, lung, heart and kidney. Scleroderma is essentially a skin disease that frequently involves the digestive system. In scleroderma, the esophagus is the most frequently affected organ of the digestive system, and esophageal dysmotility, reflux and stricture may be observed in the advanced stage. Balloon dilatation and bougienage are generally sufficient in patients developing stricture, and the number of cases in whom resection is performed is very low. In a 20-year-old patient with difficulty in taking even liquid foods, tests revealed sclerodermal involvement of the distal end of the esophagus and stricture. Esophageal resection and gastric replacement were performed. Such systemic diseases as scleroderma, although rare, must be considered in the differential diagnosis of nonmalignant dysphagia, and resection must be borne in mind as a surgical option in cases of advanced stricture.

  17. Focal Epithelial Hyperplasia. A Case Report

    Directory of Open Access Journals (Sweden)

    Rafael Pila Pérez

    2014-02-01

    Full Text Available Focal epithelial hyperplasia, also known as Heck's disease, is relatively rare, occurring mostly in children and adolescents. A case of a 20 year-old female patient treated at the Manuel Ascunce Domenech University Hospital in Camagüey due to papular lesions, which had evolved for ten months, is presented. Other viral diseases were ruled out; however based on histological studies, it was concluded that she suffered from Heck disease, which is frequently treated by dentists, but little known among pediatricians, internists and dermatologists. Because of its etiology, many cases are related to human papilloma virus infection. When the disease evolves, treatment can involve excision, laser surgery or cryotherapy. The latter method was used in this patient with satisfactory results, as she is completely asymptomatic.

  18. Macroorchidism in a Patient with FSH-Secreting Pituitary Macroadenoma

    Directory of Open Access Journals (Sweden)

    Eren Demirtaş

    2012-12-01

    Full Text Available Follicle-stimulating hormone-secreting pituitary macroadenoma (FSHoma is a very rare and usually asymptomatic entity. FSHoma can clinically present as ovarian hyperstimulation syndrome in female patients, but symptoms and clinical signs are usually not observed in males. An increase in testicular volume has been reported in male patients with FSHoma. In some male patients, the first finding may be macroorchidism. A 20-year-old male patient presented to our clinic due to enlarged testes (testicular volume: 45 cc. Scrotal ultrasonography showed macroorchidism. Tests required to determine the etiology of macroorchidism showed that the patient had an elevated FSH concentration. Macroadenoma was diagnosed based on pituitary magnetic resonance imaging. FSHoma was suspected and transsphenoidal resection was performed. Pathology test results indicated FSHoma. The present case shows that FSHoma is very rare and that it can present in association with macroorchidism in male patients. Turk Jem 2012; 16: 95-8

  19. Advanced Implant-Prosthetic Rehabilitation: How to Obtain a Correct Restoration of Both Functions and Aesthetics in Patients with Complex Combined Dental and Maxillofacial Trauma: A Case Report and Topical Review of the Literature

    Science.gov (United States)

    Fortunato, L.

    2017-01-01

    Aim. This study aims to explain the main steps that characterize the implant-prosthetic rehabilitation in complex combined dental and maxillofacial trauma. Material and Methods. A 20-year-old patient reported an extensive facial trauma which also involved the alveolar process of the maxillary bone. The patient reported a maxillofacial fracture and the loss of teeth 1.3, 1.2, 1.1, and 2.1. A “Le Fort” type 2 fracture was also reported, with the malar bone involvement. After reduction and containment of bone fractures, through appropriate mounting plates, appropriate functional and aesthetic rehabilitation of the patient were replaced thanks to a temporary removable prosthesis. After 6 months, the patient performed numerous clinical investigations, aimed at a proper planning of implant-prosthetic rehabilitation of the upper dental arch. Conclusion. With the planning of the case, as well as respecting the surrounding biological structures, the surgery of implants can be carried out with the most appropriate procedure. Lastly, new dental implants with highly bioactive surfaces have been developed, providing an excellent and rapid bone integration.

  20. Suicide Attempt by Intravenous Potassium Self-Poisoning: A Case Report

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    Florent Battefort

    2012-01-01

    Full Text Available Introduction. Overdose of potassium is not as frequently encountered in clinical practice as hyperkalaemia due to acute or chronic renal disease. However, potassium overdoses leading to serious consequences do occur. Case Presentation. A 20-year-old nurse student presented with a cardiac arrest with asystole rhythm. Beside the patient were found four 50-mL syringes and empty vials of potassium chloride (20 mL, 10%. After initial resuscitation with epinephrine, 125 mL of a 4.2% intravenous solution of sodium bicarbonate were injected which resulted in the recovery of an effective cardiac activity. The patient recovered without sequelae. Conclusion. The difficulty in this case was to recognize the potassium poisoning. The advanced resuscitation with the use of a specific treatment helped to resuscitate the patient.

  1. Primary pigmented nodular adrenocortical disease associated with Carney complex: case report and literature review

    Directory of Open Access Journals (Sweden)

    Fabrícia Torres Gonçalves

    Full Text Available CONTEXT: Carney complex (CNC, a familial multiple neoplasm syndrome with dominant autosomal transmission, is characterized by tumors of the heart, skin, endocrine and peripheral nervous system, and also cutaneous lentiginosis. This is a rare syndrome and its main endocrine manifestation, primary pigmented nodular adrenal disease (PPNAD, is an uncommon cause of adrenocorticotropic hormone-independent Cushing's syndrome. CASE REPORT: We report the case of a 20-year-old patient with a history of weight gain, hirsutism, acne, secondary amenorrhea and facial lentiginosis. Following the diagnosing of CNC and PPNAD, the patient underwent laparoscopic bilateral adrenalectomy, and she evolved with decreasing hypercortisolism. Screening was also performed for other tumors related to this syndrome. The diagnostic criteria, screening and follow-up for patients and affected family members are discussed.

  2. Subcutaneous Emphysema, Pneumomediastinum and Pneumothorax in a Patient with Dermatomyositis

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    Mehdi Bakhsaee

    2017-03-01

    Full Text Available Introduction:Spontaneous pneumomediastinum, pneumothorax, and subcutaneous emphysema are rare, but serious complications of inflammatory myopathies and occur more commonly in DM than PM. complications of dermatomyositis (DM and polymyositis (PM, both of which can be fatal. Case Report:A 20-year-old woman was admitted with neck pain, dyspnea, cough, and fever. She had been diagnosed with dermatomyositis 21 months prior. A thorax computed tomography (CT scan revealed ground glass opacities in her lungs, pneumomediastinum, pneumothorax, and subcutaneous emphysema. Despite intensive immunosuppressive therapy, clinical deterioration and radiological progression were observed, ultimately the patient died. Conclusion:During the care for a patient with dermatomyositis, the otorhinolaryngologist should be cautious of rapidly progressive and fatal neck subcutaneous emphysema. For a patient with dermatomyositis and with normal bronchoscopy and esophagoscopy, the main treatment is control of dermatomyositis with medical therapy. Therefore, a tracheostomy and/or mechanical ventilation may not be necessary.

  3. Subcutaneous Emphysema, Pneumomediastinum and Pneumothorax in a Patient with Dermatomyositis

    Science.gov (United States)

    Bakhshaee, Mehdi; Jokar, Mohammad Hassan; Mirfeizi, Zahra; Atabati, Elham; Tarighat, Somayeh

    2017-01-01

    Introduction: Spontaneous pneumomediastinum, pneumothorax, and subcutaneous emphysema are rare, but serious complications of inflammatory myopathies and occur more commonly in DM than PM. complications of dermatomyositis (DM) and polymyositis (PM), both of which can be fatal. Case Report: A 20-year-old woman was admitted with neck pain, dyspnea, cough, and fever. She had been diagnosed with dermatomyositis 21 months prior. A thorax computed tomography (CT) scan revealed ground glass opacities in her lungs, pneumomediastinum, pneumothorax, and subcutaneous emphysema. Despite intensive immunosuppressive therapy, clinical deterioration and radiological progression were observed, ultimately the patient died. Conclusion: During the care for a patient with dermatomyositis, the otorhinolaryngologist should be cautious of rapidly progressive and fatal neck subcutaneous emphysema. For a patient with dermatomyositis and with normal bronchoscopy and esophagoscopy, the main treatment is control of dermatomyositis with medical therapy. Therefore, a tracheostomy and/or mechanical ventilation may not be necessary.

  4. PULMONARY LANGERHANS CELL HISTIOCYTOSIS PRESENTING AS SIMULTANEOUS BILATERAL SPONTANEOUS PNEUMOTHORAX IN A NON-SMOKER PATIENT

    Directory of Open Access Journals (Sweden)

    M. Vaziri

    2008-06-01

    Full Text Available Pulmonary Langerhans Cell Histiocytosis (PLCH is a rare idiopathic disorder that primarily affects young adult cigarette smokers. Affected patients often present with cough and dyspnea and about 20% of patients present with or later develop pneumothorax. It is striking that more than 90% of patients are smokers. We report a very unusual case of PLCH in a 20-year- old male patient with no smoking history in whom a life- threatening complication such as simultaneous bilateral pneumothorax was the presenting feature. The final diagnosis was made by open surgical biopsy and recurrent pneumothoraces necessitated surgical management with pleurodesis. We emphasize the early use of pleurodesis in managing patients with PLCH and spontaneous pneumothorax.

  5. Retroperitoneal abscess and acute acalculous cholecystitis after iatrogenic colon injury: report of a case

    Science.gov (United States)

    Dong, Chengwei; Wang, Yuxu; Hu, Sanyuan; Du, Futian; Ding, Wei

    2015-01-01

    Acute acalculous cholecystitis has a high mortality rate due to the difficulties in early diagnosis and high rate of complications like empyema, gangrene and perforation. We report a case of 20-year-old male with acute severe pancreatitis, acute renal failure and acute peripancreatic fluid collection who was transferred to our department after blood filtration treatment in ICU. After percutaneous catheter drainage for 20 hours, the patient got a high fever. Computed tomography revealed retroperitoneal colon injury. In this case, percutaneous catheter drainage was performed again and the pus cavity was flushed regularly, after which the patient’s state gradually improved. Unpredictably, septic shock appeared on the 51st day. Repeated computed tomography revealed acute acalculous cholecystitis and abscess formation. After percutaneous transhepatic gallbladder catheterization and drainage, the patient got better gradually. Three months later the retroperitoneal catheter was removed. Four months later, ultrasound examination showed normal gallbladder and the catheter was removed. PMID:26131252

  6. Castleman’s Disease Associated with Mitral Valve Prolapse in a 22 Years Old Patient

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    M. Vaziri

    2008-01-01

    Full Text Available Introduction: Chronic granulomatous disease (CGD is an inherited disorder of phagocyte function. The defect of intracellular killing in phagocytes is the cause of recurrent pyogenic infection of patients. Clinical presentations and infections mostly occur during the first 2 years of life and early diagnosis of disease can prevent or decrease the rates of recurrence of infections and mortality.Case Report: This case report represents a 21 years old man who was admitted and underwent repeated surgery due to pyogenic infections for CGD. The second case was his 20 years old sister who was underwent surgery due to cervical abscess.Conclusion: This case-report implies that CGD may rarely go undiagnosed until adulthood, so in adults who develop recurrent pyogenic infection, we should be suspicious to CGD, and Nitroblue tetrazolium test is the convenient method for its diagnosis.

  7. Captopril-induced sialadenitis in a patient with end-stage renal disease

    Science.gov (United States)

    Mahdiabadi, Fatemeh Musavi; Nikvarz, Naemeh

    2016-01-01

    Sialadenitis is a rare adverse effect of captopril. We report a case of captopril-induced sialadenitis in a patient with end-stage renal disease (ESRD). A 20-year-old man with ESRD encountered parotid and submandibular swelling after receiving two doses of captopril, administered sublingually. Despite of prescribing dexamethasone, resuming hemodialysis, and discontinuing other drugs that also can cause parotitis, he improved later than what was reported in patients with normal renal function. In conclusion recovery from captopril-induced sialadenitis in patients with ESRD may be more prolonged than that of patients with normal renal function; moreover, early hemodialysis which helps in drug removal may be the most effective treatment. PMID:27162811

  8. Fall-related injuries among youth under 20 years old who were treated in Nicaraguan emergency departments, 2004 Lesiones relacionadas con caídas en menores de 20 años de edad que fueron tratados en departamentos de emergencias de Nicaragua, 2004

    Directory of Open Access Journals (Sweden)

    María de Lourdes Martínez-Trujillo

    2011-04-01

    Full Text Available OBJECTIVE: To describe the circumstances of fall-related injuries among youth 0-19 years treated in emergency departments in Nicaragua; to estimate the incidence rates (IR of falls; and, to identify areas for prevention efforts. MATERIAL AND METHODS: All patients OBJETIVO: Describir las lesiones relacionadas con caídas entre los niños y adolescentes menores de 20 años de edad que fueron tratados en departamentos de emergencia de Nicaragua, 2004. Describir las circunstancias y estimar la tasa de incidencia (TI de las caídas entre niños y adolescentes de 0-19 años atendidos en las salas de emergencia en Nicaragua. Además, identificar áreas dónde dirigir los esfuerzos de prevención. MATERIALES Y MÉTODOS: Se seleccionaron todos los pacientes (6593 de 0-19 años lesionados por caídas atendidos en emergencia por el Sistema de Vigilancia de Lesiones en 2004 en las ciudades de Managua, León, Jinotepe y Ciudad Sandino. RESULTADOS: En 2004, la TI para caídas en niños y adolescentes 0-19 años fue 104.2 por 10000 habitantes. La TI en varones fue dos veces más alta que en mujeres. Los principales objetos involucrados fueron árboles (23.3% y camas (15.2%. La principal naturaleza de lesión fue fractura (35.7%. CONCLUSIONES: Mobiliario, lugares de recreación y ambiente físico fueron las áreas identificadas. Desarrollar intervenciones incluyendo cambios en el ambiente del hogar y áreas recreacionales, así como programas educacionales, resulta muy útil para adolescentes y cuidadores.

  9. Autologous osteochondral plug transplantation for osteochondrosis of the second metatarsal head: a case report

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    Kokubu Takeshi

    2011-07-01

    Full Text Available Abstract Introduction Osteochondrosis of the second or third metatarsal head is a rare condition called Freiberg's disease. To relieve foot pain, conservative treatment with a foot orthosis to reduce weight-bearing and immobilize the foot are recommended. In cases in which such treatments have proved to be ineffective, several surgical treatments have been performed. The appropriate surgical treatment for Freiberg's disease remains controversial. Case presentation We describe the case of a 20-year-old Japanese woman with a three-year history of right forefoot pain and no history of trauma. Two years after treatment by autologous osteochondral plug transplantation, she has neither complaints nor symptoms. Conclusion Autologous osteochondral plug transplantation represents a potentially successful surgical arthroplastic option in preserving the metatarsophalangeal joint in patients with Freiberg's disease.

  10. Fulminant necrotizing fasciitis following the use of herbal concoction: a case report

    Directory of Open Access Journals (Sweden)

    Nasir Abdulrasheed A

    2010-10-01

    Full Text Available Abstract Introduction Necrotizing fasciitis is a rare and life-threatening rapidly progressive soft tissue infection. A fulminant case could involve muscle and bone. Necrotizing fasciitis after corticosteroid therapy and intramuscular injection of non-steroidal anti-inflammatory drugs has been reported. We present a case of fulminant necrotizing fasciitis occurring in a patient who used a herbal concoction to treat a chronic leg ulcer. Case presentation A 20-year-old Ibo woman from Nigeria presented with a three-year history of recurrent chronic ulcer of the right leg. She started applying a herbal concoction to dress the wound two weeks prior to presentation. This resulted in rapidly progressive soft tissue necrosis that spread from the soft tissue to the bone, despite aggressive emergency debridement. As a result she underwent above-knee amputation. Conclusion The herbal concoction used is toxic, and can initiate and exacerbate necrotizing fasciitis. Its use for wound dressing should be discouraged.

  11. Combined choroidal neovascularization and hypopituitarism in a patient with homozygous mutation in methylenetetrahydrofolate reductase gene

    Directory of Open Access Journals (Sweden)

    Aydogan Aydogdu

    2014-01-01

    Full Text Available We report a case of choroidal neovascularization (CNV secondary to methylenetetrahydrofolate reductase (MTHFR gene mutation in a 20-year-old male patient with hypopituitarism. Treatment with three consecutive injections of intravitreal ranibizumab (anti-vascular endothelial growth factor resulted in significant improvement of the patient′s vision and the appearance of the macula. A search of the literature produced no previously reported case of MTHFR gene mutation associated both CNV and possibly hypopituitarism. With hormone replacement therapy of hypopituitarism, acetyl salicylic acid 100 mg/day also was started. The patient was clinically stable both for CNV and other thromboembolic disorders over a 6-month follow-up and also 1-year follow-up period.

  12. A Patient with G6PD Deficiency and Falciparum Malaria

    Directory of Open Access Journals (Sweden)

    Y Fagani

    2007-04-01

    Full Text Available A 20 year old male patient from Afghanistan with a history of G6PD deficiency and clinical manifestations of malaria referred to Bou-Ali Hospital in Tehran, capital of Iran. Giemsa stained thick blood films revealed an infection of Plasmodium falciparum with 33700 parasite/μL of blood. The patient was successfully treated according to malaria treatment guideline.

  13. First Case Report of Turcot Syndrome Type 1 in Colombia

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    Vallejo Dora

    2012-01-01

    Full Text Available Turcot syndrome is an autosomal recessive disorder clinically characterized by the occurrence of primary tumors of the central nervous system and adenomatous colonic polyps during the first or second decades of life, with a spectrum of clinical features such as “café-au-lait” spots, axillary freckling, and hyperpigmented spots. Currently its prevalence globally and in Colombia remains unknown. We present the case of a 20-year-old male with a clinical presentation of both glioblastoma multiforme and multiple adenomatous colonic polyps. The molecular genetics study revealed a mutation in KrasAsp12 gene and altered expression of HMSH2 and HMSH6 proteins encoded by the DNA mismatch repair genes in two of the colonic polyps. Even though this clinical presentation may suggest a shorter survival rate, this patient is still alive after seven months of treatment. A literature review complements this report.

  14. Unusual case of mixed form of femoroacetabular impingement combined with nonspecyfic synovitis of the hip joint in a young adult: A case report

    Directory of Open Access Journals (Sweden)

    Mladenović Marko

    2015-01-01

    Full Text Available Introduction. Minimal bone changes in the acetabulum and/or proximal femur, through mechanism known as femoroacetabular impingement, during flexion, adduction and internal rotation lead to early contact between femoral head-neck junction and acetabular brim, in anterosuperior region. Each additional pathological substrate which further decreases specified clearance provokes earlier onset of femoroacetabular impingement symptoms. Case report. We presented a 20-year-old male patient with groin pain, limping, positive impingement test, radiological signs of mixed form of femoroacetabular impingement and unrecognized chronic hypertrophic synovitis with earlier development of clinical hip symptoms than it has been expected. Open surgery of the left hip was done. Two years after the surgery, patient was asymptomatic, painless, and free of motion, with stable x-rays. Conclusion. Hypertrophic synovial tissue further reduces the distance between the femoral head-neck junction and the acetabulum, leading to the earlier onset of femoroacetabular impingement symptoms. Surgical treatment is the method of choice.

  15. Relationship between Trust and Social Consensus among Citizens of 20 Years Old and Above in Gonbadekavoos

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    Gholamreza Khoshfar

    2014-05-01

    The results of the descriptive findings shows that social consensus average is 3.07 in a 0-5 scale, which means it is average to up, and trust average is 2.70, a little bit below the average point (3. Different dimensions of trust, including personal, generalized and institutional each have the averages of 3.20, 2.10 and 2.89 respectively, and the average for mediating variable, national identity, is 3.53. 59% of the sample are men and 70% of them are in the age group of 20-39 years old. More than two third of the sample are born in city areas and about 75% them are married. More than two third of the participants are working and about 68% of them own a house. About 43% of the sample are Fars, about 41% are Turkmen and the rest are Turk (9/1%, Sistani (2/9%, Baluch (1/8 % and 1/5% belonged to other ethnic backgrounds. The analysis indicates that there is a significant relationship between trust and social consensus and this is a moderate relationship (R=0/41. With regard to the amount of k-Square coefficient, the trust variable can predict about 17% of the changes of the dependent variable, social consensus. Institutional trust has the most impact alone on social consensus. It alone predicted 17% of the changes of social consensus and generalized trust explained only 0/7% of these changes. National identity as a mediating variable predicted about 40% of the changes of social consensus. The results of multiple regression analysis shows that a moderate correlation (R2=0/248 exists between independent and dependent variables. The results showed that relationship between trust and social consensus among the Fars is stronger compared to other ethnic groups.

  16. Prevalence of malocclusions in the 13-20-year-old categories of football athletes

    Directory of Open Access Journals (Sweden)

    Luci Alves de Souza

    2011-02-01

    Full Text Available The dentist can offer athletes improvement in their physical performance through the maintenance of oral health, preventing and treating any and all changes in the stomatognathic system, such as dental malocclusions, that compromise the athletes' performance. The objective of this study is to research the presence of dental malocclusions in athletes of the category between 13 and 20 years of age, from the São Paulo Football Club. 84 athletes participated in this study, dealing with the following topics: molar relation (Angle's classification; presence of overbite; underbite; overcrowding; abnormal spacing; open bite; and anterior, posterior, bilateral and unilateral crossbite; midline deviation and facial type (mesofacial, brachyfacial and dolichofacial. Only one table was made, showing percentages. In regard to Angle's molar relation, 89% are in Class I, 8% in Class II, 3% Class III, 9% of the athletes had overbite, 4% had underbite, 13% had overcrowding and 21% had abnormal spacing. In regard to the bite, 11% presented anterior open bite. In regard to crossbite, 7% presented unilateral crossbite on the right side and 2% on the left side; 5% presented posterior crossbite and 4% anterior crossbite. In regard to midline deviations, 4% presented deviation in the maxilla and 33% in the mandible. In regard to facial type: 39% are dolichofacial, 4% brachyfacial and 57% mesofacial. Based on the results shown, proposals for the implementation of dental, phoniatric, and Ear, Nose and Throat (ENT practices are already being discussed with the multidisciplinary team of the club involved.

  17. Unilateral Vogt-Koyanagi-Harada Disease: A Clinical Case Report

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    Arminda Neves

    2015-10-01

    Full Text Available Purpose: To report a case of a 20-year-old female with decreased visual acuity (VA in the left eye (LE. Methods: This is a retrospective and descriptive case report based on data from clinical records, patient observation and analysis of diagnostic tests. Results: A 20-year-old female presented with decreased VA in the LE for 3 days. Best-corrected visual acuity (BCVA was 20/20 in the right eye (RE and 20/40 in the LE. Pupillary function, intraocular pressure, results of external segment examinations and slit-lamp biomicroscopy were normal, bilaterally. RE fundoscopy was normal, and in the LE it revealed papillitis and posterior pole exudative retinal detachment. Optical coherence tomography (OCT confirmed the macular serous retinal detachment and showed thickening of the posterior choroid also revealed by orbital ultrasound and magnetic resonance imaging (MRI. Fluorescein angiography showed angiographic features typical of Vogt-Koyanagi-Harada (VKH disease: disseminated spotted choroidal hyperfluorescence and choroidal multifocal hypofluorescence, multifocal profuse leakage in the retina with pooling, serous retinal detachment and optic disc hyperfluorescence. Serological testing for the diagnosis of infectious pathologies was negative, and the review of systems was normal. The patient received systemic steroids and cyclosporine. LE BCVA improved up to 20/20 at 18 months after the diagnosis, with complete reabsorption of subretinal fluid and normal retinal and choroidal thickness by OCT. Conclusion: Despite the unilateral involvement, the clinical and angiographic features were typical of VKH disease, and ophthalmologists should be aware to recognize this rare clinical variant of the disease.

  18. Simultaneous bilateral femoral neck fractures after electrical shock injury: a case report

    Institute of Scientific and Technical Information of China (English)

    Harminder Singh Sohal; Darsh Goyal

    2013-01-01

    Simultaneous bilateral fractures of the femoral necks are rare injuries,especially when there is no underlying pathological condition.We report a 20-year-old man who sustained bilateral femoral neck fractures resulting from an accidental electric shock with 440 Ⅴ direct current.Simultaneous bilateral femoral neck fractures after electrical shock injury without falling from a height are rather uncommon in clinic.The main cause of the fracture may be muscle contraction.This case highlights that even in the absence of primary and secondary bone disease,bilateral fractures of the femoral necks can occur following electric shock injury.We successfully managed this case with bilateral cannulated screw fixation without bone grafting.Surgeons caring for patients with electrical injury should be aware of the possibility of skeletal injuries which can go unnoticed,leading to delay in diagnosis and increased risk of complications.

  19. Meningeal involvement in Wegener granulomatosis: case report and review of the literature.

    Science.gov (United States)

    Soriano, A; Lo Vullo, M; Casale, M; Quattrocchi, C C; Afeltra, A

    2012-01-01

    Wegener Granulomatosis (WG) is a multisystem autoimmune disorder characterized by necrotizing granulomatous vasculitis that most commonly involves the upper respiratory tract, lungs, and kidneys. The involvement of the central nervous system (CNS) is infrequent and can cause stroke, cranial nerve abnormalities, cerebrovascular events, seizures, and meningeal involvement. Meningeal involvement is rare and may occur due to local vasculitis, directly spread from adjacent disease in the skull base, paranasal or orbital region. We describe the case of a 20-year-old Caucasian man who was diagnosed with sinonasal WG with frontal focal meningeal involvement. A literature review on diagnosis and treatment of meningeal involvement in course of WG was carried out. The importance of an early diagnosis and treatment of localized WG has been emphasized, in order to avoid the progression to a severe form of disease, especially in younger patients and in paucisymptomatic cases.

  20. Delayed contact sensitivity on the lips and oral mucosa due to propolis-case report.

    Science.gov (United States)

    Brailo, V; Boras, Vanja Vucicevic; Alajbeg, I; Juras, Vidovic

    2006-07-01

    We report a rare case of a patient who was referred to the Department of Oral medicine in Zagreb, Croatia. The patient was 20 years old, otherwise healthy and not taking any medication. She presented with irregular erosions partially covered with pseudomembranes that involved both lips and retrocomissural mucosa. Discrete erosion was also noticed on her lower lingual gingiva in the area 42. She reported a propolis solution self-medication for treatment of recurrent aphthous ulcers. After ten days of propolis application, lip and oral lesions developed. Patch test to propolis was proven. We highlight the fact that some folk medicine medications, such as propolis, although being known for many decades to be helpful in various conditions, in some individuals might lead to unwanted side-effects due to its antigenic potential. Additionally, every colleague, during the differential diagnosis of the oral lesions must bear in mind unwanted reactions to folk medicine products.

  1. Seizure-like activity during fentanyl anesthesia. A case report.

    OpenAIRE

    Webb, M. D.

    1990-01-01

    Fentanyl induced seizures have been described previously in the literature. Clinical observations has labeled the movements seen in fentanyl anesthesia as seizure activity but electroencephalographic studies have not supported this. A case of seizure-like activity after the administration of fentanyl in a 20-year-old female is reported.

  2. Plasmodium vivax induced myocarditis: A rare case report

    Directory of Open Access Journals (Sweden)

    N Gupta

    2013-01-01

    Full Text Available Malaria is one of the commonest parasitic disease in the tropics since ages. However the plasmodium still continues to give surprises to all of us. In the similar context we report a case of Plasmodium vivax induced myocarditis in a 20 year old male and review the literature related to this rare entitiy.

  3. Endobronchial metastasis from hepatocellular carcinoma – a case description with literature review

    OpenAIRE

    Szumera-Ciećkiewicz, Anna; Olszewski, Włodzimierz T.; Piech, Krzysztof; Głogowski, Maciej; Prochorec-Sobieszek, Monika

    2013-01-01

    Endobronchial metastases from hepatocellular carcinoma are very rare. Up to date, no more than 7 cases were reported. The authors present a case of 20-year old female with metastatic hepatocellular carcinoma to superior lobar bronchus. Examination of cytological and small biopsy specimens obtained from bronchoscopy revealed characteristic microscopic features and immunohistochemical profile of hepatocellular carcinoma.

  4. Endobronchial metastasis from hepatocellular carcinoma – a case description with literature review

    Science.gov (United States)

    Szumera-Ciećkiewicz, Anna; Olszewski, Włodzimierz T; Piech, Krzysztof; Głogowski, Maciej; Prochorec-Sobieszek, Monika

    2013-01-01

    Endobronchial metastases from hepatocellular carcinoma are very rare. Up to date, no more than 7 cases were reported. The authors present a case of 20-year old female with metastatic hepatocellular carcinoma to superior lobar bronchus. Examination of cytological and small biopsy specimens obtained from bronchoscopy revealed characteristic microscopic features and immunohistochemical profile of hepatocellular carcinoma. PMID:24040462

  5. Hyaline fibromatosis of Hoffa's fat pad in a patient with a mild type of hyaline fibromatosis syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Raak, Sjoerd M. van [Albert Schweitzer Hospital, Department of Radiology, Dordrecht (Netherlands); Meuffels, Duncan E. [Erasmus MC - University Medical Center, Department of Orthopaedic Surgery, Rotterdam (Netherlands); Leenders, Geert J.L.H. van [Erasmus MC - University Medical Center, Department of Pathology, Rotterdam (Netherlands); Oei, Edwin H.G. [Erasmus MC - University Medical Center, Department of Radiology, Rotterdam (Netherlands)

    2014-04-15

    Hyaline fibromatosis syndrome (HFS) is a rare, homozygous, autosomal recessive disease, characterized by deposition of hyaline material in skin and other organs, resulting in esthetic problems, disability, and potential life-threatening complications. Most patients become clinically apparent in the first few years of life, and the disorder typically progresses with the appearance of new lesions. We describe a rare case of a 20-year-old patient with juvenile-onset mild HFS who presented with a history of progressive anterior knee pain. Detailed magnetic resonance (MR) imaging findings with histopathological correlation are presented of hyaline fibromatosis of Hoffa's fat pad, including differential diagnosis. The diagnosis of HFS is generally made on basis of clinical and histopathological findings. Imaging findings, however, may contribute to the correct diagnosis in patients who present with a less typical clinical course of HFS. (orig.)

  6. Primary cutaneous mucormycosis in a patient with burn wounds due to Lichtheimia ramosa.

    Science.gov (United States)

    Kaur, Ravinder; Bala, Kiran; Ahuja, Rajeev B; Srivastav, Prabhat; Bansal, Umesh

    2014-10-01

    Mucormycosis is usually an invasive mycotic disease caused by fungi in the class mucormycetes. Here we report a case of cutaneous mucormycosis due to Lichtheimia ramosa in a 20-year-old female patient with burn injuries. She was admitted to the hospital with accidental flame burns covering 60 % total burn surface area. After 15 days of admission to hospital, the burn wound showed features of fungal infection. Culture showed white cottony growth belonging to the Mucorales order. Morphological identification confirmed it as L. ramosa. She was managed surgically and medically with the help of amphotericin B. Patient survived due to prompt diagnosis and appropriate medical and surgical treatment. Early diagnosis is critical in prevention of morbidity and mortality associated with the disease. Fungal infection in burn wounds can be difficult to diagnose and manage.

  7. [A patient who refused treatment after self-poisoning with paracetamol

    NARCIS (Netherlands)

    Kramers, C.; Jansman, F.G.A.; Droogleever Fortuyn, H.A.

    2006-01-01

    Two patients, a 20-year-old man and a 33-year-old woman, were admitted with paracetamol poisoning. Both patients refused treatment initially but eventually complied. The man had a paracetamol concentration of 47.5 mg/l 2.5-5.0 h after ingestion, so antidote treatment was not considered necessary. Th

  8. Advanced intraligamentary pregnancy: case report; Gravidez abdominal intraligamentar avancada: relato de caso

    Energy Technology Data Exchange (ETDEWEB)

    Holzhacker, Suzane; Elito Junior, Julio; Santana, Renato Martins; Hisaba, Wagner [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Escola Paulista de Medicina. Dept. de Obstetricia

    2008-09-15

    Intraligamentary pregnancy is an ectopic pregnancy developing within the broad ligament of the uterus. A case of a 20-year-old primigestation primipara woman is reported. The patient at 10 weeks of gestation, presented acute and continuous hypo gastric pain and was referred to ultrasonography examination, showing ectopic pregnancy and oligamnios. Another exam revealed right para-uterine abdominal pregnancy, fetal biometry of 16 weeks, placenta attached to mesosalpinx and severe oligamnios. Considering the fetal prognostics and the proximity of the placenta to iliac blood vessels, artheriographic examination was performed for evaluation of placenta insertion. Surgical procedures as salpingo-oophorectomy at the right side, appendectomy and removal of the fetus were performed.

  9. Sepsis and meningoencephalitis due to Rhodotorula glutinis in a patient with systemic lupus erythematosus, diagnosed at autopsy

    Directory of Open Access Journals (Sweden)

    Pamidimukkala Umabala

    2007-01-01

    Full Text Available Rhodotorula species have been reported as a causative agent of opportunistic mycoses in immunocompromised hosts. We report a case of sepsis and meningoencephalitis caused by Rhodotorula glutinis in a 20-year-old female patient with systemic lupus erythematosus (SLE, which was diagnosed at autopsy. The patient presented with longstanding fever. She was diagnosed with SLE after admission to the hospital and died on day 5 of the hospital stay. Autopsy was performed to confirm the presence of infection. Sepsis and meningoencephalitis due to Rhodotorula glutinis was confirmed by postmortem blood cultures and histopathological examination of biopsies taken from the brain at autopsy. Infection by Rhodotorula spp. is rare but can be fatal in immunocompromised hosts. Infections by such uncommon yeasts may often be difficult to diagnose, especially in the setting of febrile neutropenia. This report also emphasizes the value of autopsy as a powerful educational tool.

  10. Brucellosis - diagnostic dilemma: Case report

    OpenAIRE

    Bojić Biljana; Vujošević Milica; Nikolić Svetlana; Dulović Olga; Grebenarević Jelica; Milinković Zoran; Gvozdenović Jasna J.

    2002-01-01

    The authors present a case of a 20-year old student from Belgrade, who was admitted to the Institute of Infectious Diseases with fever, muscle and spine pains, strong headacke and malice. During the clinical examination bilateral sacroileitis was found. Serological analyses confirmed brucellosis. Epidemiological data showed that she lived in Kosovo and Metohia in 1997, where she consumed diary products from domestic animals this might be the reason of the acquired infection. With appropriate ...

  11. Catatonia in encephalitis and nonconvulsive seizures: a case report and review of the literature.

    Science.gov (United States)

    Sahaya, Kinshuk; Lardizabal, David

    2010-03-01

    A 20-year-old woman was admitted for psychosis. On further investigation, she was found to be have viral encephalitis and generalized nonconvulsive seizures. After the seizures were controlled, she remained in a prolonged catatonic state. Repeated intravenous benzodiazepine administration, improved her cognition dramatically. This case emphasizes that catatonia may occur after encephalitis and nonconvulsive seizures.

  12. Early-Onset Signet-Ring Cell Adenocarcinoma of the Colon: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Maliha Khan

    2017-01-01

    Full Text Available Colorectal cancer (CRC remains the second leading cause of cancer-related deaths in the United States. While a decline has been observed in the older population, the occurrence of CRC in the adolescent and young adult (AYA population has increased over the past two decades. The histopathologic characteristics and clinical behavior of CRC in AYA patients have been shown to be distinct from those of CRC in older adults. The rarer subtypes of CRC such as mucinous adenocarcinoma and signet-ring cell carcinoma are associated with a poorer prognosis compared to the more common subtypes. Here we report a case of a 20-year-old man who was diagnosed with stage IVB (T4 N2 M1, with peritoneal carcinomatosis signet-ring cell adenocarcinoma of the colon. The scarcity of information on these rarer subtypes merits further study and investigation.

  13. Bleomycin-Induced Flagellate Erythema in a Patient Diagnosed with Ovarian Yolk Sac Tumor

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    Stergios Boussios

    2015-01-01

    Full Text Available Flagellate linear hyperpigmentation can rarely be caused by the chemotherapy agent, bleomycin. Herein, we describe the case of a 20-year-old woman treated with bleomycin for an ovarian yolk sac tumor and review the prominent features of this form of dermatitis.

  14. Multifocal epithelial hyperplasia. Report of nine cases.

    Science.gov (United States)

    Ledesma-Montes, Constantino; Vega-Memije, Elisa; Garcés-Ortíz, Maricela; Cardiel-Nieves, Maritza; Juárez-Luna, Claudia

    2005-01-01

    Multifocal epithelial hyperplasia (MEH) is also known as focal epithelial hyperplasia, Heck's disease or multifocal papillomavirus-induced epithelial hyperplasia. It is characterised by the presence of multiple lesions in the oral mucosa of children and it has been associated with the presence of the human papillomavirus. The aim of this study was to determine the clinico-pathological features of the cases diagnosed as MEH in the Service of Dermatology of the Hospital Manuel Gea González (SDHMGG). The files of the SDHMGG were reviewed and all cases diagnosed as MEH were retrieved. Nine MEH cases were found. Most of the patients were 20 year-old or younger (67%) and females were more commonly affected (78%). All patients presented multiple lesions and always, close relatives with similar lesions were found. Lesions were located most commonly in the buccal mucosa, lower lip and commissures. MEH is a soft tissue intraoral condition that needs treatment solely of the traumatised lesions or those with cosmetic problems. Remaining lesions will disappear with the age of the patients. It is suggested that this entity should be named multifocal epithelial hyperplasia since this name describes better the clinico-pathological and microscopic features of the disease.

  15. Invisalign treatment in periodondal patient: case report

    Science.gov (United States)

    BARLATTANI, A.; MAMPIERI, G.; OTTRIA, L.; BOLLERO, P.

    2010-01-01

    SUMMARY Scope of work. To evaluate the results obtained from the use of removable orthodontic aligners in patients with periodontal and systemic issues to improve the aesthetics of the smile. Materials and methods. Invisalign technique, a new technique based on the use of orthodontic removable transparent overlay representing the mechanotherapy. This technique through a dedicated software (Clin-Check) enables you to view the 3D resolution of the malocclusion. Results. In the case study examined the results support the Invisalign treatment in periodontal patients with a systemic disease, both for an easier home oral hygiene and also to maintain alignment and an aesthetic smile achieved without the use of invasive techniques. Conclusion. The Invisalign orthodontic treatment is ideal for patients with periodontal problems. The removal of the masks ensures control of normal oral hygiene but also requires the cooperation of the patient during the treatment. PMID:23285373

  16. Gastric varicella: two cases in cancer patients

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    Violeta María Sastre-Lozano

    Full Text Available Gastric involvement with the varicella-zoster virus is an uncommon clinical condition where early suspicion and diagnosis are important to prevent the consequences deriving from its high morbidity and mortality, which in immunocompromised patients oscillate between 9% and 41% according to the various series. Two cases of gastric involvement with the varicella-zoster virus (VZV in two patients with blood cancer are reported below. Gastric lesions are usually preceded by typical papulovesicular skin lesions. When gastric involvement is the first symptom of the disease its diagnosis and management may be delayed, which may entail severe consequences for immunocompromised patients. It is therefore that we suggest its inclusion in the algorithm for immunocompromised patients with abdominal pain and ulcer-like endoscopic lesions.

  17. Invisalign treatment in periodondal patient: case report.

    Science.gov (United States)

    Barlattani, A; Mampieri, G; Ottria, L; Bollero, P

    2009-10-01

    SCOPE OF WORK.: To evaluate the results obtained from the use of removable orthodontic aligners in patients with periodontal and systemic issues to improve the aesthetics of the smile. MATERIALS AND METHODS.: Invisalign technique, a new technique based on the use of orthodontic removable transparent overlay representing the mechanotherapy. This technique through a dedicated software (Clin-Check) enables you to view the 3D resolution of the malocclusion. RESULTS.: In the case study examined the results support the Invisalign treatment in periodontal patients with a systemic disease, both for an easier home oral hygiene and also to maintain alignment and an aesthetic smile achieved without the use of invasive techniques. CONCLUSION.: The Invisalign orthodontic treatment is ideal for patients with periodontal problems. The removal of the masks ensures control of normal oral hygiene but also requires the cooperation of the patient during the treatment.

  18. Ocular complication of malar fracture and its handling. Case report

    Directory of Open Access Journals (Sweden)

    León Miguel E.

    2004-09-01

    Full Text Available Antecedents: The superior orbital fissure syndrome (SOFS is a rare complication in patient with maxillofacial fractures, that consists of a direct compression or hematoma of the structures related to the SOFS. The characteristic clinics are: gross and persistent edema of the periorbital tissues; proptosis and subconjuntival echyimosis; ptosis and ophtalmoplegia; dilatation of the pupil; direct light, reflex absent, inderect reflex (consensual present; loss of the accommodation reflex; loss of corneal reflex; anesthesia of the eyelid and the front; radiological evidence of reduction in the dimensions of the SOF. Objetive: The objective of this report is to present a clinical case of a patient who underwent the syndrome of the superior orbitaria fissure, its the pos surgery handling and results. Materials: It is presented a clinical case of a 20-year-old age patient, who in his postoperatorio immediate of fracture reduction malar presented the characteristic clinics and radiological of the SOFS. An updated revision of the subject and the different options from treatment appears. Results: This case was handled quickly with megadosis of corticoides and the patient recovered totally his normal visual function. Conclusions: The conducted treatment was successful.

  19. A Case of Cardiac Arrest Due to Late Diaphragm Hernia

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    Duygu Mergan Ižliklerden

    2013-04-01

    Full Text Available Traumatic diaphragm hernias are seen in 0.5-6% of blunt traumas and early diagnosis of these cases is difficult. Traumatic diaphragm hernias can produce symptoms and be diagnosed in weeks, months, and sometimes in years. A 20-year-old male patient had a history of a fall from a tree eight years prior. He had complaints of postprandial pain in the epigastrium continuing for several years. Over the previous two weeks, the patient%u2019s complaints of chest pain and difficulty in breathing increased. On PA chest graphy, increased air fluid levels were seen in left lower zone. The patient that hospitalized for examination had a mediastinal shift suddenly and caused cardiac arrest on the second day. By performing anterolateral thoracotomy, the patient received cardiac by manual cardiac massage. Following a response to resuscitation, during exploration of the patient, it was observed that the stomach was perforated towards the thorax. The stomach and the diaphragm were primary repaired and he was discharged on the postoperative seventh day. It is difficult to diagnose diaphragm ruptures in early periods following trauma and thus causes a delay in treatment. This study presents a case that was diagnosed eight years after blunt trauma and had cardiac arrest due to mediastinal shift preoperatively.

  20. Pyoderma gangrenosum in burned patient: Case report

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    Obradović-Tomašev Milana

    2015-01-01

    Full Text Available Introduction. Pyoderma gangrenosum is a rare, chronic, destructive, ulcerating skin disease of uncertain etiology. It develops most frequently in patients between 25-45 years of age and affects both sexes equally. Case report. We present a case of pyoderma gangrenosum in a young female patient who sustained a burn injury of 40% total body surface area. She underwent four operations. She developed a wound infection and urinary infection during her hospital stay. By the end of hospitalization, the papules followed with coalesce of ulcerations formed on the previously epithelized areas of her legs. The patient complained of the intensive pain localized on these surfaces. Since pyoderma gangrenosum was suspected, a dermatologist was included in treatment. Therapy was initiated (methylprednisolone 60 mg per day intravenously with gradual reduction of the dosage. The patient was discharged from hospital two weeks later with almost fully complete cicatrization and epithelization. Conclusion. Pyoderma gangrenosum is still difficult to be diagnosed in the absence of specific and sensitive diagnostic methods; however, it is crucial to be suspected as early as possible and to start treatment immediately. Multidisciplinary approach is essential for optimal results.

  1. [The heart failure patient: a case report].

    Science.gov (United States)

    Alconero-Camarero, Ana Rosa; Arozamena-Pérez, Jorge; García-Garrido, Lluïsa

    2014-01-01

    Given its prevalence, high mortality rate, morbidity, chronicity and use of resources, heart failure (HF) is a priority issue from a social and health standpoint, due to the ageing population and to lack of adherence to and the complexity of treatment. For these reasons, an individualized care plan needs to be established to meet the real and potential needs of the patient diagnosed with HF. A clinical case is presented of a patient admitted to the Cardiology Critical Care (CCC) unit of a tertiary hospital. A patient care plan was prepared following the steps of the scientific method and relying on the NANDA taxonomy, and the NOC and NIC to design goals and nursing interventions, respectively.

  2. Post-prandial reactive hypoglycaemia and diarrhea caused by idiopathic accelerated gastric emptying: a case report

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    Balan Kottekkattu

    2011-05-01

    Full Text Available Abstract Introduction The majority of cases of post-prandial reactive hypoglycemia are considered idiopathic. Abnormalities of B-cell function and glucose regulation by insulin and glucagon have been postulated as causes but associated gastrointestinal dysfunction has not been reported. We report the first case of accelerated gastric emptying associated with post-prandial reactive hypoglycemia, abdominal bloating and diarrhea. We consider that gastric dysmotility is an important cause of this condition as treatment of the underlying abnormal gastric emptying allows effective control of symptoms. Case presentation A 20-year-old Caucasian woman presented with post-prandial fatigue, sweating, nausea, faintness and intermittent confusion, which had led to pre-syncope and syncope on occasions. She also experienced marked abdominal bloating and diarrhea over the same period. These episodes responded to oral administration of sweet drinks. Her symptoms were ameliorated by modification of her diet. Conclusion This is an original case report of the association of idiopathic accelerated gastric emptying with post-prandial reactive hypoglycemia and diarrhea. Family physicians, endocrinologists and gastroenterologists often consult patients with a constellation of post-prandial symptoms, which are considered to be idiopathic in most cases. This case indicates that gastric dysmotility might be the primary cause of these symptoms in some patients and, if found, offers a therapeutic target which in our case was successful.

  3. Littoral Cell Angioma in a Patient with Crohn's Disease

    Science.gov (United States)

    Björnsson, Bergthor; Ignatova, Simone; Sandström, Per; Ekstedt, Mattias

    2015-01-01

    Littoral cell angioma is a rare vascular tumor of the spleen. The pathogenesis is unknown but the lesion is associated with several malignancies and immunological disorders. The diagnosis requires histopathological examination. The malignant potential of this lesion is unknown, which is why splenectomy is recommend for all cases. Symptomatic cases generally suffer from hypersplenism and pyrexia. A previously healthy 20-year-old female was diagnosed with colonic Crohn's disease; as part of the work-up a magnetic resonance enterography was performed which showed multiple signal changes of the spleen. The patient reported chronic abdominal pain in the left upper quadrant, malaise, and fever. The unknown splenic lesions prompted a laparoscopic splenectomy; pathology revealed a littoral cell angioma. The abdominal pain and malaise remitted but the fever persisted one year despite adequate treatment of the patient's Crohn's disease. Littoral cell angioma is associated with immune-dysregulation including Crohn's disease with several reported cases. Signs and symptoms of hypersplenism and splenic lesions on imaging should raise suspicion of littoral cell angioma in patients with Crohn's disease. Magnetic resonance enterography to assess disease severity in Crohn's disease may provide an opportunity to study the prevalence and natural history of this rare splenic tumor. PMID:25705528

  4. Benign monomelic amyotrophy with proximal upper limb involvement: case report

    OpenAIRE

    Neves,Marco Antonio Orsini; Marcos R. G.de Freitas; Mello,Mariana Pimentel; Dumard,Carlos Henrique; Gabriel R. de Freitas; Nascimento, Osvaldo J.M.

    2007-01-01

    Monomelic amyotrophy (MA) is a rare condition in which neurogenic amyotrophy is restricted to an upper or lower limb. Usually sporadic, it usually has an insidious onset with a mean evolution of 2 to 4 years following first clinical manifestations, which is, in turned, followed by stabilization. We report a case of 20-years-old man who presented slowly progressive amyotrophy associated with proximal paresis of the right upper limb, which was followed by clinical stabilization 4 years later. E...

  5. Progressively Unstable C2 Spondylolysis Requiring Spinal Fusion: Case Report

    OpenAIRE

    Nishimura, Yusuke; ELLIS, Michael John; Anderson, Jennifer; Hara, Masahito; Natsume, Atsushi; GINSBERG, Howard Joeseph

    2014-01-01

    Cervical spondylolysis is a rare condition defined as a corticated cleft at the pars interarticularis in the cervical spine. This is the case of C2 spondylolysis demonstrating progressive significant instability, which was successfully treated by anterior cervical discectomy and fusion (ACDF) with cervical anterior plate. We describe a 20-year-old female with C2 spondylolysis presenting with progressive worsening of neck pain associated with progressive instability at the C2/3 segment. The pr...

  6. Osteochondroma of the temporomandibular joint: a case report

    OpenAIRE

    UTUMI, Estevam Rubens; Pedron,Irineu Gregnanin; Perrella, Andréia; Zambon,Camila Eduarda; CECCHETI, Marcelo Minharro; Cavalcanti,Marcelo Gusmão Paraíso

    2010-01-01

    Osteochondroma of the mandibular condyle has been found in the oral and maxillofacial region rarely. This paper describes a case of osteochondroma of the mandibular condyle in a 20-year-old woman, who was referred to our service with facial asymmetry, prognathic deviation of chin, cross-bite to the contralateral side, changes in condylar morphology, limited mouth opening, and malocclusion. Computed tomography (CT) was performed for better evaluation to the pathological conditions on the tempo...

  7. [A rare case of schwannoma of the tongue].

    Science.gov (United States)

    Grabowski, Leszek

    2008-01-01

    Author described a rare case of lingual Schwannoma in 20 years old female. After complete surgical excision she has not shown recurrence during 2 years of follow-up. Schwannomas are peripheral nerve tumors of nerve sheath origin. Extracranial schwannoma in the head and neck region comprise 25-45% of all shwannomas, but only 1% are located intraoral and usually present as slow growing mass of long duration, producing few symptoms. The treatment is surgical excision.

  8. Pregnancy in dialysis patients: a case series

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    Al-Saran Khalid A

    2008-01-01

    Full Text Available Abstract Fertility is markedly reduced in patients with chronic renal failure. For women with pre-existing renal disease, pregnancy is associated with an increased rate of fetal complications and a considerable risk of renal disease progression. Due to substantial improvements in antenatal and neonatal care, fetal outcome has improved considerably in the last two decade. A Saudi survey which examined the frequency of pregnancy among women in end stage renal disease (ESRD and undergoing regular hemodialysis (HD, showed an incidence of 7% over a five year period (1.4 per year. This may reflect the cultural endorsement of having offspring. We hereby report 2 cases of successful pregnancy managed at the Prince Salman Center for Kidney Diseases (PSCKD.

  9. Heartworm disease: Case study in dog patient

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    Spasojević-Kosić Ljubica

    2011-01-01

    Full Text Available Dirofilaria immitis is a parasite in a. pulmonalis in domestic and wild carnivora. Partial development and the transfer of this parasite among carnivora takes place through the mosquito, which makes possible the maintaining and spreading of this parasite among populations of susceptible animals. Heartworm disease, which is caused by Dirofilaria immitis, is most often manifested as changes in the respiratory and cardiovascular systems. This paper presents the case of heartworm disease in a dog. The therapy used to treat this disease in the dog was a combination of doxycycline and ivermectin. The blood test results indicated a rapid decrease in the number of microfilaria and lowering of the antigen level of the adult parasite. The conducted general and special clinical examinations of the respiratory and cardiovascular systems registered an improvement in the clinical condition of the patient.

  10. Coronary Artery Fistula-Associated Endocarditis: Report of Two Cases and a Review of the Literature.

    Science.gov (United States)

    Wang, Fang; Cranston-D'Amato, Hope; Pearson, Anthony

    2015-12-01

    Coronary artery fistulae (CAF) are rare congenital anomalies and reported to have an incidence of 0.1-0.2% of all coronary angiograms. An association between fistulae and nonatherosclerotic coronary artery aneurysms is even more rare. In childhood, patients are mostly asymptomatic; however, patients older than 20 years old may present with signs of infective endocarditis, myocardial ischemia, congestive heart failure, and aneurysm rupture. CAF are typically identified by coronary angiography; however, there are some limited studies showing that transesophageal echocardiography (TEE) can also be useful in identifying CAF. Here we report two cases of endocarditis secondary to congenital coronary artery fistulae draining into either a cardiac cavity or a coronary sinus, which were detected by TEE. Vegetations were found at the site of the fistulae drainage. Management for young patients is either percutaneous or surgical intervention. For elderly patients with multiple comorbidities, conservative treatment is another option. In these two cases, treating endocarditis with proper antibiotics and supportive treatment, the patients' conditions improved significantly.

  11. Cooling in Surgical Patients: Two Case Reports

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    Bibi F. Gurreebun

    2014-01-01

    Full Text Available Moderate induced hypothermia has become standard of care for children with peripartum hypoxic ischaemic encephalopathy. However, children with congenital abnormalities and conditions requiring surgical intervention have been excluded from randomised controlled trials investigating this, in view of concerns regarding the potential side effects of cooling that can affect surgery. We report two cases of children, born with congenital conditions requiring surgery, who were successfully cooled and stabilised medically before undergoing surgery. Our first patient was diagnosed after birth with duodenal atresia after prolonged resuscitation, while the second had an antenatal diagnosis of left-sided congenital diaphragmatic hernia and suffered an episode of hypoxia at birth. They both met the criteria for cooling and after weighing the pros and cons, this was initiated. Both patients were medically stabilised and successfully underwent therapeutic hypothermia. Potential complications were investigated for and treated as required before they both underwent surgery successfully. We review the potential side effects of cooling, especially regarding coagulation defects. We conclude that newborns with conditions requiring surgery need not be excluded from therapeutic hypothermia if they might benefit from it.

  12. Virtual Patient Case Sharing Across Two Schools of Pharmacy.

    Science.gov (United States)

    Smith, Michael A; Siemianowski, Laura A; Benedict, Neal

    2016-11-25

    Objective. To expand the use of virtual patients at 2 schools of pharmacy through virtual patient case sharing. Design. Faculty members at two schools of pharmacy collaborated to expand the use of virtual patients. Two simulation programs, vpSim and DecisionSim (Decision Simulation, LLC, Chadsford, PA), were used to create interactive patient cases for a required course and an elective course at the different schools. Each school developed cases for their own use and then shared the cases with the other school. Assessment. The development, sharing, and subsequent modification of cases were examined using a standardized data collection form completed by both schools. Survey instruments were used to gather data regarding faculty perception and student satisfaction. Pre- and post-tests were administered to assess student learning. Five cases were developed and shared between the institutions. The time spent constructing new cases (22 hours/case) was significantly longer than the time spent modifying the shared cases (1.2 hours/case). Faculty members and students were largely satisfied with case sharing and the use of virtual patient cases, respectively. Virtual patients significantly enhanced student learning of material (mean score: 3.2 vs 3.6 on a 5-point scale). Conclusions. The sharing of virtual patient cases may allow institutions to overcome barriers to implementation of virtual patient programs, namely faculty resources, while improving student learning and satisfaction.

  13. Use of Fibula Bridge Graft Technique to Treat a Distal Tibia Non Union- A Case Report

    OpenAIRE

    Amyn Rajani; Chandu J Thakkar; Ravi Shah; Ashok Shyam

    2013-01-01

    Introduction: Compound distal tibia fractures have high incidence of nonunions and have varied presentation as far as status of fibula is concerned. If fibula is sufficiently healthy we can use it for bridging the nonunion of tibia. Case Report: We present a case of 20 year old female with compound and segmental tibia fracture. Primary stablisation by external fixation and later cast brace application achieved union at the proximal end of the segmental fragment with non union at the distal en...

  14. Distal renal tubular acidosis without renal impairment after use of tenofovir: a case report

    OpenAIRE

    2016-01-01

    Background Tenofovir, one of antiretroviral medication to treat human immunodeficiency virus (HIV) infection, is known to cause proximal renal tubular acidosis such as Fanconi syndrome, but cases of distal renal tubular acidosis had never been reported. Case presentation A 20-year-old man with HIV infection developed nausea and vomiting without diarrhea after starting antiretroviral therapy. Arterial blood gas revealed non-anion-gap metabolic acidosis and urine test showed positive urine anio...

  15. Prosthetic treatment in dentinogenesis imperfecta type II: a case report

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    Sedat Güven

    2016-05-01

    Full Text Available INTRODUCTION: Dentinogenesis imperfecta (DI or hereditary opalescent dentin is an autosomal dominant disorder affecting both primary and permanent dentition. Early diagnosis and treatment of DI is important for normal facial growth and esthetic continuity by preserving occlusion and tooth structure. It also provides psychological motivation by increasing the patient’s quality of life. Providing functional dentition in DI patients prevents loss of the vertical dimension, while enabling normal growth of the facial bones and jaw joint. CASE REPORT: A 20-year-old male with DI was referred to our clinic with chewing difficulty and esthetic and speech problems. His brother also had this disease. Oral examination showed the loss of many teeth and the absence of enamel on most of the remaining teeth, causing discoloration and exposing soft dentinal tissue with calcification disorder. Despite widespread attrition of the teeth, pulp chambers were not exposed. The tip of the lower jaw was prominent in the patient’s profile. Placing metal-ceramic fixed dentures in the lower jaw and an overdenture prosthesis in the upper jaw improved the patient’s psychological state as well as his function, phonation, and esthetics. CONCLUSION: This case report presents the intraoral findings in a patient with DI, including the histopathological findings, and the prosthetic treatment approach and the treatment outcome.

  16. Subcutaneous Emphysema, Pneumomediastinum and Pneumothorax in a Patient with Dermatomyositis

    OpenAIRE

    Mehdi Bakhsaee; Mohammad Hassan Jokar; Zahra Mirfeizi; Elham Atabati; Somayeh Tarighat

    2017-01-01

    Introduction:Spontaneous pneumomediastinum, pneumothorax, and subcutaneous emphysema are rare, but serious complications of inflammatory myopathies and occur more commonly in DM than PM. complications of dermatomyositis (DM) and polymyositis (PM), both of which can be fatal. Case Report:A 20-year-old woman was admitted with neck pain, dyspnea, cough, and fever. She had been diagnosed with dermatomyositis 21 months prior. A thorax computed tomography (CT) scan revealed ground glass opacities i...

  17. Posterior communicating artery aneurysm in a 20 year old boy presenting as non-isolated third nerve palsy

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    H C Obiudu

    2009-01-01

    Result: A clinical diagnosis of left third and fourth cranial nerve palsies from intracranial space-occupying lesion was made. Computed tomography and computed tomography angiography confirmed left posterior communicating artery aneurysm. Conclusion: Any degree of pupillary involvement in third nerve palsy, whether isolated or not should warrant neuroimaging in view of the high mortality risk from intracranial aneurysms.

  18. Surgical correction of congenital esotropia alternating and subsequent abnormal correspondence retinal: a case report

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    Luigi Mazzeo

    2015-10-01

    Full Text Available Introduction: Accomodative esotropia is secondary to inappropriate convergence during accomodative effort in an uncorrected hyperope and is often familial. Case presentation: we report the case of 20 year old Caucasian patient with congenital esotropia alternating, of 30 prism diopters distance (5 m and 40 prism diopters of esotropia at near, in both eyes. Measures: Was performed strabismus, in peribulbar anesthesia, the right medial rectus was cashed 3.0mm, the left medial rectus was collected 3.5 mm. Results: Immediately after surgery, the patient complained of intermittent diplopia, resolved with orthotic exercise which stimulated binocular vision, Conclusion: This case report suggests that the surgical correction strabismus, should be considered with due caution in the treatment of congenital esotropia alternating and branches, and in some clinical scenarios selected to avoid the complication of postoperative diplopia, that in the case report resolved so benign. After three months surgical treatmen, remains a small angle strabismus aesthetically acceptable, has not given double vision and remains abnormal retinal correspondence with orthotic exercise.

  19. 成人先天性巨趾畸形两例报告%Two cases of adult congenital macrodactylia

    Institute of Scientific and Technical Information of China (English)

    卢明峰; 曹学伟

    2016-01-01

    Objective To analyze and discuss the clinical therapy and treatment outcomes of congenital gigantism of the foot. Methods The clinical documents of 2 cases of congenital gigantism of the foot were retrospectively analyzed. The 2 patients’ average age was 20 years old. All the deformities were found at birth. The cases of multiple toes involved were more than that of single toe, and the cases of tibial toe involved were more than that of fibular toe. The forefoot was enlarged. All the phalanges involved and partial metatarsal bones were enlarged. Marked increase in subcutaneous fat was found in all the cases in the operation, which infiltrated the interossei and articular capsules. The appearance of the nerves and their branches in the foot were normal and fatty infiltration was not discovered. Corrective osteotomy and reconstruction of tendon check point were performed on the 2 patients, who were followed up for 1 year. The appearance and function of the limb were observed. Results The 2 patients were satisfactory with the postoperative function and appearance. Conclusions According to the age, clinical classification, degree of pathological changes and limb function, the 2 cases of the digital gigantism of the foot are in progress. To save the function, we choose corrective osteotomy and reconstruction of tendon check point. The function and appearance of the 2 patients’ toes get improved after the surgery. The blood supply, feelings and activities of the toes are well during the follow-up.

  20. Learners' Critical Thinking Processes when using Virtual Patient Cases.

    Science.gov (United States)

    Burrows, Andrea M; Norman, Wendy V; Currie, Leanne M

    2012-01-01

    Virtual patients (VP) are interactive computer simulations used in health education to increase student exposure to a variety of clinical cases and to develop critical thinking skills. Interdisciplinary student teams developed five VP cases focused on providing education in family planning. The cases pose questions that are complex and ill-defined to promote critical thinking. In Fall 2011-Spring 2012 we will conduct a laboratory study to examine whether complexity of virtual patient case impacts learners' critical thinking.

  1. Detection of Hepatitis C Virus Coinfection in Patients with Dengue Diagnosis

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    Carlos Machain-Williams

    2014-01-01

    Full Text Available Coinfection produced by dengue virus (DENV and hepatitis C virus (HCV is a serious problem of public health in Mexico, as they both circulate in tropical zones and may lead to masking or complicating symptoms. In this research, we detected active coinfected patients by HCV residing in the endemic city of Mérida, Yucatán, Mexico, with positive diagnosis to dengue during the acute phase. We performed a retrospective analysis of 240 serum samples from dengue patients. The IgM-ELISA serological test was used for dengue diagnosis, as well as viral isolation to confirm infection. DENV and HCV were detected by RT-PCR. Thus, 31 (12.9% samples showed DENV-HCV coinfection, but interestingly the highest frequency of coinfection cases was found in male patients presenting hemorrhagic dengue in 19/31 (61.29%, with a predominance of 12 : 7 in males. Firstly, coinfection of DENV-HCV in Mérida, Mexico, was detected in young dengue patients, between 11 and 20 years old (38.7%, followed by those between 21 and 30 years old (32%; only 16.13% were between 0 and 10 years of age. Diagnosis of HCV infection in patients with dengue is highly recommended in order to establish potential risk in clinical manifestations as well as dictate patients' special care.

  2. Aggressive orbital optic nerve meningioma with benign microscopic features: a case report.

    Science.gov (United States)

    Amoli, F Asadi; Mehrabani, P Mansouri; Tari, A Sadeghi

    2007-12-01

    Primary optic nerve meningiomas occur at lower ages than meningiomas arising from the coverings of the brain and spinal cord. Here we report the case of a 20-year-old female with an aggressive orbital meningioma referred to the Ophthalmology Department of the Farabi Hospital in Tehran. The patient had a history of orbital meningioma from 10 years ago and several surgical resections due to tumor recurrence during these 10 years. On admission, the patient had a large orbital mass and severe proptosis. MRI images revealed a large left orbital mass with optic nerve involvement and extension to the left maxillary sinus, pterygoid fossa and the dura in the floor of the anterior fossa. Fine-needle aspiration cytology of the mass confirmed tumor recurrence. The patient first received radiotherapy due to the inoperable mass, and the tumor was resected 1.5 month later. Microscopic study showed meningotheliomatous meningioma with extensive involvement of the optic nerve and invasion of the optic disc, sclera and choroid. The interesting aspect of this case was the aggressive behavior of the tumor with intraocular invasion, despite its benign histopathological features, which led to wide exenteration of the eye together with resection of the upper and lower lids.

  3. Appendicular peritonitis in situs inversus totalis: a case report

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    Dia Abdarahmane

    2010-05-01

    Full Text Available Abstract Introduction Situs inversus is a congenital anomaly characterized by the transposition of the abdominal viscera. When associated with dextrocardia, it is known as situs inversus totalis. This condition is rare and can be a diagnostic problem when associated with appendicular peritonitis. Case presentation We report the case of a 20-year-old African man who presented to the emergency department with a 4-day history of diffuse abdominal pain, which began in his left iliac region and hypogastrium. After examination, we initiated a surgical exploration for peritonitis. We discovered a situs inversus at the left side of his liver, and his appendix was perforated in its middle third. A complementary post-operative thoracic and abdominal tomodensitometry revealed a situs inversus totalis. Conclusion Appendicular peritonitis in situs inversus is a rare association that can present a diagnostic problem. Morphologic exploration methods such as ultrasonography, tomodensitometry, magnetic resonance imaging, and laparoscopy may contribute to the early management of the disease and give guidance in choosing the most appropriate treatment for patients.

  4. Isolated Multiple Fragmented Cricoid Fracture Associated with External Blunt Neck Trauma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Hoon; Hwang, Yoon Joon; Kim, Yong Hoon; Seo, Jung Wook; Cho, Hyeon Je; Kim, Yeon Soo [Inje University School of Medicine, Ilsan Paik Hospital, Goyang (Korea, Republic of)

    2010-08-15

    Blunt laryngeal trauma is a relatively uncommon but possibly life-threatening injury. An isolated cricoid fracture associated with blunt trauma is rare. We report a case of an isolated multiple fragmented cricoid cartilage fracture that developed in a 20-year-old man after a blunt neck trauma that occurred during a baseball game and was diagnosed by 64-slice multidetector computed tomography (MDCT)

  5. Pleomorphic xanthoastrocytoma - a case report; Xantoastrocitoma pleomorfico - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Magnago, Marcelo; Sales, Anderson Ribeiro de; Marchiori, Edson; Machado, Bruno Beber; Muniz, Maria Angelica Soares [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Santos, Alair Augusto S.M.D. dos [Hospital Universitario Antonio Pedro, Niteroi, RJ (Brazil). Servico de Radiologia; Amaral, Leonardo Portugal G. [Universidade Federal, Rio de Janeiro, RJ (Brazil). Inst. de Biofisica Carlos Chagas Filho. Curso de Pos-graduacao Medica

    2000-12-01

    The authors report a case of a 20-year-old woman whose first symptom was severe headache followed by seizures. Conventional X-ray, computed tomography and magnetic resonance of the head showed an expansive mass on the right parietal lobe, close to the occipital horn of the lateral ventricle. Osteolysis of the internal table and expansion of the external table of the skull were also observed. After surgery, the diagnosis of pleomorphic xantho astrocytoma was established by histopathologic analysis. (author)

  6. Sickle-β+ thalassemia with splenic calcification and bone marrow infarction: a case report

    OpenAIRE

    2008-01-01

    We came across an unusual case of a 20 years old male from north India who presented with repeated episodes of pyrexia of unknown origin (PUO) and history of chronic hemolytic anemia. On investigation he was detected to have Sickle-β+ Thalassemia and subtle features of hyposplenism. Radiological investigations revealed extensive splenic calcification and bone marrow examination to evaluate for PUO showed extensive bone marrow infarction and fibrosis. Molecular diagnosis for beta thalassemia m...

  7. Spontaneous large renal pelvis hematoma in ureteropelvic junction obstruction presenting as an acute abdomen: Rare case report.

    Science.gov (United States)

    Sawant, Ajit; Kasat, Gaurav; Pawar, Prakash; Tamhankar, Ashwin

    2016-01-01

    Patients with ureteropelvic junction (UPJ) obstruction can present with flank pain or hematuria. We present 20-year-old male presenting with acute pain in lumbar and right fossa with tenderness and guarding, this case was clinically mimicking general surgical emergency. On computed tomography with urography and angiography, there was 15 cm × 11 cm × 10 cm size non-enhancing hyperdense lesion (average Hounsfield units - +64) in right renal pelvis suggestive of hematoma. Patient's diethylenetriaminepentaacetic acid diuretic renography was suggestive of right kidney glomerular function rate of 48.4 ml/min with the relative function of 43%, Peak to half peak was not achieved. The patient was managed by retrograde ureteropyelography and double J stenting. After 1 month, clot size decreased to 4 cm × 3 cm × 2 cm. The patient had undergone open reduction Anderson hynes dismembered pyeloplasty with the removal of pelvis clot after 6 weeks. We report the first case of UPJ obstruction presenting as an acute abdomen and spontaneous hematuria with large pelvis clot without rupture of the renal pelvis.

  8. Spontaneous large renal pelvis hematoma in ureteropelvic junction obstruction presenting as an acute abdomen: Rare case report

    Directory of Open Access Journals (Sweden)

    Ajit Sawant

    2016-01-01

    Full Text Available Patients with ureteropelvic junction (UPJ obstruction can present with flank pain or hematuria. We present 20-year-old male presenting with acute pain in lumbar and right fossa with tenderness and guarding, this case was clinically mimicking general surgical emergency. On computed tomography with urography and angiography, there was 15 cm × 11 cm × 10 cm size non-enhancing hyperdense lesion (average Hounsfield units - +64 in right renal pelvis suggestive of hematoma. Patient's diethylenetriaminepentaacetic acid diuretic renography was suggestive of right kidney glomerular function rate of 48.4 ml/min with the relative function of 43%, Peak to half peak was not achieved. The patient was managed by retrograde ureteropyelography and double J stenting. After 1 month, clot size decreased to 4 cm × 3 cm × 2 cm. The patient had undergone open reduction Anderson hynes dismembered pyeloplasty with the removal of pelvis clot after 6 weeks. We report the first case of UPJ obstruction presenting as an acute abdomen and spontaneous hematuria with large pelvis clot without rupture of the renal pelvis.

  9. A Case Report of Prilocaine-Induced Methemoglobinemia after Liposuction Procedure

    Directory of Open Access Journals (Sweden)

    Birdal Yildirim

    2015-01-01

    Full Text Available Prilocaine-induced methemoglobinemia is a rarely seen condition. In this paper, a case is presented with methemoglobinemia developed secondary to prilocaine use in a liposuction procedure, and the importance of this rarely seen condition is emphasized. A 20-year-old female patient presented with complaints of prostration, lassitude, shivering, shortness of breath, and cyanosis. It was learned that the patient underwent nearly 1000 mg prilocaine infiltration 8 hours priorly during a liposuction procedure. At admission, her blood pressure (130/80 mmHg, pulse rate (140 bpm, body temperature (36°C, and respiratory rate (40/min were recorded. The patient had marked acrocyanosis. The arterial blood gas methemoglobin level was measured as 40%. The patient received oxygen therapy with a mask and was administered vitamin C in normal saline (500 mg tid, N-acetylcysteine (300 mg tid, and 50 mg 10% methylene blue in the intensive care unit of the internal medicine department. Methemoglobin level dropped down to 2% after her treatment with methylene blue and she was clinically cured and discharged 2 days later. Emergency service physicians should remember to consider methemoglobinemia when making a differential diagnosis between dyspnea and cyanosis developing after prilocaine infiltration performed for liposuctions in the adult age group.

  10. [Convulsive seizures and polyneuritis in a patient with lupus treated with metronidazole (author's transl)].

    Science.gov (United States)

    Herreman, G; Krainik, F; Betous, F; Nicolas, M O; Mundler, B

    1981-01-01

    A 20-year-old patient with biologically-confirmed lupus developed a perirenal abscess following puncture biopsy of the kidney. Postoperative treatment included metronidazole at a mean dose of 2.5 g daily for 68 days (total dose : 165 g). Generalised convulsive seizures occurred on four occasions, associated with paresthesia of the four limbs, but without loss of motor or reflex activity, though some distal hypoesthesia was detected. An acute lupus attack was eliminated, the convulsive seizures not recurring after discontinuation of treatment, and the paresthesias diminishing progressively over a period of three months. Electrical investigations showed lack of motor anomalies but a marked reduction in sensory conduction. This is the 13th reported case of polyneuritis due to metronidazole, the 4th case of convulsive seizures, and the first case in which both manifestations occurred. The plasma concentration curve after oral administration of 1 g of the product to this patient demonstrated that the product was not being metabolised in a pathological manner.

  11. Littoral Cell Angioma in a Patient with Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Joel Johansson

    2015-01-01

    Full Text Available Littoral cell angioma is a rare vascular tumor of the spleen. The pathogenesis is unknown but the lesion is associated with several malignancies and immunological disorders. The diagnosis requires histopathological examination. The malignant potential of this lesion is unknown, which is why splenectomy is recommend for all cases. Symptomatic cases generally suffer from hypersplenism and pyrexia. A previously healthy 20-year-old female was diagnosed with colonic Crohn’s disease; as part of the work-up a magnetic resonance enterography was performed which showed multiple signal changes of the spleen. The patient reported chronic abdominal pain in the left upper quadrant, malaise, and fever. The unknown splenic lesions prompted a laparoscopic splenectomy; pathology revealed a littoral cell angioma. The abdominal pain and malaise remitted but the fever persisted one year despite adequate treatment of the patient’s Crohn’s disease. Littoral cell angioma is associated with immune-dysregulation including Crohn’s disease with several reported cases. Signs and symptoms of hypersplenism and splenic lesions on imaging should raise suspicion of littoral cell angioma in patients with Crohn’s disease. Magnetic resonance enterography to assess disease severity in Crohn’s disease may provide an opportunity to study the prevalence and natural history of this rare splenic tumor.

  12. 1416例门诊干眼病病因调查分析%Analysis cause of dry eye in 1416 cases of out-patient

    Institute of Scientific and Technical Information of China (English)

    王宏; 张月梅; 雷迅文

    2009-01-01

    Objective To examine the patients with dry eye in out-patient and to analyze the distribution and the relevant factors of dry eye.Methods A total of 4563 eases of outpatients conducted a questionnaire survey,combined with slit-lamp microscope,tear secretion test,tear film break-up time and cornea and conjunetiva staining to confirm the diagnosis.Results The prevalence of dry eye in out-patients aeenunted for 31.03%,among those cases that older than 45 years old,20-45 years old,and younger than 20 years old,the incidence was 9.14%,15.80%,6.09% respectively.The incidence of female and male was of 21.08%,9.95% respectively.In the office worker,labour,house keeper,often wearing enntaet lenses the incidence rates were 27.68%,19%,10.73%,9.75% respectively in those dry eye patients.The occurrence of dry eye had significant correlation with age,gender and occupation.Conclusions The risk factors are the bad working environment,abuse of eye drops,excessive using eyes and wear contact lenses,the cause of dry eye is closely related with age.%目的 通过对眼科门诊就诊患者干眼病的检杏,分析干眼病的分布人群及干眼病的相关因素.方法 对4563例眼科门诊患者进行问卷调查,结合裂隙灯显微镜,泪液分泌试验,泪膜破裂时间及角结膜染色检查确定诊断.结果 眼科门诊患者中,干眼病患病率为31.03%,其中大于45岁、20~45岁、小于20岁发病率分别为9.14%、15.80%、6.09%;女性、男性发病率分别为21.08%、9.95%.干眼病患者中职员、工人、家务、经常配戴隐形眼镜者发病率分别为27.68%、19%、10.73%、9.75%.干眼病的发生与年龄、性别及职业明显相关.结论 不良的工作环境、滥用滴眼液、过度用眼及配戴角膜接触镜等是十眼病发生的高危因素,干眼病的病因与年龄密切相关.

  13. Vaccination Against Hepatitis A for Hemophilic Patients: Is It Necessary?

    Directory of Open Access Journals (Sweden)

    Mirzaei

    2016-04-01

    Full Text Available Background Hemophilic patients require long-life intravenous infusion of factor concentrates to treat bleedings. This could increase the risk of transmission of blood-borne infections like hepatitis C. Objectives The current study was aimed at investigating the immunity status against hepatitis A in hemophilic patients in south Khorasan and evaluating the necessity of hepatitis A vaccination for this population. Patients and Methods A cross-sectional descriptive study was conducted between 2014 and 2015 on all hemophilic patients of south Khorasan province, Iran (n = 108 for anti-HAV total, anti- HCV, HBs-Ag, anti-HIV, and anti-HTLV-I /II. Note that no one had already received a hepatitis A vaccine. Results As our results show, 77.8% of the participants (59% under 20 and 88.4% above 20 years old were seropositive for anti-HAV total; 20.4% and 2.8% (three patients of the cases were anti-HCV positive and anti-HTLV-1 positive, respectively, while none of the subjects were HBS-Ag or HIV-Ab positive. Seventeen of the patients (15.75% showed a co-infection of HAV with HCV, and five HCV-infected patients (22.73% had no immunity against hepatitis A. There was a significant relationship between age, rural life, and anti-HAV positive state in our patients (P 0.05 was detected. Conclusions More than 40% of the hemophilic patients under 20 years of age in the present study had no immunity against hepatitis A, and 23% of hepatitis C patients had not had a hepatitis A co-infection yet. Since hepatitis A can show a fulminant course in hepatitis C patients, vaccination against hepatitis A seems necessary in hemophilic patients in the region.

  14. Vaccination Against Hepatitis A for Hemophilic Patients: Is It Necessary?

    Science.gov (United States)

    Mirzaei, Jamal; Ziaee, Masood; Farsad, Seyed Ali; Fereydooni, Mohammad; Anani Sarab, Gholamreza; Rezvani Khorashad, Mohammad Reza

    2016-01-01

    Background Hemophilic patients require long-life intravenous infusion of factor concentrates to treat bleedings. This could increase the risk of transmission of blood-borne infections like hepatitis C. Objectives The current study was aimed at investigating the immunity status against hepatitis A in hemophilic patients in south Khorasan and evaluating the necessity of hepatitis A vaccination for this population. Patients and Methods A cross-sectional descriptive study was conducted between 2014 and 2015 on all hemophilic patients of south Khorasan province, Iran (n = 108) for anti-HAV total, anti- HCV, HBs-Ag, anti-HIV, and anti-HTLV-I /II. Note that no one had already received a hepatitis A vaccine. Results As our results show, 77.8% of the participants (59% under 20 and 88.4% above 20 years old) were seropositive for anti-HAV total; 20.4% and 2.8% (three patients) of the cases were anti-HCV positive and anti-HTLV-1 positive, respectively, while none of the subjects were HBS-Ag or HIV-Ab positive. Seventeen of the patients (15.75%) showed a co-infection of HAV with HCV, and five HCV-infected patients (22.73%) had no immunity against hepatitis A. There was a significant relationship between age, rural life, and anti-HAV positive state in our patients (P 0.05) was detected. Conclusions More than 40% of the hemophilic patients under 20 years of age in the present study had no immunity against hepatitis A, and 23% of hepatitis C patients had not had a hepatitis A co-infection yet. Since hepatitis A can show a fulminant course in hepatitis C patients, vaccination against hepatitis A seems necessary in hemophilic patients in the region. PMID:27257430

  15. Brodie's Abscess in a Patient Presenting with Sickle Cell Vasoocclusive Crisis.

    Science.gov (United States)

    Ogbonna, Onyekachi Henry; Paul, Yonette; Nabhani, Hasan; Medina, Adriana

    2015-01-01

    First described by Sir Nicholas Brodie in 1832, Brodie's abscess is a localized subacute or chronic infection of the bone, typically seen in the metaphases of long bones in children and adolescents. The diagnosis can prove to be enigmatic due to absence of clinical signs and symptoms of systemic disease. We report a very interesting case of Brodie's abscess masquerading as sickle cell vasoocclusive crisis in a 20-year-old female with sickle cell disease and review the literature.

  16. Coping with chronic illness: A study with end-stage renal disease patients

    OpenAIRE

    Cassaretto, Mónica; Paredes, Rosario

    2012-01-01

    This study identifies coping styles and strategies used by 40 end-stage renal disease patients over 20 years old who receive treatment in a general hospital in Peru. The instruments applied were a personal sociodemographic questionnaire and the Coping Inventory (Carver, Scheier & Weintraub, 1989). Results showed that emotion focused coping were most frequently used followed by problem focused coping. Planning, acceptance and positive reinterpretation-growth coping strategies were more frequen...

  17. Mesalamine-induced myopericarditis: a case report

    Directory of Open Access Journals (Sweden)

    Sónia Bernardo

    Full Text Available Myopericarditis has occasionally been reported as a side effect of mesalamine in patients with inflammatory bowel disease. We present a 20-year-old woman with ulcerative colitis admitted with chest pain. After thorough investigation she was diagnosed with myopericarditis potentially related to mesalamine. There was complete clinical and laboratorial recovery following drug withdrawal. Although uncommon, the possibility of myopericarditis should be considered in patients with inflammatory bowel disease presenting with cardiac complaints. Early recognition can avoid potential life-threatening complications.

  18. Focal adenomyosis (intramural endometriotic cyst) in a very young patient - differential diagnosis with uterine fibromatosis

    Science.gov (United States)

    Manta, L; Suciu, N; Constantin, A; Toader, O; Popa, F

    2016-01-01

    Introduction. Adenomyosis is a widespread disease usually affecting the late reproductive years of the women’s life, which has a great impact on their fertility. The most common form is diffuse adenomyosis, while focal adenomyosis, a cystic variant, is very rare, particularly in patients younger than 30 years old. Materials and methods. We reported a rare case of a 20-year-old Caucasian woman with cystic adenomyosis who was admitted in our service with severe chronic pelvic pain, dysmenorrhea, and menorrhagia, who had received conservative surgical treatment to preserve fertility and improve her obstetrical prognosis. Results and Discussions. Although the necrobiosis of a uterine fibroid was suspected preoperatively, the extemporaneous histopathological exam revealed adenomyosis associated with fibroleiomyoma with hyaline dystrophy and multiple foci of endometriosis of cystic formation in the wall of a young woman without any risk factors. Conclusion. Although a rare lesion in young patients, cystic adenomyosis should be considered when chronic pelvic pain is exacerbated during menstruation and is associated with a uterine tumor. In young patients, the differential diagnosis should be made with uterine malformations (hematometra), necrobiosis of uterine fibroids, pelvic endometriosis. The surgical treatment should be conservative with the excision of the lesion, always taking into account fertility preservation in young patients. PMID:27453751

  19. Nonossifying fibroma developed in metaphysis and epiphysis--a case report.

    Science.gov (United States)

    Noh, Jung Ho; Ryu, Kyung Nam; Bae, Ji Yoon; Roh, Young Hak; Choi, In Seok

    2013-04-01

    Nonossifying fibroma is developed in childhood and adolescence and is usually asymptomatic. It is typically arises in the metaphysis of long bone and migrates toward the diaphysis with growth. We present a very rare case of nonossifying fibroma involving metaphysis and epiphysis of the distal femur in a 20-year-old man. Nonossifying fibroma is a benign fibroblastic lesion, which is also termed benign cortical defect and fibroxanthoma. A nonossifying fibroma rarely causes problems and does not interfere with healing or growth. The lesions are usually asymptomatic. With growth and remodeling of the bone, the lesion typically disappears and is replaced with normal bone. However, the lesion may weaken the involved bone, causing fracture. The lesion typically arises in the metaphysis of long bones and may migrate toward the diaphysis with growth. There have never been reports of nonossifying fibroma involving epiphysis that we know of. We report a very rare case of nonossifying fibroma involving metaphysis and epiphysis in a young adult. Written, informed consent was obtained from the patient to publish this case report, including the images.

  20. Learning based on patient case reviews: an interview study

    Directory of Open Access Journals (Sweden)

    Søndergaard Jens

    2008-09-01

    Full Text Available Abstract Background Recent theories on adult learning recommend that learning is situated in real-life contexts. Learning is considered a continuous process in which every new experience builds on, and integrates with, previously accumulated experiences. Reviewing and reflecting on patient cases is in line with this learning approach. There has, however, been remarkably little research into how patient cases might be applied in professional education. The purpose of this article is to present family physicians' perceptions of the learning process initiated by reviewing patient cases. Methods Thirteen family physicians, who had all participated in a large project on cancer diagnosis in family practice (the CAP-project, currently carried out at the Research Unit for General Practice, University of Aarhus were interviewed on their experiences of reviewing patient cases. In the CAP-project family physicians (n = 467, 81% in the County of Aarhus (640 000 inhabitants completed 2,212 (83% detailed questionnaires on all newly diagnosed patients with cancer encountered in their practices during a one year period (2004–2005. In order to complete the questionnaire the family physicians were required to perform a systematic case review of each patient: they had to consult their records to provide dates of symptom-presentation, investigations and treatments initiated, and reflect on previous encounters with the patients to give detailed information on his/hers knowledge of the patients' care seeking behaviour, mental health and risk factors. The purpose of this article is to present indebt interview-data on family physicians' perceptions of the learning process initiated by reviewing patient cases, and their evaluations of using patient case reviews as a learning method in family practice. Results The process of reflection initiated by reviewing patient cases enabled family physicians to reconsider their clinical work procedures which potentially supported

  1. Early respiratory insufficiency in the ALS patient: a case study.

    Science.gov (United States)

    Houseman, Gail; Kelley, Mary

    2005-08-01

    Respiratory insufficiency is a problem that develops in nearly all people diagnosed with amyotrophic lateral sclerosis (ALS). Noninvasive positive pressure ventilation (NIPPV) is the treatment of choice for ALS patients with respiratory insufficiency. Forced vital capacity (FVC) is the test most commonly used to qualify ALS patients for NIPPV; however, some research suggests FVC may not be the best tool to measure early respiratory insufficiency in all patients with ALS. This case study introduces an ALS patient who had normal FVC results, symptoms of respiratory insufficiency, and abnormal nocturnal oximetry. After NIPPV initiation, the patient reported improved sleep and less daytime fatigue, which he associated with the start of NIPPV treatment.

  2. Raoultella ornithinolytica bacteremia in cancer patients: report of three cases.

    Science.gov (United States)

    Hadano, Yoshiro; Tsukahara, Mika; Ito, Kenta; Suzuki, Jun; Kawamura, Ichiro; Kurai, Hanako

    2012-01-01

    Raoultella ornithinolytica is a Gram-negative aerobic bacillus reclassified in the new genus from the Klebsiella species based on new genetic approaches; however, human infections caused by R. ornithinolytica are rare. We herein report three cases of R. ornithinolytica bacteremia associated with biliary tract infections in cancer patients. R. ornithinolytica can be a causative pathogen of biliary tract infection in cancer patients.

  3. Two cases of paralitic ileus in onco-hematologic patients

    Directory of Open Access Journals (Sweden)

    Francesca Carraro

    2012-01-01

    Full Text Available ileus is a severe complication resulting from a variety of disorders. It occurs most commonly in patients with serious underlying medical or surgical conditions. Prompt diagnosis and appropriate management may improve the outcome. We describe 2 cases of onco-hematologic patients who presented this complication after intensive chemotherapy.

  4. Two cases of paralitic ileus in onco-hematologic patients

    Science.gov (United States)

    Carraro, Francesca; Rivetti, Elisa; Romano, Erica; Fagioli, Franca

    2012-01-01

    Paralytic ileus is a severe complication resulting from a variety of disorders. It occurs most commonly in patients with serious underlying medical or surgical conditions. Prompt diagnosis and appropriate management may improve the outcome. We describe 2 cases of onco-hematologic patients who presented this complication after intensive chemotherapy. PMID:22690309

  5. Cacogeusia following pine nut ingestion: a six patient case series.

    Science.gov (United States)

    Hampton, Rachael L; Scully, Crispian; Gandhi, Shan; Raber-Durlacher, Judith

    2013-01-01

    This is a retrospective case series of 6 patients complaining of a bad taste (cacogeusia) specifically metallogeusia, following the ingestion of pine nuts.(1) The taste arose always within 48h of ingestion, and in all but one patient spontaneously resolved within 14 days. Pine nuts also have a potential for triggering anaphylaxis.(2).

  6. Ocular manifestations of Noonan syndrome in twin siblings: A case report of keratoconus with acute corneal hydrops

    Directory of Open Access Journals (Sweden)

    Anna Lee

    2014-01-01

    Full Text Available Ocular manifestations of Noonan syndrome (NS in a set of healthy 20-year-old African-American fraternal twins are reported with emphasis on a rare finding of keratoconus with acute corneal hydrops in one twin. Both the twins had learning disabilities and attended a special needs school. Evaluation included visual acuity assessment, tonometry and external eye, slit lamp and dilated fundus examinations, topography with Pentacam and external photographs. The first case was more remarkable as keratoconus with acute corneal hydrops was observed. The patient presented with severe cloudy vision that had worsened over a span of 1 month. It improved significantly on follow-up. The second case included a unique constellation of ocular pathology that highlights the diversity of NS manifestations even amongst twins. Conservative treatment of keratoconus with acute corneal hydrops in a NS patient helped largely resolve the patient′s condition. We report the diverse spectrum of ocular manifestations associated with this rare congenital disorder.

  7. Double orifice mitral valve: A case report

    Directory of Open Access Journals (Sweden)

    Musić Ljilja

    2016-01-01

    Full Text Available Introduction. Double orifice mitrol valve (DOMV is a very rare congenital heart defect. Case report. We reported 20-year-old male referred to our center due to evaluation of his cardiologic status. He was operated on shortly after birth for a tracheoesophageal fistula. Accidentally, echocardiography examination at the age of 4 years revealed double orifice mitral valve (DOMV without the presence of mitral regurgitation, as well as mitral stenosis, with normal dimensions of all cardiac chambers. The patient was asymptomatic, even more he was a kick boxer. His physical finding was normal. Electrocardiography showed regular sinus rhythm, incomplete right bundle branch block. Transthoracic echocardiography (TTE examination revealed the normal size of the left atrial, mitral leaflets were slightly more redundant. The left and right heart chambers, aorta, tricuspid valve and pulmonary artery valve were normal. During TTE examination on a short axis view two asymmetric mitral orifices were seen as a double mitral orifice through which we registered normal flow, without regurgitation and mitral stenosis. Transesophageal echocardiography (TEE examination from the transgastric view at the level of mitral valve, showed 2 single asymmetric mitral orifices separated by fibrous tissue, mitral leaflet with a separate insertion of hordes for each orifice. Conclusion. The presented patient with DOMV is the only one recognized in our country. The case is interesting because during 16-year a follow-up period there were no functional changes despite the fact that he performed very demanded sport activities. This is very important because there is no information in the literature about that.

  8. Connecting Hospitalized Patients with Their Families: Case Series and Commentary

    OpenAIRE

    Kourosh Parsapour; Kon, Alexander A.; Madan Dharmar; McCarthy, Amy K.; Hsuan-Hui Yang; Smith, Anthony C; Janice Carpenter; Sadorra, Candace K.; Farbstein, Aron D.; Hojman, Nayla M.; Gary L. Wold; Marcin, James P.

    2011-01-01

    The overall aim of this project was to ascertain the utilization of a custom-designed telemedicine service for patients to maintain close contact (via videoconference) with family and friends during hospitalization. We conducted a retrospective chart review of hospitalized patients (primarily children) with extended hospital length of stays. Telecommunication equipment was used to provide videoconference links from the patient's bedside to friends and family in the community. Thirty-six case...

  9. Renal transplantation in HIV patients: A series of four cases

    OpenAIRE

    2012-01-01

    Human immunodeficiency virus (HIV) infection in a patient with end-stage renal disease was considered a contraindication for renal transplantation till now despite the advent of highly active antiretroviral therapy with the apprehension that immunosuppression would further jeopardize the already compromised immune status of the patients. Renal transplantation in HIV patients is rare in developing countries including ours. Here we report a series of four cases of renal transplantation in HIV p...

  10. Submandibular sialolithiasis in pediatric patient. Case report

    Directory of Open Access Journals (Sweden)

    Cindy Campos-Villanueva

    2014-10-01

    Full Text Available Sialolithiasis is an obstructive pathology of the salivary gland character- ized by the formation of stones in the ductal system or parenchyma. Its incidence is greater in the submandibular gland in 85%, 10% to the parotid gland and 5% to the gland sublingual. Its etiology is attributed to the deposition of inorganic material around an organic nest with salivary mucin, desquamated epithelial cells and bacteria as well as to the anatomical distribution of the gland with respect to its excretor conduct. The sialolit is formed by calcium phosphate compound, small amounts of carbonates in the hydroxyapatite form, magnesium, potas- sium and ammonia. On patients with sialolithiasis symptoms hydration is essential, moist has is to be applied and massaged into the affected gland, while sialogogues intake and salivary production promoting stone passage through the conduit. Sometimes the obstruction of the saliva output may be signs and symptoms of an infectious process. Almost half of the submandibular sialoliths are located in the middle third or distal duct and are susceptible to elimination under conservative treatment or lithectomy. Sialolithiasis is an unusual condition in the pediatric patient. This article includes a review of the literature presenting the etiology, diagnosis aids and conservative or surgical treatments.

  11. Disseminated orbital actinomycetoma: A case report

    Directory of Open Access Journals (Sweden)

    Shanbhag Nita

    2010-01-01

    Full Text Available Mycetoma is a chronic granulomatous infection. Lower extremities are commonly involved. A 20-year-old male came with complaints of multiple sinuses on scalp, left eyelid swelling with a sinus and dystopia, since one year. On examination there was relative proptosis in left eye of 2 mm. Computed tomography scan showed soft tissue swelling of the pre-septal area of the left upper eyelid with orbital involvement. Magnetic resonance imaging showed increased left orbital volume and evident dystopia. Microbiology testing of the erosive scalp and lid lesions showed genus Nocardia, suggestive of actinomycetoma. This case is presented as it shows an unusual involvement of the orbit.

  12. RETINAL HAEMORRHAGE IN PLASMODIUM VIVAX PATIENTS- 2 RARE CASE REPORTS

    Directory of Open Access Journals (Sweden)

    Sangeeta

    2012-12-01

    Full Text Available ABSTRACT: Retinal haemorrhage is commonly detected during opht halmoscopic examination of patients with Plasmodium falciparum infections. Ho wever, it is observed very rarely in Plasmodium vivax infections. Only six cases of reti nal haemorrhage have been reported so far in Plasmodium vivax infections. We review the literatu re and discuss two such cases of retinal haemorrhage that presented at our hospital. It is sug gested that retinal haemorrhage be routinely ruled out in all malaria patients, and Pla smodium vivax infection be considered in patients with unexplained retinal haemorrhage and fev er.

  13. Jogging Therapy for Hikikomori Social Withdrawal and Increased Cerebral Hemodynamics: A Case Report.

    Science.gov (United States)

    Nishida, Masaki; Kikuchi, Senichiro; Fukuda, Kazuhito; Kato, Satoshi

    2016-01-01

    Severe social withdrawal, called hikikomori, has drawn increased public attention. However, an optimal clinical approach and strategy of treatment has not been well established. Here, we report a case of hikikomori for which an exercise intervention using jogging therapy was effective, showing cerebral hemodynamic improvement. The patient was a 20 year old Japanese male who was hospitalized in order to evaluate and treat severe social withdrawal. Although depressive and anxiety symptoms partially subsided with sertraline alone, social withdrawal persisted due to a lack of self confidence. With his consent, we implemented exercise therapy with 30 minutes of jogging three times a week for three months. We did not change the pharmacotherapy, and his social withdrawal remarkably improved with continuous jogging exercise. Using near infrared spectroscopy to evaluate hemodynamic alteration, bilateral temporal hemodynamics considerably increased after the three-month jogging therapy. Regarding exercise therapy for mental illness, numerous studies have reported the effectiveness of exercise therapy for major depression. This case implied, however, that the applicability of exercise therapy is not limited to major depressive disorder. Jogging therapy may contribute to reinforcing self confidence associated with "resilience" in conjunction with neurophysiological modulation of neural networks.

  14. Holoprosencephaly and cleidocranial dysplasia in a patient due to two position-effect mutations: case report and review of the literature.

    Science.gov (United States)

    Fernandez, B A; Siegel-Bartelt, J; Herbrick, J-A S; Teshima, I; Scherer, S W

    2005-10-01

    Holoprosencephaly (HPE) is a genetically heterogeneous developmental field defect in which midline cleavage of the forebrain and craniofacial structures is impaired. Based on the analysis of HPE patients with chromosome rearrangements, at least six loci for the disorder have been assigned. The sonic hedgehog gene (SHH) at 7q36 has been identified as the HPE3 locus. Cleidocranial dysplasia (CCD) is an autosomal dominant skeletal disorder characterized by clavicular, pelvic and dental anomalies. It is caused by mutations in the osteoblast-specific transcription factor CBFA1/RUNX2, which maps to 6p21. We report a 20-year-old female with premaxillary agenesis (part of the HPE spectrum), as well as skeletal abnormalities and impacted teeth reminiscent of CCD. She carries a de novo 6;7 reciprocal translocation, with breakpoints at 6p21.1 and 7q36. We have shown previously that the 7q36 breakpoint maps 15 kb telomeric to the 5' end of SHH, which explains the patient's HPE phenotype. Now, using fluorescence in situ hybridization, we have identified a P1 artificial chromosome clone 800 kb upstream of CBFA1/RUNX2 that spans the 6p breakpoint. We propose that the proband's complex phenotype is due to two position-effect (PE) mutations, one at each translocation breakpoint, which have altered the expression of the SHH and CBFA1/RUNX2 genes. The role of PE mutations in human disease is also reviewed.

  15. Chondroblastic osteosarcoma of the left zygomatic bone: Rare case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Shubhangi Khandekar

    2014-01-01

    Full Text Available Chondroblastic osteosarcoma (COS, a subgroup of intramedullary osteosarcoma (OS, is the most common osteosarcoma that occurs in adolescents and early adulthood. The COS has similar clinical and radiological features to those of conventional OS. We present a case of 20-year-old male patient with the chief complaint of pain and swelling in the left zygomatic region. The computed tomography (CT and three-dimensional (3D CT face showed erosion, calcific foci, sunray type of spicules suggestive of OS. On fine-needle aspiration cytology (FNAC examination, initial diagnosis was malignant chondroid lesion, with differential diagnosis of mesenchymal chrondrosarcoma, COS on incisional biopsy and finally COS on excisional biopsy. The patient underwent radical resection of left zygomatic arch, followed by chemotherapy. Although clinically unsuspected in this unusual site, histopathology along with immunohistochemistry (IHC results confirmed the COS. Because zygomatic location of COS is very rare, this report aimed to discuss clinical, radiographic, histopathologic, IHC findings and diagnostic pitfalls of COS in light of the literature.

  16. TMJ Ankylosis: Multidisciplinary Approach of Treatment for Dentofacial Enhancement—A Case Report

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    Pavankumar Janardan Vibhute

    2011-01-01

    Full Text Available This report describes the multidisciplinary phasewise treatment of a 20-year-old female patient having unilateral right TMJ bony (true ankylosis whose mouth opening was restricted to 2 mm and mandibular retrognathism; additionally, she was also suffering from speech problems, snoring, difficulty in breathing, and low level of self-esteem and self-confidence. Bilateral gap arthroplasty and temporalis myofascial graft interpositioning through preauricular approach were done in surgical phase followed by the aggressive jaw physiotherapy in postsurgical period. Oral prophylaxis and restorations were followed by the fixed orthodontic therapy to resolve bimaxillary protrusion. Advancement sliding genioplasty was performed to enhance the chin button. Speech therapy and psychological counseling were also performed from time to time to boost up the self-esteem and self-confidence. At the end of treatment, facial esthetics was improved considerably and patient got over the impact of disfigurement, impaired functions, and psychosocial stigma. Rationale to use the multidisciplinary team approach in treatment of such cases is discussed.

  17. A Patient With Plaque Type Morphea Mimicking Systemic Lupus Erythematosus

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    Wardhana Wardhana

    2015-04-01

    Full Text Available Morphea is an uncommon connective tissue disease with the most prominent feature being thickening or fibrosis of the dermal without internal organ involvement. It is also known as a part of localized scleroderma. Based on clinical presentation and depth of tissue involvement, morphea is classified into several forms, and about two thirds of adults with morphea have plaque type. Overproduction of collagen production by fibroblast is the cause of abnormality in morphea, and the hyperactivity mechanism of fibroblast is still unknown, although there are several mechanisms already proposed. Plaque type morphea is actually a benign and self limited. Plaque type morphea that mimicking systemic lupus erythematosus in clinical appearance, such as alopecia and oral mucosal ulcers, is uncommon. A case of plaque type morphea mimicking systemic lupus erythematosus in a 20 year old woman was discussed. The patient was treated with local and systemic immunosuppressant and antioxydant. The patient’s condition is improved without any significant side effects. Key words: morphea, plaque type.

  18. [Pelvic actinomycosis in menopausal patient, case review].

    Science.gov (United States)

    Treviño Salinas, Emilio Modesto; Martínez Palones, José María; Pérez Benavente, Ma Asunción; Xercavins Montosa, Jordi

    2003-10-01

    Pelvic actinomycosis is a granulomatous chronic illness due to anaerobic, gram-positive, branching filamentous bacteria (Actinomyces israelii), this and other species of actinomyces occur in the normal flora of the gastrointestinal and genital tract in humans. Infection is associated in women using an IUD (Intrauterine device) for long periods and it has the characteristic of simulate malignant diseases causing most of the times wrong preoperative diagnosis. We analyzed a postmenopausal patient who was treated surgically without specific diagnosis, then by anatomo-pathologic study of the specimen the result was actinomycosis. The main purpose to obtain the correct preoperative diagnosis is because we have to use antibiotics in the treatment and it may reduce the frequency of radical surgeries.

  19. Subdural hematoma cases identified through a Danish patient register

    DEFF Research Database (Denmark)

    Poulsen, Frantz Rom; Halle, Bo; Pottegård, Anton;

    2016-01-01

    PURPOSE: This study aimed to assess the usefulness of Danish patient registers for epidemiological studies of subdural hematoma (SDH) and to describe clinical characteristics of validated cases. METHODS: Using a patient register covering a geographically defined area in Denmark, we retrieved...... moderate for patients recorded under code I620 (62%). cSDH represented 57% of verified cases, and aSDH the remaining 43%. cSDH differed markedly from aSDH with regard to a number of clinical characteristics, including a much lower mortality (OR 0.2, 95%CI 0.1-0.3). However, preadmission antithrombotic drug...... hospital contacts recorded under SDH International Classification of Diseases version 10 codes S065 and I620 in 2000-2012. Neurosurgeons reviewed medical records of all potential cases. Based on brain scan results, verified cases were classified by SDH type (chronic SDH (cSDH) or acute SDH (aSDH)). Thirty...

  20. Three distinct cases of copper deficiency in hospitalized pediatric patients.

    Science.gov (United States)

    Dembinski, Karolina; Gargasz, Anne Elizabeth; Dabrow, Sharon; Rodriguez, Lisa

    2012-08-01

    Although copper deficiency is a rare occurrence in the developed world, attention should be given to the proper supplementation of minerals to at-risk pediatric patients. This study presents 3 distinct cases of copper deficiency in hospitalized patients aged 14 months, 6 years, and 12 years. Two patients had short bowel syndrome, requiring prolonged parenteral nutrition or complex intravenous fluid supplementation. The third patient was severely malnourished. Copper deficiency manifested in all of our patients as either microcytic anemia or pancytopenia with myelodysplastic syndrome. Copper deficiency is an important diagnosis to be considered in patients with prematurity, parenteral nutrition dependency, malabsorption, and/or those with malnutrition. More studies are needed to establish appropriate amounts of copper supplementation to replenish copper stores in deficient patients.

  1. General Characteristics of HIV/AIDS Patients in Ditan Hospital

    Institute of Scientific and Technical Information of China (English)

    刘彦春; 徐克沂; 张福杰; 赵红心; 李兴旺; 李秀兰; 闫会文

    2004-01-01

    Objective: To elucidate general characteristics of HIV/AIDS patients seeking care at Ditan Hospital in an attempt to guide early diagnosis in routine medical care. Materials and methods: A retrospective analysis of 185 HIV/AIDS cases from January 1990 to June 2002 was completed using SPSS statistical analysis. Results: Male to female ratio was 1.8:1. Subjects ranged in age from 1 year old to 64 years old. 16 cases were younger than 20 years old with the median age among the younger subset at 7.7 years. 169 cases were older than 20 years old with a median age of 36 years old. 29% of the subjects were peasants. The remaining 71%, were of other unspecifiedoccupations. 90.8% of individuals were of Han descent while 3.7% of individuals were of a minority heritage. 50.3% of subjects were married; 23.8% have never married; 8.1% were divorced; and the remaining 17.8% were of unknown marital status. Of those represented in this study, 36.8% came from the Henan province; 17.8% were from Beijing; 8.6% were from Shanxi; 31.4% from the other 20 provinces of China; and 5.4% from outside of China. Mode of transmission: 40.0% (74/185) contracted HIV through unprotected sexual contact; 29.2% (54/185) through receiving blood or plasma transfusions; 21.1%(39/185) through donating plasma; 7 cases were intravenous drug users; 7 cases were vertically transmitted. Mode of transmission was unknown in 4 cases. Clinical categories: An included 45 cases; B included 85 cases: C consisted of 76 cases. 12 cases were deceased. Initial presentation: 39 cases presented with_fever ,cough and diarrhea. 37 cases had fever and cough only-38 cases presented with chronic diarrhea. 16 cases were discovered incidentally at time of operation. 8 cases presented with fungal infection of the oral cavity or in esophagus. The common HIV associated symptoms and opportunistic infections were: weight loss and diarrhea, respiratory diseases, dermatologic diseases, anemia, neutropenia. Diseases of other organ

  2. Phenotypic contrasts of Duchenne Muscular Dystrophy in women: Two case reports

    Directory of Open Access Journals (Sweden)

    Karen T. Nozoe

    2016-07-01

    Full Text Available We discussed two cases of symptomatic female carriers to Duchenne Muscular Dystrophy. The first case is a 20 year-old girl with classical phenotypic manifestation of the disease, similar to the condition in boys. The case 2 is a 62 year-old woman with progressive muscular weakness. The disease is much less common in woman than men so both cases described here are considered rare forms of the disease, with several clinical implications. In both cases, a progressive muscle weakness, impairment in walking and sleeping was observed, in addition to obstructive sleep apnea syndrome and alveolar hypoventilation, that required noninvasive ventilatory support.

  3. Coexistence of primary sclerosing cholangitis in a patient with myasthenia gravis

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    P J Lorenzoni

    2011-01-01

    Full Text Available Myasthenia gravis (MG is an immune-mediated disease that compromises the postsynaptic membrane of the neuromuscular junction. Primary sclerosing cholangitis (PSC is considered an immune-mediated cholestatic liver disease. Both MG and PSC include an autoimmune pathogenesis, so there is some evidence that patients with MG or PSC have a higher risk of developing autoantibodies and other immune disorders than normal controls, but the coexistence of these two disorders has never been documented. We report a 40-year-old woman who presented with MG when she was 20 years old and developed PSC 20 years after a thymectomy. Liver biochemistry revealed cholestasis. Magnetic resonance imaging showed multifocal strictures and beads involving the intrahepatic bile ducts. A liver biopsy confirmed sclerosing cholangitis. Serological analysis demonstrated positive autoantibodies (Anti-nuclear antibodies, anti-smooth muscle antibodies. Repetitive stimulation had a decremental response, and antibodies to acetylcholine receptors were detectable. To our knowledge, this is the first case of PSC in a patient with MG. The main characteristics of both MG and PSC combination are discussed.

  4. The Effect of Recombinant Granulocyte Colony-Stimulating Factor on Oral and Periodontal Manifestations in a Patient with Cyclic Neutropenia: A Case Report

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    Sergio Matarasso

    2009-01-01

    Full Text Available Cyclic Neutropenia (CN is characterized by recurrent infections, fever, oral ulcerations, and severe periodontitis as result of the reduced host defences. The previous studies have established the effectiveness of recombinant granulocyte colony-stimulating factor (GCSF to increase the number and the function of neutrophils in the peripheral blood in this disease. In a 20-year-old Caucasian female with a diagnosis of cyclic neutropenia, oral clinical examination revealed multiple painful ulcerations of the oral mucosa, poor oral hygiene conditions, marginal gingivitis, and moderate periodontitis. The patient received a treatment with G-CSF (Pegfilgrastim, 6 mg/month in order to improve her immunological status. Once a month nonsurgical periodontal treatment was carefully performed when absolute neutrophil count (ANC was ≥500/L. The treatment with G-CSF resulted in a rapid increase of circulating neutrophils that, despite its short duration, leaded to a reduction in infection related events and the resolution of the multiple oral ulcerations. The disappearance of oral pain allowed an efficacy nonsurgical treatment and a normal tooth brushing that determined a reduction of probing depth (PD≤4 mm and an improvement of the oral hygiene conditions recorded at 6-month follow-up.

  5. Connecting hospitalized patients with their families: case series and commentary.

    Science.gov (United States)

    Parsapour, Kourosh; Kon, Alexander A; Dharmar, Madan; McCarthy, Amy K; Yang, Hsuan-Hui; Smith, Anthony C; Carpenter, Janice; Sadorra, Candace K; Farbstein, Aron D; Hojman, Nayla M; Wold, Gary L; Marcin, James P

    2011-01-01

    The overall aim of this project was to ascertain the utilization of a custom-designed telemedicine service for patients to maintain close contact (via videoconference) with family and friends during hospitalization. We conducted a retrospective chart review of hospitalized patients (primarily children) with extended hospital length of stays. Telecommunication equipment was used to provide videoconference links from the patient's bedside to friends and family in the community. Thirty-six cases were managed during a five-year period (2006 to 2010). The most common reasons for using Family-Link were related to the logistical challenges of traveling to and from the hospital-principally due to distance, time, family commitments, and/or personal cost. We conclude that videoconferencing provides a solution to some barriers that may limit family presence and participation in care for hospitalized patients, and as a patient-centered innovation is likely to enhance patient and family satisfaction.

  6. Connecting Hospitalized Patients with Their Families: Case Series and Commentary

    Directory of Open Access Journals (Sweden)

    Kourosh Parsapour

    2011-01-01

    Full Text Available The overall aim of this project was to ascertain the utilization of a custom-designed telemedicine service for patients to maintain close contact (via videoconference with family and friends during hospitalization. We conducted a retrospective chart review of hospitalized patients (primarily children with extended hospital length of stays. Telecommunication equipment was used to provide videoconference links from the patient's bedside to friends and family in the community. Thirty-six cases were managed during a five-year period (2006 to 2010. The most common reasons for using Family-Link were related to the logistical challenges of traveling to and from the hospital—principally due to distance, time, family commitments, and/or personal cost. We conclude that videoconferencing provides a solution to some barriers that may limit family presence and participation in care for hospitalized patients, and as a patient-centered innovation is likely to enhance patient and family satisfaction.

  7. A case of hyperprolactinemia in patient with metastatic breast cancer: clinical case presentation

    Directory of Open Access Journals (Sweden)

    L. K. Dzeranova

    2012-01-01

    Full Text Available The described clinical case illustrates the importance of careful medical care and follow-up for oncology patients which can prevent high degree of tumor dissemination in case of the disease progression and improve survival rate and quality of life.

  8. Acquired Lymphangioma Circumscriptum Caused Macroglossia: A Case Report

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    Mahmut Sami Metin

    2015-03-01

    Full Text Available Lymphangioma circumscriptum (LC is a hamartomatous vascular malformation of lymphatic channels. The etiology is not fully understood. It is usually congenital. Lesions are characterized as thin-walled and grouped vesicles. Lesions are usually seen on proximal extremities, shoulder, axilla, abdomen and neck. They are rarely seen on genital and oral mucosa. Our case was 20 years old male suffering from growing, pain and burning of tongue for 2 months durations. There was a plaque consisted of grouped vesicles on tongue in dermatological examination. Biopsy was obtained. LC was diagnosed. We decided to report this case since acquired LC on tongue and macroglossi is very rare in literature.

  9. Sexual Functions in Obsessive Compulsive Disorder Patients: A Case Report

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    Nergis LAPSEKİLİ

    2012-11-01

    Full Text Available Introduction: Obsessive-compulsive disorder (OCD, even if the patient’s obsession content is not related to sexuality, may be a problem in the sexual lives of individuals. In this article, sexual function in obsessive compulsive disorder patients is discussed based on an OCD case. Case: Male 36 years old and female 32 years old couple. Man had complaints of lack of control of ejaculation and woman had complaints of lack of orgasm. Man was diagnosed with premature ejaculation and woman was diagnosed with aversion and anorgasmia according to DSM-IV (Diagnostic and Statistical Manual Of Mental Disorders criteria. During therapy, the female patient was diagnosed with OCD as well. Loss of control was not acceptable to the patient. Thus she was avoiding from exhilarating stimuli. After cognitive restructuring of her evaluations about control, sex therapy was continued. At the end of the therapy the avoidance of the patient disappeared and anorgasmia was treated and ejeculation time of the male patient was 15 minutes. Conclusion: Sexual dysfunction is a common problem in patients with OCD. Patient may have avoidance that may adversely affect her sexuality. If a patient has avoidance about sexuality, the reason of this avoidance may or may not be the usual and expected thought content like avoidance of contamination. The evaluations of OCD patients about control may also adversely affect their sexuallity. The thought leading to avoidance behavior, may vary from patient to patient. However, to identify these thoughts with cognitive interventions and work with them will improve.the patient.

  10. Leukopenia in a patient on haloperidol decanoate: a case report

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    Samreen Ahmed

    2015-12-01

    Full Text Available We are reporting a case of leukopenia developed in a patient on haloperidol decanoate injections. A literature review revealed it as an uncommon side effect of antipsychotics; however, regular monitoring of blood cell count is crucial in patients on antipsychotics. In this case report, we discussed the effective doses, side effects, and drug interactions of haloperidol decanoate. Neuroleptic malignant syndrome is a rare but serious side effect of haloperidol. [Int J Basic Clin Pharmacol 2015; 4(6.000: 1290-1291

  11. Myocardial revascularization in patient with situs inversus totalis: case report

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    Soncini da Rosa George Ronald

    2002-01-01

    Full Text Available This is a report of an unusual case of a patient, with dextrocardia and a "situs inversus totalis". She presented angina pectoris during an ECG stress test. The coronary arteriography revealed severe obstruction in the main left coronary artery. The patient underwent coronary artery bypass grafting surgery. We did not find a similar case in the national medical literature. The myocardial revascularization performed utilizing the right mammary artery for anterior descending artery and saphenous vein grafts for first diagonal branch and first marginal branch.

  12. Death caused by heat stroke: Case report

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    Savić Slobodan

    2014-01-01

    Full Text Available Introduction. Heat stroke is the most dangerous among numerous disorders caused by elevated environmental temperature. It is characterized by an increased body temperature of over 40°C, the dysfunction of the central nervous system and the development of multiple organ failure. The aim of this paper was to highlight problems in the clinical and post-mortal diagnosis of fatal heat stroke. Case Outline. A 20-year-old male was found unconscious on the street; on admission at the Emergency Center, Clinical Center of Serbia, Belgrade, he was in a coma. The body temperature of 40°C was maintained despite the applied therapy, meningeal signs were negative, tachycardia with gallop rhythm, hypotension, bleeding from the nose and mouth, and presence of skin bruises. Laboratory findings: highly elevated LDH and creatine kinase, elevated serum creatinine, AST, and signs of DIC. Lethal outcome occurred 6 hours after admission, and the case remained clinically unsolved. Autopsy showed signs of hemorrhagic diathesis, brain and pulmonary edema, and microscopic examination revealed general congestion, internal bleeding in various organs, cerebral edema, massive blood aspiration and pulmonary edema. Toxicological and bacteriological examinations were negative. Based on these findings and subsequently obtained data on the conditions at the workplace where the young man had a part-time job, it was concluded that the violent death was caused by heat stroke. Conclusion. Since heat stroke is associated with a high mortality rate and high incidence of serious and permanent organ damage in survivors, it is important to make the diagnosis of heat stroke as quickly as possible and apply appropriate treatment. Misdiagnosis of heat stroke, and consequently inadequate treatment, with a potential fatal outcome for the patient, can be the reason for blaming doctors for the legal offense of medical malpractice in failing to administer first aid.

  13. Emphysematous liver abscess in diabetic patient: two cases report

    Energy Technology Data Exchange (ETDEWEB)

    Rhim, Hyun Chul; Koo, Ja Hong; Kim, Sung Tae; Kim, Yong Soo; Koh, Byung Hee; Cho, On Koo [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1995-07-15

    There has not been any report on massive air-containing liver abscess in diabetic patients, although emphysematous cholecystitis or pyelonephritis is a well-known complication in them. Authors report two cases of emphysematous liver abscess in diabetic patient, which showed typical findings of massive air-containing hepatic abscess on ultrasonography and computed tomography, but very poor prognosis in spite of immediate and successful percutaneous drainage procedure.

  14. First documented case of successful kidney transplantation from a donor with acute renal failure treated with dialysis.

    Science.gov (United States)

    Bacak-Kocman, Iva; Peric, Mladen; Kastelan, Zeljko; Kes, Petar; Mesar, Ines; Basic-Jukic, Nikolina

    2013-10-01

    There is a widening gap between the needs and possibilities of kidney transplantation. In order to solve the problem of organ shortage, the selection criteria for kidney donors have been less stringent over the last years. Favorable outcome of renal transplantation from deceased donors with acute renal failure requiring dialysis may have an important role in expanding the pool of donors. We present the case of two renal transplantations from a polytraumatized 20-years old donor with acute renal failure requiring dialysis. One recipient established good diuresis from the first post-transplant day and did not require hemodialysis. The second recipient had delayed graft function and was treated with 8 hemodialysis sessions. The patient was discharged with good diuresis and normal serum creatinine. After two years of follow-up, both recipients have normal graft function. According to our experience, kidneys from deceased young donors with acute renal failure requiring dialysis may be transplanted, in order to decrease the number of patients on transplantation waiting lists.

  15. Case report - Bilateral renal aspergillosis in a patient with AIDS : A case report and review of reported cases

    NARCIS (Netherlands)

    Oosten, A.W.; Sprenger, H.G.; Van Leeuwen, J.T.M.; Meessen, N.E.L.; Van Assen, S.

    2008-01-01

    Renal aspergillosis is an extremely uncommon complication in HIV-infected patients. In general, prognosis is poor and the need for nephrectomy is emphasized. We report the case of a 37-year-old patient with AIDS since April 2003 (CD4 count 10 cells/mm(3), a high viral load, Candida esophagitis, bila

  16. Angina in a diabetic patient: a case of integrated approach

    Directory of Open Access Journals (Sweden)

    Eugenio Roberto Cosentino

    2008-09-01

    Full Text Available Diabetes mellitus, both of type 1 and 2, is an important risk factor for the development of atherosclerosis: in diabetic patients vascular atherosclerotic complications are responsible of approximately 80% of all the deaths. There is no doubt that patients affections originating from diabetes and coronaropathy remain at high risk. For this reason it is essential to adopt an aggressive strategy of secondary prevention. We report a case of a patient with multiple risk factors for cardiovascular diseases: the successful management was due to an integrated approach that involved the general practitioner and cardiologist.

  17. A Case Report of Paralytic Patient Associated with Diabetes Mellitus

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    Byoung-woo Kim

    2009-09-01

    Full Text Available Objectives : This report aimed to study of paralytic patient associated with Diabetes Mellitus. Methods : Diabetes Mellitus has one of the highest death rate, because of it induces various complications. Especially paralytic patients who associated with diabetes mellitus are slow in recovery and easy to induce many complications. So control of the diabetes mellitus is the most important thing to treatment. We observed and treated with Cheunhwasangamibang and acupunture. Results : The paralytic patient with Diabetes Mellitus was treatment with Cheunhwasangamibang and improvement was seen. Conclusions : Results in this case support a role for Cheunhwasangamibang in controlling Diabetes Mellitus

  18. A case of phrynoderma in a patient with Crohn's disease.

    Science.gov (United States)

    Cobos, Gabriela; Cornejo, Christine; McMahon, Patrick

    2015-01-01

    Phrynoderma is a type of follicular hyperkeratosis associated with nutritional deficiencies. It is rarely seen in developed countries, although cases have been reported in patients with severe malnutrition or malabsorption secondary to various causes. This report describes a 19-year-old patient with poorly controlled Crohn's disease and malnutrition who developed the characteristic hyperkeratotic papules and plaques on his trunk and extremities in the setting of low serum vitamin A levels. To our knowledge, there are no reports of phrynoderma associated with Crohn's disease. It is likely that our patient's low vitamin A level and subsequent phrynoderma was the result of increased Crohn's disease activity and malnutrition.

  19. Case report: intra-tendinous ganglion of the anterior cruciate ligament in a young footballer

    Directory of Open Access Journals (Sweden)

    Watson Thomas P

    2006-11-01

    Full Text Available Abstract A 20-year-old male medical student and keen rugby player presented with a 12-month history of progressively worsening right knee pain and stiffness with no history of trauma. Clinical examination revealed effusion and posterior knee pain exacerbated by end range movement and an extension lag of 15 degrees. Physiotherapy to improve the range of motion proved unsuccessful. Magnetic resonance imaging showed that the ACL was grossly thickened and displaced by material reported as mucoid in nature. There were also areas of focally high signal in relation to its tibial attachment and intra osseous small cysts. Arthroscopic examination revealed a ganglion related to the tibial attachment of the ACL and gross thickening and discoloration of the ACL. Biopsies were taken showing foci of mucoid degeneration in the ACL. A large intra-ACL mass of brownish coloured tissue was excised arthroscopically. Already at 2 weeks follow up the patient had greatly improved range of movement and was pain free. However, upon returning to rugby, joint instability was noticed and a tear of the ACL was confirmed. This rare clinical condition can be diagnosed with MRI and arthroscopic debridement effectively relieves symptoms. This case report illustrates that augmentation or reconstruction may end up being the definitive treatment for athletes. It may also offer some support to the argument that mucoid degeneration and ganglion cyst formation share a similar pathogenesis to intra-osseous cyst formation.

  20. Dislocation of the fibular head in an unusual sports injury: a case report

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    Ahmad Riaz

    2008-05-01

    Full Text Available Abstract Introduction One of the primary functions of the proximal tibiofibular joint is slight rotation to accommodate rotational stress at the ankle. Proximal tibiofibular joint dislocation is a rare injury and accounts for less than 1% of all knee injuries. This dislocation has been reported in patients who had been engaged in football, ballet dancing, equestrian jumping, parachuting and snowboarding. Case presentation A 20-year-old man was injured whilst playing football. He felt a pop in the right knee and was subsequently unable to bear weight on it. The range of movement in his knee joint was limited. Anterior-posterior and lateral X-rays of the knee revealed anterolateral dislocation of the proximal tibiofibular joint. Comparison views confirmed the anterolateral dislocation. He had a failed manipulation under anaesthesia and the joint needed an open reduction in which the fibular head was levered back into place. Operative findings revealed a horizontal type of joint. Conclusion An exceedingly rare dislocation of a horizontal type of proximal tibiofibular joint was presented following a football injury. This dislocation was irreducible by a closed method.

  1. Bickerstaff’s brainstem encephalitis, Miller Fisher syndrome and Guillain-Barré syndrome overlap in an asthma patient with negative anti-ganglioside antibodies

    Directory of Open Access Journals (Sweden)

    Han Chongyu

    2012-06-01

    Full Text Available Abstract Background Bickerstaff’s brainstem encephalitis (BBE, together with Miller Fisher syndrome (MFS and Guillain-Barré syndrome (GBS were considered to form a continuous clinical spectrum. An anti-GQ1b antibody syndrome has been proposed to underlie the common pathophysiology for the three disorders; however, other studies have found a positive anti-GM1 instead of anti-GQ1b antibody. Case presentation Here we report a 20-year-old male patient with overlapping BBE, MFS and GBS. The patient had a positive family history of bronchial asthma and had suffered from the condition for over 15 years. He developed BBE symptoms nine days after an asthma exacerbation. During the course of illness, he had significantly elevated IgE levels in both serum and cerebrospinal fluid. Serologic analysis of antibodies against ganglioside complexes (anti-GDIa, anti-GDIb, anti-GM1, anti-GM2, anti-GM3, anti-GQIb and anti-GTIb antibodies showed negative results. Conclusions Since asthma has recently been related to autoimmune disease, our case supports an autoimmune mechanism underlying the clinical spectrum composed of BBE, MFS and GBS. However, contrary to a proposed anti-GQ1b antibody syndrome, we would suggest that pathogenesis of this clinical spectrum is not limited to anti-ganglioside antibodies.

  2. [Visceral leishmaniasis and pregnancy in renal transplanted patient: case report].

    Science.gov (United States)

    Silva, Jaqueline de Almeida; Araújo, Ivan de Melo; Pavanetti, Luiz Carlos; Okamoto, Liene Shigaki; Dias, Mônica

    2015-01-01

    Visceral leishmaniasis (VL) is a severe and potentially fatal disease caused by different Leishmania species, Leishmania chagasi prevailing in Brazil. Main symptoms include fever, malaise, anorexia, weight loss and abdominal enlargement with typically occurring hepatosplenomegaly Currently, VL is considered an opportunistic infection in immunocompromised hosts, including solid organ transplanted patients. The present study reports a case of VL associated to pregnancy after renal transplantation.

  3. Hospital‑based case management for migrant patients

    DEFF Research Database (Denmark)

    Ølholm, Anne Mette; Christensen, Janne B; Kamionka, Stine Lundstrøm

    2016-01-01

    to patients with a refugee or immigrant background. Provision of specialized services for migrant patients, including case management with multidisciplinary physical, cognitive and social interventions, has been suggested as a way to tackle inequalities in response to a growing recognition of the complexity...... of both their health needs and the skills needed to meet these. However, categorical care is generally considered to be stigmatizing and to decrease care quality. The evidence base for both arguments is unclear. The aim of this review was therefore to investigate the effectiveness of specialized hospital...... - b ased case management for ethnic minority patients. Methods: This review used a health technology assessment model, including a systematic search of literature in the PubMed, Embase, the Cochrane Library, Sociological Abstracts, the Cumulative Index to Nursing and Allied Health Literature databases...

  4. A Case Report for a Complex Denture Case on a Special Care Patient with Osteogenesis Imperfecta.

    Science.gov (United States)

    Sawyer, Colin; Drysdale, David

    2015-05-01

    This case report presents a patient with Dentogenesis Imperfecta (DI) associated with Osteogenesis Imperfecta (OI) and its subsequent dental manifestations. The patient in this report (see Figure 1) has spent his life living with his disability type III OI (also known as brittle bone disease) and its degenerative affects. The patient is independent and enjoys his social life but felt his existing dentures were having an adverse effect on the quality of his life. The patient attended Dorset County Hospitals Special Care Dentistry and on clinical examination it was noted the patient was partially dentate with a class III malocclusion and brownish discoloration of the remaining teeth caused by enamel hypoplasia. Treatment for this patient would entail making a maxillary complete denture and a mandibular partial chrome denture, normally quite simple tasks but due to the DI and its dental manifestations, the treatment would be complicated. This case demonstrates how a complex case treated by a collaborative dental team using their different skills and knowledge can lead to a successful and rewarding treatment for both patient and team.

  5. Tumor rabdoide/teratoide atípico del sistema nervioso central: Presentación de un caso Atypical teratoid/rhabdoid tumor of the central nervous system: Case report

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    José Martín Bernal

    2012-12-01

    Full Text Available Reportamos un caso de tumor rabdoide/teratoide atípico del sistema nervioso central (SNC en un paciente de sexo masculino, de 20 años de edad, que se encontraba en tratamiento médico desde hacía seis años por diagnóstico de epilepsia. Concurrió a nuestro hospital para realizarse una resonancia magnética (RM, en la cual se visualizó una lesión lobulada de 10 cm de diámetro máximo en la línea media de la región frontal. Los tumores rabdoides/teratoides atípicos del sistema nervioso central son infrecuentes y sólo unos pocos casos fueron reportados en pacientes adultos.We report a case of atypical teratoid/ rhabdoid tumor of the central nervous system in a 20 year-old male, who was under treatment for epilepsy since six years ago. The patient presented at our hospital for magnetic resonance imaging (MRI, which demonstrated a midline lobulated frontal lesion with a maximum diameter of 10 cm. Atypical teratoid/rhabdoid tumors of the central nervous system are infrequent and only a few cases have been reported in adult patients.

  6. [Nursing care in patients undergoing radiological surgery. A case report].

    Science.gov (United States)

    Armero-Barranco, David; Ruiz-Mateos, María; Alcaraz-Baños, Miguel; Bernal-Páez, Fernando Luis

    2007-01-01

    We report the case of a 73-year-old man with medical diagnoses of long-standing diabetes mellitus, chronic ischemia of the lower limbs and intermittent claudication, for which the patient had been treated with minimally invasive radiological surgery. On arrival at the radiology unit, the patient had nursing diagnoses of anxiety and fear. Intraoperatively, the client had nursing diagnoses of pain, urine retention and infection risk. At discharge, a collaboration problem was detected and hemorrhagic risk. The patient received individualized nursing care. Interventions were planned following the nursing intervention classification (NIC) and the expected results for these interventions followed the Nursing Outcomes Classification (NOC) taxonomy. The application of an appropriate nursing care plan contributes to making the patient's hospital stay easier, more comfortable and less traumatic.

  7. Benign monomelic amyotrophy with proximal upper limb involvement: case report.

    Science.gov (United States)

    Neves, Marco Antonio Orsini; Freitas, Marcos R G de; Mello, Mariana Pimentel de; Dumard, Carlos Henrique; Freitas, Gabriel R de; Nascimento, Osvaldo J M

    2007-06-01

    Monomelic amyotrophy (MA) is a rare condition in which neurogenic amyotrophy is restricted to an upper or lower limb. Usually sporadic, it usually has an insidious onset with a mean evolution of 2 to 4 years following first clinical manifestations, which is, in turned, followed by stabilization. We report a case of 20-years-old man who presented slowly progressive amyotrophy associated with proximal paresis of the right upper limb, which was followed by clinical stabilization 4 years later. Eletroneuromyography revealed denervation along with myofasciculations in various muscle groups of the right upper limb. We call attention to this rare location of MA, as well as describe some theories concerning its pathophysiology .

  8. Myofascial trigger points in cluster headache patients: a case series

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    Rico-Villademoros Fernando

    2008-12-01

    Full Text Available Abstract Active myofascial trigger points (MTrPs have been found to contribute to chronic tension-type headache and migraine. The purpose of this case series was to examine if active trigger points (TrPs provoking cluster-type referred pain could be found in cluster headache patients and, if so, to evaluate the effectiveness of active TrPs anaesthetic injections both in the acute and preventive headache's treatment. Twelve patients, 4 experiencing episodic and 8 chronic cluster headache, were studied. TrPs were found in all of them. Abortive infiltrations could be done in 2 episodic and 4 chronic patients, and preemptive infiltrations could be done in 2 episodic and 5 chronic patients, both kind of interventions being successful in 5 (83.3% and in 6 (85.7% of the cases respectively. When combined with prophylactic drug therapy, injections were associated with significant improvement in 7 of the 8 chronic cluster patients. Our data suggest that peripheral sensitization may play a role in cluster headache pathophysiology and that first neuron afferent blockade can be useful in cluster headache management.

  9. Atrial dissociation in a middle aged patient: a case report.

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    Shokoufeh Hajsadeghi

    2014-08-01

    Full Text Available Atrial dissociation is characterized by different types of P waves captured in an electrocardiogram, usually seen in critically ill or post-cardiac transplantation patients. Our case demonstrates a 55-year-old man, presenting with chest pain (unstable angina in the emergency department with transient double-P waves; representing the phenomenon. Our case did not have any of the suggested causes or any known cardiac problems; therefore, with ruling out other differential diagnosis, researches must be done to find another explanation, if repeated.

  10. [Monogenic form of diabetes mellitus due to HNF4α mutation (MODY-1) - the first case in Hungary].

    Science.gov (United States)

    Jermendy, György; Balogh, István; Gaál, Zsolt

    2016-03-20

    The classification of diabetes mellitus in adolescents and young adults is often difficult. The diagnosis of the monogenic form of diabetes may have substantial influence on quality of life, prognosis and the choice of the appropriate treatment of affected patients. Among MODY (maturity-onset of diabetes in the young) MODY-1 is rarely detected, only 13 families were described in 2000, and 103 different mutations in 173 families were known in 2013 worldwide. The authors present the first Hungarian case of a monogenic form of diabetes due to HNF4α mutation (MODY-1). The diabetes of the index patient No. 1 (42-year-old woman with insulin treated diabetes) was diagnosed as gestational diabetes at age of 20 when she was treated with diet only. Later, insulin treatment has been initiated when marked hyperglycaemia was detected during an episode of acute pneumonia at age of 26. The diabetes of the index patient No. 2 (20-year-old daughter of the index patient No. 1, treated also with insulin) was diagnosed as type 2 diabetes at age of 13 and the patient was treated with diet only. Later the classification was modified to type 1 and insulin therapy was initiated at age of 14. The manifestation of diabetes, the familial occurrence and the low dose insulin requirement were suggestive for monogenic diabetes. Using molecular genetic method a mutation (c.869G>A, p.R290H) of HNF4α gene was found and MODY-1 was diagnosed in both cases. Insulin therapy was switched to treatment with low dose sulfanylurea and an excellent glycaemic control was achieved and sustained at follow-up of 1-year. No further positive cases were found during screening of other family members.

  11. The patient suicide attempt – An ethical dilemma case study

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    Lin Jie

    2015-12-01

    Results: In Mr Green's case, the nurse chose to share the information of Mr Green's suicide attempt with other health care professionals. The nursing team followed the self-harm and suicide protocol of the hospital strictly, they maintained the effective communication with Mr Green, identified the factors which cause patient's suicide attempt, provided the appropriate nursing intervention to deal will these risk factors and collaborated with other health care professionals to prefect the further care. The patient transferred to a palliative care service with no sign of suicide attempt and other self-harm behaviors and passed away peacefully 76 days after discharged with his relatives and pastors accompany.

  12. An Unusual Case: Salmonella UTI and Orchitis in HIV Patient

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    Sabrina Arshed

    2015-01-01

    Full Text Available Salmonellosis is a major cause of gastroenteritis in the United States; however, nontyphoidal strains of Salmonella have also been known to cause urinary tract infections, usually transmitted via the fecal-urethral route. This can lead to critical illness in those patients with immune deficiencies, especially HIV, cancer patients, and those with diabetes mellitus. However, the spread of the infection from the urinary tract to involve the testicles and epididymis is very rare. Here, we present the first documented case of an immune-compromised young male with a urinary tract infection with orchitoepididymitis.

  13. Calciphylaxis - A case study in a patient with Maori heritage.

    Science.gov (United States)

    Kingi, Lawrence; Grech, Roger; Lam, Michael; Dissanayake, Ajith; Otter, Simon

    2016-11-01

    This case history describes a rare complaint - Calciphylaxis, seen in a New Zealand Maori patient undergoing renal dialysis. This condition causes non-healing tissue ulceration, typically with sepsis and is associated with a very high mortality rate. The need for vigilance among health professionals is highlighted, including the risk factors that may faciliate an early diagnosis; together with the value associated with a multi-disciplinary team approach to management.

  14. Cognitive rehabilitation in neuro-oncological patients: three case reports

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    Chiara Zucchella

    2012-06-01

    Full Text Available Cognitive impairment is one of the most common neurological disorders in neuro-oncological patients, linked with morbidity, disability, and poor quality of life. As pharmacologic interventions have not yet proven effective in the treatment of cognitive deficits, cognitive rehabilitation could represent an alternative approach. This paper presents three case studies, describing the cognitive intervention and discussing its effectiveness in the light of current evidence.

  15. Anesthetic management of a patient with multiple sclerosis - case report

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    Eduardo Barbin Zuccolotto

    Full Text Available Abstract Background and objectives: Multiple sclerosis is a demyelinating disease of the brain and spinal cord, characterized by muscle weakness, cognitive dysfunction, memory loss, and personality disorders. Factors that promote disease exacerbation are stress, physical trauma, infection, surgery, and hyperthermia. The objective is to describe the anesthetic management of a case referred to urological surgery. Case report: A female patient, 44 years of age, with multiple sclerosis, diagnosed with nephrolithiasis, referred for endoscopic ureterolythotripsy. Balanced general anesthesia was chosen, with midazolam, propofol and remifentanil target-controlled infusion; sevoflurane via laryngeal mask airway; and spontaneous ventilation. Because the patient had respiratory difficulty presenting with chest wall rigidity, it was decided to discontinue the infusion of remifentanil. There was no other complication or exacerbation of disease postoperatively. Conclusion: The use of neuromuscular blockers (depolarizing and non-depolarizing is a problem in these patients. As there was no need for muscle relaxation in this case, muscle relaxants were omitted. We conclude that the combination of propofol and sevoflurane was satisfactory, not resulting in hemodynamic instability or disease exacerbation.

  16. GRAVES’ OPHTHALMOPATHY IN A EUTHYROID PATIENT - A RARE CASE REPORT

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    Phani Kumar

    2014-06-01

    Full Text Available Purpose: To present a case of Graves’ Ophthalmopathy, with normal thyroid profile and negative Thyrotropin receptor antibody (TRAb with elevated thyroid stimulating antibody (TSAb level in an elderly individual. METHODS: A 60years-old man presented with a complaint of prominence of both eyes for 5months and swelling and pain for last 15days, was examined with thyroid function test, Thyrotropin receptor antibody (TRAb and thyroid stimulating antibody (TSAb along with computed tomography (CT brain and orbit. He was started on IV methyl Prednisolone 1gm/day for 3 days/week and tapered off. RESULTS: The patient was with normal thyroid profile, negative Thyrotropin receptor antibody (TRAb with elevated thyroid stimulating antibody (TSAb level. CECT orbit revealed fusiform swelling of recti muscles with sparing of tendinous insertion in both eyes suggestive of bilateral Grave’s ophthalmopathy. CONCLUSION: In this case study, we reported a case of Graves’ Ophthalmopathy with normal thyroid profile and negative TRAb. The only laboratory basis for diagnosing this patient as having Graves’ disease was his elevated TSAb level. The patient had remarkable improvement in his eye symptoms following steroid therapy.

  17. Cutaneous manifestations in renal failure patients: A case series

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    Banerjee S

    2007-01-01

    Full Text Available Cutaneous involvement in renal disease is due to a host of factors ranging from metabolic disturbances to immunosuppressive drugs. Herein we report a series of six cases of renal failure with varied cutaneous manifestations ranging from infections to neoplasms due to prolonged immunosuppression. Our first case had cutaneous cryptococcosis where skin lesions gave a clue to the diagnosis of altered sensorium and underlying meningitis. The second case initially presented with florid warts and was treated successfully but later presented with an explosive recurrence of skin lesions due to malignant transformation. Our third case had basal cell carcinoma over the presternal region that was successfully treated with liquid nitrogen cryotherapy. Our fourth case had diabetic nephropathy that presented with septicemia and purpura fulminans. The last case had cutaneous manifestations of drug therapy because of heparin infusion. To conclude, cutaneous manifestations in patients with renal failure are varied and a high degree of suspicion is needed for early diagnosis and aggressive treatment to effectively combat mortality and morbidity.

  18. Patients with Acromegaly Presenting with Colon Cancer: A Case Series

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    Murray B. Gordon

    2016-01-01

    Full Text Available Introduction. Frequent colonoscopy screenings are critical for early diagnosis of colon cancer in patients with acromegaly. Case Presentations. We performed a retrospective analysis of the incidental diagnoses of colon cancer from the ACCESS trial (ClinicalTrials.gov identifier: NCT01995734. Colon cancer was identified in 2 patients (4.5%. Case  1 patient was a 36-year-old male with acromegaly who underwent transsphenoidal surgery to remove the pituitary adenoma. After surgery, the patient underwent routine colonoscopy screening, which revealed a 40 mm tubular adenoma in the descending colon. A T1N1a carcinoma was surgically removed, and 1 of 22 lymph nodes was positive for metastatic disease, leading to a diagnosis of stage 3 colon cancer. Case  2 patient was a 50-year-old male with acromegaly who underwent transsphenoidal surgery to remove a 2 cm pituitary adenoma. The patient reported severe cramping and lower abdominal pain, and an invasive 8.1 cm3 grade 2 adenocarcinoma with signet rings was identified in the ascending colon and removed. Of the 37 lymph nodes, 34 were positive for the presence of tumor cells, and stage 3c colon cancer was confirmed. Conclusion. Current guidelines for colonoscopy screening at the time of diagnosis of acromegaly and at appropriate follow-up intervals should be followed.

  19. Patients with Acromegaly Presenting with Colon Cancer: A Case Series

    Science.gov (United States)

    Nakhle, Samer; Ludlam, William H.

    2016-01-01

    Introduction. Frequent colonoscopy screenings are critical for early diagnosis of colon cancer in patients with acromegaly. Case Presentations. We performed a retrospective analysis of the incidental diagnoses of colon cancer from the ACCESS trial (ClinicalTrials.gov identifier: NCT01995734). Colon cancer was identified in 2 patients (4.5%). Case  1 patient was a 36-year-old male with acromegaly who underwent transsphenoidal surgery to remove the pituitary adenoma. After surgery, the patient underwent routine colonoscopy screening, which revealed a 40 mm tubular adenoma in the descending colon. A T1N1a carcinoma was surgically removed, and 1 of 22 lymph nodes was positive for metastatic disease, leading to a diagnosis of stage 3 colon cancer. Case  2 patient was a 50-year-old male with acromegaly who underwent transsphenoidal surgery to remove a 2 cm pituitary adenoma. The patient reported severe cramping and lower abdominal pain, and an invasive 8.1 cm3 grade 2 adenocarcinoma with signet rings was identified in the ascending colon and removed. Of the 37 lymph nodes, 34 were positive for the presence of tumor cells, and stage 3c colon cancer was confirmed. Conclusion. Current guidelines for colonoscopy screening at the time of diagnosis of acromegaly and at appropriate follow-up intervals should be followed. PMID:28025627

  20. Nurse case managers: patient care implications at a Pakistani university.

    Science.gov (United States)

    Walani, Laila

    The role of the nurse in hospital is varied and some are choosing to incorporate more managerial and administrative skills into their clinical role. One such role is that of the nurse case manager (NCM). This particular role concentrates on involving the family and the patient in his or her own care, facilitation of the care plan, and open discussions between the patient, medics and nursing staff. NCMs in the author's hospital have made a remarkable contribution to patient care. It is a challenging and exceedingly demanding role in both developing and developed countries, but one that is increasingly important. The NCMs are involved in coordination, facilitation of core process and mobilization of resources, not only in hospital but at the patient's home. In this short introductory article the role of NCM is highlighted and the author discusses how this diverse role is concerned with patient care. NCMs work with multidisciplinary teams to enhance the patient's care process. Their attention is also given to cost reduction and clinical pathway management.

  1. Pediatric patient with Bombay blood group: A rare case report

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    Sudeshna Bhar (Kundu

    2015-01-01

    Full Text Available Bombay blood group is a rare blood group in which there is the absence of H antigen and presence of anti-H antibodies. At the time of blood grouping, this blood group mimics O blood group due to the absence of H antigen, but it shows incompatibility with O group blood during cross matching. Serum grouping or reverse grouping are essential for confirmation of the diagnosis. Patients carrying this blood group can receive blood only from a person with this blood group. Reported cases of anesthesia in the pediatric patient with Bombay blood group are relatively rare. Here, we present successful anesthetic management along with intraoperative blood transfusion in a pediatric patient with Bombay blood group posted for ovarian cystectomy.

  2. Pediatric patient with Bombay blood group: A rare case report.

    Science.gov (United States)

    Bhar Kundu, Sudeshna; De, Anisha; Saha, Anindita; Bhattacharyya, Chiranjib

    2015-01-01

    Bombay blood group is a rare blood group in which there is the absence of H antigen and presence of anti-H antibodies. At the time of blood grouping, this blood group mimics O blood group due to the absence of H antigen, but it shows incompatibility with O group blood during cross matching. Serum grouping or reverse grouping are essential for confirmation of the diagnosis. Patients carrying this blood group can receive blood only from a person with this blood group. Reported cases of anesthesia in the pediatric patient with Bombay blood group are relatively rare. Here, we present successful anesthetic management along with intraoperative blood transfusion in a pediatric patient with Bombay blood group posted for ovarian cystectomy.

  3. Anaphylactic reactions in anaesthetised patients - four cases of chlorhexidine allergy

    DEFF Research Database (Denmark)

    Garvey, L H; Roed-Petersen, J; Husum, B

    2001-01-01

    Chlorhexidine is widely used all over the world in many different preparations. In Denmark chlorhexidine is the standard skin disinfectant used before surgery or invasive procedures and it is widely used in the general population in mouthwash or for disinfection of minor scratches etc. The potent......Chlorhexidine is widely used all over the world in many different preparations. In Denmark chlorhexidine is the standard skin disinfectant used before surgery or invasive procedures and it is widely used in the general population in mouthwash or for disinfection of minor scratches etc...... into the operation and all four patients required treatment with adrenaline. All four patients had a history of minor symptoms like rashes or faints in connection with previous surgery/invasive procedures. Allergy to chlorhexidine may be more prevalent in surgical patients and cases may have been overlooked due...

  4. 青年恶性胸膜间皮瘤1例临床分析%Young patient with malignant pleural mesothelioma:a case report and clinical analysis

    Institute of Scientific and Technical Information of China (English)

    肖晓辉; 刘华; 蔡曦光; 张方; 虎维东; 王娜

    2014-01-01

    Objective To discuss the clinical features,diagnosis,and treatment of malignant pleural mesothelioma (MPM).Methods One young case of MPM treated in the department of respiratory medicine,Gansu provincial people's hospital in February 2013 was reported and related literatures were reviewed.Results The male patient,20 years old,denied the history of asbestos exposure,had cough and shortness of breath for more than two weeks.Chest X-ray showed large pleural effusion in the left.After the drainage of pleural effusion for 10 000 ml,chest CT showed low-density mass in the left chest.After pleural biopsy,pathology result showed MPM (tubular papillary variant).Combined with the characteristics of this patient and review of the literatures,young patients with MPM were rare,characterized with only pleural effusion,or without any clinical manifestations.Conclusions MPM is a highly aggressive tumor,lacking of specific clinical manifestations.It can not only occur at any age,but also have no history of asbestos exposure.It should be emphasized to raise awareness of the disease for early diagnosis and early treatment in order to improve the quality of life and survival of patients.%目的 探讨恶性胸膜间皮瘤(MPM)的临床特点、诊断及治疗.方法 报告2013年2月甘肃省人民医院呼吸科收治的1例青年MPM病例及相关内容综述.结果 患者,男,20岁,否认石棉接触史,咳嗽、气短2周,胸片提示左侧大量胸腔积液.引流胸水10 000 ml后复查胸部CT示左侧胸腔内低密度肿块影,行胸膜穿刺活检,病理结果为:MPM(腺管乳头状型).结合此例患者特点和文献复习,青年MPM患者少见,可仅表现为胸腔积液,亦可无任何临床表现.结论 MPM属高度侵袭性肿瘤,临床表现缺乏特异性,可发生于任何年龄,亦可无石棉接触史,需提高对该疾病的认识及诊断水平,以便早期诊断、早期治疗,提高患者生存质量及生存期.

  5. Localized Tetanus in an Adult Patient: Case Report

    Science.gov (United States)

    Gulamhussein, Mohamed Amirali; Li, Yueyang; Guha, Abhijit

    2016-01-01

    Introduction: Tetanus is a severe and potentially fatal infection caused by the bacterium Clostridium tetani. Of all the cases described in literature, generalized tetanus is by far the most common presentation, but it may also present as neonatal tetanus, cephalic tetanus, and localized tetanus, the latter two being much rarer. In this case report, we present the rare form of this disease, i.e., localized tetanus in an adult male with a history of minimal trauma as well as a late, unusual mode of presentation. Case Report: A 35-year-old Caucasian male presented with an acutely painful, swollen right thumb associated with a small superficial collection on the dorsal aspect of the base of the thumb. A formal wound exploration and washout were carried out in theater, however, at the time of tourniquet inflation, the right hand went into a carpopedal spasm and remained in that position until an infusion of a muscle relaxant was given. The findings were consistent with a case of localized tetanus. The patient was treated with human immunoglobulin and tetanus toxoid and safely discharged home 48 h later without any complications. Conclusion: This case report emphasizes the importance of the recognition of a rare form of this fatal infectious disease, which may present with prodromal symptoms before the generalized form shows its clinical effects. Moreover, the astute clinician should be aware of the variable presentations of this infectious disease, with early identification greatly reducing the associated risks of morbidity and mortality. PMID:28164065

  6. [Tongue retraining and occlusal stability in a young adult. Case report].

    Science.gov (United States)

    Houb-Dine, Afaf; Bahije, Loubna; Zaoui, Fatima

    2012-01-01

    The clinical observation describes the case of a 20-year-old woman who has consulted for aesthetic and functional reasons. She presents a skeletal class III normodivergent, an occlusal class III with a lower proalveoli quite marked. In addition, a lingual dysfunction which manifests itself by important anterior diastema and dento-dental disharmony at the upper jaw complicates the case. The undertaken therapeutic project starts with a first step of a lingual praxis rehabilitation, followed by an orthodontic step and upper lateral incisors-plasty. The purpose of those results is the evaluation of the stability two years later, which was reported positive.

  7. Vascular parkinsonism: a case series of 17 patients

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    Thiago Cardoso Vale

    2013-10-01

    Full Text Available Objective To report the clinical and neuroimaging findings in a case series of vascular parkinsonism (VP. Methods Seventeen patients with VP were evaluated with motor, cognitive, and neuroimaging standardized tests and scales. Results All patients had arterial hypertension. Ten patients were male and the mean age of the whole sample was 75.8±10.1 years. The mean age of parkinsonism onset was 72.2±10.0 years. Common clinical features were urinary incontinence (88.2%, lower limb parkinsonism with freezing of gait and falls (82.3%, and pyramidal signs (76.4%. The mean Unified Parkinson’s Disease Rating Scale (UPDRS and Hoehn-Yahr scores were 72.5±21.6 points and 3.3±0.9 points, respectively. Sixteen (94.1% patients had freezing of gait and executive dysfunction. Twelve (70.5% patients had probable vascular dementia. The mean dose of levodopa was 530.9 mg/day. Unresponsiveness to the drug was confirmed by a 6.9 mean point reduction in the UPDRS score after the “practically defined off” test. Conclusion This series provides a profile of VP with predominant lower-limb involvement, freezing of gait and falls, pyramidal signs, executive dysfunction, concomitant vascular dementia, and poor levodopa response.

  8. Brucella bacteremia in patients with acute leukemia: a case series

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    Al-Anazi Khalid

    2007-11-01

    Full Text Available Abstract Background Brucellosis may cause serious infections in healthy individuals living in countries that are endemic for the infection. However, reports of brucella infections in immunocompromised hosts are relatively rare. Case Presentations Reported here are two patients with acute leukemia who developed Brucella melitensis bacteremia during their follow up at the Armed Forces Hospital in Riyadh. The first patient developed B. melitensis bacteremia during the transformation of his myelodysplasia into acute myeloid leukemia. The second patient developed B. melitensis bacteremia while his acute lymphoblastic leukemia was under control. Interestingly, he presented with acute cholecystitis during the brucella sepsis. Both brucella infections were associated with a marked reduction in the hematological parameters in addition to other complications. The bacteremic episodes were successfully treated with netilmicin, doxycycline and ciprofloxacin. Conclusion Brucellosis can cause systemic infections, complicated bacteremia and serious morbidity in patients with acute leukemia living in endemic areas. These infections may occur at the presentation of the leukemia or even when the leukemia is in remission. Nevertheless, the early diagnosis of brucellosis and the administration of appropriate antimicrobial therapy for sufficient duration usually improves the outcome in these immunocompromised patients.

  9. Restructuring patient flow logistics around patient care needs: implications and practicalities from three critical cases.

    Science.gov (United States)

    Villa, Stefano; Barbieri, Marta; Lega, Federico

    2009-06-01

    To make hospitals more patient-centered it is necessary to intervene on patient flow logistics. The study analyzes three innovative redesign projects implemented at three Italian hospitals. The three hospitals have reorganized patient flow logistics around patient care needs using, as proxies, the expected length of stay and the level of nursing assistance. In order to do this, they have extensively revised their logistical configuration changing: (1) the organization of wards, (2) the hospital's physical lay-out, (3) the capacity planning system, and (4) the organizational roles supporting the patient flow management. The study describes the changes implemented as well as the results achieved and draws some general lessons that provide useful hints for those other hospitals involved in such type of redesign projects. The paper ends by discussing some policy implications. In fact, the results achieved in the three cases investigated provide interesting material for further discussion on clinical, operational, and economic issues.

  10. Uncommon toxicity of low-dose methotrexate: case report

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    Zohreh Yousefi

    2015-10-01

    Full Text Available Background: Standard treatment of Gestational Trophoblastic Disease (GTD is chemotherapy. Single-agent chemotherapy regime including Methotrexate (MTX or Actinomycin. Single-agent is widely used in treatment of persistent trophoblastic disease. We reported an uncommon toxicity of low-dose single-agent methotrexate in a patient. Case Presentation: A 20-year-old woman, primary gravid after two months missed period and spotting with diagnosis of incomplete abortion with uterine size equivalent of ten weeks pregnancy (8-10 cm underwent evacuation curettage. In serial follow-up, based on rise of beta-hCG titer and absence of metastatic disease, it was categorized as low-risk persistent trophoblastic disease. She was referred to gynecology oncology center of Ghaem Hospital, Mashhad University of Medical Sciences in May 2014. Because of rise of beta-hCG titer, after complete metastatic work-up and lack of disease in other sites, persistent disease was diagnosed and candidate for chemotherapy (single agent low-dose. The patient received first course of therapy with MTX (50 mg/m², intra muscular. Unfortunately, after two days of treatment she developed uncommon severe toxicity, fever, severe nausea and vomiting, tachycardia, and generalized weakness. Also, we found hematologic abnormality (WBC: -14000-15000 µI, platelet- 540 µI and sever neutropenia, and abnormal rising in liver function test (SGOT, SGPT (three to four times and renal function test (BUN and Creatinine (two times. In addition, she had disseminated erosive lesion in all of body especially in face. Due to the fatal side effects of chemotherapy, she was admitted to intensive care unit (ICU. Fortunately, after two to three weeks, she was improved by conservative management. After few weeks beta-hCG titer was in normal limit. However she had normal serial beta-hCG in one year of follow-up. Conclusion: It is important to emphasis unpredictable side effects of chemotherapy with low

  11. Neoplasia cística mucinosa do pâncreas durante a gestação: Relato de Caso Mucinous cystic neoplasm of the pancreas during pregnancy: Case Report

    Directory of Open Access Journals (Sweden)

    Euclides Dias Martins Filho

    2011-06-01

    Full Text Available O objetivo deste estudo é relatar o caso de uma gestante de 20 anos portadora de neoplasia cística mucinosa do pâncreas. Evidências sugerem que essa neoplasia é dependente dos hormônios estrógeno-progesterona levando a um importante crescimento durante a gestação e ainda apresentar, mesmo baixo, um potencial para degeneração maligna. O motivo deste relato é a raridade da doença associada a gestação em uma paciente tão jovem. Foi realizada pancreatectomia corpo-caudal no segundo trimestre da gestação com boa evolução materna e fetal.The aim of this study is to report the case of a 20 years old pregnant woman with a mucinous cystic neoplasm of the pancreas. Evidence suggests that this neoplasm is dependent on estrogen-pro-gesterone leading to a significant growth during pregnancy and beyond this a potential malignant degeneration, even low. The reason of this case-study is the rarity of the disease associated with pregnancy in a patient so young. A body-tail pancreatectomy was performed in the second trimester of pregnancy with good maternal and fetal outcomes.

  12. A rare case of Histoplasma fungemia in an AIDS patient

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    V P Baradkar

    2011-01-01

    Full Text Available Disseminated cases of histoplasmosis in acquired immune deficiency syndrome (AIDS are rarely reported from India. Most of these cases report isolation of this fungus from the bone marrow, lymph node aspirate, spleenic aspirate, and biopsies. We report isolation of Histoplasma capsulatum from the blood of an AIDS patient. A 30-year-old male from Utter Pradesh was admitted with fever, loss of appetite, and nausea since two months. Few intracellular and extracellular budding cells were observed on bone marrow examination on the fifth day of admission. Diagnosis was confirmed by blood cultures taken on the 11th day of admission. Amphotericin B was started, but the patient′s condition deteriorated and he died.

  13. Macroamylasemia in a patient with acute appendicitis: a case report.

    Science.gov (United States)

    Um, J W; Kim, K H; Kang, M S; Choe, J H; Bae, J W; Hong, Y S; Suh, S O; Kim, Y C; Whang, C W; Kim, S M

    1999-12-01

    Macroamylasemia is a condition of persistent, elevated serum amylase activity with no apparent clinical symptoms of a pancreatic disorder. In Korea, however, no such case has been reported to date. We report a case of a 17-year-old female diagnosed with macroamylasemia and acute appendicitis. One day earlier, she developed epigastric and right lower quadrant abdominal pain. She was characterized by high level of serum amylase, but normal lipase. Amylase isoenzyme analysis demonstrated increased fraction of salivary type and follow-up amylase level was persistently increased. Immunofixation disclosed the macroamylase binding with an immunoglobulin, consisting of IgA and kappa chain. The patient was treated by appendectomy, and the abdominal pain subsided.

  14. Periodontal disease in a patient receiving Bevacizumab: a case report

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    Gujral Dorothy M

    2008-02-01

    Full Text Available Abstract Introduction Bevacizumab is a monoclonal antibody that inhibits the action of vascular endothelial growth factor (VEGF thereby acting as an angiogenesis inhibitor. As a result, supply of oxygen and nutrients to tissues is impaired and tumour cell growth is reduced. Reported side effects due to bevacizumab are hypertension and increased risk of bleeding. Bowel perforation has also been reported. Periodontal disease in patients on bevacizumab therapy has not been reported before. Case Presentation We report a case of a forty-three year old woman who developed periodontitis whilst receiving bevacizumab for lung cancer. The periodontal disease remained stable on discontinuation of the drug. Conclusion Further investigations are needed to determine the mechanism for bevacizumab-induced periodontal disease.

  15. Analysis of the emergency hospital patient flow: a case study

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    José Aparecido Bellucci Júnior

    2015-03-01

    Full Text Available This qualitative study, using a case study design, had the aim to analyze the service flow at two emergency hospital units. The study was developed in November and December 2010, at a service where care is provided by means of embracement with risk classification and at another one where patients are seen on a first come, first served basis. Data were collected by means of direct observation of the practice, with records made on field notes that were treated with the content analysis technique. The analyses of the collected information resulted in two thematic categories: Caring for users at emergency hospital services and Embracing users and families. In conclusion, neither of the services had a counter-referral system; care at the service that adopts embracement with risk classification was continuous and hierarchized; the flow of patients was more dynamic and; the nurse had more autonomy for making clinical decisions.

  16. Necrotizing ulcerative gingivitis and the orthodontic patient: a case series.

    Science.gov (United States)

    Sangani, Indiya; Watt, Eileen; Cross, David

    2013-03-01

    Necrotizing ulcerative gingivitis (NUG) can be a painful periodontal disease that can lead to loss of the interdental papillae. It is usually accompanied by systemic signs of fever, malaise and cervical and submandibular lymphadenopathy. It is caused by the profileration of anaerobic bacteria and has been linked to smoking and immunosuppression. This case series reports the occurrence of NUG in orthodontic patients and demonstrates that there is a varying scale of severity of the condition. Orthodontists should be aware of the clinical signs of NUG to ensure early detection and treatment of their patients in order to prevent irreversible loss of the interdental papillae and reduce the likelihood of recurrence. A treatment regime is suggested.

  17. A case of progeria syndrome treated as VIP patient

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    Seema Mahant, Mahant PD, C.M. Reddy

    2014-11-01

    Full Text Available Progeria is rare autosomal recessive genetic disease with an incidence of about one in eight million. He was 16 years old boy lying on the couch. He was short stature thin with minimal subcutaneous tissue, skin was thin and fragile with loss of hair over scalp, eyebrows and eyelashes, and his face was dismorphic with prominent eyes, beaked nose, small jaw and large cranium with visible veins over it. His voice was thin and high pitched. Overall, this gives them an extremely aged nearly 70 -80 years old man look. The patient was a known case of progeria syndrome and he was treated as a VIP patient by all faculty members and staff, though he belongs low socioeconomic status, no political issue with them. But still he was a VIP.

  18. Moyamoya disease: report of three cases in Brazilian patients

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    FRANCO CLÉLIA MARIA RIBEIRO

    1999-01-01

    Full Text Available Moyamoya disease (MMD is a chronic occlusive cerebrovascular disease of unknown etiology reported mainly in the Japanese. Most cases occur in children. The disease is rare in non-Oriental adults manifesting itself mostly as intracerebral hemorrhages. We describe MMD in 2 non-Oriental young adults and one adolescent that developed cerebral infarctions. The adults were medicated with aspirin and no medication was given to the adolescent. All patients did not deteriorate in a follow-up period from 1 to 4 years. Although rare, MMD is an important cause of stroke in young individuals and may well be underreported: only 18 patients have been reported till 1997 in Brazil. Neurologists should include MMD in differential diagnosis of ischemic and hemorrhagic strokes in young adults.

  19. Diabetic ketoacidosis in a patient with acromegaly, a case report

    OpenAIRE

    O. Akha; R Rajabian; R. Aboutorabi; S. Teymouri

    2007-01-01

    Abstract Although impaired glucose tolerance affects 36% and overt diabetes mellitus can be seen in 30% of cases with acromegaly, diabetic ketoacidosis is rarely reported in patients with this disease. We present an unusual complication of acromegaly: a 22 year old woman with amenorrhea (6 month ago) and blurred vision of left eye (4 month ago) referred to Ghaem neurology clinic in Mashhad. With a growth hormone (GH) level of =100ng/ml, Insulin like growth factor-1 (IGF-1) =1560 ng/ml and pit...

  20. Four Cases of Angular Cheilitis in Orthodontic Patients

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    P Kafaie

    2006-07-01

    Full Text Available Contact dermatitis is an inflammatory reaction of the skin and mucosa to either external or internal factors. It can be divided to two forms of irritant contact dermatitis and allergic contact dermatitis. Nickel is one of the most common materials that causes allergic contact dermatitis and is widely used in orthodontic appliances. The inflammatory reaction to this metal in orthodontics is usually stomatitis and angular cheilitis is very rare. We report 4 cases of angular cheilitis in orthodontic patients and discuss about their causes and treatments.

  1. Thrombolysis in a Stroke Patient on Dabigatran Anticoagulation: Case Report and Synopsis of Published Cases

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    Waltraud Pfeilschifter

    2013-03-01

    Full Text Available We present the case of an aphasic 77-year-old stroke patient with left distal M1 occlusion who received rt-PA for thrombolysis while on oral anticoagulant treatment with dabigatran (150 mg b.i.d.. Coagulation parameters were normal (thrombin time 20 s, aPTT 20 s, INR 1.08 and the patient improved from an NIHSS of 15 to 5 within 24 h with sonographic evidence of M1 recanalization. She did not develop intracranial bleeding complications but showed unusually large diffuse skin ecchymoses. In our report, we give an overview of all reported cases of thrombolysis under dabigatran anticoagulation and discuss the questions of medication adherence under novel oral anticoagulants (NOA and the safety of NOA in terms of secondary intracerebral hemorrhage after stroke.

  2. Traumatic Posterior L4–L5 Fracture Dislocation of the Lumbar Spine: A Case Report

    Science.gov (United States)

    Zarate-Kalfopulos, Baron; Romero-Vargas, Samuel; Alcántara-Canseco, Cesar; Rosales-Olivarez, Luis Miguel; Alpizar-Aguirre, Armando; Reyes-Sánchez, Alejandro

    2012-01-01

    Study Design Case report. Objective The diagnosis and surgical management of a patient with traumatic bilateral posterior dislocation of L4–L5 is presented with a thorough review of the existing literature. Summary of Background Data Traumatic dislocation of L4–L5 has been reported in the English literature in only five cases; of these, only two were retrolisthesis. Methods A 20-year-old patient was involved in a high-energy vehicular accident and presented with back pain and inability to ambulate. Neurological assessment showed motor strength grade 2/5 in the proximal lower-extremity muscle groups (L1–L3 myotomes) and 0/5 strength distally (L4–S1 myotomes); in addition, incontinence of sphincters was found. X-rays and computed tomography (CT) scan revealed a three-column ligamentous injury with posterior fracture-dislocation of the L4 vertebral body with complete posterior displacement of L4 to L5 vertebral body. The patient underwent posterior approach with reduction, transpedicular fixation, and posterolateral fusion with autologous bone graft. Results At 1-year follow-up, the patient had recovered muscular strength in proximal lower-extremities muscle groups, sphincter function had fully recovered, and he was able to ambulate with crutches. There was no recovery of distal extremity sensorimotor function. Plain radiograph and CT scan showed good alignment and progressive maturation of his fusion procedure. Conclusion Traumatic retrolisthesis of L4–L5 is a high-energy unstable fracture; reduction of the dislocation is challenging because of the heavy forces acting in the lower lumbar spine. Instrumented fusion restores alignment and maintains segmental stability. PMID:24353974

  3. A CASE OF RENAL DISEASE IN HIV INFECTED PATIENT

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    Ni Made Vina Septiani

    2013-11-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Kidney diseases in human immunodeficiency virus (HIV infected patients has been been fourth leading cause of death after sepsis, pneumonia, and liver disease. HIV-associated nephropathy (HIVAN is the most common. We report a case, a male patient, 48 years, who experienced shortness of breath, cough and intermittent fever and has been reported as HIV positive, without previous antiretroviral treatment and last CD4+ count is 89 cells/mm3. There are elevated BUN and SC from day to day during treatment and proteinuria +2 as a sign of kidney disease with normal blood pressure and there was no edema. Patients given an antibiotic and ACE inhibitors as antiproteinuria. Patients with suspicion of HIVAN in this case can progress very rapidly and causes progressive decline in renal function. Prognosis of patients with HIVAN if not handled properly will develop end stage renal disease (ESRD in 1-4 months and had a mortality rate 4.7 times higher than HIV patients without renal impairment. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  4. Coping with chronic illness: A study with end-stage renal disease patients

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    Mónica Cassaretto

    2006-06-01

    Full Text Available This study identifies coping styles and strategies used by 40 end-stage renal disease patients over 20 years old who receive treatment in a general hospital in Peru. The instruments applied were a personal sociodemographic questionnaire and the Coping Inventory (Carver, Scheier & Weintraub, 1989. Results showed that emotion focused coping were most frequently used followed by problem focused coping. Planning, acceptance and positive reinterpretation-growth coping strategies were more frequently used by these patients, whereas mental disengagement, suppression of competing activities and behavioral disengagement were the less frequently used coping strategies. Other differences between coping styles and strategies and sociodemographic and medical variables were analyzed.

  5. Exfoliative Cheilitis a male patient – a case report

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    Mohammad S. Nayaf

    2015-01-01

    Full Text Available Introduction: Exfoliative cheilitis, one of a spectrum of diseases that affect the vermilion border of the lips, is uncommon and has no known cause. It is a chronic superficial inflammatory disorder of the vermilion borders of the lips characterized by persistent scaling; it can be a difficult condition to manage. The diagnosis is now restricted to those few patients whose lesions cannot be attributed to other causes, such as contact sensitization or light. Case Report: We present a 17 year-old male presented to the out clinic in Baghdad with the chief complaint of a persistent scaly on his lower lips. The patient reported that the skin over the lip thickened gradually over a 3 days period and subsequently became loose, causing discomfort. Once he peeled away the loosened layer, a new layer began to form again. Conclusion: The lack of specific treatment makes exfoliative cheilitis a chronic disease that radically affects a person’s life. The aim of this paper is to describe a case of recurrent exfoliative cheilitis successfully treated with intralesional corticosteroids and to present possible hypotheses as to the cause.

  6. 605 X-linked Agammaglobulinemia: Report of 4 Cases of Mexican Patients at Civil Hospital of Guadalajara Dr Juan I. Menchaca

    Science.gov (United States)

    Nuñez-Nuñez, Maria Enriqueta; Padilla-Jimenez, Alondra; Cortes-Grimaldo, Rosa Maria; Ortega-Cisneros, Margarita; Moran-Mendoza, Rocio; Torres-Lozano, Carlos

    2012-01-01

    Background The X-linked agammaglobulinemia is a primary immunodeficiency featured by hypogammaglobulinemia, recurrent infections and low levels of circulating B Lymphocytes, caused by a mutation of the tyrosine kinase of Bruton (Btk). The aim of this work is to present clinical and laboratory evidence of 4 patients with high suspect to bear a Bruton's agammaglobulinemia. Methods We review medical records of 4 patients bearing a humoral immunodeficiency probably Bruton's agammaglobulinemia. Results Patient 1: 20 years old with IgG of 197 mg/dL, IgM 14.6 mg/dL, IgA 10 mg/dL, IgE 0 UI/mL and B cells 0.02%. He has a brother with hypogammaglobulinemia, 2 maternal uncles died with history of recurrent infections. Patient 2: 13 years old, with IgG 33.3 mg/dL, IgM 6.07 mg/dL, IgA 6.07 mg/dL, IgE 0.5 UI/mL and B cells 0.03%. Six maternal uncles and 2 aunts have died at early age. Patient 3: 6 years old, IgG, IgM, IgA and IgE not detectable and B cells 0.4%. One brother died as newborn. Patient 4: 6 years old, with IgG 33 mg/dL, IgM 98.7 mg/dL, IgA 6.67 mg/dL and B cells 2%. The IgM maintained elevated until the age of 4 years old, afterwards was undetectable. He had 2 maternal uncles that had died at early age. All of our patients have presented infections before 6 months of age such as otitis, pansinusitis, septic arthritis, mastoiditis, pneumonia. Two of them with pleural efusion and patient 4 with bronchiectasis and atelectasis. Conclusions Because of the clinical findings of our 4 patients, immunoglobulin levels, the low percentage of B cells, the early death of family members and all of them arer males, we consider that the molecular defect in our patients could be at Btk gene and the diagnosis most probable would be Bruton's agammaglobulinemia.

  7. [Verbal patient information through nurses--a case of stroke patients].

    Science.gov (United States)

    Christmann, Elli; Holle, Regina; Schüssler, Dörte; Beier, Jutta; Dassen, Theo

    2004-06-01

    The article represents results of a theoretical work in the field of nursing education, with the topic: Verbal Patient Information through Nurses--A Case of Stroke Patients. The literature review and analysis show that there is a shortage in (stroke) patient information generally and a lack of successful concepts and strategies for the verbal (stroke) patient information through nurses in hospitals. The authors have developed a theoretical basis for health information as a nursing intervention and this represents a model of health information as a "communicational teach-and-learn process", which is of general application to all patients. The health information takes place as a separate nursing intervention within a non-public, face-to-face communication situation and in the steps-model of the nursing process. Health information is seen as a learning process for patients and nurses too. We consider learning as information production (constructivism) and information processing (cognitivism). Both processes are influenced by different factors and the illness-situation of patients, personality information content and the environment. For a successful health information output, it is necessary to take care of these aspects and this can be realized through a constructivational understanding of didactics. There is a need for an evaluation study to prove our concept of health information.

  8. A case of minimal change disease in a Fabry patient.

    Science.gov (United States)

    Zarate, Yuri A; Patterson, Larry; Yin, Hong; Hopkin, Robert J

    2010-03-01

    Fabry disease is an X-linked lysosomal storage disorder caused by mutations of the GLA gene and deficiency in alpha-galactosidase A activity. Glycosphingolipids accumulation causes renal injury that manifests early during childhood as tubular dysfunction and later in adulthood as proteinuria and renal insufficiency. Nephrotic syndrome as the first evidence of Fabry-related kidney damage is rare. We report the case of a teenager with known Fabry disease and normal renal function who developed acute nephrotic syndrome. He was found to have typical glycosphingolipids accumulation with no other findings suggestive of alternative causes of nephrotic syndrome on kidney biopsy. After treatment with enzyme replacement therapy and oral steroids, he went into complete remission from nephrotic syndrome, a response that is atypical for Fabry disease patients who develop heavy proteinuria as a result of longstanding disease and chronic renal injury. The nephrotic syndrome in this patient appears to have developed secondary to minimal change disease. We recommend considering immunotherapy in addition to enzyme replacement therapy in those patients with confirmed Fabry disease and acute nephrotic syndrome with clinical and microscopic findings suggestive of minimal change disease.

  9. Leptospirosis patient with AIDS the first case reported

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    Elizabeth de Souza Neves

    1994-03-01

    Full Text Available A case of renal icterohaemorrhagic leptospirosis involving a patient with acquired immunodeficiency syndrome (AIDS is reported. Despite the low levels of CD4+ Tlymphocytes, the clinical course of leptospirosis was similar to that observed in non-immunodepressed patients, and no worsening of AIDS occurred due to the infebtion by the spirochete. Serologic conversion was observed in the microscopic agglutination test, with maximum titer of1:3,200. The patient had positive urine cultures for Leptospira interrogans for two months, whereas blood cultures were negative.Os autores relatam um caso de forma íctero- hemorrágica de leptospirose ocorrida em paciente com síndrome de imunodeficiência adquirida (SIDA. A evolução clínica da leptospirose se deu de modo semelhante ao observado em pacientes sem imunodepressão, apesar dos níveis muito baixos de linfócitos TCD4+. Tampouco houve agravamento da SIDA em decorrência da infecção pelo espiroqueta. Observou-se conversão sorológica na prova de aglutinaçãomicroscópica com títulos máximos de 1:3.200. O paciente permaneceu por dois meses com urinocultura positiva para Leptospira interrogans, sendo as hemoculturas negativas.

  10. Diabetic ketoacidosis in a patient with acromegaly, a case report

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    O. Akha

    2007-01-01

    Full Text Available Abstract Although impaired glucose tolerance affects 36% and overt diabetes mellitus can be seen in 30% of cases with acromegaly, diabetic ketoacidosis is rarely reported in patients with this disease. We present an unusual complication of acromegaly: a 22 year old woman with amenorrhea (6 month ago and blurred vision of left eye (4 month ago referred to Ghaem neurology clinic in Mashhad. With a growth hormone (GH level of =100ng/ml, Insulin like growth factor-1 (IGF-1 =1560 ng/ml and pituitary macro adenoma in magnetic resonance imaging (MRI, she was candidated for surgery. A few hours before surgery she had dyspnea, loss of consciousness, fever and with blood sugar (BS =500 mg/ml, Hco3=2.4, PH=7.06 and keton in urine. Diabetic ketoacidosis was diagnosed. The patient was treated with high dose of insulin (500 IU/day and hydration. After octerotide administration the need for insulin decreased and after pituitary adenectomy, there was no need for insulin therapy and the patient was discharged on metformin (one tablet per day.

  11. Chiropractic management of low back pain in a patient with a transfemoral amputation

    Science.gov (United States)

    Illes, Jennifer D.; Maola, Chad J.

    2012-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a patient with a unilateral transfemoral amputation and low back pain (LBP). Clinical Features A 20-year-old woman with right transfemoral amputation and a right upper extremity amputation due to amniotic band syndrome had approximately 40 different prosthetic lower extremities in the prior 20 years. She presented for chiropractic care for LBP (5/10 numeric pain scale) that she experienced after receiving a new right prosthetic leg. The pain increased with walking, attempts to exercise, and lying supine. Physical evaluation revealed asymmetrical leg length (long right limb); restricted left ankle dorsiflexion; restricted lumbopelvic motion; and hypertonicity of the left triceps surae muscle complex as well as the gluteus maximus, quadratus lumborum, and erector spinae bilaterally. Gait examination revealed a right Trendelenberg gait as well as a pattern of left vaulting. The working diagnosis was sacroiliac joint dysfunction, with lumbar facet syndrome secondary to a leg length inequality causing alteration in gait. Intervention and Outcome Chiropractic management included manipulative therapy to the lumbar spine and pelvis, trigger point therapy of hypertonic musculature, and strengthening of pelvic musculature. In addition, the patient's prosthetist shortened her new prosthetic device. After 18 treatments, LBP severity was resolved (0/10); and there was an overall improvement with gait biomechanics. Conclusion This case illustrates the importance of considering leg length inequality in patients with amputations as a possible cause of lower back pain, and that proper management may include adjusting the length of the prosthetic device and strengthening of the hip flexors and abductors, in addition to trigger point therapy and chiropractic manipulation. PMID:23450067

  12. Chronic infection due to Fusarium oxysporum mimicking lupus vulgaris: case report and review of cutaneous involvement in fusariosis.

    Science.gov (United States)

    Pereiro, M; Abalde, M T; Zulaica, A; Caeiro, J L; Flórez, A; Peteiro, C; Toribio, J

    2001-01-01

    A 67-year-old female presented with a 20-year-old lesion involving the right ear and preauricular area mimicking tuberculous lupus. Fusarium oxysporum infection was confirmed by biopsy studies and cultures. The biopsy specimen showed an unusually extensive dermal invasion with fungal hyphae. This is an uncommon clinical presentation for Fusarium infection in a healthy patient. When referred to us, the patient had received antifungal therapy with itraconazole without any benefit. Improvement was obtained with fluconazole therapy. The spectrum of cutaneous involvement related to Fusarium spp. includes toxic reactions, colonization, superficial indolent infection, deep cutaneous or subcutaneous infections and disseminated infection.

  13. Eosinophilia in a patient with cyclical vomiting: a case report

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    Fitzgerald S Matthew

    2004-05-01

    Full Text Available Abstract Background Eosinophilic gastritis is related to eosinophilic gastroenteritis, varying only in regards to the extent of disease and small bowel involvement. Common symptoms reported are similar to our patient's including: abdominal pain, epigastric pain, anorexia, bloating, weight loss, diarrhea, ankle edema, dysphagia, melaena and postprandial nausea and vomiting. Microscopic features of eosinophilic infiltration usually occur in the lamina propria or submucosa with perivascular aggregates. The disease is likely mediated by eosinophils activated by various cytokines and chemokines. Therapy centers around the use of immunosuppressive agents and dietary therapy if food allergy is a factor. Case presentation The patient is a 31 year old Caucasian female with a past medical history significant for ulcerative colitis. She presented with recurrent bouts of vomiting, abdominal pain and chest discomfort of 11 months duration. The bouts of vomiting had been reoccurring every 7–10 days, with each episode lasting for 1–3 days. This was associated with extreme weakness and cachexia. Gastric biopsies revealed intense eosinophilic infiltration. The patient responded to glucocorticoids and azathioprine. The differential diagnosis and molecular pathogenesis of eosinophilic gastritis as well as the molecular effects of glucocorticoids in eosinophilic disorders are discussed. Conclusions The patient responded to a combination of glucocorticosteroids and azathioprine with decreased eosinophilia and symptoms. It is likely that eosinophil-active cytokines such as interleukin-3 (IL-3, granulocyte macrophage colony stimulating factor (GM-CSF and IL-5 play pivotal roles in this disease. Chemokines such as eotaxin may be involved in eosinophil recruitment. These mediators are downregulated or inhibited by the use of immunosuppressive medications.

  14. Plastic Fibula Bone Deformity with Ipsilateral Fracture of Tibiain Adults: A Case Report

    OpenAIRE

    Abbas Abdoli Tafti; Sanazsadat Sajadi; Maryam Shahmoradi

    2015-01-01

    Plastic bowing is a constant deformation of long bones occurring after a long standing force to bone. This type of fracture is seen in children and is uncommon in the adults. In this paper we report a case of fibular plastic deformity with ipsilateral tibia fracture in a 20 years old man that occurred after a direct hit. At the initial examination vital signs were stable and radiography of tibia and fibula fracture with plastic deformation were clear. In order to treat him we performed fib...

  15. Orthopedic Management of Patients with Pompe Disease: A Retrospective Case Series of 8 Patients

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    Gerrit Haaker

    2014-01-01

    Full Text Available Introduction. Pompe disease (PD, a lysosomal storage disease as well as a neuromuscular disorder, is a rare disease marked by progressive muscle weakness. Enzyme replacement therapy (ERT in recent years allowed longer survival but brought new problems to the treatment of PD with increasing affection of the musculoskeletal system, particularly with a significantly higher prevalence of scoliosis. The present paper deals with the orthopedic problems in patients with PD and is the first to describe surgical treatment of scoliosis in PD patients. Patients and Methods. The orthopedic problems and treatment of eight patients with PD from orthopedic consultation for neuromuscular disorders are retrospectively presented. We analyzed the problems of scoliosis, hip dysplasia, feet deformities, and contractures and presented the orthopedic treatment options. Results. Six of our eight PD patients had scoliosis and two young patients were treated by operative spine stabilization with benefits for posture and sitting ability. Hip joint surgery, operative contracture release, and feet deformity correction were performed with benefits for independent activity. Conclusion. Orthopedic management gains importance due to extended survival and musculoskeletal involvement under ERT. Surgical treatment is indicated in distinct cases. Further investigation is required to evidence the effect of surgical spine stabilization in PD.

  16. HIV positive patient with HSV-2 encephalitis: case report.

    Science.gov (United States)

    Pagliano, Pasquale; Ascione, Tiziana; Carleo, Maria Aurora; Boccia, Giovanni; De Caro, Francesco; Tortora, Fabio

    2016-09-01

    Incidence of brain infections in Human Immunodeficiency Virus (HIV) positive patients is reduced after the availability of current high active antiretroviral therapy (HAART). Herpes Simplex Virus type 2 (HSV-2) is an infrequent cause of encephalitis in HIV patients despite it is frequently involved in sexual transmitted infections. Here, we report a case of HSV-2 encephalitis occurring in a patient without full suppression of HIV replication within the brain. A 38 year-old HIV infected man was admitted to our department because of recurrent generalized seizure and fever during the previous 24 hours. Eight months before our observation the patient was switched from a protease inhibitor based regimen to a rilpivirine-based regimen without any evidence of HIV-RNA replication in the plasma. When the patient was admitted in our hospital, he was febrile and moderately confused, no deficit of cranial nerves was reported, motility was conserved, but he was unable to walk. Laboratory examinations performed at admission demonstrated an increase of cerebrospinal fluid (CSF) protein and cells with lymphocyte prevalence, and normal CSF glucose. HSV-2-DNA and HIV-RNA were present within CSF at admission. Nuclear Magnetic Resonance imaging of the brain revealed lesions of the medial part of both temporal lobes including hippocampus without any sign of bleeding. A 21-day course of acyclovir therapy was administered with consistent improvement of clinical findings and disappearance of HSV-2-DNA within CSF. After the episode, HAART was switched to a regimen with high CSF penetrability containing abacavir, lamivudine, darunavir and ritonavir. Twelve months after HSV-2 encephalitis neurologic evaluation was normal, but symptoms of depression were reported, HIV-RNA remained undetectable both in the plasma and CSF, and CD4+ lymphocytes were above 500/μL. No opportunistic infection was reported. Patients switched to regimen well tolerated such those containing rilpivirine, that have

  17. Obstructive Sleep Syndrom in Patient with Plonjon Guatr: Case Report

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    Haldun sevketbeyoglu

    2014-08-01

    Full Text Available A large number of predisposing factors (obesity, nasal obstruction, adenoid hypertrophy, macroglossia, etc. are reported to be associated with obstructive sleep apnea syndrome (OUAS. In addition to these factors, the large goiter and hypothyroidism were reported to be associated with OSAS as well. However, this relationship could not yet be fully demonstrated. In our case related to plonjon goiter, we wanted to show the effect of hyroidectomy to OSAS and #8211;if there is- and the relationship between pressure and OSAS. Two years ago, a 72-year-old female with BMI: 26.8 kg/m2 patient was admitted to our clinic with complaints of respiratory standstill during sleep, snoring, morning headaches and drowsiness during daylight. In the chest X-ray, chest computed tomography and ultrasonography applied to the patient, it was detected that the trachea was deviated to the left due to euthyroid plonjon goiter and severe OSAS and polisomnografisi (PSG was diagnosed for the patient. The patients apnea-hypopnea index (AHI was measured 63.1/h. With the aim of treatment, in 7cm H2O pressure, nasal continuous positive airway pressure (nCPAP was applied to the patient and AHI decreased to the level of 11.4/h. Thyroidectomy was performed one month after the diagnosis. AHI was found 34.8 /h on the PSG applied for the purpose of 8 week-postoperative control. There were recovery on the levels of total sleep time, AHI, obstructive apnea index, hypopnea index, average desaturation index, stage 3 and REM as 16%, 44.8%, 84.7%, 19%, 38.3%, 52.4% and 28% respectively when compared the preoperative term with and postoperative term. It was demonstrated that there was no change of the in the degree of OSAS after thyroidectomy but only some partial improvement in the OSAS. The conclusion that there may be some improvements in nCPAP pressures after thyroidectomy and nCPAP treatment should not be stopped was reached. Also, it should be kept in mind that patients who apply to

  18. Retained Fetal Bone in Infertile Patients: Two Case Reports

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    Ensieh ShahrokhTehraninejad

    2009-01-01

    Full Text Available The prolonged retention of fetal bone structure is an uncommon condition after a previous abortion.We describe two cases with fetal bone fragment amongst 3589 hysteroscopies (0.05%, who hadno complaint other than secondary infertility. In both patients, hyperechogenic areas were foundthrough transvaginal ultrasound and the bones were removed by hysteroscopy. Despite meticulousevaluation during hysteroscopy, some bones were not observed and were stable during the nextsonography. According to the formation of fetal bones after 11 weeks of pregnancy; patientswith secondary infertility who have a history of abortion that progressed beyond this time andendometrial hyperechoic areas by transvaginal ultrasound should be evaluated for any retainedfetal bone. Hysteroscopy should be performed under abdominal ultrasonography guide to ensurefetal bone tissue is entirely removed during a single surgery.

  19. An Investigation into Associations with Attachment, Companion Pet Attachment, Empathy, and Prosocial Behaviors in 18-20 Year Old College Students: A Mixed Methods Study

    Science.gov (United States)

    Anderson, Christian

    2010-01-01

    This study examines empathy, parental attachment, companion pet attachment and social behaviors in a sample of 120 students between the ages of 18-20 enrolled at Front Range Community College in Westminster CO during the fall semester 2008. The study is based on the research questions posed by Thompson and Gullone (2008) but pays particular…

  20. Shallow groundwater from the far north of Cameroon (southern Lake Chad): revisiting a 20 years old survey of hydrochemistry and stable isotopes

    Science.gov (United States)

    Ketchemen-Tandia, Beatrice; Mohammad, Bello; Fouepe, Alain; Ngo Boum, Suzanne; Nlend, Bertil; Garel, Emilie; Celle-Jeanton, Helene; Huneau, Frederic

    2016-04-01

    Two field hydrogeological investigation surveys were conducted in 1992 and 2013 using hydrochemistry and isotope techniques in the far north part of Cameroon which corresponds to the southern part of Lake Chad basin. All of these data relate to groundwater and surface water which were collected at the same places to potentially reveal any temporal variation in the chemical and isotopic characteristics of the water resources. Groundwater show mainly a Ca-HCO3 water type but CaMg-Cl and Na-HCO3 water types can also be found. The groundwater chemistry is resulting from many processes including pure silicate weathering and cation exchange. It is found that the nitrate content after 20 years has increased by an average factor of 6. These high concentrations in nitrate (up to 400 mg/l) are related to local anthropogenic activities and to the very bad conditions of maintaining of wells and boreholes. This pollution is also correlated to the population growth over the past two decades in the region. The isotopic content of groundwater is ranging from -6.87‰ to -0.32‰ for δ18O in 2013 and from -6.03‰ to +0.25‰ in 1992 without noticeable evolution through time. The conventional δD-δ18O diagram indicates that the groundwater has a meteoric origin more or less influenced by evaporation processes. Different processes involving different water sources were highlighted: (i) groundwater which has been affected by evaporation or in communication with evaporated surface waters; (ii) groundwater which is very close to the Global Meteoric Water Line and corresponding to a recent and direct recharge from precipitation; (iii) groundwater which is more depleted corresponding to a mixing between shallow and deep groundwater. This research is partly supported by the RAF7012and RAF7011 project from IAEA.

  1. Emotional disorders in patients with cerebellar damage – case studies

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    Siuda, Katarzyna

    2014-04-01

    Full Text Available Aim: Growing number of research shows the role of the cerebellum in the regulation of affect. Lesions of the cerebellum can lead to emotional disregulation, a significant part of the Cerebellar Cognitive Affective Syndrome. The aim of this article is to analyze the most recent studies concerning the cerebellar participation in emotional reactions and to present three cases: two female and one male who suffered from cerebellar damage and presented post-traumatic affective and personality change. Method: The patients’ neuropsychological examination was performed with Raven’s Progressive Matrices Test – standard version, Trial Making Test, Wisconsin Card Sorting Test, Auditory Verbal Learning Test by Łuria, Benton Visual Retention Test, Verbal Fluency Test, Stroop Interference Test, Attention and Perceptivity Test (Test Uwagi i Spostrzegawczości TUS, Frontal Behavioral Inventory (FBI. Results: The review of the literature suggest cerebellar participation, especially teh vermis and paravermial regions, in the detection, integration and filtration of emotional information and in regulation of autonomic emotional responses. In the described patients we observed: oversensitivity, irritability, impulsivity and self-neglect. The man and the woman with right-sided lesions presented similar symptoms: rigidity of thought, stubbornness, lack of criticism, jocular and inappropriate behavior. The woman with left-sided cerebellar lesion was adynamic, apathic and passive, she presented emotional blunting, social isolation, lack of interests and motivation, general cognitive slowdown. Conclusions: Both the analyzed research and the described cases indicate the connection between the cerebellum and emotion regulation. The symptoms presented by the described patients were most probably a consequence of damaged cerebellar projections to subcortical structures (the limbic system and frontal areas. The diversification of symptoms depending on the localization

  2. Rosiglitazone as an option for patients with acromegaly: a case series

    OpenAIRE

    Bahena-García Ana; Tamez-Pérez Héctor E; Gómez de Ossio María D; Gutiérrez-Hermosillo Hugo; Tamez-Peña Alejandra L

    2011-01-01

    Abstract Introduction In the patient with acromegaly, pituitary surgery is the therapeutic standard. Despite undergoing surgery, a significant number of patients with acromegaly continue to have uncontrolled growth hormone secretion. These patients require other treatments such as external irradiation and/or drug therapy. Case presentation We present the clinical and laboratory responses to six months of treatment with rosiglitazone in four cases. In all four cases, the patients had persisten...

  3. Case Specificity of Standardized-Patient Examinations: Consistency of Performance on Components of Clinical Competence within and between Cases.

    Science.gov (United States)

    Colliver, Jerry A.; And Others

    1990-01-01

    Standardized patient case problems were administered to approximately 280 final year medical students. Results indicate that performance on a given component of clinical competence shows less consistency when measured on different cases than does performance on different components measured on the same case. (TJH)

  4. Morvan Syndrome: A Case Report With Patient Narrative and Video.

    Science.gov (United States)

    Maskery, Mark; Chhetri, Suresh K; Dayanandan, Rejith; Gall, Claire; Emsley, Hedley C A

    2016-01-01

    A 74-year-old gentleman was admitted to the regional neurosciences center with encephalopathy, myokymia, and dysautonomia. Chest imaging had previously identified an incidental mass in the anterior mediastinum, consistent with a primary thymic tumor. Antivoltage-gated potassium channel (anti-VGKC) antibodies were positive (titer 1273 pmol/L) and he was hypokalemic. Electromyogram and nerve conduction studies were in keeping with peripheral nerve hyperexcitability syndrome, and an electroencephalogram was consistent with encephalopathy. A diagnosis of Morvan syndrome was made, for which he was initially treated with high-dose steroids, followed by a 5-day course of intravenous immunoglobulin (IVIG) therapy. He also underwent thymectomy, followed by a postexcision flare of his symptoms requiring intensive care management. Further steroids, plasmapheresis, and IVIG achieved stabilization of his clinical condition, enabling transfer for inpatient neurorehabilitation. He was commenced on azathioprine and a prolonged oral steroid taper. A subsequent presumed incipient relapse responded well to further IVIG treatment. This case report documents a thymoma-associated presentation of anti-VGKC-positive Morvan syndrome supplemented by patient and carer narrative and video, both of which provide valuable further insights into this rare disorder. There are a limited number of publications surrounding this rare condition available in the English literature. This, combined with the heterogenous presentation, association with underlying malignancy, response to treatment, and prognosis, provides a diagnostic challenge. However, the association with anti-VGKC antibody-associated complexes and 2 recent case series have provided some scope for both accurate diagnosis and management.

  5. An unusual case of cryoglobulinemic purpura in elderly patient

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    Mauro Turrin

    2015-03-01

    Full Text Available Cryoglobulinemia is associated with infections, in particular chronic hepatitis C, autoimmune diseases, and lymphoproliferative disorders. Its frequency seems to be higher than is commonly considered, even in elderly patients.We describe the case of an elderly patient with diabetes, nephroangiosclerosis and purpura who presented marked and persistent increase in rheumatoid factor, hypocomplementemia and cryoglobulinemia with nephrotic disagreement unrelated to HCV. A thirteen‑month follow‑up showed neither immunorheumatologic nor neoplastic disorders. In literature, associations with hepatic pseudocyst is not described and a lack of association with HCV is very rare. Therefore, the hypothesis of “essential” mixed cryoglobulinemia (EMC associated with nephrotic syndrome was formulated. Renal disease associated with EMC (unrelated to HCV is characterized by the high prevalence of primary Sjögren syndrome and overt B‑cell non‑Hodgkin’s lymphoma for which repetitive clinical evaluation is necessary.http://dx.doi.org/10.7175/cmi.v9i1.1165

  6. Performance of the AST to Platelet Ratio Index (APRI) as a Noninvasive Marker of Fibrosis in Pediatric Patients with Chronic Viral Hepatitis

    OpenAIRE

    2010-01-01

    We investigated the performance of AST to platelet ratio index (APRI) as a non-invasive marker of fibrosis and cirrhosis in children with chronic viral hepatitis. All patients 0–20 years old with chronic hepatitis B or C seen at a tertiary medical center from 1992–2008 were identified. 36 patients were evaluated with 48 biopsy results. The areas under the ROC curve were 0.71 for fibrosis and 0.52 for cirrhosis. When examining subgroups, the APRI performed better in older patients and in those...

  7. Rosiglitazone as an option for patients with acromegaly: a case series

    Directory of Open Access Journals (Sweden)

    Bahena-García Ana

    2011-05-01

    Full Text Available Abstract Introduction In the patient with acromegaly, pituitary surgery is the therapeutic standard. Despite undergoing surgery, a significant number of patients with acromegaly continue to have uncontrolled growth hormone secretion. These patients require other treatments such as external irradiation and/or drug therapy. Case presentation We present the clinical and laboratory responses to six months of treatment with rosiglitazone in four cases. In all four cases, the patients had persistent growth hormone overproduction despite previous surgical treatment and other conventional therapy. Case 1 is a 57-year-old Caucasian woman, case 2 is a 51-year-old Hispanic man, case 3 is a 32-year-old Hispanic woman, and case 4 is a 36-year-old Hispanic man. In three of these patients, basal and nadir growth hormone and insulin-like growth factor 1 levels were significantly decreased (P P Conclusion Rosiglitazone could be a treatment option in select patients with acromegaly.

  8. Endoscopic identification of Peyer's patches of the terminal ileum in a patient with Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    Hiroshi Ishimoto; Hajime Isomoto; Saburo Shikuwa; Chun Yang Wen; Takashi Suematu; Masahiro Ito; Ikuo Murata; Hiromi Ishibashi; Shigeru Kohno

    2004-01-01

    We presented a 20-year-old patient with Crohn′s disease (CD). Colonoscopy revealed longitudinal ulceration in the terminal ileum and rectal aphtoid ulcers. After treatment with mesalamine and total parenteral nutrition, repeat colonoscopy revealed a granular elevated area in the terminal ileum, which appeared as an irregular dome-like elevation with irregularly arranged villi on magnifying endoscopy. Biopsy specimens taken from the region showed microgranulomas and lymphoid hyperplasia. Scanning electron microscopy revealed the presence of M cells, confirming that the area corresponded to Peyer′s patches. Peyer′s patches by magnifying endoscopy and electron microscopy may provide insights into the pathogenesis of CD.

  9. Listening to "How the Patient Presents Herself": A Case Study of a Doctor-Patient Interaction in an Emergency Room

    Science.gov (United States)

    Delbene, Roxana

    2015-01-01

    This is a case-study based on a micro-ethnography analyzing a doctor-patient interaction in an emergency room (ER) in New York City. Drawing on the framework of narrative medicine (Charon, 2006), the study examines how a phenomenological approach to listening to the patient facilitated the patient's narrative orientation not only to relevant…

  10. Temporomandibular joint pain-dysfunction syndrome in patients from “Guillermo Tejas” polyclinic

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    Delarays Ossani Pérez Alfonso

    2015-09-01

    Full Text Available Background: when the physiological levels of the components of the temporomandibular joint are altered by any risk factor, there can appear functional and structural disorders with their corresponding clinical repercussions, which are part of the temporomandibular joint pain-dysfunction syndrome.Objective: to characterize clinically and epidemiologically those patients suffering from temporomandibular joint pain-dysfunction syndrome of “Guillermo Tejas” polyclinic in Las Tunas municipality, from November, 2012 to October, 2014.Methods: a descriptive study was carried out in patients from 12 to 20 years old who came to the dental clinic of the above mentioned polyclinic and time period. The universe consisted of 135 patients who entered the service and the sample was comprised 75 patients diagnosed with temporomandibular joint pain-dysfunction syndrome.Results: females were the most representative ones; regarding age, the groups of 18, 19 and 20 years old patients prevailed. The most frequent para-functional habits were unilateral mastication and bruxism. The prevailing associated factors were occlusal disharmonies. The joint noise and mandibular deviation were the most frequent symptoms and signs.Conclusions: it was possible to characterize clinically and epidemiologically those patients suffering from temporomandibular joint pain-dysfunction syndrome, more frequently found in those older than 18 years old.

  11. Clinical and pathological analysis of 116 cases of adult adrenal cortical adenoma and literature review

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    Jia AH

    2015-05-01

    Full Text Available Ai-Hua Jia,1 Hong-Quan Du,2 Min-Hua Fan,2 Yu-Hong Li,1 Jun-Long Xu,1 Gui-Fen Niu,2 Jie Bai,2 Guang-Zhen Zhang,2 Yu-Bo Ren1 1Department of Pathology, Liaocheng People’s Hospital, Liaocheng, People’s Republic of China; 2Department of Endocrinology, Liaocheng People’s Hospital, Liaocheng, People’s Republic of China Background: The aim of this study is to investigate origin, gross features, microscopic features, immunohistochemical properties, and differential diagnosis of adrenal cortical adenoma (ACA in patients20 years old.Methods: The clinicopathological features of 116 cases of ACA and the immunohistochemical features of 50 cases of ACA were evaluated, and the relevant literature was reviewed.Results: In our cohort, 76.72% (89/116 of the cases were functional, and 27 cases had non-functional, benign adrenal adenomas. ACA presented as an island tumor with an envelope, and the mean tumor size was 3.6 cm (range 1–5 cm, with a mean tumor weight of 9.28 g (range 5–113 g. The shape of the tumor cells was consistent, and mitosis was rarely observed. Forty of the 46 patients with cortisol-secreting ACA had tumors containing granule cells. Primary aldosteronism was observed in 43 cases. Thirty-eight cases had endoscopically visible tumors, with clear cells and lipid-rich cytoplasm arranged in irregular patches or strips. Cortisol-producing ACAs were associated with atrophy of the non-tumorous cortex. Adrenocortical adenomas displayed positive immunohistochemical staining for MELAN-A, Syn (46 of 50 cases of ACA, NSE (44 of 50 cases of ACA, Vim (42 of 50 cases of ACA and Ki-67 <5% (24 of 50 cases of ACA; the remaining 26 cases were negative for Ki-67.Conclusion: Prediction of endocrine syndrome in functional ACA was possible based on its structure and morphologic features, which could prevent an unanticipated postoperative crisis. However, a clinical study is needed to validate these findings. Keywords: adrenal cortical adenoma

  12. Arachnoid cyst in a patient with psychosis: Case report

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    Guimarães João

    2007-06-01

    Full Text Available Abstract Background The aetiology of a psychotic disturbance can be due to a functional or organic condition. Organic aetiologies are diverse and encompass organ failures, infections, nutritional deficiencies and space-occupying lesions. Arachnoid cysts are rare, benign space-occupying lesions formed by an arachnoid membrane containing cerebrospinal fluid (CSF. In most cases they are diagnosed by accident. Until recently, the coexistence of arachnoid cysts with psychiatric disturbances had not been closely covered in the literature. However, the appearance of some references that focus on a possible link between arachnoid cysts and psychotic symptoms has increased the interest in this subject and raised questions about the etiopathogeny and the therapeutic approach involved. Clinical presentation We present the clinical report of a 21-year-old man, characterised by the insidious development of psychotic symptoms of varying intensity, delusional ideas with hypochondriac content, complex auditory/verbal hallucinations in the second and third persons, and aggressive behaviour. The neuroimaging studies revealed a voluminous arachnoid cyst at the level of the left sylvian fissure, with a marked mass effect on the left temporal and frontal lobes and the left lateral ventricle, as well as evidence of hypoplasia of the left temporal lobe. Despite the symptoms and the size of the cyst, the neurosurgical department opted against surgical intervention. The patient began antipsychotic therapy and was discharged having shown improvement (behavioural component, but without a complete remission of the psychotic symptoms. Conclusion It is difficult to be absolutely certain whether the lesion had influence on the patient's psychiatric symptoms or not. However, given the anatomical and neuropsychological changes, one cannot exclude the possibility that the lesion played a significant role in this psychiatric presentation. This raises substantial problems when it

  13. Spinal epidural abscess in hemodialysis patients: a case series and review.

    Science.gov (United States)

    Wong, San S; Daka, Smitha; Pastewski, Andrew; Kyaw, Win; Chapnick, Edward; Sepkowitz, Douglas

    2011-06-01

    Spinal epidural abscess (SEA) is a rare but potentially devastating condition. We noticed an increase in the number of cases of SEA, with the majority in hemodialysis (HD) patients. This prompted a retrospective chart review of all cases of SEA admitted from 2000 to 2005 and a literature search of similar cases. We identified 19 SEA cases treated at Long Island College Hospital during this 6-year period, of which six were on HD: four were dialyzed via catheter, one via arteriovenous fistula, and in one the method of dialysis was not documented. Four patients had bacteremia with Staphylococcus aureus. Four patients presented with paresis or paralysis; only one improved. The mortality rate was 33% (2/6). We found 30 other cases of SEA in patients on HD from the literature. These 36 HD cases were compared with 85 SEA cases that were not on HD (13 from our study and 72 described in two large case series). The mortality rate was noted to be much higher in HD patients (23% [6/26] versus 7% [6/85]). Neurologic deficit at presentation was noted in 47% (17/36) of HD patients versus 69% (59/85) of non-HD patients, but neurologic improvement was higher in non-HD patients (71% [42/59] versus 29% [5/17]). This is the largest literature review of SEA in patients on HD. When compared with non-HD patients, HD patients had a higher mortality rate and were less likely to improve neurologically.

  14. Study of chronic hemolytic anaemia patients in Rio de Janeiro: prevalence of anti-human parvovirus B19 IgG antibodies and the developement aplastic crises

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    SANT'ANNA Anadayr L.M.

    2002-01-01

    Full Text Available The prevalence of anti-human parvovirus B19 IgG antibodies was determined in sera from 165 chronic hemolytic anemia patients, receiving medical care at Instituto Estadual de Hematologia (IEHE, Rio de Janeiro, during the year of 1994. This sample represents around 10% of the chronic hemolytic anemia patients attending at IEHE. Most of these patients (140 have sickle cell disease. Anti-B19 IgG antibodies were detected in 32.1% of patients. No statistically significant difference (p > 0.05 was seen between IgG antibody prevalence in male (27.8% and female (35.5% patients. Anti-B19 IgG antibodies were more frequent in older (37.6% than younger (28.2% than 20 years old patients, although this difference had no statistical significance (p > 0.05. Anti-B19 IgG antibody prevalence showed that 67.9% of patients enrolled in the study were susceptible to B19 acute infection. With the aim to detect acute B19 infection, patients follow up continued until February 1996. During this period four patients presented transient aplastic crisis due to human parvovirus B19 as confirmed by the detection of specific IgM antibodies. All four patients were younger than 20 years old, and 3 were younger than 10 years old. Three of them were sickle cell disease patients. Three of the four acute B19 infection occurred during 1994 springtime.

  15. Study of chronic hemolytic anaemia patients in Rio de Janeiro: prevalence of anti-human parvovirus B19 IgG antibodies and the development aplastic crises.

    Science.gov (United States)

    Sant'Anna, Anadayr L M; Garcia, Rita de Cássia N Cubel; Marzoche, Mônica; da Rocha, Heloisa Helena A Gallo; Paula, Maria Tereza M; Lobo, Clarisse C; Nascimento, Jussara P

    2002-01-01

    The prevalence of anti-human parvovirus B19 IgG antibodies was determined in sera from 165 chronic hemolytic anemia patients, receiving medical care at Instituto Estadual de Hematologia (IEHE), Rio de Janeiro, during the year of 1994. This sample represents around 10% of the chronic hemolytic anemia patients attending at IEHE. Most of these patients (140) have sickle cell disease. Anti-B19 IgG antibodies were detected in 32.1% of patients. No statistically significant difference (p > 0.05) was seen between IgG antibody prevalence in male (27.8%) and female (35.5%) patients. Anti-B19 IgG antibodies were more frequent in older (37.6%) than younger (28.2%) than 20 years old patients, although this difference had no statistical significance (p > 0.05). Anti-B19 IgG antibody prevalence showed that 67.9% of patients enrolled in the study were susceptible to B19 acute infection. With the aim to detect acute B19 infection, patients follow up continued until February 1996. During this period four patients presented transient aplastic crisis due to human parvovirus B19 as confirmed by the detection of specific IgM antibodies. All four patients were younger than 20 years old, and 3 were younger than 10 years old. Three of them were sickle cell disease patients. Three of the four acute B19 infection occurred during 1994 springtime.

  16. Endocarditis lenta-patient survived septic shock: a case report

    Directory of Open Access Journals (Sweden)

    Amra Macić Džanković

    2012-09-01

    Full Text Available Infective endocarditis is defi ned as an infection of the endocardial surface of the heart. Its intracardiac effects include severe valvular insuffi ciency, which may lead to intractable congestive heart failure and myocardialabscesses. This disease still carries a poor prognosis and a high mortality.A severe case of infective endocarditis with its complications is presented. A man with aortic prosthetic valve due to earlier aortic stenosis and corrected aortal coarctation and implanted pacemaker presentedwith prolonged unexplained fever, malaise, sweating, weight loss (15 kg/4 months and lumbar pain. He was treated with broad-spectrum antibiotics prior IE diagnosis was considered. Echocardiogram showedaortic vegetations and possible periaortal abscess formation. Nonspecifi c infl ammation parameters were high positive. Cultures were constantly negative. His condition had deteriorated suddenly, and he had presentedwith worsening of cutaneous vasculitis, subacute glomerulonephritis and subsequent acute respiratory distress syndrome and septic shock. This patient survived with residual bilateral necrosis of the feet andtoxic peroneal paresis. At the end transthoracic echocardiogram showed enlarged heart chambers, LV mild dilated and concentric hypertrophy with ejection fraction about 40%, degenerative postinfl ammatory mitralvalve changes, mild mitral regurgitation and tricuspid regurgitation, postinfl ammatory aortic root fi brosis and moderate aortic valve stenosis (AVPG max 50,9 mmHg, AVPG mean 24 mmHg with no pericardial effusion. Initial suspicion of Q fever was defi nitely excluded by serological testing showing nonspecifi c IgM positivity,probably rheumatoid factor related.

  17. [A case of Xanthinuria in a patient with marked hypouricemia].

    Science.gov (United States)

    Martella, Vilma; Sozzo, Efisio; Montagna, Elio; Stefanizzi, Salvatore; Cito, Annarita; Marinello, Enrico; Terzuoli, Lucia; Micheli, Vanna; Napoli, Marcello

    2011-01-01

    Xanthinuria is a rare autosomal recessive disorder associated with a deficiency of xanthine oxidoreductase (XOR), which normally catalyzes the conversion of hypoxanthine to uric acid. The effects of this deficit are an elevated concentration of hypoxanthine and xanthine in the blood and urine, hypouricemia, and hypouricuria. The deficit in XOR can be isolated (type I xanthinuria) or associated with a deficit in aldehyde oxidase (type II xanthinuria) and sulfite oxidase (type III xanthinuria). While the first two variants have a benign course, are often asymptomatic (20%), and clinically indistinguishable, type III xanthinuria is a harmful form that leads to infant death due to neurological damage. The clinical symptoms (kidney stones, CKD, muscle and joint pain, peptic ulcer) are the result of the accumulation of xanthine, which is highly insoluble, in the body fluids. We describe a case of type I xanthinuria in a 52-year-old woman who presented with hypouricemia, hypouricuria and kidney stones. The diagnosis was based on purine catabolite levels in urine and serum measured by 3 nonroutine methods: high-pressure liquid chromatography, mass spectrometry, and magnetic resonance imaging. To identify the type of xanthinuria the allopurinol test was used. We believe that these tests will facilitate the diagnosis of xantinuria especially in asymptomatic patients without the need for a biopsy of the liver or intestines, which is useful only for scientific purposes.

  18. Primary breast lymphoma in an immunocompromised male patient: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Bong Guk; Park, Jeong Seon; Koo, Hye Ryoung; Kim, Soo Yeon; Jang, Ki Seok [Hanyang University Medical Center, Hanyang University College of Medicine, Seoul (Korea, Republic of); Kim, Jin Young; Choi, Yun Young [Dept. of Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri (Korea, Republic of)

    2015-10-15

    Primary breast lymphoma in a male patient is extremely rare. We report a case of primary breast lymphoma in an immunocompromised male patient, after renal transplantation. The sonographic and histological features are described in depth.

  19. Appearance of Systemic Lupus Erythematosus in Patients with Myasthenia Gravis following Thymectomy: Two Case Reports

    OpenAIRE

    2004-01-01

    We report two cases of systemic lupus erythematosus (SLE) in myasthenia gravis (MG) patients who had undergone thymectomy. SLE developed in the patients 3 months or 13 yr after thymectomy, and polyarthritis was the main clinical manifestation of SLE. Both patients fulfilled at least four of the revised criteria for the classification of SLE. In this report, we describe two postthymectomy lupus patients and perform a comparative review of previous cases.

  20. Appearance of systemic lupus erythematosus in patients with myasthenia gravis following thymectomy: two case reports.

    Science.gov (United States)

    Park, Mi Jeong; Kim, Yun A; Lee, Shin Seok; Kim, Byeong Chae; Kim, Myeong Kyu; Cho, Ki Hyun

    2004-02-01

    We report two cases of systemic lupus erythematosus (SLE) in myasthenia gravis (MG) patients who had undergone thymectomy. SLE developed in the patients 3 months or 13 yr after thymectomy, and polyarthritis was the main clinical manifestation of SLE. Both patients fulfilled at least four of the revised criteria for the classification of SLE. In this report, we describe two postthymectomy lupus patients and perform a comparative review of previous cases.

  1. The Xmnl polymorphic site 5 ' to the gene G gamma in a Brazilian patient with sickle cell anaemia - fetal haemoglobin concentration, haematology and clinical features

    OpenAIRE

    Belini Junior, Edis [UNESP; Cancado, Rodolfo D.; Domingos, Claudia R.B.

    2010-01-01

    We report a 20-year-old female with sickle cell anaemia and with an HbF concentration of 15.8%. The patient was not using hydroxyurea and was not receiving regular blood transfusions. The patient never had chronic manifestations of sickle cell anaemia, only pain crises of a mild intensity. After laboratory tests, we found that she was homozygous for HbS with the Bantu/atypical haplotype, and was heterozygous for the XmnI site. The influence of the XmnI site on the expression of HbF can explai...

  2. 40. Hoarseness of voice as a primary presentation of pulmonary hypertension: A rare case of Ortner’s (cardio-vocal syndrome

    Directory of Open Access Journals (Sweden)

    K. Naeem

    2016-07-01

    Full Text Available Ortner’s (cardio-vocal syndrome is a rare disease entity that involves compression of the left recurrent laryngeal nerve due to enlargement of cardiovascular structures. The syndrome was first described by Norbert Ortner (an Austrian physician in 1897 and is usually reported to be associated with mitral stenosis. However, we report a rare case when a 20-year-old girl presented with hoarseness of voice and was found to have an enlarged main pulmonary trunk due to pulmonary hypertension that was compressing the left recurrent laryngeal nerve. The case highlights a rare presentation of a relatively common disease and stresses the importance of detailed cardiac workup in a patient with hoarseness of voice. We present the case and review the literature. A 20-year-old lady was referred from primary health center due to complaints of hoarseness of voice for the last four months. She reported only mild exertional palpitations and shortness of breath. She did not report any previous cardiac problem in childhood. Examination revealed a loud pulmonary component of 2nd heart sound, a pan-systolic murmur at the tricuspid area, and a palpable thrill. There was no evidence of right heart failure or any stigmata of connective tissue disease. Electrocardiography showed sinus rhythm with dominant R-wave in lead V1 indicating right ventricular hypertrophy. Laboratory tests did not reveal any abnormality. 2-D transthoracic echocardiograhy revealed normal left ventricle in size and function, right ventricular hypertrophy (6 mm thickness of free wall, mild to moderate tricuspid regurgitation, pulmonary hypertension (pulmonary pressure 60–65 mmHg and an enlarged main pulmonary trunk. Computed tomography (CT of the chest showed dilated main pulmonary trunk (max diameter 42 mm. An angiogram excluded pulmonary emboli. The patient was also seen by the Otolaryngology team in view of the main complaint of hoarseness of voice. Indirect laryngoscopy showed left vocal

  3. Clinical Analysis of 5 Cases of Laparoscopy in Pregnant Patients

    Institute of Scientific and Technical Information of China (English)

    杨佳欣; 冷金花; 郎景和

    2003-01-01

    @@ Five pregnant patients were given laparoscopicsurgery in PUMCH in recent two years. All the pa-tients have the indications for operation. The age ofthe patients was 25 to 33 years old. The operationwas done in the first and second trimester. The dura-tion of the operation was about 30 mins with no ma-nipulation of the cervix.

  4. [A recurrent case of adult favus successfully treated with terbinafine].

    Science.gov (United States)

    Erkan, Deniz; Kolukırık, İlkay; Acar, Alpaslan; Kandemir, Hazal; İlkit, Macit

    2015-10-01

    Favus or tinea capitis favosa, is a chronic inflammatory dermatophytosis of the scalp. The disease is particularly common in children aged 6 to 10 years, more often in boys, and it also occurs in adults. Human-to-human transmission is therefore possible. Anthropophilic Trichophyton schöenleinii is responsible for over 95% of favus cases. In addition, there are rare cases of anthropophilic T.violaceum, zoophilic (T.verrucosum, T.quinckeanum, and Microsporum canis) and geophilic M.gypseum species recorded as agents of favus. It is also reported in mice (T.quinckeanum), poultry (M.gallinae), and cats (M.incurvatum). Favus is common in Iran, Nigeria, and China, however it has been reported rarely in the last two decades in Turkey. Although Turkish records are not sufficient to indicate an accurate incidence rate, favus is still present in Turkey. In this report, a 20-year-old female with favus was presented. She had squames and areas of alopecia on the right frontoparietal area of her scalp. Scalp biopsy and hair follicle samples were taken for histopathological examination and fungal culture. According to the conventional identification by mycological methods and internal transcribed spacer (ITS) sequencing analysis, the pathogen was identified as T.schöenleinii. The patient was treated with oral terbinafine (250 mg/day) for 4 weeks and topical isoconazole and ketoconazole for 6 weeks. Clinical recovery was observed after 6 weeks, however, fungal culture could not be repeated. Six months after the initial presentation, the patient's symptoms recurred due to the poor adherence and T.schöenleinii was repeatedly grown in culture. Antifungal treatment was administered with the same drugs for the same period. There was a clinical and mycological recovery 8 months after initial presentation. Favus, which is not frequently observed in adults, is an uncommon disease. Confusion arises in its diagnosis because other diseases have similar clinical appearances, and

  5. Unusual pulmonary Enterocytozoon bieneusi microsporidiosis in an AIDS patient: case report and review.

    Science.gov (United States)

    Sodqi, Mustapha; Brazille, Patricia; Gonzalez-Canali, Gustavo; Cornet, Muriel; Piketty, Christophe; Weiss, Laurence

    2004-01-01

    Enterocytozoon bieneusi is an agent of intestinal microsporidiosis leading to chronic diarrhoea in AIDS patients. Pulmonary involvement may occur but remains rare with only 4 cases reported in the literature. We report here the fifth case of pulmonary localization of E. bieneusi in a severe immunocompromized HIV-infected patient with intestinal and pulmonary symptoms.

  6. Case management in aftercare of involuntarily committed patients with substance abuse

    DEFF Research Database (Denmark)

    Lindahl, Marianne Larsson; Berglund, Mats; Tönnesen, Hanne

    2013-01-01

    Case management has since the 1970s been widely used to co-ordinate services for mental health patients. The methodology has expanded to support patients in many different types of conditions. This study is one of very few randomized trials on case management in a European setting. It examined...

  7. Disseminated Aspergillosis due to Aspergillus niger in Immunocompetent Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Ulku Ergene

    2013-01-01

    Full Text Available Invasive aspergillosis is a major cause of morbidity and mortality in immunocompromised patients. Many cases of pulmonary, cutaneous, cerebral, and paranasal sinus aspergillosis in immunocompetent patient were defined in literature but disseminated aspergillosis is very rare. Here we present an immunocompetent case with extrapulmonary disseminated aspergillosis due to Aspergillus niger, totally recovered after effective antifungal treatment with voriconazole.

  8. Renal Cell Carcinoma in A Patient with Kartagener Syndrome: First Case Report in English Language

    Directory of Open Access Journals (Sweden)

    Erkin Sağlam

    2015-03-01

    Full Text Available Cardiac and pulmonary anomalies are common among patients with situs inversus totalis. Renal anomalies, including renal agenesis, dysplasia, hypoplasia, ectopia, polycystic kidney, and horseshoe kidney have been reported. We report a case of renal cell carcinoma in a patient with situs inversus totalis (SIT. Our case represents the fourth case report of renal cell carcinoma in a patient with situs inversus totalis and to the best of our knowledge this is the first report in English language. Due to the higher frequency of cardiac, pulmonary, renal, and vascular anomalies the management of patients with situs inversus and urologic disease requires careful preoperative evaluation.

  9. [Case report: hookworm infection in a patient with severe anemia].

    Science.gov (United States)

    Yilmaz, Hasan; Taş Cengiz, Zeynep; Ciçek, Mutalip; Dülger, Ahmet Cumhur

    2009-01-01

    In this study, a patient who was hospitalized with a severe anemia in the Internal Medicine Clinic of the Health Research and Application Hospital of Yüzüncü Yil University for one week is presented. The patient had fatigue, paleness and dizziness for one month and approximately 12 kg weight lost for four mounts previous to admission.. Severe iron deficiency anemia was diagnosed in the patient by laboratory analyses. Because there were no hematologic factors associated with severe anemia, the stool examination was also performed. In the Parasitology Laboratory, stool microscopy of the patient revealed numerous ova of hookworm. General condition of the patient well improved with anti-parasitic and anti-anemia treatment. It was concluded that patients with iron deficiency anemia diagnosed in health centers should be also examined for the intestinal parasitic diseases encountered rarely, and physicians should consider non-endemic parasitic diseases in their provinces.

  10. ANANKASTIK PERSONALITY DISORDER IN SCHIZOPHRENIA PARANOID PATIENT: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Damarnegara ..

    2014-02-01

    Full Text Available Anankastik personality disorder is a health problem that can disturb the activities of person and can accompany a variety of other mental health problems. The patient in thiscase is a patient with an anankastik or obsessive compulsive personality disorder withthe axis I diagnoses is Paranoid Schizophrenia and was given haloperidol 2x5mg, buthave not done psychotherapy because the patient has not been cooperative. Theprognosis is dependent on patient compliance in taking medication and controls for thesetting of the dose, and the support of her family. 

  11. Primary amoebic meningoencephalitis: first reported case from Rohtak, North India

    Directory of Open Access Journals (Sweden)

    Naveen Gupta

    2009-06-01

    Full Text Available A fatal case of primary amoebic encephalitis (PAM in a 20 year old boy, a proven case of acute leukemic leukemia (ALL type L2, in remission is described. No history of swimming could be elicited. The clinical presentation, the isolation of the amoeba from the cerebrospinal fluid (CSF, the poor response to amphotericin B, and the ultimately fatal outcome are all consistent with the diagnosis of PAM. On the basis of its ability to grow at temperature 42ºC and 45ºC, morphology of trophozoite, and the presence of flagellate forms in CSF, the amoeba was identified as Naegleria fowleri. Other drugs used in combination with amphotericin B are tetracycline, rifampicin, and miconazole. A possibility of PAM should always be considered in all cases of acute purulent meningoencephalitis in which no bacteria or fungus are found.

  12. Primary amoebic meningoencephalitis: first reported case from Rohtak, North India.

    Science.gov (United States)

    Gupta, Naveen; Bhaskar, Hemlata; Duggal, Shalini; Ghalaut, Pratap S; Kundra, Shailja; Arora, Des R

    2009-06-01

    A fatal case of primary amoebic encephalitis (PAM) in a 20 year old boy, a proven case of acute leukemic leukemia (ALL) type L2, in remission is described. No history of swimming could be elicited. The clinical presentation, the isolation of the amoeba from the cerebrospinal fluid (CSF), the poor response to amphotericin B, and the ultimately fatal outcome are all consistent with the diagnosis of PAM. On the basis of its ability to grow at temperature 42 degrees C and 45 degrees C, morphology of trophozoite, and the presence of flagellate forms in CSF, the amoeba was identified as Naegleria fowleri. Other drugs used in combination with amphotericin B are tetracycline, rifampicin, and miconazole. A possibility of PAM should always be considered in all cases of acute purulent meningoencephalitis in which no bacteria or fungus are found.

  13. Candida Parapsilosis Arthritis Involving the Ankle in a Diabetes Patient: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Jin Kyeong; Chun, Kyung Ah [Dept. of Radiology, The Catholic University of Korea Uijeongbu St. Mary' s Hospital, Uijeongbu (Korea, Republic of)

    2011-06-15

    Candida parapsilosis is a rare opportunistic fungal pathogen of the musculoskeletal region. Immune function of almost all patients is severely disturbed. Most reported cases of septic arthritis of joints by Candida involve the knee, especially Candida parapsilosis. To our knowledge, there has been only one case report of Candida parapsilosis involving the ankle presented on only plain radiography. We report a case of Candida parapsilosis arthritis involving the ankle in a diabetes patient which was shown on MR imaging.

  14. Syphilitic meningitis in HIV-patients with meningeal syndrome: report of two cases and review

    OpenAIRE

    2001-01-01

    Few patients with symptomatic neurosyphilis present with signs and symptoms of acute meningitis. Here we report two cases of syphilitic meningitis diagnosed in HIV patients with meningeal syndrome. The first case, a 30-year-old black bisexual male, had concurrent meningeal and ocular syphilis with persistent unusually low CSF glucose levels. He responded well to 21 days of intravenous penicillin therapy. The second case was a 55-year-old female with epilepsy, depression, behavioral disorder a...

  15. Colonic perforation in a patient with systemic lupus erythematosus accompanied by cytomegalovirus infection: A case report

    OpenAIRE

    Yuichi Tachikawa; Hiroaki Nozawa; Junichiro Tanaka; Takeshi Nishikawa; Toshiaki Tanaka; Tomomichi Kiyomatsu; Keisuke Hata; Kazushige Kawai; Shinsuke Kazama; Hironori Yamaguchi; Soichiro Ishihara; Eiji Sunami; Joji Kitayama; Madoka Fujisawa; Katutoshi Takahashi

    2016-01-01

    Introduction: Cytomegalovirus (CMV) infection of the gastrointestinal tract is an uncommon illness, but can be observed in immunocompromised patients. Systemic lupus erythematosus (SLE) patients are generally at high risk of CMV infection. Here we report a subacute progressive case of colitis in SLE accompanied by cytomegalovirus infection. Presentation of case: The patient, a 79-year-old woman, was hospitalized complaining of fever, polyarthritis, and skin ulcer that had lasted seven days...

  16. MRSA Infection in Patients Hospitalized at Sanglah Hospital: A Case Series

    OpenAIRE

    A.A. Ayu Yuli Gayatri; Susila Utama; Agus Somia Agus Somia; Merati, Tuti P.

    2015-01-01

    This is the first report of MRSA infection in Sanglah Hospital. We reviewed eight patients with MRSA infection from microbiologi laboratory records between January and May 2011, than followed by tracing medical records to obtained data of the patients. Five of cases with sepsis, 1 case with osteomyelitis, and the two others with mediastinitis and pneumonia. The patients were kept in private isolated room and barrier-nursing technique was strictly followed. Further action was culturing specime...

  17. Multiple abdominal cysts in a patient with Gorlin-Goltz syndrome: a case report.

    Science.gov (United States)

    Haenen, F; Hubens, G; Creytens, D; Vaneerdeweg, W

    2013-01-01

    A rare case of symptomatic mesenteric cysts in a patient with Gorlin-Goltz syndrome, associated with various neoplasms, is presented. The patient, known with Gorlin-Goltz syndrome, consulted with increasingly severe abdominal pain and large abdominal cysts. At surgery, the cysts were excised and the postoperative course was uneventful. In conclusion, this case reminds clinicians to always maintain a wide differential diagnosis when dealing with patients known with Gorlin-Goltz syndrome.

  18. Pulmonary and endobronchial mucormycosis in a diabetic patient: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Eun; Kim, Yoo Kyung; Koo, Heasoo; Kim, Ho Jung; Choi, Soo Seung [College of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2000-02-01

    Pulmonary mucormycosis is an opportunistic infection manifested by a fatal angioinvasive fungal pneumonia in immunocompromised patients or those suffering from uncontrolled diabetes. The radiologic findings are nonspecific, but there have been several reports of cases of pulmonary mucormycosis in which characteristic endobronchial lesions were present, with a more indolent clinical course in diabetic patients. We describe a case of pulmonary mucormycosis in a diabetic patient in whom endobronchial involvement was apparent. (author)

  19. Case series: imaging features of intraductal papillomas in patients presenting as nipple discharge

    Directory of Open Access Journals (Sweden)

    Vedita Dhull

    2016-07-01

    Results: 7/25 patients had intraductal papilloma as proven by surgery/ FNA. Mass lesion was identified in all 7 cases on sonography and MRI while it was detected in only 3 cases on mammography. Dilated ducts were demonstated in all 7 cases on sonography, in 6 cases on CE- MRI and 5 cases on mammography respectively. Conclusions: Mammography has limited diagnostic accuracy in patients with unexplained nipple discharge and MRI should be considered the diagnostic technique of choice in this clinical setting, with relevant corresponding area focussed on sonography. [Int J Res Med Sci 2016; 4(7.000: 2878-2882

  20. Cryptococcal meningitis in aids patients - A report of two cases

    Directory of Open Access Journals (Sweden)

    Arora U

    2001-01-01

    Full Text Available A fiftyfive year old gentleman with HIV infection was investigated for meningitis.Cryptococcus neoformans was isolated.Second case was a lady of 42 years, with HIV infection, was also investigated for meningitis. Cryptococcus neoformans was isolated. Antigen was detected in CSF as well as serum in both the cases.

  1. The effect of constructing versus solving virtual patient cases on transfer of learning

    DEFF Research Database (Denmark)

    Tolsgaard, Martin G; Jepsen, Rikke M H G; Rasmussen, Maria B;

    2016-01-01

    The purpose of this study was to explore the effect of actively constructing virtual patient (VP) cases compared with solving VP cases on knowledge gains, skills transfer and time spent on cases. Forty-five fourth-year medical students were randomized to constructing (VP-construction, n = 23) or ...

  2. Binocular Vision Problems in Refractive Surgery Patients: Vision Therapy Case Reports

    Directory of Open Access Journals (Sweden)

    Gina Day, OD

    2015-02-01

    Full Text Available Background: Some post-LASIK patients complain of blurry distance vision months after refractive surgery, despite good corneal healing and negligible refractive error. We postulated that perceiving blur in the absence of refractive error or significant monocular aberrations might result from poor binocular control. Binocular vision testing in a series of such patients revealed convergence problems in 83% of cases. Case Reports: We report on 8 patients (average age 37.4 yrs who completed up to 40 sessions of vision therapy (VT, either completely via computer or in a combination of computer orthoptics and office vision therapy. Seven patients had received LASIK; one had PRK. Optometric measurements and symptoms were recorded before and after VT treatment, starting at least 3 months after refractive surgery. Near point of convergence improved in 7 cases following VT, and convergence break and/or recovery improved in 6 cases. Six cases reported symptom reduction, and pre-presbyopic cases tended to improve accommodative facility. The number of binocular functions showing improvement per case correlated with the number of VT sessions completed. Convergence changes were statistically significant when pre-/post-VT data were compared for these cases as a group. Conclusion: Patients complaining of distance blur following refractive surgery may have undiagnosed binocular vision problems. VT incorporating an internet orthoptics component improved convergence ability in the cases reported here, and most patients reported symptomatic relief.

  3. Art Therapy Outcomes in the Rehabilitation Treatment of a Stroke Patient: A Case Report

    Science.gov (United States)

    Kim, Sun-Hyun; Kim, Min-Young; Lee, Jae-Hyuk; Chun, Sae-il

    2008-01-01

    This case report discusses the potential for art therapy to aid in the recovery of early-chronic stroke patients. The patient was diagnosed with having a subarachnoid hemorrhage from a cerebral aneurysm rupture 1 year prior to hospitalization. Therapies used as part of the patient's treatment included 10 weeks of art therapy conducted twice a…

  4. Using simulation in out-patient queues: a case study.

    Science.gov (United States)

    Huarng, F; Lee, M H

    1996-01-01

    Overwork and overcrowding in some periods was an important issue for the out-patient department of a local hospital in Chia-Yi in Taiwan. The hospital administrators wanted to manage the patient flow effectively. Describes a study which focused on the utilization of doctors and staff in the out-patient department, the time spent in the hospital by an out-patient, and the length of the out-patient queue. Explains how a computer simulation model was developed to study how changes in the appointment system, staffing policies and service units would affect the observed bottleneck. The results show that the waiting time was greatly reduced and the workload of the doctor was also reduced to a reasonable rate in the overwork and overcrowding periods.

  5. Sarcoidosis in Melanoma Patients: Case Report and Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Beutler, Bryce D., E-mail: brycebeutler@hotmail.com [School of Allied Health Sciences, University of Nevada, Las Vegas, 1060 Wiegand Road, Encinitas, CA 92024 (United States); Cohen, Philip R., E-mail: brycebeutler@hotmail.com [Department of Dermatology, University of California San Diego, 10991 Twinleaf Court, San Diego, CA 92131 (United States)

    2015-06-15

    Sarcoidosis is a systemic inflammatory disease characterized by the development of noncaseating granulomas in multiple organ systems. Many hematologic malignancies and solid tumors, including melanoma, have been associated with sarcoidosis. We describe the clinical and pathologic findings of a 54-year-old man with melanoma-associated sarcoidosis. In addition, we not only review the literature describing characteristics of other melanoma patients with sarcoidosis, but also the features of melanoma patients with antineoplastic therapy-associated sarcoidosis. Sarcoidosis has been described in 80 melanoma patients; sufficient information for analysis was provided in 39 of these individuals. In 43.6% of individuals (17 out of 39), sarcoidosis was directly associated with melanoma; in 56.4% of oncologic patients (22 out of 39), sarcoidosis was induced by antineoplastic therapy that had been administered for the treatment of their metastatic melanoma. The discovery of melanoma preceded the development of sarcoidosis in 12 of the 17 (70.5%) individuals who did not receive systemic treatment. Pulmonary and/or cutaneous manifestations of sarcoidosis were common among both groups of patients. Most patients did not require treatment for sarcoidosis. Melanoma patients—either following antineoplastic therapy or without systemic treatment—may be at an increased risk to develop sarcoidosis. In antineoplastic therapy naive melanoma patients, a common etiologic factor—such as exposure to ultraviolet light—may play a role in their developing melanoma and sarcoidosis.

  6. Multiple thymoma in a patient with myasthenia gravis: case report

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Eun Sook; Jeon, Kyung Nyeo; Bae, Kyung Soo; Yoo, Jin Jong [College of Medicine, Gyeongsang National Univ., Jinju (Korea, Republic of); Kang, Duk Sik [College of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

    2004-02-01

    A thymoma often occurs in patients with myasthenia gravis, but the development of multiple thymoma is very rare. The authors report the radiologic and pathologic findings of multiple invasive thymoma in a 59-year-old male with myasthenia gravis.

  7. Tuberculous disseminated lymphadenopathy in an immunocompetent non-HIV patient: a case report

    Directory of Open Access Journals (Sweden)

    Karadonta Argiroula-Vasiliki

    2009-12-01

    Full Text Available Abstract Introduction In cases of patients with disseminated lymphadenopathy, the differential diagnosis has to include both benign and malignant causes, including sarcoidosis, metastatic disease, lymphoma and, although rarely present, tuberculosis. Tuberculosis is still one of the most frequently occurring infectious diseases worldwide. However, disseminated mycobacterial lymphadenitis is rare in immunocompetent patients. Case presentation We present the case of a 56-year-old Caucasian Greek male, who was immunocompetent and HIV negative, with a two-month history of recurring fever, loss of appetite and disseminated lymphadenopathy. The patient was diagnosed with mycobacterial lymphadenopathy. Conclusion This case highlights the need for suspicion in order to identify mycobacterial infection in patients with generalized lymphadenopathy, since misdiagnosis is possible and may lead to fatal complications for the patient.

  8. Paraquat Poisoning in Patients With HIV Infection: A Case Report and Literature Review.

    Science.gov (United States)

    Tsai, Jun-Li; Chen, Cheng-Hsu; Wu, Ming-Ju; Tsai, Shang-Feng

    2016-04-01

    Paraquat poisoning is very severe. Most victims, including those who have ingested a small amount, will die from Paraquat poisoning. The cause of death in the majority of such cases is lung fibrosis. Paraquat poisoning in patients with positive human immunodeficiency virus (HIV) infection status has seldom been reported. Herein, we report a case of an HIV patient with Paraquat poisoning who had an excellent outcome even without standard treatment. Currently, only 3 such cases have been reported in the literature and in each case there was a good outcome, which was not expected according to predictive models. A possible mechanism may involve the relative lack of functional macrophages in HIV patients, which would tend to result in much less severe lung injury. None of the available predictive models of Paraquat poisoning appear to be appropriate for HIV patients.Paraquat poisoning in HIV patients may have better survival due to less lung injury.

  9. What Does ePrescribing Mean for Patients? A Case Study of the Perspectives of Hospital Renal Patients

    Directory of Open Access Journals (Sweden)

    Lisa Lee

    2015-11-01

    Full Text Available BACKGROUND: Hospital ePrescribing systems are expected to improve quality of care for patients, yet the perspectives of patients themselves have seldom been explored in the context of ePrescribing deployments.OBJECTIVE: We sought to understand the significance of ePrescribing for patients through a case study of renal in-patients on a hospital ward, before and after the introduction of an ePrescribing system.METHODS: Three data sources were drawn on as part of the case study: interviews with representatives from national patient groups (n = 10, in-patients on a renal ward (n = 11 pre-implementation; n = 12 post-implementation and fieldnotes (n = 25 of observations made on the case study ward. Data were analysed thematically focusing on: (1 perceived benefits of ePrescribing; (2 patient awareness and understanding of the medications prescribed and (3 patient views on medicines reconciliation at admission and discharge.RESULTS: While ePrescribing was viewed positively overall, its implementation in the case study site failed to address the lack of patient involvement in the prescribing process and poor medication counselling upon discharge. Importantly, the limited impact of the ePrescribing system in these particular areas appeared to be the result of institutional and cultural practices rather than solely technological factors.CONCLUSIONS: The introduction of ePrescribing systems offers new opportunities to improve sharing of knowledge and communication with all those involved in the patient’s care pathways, including patients, carers and healthcare professionals across diverse care settings. Achieving this will, first and foremost, require significant cultural and policy shifts in how the patient’s role is perceived by clinicians in relation to medicines management.

  10. A Case Report of Paralytic Patient Associated with Diabetes Mellitus

    OpenAIRE

    2009-01-01

    Objectives : This report aimed to study of paralytic patient associated with Diabetes Mellitus. Methods : Diabetes Mellitus has one of the highest death rate, because of it induces various complications. Especially paralytic patients who associated with diabetes mellitus are slow in recovery and easy to induce many complications. So control of the diabetes mellitus is the most important thing to treatment. We observed and treated with Cheunhwasangamibang and acupunture. Results : The pa...

  11. Unusual case of Hashimoto’s encephalopathy and pseudo-obstruction in a patient with undiagnosed hypothyroidism: a case report

    OpenAIRE

    Shera, Irfan A; Vyas, Anurag; Bhat, Mohd Shafi; Yousuf, Qayser

    2014-01-01

    Introduction Hashimoto’s encephalopathy is a relatively rare condition associated with an elevated concentration of circulating serum anti-thyroid antibodies, and is usually responsive to steroid therapy. However, hypothyroidism is a rare cause of pseudo-obstruction so here we present a case report of Hashimoto’s encephalopathy with gut pseudo-obstruction in an undiagnosed hypothyroid patient. Case presentation A diagnosis of unknown aetiology of encephalopathy with gut dysmotility in an undi...

  12. Jarcho-Levin syndrome with diastematomyelia: Case report of an adult patient and review of literature

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Seon; Lee, Ji Hae; Kang, Mi Jin; Baek Kyung Eun; Kim, Jae Hyung; Jeong, Myeong Ja; Kim, Soung Hee; Kim, Ji Young; Kim, Soo Hyun; Lee, Han Bee [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    Jarcho-Levin syndrome (JLS) is a rare congenital dysostosis characterized by multiple vertebral and costal anomalies. The combination of JLS and neural tube defect is rare. Only six cases of JLS accompanying diastematomyelia have been reported; all were in infants or children. We present the case of a 37-year-old female patient with JLS who also had diastematomyelia in lumbar vertebral level. This is the seventh case of JLS with diastematomyelia, and the first adult case.

  13. Qigong program on insomnia and stress in cancer patients: A case series report

    OpenAIRE

    Seungmo Kim; Sangnam Lee; Osung Kwon; Seonghoon Park; Jungchul Seo; Kyungsoon Kim

    2015-01-01

    Background: In recent years, the interest in Qigong as an alternative therapy has grown following reports of its ability to regulate psychological factors in cancer patients. This is a case series to evaluate the outcome measures of Qigong when used as an adjunct to standard medical care to treat insomnia and stress in cancer patients. Patients and methods: The Qigong program was applied to four cancer patients with insomnia, stress, and anxiety. The program consisted of 30-min sessions invol...

  14. Infectious keratitis in patients undergoing Boston Type 1 keratoprosthesis (Boston KPro procedure: case series

    Directory of Open Access Journals (Sweden)

    Heloisa Moraes do Nascimento

    2011-04-01

    Full Text Available Description of two cases of infectious keratitis in patients after Boston Type 1 keratoprosthesis (Boston KPro implantation. The first case refers to a patient that had the device indicated due to limbal deficiency secondary to severe dry eye who presented a fungal infection by Aerobasidium pullulans that was successfully treated with amphotericin B eye drops. The second case reports a patient with Boston KPro implantation due to previous corneal transplant rejection showing bacterial keratitis in the fourth postoperative month. The etiologic agent was identified asStreptococcus sp and topical treatment with vancomycin was effective. The importance of postoperative surveillance in Boston KPro eyes is discussed.

  15. Neuroleptic malignant syndrome and serotonin syndrome in a female patient: a clinicopathologic case.

    Science.gov (United States)

    Gómez-Esteban, Juan Carlos; Barcena, Joseba; Forcadas, Maribel; Somme, Johanne; Agundez, Marta; Tijero, Beatriz; Zarranz, Juan J

    2009-01-01

    We report the case of a 24-year-old female patient who initially developed a neuroleptic malignant syndrome after haloperidol exposure and experienced 6 years later a serotonin syndrome after repeated fluoxetine exposure. The patient did not respond to symptomatic treatment and died in this latter episode. At necropsy, no gross or microscopic changes were seen with conventional histological stains, and immunohistochemical stains were negative. This is the first clinicopathologic case of a patient who experienced both neuroleptic malignant and serotonin syndromes. We speculate that this case argue in favor that both syndromes share some fundamental pathogenetic mechanisms.

  16. MR imaging of dural sinus thrombosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Si Kyung; Han, Chun Hwan; Lee, Moon Ok; Park, Kyung Joo; Lee, Joo Hyuk [Kang Nam General HosPital, Public Corporation, Seoul (Korea, Republic of)

    1993-01-15

    We present a case of angiographically confirmed transverse and sigmoid sinus thrombosis, image with MR, in a 20 year old male with a history of otitis media and maxillary sinusitis. T1-weighted image demonstrated an iso signal intensity mass with tubular-shaped low signal intensity in right transverse and sigmoid sinus. The thrombus had high signal intensity on T2-weighted image. The signal intensity of the thrombus on Gd-DTPA enhanced T1-weighted image was unusually high similar to that of transverse sinus. Although dural sinus thrombosis has a non-specific MR signal intensity, findings of MRI in this case may serve as an aid in future evaluation of venous thrombosis.

  17. Pott's Disease in a Pediatric Patient. A Case Report

    Directory of Open Access Journals (Sweden)

    Lourdes Marimón Amador

    2014-08-01

    Full Text Available The case of a four-year old boy with Pott's disease diagnosed by clinical, radiological and laboratory study at the Guido Valladares National Hospital in East Timor is presented. Inquiries about the etiopathogenesis of the disease in relation to the family and personal history were conducted. This is a very complex and clinically important case since a rare and serious complication was observed in the child. It is concluded that early diagnosis of this condition is essential due to its poor prognosis once developed.

  18. Treating bipolar disorder in patients with renal failure having haemodialysis: two case reports

    Directory of Open Access Journals (Sweden)

    Annadatha Srinivas

    2008-07-01

    Full Text Available Abstract Background There is little published guideline or evidence on treating bipolar affective disorder in patients with renal failure having haemodialysis. Case We present two patients with bipolar affective disorder with renal failure having haemodialysis. We used lorazepam in one patient to manage the immediate risk of non-engagement with dialysis. Risperidone was added in the second patient for managing psychotic symptoms. Valproate was started as a mood stabiliser and titrated upwards for long-term management of the illness. Conclusion We discuss the similarities in the two cases and the care plan we used to manage them.

  19. Cases of Echinococcus granulosus Sensu Stricto Isolated from Polish Patients: Imported or Indigenous?

    Directory of Open Access Journals (Sweden)

    Monika Dybicz

    2015-01-01

    Full Text Available The cases of nine Polish patients with diagnosed cystic echinococcosis (CE were examined. A total of nine isolates obtained postoperatively were investigated using PCR and sequencing. The mitochondrial region of nad1 gene was amplified. This PCR and sequencing analysis revealed the presence of Echinococcus canadensis G7 in seven patients and E. granulosus G1 in two patients. These data demonstrate that E. canadensis is the predominant causative agent of human cystic echinococcosis in Poland. E. granulosus G1 detection in Polish patients suggests that the parasite was imported; however it does not exclude the possibility that these cases could have been of Polish origin.

  20. Cases of Echinococcus granulosus Sensu Stricto Isolated from Polish Patients: Imported or Indigenous?

    Science.gov (United States)

    Dybicz, Monika; Borkowski, Piotr Karol; Dąbrowska, Julia; Chomicz, Lidia

    2015-01-01

    The cases of nine Polish patients with diagnosed cystic echinococcosis (CE) were examined. A total of nine isolates obtained postoperatively were investigated using PCR and sequencing. The mitochondrial region of nad1 gene was amplified. This PCR and sequencing analysis revealed the presence of Echinococcus canadensis G7 in seven patients and E. granulosus G1 in two patients. These data demonstrate that E. canadensis is the predominant causative agent of human cystic echinococcosis in Poland. E. granulosus G1 detection in Polish patients suggests that the parasite was imported; however it does not exclude the possibility that these cases could have been of Polish origin.

  1. Features of coexisting granulomatosis with polyangiitis in a patient with pemphigus vulgaris: a case report.

    Science.gov (United States)

    Cala, Cather M; Sami, Naveed

    2015-01-01

    Pemphigus vulgaris (PV) and granulomatosis with polyangiitis (Wegener's or GPA) are two rare autoimmune disorders. Both can involve the upper airways, and diagnosis can be difficult in the absence of extra-airway symptoms. We report the case of a patient with well-controlled PV but persistent upper respiratory tract symptoms. Further evaluation revealed perforation of the nasal septum and elevated serologies consistent with GPA. The patient improved with rituximab treatments. This case demonstrates that alternative concomitant diagnosis should be considered in patients with symptoms suggestive of recalcitrant PV and/or GPA, since these patients may require more aggressive initial treatment.

  2. Colonic perforation in a patient with systemic lupus erythematosus accompanied by cytomegalovirus infection: A case report

    Directory of Open Access Journals (Sweden)

    Yuichi Tachikawa

    2016-01-01

    Conclusion: Our case underscores the importance of exploring the possibility of CMV infection as a differential diagnosis in SLE patients with obvious gastrointestinal symptoms who were treated by immunosuppressive drugs.

  3. [Rhegmatogenous retinal detachment in a patient with previous penetrating keratoplasty (clinical case)].

    Science.gov (United States)

    Burcea, M; Muşat, O; Gheorghe, Andreea; Mahdi, Labib; Colta, Diana; Cernat, Corina; Mansour, Agajani

    2014-01-01

    We present the case of a 54 year old patient diagnosed with rhegmatogenous retinal detachment and perforating keratoplasty. Surgery is recommended and we performed posterior vitrectomy, endolaser, and internal heavy oil tamponade. The post-operative course was favorable.

  4. CASE OF REACTIVE PANCREATITIS IN PATIENTS WITH CHRONIC NON-ATROPHIC GASTRITIS FOLLOWING SEXUAL INTERCOURSE

    OpenAIRE

    Avramenko, A. A.

    2017-01-01

    It was analyzed the case of reactive pancreatitis in patients with chronic non-atrophic gastritis, which passed a comprehensive examination and planned to undergo a course of treatment. It was found that reactive pancreatitis developed after sexual intercourse.

  5. Accessory wandering spleen: Report of a case of laparoscopic approach in an asymptomatic patient

    Directory of Open Access Journals (Sweden)

    Alessandro Perin

    2014-01-01

    CONCLUSION: We suggest performing surgery with a laparoscopic approach in patients with accessory wandering spleen, though asymptomatic, because of the risk of serious complications in case of accessory spleen torsion.

  6. Rapid Revival of a Patient after very Severe Metabolic Acidosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Sajad Ahmadi

    2013-01-01

    Full Text Available Background: Metabolic acidosis is a fatal finding in trauma patients thatcomplicates the process of resuscitation.Case: The case was a 37-year-old man with open fracture in both legs and fracturein second lumbar vertebral (L2. The serial arterial blood gas (ABG test resultsshowed a pH value of 6.7 indicating a very severe and special case of metabolicacidosis. The rate of mortality for such a case was very high. The patient wastreated with sodium bicarbonate and successfully revived after four hours posttreatment and metabolic acidosis was resolved.Conclusion: This indicated that bicarbonate administration is useful for verysevere cases. The good condition of the patient after survival from the severeacademia allowed for extubation.

  7. Developing retroperitoneal anaplastic carcinoma with choriocarcinoma focus after ovarian non-gestastional choriocarcinoma: Case report

    Directory of Open Access Journals (Sweden)

    Nikolić Branka

    2012-01-01

    Full Text Available Introduction. Choriocarcinoma is a malignant form of gestational trophoblastic neoplasm (GTN. It is a rare event but also a curable malignancy. In the majority of instancies it developes after any gestational event. In some cases it developes as non-gestational extrauterine malignancy. Prognosis of choriocarcinoma is poor when invasion and metastases appear early and spread fast. This form of choriocarcinoma can lead to incurable and letal outcome. Case report. We presented a 20-year-old patient with abdominal and retroperitoneal malignancy - anaplastic carcinoma combined with choriocarcinoma metastases in. Tumor developed three months after left adnexectomy which had been done because of adnexal tumor. Choriocarcinoma was immunohistochemicaly confirmed in adnexal masses. Two courses of chemotherapy, metotrexate + folic acid (MTX+FA regimen, were administrated. The initial serum beta human chorionic gonadotropin level stayed unknown as well as the last one after the treatment. The patient came from the other country and was hospitalized because of pelvic and abdominal pain and palpable abdominal masses in hypogastrium with progressive anemia. The human chorionic gonadotropin level was 38 mIU/L. Tumor biopsy was done and choriocarcinoma metastases were immunohistochemicaly confirmed with predominant anaplastic carcinoma. Five day course of MTX + cyclophosphamide regimen was administrated and the patient was prepared for operative treatment. Relaparotomy was perforemed and tumor completely exceeded. Tumor mass mostly developed retroperitonely and partialy in abdominal cavity infiltrating intestinal wall with rupture of sigmoid colon. Anaplastic carcinoma, with large fields of necrosis and bleeding, was confirmed after histological examination. Immunohistochemical examination excluded choriocarcinoma in tumor mass. After 20 blood units transfusion, one course of chemotherapy and tumor excision, the patient left hospital on the 9th postoperative day

  8. Oesophagobronchial fistula caused by varicella zoster virus in a patient with AIDS: a unique case

    Science.gov (United States)

    Moretti, F; Uberti-Foppa, C; Quiros-Roldan, E; Fanti, L; Lillo, F; Lazzarin, A

    2002-01-01

    Human herpesvirus oesophagitis in human immunodeficiency virus positive patients is caused by cytomegalovirus and herpes simplex virus; no cases of oesophagitis and oesophagobrochial fistula as a result of varicella zoster virus (VZV) have been reported to date. This report describes the case of a patient with a 2–3 mm deep oesophageal ulcer whose viral culture was positive for VZV. The patient was treated with acyclovir with resolution of the symptomatology. After the end of the induction treatment, because of the onset of fever and fits of coughing during eating, the patient underwent oesophagography, which showed an ulcer with an oesophagobronchial fistula in the middle and lower third of the oesophagus. This case report stresses the role of VZV infection as a possible cause of oesophagobronchial fistula, a rare but benign condition in patients with AIDS. PMID:11986352

  9. Intramuscular lorazepam in catatonia in patients with acute renal failure: a report of two cases.

    Science.gov (United States)

    Huang, Chao-En; Huang, Tiao-Lai

    2010-01-01

    Cases of catatonia in patients with renal failure have been rarely reported. In this report, we describe two renal-insufficient patients with catatonia who had a good response to intramuscular lorazepam whereby the catatonic symptoms were relieved. Case 1 involved a patient with end-stage renal disease and severe pneumonia related respiratory failure. He responded well to intramuscular lorazepam (total dose, 4 mg) whereby the catatonia was elieved. Case 2 involved a patient with alcoholic liver cirrhosis and rhabdomyolysis-related acute renal failure. He showed great improvement with intramuscular lorazepam (2 mg) whereby the catatonia was subsequently relieved. This report demonstrates that intramuscular lorazepam is safe, effective and rapid in relieving catatonia associated with renal function impairment. Neither of the patients had a recurrence of catatonia during a period of 6- months follow-up. In conclusion, intramuscular lorazepam may play an important role in the treatment of catatonia associated with renal insufficiency.

  10. Maxillary frenectomy using a carbon dioxide laser in a pediatric patient: a case report.

    Science.gov (United States)

    Shetty, Kishore; Trajtenberg, Cynthia; Patel, Chandni; Streckfus, Charles

    2008-01-01

    Dental lasers contribute significantly to the field of cosmetic dentistry, providing an invaluable resource for clinicians who perform different types of esthetic procedures. An increasing number of general dentists are using the carbon dioxide (CO2) laser for surgical procedures. However, the literature about using a CO2 laser to perform oral soft tissue ablation in the pediatric patient is limited. This case report presents a successful case of a maxillary labial frenectomy in a pediatric patient using a CO2 laser.

  11. A Novel Case of Symptomatic BK Viraemia in a Patient Undergoing Treatment for Hodgkin Lymphoma

    Directory of Open Access Journals (Sweden)

    Jacinta Perram

    2014-01-01

    Full Text Available Symptomatic BK viral infection in the immunocompromised host is well described, most commonly seen in renal transplant recipients, bone marrow transplant recipients, and HIV positive patients. The present case describes a novel clinical scenario of symptomatic urological BK virus infection in a patient receiving treatment for Hodgkin lymphoma. This case highlights the importance of casting a wide diagnostic net for adverse events encountered with novel therapeutic agents or regimens.

  12. Inhalation of a safety pin by a laryngectomized patient: a case report.

    Science.gov (United States)

    Finkelstein, D M; Noyek, A M; Friedberg, J; Goldberg, M

    1989-06-01

    Otolaryngologists are well aware of the potentially devastating consequences of inhaling a sharp foreign body. We report here a case of a laryngectomized patient who accidentally inhaled a safety pin through his tracheal stoma under highly unusual circumstances. This proved to be a life-threatening situation which resolved only after a complicated hospital admission culminating in a thoracotomy. We use this case to suggest guidelines that otolaryngologists may wish to discuss with their laryngectomized patients with regard to stomal care.

  13. Disulfiram-induced seizures with convulsions in a young male patient: A case study.

    Science.gov (United States)

    Vrishabhendraiah, Santosh Shanbhog; Gopal Das, C M; Jagadeesh, M Kasi; Mruthyunjaya, N

    2015-01-01

    Disulfiram is the aversive therapeutic agent which has been used to treat alcohol dependence more than 50 years. It causes the complications like neurological toxicity, postural hypotension, circulatory collapse, mental confusion, etc. The aim of our study was to report a rare case of disulfiram-induced seizures in a patient of alcohol dependence syndrome. This case study is about a 35-year-old male patient who had one episode of seizures during treatment with disulfiram.

  14. Nocardia farcinica lung infection in a patient with cystic fibrosis: a case report

    OpenAIRE

    2010-01-01

    Abstract Introduction Respiratory tract infections are the major causes of morbidity and mortality in patients with cystic fibrosis. Nocardia are rarely implicated in these infections and few reports of the involvement of this species are found in the literature. Case presentation We describe a case of lung infection followed by chronic colonization of trimethoprim and sulfamethoxazole resistant Nocardia farcinica in a patient with cystic fibrosis. The chronic colonization of this uncommon ba...

  15. Rubella Virus-associated Anterior Uveitis in a Vaccinated Patient: A Case Report.

    Science.gov (United States)

    ten Berge, Josianne C E M; van Daele, Paul L A; Rothova, Aniki

    2016-01-01

    Rubella virus is involved in the pathogenesis of Fuchs heterochromic uveitis and almost all cases in Europe show an active antibody production in the aqueous humor against rubella virus. Herein we report a case of a fully vaccinated patient with common variable immunodeficiency who developed unilateral Fuchs heterochromic uveitis secondary to rubella virus which was proven by intraocular fluid examination. Awareness of rubella associated anterior uveitis should remain also in vaccinated patients, especially those without a fully competent immune system.

  16. Yellow fever vaccine used in a psoriatic arthritis patient treated with methotrexate: a case report:

    OpenAIRE

    Štuhec, Matej

    2014-01-01

    The yellow fever vaccines on the market are contraindicated for immunocompromised and elderly patients. A case of yellow fever vaccine used in a 27-year-old Slovenian male with psoriatic arthritis during treatment with methotrexate is described. We demonstrate a positive case, since there were noadverse effects in concurrent administration of yellow fever vaccine and methotrexate. This patient did not show severe adverse reactions and did not contract yellow fever despite potential exposure. ...

  17. Prosthodontic Management of a Patient with Oligodontia: A Case Report

    Directory of Open Access Journals (Sweden)

    Malkondu Özlem

    2014-03-01

    Full Text Available Oligodontia or severe hypodontia is a rare developmental dental anomaly which is described as congenital absence of 6 or more teeth excluding the third molars. In this case report, the treatment of a 31-yearold woman with congenital absence of 9 permanent teeth is described. The treatment with occlusal appliance and fixed a partial dentures ended up in functional and aesthetic results.

  18. Emotional disorders in patients with cerebellar damage – case studies

    OpenAIRE

    Siuda, Katarzyna; Chrobak, Adrian Andrzej; Starowicz-Filip, Anna; Tereszko,Anna; Dudek, Dominika

    2014-01-01

    Aim: Growing number of research shows the role of the cerebellum in the regulation of affect. Lesions of the cerebellum can lead to emotional disregulation, a significant part of the Cerebellar Cognitive Affective Syndrome. The aim of this article is to analyze the most recent studies concerning the cerebellar participation in emotional reactions and to present three cases: two female and one male who suffered from cerebellar damage and presented post-traumatic affective and personality chang...

  19. Four Cases of Angular Cheilitis in Orthodontic Patients

    OpenAIRE

    P Kafaie; S Yassaei

    2006-01-01

    Contact dermatitis is an inflammatory reaction of the skin and mucosa to either external or internal factors. It can be divided to two forms of irritant contact dermatitis and allergic contact dermatitis. Nickel is one of the most common materials that causes allergic contact dermatitis and is widely used in orthodontic appliances. The inflammatory reaction to this metal in orthodontics is usually stomatitis and angular cheilitis is very rare. We report 4 cases of angular cheilitis in orthodo...

  20. Clinicopathological analysis of patients with gastric cancer in 1200 cases

    Institute of Scientific and Technical Information of China (English)

    Wei Xin Niu; Xin Yu Qin; Han Liu; Cheng Pei Wang

    2001-01-01

    @@INTRODUCTION Gastric cancer is one of the most common fatal malignancies in the world. The prognosis is generally poor in advanced gastric cancer .The low survival is related to delayed diagnosis, metastasis and recurrence after operation .The aim of this paper was to find correlation between clinical factors was to find correlation between clinical factors and biologic behavior of gastric cancer in a series of 1200 patients undergoing surgical resection.

  1. An Unusual Case of Pulmonary Nocardiosis in Immunocompetent Patient

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    Zehra Yaşar

    2014-01-01

    Full Text Available Pulmonary nocardiosis is a subacute or chronic necrotizing pneumonia caused by aerobic actinomycetes of the genus Nocardia and rare in immune-competent patients. A 35-year-old male, who had treated with antituberculosis drugs, presented with cough, dyspnea, and expectoration with episodes of hemoptysis with purulent sputum. The diagnosis of nocardiosis was made by microscopic examination of the surgically resected portion of the lung and revealed filamentous Gram-positive bacteria.

  2. Prediction of patient survival in cases of acute paraquat poisoning.

    Directory of Open Access Journals (Sweden)

    Sae-Yong Hong

    Full Text Available Paraquat concentration-time data have been used to predict the clinical outcome following ingestion. However, these studies have included only small populations, although paraquat poisoning has a very high mortality rate. The purpose of this study was to develop a simple and reliable model to predict survival according to the time interval post-ingestion in patients with acute paraquat poisoning. Data were retrospectively collected for patients who were admitted with paraquat poisoning to Soonchunhyang University Choenan Hospital between January 2005 and December 2012. Plasma paraquat levels were measured using high-performance liquid chromatography. To validate the model we developed, we used external data from 788 subjects admitted to the Presbyterian Medical Center, Jeonju, Korea, between January 2007 and December 2012. Two thousand one hundred thirty six patients were included in this study. The overall survival rate was 44% (939/2136. The probability of survival for any specified time and concentration could be predicted as (exp(logit/(1+exp(logit, where logit = 1.3544+[-3.4688 × log10(plasma paraquat μg/M[Formula: see text

  3. Prediction of patient survival in cases of acute paraquat poisoning.

    Science.gov (United States)

    Hong, Sae-Yong; Lee, Ji-Sung; Sun, In O; Lee, Kwang-Young; Gil, Hyo-Wook

    2014-01-01

    Paraquat concentration-time data have been used to predict the clinical outcome following ingestion. However, these studies have included only small populations, although paraquat poisoning has a very high mortality rate. The purpose of this study was to develop a simple and reliable model to predict survival according to the time interval post-ingestion in patients with acute paraquat poisoning. Data were retrospectively collected for patients who were admitted with paraquat poisoning to Soonchunhyang University Choenan Hospital between January 2005 and December 2012. Plasma paraquat levels were measured using high-performance liquid chromatography. To validate the model we developed, we used external data from 788 subjects admitted to the Presbyterian Medical Center, Jeonju, Korea, between January 2007 and December 2012. Two thousand one hundred thirty six patients were included in this study. The overall survival rate was 44% (939/2136). The probability of survival for any specified time and concentration could be predicted as (exp(logit))/(1+exp(logit)), where logit = 1.3544+[-3.4688 × log10(plasma paraquat μg/M[Formula: see text])]+[-2.3169 × log10(hours since ingestion)]. The external validation study showed that our model was highly accurate for the prediction of survival (C statics 0.964; 95% CI [0.952-0.975]). We have developed a model that is effective for predicting survival after paraquat intoxication.

  4. Knowledge of renal histology alters patient management in over 40% of cases.

    Science.gov (United States)

    Richards, N T; Darby, S; Howie, A J; Adu, D; Michael, J

    1994-01-01

    There is great debate as to whether the benefit gained from the knowledge of renal histology outweighs the risk to the patient from the biopsy procedure. We conducted a prospective study of 276 native renal biopsies performed on 266 patients from a single centre in 1991 to assess the effect of the knowledge of renal histology on patient management. Biopsies were performed under ultrasound guidance using the Trucut biopsy needle. The indications for biopsy were: non-nephrotic proteinuria alone (25), haematuria and proteinuria (28), nephrotic range proteinuria (28), acute renal failure (31), haematuria alone (36), and chronic renal failure (128). Two hundred and sixty-three biopsies were successful. The mean number of glomeruli obtained was 23, range 0-115. Eight patients developed macroscopic haematuria of which two required blood transfusion. The result of the biopsy altered management in 24/28 (86%) of cases of nephrotic range proteinuria, 22/31 (71%) of cases of acute renal failure, 58/128 (45%) of cases of chronic renal failure, 9/28 (32%) of cases with haematuria and proteinuria, 3/25 (12%) of cases with non-nephrotic proteinuria alone, and 1/36 (3%) of cases with haematuria alone. management was altered in 42% of cases overall. These data suggest that knowledge of renal histology is essential in the management of patients with renal disease.

  5. [Biliary lithiasis in patients over 75. 100 cases operated upon (author's transl)].

    Science.gov (United States)

    Moreaux, J; Bonnet, J L; Gerum, A

    1982-02-27

    This is a retrospective study of 100 elderly patients (36 men and 64 women aged 75 years or more) operated upon for biliary tract calculi. Thirty-one patients had one or several underlying visceral diseases and 5 had associated carcinoma of the digestive tract. Calculi of the common bile duct were present in 48 cases, and 41 patients had acute infection, including cholecystitis (14) and cholangitis (27). Surgery included cholecystectomy in every case and opening of the common bile duct in 49 cases with either choledocho-duodenal anastomosis (31 cases) or external biliary drainage (18 cases). Only one patient with gastric carcinoma died. The morbidity rate was low (11 post-operative complications) and each group of patients spent about the same time in hospital. Neither mortality nor morbidity were aggravated by the presence of calculi in the common bile duct and/or acute infection. In uncomplicated lithiasis the surgical indications mainly depend upon the severity of underlying visceral diseases. Early intervention seems desirable in most patients with acute cholecystitis or cholangitis. Surgery of the biliary tract is basically the same in elderly and in young patients, but the operation must be simple and, if possible, complete. The quality of medical surveillance and nursing has considerable influence on the results.

  6. The prognosis in cases of hepatocellular carcinoma after hepatectomy: young patients versus older patients

    Science.gov (United States)

    Lee, Ji Soo; Lee, Seunghwan; Choi, Jin-Yong; Cho, Wontae; Choi, Gyu-Seoung; Park, Jae Berm; Kwon, Choon Hyuck David; Kim, Sung Joo; Joh, Jae-Won

    2015-01-01

    Backgrounds/Aims Hepatocellular carcinoma (HCC) is uncommon in young adults and the prognosis of these patients is still unclear. In this retrospective study, we compared the clinicopathological characteristics and outcomes of young patients with HCC with those of older patients with HCC. Methods We retrospectively reviewed the clinicopathological characteristics of a total of 1,124 patients with HCC who underwent hepatectomy at our institution between 2006 and 2010. Patients ≤40 years of age at the time of HCC diagnosis were classified in the younger group. Results One hundred and three patients (9.2%) were classified in the younger group. whereas, 1021 patients were classified in the older group. The incidences of hepatitis B virus infection, alpha-fetoprotein (AFP) levels, and indocyanine green retention test were all higher in younger patients than in older patients (pPIVKA-II) and alkaline phosphatase, portal vein tumor thrombosis, and intrahepatic metastasis were all predisposing factors for tumor recurrence after hepatectomy. Conclusions Although the AFP levels were higher in younger patients with HCC than in older patients with HCC, disease-free survival and overall survival after liver resection were not significantly different between the two groups. PMID:26693234

  7. Patient advisory groups in practice improvement: sample case presentation with a discussion of best practices.

    Science.gov (United States)

    Angstman, Kurt B; Bender, Robert O; Bruce, Steven M

    2009-01-01

    Using patient advisory groups can affect practice changes and create a patient-centric focus for a primary care practice. A successful patient advisory group has been developed for our primary care clinics. Utilizing this group, we have implemented practice improvement changes that have had a significant impact in patient care. This will be demonstrated in a case presentation involving the implementation of depression care managers at our practice sites. We will review key "best practices," as defined by the group, regarding size, composition, and meeting frequency that can be used for the development of a clinical patient advisory group.

  8. Solid Pseudopapillary Neoplasm of the Pancreas in Young Male Patients: Three Case Reports

    Directory of Open Access Journals (Sweden)

    Akira Aso

    2017-01-01

    Full Text Available A preoperative diagnosis of solid pseudopapillary neoplasms (SPNs in young male patients is difficult to achieve using radiological images. We herein present three cases of young male patients with relatively small SPNs. Endoscopic ultrasound (EUS showed well-encapsulated, smooth-surfaced, heterogeneous solid lesions in all patients, and all preoperative diagnoses were achieved by EUS-guided fine needle aspiration (EUS-FNA. The final pathological diagnosis after surgery was an SPN with a Ki-67 labeling index of <2%. SPNs should be considered even in young male patients. EUS with EUS-FNA could be a useful diagnostic modality for SPNs even in young male patients.

  9. Anesthetic management of a patient with stiff-person syndrome and thymoma: a case report

    Institute of Scientific and Technical Information of China (English)

    QIN Xiang; WANG Dong-xin; WU Xin-min

    2006-01-01

    @@ Stiff-person syndrome (SPS, also called stiff-man syndrome) is a rare neurological disease with autoimmune features. It is characterized by fluctuating and progressive muscle rigidity, and episodic spasm that prominently involve axial and limb musculature.1,2 Herein we report a case of anesthetic management of a patient with SPS for thymectomy and review several other cases.

  10. Manual therapy in the management of a patient with a symptomatic Morton's Neuroma: A case report.

    Science.gov (United States)

    Sault, Josiah D; Morris, Matthew V; Jayaseelan, Dhinu J; Emerson-Kavchak, Alicia J

    2016-02-01

    Patients with Morton's neuroma are rarely referred to physical therapy. This case reports the resolution of pain, increase in local pressure pain thresholds, and improvement of scores on the Lower Extremity Functional Scale and Foot and Ankle Ability Measure following a course of joint based manual therapy for a patient who had failed standard conservative medical treatment.

  11. A clinical case of effective treatment of giant prolactinoma in patient with morbid obesity

    Directory of Open Access Journals (Sweden)

    S Vorotnikova

    2014-06-01

    Full Text Available Numerous studies showed an association between prolactin levels and body weight, with increased prevalence of obesity in patients with prolactinomas. Recent data indicate potential positive influence of cabergoline treatment to metabolic disorders in these patients. This clinical case demonstrates of a man with morbid obesity and giant prolactinoma which was successfully treated by high-dose cabergoline.

  12. A Case of Mixed Infections in a Patient Presenting with Acute Febrile Illness in the Tropics

    Directory of Open Access Journals (Sweden)

    L. S. Yong

    2013-01-01

    Full Text Available Concurrent infections with more than one etiological agent can result in an illness with overlapping symptoms, resulting in a situation where the diagnosis and management of such a patient could be challenging. We report a case of vivax malaria in a patient who was also serologically positive for leptospirosis and dengue.

  13. Case report: two patients with oculocerebrocutaneous syndrome and terminal digital amputations.

    Science.gov (United States)

    Asher, Nathan G; Olney, Ann H; Schaefer, G Bradley

    2008-12-01

    We report 2 cases of patients with a rare multiple anomaly condition reported as Dellman (oculocerebrocutaneous) syndrome. In this article we discuss the clinical features and genetics of this condition. Notably, both of these patients have digital abnormalities which have not been previously described in the literature.

  14. Two dentigerous cysts in the mandible of one patient. Case report.

    Science.gov (United States)

    Smith, G

    1996-10-01

    This paper reports a case of two separate dentigerous cysts in the mandible of one patient. An unusual feature was the relationship of one of the cysts to an unerupted lateral incisor. The prudence of accounting for any missing teeth in patients and the value of panoramic radiographic screening is illustrated.

  15. Case Report: Testicular failure possibly associated with chronic use of methylphenidate [v1; ref status: indexed, http://f1000r.es/48z

    Directory of Open Access Journals (Sweden)

    Ranjith Ramasamy

    2014-09-01

    Full Text Available Methylphenidate is a commonly prescribed treatment for attention deficit hyperactivity disorder (ADHD. However, little is known about its adverse effects on the male reproductive system. We report a 20-year-old male patient whose chief complaint was of delayed puberty. He spoke in a high-pitched voice and complained of lack of body hair, impaired libido, inadequate erectile function, chronic fatigue, and low energy. He had been treated with methylphenidate as an infant and had continued treatment for 17 years. On examination, the patient was lean and visibly lacked facial or body hair. He further explained that he had never been able to grow underarm or facial hair and that he was often mistakenly considered a young teenager rather than a 20-year-old. The patient’s genitalia were categorized as Tanner Stage 2. Laboratory studies confirmed low serum follicle-stimulating hormone (FSH, luteinizing hormone (LH, and testosterone levels. The patient was given exogenous testosterone supplementation with pellets and human chorionic gonadotropin to maintain testicular size. After 4 months his symptoms improved and he demonstrated signs of puberty. Our goal is to further elucidate the possible impact of methylphenidate on the male reproductive system.

  16. First Case of Zika Virus Infection in a HIV+ Patient.

    Science.gov (United States)

    Barreiro, Pablo

    2016-01-01

    Zika virus is an enveloped, single-stranded RNA virus that belongs to the flavivirus genre. As with arbovirus, it is transmitted by arthropods (mosquitoes), both Aedes aegypti (urban) and albopictus (rural). Zika virus was first isolated in 1947 from monkeys in Uganda. The first human cases were reported in 1952 in East Africa. Outbreaks were reported in Micronesia (2007), Polynesia (2013), and Chile (2014). Both diagnostic procedures and therapeutics are poorly developed. Serological tests cross-react with dengue and there are neither specific antivirals nor vaccines.

  17. Identity theft in community mental health patients: two case reports.

    Science.gov (United States)

    Klopp, Jonathon; Konrad, Shane; Yanofski, Jason; Everett, Anita

    2007-05-01

    Identity theft is a serious problem in the United States, and persons with enduring mental illnesses may be particularly vulnerable to becoming victims of this crime. Victims of identity theft experience a variety of consequences that include financial loss and serious emotional distress. Little is known about the impact of identity theft on individuals with mental illnesses. The two cases from a community mental health center presented in this article demonstrate many of the facets that may be associated with an increased risk for becoming the victim of identity theft. A summary of preventive steps as well as steps involved in resolving the crime once one has become a victim are presented.

  18. A patient with isolated pancreatic tuberculosis: case report

    Directory of Open Access Journals (Sweden)

    Ramin Ebrahimian

    2015-09-01

    Conclusion: During surgery, a completely necrotic mass was in the pancreatic head. samples were sent for frozen section. The tuberculosis granuloma was diagnosed. Four drug anti-tuberculosis medication was started and continued for six months. Repeat imaging of the abdomen performed 6-months after the initiation of anti-TB therapy revealed complete resolution of the pancreatic mass, and antitubercular therapy was discontinued after a 6-month duration. Pancreatic tuberculosis can present with a variable spectrum of imaging findings. Furthermore, TB should be considered as a cause of any suspicious pancreatic lesion, especially in patients from areas where the infection is endemic.

  19. Prosthetic rehabilitation of a Crouzon patient: A case report

    Directory of Open Access Journals (Sweden)

    Hanefi Kurt

    2010-01-01

    Full Text Available Crouzon syndrome is a rare genetic disorder, which can be defined as a variation of craniofacial dysostosis caused by the premature obliteration and ossification of two or more sutures. The growth pattern results in pseudoprognathism and malocclusions including an overcrowded or a widely spaced dentition. Specifically maxillary arch is narrow, high, and V-shaped. Cleft palate and bifid uvula are other possible features in the oral cavity. This report describes a non-surgical treatment model to overcome the remaining significant Class III intermaxillary relation and excessive tooth loss to recover function and aesthetics for a 25-year-old Crouzon patient.

  20. [Medical, social, and economic effectiveness of treatment of day-case patients with peptic ulcer].

    Science.gov (United States)

    Butorov, I V; Osoianu, Iu P; Maksimov, V V; Butorov, S I

    2006-01-01

    The purpose of the study was to evaluate medical, social, and economic effectiveness of treatment of day-case patients with peptic ulcer (PU). The subjects of the study were 60 day-case patients with duodenal ulcer aged 18 to 60, who underwent clinical and instrumental examination including esophagogastroduodenoscopy with biopsy and Helicobacter pylori (HP) detection. The patients received 7-day eradication therapy, which included omeprazol in a dose of 20 mg twice a day, clarithromycin--500 mg twice a day, and metronidazole--500 mg twice a day. There was a control group, which included 60 inpatients treated in Gastroenterology Division of the hospital. The use of the three-component medication in the day-case patients and the inpatients led to disappearance of pain syndrome 7.4 +/- 0.3 and 8.6 +/- 0.2 days after the beginning of the treatment, respectively; dyspepsia disappeared in the day-case patients and the inpatients 7.6 +/- 0.2 and 8.8 +/- 0.3 days after the beginning of the treatment, respectively. HP eradication was effective in 86.7% of the day-case patients, and in 88.3% of the inpatients. The course of the disease was recurrence-free during two years in 80% of the day-case patients, and in 76.4% of the inpatients; the cost of the treatment was 2.1 times higher in the group of inpatients. The results show that high effectiveness of the three-component medication, judging by the results of HP eradication, terms of disappearance of pain syndrome and ulcer healing, allows recommending this regimen for wide clinical application in day-case patients with PU.

  1. ANCA-associated vasculitis in scleroderma: a case series of fourteen patients

    OpenAIRE

    Liang, Kimberly P.; Michet, Clement J

    2011-01-01

    Antimyeloperoxidase (MPO), perinuclear antineutrophil cytoplasmic antibodies (pANCA), and/or clinically evident vasculitis in patients with scleroderma have been reported only rarely. The clinical significance and prognosis of ANCA-associated vasculitis in systemic sclerosis is uncertain. To report a case and identify the clinical characteristics of scleroderma patients with ANCA-associated vasculitis. Patients with both vasculitis and scleroderma occurring between 1976 to 2006 were identifie...

  2. Unplanned Alternatives For Enteral Nutrition In Postsurgical Patients: Three Individual Cases

    OpenAIRE

    Yürüker, S. Savaş; Topgül, Koray; Anadol, A Ziya

    2006-01-01

    Aim: Enteral nutrition in surgical patients is not only physiological but also cheap. On the contrary, parenteral nutrition is more expensive and has several complications. In this report, we present three different cases in which we had to administer long term parenteral nutrition but somehow could be managed by unique applications of enteral nutrition. Patients and Methods: Three patients (one with pancreas cancer, one with gunshot wound and one with mesenteric vascular disease) were ad...

  3. Thyroglossal Duct Cyst Carcinomas in Pediatric Patients: Report of Two Cases with a Comprehensive Literature Review.

    Science.gov (United States)

    Thompson, Lester D R; Herrera, Hannah B; Lau, Sean K

    2017-03-14

    Thyroglossal duct cyst (TGDC) carcinomas are rarely encountered in the pediatric population. The clinical behavior of these tumors in the pediatric setting is unclear and management is not well defined. Two cases of pediatric thyroglossal duct cyst carcinoma were identified in a review of all thyroglossal duct cysts diagnosed over a ten year period. These two cases were analyzed along with 57 cases of thyroglossal duct cyst carcinoma affecting patients less than 21 years of age compiled from the English literature. Fifty-nine patients (36 females, 23 males) aged 6-20 years (mean 15.0 years) were identified. All presented with an anterior midline neck mass, which was typically mobile and non-tender. The average tumor size was 2.6 cm. Histologically, all tumors were papillary thyroid carcinomas arising in a background of a thyroglossal duct cyst. The tumors exhibited a papillary, follicular, or mixed architecture with classical papillary thyroid carcinoma nuclear features. Soft tissue extension was present in 16 cases. All patients were managed surgically with a Sistrunk procedure, with additional thyroidectomy performed in 29 patients, combined with a lymph node dissection (n = 15), or a Sistrunk and lymph node dissection (n = 5). All patients were stage I at presentation, with 11 showing lymph node metastases. Postoperative radioactive iodine was employed in 20 patients. A papillary carcinoma of the thyroid gland was reported in four of the patients who had concurrent/subsequent thyroidectomies. Recurrences were reported in four patients, with distant metastases in one patient, who died of disease (13 months). Follow up data was available for 45 patients, with an overall mean follow-up of 54.5 months. All patients were alive, with the exception of one who died with disease. TGDC carcinomas in pediatric patients is associated with a good overall prognosis, best managed by Sistrunk procedure alone, with selected lymph node dissection if clinically

  4. Positional Stretching of the Coracohumeral Ligament on a Patient with Adhesive Capsulitis: A Case Report

    OpenAIRE

    Ruiz, Jose Orlando

    2009-01-01

    Idiopathic frozen shoulder is a common medical diagnosis for patients seeking physical therapy. Radiographic and surgical evidence exists that describes the coracohumeral ligament (CHL) as a major contributor to lack of external rotation in patients diagnosed with frozen shoulder. No stretching techniques targeting the anatomical fiber orientation of the CHL have been reported in the literature. This single-patient case-report describes the use of a positional stretching technique of the CHL ...

  5. Bacteriemia by Capnocytophaga spp in patient with chronic limphoblastic leukaemia: a clinical case

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    Maria Teresa Allù

    2008-06-01

    Full Text Available Capnocytophaga spp., capnophilic and Gram-negative fusiform rods with gliding motility, are common inhabitants of the oral cavity.These microorganisms have been implicated as the causative agent of septicaemia in immunocompromised patients and only occasionally in immunocompetent subjects. In this report, a case of septicaemia caused by Capnocytophaga in a neutropenic patient who had stomatitis and pulmonary infiltrates is described. Antibiotic therapy was adjusted according to the susceptibility pattern of the isolate and the patient subsequentlyrecovered.

  6. Refeeding syndrome in a vegan patient with stage IV gastric cancer: a novel case.

    Science.gov (United States)

    Brown, Teresa V; Moss, Rebecca A

    2015-03-01

    The refeeding syndrome encompasses the complex physiologic state that occurs in malnourished patients who receive nutrition after a period of decreased oral intake. The hallmark of the syndrome is hypophosphatemia, though other electrolyte imbalances and severe fluid shifts are commonly involved. Patients with newly diagnosed malignancies and those undergoing treatment for malignancies are at increased risk for developing the refeeding syndrome, however there are few reported cases or other data in the oncology literature regarding this syndrome in cancer patients.

  7. LIPOMA OF HAND AND FINGER : A 6 PATIENT CASE SERIES

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    Prakash Kumar

    2014-01-01

    Full Text Available INTRODUCTION: Lipoma , the ubiquitous benign tumor , is not very common in the hand and that to involving the palmar space or finger is very rare. This series of case presentation lays emphasis on consideration of lipoma in the differential diagnosis of swellings/ soft tissue tumors of the hand and the use o f imaging studies in their diagnosis. We report a ser ies of six cases of lipoma in different parts and planes of hand , involving palm and fingers . An uncommon site , size , shape , plane and age of occurrence of this common tumor warrants it’s reporting and an effort had been made to highlight the management. CONCLUSION : Hand lipoma is rare entity for a surgeon in the differential diagnosis of soft tissue tumors with radiology being an invaluable tool. Though rare but frequently seen in this pa rt of country , Precise surgical techniques with a sound anatomic knowledge helps in complete excision without damaging the vital structures and abates recurrences Lipoma , subcutaneous , mid - palmar space.

  8. Age Is No Longer a Limit: Two Cases of Hepatectomy in Patients Over 90 Years Old

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    Shugo Uwatoko

    2015-02-01

    Full Text Available Hepatocellular carcinoma (HCC is a common malignant tumor with poor prognosis. The age of patients affected by HCC is considered to be increasing, and several studies have reported significantly higher rates of morbidity and mortality after hepatectomy for HCC in elderly patients. However, other studies have reported that the short- and long-term outcomes of surgery for HCC in elderly patients are similar to those in younger patients. Whether the indications for hepatic resection in elderly patients resemble those in younger patients has thus been questioned. We describe two cases of patients over 90 years old who underwent major hepatectomy for HCC, representing the oldest patients in the world to have done so.

  9. Brown tumors in patients with chronic renal failure and secondary hyperparathyroidism: Report of 12 cases

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    Fatma Lilia

    2010-01-01

    Full Text Available Brown tumors are unusual but serious complications of renal osteodystrophy. We retrospectively studied 12 patients presenting with chronic renal failure and brown tumor related to secondary hyperparathyroidism. Eleven patients were on chronic hemodialysis. The median duration between renal failure and end stage renal failure was 36 months (range: 12-190 months and the median duration in dialysis for 11 cases: 92 months (range: 72-252 months. The bone pain was noted in all cases (100%, pathological fracture in one case (8% and a palpable bone tumor in 10 cases (83%. Elevated serum Calcium (> 2.35 mmol/L was noted in four cases (33%, elevated serum Phosphate (> 1.78 mmol/L in ten cases (80%, elevated serum Alkaline Phosphate (> 290 UI/L in all cases and intact PTH was > 300 pg/mL in all cases with a serum median rate at 1475 pg/mL (range: 682-3687 pg/L. Subtotal parathyroidectomy was performed in all cases with a resultant decrease in size of brown tumors. We report here patient with CKD with unusual frequency and variable locations. This may be attributed tothe lack of the new calcium free phosphate binders and calcimimetics.

  10. Prevalence of Intestinal Protozoa among Saudi Patients with Chronic Renal Failure: A Case-Control Study

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    Yousry A. Hawash

    2015-01-01

    Full Text Available It has been hypothesized that chronic renal failure (CRF predisposes patients to infection with intestinal protozoa. We tested this hypothesis with a matched case-control study to determine the prevalence of these protozoa and their diarrhea associated symptoms among 50 patients with CRF (cases from Taif, western Saudi Arabia. Fifty diarrheal patients without CRF were recruited in the study as controls. Participants were interviewed by a structured questionnaire and stool samples were collected. Samples were thoroughly examined with microscopy and three coproantigens detection kits. Enteric protozoa were detected in 21 cases and 14 controls. Blastocystis spp. were the most predominant parasite (16% in cases versus 8% in controls, followed by Giardia duodenalis (10% in cases versus 12% in controls and Cryptosporidium spp. (10% in cases versus 6% in controls. Cyclospora cayetanensis was identified in two cases, while Entamoeba histolytica was described in one case and one control. Intestinal parasitism was positively associated with the male gender, urban residence, and travel history. Clinical symptoms of nausea/vomiting and abdominal pain were significantly varied between the parasitized cases and controls (P value ≤ 0.05. Given the results, we recommend screening all diarrheal feces for intestinal protozoa in the study’s population, particularly those with CRF.

  11. Rapidly expanding lung abscess caused by Legionella pneumophila in immunocompromised patients: a report of two cases.

    Science.gov (United States)

    Miyara, Takayuki; Tokashiki, Kaori; Shimoji, Tsutomu; Tamaki, Kazunori; Koide, Michio; Saito, Atsushi

    2002-02-01

    We describe two cases of lung abscess caused by Legionella pneumophila in immunocompromised patients. The first case had been treated initially with 60 mg prednisolone for ulcerative colitis, and L. pneumophila serogroup 1 was isolated from sputum samples after cavitation of the lung lesion. The second case was diagnosed as plasma cell lymphoma at post-mortem examination. L. pneumophila serogroup 5 was isolated from the contents of lung abscess, together with Enterococcus faecium and Prevotella intermedia in the post-mortem examination. Lung abscess caused by Legionella is unusual. Here, we discuss the difficulty of diagnosis of legionellosis in patients with unusual chest radiographic findings.

  12. A Case of Multicentric Carcinoid in a Patient with Psoriatic Spondyloarthropathy

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    Nabil George

    2015-01-01

    Full Text Available We describe the first case of a patient presenting with multicentric carcinoid occurring in the lung and subsequently in the rectum, with chronic psoriatic arthritis. Although reports have been published regarding carcinoid syndrome occurring alongside rheumatoid arthritis, no reports have been made on such a case. Initial presentation of carcinoid syndrome in this patient was insidious and atypical with few symptoms, including shortness of breath and long standing abdominal bloating. Several years later a sudden change in bowel habit prompted a colonoscopy with biopsy that revealed a carcinoid rectal polyp. The case we report describes a rare presentation of carcinoid syndrome in chronic psoriatic arthropathy.

  13. Coronary artery bypass surgery in a patient with Kartagener syndrome: a case report and literature review

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    Bougioukas Ioannis

    2010-08-01

    Full Text Available Abstract Kartagener syndrome consists of congenital bronchiectasis, sinusitis, and total situs inversus in half of the patients. A patient diagnosed with Kartagener syndrome was reffered to our department due to 3-vessel coronary disease. An off-pump coronary artery bypass operation was performed using both internal thoracic arteries and a saphenous vein graft. We performed a literature review for cases with Kartagener syndrome, coronary surgery and dextrocardia. Although a few cases of dextrocardia were found in the literature, no case of Kartagener syndrome was mentioned.

  14. Coronary artery bypass surgery in a patient with Kartagener syndrome: a case report and literature review.

    Science.gov (United States)

    Bougioukas, Ioannis; Mikroulis, Dimitrios; Danner, Bernhard; Lawal, Lukman; Eleftheriadis, Savvas; Bougioukas, George; Didilis, Vassilios

    2010-08-26

    Kartagener syndrome consists of congenital bronchiectasis, sinusitis, and total situs inversus in half of the patients. A patient diagnosed with Kartagener syndrome was referred to our department due to 3-vessel coronary disease. An off-pump coronary artery bypass operation was performed using both internal thoracic arteries and a saphenous vein graft. We performed a literature review for cases with Kartagener syndrome, coronary surgery and dextrocardia. Although a few cases of dextrocardia were found in the literature, no case of Kartagener syndrome was mentioned.

  15. Depression and Anxiety Disorders among Patients with Psoriasis: A Hospital-Based Case-Control Study

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    Masoud Golpour

    2012-01-01

    Full Text Available Background. Psoriasis is a common, genetically determined inflammatory and proliferative disease of the skin. Psychological stress can exacerbate the disease. This study sought to investigate the depression and anxiety disorders among patients with psoriasis and control group. Method. In this hospital-based case-control study, One hundred patients with psoriasis (case referred to the dermatology department and 100 patients with otolaryngology problems and dermatological healthy volunteers (control who referred to the Otolaryngology Department of Bouali Sina Hospital in Sari, Iran, in 2007 were studied. Demographic characteristics were recorded. Beck Depression Inventory and Spielberger State-Trait Anxiety Scale I-II were administered to the patients in both groups. Data were analyzed using SPSS statistical software and descriptive statistical tests. Results. From One-hundred patients in each group, 44 (45% were men. Depression score was 67% and 12% in psoriatic patients and control, respectively. The Beck depression scores of patients with psoriasis were significantly higher than scores of the control group (<0.05. Based on Spielberger State-Trait Anxiety Scale, anxiety was found in 45% of patients in case group and 18% of controls. Conclusion. The results revealed that psoriatic patients reported significantly higher degrees of depression and anxiety than controls. In addition, psoriatic women were more depressed than psoriatic men.

  16. Pregnancy in end-stage renal disease patients on hemodialysis: two case reports

    OpenAIRE

    Swaroop, Rohina; Zabaneh, Raja; Parimoo, Nakul

    2009-01-01

    Introduction Pregnancy in patients with end-stage renal disease is rare due to numerous factors that impair fertility. Even if pregnancy does occur pregnancy outcome with a live birth has a low success rate. Case presentation We report two cases of successful pregnancy in patients with end-stage renal disease on hemodialysis. Conclusion The purpose of hemodialysis is not only to maintain life but also to make quality of life as normal as possible for the end-stage renal disease patient. Propa...

  17. A rare case of velopharyngeal insufficiency in a patient with Behçet’s disease

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    Kamil Hakan Kaya

    2015-07-01

    Full Text Available Velopharyngeal insufficiency (VPI, in which the velopharyngeal port does not close during speech, is an important condition that reduces the quality of life in affected patients. Behçet’s disease (BD is a systemic autoimmune vasculitis with effects on many organs and systems in the body. Patients with BD may have otorhinolaryngological symptoms as part of its multi-system disease involvement. In rare cases, autoimmune diseases have been linked to VPI. Here we report the first case of BD diagnosed in a patient with VPI.

  18. The Evaluation of Nursing Care Satisfaction and Patient Learning Needs in day Case Surgery.

    Science.gov (United States)

    Goktas, Sonay B; Yildiz, Tülin; Nargiz, Sibel Kosucu

    2015-12-01

    Patients in surgical service units have higher expectations for treatment and care. The aims of this study were to determine nursing care satisfaction and information requirements at the time of discharge of patients from a day surgery unit and to assess the effects of demographics. The study was conducted on 291 patients undergoing day case surgery. Patient perception scale for nursing care (PPSN) and the patient learning needs scale (PLNS) were used and total and sub-dimension points averages were calculated and then compared with demographic data using the Kruskal-Wallis test. The results were evaluated at the p patients, 58.8 % (n = 171) were females and the average age was 49.5 ± 15.3 years. PPSN and PLNS total point averages were 68.16 ± 10.17 and 178.53 ± 27.59, respectively. A significant difference was determined in PPSN total point average with regard to previous hospitalisations; the PPSN total point average was higher for patients with prior hospitalisations (p patient satisfaction and patient information requirements could change according to demographic features of the patients at a day case surgery unit. In this respect, healthcare providers should offer healthcare services by evaluating the personal characteristics of patients because this is important for their satisfaction.

  19. A rare case of cytomegalovirus papillitis in patient with immunodeficiency

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    Dinda A. Devona

    2016-10-01

    Full Text Available A 26-year-old male diagnosed with AIDS came with sudden blurred vision and central sco-toma in left eye since 2 weeks before admission. His visual acuity was counting finger at 5 meters with normal IOP and anterior segment. The posterior segment revealed edematous optic nerve covered by exudates and hemorrhages. Due to low CD4+ count and serological test result, we considered a HIV-related opportunistic ocular infection, specifically HSV infection. As visual acuity worsened during treatment with acyclovir, we performed PCR ex-amination from aqueous tap which revealed positive CMV DNA. Unfortunately, the visual acuity had worsened to no light perception before he received any specific anti-CMV agent. CMV papillitis is an unusual presentation of CMV retinitis. PCR examination from aqueous or vitreous tap should be performed while waiting for serological test result, especially in doubtful cases. Therefore, appropriate diagnosis and management can be established early to prevent irreversible visual loss.

  20. Case report of Schizophyllum commune sinusitis in an immunocompetent patient

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    Luz Ángela Castro

    2010-09-01

    Full Text Available Schizophyllum commune is a basidiomycete fungus with broad distribution in nature; however, it is a rare cause of infectious disease. We report the isolation of this mould in a 46 year-old immunocompetent patient with chronic sinusitis previously treated with multiple antibiotics and topical nasal steroids. Material obtained via a left maxillary sinus antrostomy showed septate hyaline hyphae with clamp connections on direct examination with KOH and histopathological studies. Further growth on Sabouraud agar produced a white mould that, based on its microscopic and macroscopic characteristics, was identified as S. commune. Despite its low frequency, this fungus should be considered a possible pathogen, particularly in samples obtained from paranasal sinuses.

  1. Pseudoepitheliomatous hyperplasia in trophic ulcers in leprosy patients. A 28-case study.

    Science.gov (United States)

    Grauwin, M Y; Mane, I; Cartel, J L

    1996-09-01

    Between 1984 and 1993, pseudoepitheliomatous hyperplasia developing in chronic ulcers were observed in 28 former Senegalese leprosy patients, which amounts to an annual frequency of 1.9 per 1000 ulcers. Correct diagnosis could only be made by histopathological examination of specimens taken from the depth of the lesion. Amputation was carried out on 17 patients and local excision on the other 10. Recurrence of growth was observed in 8 of the 10 patients treated by excision; in all of these 8 cases below knee amputation had to be subsequently performed. From our experience, it may be assumed that local excision should be carried out only in the case of small tumours. Since the aim of surgical procedure is to allow the patient to have physical autonomy, below knee amputation, followed by adaptation of prosthesis, should be the procedure chosen in the other cases.

  2. Nocardia farcinica lung infection in a patient with cystic fibrosis: a case report

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    Rolain Jean-Marc

    2010-03-01

    Full Text Available Abstract Introduction Respiratory tract infections are the major causes of morbidity and mortality in patients with cystic fibrosis. Nocardia are rarely implicated in these infections and few reports of the involvement of this species are found in the literature. Case presentation We describe a case of lung infection followed by chronic colonization of trimethoprim and sulfamethoxazole resistant Nocardia farcinica in a patient with cystic fibrosis. The chronic colonization of this uncommon bacterium in patients with cystic fibrosis was proved using a newly developed real-time polymerase chain reaction assay, which indicates that this bacterium, despite treatment, is difficult to eradicate. Conclusion Our case report confirms that this organism can be recovered in persons with cystic fibrosis. Its eradication is necessary especially if the patient is to undergo lung transplantation.

  3. Membranous nephropathy in a patient with hereditary angioedema: a case report

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    Majoni Sandawana W

    2008-10-01

    Full Text Available Abstract Introduction Hereditary angioedema is the commonest inherited disorder of the complement system and has been associated with several immune glomerular diseases. A case of nephrotic syndrome and renal impairment due to idiopathic membranous glomerulonephritis in a patient with hereditary angioedema has not been described before. Case presentation We present the first reported case of the association of membranous nephropathy and hereditary angioedema in a 43-year-old male Caucasian patient who presented with acute intestinal angioedema, hypertension, acute pancreatitis, renal impairment and generalised body swelling due to severe nephrotic syndrome. We present the challenges involved in the clinical management of the patient. Conclusion This patient's presentation with severe nephrotic syndrome, renal impairment and hypertension required aggressive treatment of the membranous nephropathy given the high risk for progression to end stage renal failure. The contraindication to angiotensin converting enzyme inhibitors and angiotensin II receptor blockers in this patient, the lack of published evidence on the use of alkylating agents and other immunosuppressive agents in patients with hereditary angioedema and the lack of published data on the management of similar cases presented a clinical challenge in this patient's management.

  4. Inter-organisational communication for patients being case managed by community matrons.

    Science.gov (United States)

    Thomas, Paul; Stoddart, Gilly; Nota, Johnny; Teh, Ling; Wells, Victoria; Dhillon, Gouri; Leese, Yvonne

    2010-12-01

    Background Poor communication between community matrons (CMs), in-hours and out-of-hours (OoH) general practitioners (GPs) causes uncertainty and inefficiencies. Setting A practice-based commissioning group in West London and the associated CMs who case manage high users of hospital services. Question What helps good communication between CMs, GPs and OoH services to ensure that the right patients are case managed and hospital admissions are avoided? Methods Whole system participatory action research, with four stages: 1) identify communication problems as perceived by a wide range of stakeholders; 2) draw a diagram of the existing communication system, and with stakeholders redraw this to overcome its weaknesses; 3) pilot the changes proposed; 4) gain consensus among stakeholders about policy. Results Stakeholders agreed that standards should be adopted to improve communication for the care of patients who are case managed by CMs. Routine passage of information between GP, CMs and the OoH services would achieve this, and is feasible. Specifically: routine information (termed Special Patient Notes) should be sent to the OoH service about vulnerable patients, including those who are case managed by CMsclear information about CM attachment to general practices and how to refer to them should be easily accessibleGPs and CMs should meet quarterly for mutual learning and to discuss patientsthe OoH service electronically should cascade information to GPs, CMs and others named in the Special Patient Notescommissioners should routinely gather data to compare clusters of general practices for i) referrals to CMs, ii) posting Special Patient Notes, iii) unscheduled consultations and hospital admissions of all patients including those being case managed. Discussion This project revealed system-wide communication problems for the care of patients being case managed by CMs, and ways to overcome these. Commissioners could insist that these are adopted locally, and gather data to

  5. A rare case of fibrostenotic endobronchial tuberculosis of trachea

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    Cassiopia Cary

    2015-12-01

    Full Text Available Endobronchial tuberculosis (EBTB is a sequelae of pulmonary tuberculosis (TB that extends to the endobronchial or endotracheal wall causing inflammation, edema, ulceration, granulation or fibrosis of mucosa and submucosa. This case depicts a 20 year old foreign-born woman with a history of active pulmonary TB on anti-TB chemotherapy, who presented with worsening stridor, dyspnea, cough and weight loss. The disease state was diagnosed with multiple modalities including, spirometry, CT scan of the neck, and bronchoscopy. The biopsies of the tracheal web revealed fibrotic tissue without any granulomas or malignancy establishing the diagnosis of EBTB. Serial balloon dilations and anti-neoplastic therapy with Mitomycin C was used to accomplish sufficient airway patency to relieve her symptoms. ETBT is a rare consequence of TB, which although has a low incidence in the United States, so physicians should have a high clinical suspicion based on the need for prompt intervention.

  6. A Rare Case of Hemifacial Flushing and Hyperhydrosis: Harlequin Syndrome

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    Selma Korkmaz

    2015-09-01

    Full Text Available Harlequin syndrome (HS is a rare disorder, characterized by hemifacial flushing and sweating. This condition is induced by exercise, heat and emotional factors. There are sudomotor and vasomotor deficits in the cervical sympathetic chain. The syndrome is usually benign and does not require treatment. Most of the HS cases are primary in nature and no underlying cause can be identified, but may be associated with a secondary cause such as organic lesion. Here, we diagnosed idiopathic HS in a 20-year-old female who presented with increased facial flushing and sweating in the left half of the face which were mainly induced by exercise and emotional factors and it was reported together with literature.

  7. Torção hepática e obstrução de cólon transverso: relato de um caso e revisão da literatura Hepatic torsion with colonic obstruction: a case report and review of the literature

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    Luiz Eduardo Grasso Filho

    2001-02-01

    Full Text Available Os autores relatam o caso de uma paciente de 20 anos de idade, sem antecedentes patológicos, que apresentou quadro de abdome agudo obstrutivo. Realizou exames radiológicos, ultra-som e tomografia computadorizada, seguidos de laparotomia exploradora, sendo constatadas: a rotação hepática completa para o hipocôndrio esquerdo; b hipotensão severa por compressão da veia cava inferior; c malformação congênita dos ligamentos falciforme e coronários; d obstrução do cólon transverso por bridas constritivas congênitas; e importante distensão gasosa de alças cólicas no hipocôndrio direito. Foram ressecadas as bandas pericólicas, com redução imediata da dilatação no hemiabdome direito, havendo retorno espontâneo do fígado à posição anatômica. Esta condição ímpar, e os outros três casos similares já descritos na literatura mundial, são comentados neste trabalho.The authors report a case of a 20-year-old patient with the following clinical features: a complete rotation of the liver into the left upper quadrant; b severe hypotension secondary to inferior vena cava compression; c congenital malformation of falciform and coronary ligaments; d obstruction of the transverse colon due to congenital peritoneal fibrotic bands; e massive colonic dilatation in the right upper quadrant. The patient was treated by resection of the pericolonic bands, and during the operation the liver returned to its anatomic position, in the right upper abdomen. This unique condition, and the three other similar cases reported in the world literature are discussed.

  8. Cytodiagnosis of histoplasmosis: case reports from two patients with variable clinical presentation.

    Science.gov (United States)

    Singh, Sunita; Chhabra, Sonia; Goyal, Ruchi; Garg, Shilpa

    2012-12-01

    Histoplasmosis has emerged as an important opportunistic fungal infection in immunocompromised patients. Histoplasma is a dimorphic fungus that primarily involves lung and the environmental reservoir is soil. Although several cases of histoplasmosis have been reported in India but cytological diagnosis was made in a few cases. We are presenting two cases of histoplasmosis diagnosed on fine-needle aspiration cytology. In the first case, pulmonary histoplasmosis was diagnosed on transbronchial needle aspiration of lung in a 41-year-old immunocompetent male, while second case was of disseminated histoplasmosis in 40-year-old immunocompromised female diagnosed on cytology of cervical lymph node. FNAC is a simple, safe, and rapid technique to establish the initial diagnosis, thus promoting early treatment and favorable outcome especially in the immunocompromised patients.

  9. Risk factors in pediatric asthmatic patients. Cases and control studies.

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    Rafael Alejandro Gómez Baute

    2003-04-01

    Full Text Available Background: Asthma constitutes the first disease among chronic diseases in children. The morbid-mortality promoted to continue being elevated in spite of the new therapies. For this reason it is a disease with high priority for investigation in pediatric ages. Method: A control and case group study was carried out. The samples was composed by 72 asthmatic children from three General Comprehensive doctor offices from Palmira health area located in Cienfuegos Province, Cuba; and a control group of 72 children apparently healthy from the same population. A questionnaire with the different risk variables was elaborated. Odds ratio technique was used to estimate the risk. Results: low weight at birth, family history of asthma, brochiolitis antecedent and the excessive usage of antibiotics in children under 1 year old were the main risks found. Conclusions: It is conclusive that the exposure to home allergen plus a genetic favorable factor, the prematurity, and brochiolitis constituted the most outstanding elements to suffer from asthma in the population studied.

  10. Acute Pulmonary Edema in an Eclamptic Pregnant Patient: A Rare Case of Takotsubo Syndrome

    Science.gov (United States)

    Karamchandani, Kunal; Bortz, Brandon; Vaida, Sonia

    2016-01-01

    Patient: Female, 35 Final Diagnosis: Takotsubo cardiomyopathy Symptoms: Seizures Medication: — Clinical Procedure: Cesarean section Specialty: Critical Care Medicine Objective: Rare co-existance of disease or pathology Background: Acute pulmonary edema in a pregnant patient is associated with significant morbidity and mortality. Takotsubo syndrome, or stress-induced cardiomyopathy, is a rare cause of acute pulmonary edema in a pregnant patient, especially prior to delivery of the fetus. Case Report: We describe a case of a pregnant patient who presented with acute pulmonary edema and eclampsia and was found to have Takotsubo syndrome. To the best of our knowledge, eclampsia as a precipitating factor for Takotsubo syndrome has not been described in literature. Conclusions: Clinicians taking care of pregnant patients should be aware of the potential link between eclampsia and Takotsubo cardiomyopathy. Prompt correction of the precipitating cause along with supportive management as described is the key to a successful outcome. PMID:27658947

  11. Medical management of aortic coarctation is feasible & durable in selected patients: a case report & literature review.

    Science.gov (United States)

    Khan, Asif N; Carter, William; Mousa, Albeir Y

    2015-01-01

    Long-term survival in patients with complete aortic coarctation (AC) without surgical repair has not been well characterized and is rarely documented. We report a case of an 84 year old male with complete aortic coarctation with history of hypertension for more than 40 years. Since the diagnosis was made in early 1950's medical treatment to control hypertension was initiated as patient was deemed high risk for surgical intervention. He has survived to the age of 84 years with minimal medical problems. This report also reviews the few documented cases of prolonged survival in patients with aortic coarctation. This report demonstrates that prolonged survival is possible in patients with documented complete coarctation and awareness of this report may influence the decision to use medical treatment for selected elderly patients with high risk of mortality associated with surgical repair.

  12. The emotional experience of patient care: a case for innovation in health care design.

    Science.gov (United States)

    Altringer, Beth

    2010-07-01

    This paper considers recent developments in health care facility design and in the psychology literature that support a case for increased design sensitivity to the emotional experience of patient care. The author discusses several examples of innovative patient-centred health care design interventions. These generally resulted in improvements in the patient and staff experience of care, at less cost than major infrastructural interventions. The paper relates these developments in practice with recent neuroscience research, illustrating that the design of the built environment influences patient emotional stress. In turn, patient emotional stress appears to influence patient satisfaction, and in some instances, patient outcomes. This paper highlights the need for further research in this area.

  13. Health related quality of life may increase when patients with a stoma attend patient education - a case-control study

    DEFF Research Database (Denmark)

    Danielsen, Anne Kjaergaard; Rosenberg, Jacob

    2014-01-01

    included 50 patients in the study. Health related quality of life was measured before hospital discharge, three months and six months after stoma creation. The program included educational interventions involving lay-teachers, alongside health professional teachers. RESULTS: We found a significant rise......INTRODUCTION: Adaptation to living with a stoma is complex, and studies have shown that stoma creation has a great impact on patients' health related quality of life. The objective was to explore the effect of a structured patient education program on health related quality of life. Therefore, we...... implemented interventions aimed at increasing health related quality of life during and after hospital admission. MATERIALS AND METHODS: We designed a case/control study aimed at adult patients admitted to the surgical ward for stoma creation, irrespective of type of stoma or reason for creation of stoma. We...

  14. CASE-REPORT Case study of a patient presenting both type II bipolar affective disorder and Klinefelter syndrome.

    Science.gov (United States)

    Delavenne, H; Khoury, J M; Thibaut, F; Garcia, F D

    2016-10-17

    Klinefelter syndrome (KS) is the most common sex chromosomal disorder with an estimated prevalence of 1 in 500-1000. Increased incidences of anxiety, depression, substance abuse, psychotic and behavioral disorders, and sexual disorders have been reported in patients with KS. The aim of this case study was to report a case of a man with untreated KS who was also diagnosed with type II bipolar disorder. This case report raises awareness regarding psychiatric diagnoses that may be associated with such a highly prevalent condition. A 46-year-old man who had previously been diagnosed with an untreated KS was examined in our Psychiatric Department with an acute hypomanic episode. Clinical improvement was observed within 4 days and psychiatric symptoms were resolved in 7 days without use of medication. A psychiatric history of a depressive episode and at least two hypomanic episodes, as well as a family history of two relatives diagnosed with bipolar disorder, strongly suggest that our patient has type II bipolar disorder. Bipolar disorder may be a comorbid disorder in patients with KS. Routine screening for mood disorders and appropriate referral and evaluation should be performed. Future genetic research is warranted to explore why some chromosomal abnormalities (e.g., duplications), especially those located on the X chromosome, such as Klinefelter syndrome, may be associated with a bipolar or psychotic disorder in some individuals but not in others.

  15. Orthodontic and orthognathic management of a patient with osteogenesis imperfecta and dentinogenesis imperfecta: a case report.

    Science.gov (United States)

    Kindelan, J; Tobin, M; Roberts-Harry, D; Loukota, R A

    2003-12-01

    This case report describes a patient's severe Class III malocclusion, managed with a combination of orthodontic and orthognathic treatment. The medical history was complicated by osteogenesis imperfecta and dentinogenesis imperfecta. In addition the patient was a Jehovah's Witness. Patients with osteogenesis imperfecta carry an increased risk of perioperative haemorrhage, and this led to bimaxillary surgery being carried out as two discrete surgical episodes for the patient described. In addition, the risk of enamel fracture led to orthodontic bands being cemented on all teeth. In spite of the increased risks a successful outcome was achieved.

  16. An unusual case of atrophic mandible fracture in a patient with osteogenesis imperfecta and on oral bisphosphonate therapy: Case report

    Directory of Open Access Journals (Sweden)

    Abdulrahman Al-Osaimi

    2014-04-01

    Full Text Available Fractures of severely atrophic (height < 10 mm edentulous mandibles are infrequent and challenging to manage. Factors such as sclerotic bone and decreased vascularity combined with systemic diseases complicate the management of such fractures. Osteogenesis imperfecta (OI is a heterogeneous group of inherited disorders of type I collagen metabolism. Patients with OI characteristically present with histories of long bone fractures, deformities, blue sclerae, and opalescent dentin. However, fractures of the facial skeleton are rare. Bisphosphonate therapy has been proven to effectively reduce the fracture risk in patients with OI. The purpose of this clinical report is to present an unusual case of spontaneous fracture of the atrophic mandible in a patient with OI. Despite open reduction and internal fixation (ORIF with miniplate osteosynthesis, the patient developed a second fracture at a screw placement site distal to the first fracture. The patient was successfully treated with ORIF using locking reconstruction plates fixed in the symphyseal and angle regions. Bone healing following ORIF was normal, and no clinical sign of osteonecrosis as a result of bisphosphonate therapy was observed. Patients with OI can present with spontaneous fractures of already weakened mandibles. Although such fractures can be managed with care using established protocols, further research is required to examine the effects of concomitant medication, such as bisphosphonates.

  17. Audit of patient acceptance of nasal surgery as a day case procedure.

    Science.gov (United States)

    Tierney, P A; Samuel, D; Patel, K S; Thomas, D M

    1996-01-01

    A greater emphasis on day case surgery within the health service is seen as a method of improving efficiency and reducing expenditure. We interviewed 90 consecutive patients undergoing nasal surgery who had been preoperatively assessed as being fit for day case surgery. They were randomised into three groups regarding the duration of postoperative nasal packing. All patients stayed overnight following surgery and were interviewed prior to discharge. Some 52% of the overall sample would be happy to have nasal surgery performed as a day case. If the nasal pack was removed after two hours, this figure rose to 67%. This difference in patient acceptance did not attain statistical significance overall, but there was a significant difference in those undergoing submucosal resection. There was no difference in the age, sex distribution or type of surgery performed between each group. The audit commission quotes patient satisfaction with day case surgery at 80%. Nasal surgery was not examined in their report, but was included as one of a set of procedures suitable for consideration. Although day case nasal surgery may be safe, further research regarding patient acceptance is required.

  18. Three-year observation of the patients with bullous pemphigoid: 29 cases

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    Özlem Ekiz

    2013-12-01

    Full Text Available Background and Design: Bullous pemphigoid (BP is a chronic, autoimmune, subepidermal blistering disease. The aim of this study was to determine the clinico-epidemiologic data’s of patients diagnosed as BP in our clinic and compare these data with other studies in our country and in the world. Material and Method: We researched the documents of BP cases diagnosed by clinical and histopathological examinations from January 2009 to January 2013, retrospectively. We evaluated clinical and dermographical characteristics of all patients such as age, sex, existence of oral mucosal lesions, association of pruritus, duration of disease, presence of triggering factors, features of skin lesions, results of direct immunofluorescence (DIF investigation, drug intake, recurrence and mortality rates and causes of detected mortality. Results: Of the 29 patients included in the study %48,3 were female, %51,7 were male. The average age was 70,17 and the mean duration of disease was 15.41 months. In five cases oral mucosal involvement and in 24 cases pruritus was detected. Drugs in three cases and malignity in one case were assessed as triggering factors. The results of DIF investigation revealed the linear IgG and C3 deposition at the dermoepidermal junction in 12 cases, C3 deposition in 10 cases. The initial treatment was topical corticosteroid in 11, tetracycline and nicotinamide combination in six, systemic corticosteroid in 10 individuals. After initial therapy recurrence appeared in 7 patients in one year. Mortality during hospitalization was observed in 2 cases. Conclusions: We presented the clinical and epidemiological features of patients diagnosed as BP in our clinics in the last three years. Because of having different ethnical originated, heterogeneous population of our city, we believe that our investigation will contribute to having opinion about epidemiology of BP in our country. Nevertheless, prospective, long term and multicentre studies based on

  19. Split cord malformation (scm in paediatric patients : outcome of 19 cases.

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    Kumar R

    2001-04-01

    Full Text Available There had been considerable debate regarding the surgical outcome of neuro-orthopaedic syndromes (NOS and neurological syndromes in cases of split cord malformation (SCM. On retrospective analysis of 19 cases of SCM, thirteen were grouped under (Pang type I and 6 in type II. Their age ranged from 1 month to 9 years (mean 3.5 years. 14 of these were male children. The NOS without neurological signs was detected in 6 cases where as pure neurological signs without NOS were seen in 8 patients. However, the rest 5 had mixed picture of NOS and neurological dysfunction. Nine of 19 cases presented with cutaneous stigmata, mainly in the form of hairy patch. 18 cases had other associated craniospinal anomalies i.e. hydrocephalus, meningomyelocoele, syrinx, dermoid, teratoma etc. Detethering of cord was done in all cases by removal of fibrous/bony septum. Associated anomalies were also treated accordingly. Follow up of these cases ranged from 6 months to 6 years. Six cases of NOS group neither showed deterioration nor improvement, and remained static on follow up. However, four of 8 children with neurological signs showed improvement in their motor weakness, and 1 in saddle hypoaesthesia as well as bladder/bowel function. In 5 cases of mixed group, two had improvement in their weakness and one in hypoaesthesia, but no change was noticed in NOS of this group as well. Hence surgery seemed to be effective, particularly in patients with neurological dysfunction.

  20. Intracranial melanocytic meningeal tumours and melanosis oculi: case report and literature review

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    Doglietto Francesco

    2012-06-01

    Full Text Available Abstract Background Melanocytic meningeal tumours are rare extra-axial neoplasms of the nervous system, with only three reported cases in the cavernous sinus. Herein we describe for the first time the association of ocular melanosis and multiple intracranial melanocytic meningeal tumours, with the presenting lesion being in the cavernous sinus. The importance of this association is discussed together with the diagnostic and therapeutic challenges of the case. Case presentation A 20-year-old man presented with a left sixth cranial nerve deficit; general examination documented only congenital melanosis of the homolateral eye. MRI examination showed a space occupying lesion in the left cavernous sinus, which was followed conservatively for 2 years, until a new space occupying lesion was evident at the level of the right frontal convexity: both lesions presented with neuroradiological characteristics suggestive of melanin content. The frontal convexity lesion was removed: intraoperatively the dura was markedly and diffusely melanotic. Histological examination documented a melanocytic meningeal tumour, with a proliferative index of 3 %. The patient underwent 3D-Conformal Radiation Therapy on the lesion of the cavernous sinus (total dose 5040 cGy, with initial tumour reduction. Three years later, due to a symptomatic growth, he underwent partial removal of the lesion in the cavernous sinus. Histological examination was unchanged. He then received adjuvant Temozolomide with Low Dose Fractionated Radiation Therapy (LD-FRT. Due to further disease progression cisplatin plus fotemustine were administered, concomitant with LD-FRT: after two cycles MRI documented significant disease regression. After a period of apparent disease control, the patient presented with persistent cough and evidence of multiple thoracic metastases, which lead to his death, seven years after presentation. Conclusions Intracranial melanocytic meningeal tumours are challenging

  1. Apnea-hypopnea index use among intensive care patients: a case series

    Science.gov (United States)

    2014-01-01

    Introduction ApneaLink™ (RESMED-Munich, Germany) is a simple and inexpensive device that determines the apnea-hypopnea index. The sensitivity and specificity of the apnea-hypopnea index are 100 and 87.5%, respectively. Our hypothesis can be used to create a treatment plan using the apnea-hypopnea index for intensive care unit patients. Case presentation This treatment plan has been created by determining the apnea-hypopnea index of eight Caucasian patients with a variety of diagnoses. Case 1 is that of a 70-year-old man diagnosed with rectum cancer and scheduled for elective surgery. Case 2 is that of a 65-year-old man diagnosed with rectum cancer and scheduled for elective surgery. Case 3 is that of a 78-year-old woman diagnosed with chronic obstructive pulmonary disease-pneumonia. Case 4 is that of a 26-year-old man diagnosed with head trauma. Case 5 is that of an 80-year-old man diagnosed with cerebrovascular disease. Case 6 is that of a 79-year-old man diagnosed with cerebrovascular disease. Case 7 is that of an 8-year-old girl diagnosed with ventricular septal defect-epidural hemorragia. Case 8 is that of a 42-year-old man diagnosed with subarachnoid hemorrage. Conclusions The apnea-hypopnea index can be informative regarding prognosis and outcomes, and helps to take precautions and develop new treatment strategies among critical patients in intensive care. The integration of developments in sleep medicine to intensive care unit practices means that we can be more informed about critical patients. PMID:24906620

  2. Accelerated active case detection of visceral leishmaniasis patients in endemic villages of Bangladesh.

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    Jahanara Khatun

    Full Text Available BACKGROUND: The visceral leishmaniasis (VL elimination program in Bangladesh is in its attack phase. The primary goal of this phase is to decrease the burden of VL as much as possible. Active case detection (ACD by the fever camp method and an approach using past VL cases in the last 6-12 months have been found useful for detection of VL patients in the community. We aimed to explore the yield of Accelerated Active Case Detection (AACD of non-self reporting VL as well as the factors that are associated with non-self reporting to hospitals in endemic communities of Bangladesh. METHODS: Our study was conducted in the Trishal sub-district of Mymensingh, a highly VL endemic region of Bangladesh. We used a two-stage sampling strategy from 12 VL endemic unions of Trishal. Two villages from each union were selected at random. We looked for VL patients who had self-reported to the hospital and were under treatment from these villages. Then we conducted AACD for VL cases in those villages using house-to-house visit. Suspected VL cases were referred to the Trishal hospital where diagnosis and treatment of VL was done following National Guidelines for VL case management. We collected socio-demographic information from patients or a patient guardian using a structured questionnaire. RESULTS: The total number of VL cases was 51. Nineteen of 51 (37.3% were identified by AACD. Poverty, female gender and poor knowledge about VL were independent factors associated with non self-reporting to the hospital. CONCLUSION: Our primary finding is that AACD is a useful method for early detection of VL cases that would otherwise go unreported to the hospital in later stage due to poverty, poor knowledge about VL and gender inequity. We recommend that the National VL Program should consider AACD to strengthen its early VL case detection strategy.

  3. Are urological procedures in tetraplegic patients safely performed without anesthesia? a report of three cases

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    Vaidyanathan Subramanian

    2012-02-01

    Full Text Available Abstract Background Some tetraplegic patients may wish to undergo urological procedures without anaesthesia, but these patients can develop autonomic dysreflexia if cystoscopy and vesical lithotripsy are performed without anaesthesia. Case presentation We describe three tetraplegic patients, who developed autonomic dysreflexia when cystoscopy and laser lithotripsy were carried out without anesthesia. In two patients, who declined anaesthesia, blood pressure increased to more than 200/110 mmHg during cystoscopy. One of these patients developed severe bleeding from bladder mucosa and lithotripsy was abandoned. Laser lithotripsy was carried out under subarachnoid block a week later in this patient, and this patient did not develop autonomic dysreflexia. The third patient with C-3 tetraplegia had undergone correction of kyphoscoliotic deformity of spine with spinal rods and pedicular screws from the level of T-2 to S-2. Pulmonary function test revealed moderate to severe restricted curve. This patient developed vesical calculus and did not wish to have general anaesthesia because of possible need for respiratory support post-operatively. Subarachnoid block was not considered in view of previous spinal fixation. When cystoscopy and laser lithotripsy were carried out under sedation, blood pressure increased from 110/50 mmHg to 160/80 mmHg. Conclusion These cases show that tetraplegic patients are likely to develop autonomic dysreflexia during cystoscopy and vesical lithotripsy, performed without anaesthesia. Health professionals should educate spinal cord injury patients regarding risks of autonomic dysreflexia, when urological procedures are carried out without anaesthesia. If spinal cord injury patients are made aware of potentially life-threatening complications of autonomic dysreflexia, they are less likely to decline anaesthesia for urological procedures. Subrachnoid block or epidural meperidine blocks nociceptive impulses from urinary bladder

  4. Cyclophosphamide-Induced Severe Acute Hyponatremic Encephalopathy in Patients with Breast Cancer: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Michelle Baker

    2014-07-01

    Full Text Available Background: Cyclophosphamide is an alkylating agent widely used in antineoplastic and immunosuppressive therapies. Symptomatic hyponatremia can be a rare but life-threatening complication in patients treated with cyclophosphamide. Case Presentations: We report 2 patients who presented with severe acute hyponatremic encephalopathy after receiving their first cycles of a low-dose cyclophosphamide-containing regimen for breast cancer. In case 1, a 58-year-old female received the combination of docetaxel and cyclophosphamide, and in case 2, a 56-year-old female received the combination of doxorubicin and cyclophosphamide. Both patients recovered after correction of their serum sodium concentration without neurological deficits. Future cycles of chemotherapy were well tolerated without recurrence of hyponatremia after cyclophosphamide was discontinued from the respective regimens. Conclusion: Clinicians must always keep in mind that acute hyponatremic encephalopathy can be induced by low-dose cyclophosphamide.

  5. Unplanned decannulation of tracheotomy tube in massive burn patients: a retrospective case series study

    Institute of Scientific and Technical Information of China (English)

    BEN Dao-feng; MA bing; XIA Zhao-fan; L(U) Kai-yang; CHEN Xu-lin; YU Xi-ya; XI Hui-Jun; CHANG Fei; ZHU Shi-hui; TANG Hong-tai; LU Wei

    2011-01-01

    Background Unplanned extubation is associated with adverse outcomes in intensive care unit.The massive burn patient differs from other critically ill patients in many ways.However,little is known about the unplanned decannulation (UD) in Burn Intensive Care Unit.This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients.Methods A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively.A total of 21 patients with 29 UD events were identified.Demographic data,diagnosis,intervention,UD events and outcome of UD patients were collected.Differences in proportions were compared using the chi-square (X2) or Fisher's exact test.Results Patients with UD were often burned with head and neck (67%) and combined with inhalation injury (62%).The majority of them (76%) were transferred patients,occurred early (55%) and were accidental UD (79%).UD events tended to happen in day shift (90%) and to be associated with the medical procedure that was performing by caregivers at besides (79%).Loose of the stabilizing rope,medical procedure and tracheotomy malposition were the main causes of UD.Early UD and reintubation failure were associated with patients' death.Conclusions UD happened to massive burn patients can lead to patient death.Careful management of respiratory tract was essential for massive burn patients.

  6. The research of 35 cases of wound treatment in elderly patients with pressure sore

    Directory of Open Access Journals (Sweden)

    Man XIA

    2014-07-01

    Full Text Available Objective: To research the method by which each period of the aged patients with decubitus ulcer best effect, shorten the time of wound healing. Methods: With the implementation of a variety of ways through the 35 cases of elderly patients for a period of from January 2012 to February 2014 decubitus ulcer in our hospital, to research the best way of wound healing, get some treatment of elderly patients with wound experience. Result: According to the different situations of patients, using different methods, or the combined treatment, patients with ulcer wound were all well healed. Conclusion: The research found that the treatment of wounds with each method has different advantages and disadvantages. The doctors should choose the proper treatment method according to the specific circumstances of patients. The research gathered the experience of bedsore treatment and provided convenience for the future clinical work.

  7. Body image among eating disorder patients with disabilities: a review of published case studies.

    Science.gov (United States)

    Cicmil, Nela; Eli, Karin

    2014-06-01

    While individual cases of eating disorder (ED) patients with disabilities have been reported, there has been little synthesis of their experiences of body image and thin idealization. This study reviews 19 published clinical reports of ED patients with sensory, mobility-related, or intellectual disabilities and evaluates the extent to which their experiences align with or challenge current conceptions of body image in ED. ED patients with visual impairment reported a profound disturbance of body image, perceived intersubjectively and through tactile sensations. Reducing dependence in mobility was an important motivation to control body size for ED patients with mobility-related disabilities. ED as a way of coping with and compensating for the psychosocial consequences of disability was a recurrent theme for patients across a range of disabilities. These experiential accounts of ED patients with disabilities broaden current understandings of body image to include touch and kinaesthetic awareness, intersubjective dynamics, and perceptions of normalcy.

  8. Management of patients with stercoral perforation of the sigmoid colon: Report of five cases

    Institute of Scientific and Technical Information of China (English)

    Wen-Shih Huang; Chia-Siu Wang; Ching-Chuan Hsieh; Paul Y Lin; Chih-Chien Chin; Jeng-Yi Wang

    2006-01-01

    To our knowledge, stercoral perforation of the colon is rarely seen with fewer than 90 cases reported in the literature till date. We explored the principles of management to prevent impending mortality in five patients with this condition. Five patients, two males and three females, whose median age was 64 years,had sustained stercoral perforation of the sigmoid colon.Chronic constipation was the common symptom among these patients. Three patients underwent a Hartmann's procedure and another two were treated with segmental colectomy with anastomosis and diverting colostomy.There was one surgical mortality and the other patients had an uneventful hospital stay. Timely intervention to prevent and/or treat any associated sepsis along with extensive peritoneal lavage and surgical intervention to remove diseased colonic tissue at the primary stercoral ulceration site coupled with aggressive therapy for peritonitis are key treatment modalities in salvaging patients presenting with stercoral perforation of the colon.

  9. Antiretroviral Drug-Associated Oral Lichenoid Reaction in HIV Patient: A Case Report

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    Pratanporn Arirachakaran

    2010-01-01

    Full Text Available Antiretroviral therapy has changed the course of HIV disease and improved quality of life in HIV patients. Incidence of an oral lichenoid drug reaction induced by zidovudine is not common. Once it occurs, it affects a patient's well being, in particular their oral functions. Here we report the first case of a 34-year-old Thai man with painful erosive lesions involving the lip and buccal mucosa. Treatment with topical fluocinolone acetonide 0.1% alleviated the patient's oral pain, but it was not until the subsequent withdrawal of zidovudine that the patient showed improvement and resolution of the lesions. Long-term follow-up was useful in the management of this patient, and no recurrence of the lesion was found during 21-month follow-up in this patient.

  10. Osteochondromas: An Unusual Cause of Vascular Disease in Young Patients: 2 Clinical Cases.

    Science.gov (United States)

    Parente, Basso; Fiorucci, Beatrice; Simonte, Gioele; Brambilla, Deborah Maria; Lenti, Massimo

    2016-04-01

    Osteochondroma is the most common benign tumor of bones in young patients. It is an unusual cause of nonatherosclerotic peripheral arteriopathy. It is mostly detected in youth and, thus, diagnosis can be delayed since symptoms such as claudication can be confused with muscular cramps. In case of clinical suspicion of peripheral artery disease in the young, the presence of an exostosis should be suspected. We reported our experience of 2 young patients with limb ischemia due to ab extrinseco compression of popliteal artery. In both cases, surgical exeresis of a lower limb exostosis was performed. In the first case, bypass surgery was not required since arterial wall was not damaged. In the second case, an autologous inverted saphenous vein femoro popliteal bypass was performed.

  11. Cortical sensory loss in a patient with posterior cortical atrophy: a case report.

    Science.gov (United States)

    Hsu, Jung-Lung; Chen, Wei-Hung; Chiu, Hou-Chang

    2004-02-01

    Patients with posterior cortical atrophy (PCA) who present with initial symptoms of higher visual function deficits eventually develop alexia, aphasia, and components of Balint's syndrome or Gerstmann's syndrome. Recently, pathological findings were reported for these patients that are generally suggestive of Alzheimer's disease even though Creutzfeldt-Jakob disease (CJD) was presumed as an alternative cause of some autopsy-diagnosed PCA cases. Here, we report a case with a four-year progression of cognitive and higher visual function deterioration, and with features not described in previously reported PCA cases (i.e., a distinct sensory complaint and early frontal lobe involvement). To summarize, this case belongs to perceptual-motor syndrome of asymmetric cortical degeneration and the underlying neuropathology is more suggestive of Alzheimer's disease than of Creutzfeldt-Jakob disease.

  12. Acute Pulmonary Edema in an Eclamptic Pregnant Patient: A Rare Case of Takotsubo Syndrome.

    Science.gov (United States)

    Karamchandani, Kunal; Bortz, Brandon; Vaida, Sonia

    2016-09-23

    BACKGROUND Acute pulmonary edema in a pregnant patient is associated with significant morbidity and mortality. Takotsubo syndrome, or stress-induced cardiomyopathy, is a rare cause of acute pulmonary edema in a pregnant patient, especially prior to delivery of the fetus. CASE REPORT We describe a case of a pregnant patient who presented with acute pulmonary edema and eclampsia and was found to have Takotsubo syndrome. To the best of our knowledge, eclampsia as a precipitating factor for Takotsubo syndrome has not been described in literature. CONCLUSIONS Clinicians taking care of pregnant patients should be aware of the potential link between eclampsia and Takotsubo cardiomyopathy. Prompt correction of the precipitating cause along with supportive management as described is the key to a successful outcome.

  13. Migraine with persistent aura in a Mexican patient: case report and review of the literature.

    Science.gov (United States)

    San-Juan, O D; Zermeño, P F

    2007-05-01

    Persistent aura symptoms in patients with migraine are rare but well documented. The International Headache Society defines persistent aura without infarction as when the aura symptoms persist for > 1 week without radiographic evidence of infarction. The visual aura of migraine attacks has been explained by cortical spreading depression. We describe a case of a 28-year-old Mexican woman, who presented with persistent aura symptoms, and a literature review. The patient had a 24-year history of migraine headache. In November 2005 the patient had an attack which started with scintillating scotomas bilaterally associated with photopsias and amaurosis followed by migraine headache. All imaging studies were negative. The episode lasted 35 days and probably resolved with nimodipine therapy. Persistent aura symptoms are rare entities. This is the first case documented of a Mexican patient with persistent aura without infarction and probably resolved with nimodipine therapy.

  14. Pulmonary nocardiosis in patients with connective tissue disease: A report of two cases.

    Science.gov (United States)

    Hagiwara, Shinya; Tsuboi, Hiroto; Hagiya, Chihiro; Yokosawa, Masahiro; Hirota, Tomoya; Ebe, Hiroshi; Takahashi, Hiroyuki; Ogishima, Hiroshi; Asashima, Hiromitsu; Kondo, Yuya; Umeda, Naoto; Suzuki, Takeshi; Hitomi, Shigemi; Matsumoto, Isao; Sumida, Takayuki

    2014-02-01

    Reported here are 2 patients with connective tissue disease who developed pulmonary nocardiosis. Case 1 involved a 73-year-old man with malignant rheumatoid arthritis treated with prednisolone 25 mg/day. Chest X-rays revealed a pulmonary cavity and bronchoscopy detected Nocardia species. The patient was successfully treated with trimethoprim/sulfamethoxazole. Case 2 involved a 41-year-old woman with systemic lupus erythematosus. The patient received remission induction therapy with 50 mg/day of prednisolone and tacrolimus. Six weeks later, a chest CT scan revealed a pulmonary cavity; bronchoscopy resulted in a diagnosis of pulmonary nocardiosis. The patient had difficulty tolerating trimethoprim/sulfamethoxazole, so she was switched to and successfully treated with imipenem/cilastatin and amikacin.

  15. Patient Mobility in Times of Austerity: A Legal and Policy Analysis of the Petru Case.

    Science.gov (United States)

    Frischhut, Markus; Fahy, Nick

    2016-03-01

    The case-law of the Court of Justice (ECJ) on patient mobility was recently challenged by a ruling that a patient could go to Germany for treatment when facilities in Romanian hospitals were inadequate. Given the reported impact of austerity measures in the field of health care this raises the question; what is the impact of the ECJ's ruling on how Member States can manage expenditure and limit outflows of patients and how should such measures be legally evaluated? The objective of this article is to analyse potential impact on health systems in the context of increasing pressure on public financing for health. While the ECJ mainly referred to the requirement of treatment in due time, we also analyse possible austerity reductions of the basket of care against the background of EU law (i.e., EGJ case-law, patient mobility directive, Charter of Fundamental rights and social security regulation).

  16. Achromobacter Xylosoxidans Bloodstream Infection in Elderly Patient with Hepatocellular Carcinoma: Case Report and Review of Literature.

    Science.gov (United States)

    Raghuraman, Kausalya; Ahmed, Nishat H; Baruah, Frincy K; Grover, Rajesh K

    2015-01-01

    Achromobacter xylosoxidansis a nonfermentative Gram-negative organism, known to cause opportunistic infection in humans. We report a case of septicemia in a 76-year-old male patient with underlying hepatocellular carcinoma due to A. xylosoxidans, which showed a different antimicrobial susceptibility pattern from what is usually reported. From aerobic blood culture of the patient, A. xylosoxidans was isolated which was found to be sensitive to amoxicillin-clavulanic acid, piperacillin-tazobactam, ceftazidime, cefoperazone-sulbactam, meropenem, minocycline, tigecycline, and trimethoprim/sulfamethoxazole. The patient recovered with amoxicillin-clavulanic acid treatment, which was given empirically to the patient. The present case highlights the possible role of amoxicillin-clavulanic acid for treatment of bloodstream infection with A. xylosoxidans.

  17. Achromobacter Xylosoxidans bloodstream infection in elderly patient with Hepatocellular Carcinoma: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Kausalya Raghuraman

    2015-01-01

    Full Text Available Achromobacter xylosoxidansis a nonfermentative Gram-negative organism, known to cause opportunistic infection in humans. We report a case of septicemia in a 76-year-old male patient with underlying hepatocellular carcinoma due to A. xylosoxidans, which showed a different antimicrobial susceptibility pattern from what is usually reported. From aerobic blood culture of the patient, A. xylosoxidanswas isolated which was found to be sensitive to amoxicillin-clavulanic acid, piperacillin-tazobactam, ceftazidime, cefoperazone-sulbactam, meropenem, minocycline, tigecycline, and trimethoprim/sulfamethoxazole. The patient recovered with amoxicillin-clavulanic acid treatment, which was given empirically to the patient. The present case highlights the possible role of amoxicillin-clavulanic acid for treatment of bloodstream infection with A. xylosoxidans.

  18. Aortitis in patients with psoriatic arthropathy: report of two cases and review of the literature

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    Gleb Slobodin

    2014-11-01

    Full Text Available Aortitis, which is well described in patients with other spondyloarthritides, has been rarely cited in relation to psoriatic arthropathy (PsA. Two patients with known PsA, who developed aortitis, are reported herein. The PubMed database was searched using the following keywords: aortitis, Takaysu arteritis, PsA, ankylosing spondylitis, reactive arthritis, inflammatory bowel disease. The relevant articles were critically reviewed and pertinent data organized. Analysis of 5 cases of aortitis in patients with PsA, including the 2 cases reported herein, revealed no specific pattern of PsA joint involvement in the patients who developed aortitis. All aortic segments can be involved and complications, such as insufficiency of the aortic valve and stenosis of the major aortic branches, have been described. The genetic association involving the IL12B locus may be involved in the clinical association of aortitis and spondyloarthritis.

  19. Solid pseudopapillary neoplasm of the pancreas in pediatric patients: A case report and institutional case series

    Directory of Open Access Journals (Sweden)

    Justin B. Mahida

    2015-04-01

    Full Text Available Solid pseudopapillary neoplasm (SPN of the pancreas is a rare tumor presenting in adolescent and young adult females. A previously healthy 13 year-old female presented to our institution with abdominal pain and emesis. Imaging revealed a pancreatic cystic mass. Endoscopic ultrasound (EUS with fine needle biopsy suggested SPN. Pathologic evaluation following resection revealed immunohistochemical (IHC staining positive for β-catenin and α-1-antitrypsin despite extensive necrosis. We discuss this patient as well as our institutional series of SPN of the pancreas, describing the evaluation, management, and histopathology of this rare tumor.

  20. Ralstonia pickettii bacteremia in hemodialysis patients: a report of two cases

    Science.gov (United States)

    Tejera, Darwin; Limongi, Gino; Bertullo, Mauricio; Cancela, Mario

    2016-01-01

    Ralstonia pickettii is a low-virulence gram-negative bacillus that may be associated with infections related to health care and may cause bacteremia. Ralstonia pickettii bacteremia is uncommon but is related to the contamination of medical products, mainly in immunodepressed patients. We present two cases of patients on chronic hemodialysis with Ralstonia pickettii bacteremia linked to contamination of the dialysis water. Similar cases have been published with links to intravenous fluid administration, medication ampules, and the use of extracorporeal oxygenation membranes, among other factors. The detection of Ralstonia pickettii bacteremia should provoke suspicion and a search for contaminated medical products, fluids, and/or medications. PMID:27410414

  1. Pleural empyema due to Salmonella enterica serovar Enteritidis in an immunocompetent elderly patient: a case report

    Science.gov (United States)

    Karachalios, Kostis; Siagris, Dimitrios; Lekkou, Alexandra; Anastassiou, Evangelos D.; Spiliopoulou, Iris; Gogos, Charalambos

    2016-01-01

    Introduction: Pleural empyema as a focal infection due to Salmonella enterica serovar Enteritidis is rare and most commonly described among immunosuppressed patients or patients who suffer from sickle cell anaemia and lung malignancies. Case presentation: Here, we present an 81-year-old immunocompetent Greek woman with bacteraemia and pleural empyema due to Salmonella Enteritidis without any gastrointestinal symptoms. Conclusion: In our case, we suggest that patient’s pleural effusion secondary to heart failure was complicated by empyema and that focal intravascular infection was the cause of bacteraemia. PMID:28348773

  2. The strange case of a patient affected by acromegaly with osteoporomalacia without hypogonadism

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    S. Caprio

    2011-09-01

    Full Text Available Acromegaly is a rare disease that, in the majority of cases, is due to the presence of a benign growth hormone (GH- producing tumor of the pituitary. Growth hormone has profound effects on linear bone growth, bone metabolism, and bone mass. In acromegaly, the skeletal effects of chronic GH excess have been mainly addressed by evaluating bone mineral density (BMD. Most data were obtained in patients with active acromegaly, and apparently high or normal BMD was observed in the absence of hypogonadism. The Autors describe a case of patient affected by acromegaly without hypogonadism with serious osteoporosis and biological signs of osteomalacia.

  3. Major surgery in an osteosarcoma patient refusing blood transfusion: case report

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    Shanmugam Rukmanikanthan

    2010-11-01

    Full Text Available Abstract We describe an unusual case of osteosarcoma in a Jehovah's Witness patient who underwent chemotherapy and major surgery without the need for blood transfusion. This 16-year-old girl presented with osteosarcoma of the right proximal tibia requiring proximal tibia resection, followed by endoprosthesis replacement. She was successfully treated with neoadjuvant chemotherapy and surgery with the support of haematinics, granulocyte colony-stimulating factor, recombinant erythropoietin and intraoperative normovolaemic haemodilution. This case illustrates the importance of maintaining effective, open communication and exploring acceptable therapeutic alternative in the management of these patients, whilst still respecting their beliefs.

  4. Clinical Presentation of a Patient with Localized Acquired Cutis Laxa of Abdomen: A Case Report

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    Tugomir Gverić

    2010-01-01

    Objective. The aim of this case report was to present our patient suffering from CL, and to evaluate clinical presentation, diagnostic and therapeutic difficulties in this rare condition. Case Report. A 30-year-old female patient was admitted to our Hospital due to localized loose and sagging skin of abdomen, induced by prior cesarean section 6 years ago. CL has been diagnosed based on the clinical picture and pathohistological appearance. Conclusion. Reconstructive surgery provides a dramatic cosmetic improvement with significant psychosocial benefit. Repeated surgical procedures may be required to correct the lax skin, which worsens with age.

  5. Isolated pulmonary candidiasis in a patient with diabetes mellitus: A rare case report

    Science.gov (United States)

    Hakamifard, Atousa; Khorvash, Farzin; Raisi, Arash

    2016-01-01

    Fungal infections are as a cause of morbidity and mortality in immunocompromise patients. Because the respiratory tract is colonized with Candida, the presence of this agent in respiratory specimens makes the diagnosis of Candida pneumonia problematic. Candida pneumonia is a rare infection, and the majority of cases are secondary to hematogenous dissemination. Furthermore isolated Candida pneumonia originating from endotracheal inoculation is an extremely rare entity. We describe a case of isolated pulmonary candidiasis in the form multiple nodular lesions in a patient with long-term history of diabetes mellitus without evidence of fungemia or systemic involvement who responded to antifungal therapy. PMID:27656615

  6. Yellow fever vaccine used in a psoriatic arthritis patient treated with methotrexate: a case report.

    Science.gov (United States)

    Stuhec, Matej

    2014-01-01

    The yellow fever vaccines on the market are contraindicated for immunocompromised and elderly patients. A case of yellow fever vaccine used in a 27-year-old Slovenian male with psoriatic arthritis during treatment with methotrexate is described. We demonstrate a positive case, since there were no adverse effects in concurrent administration of yellow fever vaccine and methotrexate. This patient did not show severe adverse reactions and did not contract yellow fever despite potential exposure. More research is needed on possible adverse effects of concurrent administration of yellow fever vaccine and methotrexate to determine the potential of this method for more frequent use.

  7. Anesthesia for Lobectomy in a Pediatric Patient` with Cystic Fibrosis: A Case Report

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    Seyedhejazi Mahin

    2014-07-01

    Full Text Available Cystic Fibrosis is the most common autosomal recessive disease which causes a lot of complications and there are some needed operations in lifelong of such patients. Anesthesia in these patients requires particular attention and a full cooperation of surgeon, anesthetist and pediatrician .We reported a case of lobectomy with lung separation in a 4.5 years old child with cystic fibrosis which was performed with minor complications in the hope that an awareness of such situations may turn up similar cases of study.Keywords: Cystic Fibrosis, Anesthesia, Pulmonic Lobectomy

  8. Osteomyelitis and pyoarthritis resulting from local paracoccidioidomycosis in an immunocompetent patient: a case report

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    Michelan Michel

    2012-10-01

    Full Text Available Abstract Introduction Paracoccidioidomycosis is a type of mycosis that is endemic to Brazil and is triggered by the fungus Paracoccidioides brasiliensis. Isolated bone involvement in this disease is very rare, especially in children. To the best of our knowledge this report documents the first case of an immunocompetent pediatric patient in which paracoccidioidomycosis of the hip articulation was the sole manifestation of the disease (that is, there were no pulmonary or skin lesions. Case presentation An 11-year-old Brazilian Caucasian boy from a rural area was examined in the orthopedic ward of our emergency department. Our patient reported a three-month history of pain in the right hip with intermittent claudication and also complained of recurring episodes of intense pain and an inability to walk, which he had been experiencing for the previous five days. He additionally presented with a fever that had persisted for two days. Our patient’s medical history did not include any clinical respiratory manifestations, skin lesions, history of trauma or immunosuppression risk factors. Conclusions This is one of the very few reported cases of isolated articular involvement in osteomyelitis in a pediatric immunocompetent patient. Paracoccidioidomycosis should be considered among the differential diagnoses in such cases, especially in cases of patients who reside in rural areas where the condition is considered to be endemic, in order to administer the proper course of treatment in a timely fashion and improve the chances of a favorable prognosis.

  9. Disseminated nocardiosis with psoas abscess in a patient with AIDS: first reported case.

    Science.gov (United States)

    Corti, Marcelo; Solari, Rubén; De Carolis, Luis; Cangelos, Diana; Bianchi, Mario; Negroni, Ricardo

    2008-01-01

    Psoas muscle abscess is an uncommon infection that have been diagnosed increasingly in the last years. We present a case of a patient with advanced human immunodeficiency virus infection who developed a disseminated infection due to Nocardia asteroides sensu stricto type VI with psoas abscess. To our knowledge no other cases of Nocardia psoas abscess in the setting of HIV infection have been reported in the literature.

  10. Colonic necrosis and perforation due to calcium polystyrene sulfonate in a uraemic patient: a case report

    OpenAIRE

    Akagun, Tulin; Yazici, Halil; Gulluoglu, Mine G.; Yegen, Gulcin; Turkmen, Aydin

    2011-01-01

    Sodium or calcium polystyrene sulfonate (Kayexalate or analog) is an ion-exchange resin commonly used to treat hyperkalaemia in patients with chronic kidney disease. It is known to cause digestive complications, such as nausea, vomiting and constipation. Although rare, colonic necrosis and perforation are very severe complications associated with the medication. In this case report, we present a case of calcium polystyrene sulfonate-induced colonic necrosis and perforation to remind clinician...

  11. Mixed tumour of schwannoma and meningioma in a patient with neurofibromatosis-2 : a case report.

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    Elizabeth J

    2001-10-01

    Full Text Available The co-existence of schwannoma and meningioma as a mixed intracranial tumour is uncommon and so far only eight cases have been published in the literature. Because of rarity, we report a unique case of mixed tumour having schwann cell and meningeal components, in a patient with neurofibromatosis type -2 (NF-2. The possible mechanisms for the occurrence of these mixed tumours are discussed.

  12. Fournier's gangrene in a patient after third-degree burns: a case report

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    Iavazzo Christos

    2009-05-01

    Full Text Available Abstract Introduction Fournier's gangrene is characterized by tissue ischemia leading to rapidly progressing necrotizing fasciitis. Case presentation We present the case of a patient with Fournier's gangrene after third-degree burns. Clinical manifestations, laboratory results and treatment options are discussed. Conclusion Fournier's gangrene is a surgical emergency. Although it can be lethal, it is still a challenging situation in the field of surgical infections.

  13. Follow-up of patient with Gorlin-Goltz Syndrome – a case report

    OpenAIRE

    Alexsandra da Silva Botezeli STOLZ; Marcia Oliva de OLIVEIRA; Ferreira, Fabiana Vargas; Celina Maria UGGERI

    2010-01-01

    Introduction: The Gorlin-Goltz Syndrome, also known as Nevoid Basal Cell Carcinoma Syndrome, is a dominant autosomal hereditary disorder which is characterized by the presence of multiple jaw keratocysts and basal cell carcinomas, besides musculoskeletal, neurological, dermatological and endocrine abnormalities. Case report: This paper reports the case of a fifteen-year-old patient who was referred to the Faculty of Dentistry of the Federal University of Santa Maria (RS, Brazil) and presented...

  14. Atlantoaxial Ankylosis Detected on Neck CT Scans in a Patient with Ankylosing Spondylitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Ah; Lee, Seung Hun; Joo, Kyung Bin [Dept. of Radiology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of); Ryu, Jeong Ah [Dept. of Radiology, Guri Hospital, Hanyang University College of Medicine, Guri (Korea, Republic of); Kim, Tae Hwan [Dept. of Rheynmatology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2011-07-15

    Ankylosing spondylitis is a chronic inflammatory disorder of unknown cause that principally affects the axial skeleton. The cervical spine is also vulnerable to this disease process and the characteristic feature of cervical involvement is atlantoaxial subluxation. However, only a few cases of atlantoaxial ankylosis have been reported to date. We report a case of atlantoaxial ankylosis in a patient with ankylosing spondylitis with radiologic findings incidentally detected on neck CT scans.

  15. Cavernous mesenteric lymphangiomatosis mimicking metastasis in a patient with rectal cancer: A case report

    Institute of Scientific and Technical Information of China (English)

    Seong Su Hwang; Hyun Joo Choi; Soo Youn Park

    2009-01-01

    Lymphangioma usually occurs in children and usually involves the skin. Mesenteric lymphangioma is extremely rare in adults. Typically, lymphangioma appears on computed tomography (CT) as a lower attenuation of a cystic mass, however, some cases appear to be a solid mass. We describe the CT and 18FFDG positron emission tomography/CT appearance in a case of jejunal and mesenteric cavernous lymphangiomatosis mimicking metastasis in an adult patient with rectal cancer.

  16. Severe manifestation of psoriasis in a HIV infected patient: a case report

    Directory of Open Access Journals (Sweden)

    Alper Gunduz

    2015-12-01

    Full Text Available The human immunodeficiency virus (HIV epidemic in Turkey reveals a slow progression and at the end of November 2015, the total official number was reported to be 11,109 cases. Approximately 90% of HIV patients develop some type of skin disease. Especially patients with psoriasis and HIV infection often present with more severe and treatment-refractory cutaneous disease. Herein, we describe a case of a patient with previously known psoriasis worsened by HIV infection. A 37-year-old housewife was admitted to our clinic with previously known psoriasis worsened during the last two years with conversion to erythrodermic psoriasis which was not controlled even by PUVA, methotrexate and systemic cyclosporine. The patient had positive HIV antibody test. HIV RNA viral load was 120.000 copy/ml and CD4 count 88/ mm3 . She also had oral candidiasis and Pneumocystis jirovecii pneumonia. The patient received antiretroviral treatment including tenofovir/emtricitabine and lopinavir/ritonavir. Symptoms resolved gradually within one month with almost complete impovement of her erythrodermic psoriasis. . Four years later the patient was still on tenofovir/emtricitabine and lopinavir/ritonavir without concomitant spesific psoriasis treatment. Psoriasis manifestations can be severe in AIDS patients. Clinicians face diagnostic and therapeutic difficulties when psoriasis coexists with HIV infection. The HIV test should be considered in patients affected by severe erythrodermic psoriasis and resistant to conventional and biological treatments. [Dis Mol Med 2015; 3(4.000: 43-45

  17. Applying patient centered approach in management of pulmonary tuberculosis: A case report from Malaysia.

    Science.gov (United States)

    Atif, M; Sulaiman, Sas; Shafi, Aa; Muttalif, Ar; Ali, I; Saleem, F

    2011-06-01

    A 24 year university student with history of productive cough was registered as sputum smear confirmed case of pulmonary tuberculosis. During treatment, patient suffered from itchiness associated with anti tuberculosis drugs and was treated with chlorpheniramine (4mg) tablet. Patient missed twenty eight doses of anti tuberculosis drugs in continuation phase claiming that he was very busy in his studies and assignments. Upon questioning he further explained that he was quite healthy after five months and unable to concentrate on his studies after taking prescribed medicines. His treatment was stopped based on clinical improvement, although he did not complete six months therapy. Two major reasons; false perception of being completely cured and side effects associated with anti TB drugs might be responsible for non adherence. Non sedative anti histamines like fexofenadine, citrizine or loratidine should be preferred over first generation anti histamines (chlorpheniramine) in patients with such lifestyle. Patient had not completed full course of chemotherapy, which is preliminary requirement for a case to be classified as "cure" and "treatment completed". Moreover, patient had not defaulted for two consecutive months. Therefore, according to WHO treatment outcome categories, this patient can neither be classified as "cure" or "treatment completed" nor as "defaulter". Further elaboration of WHO treatment outcome categories is required for adequate classification of patients with similar characteristics. Likelihood of non adherence can be significantly reduced by applying the WHO recommended "Patient Centered Approach" strategy. Close friend, class mate or family member can be selected as treatment supporter to ensure adherence to treatment.

  18. Zinc-deficiency acrodermatitis in a patient with chronic alcoholism and gastric bypass: a case report

    Directory of Open Access Journals (Sweden)

    Dariush Shahsavari

    2014-07-01

    Full Text Available Acquired adult-onset zinc deficiency is occasionally reported in patients with malnutrition states, such as alcoholism, or malabsorptive states, such as post-bariatric surgery. The defining symptoms of hypozincemia include a classic triad of necrolytic dermatitis, diffuse alopecia, and diarrhea. We report a case of zinc deficiency in a 39-year-old man with history of gastric bypass surgery and alcoholism. For this patient, severe hypozincemia confirmed acrodermatitis, and zinc supplementation was met with gradual improvement.

  19. Palmar-plantar erythrodysesthesia, clinical case presentation in a patient with craniopharyngioma and sickle cell anemia

    OpenAIRE

    Lora-Fernández Alberto Carlos; Arias-Arias Ramón

    2010-01-01

    The sickle-cell disease complicatiosn include acute isquemic crisis in extremities and organs, occur to fuctional and estructural alteration in oxigen transport toward tissue, our case of a patient with craniopharyngioma after posoperatory tumoral resection show necrosis in hand and foot, conduce to amputation, describe this clinic presentation after a allergic reaction to vancomicine and ceftriazone associated the hemoglobinopatie of the patient and management instaurated.RESUMENLas complica...

  20. Temporary ileostomy for the preservation of colon fistula in patients with postoperative complications: case report

    OpenAIRE

    Solaine Chiminácio De Oliveira Patrício; Alcides José Branco Filho; Ana Carla Broetto Biazon

    2011-01-01

    Among the postoperative complications in the digestive system, the fistulae are the most common ones. The changes resulting from these fistulae are very important, once they can determine the patient's situation and the development of multiple organic failures. This paper reports the case of a patient who had relevant complications after having undergone temporary ileostomy to maintain the colon fistulized. About 90 to 95% of the digestive tract fistulae have spontaneous resolution. In so...

  1. Parenthood in patients with acute promyelocytic leukemia after treatment with arsenic trioxide: a case series.

    Science.gov (United States)

    Gupta, Shilpa; Bagel, Bhausaheb; Gujral, Sumeet; Subramanian, P G; Khattry, Navin; Menon, Hari; Nair, Reena

    2012-11-01

    Arsenic trioxide, believed to be a carcinogen and a teratogen, has found its niche in the treatment of acute promyelocytic leukemia (APL). APL is a disease affecting young patients. Post-treatment fertility and outcome of pregnancy are always a concern in a disease with high cure rates. We report a case series of six patients who were treated successfully for APL with arsenic trioxide and who parented at least one healthy offspring after completing their treatment.

  2. Spinal supports and physical therapy in patients with low back pain: a case series

    OpenAIRE

    Podichetty, Vinod K; Varley, Eric S.

    2009-01-01

    The association of low back pain with physical workload in seated workstation related jobs has been debated and remains controversial. Clinical studies eliciting the natural history of the disease in this emerging population are insufficient to make definitive conclusions. We report four consecutive cases of patients suffering from low back pain presenting to a tertiary spine clinic with severe non-specific low back pain. Two patients as age-matched controls with persistent low back pain were...

  3. CHRONIC COMPARTMENT SYNDROME OF LOWER LEG. AN UNUSUAL CASE IN NON ATHLETIC PATIENT.

    Directory of Open Access Journals (Sweden)

    Andrea Schiavone

    2016-10-01

    Full Text Available Chronic exertional anterior compartment syndrome is debilitating disease of lower limb. The clinical picture is characterised by limited symptomology at rest, pain during sporting activities, tumefaction and contractures of limb as well impotency by pain of the entire forefoot and hypoesthesia. Usually the most affected patients are athletes. We analyse a case of chronic post traumatic compartment syndrome of the anterior tibial muscle in an unsportsmanlike patient.

  4. Prehospital Use of the Intubating Laryngeal Mask Airway in Patients with Severe Polytrauma: A Case Series

    Directory of Open Access Journals (Sweden)

    Andrew M. Mason

    2009-01-01

    Full Text Available A case series of five patients is described demonstrating the utility of the intubating laryngeal mask airway in the prehospital setting, both as a primary airway rescue device and as a bridge to tracheal intubation. All patients were hypoxaemic, had sustained severe polytrauma and were trapped in their vehicles following road traffic collisions. A probability of survival study showed better-than-predicted outcomes for the group as a whole.

  5. Dental findings in patients with West syndrome: a report of two cases.

    Science.gov (United States)

    Khatri, Amit; Kalra, Namita; Tyagi, Rishi; Baweja, Mani; Khandelwal, Deepak

    2014-01-01

    West syndrome a rare, severe form of epilepsy occurs in early infancy. It is characterized by a triad consisting of infantile spasms that occurs in clusters, arrest of psychomotor development and hypsarrhythmia on electroencephalogram. We present here two cases of west syndrome where patients required dental care due to the presence of certain dental findings. Preventive measurements such as controlled diet and proper oral hygiene along with professional dental management are recommended in patients with west syndrome to avoid dental problems.

  6. A rare case of Herpes zoster oticus in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Ganesh Prabhakar Dhavalshankh

    2012-10-01

    Full Text Available Herpes zoster oticus in healthy persons is uncommon, though it has been described in immunocompromised patients. We describe a case of disseminated herpes zoster oticus in an elderly man with no apparent immunosuppressive condition. The patient was treated successfully with oral Acyclovir. We suggest that disseminated zoster can occur in an immunocompetent host and should be promptly recognized and treated to prevent serious complications.

  7. Myocutaneous Mucormycosis in a Diabetic Burnt Patient Led to Upper Extremity Amputation; A Case Report

    Directory of Open Access Journals (Sweden)

    Mehdi Ayaz

    2017-01-01

    Full Text Available Mucormycosis is a rare opportunistic fungal infection that can implicate cranial sinuses, brain, lungs, gastrointestinal tract and skin. Although it can occur in patients with competent and incompetent immunity such as patients with diabetes mellitus, lymphoma, leukemia and burns, but it has an aggressive, malignant and lethal course in patients with incompetent immunity. To enforce the importance of burn in patients with underlaying diseases such as diabetes, we are going to report a rare case of diabetic burnt patient complicated by right upper extremity myocutaneous mucormycosis. We selected this case to emphasis the importance of underlying disease (diabetes mellitus with cutaneous burn, aggressive treatment of fungal infection in these patients and referring such case to burn center to prevent catastrophic results. A 50-year-old woman was introduced to us after several days of medical and surgical care of right upper extremity and trunk split-thickness burn. Due to gross muscle necrosis of right upper extremity and poor general condition of the patient, she was taken to the operating room that led to right upper extremity amputation and several times of aggressive debridement to save her life. Pathologic report was indicative of mucormycosis. We can conclude from this case that: 1 Burn, even partially thickness and with little body surface area, should be referred to burn center for better care 2 No response to usual medical treatment should make us more sensitive to consider the unusual causes of infection such as fungi 3 Suspected dead tissues should be excised aggressively especially if suspiciousness to wound sepsis and fungal infection is present especially in an immunocompromised patient.

  8. Oral medicine case book 51: actinic cheilitis in a patient with oculocutaneous albinism.

    Science.gov (United States)

    Wood, N H; Moodley, A

    2013-07-01

    Patients with oculocutaneous albinism are more prone to sun-induced damage due to the lack of melanin. Actinic cheilitis is a potentially malignant disorder that occurs due to chronic UV-B radiation to the vermillion region of the lip, a region that is already at risk due to its morphology. A case of actinic cheilitis in a patient with oculocutaneous albinism is presented with a literature review.

  9. Breakthrough trichosporonosis in patients receiving echinocandins: case report and literature review

    Institute of Scientific and Technical Information of China (English)

    LIAO Yong; Thomas Hartmann; ZHENG Tao; YANG Rong-ya; AO Jun-hong; WANG Wen-ling

    2012-01-01

    Trichosporon species now ranks as the second most common cause of disseminated yeast infections with a high mortality rate.Breakthrough trichosporonosis in patients receiving echinocandins therapy is being recognized recently.We present a case of breakthrough trichosporonosis with acute viral myocarditis while receiving caspofungin therapy.Trichosporon infection should be considered in patients,who have risk factors for invasive fungal infection and develop unexplained clinical manifestations of infection despite treatment with echinocandins.

  10. Aortic Dissection of Unknown Origin in a Young Patient: A Case Report

    OpenAIRE

    Majid Hajimaghsoudi; Faeze Zeinali; Mehdi Bagherabadi; Morteza Saeedi

    2016-01-01

    Aortic dissection occurs when a tear develops in the wall of the aorta, which is rare in the young population. This fatal disorder is hard to diagnose, especially in young patients. We present the case of aortic dissection in a 15-year-old boy referred to the Emergency Department of Yazd University of Medical Sciences in November 2015. The patient presented to our department with sudden acute chest pain. Emergent computed tomography (CT) scanning of the brain, chest, and abdomen reflected bil...

  11. Multicentric Castleman's disease and Kaposi's sarcoma in a cyclosporin treated, HIV-1 negative patient: case report

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    van Oers MHJ

    2003-12-01

    Full Text Available Abstract Background Multicentric Castleman's disease (MCD is a rare disease, but is more frequent in AIDS patients. MCD has only been reported twice before in patients receiving immunosuppressive therapy after renal transplantation, and never in patients receiving immunosuppressive therapy without transplantation. About half of the cases of MCD are human herpesvirus 8 (HHV8 – related, in contrast to Kaposi's sarcoma, a more common complication arising after immunosuppression, where the virus is found in virtually all cases. Case presentation We report a HIV-1 negative, non-transplant patient who developed HHV8-associated multicentric Castleman's disease and Kaposi's sarcoma after 17 years of immunosuppressive treatment with cyclosporin A for a minimal change nephropathy. Chemotherapy with liposomal doxorubicin resolved both symptoms of multicentric Castleman's disease and Kaposi's sarcoma in this patient. A concomitant decline in the HHV8 viral load in serum/plasma, as determined by a quantitative real-time PCR assay, was observed. Conclusions Multicentric Castleman's disease can be a complication of cyclosporin A treatment. Both multicentric Castleman's disease and Kaposi's sarcoma in this patient were responsive to liposomal doxorubicin, the treatment of choice for Kaposi's sarcoma at the moment, again suggesting a common mechanism linking both disorders, at least for HHV8-positive multicentric Castleman's disease and Kaposi's sarcoma. HHV8 viral load measurements can be used to monitor effectiveness of therapy.

  12. Case presentation of an intranasal ectopic tooth in a pediatric patient.

    Science.gov (United States)

    Yu, Chao; Gu, Deying; An, Junnan; Tang, Yuedi

    2015-01-01

    An ectopic tooth in the nasal cavity is a rare phenomenon, especially on the inferior turbinate. In most of the reported cases, no etiological explanation of the intranasal teeth has been suggested or found. In children, intranasal ectopic teeth are usually associated with cleft lip and alveolus. Here, we report a rare case of a pediatric patient with unilateral nasal obstruction due to an intranasal ectopic tooth originating from the inferior turbinate without any facial and dental deformities. This case is unique due to the unusual location of the ectopic tooth and its presentation in a child without facial and dental deformities.

  13. Anesthetic management in a patient with giant growing teratoma syndrome: a case report

    OpenAIRE

    Ohashi, Nobuko; Imai, Hidekazu; Tobita, Toshiyuki; Ishii, Hideaki; Baba, Hiroshi

    2014-01-01

    Introduction Growing teratoma syndrome is a rare occurrence with an ovarian tumor. Anesthesia has been reported to be difficult in cases of growing teratoma syndrome of the cystic type due to the pressure exerted by the tumor. However, there have been no similar reports with the solid mass type. Here, we report our experience of anesthesia in a case of growing teratoma syndrome of the solid type. Case presentation The patient was a 30-year-old Japanese woman who had been diagnosed with an ova...

  14. Pulmonary thromboembolism and sudden death in psychiatric patients: Two cases reports

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    Marinković Nadica

    2017-01-01

    Full Text Available Introduction. Pulmonary thromboembolism occurs usually by running a thrombus from the deep veins of the legs rarely periprostatic or periuteric veins. Virchow's triad of necessary conditions for the occurrence of thrombosis involves disruption of blood flow, disruption of blood chemistry and damage to the vessel wall. Venous thrombosis is often associated with the implementation of antipsychotic therapy. Case report. We reported two cases of sudden death of psychiatric patients who were in both cases fixed during hospitalization. The first case was a 26-year-old woman treated a year with the diagnose of postpartum reactive psychosis. She was hospitalized because of mental state worsening with a dominant depressed mood, visual and auditory hallucinations. Her therapy was determined by diazepam, clozapine, haloperidol and lamotrigine. Suddenly, the patient died on the fifth day of hospitalization. The autopsy showed massive thromboembolism of the pulmonary artery branches. Toxicological analysis revealed the presence of therapeutic doses of antipsychotics. The second case was a-45-yearold men, a long-time alcoholic. On admission, the diagnosis of delirium tremens was established, and diazepam and haloperidol were administered. On the fifth day of hospitalization, he suddenly died. The autopsy showed thromboembolism of the branch of the pulmonary artery. Toxicological analysis established the presence of nordiazepam in urine (0.06 mg/L. Both patients were fixed during hospitalization. Conclusion. Both presented psychiatric patients were younger than 50 years, were not overweight, did not have changes of the venous blood vessels. Nowadays, when the issue of medical responsibility often arises in these and similar cases of sudden death in patients treated in psychiatric clinics, the questions on medical malpractice could be expected.

  15. Rupioid histoplasmosis: first case reported in an AIDS patient in Argentina.

    Science.gov (United States)

    Corti, Marcelo; Villafañe, María F; Palmieri, Omar; Negroni, Ricardo

    2010-01-01

    Disseminated histoplasmosis is a relatively common AIDS-defining illness, occurring in almost 4% of patients living in endemic areas and it may be the first clinical expression of the HIV infection. A broad spectrum of clinical skin lesions associated with Histoplasma capsulatum infection have been described in AIDS patients, such as erythematous macules, papules, nodules, and pustules. Herpetic, acneiform, erythema multiforme-like, molluscum contagiosum-like, vasculitic, and exfoliative forms have also been reported. To our knowledge, this is the first case of disseminated histoplasmosis in an AIDS patient presented as a rupioid eruption.

  16. [Use of hypnosis in treating a patient with dental anxiety: A case study].

    Science.gov (United States)

    Meyerson, J; Ratson, T

    2015-10-01

    Dental anxiety is quite common and may lead to dental neglect due to lack of regular visits to the dental clinic. The difficulties in managing anxious patients are characterized by prolonged visits, a tendency to cancel appointments and a tense atmo- sphere during treatment. The use of hypnosis while treating an anxious patient can help create a posi- tive environment and shorten the duration of dental appointments as well. The article describes a case in which hypnosis was used while treating a patient who had suffered from dental anxiety for over 20 years.

  17. Stent Thrombosis Patients with Hyporesponsiveness to Clopidogrel, Prasugrel, and Ticagrelor: A Case Series Using Short Thromboelastography

    Directory of Open Access Journals (Sweden)

    Bartosz Olechowski

    2016-01-01

    Full Text Available Patients after percutaneous coronary intervention (PCI with stent implantation and functional hyporesponsiveness to P2Y12 inhibitors are at higher risk of ischaemic events, particularly stent thrombosis (ST. It is currently not routine practice to assess the functional response to these agents. However, concern over functional hyporesponsiveness to clopidogrel has led to widespread uptake of prasugrel and ticagrelor as the default P2Y12 inhibitor after stent implantation in patients with acute coronary syndrome. Here we report, for the first time, 3 cases in which patients who have had ST exhibit hyporesponsiveness to clopidogrel, prasugrel, and ticagrelor.

  18. Negative pressure pulmonary edema after nasal fracture reduction in an obese female patient: a case report

    Science.gov (United States)

    Choi, Eunkyung; Yi, Junggu; Jeon, Younghoon

    2015-01-01

    Postoperative negative pressure pulmonary edema (NPPE) is a rare, but well-known life-threatening complication of acute upper airway obstruction (UAO) which develops after general anesthesia. The pronounced inspiratory efforts following UAO lead to excessive negative inspiratory pressure, which may cause acute pulmonary edema. Early recognition and prompt treatment of NPPE is necessary to prevent patient morbidity and mortality. In addition, the physician should carefully manage the patient who has risk factors of UAO to prevent this situation. We experienced a case of NPPE following laryngospasm after tracheal extubation in an obese patient who underwent open reduction of orbital wall and nasal bone surgery. PMID:26316826

  19. Mucormycosis complicating lower limb crash injury in a multiple traumatised patient: an unusual case.

    Science.gov (United States)

    Stasiak, Mariusz; Samet, Alfred; Lasek, Jerzy; Wujtewicz, Maria; Witkowski, Zbigniew; Komarnicka, Jolanta; Golabek-Dropiewska, Katarzyna; Rybak, Bartosz; Gross, Marta; Marks, Wojciech

    2009-01-01

    Necrotising skin and soft tissues infections are most commonly bacterial in origin. However, saprophytic fungi of the class Zygomycetes, family Mucoraceae, can cause highly aggressive infections (mucormycoses) mainly in immunocompromised patients. Severe trauma is one of the major risk factors for mucormycosis. Fungal traumatic wound infection is an unusual complication associated with crash limb injury. This report describes a case of serious necrotising soft tissue infection caused by Mucor sp following primary fungal environmental wound contamination in a multiply injured patient. Despite undelayed diagnosis and proper treatment (surgical debridement and limb amputation, amphotericin B therapy) the patient presented a fatal outcome.

  20. Case report 557: Solitary intramuscular myxoma in a patient with polyostotic fibrous dysplacia

    Energy Technology Data Exchange (ETDEWEB)

    Glass-Royal, M.C.; Nelson, M.C.; Albert, F.; Lack, E.E.; Bogumill, G.P. (Georgetown Univ., Washington, DC (USA). Medical Center)

    1989-08-01

    We report a case of solitary intramuscular myxoma in a patient with polyostotic fibrous dysplasia and pigmented macules. MR played an important role in the patient's pre-operative evaluation. It has been demonstrated in a review of the literature that a definite relationship exists between myxoma of soft tissues and fibrous dysplasia of the skeleton. Multiple myxomas in a patient with fibrous dysplasia are common and a relationship also exists between myxoma of the soft tissues and the McCune-Albright syndrome. (orig./GDG).

  1. Rare case of obturator hernia in a patient with Marfan's syndrome.

    Science.gov (United States)

    Peter, R; Indiran, V; Kannan, K; Maduraimuthu, P; Varadarajan, C

    2014-06-01

    Obturator hernia is a very rare type of abdominal hernia which constitutes hernias. It is an important cause of small bowel obstruction which is associated with a high mortality rate if left untreated. Obturator hernia typically occurs in an elderly women or patients with chronically raised intraabdominal pressure or previous multiple pregnancies. We report a case of obstructed obturator hernia in a young female patient with Marfan's syndrome complicated with dissecting aortic aneurysm and chronic kidney disease. Though recurrent and incisional hernia constitutes one of the minor diagnostic criteria of Marfan's syndrome, obturator hernia being a very rare entity, has been reported very rarely in a patient with Marfan's syndrome.

  2. Mycobacterium ulcerans infection as a cause of chronic diarrhea in an AIDS patient: A case report

    Institute of Scientific and Technical Information of China (English)

    Jin-Gook Huh; Myoung-Don Oh; You-Sun Kim; Jong-Sung Lee; Tae-Yeob Jeong; Soo-Hyung Ryu; Jung-Hwan Lee; Jeong-Seop Moon; Yun-Kyung Kang; Myung-Shup Shim

    2008-01-01

    Chronic diarrhea is one of the most frequent gastro-intestinal manifestations in acquired immunodeficiency syndrome (AIDS).Protozoa and nontuberculous mycobacteria (NTM) are opportunistic pathogens that can easily infect these patients.Among the NTM,Mycobacterium avium complex (MAC) is the most frequently observed pathogen in HIV-infected patients.However,NTMs other than MAC have not been reported as a gastrointestinal pathogen as yet.We present a case of chronic diarrhea in an AIDS patient in whom Mycobacterium ulcerans and cryptosporidium co-infection is evidenced from colonic tissue.

  3. [Bilateral quadriceps rupture in a patient with osteogenesis imperfecta. A case report].

    Science.gov (United States)

    Salcedo-Dueñas, Jesús Alejandro; Torres Castro, Carlos; Estrada Gómez, José Andrés; Algarín Reyes, José Antonio; Bello González, Alejandro

    2009-01-01

    We present the case of a 24-year-old patient with bilateral quadriceps rupture and history of type I congenital osteogenesis imperfecta diagnosed clinically and with ultrasound. Bilateral quadriceps tenoplasty was performed with an anterior approach and without any complications. The patient was discharged with bilateral neoprene knee-guards. The sutures were removed at the 21-day follow-up visit, rehabilitation was started at six weeks and the patient was doing well at the 2- and 3-month follow-up visits. Timely management and early rehabilitation contribute to decrease the risk of sequelae despite the poor functional prognosis.

  4. Dental team management for a patient with Klippel-Feil syndrome: case report.

    Science.gov (United States)

    de Lima, Marina de Deus Moura; Ortega, Karem Lopez; Araújo, Luis Carlos Arias; Soares, Marcelo Melo; de Magalhães, Marina Helena Cury Gallottini

    2009-01-01

    Klippel-Feil syndrome (KFS) is a rare congenital abnormality characterized by a short neck, a low posterior hairline, and limited head movement. Occasionally, patients with KFS may also show signs of deafness, intellectual disability, cardiac malformation, palpebral ptosis, facial nerve paralysis, cleft palate, and scoliosis. Although some researchers have documented this syndrome, scant attention has been paid to craniomaxillofacial manifestations and dental treatment of patients with KFS. The objective of this case report was to describe the planning and execution of dental treatment for a 10-year-old male patient with KFS.

  5. Three cases of severely disseminated Staphylococcus aureus infection in patients treated with tocilizumab

    DEFF Research Database (Denmark)

    Nguyen, Mai; Pødenphant, Jan; Ravn, Pernille

    2013-01-01

    We report three cases of severe disseminated Staphylococcus aureus infection in patients with rheumatoid arthritis (RA) treated with tocilizumab. Tocilizumab is a new drug, unknown to most internists, and injections given weeks before admission may not be considered by the patient as part......-intensive diagnostic work-up and early treatment should be performed. Systematic postmarketing studies are needed to clarify if there is a true increased risk of disseminated S aureus infections. We suggest caution when prescribing tocilizumab to patients with prosthetic joints and/or prior invasive S aureus...

  6. Use of Fibula Bridge Graft Technique to Treat a Distal Tibia Non Union- A Case Report

    Directory of Open Access Journals (Sweden)

    Amyn Rajani

    2013-01-01

    Full Text Available Introduction: Compound distal tibia fractures have high incidence of nonunions and have varied presentation as far as status of fibula is concerned. If fibula is sufficiently healthy we can use it for bridging the nonunion of tibia.Case Report: We present a case of 20 year old female with compound and segmental tibia fracture. Primary stablisation by external fixation and later cast brace application achieved union at the proximal end of the segmental fragment with non union at the distal end. This was then treated with bridge grafting of fibula and screw fixation of fibula to the tibia. Five years follow shows good clinical and functional outcome without any complications.Conclusion: Its infrequent to find fibula spanning across the tibia nonunion, however when available this can be used as bridge graft to promote healing.

  7. Primitive neuroectodermal tumor in a mixed germ cell tumor - A rare case report

    Directory of Open Access Journals (Sweden)

    Khushboo Dewan

    2015-01-01

    Full Text Available A rare case of testicular tumor in a 20-year-old male with Primitive Neuroectodermal Tumor (PNET was reported. Imaging studies showed a large heterogenous mass in the right scrotal sac and a large retroperitoneal mass with metastasis in the lung and liver. Serum alpha fetoprotein (AFP was markedly elevated with moderate increase in serum β-human chorionic gonadotropin (hCG levels. After orchidectomy, a histological diagnosis of mixed germ cell tumor-teratoma with primitive neuroectodermal, embryonal, and yolk sac components was made. Some scattered embryoid bodies representative of primitive germ cell tumor were also present. Morphological diversity including PNET prompted the authors to report this case as PNET points toward a poor prognosis.

  8. Leptospira Exposure and Patients with Liver Diseases: A Case-Control Seroprevalence Study

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Hernández-Tinoco, Jesús; Ramos-Nevárez, Agar; Margarita Cerrillo-Soto, Sandra; Alberto Guido-Arreola, Carlos

    2016-01-01

    The seroepidemiology of Leptospira infection in patients suffering from liver disease has been poorly studied. Information about risk factors associated with infection in liver disease patients may help in the optimal planning of preventive measures. We sought to determine the association of Leptospira IgG seroprevalence and patients with liver diseases, and to determine the characteristics of the patients with Leptospira exposure. We performed a case-control study of 75 patients suffering from liver diseases and 150 age- and gender-matched control subjects. Diagnoses of liver disease included liver cirrhosis, steatosis, chronic hepatitis, acute hepatitis, and amoebic liver abscess. Sera of participants were analyzed for the presence of anti- Leptospira IgG antibodies using a commercially available enzyme immunoassay. Anti-Leptospira IgG antibodies were found in 17 (22.7%) of 75 patients and in 15 (10.0%) of 150 control subjects (OR = 2.32; 95% CI: 1.09-4.94; P=0.03). This is the first age- and gender-matched case control study about Leptospira seroprevalence in patients with liver diseases. Results indicate that Leptospira infection is associated with chronic and acute liver diseases. Results warrants for additional studies on the role of Leptospira exposure in chronic liver disease. PMID:27493589

  9. MULTIMODAL PHYSIOTHERAPEUTIC APPROACH IN TREATING A PATIENT WITH ACUTE CERVICAL DISC PROLAPSE: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Rathish Manickam

    2015-12-01

    Full Text Available Background and Purpose: Cervical disc prolapse is one of the leading cause of morbidity and affecting the patients routine work of their ADL. Due to severity of symptoms and patients feeling of insecurity, physiotherapeutic conservative approach is questionable and has become challengeable against surgery. The purpose of this case report is to explore the efficacy of multimodal physiotherapeutic approach in treating a patient with acute cervical disc prolapse. Case Description: 33 year old male patient was diagnosed with acute cervical disc prolapse and the pain was radiating to the right upper limb associated with numbness. The patient was given initially physiotherapeutic modalities like cryotherapy, ultrasound and mechanical traction to reduce pain. Muscle Energy Technique was also implemented for initial days along with cryotherapy based on cryokinetics concept to enhance movements of cervical spine. Mckenzie exercises with appropriate techniques was administered for 10 days along with retraction exercise, basic ROM and neck isometrics as a home program. The patient received treatment for a period of 12 days. Outcome Measures: The outcome measures used were Numeric Pain Rating Scale, Neck Disability Index, Tampa Scale for Kinesiophobia, and Cervical ROM. Conclusion: Multimodal physiotherapeutic approach along with Mckenzie technique played a significant role in alleviating pain, numbness and improvement of the patient functionally for return to his normal work.

  10. Lumbar disc herniation in three patients with cystic fibrosis: a case series

    Directory of Open Access Journals (Sweden)

    Gruebl Armin

    2011-09-01

    Full Text Available Abstract Introduction To date, lumbar disc herniation has not been reported in the context of cystic fibrosis even though back pain and musculoskeletal problems are very common in patients with cystic fibrosis. Case presentation We report on three patients with cystic fibrosis who experienced lumbar disc herniation in the course of their disease at ages 19 to 21 years (a 22-year-old Caucasian man, a 23-year-old Caucasian man, and a 21-year-old Caucasian woman. Our third patient eventually died because of her deteriorated pulmonary situation, which was influenced by the lumbar disc herniation as it was not possible for her to perform pulmonary drainage techniques properly because of the pain. Conclusions Lumbar disc herniation can lead to a vicious cycle for patients with cystic fibrosis as it may promote pulmonary infections. This report highlights the need to investigate patients correctly.

  11. Quality of uncomplicated malaria case management in Ghana among insured and uninsured patients

    DEFF Research Database (Denmark)

    Fenny, Ama P; Hansen, Kristian S; Enemark, Ulrika

    2014-01-01

    INTRODUCTION: The National Health Insurance Act, 2003 (Act 650) established the National Health Insurance Scheme (NHIS) in Ghana with the aim of increasing access to health care and improving the quality of basic health care services for all citizens. The main objective is to assess the effect...... of health insurance on the quality of case management for patients with uncomplicated malaria, ascertaining any significant differences in treatment between insured and non-insured patients. METHOD: A structured questionnaire was used to collect data from 523 respondents diagnosed with malaria......, laboratory tests conducted and type of drugs prescribed. Insurance status of patients, age, gender, education level and occupation were asked in the interviews. RESULTS: Of the 523 patients interviewed, only 40 (8%) were uninsured. Routine recording of the patients' age, weight, and temperature was high...

  12. Mycobacterium genavense Infections in a Tertiary Hospital and Reviewed Cases in Non-HIV Patients

    Directory of Open Access Journals (Sweden)

    M. Santos

    2014-01-01

    Full Text Available Mycobacterium genavense is a relatively new species of nontuberculous mycobacterium reported to cause disseminated infections in patients with AIDS and later on in non-HIV immunosuppressed patients. We describe clinical and laboratory features and response to therapy in 7 patients, three of them with HIV infection and four non-HIV—three organ transplant recipients and one with hyper-IgE syndrome—in Valencia, Spain, in a ten years period. We then summarize the published cases of M. avium complex infection, with invasion of peripheral blood, liver, spleen, bone marrow, lymph nodes, and lungs. In clinical samples a large number of acid-fast bacilli were observed. M. genavense grew only from liquid media and after a prolonged incubation period. Its identification was accomplished through molecular methods. Patients were treated with prolonged combinations of antimicrobial agents. There was clinical favourable outcome in 4 patients.

  13. Chondrosarcoma of the mandibular condyle in a patient with Werner syndrome: a case report.

    Science.gov (United States)

    Goutzanis, Labros; Kalfarentzos, Evagelos F; Petsinis, Vassilis; Papadogeorgakis, Nick

    2013-10-01

    Werner syndrome, also called progeria of the adult and pangeria is a rare autosomal recessive disorder that affects connective tissue throughout the body. It is associated with premature ageing and an increased risk of cancer and other diseases. The mean survival for patients with Werner syndrome is 47 years. Death usually occurs when patients are aged 30-65 years because of atherosclerosis or malignant tumours. The purpose of this paper is to present a patient with Werner syndrome exhibiting a chondrosarcoma of the left temporomandibular joint and ramus. To the best of our knowledge this is the first case, of a Werner syndrome patient with an associated head and neck chondrosarcoma being reported. The diagnostic procedure followed and management of the patient are outlined in the paper as well.

  14. Prevalence of Small Intestinal Bacterial Overgrowth among Chronic Pancreatitis Patients: A Case-Control Study

    Science.gov (United States)

    Bouchard, Simon; Sidani, Sacha

    2016-01-01

    Background. Patients with chronic pancreatitis (CP) exhibit numerous risk factors for the development of small intestinal bacterial overgrowth (SIBO). Objective. To determine the prevalence of SIBO in patients with CP. Methods. Prospective, single-centre case-control study conducted between January and September 2013. Inclusion criteria were age 18 to 75 years and clinical and radiological diagnosis of CP. Exclusion criteria included history of gastric, pancreatic, or intestinal surgery or significant clinical gastroparesis. SIBO was detected using a standard lactulose breath test (LBT). A healthy control group also underwent LBT. Results. Thirty-one patients and 40 controls were included. The patient group was significantly older (53.8 versus 38.7 years; P PERT), and severity of symptoms. Conclusion. The prevalence of SIBO detected using LBT was high among patients with CP. There was no association between clinical features and the risk for SIBO. PMID:27446865

  15. First cases of KPC-type carbapenemase-producing bacteria in patients in New Zealand hospitals.

    Science.gov (United States)

    Heffernan, Helen; Dyet, Kristin; Munroe, Sean; Creighton, Julie; Chan, Sam; Taylor, Susan; Mansell, Chris

    2014-12-01

    The emergence and global spread of Klebsiella pneumoniae carbapenemases (KPCs) is a significant public health problem. Between October 2010 and July 2013, KPC-producing K. pneumoniae were isolated from four patients in New Zealand hospitals. These cases are the first known isolations of KPC-producing organisms in New Zealand. All four patients were transferred from, or had recently been in, hospitals in countries where KPC-producing organisms are prevalent (China, India, Greece and Italy). The blaKPC-2 gene was identified in the isolates from three patients and blaKPC-3 was identified in the isolate from the remaining patient. The isolates belonged to different multilocus sequence type clonal complexes, usually those prevalent in the country in which the patient had been previously hospitalised. Currently in New Zealand, the common factor associated with having a KPC-producing organism is prior hospitalisation in another country where these organisms are prevalent.

  16. Posttransplantation malignancy in a patient presenting with weight loss and changed bowel habits: a case report

    Directory of Open Access Journals (Sweden)

    Luft Friedrich C

    2006-05-01

    Full Text Available Abstract Backround Advancements in immunosuppressive therapy have significantly improved patient and graft survival following renal transplantation. This is paralleled by an increasing occurrence of posttransplantation malignancy. Case presentation We report on a patient who presented with a history reminding of colon cancer seven years after receiving a kidney transplant. Initial diagnostic imaging seemed to confirm this diagnosis showing a constricting colonic lesion. To our surprise, colonoscopy findings were unremarkable. Review of the imaging studies revealed that the tumor-like picture was caused by the renal graft impressing the intestine. The following search for malignancy in other locations resulted in the diagnosis of glioblastoma multiforme of which the patient died several weeks later. Conclusion Follow-up of renal transplant patients must include screening tests directed at tumor detection. Imaging studies and other tests in this patient group should be interpreted by physicians who are familiar with transplant related peculiarities.

  17. Challenges in the management of a patient with Cowden syndrome: case report and literature review

    Directory of Open Access Journals (Sweden)

    Melbārde-Gorkuša Inga

    2012-04-01

    Full Text Available Abstract We would like to present a patient with a classical phenotype of a rare disorder - Cowden syndrome, its diagnostics and management challenges. A breast surgeon has to be aware of this rare condition when treating a patient with breast manifestations of Cowden syndrome and has to refer the patient to a clinical geneticist for further evaluation. Sequencing of the PTEN gene showed the Asp24Gly mutation. According to the latest literature data, the lifetime risk of breast cancer for Cowden syndrome patients is 81% and surgery is a justified option to reduce the risk of breast cancer. Bilateral risk-reducing mastectomy with immediate reconstruction was performed to eliminate further risk of breast cancer. 3 years after the risk-reducing breast surgery the patient is satisfied with the outcome. This is to our best knowledge the first reported Cowden syndrome case with follow-up data after risk-reducing measures have been taken.

  18. Unnecessary extractions in patients with hemicrania continua: case reports and implication for dentistry.

    Science.gov (United States)

    Prakash, Sanjay; Shah, Nilima D; Chavda, Bhavna V

    2010-01-01

    Headache and facial pain are both very high in the general population. Headache has been identified as one of the associated conditions in patients with chronic orofacial pain. The interrelation between the two has not been explored in the literature. Patients with facial pain often initially seek the care of a dentist. Misdiagnosis and multiple failed treatments (including invasive procedures) are very common in this population. This case report describes four patients whose condition fulfilled the International Headache Society's criteria for hemicrania continua but whose teeth were extracted because their pain was suspected to be of odontogenic origin. Each patient's records and the literature were reviewed for possible reasons for the unnecessary extractions. The findings suggest that initial treatment with drugs specific for primary headache disorders should be instituted before subjecting patients to invasive procedures.

  19. An atypical case of successful resuscitation of an accidental profound hypothermia patient, occurring in a temperate climate.

    LENUS (Irish Health Repository)

    Coleman, E

    2010-03-01

    Cases of accidental profound hypothermia occur most frequently in cold, northern climates. We describe an atypical case, occurring in a temperate climate, where a hypothermic cardiac-arrested patient was successfully resuscitated using extracorporeal circulation (ECC).

  20. PatientsLikeMe the case for a data-centered patient community and how ALS patients use the community to inform treatment decisions and manage pulmonary health.

    Science.gov (United States)

    Frost, J; Massagli, M

    2009-01-01

    What happens when patients go online to not only discuss health and daily living but to share detailed health data? PatientsLikeMe is an online platform where patients with life-altering conditions share structured information about symptoms, treatments, and outcomes, view individual and aggregated reports of these data, and discuss health and garner support on forums and through private messages. In this case study, we describe the components of this platform and how people with Amyotrophic lateral sclerosis have used the site to manage and improve pulmonary health. A qualitative analysis of forum content containing preset terms reveals patterns in use. As in other online communities, members of PatientsLikeMe offer one another support based on their own personal experience and advise each other on both medical issues and how to improve day-to-day life. Unique to this patient platform, members tailor questions and consults by referencing concrete data displayed for each patient member. PatientsLikeMe adds data into patient investigations on how to improve daily life and long term health outcomes.

  1. Suicide attempt in ulcerative colitis patient after 4months of infliximab therapy - A case report

    NARCIS (Netherlands)

    E.J. Eshuis; K.M.M.Y. Magnin; P.C.F. Stokkers; W.A. Bemelman; J. Bartelsman

    2010-01-01

    In the summary of product characteristics of infliximab (IFX), psychiatric side effects are reported to be rare, and in literature only limited data exist. This report presents a case of a patient with ulcerative colitis who developed a depression with psychotic symptoms during IFX therapy and made

  2. Primary sclerosing cholangitis in patients with ulcerative colitis: two case reports

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Se Hwan; Lee, Dong Ho; Choi, Dong Sik; Ko, Young Tae [Kyunghee University Hospital, Seoul (Korea, Republic of)

    1999-02-01

    Primary sclerosing cholangitis, a chronic cholestatic liver disease, is uncommon and is characterized by inflammation and fibrosis of the bile ducts. It frequently occurs in association with ulcerative colitis. We describe two cases of primary sclerosing cholangitis in patients with ulcerative colitis.

  3. Variation in case-mix between hospitals treating colorectal cancer patients in the Netherlands

    NARCIS (Netherlands)

    Kolfschoten, N.E.; Marang van de Mheen, P.J.; Gooiker, G.A.; Eddes, E.H.; Kievit, J.; Tollenaar, R.A.E.M.; Wouters, M.W.; Bemelman, W.A.; Busch, O.R.; Dam, R.M. van; Harst, E. van der; Jansen-Landheer, M.L.E.A; Karsten, T.M.; Krieken, J.H.J.M. van; Kuijpers, W.G.T.; Lemmens, V.E.; Manusama, E.R.; Meijerink, W.J.H.J.; Rutten, H.J.; Wiggers, T.; Velde, C.J. van de

    2011-01-01

    AIMS: The purpose of this study was to determine how expected mortality based on case-mix varies between colorectal cancer patients treated in non-teaching, teaching and university hospitals, or high, intermediate and low-volume hospitals in the Netherlands. MATERIAL AND METHODS: We used the databas

  4. A young patient with polyarthralgia and hearing loss: a case report of Muenke syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Didolkar, Manjiri M.; Vinson, Emily N.; Gaca, Ana M. [Duke University Medical Center, Department of Radiology, Durham, NC (United States)

    2009-10-15

    There are few reports of the typical radiographic findings in the hands and feet of patients with Muenke syndrome. We present a case report of a young girl with Muenke syndrome, whose diagnosis was made following the observation of coalitions and coned epiphyses on hand radiographs. (orig.)

  5. Rapidly progressive glomerulonephritis in a patient with renal amyloidosis: Case report and review of the literature

    OpenAIRE

    Anupama, Y. J.; Vankalakunti, M.

    2012-01-01

    Renal amyloidosis is characterized by progressive deposition of extracellular material, most commonly in the glomeruli. Most often, patients present with nephrotic range proteinuria and the disease progresses gradually to renal failure. Rapid worsening of renal functions is rare. We report a case of crescentic glomerulonephritis superimposed on amyloidosis, clinically presenting as rapidly progressive renal failure, and present a review of the literature.

  6. A case of spontaneous hypoglycaemia and impaired glucose tolerance in the same patient.

    LENUS (Irish Health Repository)

    Thabit, Hood

    2012-01-31

    We present a rare case of an insulin-like growth factor-2 (IGF-2)-secreting tumour of the thorax. This patient demonstrated the combination of fasting hypoglycaemia and impaired glucose tolerance on oral glucose tolerance testing, which has not been previously described in this condition. A review of the literature of IGF-2-secreting intrathoracic tumours is presented here.

  7. Bacillary angiomatosis in HIV-positive patient from Northeastern Brazil: a case report

    Directory of Open Access Journals (Sweden)

    Renata Félix da Justa

    2011-10-01

    Full Text Available It is a report of disseminated bacillary angiomatosis (BA in a 23-year-old female patient, who is HIV-positive and with fever, weight loss, hepatomegaly, ascites, and papular-nodular skin lesions. The clinical and diagnostic aspects involved in the case were discussed. Bacillary angiomatosis must always be considered in the diagnosis of febrile cutaneous manifestations in AIDS.

  8. Experience of long-term belimumab use in patients with systemic lupus erythematosus (a case report

    Directory of Open Access Journals (Sweden)

    Natalia Gennadyevna Klyukvina

    2013-01-01

    Full Text Available In the past years considerable progress has been made in the treatment of systemic lupus erythe-matosus; however, not all questions have been answered. The range of medications has substan-tially increased. The paper describes a case of the long-term use of the new genetically engineered agent belimumab in a patient with systemic lupus erythematosus.

  9. Medical students¿ assessment of pediatric patients - teaching and evaluation using video cases

    DEFF Research Database (Denmark)

    Malon, Michelle; Cortes, Dina; Greisen, Gorm

    2014-01-01

    BackgroundWe introduced video-based teaching in pediatrics. We evaluated the impact of a pediatric video program on student performance in assessing pediatric patients presented as video cases. The program consisted of a library of pediatric videos, and inclusion of these in the teaching...

  10. Using case-mix information in strategic hospital marketing. Deriving market research from patient data.

    Science.gov (United States)

    Little, A

    1992-01-01

    Hospital survival requires adaptation, adaptation requires understanding, and understanding requires information. These are the basic equations behind hospital strategic marketing, and one of the answers may lie in hospitals' own patient-data systems. Marketers' and administrators' enlightened application of case-mix information could become one more hospital survival tool.

  11. [Phenotypic variability in 47, XXX patients: Clinical report of four new cases].

    Science.gov (United States)

    Goldschmidt, Ernesto; Márquez, Marisa; Solari, Andrea; Ziembar, María I; Laudicina, Alejandro

    2010-08-01

    The 47, XXX karyotype has a frequency of 1 in 1000 female newborns. However, this karyotype is not usually suspected at birth or childhood. These patients are usually diagnosed during adulthood when they develop premature ovarian failure or infertility, because the early phenotype doesn t have any specific features. The study describes four cases and the clinical variability of the 47, XXX karyotype.

  12. Pulmonary tuberculosis in a patient with rheumatoid arthritis undergoig immunosuppressive treatment: case report

    Directory of Open Access Journals (Sweden)

    Sandro Ceratti

    2014-02-01

    Full Text Available Rheumatoid arthritis is a disease which characteristically affects the joints. Because it is an autoimmune disease, immunosuppressive drugs are widely used in its treatment. The present case report illustrates the association of immunosuppressive treatment with the development of opportunistic infections in a 64-year-old patient.

  13. Bipolar hip hemiarthroplasty in a patient with an above knee amputation: a case report

    Directory of Open Access Journals (Sweden)

    Liebergall Meir

    2009-07-01

    Full Text Available Abstract The treatment of an above knee amputee who has sustained a fracture of femoral neck is a challenge for both the orthopaedic surgeon and the rehabilitation team. We present a case of such a patient and discuss different difficulties in his treatment.

  14. Bilateral simultaneous quadriceps tendon rupture in a patient with secondary hyperparathyroidism: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yeon Soo; Son, Sang Beom; Han, Chang Whan; Kang, Si Won [Taejon St. Mary' s Hospital, The Catholic Univ. of Korea, Taejon (Korea, Republic of)

    2001-11-01

    Simultaneous bilateral rupture of the quadriceps tendon without a significant history of trauma may occur in association with chronic metabolic disorders such as chronic renal failure and secondary hyperparathyroidism, though has rarely been reported. We describe a case of spontaneous bilateral quadriceps tendon rupture in a 36-year-old female patient with secondary hyperparathyroidism.

  15. Ultrasonographic findings of aspergillus bursitis in a patient with a renal transplantation: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byeong Seong; Yang, Myeon Jun; Kim, Young Min; Youm, Yoon Seok; Choi, Seong Hoon; Park, Sung Bin; Jeong, Ae Kyung [University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan (Korea, Republic of)

    2008-04-15

    Aspergillus bursitis is an uncommon condition demonstrated as a nonspecific soft tissue mass. To our knowledge, the ultrasonographic findings of aspergillus bursitis in immunocompromised patients have not been previously reported. Here, we report a case of aspergillus bursitis in a renal transplant recipient, accompanied by the associated ultrasonographic findings.

  16. Acute hepatitis in a patient using a Chinese herbal tea - a case report

    NARCIS (Netherlands)

    Levi, M; Guchelaar, HJ; Woerdenbag, HJ

    1998-01-01

    A case is presented of reversible acute hepatitis in a patient using a Chinese herbal tea. Upon identification of the tea mixture Aristolochia species, including A. debilis, which contains the highly toxic aristolochic acid, could be identified. We conclude that the acute hepatitis as described in t

  17. A case report on management of synergistic gangrene following an incisional abdominal hernia repair in an immunocompromised obese patient

    Directory of Open Access Journals (Sweden)

    N. Merali

    2015-01-01

    Conclusion: This case has demonstrated how a planned multidisciplinary action can produce prosperous results in a severely obese immunocompromised patient with an SSI, following an incisional hernia repair.

  18. Distraction osteogenesis therapy in patients affected by Goldenhar syndrome: a case series

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    Francesco Grecchi

    2011-06-01

    Full Text Available Background: Hemifacial microsomia (HM is a syndrome characterized by the presence of structural alterations of the skeletal, nervous, vascular, and muscular structures derived from the first and second branchial arch. Goldenhar syndrome (Gs consistisof the triad of craniofacial microsomia, ocular dermoid cysts, and spinal anomalies. When the patient has hypoplasia of the mandible, orthognatic surgery or distraction osteogenesis (DO can be used to correct the asymmetry. Mandibular DO has been applied for many years, but long-term reports showed controversial results. The aim of this paper is to describe three cases of patients affected by Gs in which DO was performed to correct the mandibular asymmetry. Case series: The cases reported show an increasing degree of dismorphism which required a increasing complexity of the surgical approach: a single mandibular DO in the first patient, and a mandibular DO associated with a Le Fort I osteotomy in the second one, a double mandibular DO associated with Le Fort I and surgical disjunction of the middle palatal suture in the third case. Discussion: The effects of DO involve not only the skeletal segment but also all the surrounding soft tissues. DO leads to rapid and remarkable improvement in facial symmetry due to emimandible hypoplasia. When correct spatial repositioning of the maxilla cann ot be expected, mandibular DO can be carried out by associating a Le Fort I osteotomy. In this way DO minimize the need for major osteotomies and allows an earlier treatment in selected cases.

  19. A Case of Stercoral Perforation Detected on CT Requiring Proctocolectomy in a Heroin-Dependent Patient

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    William H. Seligman

    2016-01-01

    Full Text Available Stercoral perforation of the colon is rare but carries with it significant morbidity and mortality. Stercoral perforation usually occurs in elderly, immobile patients with chronic constipation. In this manuscript, we report the case of stercoral perforation in a patient due to chronic heroin dependence. We report the case of a 56-year-old male patient with stercoral perforation, diagnosed by computed tomography, secondary to heroin dependence, requiring proctocolectomy and an end ileostomy. There are very few reports in the literature describing cases of stercoral perforation and questions have been asked about the importance of preoperative cross-sectional imaging. In our case, the diagnosis of stercoral perforation was made only on CT. Although this is not the first such case to be reported, it is significant as preoperative CT imaging was influential not only in determining the aetiology of the abdominal distension seen on the plain film, but also in detecting the pneumoperitoneum which was not evident clinically or on plain radiographs.

  20. Treatment outcome with guiding flange prosthesis in hemimandibulectomy patients: Case series of three patients

    Science.gov (United States)

    Kar, Sushil; Tripathi, Arvind; Madhok, Riti

    2015-01-01

    There are various indications that may necessitate partial or complete resection of the mandible, from trauma to congenital deformities. However, the most prevalent indication that requires surgical resection of the mandible along with the involved adjacent oral structures is the presence of a locally aggressive neoplastic growth. The resultant continuity defect leads to an alteration in the range and direction of mandibular movement, impedes clear articulation of syllables and cosmetic disfigurement. The role of a prosthodontist is paramount in bringing about the restoration of the esthetic and functional dysfunction. This article discusses a series of hemimandibulectomy cases wherein mandibular deviation was successfully corrected using guide-flange prosthesis. PMID:26981486

  1. Pulmonary histoplasmosis in a immunocompetent patient: A case report and literature review

    Science.gov (United States)

    Zhu, Cui; Wang, Ge; Chen, Qiong; He, Bixiu; Wang, Lijing

    2016-01-01

    In the present study, the case of a 54-year-old male patient diagnosed with pulmonary histoplasmosis is reported, with the aim to increase the understanding of the disease characteristics and thereby facilitate the diagnosis and treatment of pulmonary histoplasmosis. Clinical manifestations, diagnosis, treatment and clinical outcomes of the present case of pulmonary histoplasmosis were described. In addition, 76 histoplasmosis patients with complete clinical data were reviewed by searching the literature for relevant studies published during 1990 and 2015. The disease was mainly manifested as cough in the present case, while imaging examination detected a lump shadow in the right lung, accompanied by exudative lesions. Initially, the patient was suspected to have bacterial pneumonia, but subsequently the diagnosis of pulmonary histoplasmosis was confirmed by lung biopsy. The symptoms were alleviated following itraconazole treatment. The patient was physically stable and had no recurrence during the subsequent follow-up period. In conclusion, pulmonary histoplasmosis is characterized by non-specific clinical and imaging manifestations, and lung tissue biopsy or respiratory pathogen culture are regarded as the diagnostic gold standards. Individualized antifungal medication should be administered based upon the patients' situation in terms of dosage and duration. PMID:27882146

  2. Three cases of bone metastases in patients with gastrointestinal stromal tumors

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    Maurizio Zompatori

    2011-04-01

    Full Text Available Gastrointestinal stromal tumors (GISTs are rare, but represent the most common mesenchymal neoplasms of the gastrointestinal tract. Tumor resection is the treatment of choice for localized disease. Tyrosine kinase inhibitors (imatinib, sunitinib are the standard therapy for metastatic or unresectable GISTs. GISTs usually metastasize to the liver and peritoneum. Bone metastases are uncommon. We describe three cases of bone metastases in patients with advanced GISTs: two women (82 and 54 years of age, and one man (62 years of age. Bones metastases involved the spine, pelvis and ribs in one patient, multiple vertebral bodies and pelvis in one, and the spine and iliac wings in the third case. The lesions presented a lytic pattern in all cases. Two patients presented with multiple bone metastases at the time of initial diagnosis and one patient after seven years during the follow-up period. This report describes the diagnosis and treatment of the lesions and may help clinicians to manage bones metastases in GIST patients.

  3. Case management of chiropractic patients with cervical brachialgia: A survey of French chiropractors

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    Guenoun Olivier

    2011-09-01

    Full Text Available Abstract Background Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues. Objectives The first objective was to investigate if French chiropractors' management choices appeared reasonable for various neck problem scenarios. The second objective was to investigate if there was agreement between chiropractors on the patient management. The third objective was to see to which degree and at what stages chiropractors would consider to interact with other health-care practitioners, such as physiotherapists, general practitioners and specialists. Method A questionnaire was sent to a randomly selected sample of all French chiropractors known to the national chiropractic college. It consisted of an invitation to participate in the study, a brief case description, and drawings of five stages of how a case of neck pain gradually evolves into a brachialgia to end up with a compromised spinal cord. Each stage offered five management choices. Participants were asked at what stages patients would be treated solely by the chiropractor and when patients would be referred out for second opinion or other care without chiropractic treatment, plus an open ended option, resulting in a "five-by-six" table. The percentages of respondents choosing the different management strategies were identified for the different scenarios and the 95% confidence intervals were calculated. There was a pre hoc agreement on when chiropractic care would or would not be suitable. Consensus was arbitrarily defined as "moderate" when 50- 69% of respondents agreed on the same management choice and as "excellent" when 70% or more provided the same answer. It was expected that inter professional contacts would be rare. Results The response rate was 53% out of 254 potential participants. The first two uncomplicated cases would generally have been treated by the chiropractors. As the patient worsened, the responses tended towards

  4. Two unusual causes of peripatellar nonmetastatic positive bone scans in patients with malignancies: case reports.

    Science.gov (United States)

    Turner, J W; Syed, I B; Spencer, R P

    1976-08-01

    Bone scans performed with 99mTc-polyphosphate in two patients with epidermoid carcinoma of the lung each showed activity in one knee area. In the first case, radiographs of the area revealed Pellegrini-Stieda calcification over the internal femoral condyle. Uptake corresponded to this process, rather than to a lesion deep in the bone. In the second case, the activity accumulation in the right tibia was the only abnormality noted in the scan. An open biopsy revealed Paget's disease, and no radiographic evidence of Paget's disease was found in any other bone. These cases again illustrate that localized accumulation of a bone-scanning agent, in patients with known primary tumors, does not necessarily denote malignancy in bone.

  5. Two unusual causes of peripatellar nonmetastatic positive bone scans in patients with malignancies: case reports

    Energy Technology Data Exchange (ETDEWEB)

    Turner, J.W.; Syed, I.B.; Spencer, R.P.

    1976-08-01

    Bone scans performed with /sup 99m/Tc-polyphosphate in two patients with epidermoid carcinoma of the lung each showed activity in one knee area. In the first case, radiographs of the area revealed Pellegrini-Stieda calcification over the internal femoral condyle. Uptake corresponded to this process, rather than to a lesion deep in the bone. In the second case, the activity accumulation in the right tibia was the only abnormality noted in the scan. An open biopsy revealed Paget's disease, and no radiographic evidence of Paget's disease was found in any other bone. These cases again illustrate that localized accumulation of a bone-scanning agent, in patients with known primary tumors, does not necessarily denote malignancy in bone.

  6. EDTA Dependent Pseudothrombocytopenia In A Patient With Scrub Typhus - A Case Report

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    Bhavya P Mohan

    2016-01-01

    Full Text Available We report a case of EDTA induced pseudothrombocytopenia (EDTA-PTCP in a patient with scrub typhus who was referred as a case of PUO with marked thrombocytopenia and treated with platelet transfusion. Blood smear examination revealed numerous platelet aggregates. CBC analysis using citrate and lithium-heparin as anticoagulants as well as a peculiar WBC histogram aided in prompt diagnosis of the condition. The prevalence of EDTA-PTCP in general hospital population is approximately 0.1%. It is usually not associated with hemorrhagic manifestations. Hence cases of thrombocytopenia should be carefully evaluated to rule out this form of artefactual thrombocytopenia. Timely diagnosis of this innocuous but misleading in vitro phenomenon can save the patient from unnecessary transfusions and invasive procedures.

  7. Combined cataract surgery on a Marfan-syndrome patient (case report).

    Science.gov (United States)

    Biró, Zsolt; Szabó, Ilona; Pámer, Zsuzsanna

    2014-01-01

    Combined cataract surgery of an ectopic lens was performed on a 10 years old girl with Marfan-syndrome. A Cionni capsular tension ring was implanted into the capsular bag, and the bag was pulled to its place and fixed with a scleral suture. Because of the young age of the patient a primary posterior capsulorhexis was performed, through which anterior vitrectomy was carried out and the artificial lens was implanted into the capsular bag. In the literature several surgical solutions are advised for the treatment of the ectopic lens in patients with Marfan-syndrome. We have performed a successful surgery combined with posterior capsulorhexis in our case. Because of its rarity and special surgical solution, we think this case report is interesting and can be helpful in such cases to be published.

  8. Syphilitic meningitis in HIV-patients with meningeal syndrome: report of two cases and review

    Directory of Open Access Journals (Sweden)

    Carmo Ricardo Andrade

    2001-01-01

    Full Text Available Few patients with symptomatic neurosyphilis present with signs and symptoms of acute meningitis. Here we report two cases of syphilitic meningitis diagnosed in HIV patients with meningeal syndrome. The first case, a 30-year-old black bisexual male, had concurrent meningeal and ocular syphilis with persistent unusually low CSF glucose levels. He responded well to 21 days of intravenous penicillin therapy. The second case was a 55-year-old female with epilepsy, depression, behavioral disorder and confusion. The diagnosis of HIV infection was made after onset of the syphilitic meningitis. She was treated with 21 days i.v. penicillin with improvement in her clinical condition. The clinical aspects of combined neurosyphilis and HIV infection, plus special features of diagnosis and treatment are discussed.

  9. Implant insertion in a patient with Albers-Schonberg’s disease: case report and literature review

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    Manuela Rapani

    2013-03-01

    Full Text Available Background The aim of the present report was to present the clinical, radiological and histological outcomes of a case of implant placement in the upper jaw of a patient affected by osteopetrosis. Case report In a 68 years old patient, 2 implants were placed in a portion of bone with areas with high density bone. Histological evaluation confirmed the radiological diagnosis of osteopetrosis. Implants were loaded 8 months after their placement. No complications or adverse reactions were observed after a 24-month follow up. Conclusion Within the limitations of the present report, it can be concluded that a successful implant rehabilitation can be done in patients affected by osteopetrosis. Further studies, on a larger sample size, are needed to confirm this result.

  10. Unusual amnesia in a patient with VGKC-Ab limbic encephalitis: a case study.

    Science.gov (United States)

    Kartsounis, Luke D; de Silva, Rajith

    2011-04-01

    We describe the case of a patient with confirmed voltage-gated potassium channel antibody-associated encephalitis (VGKC-Ab). MRI studies revealed bilateral hyper-intensity in the hippocampi, with their volumes preserved. At presentation, the patient's anterograde and retrograde memory skills were found to be impaired and he showed fluctuation in his ability to recall familiar information. Following treatment with immunotherapy, his condition improved considerably and, in a series of follow up assessments, he performed satisfactorily (i.e., within the average range or above) on formal tests of memory, as well as on a range of other cognitive tests, including tests of executive function. By contrast, in the context of contemporaneous unstructured interviews, he showed a strong tendency to confabulate. We argue that the reported case broadens the phenomenology of VGKC-Ab limbic encephalitis and raises important theoretical questions about the aetiology of this patient's most unusual memory disorder.

  11. Rapid ventricular pacing for a basilar artery pseudoaneurysm in a pediatric patient: case report.

    Science.gov (United States)

    Nimjee, Shahid M; Smith, Tony P; Kanter, Ronald J; Ames, Warwick; Machovec, Kelly A; Grant, Gerald A; Zomorodi, Ali R

    2015-06-01

    Large cerebral aneurysms of the basilar apex are difficult to treat. Recently, endovascular treatment has mitigated much of the morbidity associated with treating these lesions. However, the morphology of aneurysms of the vertebrobasilar system can preclude endovascular treatment. Rapid ventricular pacing (RVP) facilitates open surgical treatment of cerebral aneurysms. It can assist in reducing the pressure of the neck of the aneurysm, allowing safe application of a clip. The authors present a case of a pediatric patient who developed a basilar artery pseudoaneurysm that required surgery. Given the large size of the aneurysm, RVP was performed, allowing the surgeons to dissect the dome of the aneurysm from the surrounding tissue and pontine perforating branches away from the lesion to safely clip the lesion. The patient had an uneventful recovery. To the authors' knowledge, this represents the first known case of RVP to aid in basilar artery clip occlusion in a pediatric patient.

  12. Dental management considerations for a patient taking dabigatran etexilate: a case report.

    Science.gov (United States)

    Romond, Kelli K; Miller, Craig S; Henry, Robert G

    2013-09-01

    Dabigatran is a direct thrombin inhibitor approved to help prevent thrombotic events in patients with atrial fibrillation. As a rather new drug approval, information on management of bleeding during dental surgery in patients taking dabigatran is sparse. In this case report, a 67-year old male with a positive history for atrial fibrillation, coronary artery disease, intermittent angina, hypertension, type 2 diabetes and normal renal function was taking dabigatran 150 mg, 2 times daily. He underwent 8 surgical extractions, alveoloplasty and tuberosity reduction. Per guidelines prescribed by van Ryn et al., the patient's dabigatran was held the night before surgery and resumed the day after. Adverse outcomes were not observed during the procedure or in the 7-month postoperative period. This case suggests that due to its short half-life, dabigatran can be temporarily discontinued 24 h prior to elective oral surgery with consent of the physician and restarted the following day resulting in minimal complications.

  13. Percutaneous pedicle screw for unstable spine fractures in polytraumatized patients: A report of two cases

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    Boon Beng Tan

    2012-01-01

    Full Text Available Unstable spine fractures commonly occur in the setting of a polytraumatized patient. The aim of management is to balance the need for early operative stabilization and prevent additional trauma due to the surgery. Recent published literature has demonstrated the benefits of early stabilization of an unstable spine fracture particularly in patients with higher injury severity score (ISS. We report two cases of polytrauma with unstable spine fractures stabilized with a minimally invasive percutaneous pedicle screw instrumentation system as a form of damage control surgery. The patients had good recovery from the polytrauma injuries. These two cases illustrate the role of minimally invasive stabilization, its limitations and technical pitfalls in the management of unstable spine fractures in the polytrauma setting as a form of damage control surgery.

  14. Chyliform effusion without pleural thickening in a patient with rheumatoid arthritis: A case report

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    Crina Muresan

    2015-01-01

    Full Text Available Pseudochylothorax, also known as chyliform effusion rich in cholesterol crystals, is a rare entity that sometimes occurs in long-standing rheumatoid arthritis (RA and is usually associated with thickened pleura. There have only been a few case reports in the literature on pseudochylothorax unassociated with pleural thickening and with a short duration of articular symptoms in patients with RA. We report the case of a 70-year-old male patient with a history of RA and heart failure due to severe aortic stenosis, who presented with signs and symptoms of decompensated heart failure due to a moderate right-sided pleural effusion that was consequently proved to be pseudochylothorax unassociated with pleural thickening on chest computed tomography (CT scan. The patient's outcome was favorable after thoracocentesis was carried out and leflunomide was added to the standard heart failure treatment.

  15. Anterior ischaemic optic neuropathy in patient with rheumatoid arthritis--case report.

    Science.gov (United States)

    Perić, S; Cerovski, B; Perić, P

    2001-01-01

    This case report presents a patient with long-lasting rheumatoid arthritis (RA) of fourth clinical grade, having ocular complications. RA was diagnosed according to current modified ARA criteria from 1987. Upon admission to the Department of Ophthalmology clinical examination revealed anterior ischaemic optic neuropathy (AION), which is not characteristic manifestation of RA in the eye. The occurrence of AION in patients with RA has been explained in literature as a secondary manifestation of hypertension in these patients or, by the presence of other connective tissue disease apart from RA (for example, MCTD--mixed connective tissue disease). Both mentioned causes were excluded in our case, as well as any other condition that could lead to AION. Therefore, we had concluded that AION presented a late complication of RA.

  16. Orthodontic treatment in patient with idiopathic root resorption: A case report

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    Diego Rey

    2015-02-01

    Full Text Available Multiple idiopathic external root resorption is a rare pathological condition usually detected as an incidental radiographic finding. External root resorption of permanent teeth is a multifactorial process related to several local and systemic factors. If an etiological factor cannot be identified for root resorption, the term "idiopathic" is applied. This report presents a case of multiple idiopathic apical root resorption. The condition was found in a young female patient seeking orthodontic treatment due to malocclusion. This kind of resorption starts apically and progresses coronally, causing a gradual shortening and rounding of the remaining root. Patients with this condition are not the ideal candidates for orthodontic treatment; however, the aim of this report is to describe an unusual case of idiopathic root resorption involving the entire dentition, and to present the orthodontic treatment of this patient. It describes the progress and completion of orthodontic therapy with satisfactory end results.

  17. Pulmonary Infection Caused by Achromobacter xylosoxidans in a Patient with Carcinoma of Epiglottis: A Rare Case.

    Science.gov (United States)

    Roy, Priyamvada

    2014-05-01

    Achromobacter xylosoxidans is an aerobic, motile, oxidase and catalase positive, non-fermenting, gram negative bacillus. It is an opportunistic pathogen which is responsible for various nosocomial and community-acquired infections. However, there are only very few reports of pulmonary infections caused by this bacterium in cancer patients. We are presenting a case of a patient with carcinoma of epiglottis, who developed pulmonary infection caused by Achromobacter xylosoxidans. According to the available literature, this is the first case of pulmonary infection caused by Achromobacter xylosoxidans, which was detected in a cancer patient in India. Since Achromobacter xylosoxidans demonstrates resistance to many classes of antimicrobials, vigilant and efficient microbiological work-ups and surveillances are needed, to diagnose infections caused by this rare pathogen in clinical settings.

  18. Follow-up of patient with Gorlin-Goltz Syndrome – a case report

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    Alexsandra da Silva Botezeli STOLZ

    2010-06-01

    Full Text Available Introduction: The Gorlin-Goltz Syndrome, also known as Nevoid Basal Cell Carcinoma Syndrome, is a dominant autosomal hereditary disorder which is characterized by the presence of multiple jaw keratocysts and basal cell carcinomas, besides musculoskeletal, neurological, dermatological and endocrine abnormalities. Case report: This paper reports the case of a fifteen-year-old patient who was referred to the Faculty of Dentistry of the Federal University of Santa Maria (RS, Brazil and presented multiple jaw keratocysts, which were surgically removed in several steps. The patient is under observation for 48 months, including clinical and radiographic evaluations. Conclusion: It can be concluded that systematic and regular monitoring may avoid possible harmful consequences to the patient.

  19. Peritoneal tuberkulose hos en tidligere rask 20-årig dansk kvinde

    DEFF Research Database (Denmark)

    Hansen, Kristina Bjerre; Wejse, Christian

    2014-01-01

    Peritoneal tuberculosis (PT) is very uncommon and presents a diagnostic challenge, especially in women. Patients often present with non-specific symptoms mimicking advanced stage ovarian cancer. In this case a 20-year-old woman without known exposure to tuberculosis presented with abdominal...

  20. The electrocardiogram in traumatic right atrial rupture

    NARCIS (Netherlands)

    van Veldhuisen, DJ; van den Berg, MP

    1999-01-01

    We:report the case of a previously healthy 20-year-old man who had a traumatic rupture of the right atrium. On admission an electrocardiogram (ECG) was recorded which is highly remarkable and, retrospectively, suggestive for the diagnosis. The patient died soon after the EGG, and the diagnosis was m