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Sample records for deep bite patients

  1. Cervical vertebral body fusions in patients with skeletal deep bite.

    Science.gov (United States)

    Sonnesen, Liselotte; Kjaer, Inger

    2007-10-01

    Cervical column morphology was examined in 41 adult patients with a skeletal deep bite, 23 females aged 22-42 years (mean 27.9) and 18 males aged 21-44 years (mean 30.8) and compared with the cervical column morphology in an adult control group consisting of 21 subjects, 15 females, aged 23-40 years (mean 29.2 years) and six males aged 25-44 years (mean 32.8 years) with neutral occlusion and normal craniofacial morphology. None of the patients or control subjects had received orthodontic treatment. For each individual, a visual assessment of the cervical column and measurements of the cranial base angle, vertical craniofacial dimensions, and morphology of the mandible were performed on a profile radiograph. In the deep bite group, 41.5 per cent had fusion of the cervical vertebrae and 9.8 per cent posterior arch deficiency. The fusion always occurred between C2 and C3. No statistically significant gender differences were found in the occurrence of morphological characteristics of the cervical column (females 43.5 per cent, males 38.9 per cent). Morphological deviations of the cervical column occurred significantly more often in the deep bite group compared with the control group (P vertical jaw relationship (P < 0.05), overbite (P < 0.001), and upper incisor inclination (P < 0.01) were significantly correlated with fusion of the cervical vertebrae (R(2) = 0.40).

  2. Temporomandibular disorders and psychological status in adult patients with a deep bite

    DEFF Research Database (Denmark)

    Sonnesen, Liselotte; Svensson, Peter

    2008-01-01

    Temporomandibular disorders (TMDs) and psychological status were examined in adult patients with a deep bite and compared with an adult age- and gender-matched control group with neutral occlusion. The deep bite group consisted of 20 females (mean age 30.3 years) and 10 males (mean age 33.1 years...

  3. Studying the effects of Bite plane application in intruding and extruding the teeth in patients with deep bite

    Directory of Open Access Journals (Sweden)

    M. Shirazi

    1987-08-01

    Full Text Available Deep bite is a major clinical problem manifested as higher than normal overbite in anterior region of the jaws. Various studies were conducted to identify the effects of using bite plan and its results. 14 subjects with deep bite were selected out of 400 students of a school who had not proximal caries and had not lost any permanent teeth with healthy periodontal condition. 8 patients were considered as case group and the 6 other as the control group. In case group, a simple labial arc with acrylic palate that caused a gap in occlusion was placed. 2 lateral radiographs were obtained both pre and post 14 months treatment period. After cephalometric analysis, due to bite plane application significant intrusion in mandibular  incisors were observed as well as elongation in both maxillary and mandibular molars.

  4. Assessment of pain sensitivity in patients with deep bite and sex- and age-matched controls

    DEFF Research Database (Denmark)

    Sonnesen, Ane Liselotte; Svensson, Peter

    2011-01-01

    AIMS: To compare pain sensitivity between deep bite patients and a sex- and age-matched control group with normal occlusion. METHODS: Pain sensitivity was assessed by injections of the excitatory amino acid glutamate into the masseter and brachioradialis muscles. Intensity of glutamate-evoked pain...... was scored by the subjects ( n = 60) on a 0 to 10 cm visual analog scale. Subjects drew the perceived pain area on a face and arm chart and described the quality of pain on the McGill Pain Questionnaire. Thresholds for cold detection, cold pain, cold tolerance, warmth detection, heat pain, and heat tolerance...... were assessed on the masseter and brachioradialis muscles. Pressure pain threshold and pain tolerance threshold were determined on the temporomandibular joint, masseter, anterior temporalis, and brachioradialis muscles. The differences between groups, age, and gender were tested by two-way ANOVA...

  5. MANAGEMENT OF TEMPORO MANDIBULAR DISORDER (TMD IN PATIENT WITH LOW VERTICAL DIMENSION AND DEEP ANTERIOR BITE

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    Henni Koesmaningati

    2015-06-01

    Full Text Available The cases of TMD are complex and multifactorial, therefore the management should be done by several disciplines. In this report, a 27-year-old man came to the teaching hospital of the University of Indonesia Faculty of Dentistry’s Prosthodontic Department complaining about clicking sound and pain around his right joint. He received orthodontic treatment 9 years ago with removable appliance at a private practice and had 4 premolar extractions. The patient’s face looked asymmetric, with a low vertical dimension, a Class II occlusion, and an anterior deep bite. Besides that, he clenched his teeth during emotional stress. Lateral transcranial photo showed that the position of the left condyle was relatively normal or slightly anterior, and the right condyle was in the superoposterior position in the fossa with an abnormal shape. To solve this problem, the patient was referred to the Orthodontic Department to get a correct vertical dimension and normal anterior overbite. After 6 years, the patient was again referred to the Prosthodontic Department, but the result was not successful. In order to get the right vertical dimension, an occlusal splint was fabricated to achieve a comfort jaw relation. In this position, the overbite was 2 mm, but the space between the upper and lower posterior teeth was 5 mm. In this situation, full veneer crowns were not impossible to fabricate. Finally, to maintain this comfort position, the patient was suggested to wear the occlusal splint and come regularly for control every 6 months.

  6. Two-phase orthodontic treatment in a patient with turner syndrome: an unusual case of deep bite.

    Science.gov (United States)

    Aristizábal, Juan Fernando; Smit, Rosana Martínez

    2015-05-01

    Turner syndrome is caused by complete or partial absence of one X chromosome. These patients usually have a delay in growth and altered body proportions, causing sexual infantilism, short stature, delayed bone maturation, and variations in craniofacial morphology, among other systemic complications. The skeletal features associated with this syndrome include maxillary growth reduction with midface hypoplasia; mandibular micrognathia; high, narrow palate; V-shaped maxillary arch; and open bite. This case report shows a two-phase orthodontic treatment in a patient with Turner syndrome with a Class II malocclusion and severe deep bite, which is an unusual feature in patients with this disease. A conventional orthodontic treatment was performed, and after 20 months in retention the patient remains stable.

  7. Jaw-motor effects of experimental jaw-muscle pain and stress in patients with deep bite and matched control subjects

    DEFF Research Database (Denmark)

    Sonnesen, Liselotte; Svensson, Peter

    2013-01-01

    OBJECTIVE: The effect of experimental jaw-muscle pain and stress on masticatory muscle activity in TMD-patients has been discussed. Furthermore, associations between TMD and deep bite patients have been studied. Accordingly in the present study, comparison of EMG responses at rest, maximal...... clenching, during evoked pain and stress between deep bite patients and controls was investigated. DESIGN: In 30 deep bite patients and in 30 sex-/age-matched controls with neutral occlusion EMG activity was recorded bilaterally from masseter and anterior temporalis muscles before and during evoked pain...... and before and during a stress task. Evoked pain was induced by injections of glutamate into the masseter (local pain) and brachioradialis (remote pain) muscles and resting EMG activity was recorded before and after 1, 2, 3, 4, 5 and 10min. A precision task was used to simulate a stressful condition and EMG...

  8. Talking to Patients about Preventing Tick Bites

    Centers for Disease Control (CDC) Podcasts

    2012-02-14

    This podcast will help health care providers identify patients who are at increased risk of getting tick bites and provide these patients with tick bite prevention and removal tips.  Created: 2/14/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/14/2012.

  9. Complete oral rehabilitation of a deep bite patient with Ewing’s sarcoma; surgical and prosthetic phases: A clinical report

    Directory of Open Access Journals (Sweden)

    Mehran Bahrami

    2017-01-01

    Full Text Available Introduction: Ewings sarcoma (ES is an unusual, aggressive malignant neoplasm occurring primarily in the long bones of the lower and upper extremities followed by pelvis, ribs, vertebrae, skull, and jaws-bones. Patients with ES tumor need long-term complete oral reconstruction. The location of the primary tumor in the face is predominantly in the mandible, and usually in the posterior mandible. Case Report: Here, both surgical procedures and prosthetic reconstruction in three stages of a 10-year-old childs life presented. Definitive prosthetic reconstruction is extremely challenging in such patients after previous excessive surgical resection, especially when the patient has complex dental abnormality. Fixed dental prostheses and implant-supported fixed restorations have been selected as the preferred treatment option in this case after increasing occlusal vertical dimension (OVD to create sufficient interocclusal space (IOS. Discussion: In this case, ES patient treated in three phases. In the first-stage, only surgical resection of tumor and bone graft reconstruction with titanium plate fixation was performed. In the second-stage, Lefort I surgery for maxilla with dental implants insertion in mandible was done simultaneously. For definitive restorations fabrication, it was mandatory to increase occlusal vertical dimension (OVD to create sufficient inter-occlusal space (IOS for the restorations. OVD has been altered to achieve more stable relationship of mandibular teeth with maxillary teeth, and to obtain an optimum esthetic and functional result. Several factors should be considered as determinants for increasing the OVD such as remaining tooth structure, the space available for the restorations such as the current situation, occlusal variables, and esthetics.

  10. The Protocol of Fixed Reconstruction for Severely Worn Teeth Combined with Anterior Deep Bite

    Directory of Open Access Journals (Sweden)

    Ya-Wen Zhao

    2017-01-01

    Full Text Available Full mouth reconstruction is one of the most effective methods to restore severe worn teeth that have suffered reduced vertical dimension. Although the use of the overlay splint restoration for a trial period allowing the patient to adapt to an increased vertical dimension is the recognized method, the specific protocol from the transitional splint to the fixed reconstruction is yet to be established. This case report describes a 50-year-old female patient who has severely worn teeth combined with an anterior deep bite and chewing pain. The protocol of the treatment process is described.

  11. Correlations between dentoskeletal variables and deep bite in Class II Division 1 individuals

    Directory of Open Access Journals (Sweden)

    Leandro Silva Marques

    2011-02-01

    Full Text Available This study aimed to evaluate the cephalometric pattern of Class II Division 1 individuals with deep bite, and to determine possible correlations between dentoskeletal variables and deep bite. Comparisons were also made between genders and cases that were to be treated both with and without premolar extraction. A total of 70 lateral cephalograms were used, from both male (n = 35 and female (n = 35 individuals with an average age of 11.6 years, who simultaneously presented with ANB > 5º and overbite > 4 mm. Statistical analysis involved parametric (t-test and non-parametric (Mann-Whitney tests for independent samples, as well as the Spearman correlation test (p < 0.05. The values of Go-Me, Ar-Pog, PM-1 and PM-CMI were higher in males (p < 0.05. However, no significant differences were found among the averages of the cephalometric measurements when the sample was divided by treatment with and without extraction. Deep bite was positively correlated to the PM-1 and SNA measurements, and negatively correlated to the Go-Me, Ar-Pog, SNB and SNGoMe measurements. The main factors associated with the determination of deep bite in Angle's Class II Division 1 cases were: greater lower anterior dentoalveolar growth and/or lower incisor extrusion, horizontal growth pattern, maxillary protrusion and mandibular retrusion.

  12. 两种加载方式前牙闭锁性深覆(牙合)颞下颌关节的三维有限元分析%Three-dimensional finite element study on stress distribution of temporomandibular joint in patients with close anterior deep bite under two loading conditions

    Institute of Scientific and Technical Information of China (English)

    唐顼晶; 刘月华; 王冬梅; 刘海江

    2012-01-01

    Objective To investigate the stress distribution and biomechanic characters of temporomandibular joint(TMJ) by loading on the anterior close deep bite occlusion finite element models. Methods On the basis of the anterior close deep bite finite element model,analyse the TMJ stress distributions of the anterior close deep bite finite element models under two loading conditions. Results Loading on the finite element model of close deep bite finite element model revealed that under conditions two the stress distribution pattern was similar to that of conditions one, however.the stress value and its variation was significantly increased. Conclusion It can be concluded that the TMJ is over loaded in the close deep bite patients especially with the functional mandibular retraction which may lead to temporomandibular disorders.%目的:研究单纯性和伴功能性下颌后退前牙闭锁性深覆(牙合)颞下颌关节髁突、关节窝和关节盘的受力情况.方法:利用笔者已建立的前牙闭锁性深覆(牙合)的三维有限元模型,分两种工况进行力学加载,以观察不同组织部位的应力分布情况.结果:三维有限元分析表明前牙闭锁性深覆(牙合)斜向加载时颞下颌关节的受力情况与垂直加载时的分布特点基本相似,但应力值增大,变化范围也有所增加.结论:伴功能性下颌后退的前牙闭锁性深覆(牙合)颞下颌关节应力值增大,变化范围的增加可能是其易导致颞下颌关节紊乱综合征的病因之一.

  13. Limitations in the surgical treatment of skeletal Class II deep bite malocclusions.

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    Nassif, Laeticia; Anhoury, Patrick; Chebel, Naji Abou

    2010-01-01

    The present article illustrates a treatment option for managing the skeletal Class II malocclusion complicated by a deep bite and short face in an adult and emphasizes the limitations of such an approach and its potential complications. The patient had an inadequate tooth display upon smiling and a deep lower curve of Spee. Treatment consisted of a double jaw surgery with a maxillary three-piece LeFort to expand, downgraft, and advance the maxilla and a bilateral sagittal split osteotomy to advance the mandible. Treatment was staged so that the leveling of the mandibular arch was completed postsurgically by extrusion of the mandibular buccal segments. During surgery, the mandible was rotated clockwise at the osteotomy site to bring the chin down. This treatment approach resulted in a dramatic increase in the lower facial height, as well as an improvement in skeletal and occlusal relationships, with a much improved tooth display upon smiling, despite the few complications that occurred. © 2011 BY QUINTESSENCE PUBLISHING CO, INC.

  14. The Compartment Syndrome Associated with Deep Vein Thrombosis due to Rattlesnake Bite: A Case Report.

    Science.gov (United States)

    Tincu, Radu Ciprian; Ghiorghiu, Zoie; Tomescu, Dana; Macovei, Radu Alexandru

    2017-08-04

    Snakebite is a health issue specific to some parts of the world, especially in the tropical areas, where it produces many victims. The main clinical damage caused by snakebite involves haemotoxic, neurotoxic and myotoxic reactions. We report the case of a young woman suffering from snakebite who developed deep vein thrombosis and compartment syndrome. We present the case of a 32-year-old Romanian woman who was injured by her own Crotalinae snake (also known as pit viper or rattlesnake) on her left forearm. When admitted to our Emergency Department, she was conscious with a Glasgow coma scale of 12/15, somnolent, febrile, suffering of headache, tachypnoea; the marks of the snakebite were located in the distal part of the anterior left forearm; she had pain and bleeding at the bite site and swelling of the left upper limb with lymphangitis up to the axilla. She experienced fasciotomy-requiring compartment syndrome of the upper limb and required unfractionated heparin and close monitoring using activated partial thromboplastin time evolution due to micro-thrombosis in the brachial vein. Local improvement was achieved in the next 4 days with progressive diminishment of local tenderness and swelling. Limb deep vein thrombosis might be induced by snakebite, despite the pro-haemorrhagic general condition induced by the envenomation. A high index of clinical suspicion is needed for early diagnosis and timely management, which can improve survival of these patients.

  15. Severe Class II anterior deep bite malocclusion treated with a C-lingual retractor.

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    Kim, Seong-Hun; Park, Young-Guk; Chung, Kyurhim

    2004-04-01

    A C-lingual retractor was placed on the lingual aspects of the six maxillary anterior teeth in a 24-year-old female patient with a Class II anterior deep-bite malocclusion. The treatment plan consisted of extracting both the upper first premolars and intruding and retracting the upper six anterior teeth. Transpalatal arches were soldered to the upper first and second molar bands and used as an intra-arch anchor unit for upper space closure. Double NiTi closed coil springs were used palatally between the hooks of the C-lingual retractor and the transplantar arches. A high-pull headgear was used for anchorage reinforcement during en masse retraction. It took 14 months to treat this patient. The correct overbite and overjet was obtained by simultaneously intruding and retracting the upper six anterior teeth into their proper positions by C-lingual retractor mechanics, which contributed to an improvement in facial balance. The treatment result was stable 6 months after debonding. The application of this new appliance, consideration in case selection, and sequence of treatment are presented.

  16. ACTN3 R577X Genotypes Associate with Class II and Deep Bite Malocclusions

    Science.gov (United States)

    Zebrick, Brian; Teeramongkolgul, Teesit; Nicot, Romain; Horton, Michael J.; Raoul, Gwenael; Ferri, Joel; Vieira, Alexandre R.; Sciote, James J.

    2014-01-01

    Introduction α-actinins are myofibril anchor proteins which influence contractile properties of skeletal muscle. ACTN2 is expressed in slow type I and fast type II fibers whereas ACTN3 is expressed only in fast fibers. ACTN3 homozygosity for the 577X stop codon (i.e. changing 577RR to 577XX - the R577X polymorphism) results in the absence of α-actinin-3 in about 18% of Europeans, diminished fast contractile ability, enhanced endurance performance and reduced bone mass or bone mineral density. We have examined ACTN3 expression and genetic variation in masseter muscle of orthognathic surgery patients to determine genotype associations with malocclusion. Methods Clinical information, masseter muscle biopsies and saliva samples were obtained from 60 subjects. Genotyping for ACTN3 SNPs, RT-PCR quantitation of muscle gene message and muscle morphometric fiber type properties were compared to determine statistical differences between genotype and phenotype. Results Muscle mRNA expression level was significantly different for ACTN3 SNP genotypes (p<0.01). The frequency of ACTN3 genotypes was significantly different for sagittal and vertical classifications of malocclusion with the clearest association being elevated 577XX genotype in skeletal class II malocclusion (p = 0.003). This genotype also resulted in significantly smaller diameter of fast type II fibers in masseter muscle (p = 0.002). Conclusion ACTN3 577XX is overrepresented in skeletal class II malocclusion, suggesting a biologic influence during bone growth. ACTN3 577XX is underrepresented in deep bite malocclusion, suggesting muscle differences contribute to variations in vertical facial dimensions. PMID:25439211

  17. Cervical vertebral column morphology and head posture in preorthodontic patients with anterior open bite.

    Science.gov (United States)

    Kim, Phong; Sarauw, Martin Toft; Sonnesen, Liselotte

    2014-03-01

    Cervical vertebral column morphology and head posture were examined and related to craniofacial morphology in preorthodontic children and adolescents with anterior open bite. One hundred eleven patients (ages, 6-18 years) with an anterior open bite of more than 0 mm were divided into 2 groups of skeletal or dentoalveolar open bite. The skeletal open-bite group comprised 38 subjects (19 girls, 19 boys). The dentoalveolar open-bite group comprised 73 subjects (43 girls, 30 boys). Visual assessment of the cervical column and measurements of craniofacial morphology and head posture were made on profile radiographs. Deviations in the cervical vertebral column morphology occurred in 23.7% of the subjects in the skeletal open-bite group and in 19.2% in the dentoalveolar open-bite group, but the difference was not significant. Head posture was significantly more extended in the skeletal open-bite group compared with the dentoalveolar open-bite group (craniovertical angle [Mx/VER], P vertical craniofacial dimensions (P column morphology is described for the first time in children and adolescents with open bite. No significant differences in the cervical vertebral column's morphologic deviations were found between the skeletal and the dentoalveolar open-bite groups. Significant differences were found in head posture between the groups and with regard to associations with craniofacial dimensions. This might indicate a respiratory etiologic component in children with anterior open bite. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  18. A new bite block for panoramic radiographs of anterior edentulous patients: A technical report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Woong; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of); Symkhampha, Khanthaly [Dept. of Oral and Maxillofacial Radiology, Department of Basic Science, Faculty of Dentistry, University of Health Sciences, Vientiane (Lao People' s Democratic Republic)

    2015-06-15

    Panoramic radiographs taken using conventional chin-support devices have often presented problems with positioning accuracy and reproducibility. The aim of this report was to propose a new bite block for panoramic radiographs of anterior edentulous patients that better addresses these two issues. A new panoramic radiography bite block similar to the bite block for dentulous patients was developed to enable proper positioning stability for edentulous patients. The new bite block was designed and implemented in light of previous studies. The height of the new bite block was 18 mm and to compensate for the horizontal edentulous space, its horizontal width was 7 mm. The panoramic radiographs using the new bite block were compared with those using the conventional chin-support device. Panoramic radiographs taken with the new bite block showed better stability and bilateral symmetry than those taken with the conventional chin-support device. Patients also showed less movement and more stable positioning during panoramic radiography with the new bite block. Conventional errors in panoramic radiographs of edentulous patients could be caused by unreliability of the chin-support device. The newly proposed bite block for panoramic radiographs of edentulous patients showed better reliability. Further study is required to evaluate the image quality and reproducibility of images with the new bite block.

  19. Cervical vertebral column morphology and head posture in preorthodontic patients with anterior open bite

    DEFF Research Database (Denmark)

    Kim, Phong; Sarauw, Martin Toft; Sonnesen, Liselotte

    2014-01-01

    INTRODUCTION: Cervical vertebral column morphology and head posture were examined and related to craniofacial morphology in preorthodontic children and adolescents with anterior open bite. METHODS: One hundred eleven patients (ages, 6-18 years) with an anterior open bite of more than 0 mm were...... divided into 2 groups of skeletal or dentoalveolar open bite. The skeletal open-bite group comprised 38 subjects (19 girls, 19 boys). The dentoalveolar open-bite group comprised 73 subjects (43 girls, 30 boys). Visual assessment of the cervical column and measurements of craniofacial morphology and head...... posture were made on profile radiographs. RESULTS: Deviations in the cervical vertebral column morphology occurred in 23.7% of the subjects in the skeletal open-bite group and in 19.2% in the dentoalveolar open-bite group, but the difference was not significant. Head posture was significantly more...

  20. Herpes labialis in patients with Russell's viper bite and acute kidney injury: a single center experience.

    Science.gov (United States)

    Waikhom, Rajesh; Sapam, Ranjeeta; Patil, Krishna; Jadhav, Jaya Prada; Sircar, Dipankar; Roychowdhury, Arpita; Dasgupta, Sanjay; Pandey, Rajendra

    2011-06-01

    Snake bite is an important health hazard in tropical countries and is associated with significant morbidity and mortality. Herpes labialis is a common ailment caused by the Herpes simplex virus. There is no published data showing any association between the snake bite and development of Herpes labialis. Here, we present a series of patients who developed Herpes labialis after Russell's viper bite and had acute kidney injury. We attempted to find whether snake bite is an immunosuppressed state and whether it could have pre-disposed the patients to the development of these lesions.

  1. Bite force in patients with functional disturbances of the masticatory system.

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    Helkimo, E; Carlsson, G E; Carmeli, Y

    1975-10-01

    In thirty patients (24 women and 6 men) treated because of dysfunction of the masticatory system at the department of Stomatognathic Physiology, University of Gothenburg, bite force was registered before, during and after treatment had been completed. In the controls, thirty-six dental students and trainee dental nurses, with no dysfunction of the masticatory system, bite force was registered on two occasions. Bite force was measured between the first molars on each side and between the central incisors. Also finger force was registered. The force measurements were made at five different levels, increasing from very weak to maximum force. Repeated tests of bite force in the control group, made at intervals of about 1 week, gave almost identical results. Bite force in the patient group was lower than in the control group at the first registration but increased with palliation of the symptoms during treatment. There was no significant difference in bite force between the affected and the unaffected side.

  2. BITE-FORCE ENDURANCE IN PATIENTS WITH TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND INTERNAL DERANGEMENT

    NARCIS (Netherlands)

    STEGENGA, B; BROEKHUIJSEN, ML; DEBONT, LGM; VANWILLIGEN, JD

    1992-01-01

    The aim of this study was to investigate the potential clinical relevance of testing bite force endurance in patients with articular temporomandibular disorders. The endurance of a 50 N bite force was measured in 51 patients with painful temporomandibular joint disorders. The results were compared t

  3. Orthodontic treatment for deep bite and retroclined upper front teeth in children.

    Science.gov (United States)

    Millett, D T; Cunningham, S J; O'Brien, K D; Benson, P; Williams, A; de Oliveira, C M

    2006-10-18

    Correction of the type of dental problem where the bite is deep and the upper front teeth are retroclined (Class II division 2 malocclusion) may be carried out using different types of orthodontic treatment. However, in severe cases, surgery to the jaws in combination with orthodontics may be required. In growing children, treatment may sometimes be carried out using special upper and lower dental braces (functional appliances) that can be removed from the mouth. In many cases this treatment does not involve taking out any permanent teeth. Often, however, further treatment is needed with fixed braces to get the best result. In other cases, treatment aims to move the upper first permanent molars backwards to provide space for the correction of the front teeth. This may be carried out by applying a force to the teeth and jaws from the back of the head using a head brace (headgear) and transmitting this force to a part of a fixed or removable dental brace. This treatment may or may not involve the removal of permanent teeth. In some cases, neither functional appliances nor headgear are required and treatment may be carried out without extraction of any permanent teeth. Instead of using a headgear, in certain cases, the back teeth are held back in other ways such as with an arch across or in contact with the front of the roof of the mouth which links two bands glued to the back teeth. Often in these cases, two permanent teeth are taken out from the middle of the upper arch (one on each side) to provide room to correct the upper front teeth. It is important for orthodontists to find out whether orthodontic treatment only, carried out without the removal of permanent teeth, in children with a Class II division 2 malocclusion produces a result which is any different from no orthodontic treatment or orthodontic treatment only involving extraction of permanent teeth. To establish whether orthodontic treatment, carried out without the removal of permanent teeth, in children

  4. Bite wounds and antibiotic prescription among patients presenting to an Australian emergency department.

    Science.gov (United States)

    Birdsey, Matthew; Edwards, Gail; Abetz, Jeremy; Jennings, Natasha; Mitra, Biswadev

    2016-07-01

    Emergency department presentations after mammalian bites may be associated with injection of bacteria into broken skin and may require prophylactic antibiotics to prevent subsequent infection. We aim to describe the epidemiology of patients presenting with a mammalian bite injury and antibiotic choice to an Australian adult tertiary centre. A retrospective cohort study was performed capturing all presentations after mammalian bite wounds between 01 Jan 2014 and 31 Dec 2014. An explicit chart review was conducted to determine management of each case. Cases were subgrouped into high- and low-risk groups as defined by the Australian Therapeutic Guidelines for animal bites. There were 160 cases of mammalian bite wounds included, with 143 (89.4%) patients grouped as high-risk and 17 (10.6%) patients identified as low-risk. High-risk features were delayed presentation > 8 hours (57 patients, 35.6%), bites to the head, hand or face (113 patients, 70.6%), and puncture wounds unable to be adequately debrided (74 patients, 46.3%). There was a significant association with delayed presentation of more than eight hours and clinically established infection [OR 36.2; 95% CI: 12.6-103.6; P antibiotics that adhered to current guidelines occurred in 99 (61.9%) cases. This study highlights variability in antibiotic prescription practice among clinicians and the need for ongoing education on antibiotic stewardship. Intervention strategies, including ongoing education, are indicated to improve adherence to antibiotic guidelines. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Clinical treatment of deep overbite by bite plate comebined with archwire%摇椅弓结合上颌前牙平面导板在打开咬合中的临床应用

    Institute of Scientific and Technical Information of China (English)

    徐春华

    2012-01-01

    Objective To discuss the clinical treatment of deep overbite by archwire combined with bite plate. Methods Twenty-three patients of class Ⅱ deep overbite and severer were treated by archwire combined with bite plate. Results Compared with single use of edgewise appliance, the way of treating deep overbite by archwire combined with bite plate was more effective and cost shorter time than edgewise appliance through hoisting molars and depressing former teeth. Conclusion The way treating deep overbite by archwire combined with bite plate should be applied in clinics for it can undo occlusion quick and effectively.%目的 探讨上颌平面导板结合摇椅弓矫治深覆的临床应用.方法 选择23例深覆Ⅱ度或以上的患者,采用上颌平面导板结合摇椅弓打开咬合以矫治深覆.结果 上颌平面导板结合摇椅弓矫治深覆,与单纯使用方丝弓矫治器相比,通过升高后牙,压低前牙,明显缩短疗程,有效矫治深覆.结论 上颌平面导板结合摇椅弓矫治深覆,能快速打开咬合,矫治的效果比较明值得在临床中广泛应用.

  6. Lizard Bites

    Science.gov (United States)

    ... Mite Bites Mollusk Stings Puss Moth Caterpillar Stings Scorpion Stings Sea Urchin Stings Snakebites Spider Bites Stingray ... Mite Bites Mollusk Stings Puss Moth Caterpillar Stings Scorpion Stings Sea Urchin Stings Snakebites Spider Bites Stingray ...

  7. Epidemiological and clinical manifestations of patients hospitalized with brown recluse spider bite.

    Science.gov (United States)

    Dyachenko, P; Ziv, M; Rozenman, D

    2006-10-01

    Necrotic arachnidism represents a common health problem and standard treatments are usually safe and effective. The aim of this study was to review documented Loxosceles species spider envenomations and identify the natural history of affected patients. A retrospective single-centre study included 52 patients with necrotic arachnidism hospitalized in the dermatology department between 1997 and 2004. We examined the relationship between the epidemiological, clinical and laboratory parameters and degree of lesion severity, length of hospitalization and time to complete healing. The bites occurred predominantly in rural areas, 67% between April and August. Only 35% of the patients sought medical care within 24 h post bite. Most bites were of the extremities (67%). Time to complete healing ranged from 14 days to more than 8 weeks (mean, 4.8 weeks). A marked relationship was found between age, comorbidities, lesion severity and time to complete healing (P spider bites frequently induce necrotic, slowly healing ulcers on the fatty areas of the body. Early, appropriate systemic therapy may provide clinical benefit.

  8. Risk factors for low molar bite force in adult orthodontic patients

    DEFF Research Database (Denmark)

    Andersen, Malene Krogh; Sonnesen, Ane Liselotte

    2013-01-01

    The aim was to analyse which parameters in a standard orthodontic material are most important for identifying factors for low bite force. Such analyses have not previously been reported in adult orthodontic patients. The sample comprised 95 adults (67 females and 28 males) aged 18-55 years sequen...... angle are at risk of having low bite force. This may prove valuable in the clinic, especially in orthodontic cases with an increased need for vertical anchorage during treatment.......The aim was to analyse which parameters in a standard orthodontic material are most important for identifying factors for low bite force. Such analyses have not previously been reported in adult orthodontic patients. The sample comprised 95 adults (67 females and 28 males) aged 18-55 years...... sequentially admitted for conventional orthodontic treatment. All subjects had moderate to severe malocclusions. Bite force was measured by a pressure transducer, craniofacial dimensions and head posture were measured on profile radiographs, number of teeth in contact were evaluated with a plastic strip...

  9. Acute interstitial nephritis in patients with viperine snake bite: Single center experience of a rare presentation

    Directory of Open Access Journals (Sweden)

    Vishal Golay

    2012-01-01

    Full Text Available Acute renal failure following vasculotoxic viperine snake bites is very common in South Asia. Acute tubular necrosis and acute cortical necrosis are the common findings, with acute interstitial nephritis (AIN being a rare presentation. We conducted renal biopsies in all patients who were admitted in our institute with viperine snake bite-related acute kidney injury (AKI and who did not improve after three weeks of supportive care. Patients who had findings of AIN on renal histology were included for this study. Of a total of 42 patients, there were five patients (11.9% with AIN. Our series of five patients is the largest series of this rare presentation in the literature. All of these five patients had features of severe envenomation, severe AKI network stage of AKI and very high antivenom requirements. They had a very prolonged stay in the hospital, and four of the five patients developed chronic kidney disease on follow-up. The overall outcome in this group was worse as compared with those who did not have AIN. AIN following viperine snake bites is not a very rare presentation. The reason for the development of this pathology is unclear, but direct venom-related effects are possible. This presentation portends a poor overall long-term prognosis as demonstrated in our case series.

  10. Spider Bite in Iran.

    Science.gov (United States)

    Sanaei-Zadeh, Hossein

    2017-07-01

    Some of the world's most dangerous spiders have been certified in some areas of Iran. Spider bites are common in some geographical areas, and are sporadic in some regions. Spider bites can be classified as latrodectism or loxoscelism. If the patient had not seen the spider, the clinical manifestations of latrodectism could be easily mistaken for other types of bite or sting; or an infectious disease, and withdrawal symptoms, and also loxoscelism could be mistaken for cellulitis, various types of skin infection, or even a sting from a Gadim scorpion (Hemiscorpius lepturus). Given the nonspecific presentation of spider bites, one must keep the diagnosis in mind, and question patients, regarding possible exposure to spiders. Physicians recommend becoming familiar with the geographical distribution of Iranian dangerous spiders, clinical manifestations, and management of their bites. The most useful treatment for spider bite is anti-venom administration. Producing spider bite anti-venom in the Razi Vaccine and Serum Research Institute is under investigation.

  11. Long-term outcome in a patient with a dentoskeletal open-bite malocclusion treated without extraction.

    Science.gov (United States)

    Celli, Daniel; Gasperoni, Enrico; Deli, Roberto

    2007-01-01

    This case report describes the treatment of a patient with a Class II malocclusion with an anterior open bite. The patient, a girl 16 years of age, had a significant anteroposterior discrepancy and a high-angle tendency. Her face was convex, with competent lips. Intraorally she had an anterior open bite of 3 mm, space in the mandibular arch, and an overjet of 2 mm. High-pull headgear, anterior intermaxillary elastics, and appropriate wire bending were used to close the bite and to correct the anteroposterior dental relationship. Modification of a tongue thrust habit helped to correct this significant malocclusion and provided stability at 11 years posttreatment.

  12. Snake bites

    Science.gov (United States)

    Bites - snakes ... Snake bites can be deadly if not treated quickly. Because of their smaller body size, children are ... risk for death or serious complications due to snake bites. The right antivenom can save a person's ...

  13. Animal Bites

    Science.gov (United States)

    ... or territory. Attacks by pets are more common. Animal bites rarely are life-threatening, but if they become infected, you can develop serious medical problems. To prevent animal bites and complications from bites Never pet, handle, ...

  14. 玻璃离子水门汀固定平导矫治深覆(牙合)的临床研究%A clinical study of fixed glass ionomer cement fiat bite plate for deep overbite correction

    Institute of Scientific and Technical Information of China (English)

    罗小安; 郑晓丹

    2015-01-01

    目的 探讨玻璃离子水门汀固定平导矫治前牙深覆(牙合)的有效性.方法 选择30例深覆(牙合)患者,应用玻璃离子水门汀固定平导打开咬合,对矫治前后组织变化进行分析比较.结果 L1-MP减小2.03 mm(P<0.01);U6-PP、L6-MP、GoGn-SN分别增大1.12 mm、0.88 mm、5.38°(P<0.01).结论 玻璃离子水门汀固定平导能有效矫治前牙深覆(牙合).%Objective To investigate the efficiency of fixed glass ionomer cement flat bite plate in deep overbite correction.Methods The study comprised of 30 patients with deep overbite.All patients were treated with fixed glass ionomer cement flat bite plate.The changes before and after treatment were measured and compared.Results After the treatment, L1-MP decreased by 2.03 mm significantly (P<0.01).U6-PP, L6-MP, GoGn-SN all increased by 1.12mm, 0.88 mm and 5.38 degree, respectively(P<0.01).Conclusions Fixed glass ionomer cement flat bite plate can effectively correct anterior deep overbite.

  15. Cerebral activation during unilateral clenching in patients with temporomandibular joint synovitis and biting pain: an functional magnetic resonance imaging study

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan-ping; MA Xu-chen; JIN Zhen; LI Ke; LIU Gang; ZENG Ya-wei

    2011-01-01

    Background Functional magnetic resonance is a non-invasive method that can examine brain activity and has been widely used in various fields including jaw movement and pain processing. Temporomandibular disorder (TMD) is one of the most frequent facial pain problems. The objective of this study was to investigate the brain activities using functional magnetic resonance imaging (fMRI) during unilateral maximal voluntary clenching tasks in the TMD synovitis patients with biting pain.Methods Fourteen TMD synovitis patients with unilateral biting pain and 14 controls were included in the study.Contralateral biting pain was defined as right molar clenching causing left temporomandibular joint (TMJ) pain. Ipsilateral biting pain was defined as right molar clenching causing right TMJ pain. Symptom Check List-90 (SCL-90) was administered to the patients and controls. Independent sample t-test was used to compare the SCL-90 subscales between the two groups. Unilateral clenching tasks were performed by the patients and controls. Imaging data were analyzed using SPM99.Results Patients were divided into contralateral TMD biting pain group (n=8) and ipsilateral TMD biting pain group (n=6). The SCL-90 subscales were significantly different between the two groups for somatization, depression, anxiety,phobic anxiety, and paranoid ideation. Group analysis of the controls demonstrated brain activations in the inferior frontal gyrus, precentral gyrus, middle frontal gyrus, superior temporal gyrus, and insular. The areas of activation were different between right and left clenching task. In TMJ synovitis patients with contralateral or ipsilateral biting pain, the group analysis showed activations in the inferior frontal gyrus, superior temporal gyrus, medium frontal gyrus, precentral gyrus,and anterior cingulate cortex.Conclusions The inferior frontal gyrus and precentral gyrus play essential roles during the unilateral clenching task.Activation of anterior cingulate cortex in the

  16. Maxillomandibular relationship in TMD patients before and after short-term flat plane bite plate therapy.

    Science.gov (United States)

    Fu, Alexander S; Mehta, Noshir R; Forgione, Albert G; Al-Badawi, Emad A; Zawawi, Khalid H

    2003-07-01

    This study assessed the maxillomandibular relationship in temporomandibular disorders (TMD) patients, before and after short-term, flat plane bite plate therapy. It was of interest to determine the incidence and degree of mandibular deviation in a group of TMD patients and whether the mandible would shift to the midline and consequently affect reported symptoms. Seventeen female and three male subjects (age range 19-60) were included in the study. Thirteen subjects were diagnosed with myofascial pain while seven were diagnosed as exhibiting disk displacement with reduction (Research Diagnostic Criteria). After taking impressions for these subjects, casts were fabricated and mounted. Maxillomandibular relationship was evaluated by the Denar Centric Check system (Anaheim, CA). The maxillary and mandibular labial frena were used as a reference to evaluate mandibular shift. Symptom questionnaires were used to assess temporomandibular joint pain and clicking. All subjects exhibited deviation (12 subjects to the right and 8 subjects to the left) prior to bite plate therapy. After flat plane bite plate therapy, the mandibular position of all subjects shifted toward the labial frenum midline position. Based on the Binomial test, the shift was significant (p occlusal obstructions are eliminated, the mandible will drift to this position.

  17. STUDY OF ACUTE KIDNEY INJURY IN SNAKE BITE PATIENTS

    Directory of Open Access Journals (Sweden)

    Suma Dasaraju

    2017-04-01

    Full Text Available BACKGROUND Snake venom is well known to cause toxic damage to the kidneys (Schreiner and Maher, 1965. This study is an attempt to evaluate the snakebite-induced Acute Kidney Injury (AKI. MATERIALS AND METHODS 50 patients with snakebite-induced acute kidney injury were selected randomly and their clinical profile was assessed. Acute kidney injury was evaluated using noninvasive laboratory methods. Inclusion Criteria- 1. History of snakebite; 2. Presence of AKI. Exclusion Criteria- Pre-existing renal diseases, after establishing the diagnosis, patients were started on conservative treatment including ASV, blood/blood products and haemodialysis as required. RESULTS Out of 50 patients included in the study, majority of them were males (62% with mean age of presentation 43.8 ± 12.63 years. The mean interval between snakebite and presentation to hospital was 15.37 hours. In them, 98% patients presented with local signs of inflammation, 52% of patients presented with coagulation abnormality and 60% with decreased urine output. Comparison between good outcome (recovered from AKI and poor outcome (not recovered from AKI shows significant pvalue for ‘lapse of time in hours’ in presenting to the hospital after snakebite (p value 0.005 and ‘alternative treatment taken’ before coming to the hospital (p value 0.001. CONCLUSION Poisonous snakebites have common manifestations of cellulitis, abnormal coagulation profile and decreased urine output. Overall mortality due to snakebite-induced AKI is 6%. Patients who did not recover from AKI had lapse of time in presenting to the hospital and abnormal coagulation profile.

  18. Compartment Syndrome Following Snake Bite

    National Research Council Canada - National Science Library

    Dhar, Dinesh

    2015-01-01

    .... The local effects of snake bite include tissue necrosis, edema, and compartment syndrome. Patients may also be left with permanent physical deformities due to residual sequelae of the snake bite...

  19. Dog bites

    OpenAIRE

    Muñoz Leyva, Felipe; Pontificia Universidad Javeriana

    2011-01-01

    Introduction: Although no official data exists for Colombia, dog bites are not infrequent consults to the emergency department on a global scale. In the urban or rural setting, it is likely that Colombian emergency department physicians face patients with such consults in their clinical practice. It is imperative that those physicians become familiar with the current national guidelines and protocols for the attention of such patients, since he/she must act pertinently according to the resour...

  20. Dog bites

    OpenAIRE

    Muñoz Leyva, Felipe; Pontificia Universidad Javeriana

    2011-01-01

    Introduction: Although no official data exists for Colombia, dog bites are not infrequent consults to the emergency department on a global scale. In the urban or rural setting, it is likely that Colombian emergency department physicians face patients with such consults in their clinical practice. It is imperative that those physicians become familiar with the current national guidelines and protocols for the attention of such patients, since he/she must act pertinently according to the resour...

  1. [Tetanus after cat scratch and bites in a previously immunized patient].

    Science.gov (United States)

    Fica, Alberto; Gaínza, Daniela; Ortigosa, Pablo

    2017-04-01

    Tetanus is declining due to vaccination, professional labor management and appropriate wound care. Tetanus cases have been reported despite immunization. We report the case of a previously healthy 21 years old female patient that presented a mild generalized tetanus requiring admission after mild and recurrent cat scratch and bites. She had received six vaccine shots during childhood, and a booster dose five years earlier after a rabbit bite. Symptoms appeared seven weeks after the last contact, and included headache, muscle spasms and mild opisthotonus. Laboratory evaluation, including CSF analysis and microbiological investigation, as well as imaging studies were all normal. The patient received 6,000 IU of human antitoxin immunoglobulin. No autonomic manifestations or respiratory compromise were registered. Symptoms resolved rapidly and she was discharge after seven days with an order to complete a tetanus toxoid immunization schedule with three doses. Tetanus is possible in urban settings with a declining epidemiologic curve of disease in previously immunized patients. Severity of disease is modulated by previous vaccination.

  2. Mosquito Bites

    Science.gov (United States)

    ... larvae, then pupae, and then they become adult mosquitos. The males live for about a week to ... can live for months. What health problems can mosquito bites cause? Most mosquito bites are harmless, but ...

  3. Evaluation of Treatments in Patients with Nocturnal Bruxism on Bite Force and Occlusal Contact Area: A preliminary report

    Science.gov (United States)

    Alkan, Alper; Bulut, Emel; Arici, Selim; Sato, Shuichi

    2008-01-01

    Objectives The purpose of this study was to investigate the short-term effects of occlusal splint therapy and tricyclic antidepressants on the bite force and occlusal contact area of patients presenting with nocturnal bruxism. Methods A maxillary full-coverage hard acrylic splint was applied to the five patients (Group S). Five patients took a tricyclic antidepressant (Amitriptiline HCl, 10 mg/day) for 3 months (Group A) and a control group (Group C) comprising of 10 dental school students with normal occlusion was also formed. Using a Dental Prescale (Fuji Photo Film Corporation, Tokyo, Japan) and an Occluzer computer (FPD703, Fuji Photo Film Corporation, Tokyo, Japan) the bite force and occlusal contact area were measured. The evaluations were made just before the treatment and at 1 month and 3 months of treatment. Results The bite force and occlusal contact area before treatment in study Groups A and S were found to be higher than those in the Group C. Furthermore, the bite force and occlusal contact area increased during treatment in Group A whilst they decreased in Group S. Bite force and occlusal contact area in Group S were lower at both 1 month and 3 months of treatment than in Group C. Conclusions It could be tentatively suggested that occlusal splint therapy may be more effective than tricyclic antidepressant in the treatment of bruxism. Further investigations of this measurement method involving larger study populations and a longer follow-up period are needed. PMID:19212534

  4. Orthodontic treatment in a patient with unilateral open-bite and Becker muscular dystrophy. A 5-year follow-up

    Directory of Open Access Journals (Sweden)

    Juan Fernando Aristizabal

    2014-12-01

    Full Text Available INTRODUCTION: Becker muscular dystrophy is an X-chromosomal linked anomaly characterized by progressive muscle wear and weakness. This case report shows the orthodontic treatment of a Becker muscular dystrophy patient with unilateral open bite.METHODS: To correct patient's malocclusion, general anesthesia and orthognathic surgery were not considered as an option. Conventional orthodontic treatment with intermaxillary elastics and muscular functional therapy were employed instead.RESULTS: After 36 months, open bite was corrected. The case remains stable after a 5-year post-treatment retention period.

  5. [Mammal bite management].

    Science.gov (United States)

    Contreras-Marín, Misael; Sandoval-Rodríguez, Jorge Issac; García-Ramírez, Raúl; Morales-Yépez, Héctor Adolfo

    Animal bites are a major public health problem, it is estimated that 2% of the population is bitten each year. Most bites are by dogs and the risk factors include young children, men, certain breeds of dogs and untrained dogs. The risk of infection after bites differs between animal species and depends on the animal teeth and oral flora. Animal bites are still a major cause of morbidity in patients of all ages and have caused several preventable childhood deaths. These wounds often become infected. If the wound requires it, early surgical evaluation must be performed. The use of antibiotics is only recommended for high risk bite wounds. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  6. Traveler's Health: Avoid Bug Bites

    Science.gov (United States)

    ... Blood Clots Bug Bites Business Travel Cold Climates Counterfeit Drugs Cruise Ship Travel Families with Children Fish ... insect repellents that contain at least 20% DEET (products include Cutter Backwoods and Off! Deep Woods) for ...

  7. Computerized axiography in TMD patients before and after therapy with 'function generating bites'.

    Science.gov (United States)

    Piancino, M G; Roberi, L; Frongia, G; Reverdito, M; Slavicek, R; Bracco, P

    2008-02-01

    The study evaluates the temporomandibular joint (TMJ) movements of patients with signs and symptoms of temporomandibular disorders (TMD) before and after therapy with the functional appliances of the 'function generating bite' (FGB) type. Thirty subjects suffering from TMD were selected and divided into two groups: group A (young patients: four males, nine females, mean age +/- standard deviation: 13.3+/-1.5 years); group B (adults: three males, 14 females, mean age +/- standard deviation: 23.2+/-4.4 years). A control group comprised 13 healthy subjects with perfect normal occlusion, TMD-free, was matched for age and sex with patient groups and was examined at T0 and after 12 months (T1). Computerized axiography was performed before and after therapy (average 13 months) with FGBs to evaluate any difference in condyle border movements. Results showed a statistically significant improvement after treatment, for groups A and B, in length, clicks, tracings with normal morphology, superimposition, deviations, regularity and return to starting position and speed (statistical analysis: chi-squared test) except for the symmetry of tracings which was significantly improved only for the young patient group. No statistically significant differences at time T0/T1 were found in the control group. In conclusion, the study shows that the TMJ tracings of TMD patients before and after therapy with 'FGB' significantly improve especially in young patients. FGB may be a useful appliance to improve TMJ function in young and adult TMD patients requiring orthodontic treatment.

  8. Antibiotic treatment following a dog bite in an immunocompromized patient in order to prevent Capnocytophaga canimorsus infection: a case report

    OpenAIRE

    Hloch, Ondrej; Mokra, Dana; Masopust, Jan; Hasa, Jan; Charvat, Jiri

    2014-01-01

    Background Capnocytophaga canimorsus is a commensal bacterium found in the saliva of dogs and cats. Clinically significant infections in humans after a bite are often associated with the presence of immune deficiency. Early recognition and appropriate treatment are crucial for patient survival. In addition, patients with immune deficiency are susceptible to serious life-threatening nosocomial infections, which may also influence the prognosis of patients with Capnocytophaga canimorsus infecti...

  9. Craniofacial Morphology Affects Bite Force in Patients with Painful Temporomandibular Disorders.

    Science.gov (United States)

    Bavia, Paula Furlan; Vilanova, Larissa Soares Reis; Garcia, Renata Cunha Matheus Rodrigues

    2016-01-01

    Craniofacial morphology affects masticatory performance in healthy dentate subjects, but little is known about its effects in patients with painful temporomandibular disorders (TMDs). Forty-eight female patients (mean age of 28±5.8 years) with painful TMDs underwent lateral cephalometric radiography. Using Ricketts' cephalometric analysis and the Vert method, subjects were assigned to three groups according to their craniofacial morphology: brachyfacial (n=22), mesofacial (n=13), and dolichofacial (n=13). Research diagnostic criteria for TMD were used to confirm the TMD diagnosis for each patient. Pain intensity was reported by each patient based on a visual analog scale (VAS). Maximum bite force (MBF) was measured with pressure sensors placed on the first molar site. Masticatory performance (MP) was assessed by chewing a silicone-based artificial material and determining the resulting particle size by the sieve method. Chewing ability (CA) was evaluated for seven food types and analyzed by a VAS questionnaire. Data were analyzed by one-way ANOVA followed by a Tukey-Kramer test (pcraniofacial morphology affects the MBF without impairing MP or CA in patients with painful TMDs.

  10. Bug Bites and Stings

    Science.gov (United States)

    ... and Wasp Stings Flea and Tick Bites Mosquito Bites Spider Bites What to Do Serious Stuff — Get Medical ... diseases, such as malaria and dengue fever. Spider Bites Most spider bites are minor, although they can cause mild ...

  11. Interdisciplinary management of an adult patient with class II div 1 Malocclusion, Anterior Open Bite and multiple missing molars

    Directory of Open Access Journals (Sweden)

    Rohit Mehrotra

    2014-01-01

    Full Text Available This case report describes the esthetic and functional rehabilitation of a female patient in her mid forties having Class II Div 1 malocclusion, anterior open bite and multiple missing molars, with orthodontics and implant prosthodontics. The patient had bilaterally missing upper first and third molars and lower first and second molars. Orthodontic treatment using skeletal anchorage was performed to retract and align the upper anteriors and correct the open bite. In the upper arch, first molar spaces were closed and no prosthesis was needed. In the lower arch, the anteriors and premolars were aligned and implants were placed bilaterally to replace the missing molars and provide proper occlusion with the upper posteriors. Significant improvement in the occlusion, smile and facial esthetics was achieved. This article highlights the importance of an interdisciplinary team approach for providing optimum treatment to many adult patients.

  12. Stork bite

    Science.gov (United States)

    ... newborns. A stork bite is due to a stretching (dilation) of certain blood vessels. It may become ... all birthmarks during a routine well-baby exam . Prevention There is no known prevention. Alternative Names Salmon ...

  13. Tick Bites

    Science.gov (United States)

    ... that go outdoors, you need to beware of ticks. Ticks are small bloodsucking parasites. Many species transmit diseases ... of the diseases you can get from a tick bite are Lyme disease, ehrlichiosis, Rocky Mountain spotted ...

  14. Animal Bites

    Science.gov (United States)

    ... to 15 to 20 of every 100 following dog or human bites. Treatment If your child is bleeding from ... dangerous than those from tame, immunized (against rabies) dogs and cats. The health of the animal also is important, so if ...

  15. Efficacy of cervicothoracic sympathectomy versus conservative management in patients suffering from incapacitating Raynaud's syndrome after frost bite.

    Science.gov (United States)

    Khan, Mohammad Iqbal; Tariq, Mohammad; Rehman, Ahmed; Zafar, Afsheeen; Sheen, Salman Najam

    2008-01-01

    Raynaud's syndrome is a known complication of cold injuries. Stress, smoking and metabolic diseases may further aggravate the disease course. The purpose of this study was to determine the efficacy of Cervico-thoracic sympathectomy as compared to conservative management in severe Raynaud's syndrome after frostbite. This non-randomized controlled trial was conducted at Railway Hospital, Rawalpindi and Islamic International Medical Complex, Islamabad between January 1999 and June 2006. All patients sustained severe cold trauma in the mountain ridges of Himalayas in Kashmir. In all cases, an informed consent was obtained from patients and families. All operations performed were free of charges. Out of the total 48 patients who developed incapacitating Raynaud's syndrome of the upper limbs after frost bite, 17 patients underwent thoracic sympathectomy through anterior supraclavicular route. Remaining 31 patients were treated conservatively and were placed in the control group. Data was collected on pre-designed proforma and assessed using SPSS (version 11). Chi-square test was applied to assess the effectiveness of the two treatment modalities. All operated cases initially showed improvement in symptoms and incapacitation. Among sympathectomised patients, 11 patients became symptom free and 3 patients showed mild but improved symptoms. Two patients after initial transient improvement developed incapacitating symptoms requiring further treatment, one patient developed gangrene ofdistal phalanx nine month after sympathectomy requiring amputation of the finger. Frequency of attacks and duration between the attacks reduced in all operated patients of cervical sympathectomy (p treatment in patients having severe Raynaud's disease of upper limbs secondary to frost bite.

  16. Ultrasound findings in 42 patients with cytotoxic tissue damage following bites by South African snakes.

    Science.gov (United States)

    Wood, Darryl; Sartorius, Benjamin; Hift, Richard

    2016-07-01

    Snakebites that have cytotoxic venom can cause significant soft tissue swelling. Assessing the site and degree of swelling using ultrasound as a non-invasive technique would be an important tool for instituting appropriate treatment. Forty-two patients who presented to a referral hospital in South Africa with cytotoxic swelling of the limbs from snakebite were assessed using ultrasound. The envenomed limb of each patient was scanned at the point of maximal swelling and compared with the unaffected limb at the same site. Data were presented as an expansion coefficient defined as the ratio of the thickness of tissue structure (subcutaneous tissue or muscle compartment) in the envenomed limb to that in the unaffected limb. A p value of 0.05 was regarded as significant, and 95% CIs were expressed throughout. The majority of bites were in the upper limb (27/42). Twenty-five patients were children less than 12 years. Tissue expansion was noted in both the subcutaneous and muscle compartments of the envenomed limbs. The site of swelling was predominantly in the subcutaneous tissues, while swelling in muscle compartment was limited (the mean expansion coefficient for subcutaneous tissues was 2.0 (CI 1.7 to 2.3) vs 1.06 (CI 1.0 to 1.1), respectively). The difference between the groups was significant (pcompartment syndrome, showed marked swelling in the muscle group. Basic ultrasound techniques may be used to identify the site and degree of tissue swelling from cytotoxic envenomation. It is a non-invasive, painless procedure that can assist the clinician to assess the injured limb and may also be of benefit to monitor the progression of swelling. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Surgical Management of Multijoint Septic Arthritis due to Rat-Bite Fever in a Pediatric Patient: A Case Study

    Directory of Open Access Journals (Sweden)

    Adam M. Wegner

    2017-01-01

    Full Text Available In the United States, rat-bite fever is a rare systemic illness principally caused by Streptobacillus moniliformis, an organism found in the nasopharyngeal flora of rodents. Infection through direct exposure to rat excreta such as saliva, urine, or feces can lead to fever, rash, and an asymmetric migratory polyarthritis. As rodents are becoming more popular as pets, more pediatric cases are being documented. We report a pediatric case of delayed onset septic arthritis in the left wrist and right knee due to S. moniliformis from a rat bite. Previously reported pediatric case studies of suppurative arthritis due to S. moniliformis have only involved the hip. This case study demonstrates the importance of a thorough exposure history and consideration of zoonotic infections as a cause of septic arthritis in a pediatric patient that requires antibiotics and surgical intervention.

  18. The prognostic value of the neutrophil/lymphocyte ratio in patients with snake bites for clinical outcomes and complications.

    Science.gov (United States)

    Elbey, Bilal; Baykal, Burhan; Yazgan, Ümit Can; Zengin, Yılmaz

    2017-02-01

    Snake bites have cardiotoxicity, neurotoxic, myotoxic, nephrotoxic, and hemotoxic features. The neutrophil/lymphocyte ratio (NLR) provides valuable information for the determination of the diagnosis and prognosis of various diseases. In this study, we aimed to investigate the relationship between NLR with the development of complications and duration of hospital stay in snakebite cases. In this study, 107 patients with snakebite complaints that applied to a tertiary care university hospital between 2011 and 2014 were retrospectively reviewed. The control group compromised of 107 age-and gender-matched healthy subjects. These patients were examined using their previous laboratory results, bite areas pictures, geographic location, and analysis of complications that developed during the hospitalization. Patients in our snake bites group (n = 107), included males (64%) and females (36%). When NLR1-NLR2, NLR1-NLR3, and NLR2-NLR3 were compared, a statistically significant difference was found (p Compartment syndrome occurred in 3.73% of patients. In one case that developed compartment syndrome, a finger amputation was made. When 8 patients with a complication were compared with patients having snakebite but no complication, the initial NLR was found to be higher and statistically significant (p = 0.042). The average length of stay of patients in the hospital was 9 days. In the analysis of the correlation between the duration of hospitalization and NLR, the patients with a high level of NLR were found to have a longer hospital stay compared to lower NLR levels (p = 0.012). NLR was significantly increased in patients that developed complications and needed a longer stay in the hospital.

  19. Cat and Dog Bites

    Science.gov (United States)

    ... Prevention and Wellness Staying Healthy Pets and Animals Cat and Dog Bites Cat and Dog Bites Pets and AnimalsPrevention and WellnessStaying Healthy Share Cat and Dog Bites Cat and dog bites are ...

  20. Spider bites - Assessment and management.

    Science.gov (United States)

    Braitberg, George; Segal, Leslie

    2009-11-01

    Spider bite is common, but most species cause minimal or no effects. Patients may be misinformed regarding the nature and consequences of a bite. Understanding the current literature can assist the physician in the management of spider bite patients. This article reviews the current literature on spider bites and describes the clinical assessment and management of the medically important spider bites. Most spider bite is minor and causes nothing more than local irritation. Some spiders can cause significant morbidity and rarely, mortality. Lay identification of the spider has not been shown to be reliable. Latrodectism (red back spider envenomation) is characterised by pain (local, radiating, and regional); systemic symptoms occur less commonly. Funnel web spider bite is a medical emergency; a pressure immobilisation bandage should be applied and the patient transferred to a hospital with available antivenom and resuscitation facilities. Clinicians must consider spider bite in the differential diagnosis of unexplained autonomic and neurological dysfunction, particularly in children. In Australia, skin ulceration is more likely to be an infective, inflammatory or traumatic cause than a case of necrotising arachnidism.

  1. Subcutaneous abscess caused by Pasteurella multocida in a patient due to a cat bite

    Institute of Scientific and Technical Information of China (English)

    ZONG Zhi-yong; GAO Yan-yu; WANG Xiao-hui

    2005-01-01

    @@ Pasteurella multocida (P. multocida), a Gramnegative pathogen, is mainly associated with animal infections. Human P. multocida infections are occasionally encountered and most human cases are due to the animal exposure or contact, especially due to cat bites.1 In China, P. multocida infections are rarely described.

  2. Medical Mysteries: "We Feel Deep Compassion for Patients..."

    Science.gov (United States)

    ... Javascript on. Feature: Medical Mysteries “We feel deep compassion for patients...” Past Issues / Spring 2011 Table of ... maybe even relief. As doctors, we feel deep compassion for patients who have been without hope because ...

  3. Improving masticatory performance, bite force, nutritional state and patient's satisfaction with implant overdentures: a systematic review of the literature.

    Science.gov (United States)

    Boven, G C; Raghoebar, G M; Vissink, A; Meijer, H J A

    2015-03-01

    Oral function with removable dentures is improved when dental implants are used for support. A variety of methods is used to measure change in masticatory performance, bite force, patient's satisfaction and nutritional state. A systematic review describing the outcome of the various methods to assess patients' appreciation has not been reported. The objective is to systematically review the literature on the possible methods to measure change in masticatory performance, bite force, patient's satisfaction and nutritional state of patients with removable dentures and to describe the outcome of these. Medline, Embase and The Cochrane Central Register of Controlled Trials were searched (last search July 1, 2014). The search was completed by hand to identify eligible studies. Two reviewers independently assessed the articles. Articles should be written in English. Study design should be prospective. The outcome should be any assessment of function/satisfaction before and at least 1 year after treatment. Study population should consist of fully edentulous subjects. Treatment should be placement of any kind of root-form implant(s) to support a mandibular and/or maxillary overdenture. Fifty-three of 920 found articles fulfilled the inclusion criteria. A variety of methods was used to measure oral function; mostly follow-up was 1 year. Most studies included mandibular overdentures, three studies included maxillary overdentures. Implant-supported dentures were accompanied by high patient's satisfaction with regard to denture comfort, but this high satisfaction was not always accompanied by improvement in general quality of life (QoL) and/or health-related QoL. Bite force improved, masseter thickness increased and muscle activity in rest decreased. Patients could chew better and eat more tough foods. No changes were seen in dietary intake, BMI and blood markers. Improvements reported after 1 year apparently decreased slightly with time, at least on the long run. Treating

  4. Spider bite.

    Science.gov (United States)

    Isbister, Geoffrey K; Fan, Hui Wen

    2011-12-10

    Spiders are a source of intrigue and fear, and several myths exist about their medical effects. Many people believe that bites from various spider species cause necrotic ulceration, despite evidence that most suspected cases of necrotic arachnidism are caused by something other than a spider bite. Latrodectism and loxoscelism are the most important clinical syndromes resulting from spider bite. Latrodectism results from bites by widow spiders (Latrodectus spp) and causes local, regional, or generalised pain associated with non-specific symptoms and autonomic effects. Loxoscelism is caused by Loxosceles spp, and the cutaneous form manifests as pain and erythema that can develop into a necrotic ulcer. Systemic loxoscelism is characterised by intravascular haemolysis and renal failure on occasion. Other important spiders include the Australian funnel-web spider (Atrax spp and Hadronyche spp) and the armed spider (Phoneutria spp) from Brazil. Antivenoms are an important treatment for spider envenomation but have been less successful than have those for snake envenomation, with concerns about their effectiveness for both latrodectism and loxoscelism. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Human bites - self-care

    Science.gov (United States)

    Bites - human - self-care ... Human bites can occur in 2 ways: If someone bites you If your hand comes into contact ... bite to express anger or other negative feelings. Human bites may be more dangerous than animal bites. ...

  6. Diabetic gangrene in multiple fingers and toes after a dog bite in an elderly patient with type 2 diabetes.

    Science.gov (United States)

    Oya, Junko; Hanai, Ko; Miura, Junnosuke; Maruyama, Satoko; Ishii, Akiko; Syono, Kazu; Shinjo, Takamichi; Iwamoto, Yasuhiko

    2011-01-01

    A 78-year-old diabetic woman experienced multiple sites of gangrene not only in fingers that were directly bitten by a dog but also in fingers and toes that had not beenbitten. Her glycemic control was fair and microvascular complications were mild. There were no clinical findings related to angitis, collagenosis or severe infection. The fingers and toes with gangrene were amputated. The pathological diagnosis was diabetic gangrene. This report presents a case of multiple sites of gangrene of the fingers and toes after a dog bite in an elderly patient with type 2 diabetes.

  7. Temporalis and masseter muscle activity in patients with anterior open bite and craniomandibular disorders

    DEFF Research Database (Denmark)

    Bakke, Merete; Michler, L

    1991-01-01

    values, particularly in subjects with muscular affection, but maximal activity increased significantly when biting on the splint. Maximal voluntary contraction was positively correlated to molar contact and negatively to anterior face height, mandibular inclination, vertical jaw relation and gonial angle......, occlusal stability by tooth contacts, and craniomandibular function by clinical and radiological examination. Electromyographic activity was recorded by surface electrodes after primary treatment with a reflex-releasing, stabilizing splint. Maximal voluntary contraction was reduced compared to reference...

  8. Reversible myocarditis after spider bite.

    Science.gov (United States)

    Kara, Hasan; Ak, Ahmet; Bayir, Aysegul; Avci, Ahmet

    2013-04-08

    Black widow spiders (Latrodectus tredecimguttatus) are poisonous spiders endemic in Turkey. Latrodectus bites may cause myocarditis with increased cardiac enzymes. We treated two men (aged 20 and 33 years) who had myocarditis after black spider bites with leucocytosis and elevated levels of troponin I, creatine kinase and creatine kinase-MB fraction. Both patients had normal results on an ECG, and one patient had abnormal echocardiography with minimal left ventricular wall movement disorder. Both patients were hospitalised in the intensive care unit and treated with intravenous fluids, analgesics, spasmolytic drugs, tetanus prophylaxis and cardiac monitoring. The levels of troponin I, creatine kinase and creatine kinase-MB fraction improved, and the patients were discharged home on the third and fifth hospital day without complications. Myocarditis after a Latrodectus bite is rare, but may be associated with serious complications. Therefore, in regions endemic with Latrodectus spiders, prudent treatment of spider bites may include cardiac evaluation and monitoring.

  9. Deep Vein Thrombosis Prophylaxis in Trauma Patients

    Directory of Open Access Journals (Sweden)

    Serdar Toker

    2011-01-01

    Full Text Available Deep vein thrombosis (DVT and pulmonary embolism (PE are known collectively as venous thromboembolism (VTE. Venous thromboembolic events are common and potentially life-threatening complications following trauma with an incidence of\t5 to 63%. DVT prophylaxis is essential in the management of trauma patients. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Traditionally, pelvic and lower extremity fractures, head injury, and prolonged immobilization have been considered risk factors for VTE; however it is unclear which combination of risk factors defines a high-risk group. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC filters. The available pharmacologic agents include low-dose heparin (LDH, low molecular weight heparin (LMWH, and factor Xa inhibitors. Mechanical prophylaxis methods include graduated compression stockings (GCSs, pneumatic compression devices (PCDs, and A-V foot pumps. IVCs are traditionally used in high risk patients in whom pharmacological prophylaxis is contraindicated. Both EAST and ACCP guidelines recommend primary use of LMWHs in trauma patients; however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients.

  10. Deep vein thrombosis prophylaxis in trauma patients.

    Science.gov (United States)

    Toker, Serdar; Hak, David J; Morgan, Steven J

    2011-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism (PE) are known collectively as venous thromboembolism (VTE). Venous thromboembolic events are common and potentially life-threatening complications following trauma with an incidence of 5 to 63%. DVT prophylaxis is essential in the management of trauma patients. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Traditionally, pelvic and lower extremity fractures, head injury, and prolonged immobilization have been considered risk factors for VTE; however it is unclear which combination of risk factors defines a high-risk group. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC) filters. The available pharmacologic agents include low-dose heparin (LDH), low molecular weight heparin (LMWH), and factor Xa inhibitors. Mechanical prophylaxis methods include graduated compression stockings (GCSs), pneumatic compression devices (PCDs), and A-V foot pumps. IVCs are traditionally used in high risk patients in whom pharmacological prophylaxis is contraindicated. Both EAST and ACCP guidelines recommend primary use of LMWHs in trauma patients; however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients.

  11. Insect Bites and Stings

    Science.gov (United States)

    Most insect bites are harmless, though they sometimes cause discomfort. Bee, wasp, and hornet stings and fire ant bites usually hurt. Mosquito and flea bites usually itch. Insects can also spread diseases. In the United States, ...

  12. Dog Bite Emergencies

    Science.gov (United States)

    ... Emergency Care Animal Welfare Veterinary Careers Public Health Dog bite emergencies What do I do if I’ ... vaccination records. What do I do if my dog bites someone? Dog bites are scary for everyone ...

  13. Spider Bites (For Parents)

    Science.gov (United States)

    ... TV, Video Games, and the Internet First Aid: Spider Bites KidsHealth > For Parents > First Aid: Spider Bites ... rare. Signs and Symptoms Of a brown recluse spider bite: red blister in the center with surrounding ...

  14. Avoid Mosquito Bites

    Science.gov (United States)

    ... Submit What's this? Submit Button Past Emails Avoid Mosquito Bites Language: English (US) Español (Spanish) Recommend on ... finding a travel medicine clinic near you. Prevent Mosquito Bites While Traveling Mosquito bites are bothersome enough, ...

  15. Compartment Syndrome Following Snake Bite

    Directory of Open Access Journals (Sweden)

    Dinesh Dhar

    2015-03-01

    Full Text Available Snake bites are an important public health problem worldwide. Snake venom causes both systemic and local complications, which can prove fatal if not treated on time. The local effects of snake bite include tissue necrosis, edema, and compartment syndrome. Patients may also be left with permanent physical deformities due to residual sequelae of the snake bite. Compartment syndrome after a snake bite is an uncommon occurrence. The effects are more pronounced in children possibly due to the the reduced total dilution volume in children. The administration of anti-snake venom is the only specific therapy. Compartment syndrome occurs due to a vicious cycle of edema causing hypoxia and acidosis, which further increases capillary permeability and fluid extravasation. This results in a volume increase in the closed fascial compartment, which ultimately compromises circulation and causes irreversible muscle and nerve damage. Our report describes a case of upper limb compartment syndrome following a snake bite on the right wrist of a five-year-old girl who presented eight-hours after the snake bite to the emergency department of Nizwa Regional Referral Hospital. The patient received early and appropriate care but progressed to develop compartment syndrome for which she had to be taken to the operating theatre for emergency fasciotomy. All clinicians should be able to recognize the early symptoms and signs of an evolving compartment syndrome in absence of intracompartmental measuring equipment. The timely fasciotomy in our patient helped the patient achieve excellent functional results.

  16. [Meningitis due to Capnocytophaga canimorsus without dog bite].

    Science.gov (United States)

    Drouet, Alain; Smati, Salim; Ferrer, Marie-Hélène; Martinez, Jean-Yves; Guilloton, Laurent; Felten, Dominique

    2006-03-01

    Capnocytophaga canimorsus is a fusiform and filamentous gram-negative rod, part of the normal oral flora of dogs and cause rare human febrile acute meningitis, usually severe but curable. A sixty years old man presented a severe acute meningitis with fever and confusion. CSF show 4,000 cells/mm3 with 83% neutrophilis, increased protein level (5,02 g/L), very low glucose and positive Gram stain result. The patient fully and quickly recovered with antibiotherapy for 22 days. Bacteriological diagnosis was made by genomic study from CSF culture. The patient has a close contact with his dog without being recently bitten. Diagnosis, suggested by bites or contact with dog or cat, gram-negative bacilli with gram stain of CSF specimen, is possible by prolonged culture of CSF or blood sample, with if necessary genomic study. Antibioprophylaxis is strongly recommended in cases of deep bite wounds and for immunocompromised patients.

  17. Root resorption of anterior teeth by using elastic flat bite plate during orthodontic treatment of deep overbite%深覆患者弹性颌平面导板矫治后下前牙牙根吸收情况观察

    Institute of Scientific and Technical Information of China (English)

    常永春; 郭杰

    2015-01-01

    Objective To observe the root resorption of the anterior teeth by using elastic flat bite plate during ortho-dontic treatment of deep overbite.Methods Sixty-one cases with deep overbite were selected and randomly divided into the observation group (21 cases for the young subgroup, 12 cases for the adult subgroup) and the control group (17 cases for the young subgroup, 11 cases for the adult subgroup) .Both groups underwent orthodontic treatment, and we used elas-tic flat bite plate in the observation and rigid flat bite plate in the control group, respectively.Periapical films were taken before and after the process of stimulating root resorption, and the root resorption of anterior teeth was measured.Results The patients in the two groups obtained satisfactory results and the effect of bite-opening was obvious.Root resorption a-mount in the observation group was (0.79 ±0.29) mm, during which the root resorption amount for the young subgroup was (0.69 ±0.29) mm and adult subgroup was (0.96 ±0.19) mm, and they were respectively(1.03 ±0.25), (0.91 ± 0.23) and (1.21 ±1.18) mm in the control group.Significant differences were found between the two groups ( all P<0.05).Conclusion The root resorption of the anterior teeth caused by elastic flat bite plate during orthodontic treatment of deep overbite is lighter than the traditional rigid plane bite plate.%目的:观察深覆患者弹性颌平面导板矫治后下前牙牙根吸收情况。方法深覆患者61例,随机分为观察组33例(青少年、成年患者各21、12例)、对照组28例(青少年、成年患者各17、11例)。两组均进行深覆矫治,其中观察组戴用弹性平面导板,对照组戴用硬性平面导板。分别于治疗前后拍摄根尖X线片,测算下前牙牙根吸收量。结果两组均取得满意疗效,打开咬合效果明显。观察组下前牙牙根吸收量为(0.79±0.29) mm,其中青少年亚组为(0.69±0.29

  18. Conservative treatment for a growing patient with a severe, developing skeletal Class III malocclusion and open bite.

    Science.gov (United States)

    Xu, Yue; Zhu, Ping; Le, Linda; Cai, Bin

    2014-06-01

    An 8-year-old Chinese girl sought treatment for a severe skeletal Class III malocclusion and open-bite skeletal pattern. Traditionally, patients with a skeletal Class III malocclusion are treated after they have stopped growing, and then they are treated with a combined orthodontic and orthognathic surgery approach. But the risks and expenses of this treatment plan are not acceptable to all patients. This young patient was treated with facemask therapy, a maxillary expansion device, and a molar occlusal splint for maxillary developmental stimulation with control of vertical jaw growth. After the completion of orthopedic therapy, 2 × 4 technology was used to adjust molar positions. A bonded tongue crib was used in the early permanent dentition to help the patient break her bad tongue habits. Straight-wire appliances were used for 16 months to adjust the occlusal relationship. This achieved significant improvement in anterior tooth relationships and facial profile esthetics. At the 2-year posttreatment follow-up, the results were satisfactory. The success of the sagittal relationship correction between the maxilla and the mandible for a skeletal Class III malocclusion depends on the coordination of transverse and vertical relationships combined with the growth potential of each patient.

  19. INTERVENTION PROGRAM FOR NURSING STAFF REGARDING APPROACH TO A PATIENT WITH SPIDER PHOBIA AND/OR BITE.

    Science.gov (United States)

    Al-Agroudi, Mahfouz Ahmad; Ahmed, Salwa Abdalla Mohammad; Morsy, Tosson A

    2016-04-01

    Spider bites are uncommon medical events, since there are limited number of spiders world-wide with fangs strong enough to pierce human skin, and most spiders bite humans only as a final defense when being crushed between skin and another object. Thus, most lesions attributed to spider bites are caused by some other etiology. The spiders that can cause medically significant bites include widow and false widow spiders (worldwide), recluse spiders (mostly North and South America), Australian funnel web spiders (eastern coastal Australia) and Phoneutria spiders (Brazil). Acute spider bites most commonly result in a solitary papule, pustule, or wheal. Systemic symptoms can accompany envenomation of widow; funnel web, and Phoneutria spiders, and less often, those of recluse spiders.

  20. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... plans and activities Video library Find a dermatologist Home Public and patients Skin, hair, and nail care ... bites and stings can be safely treated at home. To treat bug bites and stings at home, ...

  1. Swiss prospective study on spider bites.

    Science.gov (United States)

    Gnädinger, Markus; Nentwig, Wolfgang; Fuchs, Joan; Ceschi, Alessandro

    2013-09-04

    Knowledge of spider bites in Central Europe derives mainly from anecdotal case presentations; therefore we aimed to collect cases systematically. From June 2011 to November 2012 we prospectively collected 17 cases of alleged spider bites, and together with two spontaneous notifications later on, our database totaled 19 cases. Among them, eight cases could be verified. The causative species were: Cheiracanthium punctorium (3), Zoropsis spinimana (2), Amaurobius ferox, Tegenaria atrica and Malthonica ferruginea (1 each). Clinical presentation was generally mild, with the exception of Cheiracanthium punctorium, and patients recovered fully without sequelae. In Switzerland, spider bites generally have a benign clinical course, which is characterised by minor effects, with rapid and complete recovery. Since only verified spider bites can be regarded as spider bites, in the case of clinically important arachnidism, the spider should be sent to an expert for identification. Our study may help to diminish spider fear and reassure people who have experienced a bite.

  2. Maximal bite force and surface EMG in patients with myasthenia gravis

    NARCIS (Netherlands)

    Weijnen, FG; Wokke, JHJ; Kuks, JBM; van der Glas, HW; Bosman, F

    2000-01-01

    Masticatory muscle strength was quantified in patients with bulbar myasthenia gravis and compared with that of patients with ocular myasthenia gravis, patients in clinical remission (whether or not pharmacological) who previously suffered from bulbar myasthenia gravis, and healthy subjects. Maximal

  3. Human bites (image)

    Science.gov (United States)

    Human bites present a high risk of infection. Besides the bacteria which can cause infection, there is ... the wound extends below the skin. Anytime a human bite has broken the skin, seek medical attention.

  4. Prevent Bite Wounds

    Science.gov (United States)

    ... Children > Health Issues > Conditions > Prevention > Prevent Bite Wounds ... animals or other humans. Consider the following statistics: there are about 4.5 million dog bites reported annually in the United States, along ...

  5. A comparison of the ratio of patient's height to thyromental distance with the modified Mallampati and the upper lip bite test in predicting difficult laryngoscopy

    OpenAIRE

    Mohammadreza Safavi; Azim Honarmand; Narges Zare

    2011-01-01

    Background: The aim of the present study was to compare the ability to predict difficult visualization of the larynx from the following preoperative airway predictive indices, in isolation and combination: modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD) and the Upper-Lip-Bite test (ULBT). Methods: We collected data on 603 consecutive patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation and then evaluated all thr...

  6. Population Pharmacokinetics of an Indian F(ab'2 Snake Antivenom in Patients with Russell's Viper (Daboia russelii Bites.

    Directory of Open Access Journals (Sweden)

    Geoffrey K Isbister

    Full Text Available There is limited information on antivenom pharmacokinetics. This study aimed to investigate the pharmacokinetics of an Indian snake antivenom in humans with Russell's viper bites.Patient data and serial blood samples were collected from patients with Russell's viper (Daboia russelii envenoming in Sri Lanka. All patients received Indian F(ab'2 snake antivenom manufactured by VINS Bioproducts Ltd. Antivenom concentrations were measured with sandwich enzyme immunoassays. Timed antivenom concentrations were analysed using MONOLIXvs4.2. One, two and three compartment models with zero order input and first order elimination kinetics were assessed. Models were parameterized with clearance (CL, intercompartmental clearance (Q, central compartment volume (V and peripheral compartment volume (VP. Between-subject-variability (BSV on relative bioavailability (F was included to account for dose variations. Covariates effects (age, sex, weight, antivenom batch, pre-antivenom concentrations were explored by visual inspection and in model building. There were 75 patients, median age 57 years (40-70 y and 64 (85% were male. 411 antivenom concentration data points were analysed. A two compartment model with zero order input, linear elimination kinetics and a combined error model best described the data. Inclusion of BSV on F and weight as a covariate on V improved the model. Inclusion of pre-antivenom concentrations or different batches on BSV of F did not. Final model parameter estimates were CL,0.078 L h(-1, V,2.2L, Q,0.178 L h(-1 and VP,8.33L. The median half-life of distribution was 4.6 h (10-90%iles:2.6-7.1 h and half-life of elimination, 140 h (10th-90th percentilesx:95-223h.Indian F(ab'2 snake antivenom displayed biexponential disposition pharmacokinetics, with a rapid distribution half-life and more prolonged elimination half-life.

  7. Australian wolf spider bites (Lycosidae): clinical effects and influence of species on bite circumstances.

    Science.gov (United States)

    Isbister, Geoffrey K; Framenau, Volker W

    2004-01-01

    Necrotic arachnidism continues to be attributed to wolf spider bites. This study investigates the clinical effects of bites by wolf spiders in Australia (family Lycosidae). Subjects were recruited prospectively from February 1999 to April 2001 from participating emergency departments or state poison information centers. Subjects were included if they had a definite bite by a wolf spider and had collected the spider, which was later identified by an arachnologist. Spiders were identified to the lowest taxonomic level possible and cephalothorax width was measured to correlate bite effects and spider size. There were 45 definite wolf spider bites (23 male and 22 female patients; age range 1 to 69 years, median age 28 years). Species level identifications (14 species) were possible for 31 of 43 spiders belonging to seven different generic groupings. Most bites were by spiders from four generic groupings, Tasmanicosa (including 'Lycosa') (15), Venatrix (8), Venator (10), and Hogna (7). Bites occurred more commonly in south-eastern Australia and occurred throughout the year, with 7 bites (16%) in late autumn or winter. In 7 cases (16%) the person was swimming in or cleaning a pool. Seventy-two percent of bites occurred on distal parts of limbs. Pain occurred in all bites and was severe in 11 cases (24%), with a median duration of 10 min (IQR: 2-60 min). Other effects included puncture marks/bleeding (33%), swelling (20%), redness (67%), and itchiness (13%). Minor systemic effects occurred in three patients (7%): nausea (two), headache (one) and malaise (one). There were no cases of necrotic ulcers [0%; 97.5% CI 0-8%]. Tasmanicosa spider bites caused significantly more itchiness and redness, and large spiders (>5 mm) more often caused severe pain and left fang marks. Wolf spider bites cause minor effects, no more severe than most other spiders, and do not appear to cause necrotic ulcers. The effects are likely to be due to mechanical injury, although minor local

  8. Bites and stings.

    Science.gov (United States)

    Charles, Janice; Fahridin, Salma; Britt, Helena

    2009-11-01

    Of the 426 bite or sting problems managed, 312 (73%) were caused by insects. There were 114 other types of bites recorded, the most common being dog and spider bites. There were five cases of toxicity from aquatic animal stings or adverse reactions to bee stings (Table 1).

  9. Open Fracture of the Forearm Bones due to Horse Bite

    Directory of Open Access Journals (Sweden)

    John Ashutosh Santoshi

    2014-01-01

    Full Text Available Introduction: Fractures have been described mainly following falling accidents in horse-related injuries. Horse bites are uncommon accidents. We present a case of open fracture of the forearm due to horse bite. Case Report: A 35-year-old male farm-worker presented to the emergency room with alleged history of horse bite to the right forearm about 2 hours prior to presentation while feeding the horse. There was deformity of the forearm with multiple puncture wounds, deep abrasions and small lacerations on the distal-third of the forearm. Copious irrigation with normal saline was done and he was administered anti-tetanus and post-exposure rabies prophylaxis. Prophylactic antibiotic therapy was commenced. Radiographs revealed fracture of radius and ulna in the mid-shaft region. He underwent emergency wound debridement, and the ulna was stabilised with an intra-medullary square nail. Seventy-two hours later, he underwent re-debridement and conversion osteosynthesis. He had an uneventful recovery and at three-month follow-up, the fractures had healed radiographically in anatomic alignment. At two-year follow-up, he is doing well, is pain free and has a normal range of motion compared to the contralateral side. Conclusion: Horse bites behave as compound fractures however rabies prophylaxis will be needed and careful observation is needed. Early radical debridement, preliminary skeletal stabilisation, re-debridement and conversion osteosynthesis to plate, and antibiotic prophylaxis were the key to the successful management of our patient. Keywords: Horse; animal bite; forearm; open fracture

  10. Heridas por Mordedura / Bites Injuries

    Directory of Open Access Journals (Sweden)

    Coturel A

    2015-11-01

    Full Text Available Injuries for animal bites are a common cause of consultation to emergency services. However there are still controversies about some aspects of their treatment. It is not recommended to brush the wound area but to flush the surface with isoosmolar saline. The primary wound closure is justified when improves the cosmetic outcome and has no increase risk of infection. Antibiotic prophylaxis is allways indicated in cats or humans bites. The drug of choice is amoxicillin clavulanate.The tetanus vaccine should be indicated when the patient has not full vaccination scheme and rabies vaccine in cases of suspected or confirmed infected animals.

  11. [Compartment syndrome following adder bites].

    Science.gov (United States)

    Roed, Casper; Bayer, Lasse; Lebech, Anne-Mette Kjaer; Poulsen, Jesper Brøndum; Katzenstein, Terese

    2009-01-26

    Bites from the adder, Vipera Berus, can have serious clinical consequences due to systemic effects. Meanwhile, the local swelling calls for attention as well. Two cases of seven- and eleven-year-old boys are reported. The first patient was bitten in the 5th toe, the second in the thumb. Both developed fasciotomy-requiring compartment syndrome of the lower and upper limb, respectively. Recognition of this most seldom complication of an adder bite is vital to save the limb. We recommend that the classical signs and symptoms of compartment syndrome serve as indication for surgery. However, compartment pressure measurement can be helpful in the assessment of children.

  12. Acute carpal tunnel syndrome of the hand following a cat bite.

    Science.gov (United States)

    Sbai, Mohamed Ali; Dabloun, Slim; Benzarti, Sofien; Khechimi, Myriam; Jenzeri, Abdesselem; Maalla, Riadh

    2015-01-01

    Cat bites at the hand are common situation in emergency departments. Neglected or poorly supported, these lesions sometimes lead to serious injuries that may compromise the function of the hand. Pasteurellamultocida is the most offending germ in these lesions, despite their sensitivity to antibiotics; it can sometimes lead to deep infections involving the skin, bones and joints. Acute carpal tunnel syndrome is exceptional after cat bite. We report a case of a 56 Year old female presenting with an acute carpal tunnel syndrome associated with compartment syndrome of the right hand 6 days after a cat bite of her right thumb. The patient was treated by surgery to relieve the median nerve. Microbiology identified PasteurellaMultocida.

  13. Thirty Days without a Bite: Wernicke's Encephalopathy in a Patient with Paranoid Schizophrenia.

    Science.gov (United States)

    Langlois, Mélanie; Doré, Marie-Claire; Laforce, Robert

    2014-09-25

    Wernicke's Encephalopathy (WE) is a preventable neurologic condition characterized by altered mental status, ophthalmoplegia, and ataxia. Although historically associated with alcoholism, a few authors have described WE in patients with non-alcohol related psychiatric disorders. We report herein the case of a 36-year-old young man with paranoid schizophrenia who was brought to hospital for confusion and difficulties with his vision. His roommate said he had gone about thirty days without eating '…because he was on a slimming cure'. History and physical examination suggested WE as a result of isolation and poor diet leading to nutritional deficiency. This was confirmed by brain magnetic resonance imaging showing classic thalamic, mammillary bodies and brainstem lesions. Of note, his cognitive profile was far more heterogeneous than what had classically been described in the literature and involved both cortical and subcortical pathology, generating memory but also significant executive deficits. Intravenous treatment with thiamine was given and our patient showed mild improvements in visual acuity and nystagmus. However, persistent cognitive and physical disabilities consistent with Korsakoff syndrome remained, and he now lives in a supervised home. This case illustrates the tragic consequences of nutritional deficiencies in a patient with paranoid schizophrenia. The threshold to suspect WE in schizophrenic patients should be lowered and in doubt prophylactic parenteral thiamine should be administered.

  14. Management of Deep Vein Thrombosis (DVT) Prophylaxis in Trauma Patients.

    Science.gov (United States)

    Paydar, Shahram; Sabetian, Golnar; Khalili, Hosseinali; Fallahi, Javad; Tahami, Mohammad; Ziaian, Bizhan; Abbasi, Hamid Reza; Bolandparvaz, Shahram; Ghaffarpasand, Fariborz; Ghahramani, Zahra

    2016-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism (PTE) are known as venous thromboembolism (VTE). DVT occurs when a thrombus (a blood clot) forms in deep veins of the body, usually in the lower extremities. It can cause swelling or leg pain, but sometimes may occur with no symptoms. Awareness of DVT is the best way to prevent the VTE. Patients with trauma are at increased risk of DVT and subsequent PE because of coagulopathy in patients with multiple trauma, DVT prophylaxis is essential but the VTE prophylaxis strategy is controversial for the trauma patients. The risk factors for VTE includes pelvic and lower extremity fractures, and head injury.

  15. Prospective screening for deep vein thrombosis in high risk patients.

    Science.gov (United States)

    Barnes, R W

    1977-08-01

    In 257 patients undergoing total hip replacement, gastric bypass for morbid obesity, major abdominal surgery, and major leg amputation, Doppler ultrasonic screening revealed only five instances of deep vein thrombosis. The present study suggests that Doppler screening of high risk patients is a useful alternative to routine anticoagulant prophylaxis of venous thromboembolic disease.

  16. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Mohs AUC MyDermPath+ Psoriasis Patient education resources Practice Management Center Coding and reimbursement Coding MACRA Fee schedule ... your nails: Some doctors recommend taking a gradual approach to break the habit. Try to stop biting ...

  17. Animal bites - self-care

    Science.gov (United States)

    Bites - animals - self-care ... Most animal bites come from pets. Dog bites are common and most often happen to children. Cat bites are ... which can cause deeper puncture wounds. Most other animal bites are caused by stray or wild animals, ...

  18. [The dental and skeletal effects of the jumping-the-bite plate and high-pull headgear combination. A clinical study of treated patients].

    Science.gov (United States)

    Wichelhaus, A; Sander, F G

    1995-07-01

    While planning treatment of the 30 patients with a dental and skeletal class II anomaly on which this study is based, the primary treatment goals were correction of the dental and skeletal structures and attenuation of vertical growth by means of influencing the maxillary skeletal structures and the resultant mandibular reaction. The desired treatment results were achieved in all patients. Even so, however, the effects on individual patients in respect to skeletal influences were markedly different. It was especially helpful that during therapy simultaneously with exerting influence on the maxillary base plane, the influencing of the occlusal plane occurred in the same direction. Through the additional application of high-pull headgear, maxillary growth was clearly restrained and the inclination of the maxillary base plane inhibited. Even difficult skeletal discrepancies, sagittal as well as vertical, can be treated with the bite-jump appliance in combination with a high-pull headgear. This also makes it possible to achieve protrusive repositioning of the mandible in patients with a pronounced vertical growth pattern without causing on open bite. In retrospective the patients' treatment plans proved to be completely appropriate, however, the fact should not be overlooked that changing the occlusal plane is essential for the realization of a positive therapeutic result.

  19. Utilization of a modified bite guard for preventing traumatic macroglossia.

    Science.gov (United States)

    Karayazgan-Saracoglu, Banu; Kecik, Defne

    2011-01-01

    This clinical report describes the treatment of a patient having traumatic macroglossia due to schwannoma in the craniocervical region. Enlarged tongue or macroglossia may compromise vital functions of the patient. To avoid a chronic tongue bite trauma, a bite guard that was inspired from a habit breaker was fabricated. Tongue injury has significantly healed with the use of this appliance, and the patient was able to masticate without biting on his tongue.

  20. Deep brain stimulation for dystonia : Patient selection and outcomes

    NARCIS (Netherlands)

    Speelman, J. D.; Contarino, M. F.; Schuurman, P. R.; Tijssen, M. A. J.; de Bie, R. M. A.

    2010-01-01

    In a literature survey, 341 patients with primary and 109 with secondary dystonias treated with deep brain stimulation (DBS) of the internal segment of the globus pallidus (GPi) were identified. In general, the outcomes for primary dystonias were more favourable compared to the secondary forms. For

  1. [Snake bite injuries].

    Science.gov (United States)

    Turchányi, B; Szalontay, T; Zacher, G

    2000-05-14

    Authors treated five patients who suffered venomous snake-bite injury. Although these snakes are not native in Hungary, this kind of injury is estimated to be more frequent, because of the increasing number of the private collections and illegal import of these reptiles. The local and general symptoms, the therapeutic steps are summarised in this study considering the literature as well. Two patients did not show any systemic or local symptoms at the level of injury, they needed only short observation, and woundcare. The other three patients had serious transient systematic symptoms (vasolability, hypotension/shock, coagulopathy, confusion). Two of them were given specific antivenom. As the third patient did not agree with the serum therapy, plasmapheresis was the choice to treat him, and it seemed to be effective. Few hours later the patients needed surgery because of serious compartment syndrome of their affected upper extremity. Surgical decompression of all the compartments and different possibilities of the secondary skin closure technique are demonstrated. Two patient healed completely, but the right thumb of the third was lost. Authors summarise the effects of the poisons, the symptoms, and the basic therapeutic steps during the first aid and in the primary hospital phase, respectively. They point out the indications of the serum therapy and the correct surgical decompression of the injured extremity.

  2. A survey on animal bite in children less than 16 years old in Bushehr 2001-2006

    Directory of Open Access Journals (Sweden)

    Gisoo Hatami

    2007-02-01

    Full Text Available Background: Animal bite, particularly dog bite is a prevalent public health problem which has not been taken into consideration properly. Especially, children have less experience in handling dogs and do not consider the related dangers seriously. The aim of this study was to determine incidence and related factors of animal bite in children less than 16 years old in Bushehr. Methods: In a prospective survey, all children (or their parents younger than 16 years with an animal bite were interviewed from March 2001 to March 2006 in Bushehr. Some information was collected from their medical records. Results: A total of 240 children (mean age 9.14 years, minimum 90 days and maximum 15 years old were identified. The annual incidence of animal bite was 0.19 per 1000 children between 0-15 years of age. Animal bite was higher in 10-15 years old patients and its rate was low in younger children. The most common animal bite was dog bite (79.6% and in 84.2% of cases the animal was domestic. Most of the children (65% had single lesion. The affected region in under 5 years age group and ≥5 years age group were upper limb (41.5% and lower limb (55.3% respectively (P=0.0001. The prevalence of cat bite injury was almost two times higher in girls than boys. Also cat and monkey bites were more frequent in urban than rural areas. Inpatient treatment was required in 3 cases (1.3%. All patients received Rabies immunoglobulin and completed courses of vaccination (3 or 5 times according to animal being captured or escaped. No significant associations were found between the number of wounds (single or multiple, degree of wounds (superficial or deep, sex and age (<5 or ≥5 years old with the kind of animal (domestic or wild. Conclusion: Dog bite in children is frequent. Since the cost of post exposure prophylaxis is very high for national health sector, preventive strategies should focus on public education, especially for children.

  3. Syndromic approach to treatment of snake bite in Sri Lanka based on results of a prospective national hospital-based survey of patients envenomed by identified snakes.

    Science.gov (United States)

    Ariaratnam, Christeine A; Sheriff, Mohamed H Rezvi; Arambepola, Carukshi; Theakston, R David G; Warrell, David A

    2009-10-01

    Of 860 snakes brought to 10 hospitals in Sri Lanka with the patients they had bitten, 762 (89%) were venomous. Russell's vipers (Daboia russelii) and hump-nosed pit vipers (Hypnale hypnale) were the most numerous and H. hypnale was the most widely distributed. Fifty-one (6%) were misidentified by hospital staff, causing inappropriate antivenom treatment of 13 patients. Distinctive clinical syndromes were identified to aid species diagnosis in most cases of snake bite in Sri Lanka where the biting species is unknown. Diagnostic sensitivities and specificities of these syndromes for envenoming were 78% and 96% by Naja naja, 66% and 100% by Bungarus caeruleus, 14% and 100% by Daboia russelii, and 10% and 97% by Hypnale hypnale, respectively. Although only polyspecific antivenoms are used in Sri Lanka, species diagnosis remains important to anticipate life-threatening complications such as local necrosis, hemorrhage and renal and respiratory failure and to identify likely victims of envenoming by H. hypnale who will not benefit from existing antivenoms. The technique of hospital-based collection, labeling and preservation of dead snakes brought by bitten patients is recommended for rapid assessment of a country's medically-important herpetofauna.

  4. Rat Bite Fever

    Science.gov (United States)

    ... Español Text Size Email Print Share Rat Bite Fever Page Content Article Body Rat-bite fever is a disease that occurs in humans who ... ingestion of contaminated food or milk products (Haverhill fever). Most cases in the United States are caused ...

  5. Insect bites and stings

    Science.gov (United States)

    ... likely to cause itching than pain. Insect and spider bites cause more deaths from venom reactions than bites from snakes. ... are harmless. If possible, bring the insect or spider that bit you with you when you go for medical treatment so it can be identified.

  6. Tick bite granuloma : recommendations for surgical treatment

    OpenAIRE

    Hirota, Keisuke; Kurosawa, Yoshinaga; Goto, Keisuke; Adachi, Koji; Yoshida, Yuichi; Yamamoto, Osamu

    2015-01-01

    Tick bite is known as a possible cause of some infectious diseases such as Lyme disease, spotted fever and related illnesses. The reaction to a tick bite may persist for several months to several years and can sometimes cause histopathological granuloma. The long-term reaction to salivary extracts from the tick could be responsible for development of granuloma in our patient. We recommended complete resection as the only sure way to treat formed granuloma.

  7. Rhabdomyolysis and Acute Renal Failure After Fire Ant Bites

    OpenAIRE

    Koya, Supriya; Crenshaw, Daryl; Agarwal, Anupam

    2007-01-01

    We describe a 59-year-old patient who developed acute renal failure because of rhabdomyolysis after extensive red fire ant bites. This case illustrates a serious systemic reaction that may occur from fire ant bites. Consistent with the clinical presentation in rhabdomyolysis associated with non-traumatic causes, hyperkalemia, hypophosphatemia, hypocalcemia, and high anion gap acidosis were not observed in this patient. While local allergic reactions to fire ant bites are described in the lite...

  8. Bite Mark Analysis

    Directory of Open Access Journals (Sweden)

    SK Padmakumar

    2014-07-01

    Full Text Available Bite mark analysis plays an important role in personal identi- fi cation in forensic odontology. They are commonly seen in violent crimes such as sexual assaults, homicides, child abuse, etc. Human bites are common on the face and are usually seen on prominent locations of the face such as the ears, nose and lips. Individual characteristics recorded in the bite marks such as fractures, rotations, attrition, and congenital malformations are helpful in identifying the individual who caused it. We are reporting the case of a 55-year-old lady with bite marks on her left ear, who was allegedly assaulted by the suspect. On the basis of characteristic features of the suspect’s dentition, it was concluded that the bite marks seen on the victim was most probably caused by the suspect.

  9. Black widow spider bite: a case study.

    Science.gov (United States)

    Gaisford, Kristine; Kautz, Donald D

    2011-01-01

    This article is a case study of a patient cared for in the hours before her death. After the patient's death, we learned the patient died of a black widow spider bite. This article sheds light on the potential seriousness of this venom and allows for more rapid detection and treatment of those who are unfortunate enough to be bitten. The authors have documented the sequence of events for the patient, outlined the care the patient received, examined the pathophysiology of the body to a spider bite, and then made a passionate appeal for other nurses who work in critical care to do the same with patients in similar situations.

  10. 犬咬伤患者的伤口处置及护理%Dog bite wound management and care of patients

    Institute of Scientific and Technical Information of China (English)

    陈卫萍

    2016-01-01

    Objective Discussion perfect nursing measures and treatment of the wound well for dog bite injury ,in order to avoid the incidence of rabies.Methods For our central clinic in January 2013~December 2014 for treatment of 744 cases of dog bite wounds were properly disposed of in a timely manner, perfect care, standard immunization.Results None of the 744 cases of rabies occur.ConclusionTimely and proper treatment of wounds, improving care measures, enhangcing patients' compliance, and injection of rabies vaccine and rabies passive immunization preparations in the whole process that can make the patient recover as soon as possible.%目的:探讨犬咬伤者的伤口处置及完善护理措施,避免狂犬病的发生.方法:对我中心门诊2013年1月~2014年12月就诊的744例犬咬伤者进行及时正确地伤口处置、完善护理、规范免疫接种.结果:744例无一例发生狂犬病.结论:及时正确地处理伤口;完善护理措施,提高患者的依从性,全程注射狂犬疫苗和狂犬病被动免疫制剂,使患者尽快地康复.

  11. Effect of molar intrusion with temporary anchorage devices in patients with anterior open bite: a systematic review

    Directory of Open Access Journals (Sweden)

    Ahmad Saleem Alsafadi

    2016-03-01

    Full Text Available Abstract Objective The objective of the study is to assess the effect of molar intrusion with temporary anchorage devices on the vertical facial morphology and mandibular rotation during open bite treatment in the permanent dentition. Methods We performed a systematic review of the published data in seven electronic databases up to September 2015. We considered studies for inclusion if they were examining the effects of posterior teeth intrusion on the vertical facial morphology with open bite malocclusion in the permanent dentition. Study selection, risk of bias assessment, and data-extraction were performed in duplicate. Meta-analysis was not possible due to dissimilarity and heterogeneity among the included studies. Results Out of the 42 articles that met the initial eligibility criteria, 12 studies were finally selected. Low level of scientific evidence was identified after risk of bias assessment of the included studies with no relevant randomized controlled trial performed. Out of the 12 selected studies, five studies used miniplates and seven studies used miniscrews. Mandibular counterclockwise rotation was found to be between 2.3° and 3.9° in six studies (as sassed by mandibular plane angle, between MeGo or GoGn and SN or FH plane while it was less than 2° in the remaining studies. Conclusions Current weak evidence suggests that molar intrusion with temporary anchorage devices may cause mandibular counterclockwise autorotation. Future well-conducted and clearly reported multicenter randomized controlled trials that include a non-treatment control group are needed to make robust recommendations regarding the amount of mandibular rotation during open bite treatments.

  12. Hypopituitarism in patients with vasculotoxic snake bite envenomation related acute kidney injury: a prospective study on the prevalence and outcomes of this complication.

    Science.gov (United States)

    Golay, Vishal; Roychowdhary, Arpita; Dasgupta, Sanjay; Pandey, Rajendra

    2014-04-01

    Acute kidney injury (AKI) is common in patients with vasculotoxic snake bite (SB) envenomation but hypopituitarism (HP) is an uncommonly reported complication. We conducted a prospective observational study on survivors of SB-AKI who were evaluated and followed up from September 2010 till September 2012. Pituitary function tests were done if they developed any symptoms of HP. MRI of the hypothalamo-pituitary axis was done in those with documented HP. Response to therapy in the form of improvement in the quality of life (QoL) was evaluated by asking patients to mark on a visual analogue scale marked over 0-100 mm which was reported as percentage improvement. 126 patients were included for this study (30 were lost to follow up and were excluded). 25 cases were clinically suspected to have pituitary dysfunction and underwent evaluation with 9 (9.37%, n = 96) found to have evidence of HP. One child had partial empty sella on MRI with anterior as well as posterior pituitary abnormality and stunting; imaging was normal in others. Higher number of patients with HP had hypotension (p = 0.005, n = 7), coagulation abnormalities (p = 0.005, n = 9), severe clinical snake bite envenomation (p = 0.024, n = 9) and progression to chronic kidney disease (CKD) (p = 0.001, n = 5) as compared to those who did not. Dialysis dependence at presentation was not significantly different (p = 0.348, n = 9). Only development of CKD on follow up predicted the development of HP. Patients had an improvement in the QoL after treatment with mean score on the visual analogue scale of 66.67 ± 14.14%. HP is not very uncommon in patients with severe vasculotoxic SB-AKI. Threshold of clinical suspicion and evaluation should be low as it causes significant morbidity.

  13. [Calcified deep vein thrombosis in a patient with recurrent deep vein thrombosis and sarcoidosis].

    Science.gov (United States)

    Krmek, Dubravka Zupanić; Brajković, Ivana; Bekić, Dinko; Krnić, Antun; Jurković, Petar; Pavlović, Tomislav

    2013-12-01

    In this article, we present a rare case of calcified deep vein thrombosis in a 42-year-old female patient with frequent relapses of pulmonary sarcoidosis since 1995, for which she was on maintenance therapy with corticosteroids and with consequential secondary diabetes. Recent femoral vein thrombosis was diagnosed with color Doppler in 2012. At the same time, calcified occlusive thrombus in vena cava inferior from the level of renal vein to the confluence of hepatic veins was diagnosed on abdominal multi-slice computed tomography (MSCT). Digital subtraction venography (DSV) revealed a well-developed collateral circulation through the paravertebral veins, azygos and hemiazygos vein. There were no risk factors for thrombosis other than sarcoidosis and diabetes. Deep vein thrombosis is rarely described with sarcoidosis, but according to literature reports, it usually appears as a recurrence and simultaneously at multiple locations. According to the current knowledge, we cannot say for sure whether it is a disease with an increased risk of deep vein thrombosis or there is a combination of multiple risk factors present simultaneously.

  14. Animal and Human Bites: Prophlaxis and Approach to the Treatment

    Directory of Open Access Journals (Sweden)

    Ahmet KARAKAŞ

    2010-09-01

    Full Text Available Human and animal bites can cause complications ranging from slight injuries to serious infections. Infections can originate from the biter’s oral cavity and victims’s skin flora. Compared with animal bites, human bites have a higher risk of infection development. Most of the wound infections due to bites are caused by polymicrobials. Pasteurella species, streptococci, staphylococci, Moraxella, Corynebacterium, and Neisseria spp., Bergeyella zoohelcum and Capnocytophaga species are the most frequently isolated pathogens. Dogs (85-90 %, cats (5-10 %, humans (2-3 % and rodents (2-3 % are responsible for most of the bite injuries. Injuries due to dog bites occur mostly in men older than 20 years old and usually on the extremities. Cat bites and related injuries are found in 66 % on the upper extremities, typically on the hands. Bites of human origin are mostly occur in males between the ages of 20-30, and especially seen on the arms, fingers and head-neck regions. Most of the bites from rodents have a rat origin. Those bites often happen at night , especially on the face or hand of children under five years old who live in poor hygienic conditions. The dog bites are mostly due to the crush-style injuries and in 4-25 % of those injuries an infection develops in about 24 hours. Because of their sharp teeth, cats cause puncture-type wounds. Approximately 30-50 % of the cat bite wounds become infected 12 hours later. Hand, face and genital region wounds have a higher risk for the occurrence of an infection, because of their special anatomical structure. In case of risk factors such as diabetes mellitus, kidney failure, long term steroid use, splenectomy, extreme ages (children and elderly people and systemic lupus erythematosus (SLE, infection could easily spread to the deep tissues. The suturing of bite wounds remain controversial. Infected wounds and bites older than 24 hours could be left open. Cosmetically problematic wounds like on the face

  15. Dog-bite induced sepsis : a report of four cases

    NARCIS (Netherlands)

    Hovenga, S; Tulleken, JE; Moller, LVM; Jackson, SA; Van der Werf, TS; Zijlstra, JG

    1997-01-01

    Occasionally, a dog-bite is complicated by a systemic overwhelming infection. We report four consecutive patients who were admitted to our intensive care unit because of sepsis syndrome following dog-bites. The history of these patients did not reveal any immunocompromising conditions. Capnocytophag

  16. Primate bites in Gibraltar--minor casualty quirk?

    Science.gov (United States)

    Campbell, A C

    1989-10-01

    In one year 55 patients presented to the casualty department of St Bernard's Hospital, Gibraltar, with a primate bite. The implications of such wounds on the health of these patients is contrasted with the morbidity and mortality associated with primate bites in the African subcontinent.

  17. Rat-bite fever

    Science.gov (United States)

    Streptobacillary fever; Streptobacillosis; Haverhill fever; Epidemic arthritic erythema; Spirillary fever; Sodoku ... Rat-bite fever can be caused by 2 different bacteria, Streptobacillus moniliformis or Spirillum minus. Both of these are found in ...

  18. Fire Ant Bites

    Science.gov (United States)

    ... Favorite Name: Category: Share: Yes No, Keep Private Fire Ant Bites Share | Fire ants are aggressive, venomous insects that have pinching ... across the United States, even into Puerto Rico. Fire ant stings usually occur on the feet or ...

  19. Etiological aspects of anterior open bite

    Directory of Open Access Journals (Sweden)

    Stojanović Ljiljana

    2007-01-01

    Full Text Available Introduction. Open bite is a multifactorial phenomenon and no single factor can account for open-bite. Etiology plays an important role in diagnosis. Heredity, unfavorable growth patterns, incorrect jaw postoure, are the characteristics of skeletal open bite. Digit sucking. Depending on where the thumb is placed, a number of different types of dental problems can develop. Malocclusions of the late mixed or permanent dentitions, caused by thumb sucking are not self corrected and orthodontic treatment is necessary for their correction. Lymphatic tissue. In order to produce oral respiration, the mandible is postured inferiorly with the tongue protruded and resting against the oral floor. This postural alteration induces dental and skeletal modifications similar to those caused by thumb sucking. This may cause excessive eruption of the posterior teeth, leading to an increase in the vertical dimension of the face and result in development of anterior open bite. Tongue thrust. Tongue habits cause an anterior open bite or they develop secondarily to thumb sucking. In skeletal open bite the tongue habit acts as a secondary factor which helps to maintain or exacerbate the condition. Many orthodontists have had a discouraging experience of completing dental treatment, with what appeared to be good results, only to discover that the case had relapsed because the patient had a tongue thrust swallowing pattern. Conclusion. Dentoalveolar or habitual open bite is caused by habits, which influence the growth and development of dentoalveolar processes and contribute to occlusal disharmonies. Prior to eruption of adult dentition, open bite related to oral habits is usually not a concern as when the habits stop, because the erupting dentition tends to improve spontaneously. Treatment is usually not necessary until permanent teeth erupt (~6 years old. .

  20. Animal Bites - Multiple Languages

    Science.gov (United States)

    ... V W XYZ List of All Topics All Animal Bites - Multiple Languages To use the sharing features on this page, ... Library of Medicine Vietnamese (Tiếng Việt) Expand Section Animal Bites and Scratches - Tiếng Việt (Vietnamese) ... Health Information Translations Characters not displaying correctly on this page? See language display issues . Return to the MedlinePlus Health Information ...

  1. Child health update. Management of dog bites in children.

    Science.gov (United States)

    Sabhaney, Vikram; Goldman, Ran D

    2012-10-01

    A 4-year-old girl was playing with her neighbour's dog. The dog became excited and bit the girl on the forearm, leaving a puncture wound. As a result of the injury, she has presented to my office. Should she be treated with antibiotics? If so, which antibiotic should be used and for how long? Initiation of prophylactic antibiotics is indicated if the dog bite has undergone primary closure; if there is a moderate or severe bite wound; for puncture wounds (especially if penetration of bone, tendon sheath, or joint), facial bites, bites to the hands or feet, or genital area bites; or wounds sustained by victims who are immunocompromised or asplenic. The first-line choice of antibiotic is amoxicillin-clavulanate. Appropriate tetanus and rabies prophylaxis as indicated should also be a part of caring for a patient who has sustained a dog bite, as well as local debridement and thorough cleaning of the wound.

  2. Outcomes and stability in patients with anterior open bite and long anterior face height treated with temporary anchorage devices and a maxillary intrusion splint

    Science.gov (United States)

    Scheffler, Nicole R.; Proffit, William R.; Phillips, Ceib

    2015-01-01

    Introduction Temporary skeletal anchorage devices now offer the possibility of closing anterior open bites and decreasing anterior face height by intruding maxillary posterior teeth, but data for treatment outcomes are lacking. This article presents outcomes and posttreatment changes for consecutive patients treated with a standardized technique. Methods The sample included 33 consecutive patients who had intrusion of maxillary posterior teeth with a maxillary occlusal splint and nickel-titanium coil springs to temporary anchorage devices in the zygomatic buttress area, buccal and apical to the maxillary molars. Of this group, 30 had adequate cephalograms available for the period of treatment, 27 had cephalograms including 1-year posttreatment, and 25 had cephalograms from 2 years or longer. Results During splint therapy, the mean molar intrusion was 2.3 mm. The mean decrease in anterior face height was 1.6 mm, less than expected because of a 0.6-mm mean eruption of the mandibular molars. During the postintrusion orthodontics, the mean change in maxillary molar position was a 0.2-mm extrusion, and there was a mean 0.5-mm increase in face height. Positive overbite was maintained in all patients, with a slight elongation (<2 mm) of the incisors contributing to this. During the 1 year of posttreatment retention, the mean changes were a further eruption of 0.5 mm of the maxillary molars, whereas the mandibular molars intruded by 0.6 mm, and there was a small decrease in anterior face height. Changes beyond 1 year posttreatment were small and attributable to growth rather than relapse in tooth positions. Conclusions Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior open bites, but 0.5 to 1.5 mm of reeruption of these teeth is likely to occur. Controlling the vertical position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height

  3. Redirected lysis of human melanoma cells by a MCSP/CD3-bispecific BiTE antibody that engages patient-derived T cells.

    Science.gov (United States)

    Torisu-Itakura, Hitoe; Schoellhammer, Hans F; Sim, Myung-Shin; Irie, Reiko F; Hausmann, Susanne; Raum, Tobias; Baeuerle, Patrick A; Morton, Donald L

    2011-10-01

    Melanoma-associated chondroitin sulfate proteoglycan (MCSP; also called HMW-MAA, CSPG4, NG2, MSK16, MCSPG, MEL-CSPG, or gp240) is a well characterized melanoma cell-surface antigen. In this study, a new bispecific T-cell engaging (BiTE) antibody that binds to MCSP and human CD3 (MCSP-BiTE) was tested for its cytotoxic activity against human melanoma cell lines. When unstimulated peripheral mononuclear blood cells (PBMCs) derived from healthy donors were cocultured with melanoma cells at effector:target ratios of 1:1, 1:5, or 1:10, and treated with MCSP-BiTE antibody at doses of 10, 100, or 1000 ng/mL, all MCSP-expressing melanoma cell lines (n=23) were lysed in a dose-dependent and effector:target ratio-dependent manner, whereas there was no cytotoxic activity against MCSP-negative melanoma cell lines (n=2). To investigate whether T cells from melanoma patients could act as effector cells, we cocultured unstimulated PBMCs with allogeneic melanoma cells from 13 patients (4 stage I/II, 3 stage III, and 6 stage IV) or with autologous melanoma cells from 2 patients (stage IV). Although cytotoxic activity varied, all 15 PBMC samples mediated significant redirected lysis by the BiTE antibody. When PBMC or CD8 T cells were prestimulated by anti-CD3 antibody OKT-3 and interleukin-2, the MCSP-BiTE concentrations needed for melanoma cell lysis decreased up to 1000-fold. As MCSP is expressed on most human melanomas, immunotherapy with MCSP/CD3-bispecific antibodies merits clinical investigation.

  4. A cost-effectiveness analysis of using TheraBite in a preventive exercise program for patients with advanced head and neck cancer treated with concomitant chemo-radiotherapy

    NARCIS (Netherlands)

    Retel, Valesca P.; van der Molen, Lisette; Steuten, Lotte Maria Gertruda; van den Brekel, Michiel W.; Hilgers, Frans J.

    2016-01-01

    Previous studies have shown that a “Preventive Exercise Program” (PREP) is cost-effective compared to the standard exercise program provided in “Usual Care” (UC) in patients with advanced head and neck cancer. The current paper specifically estimates the cost-effectiveness of the TheraBite jaw

  5. Instrument for measuring human biting force

    Science.gov (United States)

    Kopola, Harri K.; Mantyla, Olavi; Makiniemi, Matti; Mahonen, Kalevi; Virtanen, Kauko

    1995-02-01

    Alongside EMG activity, biting force is the primary parameter used for assessing the biting problems of dentulous patients and patients with dentures. In a highly conductive oral cavity, dielectric measurement methods are preferred, for safety reasons. The maximum biting force for patients with removable dentures is not more than 100 ... 300 N. We report here on an instrument developed for measuring human biting force which consists of three units: a mouthpiece, a signal processing and interface unit (SPI), and a PC. The mouthpiece comprises a sensor head of thickness 3.4 mm, width 20 mm and length 30 mm constructed of two stainless steel plates and with a fiber optic microbending sensor between them. This is connected to the SPI unit by a three-meter fiber optic cable, and the SPI unit to the PC by an RS connection. A computer program has been developed that includes measurement, display, zeroing, and calibration operations. The instrument measures biting force as a function of time and displays the time-dependent force profile and maximum force on a screen or plots it in hard copy. The dynamic measurement range of the mouthpiece is from 0 to 1000 N, and the resolution of the instrument is 10 N. The results of preliminary clinical measurements and repeatability tests are reported.

  6. Tick Bite by Nymphal Amblyomma testudinarium

    Science.gov (United States)

    Kim, Yeong Ho; Lee, Ji Hyun; Park, Young Min

    2016-01-01

    Ticks are parasites that usually suck the blood of wild or domestic animals; rarely, they ingest human blood and spread various febrile infectious diseases along with skin problems. Out of 40 cases of tick bite reported in Korea, only 3 were caused by nymphal ticks, and tick bites by nymphal Amblyomma testudinarium have not been reported previously. Herein, we report a rare case of tick bite by nymphal A. testudinarium. A 57-year-old woman presented with an asymptomatic solitary erythematous nodule on the left thigh that had been present for 6 days. The tick, which the patient removed from the lesion and brought to the hospital, was identified as a nymphal A. testudinarium. Doxycycline (200 mg) was used as treatment, and after seven days of use, the patient improved and no other lesions were detected. PMID:27904278

  7. Lethal case of Vipera bersus bite.

    Science.gov (United States)

    Tranca, Sebastian; Cocis, Mihaela; Antal, Oana

    2016-01-01

    Adder bites are rare events, but they can be fatal. Three adder types live in Romania - Vipera ammodytes, Vipera ursini and Vipera berus. Most adder bites happen during the summer with a peak incidence between July and August. Here we present the case of a 56 years old male patient who was bitten by an adder. The clinical presentation was severe from the beginning with a GCS of 3 points, respiratory and cardiovascular failure; despite of adequate treatment the patient developed multiorgan dysfunction and died 36 hours after the ICU admission. The aim of this report is to raise awareness that snake bites can have a life-threatening course and need immediate attention and medical care.

  8. Assessment of the dentoskeletal changes following the use of twin-block functional appliance and inclined anterior bite plan in the patients with class II malocclusion div 1 in 11-14 years old

    Directory of Open Access Journals (Sweden)

    Allahyar Geramy

    2015-12-01

    Full Text Available Background and Aims: Cl II malocclusion is one of the most common abnormalities in human societies and using a simple, affordable and accessible treatment that can be provided by general practitioners or specialists, to prevent future malocclusion complications is vital. Cl II malocclusion treatment using functional appliances such as twin block and anterior inclined bite plan have less cost, side effects and complications compared to fixed orthodontic or orthosurgery. Until now, the dentoskeletal changes resulting from the application of twin block and anterior inclined bite plan in patients with Class II malocclusion has not been evaluated. The objective of the present study was to assess the dentoskeletal changes following the use of twin-block functional appliance and inclined anterior bite plan in the patients with class II malocclusion div 1 during mixed dentition. Materials and Methods: In this retrospective cohort trial, 60 patients with the definitive diagnosis of Class II div. 1 malocclusion having ANB>2 and FMA angel between 20 and 30 and without any previous treatment or syndrome who were treated with twin-block or inclined anterior bite plan appliance were selected and their lateral cephalometries were traced before and after treatment. Selected distance and angular landmarks were measured on the cephalograms with the good reliability (ICC=0.953 and the changes occurred in the landmarks were statistically analyzed using Student t test. Results: Due to the increased mandibular growth, most of the landmarks experienced significant changes following the treatment with twin-block and inclined bite plan (P0.05, however, SNA (P=0.04, overjet (P=0.007 and wits appraisal (P=0.004 changed differently after using the appliances. Conclusion: Despite with most similarities of both twin-block and anterior inclined bite plan to correct class II div. 1 malocclusion, Due to the advantages of anterior inclined bite plan such as less size, good

  9. Simulation of a flow around biting teeth

    Science.gov (United States)

    Narusawa, Hideaki; Yamamoto, Eriko; Kuwahara, Kunio

    2008-11-01

    We simulated a flow around biting teeth. The decayed tooth is a disease that a majority of people are annoyed. These are often generated from a deep groove at occlusal surface. It is known that a person who bites well doesn't suffer from a decayed tooth easily. Biting forces reach as much as 60 kg/cm^2 by an adult male, and when chewing, upper and lower teeth approach to bite by those forces. The crushed food mixed with saliva becomes high viscosity fluid, and is pushed out of ditches of teeth in the direction of the cheek or the tongue. Teeth with complex three dimension curved surface are thought to form venturi at this time, and to generate big pressure partially. An excellent dental articulation will possibly help a natural generation of a flow to remove dental plaque, i.e. the cause of the decayed tooth. Moreover, the relation of this flow with the destruction of the filled metal or the polymer is doubted. In this research, we try to clarify the pressure distributions by this flow generation as well as its dynamics when chewing. One of our goals is to enable an objective design of the shape of the dental fillings and the artificial tooth. Tooth has a very small uneven ground and a bluff body. In this case, to calculate a computational numerical simulation to solve the Navier-Stokes equations three dimension Cartesian coordinate system is employed.

  10. Marine animal stings or bites

    Science.gov (United States)

    ... poisonous bites or stings from any form of sea life, including jellyfish. There are about 2,000 species ... bites or stings from various types of marine life, including: jellyfish ... sea urchins, sea anemone, hydroid, coral, cone shell, sharks, ...

  11. Animal bite - first aid - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100214.htm Animal bite - first aid - series—Procedure, part 1 To ... D.A.M., Inc. Related MedlinePlus Health Topics Animal Bites A.D.A.M., Inc. is accredited ...

  12. Insect bite reactions

    Directory of Open Access Journals (Sweden)

    Sanjay Singh

    2013-01-01

    Full Text Available Insects are a class of living creatures within the arthropods. Insect bite reactions are commonly seen in clinical practice. The present review touches upon the medically important insects and their places in the classification, the sparse literature on the epidemiology of insect bites in India, and different variables influencing the susceptibility of an individual to insect bites. Clinical features of mosquito bites, hypersensitivity to mosquito bites Epstein-Barr virus NK (HMB-EBV-NK disease, eruptive pseudoangiomatosis, Skeeter syndrome, papular pruritic eruption of HIV/AIDS, and clinical features produced by bed bugs, Mexican chicken bugs, assassin bugs, kissing bugs, fleas, black flies, Blandford flies, louse flies, tsetse flies, midges, and thrips are discussed. Brief account is presented of the immunogenic components of mosquito and bed bug saliva. Papular urticaria is discussed including its epidemiology, the 5 stages of skin reaction, the SCRATCH principle as an aid in diagnosis, and the recent evidence supporting participation of types I, III, and IV hypersensitivity reactions in its causation is summarized. Recent developments in the treatment of pediculosis capitis including spinosad 0.9% suspension, benzyl alcohol 5% lotion, dimethicone 4% lotion, isopropyl myristate 50% rinse, and other suffocants are discussed within the context of evidence derived from randomized controlled trials and key findings of a recent systematic review. We also touch upon a non-chemical treatment of head lice and the ineffectiveness of egg-loosening products. Knockdown resistance (kdr as the genetic mechanism making the lice nerves insensitive to permethrin is discussed along with the surprising contrary clinical evidence from Europe about efficacy of permethrin in children with head lice carrying kdr-like gene. The review also presents a brief account of insects as vectors of diseases and ends with discussion of prevention of insect bites and some

  13. Upper extremity deep vein thrombosis in a military patient.

    Science.gov (United States)

    Bullock, Charlotte; Johnston, A McD

    2016-08-01

    We describe the case of a 23-year-old serviceman on overseas deployment who presented with a painful, swollen arm. Investigations showed an upper extremity deep vein thrombosis (UEDVT) of the right arm with an associated asymptomatic pulmonary embolism, which was treated with warfarin anticoagulation. Further investigation identified positional obstruction at the thoracic outlet, and the patient was diagnosed with Paget-Schroetter syndrome. He underwent elective resection of the first rib, and has now returned to normal duties. After review of the literature on UEDVT, it is suggested that in this military patient, the occurrence of an anatomical variant put him at risk of upper limb venous thrombosis, which was probably potentiated by the occupational factor of carrying a rifle. The external compression of the subclavian vein from the rifle butt and hypertrophied muscles, in addition to the anatomical variation, caused repetitive microtrauma of the vessel intima, which precipitated venous thrombosis.

  14. Bite by moray eel

    Directory of Open Access Journals (Sweden)

    JP Barreiros

    2008-01-01

    Full Text Available Injuries caused by moray eels are not a common problem, but are distributed throughout the globe, affecting mainly fishermen while manipulating hooked or netted fish. On a lesser scale, scuba divers and snorkelers, practicing or not spear fishing, are occasional victims of bites. With more than 185 species distributed among 15 genera, mostly in tropical to temperate shallow water, moray eels easily come into contact with humans and occasional injuries are not uncommon. The current study reports one case of moray eel bite and discusses the circumstances in which the accident happened, as well as wound evolution and therapy.

  15. Hypopituitarism and AutoimmuneThyroiditis Following Snake Bite: An Unusual Clinical Scenario.

    Science.gov (United States)

    Shetty, Sahana; Abi, Manesh S; Hickson, Ravali; David, Thambu; Rajaratnam, Simon

    2014-11-01

    Snake venom can cause local tissue damage and lead to coagulopathy, shock, neurotoxicity and acute kidney injury. Hypopituitarism is a rare complication following snake bite. It has been described following Russell's viper bite from Burma and South India. Herein we describe a patient who presented with severe thyrotoxicosis and partial hypopituitarism following snake bite.

  16. Streptococcus oralis cerebral abscess following monkey bite in a 2-month-old infant.

    Science.gov (United States)

    Thiagarajan, Srinivasan; Krishnamurthy, Sriram; Raghavan, Renitha; Mahadevan, Subramanian; Madhugiri, Venkatesh S; Sistla, Sujatha

    2016-05-01

    Although cerebral abscesses caused by animal bites have been reported, they are extremely rare in infants and have not been described following monkey bite. A 55-day-old male infant presented with a multi-loculated Streptococcus oralis cerebral abscess following a monkey bite on the scalp. There was a clinical response to antibiotic therapy and repeated surgical aspiration followed by a ventriculoperitoneal shunt. This is the first report of a patient with a brain abscess following a monkey bite.

  17. Long-term complications of snake bites to the upper extremity.

    Science.gov (United States)

    Cowin, D J; Wright, T; Cowin, J A

    1998-01-01

    The purpose of this study was to determine long-term complications of upper-extremity snake envenomations. The records of 73 patients, who were seen for snake bites were obtained; 46 of these patients had bites to the upper extremity, and 27 had bites to the lower extremity. These patients were graded according to the severity of the bite. The snakes involved were eastern diamondback rattlesnake, coral snake, pigmy rattlesnake, water moccasin, and unknown. Fourteen of the 46 patients receiving upper extremity bites were examined by a hand surgeon and an occupational hand therapist 1 to 3.2 years after their bite. Subjective pain data, range-of-motion, intrinsic, extrinsic, finger-flexion tightness, grip strength, pinch strength and objective sensory data were collected. Four patients had continued pain and tissue atrophy at the bite site. There were no long-term sequelae from a missed compartment syndrome.

  18. DEEP VEIN THROMBOSIS IN PATIENT WITH VON WILLEBRAND DISEASE

    Directory of Open Access Journals (Sweden)

    V. A. Elykomov

    2016-01-01

    Full Text Available Objective: to identify the possible factors of thrombogenic risk and ways of its prevention in patients with von Willebrand disease.Case description. Patient X., 42 years old, who suffers from von Willebrand disease type 3 with 5-years of age. Asked on reception to the traumatologist in the polyclinic of the Regional Hospital with pain in the left hip joint. Recommended planned operative treatment in the Altai Regional Clinical Hospital. Preoperative preparation included the infusion of concentrate of von Willebrand factor and coagulation factor VIII. Operation – cement total arthroplasty of the left hip joint. In the postoperative period analgesic treatment, elastic compression of the lower extremities, iron supplements, also conducted infusion of concentrate of von Willebrand factor and coagulation factor VIII for 20 days and thromboprophylactic with dabigatran. On the 3rd day after the operation the patient revealed deep vein thrombosis of the femoral segment (floating clot.Results. The patient was operated for emergency indications in the Department of endovascular surgery – installation of venous cava filter “Volan”. Dabigatran is cancelled, appointed clexane for 3 months. In our clinical example the patient lacked risk factors of pulmonary embolism as obesity, age, smoking, prolonged immobilization, estrogen therapy. Overdose of factor VIII were not observed – the level of factor did not exceed 135 % on transfusions. At the same time, the patient was found polymorphisms in the genes ITGA2, FGB, MTHFR, MTR – heterozygote, MTRR – mutant homozygote, which may indicate the genetic factors of thrombogenic risk. Also a significant risk factor was massive surgical intervention (total hip replacement. Despite preventive measures (elastic compression, thromboprophylactic dabigatran, early activation we cannot to avoid thrombotic complications.Conclusion. This article presents a case demonstrating a thrombotic complication in patients

  19. Perawatan Maloklusi Klas III Skeletal disertai Open Bite dengan Teknik Begg

    Directory of Open Access Journals (Sweden)

    Putu Ika Anggaraeni

    2015-12-01

    Full Text Available Overjet negatif pada maloklusi klas III dapat terjadi karena penyimpangan hubungan incisivus atas dan bawah, adanya malrelasi antara maksila dan mandibula, atau kombinasi keduanya. Maloklusi klas III dapat disertai dengan crowding, deep bite, maupun open bite. Tujuan perawatan adalah untuk mengoreksi cross bite dan open bite, memperoleh overjet dan overbite normal serta hubungan oklusal yang stabil. Pasien laki-laki usia 15 tahun dengan maloklusi Angle klas III dan relasi skeletal klas III, mandibula protrusif, cross bite anterior (overjet -3 mm, open bite 12-22 terhadap 43-34, cross bite posterior bilateral, dan pergeseran garis tengah inter incisivus rahang bawah kekanan 0,7 mm. Perawatan ortodontik dilakukan dengan alat cekat teknik Begg, diawali dengan pencabutan gigi 34 dan 44 serta grinding gigi anterior rahang atas. Elastik intermaksiler klas III, elastik cross posterior, dan elastik vertikal digunakan untuk koreksi cross bite anterior dan posterior serta open bite. Kesimpulan dari hasil perawatan dengan teknik Begg, cross bite anterior dan posterior serta open bite terkoreksi (overjet 2 mm dan overbite 2 mm. Garis tengah inter incisivus rahang bawah dan rahang atas sejajar dengan garis tengah wajah. Maj Ked Gi; Desember 2013; 20(2: 192-198.

  20. African tick bite fever

    DEFF Research Database (Denmark)

    Johansen, Jakob Aaquist; Thybo, Søren

    2011-01-01

    The incident of spotted fever imported to Denmark is unknown. We present a classic case of African Tick Bite Fever (ATBF) to highlight a disease, which frequently infects wildlife enthusiasts and hunters on vacation in South Africa. ATBF has a good prognosis and is easily treated with doxycyclin...

  1. Mosquito Bites are Bad!

    Centers for Disease Control (CDC) Podcasts

    2016-08-11

    In this podcast for kids, the Kidtastics talk about the dangers of mosquito bites and how to prevent getting them.  Created: 8/11/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 8/11/2016.

  2. Rat bite fever.

    NARCIS (Netherlands)

    Gaastra, W.; Boot, R.G.A.; Ho, H.; Lipman, L.J.A.

    2009-01-01

    Rat bite fever (RBF) is a bacterial zoonosis for which two causal bacterial species have been identified: Streptobacillis moniliformis and Spirillum minus. Haverhill fever (HF) is a form of S. moniliformis infection believed to develop after ingestion of contaminated food or water. Here the

  3. Airway management in patients with deep neck infections

    Science.gov (United States)

    Cho, Soo Young; Woo, Jae Hee; Kim, Yoon Jin; Chun, Eun Hee; Han, Jong In; Kim, Dong Yeon; Baik, Hee Jung; Chung, Rack Kyung

    2016-01-01

    Abstract Securing the airway in patients undergoing surgical intervention to control a deep neck infection (DNI) is challenging for anesthesiologists due to the distorted airway anatomy, limited mouth opening, tissue edema, and immobility. It is critical to assess the risk of a potential difficult airway and prepare the most appropriate airway management method. We reviewed our anesthetic experiences managing patients with DNIs, focusing on the need for video-laryngoscope or awake fiberoptic intubation beyond a standard intubation from the anesthesiologist's perspective. When patients had infections in the masticatory space, mouth of floor, oropharyngeal mucosal space, or laryngopharynx, their airways tended to be managed using methods requiring more effort by the anesthesiologists, and more extensive equipment preparation, compared with use of a standard laryngoscope. The degree to which the main lesion influenced the airway anatomy, especially at the level of epiglottis and aryepiglottic fold was related to the airway management method selected. When managing the airways of patients undergoing surgery for DNIs under general anesthesia, anesthesiologists should use imaging with computed tomography to evaluate the preoperative airway status and a comprehensive understanding of radiological findings, comorbidities, and patients’ symptoms is needed. PMID:27399122

  4. 26例犬咬伤开放伤口的护理%Nursing care of 26 patients with open wounds due to dog bite injuries

    Institute of Scientific and Technical Information of China (English)

    吴淑华; 胡艳丽; 李健慧

    2012-01-01

    总结了应用现代敷料治疗26例犬咬伤患者开放伤口的经验.对患者局部伤口进行评估,根据伤口特点选择合适的敷料,保持创面清洁,通畅引流,对于伴有软组织撕脱伤的患者局部伤口可适当加压,促进愈合.本组26例伤口共102处,治疗时间12~28d,均恢复良好.%This paper summarizes the experience of using modern bandage and dressing on open wounds caused by dog bites in 26 patients. After wound assessment, the right dressings were used. The other key points of nursing are keeping the wounds clean, maintaining drainage unobstructed, and appropriate pressure for wounds with soft tissue avulsion to promote wound healing. The 26 patients with multiple wounds had been treated for 12 to 28 days and recovered well.

  5. Predictive value of upper lip bite test and ratio of height to thyromental distance compared to other multivariate airway assessment tests for difficult laryngoscopy in apparently normal patients

    Directory of Open Access Journals (Sweden)

    Pratibha Jain Shah

    2013-01-01

    Full Text Available Background: Various anatomical measurements and non-invasive clinical tests, singly or in various combinations can be performed to predict difficult intubation. Recently introduced "Upper lip bite test" (ULBT and "Ratio of height to Thyromental distance" (RHTMD are claimed to have high predictability. We conducted a study to compare the Predictive Value of ULBT and RHTMD with Mouth opening (Inter-Incisor gap (IIG, Modified Mallampatti Test (MMT, Head and neck movement (HNM and Thyromental Distance (TMD for Difficult Laryngoscopy. Materials and Methods: In this prospective, single blinded observational study, 480 adult patients of either sex, ASA grade I and II were assessed and graded for ULBT, RHTMD, TMD, MMT, IIG, and HNM according to standard methods and correlated with the Cormack and Lehane grade. Results: ULBT and RHTMD had highest sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio, i.e., 74.63%, 91.53%, 58.82%, 95.7%, 31.765 and 71.64%, 92.01%, 59.26%, 95.24%, 8.96 respectively, compared to TMD, MMT, IIG and HNM. Conclusions: ULBT is the best predictive test for difficult laryngoscopy in apparently normal patients but RHTMD can also be used as an acceptable alternative.

  6. Predictive value of upper lip bite test and ratio of height to thyromental distance compared to other multivariate airway assessment tests for difficult laryngoscopy in apparently normal patients.

    Science.gov (United States)

    Shah, Pratibha Jain; Dubey, Kamta Prasad; Yadav, Jai Prakash

    2013-04-01

    Various anatomical measurements and non-invasive clinical tests, singly or in various combinations can be performed to predict difficult intubation. Recently introduced "Upper lip bite test" (ULBT) and "Ratio of height to Thyromental distance" (RHTMD) are claimed to have high predictability. We conducted a study to compare the Predictive Value of ULBT and RHTMD with Mouth opening (Inter-Incisor gap) (IIG), Modified Mallampatti Test (MMT), Head and neck movement (HNM) and Thyromental Distance (TMD) for Difficult Laryngoscopy. In this prospective, single blinded observational study, 480 adult patients of either sex, ASA grade I and II were assessed and graded for ULBT, RHTMD, TMD, MMT, IIG, and HNM according to standard methods and correlated with the Cormack and Lehane grade. ULBT and RHTMD had highest sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio, i.e., 74.63%, 91.53%, 58.82%, 95.7%, 31.765 and 71.64%, 92.01%, 59.26%, 95.24%, 8.96 respectively, compared to TMD, MMT, IIG and HNM. ULBT is the best predictive test for difficult laryngoscopy in apparently normal patients but RHTMD can also be used as an acceptable alternative.

  7. Accidental hypothermia and frost-bite in Antarctica.

    Science.gov (United States)

    Sullivan, P G

    1987-02-02

    Two members of an Australian Antarctic expedition suffered hypothermia and frost-bite when they were stranded onshore after their small boat was swamped. Their efforts at field survival until recovery, six hours later, are described. At rescue one patient was found to have frost-bite and a core temperature of 30 degrees C. He was treated successfully by rapid rewarming in a hot bath. The other victim was considerably less hypothermic and suffered only mild frost-bite. Contrary to expectations the tall thin patient fared much better than the short heavier one. Possible explanations for this difference are discussed.

  8. An Analytical Study of Mammalian Bite Wounds Requiring Inpatient Management

    Directory of Open Access Journals (Sweden)

    Young-Geun Lee

    2013-11-01

    Full Text Available BackgroundMammalian bite injuries create a public health problem because of their frequency, potential severity, and increasing number. Some researchers have performed fragmentary analyses of bite wounds caused by certain mammalian species. However, little practical information is available concerning serious mammalian bite wounds that require hospitalization and intensive wound management. Therefore, the purpose of this study was to perform a general review of serious mammalian bite wounds.MethodsWe performed a retrospective review of the medical charts of 68 patients who were referred to our plastic surgery department for the treatment of bite wounds between January 2003 and October 2012. The cases were analyzed according to the species, patient demographics, environmental factors, injury characteristics, and clinical course.ResultsAmong the 68 cases of mammalian bite injury, 58 (85% were caused by dogs, 8 by humans, and 2 by cats. Most of those bitten by a human and both of those bitten by cats were male. Only one-third of all the patients were children or adolescents. The most frequent site of injury was the face, with 40 cases, followed by the hand, with 16 cases. Of the 68 patients, 7 were treated with secondary intention healing. Sixty-one patients underwent delayed procedures, including delayed direct closure, skin graft, composite graft, and local flap.ConclusionsBased on overall findings from our review of the 68 cases of mammalian bites, we suggest practical guidelines for the management of mammalian bite injuries, which could be useful in the treatment of serious mammalian bite wounds.

  9. Deep Patient: An Unsupervised Representation to Predict the Future of Patients from the Electronic Health Records

    Science.gov (United States)

    Miotto, Riccardo; Li, Li; Kidd, Brian A.; Dudley, Joel T.

    2016-05-01

    Secondary use of electronic health records (EHRs) promises to advance clinical research and better inform clinical decision making. Challenges in summarizing and representing patient data prevent widespread practice of predictive modeling using EHRs. Here we present a novel unsupervised deep feature learning method to derive a general-purpose patient representation from EHR data that facilitates clinical predictive modeling. In particular, a three-layer stack of denoising autoencoders was used to capture hierarchical regularities and dependencies in the aggregated EHRs of about 700,000 patients from the Mount Sinai data warehouse. The result is a representation we name “deep patient”. We evaluated this representation as broadly predictive of health states by assessing the probability of patients to develop various diseases. We performed evaluation using 76,214 test patients comprising 78 diseases from diverse clinical domains and temporal windows. Our results significantly outperformed those achieved using representations based on raw EHR data and alternative feature learning strategies. Prediction performance for severe diabetes, schizophrenia, and various cancers were among the top performing. These findings indicate that deep learning applied to EHRs can derive patient representations that offer improved clinical predictions, and could provide a machine learning framework for augmenting clinical decision systems.

  10. Acute generalized exanthematous pustulosis associated with spider bite*

    OpenAIRE

    Milman, Laura de Mattos; Müller,Giana Paula; de Souza, Paulo Ricardo Martins; Grill, Aline Barcellos; Rhoden, Deise Louise Bohn; Mello-da-Silva, Carlos Augusto; Vettorato,Gerson

    2016-01-01

    Abstract: Acute generalized exanthematous pustulosis (AGEP) is an acute febrile rash, usually induced by drugs, which recently has been linked to spider bite. We report a case of a male patient, 48 years old, with an erythematous rash accompanied by fever and small non-follicular pustules. He reported previous pain in the buttock with the onset of a necrotic plaque. The lesion was compatible with spider bite of the genus Loxosceles. According to the EuroSCAR group instrument, the patient scor...

  11. Food aroma affects bite size

    Directory of Open Access Journals (Sweden)

    de Wijk René A

    2012-03-01

    Full Text Available Abstract Background To evaluate the effect of food aroma on bite size, a semisolid vanilla custard dessert was delivered repeatedly into the mouth of test subjects using a pump while various concentrations of cream aroma were presented retronasally to the nose. Termination of the pump, which determined bite size, was controlled by the subject via a push button. Over 30 trials with 10 subjects, the custard was presented randomly either without an aroma, or with aromas presented below or near the detection threshold. Results Results for ten subjects (four females and six males, aged between 26 and 50 years, indicated that aroma intensity affected the size of the corresponding bite as well as that of subsequent bites. Higher aroma intensities resulted in significantly smaller sizes. Conclusions These results suggest that bite size control during eating is a highly dynamic process affected by the sensations experienced during the current and previous bites.

  12. Describing the relationship between cat bites and human depression using data from an electronic health record.

    Directory of Open Access Journals (Sweden)

    David A Hanauer

    Full Text Available Data mining approaches have been increasingly applied to the electronic health record and have led to the discovery of numerous clinical associations. Recent data mining studies have suggested a potential association between cat bites and human depression. To explore this possible association in more detail we first used administrative diagnosis codes to identify patients with either depression or bites, drawn from a population of 1.3 million patients. We then conducted a manual chart review in the electronic health record of all patients with a code for a bite to accurately determine which were from cats or dogs. Overall there were 750 patients with cat bites, 1,108 with dog bites, and approximately 117,000 patients with depression. Depression was found in 41.3% of patients with cat bites and 28.7% of those with dog bites. Furthermore, 85.5% of those with both cat bites and depression were women, compared to 64.5% of those with dog bites and depression. The probability of a woman being diagnosed with depression at some point in her life if she presented to our health system with a cat bite was 47.0%, compared to 24.2% of men presenting with a similar bite. The high proportion of depression in patients who had cat bites, especially among women, suggests that screening for depression could be appropriate in patients who present to a clinical provider with a cat bite. Additionally, while no causative link is known to explain this association, there is growing evidence to suggest that the relationship between cats and human mental illness, such as depression, warrants further investigation.

  13. Myocarditis following katipo spider bite.

    Science.gov (United States)

    Crook, Ruth; Harrison, Nigel; Gibbons, Derek

    2010-05-14

    We report the case of a 22-year-old man who developed severe myocarditis following a presumed katipo spider bite. Katipo spiders are thought to be one of the most poisonous native creatures in New Zealand. No deaths from katipo spider bites have been reported since the 19th Century. A literature search reveals no previously reported cases of myocarditis following a bite from a katipo spider. The clinical presentation of latrodectism is discussed.

  14. [Arthropod bite reactions and pyodermias].

    Science.gov (United States)

    Hengge, U R

    2008-08-01

    Tourists in the tropics often develop reactions to bites or stings of mosquitoes, fleas, mites, ants, bedbugs, beetles, larva, millipedes, spiders and scorpions. In addition, they may have fresh or salt water exposure to sponges, corals, jellyfish and sea urchins with resultant injury and inflammation. Bacterial skin infections (pyodermias) can follow bites or stings as well as mechanical trauma. The most common bacteria involved in skin infections are staphylococci and streptococci. For tourists, bacterial infections are often complicating a pruritic bite reaction and scratching. It is important to know the cause of the bite reaction and pyoderma in order to take appropriate therapeutic measures.

  15. A comparison of the ratio of patient's height to thyromental distance with the modified Mallampati and the upper lip bite test in predicting difficult laryngoscopy.

    Science.gov (United States)

    Safavi, Mohammadreza; Honarmand, Azim; Zare, Narges

    2011-07-01

    THE AIM OF THE PRESENT STUDY WAS TO COMPARE THE ABILITY TO PREDICT DIFFICULT VISUALIZATION OF THE LARYNX FROM THE FOLLOWING PREOPERATIVE AIRWAY PREDICTIVE INDICES, IN ISOLATION AND COMBINATION: modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD) and the Upper-Lip-Bite test (ULBT). We collected data on 603 consecutive patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation and then evaluated all three factors before surgery. An experienced anesthesiologist, not informed of the recorded preoperative airway evaluation, performed the laryngoscopy and grading (as per Cormack and Lehane's classification). Sensitivity, specificity, and positive and negative predictive value, Receiver operating characteristic (ROC) Curve and the area under ROC curve (AUC) for each airway predictor in isolation and in combination were determined. Difficult laryngoscopy (Grade 3 or 4) occurred in 41 (6.8%) patients. The main endpoint of the present study, the AUC of the ROC, was significantly lower for the MMT (AUC, 0.511; 95% CI, 0.470-0.552) than the ULBT (AUC, 0.709; 95% CI, 0.671-0.745, P=0.002) and the RHTMD score (AUC, 0.711; 95% CI, 0.673-0.747, P=0.001). There was no significant difference between the AUC of the ROC for the ULBT and the RHTMD score. By using discrimination analysis, the optimal cutoff point for the RHTMD for predicting difficult laryngoscopy was 21.06 (sensitivity, 75.6%; specificity, 58.5%). The RHTMD is comparable with ULBT for prediction of difficult laryngoscopy in general population.

  16. The impact of snake bite on household economy in Bangladesh.

    Science.gov (United States)

    Hasan, S M K; Basher, A; Molla, A A; Sultana, N K; Faiz, M A

    2012-01-01

    The present study aims to assess the different types of costs for treatment of snake bite patients, to quantify household economic impact and to understand the coping mechanisms required to cover the costs for snake bite patients in Bangladesh. The patients admitted to four tertiary level hospitals in Bangladesh were interviewed using structured questionnaires including health-care-related expenditures and the way in which the expenditures were covered. Of the snakes which bit the patients, 54.2% were non-venomous, 45.8% were venomous and 42.2% of the patients were given polyvalent antivenom. The total expenditure related to snake bite varies from US$4 (US$1 = Taka 72) to US$2294 with a mean of US$124 and the mean income loss was US$93. Expenditure for venomous snake bite was US$231, which is about seven times higher than non-venomous snake bite (US$34). The treatment imposes a major economic burden on affected families, especially in venomous snake bite cases.

  17. Take an Adventure Bite

    Directory of Open Access Journals (Sweden)

    Brian Brandt

    2013-06-01

    Full Text Available The Adventure Bites - Cooking with Kids program enhanced nutrition curriculum by including a Life Skill development focus and a family night - to improve youth nutrition behaviors. The data was collected using the WSU 4-H Life Skills pre-post youth evaluations, staff surveys, a parent retrospective pre-post survey, and comparison data from non-program sites. The results support adding Life Skills and family night events into youth nutrition curricula. There are opportunities to improve evaluation and do further testing, to determine what the individual impact of Life Skill development and/or individual impact of having family nights had on changes in youth behaviors regarding nutrition.

  18. A Case of Cardboard Boxes Likely Facilitating the Biting of a Patient by Trypanosoma cruzi-Infected Triatomine Bugs

    Science.gov (United States)

    Dolhun, Eduardo P.; Antes, Andrew W.

    2016-01-01

    Chagas disease is a vector-borne and potentially fatal parasitic disease that is transmitted by the triatomine bug, a nocturnal feeding, flying arthropod, often referred to by its colloquial name, the “kissing bug.” Vector-borne transmission is considered the most important means of spreading Chagas disease in endemic and nonendemic areas. Corrugated cardboard boxes may accelerate the spread of these insect vectors to nonendemic areas through their ability to harbor and transport small terrestrial arthropods such as silverfish, termites, and cockroaches. We report the case of a patient living in northern California who presented to a community clinic 6 weeks after being bitten by a positively identified triatomine bug. A local pest control company identified a total of eight adult Triatoma protracta, nine nymphs, and two eggs; all within the patient's bedding. No bugs were found outside of the patient's bedroom. The Centers for Disease Control and Prevention confirmed one adult female was positive for Trypanosoma cruzi via polymerase chain reaction. The patient's bedroom doubled as an office and regularly received and stored corrugated cardboard shipping boxes. Corrugated cardboard boxes have been used to trap and study the triatomine bug. This is the first documented case that provides circumstantial evidence that corrugated cardboard boxes may be an inadvertent and unrecognized factor in the spread of Chagas disease. PMID:27601526

  19. Dilemmas in Treatment of Recurrent Recalcitrant Dental Anterior Open Bite.

    Science.gov (United States)

    Palencar, Adrian J

    2016-01-01

    An anterior open bite is one of the most difficult occlusal abnormalities to treat. Quite often this aberration entails dental component and/or skeletal component. The skeletal open bite will require intrusion of the posterior sextants with the assistance of bite blocks, temporary anchorage devices, high pull headgear, and as a last resort - orthognathic surgery. The orthodontic treatment should be augmented with the orofacial myofunctional therapy. In this article, the author describes 3 different variations of treatment of the dental anterior open bite, first on acrylic models, and then on the actual patients. Consideration should be given to patients with a 'short upper lip," and in this case, surgical correction should be entertained.

  20. Esthetic correction in open bite

    Directory of Open Access Journals (Sweden)

    Swapnil Parlani

    2011-01-01

    Full Text Available Deleterious oral habits, which are persistent, can lead to poor esthetics of a beautiful face. Conventional treatment modalities for an open bite usually include orthodontic treatment and/or skeletal surgery. This article focuses on a different treatment modality for an anterior open bite.

  1. Funnel-web spider bite

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002844.htm Funnel-web spider bite To use the sharing features on this ... effects of a bite from the funnel-web spider. Male funnel-web spiders are more poisonous than females. This article ...

  2. Function and structure of the deep cervical extensor muscles in patients with neck pain.

    Science.gov (United States)

    Schomacher, Jochen; Falla, Deborah

    2013-10-01

    The deep cervical extensors are anatomically able to control segmental movements of the cervical spine in concert with the deep cervical flexors. Several investigations have confirmed changes in cervical flexor muscle control in patients with neck pain and as a result, effective evidence-based therapeutic exercises have been developed to address such dysfunctions. However, knowledge on how the deep extensor muscles behave in patients with neck pain disorders is scare. Structural changes such as higher concentration of fat within the muscle, variable cross-sectional area and higher proportions of type II fibres have been observed in the deep cervical extensors of patients with neck pain compared to healthy controls. These findings suggest that the behaviour of the deep extensors may be altered in patients with neck pain. Consistent with this hypothesis, a recent series of studies confirm that patients display reduced activation of the deep cervical extensors as well as less defined activation patterns. This article provides an overview of the various different structural and functional changes in the deep neck extensor muscles documented in patients with neck pain. Relevant recommendations for the management of muscle dysfunction in patients with neck pain are presented.

  3. Increasing infection rate in multiple implanted pulse generator changes in movement disorder patients treated with deep brain stimulation

    DEFF Research Database (Denmark)

    Thrane, Jens F; Sunde, Niels A; Bergholt, Bo

    2014-01-01

    Increasing infection rate in multiple implanted pulse generator changes in movement disorder patients treated with deep brain stimulation......Increasing infection rate in multiple implanted pulse generator changes in movement disorder patients treated with deep brain stimulation...

  4. [Clinically non-symptomatic pulmonary embolism in patients with deep vein thrombosis of the lower limb].

    Science.gov (United States)

    Janica, Jacek Robert; Kordecki, Kazimierz; Jurgilewicz, Dorota; Polaków, Jerzy; Budlewski, Tadeusz; Walecki, Jerzy; Pepiński, Witold

    2002-06-01

    The pulmonary embolism (PE) is the common and severe complication of the deep vein thrombosis of the lower limbs. The lack of accurate diagnosis of PE is a cause of 5-10% of the hospital deaths. The aim of the study was to assess the incidence of the pulmonary embolism in patients with the deep vein thrombosis of the lower limbs with no clinical symptoms of pulmonary embolism. Pulmonary perfusion scintigraphy was performed in 25 patients with angiographic findings confirmative to the deep vein thrombosis of the lower limbs. The results of the study were analysed according to the PIOPED criteria. In the group of patients with common thrombosis of the deep vein a high probability of lung embolism was assessed in 70%, medium and low by 12% in each group, and very low in 6%. In the group of patients with femoral thrombosis of the deep vein a high probability of lung embolism was assessed in 60%, medium in 20% and very low in 20%. In the group of patients with calf thrombosis of the deep vein high, medium and very low probability of lung embolism was assessed by 25% in each group. Results of this study indicate the need of searching the pulmonary embolism in patients with thrombosis of the deep vein of the lower limbs despite the lack of clinical symptoms of the pulmonary embolism.

  5. New Mexico rattlesnake bites: demographic review and guidelines for treatment.

    Science.gov (United States)

    Downey, D J; Omer, G E; Moneim, M S

    1991-10-01

    The demographic features, treatment, and outcome of 36 rattlesnake envenomation cases are reviewed. Two populations at special risk are identified: (1) young children (12/36) who sustain lower extremity bites, and (2) adults who consume alcohol and handle snakes (10/36) who sustain upper extremity bites. Antivenin was used in 22 cases with only one serious case of serum sickness. Three definite diagnoses of compartment syndrome were made on the basis of elevated compartment pressures. Hand bites accounted for 20 of the 36 cases. The greatest functional disability followed digit bites in that 11 patients developed decreased motion and sensation. The indications for fasciotomy and debridement are discussed, both for digit and non-digit envenomations. General treatment recommendations are given.

  6. Tissue factor pathway inhibitor relates to fibrin degradation in patients with acute deep venous thrombosis

    DEFF Research Database (Denmark)

    Sidelmann, Johannes J; Bladbjerg, Else-Marie; Gram, Jørgen

    2008-01-01

    Reduced concentration of tissue factor pathway inhibitor is a risk factor for development of deep venous thrombosis, whereas elevated concentrations of tissue factor pathway inhibitor are observed in patients with acute myocardial infarction and disseminated intravascular coagulation. Presently, we...... studied the association between inflammation, endothelial cell perturbation, fibrin degradation and the concentration of tissue factor pathway inhibitor in patients suspected for acute deep venous thrombosis. We determined the tissue factor pathway inhibitor -33T/C polymorphism, free and total tissue...... factor pathway inhibitor, C-reactive protein, von Willebrand factor and D-Dimer in 160 consecutive patients admitted to hospital with a tentative diagnosis of acute deep venous thrombosis. Deep venous thrombosis was identified in 57 patients (18 distal and 39 proximal). The distribution of the tissue...

  7. Relationship between Neutrophil-to-Lymphocyte Ratio and Prognosis in Patients with Deep Neck Space Infection

    Directory of Open Access Journals (Sweden)

    Engin Şengül

    2016-03-01

    Full Text Available Objective: The aim of this study was to demonstrate if there is any relation between the neutrophil-to-lym­phocyte ratio and prognosis in patients with deep neck space infections Methods: One hundred eight patients who were interned and treated due to deep neck infection in department of otolaryngology between January 2010 and January 2015 were analyzed. Demographics, clini­cal data, complications and treatment results of patients were evaluated. Pediatric patients between the age of 0 and 14, the patients who had only peritonsillary abscess, infection secondary to trauma were excluded from study. During follow-up and treatment duration the patients with deep neck infections were divided into two groups ac­cording to whether they had any complication (group 1 or not (group 2. Results: Fourteen (13% patients with deep neck in­fections had life-threatening complications whereas 94 (87% did not have any complication during follow-up and treatment duration. The mean neutrophil-to-lymphocyte ratio in patients with complications was significantly high­er than the patients without any complications (p0.05. Conclusion: This study showed that the neutrophil-to-lymphocyte ratio can be used as a cheap, easily obtained and predictive prognostic factor in patients with deep neck infections.

  8. Relative Risk of Deep Vein Thrombosis in Very Elderly Patients Compared With Elderly Patients.

    Science.gov (United States)

    Yayan, Josef; Bals, Robert

    2016-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism are major causes of morbidity and mortality in patients during hospitalization; previous studies have proposed that an advanced age of more than 60 years is a risk factor for these conditions. This study analyzes the relative risk of DVT in very elderly patients older than 90 years of age compared with elderly patients aged 80 to 89 years. The study was performed at the Department of Internal Medicine, University Hospital of Saarland, Homburg/Saar, Germany, between 2004 and 2012. After completing ultrasound examinations, 20 (64.52%, 12 [60%] female patients, mean age 91.8 ± 1.83 years) of the 31 patients in the study group and 132 (62.26%, 87 [65.91%] female patients, mean age 83.84 ± 2.66 years) of the 212 patients in the control group were diagnosed with DVT. An increased relative risk of DVT was not discovered in the very elderly patients (relative risk, 1.04; P = .80).

  9. OCULAR MANIFESTATION AND LONG STANDING VISUAL IMPAIRMENT FOLLOWING VENOMOUS SNAKE BITE

    Directory of Open Access Journals (Sweden)

    Somnath

    2015-06-01

    Full Text Available OBJECTIVE : Snake bite is an environmental hazard associated with significant ocular morbidity and some have sight threatening complications . Objective of this study was to determine the ocular manifestations and long standing visual impairment fo llowing snake bite and to acquaint the ophthalmologists and related health professionals about the sight threatening ocular complications related to snake bite . METHODS : Prospective data was collected from the Dept . of Internal Medicine , Burdwan Medical Co llege , a rural based tertiary care hospital in eastern India . All snake bite patients admitted in the Department of Internal Medicine were examined and all patients with ocular manifestations were included in the study . RESULTS : Out of 245 cases of snake b ite , 51 ( 27 . 27% cases of venomous snake bite with ocular findings were included in this study . Thirty three ( 64 . 71% out of 51 were vasculotoxic and 18 ( 35 . 29% were neurotoxic in nature . Commonest ocular manifestation of neurotoxic bite was ptosis , followed by diplopia , ophthalmoplegia and optic neuritis . In vasculotoxic snake bites retinal and vitreous hemorrhage ( 36 . 36% was most common followed by subconjunctival hemorrhage and chemosis ( 27 . 28% , lid oedema ( 18 . 18% , hyphaema ( 12 . 12% and anterior uveitis ( 6 . 06% . Causes of long standing visual impairment were retinal hemorrhage in one patient and vitreous hemorrhage in two patients . CONCLUSIONS : Ocular morbidity following snake bite were more common among young males . Majority of long standing vis ual impairment were associated with vasculotoxic snake bite and required long term follow - up .

  10. Predictive value of upper lip bite test and ratio of height to thyromental distance compared to other multivariate airway assessment tests for difficult laryngoscopy in apparently normal patients

    OpenAIRE

    Pratibha Jain Shah; Kamta Prasad Dubey; Jai Prakash Yadav

    2013-01-01

    Background: Various anatomical measurements and non-invasive clinical tests, singly or in various combinations can be performed to predict difficult intubation. Recently introduced "Upper lip bite test" (ULBT) and "Ratio of height to Thyromental distance" (RHTMD) are claimed to have high predictability. We conducted a study to compare the Predictive Value of ULBT and RHTMD with Mouth opening (Inter-Incisor gap) (IIG), Modified Mallampatti Test (MMT), Head and neck movement (HNM) and Thyroment...

  11. TheraBite exercises to treat trismus secondary to head and neck cancer

    NARCIS (Netherlands)

    Kamstra, Jolanda I.; Roodenburg, Jan L. N.; Beurskens, Carien H. G.; Reintsema, Harry; Dijkstra, Pieter U.

    2013-01-01

    The aim of this study was to evaluate the effect of TheraBite exercises on mouth opening and to analyze factors influencing this effect in a patient record evaluation. Effect of exercises with a TheraBite to treat trismus was evaluated in 69 head and neck cancer patients of two university medical ce

  12. TheraBite exercises to treat trismus secondary to head and neck cancer

    NARCIS (Netherlands)

    Kamstra, Jolanda I.; Roodenburg, Jan L. N.; Beurskens, Carien H. G.; Reintsema, Harry; Dijkstra, Pieter U.

    The aim of this study was to evaluate the effect of TheraBite exercises on mouth opening and to analyze factors influencing this effect in a patient record evaluation. Effect of exercises with a TheraBite to treat trismus was evaluated in 69 head and neck cancer patients of two university medical

  13. TheraBite exercises to treat trismus secondary to head and neck cancer

    NARCIS (Netherlands)

    Kamstra, Jolanda I.; Roodenburg, Jan L. N.; Beurskens, Carien H. G.; Reintsema, Harry; Dijkstra, Pieter U.

    2013-01-01

    The aim of this study was to evaluate the effect of TheraBite exercises on mouth opening and to analyze factors influencing this effect in a patient record evaluation. Effect of exercises with a TheraBite to treat trismus was evaluated in 69 head and neck cancer patients of two university medical ce

  14. The Crown Bite Jumping Herbst.

    Science.gov (United States)

    Owen, Reuel

    2003-01-01

    The Crown Bite Jumping Herbst Appliance is evaluated and combined with Straight Wire Arch Fixed Orthodontics in treatment of Class II, Division I malocclusions. This article will evaluate a combined orthodontic approach of "straightening teeth" and an orthognathic approach of "moving jaws or making skeletal changes." Orthodontic treatment cannot be accomplished well without establishing a healthy temporomandibular joint. This is defined by Keller as a joint that is "noiseless, painless and has a normal range of motion without deviation and deflection." It is not prudent to separate orthodontic treatment as its own entity without being aware of the changes in the temporomandibular joint before, during and after treatment. In other words, "If you're doing orthodontics you're doing TMJ treatment." One should treat toward a healthy, beautiful face asking, "Will proposed treatment achieve this goal?" Treatment should be able to be carried out in an efficient manner, minimizing treatment time, be comfortable and affordable for the patient, and profitable for the dentist. The finished treatment should meet Andrews' Six Keys of Occlusion, or Loudon's Twelve Commandments. Above all, do no harm to the patient. We think that a specific treatment plan can embrace these tenets. The focus will be to show Class II treatment using a modified Herbst Appliance and fixed straight wire orthodontics.

  15. Animal Bites of the Hand

    Science.gov (United States)

    ... your bite may be infected include: Swelling Redness Warmth Continued pain beyond 24 hours Drainage from the wound Signs that your infection may be spreading include: Red streaks up the arm or forearm Swollen glands ...

  16. Ticks and Diseases: Bite Fright!

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Ticks and Diseases Bite Fright! Past Issues / Spring - Summer ... can bring on serious health problems. What Are Ticks? If you spend any time outdoors, you've ...

  17. Suspected dog bite associated HIV horizontal transmission in Swaziland

    Directory of Open Access Journals (Sweden)

    Ganizani Mlawanda

    2013-01-01

    Full Text Available Background: Dog bites may lead to transmission of bacteria and viruses over and above tetanus and rabies. Theoretically human immunodeficiency virus (HIV, Hepatitis B and Hepatitis C may be transmitted after dog bites where transfer of blood from one victim to another occur in clinical practice HIV, Hepatitis B and Hepatitis C are not considered when making treatment decisions, nor adequate patient history taken to consider all potential risks after dog bites in succession.Objective: To present case of suspected HIV transmission after dog bites in close succession involving two HIV sero-discordant victims.Management and outcome: HIV rapid test and/or HIV Ribonucleic acid (RNA polymerasechain reaction (PCR results for the victim(s at presentation and a month later.Results: Two night patrol guards presented to casualty after dog bites in close succession by the same dog. They were managed according to the dog bite protocol. Thinking out of the box, the first victim was found to be HIV positive by rapid test whilst the second victim was negative based on both HIV rapid test and HIV RNA PCR. One month after the dogbites, a case of HIV sero-conversion was confirmed in the second victim despite post-exposure prophylaxis (PEP.Discussion: Although an isolated case, shouldn’t clinicians re-think the significance of HIV transmission after animal bites where there is repeated blood exposure in several people insuccession?Conclusion: Clinicians should be aware of the potential of HIV, Hepatitis B and C transmission, when faced with dog bites in succession. 

  18. Prevalence of deep vein thrombosis in patients with paraplegia caused by traumas

    Directory of Open Access Journals (Sweden)

    Nelson Mesquita Junior

    2013-12-01

    Full Text Available BACKGROUND: Deep vein thrombosis is a common disease among people who are immobilized. Immobility is inherent to paraplegia and leads to venous stasis, which is one of the factors covered by Virchow's triad describing its development. Trauma is the primary cause of paraplegia and is currently increasing at a rate of 4% per year. OBJECTIVE: To determine the prevalence of deep vein thrombosis in paraplegic patients whose paraplegia was caused by traumas, using color Doppler ultrasonography for diagnosis. METHODS: This was a cross-sectional observational study of 30 trauma-induced paraplegia patients, selected after analysis of medical records at the neurosurgery department of a University Hospital in Curitiba, Brazil, and by a proactive survey of associations that care for the physically disabled. The prevalence of deep vein thrombosis was analyzed using 95% confidence intervals. RESULTS: Spinal cord trauma was the cause of paraplegia in 29 patients. The most common cause of trauma was gunshot wounding, reported by 17 patients. Deep vein thrombosis was diagnosed by color Doppler ultrasonography in 14 patients in the sample. The most often affected vein was the posterior tibial, in 11 patients. The left lower limb was involved three times more often than the right. Edema was observed in 25 individuals, cyanosis in 14, ulcers in 8 and localized increase in temperature in 13. CONCLUSIONS: Deep vein thrombosis was prevalent, occurring in 46.7% of the patients.

  19. Epidemiological aspects of snake bites on a Liberian rubber plantation.

    Science.gov (United States)

    Stahel, E

    1980-12-01

    During a one-year period 95 patients with a history of snake bite were admitted to the hospital of a Liberian rubber plantation. The population at risk included the field workers (tappers and slashers) with an incidence of 4.2 symptomatic snake bites per thousand per year. The incidence of symptomatic bites was 1.7 per thousand in the group of non-field employees and 0.4 per thousand per year in the group of non-employees. The temporary disability was between 3 and 5 days, and the loss of workings days due to snake bites was one day per 10,000 working days on the plantation. Among the 95 patients 27 did not show any symptoms of envenoming except occasional fang marks. 64 patients developed cytotoxic symptoms alone. In this group, the night adder (Causus maculatus) was the main responsible snake. 4 patients showed signs of systemic envenoming. Two were haematological and two were neurological in nature and caused by Bitis species and Naja species, respectively. No fatalities were noted. A definite maximum of snake bites was observed during October and November which corresponds to the transition from rainy to dry season.

  20. Bite through the tent.

    Science.gov (United States)

    Naue, Jana; Lutz-Bonengel, Sabine; Pietsch, Klaus; Sänger, Timo; Schlauderer, Nicola; Schmidt, Ulrike

    2012-05-01

    The authors report on a young boy who was bitten into his face by an unknown animal while being asleep in a tent. Given the bite marks and the location of the scene, members of the mustelidae and canidae families were the first "suspects." Deoxyribunucleic acid (DNA) recovered from the tent's wall was analyzed with regard to parts of the mitochondrial 12S ribosomal ribunucleic acid (12S rRNA) and cytochrome b (cytb) genes as well as nuclear short tandem repeats (STRs). Since Sanger sequencing revealed a mixed sequence with a strong human component overlying the nonhuman contributor, an animal screening using a duplex real-time polymerase chain reaction (PCR) with an intercalating dye and melt curve analysis was employed. The results were later confirmed by cloning. The applied commercial canine STR kit verified the animal family (canidae) but did not help in discriminating the species due to cross-species amplification. In the presented case, the real-time PCR assay offered the cheapest and fastest method for animal family determination, which then allowed for an appropriate and sample-saving strategy to characterize the causative animal species.

  1. "Spider bite" lesions are usually diagnosed as skin and soft-tissue infections.

    Science.gov (United States)

    Suchard, Jeffrey Ross

    2011-11-01

    Many people seek medical attention for skin lesions and other conditions they attribute to spider bites. Prior experience suggests that many of these lesions have alternate causes, especially infections with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). This study determined the percentage of emergency department (ED) patients reporting a "spider bite" who received a clinical diagnosis of spider bite by their physician vs. other etiologies, and if the diagnoses correlated with demographic risk factors for developing CA-MRSA infections. ED patients who reported that their condition was caused by a "spider bite" were prospectively enrolled in an anonymous, voluntary survey regarding details of their illness and demographic information. Discharge diagnoses were also collected and categorized as: spider bite, bite from other animal (including unknown arthropod), infection, or other diagnosis. There were 182 patients enrolled over 23 months. Seven patients (3.8%) were diagnosed with actual spider bites, 9 patients (4.9%) with bites from other animals, 156 patients (85.7%) with infections, and 6 patients (3.3%) were given other diagnoses. Four patients were given concurrent diagnoses in two categories, and 8 (4.4%) did not have the diagnosis recorded on the data collection instrument. No statistically significant associations were found between the patients' diagnostic categories and the demographic risk factors for CA-MRSA assessed. ED patients reporting a "spider bite" were most frequently diagnosed with skin and soft-tissue infections. Clinically confirmed spider bites were rare, and were caused by black widow spiders when the species could be identified. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Primary Iliac Venous Leiomyosarcoma: A Rare Cause of Deep Vein Thrombosis in a Young Patient

    Directory of Open Access Journals (Sweden)

    Nelson Oliveira

    2011-01-01

    Full Text Available Introduction. Primary venous tumours are a rare cause of deep vein thrombosis. The authors present a case where the definitive diagnosis was delayed by inconclusive complementary imaging. Clinical Case. A thirty-seven-year-old female presented with an iliofemoral venous thrombosis of the right lower limb. The patient had presented with an episode of femoral-popliteal vein thrombosis five months before and was currently under anticoagulation. Phlegmasia alba dolens installed progressively, as thrombus rapidly extended to the inferior vena cava despite systemic thrombolysis and anticoagulation. Diagnostic imaging failed to identify the underlying aetiology of the deep vein thrombosis. The definitive diagnosis of primary venous leiomyosarcoma was reached by a subcutaneous abdominal wall nodule biopsy. Conclusion. Primary venous leiomyosarcoma of the iliac vein is a rare cause of deep vein thrombosis, which must be considered in young patients with recurrent or refractory to treatment deep vein thrombosis.

  3. Primary iliac venous leiomyosarcoma: a rare cause of deep vein thrombosis in a young patient.

    Science.gov (United States)

    Oliveira, Nelson; Dias, Emanuel; Lima, Ricardo; Oliveira, Fernando; Cássio, Isabel

    2011-01-01

    Introduction. Primary venous tumours are a rare cause of deep vein thrombosis. The authors present a case where the definitive diagnosis was delayed by inconclusive complementary imaging. Clinical Case. A thirty-seven-year-old female presented with an iliofemoral venous thrombosis of the right lower limb. The patient had presented with an episode of femoral-popliteal vein thrombosis five months before and was currently under anticoagulation. Phlegmasia alba dolens installed progressively, as thrombus rapidly extended to the inferior vena cava despite systemic thrombolysis and anticoagulation. Diagnostic imaging failed to identify the underlying aetiology of the deep vein thrombosis. The definitive diagnosis of primary venous leiomyosarcoma was reached by a subcutaneous abdominal wall nodule biopsy. Conclusion. Primary venous leiomyosarcoma of the iliac vein is a rare cause of deep vein thrombosis, which must be considered in young patients with recurrent or refractory to treatment deep vein thrombosis.

  4. Mortality following snake bite envenomation by Bitis arietans in an HIV positive child: A case report.

    Science.gov (United States)

    Firth, Gregory B; Street, Matthew; Ramguthy, Yammesh; Doedens, Linda

    2016-07-01

    Snake bites occur commonly in the rural areas of South Africa. Hospitals where snake bites are uncommon should always have protocols on standby in the event of such cases presenting. This is the first reported case documenting the effect of human immunodeficiency virus (HIV) on snake bite in South African children.A case report and review of relevant information about the case was undertaken.We present a case of a 1-year-old child referred from a peripheral hospital following a snake bite to the left upper limb with a compartment syndrome and features of cytotoxic envenomation. The patient presented late with a wide area of necrotic skin on the arm requiring extensive debridement. The underlying muscle was not necrotic. Polyvalent antivenom (South African Institute of Medical Research Polyvalent Snakebite Antiserum) administration was delayed by 4 days after the snake bite. The patient was also diagnosed with HIV and a persistent thrombocytopenia possibly due to both HIV infection and the snake bite venom. Lower respiratory tract infections with subsequent overwhelming sepsis ultimately resulted in the child's death.The case highlights the challenge of treating a snake bite in a young child with HIV and the detrimental outcome of delayed treatment. A protocol is essential in the management of snake bites in all hospitals.Level IV, Case report.This case highlights the interaction of snake bite envenomation and HIV infection on thrombocytopenia.

  5. Mortality following snake bite envenomation by Bitis arietans in an HIV positive child

    Science.gov (United States)

    Firth, Gregory B.; Street, Matthew; Ramguthy, Yammesh; Doedens, Linda

    2016-01-01

    Abstract Snake bites occur commonly in the rural areas of South Africa. Hospitals where snake bites are uncommon should always have protocols on standby in the event of such cases presenting. This is the first reported case documenting the effect of human immunodeficiency virus (HIV) on snake bite in South African children. A case report and review of relevant information about the case was undertaken. We present a case of a 1-year-old child referred from a peripheral hospital following a snake bite to the left upper limb with a compartment syndrome and features of cytotoxic envenomation. The patient presented late with a wide area of necrotic skin on the arm requiring extensive debridement. The underlying muscle was not necrotic. Polyvalent antivenom (South African Institute of Medical Research Polyvalent Snakebite Antiserum) administration was delayed by 4 days after the snake bite. The patient was also diagnosed with HIV and a persistent thrombocytopenia possibly due to both HIV infection and the snake bite venom. Lower respiratory tract infections with subsequent overwhelming sepsis ultimately resulted in the child's death. The case highlights the challenge of treating a snake bite in a young child with HIV and the detrimental outcome of delayed treatment. A protocol is essential in the management of snake bites in all hospitals. Level IV, Case report. This case highlights the interaction of snake bite envenomation and HIV infection on thrombocytopenia. PMID:27399076

  6. Deep Vein Thrombosis in A Post-Coronary Artery Bypass Grafting Patient: Successful Conservative Management.

    Science.gov (United States)

    Sarker, S H; Miraj, A K; Hossain, M A; Aftabuddin, M

    2017-07-01

    Deep vein thrombosis is an alarming medical emergency. Deep vein thrombosis or deep venous thrombosis (DVT) is the formation of a blood clot (thrombus) within a deep vein predominantly in the legs. Post-Coronary Artery Bypass Grafting deep vein thrombosis is a very rare medical condition relatively in Asian. Approximately 80% of deep vein thrombosis (DVTs) is clinically asymptomatic, 20% of those that actually demonstrate signs and symptoms can be easily confused with symptoms of other commonly presenting musculoskeletal disorders. Proper medical management can reduce patient's morbidity and further burden. A 50 years old diabetic Post-Coronary Artery Bypass Grafting gentleman had been suffering for left leg swelling, high grade fever and calf muscle pain for 5 days. He had absent Arteria Dorsalis Paedis pulse on left foot, Positive Homan sign and Wells score is 7. His left leg was hugely swelled. He had normal leg hair distribution. Duplex study of Left Leg-Deep Vein Thrombosis in left lower limb (Popliteal segment) with sign of recanalization. He is also a patient of anemia of chronic disease due to hemorrhoid. Several investigations have done to find the cause of his chronic anemia. His treatment was meticulous with complete bed rest, elevation of left lower limb, heparinization, oralrivaroxaban. He had rapid recovery following treatment. Post-Coronary Artery Bypass Grafting patient should be given post-operative enoxaparin (Low molecular weight Heparin) or Heparin for 3-5 days. Early diagnosis of the disease condition reduces morbidity. Combined treatment with Rivaroxaban and Heparin is of great clinical value and outcome in a case of Post-Coronary Artery Bypass Grafting Deep Vein Thrombosis patient.

  7. Acute generalized exanthematous pustulosis associated with spider bite*

    Science.gov (United States)

    Milman, Laura de Mattos; Müller, Giana Paula; Souza, Paulo Ricardo Martins; Grill, Aline Barcellos; Rhoden, Deise Louise Bohn; Mello-da-Silva, Carlos Augusto; Vettorato, Gerson

    2016-01-01

    Acute generalized exanthematous pustulosis (AGEP) is an acute febrile rash, usually induced by drugs, which recently has been linked to spider bite. We report a case of a male patient, 48 years old, with an erythematous rash accompanied by fever and small non-follicular pustules. He reported previous pain in the buttock with the onset of a necrotic plaque. The lesion was compatible with spider bite of the genus Loxosceles. According to the EuroSCAR group instrument, the patient scored +10 indicating definite diagnosis of AGEP. As the patient had a compatible lesion and had no other triggers of AGEP, in an Loxosceles endemic area, the AGEP would be associated with spider bite, as described in other publications. PMID:27579754

  8. Acute generalized exanthematous pustulosis associated with spider bite.

    Science.gov (United States)

    Milman, Laura de Mattos; Müller, Giana Paula; Souza, Paulo Ricardo Martins; Grill, Aline Barcellos; Rhoden, Deise Louise Bohn; Mello-da-Silva, Carlos Augusto; Vettorato, Gerson

    2016-01-01

    Acute generalized exanthematous pustulosis (AGEP) is an acute febrile rash, usually induced by drugs, which recently has been linked to spider bite. We report a case of a male patient, 48 years old, with an erythematous rash accompanied by fever and small non-follicular pustules. He reported previous pain in the buttock with the onset of a necrotic plaque. The lesion was compatible with spider bite of the genus Loxosceles. According to the EuroSCAR group instrument, the patient scored +10 indicating definite diagnosis of AGEP. As the patient had a compatible lesion and had no other triggers of AGEP, in an Loxosceles endemic area, the AGEP would be associated with spider bite, as described in other publications.

  9. A clinical and epidemiological study on spider bites in Turkey

    Institute of Scientific and Technical Information of China (English)

    Yildirim Cesaretli; Ozcan Ozkan

    2011-01-01

    Objective:To classify and characterize spider bites among inquiries to the National Poison Information Center (NPIC) between1995 and2004, in terms of the epidemiology and clinical symptomatology.Methods: Clinical and epidemiological data were obtained from theNPIC’s patient records. The following information was recorded for each spider bite: demographics, circumstances of the bite, and local and systemic effects.Results: A total of82 cases were reported. The accidents were mostly seen during August. The gender distribution was59.76%male, 37.20% female, and2.44% unknown and the20-29 age group presented more spider bites. Most of the cases were in the Central Anatolia, Marmara, Mediterranean, and Black Sea regions. Local symptoms were observed in60.87% of the cases, including local pain, edema, redness, itching, debris, burning, and numbness. Systemic symptoms were observed such as nausea, vomiting, abdominal pain, lethargy, anxiety, weakness, somnolence, dyspnea, hypertension, hypotension, and hyperthermia.Conclusions: In conclusion, these findings emphasize the presence of medically important spider species in Turkey. All patients and especially pediatric patients should be admitted to the hospital. Identification of spider species may be considered a useful clinical and epidemiological tool in determining the incidence and risk of spider bites.

  10. Investigation on change regulation of blood coagulation function before and after treatment of snake bite patients%凝血功能在毒蛇咬伤治疗前后变化规律的研究

    Institute of Scientific and Technical Information of China (English)

    梁剑宁; 唐荣德; 张跃; 陈森雄; 张冠新; 郭伟文; 曾燕玲

    2015-01-01

    目的:探讨各种毒蛇咬伤患者治疗前后凝血功能的变化规律。方法选择近2年住院治疗、属于何种蛇伤诊断明确的毒蛇咬伤患者226例为研究对象,其中银环蛇咬伤39例,竹叶青蛇咬伤76例,眼镜蛇咬伤47例,眼镜王蛇咬伤24例,蝰蛇咬伤40例。这些患者在治疗前后各时段均进行5项凝血指标检测,按蛇种、时段及病情对检测结果进行统计分析。结果银环蛇咬伤轻症患者与重症患者比较,仅治疗前重症患者D二聚体(D‐D)水平明显高于轻症患者,差异有统计学意义(P<0.05);竹叶青蛇咬伤重症患者治疗前血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、和D‐D水平升高、纤维蛋白原(Fib)水平降低,Fib和D‐D水平在治疗前后与轻症差异有统计学意义(P<0.05);眼镜蛇和眼镜王蛇咬伤患者各项指标在治疗前后差异无统计学意义(P>0.05),仅眼镜蛇咬伤重症患者D‐D水平在治疗前与轻症比较差异有统计学意义(P<0.05);蝰蛇咬伤患者不论轻症或重症5项凝血指标的变化均很大,在治疗前后之间和轻重之间的多项比较差异均有统计学意义(P<0.05)。结论银环蛇、眼镜蛇和眼镜王蛇咬伤对凝血功能影响很少;竹叶青蛇咬伤重症患者可引起较严重的凝血功能异常,但治疗后恢复较快;蝰蛇咬伤可引起极大的凝血功能异常,且治疗后恢复慢。%Objective To explore the change regulation of blood coagulation function before and after treatment of snake bite pa‐tients .Methods A total of 226 hospitalized patients with clear diagnosis belong to what kind of snakes in the past two years were selected in this study ,39 cases were bit by coral ,76 cases were bit by trimeresurus stejnegeri ,47 cases were bit by cobra ,24 cases bit by king cobra ,40 cases were bit by adder .Five blood

  11. KRAS, BRAF, and TP53 deep sequencing for colorectal carcinoma patient diagnostics.

    Science.gov (United States)

    Rechsteiner, Markus; von Teichman, Adriana; Rüschoff, Jan H; Fankhauser, Niklaus; Pestalozzi, Bernhard; Schraml, Peter; Weber, Achim; Wild, Peter; Zimmermann, Dieter; Moch, Holger

    2013-05-01

    In colorectal carcinoma, KRAS (alias Ki-ras) and BRAF mutations have emerged as predictors of resistance to anti-epidermal growth factor receptor antibody treatment and worse patient outcome, respectively. In this study, we aimed to establish a high-throughput deep sequencing workflow according to 454 pyrosequencing technology to cope with the increasing demand for sequence information at medical institutions. A cohort of 81 patients with known KRAS mutation status detected by Sanger sequencing was chosen for deep sequencing. The workflow allowed us to analyze seven amplicons (one BRAF, two KRAS, and four TP53 exons) of nine patients in parallel in one deep sequencing run. Target amplification and variant calling showed reproducible results with input DNA derived from FFPE tissue that ranged from 0.4 to 50 ng with the use of different targets and multiplex identifiers. Equimolar pooling of each amplicon in a deep sequencing run was necessary to counterbalance differences in patient tissue quality. Five BRAF and 49 TP53 mutations with functional consequences were detected. The lowest mutation frequency detected in a patient tumor population was 5% in TP53 exon 5. This low-frequency mutation was successfully verified in a second PCR and deep sequencing run. In summary, our workflow allows us to process 315 targets a week and provides the quality, flexibility, and speed needed to be integrated as standard procedure for mutational analysis in diagnostics.

  12. Determinants of iron accumulation in deep grey matter of multiple sclerosis patients

    DEFF Research Database (Denmark)

    Ropele, Stefan; Kilsdonk, Iris D; Wattjes, Mike P

    2014-01-01

    BACKGROUND: Iron accumulation in deep grey matter (GM) structures is a consistent finding in multiple sclerosis (MS) patients. This study focused on the identification of independent determinants of iron accumulation using R2* mapping. SUBJECTS AND METHODS: Ninety-seven MS patients and 81 healthy...

  13. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... Tips to prevent and treat bug bites Although most bug bites are harmless, some can spread dangerous ... one’s greatest efforts, bug bites still happen. Fortunately, most bug bites and stings can be safely treated ...

  14. [Diagnostic strategy in patients with clinically suspected deep vein thrombosis

    DEFF Research Database (Denmark)

    Mantoni, Margit Yvonne; Kristensen, M.; Brogaard, M.H.;

    2008-01-01

    . MATERIALS AND METHODS: A total of 508 consecutive patients presenting in the emergency room with suspected DVT had D-dimer and DVT-score performed. Patients with non-elevated D-dimer and a low or moderate DVT score received no treatment. The remainder had ultrasound scanning from the groin to the popliteal...

  15. Domestic donkey (Equus africanus asinus bites: An unusual aetiology of severe scalp injuries in Morocco

    Directory of Open Access Journals (Sweden)

    Hatim Droussi

    2014-12-01

    Discussion: The bite of a donkey is rare aetiology of scalp injuries. Special features of these injuries, including a literature review, are discussed focusing on the care of these patients in the emergency centre, describing the surgical procedures required and antibiotic choice. Recommendations for the management of donkey bite scalp injuries are provided.

  16. Treatment of an anterior open bite with the multiloop archwire technique.

    Science.gov (United States)

    Canavarro, Cristiane; Cosendey, Vera Lúcia; Capelli, Jonas

    2009-01-01

    This is a treatment report of a patient with an anterior open bite and predominance of vertical growth. Multiloop edgewise archwire (MEAW) mechanics were used and resulted in an efficient bite closure and good occlusion. For retention, a bonded 3-3 retainer was used in the mandible whereas a wraparound retainer was employed in the maxilla.

  17. Clinical categories of exaggerated skin reactions to mosquito bites and their pathophysiology.

    Science.gov (United States)

    Tatsuno, Kazuki; Fujiyama, Toshiharu; Matsuoka, Hiroyuki; Shimauchi, Takatoshi; Ito, Taisuke; Tokura, Yoshiki

    2016-06-01

    Mosquito bites are skin irritating reactions, which usually resolve spontaneously without intensive medical care. However, in certain situations, mosquito bites may form a more vicious reaction, sometimes accompanying fever and systemic symptoms. In such cases, the presence of rare hematological disorders, abnormalities in eosinophils and/or association with Epstein-Barr virus (EBV) may underlie. Importantly, hypersensitivity to mosquito bites (HMB), which is characterized by necrotic skin reactions to mosquito bites with various systemic symptoms, is often observed in association with EBV infection and natural killer (NK) cell lymphoproliferative disorder. Exaggerated skin reaction to mosquito bites is also seen in Wells' syndrome. While strong Th2-skewing immune dysregulation is apparent in the patients, they also show robust CD4(+) T cell proliferation in response to mosquito salivary gland extracts, indicating close association between Wells' syndrome and mosquito bites. Similar skin reaction to mosquito bites is also noticed in certain types of B cell neoplasm, although the role of B cells in this peculiar reaction to mosquito bites is yet to be elucidated. In this review, we will discuss the current knowledge of exaggerated reaction toward mosquito bites seen in conjunction with these unique hematological disorders, and examine the scientific studies and observations reported in previous literatures to organize our current understanding of the pathogenesis of this distinct disorder.

  18. Deep hypothermic circulatory arrest for hemiarch replacement in a pediatric patient with moyamoya disease.

    Science.gov (United States)

    Kuwajima, Ken; Yoshitani, Kenji; Kato, Shinya; Miyazaki, Atsushi; Kamei, Masataka; Ohnishi, Yoshihiko

    2014-08-01

    Moyamoya disease is a chronic cerebrovascular occlusive disease, occurring predominantly in young populations, that causes cerebral ischemia and hemorrhage. Patients with moyamoya disease are at high risk of neurological complications during cardiac surgery because of perioperative hemodynamic changes. However, there is no established evidence on temperature management during cardiopulmonary bypass. Previous reports described normothermia or mild to moderate hypothermia during cardiopulmonary bypass in patients with moyamoya disease; however, surgical conditions, such as not having enough space to clamp the aorta or a clean surgical field, sometimes force us to use deep hypothermic circuratory arrest. We report a successful case of a pediatric patient with moyamoya disease who underwent deep hypothermic circulatory arrest (18 °C) for hemiarch replacement without neurological complications. Deep hypothermia may be an alternative technique for achieving cerebral protection in the context of moyamoya disease.

  19. Snake bite on scrotum � a case report

    Directory of Open Access Journals (Sweden)

    Anjum Arshad

    2011-10-01

    Full Text Available A 22-year old man was bitten by a snake on his scrotum. This interesting and unusual case occurred in the rural area of District Aligarh, India. The uniqueness of the case lies in the fact that scrotum is an extremely rare and unusual site for snake bite. Further, with negligible local signs of envenoming the patient presented with classical signs of neurotoxicity. Due to numerous superstitions associated with snake bite, the patient was treated with traditional home made ointment before coming to hospital. The authors realized that the case may be brought to the notice of the readers because the scrotal bite by the snake with no local signs of envenomation is the first reported case.

  20. Anaesthetic management of a patient with deep brain stimulation implant for radical nephrectomy

    Directory of Open Access Journals (Sweden)

    Monica Khetarpal

    2014-01-01

    Full Text Available A 63-year-old man with severe Parkinson′s disease (PD who had been implanted with deep brain stimulators into both sides underwent radical nephrectomy under general anaesthesia with standard monitoring. Deep brain stimulation (DBS is an alternative and effective treatment option for severe and refractory PD and other illnesses such as essential tremor and intractable epilepsy. Anaesthesia in the patients with implanted neurostimulator requires special consideration because of the interaction between neurostimulator and the diathermy. The diathermy can damage the brain tissue at the site of electrode. There are no standard guidelines for the anaesthetic management of a patient with DBS electrode in situ posted for surgery.

  1. Deep dermatophyte infection with chronic draining nodules in an immunocompromised patient.

    Science.gov (United States)

    Demidovich, C W; Kornfeld, B W; Gentry, R H; Fitzpatrick, J E

    1995-04-01

    Chronic superficial dermatophyte infection may predispose the immunocompromised patient to invasive or disseminated involvement. We report a case of deep dermatophyte infection in a patient treated with long-term corticosteroid therapy for lung disease. The patient responded well to oral griseofulvin. Previously reported cases are reviewed along with recent investigative findings in the pathogenesis of chronic dermatophyte infections. Recommendations are made for diagnosis and therapy.

  2. A cost-effectiveness analysis of using TheraBite in a preventive exercise program for patients with advanced head and neck cancer treated with concomitant chemo-radiotherapy.

    Science.gov (United States)

    Retèl, Valesca P; van der Molen, Lisette; Steuten, Lotte M G; van den Brekel, Michiel W; Hilgers, Frans J M

    2016-03-01

    Previous studies have shown that a "Preventive Exercise Program" (PREP) is cost-effective compared to the standard exercise program provided in "Usual Care" (UC) in patients with advanced head and neck cancer. The current paper specifically estimates the cost-effectiveness of the TheraBite jaw rehabilitation device (TB) which is used as part of the PREP, compared to Speech Language Pathology (SLP) sessions as part of UC, and herewith intents to inform reimbursement discussions regarding the TheraBite device. Costs and outcomes [quality-adjusted life-years (QALYs)] of the TB compared to SLP were estimated using a Markov model of advanced head and neck cancer patients. Secondary outcome variables were trismus, feeding substitutes, facial pain, and pneumonia. The incremental cost-effectiveness ratio (ICER) was estimated from a health care perspective of the Netherlands, with a time horizon of 2 years. The total health care costs per patient were estimated to amount to €5,129 for the TB strategy and €6,915 for the SLP strategy. Based on the current data, the TB strategy yielded more quality-adjusted life-years (1.28) compared to the SLP strategy (1.24). Thus, the TB strategy seems more effective (+0.04) and less costly (-€1,786) than the SLP only strategy. At the prevailing threshold of €20,000/QALY the probability for the TB strategy being cost-effective compared to SLP was 70 %. To conclude, analysis of presently available data indicates that TB is expected to be cost-effective compared to SLP in a preventive exercise program for concomitant chemo-radiotherapy for advanced head and neck cancer patients.

  3. Injurious tail biting in pigs

    DEFF Research Database (Denmark)

    D'Eath, R.B.; Amott, G.; Turner, S. P.

    2014-01-01

    not allow tail docking at all. Against this background, using a novel approach focusing on research where tail injuries were quantified, we review the measures that can be used to control tail biting in pigs without tail docking. Using this strict criterion, there was good evidence that manipulable...... substrates and feeder space affect damaging tail biting. Only epidemiological evidence was available for effects of temperature and season, and the effect of stocking density was unclear. Studies suggest that group size has little effect, and the effects of nutrition, disease and breed require further...

  4. Assessment of open and incomplete bite correction by incisor overlap and optical density of polyvinyl siloxane bite registration.

    Science.gov (United States)

    Shpack, Nir; Einy, Shmuel; Beni, Lea; Vardimon, Alexander D

    2006-04-01

    Open bite (OB) is a generalized term, which could incorporate subgroups that react differently to vertical correction. The objectives of the present study were to detect vertical treatment changes in incomplete bite (IB: inter-incisor overlap with no lower incisor contact with teeth or palate) and OB (no inter-incisor overlap) groups compared with a complete bite (CB: inter-incisor overlap with full lower incisor contact with teeth or palate) control group, to evaluate treatment response of the central and lateral incisors, and to study the vertico-sagittal interaction. Dental casts were taken at three time points, pre-treatment, post-treatment, and after one year of retention, from 54 Class II patients (22 males and 32 females with a mean age of 11 years 6 months) divided into three groups: CB (n = 21), IB (n = 18) and OB (n = 15). Measurements included incisor overlap (mm) and optical density (OD/mm2) of occlusal bite registration made of polyvinl siloxane. Both CB and IB groups demonstrated post-retention bite opening. However, bite opening in the CB group was three times greater than that in the IB group (e.g. lower lateral = -1.42 mm, 118 OD/mm2 versus -0.40 mm, 107 OD/mm2). Conversely, the OB group showed a significant (P < 0.001) bite closure (e.g. lower lateral = 1.30 mm, -377 OD/mm2). Overjet changes affected OD measurements, causing diversity in OD and millimetric measurements of the lateral incisors in the IB group. In conclusion, the OB group demonstrated a significant stable vertical correction; a post-treatment non-contact inter-incisor relationship was determined by a vertico-sagittal relapse; and full compensation of an IB was not possible.

  5. An unusual complication of snake bite

    Directory of Open Access Journals (Sweden)

    Mary Grace

    2014-01-01

    Full Text Available Anterior pituitary hypofunction is a well-known complication following snake bite. However, central diabetes insipidus as a complication of snake bite is only rarely reported in the literature. We are reporting a case of central diabetes insipidus, which developed as sequelae to viper bite.

  6. Do animals bite more during a full moon? Retrospective observational analysis.

    Science.gov (United States)

    Bhattacharjee, C; Bradley, P; Smith, M; Scally, A J; Wilson, B J

    To test the hypothesis that the incidence of animal bites increases at the time of a full moon. Retrospective observational analysis. Accident and emergency department at a general hospital in an English city. 1621 consecutive patients, irrespective of age and sex. Number of patients who attended an accident and emergency department during 1997 to 1999 after being bitten by an animal. The number of bites in each day was compared with the lunar phase in each month. The incidence of animal bites rose significantly at the time of a full moon. With the period of the full moon as the reference period, the incidence rate ratio of the bites for all other periods of the lunar cycle was significantly lower (P full moon is associated with a significant increase in animal bites to humans.

  7. A short term follow up survey for dog-bite patients with anxiety and depression%犬咬伤患者焦虑和抑郁症状的短期随访研究

    Institute of Scientific and Technical Information of China (English)

    孙达亮; 陈静; 施慎逊; 赵宝龙; 黄美华; 吴国强; 董玄柏; 王菊花

    2012-01-01

    Objective: To explore the chracteristics and correlation factors of the anxiety and depression in dog-bite patients. Method:506 Patients who met with the inclusion criteria were evaluated with the self-rating anxiety scale (SAS) and the self-rating depression scale ( SDS) at the baseline and after 4 week, and the source of dog( domesticated and undomesticated) ,the classification of wound exposure ( I , Ⅱ , ID ) .gender and age will be analyzed to find the relationship with the scores of two scales. Results: Certain proportion of anxie-ty(9. 33% )and depression(2.65% ) symptoms existed among dog-bite patients,and the incidence was significantly different between them( P <0.05). The total SAS and SDS score in dog-bite patients both decreased significantly after 4 week compared with the baseline( P < 0.05). The total SAS and SDS score at baseline showed relationship with female,undomesticated dog and the classification of wound exposure (P<0.05) ,and classification Ⅲof wound exposure showed the most significant relationship( β = 13. 365, P < 0. 05 ). Conclusion: Certain proportion of anxiety and depression symptoms existed among dog-bite patients, which showed regression relationship with female, undomesticated dog and the classification of wound exposure.%目的:探讨犬咬伤患者的焦虑抑郁情绪在短期内的变化特点及其相关因素. 方法:采用纵向研究对符合入组条件的506例犬咬伤患者应用焦虑自评量表(SAS)、抑郁自评量表(SDS)分别在犬咬伤当日和伤后4周测评,分析犬来源(家养和非家养),伤口暴露分级(Ⅰ、Ⅱ、Ⅲ),性别,年龄与总分的关系. 结果:犬咬伤患者在咬伤当日存在一定比例的焦虑(9.33%)和抑郁(2.65%)症状,两者的发生率相比差异有显著性(P<0.05),在咬伤当日和伤后4周再测评前后总分也差异有显著性(P<0.01),咬伤当日量表总分与女性、非家养、伤口暴露分级有关(P<0.05),其中Ⅲ级伤口暴

  8. Clinical experience in the therapy of bites from exotic snakes in Berlin.

    Science.gov (United States)

    Köppel, C; Martens, F

    1992-11-01

    Since there are nearly no indigenous poisonous snakes in Germany, snake bites by poisonous snakes are rare. Most serious snake bites reported to poison information centres or treated at hospitals are caused by exotic snakes that are kept in private households. Only few types of antivenom are stored in emergency depots in Germany including polyvalent antivenoms from commercial sources. Since experience with the treatment of poisonous snake bites is limited, the records of the Intensive Care Unit and the Poison Information Centre of the Universitätsklinikum Rudolf Virchow from 1980-1991 were evaluated. During this period, 51 snake bites were reported. Eleven patients who had been bitten by exotic poisonous snakes were treated in intensive care. In eight of the cases, ethanol (blood levels on admission 1.2-4.2 g-1) had played an important role in the cause of the bite. A moderate to severe local inflammation at the site of the bite followed by oedema and necrosis was typical. One patient developed respiratory failure, probably because of the neurotoxic effects of the snake venom and a compartment syndrome necessitating fasciotomy. Haemolysis was observed in four patients and coagulopathy in six patients. All patients received polyvalent antivenom within 2-12 h of the snake bite. Despite serious coagulopathy in two of the patients and respiratory arrest in one, all survived without sequelae.

  9. Proximal lower limb vein thrombosis following vipera berus hand bite.

    Science.gov (United States)

    Gary, T; Prüller, F; Froehlich, H; Werner, S; Hafner, F; Brodmann, M

    2010-05-01

    Vipera berus has a wide geographical distribution throughout Central and Northern Europe. The symptoms after a bite usually are mild, life threatening symptoms are mainly described in children. We describe a case of popliteal vein thrombosis of the right leg after systemic envenoming with Vipera berus venom after a bite in the right hand by a female Vipera berus in the alpine region of Styria, Austria. Changes of the plasmatic coagulation system were obvious in our patient. These changes were due to an activation of the coagulation system and might be the reason for the thrombotic event in this usually healthy young male person.

  10. Acute generalized exanthematous pustulosis due to insect bites?

    Directory of Open Access Journals (Sweden)

    Yasmeen J Bhat

    2015-01-01

    Full Text Available Acute generalized exanthematous pustulosis is a rare severe cutaneous adverse reaction pattern that is mostly caused by the intake of drugs and rarely associated with viral infections, food allergens or toxins. Here we present the report of three patients who got admitted in our hospital for generalized pustulosis and fever after insect bites. The diagnosis of acute generalized exanthematous pustulosis was made by EuroSCAR scoring. The drug etiology was excluded and spider bite was implicated as the etiological agent in these cases of AGEP which are the first such reported cases in India.

  11. [Snake bite in a 53-year-old female tourist].

    Science.gov (United States)

    Bertheau, S; Aghdassi, A; Otto, M; Hegenscheid, K; Runge, S; Lerch, M M; Simon, P

    2015-02-01

    Snake bites are rare events in Germany and are not life-threatening with usually only mild clinical symptoms. The most widespread venomous snake is the common European adder (Vipera berus). Here we present the case of a 53-year-old woman who was bitten by a common adder. Although the patient was initially in stable condition she developed edematous swelling of the complete lower limb, subcutaneous bleeding, and rhabdomyolysis. The aim of this report is to raise awareness that even in a central European country like Germany snake bites with a life-threatening course can occur and need immediate attention and medical care.

  12. Animal bite injuries to the face : A Case Report.

    Science.gov (United States)

    Simao, Niverso Rodrigues; Borba, Alexandre Meireles; da Silva, Andre Luis Fernandes; Vieira, Evanice Menezes Marcal; Carvalhosa, Artur Aburad; Bandeca, Matheus Coelho; Borges, Alvaro Henrique

    2013-08-01

    Traumatic lacerations to the skin are problems frequently seen and treated by emergency centers around the world. Among all wounds, dog and cat bites are commonly seen. As in many mammals, different species of microorganisms are found in dog and cat mouths with a potential pathological effect to humans, as represented by rabies. The injuries have disfiguration effect with possible psychological repercussion to the patient. This article aimed presenting up to date considerations regarding the management of animal bite injuries to the face, exemplified by a case report that should be the interest of all professions that deal with facial tissues, as dentists do. How to cite this article: Simao NR, Borba AM, da Silva ALF, Vieira EMM, Carvalhosa AA, Bandeca MC, Borges AH. Animal bite injuries to the face: A Case Report. J Int Oral Health 2013; 5(4):68-72.

  13. Segmental Orthodontics for the Correction of Cross Bites

    Science.gov (United States)

    Mathur, Rinku

    2011-01-01

    ABSTRACT Cross bite is a condition where one or more teeth may be abnormally malposed buccally or lingually or labially with reference to the opposing tooth or teeth. Cross bite correction is highly recommended as this kind of malocclusion do not diminish with age. Uncorrected cross bite may lead to abnormal wear of lower anteriors and cuspal interference, mandibular shift resulting in mandibular asymmetry and temporomandibular joint dysfunction syndrome. There are several methods for treating this type of malocclusion. In this article, segmental orthodontics has been highlighted by using 2 × 4 appliance therapy and lingual button with cross elastics. This appliance offers many advantages as it provides complete control of anterior tooth position, is extremely well tolerated, requires no adjustment by the patient and allows accurate and rapid positioning of teeth. PMID:27616858

  14. Cerebellar infarct with neurogenic pulmonary edema following viper bite

    Directory of Open Access Journals (Sweden)

    Salil Gupta

    2012-01-01

    Full Text Available Russell′s viper (Daboia russelli bites are well known to cause bleeding complications. However, thrombotic complications are rare. We present the case details of a female who was bitten by a Russell′s viper (Daboia russelli in her village. She then developed features of envenomation in the form of hemorrhagic episodes. She received 27 vials of polyvalent anti-snake venom to which the hemorrhagic complications responded. After about 48 h of the bite she developed features of cerebellar infarct along with pulmonary edema which was in all probability neurogenic in origin. She was managed with mechanical ventilation and extra ventricular drainage with good recovery. We discuss the likely pathogenesis of the infarct and pulmonary edema occurring in a patient with viper bite and other features of envenomation.

  15. 伴有颞下颌关节紊乱病的女性开《牙合》患者的《牙合》干扰特征分析%Association of skeletal and functional factors with temporomandibular disorders in women patients with open bite

    Institute of Scientific and Technical Information of China (English)

    李江宁

    2009-01-01

    al premature contact may have some relationships with TMD in open bite patients.%是伴有TMD的开患者常见的两种咬合特征.结论 本研究提示开患者中早接触等功能性因素和颞下颌关节病的发病有关.

  16. Risk factors for post-thrombotic syndrome in patients with a first deep venous thrombos

    NARCIS (Netherlands)

    Tick, L.W.; Kramer, M.H.H.; Rosendaal, F.R.; Faber, W.R.; Doggen, C.J.M.

    2008-01-01

    Background: Post-thrombotic syndrome (PTS) is a chronic complication of deep venous thrombosis (DVT). Objectives: To determine the risk of PTS after DVT and to assess risk factors for PTS. Methods: Patients were recruited from the Multiple Environmental and Genetic Assessment (MEGA) study of risk fa

  17. [Tactics of the patients management in continuing acute thrombosis of deep veins].

    Science.gov (United States)

    Prasol, V A; Mishenina, E V; Okley, D V

    2015-03-01

    Experience of active tactics of treatment application in 18 patients, suffering an acute thrombosis in system of lower vena cava, is presented. Possibilities were estimated and efficacy of active surgical tactics proved in continuing deep vein thrombosis on early stage were estimated. Active tactics, using catheter--governed thrombolysis, permits to escape pulmonary thromboembolism and to reduce a severity of further chronic venous insufficiency.

  18. Bites and Scratches (For Parents)

    Science.gov (United States)

    ... small. A child who is bitten by an animal may need antibiotics, a tetanus booster, or rarely, a series of rabies shots. A bite or scratch on a child's face, hand, or foot is ... unfamiliar or wild animal, note the location of the animal. Some animals ...

  19. [Viper (Vipera berus) snake bites].

    Science.gov (United States)

    Valenta, J; Kornalík, F

    2000-07-19

    Cases of snake bites (Vipera berus) have as compared with past years a rising trend in the Czech Republic. This ensues among other factors from a higher prevalence of snakes due to the improving ecological situation. The morbidity of snake bites is of no epidemiological importance, the frequency of snake bites amounts to several tens per year and in some clinically manifest intoxication does not develop. Nevertheless in individual cases, in children weakened subjects, a viper bite may be manifested by a serious and in exceptional instances fatal affection. Within the framework of first aid the authors do not recommend application of a tourniquet or dissecting of the wound because of undesirable potentiation of tissue traumatization. Non-specific treatment involves the administration of corticoids and antihistaminics. Specific immunotherapy, administration of horse antiserum (Ipser Europe, Pasteur Mérieux, France) is indicated only in case of systemic or very severe local symptoms and is associated with the risk of a severe allergic reaction. In case of severe systemic symptoms, symptomatic treatment in a health institution of the appropriate type is of fundamental importance. In all cases observation of the affected subject is recommended to rule out intoxication or the development of possible complications.

  20. Bimanual force coordination in Parkinson's disease patients with bilateral subthalamic deep brain stimulation.

    Directory of Open Access Journals (Sweden)

    Stacey L Gorniak

    Full Text Available OBJECTIVE: Studies of bimanual actions similar to activities of daily living (ADLs are currently lacking in evaluating fine motor control in Parkinson's disease patients implanted with bilateral subthalamic deep brain stimulators. We investigated basic time and force characteristics of a bimanual task that resembles performance of ADLs in a group of bilateral subthalamic deep brain stimulation (DBS patients. METHODS: Patients were evaluated in three different DBS parameter conditions off stimulation, on clinically derived stimulation parameters, and on settings derived from a patient-specific computational model. Model-based parameters were computed as a means to minimize spread of current to non-motor regions of the subthalamic nucleus via Cicerone Deep Brain Stimulation software. Patients were evaluated off parkinsonian medications in each stimulation condition. RESULTS: The data indicate that DBS parameter state does not affect most aspects of fine motor control in ADL-like tasks; however, features such as increased grip force and grip symmetry varied with the stimulation state. In the absence of DBS parameters, patients exhibited significant grip force asymmetry. Overall UPDRS-III and UPDRS-III scores associated with hand function were lower while patients were experiencing clinically-derived or model-based parameters, as compared to the off-stimulation condition. CONCLUSION: While bilateral subthalamic DBS has been shown to alleviate gross motor dysfunction, our results indicate that DBS may not provide the same magnitude of benefit to fine motor coordination.

  1. A nationwide study of Vipera berus bites during one year-epidemiology and morbidity of 231 cases.

    Science.gov (United States)

    Karlson-Stiber, Christine; Salmonson, Heléne; Persson, Hans

    2006-01-01

    To describe clinical course, influence of treatment, and epidemiology of Vipera berus envenomation in a defined population, and to compare the results with those of a similar, nationwide study in 1975. Design. Retrospective case review study. Case records regarding all patients treated in Swedish hospitals during 1995 for bites by the common European adder, V. berus, were studied. A severity grading was applied. Possible dropout was fewer than 10 patients. A total of 231 inpatients were treated for V. berus bites in Sweden in 1995. Children less than 10 years old were overrepresented and there was a slight predominance for males. Maximum severity of envenomation was none in 11%, minor in 47%, moderate in 29%, and severe in 13% of the cases. A few patients with initially minor or moderate symptoms eventually met the criteria of severe envenomation. Less commonly reported features were pulmonary edema, generalized plasma leakage, seizures, deep venous thrombosis, compartment syndrome, numbness and paraesthesia, and myocardial infarction. Treatment included antivenom in 42 patients [ovine Fab in 30 and equine F(ab')2 in 12 cases]. Systemic symptoms resolved during or shortly after the antivenom infusion. Extensive edema involving the trunk occurred in 5% of the cases in 1995, whereas 14% of the patients had extensive swelling in 1975. Incidence and other epidemiological data were similar to those 20 years ago, whereas the clinical course was more benign. It seems reasonable to believe that this is due to the introduction of effective antivenoms.

  2. Comparison of Efficacy Compressive Stockings with Heparin in Prevention of Deep Vein Thrombosis in Stroke Patients

    Directory of Open Access Journals (Sweden)

    Nastaran Majdi-Nasab

    2013-04-01

    Full Text Available Background: The present study is carried out to make a comparison between two pharmacological (heparin and physical (compression stockings in the prevention of deep vein thrombosis in lower limb of the patients suffered from acute stroke. Materials and Methods: In this investigation as a clinical trial, the effectiveness of the above methods on 100 patients with the stroke was compared in two groups of 50 persons. Results: Three patients in physical group and two patients in pharmacological group got deep vein thrombosis that showed no significant difference between two groups.Conclusion: In spite of no significant relationship and due to less incurrence of thrombosis in heparin group, it is more reasonable to use pharmacological methods.

  3. Animal Bites in Borujerd: An Overview of Animal Bites in Iran

    Directory of Open Access Journals (Sweden)

    Sabouri Ghannad

    2014-04-01

    Full Text Available Background Rabies has been reported as the most important endemic zoonotic disease in Iran and still remains as a major public health problem. Objectives The main objective of the current research was to study the epidemiology of animal bites in Borujerd County in Iran and to compare its prevalence to other parts of Iran from April 2006 to September 2011. Patients and Methods The data were recorded in questionnaires and analyzed by SPSS version 16. Chi-square test was performed to evaluate the relationship among variables and P value was set as 0.05. Results Dog bites were the most common (69.8%, followed by cat (17.2%, fox and wolf (1.4%, sheep and cow (2.8%, monkey and donkey (5%, mouse and squirrel (2.2% and other animals (1.6%. Leg was the most common bite site forming 46.6% of cases, followed by hands (41.8%, buttocks (4.6%, head (4% and body (2.9%. Most of the subjects belonged to the age group < 10 (175.2 per 100000 populations. The injury location was associated significantly with sex and the residential status. Conclusions This study strongly highlights a high priority goal for health authorities to develop educational programs, recommended for the general population to inform them about the benefits of continuing the medication. Vaccination of domestic dogs and also eradication of stray ones, in addition to educational programs should be prioritized by health authorities.

  4. Osteomyelitis and septic arthritis of the hand following human bites

    Energy Technology Data Exchange (ETDEWEB)

    Resnick, D.; Kerr, R.; Pineda, C.J.; Weisman, M.H.

    1985-10-01

    The spectrum of radiographic abnormalities accompanying bone and joint infection that results from human bites of the hand is presented in an analysis of 13 patients. Features include mono-articular involvement, predilection for a metacarpophalangeal joint, soft tissue swelling, joint space narrowing, bone erosions and periostitis. Magnification techniques may be required for early and accurate diagnosis. (orig.).

  5. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... Mohs AUC MyDermPath+ Psoriasis Patient education resources Practice Management Center Coding and reimbursement Coding MACRA Fee schedule ... it’s important to take steps to reduce your risk. To help prevent bug bites, dermatologists recommend the ...

  6. Clinical effects of deep cervical flexor muscle activation in patients with chronic neck pain

    OpenAIRE

    2016-01-01

    [Purpose] The purpose of this study was to investigate clinical effects of deep cervical flexor (DCF) muscles exercise on pain, Neck Disability Index (NDI), and neck and shoulder postures in patients with chronic neck pain. [Subjects and Methods] Twenty-eight patients with chronic neck pain were randomly assigned into either the general strengthening exercise (GSE) group or the DCF activation group as control and experimental groups, respectively. All exercises were performed three times per ...

  7. Globus Pallidus Interna Deep Brain Stimulation in a Patient with Medically Intractable Meige Syndrome

    Directory of Open Access Journals (Sweden)

    Dae-Woong Bae

    2014-10-01

    Full Text Available Medical therapies in patients with Meige syndrome, including botulinum toxin injection, have been limited because of incomplete response or adverse side effects. We evaluated a patient with Meige syndrome who was successfully treated with deep brain stimulation (DBS in the globus pallidus interna (GPi. This case report and other previous reports suggest that bilateral GPi DBS may be an effective treatment for medically refractory Meige syndrome, without significant adverse effects.

  8. Weight and body mass index in Parkinson's disease patients after deep brain stimulation surgery.

    Science.gov (United States)

    Tuite, Paul J; Maxwell, Robert E; Ikramuddin, Sayeed; Kotz, Catherine M; Kotzd, Catherine M; Billington, Charles J; Billingtond, Charles J; Laseski, Maggie A; Thielen, Scott D

    2005-06-01

    A retrospective chart review characterizing changes in 17 male and 10 female Parkinson's disease (PD) patients undergoing deep brain stimulation (DBS) surgery indicated that 6 mo before surgery, patients lost a mean of 5.1 lbs, whereas in the 6 mo after surgery, subjects gained a mean of 10.1 lbs; 22% gained more than 14 lbs. In 10 patients followed an additional 6 mo, weight gain continued. This weight gain may be associated with decreased energy expenditure due to subsidence of chronic tremor. The magnitude of gain underscores the need for proactive management of body weight in PD patients undergoing DBS.

  9. Rare case of dermonecrosis caused by a recluse spider bite in Europe.

    Science.gov (United States)

    Cachia, Monique; Mercieca, Liam; Mallia Azzopardi, Charles; Boffa, Michael J

    2016-07-20

    Spider poisoning is rare in Europe, with very few reported cases in the literature. Recluse spider (genus Loxosceles) bites may lead to cutaneous and systemic manifestations known as loxoscelism. We report the second known case of spider bite poisoning in Malta caused by Loxosceles rufescens (Mediterranean recluse spider). A young adult female presented with localised erythema and pain on her left thigh after a witnessed spider bite. Over a few days, the area developed features of dermonecrosis together with systemic symptoms, including fever, fatigue and a generalised erythematous eruption. She was managed by a multidisciplinary team and the systemic symptoms resolved within 6 days, while the skin lesion healed with scarring within 2 months. A recluse spider bite should be considered in patients with dermonecrosis. Although spider bite poisoning is uncommon in Europe, it is important to diagnose and manage it appropriately since it could lead to potentially serious sequelae. 2016 BMJ Publishing Group Ltd.

  10. Necrotizing fasciitis due to Streptococcus mitis caused by accidental human bite.

    Science.gov (United States)

    Bastug, Aliye; Kislak, Sumeyye; Mutlu, Nevzat Mehmet; Akcaboy, Zeynep Nur; Koksal, Asude; Sertcelik, Ahmet; Ünlü, Ramazan Erkin; Akinci, Esragul; Bodur, Hurrem

    2016-01-31

    Human bite wounds are more prone to infection than animal bites, which may cause necrotizing soft tissue infections such as myositis, fasciitis. Both aerobic and anaerobic microorganisms may be responsible, including Streptococcus spp., Staphylococcus aureus, Peptostreptococcus spp. Necrotizing fasciitis is characterized by serious tissue destruction and systemic toxicity with high morbidity and mortality. We report a patient with Streptococcus mitis associated necrotizing fasciitis on the upper extremity resulting from an accidental human bite, which caused nearly fatal infection. Prophylactic antibiotic treatment should be given after a human bite to prevent infection. If the infection signs and symptoms develop, rapid diagnosis, appropriate antibiotic and surgical therapy should be administered immediately. Streptococcus mitis is a viridans streptococcus, usually known as a relatively benign oral streptococcus. To our knowledge, this is the first necrotizing fasciitis case due to Streptococcus mitis after human bite.

  11. Nonhealing Wounds Caused by Brown Spider Bites: Application of Hyperbaric Oxygen Therapy.

    Science.gov (United States)

    Hadanny, Amir; Fishlev, Gregory; Bechor, Yair; Meir, Oshra; Efrati, Shai

    2016-12-01

    Bites by Loxosceles spiders (also known as recluse spiders or brown spiders) can cause necrotic ulcerations of various sizes and dimensions. The current standard of care for brown spider bites includes analgesics, ice, compression, elevation, antihistamines, and surgical debridement. Hyperbaric oxygen therapy (HBOT) in the treatment of brown spider bites has been administered in the early stage of ulceration, or 2 to 6 days after the bite. Unfortunately, the diagnosis of spider bite-related ulcers is often delayed and weeks or months may elapse before HBOT is considered. To evaluate the effect of HBOT on nonhealing wounds caused by brown spider bites in the late, chronic, nonhealing stage. Analysis of 3 patients with brown spider-bite healing wounds treated at The Sagol Center for Hyperbaric Medicine and Research in Israel. Patients presented 2 to 3 months after failure of other therapies including topical dressings, antibiotics, and corticosteroids. All patients were treated with daily 2 ATA (atmospheres absolute) with 100% oxygen HBOT sessions. All 3 patients were previously healthy without any chronic disease. Their ages were 30, 42, and 73 years. They were treated once daily for 13, 17, and 31 sessions, respectively. The wounds of all 3 patients healed, and there was no need for additional surgical intervention. There were no significant adverse events in any of the patients. Microvascular injury related to brown spider bites may culminate in ischemic nonhealing wounds even in a relatively young, healthy population. Hyperbaric oxygen therapy should be considered as a valuable therapeutic tool even months after the bite.

  12. Deep-Seated Fungal Infections in Immunocompromised Patients in Iran before and after Treatments

    Directory of Open Access Journals (Sweden)

    Shahindokht Bassiri Jahromi Ali Asghar Khaksar

    2005-03-01

    Full Text Available During the last two decades or so, the incidence of fungal infections has increased dramatically. Deep- seated mycoses are creating serious problems for clinicians working with certain populations of patients, such as those with cancer, the immunocompromised, and physiologically compromised.A study of fungal isolated for identification of deep fungal infections, risk factors and etiologic agents in immunocompromised patients was carried out in the section of Medical Mycology, Pasteur Institute of Iran from 1994 to 2001. Eighty two immunosupressed patients with deep fungal infection were retrospectively analyzed for etiology and risk factors. They had one or more predisposing factors to disseminated fungal infections. Diagnosis was established by demonstration of fungus in direct and cultural examinations. Candida spp. were isolated in 67% (36.5% C. albicans and 30.5% non-albincans, and Aspergillus spp. were isolated in 15% of cases. The most frequent risk factors were hematologic malignancy (ALL, lymphoma, Hodgkin, multiple myeloma and diabetes mellitus. This study suggests that in immunocompromised patients, fungal infections especially in saprophytic infections, back ground evaluation and clinical features, correspondence of clinical symptoms and laboratory examinations should be considered and investigation of other factors which created the infection will lead us to a clear picture of patients situation.

  13. Brodie bite with an extracted mandibular first molar in a young adult: a case report.

    Science.gov (United States)

    Chugh, Vinay K; Sharma, Vijay P; Tandon, Pradeep; Singh, Gyan P

    2010-05-01

    Total buccal crossbites are rare, but, when they occur, they can be extremely difficult to correct, even with surgery and orthodontics. In most patients with in-locking crossbites, the maxillary teeth erupt past their mandibular antagonists, creating severe occlusal difficulties. This article presents an adult patient with scissors-bite or partial telescoping bite bilaterally in the posterior region and an extracted mandibular first molar on the right side. She was treated with expansion of the mandibular arch, and the subsequent open bite was closed with the help of masticatory muscle exercises and high-pull headgear. The second and third molars were uprighted and moved mesially to close the extraction spaces.

  14. Patient Perspectives on Deep Brain Stimulation Clinical Research in Early Stage Parkinson's Disease.

    Science.gov (United States)

    Heusinkveld, Lauren; Hacker, Mallory; Turchan, Maxim; Bollig, Madelyn; Tamargo, Christina; Fisher, William; McLaughlin, Lauren; Martig, Adria; Charles, David

    2017-01-01

    The FDA has approved a multicenter, double-blind, Phase III, pivotal trial testing deep brain stimulation (DBS) in 280 people with very early stage Parkinson's disease (PD; IDE#G050016). In partnership with The Michael J. Fox Foundation for Parkinson's Research, we conducted a survey to investigate motivating factors, barriers, and gender differences among potentially eligible patients for participation in a trial testing DBS in early PD compared to standard medical treatment. The majority of survey respondents (72%) indicated they would consider learning more about participating. Early PD patients are therefore likely to consider enrolling in trials of invasive therapies that may slow symptom progression and help future patients.

  15. Comparison of four clinical scores for the predicting lower limb deep venous thrombosis in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    Li Zhua; Min Liu; Xiaojuan Guo; Jianguo Wang; Youmin Guo; Chen Wang; Hongxia Ma; Yulin Guo

    2008-01-01

    To evaluate Wells, Kahn, St.Andr é and Constans scores for the prediction of deep venous thrombosis in Chinese patients.Methods:One hundred and seventy-two patients, prospectively, blinded referred for evaluation with four clinical-score systems for suspected deep venous thrombosis, were examined by ultrasonography.Sensitivity, specificity, positive predictive value, nega- tive predictive value and receiver operation curves were calculated for four clinical scores.The difference between areas of the ROC curve for each of the scores was compared with others and reference line.Results:Forty-six of 172 patients had deep venous throm- bosis proven by sonography.The sensitivity, specificity, positive predictive value and negative predictive value for Wells score was 91.3%, 27.4% and 74.2% respectively, for Constans score; 95.7%, 34.9%, 34.9% and 95.7% respectively.Area under ROV curve of Constans with the reference line.Conclusion:Based on the results of our study, the sensitivity, negative prediction value and area under ROC Considering the aim of the clinical assessment, Constans score and Wells score are more efficient for Chinese hospitalized patients.

  16. Afibrinogenemia following snake bite (Crotalus durissus terrificus

    Directory of Open Access Journals (Sweden)

    C. F. S. Amaral

    1988-08-01

    Full Text Available This paper reports two cases of afibrinogenemia with normal platelet count following Crotalus durissus terrificus, snake bite Both patients presented high output acute renal failure and case two also had increased blood levels of CPK and LDH compatible with the diagnosis of rhabdomyolysis. Case one was given an unknown amount of antivenom and was treated with epsilonaminocaproic acid and a fresh whole blood transfusion and showed recovery of the coagulation disturbance 40 hours following these measures. Case two was given an adequate amount of crotalide antivenom and the coagulation tests performed 12 hours later showed a normal partial thromboplastin time and fibrinogen 86 mg/100ml. Case one presented no haemorrhagic disturbances. Case two presented persistent bleeding following venopuncture and after removal of impetigo crust in the legs. Acute renal failure was treated conservatively and both patients were discharged from the hospital with recovery of the renal function.

  17. Incidence of Postoperative Deep Venous Thrombosis Is Higher among Cardiac and Vascular Surgery Patients as Compared with General Surgery Patients.

    Science.gov (United States)

    Aziz, Faisal; Patel, Mayank; Ortenzi, Gail; Reed, Amy B

    2015-01-01

    Unlike general surgery patients, most of vascular and cardiac surgery patients receive therapeutic anticoagulation during operations. The purpose of this study was to report the incidence of deep venous thrombosis (DVT) among cardiac and vascular surgery patients, compared with general surgery. The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent surgical procedures from 2005 to 2010. Patients who developed DVT within 30 days of an operation were identified. The incidence of DVT was compared among vascular, general, and cardiac surgery patients. Risk factors for developing postoperative DVT were identified and compared among these patients. Of total 2,669,772 patients underwent surgical operations in the period between 2005 and 2010. Of all the patients, 18,670 patients (0.69%) developed DVT. The incidence of DVT among different surgical specialties was cardiac surgery (2%), vascular surgery (0.99%), and general surgery (0.66%). The odds ratio for developing DVT was 1.5 for vascular surgery patients and 3 for cardiac surgery patients, when compared with general surgery patients (P cardiac surgery was 2, when compared with vascular surgery (P cardiac surgery patients as compared with that of general surgery patients. Intraoperative anticoagulation does not prevent the occurrence of DVT in the postoperative period. These patients should receive DVT prophylaxis in the perioperative period, similar to other surgical patients according to evidence-based guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Lupus anticoagulant is significantly associated with inflammatory reactions in patients with suspected deep vein thrombosis

    DEFF Research Database (Denmark)

    Sidelmann, Johannes Jakobsen; Sjøland, Jonas A.; Gram, Jørgen

    2007-01-01

    OBJECTIVE: Lupus anticoagulant (LA) and antiphospholipid antibodies (aPL) are suggested as risk factors for development of deep vein thrombosis (DVT) among patients without systemic lupus erythematosus (SLE). Other conditions, e.g. inflammation, are reported to induce LA and it is uncertain whether...... of the International Society of Thrombosis and Haemostasis. The concentration of anticardiolipin (aCL) and beta(2)-glycoprotein I (anti-beta(2)-GPI) antibodies as well as C-reactive protein (CRP) was determined with sensitive and precise methods. RESULTS: LA was demonstrated in 8 patients with DVT and in 10 patients...... without DVT, relative risk 1.33 (CI: 0.55-3.18). No significant association was observed between aCL or anti-beta(2)-GPI and DVT. Patients suffering from DVT had significantly higher concentrations of CRP than patients without DVT. However, CRP was also significantly higher in patients positive for LA...

  19. Patient compliance and satisfaction with mechanical devices for preventing deep venous thrombosis after joint replacement.

    Science.gov (United States)

    Robertson, K A; Bertot, A J; Wolfe, M W; Barrack, R L

    2000-01-01

    A consecutive series of patients having total joint arthroplasty at a single university hospital were sequentially treated with two mechanical devices for prevention of deep venous thrombosis (DVT). The first 104 patients (group 1) wore thigh-high sequential compression device (SCD). The next 120 patients (group 2) wore a foot pump. Daily documentation of hourly compliance with each respective device was recorded until discharge. A patient satisfaction questionnaire was also obtained. Patient understanding about the devices' function aided compliance (73% compliance in group 1, and 77% in group 2). The satisfaction questionnaire revealed significantly greater satisfaction in group 2 (73%) versus group 1 (55%). Of a subgroup of 35 patients who had used both devices, 24 preferred the foot pump, 7 the SCD, and 4 had no preference. This study showed a higher degree of compliance and satisfaction for foot pumps as prophylaxis against DVT.

  20. Analysis of Dog Bites in Kashmir: An Unprovoked Threat to Population

    OpenAIRE

    2014-01-01

    Objectives: The study focuses on the analysis of regional distribution, pattern and outcome of dog bite injuries sustained in Kashmiri population and assessing the burden on society. Methods: In this retrospective survey antirabies clinic record of all patients who sought medical attention after a dog bite in tertiary centre of Kashmir SMHS hospital between April2010 to May 2013 were reviewed. Results: A total of 13852 patients registered over a period of three year with mean age 27.69...

  1. Prevention of multiple organ dysfunction syndrome in patients with extensive deep burns

    Institute of Scientific and Technical Information of China (English)

    盛志勇

    2002-01-01

    @@ Multiple organ dysfunction (or failure) syndrone (MODS or MOFS) remains a hurdle for us to overcome before further improvement in the survival rate can be achieved in the patients with extensive deep bums. It is, however, generally recognized that MODS is the final result of the liberation and interplay of multiple inflammatory mediators or cytokines, and there is a two-hit phenomenon in its pathogenesis.

  2. Elderly Patients Require Higher Doses of Sugammadex for Rapid Recovery from Deep Neuromuscular Block.

    Science.gov (United States)

    Shin, Seokyung; Han, Dong Woo; Lee, Hye Sun; Song, Mi Kyung; Jun, Eun-Kyung; Kim, So Yeon

    2016-06-01

    This study compared the doses of sugammadex needed for rapid recovery from deep neuromuscular blockade (NMB) between young and elderly adults. Twenty-two young (20-40 yrs) and 22 elderly (≥70 yrs) adults were enrolled, and deep NMB of 1-2 post-tetanic counts was maintained with rocuronium intraoperatively. Predetermined doses of sugammadex were given at the end of surgery starting at 4.0 mg/kg for the first patient of each group. Doses were decreased or increased in following patients by 0.5 mg/kg, depending on the 'success' or 'failure' of rapid recovery in the preceding patient. 'Success' was defined as adequate recovery (train-of-four ratio 0.9) within 2 min. after sugammadex administration. The median (range) of ages was 29 (20-40) and 73 (70-84) yrs for the young and elderly adults, respectively. Doses of sugammadex facilitating adequate recovery from deep NMB within 2 min. in each patient population with 50% and 95% probability were defined as ED50 and ED95 , respectively. The ED50 estimated by the Dixon's method was significantly higher in the elderly compared to young adults [4.2 ± 0.4 mg/kg versus 3.3 ± 0.3 mg/kg, p sugammadex should be considered when rapid recovery from deep NMB is needed in elderly adults. © 2015 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  3. Size of the thrombus in acute deep vein thrombosis and the significance of patients' age and sex.

    Science.gov (United States)

    Kierkegaard, A

    1981-01-01

    To determine the significance of patients' age and sex on the size of the thrombus in acute deep vein thrombosis, 420 consecutive phlebograms with acute deep vein thrombosis were studied. A significant correlation between the size of the thrombus and increasing age of the patient as well as the sex of male was noted. It is concluded that older patients and men often are at a high risk of pulmonary embolism at the time of diagnosis.

  4. Appropriate dosing of sugammadex to reverse deep rocuronium-induced neuromuscular blockade in morbidly obese patients.

    Science.gov (United States)

    Loupec, T; Frasca, D; Rousseau, N; Faure, J-P; Mimoz, O; Debaene, B

    2016-03-01

    In morbidly obese patients, the speed of reversal of neuromuscular blockade with sugammadex based on ideal body weight is still matter of debate. In this single-center, randomised, double-blinded study, neuromuscular blockade was monitored in 50 patients using acceleromyography at the adductor pollicis. At the end of surgery with deep rocuronium-induced neuromuscular blockade, patients randomly received sugammadex 4 mg.kg(-1) (high dose group), 2 mg.kg(-1) (middle dose group), or 1 mg.kg(-1) (low dose group) of ideal body weight. After administration of the first dose of sugammadex, the mean (SD) recovery time (censored at 600 s) from deep neuromuscular blockade was significantly shorter (p sugammadex administration, were 93%, 77% and 22% for these high, middle and low-dose groups respectively (p sugammadex allows suitable reversal of deep rocuronium-induced neuromuscular blockade. Monitoring remains essential to detect residual curarisation or recurarisation. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

  5. [Acute generalized exanthematous pustulosis following a spider bite: three cases from Tunisia].

    Science.gov (United States)

    Ben Said, Z; Saidi, W; Boussofara, L; Ghariani, N; Belajouza, C; Sriha, B; Denguezli, M; Nouira, R

    2010-12-01

    acute generalized exanthematous pustulosis (AGEP) is a severe eruption induced in most cases by medication; more rarely, it is associated with viral infection, food allergens or toxins. The literature contains only very rare reports of AGEP caused by a spider bite. We describe three cases of AGEP in Tunisian women following a spider bite. three Tunisian women were hospitalized in the dermatology department during the summer months presenting acute febrile pustulosis and rash occurring after a spider bite. The diagnosis of AGEP was confirmed with certainty based on the EuroSCAR score. Two patients presented marked eosinophilia. The outcome was favourable in all cases after symptomatic treatment. the factors militating in favour of spider-bite origin in these three patients were: (1) the presence of skin lesions characteristic of a spider bite; (2) the chronology of events, with eruption occurring 24 to 48 hours after the bite; and (3) the exclusion of the common causes of AGEP and the presence of marked eosinophilia in two of the cases. Our cases and the few cases published in the literature indicate that spider bites may be added to the list of the possible causes of AGEP. 2010 Elsevier Masson SAS. All rights reserved.

  6. The Influence of Visual Word Form in Reading: Single Case Study of an Arabic Patient with Deep Dyslexia

    Science.gov (United States)

    Boumaraf, Assia; Macoir, Joël

    2016-01-01

    Deep dyslexia is a written language disorder characterized by poor reading of non-words, and advantage for concrete over abstract words with production of semantic, visual and morphological errors. In this single case study of an Arabic patient with input deep dyslexia, we investigated the impact of graphic features of Arabic on manifestations of…

  7. Prediction of Deep Neck Abscesses by Contrast-Enhanced Computerized Tomography in 76 Clinically Suspect Consecutive Patients

    NARCIS (Netherlands)

    Freling, Nicole; Roele, Elise; Schaefer-Prokop, Cornelia; Fokkens, Wytske

    2009-01-01

    Objectives/Hypothesis: Contrast-enhanced computerized tomography (CECT) has become the imaging method of choice in patients with clinical suspicion of a deep neck abscess. The purpose of this retrospective study was to assess the predictive value of the diagnosis of deep neck abscess using CECT. Stu

  8. The Influence of Visual Word Form in Reading: Single Case Study of an Arabic Patient with Deep Dyslexia

    Science.gov (United States)

    Boumaraf, Assia; Macoir, Joël

    2016-01-01

    Deep dyslexia is a written language disorder characterized by poor reading of non-words, and advantage for concrete over abstract words with production of semantic, visual and morphological errors. In this single case study of an Arabic patient with input deep dyslexia, we investigated the impact of graphic features of Arabic on manifestations of…

  9. The influence of bite size and multiple bites on oral texture sensations

    NARCIS (Netherlands)

    Wijk, R.A. de; Engelen, L.; Prinz, J.F.; Weenen, H.

    2003-01-01

    The influence of bite size on sensory mouthfeel and afterfeel sensations was explored in two studies in which single bites of vanilla custard desserts were varied from 2 to 11 mL (study 1) and in which series of five bites of two different custard desserts were presented consecutively (study 2). In

  10. The influence of bite size and multiple bites on oral texture sensations

    NARCIS (Netherlands)

    Wijk, de R.A.; Engelen, L.; Prinz, J.F.; Weenen, H.

    2003-01-01

    The influence of bite size on sensory mouth- and afterfeel sensations was explored in two studies in which single bites of vanilla custard desserts were varied from 2 to 11 ml (study 1) and in which series of five bites of two different custard desserts were presented consecutively (study 2). In sin

  11. Implementation of a clinical pathway for emergency department out-patient management of deep vein thrombosis.

    LENUS (Irish Health Repository)

    Kidney, R

    2010-09-01

    There is good evidence demonstrating that outpatient management of deep venous thrombosis (DVT) is feasible and safe. However, few emergency departments in Ireland have implemented care pathways for outpatient management of DVT. The aim of this study was to examine the safety and efficacy of implementing an Emergency Department (ED)- care pathway for outpatient management of patients with DVT. A retrospective observational study of this care pathway introduced at our institution was performed. The primary outcome measure was the number of hospital admissions avoided by using the care pathway. Two hundred and eighty-four patients presenting to the ED with suspected lower limb DVT, were managed using the care pathway over a 6 month period. Forty-nine patients (17%) had a DVT diagnosed. Thirty-nine patients (81%) were suitable for outpatient DVT management. Ten patients (19%) were admitted to hospital. At 3 months there were no reported cases of the following complications: missed DVT, pulmonary embolism or death.

  12. Angle Class I malocclusion with anterior open bite treated with extraction of permanent teeth

    Directory of Open Access Journals (Sweden)

    Matheus Melo Pithon

    2013-04-01

    Full Text Available This clinical case reports the orthodontic treatment of a Class I malocclusion with anterior open bite and bimaxillary dentoalveolar protrusion in a 28-year-old female patient. The treatment of choice was to perform tooth extractions followed by retraction of the anterior teeth, with consequent closure of the anterior open bite and better accommodation of the teeth on their bony bases. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO, representing the Category 2 - i.e., an Angle Class I malocclusion, with anterior open bite, treated with extraction of permanent teeth -, as part of the requisites to become a BBO diplomate.

  13. Psychosis in secondary empty sella syndrome following a Russell's viper bite

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    Badr Ratnakaran

    2016-01-01

    Full Text Available Hypopituitarism can present with psychiatric symptoms. We report a unique case of psychosis in clear consciousness in a case of hypopituitarism due to the secondary empty sella syndrome following a Russell's viper bite which was untreated and presented with psychotic symptoms for past 13 years following the snake bite. After the diagnosis of psychosis due to hypopituitarism was made, the patient was treated with levothyroxine and prednisolone supplements and his psychotic symptoms subsided without any psychotropic drugs. Vasculotoxic snake bites can cause hypopituitarism and can present with psychosis. Further research will be needed into the prevalence of this phenomenon.

  14. Amelogenesis imperfecta and anterior open bite: Etiological, classification, clinical and management interrelationships.

    Science.gov (United States)

    Alachioti, Xanthippi Sofia; Dimopoulou, Eleni; Vlasakidou, Anatoli; Athanasiou, Athanasios E

    2014-01-01

    Although amelogenesis imperfecta is not a common dental pathological condition, its etiological, classification, clinical and management aspects have been addressed extensively in the scientific literature. Of special clinical consideration is the frequent co-existence of amelogenesis imperfecta with the anterior open bite. This paper provides an updated review on amelogenesis imperfecta as well as anterior open bite, in general, and documents the association of these two separate entities, in particular. Diagnosis and treatment of amelogenesis imperfecta patients presenting also with anterior open bite require a lengthy, comprehensive and multidisciplinary approach, which should aim to successfully address all dental, occlusal, developmental, skeletal and soft tissue problems associated with these two serious clinical conditions.

  15. Upper limb compartment syndrome after an adder bite:a case report

    Institute of Scientific and Technical Information of China (English)

    Mohamed Faouzi Hamdi; Sayed Baccari; Mehdi Daghfous; Lamjed Tarhouni

    2010-01-01

    Compartment syndrome after an adder bite is extremely rare, whose effects are only secondary to the cytotoxic and hemorrhagic effects of venom.Here we reported a case of compartment syndrome in the upper limb following an adder bite in the thenar eminence.Elevated compartment pressure was documented and immediate sur-gical fasciotomy was practiced.The patient achieved com-plete recovery with a good functional result.We discussed the controversies on fasciotomy and non-invasive measures in such a situation, and recommended intracompartmental pressure monitoring during the management of compart-ment syndrome following adder bites.

  16. Angle Class I malocclusion with anterior open bite treated with extraction of permanent teeth.

    Science.gov (United States)

    Pithon, Matheus Melo

    2013-01-01

    This clinical case reports the orthodontic treatment of a Class I malocclusion with anterior open bite and bimaxillary dentoalveolar protrusion in a 28-year-old female patient. The treatment of choice was to perform tooth extractions followed by retraction of the anterior teeth, with consequent closure of the anterior open bite and better accommodation of the teeth on their bony bases. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), representing the Category 2 -- i.e., an Angle Class I malocclusion, with anterior open bite, treated with extraction of permanent teeth --, as part of the requisites to become a BBO diplomate.

  17. Upper limb compartment syndrome after an adder bite: a case report.

    Science.gov (United States)

    Hamdi, Mohamed Faouzi; Baccari, Sayed; Daghfous, Mehdi; Tarhouni, Lamjed

    2010-04-01

    Compartment syndrome after an adder bite is extremely rare, whose effects are only secondary to the cytotoxic and hemorrhagic effects of venom. Here we reported a case of compartment syndrome in the upper limb following an adder bite in the thenar eminence. Elevated compartment pressure was documented and immediate surgical fasciotomy was practiced. The patient achieved complete recovery with a good functional result. We discussed the controversies on fasciotomy and non-invasive measures in such a situation, and recommended intracompartmental pressure monitoring during the management of compartment syndrome following adder bites.

  18. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... de12", ]; for (var c = 0; c Tips to prevent and treat bug bites Although most bug bites ... take steps to reduce your risk. To help prevent bug bites, dermatologists recommend the following tips: Use ...

  19. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... de12", ]; for (var c = 0; c Tips to prevent and treat bug bites Although most bug bites ... take steps to reduce your risk. To help prevent bug bites, dermatologists recommend the following tips: Use ...

  20. Analysis of cases caused by acute spider bite

    Institute of Scientific and Technical Information of China (English)

    Zihni Sulaj; Gentian Vyshka; Amarda Gashi

    2015-01-01

    We performed a retrospective study of 176 patients in the University Hospital Center of Tirana (Albania), during the period 2001-2011, admitted with the diagnosis of a suspected spider bite. Three fatalities were registered during this decade covered from our study, with a clinical picture of marked hypertension, tachycardia and acute cardiac failure leading to death within a minimum of 25 hours and a maximum of 42 hours from the occurrence. Out of the total of 176 patients, we had 59% (104 cases) females, and 41% males. The overwhelming majority of the patients lived in rural areas (155 of the cases); extremities were mostly affected from the bites. A summary of clinical signs and a brief review of the available literature are made in the results and discussion section of this paper. Authors advocate that special precautions should be taken especially in severe forms of interesting autonomous nerve system, with aggressive fluid resuscitation, supportive therapy and close monitoring of vital signs.

  1. A comparison of between hyomental distance ratios, ratio of height to thyromental, modified Mallamapati classification test and upper lip bite test in predicting difficult laryngoscopy of patients undergoing general anesthesia.

    Science.gov (United States)

    Honarmand, Azim; Safavi, Mohammadreza; Ansari, Narges

    2014-01-01

    Failed intubation is imperative source of anesthetic interrelated patient's mortality. The aim of this present study was to compare the ability to predict difficult visualization of the larynx from the following pre-operative airway predictive indices, in isolation and combination: Modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD), hyomental distance ratios (HMDR), and the upper-lip-bite test (ULBT). We collected data on 525 consecutive patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation and then evaluated all four factors before surgery. A skilled anesthesiologist, not imparted of the noted pre-operative airway assessment, did the laryngoscopy and rating (as per Cormack and Lehane's classification). Sensitivity, specificity, and positive predictive value for every airway predictor in isolation and in combination were established. The most sensitive of the single tests was ULBT with a sensitivity of 90.2%. The hyomental distance extreme of head extension was the least sensitive of the single tests with a sensitivity of 56.9. The HMDR had sensitivity 86.3%. The ULBT had the highest negative predictive value: And the area under a receiver-operating characteristic curve (AUC of ROC curve) among single predictors. The AUC of ROC curve for ULBT, HMDR and RHTMD was significantly more than for MMT (P 0.05). The HMDR is comparable with RHTMD and ULBT for prediction of difficult laryngoscopy in the general population, but was significantly more than for MMT.

  2. A verified spider bite and a review of the literature confirm Indian ornamental tree spiders (Poecilotheria species) as underestimated theraphosids of medical importance.

    Science.gov (United States)

    Fuchs, Joan; von Dechend, Margot; Mordasini, Raffaella; Ceschi, Alessandro; Nentwig, Wolfgang

    2014-01-01

    Literature on bird spider or tarantula bites (Theraphosidae) is rare. This is astonishing as they are coveted pets and interaction with their keepers (feeding, cleaning the terrarium or taking them out to hold) might increase the possibility for bites. Yet, this seems to be a rare event and might be why most theraphosids are considered to be harmless, even though the urticating hairs of many American species can cause disagreeable allergic reactions. We are describing a case of a verified bite by an Indian ornamental tree spider (Poecilotheria regalis), where the patient developed severe, long lasting muscle cramps several hours after the bite. We present a comprehensive review of the literature on bites of these beautiful spiders and conclude that a delayed onset of severe muscle cramps, lasting for days, is characteristic for Poecilotheria bites. We discuss Poecilotheria species as an exception from the general assumption that theraphosid bites are harmless to humans.

  3. Deep vein thrombosis: validation of a patient-reported leg symptom index

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    Caprini Carol

    2003-12-01

    Full Text Available Abstract Introduction Deep vein thrombosis (DVT is a serious health problem that affects more than 2 million people annually in the United States. Many of these patients develop asymptomatic DVT, but months to years later may experience symptomatic post-thrombotic syndrome (PTS. It is not known how many cases of PTS can be traced to "asymptomatic" DVT because venography is no longer routinely done and ultrasonography (US may miss some asymptomatic clots. As a result, a clinical tool in addition to US to detect symptom emergence or exacerbation in patients after DVT would be of value. Methods Seventy-seven patients hospitalized with an acute DVT interviewed by telephone at 3–7 days, 30–40 days, and 12-months following discharge were included in this report. All were treated with a standard anticoagulation "Clinical Pathway Protocol" between April 1999 and January 2000. Using a 14-item Deep Vein Thrombosis Leg Symptom Index (DVT-LSI, patients were queried regarding leg pain, swelling, skin discoloration, cosmetic appearance, activity tolerance, emotional distress, and leg-related sleep problems. Results The DVT-LSI for each leg was reliable at all assessments, with instrument reliability (alpha coefficients greater than 0.70 at all time points (range 0.71–0.87. DVT-LSI scores, and the percentage of patients exhibiting symptoms, were higher in the DVT-affected leg at all time points. Among patients with unilateral disease, symptom severity ratings were significantly worse for patients in the affected leg compared to the normal leg at all time points, with the exception of those with a right-leg DVT at 12 months. Patients with bilateral thrombi did not have different scores on one leg compared to the other. Conclusion The DVT-LSI is useful in assessing symptomatic clinical outcomes in patients after diagnosis of DVT, and may represent a surrogate marker for DVT otherwise presumed to be asymptomatic.

  4. Task-dependence of activity/ bite-force relations and its impact on estimation of chewing force from EMG.

    Science.gov (United States)

    Proeschel, P A; Morneburg, T

    2002-07-01

    Estimation of chewing force from electromyograms (EMGs) calibrated in isometric biting yielded strikingly high force values. We tested the hypothesis that EMG-based force predictions are excessive because of differing activity/bite-force relations in mastication and isometric biting. In nine patients, unilateral bite forces and EMGs of 4 elevator muscles were recorded during chewing and isometric clenching on a bite-fork. We estimated chewing force by substituting chewing EMGs of each muscle into isometric activity/bite-force regressions. The estimates were compared with actual chewing forces recorded by intra-oral transducers. In all muscles except the balancing-side masseter, the activity/bite-force ratio was significantly higher in chewing than in isometric biting. The actual mean chewing force amounted to 220 N, while EMG-based estimates ranged from 273 to 475 N, depending on the muscle used for estimation. The results indicate that different activity/force characteristics in dynamic and isometric biting can cause overestimation when chewing force is predicted from masticatory EMGs.

  5. Predictors of a Positive Duplex Scan in Patients with a Clinical Presentation Compatible with Deep Vein Thrombosis or Cellulitis

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    Curtis E Rabuka

    2003-01-01

    Full Text Available BACKGROUND: Deep vein thrombosis (DVT and cellulitis are common conditions whose symptoms lead patients to seek medical attention in the emergency department (ED. Distinguishing between these two conditions quickly and accurately is important.

  6. The incidence of venous thromboembolism and practice of deep venous thrombosis prophylaxis in hospitalized cirrhotic patients

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    Alqahtani Saad

    2011-01-01

    Full Text Available Abstract Background Cirrhotic patients are characterized by a decreased synthesis of coagulation and anticoagulation factors. The coagulopathy of cirrhotic patients is considered to be auto-anticoagulation. Our aim was to determine the incidence and predictors of venous thromboembolism (VTE and examine the practice of deep venous thrombosis (DVT prophylaxis among hospitalized cirrhotic patients. Methods A retrospective cohort study was performed in a tertiary teaching hospital. We included all adult patients admitted to the hospital with a diagnosis of liver cirrhosis from January 1, 2009 to December 31, 2009. We grouped our cohort patients in two groups, cirrhotic patients without VTE and cirrhotic with VTE. Results Over one year, we included 226 cirrhotic patients, and the characteristics of both groups were similar regarding their clinical and laboratory parameters and their outcomes. Six patients (2.7% developed VTE, and all of the VTEs were DVT. Hepatitis C was the most common (51% underlying cause of liver cirrhosis, followed by hepatitis B (22%; 76% of the cirrhotic patients received neither pharmacological nor mechanical DVT prophylaxis. Conclusion Cirrhotic patients are at risk for developing VTE. The utilization of DVT prophylaxis was suboptimal.

  7. Acquired and Heritable Thrombophilia in Indian Patients With Pediatric Deep Venous Thrombosis (DVT).

    Science.gov (United States)

    Pai, Navin; Ghosh, Kanjaksha; Shetty, Shrimati

    2014-09-01

    Deep venous thrombosis (DVT) in children is more often associated with underlying pathological conditions than with hereditary thrombophilia. The present study is a retrospective analysis of thrombophilia in 285 pediatric patients with venous thrombosis at different sites. Four common thrombophilia markers, that is protein C, protein S, antithrombin III, and factor V Leiden (FVL) mutation, were analyzed. Thrombosis in hepatic and portal veins was more common in pediatric patients (73%) when compared to other sites (27%). Overall, hereditary thrombophilia accounted for 15.5% of the patients with venous thrombosis. The FVL mutation, which was the major causative factor in Budd-Chiari syndrome and portal vein thrombosis cases in the adult group, was not a major contributing factor in pediatric group, that is, 1.8% of the patients. In conclusion, the risk factors for venous thrombosis vary in different age groups.

  8. Extensive Deep Venous Thrombosis in a Patient with Neurolept Malignant Syndrome despite Being on Prophylaxis

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    Jerrin C. Mathew

    2011-01-01

    Full Text Available The risk of venous thromboembolism (VTE in patients with Neuroleptic malignant syndrome (NMS and those on antipsychotic medications is well established. We present here a case whereby the patient had NMS and developed extensive deep venous thrombosis (DVT despite being on standard DVT Prophylaxis. Our case illustrates that empiric intravenous heparin for the initial few days after the onset of NMS may be considered in those with high risk of VTE, as in such patients standard DVT prophylaxis may not be sufficient. To standardize as to which patients with NMS would be at the highest risk of VTE while on standard DVT prophylaxis, the role of a standardized scoring system and a double-blind randomized trial in the future would probably be beneficial.

  9. Clinical Aspects and Emergent Management of Snake Bites Presented to Emergency Department

    Directory of Open Access Journals (Sweden)

    Bedriye Sonmez

    2014-03-01

    Full Text Available Aim: Evaluating the epidemiologic characteristics and management of snake bites presenting to emergency departments. Material and Method: In this retrospective study 74 cases of snakebites admitted to Emergency Department of Diyarbakir Training and Research Hospital between 2008 and 2009 were retrospectively evaluated. Results: Fourty-six (62.2% of patients were male and 28 (37.8% were female. Mean age of the study population was 34.85±19.17 (min 7- max 80 years. Most of the snakebites occurred between 18.00 to 06.00 hours and at home (73%. 79.7% of snake bites occurred to upper extremities. %93 of cases had intravenous administration of antivenin (one dose. Neither none of the patients needed recurrent administration. Discussion: Snake bites are still a major public health problem especially in rural areas. Particularly emergency care physicians should be adequately capable and sophisticated in multidisciplinary management of snake bites.

  10. Hypertensive encephalopathy following snake bite in a child: A diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Syed Moied Ahmed

    2013-01-01

    Full Text Available Children in rural India are a vulnerable group for snake bites. Improper elicitation of history and atypical presentations could lead to misdiagnosis and delay in treatment. We are reporting the case of an 8-year-old male child who presented with convulsions, unconsciousness and hypertension who was initially managed as a case of hypertensive encephalopathy showing no sign of improvement even after 20 hs. The history when reviewed suggested neurotoxic snake bite although the patient did not have any classical local findings. Anti-snake venom administration was followed by prompt recovery. We therefore suggest that snake bite should be considered in patients from rural background presenting with hypertension, convulsion and unconsciousness, even in the absence of classical features of snake bite.

  11. An evaluation of snake bites and antivenin use at a regional medical center.

    Science.gov (United States)

    Watson, Larry I; Spivey, Christy; Menon, Cen Rema; Kotwall, Cyrus A; Clancy, Thomas V; Hope, William W

    2010-07-01

    Snake bites are a rare but challenging problem for surgeons. The purpose of our study was to evaluate our experience with snake bites at a regional medical center. We reviewed patients treated for snake bites from 2004 to July 2008. Demographics, clinical information, and outcomes were documented. Descriptive statistics were used, and chi2, t test, and Fisher exact test were used to compare patients based on antivenin use. A P value < 0.05 was considered significant. Over the study period, 126 patients presented to the emergency department with 44 (35%) requiring hospital admission. The average age was 38 years (range, 2 to 76 years); 66 per cent were male and 95 per cent white. Bites most commonly occurred in the summer and fall months with none from December through March. Copperhead bites accounted for 50 per cent of bites. An average of 4.8 vials of antivenin was given to 61 per cent of admitted patients with 93 per cent receiving the drug within 6 hours. Minor reactions to antivenin occurred in three patients (11%). Two patients required surgery (5%), and the readmission rate was 7 per cent. There was no known morbidity or mortality. When comparing patients who received antivenin with patients who did not, the only significant clinical variables were an increased prothrombin time (12.1 vs. 11.7, respectively; P = 0.048) and a longer length of hospital stay (3 vs. 1.8 days, P = 0.0006) in patients receiving antivenin. The majority of patients with snake bites can be treated with supportive care and antivenin when indicated. Antivenin use at our institution is largely based on physical findings and not related to laboratory values.

  12. Black widow spider bites experience from tertiary care center in Saudi Arabia

    Science.gov (United States)

    Al Bshabshe, Ali; Alfaifi, Musa; Alsayed, Ahmed Fouad

    2017-01-01

    Introduction: Black widow spiders are one of the most poisonous species to humans; there are more than 30 species of widow spiders in the globe but good thing that not all of them are dangerous. Some of these spiders produce toxic venoms, which cause broad spectrum of clinical manifestations including skin lesions, neurotoxicity, cardiac toxicity and death in some occasions. In Saudi Arabia there were no much reports of black widow spider bites apart from the case series by BUCUR and his group in ALBAHA region. Settings: In 2 years period a total of 8 patients were presented to the emergency departments diagnosed to have black widow spider bites based on description by the patients. Results: 100 % of the cohort were males, aged between 25-58 years. The time between bite and presentation to emergency room was one hour in average (30 min to 4 hours). 75% occured during summer season. All of them 100% had one bite only and reported the bite to be at nighttime in 75% of the times. The average pain score at presentation was 4 /10.100% of the bites were in the lower extremities and almost all progressed to have lower back pain. Three patients had gastrointestinal tract manifestation in form of abdominal cramps and nausea. One had bilateral ptosis, none of them had cardiac or pulmonary complications. The outcome was excellent in all patients and the average of hospital stay was 2.5 days (1-5). PMID:28469986

  13. Connecting behaviour and performance: the evolution of biting behaviour and bite performance in bats.

    Science.gov (United States)

    Santana, S E; Dumont, E R

    2009-11-01

    Variation in behaviour, performance and ecology are traditionally associated with variation in morphology. A neglected part of this ecomorphological paradigm is the interaction between behaviour and performance, the ability to carry out tasks that impact fitness. Here we investigate the relationship between biting behaviour and performance (bite force) among 20 species of ecologically diverse bats. We studied the patterns of evolution of plasticity in biting behaviour and bite force, and reconstructed ancestral states for behaviour and its plasticity. Both behavioural and performance plasticity exhibited accelerating evolution over time, and periods of rapid evolution coincided with major dietary shifts from insect-feeding to plant-feeding. We found a significant, positive correlation between behavioural plasticity and bite force. Bats modulated their performance by changing their biting behaviour to maximize bite force when feeding on hard foods. The ancestor of phyllostomids was likely a generalist characterized by high behavioural plasticity, a condition that also evolved in specialized frugivores and potentially contributed to their diversification.

  14. Functional Analysis and Treatment of Nail Biting

    Science.gov (United States)

    Dufrene, Brad A.; Watson, T. Steuart; Kazmerski, Jennifer S.

    2008-01-01

    This study applied functional analysis methodology to nail biting exhibited by a 24-year-old female graduate student. Results from the brief functional analysis indicated variability in nail biting across assessment conditions. Functional analysis data were then used to guide treatment development and implementation. Treatment included a…

  15. Animal Bites Epidemiology in Shahroud City

    Directory of Open Access Journals (Sweden)

    Mohammad Amiri

    Full Text Available Introduction: Rabies is an infectious central nervous system disease that infects all mammals and man. This study aimed at investigating the epidemiology of animal bites in Shahroud. Methods: In this deh1ive study all the data related to animal bite cases in shahroud in 2008-2009 were collected based on the data registration notebooks. Results: A total of 588 cases of animal bite were reported in 2008-2009 the majority of whom (82.1% were male. Of this total 35.7% were urban and 64.3% were rural. Just 2 of the cases were foreigners. The incidence rate of animal bite in the city was 159 (27% compared to 429 cases (73% in villages. Dogs and cats accounted for about 79.1% and 12.6% of the cases respectively. 12 cases were also wolf fox and Reynard bites. All cases have completed vaccination. In 82.3% of animal bites the biter was alive after 10 days and in 2% biters were dead and in 15.6% the biter reported invisible after 10 days. The incidence rate of animal bites in Shahroud was 246 in one hundred thousand. Conclusions: Animal bites are one of the most important problems of public health. Educational activities along with the promotion of out- organizing cooperation can play a significant role in controlling this problem

  16. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Replace the nail-biting habit with a good habit: When you feel like biting your nails, try playing with a stress ball or silly putty instead. This will help keep your hands busy and away from your mouth. Identify your triggers: These could be physical triggers, ...

  17. Subthalamic nucleus deep brain stimulation in elderly patients – analysis of outcome and complications

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    Ostertag Christoph

    2007-03-01

    Full Text Available Abstract Background There is an ongoing discussion about age limits for deep brain stimulation (DBS. Current indications for DBS are tremor-dominant disorders, Parkinson's disease, and dystonia. Electrode implantation for DBS with analgesia and sedation makes surgery more comfortable, especially for elderly patients. However, the value of DBS in terms of benefit-risk ratio in this patient population is still uncertain. Methods Bilateral electrode implantation into the subthalamic nucleus (STN was performed in a total of 73 patients suffering from Parkinson's disease. Patients were analyzed retrospectively. For this study they were divided into two age groups: group I (age Results Significant differences were found in overall performance determined as ADL scores (group I: 48/71 points, group II: 41/62 points [preoperatively/6-month postoperatively] and in the rate of complications (group I: 4 transient psychosis, 4 infections in a total of 8 patients, group II: 2 deaths [unrelated to surgery], 1 intracerebral hemorrhage, 7 transient psychosis, 3 infections, 2 pneumonia in a total of 13 patients, (p Conclusion DBS of the STN is clinically as effective in elderly patients as it is in younger ones. However, a more careful selection and follow-up of the elderly patients are required because elderly patients have a higher risk of surgery-related complications and a higher morbidity rate.

  18. Case report: compartment syndrome after a suspected black widow spider bite.

    Science.gov (United States)

    Cohen, Jennifer; Bush, Sean

    2005-04-01

    Widow spider envenomations generally produce systemic neurologic syndromes without significant local injury. We report a patient who sustained a black widow spider bite to the left forearm and presented to the emergency department with rhabdomyolysis and compartment syndrome. We documented a decrease in symptoms and compartment pressure after administration of antivenom. No surgical intervention was performed. We believe this report to be the first documenting compartment syndrome associated with black widow spider bite.

  19. Prevalence of deep vein thrombosis (DVT) in non-surgical patients at hospital admission.

    Science.gov (United States)

    Lawall, Holger; Hoffmanns, Wibke; Hoffmanns, Phillip; Rapp, Uli; Ames, Michael; Pira, Alessandro; Paar, W Dieter; Bramlage, Peter; Diehm, Curt

    2007-10-01

    Venous thromboembolism (VTE) is known as a common complication in surgical and non-surgical patients. We hypothesized that according to the underlying risk factors and the acute illness, the prevalence ofVTE in non-surgical patients admitted to hospital is widely underestimated. For three months each patient admitted to the department of internal medicine with an acute illness, but without known deep venous thrombosis (DVT) was investigated by ultrasound compression sonography. Patients' history, risk factors and extent of immobilisation were documented. In patients with newly detected DVT D-dimer and fibrinogen were measured as well as computer tomography scans performed. Follow-up investigations of the DVT population were performed at four weeks and three months. Six hundred seventeen patients (49.3% men) were included. In 16 patients (men = 7) a previously unknown thrombosis (2.6%) was detected, mainly in patients with acute cardio-pulmonary disease (56%) and the elderly (mean age 75.6 years). Eight patients had femoro-popliteal (50.0%), four a femoral (25.0%), and four a popliteal vein thrombosis (25.0%). Five had pulmonary embolism (31.3%). In patients with DVT D-dimer was 875 +/- 1,228 mg/l, fibrinogen 568 +/- 215 mg/dl and C-reactive-protein 58.54 +/- 73.65 mg/dl. One patient died from sepsis during hospitalisation, one died from sudden cardiac death at home. None of the other 14 surviving patients relapsed. The study shows a 2.6% risk for DVT in outpatients with acute illness admitted to the department of internal medicine. These data demonstrate the high risk of DVT is in non-surgical patients. Early prophylaxis has to be considered in internal medicine patients especially in the elderly.

  20. Quantitative analysis of patients with celiac disease by video capsule endoscopy: A deep learning method.

    Science.gov (United States)

    Zhou, Teng; Han, Guoqiang; Li, Bing Nan; Lin, Zhizhe; Ciaccio, Edward J; Green, Peter H; Qin, Jing

    2017-06-01

    Celiac disease is one of the most common diseases in the world. Capsule endoscopy is an alternative way to visualize the entire small intestine without invasiveness to the patient. It is useful to characterize celiac disease, but hours are need to manually analyze the retrospective data of a single patient. Computer-aided quantitative analysis by a deep learning method helps in alleviating the workload during analysis of the retrospective videos. Capsule endoscopy clips from 6 celiac disease patients and 5 controls were preprocessed for training. The frames with a large field of opaque extraluminal fluid or air bubbles were removed automatically by using a pre-selection algorithm. Then the frames were cropped and the intensity was corrected prior to frame rotation in the proposed new method. The GoogLeNet is trained with these frames. Then, the clips of capsule endoscopy from 5 additional celiac disease patients and 5 additional control patients are used for testing. The trained GoogLeNet was able to distinguish the frames from capsule endoscopy clips of celiac disease patients vs controls. Quantitative measurement with evaluation of the confidence was developed to assess the severity level of pathology in the subjects. Relying on the evaluation confidence, the GoogLeNet achieved 100% sensitivity and specificity for the testing set. The t-test confirmed the evaluation confidence is significant to distinguish celiac disease patients from controls. Furthermore, it is found that the evaluation confidence may also relate to the severity level of small bowel mucosal lesions. A deep convolutional neural network was established for quantitative measurement of the existence and degree of pathology throughout the small intestine, which may improve computer-aided clinical techniques to assess mucosal atrophy and other etiologies in real-time with videocapsule endoscopy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Acute immune thrombocytopenic purpura triggered by insect bite

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    Namdev R

    2009-03-01

    Full Text Available Idiopathic Thrombocytopenic Purpura (ITP is a blood disorder characterized by an abnormal decrease in the number of platelets in the blood. Acute thrombocytopenic purpura is most commonly seen in young children, with a sudden onset, following a viral illness, vaccination or an insect bite. The report is a rare case of ITP, which was triggered by a honey-bee bite and caused continuous intermittent bleeding from the gingival sulcular region of the maxillary left permanent first molar, and ecchymotic spots on the forehead, scalp, and lower limbs. A complete hemogram revealed severe thrombocytopenia with platelet count as low as 15,000/mm3. The patient was immediately hospitalized and administered platelet replacement and medication. With this report, the authors, as dentists, emphasize the significance of recognition, early diagnosis, and referral of such patients with bleeding disorders to specialized centers, for prompt treatment.

  2. Risk factors for upper limb deep vein thrombosis associated with the use of central vein catheter in cancer patients.

    NARCIS (Netherlands)

    Verso, M.; Agnelli, G.; Kamphuisen, P.W.; Ageno, W.; Bazzan, M.; Lazzaro, A.; Paoletti, F.; Paciaroni, M.; Mosca, S.; Bertoglio, S.

    2008-01-01

    Deep vein thrombosis of upper limb is a common complication of CVC in patients with cancer. In these patients the risk factors for CVC-related thrombosis are not completely defined. The purpose of this study was to identify the risk factors for CVC-related thrombosis in patients included in a random

  3. Bite force and state of dentition.

    Science.gov (United States)

    Helkimo, E; Carlsson, G E; Helkimo, M

    1977-01-01

    The maximal bite force and the strength of the finger-thumb grip of 125 Skolt Lapps, aged 15 to 65, was measured with a specially devised apparatus. The bite force was measured with the biting fork placed between the first molars and between the incisors, respectively. The finger-thumb grip was measured by letting the subject press the prongs of the fork between the thumb and forefinger of each hand as hard as possible. The range of inter-individual variation of the maximal bite force and finger-thumb grip was great. The mean values were higher for the males than for the females. In the males the maximal bite force thus measured in the molar region was 39 kg (382 N) and 18 kg (176 N) in the incisor region. The corresponding values for the females were 22 kg (216 N) and 11 kg (108 N). The finger-thumb grip strength for males was, on the average, 10 kg (98 N); that of the females, 7 KG (69 N). The average difference in bite force between the men and the women was larger in the group with natural teeth than in the one with complete dentures. The values found for the bite force decreased with increasing age, especially for the females. Most of this reduction with increasing age was probably due to the age-dependent deterioration of the dentition. In both sexes the bite force was notably smaller among the denture wearers than among the dentate persons. The number of natural teeth varied closely with the bite force, i.e. the greater number of natural teeth the greater the bite force.

  4. [A discussion regarding reconstruction and rehabilitation of patients with deep burn wound].

    Science.gov (United States)

    Hu, Da-hai

    2009-12-01

    With the advances in resuscitation, infection control, and metabolic management, the treatment strategies for burn patients have improved remarkably in the last half century. As a result, more patients with deep burn wound survived, and how to optimize the burn wound care aiming at recovery of the normal appearance and physiologic function of patients has been investigated and discussed widely through both the whole treatment strategy making and the new techniques performing. In the present discussion, early tissue reconstruction as well as early wound covering and repair are emphasized by summarizing the improved aesthetic and functional effects obtained by applying the principles of plastic surgery in early burn wound repair, the use of composite skin grafting, the grafting with split-thickness autografts on the preserved denatured dermis or on the preserved healthy fat tissue, etc. Besides these, more attention should be given to the repair and reconstruction in specialized functional parts of the body, such as head and face, neck, hand, female breast, perineum, and joint areas, after a deep burn. The role of rehabilitation during and after the burn wound treatment process is elucidated by demonstrating its potential biophysical mechanism and preventing scar deformity. Adequate treatment of deep burn wound demands a number of important measures including the timing of surgery, adoption of essential techniques, suitable types of wound covering materials, motivated rehabilitation, and necessary psychological therapy. The optimal recovery of damaged part of body after burn should depend on the similarity of rebuild tissue structure to simulate the nature of the original tissue in the cellular, histological, anatomic characteristics, which is the aim of all burn wound care and the basis of the appearance and function repair or reconstruction.

  5. Biting

    Science.gov (United States)

    ... Distraction works wonders with kids this age. If emotions and energy levels are running high or if boredom has set in, help redirect a little one's attention to a more positive activity, like dancing to music, coloring, or playing a game. Discipline usually is ...

  6. Parkinson's disease patients with bilateral subthalamic deep brain stimulation gain weight.

    Science.gov (United States)

    Macia, Frédéric; Perlemoine, Caroline; Coman, Irène; Guehl, Dominique; Burbaud, Pierre; Cuny, Emmanuel; Gin, Henri; Rigalleau, Vincent; Tison, François

    2004-02-01

    Weight, body mass index (BMI) and energy expenditure/energy intake (EE/EI) was studied in 19 Parkinson's disease (PD) patients after subthalamic deep brain stimulation (STN-DBS) versus 14 nonoperated ones. Operated patients had a significant weight gain (WG, + 9.7 +/- 7 kg) and BMI increase (+ 4.7 kg/m2). The fat mass was higher after STN-DBS. Resting EE (REE; offdrug/ON stimulation) was significantly decreased in STN-DBS patients, while their daily energy expenditure (DEI) was not significantly different. A significant correlation was found among WG, BMI increase, and pre-operative levodopa-equivalent daily dose, their reduction after STN-DBS, and the differential REE related to stimulation and the REE in the offdrug/OFF stimulation condition. In conclusion, STN-DBS in PD induces a significant WG associated with a reduction in REE without DEI adjustment.

  7. Deep vein thrombosis of upper extremities due to reactive thrombocytosis in septic patients

    Directory of Open Access Journals (Sweden)

    Shakti Bedanta Mishra

    2014-01-01

    Full Text Available Deep venous thrombosis (DVT is not an uncommon condition in the intensive care unit (ICU, and having high morbidity and mortality. Upper limb DVT also is increasingly being recognized as a clinical entity. The presence of the indwelling catheter in neck veins is a risk for developing venous thrombus, which may be further aggravated by presence of thrombocytosis. In ICU patients with sepsis, reactive thrombocytosis has been found during the recovery phase. Here, we are presenting two cases, having thrombocytosis and central venous catheter who developed upper limb DVT.

  8. Deep cerebral microbleeds are negatively associated with HDL-C in elderly first-time ischemic stroke patients.

    Science.gov (United States)

    Igase, Michiya; Kohara, Katsuhiko; Igase, Keiji; Yamashita, Shiro; Fujisawa, Mutsuo; Katagi, Ryosuke; Miki, Tetsuro

    2013-02-15

    Cerebral microbleeds (CMBs) detected on T2*-weighted MRI gradient-echo have been associated with increased risk of cerebral infarction. We evaluated risk factors for these lesions in a cohort of first-time ischemic stroke patients. Presence of CMBs in consecutive first-time ischemic stroke patients was evaluated. The location of CMBs was classified by cerebral region as strictly lobar (lobar CMBs) and deep or infratentorial (deep CMBs). Logistic regression analysis was performed to determine the contribution of lipid profile to the presence of CMBs. One hundred and sixteen patients with a mean age of 70±10years were recruited. CMBs were present in 74 patients. The deep CMBs group had significantly lower HDL-C levels than those without CMBs. In univariable analysis, advanced periventricular hyperintensity grade (PVH>2) and decreased HDL-C were significantly associated with the deep but not the lobar CMB group. On logistic regression analysis, HDL-C (beta=-0.06, p=0.002) and PVH grade >2 (beta=3.40, p=0.005) were independent determinants of deep CMBs. Low HDL-C may be a risk factor of deep CMBs, including advanced PVH status, in elderly patients with acute ischemic stroke. Management of HDL-C levels might be a therapeutic target for the prevention of recurrence of stroke. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Cross-bite and oral health related quality of life in young people.

    Science.gov (United States)

    Masood, Mohd; Masood, Yaghma; Newton, Tim

    2014-03-01

    This study sought to assess the impact of posterior cross-bite on OHRQoL in young people aged 15-25 and to determine whether the impact on higher domains of Oral Health Impact Profile-14 (physical disability, psychological disability, social disability and handicap) is a direct function of the cross-bite or mediated through the lower domains of OHIP-14 (functional limitation, pain and discomfort). One hundred and forty-five young adults [72 cross-bite cases and 73 controls] aged 15-25 years, attending orthodontic clinics at the Faculty of Dentistry, Universiti Teknologi MARA participated in this study. Participants completed the OHIP-14 and had a clinical examination for cross-bite. Data analyses included descriptive statistics, t-test and bivariate and multivariate regression modelling. There was no significant difference between the case and control groups in gender, age and education level. The mean scores (±SD) for OHIP-14 total and all domains were significantly higher in cross-bite patients as compared to controls. The bivariate and multivariate regression analyses showed functional limitation was significantly associated with all the higher domains in all four models, whereas pain was only significantly associated with the psychological domain and discomfort was only significantly associated with the physical disability domain. The possession of a posterior cross bite has a significant association with OHRQoL especially on the functional limitation and psychological disability domains, among 15-25 years old young people. The relationship of cross-bite and lower domains of OHIP-14 with higher domains of OHIP-14 was in agreement with the relationships proposed by Locker's conceptual model of oral health. Patients with a cross bite were more limited in their oral functions and experienced greater psychological discomfort than did controls. It is possible that part of patients' rationale for seeking treatment would be to alleviate such impacts on their oral

  10. CLINICO-EPIDEMIOLOGY AND THERAPEUTIC OUTCOME OF SNAKE BITE IN KONASEEMA REGION OF ANDHRA PRADESH

    Directory of Open Access Journals (Sweden)

    Sai Krishna

    2016-03-01

    Full Text Available INTRODUCTION Snake bite is a common and frequently devastating environmental and occupational problem, especially in rural areas of tropical developing countries. Snake bite incidence is high in Andhra Pradesh. With the onset of monsoon the incidence of snake bite used to increase. METHODS Present study is a retrospective study in which all the data of snake bite cases admitted in the Konaseema Institute of Medical Sciences was collected in last two years; details of the patient was obtained from bed head ticket. RESULTS In two years of data collection, 46 snake bite cases are found as per our record. Out of 46 patients, twenty seven were male and nineteen were female. Maximum twenty two (22 patients were between ages 20 to 40 years. Out of forty six patients, forty four recovered and only two patients died, cause of death was acute pulmonary oedema with cardiac arrhythmia. DISCUSSION Most of the patients were given ASV (anti-snake venom, out of that only four patients developed reaction to ASV. Most of the patients who have received ASV were recovered. Only two deaths were reported which was due to acute pulmonary oedema with cardiac arrhythmia. CONCLUSION Awareness and education about snake is required.

  11. Falls related to accidental deactivation of deep brain stimulators in patients with Parkinson's disease living in long term care facilities.

    Science.gov (United States)

    Tousi, Babak; Wilson, Kathy

    2013-01-01

    This case series highlights three patients with Parkinson's disease residing at nursing home facilities whose deep brain stimulators were accidentally deactivated for varying lengths of time, which was associated with an increase in falls. In all three cases, neither the patients nor the caregivers were aware of the random deactivations/reactivations. We propose a specific care plan for these patients that includes further education of caregivers regarding deep brain stimulators and regular checks of the review device, especially when there is concern about a patient's mobility or balance that is out of character.

  12. Endovascular Management of Deep venous Thrombosis of Lower Extremity in Patients with Malignant Disease

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Su Jin; Kim, Jae Kyu; Jang, Nam Kyu; Han, Seung Min; Kang, Heoung Keun; Choi, Soo Jin Nah [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2009-07-15

    To evaluate the efficacy of endovascular management of lower extremity deep vein thrombosis (DVT) in patients with malignant disease. Between January 2002 and January 2008, six consecutive patients (5 male and 1 female, mean age-65 years) with lower extremity DVT and malignant disease underwent endovascular management. The duration of symptoms lasted 4-120 days (mean-31 days; 20 days or less in four patients and more than 20 days in two). A catheter-directed thrombolysis was performed via the ipsilateral popliteal vein or common femoral vein, used alone or combined with a percutaneous mechanical thrombectomy. Angioplasty or stent placement was performed in residual stenosis or occlusion of the vein. The follow-up period lasted 1-14 months (mean 7.6 months) and was performed via a color Doppler ultrasonography or computed tomographic venography. Technical success and relief from symptoms was achieved within two days was achieved in five patients. Minor hemorrhagic complications occurred in two cases: hematuria and a hematoma at the puncture site. Upon follow-up, a recurrent DVT occurred in three patients as well as a patent venous flow in two. One patient died within 1 month due to a metastatic mediastinal lymphadenopathy. Endovascular management of the lower extremity DVT is effective for quickly eliminating a thrombus, relieving symptoms, and decreasing hemorrhagic complications in patients with malignant disease.

  13. Bites by Australian mygalomorph spiders (Araneae, Mygalomorphae), including funnel-web spiders (Atracinae) and mouse spiders (Actinopodidae: Missulena spp).

    Science.gov (United States)

    Isbister, Geoffrey K; Gray, Mike R

    2004-02-01

    A number of mygalomorph spiders cause bites in Australia, including the funnel-web spiders (Hexathelidae, Atracinae: Hadronyche and Atrax) and mouse spiders (Actinopodidae: Missulena). There is ongoing debate about the significance of bites by mouse spiders and the frequency of severe envenoming by funnel-web spiders. We conducted a prospective cohort study of definite spider bites with expert spider identification and include the analysis of mygalomorph spiders here. Subjects were recruited prospectively from February 1999 to April 2003 from patients presenting to participating hospitals or contacting a state poison information centre. Forty-nine cases of bites by mygalomorph spiders were included: 16 were by funnel-web spiders, 13 by mouse spiders and 20 by other trapdoor spiders (Families Idiopidae and Nemesiidae). Of the 49 bites, 45 (92%) occurred on distal limbs (hands and feet). Local effects included severe pain (53%), puncture marks (61%) and bleeding (27%), local redness (33%). Itchiness did not occur. The following were highly statistically associated with mygalomorph spider bites compared to all other spiders (pweb spider bites, there were 10 cases with minor local effects, four with moderate envenoming (non-specific systemic or local neurotoxicity) and two with severe envenoming requiring antivenom. In addition to local effects, mouse spider bites caused local paraesthesia in three cases, local diaphoresis in one case and non-specific systemic effects in five cases, but not severe envenoming. True trapdoor spider bites caused only minor effects. The data from a mixed species sample of funnel-web spiders confirms previous observations suggesting that only a small proportion of funnel-web bites cause severe effects. Mouse spider bites are unlikely to cause major envenoming but the clinical effects are consistent with neurotoxic venom and are more severe than the trapdoor spiders.

  14. Deep vein thrombosis in a patient of Sheehan′s syndrome: Autoimmunity or hypercoagulabilty

    Directory of Open Access Journals (Sweden)

    Shahnaz Ahmad Mir

    2013-01-01

    Full Text Available Introduction: Literature is inconsistent whether patients with hypopituitarism have increased risk of thrombosis. Recent data has shown problems with the coagulation system in Sheehan′s syndrome (SS. Here, we describe a case of SS which presented with deep vein thrombosis. Objective: To describe a case of SS presenting as deep vein thrombosis. Case Report: A 30-year-old female was admitted to the general medicine ward with 1 month history of gradual onset swelling and pain in the left leg. The left calf diameter was 5 cm greater than the right. Doppler of the lower limbs revealed thrombosis in the left popliteal vein. Patient′s coagulation profile revealed a normal prothrombin time of 12 sec, activated partial thromboplastin time of 30 sec, positive D-dimer, negative protein C and protein S and normal titres of antinuclear antibodies. Echocardiography showed an ejection fraction of 52 percent. Endocrinology consultation was sought in view of clinical suspicion of hypothyroidism. Endocrinology review revealed a significant past history of primary postpartum hemorrhage, lactation failure and secondary amenorrhea since the delivery of the last child 6 years back. She had clinical features of growth hormone, thyroid hormone and adrenocorticotropic hormone deficiency. Hormonal analysis showed features of central hypothyroidism, secondary adrenal insufficiency and growth hormone deficiency which was subsequently confirmed by insulin tolerance test. Conclusion: SS patients may have increased risk of thrombosis

  15. Susceptibility to Frost-Bite

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    Bal Krishna

    1966-11-01

    Full Text Available The body protects its susceptible parts e.g. hands and feet from cold injury by allowing a surge of blood to flow through them on exposure to severe cold. This occurs through alternate vasodilatation and vasoconstriction known as Lewis Hunting Reaction. This phenomenon is influenced by several factors, which indirectly may also affect individual susceptibility to cold injury. The role of nutrition, adequate insulation of the body and positive heat balance in relation to the protective mechanism have been reviewed and discussed. Available literature on various factors has been surveyed and discussed in the light of recent advances in the physiology of cold exposure. Certain tests based on the present knowledge, to be developed and standardised for screening susceptible individuals to frost-bite have been suggested.

  16. Ileofemoral Deep Vein Thrombosis (DVT) in Steroid Treated Lepra Type 2 Reaction Patient.

    Science.gov (United States)

    Thangaraju, P; Giri, V C; Aravindan, U; Sajitha, V; Showkath Ali, M K

    2015-01-01

    In 1998 a 57-year-old man having skin leisons of 6 months duration reported to Central Leprosy Teaching and Research Institute (CLTRI), Chengalpattu. It was diagnosed as a case of borderline lepromatous leprosy with a type 2 lepra reaction, was treated with multi bacillary-multi drug therapy (MBMDT) for a period of 12 months and the patient was released from treatment (RFT) in September 1999. For reactions the patient was treated with prednisolone for more than 10 months. After 14 years in April 2013 the same patient presented to CLTRI with complaints of weakness of both hands with loss of sensation for 4 months, so making a diagnosis suggestive of MB relapse with neuritis the patient was started with MB-MDT for period of 12 months with initial prednisolone 25 mg OD dose then increased to 40 mg for painful swollen leg and to follow the neuritis associated pain and swelling. Increased dose is not beneficial and the patient was investigated for other pathology. Doppler ultra-sound revealed a left ileofemoral deep vein thrombosis (DVT) in that patient with levels. Prednisolone was withdrawn and the patient was started with anticoagulant heparin followed by warfarin. During this period rifampicin was also withdrawn. After patient was in good condition he was put on MB-MDT regimen. Till the 6th pulse the patient continues to show improvement in functions without steroids and any tenderness, he is taking multivitamins; regular physiotherapy. This DVT appears to be due to prednisolone and such causative relationship though rare should be kept in mind when patient on long term treatment with steroids/and or immobilized or on prolonged bed rest report with such symptomatology.

  17. Clinical features and risk factor analysis for lower extremity deep venous thrombosis in Chinese neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Fuyou Guo

    2015-01-01

    Full Text Available Background: Deep venous thrombosis (DVT contributes significantly to the morbidity and mortality of neurosurgical patients; however, no data regarding lower extremity DVT in postoperative Chinese neurosurgical patients have been reported. Materials and Methods: From January 2012 to December 2013, 196 patients without preoperative DVT who underwent neurosurgical operations were evaluated by color Doppler ultrasonography and D-dimer level measurements on the 3rd, 7th, and 14th days after surgery. Follow-up clinical data were recorded to determine the incidence of lower extremity DVT in postoperative neurosurgical patients and to analyze related clinical features. First, a single factor analysis, Chi-square test, was used to select statistically significant factors. Then, a multivariate analysis, binary logistic regression analysis, was used to determine risk factors for lower extremity DVT in postoperative neurosurgical patients. Results: Lower extremity DVT occurred in 61 patients, and the incidence of DVT was 31.1% in the enrolled Chinese neurosurgical patients. The common symptoms of DVT were limb swelling and lower extremity pain as well as increased soft tissue tension. The common sites of venous involvement were the calf muscle and peroneal and posterior tibial veins. The single factor analysis showed statistically significant differences in DVT risk factors, including age, hypertension, smoking status, operation time, a bedridden or paralyzed state, the presence of a tumor, postoperative dehydration, and glucocorticoid treatment, between the two groups (P < 0.05. The binary logistic regression analysis showed that an age greater than 50 years, hypertension, a bedridden or paralyzed state, the presence of a tumor, and postoperative dehydration were risk factors for lower extremity DVT in postoperative neurosurgical patients. Conclusions: Lower extremity DVT was a common complication following craniotomy in the enrolled Chinese neurosurgical

  18. Ethical Considerations for Deep Brain Stimulation Trials in Patients with Early-Onset Alzheimer's Disease.

    Science.gov (United States)

    Viaña, John Noel M; Bittlinger, Merlin; Gilbert, Frederic

    2017-01-01

    Several studies of deep brain stimulation (DBS) of the fornix or the nucleus basalis of Meynert have been recently conducted in people with Alzheimer's disease, with several recruiting participants early-onset Alzheimer's disease (EOAD). Although EOAD accounts for less than 5.5% of AD cases, ethical considerations must still be made when performing DBS trials including these participants since a portion of people with EOAD, especially those possessing autosomal-dominant mutations, have an atypical and more aggressive disease progression. These considerations include appropriate patient selection and signing of an informed consent for genetic testing; appropriate study design; potential outcomes that people with EOAD could expect; and accurate interpretation and balanced discussion of trial results. Finally, recommendations for future DBS for AD trials will be made to ensure that EOAD patients will not experience avoidable harms should they be enrolled in these experimental studies.

  19. Graduated compression stockings in the prevention of deep vein thrombosis in patients with acute myocardial infarction.

    Science.gov (United States)

    Kierkegaard, A; Norgren, L

    1993-10-01

    Venous volume (venous capacity) of the calf is low in patients with acute myocardial infarction, who also have a high risk of deep vein thrombosis (DVT). The effect of graduated compression stockings on the venous volume and on the incidence of DVT was therefore studied in 80 patients aged 70 years and above with acute myocardial infarction. Graduated compression stockings were randomly fitted to one leg, the other serving as a control, after which the venous volume was measured by strain gauge plethysmography. The incidence of DVT was measured by the 125I fibrinogen uptake test. Venous volume was significantly higher in legs treated with graduated compression stockings compared to control legs. DVT developed in eight control legs but not in any leg treated with graduated compression stockings (P = 0.003). DVT was also significantly more frequent in women compared to men and the majority of DVT developed in legs with very low venous volume values.

  20. Cheek Plumper: An Innovative Anti-cheek Biting Appliance

    Science.gov (United States)

    Srivastava, Nikhil; Kaushik, Noopur; Panthri, Prerna

    2016-01-01

    ABSTRACT One of the most challenging tasks for a pediatric dentist is the management of deleterious oral habits which adversely affect the dentofacial complex. However, if these habits can be intercepted and diagnosed well in time, they can save the patient from the psychological impact of undergoing long treatment therapies. One such rare deleterious oral habit is cheek biting that affects the buccal mucosa. Presented here is a case report which describes the interception of this deleterious habit in a 15-year-old female child who was a bilateral cheek biter with the help of an innovative intraoral appliance: The cheek plumper. How to cite this article: Rana V, Srivastava N, Kaushik N, Panthri P. Cheek Plumper: An Innovative Anti-cheek Biting Appliance. Int J Clin Pediatr Dent 2016;9(2):146-148. PMID:27365937

  1. An Innovative Miniature Bite Force Recorder.

    Science.gov (United States)

    Singh, Sarabjeet; Utreja, Ashok K; Sandhu, Navreet; Dhaliwal, Yadvinder S

    2011-01-01

    In this study, a detailed description of development of a new novel bite force recorder (gnathodynamometer) using solid state components is vividly explained. This state of the art authenticated device can be used to assess the complex function of human bite force, which is the net resultant combination of functional response of various craniomandibular structures consisting of interrelated components, like the muscles of mastication, joints, teeth and the neuromuscular system. The consistency and accuracy of the bite force recorder was reaffirmed by doing a detailed laboratory calibration and clinical testing on 30 adult subjects.

  2. Neurological manifestations of snake bite in Sri Lanka.

    Directory of Open Access Journals (Sweden)

    Seneviratne U

    2002-10-01

    Full Text Available BACKGROUND AND AIMS: Snake bite is an important cause of mortality and morbidity in certain parts of Sri Lanka. This study was designed to determine the offending snakes, neurological manifestations, disease course, and outcome in neurotoxic envenomation. METHODS AND MATERIAL: Fifty six consecutive patients admitted with neurological manifestations following snake bite were studied prospectively. Data were obtained regarding the offending snakes, neurological symptoms, time taken for onset of symptoms, neurological signs, and time taken for recovery. RESULTS: The offending snake was Russell′s viper in 27(48.2%, common and Sri Lankan krait in 19(33.9%, cobra in 3(5.4%, and unidentified in 7(12.5%. Ptosis was the commonest neurological manifestation seen in 48(85.7% followed by ophthalmoplegia (75%, limb weakness (26.8%, respiratory failure (17.9%, palatal weakness (10.7%, neck muscle weakness (7.1%, and delayed sensory neuropathy (1.8%. Neurological symptoms were experienced usually within 6 hours after the bite. Following administration of antivenom, the signs of recovery became evident within a few hours to several days. The duration for complete recovery ranged from four hours to two weeks. CONCLUSIONS: Complete recovery of neuromuscular weakness was observed in all patients except for one who died with intracerebral haemorrhage shortly after admission.

  3. Deep phenotyping of 89 xeroderma pigmentosum patients reveals unexpected heterogeneity dependent on the precise molecular defect

    Science.gov (United States)

    Fassihi, Hiva; Sethi, Mieran; Fawcett, Heather; Wing, Jonathan; Chandler, Natalie; Mohammed, Shehla; Craythorne, Emma; Morley, Ana M. S.; Lim, Rongxuan; Turner, Sally; Henshaw, Tanya; Garrood, Isabel; Giunti, Paola; Hedderly, Tammy; Abiona, Adesoji; Naik, Harsha; Harrop, Gemma; McGibbon, David; Jaspers, Nicolaas G. J.; Botta, Elena; Nardo, Tiziana; Stefanini, Miria; Young, Antony R.; Sarkany, Robert P. E.; Lehmann, Alan R.

    2016-01-01

    Xeroderma pigmentosum (XP) is a rare DNA repair disorder characterized by increased susceptibility to UV radiation (UVR)-induced skin pigmentation, skin cancers, ocular surface disease, and, in some patients, sunburn and neurological degeneration. Genetically, it is assigned to eight complementation groups (XP-A to -G and variant). For the last 5 y, the UK national multidisciplinary XP service has provided follow-up for 89 XP patients, representing most of the XP patients in the United Kingdom. Causative mutations, DNA repair levels, and more than 60 clinical variables relating to dermatology, ophthalmology, and neurology have been measured, using scoring systems to categorize disease severity. This deep phenotyping has revealed unanticipated heterogeneity of clinical features, between and within complementation groups. Skin cancer is most common in XP-C, XP-E, and XP-V patients, previously considered to be the milder groups based on cellular analyses. These patients have normal sunburn reactions and are therefore diagnosed later and are less likely to adhere to UVR protection. XP-C patients are specifically hypersensitive to ocular damage, and XP-F and XP-G patients appear to be much less susceptible to skin cancer than other XP groups. Within XP groups, different mutations confer susceptibility or resistance to neurological damage. Our findings on this large cohort of XP patients under long-term follow-up reveal that XP is more heterogeneous than has previously been appreciated. Our data now enable provision of personalized prognostic information and management advice for each XP patient, as well as providing new insights into the functions of the XP proteins. PMID:26884178

  4. Deep brain stimulation for patients with Parkinson's disease: Effect on caregiver burden.

    Science.gov (United States)

    Crespo-Burillo, J A; Rivero-Celada, D; Saenz-de Cabezón, A; Casado-Pellejero, J; Alberdi-Viñas, J; Alarcia-Alejos, R

    2016-07-18

    Our aim is to assess the burden on caregivers of patients with Parkinson's disease treated with deep brain stimulation (DBS) compared to those caring for patients at advanced stages and undergoing other treatments. We have also assessed the variables associated with presence of caregiver overload. We included consecutive patients with Parkinson's disease treated with DBS. Our control group included patients in advanced stages of Parkinson's disease undergoing other treatments. Patients were assessed with the following scales: UPDRS-II, UPDRS-III, UPDRS-IV, Hoehn and Yahr, Schwab & England, Barthel, PDQ-39, MoCA, Apathy Evaluation Scale, HADS, and the abbreviated QUIP. Caregiver burden was evaluated with the Zarit caregiver burden interview and their moods were assessed with the HADS scale. We included 11 patients treated with DBS and 11 with other treatments. For patients treated with DBS, we observed a better quality of life according to the PDQ-39 questionnaire (P=.028), and a lower score on the HADS anxiety subscale (P=.010). Caregiver overload was observed in 54.5% of the caregivers of patients in both groups (P=1.000); Zarit scores were similar (P=.835). Caregiver overload was associated with higher scores on the caregiver's Apathy Evaluation Scale (P=.048) and on the HADS anxiety subscale (P=.006). According to our results, treatment with DBS is not associated with lower caregiver burden. Apathy in patients and anxiety in caregivers are factors associated with the appearance of overload. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Focused Sonographic Examination of the Heart, Lungs and Deep Veins in Acute Admitted Patients with Respiratory Symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg; Sloth, Erik; Lassen, Annmarie Touborg;

    2012-01-01

    of the clinical examination. In addition, most of the diseases, which are commonly seen in patients with acute respiratory symptoms, can be diagnosed using sonography. Sonography could be integrated as a part of the primary evaluation, potentially improving the diagnostic performance. We therefore evaluated...... the use of sonographic examination of the heart, lungs and deep veins, performed within one hour of the primary evaluation, in acute admitted patients with respiratory symptoms. Methods: We performed a prospective cross sectional blinded observational study, conducted in a medical emergency department....... Patients were included if one or more of the following symptoms or clinical findings were present: respiratory rate > 20, saturation heart, lungs and deep veins...

  6. [Effects of Meek skin grafting on patients with extensive deep burn at different age groups].

    Science.gov (United States)

    Di, H P; Niu, X H; Li, Q; Li, X L; Xue, J D; Cao, D Y; Han, D W; Xia, C D

    2017-03-20

    Objective: To investigate the effect of Meek skin grafting on patients with extensive deep burn at different age groups. Methods: Eighty-four patients with extensive deep burns conforming to the study criteria were hospitalized in our unit from April 2011 to April 2015. Patients were divided into children group (C, with age less than 12 years old), young and middle-aged group (YM, with age more than 18 years and less than 50 years old), and old age group (O, with age more than 55 years old) according to age, with 28 patients in each group. All patients received Meek skin grafting treatment. The use of autologous skin area, operation time, wound healing time, and hospitalization time were recorded. The survival rate of skin graft on post operation day 7, complete wound healing rate in post treatment week 2, and the mortality were calculated. Data were processed with one-way analysis of variance, t test, and χ(2) test. Results: The use of autologous skin area of patients in group C was (5.1±1.0)% total body surface area (TBSA), significantly less than (8.3±1.0)%TBSA and (8.3±1.4)%TBSA in groups YM and O, respectively (with t values 32.900 and 52.624, respectively, P values below 0.05). The operation time, wound healing time, and hospitalization time of patients in group C were (1.368±0.562) h, (9.6±0.6) and (32±11) d, significantly shorter than those in group YM [(3.235±0.011) h, (16.9±2.6) and (48±12) d, respectively] and group O [(3.692±0.481) h, (17.3±2.6) and (46±13) d, respectively, with t values from 4.350 to 21.160, P values below 0.05]. The survival rate of skin graft of patients on post operation day 7 in group C was (92±15)%, significantly higher than (81±10)% and (72±12)% in groups YM and O, respectively (with t values 5.509 and 3.229, respectively, P values below 0.05). The above indexes in groups YM and O were similar (with t values from 0.576 to 22.958, P values above 0.05). Complete wound healing rate in post treatment week 2 and the

  7. Utility of abdominal sonography in patients with idiopathic deep vein thrombosis.

    Science.gov (United States)

    Netzer, P; Binek, J; Hammer, B; Schmassmann, A

    1999-05-01

    Studies have confirmed an association between idiopathic deep vein thrombosis (DVT) and malignant tumors. We assessed the usefulness of routine abdominal sonography in patients with idiopathic DVT to detect malignant tumors and other relevant findings. We retrospectively analyzed abdominal sonograms and records from 135 consecutive patients with confirmed idiopathic DVT and interviewed patients and their physicians during the follow-up period (mean, 30 months). Malignancy and other clinically relevant findings determined by sonography were tabulated, and the cost of each malignancy detected by abdominal sonography in this study was calculated. Malignant tumors were found in 14 patients (10%), 7 by routine abdominal sonography, 3 by other means during hospitalization, and 4 during the follow-up period. Other clinically relevant findings detected by routine abdominal sonography were found in 33 patients (24%). The estimated cost of discovering malignancy by using screening abdominal sonography was approximately US$3,000/malignancy. Abdominal sonography was useful in detecting a variety of clinically relevant findings in addition to half of the malignant tumors found in our study.

  8. Incidence of Deep Vein Thrombosis in Hospitalized Chinese Medical Patients and the Impact of DVT Prophylaxis.

    Science.gov (United States)

    Cheng, Gregory; Chan, Crystal; Liu, Ying Ting; Choy, Yee Fun; Wong, Mei Mei; Yeung, Pui Kwan Ernest; Ng, Ka Ling; Tsang, Lai Shan; Wong, Raymond S M

    2011-01-01

    Objective. To evaluate the incidence of deep vein thrombosis in hospitalized Chinese medical patients and the impact of DVT prophylaxis. Methods. All cases of confirmed proximal DVT from 1 January 2005 to 31 December 2008 were reviewed retrospectively to determine the presence of risk factors and whether DVT developed: during hospitalization in medical wards or in case of readmission with a diagnosis of DVT within 14 days of discharge from a recent admission to medical wards. The impact of prophylaxis will be estimated by comparing the annual incidence of proximal DVT among medical patients hospitalized from 2005 to 2007 with that of 2008 (DVT prophylaxis commonly used). Results. From 1 January 2005 to 31 December 2008, 3938 Doppler ultrasound studies were performed for suspected DVT. Proximal DVT was diagnosed in 687 patients. The calculated incidence of proximal DVT among medical patients hospitalized for at least two days was 1.8%, 2%, and 1.7% for the year 2005, 2006, and 2007, respectively. The incidence was 1.1% for 2008 (P DVT was substantial in Chinese medical patients, and DVT prophylaxis might reduce such risk.

  9. Patient education: a tool in the outpatient management of deep vein thrombosis.

    Science.gov (United States)

    Haines, S T

    1998-01-01

    A key to effective outpatient management of thromboembolic disease is patient education. Although highly effective for the treatment of deep vein thrombosis (DVT), antithrombotic treatment may fail as a result of inadequate patient education. The risk of hemorrhage from antithrombotic drugs is related to a number of factors including intensity of anticoagulation achieved, comorbid illness, concurrent drug therapy, and lifestyle. When patients receive inadequate antithrombotic treatment, the risk of recurrent thromboembolic events and long-term complications are substantially increased. A well-organized, structured education program enables patients to learn the necessary skills that permit complex and valuable therapies to be managed on an outpatient basis. Health care professionals who are part of an outpatient DVT treatment program should possess working knowledge of adult learning theory and instructional design. To be effective, education programs should be systematically planned, have an educationally sound structure, and attempt to meet specific objectives. In addition, they should build on patients' existing knowledge, skills, and attitudes. Periodic evaluation of the education program is important to ensure that overall goals are being adequately met and to identify areas of weakness.

  10. Correction of anterior open bite in a case of achondroplasia

    Directory of Open Access Journals (Sweden)

    Karpagam S

    2005-01-01

    Full Text Available Treatment planning for patients with skeletal deformities is often considered challenging. This article reports a female patient with achondroplasia who presented with severe maxillary retrognathism and vertical excess along with anterior open bite. The clinical and cephalometric findings of the patient are detailed here. The treatment plan consisted of modified anterior maxillary osteotomy for simultaneous vertical and sagittal augmentation along with orthodontic intervention. The course of surgical-orthodontic treatment and the results are presented. This treatment is to be followed by correction of vertical maxillary excess after completion of growth. This paper concludes that the dentoalveolar component of a skeletal deformity can be handled independent of the craniofacial management.

  11. Pitch Variability in Patients with Parkinson's Disease: Effects of Deep Brain Stimulation of Caudal Zona Incerta and Subthalamic Nucleus

    Science.gov (United States)

    Karlsson, Fredrik; Olofsson, Katarina; Blomstedt, Patric; Linder, Jan; van Doorn, Jan

    2013-01-01

    Purpose: The purpose of the present study was to examine the effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) and the caudal zona incerta (cZi) pitch characteristics of connected speech in patients with Parkinson's disease (PD). Method: The authors evaluated 16 patients preoperatively and 12 months after DBS surgery. Eight…

  12. Validation of the Oudega diagnostic decision rule for diagnosing deep vein thrombosis in frail older out-of-hospital patients

    NARCIS (Netherlands)

    Schouten, Henrike J.; Koek, Huiberdina L.; Oudega, Ruud; Van Delden, Johannes J M; Moons, Karel G M; Geersing, Geert Jan

    2015-01-01

    Objective. We aimed to validate the Oudega diagnostic decision rule-which was developed and validated among younger aged primary care patients-to rule-out deep vein thrombosis (DVT) in frail older outpatients. Methods. In older patients (>60 years, either community dwelling or residing in nursing ho

  13. Deep venous thrombosis and pulmonary embolism detected by FDG PET/CT in a patient with bacteremia

    DEFF Research Database (Denmark)

    Nielsen, Anne Lerberg; Thomassen, Anders; Hess, Søren

    2013-01-01

    We report incidental FDG PET/CT findings of deep venous thrombosis and pulmonary embolism in a patient with bacteremia. In this patient, diagnosis of thromboembolism was not considered until FDG PET/CT imaging was performed, and the findings prompted immediate anticoagulant therapy. The role of FDG...

  14. Prevalence of deep venous thrombosis in patients with acute exacerbation of chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    DUAN Sheng-chen; YANG Yuan-hua; LI Xu-yan; LIANG Xiao-ning; GUO Rui-jun; XIE Wan-mu; KUANG Tu-guang; DAI Hua-ping; WANG Chen

    2010-01-01

    Background Acute exacerbation of chronic obstructive pulmonary disease (COPD) is always associated with a high incidence and mortality. Because of the presence of some concomitant risk factors such as immobilization, bronchial superinfection, patients who are admitted for acute exacerbations of COPD are generally considered to be at moderate risk for the development of venous thromboembolism. In this study, we investigated the prevalence and the clinical manifestations of deep venous thrombosis (DVT) in patients with acute exacerbation of COPD.Methods From March 2007 to March 2009, 520 consecutive patients were included in this study. On admission, color Doppler ultrasound of lower extremities in all cases was performed for diagnosing DVT. Patients with DVT were compared with those without DVT from such aspects as demographics, symptoms, physical signs and risk factors.Results Among the 520 patients, DVT was found in 46 cases (9.7%). In patients with DVT, the duration of hospitalization was longer (P=0.01), and the mechanical ventilation requirement increased (P <0.001). Other indicators for patients with more possibility of DVT were immobility exceeding 3 days (P <0.001); pneumonia as concomitance (P=0.01); respiratory failure type Ⅱ (P=0.013); current smoking (P=0.001). Lower extremity pain was more common in DVT cases in comparison to those without DVT (34.8% vs. 15.2%, P=0.01 ).Conclusions The acute exacerbation of COPD patients, who were immobilized for over 3 days, complicated by pneumonia and had respiratory failure type Ⅱ, had a higher risk of DVT. In addition, DVT detection awareness should be increased in cases that had a lower extremity pain.

  15. Relationship between deep venous thrombosis and inflammatory cytokines in postoperative patients with malignant abdominal tumors

    Directory of Open Access Journals (Sweden)

    T. Du

    2014-11-01

    Full Text Available Deep venous thrombosis (DVT is a common surgical complication in cancer patients and evidence that inflammation plays a role in the occurrence of DVT is increasing. We studied a population of cancer patients with abdominal malignancies with the aim of investigating whether the levels of circulating inflammatory cytokines were associated with postoperative DVT, and to determine the levels in DVT diagnoses. The serum levels of C-reactive protein (CRP, interleukins (IL-6 and IL-10, nuclear transcription factor-κB (NF-κB and E-selectin (E-Sel were determined in 120 individuals, who were divided into 3 groups: healthy controls, patients with and patients without DVT after surgery for an abdominal malignancy. Data were analyzed by ANOVA, Dunnet's T3 test, chi-square test, and univariate and multivariate logistic regression as needed. The CRP, IL-6, NF-κB, and E-Sel levels in patients with DVT were significantly higher than those in the other groups (P<0.05. The IL-10 level was higher in patients with DVT than in controls but lower than in patients without DVT. Univariate analysis revealed that CRP, IL-6, NF-κB, and E-Sel were statistically associated with the risk of DVT (OR=1.98, P=0.002; OR=1.17, P=0.000; OR=1.03, P=0.042; and OR=1.38, P=0.003; respectively, whereas IL-10 had a protective effect (OR=0.94, P=0.011. Multivariate analysis showed that E-Sel was an independent risk factor (OR=1.41, P=0.000. Thus, this study indicated that an increased serum level of E-Sel was associated with increased DVT risk in postoperative patients with abdominal malignancy, indicating that E-Sel may be a useful predictor of diagnosis of DVT.

  16. Relationship between deep venous thrombosis and inflammatory cytokines in postoperative patients with malignant abdominal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Du, T.; Tan, Z. [National Wuhan University, Zhongnan Hospital, School of Medicine, Department of General Surgery, Wuhan, Hubei Province (China)

    2014-08-22

    Deep venous thrombosis (DVT) is a common surgical complication in cancer patients and evidence that inflammation plays a role in the occurrence of DVT is increasing. We studied a population of cancer patients with abdominal malignancies with the aim of investigating whether the levels of circulating inflammatory cytokines were associated with postoperative DVT, and to determine the levels in DVT diagnoses. The serum levels of C-reactive protein (CRP), interleukins (IL)-6 and IL-10, nuclear transcription factor-κB (NF-κB) and E-selectin (E-Sel) were determined in 120 individuals, who were divided into 3 groups: healthy controls, patients with and patients without DVT after surgery for an abdominal malignancy. Data were analyzed by ANOVA, Dunnet's T3 test, chi-square test, and univariate and multivariate logistic regression as needed. The CRP, IL-6, NF-κB, and E-Sel levels in patients with DVT were significantly higher than those in the other groups (P<0.05). The IL-10 level was higher in patients with DVT than in controls but lower than in patients without DVT. Univariate analysis revealed that CRP, IL-6, NF-κB, and E-Sel were statistically associated with the risk of DVT (OR=1.98, P=0.002; OR=1.17, P=0.000; OR=1.03, P=0.042; and OR=1.38, P=0.003; respectively), whereas IL-10 had a protective effect (OR=0.94, P=0.011). Multivariate analysis showed that E-Sel was an independent risk factor (OR=1.41, P=0.000). Thus, this study indicated that an increased serum level of E-Sel was associated with increased DVT risk in postoperative patients with abdominal malignancy, indicating that E-Sel may be a useful predictor of diagnosis of DVT.

  17. Our Clinical Experiences in Snake Bites

    Directory of Open Access Journals (Sweden)

    Demet Altun

    2016-12-01

    Full Text Available In this study, we evaluate 25 cases who were admitted to the emergency service and transferred to the intensive care unit subsequently due to snakebite, prospectively. Clinical courses, toxic effects, complications and treatment approaches were aimed to be presented. Among the patients, 16 were female and 9 were male; the mean age was 42.1 (17-74 years. It was determined that all the cases were admitted to the hospital during working in the field in Eastern Anatolia Region, between the months of May and June, and between the hours of 15:00 to 18:00. When the cases were considered in terms of bitten body part, 15 were bitten from upper extremity and 10 were bitten from lower extremity. Within an hour the patients were admitted to a health facility with the complaints of nausea, pain, numbness, swelling and redness, and patients were transferred to emergency unit approximately within 1 hour (0.5 to 2 hours following the first intervention. Tetanus immunization is administered in all cases as the first intervention. Antivenom was administered to the 9 (36% of the patients in whom steroid, antihistamine and prophylactic antibiotic therapy was given in the intensive care unit. Under the control of infection clinic, antibiotic therapy was initiated to 13 (52% patients in who cellulitis, abscess, lymphedema and compartment syndrome were developed. Healing was observed approximately within 4 days (2-6 days and recovery was observed in all the cases. Patients admitted due to snake bites should be followed closely for at least 6 to 8 hours. According to the patient’s clinical condition and laboratory test results, early intervention therapy should be regulated and antivenom therapy should be administered in the presence of systemic symptoms.

  18. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... like biting your nails, try playing with a stress ball or silly putty instead. This will help ... of hangnails, or other triggers, such as boredom, stress, or anxiety. By figuring out what causes you ...

  19. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Center Coding and reimbursement Coding MACRA Fee schedule Managing a practice Prior authorization assistance Teledermatology Compliance Choosing ... this safe, but awful-tasting formula discourages many people from biting their nails. Get regular manicures: Spending ...

  20. [Bites of venomous snakes in Switzerland].

    Science.gov (United States)

    Plate, Andreas; Kupferschmidt, Hugo; Schneemann, Markus

    2016-06-08

    Although snake bites are rare in Europe, there are a constant number of snake bites in Switzerland. There are two domestic venomous snakes in Switzerland: the aspic viper (Vipera aspis) and the common European adder (Vipera berus). Bites from venomous snakes are caused either by one of the two domestic venomous snakes or by an exotic venomous snake kept in a terrarium. Snake- bites can cause both a local and/or a systemic envenoming. Potentially fatal systemic complications are related to disturbances of the hemostatic- and cardiovascular system as well as the central or peripheral nervous system. Beside a symptomatic therapy the administration of antivenom is the only causal therapy to neutralize the venomous toxins.

  1. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... a difference Career planning Media Relations Toolkit AAD apps Academy meeting Chronic urticaria—for members Chronic urticaria— ... like biting your nails, try playing with a stress ball or silly putty instead. This will help ...

  2. Management of vascular trauma from dog bites

    National Research Council Canada - National Science Library

    Akingba, A George; Robinson, Eric A; Jester, Andrea L; Rapp, Brian M; Tsai, Anthony; Motaganahalli, Raghu L; Dalsing, Michael C; Murphy, Michael P

    2013-01-01

    Vascular trauma from large-dog bites present with a combination of crush and lacerating injuries to the vessel, as well as significant adjacent soft tissue injury and a high potential for wound complications...

  3. The 'bite' in paediatric food allergy

    African Journals Online (AJOL)

    Chantel

    Health professionals need to educate .... spread, peanut butter, polony), vegetables/mashed potato (margarine, butter, Aromat added?) History. It is not ... Cheese curls, Niknaks, cheese bites and other chips containing cheese. Smarties ...

  4. Tarantula bite leads to death and gangrene

    Directory of Open Access Journals (Sweden)

    Banerjee Kalyan

    1997-01-01

    Full Text Available Chilobrachys hardwikii-giant black hairy spider bite produced two deaths, one case of gangrene of the foot and urticarial rashes in another person in a remote village of Churulia 30 km from Asansol.

  5. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Grant Strauss and Katz Scholarship Sulzberger Institute Grant Young Investigator Awards ... this safe, but awful-tasting formula discourages many people from biting their nails. Get regular manicures: Spending ...

  6. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... a difference Career planning Media Relations Toolkit AAD apps Academy meeting Chronic urticaria—for members Chronic urticaria— ... Injured skin Nail care Artificial nails Healthy nails Child nail care Manicure safety Nail biting Younger skin ...

  7. Rat Bite Fever Resembling Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Ripa Akter

    2016-01-01

    Full Text Available Rat bite fever is rare in Western countries. It can be very difficult to diagnose as blood cultures are typically negative and a history of rodent exposure is often missed. Unless a high index of suspicion is maintained, the associated polyarthritis can be mistaken for rheumatoid arthritis. We report a case of culture-positive rat bite fever in a 46-year-old female presenting with fever and polyarthritis. The clinical presentation mimicked rheumatoid arthritis. Infection was complicated by discitis, a rare manifestation. We discuss the diagnosis and management of this rare zoonotic infection. We also review nine reported cases of rat bite fever, all of which had an initial presumptive diagnosis of a rheumatological disorder. Rat bite fever is a potentially curable infection but can have a lethal course if left untreated.

  8. Spider bite-induced erythema multiforme.

    Science.gov (United States)

    Özyurt, Selçuk; Er, Onur; Afsar, Fatma Sule; Ermete, Murat

    2013-09-01

    Erythema multiforme (EM) is an immune-mediated mucocutaneous eruption characterized by symmetrically distributed, polymorphic targetoid lesions, mostly on the distal parts of the extremities. It occurs mostly in the setting of an infection in certain predisposed individuals. A 30-year-old pregnant woman was presented with a necrotic erythematous lesion on her right thigh following a spider bite. As she was pregnant for 16 weeks, no systemic medication was given. On the 8th day of the spider bite an erythematous vesicular and targetoid rash was seen on the distal parts of her extremities. Based on the clinical and histopathological findings, lesions were diagnosed as EM. She had not used any medication for 4 months and she gave no prior history of herpetic infection. So her EM lesions were thought to be an ID reaction most probably due to the spider bite. As far as we know, this is the first reported case of EM induced by a spider bite.

  9. Epidemiology of the brown recluse spider bite.

    Science.gov (United States)

    Rhoads, Jacqueline

    2007-02-01

    The purpose of this article was to provide a comprehensive epidemiological and clinical description of the brown recluse spider bite. Review of evidenced-based scientific literature and practice guidelines. A specific descriptive case study is interwoven through the article to tie in the clinical presenting figure associated with this bite. The brown recluse lives in a circumscribed area of the United States (the south central Midwest) with a few less common recluse species living in the more sparsely populated southwest United States. In these areas, where spider populations may be dense, recluse spiders may be a cause of significant morbidity. Most spider bites are asymptomatic but what makes this bite so devastating is the toxin injected by the brown recluse spider, which can cause considerable systemic symptoms as well as necrotic skin ulcers (necrotic arachnidism). The article presents process for diagnosis and stresses the importance of identifying the spider if at all possible.

  10. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Part 1: Structure Part 2: Origin Part 3: Function Textbook Study notes Image library 3-D animated ... hair, and nail care Nail care Nail biting "); (function () { var a = "", b = [ "adid=aad-aad-1", "site= ...

  11. [Acute compartment syndrome following snake bite].

    Science.gov (United States)

    Wagner, H E; Barbier, P; Frey, H P; Janggen, F M; Rothen, H U

    1986-04-01

    The experience with snake bites, causing local complications is discussed. Whenever systemic envenomation occurs, antivenin is the treatment of choice. Tissue necroses are treated by early debridement and a possible closed compartment syndrome demands the open fasciotomy.

  12. Beware of Bug Bites and Stings

    Science.gov (United States)

    ... Consumer Updates Spider Bites Ticks and Lyme Disease: Symptoms, Treatment, and Prevention Barbecue Basics: Tips to ... Consumer Updates by email. Email Address More in Consumer Updates Animal & Veterinary Children's Health Cosmetics Dietary Supplements Drugs Food Medical ...

  13. Take a Bite Out of Mosquito Stings

    Science.gov (United States)

    ... mosquito stings Share | Take a Bite Out of Mosquito Stings This article has been reviewed by Thanai ... lactic acid and carbon dioxide attract the female mosquito to skin. She inserts the tip of her ...

  14. Oral habits of temporomandibular disorder patients with malocclusion.

    Science.gov (United States)

    Fujita, Yukie; Motegi, Etsuko; Nomura, Mayumi; Kawamura, Sakura; Yamaguchi, Daisuke; Yamaguchi, Hideharu

    2003-11-01

    The purpose of this study was to clarify the relationship between oral habits and symptoms of temporomandibular joint disorder in patients who had sought orthodontic treatment by analyzing their present and past history. The subjects were 57 female patients (average age: 23 years and 6 months old) who had visited the "Temporomandibular Disorder Section" in our orthodontic department. Their chief complaints were the symptom of TMJ and the abnormalities of occlusion such as maxillary protrusion, open bite, crowding, mandibular protrusion, cross bite, deep bite, edge-to-edge bite, and spacing. Their present conditions and past histories were examined and evaluated. The most typical primary symptom was joint sound (23 patients, 40.0%). The second was joint sound and pain (15 patients, 26.3%). Of the symptoms present at the time of examination, the most prevalent were joint sound and pain (20 patients, 35.1%). The 48 patients (82.8%) had significant oral habits. Unilateral chewing was seen in 35 patients (72.9%), bruxism in 27 (56.3%), abnormality of posture in 14 (29.2%), habitual crunching in 10 (20.8%) and resting the check on the hand in 4 (8.3%), respectively. When comparing the primary symptoms to those at the time of examination, the patients with unilateral chewing and bruxism tended to have more complicated symptoms. In conclusion, the TMD symptoms of the patients with notable oral habits did not change or become worse during a period of about 5 years.

  15. Nutritional status in Parkinson's disease patients undergoing deep brain stimulation surgery: a pilot study.

    Science.gov (United States)

    Sheard, J M; Ash, S; Silburn, P A; Kerr, G K

    2013-02-01

    People with Parkinson's disease (PD) are at higher risk of malnutrition due to PD symptoms and pharmacotherapy side effects. When pharmacotherapy is no longer effective for symptom control, deep-brain stimulation (DBS) surgery may be considered. The aim of this study was to assess the nutritional status of people with PD who may be at higher risk of malnutrition related to unsatisfactory symptom management with optimised medical therapy. This was an observational study using a convenience sample. Participants were seen during their hospital admission for their deep brain stimulation surgery. People with PD scheduled for DBS surgery were recruited from a Brisbane neurological clinic (n=15). The Patient-Generated Subjective Global Assessment (PG-SGA), weight, height and body composition were assessed to determine nutritional status. Six participants (40%) were classified as moderately malnourished (SGA-B). Eight participants (53%) reported previous unintentional weight loss (average loss of 13%). On average, participants classified as well-nourished (SGA-A) were younger, had shorter disease durations, lower PG-SGA scores, higher body mass (BMI) and fat free mass indices (FFMI) when compared to malnourished participants (SGA-B). Five participants had previously received dietetic advice but only one in relation to unintentional weight loss. Malnutrition remains unrecognised and untreated in this group despite unintentional weight loss and presence of nutrition impact symptoms. Improving nutritional status prior to surgery may improve surgical outcomes.

  16. A comparison of between hyomental distance ratios, ratio of height to thyromental, modified Mallamapati classification test and upper lip bite test in predicting difficult laryngoscopy of patients undergoing general anesthesia

    Directory of Open Access Journals (Sweden)

    Azim Honarmand

    2014-01-01

    Full Text Available Background: Failed intubation is imperative source of anesthetic interrelated patient′s mortality. The aim of this present study was to compare the ability to predict difficult visualization of the larynx from the following pre-operative airway predictive indices, in isolation and combination: Modified Mallampati test (MMT, the ratio of height to thyromental distance (RHTMD, hyomental distance ratios (HMDR, and the upper-lip-bite test (ULBT. Materials and Methods: We collected data on 525 consecutive patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation and then evaluated all four factors before surgery. A skilled anesthesiologist, not imparted of the noted pre-operative airway assessment, did the laryngoscopy and rating (as per Cormack and Lehane′s classification. Sensitivity, specificity, and positive predictive value for every airway predictor in isolation and in combination were established. Results: The most sensitive of the single tests was ULBT with a sensitivity of 90.2%. The hyomental distance extreme of head extension was the least sensitive of the single tests with a sensitivity of 56.9. The HMDR had sensitivity 86.3%. The ULBT had the highest negative predictive value: And the area under a receiver-operating characteristic curve (AUC of ROC curve among single predictors. The AUC of ROC curve for ULBT, HMDR and RHTMD was significantly more than for MMT (P 0.05. Conclusion: The HMDR is comparable with RHTMD and ULBT for prediction of difficult laryngoscopy in the general population, but was significantly more than for MMT.

  17. Reversing cognitive-motor impairments in Parkinson's disease patients using a computational modelling approach to deep brain stimulation programming.

    Science.gov (United States)

    Frankemolle, Anneke M M; Wu, Jennifer; Noecker, Angela M; Voelcker-Rehage, Claudia; Ho, Jason C; Vitek, Jerrold L; McIntyre, Cameron C; Alberts, Jay L

    2010-03-01

    Deep brain stimulation in the subthalamic nucleus is an effective and safe surgical procedure that has been shown to reduce the motor dysfunction of patients with advanced Parkinson's disease. Bilateral subthalamic nucleus deep brain stimulation, however, has been associated with declines in cognitive and cognitive-motor functioning. It has been hypothesized that spread of current to nonmotor areas of the subthalamic nucleus may be responsible for declines in cognitive and cognitive-motor functioning. The aim of this study was to assess the cognitive-motor performance in advanced Parkinson's disease patients with subthalamic nucleus deep brain stimulation parameters determined clinically (Clinical) to settings derived from a patient-specific computational model (Model). Data were collected from 10 patients with advanced Parkinson's disease bilaterally implanted with subthalamic nucleus deep brain stimulation systems. These patients were assessed off medication and under three deep brain stimulation conditions: Off, Clinical or Model based stimulation. Clinical stimulation parameters had been determined based on clinical evaluations and were stable for at least 6 months prior to study participation. Model-based parameters were selected to minimize the spread of current to nonmotor portions of the subthalamic nucleus using Cicerone Deep Brain Stimulation software. For each stimulation condition, participants performed a working memory (n-back task) and motor task (force tracking) under single- and dual-task settings. During the dual-task, participants performed the n-back and force-tracking tasks simultaneously. Clinical and Model parameters were equally effective in improving the Unified Parkinson's disease Rating Scale III scores relative to Off deep brain stimulation scores. Single-task working memory declines, in the 2-back condition, were significantly less under Model compared with Clinical deep brain stimulation settings. Under dual-task conditions, force

  18. Neuropsychological profile of Parkinson's disease patients selected for deep brain stimulation surgery

    Directory of Open Access Journals (Sweden)

    Flavia Amaral Machado

    Full Text Available ABSTRACT Background: Parkinson's disease (PD shows symptoms involving motor and non-motor complications, including cognitive and behavioral changes, such changes might to contraindicate deep brain stimulation surgery (DBS. Objective: The aim of study was to investigate the neuropsychological profile of patients with PD in a waiting list for DBS. Methods: The neuropsychological evaluation was held in 30 patients of the ISCMPA Movement Disorders Clinic, with surgical indication based on the criteria of the responsible neurologists, in the period of 12 months. Instruments used: MMSE, FAB, MoCA, BDI, Semantic Verbal Fluency, PDQ-39, PDSS; and the UPDRS and Hoehn-Yahr scale. Results: The patients were mostly male (66.7% with a mean age of 59.37 (SD 10.60 and disease duration 9.33 (SD 4.08. There was cognitive impairment in 56.7% of patients by FAB and 76.7% by MoCA. Conclusion: Even in the earliest stages of the disease, there is the incidence of non-motor symptoms, especially in those subjects who had an early onset of the disease.

  19. Body weight gain rate in patients with Parkinson's disease and deep brain stimulation.

    Science.gov (United States)

    Barichella, Michela; Marczewska, Agnieszka M; Mariani, Claudio; Landi, Andrea; Vairo, Antonella; Pezzoli, Gianni

    2003-11-01

    We evaluated body weight changes in patients with Parkinson's disease (PD) after electrode implantation for deep brain stimulation (DBS) in the subthalamic nucleus (STN) in relation to clinical improvement. Thirty PD patients who received STN DBS were included (22 men, 8 women; mean age, 60.0 +/- 7.1 years; mean PD duration, 13.5 +/- 3.7 years; mean body mass index [BMI], 21.6 +/- 3.0 kg/m2). Body weight, physical activity, and Unified Parkinson's Disease Rating Scale (UPDRS) scores were noted before and 3 and 12 months after the procedure. Significant weight gain occurred in 29 patients; the mean increase was 14.8 +/- 9.8% of initial body weight in 1 year. Of the patients, 46.5% reported weight gain in the first 3 months, 21.4% gradual weight gain in the first 6 months, and 32.1% a slow increase for 1 year. Mean BMI increased up to 24.7 +/- 3.7 kg/m2. After 1 year, mean UPDRS motor score improved significantly in off and in on; and therapy complications improved by 91.0 +/- 17.0%. BMI changes at 3 and 12 months were significantly correlated to dyskinesia score changes, and levodopa dosage was not. In PD, STN DBS produces not only symptom control, but also weight gain. DBS candidates should be given nutritional counseling before the intervention to prevent rapid and/or excessive weight gain.

  20. Clinical effects of deep cervical flexor muscle activation in patients with chronic neck pain.

    Science.gov (United States)

    Kim, Jin Young; Kwag, Kwang Il

    2016-01-01

    [Purpose] The purpose of this study was to investigate clinical effects of deep cervical flexor (DCF) muscles exercise on pain, Neck Disability Index (NDI), and neck and shoulder postures in patients with chronic neck pain. [Subjects and Methods] Twenty-eight patients with chronic neck pain were randomly assigned into either the general strengthening exercise (GSE) group or the DCF activation group as control and experimental groups, respectively. All exercises were performed three times per week over 4 weeks. NDI and numeric rating scale (NRS) score for pain were determined and radiological assessment of neck-shoulder postures (head tilt angle [HTA], neck flexion angle [NFA], and forward shoulder angle [FSA]) was performed before (baseline), 4 weeks after, and 8 weeks after exercise in order to directly compare the exercise effects between the groups. [Results] In the DCF group, the NDI, NRS score, and neck-shoulder postures (analyzed by uisng HTA, NFA, and FSA) were significantly improved. [Conclusion] DCF activation exercise was effective to alleviate pain, recover functions, and correct forward head posture in the patients with neck pain. Hence, it might be recommended in the rehabilitation of patients with chronic neck pain.

  1. Coagulation disorders in the patients with deep vein thrombosis of lower extremity

    Directory of Open Access Journals (Sweden)

    Milić Dragan J.

    2003-01-01

    Full Text Available PURPOSE Venous thromboembolism is a relevant social and health care problem for its high incidence, pulmonary embolism-related mortality and long-term sequelae which may be disabling (post-thrombotic syndrome and ulceration. PROCEDURES The aim of our work was to establish the presence of coagulation disorders (hypercoagulable states in the patients with deep vein thrombosis (DVT of the leg. Prospectively we have analyzed a group of 30 patients with echosono-graphicaly verified DVT of the leg who were admitted to the department of vascular surgery from August 1st 2000 to July 31st 2001.The following parameters were monitored: prothrombin time (PT partial thromboplastin time (PTT, fibrinogen (Fib, alpha 2 antiplasmin (A-2 AP, D-dimer (DD, antithrombin III (AT III and factor VII. FINDINGS Activation of the coagulation process was registered. The values of monitored coagulation parameters are shown in table 1. Plasma levels of monitored parameters in the patients with DVT of the leg were significantly higher than in the control subjects. CONCLUSION In patients with a DVT a hypercoagulable state is common finding. Some parameters of coagulation activity such as D-dimer might be of great interest in the diagnostic strategy of DVT.

  2. Influence of patient mispositioning on SAR distribution and simulated temperature in regional deep hyperthermia

    Science.gov (United States)

    Aklan, Bassim; Gierse, Pia; Hartmann, Josefin; Ott, Oliver J.; Fietkau, Rainer; Bert, Christoph

    2017-06-01

    Patient positioning plays an important role in regional deep hyperthermia to obtain a successful hyperthermia treatment. In this study, the influence of possible patient mispositioning was systematically assessed on specific absorption rate (SAR) and temperature distribution. With a finite difference time domain approach, the SAR and temperature distributions were predicted for six patients at 312 positions. Patient displacements and rotations as well as the combination of both were considered inside the Sigma-Eye applicator. Position sensitivity is assessed for hyperthermia treatment planning -guided steering, which relies on model-based optimization of the SAR and temperature distribution. The evaluation of the patient mispositioning was done with and without optimization. The evaluation without optimization was made by creating a treatment plan for the patient reference position in the center of the applicator and applied for all other positions, while the evaluation with optimization was based on creating an individual plan for each position. The parameter T90 was used for the temperature evaluation, which was defined as the temperature that covers 90% of the gross tumor volume (GTV). Furthermore, the hotspot tumor quotient (HTQ) was used as a goal function to assess the quality of the SAR and temperature distribution. The T90 was shown considerably dependent on the position within the applicator. Without optimization, the T90 was clearly decreased below 40 °C by patient shifts and the combination of shifts and rotations. However, the application of optimization for each positon led to an increase of T90 in the GTV. Position inaccuracies of less than 1 cm in the X-and Y-directions and 2 cm in the Z-direction, resulted in an increase of HTQ of less than 5%, which does not significantly affect the SAR and temperature distribution. Current positioning precision is sufficient in the X (right-left)-direction, but position accuracy is required in the Y-and Z-directions.

  3. Early deep brain stimulation in patients with myoclonus-dystonia syndrome.

    Science.gov (United States)

    Rocha, Helena; Linhares, Paulo; Chamadoira, Clara; Rosas, Maria José; Vaz, Rui

    2016-05-01

    Myoclonus-dystonia (MD) is a rare movement disorder which is disabling and frequently refractory to medical treatment. Deep brain stimulation (DBS) of the globus pallidus interna (GPi) has been used to treat some patients. Although there is significant motor improvement with DBS, the impact on disability and on quality of life has been infrequently reported. Also, the benefit of the procedure is not established in patients without ε-sarcoglycan gene (SGCE) mutations. We present two patients with severe MD treated with GPi-DBS, one of the patients without a SGCE mutation. Motor improvements (rest/action/total subscores of the Unified Myoclonus Rating Scale and movement subscore of the Burke-Fahn-Marsden Dystonia Rating Scale [BFMRS]) and disability (BFMRS disability subscore) were carefully evaluated preoperatively and at 6 and 12months after surgery. Quality of life (addressed using the Portuguese version of the Medical Outcomes Study 36-item Short-Form General Health Survey, version 2.0 [SF-36v2]) was tested preoperatively and 12months after DBS. At 12-month follow-up, myoclonus improved 78.6% in Patient 1 and 80.7% in Patient 2, while dystonia improved 37% and 86.7%, respectively. Improvements in disability ranged from 71.4% to 75%. With regard to quality of life, all parameters addressed by the SF-36v2 improved or stabilized in both patients. No major adverse effects were noticed. Improvements in motor symptoms are consistent with reports in the literature and were obtained regardless of the identification of a SGCE gene mutation. There were also significant benefits on disability and quality of life. DBS should be considered for MD.

  4. Complications and outcomes of brown recluse spider bites in children.

    Science.gov (United States)

    Hubbard, Jonathan J; James, Laura P

    2011-03-01

    Brown recluse spider bites may cause severe local and systemic morbidity, but data regarding morbidity in children are limited. This study reviewed inpatient medical records (n = 26; 10 years) with a discharge diagnosis of "spider bite" from a tertiary pediatric hospital. The majority (85%) of children had an inflammatory response accompanying necrosis, usually with signs of secondary cellulitis (77%). Hemolytic anemia (50%), rhabdomyolysis (27%), and acute renal failure (12%) were the most prevalent systemic effects. Hemolytic anemia was bimodal in distribution relative to the time-of-onset of the bite (early, 2.2 ± 0.4; late, 6.9 ± 1.5 days postbite, respectively; P = .004). Although no fatalities occurred in the population, 65% of children had major morbidity, including wound complications requiring surgical care and acute orbital compartment syndrome. The findings emphasize the importance of anticipatory patient/family education for outpatients and careful monitoring for systemic morbidity in inpatients. Timely and appropriate supportive care should yield favorable outcomes in most cases.

  5. Risk of Lyme disease development after a tick bite

    Directory of Open Access Journals (Sweden)

    Mladenović Jovan

    2010-01-01

    Full Text Available Background/Aim. Despite numerous research of Lyme disease (LD, there are still many concerns about environmental of infectious agent of LD, as well as its prophylaxis, diagnosis and treatment. The aim of this work was to determine the risk of LD in relation to the way of removing ticks and duration of tick attachment. Methods. In the period from 2000 to 2007 a prospective study was conducted including persons with tick bite referred to the Institute of Epidemiology, Military Medical Academy, and followed for the occurrence of early Lyme disease up to six months after a tick bite. Epidemiological questionnaire was used to collect relevant information about the place and time of tick bites, the way of a removing tick, duration of tick attachment, remnants of a tick left in the skin (parts of the mouth device and the signs of clinical manifestations of LD. Duration of tick attachment was determined on the basis of size of engorged tick and epidemiological data. Removed ticks were determined by the key of Pomerancev. Professional removing of attached tick was considered to be removing of tick with mechanical means by healthcare personnel. Fisher's exact test, Chi squares test and calculation of the relative risk (RR were used for data analysis. Results. Of 3 126 patients with tick bite, clinical manifestations of LD were demonstrated in 19 (0.61%. In the group of subjects (n = 829 in which a tick was not removed professionally there were 17 (2.05% cases with LD, while in the group of respondents (n=2 297 in who a tick was removed professionally there were 2 (0.09% cases with LD after tick bite (RR, 23.55; p < 0.0001. The disease was most frequent in the group of respondents with incompletely and unprofessionally removed ticks (2.46%. In the groups of patients with unprofessionally but completely removed ticks LD occurred in 0.89%, while in the group of subjects with a tick removed by an expert, but incompletely in 0.78% cases. The disease occurred

  6. [Epidemiology of dog bite lesions in Tierra del Fuego, Argentina].

    Science.gov (United States)

    Zanini, Fabián; Padinger, Patricia; Elissondo, María C; Pérez, Héctor

    2008-01-01

    The coexistence between man and dog has resulted in mutual benefits during thousands of years, nevertheless some problems have recently arisen where bite injuries have an important role. The aim of this work was to describe the epidemiological characteristics of dog bite lesions which occurred during a year in Tierra del Fuego. A descriptive observational, transversal study of patients who were admitted with dog bite injuries to clinic and pediatric emergency services of hospitals and health centers was carried out between 3/1/05 and 3/1/06. A total of 382 records were made. The children group represents 49.5%. The group between 5 and 9 year-old was the most affected (44.4%; IC95% 37.2-51.8). In the adult group, that between 15 and 24 year-old was the most affected (29.5%; IC95% 23.2-36.5). More lesions were registered in men (57.6%) than in women (42.4%) (chi2 = 8.6, p = 0.003). During spring and summer months, 56.5% of the lesions were registered. A 72.8% of the incidents occurred on the public highway. Dogs of big size were responsible of 49.7% (IC95% 44.6-54.9) of the injuries. The 89.8% of the incidents were caused by another person's dog. Of the lesions, 55.8% (IC95% 50.6-60.8) were registered in lower extremities and 11% (IC95% 8.1-14.7) in head and neck. These data show that dog bite lesions affect the health and impact in the quality of life of the population of Tierra del Fuego, Argentina.

  7. Twiddler's syndrome in a patient with a deep brain stimulation device for generalized dystonia

    DEFF Research Database (Denmark)

    Astradsson, Arnar; Schweder, Patrick M; Joint, Carole

    2011-01-01

    Deep brain stimulation (DBS) is the technique of neurostimulation of deep brain structures for the treatment of conditions such as essential tremor, dystonia, Parkinson's disease and chronic pain syndromes. The procedure uses implanted deep brain stimulation electrodes connected to extension leads...

  8. Evaluation of local muscle soreness treatment with anterior bite splint made of soft putty impression material

    Directory of Open Access Journals (Sweden)

    Harry Laksono

    2013-03-01

    Full Text Available Background: Local muscle soreness is the most common temporomandibular disorders complaint of patients seeking treatment in the dental clinics. The emergency treatment that can be done in the clinics to manage this disorder is by making anterior bite splint. Anterior bite splint is usually made of acrylic, but currently there is a soft putty impression material that can also be used for making anterior bite splint. The effectiveness of soft putty anterior bite splint in local muscle soreness treatment still has not clear. Purpose: To determine the effectiveness of the soft putty impression material as a material used for making anterior bite splint in the treatment of local muscle soreness. Case: Six patients was reported five female patients aged 20-40 years old and one male patient aged 37 years old with local muscle soreness. Four female patients with a “click” sound on TMJ. Case management: Make differential diagnosis with screening history (anamnesis, clinical examination consists of extra oral examination such as muscle and temporomandibular joint palpation, measure the mandibular movement, end-feel, load test, intra oral examination and radiographic evaluation. Record the results and make the diagnosis. Make a soft putty anterior bite splint, adjusted and inserted in the maxillary anterior teeth. Record the results based on signs and symptoms. Conclusion: It can be concluded that anterior bite splint made of soft putty impression material is effective for treatment the local muscle soreness.Latar belakang: Salah satu tipe temporomandibular disorders yang paling sering dijumpai di klinik dokter gigi adalah local muscle soreness. Perawatan yang dapat dengan segera dilakukan di klinik untuk mengelola gangguan tersebut adalah dengan pembuatan anterior bite splint. Biasanya anterior bite splint terbuat dari akrilik, namun saat ini telah ada bahan cetak soft putty yang memungkinkan untuk dipakai sebagai bahan pembuatan anterior bite splint

  9. Increased levels of dioxin-like substances in adipose tissue in patients with deep infiltrating endometriosis.

    Science.gov (United States)

    Martínez-Zamora, M A; Mattioli, L; Parera, J; Abad, E; Coloma, J L; van Babel, B; Galceran, M T; Balasch, J; Carmona, F

    2015-05-01

    Are the levels of biologically active and the most toxic dioxin-like substances in adipose tissue of patients with deep infiltrating endometriosis (DIE) higher than in a control group without endometriosis? DIE patients have higher levels of dioxins and polychlorinated biphenyls (PCBs) in adipose tissue compared with controls without endometriosis. Some studies have investigated the levels of dioxin-like substances, in serum samples, in patients with endometriosis, with inconsistent results. Case-control study including two groups of patients. The study group (DIE group) consisted of 30 patients undergoing laparoscopic surgery because of DIE. In all patients, an extensive preoperative work-up was performed including clinical exploration, magnetic resonance imaging (MRI) and transvaginal sonography. All patients with DIE underwent a confirmatory histological study for DIE after surgery. The non-endometriosis control group (control group), included the next consecutive patient undergoing laparoscopic surgery in our center due to adnexal benign gynecological disease (ovarian or tubal procedures other than endometriosis) after each DIE patient, and who did not present any type of endometriosis. During the surgical procedure 1-2 g of adipose tissue from the omentum were obtained. Dioxin-like substances were analyzed in adipose tissue in DIE patients and controls without endometriosis. The total toxic equivalence and concentrations of both dioxins and PCBs were significantly higher in patients with DIE in comparison with the control group (P dioxins (2,3,7,8-tetrachlorodibenzo-p-dioxin [2,3,7,8-TCDD] and 1,2,3,7,8-pentachlorodibenzo-p-dioxin [1,2,3,7,8-PeCDD]) (P dioxins and PCBs widely vary in different countries. Furthermore, the strict eligibility criteria used may preclude generalization of the results to other populations and the surgery-based sampling frame may induce a selection bias. Finally, adipose tissue was obtained only from the omentum, and not from other

  10. Body weight gain in patients with bilateral deep brain stimulation for dystonia.

    Science.gov (United States)

    Wolf, Marc E; Capelle, Hans-Holger; Lütjens, Götz; Ebert, Anne D; Hennerici, Michael G; Krauss, Joachim K; Blahak, Christian

    2016-03-01

    In patients with Parkinson's disease, significant weight gain following chronic deep brain stimulation (DBS) has been reported. Recently, relevant weight gain could be demonstrated also following subthalamic nucleus DBS in patients with primary cervical dystonia. Prospective analyses of body weight changes following DBS in patients with dystonia, however, have not been published so far. We aimed to analyse the changes of body weight following DBS in patients with dystonia. The body mass index (BMI) of 17 consecutive patients with segmental or generalised dystonia (mean age 54.6 ± 16.1 years) treated with bilateral DBS of the globus pallidus internus (GPi) (n = 14) or the thalamic ventral intermediate nucleus (n = 3) was measured preoperatively (pre-OP) and at three follow-up (FU) time points post-DBS surgery (FU1 = 7 months, FU2 = 17 months, FU3 = 72 months). All patients benefited from marked improvement in their dystonia. The mean BMI pre-OP (SD) was 22.5 (±3.7) kg/m(2) and increased stepwise to 24.0 (±3.3) kg/m(2) at FU1, 24.4 (±3.7) kg/m(2) at FU2 and 24.9 (±3.7) kg/m(2) at FU3 (p weight gain, in particular during the first 6 months post-OP. This probably is a result of improvement of dystonic motor symptoms and recovery of eating dysfunction rather than a target-specific phenomenon.

  11. Cerebral microbleeds are associated with deep white matter hyperintensities, but only in hypertensive patients.

    Science.gov (United States)

    Gao, Zhongbao; Wang, Wei; Wang, Zhenfu; Zhao, Xingli; Shang, Yanchang; Guo, Yaner; Gong, Mei; Yang, Lijuan; Shi, Xiaobing; Xu, Xian; An, Ningyu; Wu, Weiping

    2014-01-01

    Cerebral microbleeds (CMBs) and white matter hyperintensities (WMH) are the most common manifestations of small vessel disease, and often co-occur in patients with cerebral vascular disease. Hypertension is widely accepted as a risk factor for both CMBs and WMH. However, the effect of hypertension on the association between CMBs and WMH remains unclear. We hypothesized that the relationship between CMBs and WMH is determined by hypertension. One hundred forty-eight patients with acute cerebrovascular disease who were admitted to PLA general hospital in Beijing, China from February 2010 to May 2011 were recruited in this study. CMBs on T2*-weighted angiography (SWAN) were assessed using the Brain Observer Microbleed Rating Scale criteria. The severity of the WMH was separately assessed as either peri-ventricular hyperintensities (PVH) or deep white matter hyperintensities (DWMH). The association among CMBs and the severity of WMH, and hypertension were determined. CMBs were found in 65 (43.9%) patients. The frequency of CMBs was related to the severity of DWMH and PVH. CMBs were more frequently observed in patients with hypertension compared to patients without hypertension (51.3% vs. 20.0%, p = 0.001). Hypertension was an independent risk factor for CMBs (odds ratio 5.239, p = 0.001) and DWMH (odds ratio 2.373, p = 0.040). Furthermore, the relationship between the presence of CMBs and the severity of DWMH was only found in patients with hypertension (r = 0.298, pCMBs were associated with PVH independently of hypertension. This study demonstrated that hypertension determined the association between CMBs and DWMH.

  12. Cerebral microbleeds are associated with deep white matter hyperintensities, but only in hypertensive patients.

    Directory of Open Access Journals (Sweden)

    Zhongbao Gao

    Full Text Available Cerebral microbleeds (CMBs and white matter hyperintensities (WMH are the most common manifestations of small vessel disease, and often co-occur in patients with cerebral vascular disease. Hypertension is widely accepted as a risk factor for both CMBs and WMH. However, the effect of hypertension on the association between CMBs and WMH remains unclear. We hypothesized that the relationship between CMBs and WMH is determined by hypertension. One hundred forty-eight patients with acute cerebrovascular disease who were admitted to PLA general hospital in Beijing, China from February 2010 to May 2011 were recruited in this study. CMBs on T2*-weighted angiography (SWAN were assessed using the Brain Observer Microbleed Rating Scale criteria. The severity of the WMH was separately assessed as either peri-ventricular hyperintensities (PVH or deep white matter hyperintensities (DWMH. The association among CMBs and the severity of WMH, and hypertension were determined. CMBs were found in 65 (43.9% patients. The frequency of CMBs was related to the severity of DWMH and PVH. CMBs were more frequently observed in patients with hypertension compared to patients without hypertension (51.3% vs. 20.0%, p = 0.001. Hypertension was an independent risk factor for CMBs (odds ratio 5.239, p = 0.001 and DWMH (odds ratio 2.373, p = 0.040. Furthermore, the relationship between the presence of CMBs and the severity of DWMH was only found in patients with hypertension (r = 0.298, p<0.01. However, CMBs were associated with PVH independently of hypertension. This study demonstrated that hypertension determined the association between CMBs and DWMH.

  13. Deep Cerebral Microbleeds and Renal Dysfunction in Patients with Acute Lacunar Infarcts.

    Science.gov (United States)

    Saji, Naoki; Kimura, Kazumi; Yagita, Yoshiki; Uemura, Junichi; Aoki, Junya; Sato, Takahiro; Sakurai, Takashi

    2015-11-01

    Cerebral small-vessel disease (SVD) is associated with renal dysfunction such as chronic kidney disease. Although cerebral microbleeds (CMBs) are common in patients with acute lacunar infarcts (ALI), the association between renal dysfunction and CMBs in such patients remains unclear. Between April 2007 and March 2013, we evaluated consecutive first-ever ALI patients, who were admitted to our hospital within 24 hours of stroke onset. CMBs were defined as focal areas of signal loss in brain parenchyma less than 5 mm on T2(∗)-weighted gradient-echo imaging. Renal dysfunction was defined as an estimated glomerular filtration rate less than 60 mL/minute/1.73 m(2) on admission. Correlations between renal dysfunction and the presence (model 1) and location of CMBs (model 2; any deep or infratentorial CMBs) were determined by multivariable logistic regression analyses. Among 152 patients (33.6% men; mean age, 67.6 years), 53 had CMBs. Patients with CMBs were older (69.9 versus 66.3 years, P = .03) and had a higher frequency of white matter hyperintensity (WMH; 62.3% versus 25.3%, P CMBs. On multivariable analyses, renal dysfunction (odds ratio, 95% confidence interval; model 1: 2.38, 1.02-5.66; model 2: 2.78, 1.16-6.81), WMH (3.87, 1.76-8.80; 3.72, 1.64-8.71), SLI (3.85, 1.71-9.14; 4.20, 1.77-10.8), and diabetes mellitus (.26, .09-.63; .24, .08-.63) were independently associated with CMBs. In patients with ALI, renal dysfunction was positively associated with CMBs independent of cerebral SVD. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Correction of post-traumatic anterior open bite by injection of botulinum toxin type A into the anterior belly of the digastric muscle: case report

    OpenAIRE

    2013-01-01

    Post-traumatic anterior open bite can occur as a result of broken balance among the masticatory muscles. The superior hyoid muscle group retracts the mandible downward and contributes to the anterior open bite. Denervation of the digastric muscle by injection of botulinum toxin type A (BTX-A) can reduce the power of the digastric muscle and help to resolve the post-traumatic anterior open bite. A patient with a bilateral angle fracture had an anterior open bite even after undergoing three ope...

  15. Nonpigmented Chromobacterium violaceum bacteremic cellulitis after fish bite.

    Science.gov (United States)

    Yang, Ching-Huei

    2011-10-01

    A case of nonpigmented Chromobacterium violaceum bacteremic cellulitis after fish bite in Taiwan is reported. The patient was successfully treated with ciprofloxacin and doxycycline for an extended period. Chromobacterium violaceum should be listed in the differential diagnosis of patients with nonspecific cellulitis associated with marked leukocytosis and rapid progression to septicemia either with or without a distinct history of exposure to water or soil. A combination of prompt diagnosis, optimal antimicrobial therapy, and adequate therapeutic duration for C violaceum infection is the key for successful therapy.

  16. Voice features of Parkinson's disease patients with subthalamic nucleus deep brain stimulation.

    Science.gov (United States)

    Tanaka, Yasuhiro; Tsuboi, Takashi; Watanabe, Hirohisa; Kajita, Yasukazu; Fujimoto, Yasushi; Ohdake, Reiko; Yoneyama, Noritaka; Masuda, Michihito; Hara, Kazuhiro; Senda, Joe; Ito, Mizuki; Atsuta, Naoki; Horiguchi, Satoshi; Yamamoto, Masahiko; Wakabayashi, Toshihiko; Sobue, Gen

    2015-05-01

    Voice and speech disorders are one of the most important issues after subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease patients; however, their characteristics remain unclear. We performed a comprehensive voice evaluation including the multi-dimensional voice program for acoustic analysis, the GRBAS scale for perceptual analysis, and the evaluation of the voice handicap index (VHI) for psychosocial analysis. In total, 68 patients who had undergone STN-DBS (37 assessed in the on- and off-stimulation conditions) and 40 who had been treated with medical therapy alone were evaluated. Further, we performed laryngoscopic examinations in 13 STN-DBS and 19 medical-therapy-alone patients. The STN-DBS group, especially females, showed widespread impairment of voice parameters and significantly poorer VHI scores than the medical-therapy-alone group. The degree of voiceless (DUV) and strained voice were the most impaired factors in the STN-DBS group; and DUV significantly improved after stopping stimulation. Furthermore strained voice, breathiness, and asthenia improved after stopping stimulation. Laryngoscopic examination showed that abnormal laryngeal muscle contraction and incomplete glottal closure were more prominent in the STN-DBS group than in the medical-therapy-alone group. We demonstrated that (1) more widespread voice impairment in females, (2) poorer voice-related QOL, (3) worse DUV and strained voice, and (4) abnormal laryngeal muscle contraction were the characteristic voice and laryngeal findings in the STN-DBS group compared with those in the medical-therapy-alone group.

  17. Unilateral pallidal deep brain stimulation in a patient with dystonia secondary to episodic ataxia type 2.

    Science.gov (United States)

    Harries, Anwen M; Sandhu, Mandeep; Spacey, Sian D; Aly, Mohamed M; Honey, Christopher R

    2013-01-01

    This paper describes the use of deep brain stimulation (DBS) of the globus pallidus internus (GPi) in the treatment of secondary dystonia caused by expisodic ataxia type 2 (EA2). We present the case of a patient with EA2, an autosomal dominant condition, who developed late-onset cervical and right upper limb segmental dystonia. The patient underwent left GPi DBS. Within 4 months of commencing stimulation of the left GPi, the patient had resolution of his neck pain and was able to keep the head straighter for longer time intervals. There was also improvement in right arm segmental dystonia. There was an improvement in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS 21.5) of 55% at 4 months and of 51% at 22 months. The treatment of secondary dystonia is difficult and the results with GPi DBS are less favourable compared with primary dystonia. This case illustrates the successful treatment of secondary dystonia caused by EA2. Copyright © 2013 S. Karger AG, Basel.

  18. Case Report of a Newborn Injured By Human Bite

    Directory of Open Access Journals (Sweden)

    Emel Ataoğlu

    2015-03-01

    Full Text Available Bite is a type of wound received from the teeth of an animal, including humans. Human bites are third leading cause of all bites after dog and cat bites. Human bites are severe wounds due to the risk of contamination with mix oral flora and rapid tissue destruction. Bite wounds created by humans are seen in variety of circumstances including aggression, rape, murder, and child abuse. Oral cavity contains beta-hemolytic streptococci, anaerobes and other microorganisms. There have been reported cases of septicemia, severe necrotizing fasciitis, HIV infection, and death caused by human bites. Early reporting and treatment of bite wounds decrease the number and severity of wound infection. Here, we present the case of human bite in a nine-day-old girl and discuss the treatment approaches in the light of the relevant literature.

  19. Sonographic and Clinical Features of Upper Extremity Deep Venous Thrombosis in Critical Care Patients

    Directory of Open Access Journals (Sweden)

    Michael Blaivas

    2012-01-01

    Full Text Available Background-Aim. Upper extremity deep vein thrombosis (UEDVT is an increasingly recognized problem in the critically ill. We sought to identify the prevalence of and risk factors for UEDVT, and to characterize sonographically detected thrombi in the critical care setting. Patients and Methods. Three hundred and twenty patients receiving a subclavian or internal jugular central venous catheter (CVC were included. When an UEDVT was detected, therapeutic anticoagulation was started. Additionally, a standardized ultrasound scan was performed to detect the extent of the thrombus. Images were interpreted offline by two independent readers. Results. Thirty-six (11.25% patients had UEDVT and a complete scan was performed. One (2.7% of these patients died, and 2 had pulmonary embolism (5.5%. Risk factors associated with UEDVT were presence of CVC [(odds ratio (OR 2.716, P=0.007], malignancy (OR 1.483, P=0.036, total parenteral nutrition (OR 1.399, P=0.035, hypercoagulable state (OR 1.284, P=0.045, and obesity (OR 1.191, P=0.049. Eight thrombi were chronic, and 28 were acute. We describe a new sonographic sign which characterized acute thrombosis: a double hyperechoic line at the interface between the thrombus and the venous wall; but its clinical significance remains to be defined. Conclusion. Presence of CVC was a strong predictor for the development of UEDVT in a cohort of critical care patients; however, the rate of subsequent PE and related mortality was low.

  20. The Protocol of Choice for Treatment of Snake Bite

    Science.gov (United States)

    Mohammad Alizadeh, Afshin; Rahimi, Mitra; Erfantalab, Peyman; Ostadi, Ali

    2016-01-01

    The aim of the current study is to compare three different methods of treatment of snake bite to determine the most efficient one. To unify the protocol of snake bite treatment in our center, we retrospectively reviewed files of the snake-bitten patients who had been referred to us between 2010 and 2014. They were contacted for follow-up using phone calls. Demographic and on-arrival characteristics, protocol used for treatment (WHO/Haddad/GF), and outcome/complications were evaluated. Patients were entered into one of the protocol groups and compared. Of a total of 63 patients, 56 (89%) were males. Five, 19, and 28 patients were managed by Haddad, WHO, or GF protocols, respectively. Eleven patients had fallen into both GF and WHO protocols and were excluded. Serum sickness was significantly more common when WHO protocol was used while 100% of the compartment syndromes and 71% of deformities had been reported after GF protocol. The most important complications were considered to be deformity, compartment syndrome, and amputation and were more frequent after the use of WHO and GF protocols (23.1% versus 76.9%; none in Haddad; P = NS). Haddad protocol seems to be the best for treatment of snake-bitten patients in our region. However, this cannot be strictly concluded because of the limited sample size and nonsignificant P values. PMID:27738653

  1. The Protocol of Choice for Treatment of Snake Bite.

    Science.gov (United States)

    Mohammad Alizadeh, Afshin; Hassanian-Moghaddam, Hossein; Zamani, Nasim; Rahimi, Mitra; Mashayekhian, Mohammad; Hashemi Domeneh, Behrooz; Erfantalab, Peyman; Ostadi, Ali

    2016-01-01

    The aim of the current study is to compare three different methods of treatment of snake bite to determine the most efficient one. To unify the protocol of snake bite treatment in our center, we retrospectively reviewed files of the snake-bitten patients who had been referred to us between 2010 and 2014. They were contacted for follow-up using phone calls. Demographic and on-arrival characteristics, protocol used for treatment (WHO/Haddad/GF), and outcome/complications were evaluated. Patients were entered into one of the protocol groups and compared. Of a total of 63 patients, 56 (89%) were males. Five, 19, and 28 patients were managed by Haddad, WHO, or GF protocols, respectively. Eleven patients had fallen into both GF and WHO protocols and were excluded. Serum sickness was significantly more common when WHO protocol was used while 100% of the compartment syndromes and 71% of deformities had been reported after GF protocol. The most important complications were considered to be deformity, compartment syndrome, and amputation and were more frequent after the use of WHO and GF protocols (23.1% versus 76.9%; none in Haddad; P = NS). Haddad protocol seems to be the best for treatment of snake-bitten patients in our region. However, this cannot be strictly concluded because of the limited sample size and nonsignificant P values.

  2. The Protocol of Choice for Treatment of Snake Bite

    Directory of Open Access Journals (Sweden)

    Afshin Mohammad Alizadeh

    2016-01-01

    Full Text Available The aim of the current study is to compare three different methods of treatment of snake bite to determine the most efficient one. To unify the protocol of snake bite treatment in our center, we retrospectively reviewed files of the snake-bitten patients who had been referred to us between 2010 and 2014. They were contacted for follow-up using phone calls. Demographic and on-arrival characteristics, protocol used for treatment (WHO/Haddad/GF, and outcome/complications were evaluated. Patients were entered into one of the protocol groups and compared. Of a total of 63 patients, 56 (89% were males. Five, 19, and 28 patients were managed by Haddad, WHO, or GF protocols, respectively. Eleven patients had fallen into both GF and WHO protocols and were excluded. Serum sickness was significantly more common when WHO protocol was used while 100% of the compartment syndromes and 71% of deformities had been reported after GF protocol. The most important complications were considered to be deformity, compartment syndrome, and amputation and were more frequent after the use of WHO and GF protocols (23.1% versus 76.9%; none in Haddad; P = NS. Haddad protocol seems to be the best for treatment of snake-bitten patients in our region. However, this cannot be strictly concluded because of the limited sample size and nonsignificant P values.

  3. MRI displays involvement of the temporalis muscle and the deep temporal artery in patients with giant cell arteritis

    Energy Technology Data Exchange (ETDEWEB)

    Veldhoen, Simon; Bley, Thorsten A. [University Medical Center Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); Klink, Thorsten [Inselspital - University Medical Center Bern, Department of Diagnostic, Interventional and Pediatric Radiology, Bern (Switzerland); Geiger, Julia [University Medical Center Freiburg, Department of Diagnostic and Interventional Radiology, Freiburg (Germany); University Children' s Hospital Zuerich, Division of Radiology, Zuerich (Switzerland); Vaith, Peter; Glaser, Cornelia [University Medical Center Freiburg, Department of Rheumatology and Immunology, Freiburg (Germany); Ness, Thomas [University Medical Center Freiburg, Department of Ophthalmology, Freiburg (Germany); Duwendag, Dirk [University Medical Center Kiel, Department of Ophthalmology, Kiel (Germany); Both, Marcus [University Medical Center Kiel, Department of Diagnostic and Interventional Radiology, Kiel (Germany)

    2014-11-15

    To assess deep temporal artery and temporalis muscle involvement in patients with giant cell arteritis (GCA). Ninety-nine patients who received magnetic resonance imaging (MRI) and superficial temporal artery biopsy (TAB) were included in this study. Patients with positive TAB (n = 61) were defined as GCA patients, those with negative TAB (n = 38) as the GCA-negative reference group. Contrast-enhanced T1w-images were acquired utilizing 1.5 T and 3 T MRI. Two radiologists assessed the images. Mural contrast-hyperenhancement and wall thickening of the deep temporal artery and hyperenhancement of the muscle were defined as inflammation. MRI results were correlated with jaw claudication in 70 patients. The two observers found temporalis muscle involvement in 19.7 % (n = 12) and 21.3 % (n = 13) of GCA patients. It occurred bilaterally in 100 %. Specificities were 92/97 % and sensitivities were 20/21 %. Deep temporal artery involvement was found in 34.4 % (n = 21) and 49.2 % (n = 30) and occurred bilaterally in 80/90.5 %. Specificities were 84/95 % and sensitivities were 34/49 %. Both structures were affected simultaneously in 18/21.3 %. Jaw claudication correlated moderately with inflammation of the temporalis muscle (r = 0.31; p < 0.05) and the deep temporal artery (r = 0.38; p = 0.01). MRI visualizes changes in the temporalis muscle and the deep temporal artery in GCA. Moderate correlation of clinical symptoms with MRI results was observed. circle Approximately 20 % of GCA patients presented with temporalis muscle inflammation. (orig.)

  4. [Application of high-frequency ultrasound in dermabrasion of patients with deep partial-thickness burns].

    Science.gov (United States)

    Zang, C Y; Cao, Y Q; Xue, W J; Zhao, R; Zhang, M; Zhang, Y H; Feng, Z; Wang, Y B

    2017-02-20

    Objective: To investigate the application of high-frequency ultrasound in dermabrasion of patients with deep partial-thickness burns. Methods: Twenty-six patients with deep partial-thickness burns conforming to the study criteria were hospitalized in our unit from March 2015 to March 2016. Patients were all performed with dermabrasion. The structure of skin tissue and blood flow signals of uninjured side and wounds before dermabrasion, and those of wounds immediately post dermabrasion and on post dermabrasion day (PDD) 1, 3, 5, 7, 10, 14, and 21 were detected with high-frequency ultrasound, and the percentage of blood flow signals was calculated. According to the results of comparison between percentage of blood flow signals of wounds and that of normal skin before dermabrasion, patients were divided into no significant decrease group (NSD, n=19) and significant decrease group (SD, n=7). Wound healing time of patients in two groups was recorded. Data were processed with analysis of variance of repeated measurement, LSD test, t test and Chi-square test. The correlation between the percentage of blood flow signals of wounds before dermabrasion and wound healing time of 26 patients were analyzed by Spearman correlation analysis. Results: (1) Epidermis of normal skin of patients in two groups before dermabrasion showed continuous smooth linear hyperecho, which was stronger than that of dermis, and boundary of dermis and subcutaneous tissue showed stronger discontinuous linear echo than that of dermis, which gradually transited to subcutaneous tissue. In group NSD, epidermis of wound of patients before dermabrasion showed intermittent rough linear echo, which was weaker than that of normal skin epidermis, and there was no obvious abnormity of boundary between dermis and subcutaneous tissue. Immediately post dermabrasion and on PDD 1, no linear hyperecho of epidermis was observed, showing complete attrition of epidermis, and the echo of dermis and subcutaneous tissue had

  5. Human bite injuries in the oro-facial region at the Muhimbili National Hospital, Tanzania

    Directory of Open Access Journals (Sweden)

    Simon Elison NM

    2008-04-01

    Full Text Available Abstract Background Human bites in the maxillofacial region compromise function and aesthetics, resulting in social and psychological effects. There is paucity of information regarding human bite injuries in Tanzania. The aim of the study was to assess the occurrence, treatment modalities and prognosis of human bite injuries in the oro-facial region at the Muhimbili National Hospital Dar es Salaam, Tanzania. Methods In a prospective study the details of patients with human bite injuries in the oro-facial region who attended at the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital between January 2001 and December 2005 were recorded. Data included information on age, sex, site, duration of the injury at the time of reporting to hospital, reasons, details of treatment offered and outcome after treatment. Results A total of 33 patients, 13 males and 20 females aged between 12 and 49 years with human bite injuries in the oro-facial region were treated. Thirty patients presented with clean uninfected wounds while 3 had infected wounds. The most (45.5% frequently affected site was the lower lip. Treatment offered included thorough surgical cleansing with adequate surgical debridement and primary suturing. Tetanus prophylaxis and a course of broad-spectrum antibiotics were given to all the patients. In 90% of the 30 patients who were treated by suturing, the healing was uneventful with only 10% experiencing wound infection or necrosis. Three patients who presented with wounds that had signs of infection were treated by surgical cleansing with debridement, antibiotics and daily dressing followed by delayed primary suturing. Conclusion Most of the human bite injuries in the oro-facial region were due to social conflicts. Although generally considered to be dirty or contaminated they could be successfully treated by surgical cleansing and primary suture with a favourable outcome. Management of such injuries often need

  6. Deep learning for tissue microarray image-based outcome prediction in patients with colorectal cancer

    Science.gov (United States)

    Bychkov, Dmitrii; Turkki, Riku; Haglund, Caj; Linder, Nina; Lundin, Johan

    2016-03-01

    Recent advances in computer vision enable increasingly accurate automated pattern classification. In the current study we evaluate whether a convolutional neural network (CNN) can be trained to predict disease outcome in patients with colorectal cancer based on images of tumor tissue microarray samples. We compare the prognostic accuracy of CNN features extracted from the whole, unsegmented tissue microarray spot image, with that of CNN features extracted from the epithelial and non-epithelial compartments, respectively. The prognostic accuracy of visually assessed histologic grade is used as a reference. The image data set consists of digitized hematoxylin-eosin (H and E) stained tissue microarray samples obtained from 180 patients with colorectal cancer. The patient samples represent a variety of histological grades, have data available on a series of clinicopathological variables including long-term outcome and ground truth annotations performed by experts. The CNN features extracted from images of the epithelial tissue compartment significantly predicted outcome (hazard ratio (HR) 2.08; CI95% 1.04-4.16; area under the curve (AUC) 0.66) in a test set of 60 patients, as compared to the CNN features extracted from unsegmented images (HR 1.67; CI95% 0.84-3.31, AUC 0.57) and visually assessed histologic grade (HR 1.96; CI95% 0.99-3.88, AUC 0.61). As a conclusion, a deep-learning classifier can be trained to predict outcome of colorectal cancer based on images of H and E stained tissue microarray samples and the CNN features extracted from the epithelial compartment only resulted in a prognostic discrimination comparable to that of visually determined histologic grade.

  7. Multimodal Imaging in a Patient with Hemidystonia Responsive to GPi Deep Brain Stimulation

    Directory of Open Access Journals (Sweden)

    Christos Sidiropoulos

    2017-01-01

    Full Text Available Background. Dystonia is a syndrome with varied phenomenology but our understanding of its mechanisms is deficient. With neuroimaging techniques, such as fiber tractography (FT and magnetoencephalography (MEG, pathway connectivity can be studied to that end. We present a hemidystonia patient treated with deep brain stimulation (DBS. Methods. After 10 years of left axial hemidystonia, a 45-year-old male underwent unilateral right globus pallidus internus (GPi DBS. Whole brain MEG before and after anticholinergic medication was performed prior to surgery. 26-direction diffusion tensor imaging (DTI was obtained in a 3 T MRI machine along with FT. The patient was assessed before and one year after surgery by using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS. Results. In the eyes-closed MEG study there was an increase in brain coherence in the gamma band after medication in the middle and inferior frontal region. FT demonstrated over 50% more intense ipsilateral connectivity in the right hemisphere compared to the left. After DBS, BFMDRS motor and disability scores both dropped by 71%. Conclusion. Multimodal neuroimaging techniques can offer insights into the pathophysiology of dystonia and can direct choices for developing therapeutics. Unilateral pallidal DBS can provide significant symptom control in axial hemidystonia poorly responsive to medication.

  8. Association of varicosities and concomitant deep venous thrombosis in patients with superficial venous thrombosis, a systematic review

    NARCIS (Netherlands)

    Baggen, Vivan J M; Chung, Kaman; Koole, Koos; Sarneel, Michelle H J; Rutten, Frans H; Hajer, Gideon R

    2015-01-01

    BACKGROUND: In patients with superficial venous thrombosis (SVT) co-existence of deep venous thrombosis (DVT) can be present. Varicosities are considered as a risk factor for both SVT and DVT separately. However, current evidence is contradictory whether varicosities are associated with an increased

  9. Assessment of Respiratory lmpedance During Deep-Slow Breathing with lmpulse Oscillometry in Patients with Chronic Obstructive Pulmonary Disease

    Institute of Scientific and Technical Information of China (English)

    梁永杰; 蔡映云

    2003-01-01

    Objective: To observe the relationship of deep-slow respiratory pattern and respiratory impedance(RI) in patients with chronic obstructive pulmonary disease (COPD). Methods: RI under normal respiration and during deep-slow respiration was measured one after the other with impulse oscillometry for 8 patients with COPD and for 9 healthy volunteers as control. Results: When respiration was changed from normal pattern to the deep-slow pattern, the tidal volume increased and respiratory frequency significantly decreased in both groups (P<0.01), the total respiratory impedance (Z respir) showed a decreasing trend in COPD group, but with no obvious change in the control group. No change in the resonant frequency (fres) was found in both groups, and the respiratory viscous resistance obviously decreased in the COPD group(R5: P=0.0168; R20: P=0.0498; R5-R20: P=0.0388),though in the control group it was unchanged. Conclusion: IOS detection could reflect the response heterogeneity of different compartments of respiratory system during tidal breathing. During deep-slow respiration, the viscous resistance in both central airway and peripheral airway was decreased in patients with COPD. RI measurement by impulse oscillometry may be a convenient pathophysiological method for studying the application of breathing exercise in patients with COPD.

  10. Low incidence of deep vein thrombosis after knee arthroscopy without thromboprophylaxis - A prospective cohort study of 335 patients

    NARCIS (Netherlands)

    M.R. Hoppener; H.B. Ettema; C.P. Henny; C.C.P.M. Verheyen; H.R. Buller

    2006-01-01

    Background There is little data on the risk of deep vein thrombosis after knee arthroscopy. Patients and methods We performed a prospective cohort study to establish the incidence of venous thrombo-embolic (VTE) complications after knee arthroscopy in daycare, as detected by bilateral complete compr

  11. ANTERIOR OPEN-BITE TREATMENT BY MEANS OF ZYGOMATIC MINIPLATES: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Kadir BEYCAN

    2017-01-01

    Full Text Available This case report presents the treatment of a patient with skeletal Cl II malocclusion and anterior open-bite who was treated with zygomatic miniplates through the intrusion of maxillary posterior teeth. A 16-year-old female patient with a chief complaint of anterior open-bite had a symmetric face, incompetent lips, convex profile, retrusive lower lip and chin. Intraoral examination showed that the buccal segments were in Class II relationship, and there was anterior open-bite (overbite -6.5 mm. The cephalometric analysis showed Class II skeletal relationship with increased lower facial height. The treatment plan included intrusion of the maxillary posterior teeth using zygomatic miniplates followed by fixed orthodontic treatment. At the end of treatment Class I canine and molar relationships were achieved, anterior open-bite was corrected and normal smile line was obtained. Skeletal anchorage using zygomatic miniplates is an effective method for open-bite treatment through the intrusion of maxillary posterior teeth.

  12. Decreased radiation doses to tongue with “stick-out” tongue position over neutral tongue position in head and neck cancer patients who refused or could not tolerate an intraoral device (bite-block, tongue blade, or mouthpiece) due to trismus, gag reflex, or discomfort during intensity-modulated radiation therapy

    OpenAIRE

    Kil, Whoon Jong; Kulasekere, Christina; Derrwaldt, Ronald; Bugno, Jacob; Hatch, Craig

    2016-01-01

    Purpose To assess changes in oral cavity (OC) shapes and radiation doses to tongue with different tongue positions during intensity-modulated radiation therapy (IMRT) in patients with head and neck squamous cell carcinoma (HNSCC) but who refused or did not tolerate an intraoral device (IOD), such as bite block, tongue blade, or mouthpiece. Results Tongue volume outside of OC was 7.1 ± 3.8 cm3 (5.4 ± 2.6% of entire OC and 7.8 ± 3.1% of oral tongue) in IMRT-S. Dmean of OC was 34.9 ± 8.0 Gy and ...

  13. Capnocytophaga canimorsus Sepsis Following a Minor Dog Bite to the Finger: Case Report.

    Science.gov (United States)

    Dedy, Nicolas J; Coghill, Sarah; Chandrashekar, Nanda Kumar S; Bindra, Randy R

    2016-01-01

    Capnocytophaga canimorsus is a gram-negative bacillus present in the oral cavities of 22% to 74% of healthy dogs. Capnocytophaga canimorsus has unique virulence factors that enable it to evade the human immune system and cause life-threatening sepsis following a dog bite. We report a previously well 68-year-old woman who presented with septic shock and multiorgan failure following a seemingly minor dog bite to the finger. The patient required intensive care treatment, intravenous antibiotic therapy, and multiple surgical procedures including amputation of the affected finger. The septicemia and coagulopathy that ensued resulted in gangrene and amputation of additional fingers and toes. The purpose of this report is to raise awareness of this organism among hand surgeons when faced with a patient presenting in septic shock and minimal signs at the site of a dog bite.

  14. Treatment of Class II open bite in the mixed dentition with a removable functional appliance and headgear.

    Science.gov (United States)

    Ngan, P; Wilson, S; Florman, M; Wei, S H

    1992-05-01

    Early diagnosis of patients exhibiting open bites that are complicated by skeletal Class II and vertical growth problems can facilitate subsequent treatment. Eight patients with Class II skeletal open bite were treated with the high-pull activator appliance and compared to reasonably matched controls to determine the effects of the appliance. The high-pull activator was found to reduce forward growth of the maxilla and increase mandibular alveolar height, transforming the Class II molar relationship into a Class I molar relationship. The overjet and open bite were decreased, and, in addition, the appliance reduced the amount of forward and downward movement of the maxillary molars, providing vertical control of the maxilla during Class II orthopedic correction. These results demonstrated that open bite complicated by a Class II vertical growth pattern can be treated during the mixed dentition with favorable results by a combination of a removable functional appliance and high-pull headgear.

  15. A comparison of between hyomental distance ratios, ratio of height to thyromental, modified Mallamapati classification test and upper lip bite test in predicting difficult laryngoscopy of patients undergoing general anesthesia

    OpenAIRE

    Azim Honarmand; Mohammadreza Safavi; Narges Ansari

    2014-01-01

    Background: Failed intubation is imperative source of anesthetic interrelated patient′s mortality. The aim of this present study was to compare the ability to predict difficult visualization of the larynx from the following pre-operative airway predictive indices, in isolation and combination: Modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD), hyomental distance ratios (HMDR), and the upper-lip-bite test (ULBT). Materials and Methods: We collected data on...

  16. [In relation to Cleopatra and snake bites].

    Science.gov (United States)

    Espinoza, R

    2001-10-01

    Cleopatra VII, one of the last Egyptian sovereigns of the ptolomeic dynasty, is envisioned as a mythic figure, surrounded by intrigues and mystery. her mysterious death was caused, according to history, by a snake bite. This article shows some instances of great Cleopatra's life and the state of the art on snake venoms. Even at the present time, snake bites are a public health problem in Asia, Africa, Central and South America, causing more than 25,000 deaths every year. Most snake venoms have a protein structure and cause neurotoxic and hemolytic effects, altering coagulation and fibrinolysis. The mortality due to snake bites fluctuates between 1 and 22%. Specific treatment includes the use of specific antiserums with highly purified components.

  17. Human Bite of a Staff Nurse on a Psychiatric Unit.

    Science.gov (United States)

    Suguna, Anbazhagan; Joseph, Bobby

    2016-04-01

    Occupational violence among health care professionals is a cause for concern, although often neglected especially in developing countries like India. Violence undermines the healing mission of the health care organization and interferes with the ability of the health care team to optimally contribute to positive patient outcomes. The authors discuss a case of a human bite of a staff nurse on a psychiatric unit in a tertiary care Indian hospital. The reported violence against this staff nurse lead to her admission for emergency care followed by emotional stress. Issues related to prevention of occupational violence are also discussed. © 2015 The Author(s).

  18. Taking the Bite out of Bruxism (For Kids)

    Science.gov (United States)

    ... the Operating Room? Taking the Bite Out of Bruxism KidsHealth > For Kids > Taking the Bite Out of ... have bruxism (say: BRUK-siz-um). What Is Bruxism? Bruxism is the term for grinding or clenching ...

  19. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... MD, Memorial Award and Lectureship Grants from outside organizations Health Volunteers Overseas Grant Honorary International Society Annual ... an ice pack to the bite. If you experience any serious symptoms after a bug bite, such ...

  20. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... bites Although most bug bites are harmless, some can spread dangerous diseases like Zika virus, dengue, Lyme ... and tuck your shirt into your pants. You can also pre-treat outer layers of clothing with ...

  1. etiology and pathogenesis of anterior open bite: a review

    African Journals Online (AJOL)

    2010-11-11

    Nov 11, 2010 ... Malocclusion requiring treatment was diagnosed in more than ... sucking and lip biting (20-22), nail biting (22) and ... pathologies associated with AOB include cleft lip and palate as well as trauma in condylar fractures or Le.

  2. Maximum occlusal bite forces in Jordanian individuals with different dentofacial vertical skeletal patterns.

    Science.gov (United States)

    Abu Alhaija, Elham S J; Al Zo'ubi, Ibraheem A; Al Rousan, Mohammed E; Hammad, Mohammad M

    2010-02-01

    This study was carried out to record maximum occlusal bite force (MBF) in Jordanian students with three different facial types: short, average, and long, and to determine the effect of gender, type of functional occlusion, and the presence of premature contacts and parafunctional habits on MBF. Sixty dental students (30 males and 30 females) were divided into three equal groups based on the maxillomandibular planes angle (Max/Mand) and degree of anterior overlap: included short-faced students with a deep anterior overbite (Max/Mand or = 32 degrees). Their age ranged between 20 and 23 years. MBF was measured using a hydraulic occlusal force gauge. Occlusal factors, including the type of functional occlusion, the presence of premature contacts, and parafunctional habits, were recorded. Differences between groups were assessed using a t-test and analysis of variance. The average MBF in Jordanian adults was 573.42 +/- 140.18 N. Those with a short face had the highest MBF (679.60 +/- 117.46 N) while the long-face types had the lowest MBF (453.57 +/- 98.30 N; P < 0.001). The average MBF was 599.02 +/- 145.91 in males and 546.97 +/- 131.18 in females (P = 0.149). No gender differences were observed. The average MBF was higher in patients with premature contacts than those without, while it did not differ in subjects with different types of functional occlusion or in the presence of parafunctional habits.

  3. Capybara Bites: Report of Human Injury Caused by a Hydrochoerus hydrochaeris.

    Science.gov (United States)

    de Oliveira Vieira, Camille; Bernardes Filho, Fred; Azulay-Abulafia, Luna

    2015-12-01

    Health care demand due to animal bites is frequent, especially in the emergency department (ED). In addition to the physical trauma caused by bites, one should be concerned with infectious diseases that can be transmitted. The range of the lesions depends on the animal species. Bites of Hydrochoerus hydrochaeris (capybaras) in humans are relatively uncommon. Capybaras are docile animals; however, their large rodent incisive teeth could cause serious injury. Localized care, antibiotic therapy when necessary, careful examination of the structures, tetanus and rabies immunization as indicated, and follow-up are recommended for wild animal bites. The authors hereby describe and discuss the medical management of a case of multiple lesions from capybara bites on the right thigh of a man. A 54-year-old male patient was admitted to the ED with a compression bandage soaked with blood after being bitten by a capybara. At the clinical examination, the patient had two lacerating wounds and multiple abrasions on the anterior face of the right thigh. Rabies prophylaxis was administered and the wounds were irrigated and closed with sterile dressings. Oral amoxicillin/clavulanate potassium for 7 days was administered to the patient. The patient was followed up; 3 months after the attack he returned to his previous level of activity without any complication. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We recommend that practitioners and physicians should provide prompt attention due to potentially significant morbidities, particularly rabies. The adequate care of the wound will allow better aesthetic and functional results to victims of wild animal bites. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Effects of proprioceptive neuromuscular facilitation stretching and deep-breathing exercises on upper extremity lymphedema in stroke patients

    Science.gov (United States)

    Hwang, Woon Taek; Jeong, Yeon-Jae; Kim, Seong-Yeol; Jeong, Yeon-Gyu

    2016-01-01

    [Purpose] The purpose of this study was to determine the effects of deep-breathing and proprioceptive neuromuscular facilitation stretching exercises on upper limb lymphedema in stroke patients. [Subjects and Methods] The study consisted of 10 patients with lymphedema that had occurred after stroke. Neurodevelopmental treatment was applied in the same manner as that used for the existing treatment. The subjects performed deep-breathing and stretching exercises three times per week for 4 weeks (12 sessions total). Body water volume in the upper limbs was measured before and after exercise by using an InBody S10 analyzer. [Results] Performance of deep-breathing and stretching exercises significantly reduced body water volume in both the affected and unaffected arms. The extracellular-to-total cellular fluid volume ratio in the affected arm improved to 0.379 after exercise, although this change was not significant. [Conclusion] The results of the present study show that deep-breathing and proprioceptive neuromuscular facilitation stretching exercises reduce upper extremity lymphedema in stroke patients. PMID:28174433

  5. Effects of proprioceptive neuromuscular facilitation stretching and deep-breathing exercises on upper extremity lymphedema in stroke patients.

    Science.gov (United States)

    Hwang, Woon Taek; Jeong, Yeon-Jae; Kim, Seong-Yeol; Jeong, Yeon-Gyu

    2016-12-01

    [Purpose] The purpose of this study was to determine the effects of deep-breathing and proprioceptive neuromuscular facilitation stretching exercises on upper limb lymphedema in stroke patients. [Subjects and Methods] The study consisted of 10 patients with lymphedema that had occurred after stroke. Neurodevelopmental treatment was applied in the same manner as that used for the existing treatment. The subjects performed deep-breathing and stretching exercises three times per week for 4 weeks (12 sessions total). Body water volume in the upper limbs was measured before and after exercise by using an InBody S10 analyzer. [Results] Performance of deep-breathing and stretching exercises significantly reduced body water volume in both the affected and unaffected arms. The extracellular-to-total cellular fluid volume ratio in the affected arm improved to 0.379 after exercise, although this change was not significant. [Conclusion] The results of the present study show that deep-breathing and proprioceptive neuromuscular facilitation stretching exercises reduce upper extremity lymphedema in stroke patients.

  6. Effectiveness of mesoglycan in patients with previous deep venous thrombosis and chronic venous insufficiency.

    Science.gov (United States)

    Andreozzi, G M

    2007-12-01

    Retrospective analysis of mesoglycan therapeutic activity in venous disorders. The clinical data have been selected from the outpatient database of the Chair of Angiology of the University of Catania (from 1988 to 1997) through a cross survey between the prescription commercial name of mesoglycan and the key words varicose veins, deep venous thrombosis (DVT), chronic venous insufficiency (CVI), post-thrombotic syndrome (PTS), venous thrombosis, venous ulcer. Patients have been selected on the basis of definite data relative to principal diagnosis, clinical history, clinical and instrumental objective phlebological picture, posology and duration of treatment, follow-up visits in the first three years following the first observation. Group 1: 56 patients with first episode DVT; Group 2: 27 patients with recurrent DVT; Group 3: 182 patients with CVI (107 with primitive CVI and 75 with secondary CVI). The selected patients data have been included in new databases. DVT patients were evaluated for recurrence prevalence during the follow-up period (6, 12, 18, 24, 30 and 36 months). In Group 2 the recurrence prevalence in the normal follow-up period was evaluated and, in addition, the clinical chronology of the recurrence previous to observation was drawn, in order to find out the recurrence prevalence of the thrombotic episode preceding our observation. The two prevalence trends ( mesoglycan treatment and episode preceding our observation) have been compared with the Student t test. CVI patients (Group 3) were classified according to CEAP classification criteria. The effectiveness of treatment was assessed according to the changes in the scores of venous dysfunction of CEAP classification (disability score; pain; oedema; skin color change; cutaneous ulcer). The mean and standard deviation of the considered scores have been evaluated with the Student t test comparing each series with the immediately previous series and with the T0 series. The mean dose of mesoglycan was 50

  7. ECT, rTMS, and deepTMS in pharmacoresistant drug-free patients with unipolar depression: a comparative review

    Directory of Open Access Journals (Sweden)

    Salviati M

    2012-01-01

    Full Text Available Amedeo Minichino¹, Francesco Saverio Bersani¹, Enrico Capra¹, Rossella Pannese¹, Celeste Bonanno², Massimo Salviati¹, Roberto Delle Chiaie¹, Massimo Biondi¹¹Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, ²Aldo Moro University of Bari, Bari, ItalyBackground: Biological treatments are considered as additional options for the treatment of resistant unipolar depression. Controversial data exist about the efficacy and tolerability of three of the most used somatic treatments: electroconvulsive therapy (ECT, transcranial magnetic stimulation (rTMS, and deep transcranial magnetic stimulation (deepTMS. The aim of this review is to investigate and compare the efficacy and tolerability of these three techniques in drug-free patients with pharmacoresistant unipolar depression.Methods: Three independent reviewers extracted data and assessed the quality of methodological reporting of selected studies. The first outcome was the clinical response to the three different techniques defined as a percentage improvement of Hamilton Depression Rating Scale (HDRS. The second outcome was the evaluation of their neuropsychological effects. The third outcome was the evaluation of the number of remitted patients; remission was defined as an absolute HDRS-24 score of ≤11 or as an absolute HDRS-17 score of ≤8. Tolerability was the fourth outcome; it was evaluated by examining the number of dropped-out patients.Results: The comparative evaluation of HDRS percentage variations shows ECT as the most effective method after 4 weeks of therapy; on the other hand, a better efficacy is obtainable by deepTMS after 2 weeks of therapy. DeepTMS is the technique that gives the best improvement of cognitive performances. The percentage of remitted patients obtained with ECT treatment is the same obtained in the deepTMS group. Both techniques have a remitted patients percentage two times larger than the rTMS. DeepTMS shows a tolerability

  8. Animal Bites Cases Presented to a University Hospital Pediatric Emergency Room

    Directory of Open Access Journals (Sweden)

    Okşan Derinöz

    2017-04-01

    Full Text Available Introduction: Rabies is still one of the important public health problems both in the world and in our country. The highest risk of rabies comes from contact with pets, especially dogs. The aim of this study was to evaluate the treatment steps that are used in the management of cases presenting to the pediatric emergency department in a university hospital with a risk of rabies contact. Methods: Data including age, gender, site of bites, kind of animals, tetanus/rabies prophylaxis, antibiotic treatments and forensic case reports were recorded for the animal bite cases between 2009 and 2016. Results: A total of 94 patients [58 males (61.7%] with a mean age of 11.06±4.77 years (range: 2-18 were included in the study. 43.6% of the cases presented to the pediatric emergency department within eight hours after the contact. 73.4% of patients presented due to dog bites, 25.5% for cat bite and one patient was with mice bite. In 34% of cases, the bite was on the hand. 50% of the bites were on torso in the 0-5 age group, 41.7% on upper extremities in the 6-10 age group, 50% on feet in the 11-15 age group, and 53.8% on lower extremities in the 16-18 age group (p<0.05. 56.4% of cases were reported as forensic cases. In 91.5% of cases, the wounds were cleaned and dressed while in the rest, the wounds were cleaned and sutured. 17% of patients were discharged on antibiotherapy. In only one of the cases, the patient was hospitalized for parenteral antibiotherapy. All the other patients were discharged. Conclusion: Although animal bites are very common cases for both adult emergency departments and pediatric emergency department, still many mistakes can be made in the treatment of these cases. In order to prevent these mistakes, the knowledge and skills of the healthcare professionals should be enhanced.

  9. Effect of deep pressure input on parasympathetic system in patients with wisdom tooth surgery

    Directory of Open Access Journals (Sweden)

    Hsin-Yung Chen

    2016-10-01

    Conclusion: LF/HF-HRV measurement revealed balanced sympathovagal activation in response to deep pressure application. The results suggest that the application of deep pressure alters the response of HF-HRV and facilitates maintaining sympathovagal balance during wisdom tooth extraction.

  10. [Local complications after poisonous snake bite].

    Science.gov (United States)

    Kuzbari, R; Seidler, D; Deutinger, M

    1994-01-01

    The case of a zoo keeper who was bitten on the left finger by a venomous snake (Vipera xanthina) is reported. The administration of antivenom prevented the development of systemic poisoning but had no effect on the extent of the local complications. A compartment syndrome with a concomitant severe reaction at the bite site required fasciotomy of the upper and lower arm. The extensor tendon of the involved finger ruptured spontaneously, many weeks after wound healing was completed. Therefore, delayed local complications following snake bites may occur, even if signs of systemic poisoning are missing.

  11. Bite Angle Effects in Hydroformylation Catalysis

    Institute of Scientific and Technical Information of China (English)

    van LEEUWEN

    2001-01-01

    Recent advances in rhodium catalyzed hydroformylation using xanthene-based ligands will be reviewed.The calculated natural bite angles of the ligands discussed are in the range 100-123℃ While the general trend is clear-higher 1:b ratios at wider angles, small changes in the bite angle do not exhibit a regular effect on the selectivity of the reaction.The same is true for the rate of CO dissociation;the larger the rate of the CO dissociation, the larger the rate of hydroformylation, but for small changes the effects do not comply with this rule.

  12. The Safety of Using Body-Transmit MRI in Patients with Implanted Deep Brain Stimulation Devices.

    Directory of Open Access Journals (Sweden)

    Joshua Kahan

    Full Text Available Deep brain stimulation (DBS is an established treatment for patients with movement disorders. Patients receiving chronic DBS provide a unique opportunity to explore the underlying mechanisms of DBS using functional MRI. It has been shown that the main safety concern with MRI in these patients is heating at the electrode tips - which can be minimised with strict adherence to a supervised acquisition protocol using a head-transmit/receive coil at 1.5T. MRI using the body-transmit coil with a multi-channel receive head coil has a number of potential advantages including an improved signal-to-noise ratio.We compared the safety of cranial MRI in an in vitro model of bilateral DBS using both head-transmit and body-transmit coils. We performed fibre-optic thermometry at a Medtronic ActivaPC device and Medtronic 3389 electrodes during turbo-spin echo (TSE MRI using both coil arrangements at 1.5T and 3T, in addition to gradient-echo echo-planar fMRI exposure at 1.5T. Finally, we investigated the effect of transmit-coil choice on DBS stimulus delivery during MRI.Temperature increases were consistently largest at the electrode tips. Changing from head- to body-transmit coil significantly increased the electrode temperature elevation during TSE scans with scanner-reported head SAR 0.2W/kg from 0.45°C to 0.79°C (p<0.001 at 1.5T, and from 1.25°C to 1.44°C (p<0.001 at 3T. The position of the phantom relative to the body coil significantly impacted on electrode heating at 1.5T; however, the greatest heating observed in any position tested remained <1°C at this field strength.We conclude that (1 with our specific hardware and SAR-limited protocol, body-transmit cranial MRI at 1.5T does not produce heating exceeding international guidelines, even in cases of poorly positioned patients, (2 cranial MRI at 3T can readily produce heating exceeding international guidelines, (3 patients with ActivaPC Medtronic systems are safe to be recruited to future f

  13. Bacteremia with Bacteroides pyogenes after a cat bite

    DEFF Research Database (Denmark)

    Madsen, Ida Ringsborg; Justesen, Ulrik Stenz

    2011-01-01

    Animal bite wounds are often infected with bacteria from the animal's oral flora. We report what we believe to be the first case of bacteremia with Bacteroides pyogenes resulting from an infected cat bite.......Animal bite wounds are often infected with bacteria from the animal's oral flora. We report what we believe to be the first case of bacteremia with Bacteroides pyogenes resulting from an infected cat bite....

  14. Deep Vein Thrombosis, Raynaud's Phenomenon, and Prinzmetal Angina in a Patient with Glanzmann Thrombasthenia.

    Science.gov (United States)

    Nurden, Alan; Mercié, Patrick; Zely, Pascal; Nurden, Paquita

    2012-01-01

    Patients with Glanzmann thrombasthenia fail to form large platelet thrombi due to mutations that affect the biosynthesis and/or function of the αIIbβ3 integrin. The result is a moderate to severe bleeding syndrome. We now report unusual vascular behaviour in a 55-year-old woman with classic type I disease (with no platelet αIIbβ3 expression) and a homozygous ITGA2B missense mutation (E324K) affecting the terminal β-propeller domain of αIIb. While exhibiting classic bleeding symptoms as a child, in later life this woman first developed deep vein thrombosis after a long air flight then showed vascular problems characteristic of Raynaud's phenomenon, and finally this year she presented with chest pains suggestive of coronary heart disease. Yet while coronary angiography first showed a stenosis, this was not seen on a second examination when she was diagnosed with coronary spastic angina and Prinzmetal phenomenon. It is significant that the absence of platelet aggregation with physiologic agonists had not prevented any of the above cardiovascular or vascular diseases.

  15. Deep Vein Thrombosis, Raynaud's Phenomenon, and Prinzmetal Angina in a Patient with Glanzmann Thrombasthenia

    Directory of Open Access Journals (Sweden)

    Alan Nurden

    2012-01-01

    Full Text Available Patients with Glanzmann thrombasthenia fail to form large platelet thrombi due to mutations that affect the biosynthesis and/or function of the αIIbβ3 integrin. The result is a moderate to severe bleeding syndrome. We now report unusual vascular behaviour in a 55-year-old woman with classic type I disease (with no platelet αIIbβ3 expression and a homozygous ITGA2B missense mutation (E324K affecting the terminal β-propeller domain of αIIb. While exhibiting classic bleeding symptoms as a child, in later life this woman first developed deep vein thrombosis after a long air flight then showed vascular problems characteristic of Raynaud’s phenomenon, and finally this year she presented with chest pains suggestive of coronary heart disease. Yet while coronary angiography first showed a stenosis, this was not seen on a second examination when she was diagnosed with coronary spastic angina and Prinzmetal phenomenon. It is significant that the absence of platelet aggregation with physiologic agonists had not prevented any of the above cardiovascular or vascular diseases.

  16. Use of an Artificial Neural Network to Construct a Model of Predicting Deep Fungal Infection in Lung Cancer Patients.

    Science.gov (United States)

    Chen, Jian; Chen, Jie; Ding, Hong-Yan; Pan, Qin-Shi; Hong, Wan-Dong; Xu, Gang; Yu, Fang-You; Wang, Yu-Min

    2015-01-01

    The statistical methods to analyze and predict the related dangerous factors of deep fungal infection in lung cancer patients were several, such as logic regression analysis, meta-analysis, multivariate Cox proportional hazards model analysis, retrospective analysis, and so on, but the results are inconsistent. A total of 696 patients with lung cancer were enrolled. The factors were compared employing Student's t-test or the Mann-Whitney test or the Chi-square test and variables that were significantly related to the presence of deep fungal infection selected as candidates for input into the final artificial neural network analysis (ANN) model. The receiver operating characteristic (ROC) and area under curve (AUC) were used to evaluate the performance of the artificial neural network (ANN) model and logistic regression (LR) model. The prevalence of deep fungal infection from lung cancer in this entire study population was 32.04%(223/696), deep fungal infections occur in sputum specimens 44.05% (200/454). The ratio of candida albicans was 86.99% (194/223) in the total fungi. It was demonstrated that older (≥65 years), use of antibiotics, low serum albumin concentrations (≤37.18 g /L), radiotherapy, surgery, low hemoglobin hyperlipidemia (≤93.67 g /L), long time of hospitalization (≥14 days) were apt to deep fungal infection and the ANN model consisted of the seven factors. The AUC of ANN model (0.829±0.019) was higher than that of LR model (0.756±0.021). The artificial neural network model with variables consisting of age, use of antibiotics, serum albumin concentrations, received radiotherapy, received surgery, hemoglobin, time of hospitalization should be useful for predicting the deep fungal infection in lung cancer.

  17. Cheek-biting disorder: another stereotypic movement disorder?

    Science.gov (United States)

    Sarkhel, Sujit; Praharaj, Samir Kumar; Akhtar, Sayeed

    2011-12-01

    Recurrent cheek biting, a form of self-injurious behavior is a rare entity which presents mostly to dentists and dermatologists. We report a case of recurrent severe cheek biting in an adult male leading to mucosal ulceration. The stereotypic pattern of cheek biting and associated behavior bears striking resemblance to other impulse control disorders.

  18. A new skeletal retention system for retaining anterior open bites

    Directory of Open Access Journals (Sweden)

    Bodore Albaker

    2013-01-01

    Full Text Available Objectives: Relapse of anterior open bite after treatment poses a challenge to orthodontists and warrants finding new methods. We aimed to compare the effect of a skeletal retention (SR system to the conventional retention (CR commonly used. Materials and Methods: Twenty patients participated in this study. SR group ten patients (five females and five males with mean age of 16.2 years, CR group ten patients (five females and five males with mean age of 17.1 years in pretreatment stage. The SR system is comprised of four self-drilling miniscrews and vacuum retainers with interarch elastics where the CR group is comprised of removable or fixed retainers. Pretreatment (T1, posttreatment (T2, and 1-year follow up (T3 lateral cephalograms were taken and analyzed to compare the stability of both retention modalities. Results: The overbite in the CR group showed more relapse in the form of significant reduction when compared to the SR group (P < 0.001. The overbite was reduced only by 0.1 mm (±0.3 in the SR group compared to 1.4 mm (±0.9 in the CR group. In the CR group, the upper incisors and first molar showed a more significant relapse compared to the SR group (P < 0.05. Conclusion: Skeletal retention using miniscrews and vertical elastic is an effective method for retention of anterior open bite cases.

  19. Analysis of cases caused by acute spider bite

    Directory of Open Access Journals (Sweden)

    Zihni Sulaj

    2015-08-01

    Full Text Available We performed a retrospective study of 176 patients in the University Hospital Center of Tirana (Albania, during the period 2001–2011, admitted with the diagnosis of a suspected spider bite. Three fatalities were registered during this decade covered from our study, with a clinical picture of marked hypertension, tachycardia and acute cardiac failure leading to death within a minimum of 25 h and a maximum of 42 h from the occurrence. Out of the total of 176 patients, we had 59% (104 cases females, and 41% males. The overwhelming majority of the patients lived in rural areas (155 of the cases; extremities were mostly affected from the bites. A summary of clinical signs and a brief review of the available literature are made in the results and discussion section of this paper. Authors advocate that special precautions should be taken especially in severe forms of interesting autonomous nerve system, with aggressive fluid resuscitation, supportive therapy and close monitoring of vital signs.

  20. Impact of Fixed Appliance Combined with Bite Splint Treatment on Facial Soft Tissue Changes in Patients with Anterior Crossbite%固定矫治器联合后牙垫治疗前牙反对颜面软组织侧貌的影响

    Institute of Scientific and Technical Information of China (English)

    林晓瑜

    2014-01-01

    目的:探讨固定矫治器联合可摘式后牙�垫治疗前牙反�对颜面软组织侧貌的影响。方法:选取40例前牙反�患者,采用直丝弓矫治技术配合可摘式后牙�垫矫正,均未拔牙。采用X线头颅定位侧位片分析矫正后患者软组织侧貌的改变。结果:矫治后患者面型改善,反�得以矫正,牙齿排列、咬合关系改善;与矫治前相比,下唇突距减小,面突角减小,差异有统计学意义(P<0.05)。结论:固定矫治器联合可摘式后牙牙合垫治疗前牙反�对软组织侧貌有明显的改善作用。%Objective:To study the facial soft tissue changes in patients with anterior crossbite after treatment of fixed appli-ance combined with bite splint treatment .Methods :Forty cases patients with anterior crossbite were selected and treated by straight wire appliance combined with bite splint .The facial soft tissue changes after treatment were analyzed by X-ray cephalo-metric measurements .Results:After treatment ,the facial soft tissue was significantly improved ,the cross bite was relieved , and the teeth arrangement and malocclusion were also improved significantly .Compared with those before treatment ,LL-SnPg’ and G-Sn-Pog’ were decreased significantly after treatment ,the difference was statistically significant (P<0 .05) .Con-clusions:Treatment of fixed appliance combined with bite splint can significantly improve facial soft tissue changes .

  1. Bilateral deep neck space infection in pediatric patients: review of literature and report of a case.

    Science.gov (United States)

    Raghani, Manish J; Raghani, Nisha

    2015-01-01

    The diagnosis and treatment of deep neck infections is still an enigma for surgeons and physicians. Because of the complexity and the deep location of this region, the diagnosis and treatment in this area is difficult. The anatomy of deep neck spaces is highly complex and therefore precise localization of infections in this region is very difficult. The diagnoses of deep neck space infection (DNSI) are difficult because of the deep location of these spaces and are usually covered by substantial amount of normal superficial soft tissue. Access: To gain surgical access to the deep neck spaces, the superficial tissues must be crossed with the risk of injury to the neurovascular structures in the neck. Neural dysfunction, vascular erosion or thrombosis, and osteomyelitis are some of the complications of DNSI because of the proximity of nerves, vessels, bones, and other soft tissues. Deep neck spaces are communicated with each other and infections from one space can spread to adjacent space. DNSI, if not diagnosed early and promptly, may result in serious consequences even mortality. The treatment of DNSI with antibiotic therapy and drainage is most often definitive and recurrence of these cases is rare.

  2. The Effect of Bite Registration on the Reproducibility of Parallel Periapical Radiographs Obtained with Two Month Intervals

    Directory of Open Access Journals (Sweden)

    L. Khojastehpour

    2006-06-01

    Full Text Available Statement of Problem: Digital Subtraction Radiography (DSR needs reproducible alignment between the x-ray source, the object, and the film for obtaining identical projections of the same anatomic region.Purpose: The aim of this study was to evaluate the effect of bite registrations (placed on individual bite blocks on the reproducibility of parallel periapical radiographs,obtained every 2 months, in patients undergoing periodontal surgery for furcationinvolvement.Materials and Methods: Ninety eight parallel periapical radiographs were used in this study. The radiographs were taken with individual bite-blocks attached to the beamguiding device. In order to individualize the bite blocks, bite registrations were fabricated using silicon impression material, and were placed on the individual bite blocks. All radiographs in each series were processed under similar conditions and were digitized with the flatbed scanner fitted with a transparency adaptor (hp Scanjet 7400 at 300 dpi resolution. Reproducibility of this method for obtaining similar parallel periapical radiographs was assessed by measuring the horizontal and vertical distances between two selected unchanged reference points on each radiograph and comparing them in each series. Reliability of measurements was analyzed using the one wayrandom model intraclass correlation coefficient for average of raters.Results: For both measurements (Horizontal and Vertical statistically significant reliability was found between three repeated radiographs with two month intervals in 16 patients, as well as 5 repeated radiographs with two month intervals in 10 patients (P<0.001.Conclusion: The result of this study shows that bite registration on individual bite blocks is enough for obtaining identical parallel periapical radiographs.

  3. Streptobacillus moniliformis septic arthritis: a clinical entity distinct from rat-bite fever?

    Directory of Open Access Journals (Sweden)

    Wong Samson SY

    2007-06-01

    Full Text Available Abstract Background Streptobacillus moniliformis is a zoonotic agent associated with rodent contacts. Although it is more commonly reported to cause rat-bite fever with reactive arthritides, it can also lead to pyogenic infection of the joints. Case presentation We present a lady with past history of osteoarthritis developing streptobacillary septic arthritides of the right knee and left wrist, and required antibiotic and arthrotomy for treatment. We also review 11 previously reported cases of streptobacillary septic arthritis to discuss the characteristics, treatment, prognosis of the infection, and illustrates the differences between streptobacillary rat-bite fever and septic arthritis. Among this patient population, most patients had potential contact with rats (91.6%. The knee is the most commonly affected joint (58.3%, and 83.3% patients having polyarticular involvement. As opposed to rat-bite fever, fever and rash was only present in 58.3% and 16.7% of patients respectively. S. moniliformis bacteremia is uncommon (8.4% and the prognosis is good. Conclusion Arthrocentesis is useful in distinguishing streptobacillary septic arthritis from reactive arthritis of rat-bite fever. The sole use of commercial media containing sodium polyanethol sulfonate may render the bacterial culture negative. A detailed history of possible exposure to rodents should be elicited from patients with arthritis in order to facilitate microbiologic diagnosis.

  4. Modified Thurow appliance: a clinical alternative for correcting skeletal open bite.

    Science.gov (United States)

    Stuani, Maria Bernadete Sasso; Stuani, Andréa Sasso; Stuani, Adriana Sasso

    2005-07-01

    Open bite malocclusion is frequently discussed in orthodontics; diagnosis, treatment, and retention can be difficult because this malocclusion has numerous correlated etiological factors. The earlier this malocclusion is corrected, the better the prognosis will be, especially when the problem is skeletal. This article presents a patient with skeletal open bite who was treated in the mixed dentition with an orthodontic appliance that included an acrylic occlusal splint and an expansion screw, based on the original Thurow appliance, to guide the vertical force against the posterior teeth and the alveolar process.

  5. An unusual case of sustained ventricular tachycardia following a wasp bite

    Directory of Open Access Journals (Sweden)

    Tarun Sharma

    2016-01-01

    Full Text Available Sustained ventricular tachycardia (VT is a life-threatening condition which requires immediate intervention. We report a case of unusual etiology of sustained VT in a 42-year-old male after a wasp bite in the absence of anaphylaxis. The patient was treated with amiodarone and improved within 48 h. Thus, wasp stings can lead to serious tachyarrhythmias which can be life-threatening. Emergency care physicians should be aware of such arrhythmias in the setting of wasp bites which can be fatal.

  6. The black widow spider bite: differential diagnosis, clinical manifestations, and treatment options.

    Science.gov (United States)

    Shackleford, Rodney; Veillon, Diana; Maxwell, Nicole; LaChance, Lisa; Jusino, Tamara; Cotelingam, James; Carrington, Patrick

    2015-01-01

    Unrecognized and untreated black widow spider bites cause significant pain, impairment, and rarely death. The widow venom, a powerful neurotoxin known as a-latrotoxin, causes muscle pain, diaphoresis, tachycardia, flushing, and hypertension. Treatment is usually symptomatic with a combination of opioid analgesics and muscle relaxants. If symptom resolution fails, an equine IgG antiserum is available, but a high index of clinical suspicion coupled with a knowledgeable patient history often allows successful treatment, especially when the treating physician possesses awareness of this type of bite and its usual course and possible complications.

  7. Adder bite: an uncommon cause of compartment syndrome in northern hemisphere.

    Science.gov (United States)

    Evers, Lars H; Bartscher, Tanja; Lange, Thomas; Mailänder, Peter

    2010-09-20

    Snakebite envenomation is an uncommon condition in the northern hemisphere, but requires high vigilance with regard to both the systemic effects of the venom and the locoregional impact on the soft tissues. Bites from the adder, Vipera Berus, may have serious clinical consequences due to systemic effects. A case of a 44-year-old man is reported. The patient was bitten in the right hand. He developed fasciotomy-requiring compartment syndrome of the upper limb. Recognition of this most seldom complication of an adder bite is vital to save the limb. We recommend that the classical signs and symptoms of compartment syndrome serve as indication for surgical decompression.

  8. Bite-related and septic syndromes caused by cats and dogs.

    Science.gov (United States)

    Oehler, Richard L; Velez, Ana P; Mizrachi, Michelle; Lamarche, Jorge; Gompf, Sandra

    2009-07-01

    Bite infections can contain a mix of anaerobes and aerobes from the patient's skin and the animal's oral cavity, including species of Pasteurella, Streptococcus, Fusobacterium, and Capnocytophaga. Domestic cat and dog bite wounds can produce substantial morbidity and often require specialised care techniques and specific antibiotic therapy. Bite wounds can be complicated by sepsis. Disseminated infections, particularly those caused by Capnocytophaga canimorsus and Pasteurella multocida, can lead to septic shock, meningitis, endocarditis, and other severe sequelae. An emerging syndrome in veterinary and human medicine is meticillin-resistant Staphylococcus aureus (MRSA) infections shared between pets and human handlers, particularly community-acquired MRSA disease involving the USA300 clone. Skin, soft-tissue, and surgical infections are the most common. MRSA-associated infections in pets are typically acquired from their owners and can potentially cycle between pets and their human acquaintances.

  9. Transient reverse takotsubo cardiomyopathy following a spider bite in Greece: a case report.

    Science.gov (United States)

    Alexakis, Lykourgos-Christos; Arapi, Sophia; Stefanou, Ioannis; Gargalianos, Panagiotis; Astriti, Myrto

    2015-02-01

    Black widow spider is endemic in the Mediterranean area and although envenomations are rare, may occasionally lead to death. We present a case of a 64-year-old female developing a rare variant of takotsubo, stress-induced, cardiomyopathy after a spider bite. This resulted in acute heart failure within 24  hours of the bite. With medical treatment and supportive care, the patient's clinical condition improved. Reverse takotsubo cardiomyopathy was diagnosed by echocardiography, which was transient. Clinical and echocardiographic findings have been completely resolved on follow-up 46 days later. Reverse takotsubo cardiomyopathy has not been yet described following a spider bite. Doctors in the emergency department of endemic countries should be familiar with this potential complication.

  10. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... your mouth. Identify your triggers: These could be physical triggers, such as the presence of hangnails, or other triggers, such as boredom, stress, or anxiety. By figuring out what causes you to bite your nails, you can figure ...

  11. [Surgical management of animal bites in children].

    Science.gov (United States)

    Touzet-Roumazeille, S; Jayyosi, L; Plenier, Y; Guyot, E; Guillard, T; François, C

    2016-10-01

    Children represent a population at risk, because of their short size, their naivety and their attraction to animals. The face and hands are the most specific locations in young children. Wounds are often multiple. In more than half the cases, the child knows the animal, which are dogs and cats by frequency argument. The bite episode occurs mostly when the child is alone with the pet without direct supervision, while playing or stroking the animal. As in all bites, pediatric lesions are infectious, functional and aesthetic emergencies, but the goal of this work was primarily to make a point on principles of surgical management of animal bites in children, highlighting pediatric specificities. Animal bites require psychological, anesthetic and surgical treatment, adapted to the child, in a specialized structure. Hospitalization and general anesthesia are more frequent in children. Any suspicion of mistreatment (and/or abuse) should lead to the child's hospitalization, even if wounds do not justify monitoring in a surgical environment. Emergency surgery is essential to limit functional and aesthetic consequences. The healing capacities of the child and the frequent lack of co-morbidity allow a conservative surgical treatment with suture, repositioning skin flaps and controlled healing in the first place. Immobilization, drainage, and antibiotics will complete the surgery. The healing process, however, leads to a specific management during scar remodeling phase and growth. Psychological care of the child and parents should not be forgotten, and has to start at the same time as surgical treatment at in acute phase.

  12. Brown recluse spider bite on the breast.

    Science.gov (United States)

    Norris, Kori; Misra, Subhasis

    2014-05-01

    Brown recluse spiders are one of two types of spiders in the United States that can cause significant tissue damage and, in rare cases, death. Brown recluse spider bites are most often benign and self-limiting, but in a few cases can cause severe necrotic skin lesions.

  13. EduBites: Cliffs Notes for EPO

    Science.gov (United States)

    Brinkworth, Carolyn; Bartolone, L.; Wenger, M.; Martin, A.; Nichols-Yehling, M.; Llamas, J.; Hurt, R. L.; Squires, G. K.

    2013-06-01

    We present a new resource for the astronomy education community, with the goal of improving our community’s knowledge and understanding of the educational research papers pertinent to our work. When launched, EduBites will be a searchable database of summaries of peer-reviewed education papers, written by astronomy educators and posted for the entire community to use. While we are all aware that we should be basing our E/PO work on a solid research foundation, many people in the community are pushed for time when it comes to staying on top of the educational literature. EduBites aims to reduce that workload for the benefit of the entire community. Our database will ultimately tackle papers across the whole of the astronomy education spectrum, including formal and informal education, outreach, grades K-16, pedagogy, evaluation, and many other topics. We are keen to hear from anyone on the community who would be interested in joining our review team, and will welcome feedback on the EduBites user experience. EduBites is still currently under development but, when launched, it will be found at edubites.ipac.caltech.edu

  14. A phoenix of clinical toxinology: white-tailed spider (Lampona spp.) bites. A case report and review of medical significance.

    Science.gov (United States)

    White, Julian; Weinstein, Scott A

    2014-09-01

    The Australian white-tailed spiders ("WTS"; Lamponidae: notably Lampona cylindrata &Lampona murina) have a continuing reputation on Internet sites as a cause of skin ulceration, labelled "necrotic arachnidism", despite an increasing number of peer-reviewed publications debunking this reputation, with >135 confirmed cases now reported without any evidence of necrosis. We present here a case of confirmed WTS bite in a 42-year old male, followed for over a month, with photos of bite site signs and no development of skin ulceration/necrosis. The patient was initially alarmed by information on the Internet suggesting local necrosis would result from the bite. We discuss the evolution of knowledge about bites by the WTS, and the persistence of misconceptions about their factually mild medical significance. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  15. Homicide by direct snake bite: a case of contract killing.

    Science.gov (United States)

    Ambade, Vipul Namdeorao; Borkar, Jaydeo Laxman; Meshram, Satin Kalidas

    2012-01-01

    It has been estimated that five million snake bite cases occur worldwide every year, causing about 100,000 deaths. Snake bite is exclusively accidental in nature. Suicide by snake bite is very rare and homicidal snake bite is not reported. In the present case, a contract killer was hired, who used a poisonous snake to kill an elderly couple by way of direct snake bite. We believe this to be the first case reported where a snake was directly used for the murder of two victims through a contract killer.

  16. The effect of lower anterior high pull headgear on treatment of moderate open bite in adults

    Directory of Open Access Journals (Sweden)

    Rahman Showkatbakhsh

    2012-01-01

    Full Text Available Background and Aims: Various methods are used for treatment of open bite. The objective of this study was to investigate the effects of Lower Anterior High Pull Headgear (LAHPH appliance in Class I subjects with moderate open bite and high lower lip line.Materials and Methods: The study group was composed of 10 subjects with a mean age of 15.8±2.5 years and 3.05 ± 0.07 mm moderate open bite. All the patients rejected orthognathic surgery. The treatment included extraction of upper and lower second premolars followed by leveling, banding, bonding, posterior space closure, and anterior retraction. After these procedures, the open bite was reduced to 2.04±1.17 mm. Afterwards, LAHPH was applied for 18 hours per day for 8±2 months. LAHPH appliance was composed of High Pull Headgear and two hooks mounted on its inner bow. Two elastics (1.8, light, Dentaurum connected the upper hooks on the inner bow to the lower hooks on the mandibular canines vertically. The forces produced by the prescribed elastics were 10 and 60 g during mouth closing and opening, respectively. Paired T-test was used to evaluate pre-andpost-treatment outcomes.Results: The pre-and post-treatment cephalometric evaluations showed that the LAHPH reduced effectively the open bite of the patients to 0.15±1.7 mm (P<0.001.Conclusion: This appliance can be used as an acceptable method for closing the open bite in Class I subjects.

  17. Applicability of Berry′s index in bite mark analysis

    Directory of Open Access Journals (Sweden)

    Palathottungal Joseph Antony

    2015-01-01

    Full Text Available Objectives: This study attempts to highlight the usefulness of applying Berry′s Index as an adjuvant to support and aid in bite analysis. Materials and Methods: This study was conducted among 100 students between the ages of 18-30 from Mar Baselios Dental Collage, Kothamangalam. Out of the 100 subjects, there were 50 males and 50 females. The data obtained was tabulated and analyzed using Statistical Package for Social Sciences, Version 16 (SPSS. Results: The mean value of the width of the upper central incisor for male and female was 0.7602 cm and 0.7765 cm respectively. The mean value of the bizygomatic width for male and female was 12.54 cm and 12.42 cm respectively. The correlation between the upper central incisor width and the bizygomatic width was inferred to have a good positive correlation with a value 0f 0.613. Pearson correlation coefficient with greater correlation between the upper central incisor width and the bizygomatic width in female patient (r = 0.678 compared with male patient (r = 0. 525. Conclusion: Berry′s Index can be a useful adjuvant to bite analysis by providing a means of determining the facial proportions of an individual from the width of the central incisors.

  18. Management of human bites of the face in Enugu, Nigeria | Olaitan ...

    African Journals Online (AJOL)

    Log in or Register to get access to full text downloads. ... Methods:A retrospective review of the cases of human bites of the face that presented within a ten year period was carried out. ... Information obtained includes age, gender of the patients as well as that of the assailants and the relationship of the assailants to the ...

  19. Reconstructive considerations following a necrotic spider bite on the face: A case report

    Directory of Open Access Journals (Sweden)

    Joachim Mikkelsen

    2017-01-01

    Conclusion: In the few reported cases of necrotic spider bites in the facial region, active reconstructive measures have resulted in the best outcomes. Tissue expansion of local or regional skin may have a potential role, but in certain patients, simple reconstructive solutions will provide an aesthetically satisfactory result without requiring extensive or multi-stage surgeries, as demonstrated in this case.

  20. Deep Anterior Lamellar Keratoplasty in Keratoconic Patients with versus without Vernal Keratoconjunctivitis

    Science.gov (United States)

    Feizi, Sepehr; Javadi, Mohammad Ali; Javadi, Fatemeh; Jafarinasab, Mohammad Reza

    2015-01-01

    Purpose: To compare the clinical outcomes of deep anterior lamellar keratoplasty (DALK) for keratoconus in patients with vernal keratoconjunctivitis (VKC) versus those without VKC. Methods: In this retrospective comparative study, records of 262 eyes with keratoconus (Group 1) and 28 keratoconic eyes with VKC (Group 2) that had undergone DALK were compiled. Reviewed parameters included length of follow-up, best-corrected visual acuity (BCVA), refractive error, complications and cumulative graft survival. Results: Mean duration of follow-up was 38.6 ± 20.2 and 34.4 ± 20.9 months in groups 1 and 2, respectively (P = 0.21). Mean post-operative BCVA was 0.19 ± 0.11 and 0.20 ± 0.15 logMAR, in groups 1 and 2 (P = 0.79). BCVA≥20/40 was achieved in 91.6 and 88.5% of eyes in groups 1 and 2, respectively (P = 0.48). Epithelial problems were encountered in 31.3 and 42.9% of operated eyes, respectively (P = 0.16). Vascularization of suture tracts and stitch abscesses were encountered more frequently in the eyes with VKC (P = 0.01 and <0.001, respectively). At the 33-month follow-up examination, rejection-free graft survival rates were 56.0% in group 1 and 33.3% in group 2, with mean durations of 41.0 and 32.1 months, respectively (P = 0.15). Graft survival rates were 98.1% in group 1 and 95.0% in group 2, with mean durations of 88.6 and 88.4 months, respectively (P = 0.74). Conclusion: Clinical outcomes of DALK in keratoconic eyes with VKC were comparable to those in eyes with keratoconus alone. However, complications such as suture tract vascularization and stitch abscesses were more common when VKC coexisted, necessitating closer monitoring. PMID:26425311

  1. Robotic Shaving Technique in 25 Patients Affected by Deep Infiltrating Endometriosis of the Rectovaginal Space.

    Science.gov (United States)

    Pellegrino, Antonio; Damiani, Gianluca Raffaello; Trio, Claudia; Faccioli, Paolo; Croce, Paolo; Tagliabue, Fulvio; Dainese, Emanuele

    2015-01-01

    Minimally invasive surgery represents the gold standard for the management of deep infiltrating endometriosis (DIE) involving the rectovaginal septum (RVS). This analysis aimed to evaluate the feasibility of robotic-assisted laparoscopy (RAL) and clinical outcomes in terms of long-term complications, pain relief, and recurrence rate for the treatment of DIE of the RVS. A prospective cohort study of robotic procedures was performed between October 2010 and July 2014, including removal of endometriotic nodules from the RVS with rectal shaving alone or in combination with accessory procedures. In all cases, the revised American Society for Reproductive Medicine (rASRM) score for endometriosis was >40 points (stage IV). Twenty-five consecutive patients underwent RAL, with a successful complete nodule debulking by the wall shaving technique. Pathology confirmed the adequacy of the surgical specimen and the median largest endometriotic nodule was of 21 mm (range, 10-60 mm), with free margins in all cases. The median operative time from skin opening to closure was 174 minutes (range, 75-300 minutes), and blood loss was close to 0 mL. The median revised Enzian score for location A (RVS) was 2 (range, 1-3). The most frequent Enzian class was A2B0C0 (48%), followed by A3B0C0 (12%). In 3 cases (12%), partial vaginal resection was required to remove endometriotic nodules of the RVS (1 each in classes A3B0C1FI, A3B0C0FO, and A3B0C0). No intraoperative complications occurred. This series has a median long-term follow up of 22 months (range, 6-50 months) currently available with an optimal operative time, demonstrating good long-term outcomes. Our data support robotics as a safe and attractive alternative for comprehensive surgical treatment of DIE.

  2. Dysregulation of B Cell Repertoire Formation in Myasthenia Gravis Patients Revealed through Deep Sequencing.

    Science.gov (United States)

    Vander Heiden, Jason A; Stathopoulos, Panos; Zhou, Julian Q; Chen, Luan; Gilbert, Tamara J; Bolen, Christopher R; Barohn, Richard J; Dimachkie, Mazen M; Ciafaloni, Emma; Broering, Teresa J; Vigneault, Francois; Nowak, Richard J; Kleinstein, Steven H; O'Connor, Kevin C

    2017-02-15

    Myasthenia gravis (MG) is a prototypical B cell-mediated autoimmune disease affecting 20-50 people per 100,000. The majority of patients fall into two clinically distinguishable types based on whether they produce autoantibodies targeting the acetylcholine receptor (AChR-MG) or muscle specific kinase (MuSK-MG). The autoantibodies are pathogenic, but whether their generation is associated with broader defects in the B cell repertoire is unknown. To address this question, we performed deep sequencing of the BCR repertoire of AChR-MG, MuSK-MG, and healthy subjects to generate ∼518,000 unique VH and VL sequences from sorted naive and memory B cell populations. AChR-MG and MuSK-MG subjects displayed distinct gene segment usage biases in both VH and VL sequences within the naive and memory compartments. The memory compartment of AChR-MG was further characterized by reduced positive selection of somatic mutations in the VH CDR and altered VH CDR3 physicochemical properties. The VL repertoire of MuSK-MG was specifically characterized by reduced V-J segment distance in recombined sequences, suggesting diminished VL receptor editing during B cell development. Our results identify large-scale abnormalities in both the naive and memory B cell repertoires. Particular abnormalities were unique to either AChR-MG or MuSK-MG, indicating that the repertoires reflect the distinct properties of the subtypes. These repertoire abnormalities are consistent with previously observed defects in B cell tolerance checkpoints in MG, thereby offering additional insight regarding the impact of tolerance defects on peripheral autoimmune repertoires. These collective findings point toward a deformed B cell repertoire as a fundamental component of MG.

  3. Neuropsychological syndromes in patients with Parkinson’s disease after deep electric stimulation of pallidar complex structures

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    Yu V Mikadze

    2013-01-01

    Full Text Available The paper provides the results of neuropsychological examinations in 10 patients with Parkinson’s disease who underwent deep electrical stimulation of pallidar complex structures. The general neuropsychological test battery that had been developed by A.R. Luria and allowed the qualitative classification of the cognitive impairment symptoms detectable on examination to be made was used to study cognitive functions. The patients were examined before and just after surgery and in the late period (following 1—2 years. The examinations have shown that the syndromes indicative of dysfunctions in the deep, parietal, and occipital and prefrontal regions of the left hemisphere and in the parietooccipital regions of the right hemisphere are stable components that determine the pattern of cognitive disorders and are preserved throughout all examinations.

  4. Bite marks on skin and clay: A comparative analysis

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    R.K. Gorea

    2014-12-01

    Full Text Available Bite marks are always unique because teeth are distinctive. Bite marks are often observed at the crime scene in sexual and in physical assault cases on the skin of the victims and sometimes on edible leftovers in burglary cases. This piece of evidence is often ignored, but if properly harvested and investigated, bite marks may prove useful in apprehending and successfully prosecuting the criminals. Due to the importance of bite marks, we conducted a progressive randomised experimental study conducted on volunteers. A total of 188 bite marks on clay were studied. Based on these findings, 93.34% of the volunteers could be identified from the bite marks on the clay. In addition, 201 impressions on skin were studied, and out of these cases, 41.01% of the same volunteers could be identified based on the bite mark impressions on the skin.

  5. d-dimer testing as an adjunct to ultrasonography in patients with clinically suspected deep vein thrombosis: prospective cohort study

    Science.gov (United States)

    Bernardi, Enrico; Prandoni, Paolo; Lensing, Anthonie W A; Agnelli, Giancarlo; Guazzaloca, Giuliana; Scannapieco, Gianluigi; Piovella, Franco; Verlato, Fabio; Tomasi, Cristina; Moia, Marco; Scarano, Luigi; Girolami, Antonio

    1998-01-01

    Objective To investigate the efficacy of using a rapid plasma d-dimer test as an adjunct to compression ultrasound for diagnosing clinically suspected deep vein thrombosis. Design d-dimer concentrations were determined in all patients with a normal ultrasonogram at presentation. Repeat ultrasonography was performed 1 week later only in patients with abnormal d-dimer test results. Main outcome measure Patients with normal ultrasonograms were not treated with anticoagulants and were followed for 3 months for thromboembolic complications. Setting University research and affiliated centres. Subjects 946 patients with clinically suspected deep vein thrombosis. Results Ultrasonograms were abnormal at presentation in 260 (27.5%) patients. Of the remaining 686 patients tested for d-dimer, 88 (12.8%) had abnormal concentrations. During follow up venous thromboembolic complications occurred in one of the 598 patients who were not treated with anticoagulants and who had an initial normal ultrasonogram and d-dimer concentration, whereas thromboembolic complications occurred in two of the 83 untreated patients who had abnormal d-dimer concentrations but a normal repeat ultrasonogram. The cumulative incidence of venous thromboembolic complications during follow up was 0.4% (95% confidence interval 0% to 0.9%). The rapid plasma d-dimer test used as an adjunct to compression ultrasonography resulted in a reduction in the mean number of repeat ultrasound examinations and additional hospital visits from 0.7 to 0.1 per patient. Conclusions Testing for d-dimer as an adjunct to a normal baseline ultrasound examination decreased the number of subsequent ultrasound examinations considerably without any increased risk of venous thromboembolic complications in patients not receiving anticoagulants. The use of ultrasound and testing for d-dimer enabled treatment decisions to be made at the time of presentation in most patients. Key messagesPatients with clinically suspected deep vein

  6. Is thrombophilia a major risk factor for deep vein thrombosis of the lower extremities among Lebanese patients?

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    R Kreidy

    2009-07-01

    Full Text Available R Kreidy1, N Irani-Hakime21Department of Vascular Surgery, 2Department of Laboratory Medicine, Saint George Hospital, University Medical Center, University of Balamand, Beirut, LebanonAim: Factor V Leiden (R506Q mutation is the most commonly observed inherited genetic abnormality related to vein thrombosis. Lebanon has one of the highest frequencies of this mutation in the world with a prevalence of 14.4% in the general population. The aim of this study is to define risk factors including inherited genetic abnormalities among Lebanese patients with lower extremity deep vein thrombosis. We report the clinical outcome of patients with thrombophilia.Methods: From January 1998 to January 2008, 162 patients (61 males and 101 females were diagnosed with lower extremity deep vein thrombosis. Mean age was 61 years (range: 21 to 95 years.Results: The most frequent risk factors for vein thrombosis were surgery, advanced age, obesity, and cancer. Twenty-five patients had thrombophilia, 16 patients had factor V Leiden (R506Q mutation, and seven patients had MTHFR C677T mutation. Ninety-two percent of patients screened for thrombophilia were positive. Screening was requested in young patients (16, patients with recurrent (11, spontaneous (8, and extensive (5 venous thrombosis, familial history (5, pregnancy (4, estroprogestative treatment (3, and air travel (1. Nine patients had one, 11 patients had two, and five had three of these conditions. Follow-up (6 to 120 months of these 25 patients treated with antivitamin K did not reveal recurrences or complications related to venous thromboembolism.Conclusion: Factor V Leiden mutation followed by MTHFR mutation are the most commonly observed genetic abnormalities in these series. Defining risk factors and screening for thrombophilia when indicated reduce recurrence rate and complications. Recommendations for thrombophilia screening will be proposed.Keywords: venous thrombosis, risk factors, genetics, factor V

  7. Effect of deep anesthesia on blood gas and immune function in patients undergoing laparoscopic radical gastrectomy for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Zhen Wang; Xiao-Fan Li; Hui Wang; Zhi-Jun Mao; Tong Xue; Rui Yang

    2016-01-01

    Objective:To investigate the effects of deep anesthesia on blood gas and immune function in patients undergoing laparoscopic radical gastrectomy for gastric cancer. Methods:A total of 84 gastric cancer patients in our hospital were randomly divided into observation group (42 cases) and control group (42 cases). Patients in observation group were treated by deep anesthesia, while the control group was treated with shallow anesthesia. The blood gas was observed and compared before and after CO2 pneumoperitoneum, and the immune function was observed and compared before anesthesia, after operation and 72 h post-operation. Results:The PaCO2 and pH level of patients in the two groups had no significant difference before pneumoperitoneum;Compared with before pneumoperitoneum, no obvious blood gas change was observed in the observation group, the difference had no statistically significant;Blood gas level of control group was significantly higher than that of before pneumoperitoneum , the difference was statistically significant, pH (7.26±0.07) was statistically decreased;After pneumoperitoneum, the level of PaCO2 and pH was significantly different in both groups , the difference was statistically significant. Indexes of the patients in the observation and control group of CD3+, CD4+, CD4+/CD8+, NK level had no significant difference before anesthesia, the difference was not statistically significant;The immunology index of CD3+, CD4+, CD4+/CD8+and NK cell levels of the postoperative patients in both groups were significantly lower than before anesthesia, and the differences were statistically significant, but each index in the observation group decreased significantly less than that of the control group, the difference was statistically significant;The immunological indexes can be restored to before anesthesia postoperative 72 h with two groups, and had no significant difference. Conclusion:The blood gas analysis index was stable and the immune function was suppressed in

  8. Short Term Effects of Mobilization Techniques on Neck Pain and Deep Neck Flexor Muscle Endurance in Patients with Mechanical Chronic Neck Pain

    OpenAIRE

    Kılınç, Hasan Erkan; Harput, Gülcan; Baltacı, Gül; İnce, Deniz İnal

    2014-01-01

    Objectives: The aim of the study was to investigate short term effects of cervical and scapular mobilization techniques on neck pain and deep cervical muscles endurance in chronical mechanical neck pain patients. Methods: 22 chronical mechanic neck pain patients four male 18 female (mean age: mean±sd 35.59± 15.85) were included. Before treatment, neck pain level (visual analog scale) and deep neck flexor muscles endurance (in supine position with digital chronometer) of all patients were eval...

  9. Algorithmic approach to the prevention of unnecessary fasciotomy in extremity snake bite.

    Science.gov (United States)

    Türkmen, Arif; Temel, Metin

    2016-12-01

    In the literature, there is a lack of a consensus about the occurrence of the compartment syndrome due to the snake bites. There are different concepts for the surgical treatment of the threshold value of the chamber pressure. There are many different classifications and assessment criteria for the snakebites. There is not any appropriate classification in order to the assessment of extremity snake bites while making a decision for fasciotomy. We aimed to standardize the follow-up and decision making to perform fasciotomy with a new classification system for the snakebites using objective data. The data of all patients were recorded prospectively between 2006 and 2011. A total of 97 patients (64 male, 33 female) with a mean age of 30.94±14.04 were followed-up. During the evaluation of the patients, we used a new classification system that was improved for the extremity bites. We classified the patients due to their signs into four groups as for the classification system. 40 patients with compartment like symptoms were carefully followed for 48-72h, and only three patients required fasciotomy where full recovery was achieved in 37 patients. Coverage of the defects was performed with full thickness skin grafting in 4 patients and cross finger flap in two patient. In two patients, the defects were located on the palmar aspect of the thumb. Thus, we applied Kite flap for skin coverage. Reverse dorsal digital artery flap was performed in eight patients and dorsal interosseous metacarpal flap in six patients. Four patients underwent an amputation. Two patients had web reconstruction due to first web contracture. We present a large series of snake bite injuries and propose a classification and treatment recommendations. Fasciotomy should only be done while the measurement of intra-compartment pressure is above 55mmHg as snakebite can mimic the compartment syndrome. III-IV. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Correction of post-traumatic anterior open bite by injection of botulinum toxin type A into the anterior belly of the digastric muscle: case report.

    Science.gov (United States)

    Seok, Hyun; Park, Yong-Tae; Kim, Seong-Gon; Park, Young-Wook

    2013-08-01

    Post-traumatic anterior open bite can occur as a result of broken balance among the masticatory muscles. The superior hyoid muscle group retracts the mandible downward and contributes to the anterior open bite. Denervation of the digastric muscle by injection of botulinum toxin type A (BTX-A) can reduce the power of the digastric muscle and help to resolve the post-traumatic anterior open bite. A patient with a bilateral angle fracture had an anterior open bite even after undergoing three operations under general anesthesia and rubber traction. Although the open bite showed some improvement by the repeated operation, the occlusion was still unstable six weeks after the initial treatment. To eliminate the residual anterior open bite, BTX-A was injected into the anterior belly of the digastric muscle. Following injection of BTX-A, the anterior open bite showed immediate improvement. Complication and relapse were not observed during follow-up. Long-standing post-traumatic open bite could be successfully corrected by injection of BTX-A into the anterior belly of the digastric muscle without complication.

  11. Deep Feature Transfer Learning in Combination with Traditional Features Predicts Survival Among Patients with Lung Adenocarcinoma.

    Science.gov (United States)

    Paul, Rahul; Hawkins, Samuel H; Balagurunathan, Yoganand; Schabath, Matthew B; Gillies, Robert J; Hall, Lawrence O; Goldgof, Dmitry B

    2016-12-01

    Lung cancer is the most common cause of cancer-related deaths in the USA. It can be detected and diagnosed using computed tomography images. For an automated classifier, identifying predictive features from medical images is a key concern. Deep feature extraction using pretrained convolutional neural networks (CNNs) has recently been successfully applied in some image domains. Here, we applied a pretrained CNN to extract deep features from 40 computed tomography images, with contrast, of non-small cell adenocarcinoma lung cancer, and combined deep features with traditional image features and trained classifiers to predict short- and long-term survivors. We experimented with several pretrained CNNs and several feature selection strategies. The best previously reported accuracy when using traditional quantitative features was 77.5% (area under the curve [AUC], 0.712), which was achieved by a decision tree classifier. The best reported accuracy from transfer learning and deep features was 77.5% (AUC, 0.713) using a decision tree classifier. When extracted deep neural network features were combined with traditional quantitative features, we obtained an accuracy of 90% (AUC, 0.935) with the 5 best post-rectified linear unit features extracted from a vgg-f pretrained CNN and the 5 best traditional features. The best results were achieved with the symmetric uncertainty feature ranking algorithm followed by a random forests classifier.

  12. Hyperbaric oxygen therapy after Bothrops lanceolatus snake bites in Martinique: a brief report.

    Science.gov (United States)

    Hochedez, P; Thomas, L; Mehdaoui, H

    2010-01-01

    Every year 10 to 20 cases of snake bites are reported on the Caribbean island of Martinique. The only snake involved, Bothrops lanceolatus, is endemic on the island, and its bite may lead to systemic multifocal thrombotic complications in the'absence of the monospecific antivenom. Between January 1988 and January 2009, more than 250 snake bites have been reported, and five patients were treated with hyperbaric oxygen (HBO2) therapy for local complications. The patients were male, bitten on the leg or the hand, and presented with severe complications such as necrotizing soft tissue infections, compartment syndrome or abscesses despite prompt wound care and administration of antivenomous serum. Outcomes were favorable for these five patients, except for one who was left with a functional defect of the hand. Although snake bites are not part of the currently recommended indications for HBO2 therapy, local complications, namely compartment syndrome, necrotizing soft tissue infections and enhancement of healing in selected problem wounds, are approved uses of HBO2 therapy as defined by the Hyperbaric Oxygen Therapy Committee and would benefit from prospective studies.

  13. Paradoxical embolism, deep vein thrombosis, pulmonary embolism in a patient with patent foramen ovale: a case report

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    Guo Shan

    2007-09-01

    Full Text Available Abstract Introduction Coexistence of pulmonary embolism and systemic arterial embolism suggest the diagnosis of paradoxical embolism which suggests the presence of intracardiac defects such as patent foramen ovale (PFO. Case presentation A 42 year old man was found to have a paradoxical embolism in the systemic arterial circulation, in the setting of pulmonary embolism and deep vein thrombosis (DVT in the lower extremities. Conclusion Paradoxical embolism and intracardiac shunt should be immediately considered in a patient with pulmonary embolism and systemic arterial embolism. Diagnostic modalities included arteriogram and saline contrast echocardiography. Closure of intracardiac shunt is needed for patients who are at risk for recurrent embolic events.

  14. Deep Temporal Fascia Coverage of the Loading Weight in Paralytic Lagopthalmos Patients.

    Science.gov (United States)

    Singh, Mansher; Kruse, Carla; Eriksson, Elof; Caterson, E J

    2015-07-01

    Use of a weight for lagopthalmos secondary to facial nerve paralysis is the standard technique for achieving effective eyelid closure. However, because of thin and mobile skin of the eyelid and closely opposed implant, there is increased risk of complications such as implant visibility, contour deformity, and implant extrusion. The authors describe a surgical technique involving coverage of the implanted weight with contralateral deep temporal fascia. The deep temporal fascia serves as a hammock to give an interventional barrier to prevent dehiscence of the pocket and extrusion of the ocular implant. It also provides camouflage to the irregular borders of the gold weight. Autologous coverage of gold weight with deep temporal fascia provides an effective solution to commonly associated complications with the gold weights. The use of contralateral temporal fascia preserves the ipsilateral temporalis muscle for future facial nerve reconstruction.

  15. Dog Bite Injuries: Primary and Secondary Emergency Department Presentations—A Retrospective Cohort Study

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    Carmen A. Pfortmueller

    2013-01-01

    therapy (27/47 patients, 57.4%. Patients with injuries to the hand were at increased risk of secondary presentations (OR 2.08, 95% CI 1.21–3.55, P<0.006. Conclusion. Dog bite injuries to the hands are a major problem. They often lead to infectious complications. Immediate antibiotic therapy should carefully be evaluated for each patient.

  16. Rattlesnake bites in children: antivenin treatment and surgical indications.

    Science.gov (United States)

    Shaw, Brian A; Hosalkar, Harish S

    2002-09-01

    Orthopaedic surgeons working in the Americas may be consulted in the care of patients bitten by venomous rattlesnakes (genus Crotalus ), particularly with regard to the possibilities of compartment syndrome and soft-tissue destruction. Despite considerable evidence regarding the safety and efficacy of antivenin in the treatment of rattlesnake bites in adults, controversy persists regarding the roles of antivenin and surgery in the treatment of rattlesnake envenomations in children. Our hypothesis is that aggressive use of antivenin is just as effective and safe for children as it is for adults. We retrospectively reviewed the charts of twenty-four consecutive patients who had been managed at our hospital because of a bite from a western diamondback rattlesnake. Nineteen of the twenty-four patients had been envenomated. The uniformity of collected data was facilitated by the use of an intensive-care-unit protocol during the ten-year period that was reviewed. A questionnaire was developed for long-term follow-up. Aggressive use of polyvalent equine antivenin safely prevented the need for surgery in sixteen of the nineteen envenomated patients. Of the three patients who had surgical treatment, two were managed with limited soft-tissue debridement and one was managed with a fasciotomy of the leg because of a compartment syndrome that occurred when adequate antivenin was withheld. No serious adverse effects were noted in association with the antivenin, and no functional impairments were noted at the time of discharge. Antivenin, rather than surgery, is the proper initial treatment of severe rattlesnake envenomations in children.

  17. [Efficacy and safety of sugammadex (Org 25969) in reversing deep neuromuscular block induced by rocuronium or vecuronium in Japanese patients].

    Science.gov (United States)

    Takeda, Junzo; Iwasaki, Hiroshi; Otagiri, Tetsutaro; Katoh, Takasumi; Shingu, Koh; Obara, Hidefumi; Nakatsuka, Hideki; Tomiyama, Yoshinobu; Kasaba, Toshiharu

    2014-10-01

    Efficacy and safety of sugammadex in reversing neuromuscular block induced by rocuronium or vecuronium were investgated in Japanese patients. We studied 99 Japanese patients undergoing surgery requiring general anesthesia. Patients were allocated randomly to receive intubation dose of rocuronium or vecuronium. During surgery, patients received additional dose of rocuronium or vecuronium for maintenance of deep block. At 1-2 PTC, 0.5-8.0 mg . kg-1 of sugammadex was administered. The neuromuscular block was monitored with acceleromyography using TOF stimuli. Sevoflurane was administered to all treatment groups after intubation. For the rocuronium-induced neuromuscular block, the mean recovery time of the T4/T1 ratio to 0.9 decreased from 66.9 min in the sugammadex 0.5 mg kg-1 group to 1.3 min in the sugammadex 8.0 mg kg-1 group. For the vecuronium-induced neuromuscular block it decreased from 79.5 min in the sugammadex 0.5 mg . kg-1 group to 2.9 min in the sugammadex 8.0 mg . kg-1 group. No clinical evidence of recurarization or residual curarization was observed. The efficacy and safety of sugammadex were confirmed in Japanese surgical patients for reversal from deep block.

  18. [Diagnostic validity of radionuclide phlebography in the detection of clinically occult deep venous thrombosis in patients with thromboembolism].

    Science.gov (United States)

    Markovic, S; Baskot, B; Ajdinovic, B; Pervulov, S; Gligic, B; Perovanovic, M

    2001-01-01

    Diagnostic reliability of radionuclide phlebography (RNP) compared to contrast phlebography in the detection of deep veins' thrombosis (DVT) in patients with confirmed thromboembolism of the lungs (TEL) was evaluated. RNP. These findings were compared to contrast phlebography (CP), performed in the group of 25 patients in whom TEL was confirmed clinically, radiologically, scintigraphically and biochemically, but without clinical signs and symptoms of DVT. In 15 patients where RNP revealed unilateral DVT, CP finding was confirmed in all: in 6 (40%) on the left, and in 9 (60%) on the right side. In 10 patients with bilateral signs of DVT observed by scintigraphy, DVT finding was confirmed in 7 (70%), while in 3 (30%) patients, scintigraphic signs of DVT were falsely positive. In the segments of deep venous system, specificity of RNP in the detection of DVT in the lower leg was 60%, sensitivity was 100%, accuracy was 64% with 62% falsely positive findings. In the upper legs specificity was 79%, sensitivity was 100%, and accuracy was 86% with 24% falsely positive findings, while in the pelvis specificity was 87%, sensitivity was 100%, accuracy was 83% with 14% falsely positive findings.

  19. Effects of bruxism on the maximum bite force

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    Todić Jelena T.

    2017-01-01

    Full Text Available Background/Aim. Bruxism is a parafunctional activity of the masticatory system, which is characterized by clenching or grinding of teeth. The purpose of this study was to determine whether the presence of bruxism has impact on maximum bite force, with particular reference to the potential impact of gender on bite force values. Methods. This study included two groups of subjects: without and with bruxism. The presence of bruxism in the subjects was registered using a specific clinical questionnaire on bruxism and physical examination. The subjects from both groups were submitted to the procedure of measuring the maximum bite pressure and occlusal contact area using a single-sheet pressure-sensitive films (Fuji Prescale MS and HS Film. Maximal bite force was obtained by multiplying maximal bite pressure and occlusal contact area values. Results. The average values of maximal bite force were significantly higher in the subjects with bruxism compared to those without bruxism (p 0.01. Maximal bite force was significantly higher in the males compared to the females in all segments of the research. Conclusion. The presence of bruxism influences the increase in the maximum bite force as shown in this study. Gender is a significant determinant of bite force. Registration of maximum bite force can be used in diagnosing and analysing pathophysiological events during bruxism.

  20. The influence of bubbles on the perception carbonation bite.

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    Paul M Wise

    Full Text Available Although many people naively assume that the bite of carbonation is due to tactile stimulation of the oral cavity by bubbles, it has become increasingly clear that carbonation bite comes mainly from formation of carbonic acid in the oral mucosa. In Experiment 1, we asked whether bubbles were in fact required to perceive carbonation bite. Subjects rated oral pungency from several concentrations of carbonated water both at normal atmospheric pressure (at which bubbles could form and at 2.0 atmospheres pressure (at which bubbles did not form. Ratings of carbonation bite under the two pressure conditions were essentially identical, indicating that bubbles are not required for pungency. In Experiment 2, we created controlled streams of air bubbles around the tongue in mildly pungent CO2 solutions to determine how tactile stimulation from bubbles affects carbonation bite. Since innocuous sensations like light touch and cooling often suppress pain, we predicted that bubbles might reduce rated bite. Contrary to prediction, air bubbles flowing around the tongue significantly enhanced rated bite, without inducing perceived bite in blank (un-carbonated solutions. Accordingly, though bubbles are clearly not required for carbonation bite, they may well modulate perceived bite. More generally, the results show that innocuous tactile stimulation can enhance chemogenic pain. Possible physiological mechanisms are discussed.

  1. The influence of bubbles on the perception carbonation bite.

    Science.gov (United States)

    Wise, Paul M; Wolf, Madeline; Thom, Stephen R; Bryant, Bruce

    2013-01-01

    Although many people naively assume that the bite of carbonation is due to tactile stimulation of the oral cavity by bubbles, it has become increasingly clear that carbonation bite comes mainly from formation of carbonic acid in the oral mucosa. In Experiment 1, we asked whether bubbles were in fact required to perceive carbonation bite. Subjects rated oral pungency from several concentrations of carbonated water both at normal atmospheric pressure (at which bubbles could form) and at 2.0 atmospheres pressure (at which bubbles did not form). Ratings of carbonation bite under the two pressure conditions were essentially identical, indicating that bubbles are not required for pungency. In Experiment 2, we created controlled streams of air bubbles around the tongue in mildly pungent CO2 solutions to determine how tactile stimulation from bubbles affects carbonation bite. Since innocuous sensations like light touch and cooling often suppress pain, we predicted that bubbles might reduce rated bite. Contrary to prediction, air bubbles flowing around the tongue significantly enhanced rated bite, without inducing perceived bite in blank (un-carbonated) solutions. Accordingly, though bubbles are clearly not required for carbonation bite, they may well modulate perceived bite. More generally, the results show that innocuous tactile stimulation can enhance chemogenic pain. Possible physiological mechanisms are discussed.

  2. A piezo surgery with corticotomies and implant placement as part of a multidisciplinary approach to treat malocclusion disorder in an adult patient: clinical report

    OpenAIRE

    Gelpi, Federico; De Santis, Daniele; Marconcini, Simone; Briguglio, Francesco; Finotti, Marco

    2015-01-01

    This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space and an anterior deep bite. The patient required orthodontics and surgical corticotomy and implantology (both performed with a piezo device). A multidisciplinary planning approach, including orthodontics, oral and periodontic surgery, and restorative dentistry, has an important role in the final outcome of treatment. In fact a dental class I occ...

  3. Annual incidence of snake bite in rural bangladesh.

    Directory of Open Access Journals (Sweden)

    Ridwanur Rahman

    Full Text Available BACKGROUND: Snake bite is a neglected public health problem in the world and one of the major causes of mortality and morbidity in many areas, particularly in the rural tropics. It also poses substantial economic burdens on the snake bite victims due to treatment related expenditure and loss of productivity. An accurate estimate of the risk of snake bite is largely unknown for most countries in the developing world, especially South-East Asia. METHODOLOGY/PRINCIPAL FINDINGS: We undertook a national epidemiological survey to determine the annual incidence density of snake bite among the rural Bangladeshi population. Information on frequency of snake bite and individuals' length of stay in selected households over the preceding twelve months was rigorously collected from the respondents through an interviewer administered questionnaire. Point estimates and confidence intervals of the incidence density of snake bite, weighted and adjusted for the multi-stage cluster sampling design, were obtained. Out of 18,857 study participants, over one year a total of 98 snake bites, including one death were reported in rural Bangladesh. The estimated incidence density of snake bite is 623.4/100,000 person years (95% C I 513.4-789.2/100,000 person years. Biting occurs mostly when individuals are at work. The majority of the victims (71% receive snake bites to their lower extremities. Eighty-six percent of the victims received some form of management within two hours of snake bite, although only three percent of the victims went directly to either a medical doctor or a hospital. CONCLUSIONS/SIGNIFICANCE: Incidence density of snake bite in rural Bangladesh is substantially higher than previously estimated. This is likely due to better ascertainment of the incidence through a population based survey. Poor access to health services increases snake bite related morbidity and mortality; therefore, effective public health actions are warranted.

  4. Forensic odontology, part 4. Human bite marks.

    Science.gov (United States)

    Hinchliffe, J

    2011-04-23

    The aim of this paper is to give a brief overview of bite mark analysis: its usefulness and limitations. The study and analysis of such injuries is challenging and complex. The correct protocols for collection, management, preservation, analysis and interpretation of this evidence should be employed if useful information is to be obtained for the courts. It is now possible, with advances in digital technology, to produce more accurate and reproducible comparison techniques which go some way to preventing and reducing problems such as photographic distortions. Research needs to be continued to increase our knowledge of the behaviour of skin when bitten. However, when presented with a high quality bite mark showing good dental detail, and a limited, accessible number of potential biters, it can be extremely useful in establishing a link between the bitten person and the biter or excluding the innocent.

  5. Deep vein thrombosis in a patient of adenomatous polyposis coli treated successfully with aspirin: A case report

    Science.gov (United States)

    Agrawal, Neha; Santra, Tuhin; Kar, Arnab; Guha, Pradipta; Bar, Mita; Adhikary, Apu; Datta, Sumana

    2016-01-01

    Background: Deep vein thrombosis is an important cause of morbidity and mortality. However, its association with adenomatous polyposis coli is extremely rare. Here we present an interesting case of deep vein thrombosis associated with adenomatous polyposis coli. Case Presentation: A 15 year old female who was having fever and diarrhea for 5 months developed bilateral asymmetric painful swelling of lower limbs for 1 month. Doppler ultrasound of lower limbs revealed presence of thrombosis from inferior vena cava up to popliteal vein. Colonoscopy and biopsy were suggestive of adenomatous polyposis coli. However, she could not tolerate anticoagulant therapy and was put on aspirin therapy for 6 months to which she responded well with the resolution of thrombus. Conclusion: Role of aspirin therapy may be considered whenever a patient of venous thrombosis cannot tolerate anticoagulant therapy. PMID:27386068

  6. When benefitting a patient increases the risk for harm for third persons - the case of treating pedophilic Parkinsonian patients with deep brain stimulation.

    Science.gov (United States)

    Müller, Sabine; Walter, Henrik; Christen, Markus

    2014-01-01

    This paper investigates the question whether it is ethically justified to treat Parkinsonian patients with known or suspected pedophilia with deep brain stimulation - given increasing evidence that this treatment might cause impulse control disorders, disinhibition, and hypersexuality. This specific question is not as exotic as it looks at a first glance. First, the same issue is raised for all other types of sexual orientation or behavior which imply a high risk for harming other persons, e.g. sexual sadism. Second, there are also several (psychotropic) drugs as well as legal and illegal leisure drugs which bear severe risks for other persons. We show that Beauchamp and Childress' biomedical ethics fails to derive a veto against medical interventions which produce risks for third persons by making the patients dangerous to others. Therefore, our case discussion reveals a blind spot of the ethics of principles. Although the first intuition might be to forbid the application of deep brain stimulation to pedophilic patients, we argue against such a simple way out, since in some patients the reduction of dopaminergic drugs allowed by deep brain stimulation of the nucleus subthalamicus improves impulsive control disorders, including hypersexuality. Therefore, we propose a strategy consisting of three steps: (1) risk assessment, (2) shared decision-making, and (3) risk management and safeguards.

  7. Non-biting Muscidae and control methods

    DEFF Research Database (Denmark)

    Thomas, G.; Jespersen, Jørgen B.

    1994-01-01

    Many non-biting muscids (filth flies) are characterised by the habit of visiting manure or rotting organic material to Seed and/or oviposit. As these flies also often have close associations with human beings, as well as human habitations and domestic animals, they are potentially both a nuisance...... and a contributory factor in the transmission of diseases. The authors examine the biology, economic importance and control of four of the most important nonbiting muscids:...

  8. Compartmental syndrome due to viper bite.

    Science.gov (United States)

    Vigasio, A; Battiston, B; De Filippo, G; Brunelli, G; Calabrese, S

    1991-01-01

    The case is reported of a young girl who was bitten on the hand by a viper and developed compartment syndrome of the intrinsic muscles more than 24 h later. Multiple dorsal and volar fasciotomies resolved the acute episode with complete restitutio ad integrum. The clinical case is discussed in detail and the literature on these rare complications of snake bites in European countries reviewed.

  9. Deep vein thrombosis after total hip and knee arthroplasty in Indian patients

    OpenAIRE

    Jain, V.; Dhaon, B; Jaiswal, A.; Nigam, V; Singla, J

    2004-01-01

    Background: Deep vein thrombosis (DVT) is one of the most common complications of total hip (THA) and total knee arthroplasty (TKA). Though the reported incidence of DVT is very high, that of proximal DVT is low and that of fatal thromboembolism is very low. Hence the issue of prophylaxis for DVT remains controversial.

  10. Decreased plasma levels of activated factor VII in patients with deep vein thrombosis

    NARCIS (Netherlands)

    Schut, A. M.; Meijers, J. C. M.; Lisman-van Leeuwen, Y.; van Montfoort, M. L.; Roest, M.; de Groot, P. G.; Urbanus, R. T.; Coppens, M.; Lisman, T.

    2015-01-01

    BackgroundThe initiating trigger in the development of deep vein thrombosis (DVT) remains unidentified. It has been suggested that tissue factor (TF)-bearing microparticles play a key role, which indicates a role for the TF pathway in the initiation of DVT. ObjectiveTo assess the role of the TF path

  11. Continuous deep sedation for patients nearing death in the Netherlands: descriptive study

    NARCIS (Netherlands)

    J.A.C. Rietjens (Judith); J.J.M. van Delden (Johannes); B.D. Onwuteaka-Philipsen (Bregje); H.M. Buiting (Hilde); P.J. van der Maas (Paul); A. van der Heide (Agnes)

    2008-01-01

    textabstractObjectives To study the practice of continuous deep sedation in 2005 in the Netherlands and compare it with findings from 2001. Design Questionnaire study about random samples of deaths reported to a central death registry in 2005 and 2001. Setting Nationwide physician study in the Net

  12. COMPARISON OF UPPER LIP BITE TEST WITH OTHER FOUR PREDICTORS FOR PREDICTING DIFFICULTY IN INTUBATION

    Directory of Open Access Journals (Sweden)

    Balasubramanyam

    2015-05-01

    Full Text Available Unanticipated difficult tracheal intubation remains a primary concern for anaesth - esiologists, endangering the life of patients at the crucial moment. The aim of the present study is to compare Upper lip bite test (ULBT with other four predictors (Modifi ed Mallampati test MMT, Thyromental distance TMD, Sternomental distance SMD, Inter incisor distance IID for predicting difficulty in intubation. Upper lip Bite test, if proven to be effective, is very helpful to even the junior most Anaesthetist to evalua te the difficulty in tracheal intubation, and thus being ready with all the armamentarium, needed for the difficulty likely to be faced. Hence, leading to better safety of the patient and comfort of the anaesthetist. AIM OF THE STUDY: This prospective stud y was undertaken at Sri Venkatewara Medical College, Tirupati and S.V.R.R.G.G. Hospital, Tirupati, to determine the ability of Upper Lip bite test, to predict difficult/easy visualization of larynx and intubation and comparing upper lip bite test with four different tests i.e., Modified Mallampati test, sternomental distance, thyromental distance and inter incisor distance.

  13. kin reaction to bed bugs bite reflecting erythema multiforme. Case report

    Directory of Open Access Journals (Sweden)

    Michał Andres

    2015-10-01

    Full Text Available Bed bugs (Cimex spp. are wingless, hematophagous arthropods causing bites, which generates wide range of skin reaction and may be misdiagnosed with more serious disease as dermatitis herpetiformis, bullous pemphigoid or erythema multiforme. Differential diagnosis could be a challenge especially in western countries where bed bugs were forgotten since the Second World War. There are only a few reports of serious anaphylaxis after bed bugs exposition and the evidences about the role of bed bugs as vectors to some infectious diseases are not conclusive, but bites could be a source of physical ailments and psychological distress. We present a case of 24 year old female patient who had been bitten by bed bugs and primarily diagnosed with erythema multiforme. After releasing from hospitalization because of successful treatment patient developed another eruption of skin lesions, this time more characteristic to bed bugs bites during one day. The new diagnosis of bed bugs bites was confirmed with proving the presence of these arthropods in her rented apartment.

  14. Breastfeeding and non-nutritive sucking patterns related to the prevalence of anterior open bite in primary dentition

    Directory of Open Access Journals (Sweden)

    Camila Campos Romero

    2011-04-01

    Full Text Available OBJECTIVE: Nutritional, immunological and psychological benefts of exclusive breastfeeding for the frst 6 months of life are unequivocally recognized. However, mothers should also be aware of the importance of breastfeeding for promoting adequate oral development. This study evaluated the association between breastfeeding and non-nutritive sucking patterns and the prevalence of anterior open bite in primary dentition. MATERIAL AND METHODS: Infant feeding and non-nutritive sucking were investigated in a 3-6 year-old sample of 1,377 children, from São Paulo city, Brazil. Children were grouped according to breastfeeding duration: G1 - non-breastfed, G2 - shorter than 6 months, G3 - interruption between 6 and 12 months, and G4 - longer than 12 months. Three calibrated dentists performed clinical examinations and classifed overbite into 3 categories: normal, anterior open bite and deep bite. Chi-square tests (p<0.05 with odds ratio (OR calculation were used for intergroup comparisons. The impact of breastfeeding and non-nutritive sucking on the prevalence of anterior open bite was analyzed using binary logistic regression. RESULTS: The prevalence estimates of anterior open bite were: 31.9% (G1, 26.1% (G2, 22.1% (G3, and 6.2% (G4. G1 would have signifcantly more chances of having anterior open bite compared with G4; in the total sample (OR=7.1 and in the subgroup without history of non-nutritive sucking (OR=9.3. Prolonging breastfeeding for 12 months was associated with a 3.7 times lower chance of having anterior open bite. In each year of persistence with non-nutritive sucking habits, the chance of developing this malocclusion increased in 2.38 times. CONCLUSIONS: Breastfeeding and non-nutritive sucking durations demonstrated opposite effects on the prediction of anterior open bite. Non-breastfed children presented signifcantly greater chances of having anterior open bite compared with those who were breastfed for periods longer than 12 months

  15. Retrograde Tempofilter II{sup TM} Placement within the Superior Vena Cava in a Patient with Acute Upper Extremity Deep Venous Thrombosis: the Filter Stands on Its Head

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Nam Yeol [The Armed Forces Yangju Hospital, Yangju (Korea, Republic of); Chang, Nam Kyu; Lim, Jae Hoon; Kim, Jae Kyu [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2011-02-15

    The Tempofilter II is a widely used temporary vena cava filter. Its unique design, which includes a long tethering catheter with a subcutaneous anchor, facilitates the deployment and retrieval of the device. Despite this, the Tempofi lter II has been used only in the inferior vena cava of patients with lower extremity deep venous thrombosis. In this article, we present a case of superior vena cava filtering using the Tempofilter II in patients with upper extremity deep venous thrombosis

  16. Patients experiences of negative pressure wound therapy at home for the treatment of deep perivascular groin infection after vascular surgery.

    Science.gov (United States)

    Monsen, Christina; Acosta, Stefan; Kumlien, Christine

    2017-05-01

    To explore experiences of negative pressure wound therapy at home, in patients with deep perivascular groin infection after vascular surgery and management in daily life. Deep surgical site infection after vascular surgery with exposed vessels often requires long-term treatment with negative pressure wound therapy, and continued therapy at home has become routine. An explorative qualitative study. Nine men and six women with a deep surgical site infection in the groin after vascular surgery, treated in their home with negative pressure wound therapy, were interviewed. The interviews were analysed using manifest and latent content analysis. Undergoing negative pressure wound therapy at home meant a transition from being a dependent patient to a person who must have self-care competence and be involved in their own care. A need to feel prepared for this before discharge from hospital was expressed. Lack of information and feelings of uncertainty prolonged the time before feeling confident in managing the treatment. The informants gradually accepted the need to be tied up to a machine, became competent in its management and found solutions to perform everyday tasks. Overall, it was a relief to be treated at home. Several benefits of negative pressure wound therapy at home were expressed. However, unnecessary stress and anxiety were experienced due to a lack of information on the treatment and instruction concerning the equipment. Adequate information and education must therefore be provided to facilitate the transition from a patient to a person with self-care competence and ability to manage this treatment at home. The findings revealed a need for more support and knowledge in their transition from hospital care to home care with negative pressure wound therapy. Routines must be established that ensure patient safety and security in treatment at home. © 2016 John Wiley & Sons Ltd.

  17. Quantitative evaluaiton of porphyromonas gingivalis before and after non- surgical periodontal treatment in deep pockets of patients with aggressive periodontitis

    Directory of Open Access Journals (Sweden)

    Kadkhoda Z.

    2004-08-01

    Full Text Available Statement of Problem: Elimination of porphyromonas gingivalis (p.g from subgingival area in order to successfully treatment out comes in patients with Aggressive periodntitis AP is necessary. Purpose: The aim of this study was the evaluation of non-surgical treatment efficacy in reduction of bacterial population in deep pockets. Materials and Methods: In this randomized clinical trial study we evaluated the result of non- surgical therapy on reduction of p.g count from deep pockets of patients with aggressive periodontitis that had at least one (p.g plus deep pocket (>5mm in each quadrant. At first stage of non-surgical treatment intra pocket irrigation with chlorhexidin was done after scaling and root planning for all patients. In second stage (one week later antibiotics including amoxicillin- metronidazol prescribed for ten days. At base line, one, six and twelve weeks after beginning of therapy, microbial samples, plaque index, bleeding on probing index and probing pocket index were recorded. Result: There was statistically important difference between one and six weeks after treatment with base line in colony count of p.g and all of clinical indices. But in 12 weeks after therapy just, PI and PPD had statistical difference with base line. In this stage, colony count and BOP was reduced but this reduction had not statistically important difference with base line. Conclusion: Thus in present study our non- surgical strategy in elimination of p.g and clinical improvement was successful in short time but three month after therapy recurrence of disease happened in some patients.

  18. Coagulopathy after spider bites in a six-year-old boy

    Directory of Open Access Journals (Sweden)

    Ansari SH.

    2008-06-01

    Full Text Available Background: Spider bites are common in most parts of the world. In some areas, where snake or scorpion bites are common, spider bites may not be considered a significant problem by the general public and those who have been bitten by spiders may not go to a hospital. However, significant problems are observed in the victims of certain species of spiders including: widow spider (of the genus Latrodectus, including the black widow and brown spiders (of the genus Loxosceles, such as the brown recluse. Case: We report a six-year-old boy, admitted to the hospital two weeks after suffering a spider bite. The patient presented with a severe nose bleed, ecchymosis and purpura, as well as anemia, indicating a clotting disorder. Laboratory results revealed abnormal values for prothrombin time (PT >50 sec, partial thromboplastin time (PTT >120 min and fibrinogen = 0 mg/dl, whereas factor VIII was normal according to a mixing study, with a normal platelet count of 350,000/µl. The patient was managed with fresh frozen plasma every 12 h, and was discharged one week after hospital admission. At present, the patient is well with more normal laboratory results one month after treatment: PT=13.4 sec, PTT= 34 sec, fibrinogen=105 mg/dl.         Conclusions: Although spider bites are uncommon in Iran, severe systemic reactions may occur in the pediatric population requiring admission to the pediatric intensive care unit. These systemic reactions may include hemolytic anemia coagulopathy and renal failure.

  19. Magnetic resonance venography in consecutive patients with suspected deep vein thrombosis of the upper extremity: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Baarslag, H.J.; Reekers, J.A. [Academic Medical Centre, Amsterdam (Netherlands). Dept. of Radiology; Beek, E.J. van [Royal Hallamshire Hospital, Sheffield (United Kingdom). Unit of Academic Radiology

    2004-02-01

    To assess the feasibility and accuracy of two magnetic resonance (MR) venography methods in a consecutive series of patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Consecutive in- and outpatients who were referred for imaging of suspected DVTUE in a large teaching hospital during the period April 2001 to October 2002 were eligible for inclusion. All patients were scheduled to undergo contrast venography with the intention to perform additional MR venography. Both time-of-flight and gadolinium-enhanced 3D MR venography were scheduled. All MR imaging were interpreted independently by consensus of two experienced radiologists, who were blinded for contrast venography outcome. Patients were managed based on contrast venography only. A total of 44 patients were eligible for inclusion. Thirteen patients were excluded (5 refused consent, 2 inability to gain venous access, 2 renal failure, 4 logistic reasons). Contrast venography was performed in 31 patients, and demonstrated DVTUE in 11 patients. MR imaging was not feasible in 10 patients (4 unable to lie flat, 3 claustrophobia, 1 too large for MR scanner, 1 osteosynthesis of shoulder, 1 pacemaker). The sensitivity and specificity of TOF MRV versus Gadolinium 3D MRV was 71% and 89% versus 50% and 80%, respectively. A high number of patients were unable to undergo MR venography in this setting. Contrast-enhanced MRV did not improve diagnostic accuracy. The clinical utility of MR venography in the setting of suspected DVTUE seems disappointing.

  20. First Pediatric Case of Tularemia after a Coyote Bite

    Directory of Open Access Journals (Sweden)

    Bruno B. Chomel

    2016-01-01

    Full Text Available Bite-transmitted tularemia is a rare event in humans and most of the cases have been associated with cat bites. We report the first pediatric case of tularemia caused by a coyote (Canis latrans bite. Coyotes can be healthy carriers of Francisella tularensis and transmit this infectious agent through a bite. Pediatricians should be aware of this risk after a carnivore bite and implement appropriate antibiotic therapy, as amoxicillin/clavulanate potassium (Augmentin may have prolonged the typical two to three days’ incubation period commonly observed for tularemia after an animal bite and was not effective in preventing clinical signs in this child. Finally, it emphasizes again the importance of early and late serum samples for appropriate serodiagnostic.

  1. First Pediatric Case of Tularemia after a Coyote Bite

    Science.gov (United States)

    Chomel, Bruno B.; Morton, Jane A.; Kasten, Rickie W.; Chang, Chao-chin

    2016-01-01

    Bite-transmitted tularemia is a rare event in humans and most of the cases have been associated with cat bites. We report the first pediatric case of tularemia caused by a coyote (Canis latrans) bite. Coyotes can be healthy carriers of Francisella tularensis and transmit this infectious agent through a bite. Pediatricians should be aware of this risk after a carnivore bite and implement appropriate antibiotic therapy, as amoxicillin/clavulanate potassium (Augmentin) may have prolonged the typical two to three days' incubation period commonly observed for tularemia after an animal bite and was not effective in preventing clinical signs in this child. Finally, it emphasizes again the importance of early and late serum samples for appropriate serodiagnostic. PMID:26885419

  2. Propofol-based deep sedation for endoscopic retrograde cholangiopancreatography procedure in sick elderly patients in a developing country

    Directory of Open Access Journals (Sweden)

    Amornyotin S

    2011-06-01

    Full Text Available Somchai Amornyotin1,3, Udom Kachintorn2,3, Wiyada Chalayonnawin1,3, Siriporn Kongphlay1,31Department of Anesthesiology, 2Department of Medicine, 3Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandIntroduction: The aim of this study was to evaluate and compare the clinical efficacy of propofol-based deep sedation (PBDS for endoscopic retrograde cholangiopancreatography (ERCP procedure in sick (American Society of Anesthesiologists [ASA] physical status III–IV and nonsick (ASA physical status I–II elderly patients in a teaching hospital in Thailand.Methods: We undertook a retrospective review of the anesthesia or sedation service records of elderly patients who underwent ERCP procedures from October 2007 to September 2008. All patients were classified into two groups according to the ASA physical status. In group A, the patients had ASA physical status I–II, while in group B, the patients had ASA physical status III–IV. The primary outcome variable of the study was the successful completion of the procedure. The secondary outcome variables were sedation-related adverse events during and immediately after the procedure.Results: There were 158 elderly patients who underwent ERCP procedure by using PBDS during the study period. Of these, 109 patients were in group A and 49 patients were in group B. There were no significant differences in age, gender, weight, duration of ERCP, indication of procedure, and the mean dose of fentanyl, propofol, and midazolam between the two groups. All patients in both groups successfully completed the procedure except eight patients in group A and three patients in group B (P = 0.781. Overall, respiratory and cardiovascular adverse events in both groups were not significantly different. All adverse events were easily treated, with no adverse sequelae.Conclusion: In the setting of a developing country, PBDS for ERCP procedure in sick elderly patients by

  3. VARYING A V BLOCK COMPLICATING SNAKE BITE - A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Vikas

    2014-02-01

    Full Text Available Snake venom toxicities comprise mainly bleeding disorders and nephrotoxicity. Cardiotoxicity is a rare manifestation of snake bite. We describe the case of a previously healthy 23 - year - old man who developed coagulopathy and AV node dysfunction following snake bite. Electrocardiography showed all variatio ns of AV conduction dysfunction . This is the first account of AV node dysfu nction caused by a snake bite with cardiotoxi city presenting as atrioventricular block

  4. Case report: acute demyelinating encephalomyelitis following viper bite

    OpenAIRE

    Xu, Anyi; Shan, Renfei; Huang, Daochao; Zhou, Jiajia; Keenoo, Anaswasseem; Qin, Jie

    2016-01-01

    Abstract The most serious complications of the central nervous system that occur after venomous snake bite are intracranial hemorrhage and ischemic stroke. We present a rarely seen central nervous system complication, acute demyelinating encephalomyelitis, after a treated Deinagkistrodon's viper bite. On April 5, 2015, a 50-year-old male farmer was bitten on his right leg by a Deinagkistrodon's viper. The bite rendered the victim unconscious for 14 days, during which he was treated with tetan...

  5. Risk level analysis for deep vein thrombosis (DVT): A study of Turkish patients undergoing major orthopedic surgery.

    Science.gov (United States)

    Büyükyılmaz, Funda; Şendir, Merdiye; Autar, Ricky; Yazgan, İlknur

    2015-09-01

    Deep vein thrombosis (DVT) is a prevalent problem for orthopedic patients, particularly owing to the nature of operative interventions and treatment procedures, predisposing to an high risk of DVT. This descriptive study was conducted to determine the levels of risk, the risk factors, and their odds ratio for DVT in patients undergoing major orthopedic surgery. Data were collected using a Patient Information Form and the Autar DVT Risk Assessment Scale (DVTRAS) in orthopedic wards of a university hospital on postoperative day 2. Data were analyzed using descriptive, comparative analysis, and binary logistic regression. The 102 patients (mean age, 52.58 ± 21.58 years) were hospitalized for a mean of 14.35 ± 14.56. Of the sample, 53.9% were female, 65.7% had a history of previous surgery, and 54.9% had undergone total hip/knee arthroplastic surgery, 67.6% of patients wore graduated compression stockings, and 62.7% were administered liquid infusion. Those patients had moderate risk score (12.77 ± 5.66) in the Autar DVTRAS. According to binary logistic regression analysis, aging, obesity, immobility, and acute and chronic diseases were significant risk factors for postoperative DVT (p ≤ .05). This study highlights evidence on the degree of DVT risk, risk factors, and impact of venous thromboembolism in patients undergoing major orthopedic operations. For evidence-based clinical practice, these high-level risk factors should be taken into account in the prevention of DVT in orthopedic patients.

  6. Spider Bite: A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution

    Science.gov (United States)

    Giglio, Anna Maria; Scozzafava, Annamaria; Filippelli, Orazio; Serafino, Giuseppe; Verre, Mario

    2016-01-01

    The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism. Phospholipases D interact with cell membranes triggering alterations which involve the complement system and activation of neutrophils and they cause the dermonecrotic skin lesions and systemic effects. We describe a fatal case of acute intoxication caused by a spider bite probably belonging to the species Loxosceles. The initial lesion was localized to a finger of a hand. Clinical course was worsening with deep necrotic lesions on limb, shock, hemolysis, acute kidney failure, and disseminated intravascular coagulation. All therapies were ineffective. This is the first fatal case described in Europe. PMID:27651958

  7. Spider Bite: A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution

    Directory of Open Access Journals (Sweden)

    Mario Pezzi

    2016-01-01

    Full Text Available The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism. Phospholipases D interact with cell membranes triggering alterations which involve the complement system and activation of neutrophils and they cause the dermonecrotic skin lesions and systemic effects. We describe a fatal case of acute intoxication caused by a spider bite probably belonging to the species Loxosceles. The initial lesion was localized to a finger of a hand. Clinical course was worsening with deep necrotic lesions on limb, shock, hemolysis, acute kidney failure, and disseminated intravascular coagulation. All therapies were ineffective. This is the first fatal case described in Europe.

  8. Particle Transportation Through the JLab Hall A BigBite Spectrometer

    Science.gov (United States)

    Alsalmi, Sheren

    2015-04-01

    The BigBite spectrometer of the Hall A Facility of Jefferson Lab is under refurbishment for use in an experiment (E120-10-103) to measure deep inelastic electron scattering off helium-3 and tritium mirror nuclei in the valence quark region (high Bjorken x range). The experiment will use an 11 GeV upgraded beam to determine the ratio of the neutron to proton F2 inelastic structure functions, and the ratio of the down to up quark, d/u, quark probability distributions in the nucleon. The BigBite spectrometer is based on a custom-shaped dipole magnet, which provides for large momentum and angular acceptances needed for the above measurements. Simulations using a ROOT-based Monte Carlo model for tracking and visualizing scattered electrons passing through the BigBite magnet will be presented. The optics parameters of the dipole magnet have been extracted from a field map produced by a TOSCA magnetostatics calculation. The simulations are necessary to estimate the phase space of the scattered electrons inside the relocated detectors of the spectrometer, and check for electrons which could possibly miss a detector and escape detection. This work is supported by Saudi Arabian Cultural Mission SACM, Kent State University, NSF Grant PHY-1405814, and DOE Contract DE-AC05-06OR23177. Kent State University, Kent, OH, 44242.

  9. Bilateral parotid enlargement following snake bite:A rare sign

    Institute of Scientific and Technical Information of China (English)

    Madi Deepak; Achappa Basavaprabhu; John T Ramapuram; Chowta Nithyananda; Soundarya Mahalingam

    2013-01-01

    Snakebite is a common medical emergency in India. Unusual complications may occur after viper bite. Bilateral parotid enlargement after viper bite is a rare entity. An 18-year old gentleman presented to our hospital with history of viper bite. On examination he had cellulitis of right lower limb. He developed swelling of both the parotid glands 12 h after admission. He developed coagulopathy, acute renal failure and died within 48 h of hospital admission. Development of parotid swelling after snake bite is associated with poor prognosis. This case is found worth reporting as it is an unusual complication having prognostic value.

  10. Is extreme bite performance associated with extreme morphologies in sharks?

    Science.gov (United States)

    Huber, Daniel R; Claes, Julien M; Mallefet, Jérôme; Herrel, Anthony

    2009-01-01

    As top predators in many oceanic communities, sharks are known to eat large prey and are supposedly able to generate high bite forces. This notion has, however, largely gone untested due to the experimental intractability of these animals. For those species that have been investigated, it remains unclear whether their high bite forces are simply a consequence of their large body size or the result of diet-related adaptation. As aquatic poikilotherms, sharks can grow very large, making them ideal subjects with which to investigate the effects of body size on bite force. Relative bite-force capacity is often associated with changes in head shape because taller or wider heads can, for example, accommodate larger jaw muscles. Constraints on bite force in general may also be released by changes in tooth shape. For example, more pointed teeth may allow a predator to penetrate prey more effectively than blunt, pavementlike teeth. Our analyses show that large sharks do not bite hard for their body size, but they generally have larger heads. Head width is the best predictor of bite force across the species included in our study as indicated by a multiple regression model. Contrary to our predictions, sharks with relatively high bite forces for their body size also have relatively more pointed teeth at the front of the tooth row. Moreover, species including hard prey in their diet are characterized by high bite forces and narrow and pointed teeth at the jaw symphysis.

  11. Perawatan Ortodontik pada Maloklusi Klas II Divisi 1 dengan Overjet Besar dan Palatal Bite Menggunakan Alat Cekat Teknik Begg

    Directory of Open Access Journals (Sweden)

    Reni Kurniasari

    2014-06-01

    class II division 1 malocclusion using a fixed orthodontic appliance Begg technique. A 17 years old male patient, complained his crowding and protruding upper teeth. Diagnosis: class II division 1 Angle malocclusion, with class II skeletal relationship, mandibular retrusive and bidental protrusive accompanied moderate crowding, overjet 10.78 mm, palatal bite and upper dental centerline shift to the left 1.5 mm. Treatment using a fixed appliance Begg technique was initiated by extraction two first upper premolars extraction  of maxillary first premolar on both side and mandibular second premolar on both side. The first stage of treatment was conducted using multiloop arch wire 0.014”, anchorage band 45o and class II intermaxillary elastics. After seven month of treatment, the results showed crowding corrected, a large overjet and palatal bite perfectly corrected. Overjet of 2.2 mm and overbite to 2 mm. Orthodontic treatment of class II division 1 malocclusion with large overjet and palatal bite using orthodontic Begg technique showed a good result.

  12. Treatment and prevention of infection following bites of the Antarctic fur seal (Arctocephalus gazella

    Directory of Open Access Journals (Sweden)

    Kouliev T

    2015-04-01

    Full Text Available Timur Kouliev,1 Victoria Cui2 1Beijing United Family Hospital, Beijing, People's Republic of China; 2Department of Biological Sciences, Columbia University, New York, NY, USA Abstract: In recent decades, an increasing number of people have traveled to sub-Antarctic and Antarctic regions each year for research, tourism, and resource exploitation. Hunting of Antarctic fur seals (Arctocephalus gazella almost pushed the species to extinction in the early 1900s, but populations have since shown rapid and substantial recovery. The species' range has re-expanded to include several islands south of the Antarctic Convergence, most notably South Georgia, and now overlaps with many popular Antarctic travel destinations. Both male and female fur seals can become extremely aggressive when provoked, and their bites, if not properly treated, pose a significant risk of infection by microorganisms not usually encountered in cases of animal bites. In this report, we present the case of a patient treated for a fur seal bite during an Antarctic expedition cruise, review the literature concerning seal bites, and suggest the use of antibiotic prophylaxis to prevent complications. Keywords: zoonotic, polar tourism, prophylaxis, seal finger, expedition medicine

  13. Reversible Myocarditis and Pericarditis after Black Widow Spider Bite or Kounis Syndrome?

    Directory of Open Access Journals (Sweden)

    Mehmet Yaman

    2015-01-01

    Full Text Available Clinical manifestation of black widow spider bite is variable and occasionally leads to death in rural areas. Cases of myocarditis and pericarditis after black widow spider bite are rare and the associated prognostic significance is unknown. Kounis syndrome has been defined as an acute coronary syndrome in the setting of allergic or hypersensitivity and anaphylactic or anaphylactoid insults that manifests as vasospastic angina or acute myocardial infarction or stent thrombosis. Allergic myocarditis is caused by myocardial inflammation triggered by infectious pathogens, toxic, ischemic, or mechanical injuries, such as drug-related inflammation and other immune reactions. A 15-year-old child was admitted to the emergency department with pulmonary edema after spider bite. ST segment depression on ECG, elevated cardiac enzymes and global left ventricular hypokinesia (with ejection fraction of 22%, and local pericardial effusion findings confirmed the diagnosis of myopericarditis. After heart failure and pulmonary edema oriented medical therapy, clinical status improved. Patient showed a progressive improvement and LV functions returned to normal on the sixth day. Myopericarditis complicating spider bite is rare and sometimes fatal. The mechanism is not clearly known. Alpha-latrotoxin of the black widow spider is mostly convicted in these cases. But allergy or hypersensitivity may play a role in myocardial damage.

  14. Reversible Myocarditis and Pericarditis after Black Widow Spider Bite or Kounis Syndrome?

    Science.gov (United States)

    Yaman, Mehmet; Mete, Turkan; Ozer, Ismail; Yaman, Elif; Beton, Osman

    2015-01-01

    Clinical manifestation of black widow spider bite is variable and occasionally leads to death in rural areas. Cases of myocarditis and pericarditis after black widow spider bite are rare and the associated prognostic significance is unknown. Kounis syndrome has been defined as an acute coronary syndrome in the setting of allergic or hypersensitivity and anaphylactic or anaphylactoid insults that manifests as vasospastic angina or acute myocardial infarction or stent thrombosis. Allergic myocarditis is caused by myocardial inflammation triggered by infectious pathogens, toxic, ischemic, or mechanical injuries, such as drug-related inflammation and other immune reactions. A 15-year-old child was admitted to the emergency department with pulmonary edema after spider bite. ST segment depression on ECG, elevated cardiac enzymes and global left ventricular hypokinesia (with ejection fraction of 22%), and local pericardial effusion findings confirmed the diagnosis of myopericarditis. After heart failure and pulmonary edema oriented medical therapy, clinical status improved. Patient showed a progressive improvement and LV functions returned to normal on the sixth day. Myopericarditis complicating spider bite is rare and sometimes fatal. The mechanism is not clearly known. Alpha-latrotoxin of the black widow spider is mostly convicted in these cases. But allergy or hypersensitivity may play a role in myocardial damage.

  15. A qualitative investigation of the perceptions of female dog-bite victims and implications for the prevention of dog bites

    OpenAIRE

    Westgarth, Carri; Watkins, Francine

    2015-01-01

    Preventing dog bites is an increasingly important public health and political issue with implications for both human and animal health and welfare. Expert opinion is that most bites are preventable. Intervention materials have been designed to educate people on how to assess the body language of dogs, evaluate risk, and take appropriate action. The effectiveness of this approach is rarely evaluated and the incidence of dog bites is thought to be increasing. Is the traditional approach to dog ...

  16. PLASMA NEUTROPHIL GELATINASE ASSOCIATED LIPOCALIN AS AN EARLY BIOMARKER OF ACUTE KIDNEY INJURY IN SNAKE BITE

    Directory of Open Access Journals (Sweden)

    Thamarai

    2014-12-01

    Full Text Available INTRODUCTION: Acute kidney injury due to snake bite represents a frequent and devastating problem. Currently, Acute Kidney Injury is diagnosed by biochemical monitoring of increase in serum creatinine. Increase in serum creatinine represents a late indication of a functional change in glomerular function rate. Studies have shown that Neutrophil Gelatinase Associated Lipocalin has been found to be very useful for the detection of acute kidney injury within few hours of nephrotoxic insult. Limited information, however, is available regarding the study of plasma Neutrophil Gelatinase-Associated Lipocalin in snake bite. AIM: The purpose of the study was to estimate the diagnostic accuracy of plasma Neutrophil Gelatinase-Associated Lipocalin as an early biomarker of Acute Kidney Injury in patients with snake bite and to correlate with serum creatinine. If early detection of Acute Kidney Injury occurs, it can be followed by effective treatment modalities to abort the development or limit the severity of AKI. Therefore this study was designed to explore the importance of pNGAL in cases of snake bite induced AKI. MATERIALS AND METHODS: A prospective observational study was designed to study the patients admitted for the treatment of snakebite within 6 hours in a tertiary care hospital. Patients admitted for snake bite were followed by estimation of pNGAL on day 1 and serum creatinine from the period of admission for up to 5 days. A total of 130 snake bite patients were enrolled and 100 were included in the final study. Snake bite patients were classified into two groups based on the occurrence and absence of AKI. Plasma NGAL and serum creatinine was estimated by solid phase Enzyme Linked Immunosorbent Assay method and Jaffe`s method respectively. Data were entered into the excel sheet and analyzed statistically using statistical package for the social sciences (SPSS version 17. RESULTS:Among 100 snake bite patients 64 individuals had elevated p

  17. Changes in biting forces with implant-supported overdenture in the lower jaw: A comparison between conventional and mini implants in a pilot study.

    Science.gov (United States)

    Hasan, I; Madarlis, C; Keilig, L; Dirk, C; Weber, A; Bourauel, C; Heinemann, F

    2016-11-01

    The biting ability of patients improves noticeably after receiving implant-supported overdentures in comparison to conventional complete dentures. However, the change of biting with such treatment concepts has been quantitatively investigated in only a limited number of studies. The aim of the present study has been to measure the biting forces of edentulous patients with complete dentures and after receiving implant-supported overdentures. A total of 26 edentulous patients were included. Ten patients received two to four conventional implants (control group, Ø3.3-3.7mm, L11-13mm) and 16 patients received four to five mini implants (study group, Ø1.8-2.4mm, L13-15mm) inserted in the mandibular interforaminal region. All patients received a lower overdenture with ball/rubber ring attachments and a complete denture for the maxilla. The biting forces were measured using Prescale pressure sheets type low before the insertion of implants and after receiving implant-supported overdenture. The measured sheets were later scanned and analysed using FPD-8010E software. The range of biting forces before the insertion of implants was 80N-122N for the control group and 66-88N for the study group. After the insertion of implants, the range of biting forces increased to 167N-235N for the control group and to 81N-138N for the study group. However, the increase in biting forces after the insertion of implants was not significant for either group. No significant difference was obtained between the two implant systems. The biting forces improved after insertion of implants regardless of which implant system was used. However, the degree of improvement is noticeably related to the original bone quality of the mandible at the insertion regions of implants.

  18. Mechanics of bite force production and its relationship to diet in bats

    National Research Council Canada - National Science Library

    Sharlene E. Santana; Elizabeth R. Dumont; Julian L. Davis

    2010-01-01

    .... Mechanistic studies of bite force production have identified morphological features associated with bite force, and linked bite force with diet, but this approach has rarely been used in mammals. 2...

  19. Condylar repositioning using centric relation bite in bimaxillary surgery

    Science.gov (United States)

    Lee, Chang-Youn; Jang, Chang-Su; Kim, Ju-Won; Kim, Jwa-Young

    2013-01-01

    Objective The purpose of this study was to evaluate displacement of the mandibular condyle after orthognathic surgery using a condylar-repositioning device. Methods The patient group comprised 20 adults who underwent bimaxillary surgery between August 2008 and July 2011. The degree of condylar displacement was measured by pre- and postoperative tomographic analysis using centric relation bite and a wire during surgery. A survey assessing temporomandibular joint (TMJ) sound, pain, and locking was performed. The 20 tomographs and surveys were analyzed using the Wilcoxon signed-rank test and McNemar's test, respectively. Results No significant changes were observed in the anterior, superior, or posterior joint space of the TMJ (p > 0.05). In addition, no significant change was observed in TMJ sound (p > 0.05). However, TMJ pain and locking both decreased significantly after surgery (p < 0.05). Conclusions Due to its simplicity, this method may be feasible and useful for repositioning condyles. PMID:23671832

  20. Black mamba dendroaspis polylepis bite: a case report.

    Science.gov (United States)

    Závada, J; Valenta, J; Kopecký, O; Stach, Z; Leden, P

    2011-01-01

    Although very rare in a European context, a bite from the black mamba Dendroaspis polylepis is an event that poses an immediate threat to life. Given the content of neurotoxins in the snake's venom, the mortality of envenomation reaches 100% in almost every case if ventilation is not provided in a timely manner and adequate therapy initiated. The report describes a case of a snake breeder being envenomed. This 31-year-old man was bitten by a black mamba on his finger, and who subsequently developed clinical symptoms of envenoming typical for the species. Thanks to mechanical ventilation being employed promptly, with myorelaxation during generalized muscle fasciculations, and particularly owing to the eventual antivenin therapy, the patient's condition settled without consequences. In addition to describing the given case in detail, the paper discusses the composition and mechanisms of action of black mamba venom, while providing guidelines for adequate therapy.

  1. Longitudinal copy number, whole exome and targeted deep sequencing of 'good risk' IGHV-mutated CLL patients with progressive disease.

    Science.gov (United States)

    Rose-Zerilli, M J J; Gibson, J; Wang, J; Tapper, W; Davis, Z; Parker, H; Larrayoz, M; McCarthy, H; Walewska, R; Forster, J; Gardiner, A; Steele, A J; Chelala, C; Ennis, S; Collins, A; Oakes, C C; Oscier, D G; Strefford, J C

    2016-06-01

    The biological features of IGHV-M chronic lymphocytic leukemia responsible for disease progression are still poorly understood. We undertook a longitudinal study close to diagnosis, pre-treatment and post relapse in 13 patients presenting with cMBL or Stage A disease and good-risk biomarkers (IGHV-M genes, no del(17p) or del(11q) and low CD38 expression) who nevertheless developed progressive disease, of whom 10 have required therapy. Using cytogenetics, fluorescence in situ hybridisation, genome-wide DNA methylation and copy number analysis together with whole exome, targeted deep- and Sanger sequencing at diagnosis, we identified mutations in established chronic lymphocytic leukemia driver genes in nine patients (69%), non-coding mutations (PAX5 enhancer region) in three patients and genomic complexity in two patients. Branching evolutionary trajectories predominated (n=9/13), revealing intra-tumoural epi- and genetic heterogeneity and sub-clonal competition before therapy. Of the patients subsequently requiring treatment, two had sub-clonal TP53 mutations that would not be detected by standard methodologies, three qualified for the very-low-risk category defined by integrated mutational and cytogenetic analysis and yet had established or putative driver mutations and one patient developed progressive, therapy-refractory disease associated with the emergence of an IGHV-U clone. These data suggest that extended genomic and immunogenetic screening may have clinical utility in patients with apparent good-risk disease.

  2. Transient distal renal tubular acidosis following hump nosed viper bite: Two cases from Sri Lanka

    Directory of Open Access Journals (Sweden)

    Ranga M Weerakkody

    2016-01-01

    Full Text Available Hump-nosed viper (Hypnale hypnale; HNV is one of the six major snake species in Sri Lanka that cause envenomation. Nephrotoxicity, coagulopathy, and neurotoxicity are wellrecognized features of its envenomation. Type 4 renal tubular acidosis (RTA4 has only once been described previously in this condition, and we report two further cases. Two patients aged 53 and 51 presented following HNV bites with acute kidney injury and microangiopathic hemolytic anemia. Both underwent multiple cycles of hemodialysis until the polyuric phase was reached. Despite polyuria, both patients developed resistant hyperkalemia that needed further hemodialysis. The urinary pH, arterial pH, delta ratio, and transtubular potassium gradient confirmed RTA4. HNV venom has been shown to damage the proximal convoluted tubules in animal studies, but not the distal convoluted tubule, and hence the mechanism of our observation in these two patients is unclear. Unexplained hyperkalemia in recovery phase of HNV bite should raise suspicions of RTA4.

  3. Epidemiology, clinical features and risk factors for human rabies and animal bites during an outbreak of rabies in Maputo and Matola cities, Mozambique, 2014: Implications for public health interventions for rabies control.

    Science.gov (United States)

    Salomão, Cristolde; Nacima, Amílcar; Cuamba, Lutero; Gujral, Lorna; Amiel, Olga; Baltazar, Cynthia; Cliff, Julie; Gudo, Eduardo Samo

    2017-07-01

    In Mozambique, the majority of rabies outbreaks are unreported and data on the epidemiological features of human rabies and animal bites are scarce. An outbreak of human rabies in adjacent Maputo and Matola cities in 2014 prompted us to investigate the epidemiology, clinical features and risk factors of human rabies and animal bites in the two cities. We reviewed cases of human rabies and animal bites from April to July 2014, and carried out a community investigation in July and August in the neighborhoods where cases of human rabies resided. This investigation included collection of clinical, demographic and epidemiological information and a case control study to investigate the risk factors associated with human rabies. Fourteen cases of human rabies were detected in Maputo (n = 10) and Matola (n = 3) cities and neighbouring Boane district (n = 1) between April and August 2014, all of whom had been admitted to hospital. All had a recent history of dog bite. Of the 14 rabid dogs, only one had been immunized. 819 cases of animal bites were registered, of which 64.6% (529/819) were from Maputo City. Dogs were responsible for 97.8% (801/819) of all animal bites, but only 27.0% (126/467) were immunized. Factors significantly associated with human rabies were: age <15 years (p = 0.05), bite by stray dog (p = 0.002), deep wound (p = 0.02), bite in the head (p = 0.001), bite by unimmunized dog (p = 0.01), no use of soap and water (p = 0.001), and no post-exposure prophylaxis (p = 0.01). Implementation of control measures for rabies is poor in Maputo and Matola cities, where cases of human rabies were strongly associated with bites by stray and unvaccinated dogs and irregular implementation of post-exposure measures.

  4. Osteomyelitis following Domestic Animal Bites to the Hand: Two Case Reports and Practical Guidelines

    Directory of Open Access Journals (Sweden)

    Jung Soo Lim

    2016-11-01

    Full Text Available Recently, the number of cases of animal bite wounds has increased significantly in concordance with an increase in the pet population around the world. The authors report two rare cases of osteomyelitis of the phalanx following cat and dog bites. On initial physical examination, signs of a severe infection were observed. Radiographs of both patients showed the presence of osteomyelitis, and in one of the patients, the diagnosis was confirmed with a bone biopsy. After use of empirical antibiotics, intravenous antibiotic therapy that matched the identified bacterium's sensitivity was initiated, and at the same time, secure dressing including debridement was performed to induce secondary healing. In addition, the patients were closely monitored with serial X-rays, and culture and blood test follow-up. One patient fully recovered without sequelae, but the other patient suffered a loss of distal interphalangeal joint motion. When dealing with bite wounds located on the hand, it is important to visit the hospital as soon as possible and receive the appropriate treatment early. Moreover, to prevent severe complications such as osteomyelitis, it is important to administer antibiotic therapy to which the cultured bacteria are sensitive, along with proper wound management and prophylactic antibiotic treatment.

  5. Onychophagia (Nail biting), anxiety, and malocclusion.

    Science.gov (United States)

    Sachan, Avesh; Chaturvedi, T P

    2012-01-01

    Nail biting is a stress removing habit adopted by many children and adults. People usually do it when they are nervous, stressed, hungry, or bored. All of these situations are having a common phenomenon between them is anxiety. Onychophagia is also a sign of other emotional or mental disorders. It is a habit that is not easy to quit and reflection of extreme nervousness or inability to handle stressful conditions. This abnormal habit may cause various malocclusions associated with dentoalveolar segment of the oral cavity. Crowding and rotations of incisors are common with this habit.

  6. Onychophagia (Nail biting, anxiety, and malocclusion

    Directory of Open Access Journals (Sweden)

    Avesh Sachan

    2012-01-01

    Full Text Available Nail biting is a stress removing habit adopted by many children and adults. People usually do it when they are nervous, stressed, hungry, or bored. All of these situations are having a common phenomenon between them is anxiety. Onychophagia is also a sign of other emotional or mental disorders. It is a habit that is not easy to quit and reflection of extreme nervousness or inability to handle stressful conditions. This abnormal habit may cause various malocclusions associated with dentoalveolar segment of the oral cavity. Crowding and rotations of incisors are common with this habit.

  7. Evaluation of molecular genetic variation associated with deep venous thrombosis in lower limb fractures in traumatic patients

    Directory of Open Access Journals (Sweden)

    Ali Tabrizi

    2012-01-01

    Full Text Available Background: Genetic variation in multiple genes associated with hemostasis and thrombosis is well documented to impact the rates of future venous thromboembolism; in addition, trauma and orthopedic surgery in lower limb and immobilization are important factors in increasing the incidence of thrombosis. Gene mutation can be predisposing factor for thrombosis in traumatic patients under anti-coagulant agent prophylaxis. The aim of this study is to evaluate the different gene mutations in these patients. Materials and Methods: In this cross-sectional descriptive study, the sample consisted of 53 patients with deep venous thrombosis (DVT and 32 traumatic patients without thrombosis as the control group. Two groups matched together according to sex, age, weight, and medications. DNA analysis for mutation of multivariate of genes in thrombosis was studied. Results: Regarding gene variations, there was statistically significant difference only in Prothrombin (Factor II, G20210A between the patients with thrombosis and control group (P = 0.01. But, there was no difference between two groups considering other gene mutations. Mutation of Prothrombin gene (G20210A was a predictive factor for thrombosis with odds ratio of 1.1 (CI 0.3-1.9. Conclusion: According to the outcomes resulted from this study, genetic mutation in Prothrombin (Factor II [G20210A] is one of the most important genetic variations involved in traumatic patients with DVT despite prophylaxis. Genetic mutation in Prothrombin appears to be predisposing factor for thrombosis associated with trauma.

  8. Variables associated with physical health-related quality of life in Parkinson's disease patients presenting for deep brain stimulation.

    Science.gov (United States)

    Diaz, Alexandre Paim; Freitas, Fernando Cini; de Oliveira Thais, Maria Emília; da Silva Areas, Fernando Zanela; Schwarzbold, Marcelo Liborio; Debona, Rodrigo; Nunes, Jean Costa; Guarnieri, Ricardo; Martinez-Ramirez, Daniel; Prediger, Rui Daniel; Wagle Shukla, Aparna; Linhares, Marcelo Neves; Walz, Roger

    2016-11-01

    Deep brain stimulation (DBS) benefits Parkinson's disease (PD) patient's quality of life specially in domains as mobility, activities of daily living (ADL) and bodily discomfort (BD), but little is known about the variables associated with these HRQOL domains in patients presenting for DBS. The objective is to evaluate variables associated with of HRQOL in a Brazilian sample of PD patients presenting for DBS treatment, specifically in the domains related with motor symptoms. In a cross-sectional study of 59 PD patients evaluated at outpatient Unit for Movement Disorders, multiple linear regression analysis was performed to identify independent variables associated with mobility, ADL and BD domains of the 39-item Parkinson's disease questionnaire (PDQ-39). UPDRS III "on" scores, duration of the disease, age, presence of comorbidities and anxiety and depressive symptoms quantified by hospital anxiety and depression scale (HADS), were the independent variables. In our results, HADS scores were independently associated to mobility domain: β coefficient 1.36 (95 % CI 0.55-2.15) and BD domain: β coefficient 1.57 (95 % CI 0.67-2.48). UPDRS III "on" scores were independently associated to mobility domain: 0.42 (95 % CI 0.03-0.81). The model of each multiple linear regression analysis explains 25 % of the mobility domain variability (p quality of life as motor symptoms in PD patients presenting for DBS treatment. The effect of treating these psychiatric symptoms on patients' HRQOL deserves further investigation.

  9. The use of a wax bite wafer and a double computed tomography scan procedure to obtain a three-dimensional augmented virtual skull model.

    Science.gov (United States)

    Swennen, Gwen R J; Mommaerts, Maurice Y; Abeloos, Johan; De Clercq, Calix; Lamoral, Philippe; Neyt, Nathalie; Casselman, Jan; Schutyser, Filip

    2007-05-01

    A detailed visualization of the interocclusal relationship is essential in a three-dimensional virtual planning setup for orthognathic and facial orthomorphic surgery. The purpose of this study was to introduce and evaluate the use of a wax bite wafer in combination with a double computed tomography (CT) scan procedure to augment the three-dimensional virtual model of the skull with a detailed dental surface. A total of 10 orthognathic patients were scanned after a standardized multislice CT scanning protocol with dose reduction with their wax bite wafer in place. Afterward, the impressions of the upper and lower arches and the wax bite wafer were scanned for each patient separately using a high-resolution standardized multislice CT scanning protocol. Accurate fitting of the virtual impressions on the wax bite wafer was done with surface matching using iterative closest points. Consecutively, automatic rigid point-based registration of the wax bite wafer on the patient scan was performed to implement the digital virtual dental arches into the patient's skull model (Maxilim, version 2.0; Medicim NV, St-Niklaas, Belgium). Probability error histograms showed errors of wax bite wafer with the double CT scan procedure allowed for the setup of an accurate three-dimensional virtual augmented model of the skull with detailed dental surface. However, from a clinical workload, data handling, and computational point of view, this method is too time-consuming to be introduced in the clinical routine.

  10. Volkmann’s contracture of the forearm due to an insect bite: a case report and review of the literature

    Science.gov (United States)

    Srivastava, S

    2013-01-01

    Compartment syndrome affecting the upper limb is reported rarely in the literature and is usually limited to single case reports. Upper limb compartment syndrome secondary to envenomation is rare, especially in the UK. Worldwide, it has been reported resulting from snake and insect bites, mostly from snakes from the Viperidae family, and from insects such as bees and wasps. Reports from the UK are limited to one case of an adder bite. We present a case of a previously fit and well adult who developed an ischaemic contracture of the forearm after an insect bite. Surgical exploration revealed segmental necrosis and contracture of the superficial and deep flexors of the fingers, requiring fasciotomy and tendon-lengthening procedures. This is the first report of a compartment syndrome, or a late ischaemic contracture from an insect bite in the UK. Owing to the rarity of compartment syndrome of the upper limb secondary to envenomation, a delay in diagnosis and treatment can lead to irreversible changes in the muscular compartments of the forearm. PMID:23484979

  11. Volkmann's contracture of the forearm owing to an insect bite: a case report and review of the literature.

    Science.gov (United States)

    Hardwicke, J; Srivastava, S

    2013-03-01

    Compartment syndrome affecting the upper limb is reported rarely in the literature and is usually limited to single case reports. Upper limb compartment syndrome secondary to envenomation is rare, especially in the UK. Worldwide, it has been reported resulting from snake and insect bites, mostly from snakes from the Viperidae family, and from insects such as bees and wasps. Reports from the UK are limited to one case of an adder bite. We present a case of a previously fit and well adult who developed an ischaemic contracture of the forearm after an insect bite. Surgical exploration revealed segmental necrosis and contracture of the superficial and deep flexors of the fingers, requiring fasciotomy and tendon-lengthening procedures. This is the first report of a compartment syndrome, or a late ischaemic contracture from an insect bite in the UK. Owing to the rarity of compartment syndrome of the upper limb secondary to envenomation, a delay in diagnosis and treatment can lead to irreversible changes in the muscular compartments of the forearm.

  12. Systematic review for orthodontic and orthopedic treatments for anterior open bite in the mixed dentition

    Directory of Open Access Journals (Sweden)

    Lucia Pisani

    2016-09-01

    Full Text Available Abstract Background The treatment options for the early treatment of anterior open bite are still controversial. The aim of this study was to evaluate the actual available evidence on treatments of anterior open bite in the mixed dentition in order to assess the effectiveness of the early treatment in reducing open bite, the most efficacious treatment strategy and the stability of the results. Materials and methods A literature survey was done on November 15, 2015, by means of appropriate Medical Subject Headings (MeSH using the following databases: PubMed, EMBASE, Cochrane Library, LILACS, VHL, and WEB OF SCIENCE. Randomized clinical trials and studies with a control group (treated or untreated were then selected by two authors. Trials including patients with syndromes or in the permanent dentition and studies concerning treatment with extractions, full-fixed appliances, or surgery were not considered. Full articles were retrieved for abstracts or titles that met the initial inclusion criteria or lacked sufficient detail for immediate exclusion. Results Two thousand five hundred sixty-nine studies about open bite were available; the search strategy selected 240 of them. Twenty-four articles have been judged suitably for the final review, and their relevant data were analyzed. Discussion Although this review confirms the effectiveness of early treatment of open bite, particularly when no-compliance strategies are employed, meta-analysis was unfeasible due to lack of standardization, important methodological limitations, and shortcomings of the studies. Conclusions A more robust approach to trial design in terms of methodology and error analysis is needed. Besides, more studies with longer periods of follow-up are required.

  13. A case report of bilateral Brodie bite in early mixed dentition using bonded constriction quad-helix appliance.

    Science.gov (United States)

    Nojima, Kunihiko; Takaku, Sakiko; Murase, Chiaki; Nishii, Yasushi; Sueishi, Kenji

    2011-01-01

    Brodie bite is a comparatively rare type of malocclusion found in primary and mixed dentition. It not only adversely affects chewing and muscle functions, but also impairs normal growth and development of the mandible. This report describes the therapeutic results of a patient with bilateral Brodie bite in early mixed dentition after using a bonded constriction quad-helix appliance. The patient, a boy aged 9 years and 2 months, first visited our hospital after occlusal abnormality in the molar region was detected at a local dental clinic. Case analysis resulted in a diagnosis of bilateral Brodie bite with slight mandibular retrognathism. Treatment objectives were to reduce the arch width of the maxillary dentition and expand the mandibular arch in order to establish and stabilize molar occlusion and to achieve a Class I molar relation and appropriate overbite and overjet. Treatment comprised covering the occlusal surface of the maxillary molars with resin and attaching a bonded constriction quad-helix appliance joined with a 0.040-inch quad-helix wire. A bi-helix appliance was also fixed to the mandibular dentition. Brodie bite visibly improved after 5 months. Cervical headgear was then fitted and the patient observed until eruption of the permanent dentition was complete. Class I molar relation was achieved after 2 years and 6 months, although spacing remained in the maxillary and mandibular dentitions. Treatment of bilateral Brodie bite in mixed dentition by means of a bonded constriction quad-helix appliance attached to the maxillary dentition enabled effective bite opening and reduction in the width of maxillary arch independent of the patient's cooperation, providing good therapeutic outcome in a short time period.

  14. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... correct dose. For bites that itch , apply an ice pack or an over-the-counter anti-itch cream, such as hydrocortisone. Another option is to take an over-the-counter oral antihistamine. To reduce swelling , apply an ice pack to the bite. If you experience any ...

  15. Bullous reactions to bed bug bites reflect cutaneous vasculitis

    Science.gov (United States)

    This study evaluates bullous cutaneous reactions and sequential histopathology in an individual sensitized to bed bug bites in an effort to better understand the allergic response and histology associated with these bites. There was a progression of the inflammatory response across time ranging from...

  16. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... counter oral antihistamine. To reduce swelling , apply an ice pack to the bite. If you experience any serious symptoms after a bug bite, such as a rash, fever, or body aches, see your doctor or a board-certified dermatologist immediately. Make sure you tell the doctor about your recent ...

  17. Proximate determinants of bite force in Anolis lizards.

    Science.gov (United States)

    Wittorski, Antoine; Losos, Jonathan B; Herrel, Anthony

    2016-01-01

    Performance measures associated with the vertebrate jaw system may provide important insights into vertebrate ecology and evolution because of their importance in many ecologically relevant tasks. Previous studies have shown that in many taxa, evolution toward higher bite force has gone hand in hand with the evolution of larger body size. However, independent of differences in overall body size, bite force may vary depending on head size and shape as well. Moreover, the underlying musculature may also drive variation in bite force. Here, we investigate the proximate determinants of bite force in lizards of the genus Anolis. We dissected the jaw muscles and quantified muscle mass, fibre length, and cross-sectional area. Data were analysed for both sexes independently given the sexual dimorphism detected in the dataset. Our results show that the traits that explain bite force are similar in both males and females with overall body size and muscle mass being the principal determinants. Among the different muscles examined, the adductor externus and the pseudotemporalis groups were the best determinants of bite force. However, models run for males predicted the variation in bite force better than models for females, suggesting that selection on morphology improving bite force may be stronger in males. © 2015 Anatomical Society.

  18. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... correct dose. For bites that itch , apply an ice pack or an over-the-counter anti-itch cream, such as hydrocortisone. Another option is to take an over-the-counter oral antihistamine. To reduce swelling , apply an ice pack to the bite. If you experience any ...

  19. Bite angle effects of diphosphines in carbonylation reactions

    NARCIS (Netherlands)

    P.W.N.M. van Leeuwen; Z. Freixa

    2008-01-01

    This chapter contains sections titled: * Introduction * Rhodium-Catalyzed Hydroformylation o Introduction o Steric Bite Angle Effect and Regioselectivity o Electronic Bite Angle Effect and Activity o Isotope Effects [24] * Platinum-Catalyzed Alkene Hydroformylation * Palladium-Catalyzed CO/Ethene Co

  20. The incidence of deep venous thrombosis in high-risk Indian neurosurgical patients: Need for early chemoprophylaxis?

    Directory of Open Access Journals (Sweden)

    Ajith John George

    2016-01-01

    Full Text Available Introduction: Deep venous thrombosis (DVT is thought to be less common in Asians than in Caucasian population. The incidence of DVT in high-risk groups, especially the neurosurgical (NS patients, has not been well studied. This leaves no firm basis for the start of early prophylactic anticoagulation within first 5 postoperative days in Indian NS patients. This is a prospective observational study to determine the early occurrence of DVT in the NS patients. Patients and Methods: We screened 137 consecutive high-risk NS patients based on inclusion and exclusion criteria. The femoral veins were screened using Doppler ultrasound on day 1, 3, and 5 of admission into the NS Intensive Care Unit (ICU at tertiary center from South India. Results: Among 2887 admissions to NICU 147 patients met inclusion criteria. One hundred thirty seven were screened for DVT. There was a 4.3% (6/137 incidence of DVT with none of the six patients having signs or symptoms of pulmonary embolism. Among the risk factors studied, there was a significant association with femoral catheterization and a probable association with weakness/paraparesis/paraplegia. The mortality in the study group was 10.8% with none attributable to DVT or pulmonary embolism. Conclusion: There is a low incidence of DVT among the high risk neurosurgical population evaluated within the first 5 days of admission to NICU, limiting the need for early chemical thrombo-prophylaxis in these patients. With strict protocols for mechanical prophylaxis with passive leg exercise, early mobilization and serial femoral Doppler screening, heparin anticoagulation can be restricted within the first 5 days of ICU admission in high risk patients.