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Sample records for year-old boy case

  1. Giant vesical calculus in a ten year-old boy - a case report | Saleh ...

    African Journals Online (AJOL)

    This is a case of longstanding urinary tract symptoms in a 10 year old boy in which multi-modality imaging revealed multiple radio-opaque calculi including a giant vesical calculus. He had surgical removal of the stone with no post-op complications. Keywords: Giant, Vesical Calculus, 10 years old ...

  2. transverse patella fracture in a ten year old boy: case report

    African Journals Online (AJOL)

    report a case of a transverse patella fracture in a ten year old boy. He presented with ... fall, he reported that he had pain and swelling which resolved ... radiographs of the patient's right (normal) knee. Figure 1 ... the limb splinted in a back slab.

  3. Jejunal Intramural Hematoma with Bowel Obstruction in a 5-year-old Boy: A Case Report

    International Nuclear Information System (INIS)

    Kim, Seung Soo; Kim, Young Tong

    2009-01-01

    Intramural hematoma of the jejunum is rare and can be classified as trauma-related or occurring spontaneously. Spontaneous intramural hematoma commonly occurs in patients treated with warfarin. We report a case of intramural hematoma of the jejunum with intestinal obstruction in a 5-year-old boy who had neither a definite history of trauma nor the tendency to bleed

  4. Jejunal Intramural Hematoma with Bowel Obstruction in a 5-year-old Boy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Soo; Kim, Young Tong [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2009-12-15

    Intramural hematoma of the jejunum is rare and can be classified as trauma-related or occurring spontaneously. Spontaneous intramural hematoma commonly occurs in patients treated with warfarin. We report a case of intramural hematoma of the jejunum with intestinal obstruction in a 5-year-old boy who had neither a definite history of trauma nor the tendency to bleed.

  5. Transverse patella fracture in a ten year old boy: case report ...

    African Journals Online (AJOL)

    Patella fractures are rare in children. Transverse fractures in particular are an uncommon pattern. We report a case of a transverse patella fracture in a ten year old boy. He presented with inability to actively extend his left knee, two months after a fall. On evaluation he was found to have a transverse fracture of his left patella.

  6. Cementoblastoma Arising in the Maxilla of an 8-Year-Old Boy: A Case Report

    Directory of Open Access Journals (Sweden)

    Hiroyuki Harada

    2011-01-01

    Full Text Available Cementoblastoma is an uncommon disease, representing only 1–8% of all odontogenic tumours. Furthermore, this tumour is especially uncommon in children, as only five cases have been reported in this age group. Here, we describe a case of cementoblastoma arising in the maxilla of an 8-year-old boy, that was treated with a partial maxillectomy. The patient's facial appearance has remained satisfactory, and the tumour has not recurred in the 9 years after the operation.

  7. MULTIPLE MALIGNANT TUMORS IN 8-YEARS OLD BOY WITH XERODERMA PIGMENTOSUM: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    V. I. Al’banova

    2014-01-01

    Full Text Available This case report describes xeroderma pigmentosum in an 8-year old boy. At the age of 4 he was diagnosed with aggressive keratinizing squamous cell carcinoma. Surgical treatment, close-focus radiotherapy, isotretinoin and cyclosporine were ineffective. At the age of 8 he had multiple tumors on the face and concha of the ear, with destruction of adjacent bone and cartilage and regional nodal metastasing.

  8. A Case of Juvenile Huntington Disease in a 6-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Jun-Sang Sunwoo

    2010-10-01

    Full Text Available Huntington disease is a neurodegenerative disorder distinguished by the triad of dominant inheritance, choreoathetosis and dementia, usually with onset in the fourth and fifth decades. It is caused by an unstable cytosine-adenine-guanine (CAG trinucleotide repeat expansion in the gene IT15 in locus 4p16.3. Juvenile HD that constitutes about 3% to 10% of all patients is clinically different from adult-onset form and characterized by a larger number of CAG repeats typically exceeding 60. We report a case of a 6-year-old boy with myoclonic seizure and 140 CAG repeats confirmed by molecular genetic analysis.

  9. Neurocysticercosis in a 14-year-old boy in Italy: An unexpected case

    Directory of Open Access Journals (Sweden)

    Vania Giacomet

    2013-08-01

    Full Text Available Neurocysticercosis (NCC is a parasitic infection of the central nervous system caused by larvae of Taenia solium. It represents the most common cause of neurological disease in children living in developing countries. In recent years, NCC is increasingly being diagnosed also in high-socioeconomic countries, mainly due to the high rate of immigration. We describe a case of a 14-year-old Ecuadorian boy living in Italy, who experienced a generalized tonic-clonic seizure and was diagnosed with NCC. The boy was successfully managed with anticonvulsant, anticysticercal and anti-inflammatory treatment. With the present case we would like to emphasize the importance of considering NCC as a possible cause of non febrile seizures in children living in developed countries, particularly in those immigrated from an endemic region or had a long-term stay in an area of high prevalence.

  10. Colorectal Polyposis in a 15 Year Old Boy in Uganda - Case Report ...

    African Journals Online (AJOL)

    Colorectal polyps usually present as rectal bleeding and are associated with increased risk of colorectal carcinoma. This is a 15 year old boy who presented with painless rectal bleeding for 9 years and mass protruding from the anus for 2 years after passing stool. He had history of 3 nephews with similar symptoms.

  11. Childhood autism in a 13 year old boy with oculocutaneous albinism: a case report

    Directory of Open Access Journals (Sweden)

    Bakare Muideen O

    2008-02-01

    Full Text Available Abstract Introduction Hypomelanotic skin disorders like tuberous sclerosis and hypomelanosis of Ito that present with multiple systemic manifestations have been reported in association with childhood autism. Oculocutaneous albinism is another hypomelanotic skin disorder that rarely presents with multiple systemic manifestations. It is infrequently reported in association with childhood autism when compared to tuberous sclerosis and hypomelanosis of Ito. Case presentation This article reports a case of co-morbid childhood autism and oculocutaneous albinism in a 13-year old boy from Nigeria in Sub-Saharan Africa. Conclusion The observation in this case report and in two previous reports which documented association between oculocutaneous albinism and childhood autism both in the affected individuals and families of individuals with childhood autism, raises the question of a possible genetic and clinical association between oculocutaneous albinism and childhood autism. More family and genetic studies into the relationship between oculocutaneous albinism and childhood autism is desirable. This may provide useful clues into the etiology, prevention and management of childhood autism as well as oculocutaneous albinism.

  12. Churg-Strauss Syndrome in a Seven-year-old Boy: A Case Report

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    Abdolreza Malek

    2018-06-01

    Full Text Available Churg-Strauss syndrome (CSS is a type of vasculitis of small-to-medium sized vessels. This syndrome is known by a history of bronchial asthma with systemic necrotizing vasculitis and peripheral blood hypereosinophilia. It is currently called eosinophilic granulomatosis with polyangiitis (EGPA. This disease affects both genders and all age groups, but it is very rare among children. CSS diagnosis is based on clinical findings such as asthma, eosinophilia, rhinosinusitis, and signs of vasculitis in major organs. In cases where steroids alone or in combination with other immunosuppressive agents are used as treatment, the outcome and long-term survival are usually satisfying. In comparison with other types of systemic vasculitis, the mortality rate of this syndrome is low. In this study, we present the case of a 7-year-old boy with poorly controlled bronchial asthma since three years of age. This case had developed purpuric skin lesions, sinusitis, arthritis, and weakness of the limbs with symptoms of mononeuritis multiplex at the age of seven. After being admitted to our hospital, a series of studies, including complete blood count-diff, chest X-ray, paranasal sinus radiography, brain magnetic resonance imaging, nerve conduction study, spirometry, and serological tests for autoantibodies, were performed and he was diagnosed with CSS. Thereafter, he received regular corticosteroid therapy in combination with methotrexate, and his symptoms were generally well-controlled with the beginning of the treatment. The clinical characteristics, diagnosis, and management of CSS in children are also reviewed in this study.

  13. Idiopathic eosinophilic parotitis in an eight-year-old boy: a case report

    Directory of Open Access Journals (Sweden)

    Gelardi Matteo

    2011-08-01

    Full Text Available Abstract Introduction A number of medical conditions, some of them recently reported, are associated with an increased production of eosinophils. We report the first case of eosinophilic parotitis in the literature. Case presentation The patient was an eight-year-old Caucasian boy who presented with a two-year history of recurring acute parotitis with no fever. He had had a total of five episodes with no response to antibiotics, but remission had been achieved with oral corticosteroid therapy. We performed allergy tests for inhalant and food allergens and for haptens, but the results were all negative. The results of echography ruled out sialodochitis. Instead, a swab from the parotid duct led to the detection of a high number of eosinophils. Conclusions This report is first in the literature to describe a case of eosinophilic parotitis, and we suggest that a cytological assessment, which is quite simple yet rarely used by physicians, be performed when patients with parotitis of uncertain origin are under evaluation.

  14. Indifference to pain syndrome in a twelve-year-old boy (case report

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    Baghdadi T

    2007-08-01

    Full Text Available Background: People vary greatly in their response to painful stimuli, from those with a low pain threshold to those with indifference to pain. However, insensitivity to pain is a rare disorder, characterized by the lack of usual subjective and objective responses to noxious stimuli. Patients who have congenital indifference to pain sustain painless injuries beginning in infancy, but have sensory responses that are otherwise normal on examination. Perception of passive movement, joint position, and vibration is normal in these patients, as are tactile thresholds and light touch perception. Case report: A twelve-year-old boy was admitted to the hospital for a painless deformity, degeneration in both knees and a neglected femoral neck fracture that was inappropriately painless. Further examination revealed normal sensory responses, perception of passive movement, joint position, vibration tactile thresholds and light touch perception. Spinal cord and brain MRI were normal as was the electromyography and nerve conduction velocity (EMG/NCV examination. There was no positive family history for this disorder. Conclusion: The deficits present in the different pain insensitivity syndromes provide insight into the complex anatomical and physiological nature of pain perception. Reports on pain asymbolia, in which pain is perceived but does not cause suffering, and related cortical conditions illustrate that there can be losses that independently involve either the sensory-discriminative component or the affective-motivational component of pain perception, thus highlighting their different anatomical localization. The paucity of experience with this entity and the resultant diagnostic problems, the severity of the associated disabling arthropathy and underscore the importance of this case report of indifference to pain.

  15. Isolated unilateral temporalis muscle hypertrophy: First case in an 8-year-old boy and review.

    Science.gov (United States)

    Zwetyenga, N; Hallier, A; Girodon, M; Levasseur, J; Loison-Robert, L; Moris, V

    2018-02-01

    Isolated unilateral temporalis muscle hypertrophy (IUTMH) was first described in 1990 and few cases have been published since then. This disease occurs mainly in adults. There is no clear etiology of IUTMH, but bruxism is one of the risk factors. Only two cases have been described before the age of 20 years. To our knowledge, no cases have been described in persons younger than 15 years old. We report the first case of IUTMH in an 8-year-old and review the literature. This section is separated into 3 parts: (1) search for and description of clinical cases of IUTMH in our department; (2) literature search to find similar cases; (3) data analysis of all cases found. Ten patients, including our case, were found over a period of 23 years: five females and five males with a mean age of 32.8 years. One patient was 15 years old. Time between onset and diagnosis was 16.7 months. Half of the patients reported pain and three had experienced bruxism. Most of the patients had non-surgical treatment. One patient evolved favorably with no treatment. One recurrence occurred 10 years later. IUTMH can occur in childhood in a high-stress environment. Diagnosis is based on the history and clinical and imaging findings. Biopsy helps to confirm the diagnosis, but electromyograms and neurological tests contribute little. Bruxism should be taken into account. The treatment with the least inconvenience must be given. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. Abscess mimicking lung metastasis in a 10-year-old boycase report

    International Nuclear Information System (INIS)

    Roik, Danuta; Mosior, Tomasz; Sopyło, Barbara; Małdyk, Jadwiga; Brzewski, Michał

    2010-01-01

    Malignant pulmonary tumours in children are very rare; the majority are metastases. Nonspecific radiographic findings of these abnormalities are challenging and may delay the final diagnosis and treatment. A 10-year-old boy was admitted to our hospital because of the clinical and radiographic symptoms and signs of pneumonia with abscess formation in the left lower lobe. After initial improvement on antibiotic therapy, a significant deterioration of the patient’s condition was observed, together with progression in radiographic examinations. The patient was treated surgically and transferred to the Haematology and Oncology Department with a final diagnosis of pulmonary metastasis of clear cell sarcoma. Radiographic findings of metastatic diseases may mimic non-neoplastic pulmonary conditions. A lack of specific clinical symptoms and a confusing radiographic pattern in our patient with clear cell sarcoma lung metastasis caused serious diagnostic difficulties

  17. Scrotal and retroperitoneal lymphangioma of a 12-year-old boy: case report

    International Nuclear Information System (INIS)

    Zaleska-Dorobisz, U.; Koltowska, A.; Moron, K.; Jaworski, W.

    2005-01-01

    Lymphangiomas occurs in children quite frequently. They are most commonly localized in the head, neck, axilla, chest, abdomen, and retroperitoneum. Lymphangiomas of the scrotum are very rare and are usually clinically silent, so they are a challenge for radiologists performing US examination in children. They are obliged to differentiate the following lesions: torsion of the testicle, scrotal hernia, hydrocoele, and epididymal cyst, in addition to the masses of primary extra-testicular localization such as hemagioma, congenital vascular malformations, fibromas, and malignant tumors. Additional difficulties appear in boys who present acute scrotum syndrome. The paper reports the diagnostics and treatment of a huge multicystic lymphangioma situated in he scrotum and retroperitoneum of a 12-year-old boy who had fallen from a bicycle and presented acute scrotum. The lesion of the scrotum was surgically excised. Retroperitoneal lymphangioma was detected during this operation. Subsequent diagnostics was based on ultrasonography, computerized tomography, and magnetic resonance imaging of the abdominal cavity. The lymphangioma of the retroperitoneum was resected. The patient shows no evidence of recurrence after 7 years. Cystic lymphangiomas are rare but benign intra-scrotal, extra-testicular, painless masses in children. They are sonographically multicystic or multiloculated abnormalities and may show infiltrative extension to the perineum, retroperitoneum, or abdomen. Recognition of this entity and its extent is important for correct clinical management and may be for planning treatment. (author)

  18. Eosinophilic Meningitis in a 10-Year Old Nigerian Boy: A Case Report

    African Journals Online (AJOL)

    Eosinophilic meningitis is rare, commonly caused by invasion of the central nervous system by helminthes. The present case is that of a 10–year–old boy who presented with history of generalized pruritus not associated with skin eruptions, followed by pain and weakness of the extremities and loss of consciousness. Patient ...

  19. Primary Pterygium in a 7-Year-Old Boy: A Report of a Rare Case and Dilemma of its Management

    OpenAIRE

    Noor, Raja Azmi Mohd

    2003-01-01

    Primary pterygium in children is uncommon but is associated with severe visual problems. Astigmatism is the main visual problem caused by pterygium. Significant amounts of astigmatism occur long before a pterygium encroaches the visual axis. Early surgical intervention is safe and effective. It is associated with significant visual improvement in outcome. This is a case report on seven-year-old Malay boy who presented with a growth over nasal aspect of the right eye of 1 year duration. His ri...

  20. ROHHAD in a 9-year-old boy — clinical case.

    Science.gov (United States)

    Kot, Karolina; Moszczyńska, Elżbieta; Lecka-Ambroziak, Agnieszka; Migdał, Marek; Szalecki, Mieczysław

    2016-01-01

    ROHHAD syndrome (Rapid-onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation) is characterized by rapid-onset obesity in young children, hypoventilation, and hypothalamic and autonomic dysfunction. The exact aetiology of the disease remains unknown, and the number of reported cases seems to be underestimated. We present the case of a nine-year-old male patient suspected of ROHHAD due to weight gain since early childhood, decreased height velocity, hypoventilation, hypodipsia, excessive perspiration, and pyrexial episodes. The presented symptoms, and laboratory and imaging findings met the criteria of ROHHAD syndrome. ROHHAD should be considered in differential diagnosis for obesity in children. Early identification of the disease prevents potential complications specific for the syndrome, in particular a life-threatening cardio-pulmonary arrest. Patients with ROHHAD require regular follow-up by a multidisciplinary team.

  1. Case of Hypercalcemia Secondary to Hypervitaminosis A in a 6-Year-Old Boy with Autism

    Directory of Open Access Journals (Sweden)

    Arpita Kalla Vyas

    2011-01-01

    Full Text Available Vitamin A intoxication secondary to over-the-counter nutritional supplements and from its use in acne treatment has been described. However, there have been very few case reports of chronic hypervitaminosis A leading to hypercalcemia in the pediatric population. This paper describes a boy with hypercalcemia secondary to chronic vitamin A intoxication in the context of vitamin A usage for therapy of autism. In addition to discontinuation of vitamin A, hyperhydration, and furosemide, the hypercalcemia in this patient required the use of prednisone and pamidronate to normalize the calcium.

  2. Hereditary multiple exostoses in a 15-year-old boy: A case report ...

    African Journals Online (AJOL)

    Accepted: 6th September 2016. Eke GK ... in children, is a developmental lesion rather than a true neoplasm and constitutes ... to presentation, when patient was 12 years old. .... plications, possibly facing physical, psychological and.

  3. Recurrent nephrogenic adenoma in a 10-year-old boy with prune belly syndrome : a case presentation.

    Science.gov (United States)

    Vemulakonda, Vijaya M; Kopp, Ryan P; Sorensen, Mathew D; Grady, Richard W

    2008-05-01

    Nephrogenic adenoma is a rare benign lesion of the urinary tract that is associated with a history of irritation or injury of the urothelium. Predisposing factors include infection, calculi, surgery, trauma, and renal transplantation. Nephrogenic adenoma commonly presents with lower urinary tract symptoms or hematuria. We present the case of recurrent nephrogenic adenoma in a 10-year-old boy with a history of prune belly syndrome and discuss management of this disease in the pediatric population. To our knowledge this represents the first reported case of recurrent nephrogenic adenoma associated with prune belly syndrome.

  4. A Case of Tuberculous Meningitis with Paradoxical Response in a 14-Year-Old Boy

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    Murat Özer

    2016-01-01

    Full Text Available A clinical or radiological worsening of already existing lesions or an emergence of new lesions after beginning treatment in patients with tuberculosis (TB is referred to as the paradoxical response. This has aroused suspicion regarding the accuracy of diagnosis, the possibilities of treatment failure, or the presence of another underlying disease, and thus it is an important topic for clinicians to understand. In this article, the development of a paradox reaction in a 14-year-old male patient diagnosed with and treated for tuberculosis meningitis is reported. This pediatric patient with a healthy immune system is treated with steroids successfully and reported to elucidate the importance of managing the paradox of TB progression in spite of the appropriate anti-TB medications.

  5. PERFORATION OF A DUODENAL ULCER IN A 10 YEAR OLD BOY: A CASE REPORT

    OpenAIRE

    Prasenjit; Himadri Sekhar; Amalesh; Tanumoy

    2014-01-01

    In this modern era of medicine, perforation of duodenal or gastric ulcer in pediatric patients is very rare. Here we are presenting a 10 year boy presented in emergency department of our rural tertiary care hospital with complaints of diffuse abdominal pain, nausea, vomiting of 36 hours and mild fever of 12 hours duration. O/E he had tachycardia, raised temperature, generalized abdominal tenderness, guarding, rigidity and rebound tenderness. On chest x-ray, free gas under ...

  6. A case of an 8-year-old boy who was strongly suspected of suffering from familial angiolipomatosis

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    Yutaka Kanamori

    2015-06-01

    Full Text Available Familial angiolipomatosis is a rare inherited disease mainly diagnosed in the adult stage. It is usually inherited in an autosomal recessive manner; however, some cases of autosomal dominant mode of inheritance have been reported. The disease may be misdiagnosed as neurofibromatosis type I in some cases due to the similar feature of multiple subcutaneous soft masses. However, familial angiolipomatosis is not associated with malignant tumors and it is very important to distinguish these two conditions. We report here the rare case of a subcutaneous mass that was composed of fat tissues and some fibrous tissue with small venous vessels and capillaries in an 8-year-old boy whose father also has a long history of generalized multiple angiolipomas. These facts strongly suggest that the patient suffers from familial angiolipomatosis and careful follow-up is needed in the future.

  7. Acute ischemic stroke in a 6 year old boy, treated with mechanical thrombectomy: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Gi Hong; Lee, Mu Sook; Yang, Tae Ki [Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2016-11-15

    Pediatric acute ischemic stroke (AIS) is a relatively rare disease with an annual estimated incidence of 2.4-13 per 100000 children. However, pediatric AIS can lead to significant morbidity and mortality. Stroke in children differs from that in adults with respect to etiology, clinical presentation, or management. Therapeutic options for adult AIS are intravenous tissue plasminogen activator, intra-arterial pharmacological thrombolysis, and mechanical thrombectomy. However, management strategies for pediatric AIS, extrapolated largely from those of adult AIS, remain controversial. In this article, we present our experience in a boy with AIS, who was successfully treated with mechanical thrombectomy, by utilizing the Solitaire FR revascularization device.

  8. Ectopic adrenal tissue of spermatic cord in a 3- year- old boy, an incidental finding during orchidopexy: A case report

    Directory of Open Access Journals (Sweden)

    Biserka Pigac

    2017-11-01

    Full Text Available Ectopic adrenal tissue is usually found in kidney and retroperitoneum, yet other locations are considered uncommon. Spermatic cord remains one of the sites where this entity is mostly incidentally found during surgical procedure in childhood. Macroscopically, it represents as yellowish, lipomatous nodule. We present a case of ectopic adrenal tissue of spermatic cord in a 3- year- old boy, found during orchidopexy of the right testicle. Histopathological analysis of the spermatic cord nodule revealed adrenal cortical tissue composed of zona fasciculata cells. Although usually being benign and asymptomatic, cases of hyperplasia, adenoma and carcinoma arising from ectopic adrenal tissue have been reported. Therefore, removal of this tissue, when detected, is recommended.

  9. Primary pterygium in a 7-year-old boy: a report of a rare case and dilemma of its management.

    Science.gov (United States)

    Noor, Raja Azmi Mohd

    2003-07-01

    Primary pterygium in children is uncommon but is associated with severe visual problems. Astigmatism is the main visual problem caused by pterygium. Significant amounts of astigmatism occur long before a pterygium encroaches the visual axis. Early surgical intervention is safe and effective. It is associated with significant visual improvement in outcome. This is a case report on seven-year-old Malay boy who presented with a growth over nasal aspect of the right eye of 1 year duration. His right eye visual acuity is affected up to 6/12. The dilemma pased to early surgical interview is the high rate of recurrancean the young age group. This problem is highlighted in this case report.

  10. Surgical treatment of cervical unilateral locked facet in a 9-year-old boy: A case report

    Directory of Open Access Journals (Sweden)

    Mutlu Cobanoglu

    2015-01-01

    Full Text Available Most of the cervical spine injuries in the pediatric population are typically seen in the upper cervical region. Unilateral cervical facet dislocation (UFD in subaxial region is a rare injury in pediatric population. In this paper, a rare case of delayed locked UFD in a 9-year-old boy with rare injury mechanism treated surgically is reported. Clinical and radiological findings were described. The patient with C6-7 UFD without neurologic deficit was underwent open reduction and internal fixation via anterior and posterior combined approaches. Significant improvement of pain and free motion in cervical spine was obtained. There was no complication during the follow up. Only three case reports presented about the lower cervical spine injury with UFD under the age of 10 were found in the literature.

  11. Posterior mediastinal biphasic synovial sarcoma in a 12 year-old boy: A case report and review of literature

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    Pal Madhumay

    2010-01-01

    Full Text Available We report a case of biphasic synovial sarcoma of the mediastinum, a very rare tumor, in a 12-year-old boy with left-sided chest pain of 3 years duration at presentation. Chest X-ray showed left-sided opacity with loss of cardiac silhouette and the mediastinum deviated to the opposite side. Computed tomography (CT of thorax showed left-sided posterior mediastinal mass with left-sided pleural effusion and pleural thickening. CT guided fine needle aspiration cytology (FNAC from the mass reported it as spindle cell variant of adenocarcinoma. Ultrasonography (USG of the whole abdomen revealed no abnormality. The mediastinal tumor was resected by left thoracotomy and histopathological report confirmed it to be a biphasic synovial sarcoma with capsule invasion at places.

  12. Hemosiderotic dermatofibroma mimicking melanoma in a 12-year-old boy: a case report.

    Science.gov (United States)

    Acar, Emine Müge; Tad, Murat; Kilitci, Asuman; Kemeriz, Funda

    2018-06-01

    We report a case of hemosiderotic dermatofibroma presenting as a brown-black-colored nodule with peripheral extensions, which mimics melanoma. Histopathology showed completely benign features with no atypia or mitosis. Nodular extensions of childhood dermatofibromas may be related to the growth of the child not necessarily pointing to a malignant process.

  13. Penile and scrotal condyloma acuminatum in a three-year-old boy: A rare case report

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    Hulya Ozturk

    2016-07-01

    Full Text Available Condyloma acuminatum is a common sexually transmitted diseases in adults, but its presence in children is rare and could be associated with sexual abuse. We are reporting this case because of the rarity of presence of warts on the penis and the scrotum of a child, which certainly could not have been used for sexual purposes. Surgical excision of warts was performed.

  14. A pin in appendix within Amyand's hernia in a six-years-old boy: case report and review of literature

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    Jashari Hysni J

    2010-05-01

    Full Text Available Abstract Introduction Presence of vermiform appendix (non-inflamed or inflamed in inguinal hernia is called Amyand's hernia in honor to surgeon C. Amyand who published the first case of perforated appendicitis within inguinal hernia in a boy caused by ingested pin. This presentation of foreign body Amyand's hernia appendicitis is very rare, and here we present such a case. Case presentation A 6-year-old boy, white Kosovar ethnicity, presented with right groin pain, swelling and redness. Two days before admission the patient was injured by football during a children game in the right lower abdomen and the next day he complained of pain in the right inguinal area. On admission patient had a painful non-reducible mass in the right inguinal region and cellulitis. Plain abdominal x-ray showed no fluid-air levels, but a metallic foreign body (pin under right superior pubic ramus was apparent. With preoperative diagnosis of suspect incarcerated inguinal hernia with cellulitis the patient was operated on under general anaesthesia in December 2, 2006. Intraoperatively we found the inflamed vermiform appendix perforated by a pin in the hernial sac. Appendectomy and herniotomy were performed. The wound was primary closed, without any post-operative complications and follow up for the patient is three years long. Conclusion Foreign body (pin Amyand's hernia appendicitis seems to be extremely rare, maybe once in a century (Amyand 1735, Hall 1886, and our case in 2006. In patients with clinical signs of incarcerated inguinal hernia, with locally inflammatory signs, but without signs of intestinal obstruction Amyand's hernia appendicitis in differential diagnosis must be considered. In our case, it is possible that the injury during the football game might have induced perforation of the vermiform appendix with the foreign body in it.

  15. Low Spigelian hernia in a 6-year-old boy presenting as an incarcerated inguinal hernia: a case report

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    Christianakis Efstratios

    2009-01-01

    Full Text Available Abstract Introduction Lower Spigelian hernia is a very rare entity. The clinical findings are similar to those of inguinal hernias and in many cases may be misdiagnosed. In the literature, only a few references to this entity have been reported in children. To the best of our knowledge, this is the first case report of a lower Spigelian hernia in a child who presented with an acute painful scrotum. Case presentation We discuss the case of a 6-year-old Greek boy who presented to our emergency department complaining of severe pain in the left inguinal area and scrotum. The acute painful swelling started suddenly, without any obvious cause. The initial diagnosis was incarcerated inguinal hernia which was reduced with difficulty. Five days later, the patient still experienced mild pain during palpation and he was operated on. During the operation, a large lower Spigelian hernia was revealed and reconstructed. Conclusion Although Spigelian hernias are rare in children and difficult to diagnose, physicians should be aware of them and include them in the differential diagnosis.

  16. Hypothyroidism in a five-year-old boy with rhabdomyolysis and recent history of cardiac tamponade: a case report

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    Lorenzana Claudia

    2011-10-01

    Full Text Available Abstract Introduction Cardiac tamponade is a rare manifestation of hypothyroidism, and a less rare cause of pericardial effusion. The accumulation of the pericardial fluid is gradual, and often does not compromise cardiac hemodynamic function. There is a relationship between the severity and chronicity of the disease with the presence of pericardial effusion. There are few cases describing associated pericardial tamponade published in the literature. When a tamponade occurs, a concomitant provocative factor such as a viral pericarditis may be related. Our patient's case appears to be the youngest patient described so far. Case presentation We report the case of a previously healthy five-year-old Hispanic (non-indigenous boy who developed rhabdomyolysis with a history of a recent pericardial effusion and tamponade two months before that required the placement of a percutaneous pericardial drainage. Pericardial effusion was considered to be viral. Later on readmission, clinical primary hypothyroidism was diagnosed and thought to be associated with the previous cardiac tamponade. He developed rhabdomyolysis, which was considered to be autoimmune and was treated with steroids. The level of creatine phosphate kinase and creatine kinase MB fraction returned to within the reference rangeone week after our patient was started on steroids and three weeks after he was started on thyroid hormones. Conclusions Physicians should consider hypothyroidism as a differential diagnosis in patients with pericardial effusion. Pericardial effusion may progress and cause a cardiac tamponade with hemodynamic instability. The fact that our patient did not have any manifestations of hypothyroidism might have delayed diagnosis.

  17. Co-existence of Phenylketonuria and Fabry disease on a 3 year-old boy: case report

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    Bonapace Giuseppe

    2010-05-01

    Full Text Available Abstract Background The co-existence of two genetically distinct metabolic disorders in the same patient has rarely been reported. Phenylketonuria (PKU is an inborn error of the metabolism resulting from a phenylalanine hydroxylase deficiency. Fabry disease (FD is an X-linked lysosomal storage disorder due to a deficiency of the enzyme alpha-galactosidase A. Case presentation We report a case of a 3 year- old boy affected by classic PKU and FD, both confirmed by molecular data. The FD was suspected at the age of 21 months on the presence of non-specific GI symptoms (severe abdominal pain and periodically appearance of not specific episodes of gastroenteritis apparently non related to PKU. Conclusion This is the first report of co-existence of FD and PKU, two different congenital inborn of metabolism and in consideration of the prevalence of each disease this chance association is a very unusual event. The co-existence of this diseases made very difficult the correct interpretation of clinical symptoms as lack of appetite, severe abdominal pain and non-specific gastroenteritis episodes. Furthermore, this case report helps to define the early clinical phenotype of FD.

  18. Dorsal resection of a thoracic hemivertebra in a 4-year-old boy with endochondral gigantism. A case report.

    Science.gov (United States)

    Zarghooni, Kourosh; Sobotrke, Rolf; Schmidt, Heinrich; Rollinghoff, Marc; Siewe, Jan; Eysel, Peer

    2010-10-01

    The authors present what appears to be the first case of congenital kyphosis due to a T12 hemivertebra in a four-year-old boy with endochondral gigantism syndrome of unknown origin. Because of his overgrowth, the patient had severe medical and orthopaedic problems and was almost immobile. Prior to surgery, he experienced a rapidly progressive thoracolumbar kyphosis to 600 (T10-L2). MRI of the brain and spine showed critical protraction of the spinal cord and myelopathy from compression at T12. Single-stage posterior resection of the hemivertebra with spinal shortening and dorsal transpedicular instrumentation of T10-L2 was performed. Although the bone tissue was cartilaginous and dysplastic, 420 (30%) correction was achieved along with decompression of the spinal canal. The patient experienced no neurological impairment post-operatively. At follow-up examination 1.5 year after surgery, the patient's movement disorder had improved markedly and he was able to stand and walk. This very rare case demonstrates that single-stage posterior hemivertebra resection and transpedicular instrumentation for correction of congenital kyphosis can be a safe and effective procedure even in a very challenging case.

  19. Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report

    Science.gov (United States)

    Mary, Pierre; de Carvalho, Antonio; Pointe, Hubert Ducou le; Damsin, Jean-Paul; Filipe, Georges

    2007-01-01

    Acute unilateral L5 pedicle fracture associated with a pre-existing contralateral spondylolysis is a rare lesion. We report a case in a non-competitive 12-year-old boy. We present the clinical, radiological and specific management of this rare condition. The clinical and radiological draft of this patient was reviewed. The follow-up was 30 months after fracture healing. Some cases reported in the literature were analyzed and our clinical findings and therapeutic strategy was compared and discussed. Non-operative treatment was done including full-time bracing in a modified Boston brace incorporating one thigh for 3 months. Plain radiographs and computed tomographic (CT)-scan performed at 3 and 6 months showed progressive healing of the pedicle fracture and no modification of the contralateral isthmic spondylolytic lesion. At final follow-up, the patient was asymptomatic and resumed all his activities. In skeletally immature patients, we think that conservative treatment should be considered as a treatment option for this unusual injury. PMID:17520295

  20. Scrotal Swelling and Testicular Atrophy due to Schistosomiasis in a 9-Year-Old Boy: A Case Report

    Directory of Open Access Journals (Sweden)

    Peter F. Rambau

    2011-01-01

    Full Text Available Schistosomiasis is a communicable disease which commonly involves urinary bladder causing hematuria, or large bowel causing bloody stool. The common species encountered in this lake region surrounding Lake Victoria in Tanzania are Schistosoma haematobium and Schistosoma mansoni. Complications can lead to portal hypertension due portal fibrosis in liver, and fibrosis in lung can lead to pulmonary hypertension; this commonly seen with S. mansoni. Major complications of S. maeametobium are chronic cystitis with squamous metaplasia with subsequent development of squamous cell carcinoma. Involvement of spinal cord causing paraplegia has been observed in S. haematobium. Other unusual pathology of schistosomiasis has been described, such as involvement of the appendix, ovary, prostate, and cervix. Here, we present a case of schistosomiasis in a 9-year-old boy who presented with left scrotal pain for one year which was accompanied by scrotal swelling; surgical exploration was done, and the finding was hydrocele and atrophic testes with nodules on the surface. Histological examination reveals atrophic testis and heavy active granulomatous inflammation with schistosoma eggs consistent with Schistosoma haematobium in the tunica vaginalis.

  1. A three-year-old boy with X-linked adrenoleukodystrophy and congenital pulmonary adenomatoid malformation: a case report

    Directory of Open Access Journals (Sweden)

    Cakan Nedim

    2009-12-01

    Full Text Available Abstract Introduction X-linked adrenoleukodystrophy leads to demyelination of the nervous system, adrenal insufficiency, and accumulation of long-chain fatty acids. Most young patients with X-linked adrenoleukodystrophy develop seizures and progressive neurologic deficits, and die within the first two decades of life. Congenital or acquired disorders of the respiratory system have not been previously described in patients with X-linked adrenoleukodystrophy. Case presentation A 3-year-old Arabic boy from Yemen presented with discoloration of the mucous membranes and nail beds, which were considered cyanoses due to methemoglobinemia. He also had shortness of breath, fatigue, emesis and dehydration episodes for which he was admitted to our hospital. Chest radiograph and chest computed tomography scans showed congenital pulmonary adenomatoid malformation. A few weeks before the removal of the malformation, he had a significant episode of hypotension and hypoglycemia. This development required further in-hospital evaluation that led to the diagnosis of adrenal insufficiency and the initiation of treatment with corticosteroids. One year later, he developed seizures and loss of consciousness. Magnetic resonance imaging of his head showed diffuse demyelination secondary to X-linked adrenoleukodystrophy. He was treated with anti-seizure and anti-oxidants, and was referred for bone marrow transplant evaluation. Conclusion The presence of adrenal insufficiency, neurologic deficits and seizures are common manifestations of X-linked adrenoleukodystrophy. The association of congenital lung disease with X-linked adrenoleukodystrophy or Addison's disease has not been described previously.

  2. Right hepatic vein injury after blunt abdominal trauma in a 12-year-old boy- case report

    International Nuclear Information System (INIS)

    Roik, D.; Konecka, A.; Brzewski, M.; Marcinski, A.; Kaminski, A.; Piotrowska, A.; Jasinska, A.

    2008-01-01

    Blunt abdominal trauma in children is one of the most frequent causes of hospitalization. We present a rare case of traumatic liver injury. A 12-year-old boy was admitted to the Surgery Department after a bicycle fall and handlebar impact injury to the right infracostal area. At admission he was stable, with no abnormalities except for a subcutaneous hepatoma found in the injured area. Abdominal ultrasound examination revealed free intraperitoneal fluid. Computed tomography (CT) revealed irregular branching laceration of the right superior hepatic segments with extension into the hepatic veins. No active extravasation of contrast material was seen. On the next day, cause of the deterioration of the patient's condition, CT examination was repeated and revealed focal extravasation of contrast material in the portal hilum posterior to the gallbladder. An injury of the right hepatic vein was found on laparotomy. Hepatic vein injury is a rare but very serious complication after blunt liver trauma and it is an indication for surgical treatment. Diagnostic imaging is essential for therapeutic decisions, but its value is sometimes limited.The precise analysis of injury mechanism and localization may be very helpful.CT is currently the modality of choice for the evaluation of blunt liver trauma. If an active bleeding is suspected the delayed scans seem to be recommended. (author)

  3. Gender identity disorder in a five-year-old boy.

    OpenAIRE

    Herman, S. P.

    1983-01-01

    Markedly effeminate behavior in a young boy is a source of concern and confusion for parents, teachers, and the child. It also represents a therapeutic dilemma for the child psychiatrist. The case of a five-year-old boy with gender identity disorder of childhood is presented and the literature on hypotheses of etiology, treatment, and long-term follow-up is reviewed. The ethical and philosophical questions posed by such a case are discussed.

  4. Acute spinal epidural abscess in the whole spine: case report of a 2-year-old boy

    International Nuclear Information System (INIS)

    Shen, W.C.; Lee, S.K.; Ho, Y.J.; Lee, K.R.

    1992-01-01

    We report on an acute epidural abscess in a 2-year-old boy, extending from the C1 level to the L5 level. The causative agent was Staphylococcus aureus as proved by pus and blood culture. The infectious source was in the scrotum. The diffuse epidural abscess was readily detected by MRI, which showed hypo-intensity in T1 WI and hyperintensity in gradient echo T2-weighted images. The abscess capsule was enhanced by Gadolinium-DTPA. The patient recovered completely after adequate treatment with antibiotics and follow up MRI showed complete disappearance of the epidural abscess. (orig.)

  5. Duodenal adenocarcinoma in a 10-year-old boy

    Directory of Open Access Journals (Sweden)

    Zouari Mohamed

    2014-01-01

    Full Text Available Gastrointestinal malignancies are extremely rare in the paediatric population and duodenal cancers represent an even more unusual entity. It represents 0.3-1% of all gastrointestinal tumours. A case report of a 10-year-old boy with duodenal adenocarcinoma is reported and the difficulties of diagnosing and treating this rare tumour are discussed.

  6. Duodenal adenocarcinoma in a 10-year-old boy.

    Science.gov (United States)

    Mohamed, Zouari; Habib, Bouthour; Rabia, Ben Abdallah; Youssef, Hlel; Riath, Ben Malek; Youssef, Gharbi; Nejib, Kaabar

    2014-01-01

    Gastrointestinal malignancies are extremely rare in the paediatric population and duodenal cancers represent an even more unusual entity. It represents 0.3-1% of all gastrointestinal tumours. A case report of a 10-year-old boy with duodenal adenocarcinoma is reported and the difficulties of diagnosing and treating this rare tumour are discussed.

  7. Treating hoarding disorder in a 12-year-old boy

    DEFF Research Database (Denmark)

    Andersen, Tanja Margrethe Gjerlev; Thomsen, Per Hove

    2017-01-01

    In this case report hoarding disorder is described in a 12-year-old boy who suffered from obsessive collection of things. The disorder is a separate diagnostic entity in DSM-5, and it will probably be a separate disorder in ICD-11 called hoarding disorder. The disorder is generally considered...

  8. Duodenal adenocarcinoma in a 10-year-old boy | Mohamed ...

    African Journals Online (AJOL)

    Gastrointestinal malignancies are extremely rare in the paediatric population and duodenal cancers represent an even more unusual entity. It represents 0.3-1% of all gastrointestinal tumours. A case report of a 10-year-old boy with duodenal adenocarcinoma is reported and the diffi culties of diagnosing and treating this ...

  9. Atypical desquamation in a 2.5-year-old boy with Kawasaki disease: A case report.

    Science.gov (United States)

    Adib, Ali; Fazel, Ali; Nabavizadeh, Seyed Hesamedin; Alyasin, Sohaila; Kashef, Sara

    2017-02-01

    Kawasaki disease (KD) is a vasculitis that mostly affects children under 5 years of age. This article presents a 2.5-year-old boy who presented with 6 days of fever, generalized maculopapular rash, bilateral non-exudative conjunctivitis, cracked lips, right cervical lymphadenopathy, erythematous extremities, and perianal desquamation. Laboratory studies showed leukocytosis and sterile pyuria. Because diagnosis of KD was proved, oral acetylsalicylic acid with the anti-inflammatory dose and intravenous immunoglobulin were started for him. On the seventh day of admission time, he developed desquamation and erythema on the site of his right cervical lymphadenopathy as well as periungual scaling. About three weeks after starting the treatment, scaling of the cervical lymphadenopathy and periungual area stopped. Echocardiography was performed for him three times: at the time of diagnosis, four weeks, and 6 months later and revealed normal coronary arteries. We report this sign, desquamation on the site of cervical lymphadenopathy, as a new finding.

  10. Penoscrotal edema and purpura in a 12-year-old boy: a case report and review of causes.

    Science.gov (United States)

    Dudley, Anne G; Fox, Janelle A; Reyes-Múgica, Miguel; Cannon, Glenn

    2012-10-01

    We report the case of a 12-year-old patient with previously diagnosed Crohn disease who presented with penile edema and purpura, with extension into the scrotum. Subsequent work-up including biopsy led to the diagnosis of extraintestinal Crohn disease, a rare manifestation in the genital region. Prompt treatment with steroids led to complete resolution of both penoscrotal edema and purpura. We describe our case, followed by a discussion of etiologies of penoscrotal edema and purpura as a review for the practicing pediatric urologist. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  11. Oculocutaneous albinism and the oral manifestation in a 14-year-old boy - A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Deepak Sharma

    2017-01-01

    Full Text Available Albinism consists of a group of genetically inherited autosomal recessive conditions which are typically characterized by a congenital reduction or absence in melanin pigment biosynthesis which gives the natural color in the skin, iris of the eyes, and hair. A person with albinism may have one or many of the following symptoms: absence of color in the hair, skin, or iris of the eye, lighter than normal skin and hair, patchy, missing skin color, crossed eyes (strabismus, light sensitivity (photophobia, rapid eye movements (nystagmus, vision problems, or functional blindness, severe gingivitis, oral mucosal ulceration, and periodontal disease. A dentist can play a significant role in successfully treating albino patients if he/she has basic knowledge of the symptoms of albinism. We present a case report of a 14-year-old child suffering from oculocutaneous albinism who was reported to the Department of Periodontology, Himachal Pradesh Government Dental College and Hospital, Shimla, Himachal Pradesh, with a chief complaint of bleeding gums and oral malodor.

  12. Autoimmune pancreatitis in an 11-year-old boy

    International Nuclear Information System (INIS)

    Refaat, Rania; Harth, Marc; Proschek, Petra; Lindemayr, Sebastian; Vogl, Thomas J.

    2009-01-01

    We report a case of histopathologically proven autoimmune pancreatitis in an 11-year-old boy. Abdominal US and MRI showed a focal swelling of the pancreatic head, the latter also showing delayed contrast enhancement. There was diffuse irregular pancreatic duct narrowing, compression of the intrapancreatic common bile duct, and mild proximal biliary dilatation on MR cholangiopancreatography. Laboratory results revealed normal serum IgG and subclass 4 with negative autoimmune antibodies, and slightly elevated carbohydrate antigen 19-9. This highlights the differentiation of autoimmune pancreatitis from pancreatic head cancer and, to a lesser extent, other forms of pancreatitis in children. (orig.)

  13. Autoimmune pancreatitis in an 11-year-old boy

    Energy Technology Data Exchange (ETDEWEB)

    Refaat, Rania [Johann-Wolfgang-Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Ain Shams University, Department of Diagnostic and Interventional Radiology, Cairo (Egypt); Harth, Marc; Proschek, Petra; Lindemayr, Sebastian; Vogl, Thomas J. [Johann-Wolfgang-Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt am Main (Germany)

    2009-04-15

    We report a case of histopathologically proven autoimmune pancreatitis in an 11-year-old boy. Abdominal US and MRI showed a focal swelling of the pancreatic head, the latter also showing delayed contrast enhancement. There was diffuse irregular pancreatic duct narrowing, compression of the intrapancreatic common bile duct, and mild proximal biliary dilatation on MR cholangiopancreatography. Laboratory results revealed normal serum IgG and subclass 4 with negative autoimmune antibodies, and slightly elevated carbohydrate antigen 19-9. This highlights the differentiation of autoimmune pancreatitis from pancreatic head cancer and, to a lesser extent, other forms of pancreatitis in children. (orig.)

  14. Infantile-onset Alexander disease: a genetically proven case with mild clinical course in a 6-year-old Indian boy

    NARCIS (Netherlands)

    Ramesh, Konanki; Sharma, Suvasini; Kumar, Atin; Salomons, Gajja S.; van der Knaap, Marjo S.; Gulati, Sheffali

    2013-01-01

    Alexander disease is an autosomal dominant leukoencephalopathy characterized by developmental delay, macrocephaly, and characteristic neuroimaging abnormalities predominantly involving frontal lobes. We report a 6-year-old Indian boy with infantile-onset Alexander disease, who has an unusually mild

  15. A 6-year-old boy with Cornelia de Lange syndrome and Coats disease: case report and review of the literature.

    Science.gov (United States)

    Stacey, Andrew W; Sparagna, Cristina; Borri, Melissa; Rizzo, Stanislao; Hadjistilianou, Theodora

    2015-10-01

    Cornelia de Lange syndrome (CdLS) can result in multiple congenital abnormalities and numerous ocular findings. We report the case of a 6-year-old boy with history of CdLS who presented with Coats disease. The findings in this case are compared to those found in the two previously reported cases of concomitant CdLS and Coats disease. The low incidence of these two disorders makes it highly unlikely that the connection is random in these 3 cases. The number of patients with both Cornelia de Lange syndrome and Coats disease is likely underestimated due to the difficulty in examining the peripheral retina in this patient population. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  16. Omental infarction in an obese 10-year-old boy

    Directory of Open Access Journals (Sweden)

    Katerina Kambouri

    2011-09-01

    Full Text Available Primary omental infarction (POI has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intraoperative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.

  17. Septic Bursitis in an 8-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Panagiotis Kratimenos

    2014-01-01

    Full Text Available Background. The prepatellar bursa can become inflamed owing to repeated trauma. Prepatellar bursitis is extremely rare in children. Methods. We report the case of an 8-year-old boy who was treated for an erythematous, swollen, and severely painful right knee, fever, inability to bear weight on the leg, and purulent material draining from a puncture wound. We describe the differential diagnosis for tender swollen knee, including infection, gout, rheumatoid arthritis, and osteoarthritis. If untreated, prepatellar bursitis can progress to patellar osteomyelitis. Results. Wound cultures grew Streptococcus pyogenes, with the infection resolving with amoxicillin. Conclusions. A high index of suspicion is necessary in children presenting with prepatellar bursitis to prevent potentially devastating sequelae of infection of the septic joint.

  18. Histiocytosis in a 7 year old boy, a diagnostic dilemma ...

    African Journals Online (AJOL)

    by the infiltration/accumulation of histiocytic cells in affected tissues. Their mode of clinical presentation varies greatly and can represent a diagnostic challenge in our environment where there is a paucity of diagnostic facilities. This report is on a 7 year old boy with probable Histiocytosis who initially presented with signs ...

  19. Brachial Plexus Injury in a 6-Year-Old Boy with 100% Displaced Proximal Humeral Metaphyseal Fracture: A Case Presentation.

    Science.gov (United States)

    Jovanovich, Elizabeth Nora; Howard, James F

    2017-12-01

    Posttraumatic brachial plexopathies can occur following displaced proximal humeral fractures, causing profound functional deficits. Described here is an unusual case of a displaced proximal humeral metaphyseal fracture in a young child. The patient underwent closed reduction and serial casting, but hand weakness and forearm sensory loss persisted. Needle electromyography localized the injury to the mid/proximal arm near the fracture site, resulting in damage to the posterior and medial cords of the brachial plexus with profound involvement of the radial, ulnar, and median nerves and sparing of the axillary nerve. After months of occupational therapy, hand strength improved, with a nearly full return of function. V. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  20. Synergistic defects of novo FAS and homozygous UNC13D leading to autoimmune lymphoproliferative syndrome-like disease: A 10-year-old Chinese boy case report.

    Science.gov (United States)

    Gu, Hao; Ma, Jie; Chen, Zhenping; Wang, Jing; Zhang, Rui; Wu, Runhui

    2018-06-01

    Autoimmune lymphoproliferative syndrome (ALPS) usually presents in childhood with fever, nonmalignant splenomegaly and lymphadenopathy along with hemocytopenia. This case report describes a 10-year-old boy presenting with signs of autoimmune disease, splenomegaly, hepatomegaly and resistant hemocytopenia. Sirolimus controlled the relapsed thrombocytopenia after splenectomy. Sequencing of the FAS gene identified two spontaneous heterozygous mutations (c.234 T > G, p.D78E) (c.236dupA, p.P80Tfs*26). The boy's homozygous missense variation (c.2588G > A, p.G863D) (rs140184929) in UNC13D gene had been identified as being related to familial hemophagocytic lymphohistiocytosis (FHL). TCRαβ + CD4/CD8 double-negative T cells (markers of ALPS) were not significantly increased from the outset. Elevated cytokines, such as interferon (IFN)-γ, interleukin (IL)-6 and tumor necrosis factor α decreased to normal levels after splenectomy whereas IL-10 remained high. Immunological analysis of the patient revealed a marked depletion of forkhead-box P3 + expressing regulatory T cells (Treg) and Th17 cells. The obtained data demonstrate that mutations to FAS and UNC13D which result in overwhelming T-cell and macrophage activation, one associated with inhibited Treg cell development and a severe ALPS-like symptom. Therefore, we propose that variations of UND13D may be a risk factor of ALPS development. Copyright © 2017. Published by Elsevier B.V.

  1. Allergic bronchopulmonary aspergillosis with aspergillus sinusitis-′9′ year old boy

    Directory of Open Access Journals (Sweden)

    Das Pratima

    2008-01-01

    Full Text Available A case of Broncho Pulmonary Aspergillosis with Aspergillus Sinusitis was diagnosed in a nine year old boy after clinical and immunological investigations. He responded well after treatment with steroid and itraconazol.

  2. Three-year-old boy presenting in thyrotoxicosis.

    Science.gov (United States)

    Glick, J E; Wright, P E

    1998-02-01

    Thyrotoxicosis secondary to Graves' disease developed in a 3-year-old black boy with no previous history of thyroid disease. Thyrotoxicosis is a rare disorder of childhood that is characterized by an accelerated metabolism of body tissues which results from the stimulation of thyroid gland activity induced through a variety of autoantibodies. Historically, less than 5% of all incidents of Graves' disease occur in childhood, and recent studies show an incidence as low as 0.000001%. It is three to eight times more prevalent in females than in males and increases in incidence throughout childhood and adolescence. More than two thirds of childhood cases occur between the ages of 10 and 15 years. A review of the medical literature illustrates that less than 2% of hyperthyroid children in recorded cases are younger than 4 years. Records from Children's Hospital of Oklahoma in Oklahoma City support the unusual nature of this case, the hospital having seen only three children younger than 4 years requiring thyroid ablation therapy in 17 years. Physicians should consider Graves' disease in any child with clinical manifestations of hyperthyroidism, regardless of the age.

  3. An 8-Year-Old Boy With Treatment-Resistant Encopresis

    NARCIS (Netherlands)

    Stein, Martin T.; Benninga, Marc A.; Felt, Barbara T.

    2010-01-01

    CASE: Paul is an 8-year-old boy with a long-standing history of encopresis and enuresis. Potty training was initiated when he was 21/2 years old. At this time, his mother was absent from the home for 6 weeks when she cared for her ill father in a different city. The process of teaching Paul to use

  4. Pulmonary histoplasmosis presenting as chronic productive cough, fever, and massive unilateral consolidation in a 15-year-old immune-competent boy: a case report

    Directory of Open Access Journals (Sweden)

    Mshana Stephen E

    2011-08-01

    Full Text Available Abstract Introduction Severe histoplasmosis is known to be among the AIDS-defining opportunistic infections affecting patients with very low CD4 cell counts in histoplasmosis-endemic areas. Histoplasma capsulatum var. duboisii is common in West and Central Africa, where it occurs in both HIV/AIDS and non-HIV patients. Few cases of life-threatening histoplasmosis in immune-competent individuals have been reported worldwide. Case report We describe a case of pulmonary histoplasmosis diagnosed on the basis of autopsy and histological investigations. A 15-year old East African immune-competent boy with a history of smear-positive tuberculosis and a two-year history of rock cutting presented to our hospital with chronic productive cough, fever, and massive unilateral consolidation. At the time of presentation to our hospital, this patient was empirically treated for recurrent tuberculosis without success, and he died on the seventh day after admission. The autopsy revealed a huge granulomatous lesion with caseation, but no acid-fast bacilli were detected on several Ziehl-Neelsen stains. However, periodic acid-Schiff staining was positive, and the histological examination revealed features suggestive of Histoplasma yeast cells. Conclusion Severe pulmonary histoplasmosis should be considered in evaluating immune-competent patients with risk factors for the disease who present with pulmonary symptoms mimicking tuberculosis.

  5. Therapeutic options to prevent recurrence of an aggressive aneurysmatic bone cyst of the cervical spine of a 16 year old boy - a case report

    Directory of Open Access Journals (Sweden)

    Wojan Magdalena

    2011-08-01

    Full Text Available Abstract The aneurysmatic bone cyst (ABC is a benign primary bone tumour. If located in the cervical spine, its expansive growth and destructive behaviour may lead to instability and serious neurological impairment. We report a case of a 16-year-old boy with an aggressive ABC in the 7th cervical vertebra. Computertomographic and magnetic resonance imaging revealed the envelopment of the left 7th and 8th spinal nerve along with the anterior displacement of the left vertebral artery. The interdisciplinary surgical strategy consisted of a partially incomplete cyst resection, subtotal spondylectomy with posterior screw-and-rod fixation from C6-Th1, iliac crest bone grafting and anterior plating from C6-Th1. With regard to the high rate of recurrence after incomplete resection published in the recent literature, the patient was postoperatively treated by megavoltage radiotherapy with a total dose of 30Gy (daily dose of 1.8 Gy for 3 weeks. The clinical and radiographic follow-up showed complete recovery of all neurologic impairments and no signs of tumour recurrence at 3, 6 and 12 months after surgery. This case highlights diverse treatment regimens and shall outline the challenge and the problems of the interdisciplinary decision-making in adolescents presenting with ABC in high-demanding anatomical regions.

  6. Popliteal artery injury following traumatic knee joint dislocation in a 14-year-old boy: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Cvetković Slobodan

    2014-01-01

    Full Text Available Introduction. Posterior knee joint dislocation associated with injury of the popliteal artery in children is an extremely rare condition. Rapid diagnosis and treatment are essential for limb salvage and function. Case report. We reported a 14-year-old boy who suffered traumatic displacement of the right knee and contusion of the popliteal artery during motorcycle accident. The diagnosis was confirmed using Doppler and duplex ultrasonography and digital substraction transfemoral arteriography. The urgent surgical procedure was performed using posterior approach to the popliteal artery. During the surgical exploration, rupture of the posterior cruciate ligament associated with thrombosed popliteal artery have been found. The damaged popliteal artery was resected and replaced with autologous saphenous vein graft. The last stage of the procedure was a transosseous femoral fixation of posterior circuate ligament. A 3-year-follow-up after the surgery demonstrated intact arterial perfusion and very good function of the knee with a minimal difference as compared with the contralateral knee. Conclusion. Combined orthopedic and vascular injuries are very rare in children. They require combined treatment. [Projekat Ministarstva nauke Republike Srbije, br. 175008

  7. Enucleation of a large true cyst in the head of pancreas instead of Whipple procedure in an 8-year old boy: a case report

    Directory of Open Access Journals (Sweden)

    Ostadian N

    2011-02-01

    Full Text Available "nBackground: Simple cysts of pancreas are smaller than complex ones and are more likely to be located at the distal tail of the pancreas. Simple cysts are often asymptomatic and can be managed conservatively by observation. There seems to be few clinical trials to suggest the best treatments method for large symptomatic cysts of pancreas located at the head of the organ."n "nCase presentation: In this report, we describe an eight-year old boy with a large symptomatic true cyst at the head of the pancreas who was successfully treated by enucleation of the cyst, instead of the Whipple's procedure, without any ensuing complications."n "nConclusion: Regarding the rarity of simple cysts in the pancreas, lack of studies to compare different surgical procedures and suggest the best methods to treat them and the considerable morbidity and even mortality of major surgeries (e.g Whipple's procedure enucleation of these cysts seem to be appropriate for treating them with no early or late complications. More studies are needed to warrant the results of this report.

  8. Eosinophilic cystitis in a 3-year-old boy

    International Nuclear Information System (INIS)

    Breysem, L.; Smet, M.H.; Gordts, H.; Marchal, G.

    1991-01-01

    Eosinophilic cystitis is a rare in children; it also affects adults. Clinical manifestations are variable. The diagnosis can be confirmed by cystoscopy and biopsy, both rather invasive procedures, especially in younger patients. We report a 3-year-old boy with eosinophilic cystitis. The most important radiological finding was marked thickening of the bladder wall, documented on ultrasound, cystography and CT. The CT findings of eosinophilic cystitis have, to the best of our knowledge, not been reported before. In addition to ultrasound and cystography, CT clearly demonstrates extension of the inflammatory process into the perivesical tissues. (orig.)

  9. Pulmonary manifestation of immunoglobulin G4-related disease in a 7-year-old immunodeficient boy with Epstein-Barr virus infection: a case report.

    Science.gov (United States)

    Szczawinska-Poplonyk, Aleksandra; Wojsyk-Banaszak, Irena; Jonczyk-Potoczna, Katarzyna; Breborowicz, Anna

    2016-06-08

    Immunoglobulin G4-related disease (IgG4-RD) is a multiorgan fibroinflammatory condition with lymphoplasmacytic infiltrates containing abundant IgG4-positive plasma cells. The immunopathogenesis of the disease and the potential role of triggering autoantigens or infectious factors have not been clearly defined. Immunoglobulin G4-related lung disease is a new and emerging condition in pediatric patients and to date, there have been only two reports regarding pulmonary manifestation of IgG4-RD in children recently published. This is the first report of IgG4-related lung disease in an immunodeficient child with Epstein-Barr virus infection. We report on the case of a 7-year old atopic boy who was hospitalized with an initial clinical and radiological diagnosis of pneumonia, positive Epstein-Barr virus (EBV)-DNA in the blood and defective adaptive immunity. The lung CT showed a consolidated mass lesion adjacent to the posterior wall of the chest and the diaphragm. The child underwent surgical resection of the tumor, and the histologic examination of the lung specimens revealed lymphoplasmacytic infiltrates with fibrosis and vasculitis correlating with IgG4-related lung disease. Subsequent monitoring of the patient with lung CT, pulmonary function tests and IgG4 levels did not show signs of active disease. The diagnosis of IgG4-related lung disease in children is challenging because of its rarity, nonspecific symptomatology and heterogeneous morphological manifestations. Further studies are required in children with pulmonary presentation of IgG4-RD to better understand pathogenesis of this condition, possible immunological or infectious triggering factors, and finally, to determine pediatric patient-targeted therapeutic interventions.

  10. Traumatic Floating 1st Metacarpal in a 14-Year-Old Boy Managed by Close Reduction and Thumb Spica Immobilization: A Rare Case Report.

    Science.gov (United States)

    Tyagi, Himanshu Ravindra; Kamat, Nandan; Wajekar, Sagar; Mandalia, Saumil H

    2014-01-01

    Double dislocation of thumb metacarpal (MC) is a rare injury which may be secondarily complicated by growth plate injury in children. The management of floating 1st MC is also controversial since the treatment ranges from simple reduction to complex reconstruction surgeries. It is also important to understand the long-term results of different management strategies (close reduction, K-wire fixation, ligament reconstruction) as any residual stiffness or instability of thumb may result in severe disability of the hand. A 14-year-old boy with an alleged history of injury to the thumb due to a fall. The postulated mechanism of injury was forced hyperextension of thumb and axial loading of hand in the prone position. On examination, there was prominent bony swelling over the dorsal aspect of carpometacarpal (CMC) and metacarpophalangeal (MCP) joints which was very tender with diffuse swelling over entire thumb. X-ray showed dorsal dislocation of both MCP and CMC joints, without any fracture (bony avulsion) or volar plate avulsion. Treatment was by way of closed reduction performed by axial traction followed by forced flexion at MCP joint with continuous pressure over the dorsal aspect of the joint. The reduction of CMC joint was done by direct pressure over the dorsal aspect and full abduction of thumb. Following reduction, the thumb was immobilized in a thumb spica. Thus, we conclude it is possible to manage a case of floating 1st MC by closed reduction and immobilization, using proper reduction technique. However, a careful clinical and radiological assessment should be done beforehand for signs of bony injury or ligamentous instability.

  11. Odontogenic myxoma involving the orbit in a 3-year-old boy

    DEFF Research Database (Denmark)

    Schjals Hansen, Teis; Danielsson, Lina Isabella; Fast, Søren

    2016-01-01

    We present a rare case of a 3-year-old boy with an odontogenic myxoma (OM) involving the orbita. Including our case, only nine cases of OM have been reported to involve the eye in children.There is no gold standard for treatment of OM in children with orbital involvement. The recurrence rate of OM...

  12. First case report of staghorn calculi successfully removed by mini-endoscopic combined intrarenal surgery in a 2-year-old boy.

    Science.gov (United States)

    Taguchi, Kazumi; Hamamoto, Shuzo; Okada, Atsushi; Mizuno, Kentaro; Tozawa, Keiichi; Hayashi, Yutaro; Kohri, Kenjiro; Yasui, Takahiro

    2015-10-01

    Less-invasive therapy for pediatric urolithiasis is available due to the miniaturization of equipment and improved optics; however, surgical treatment strategies, especially for large calculi, remain controversial. We describe here our experience of treating a 2-year-old boy with left renal staghorn calculi with a single session of mini-endoscopic combined intrarenal surgery in the prone split-leg position with pre-ureteral stenting and the directional enhanced flow imaging ultrasound technique. This is the first report of successful pediatric mini-endoscopic combined intrarenal surgery without any major complications. We believe this technique provides an important therapeutic option for large renal calculus in pediatric patients. © 2015 The Japanese Urological Association.

  13. Nipple adenoma in a 2-year-old boy.

    Science.gov (United States)

    Fujisawa, Kou; Kato, Motoi; Kono, Tatsuki; Utsunomiya, Hiroki; Watanabe, Azusa; Watanabe, Shoji

    2018-05-01

    Nipple adenoma is an uncommon proliferative process of the breast and predominantly occurs in women aged 40-50. Its incidence is extremely low in men, and it has not been reported in a boy. Although nipple adenoma is rare and benign, being familiar with it is important because it clinically resembles Paget disease and histologically adenocarcinoma. We report a case of nipple adenoma in a boy. © 2018 Wiley Periodicals, Inc.

  14. [In-patient psychoanalytical psychotherapy of a 12 year old boy with secondary encopresis].

    Science.gov (United States)

    Pressel, Christine

    2007-01-01

    Case report on the in-patient psychoanalytical psychotherapy of a 12 year old boy, who developed a nonorganic encopresis at the age of nine after his mother died. One focal issue is his denial of this loss and the beginning of a process of mourning due to the treatment. The Operationalized Psychodynamic Diagnostics (OPD) for Children and Adolescents are illustrated for this case.

  15. Reiter's disease in a 8-year-old boy

    Directory of Open Access Journals (Sweden)

    Rohit Kapoor

    2018-01-01

    Full Text Available An 8-year-old male child presented with complaints of pain abdomen and appearance of rashes all over the body, with pain and swelling of the left knee joint. The child was a known case of developmental delay with seizure disorder, and the rashes had appeared just after starting oral valproate. On examination, the child appeared well except for the rashes and local swelling with decreased range of motion in the left knee joint. Redness around the urethral meatus was also noted. Skin biopsy revealed features suggestive of reactive arthritis. The child responded well to nonsteroidal anti-inflammatory drugs.

  16. Hepatocellular carcinoma bone metastasis in an 11-year-old boy

    Energy Technology Data Exchange (ETDEWEB)

    Lucarini, Silvia [Schulich School of Medicine and Dentistry, University of Western Ontario, Department of Diagnostic Radiology and Nuclear Medicine, London, ON (Canada); Fortier, Marielle [Children' s Hospital of Western Ontario, Department of Radiology, London, ON (Canada); Leaker, Michael [Children' s Hospital of Western Ontario, Department of Oncology, London, ON (Canada); Chhem, Rethy [Schulich School of Medicine and Dentistry, University of Western Ontario, Department of Diagnostic Radiology and Nuclear Medicine, London, ON (Canada); London Health Sciences Centre, University Hospital of Windermere, Department of Radiology, London, ON (Canada)

    2008-01-15

    Hepatocellular carcinoma (HCC) is the second most common primary hepatic malignant tumor in children older than 4 years. We describe a rare case of an 11-year-old boy with HCC who presented with HCC of the right liver lobe followed by multiple osseous metastases, confirmed by imaging and biopsy. (orig.)

  17. A foreign body within the foreskin of a 10-year-old boy | Essa ...

    African Journals Online (AJOL)

    We present a case in which a small action figure was inserted in the foreskin of a child. A 10-year-old boy presented with a swollen red penis and a foreign body that he had inserted in the foreskin 3 h earlier. He had made several unsuccessful attempts to remove it. The foreign body was removed under general anesthesia.

  18. A 6 year-old boy was referred from a district hospital with congestive ...

    African Journals Online (AJOL)

    Presentantion of the case. A 6 year-old boy was referred from a district hospital with congestive cardiac failure. His mother reported that he had become progressively short of breath over the previous two months and in the last month he had developed swelling of his feet and abdomen. He had orthopnoea and a marked ...

  19. Posterior urethral valve in a six year old boy with nocturnal ...

    African Journals Online (AJOL)

    We report a case of posterior urethral valve (PUV) in a six year old boy with nocturnal eneuresis and failure to thrive as the only presenting symptoms. The clinically occult lesion was only unravelled when micturating cystourethrogram revealed a dilated posterior urethra with a distal narrow stream of opacified urine, bilateral ...

  20. Subarachnoid Hemorrhage in a Three-year-old-boy with Left Middle ...

    African Journals Online (AJOL)

    We report a case of three-year-old boy, who presented with a history of sudden onset of headache and vomiting. Neurologically he was conscious, oriented, and with no neurological deficits (Hunt and Hess grade-2) at the time of admission. Computed Tomography (CT) scan of the brain revealed intracerebral hemorrhage [ ...

  1. Efavirenz poisoning in a 12 year old HIV negative African boy ...

    African Journals Online (AJOL)

    Efavirenz is an oral antiretroviral drug in the class of non nucleoside reverse transcriptase inhibitors. Toxicity at therapeutic doses has been documented but there is scarcity of data on presentation and management of Efavirenz overdose. We describe a case of Efavirenz poisoning in a 12-year old HIV Negative African boy ...

  2. Pulmonary Aspergillosis in a Previously Healthy 13-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Jonathan H. Rayment

    2016-01-01

    Full Text Available Chronic granulomatous disease (CGD is a rare, polygenic primary immunodeficiency. In this case report, we describe a previously healthy 13-year-old boy who presented with multifocal pulmonary aspergillosis and was subsequently diagnosed with an autosomal recessive form of chronic granulomatous disease. CGD has a variable natural history and age of presentation and should be considered when investigating a patient with recurrent or severe infections with catalase-positive organisms.

  3. Fluvoxamine-induced intracranial hypertension in a 10-year-old boy.

    Science.gov (United States)

    Samant, Hemalini; Samant, Preetam

    2018-05-01

    Drug-induced intracranial hypertension is a well-established entity. We report a rare case of intracranial hypertension with papilledema in a 10-year-old boy following use of fluvoxamine, a selective serotonin reuptake inhibitor. On discontinuing the drug, the papilledema resolved over 4 months without any residual visual anomalies. To the best of our knowledge, this is the first report of fluvoxamine-induced intracranial hypertension with papilledema.

  4. Fluvoxamine-induced intracranial hypertension in a 10-year-old boy

    Directory of Open Access Journals (Sweden)

    Hemalini Samant

    2018-01-01

    Full Text Available Drug-induced intracranial hypertension is a well-established entity. We report a rare case of intracranial hypertension with papilledema in a 10-year-old boy following use of fluvoxamine, a selective serotonin reuptake inhibitor. On discontinuing the drug, the papilledema resolved over 4 months without any residual visual anomalies. To the best of our knowledge, this is the first report of fluvoxamine-induced intracranial hypertension with papilledema.

  5. Mesenchymal hamartoma of the liver demonstrating peripheral calcification in a 12-year-old boy

    International Nuclear Information System (INIS)

    Steiner, Michael A.; Giles, Henry W.

    2008-01-01

    Mesenchymal hamartoma of the liver is a rare benign hepatic tumor that typically presents in the first 2 years of life. Approximately 85% of affected children present before the age of 3 years and less than 5% present after the age of 5 years. Although spontaneous regression has been reported in this benign tumor, most mesenchymal hamartomas gradually increase in size and can reach enormous proportions. We present an atypical case of mesenchymal hamartoma in a 12-year-old boy. The boy's age and presence of calcifications on CT demonstrate a unique presentation of this rare entity. (orig.)

  6. Motor Competence in 11-Year-Old Boys and Girls

    Science.gov (United States)

    Vedul-Kjelsås, Vigdis; Stensdotter, Ann-Katrin; Sigmundsson, Hermundur

    2013-01-01

    By using the Movement Assessment Battery (MABC), the present study investigated possible gender differences in several tasks of motor competence in children. The sample included 67 Norwegian sixth-grade children (Girls N?=?29; Boys?=?39). Boys' performance exceeds that of girls in ball skills and in one of the balance skills. No differences were…

  7. Primary pulmonary adenocarcinoma in a 16-year-old boy

    DEFF Research Database (Denmark)

    Måreng, Ane Stillits; Langer, Seppo W; Bodtger, Uffe

    2016-01-01

    -old boy who presented with metastatic primary pulmonary adenocarcinoma (T3N3M1a) and was treated aggressively, including radiation therapy for local and distant recurrence. He had complete remission, had completed his education, was employed full-time, and suffered only from mild side effects to treatment....

  8. Mask face: bilateral simultaneous facial palsy in an 11-year-old boy.

    Science.gov (United States)

    Güngör, Serdal; Güngör Raif, Sabiha; Arslan, Müjgan

    2013-04-01

    Bilateral facial paralysis is an uncommon clinical entity especially in the pediatric age group and occurs frequently as a manifestation of systemic disease. The most important causes are trauma, infectious diseases, neurological diseases, metabolic, neoplastic, autoimmune diseases and idiopathic disease (Bell's palsy). We report a case of an 11-year-old boy presenting with bilateral simultaneous peripheral facial paralysis. All possible infectious causes were excluded and the patient was diagnosed as having Bell's palsy (idiopathic). The most important approach in these cases is to rule out a life-threatening disease. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  9. Negative Impact of Troublesome Peer Interactions and Authoritarian Parenting Style on Academic Performance of a 15 year Old Boy

    OpenAIRE

    Samruddhi Karnik; Neha Sahasrabudhe

    2017-01-01

    Adolescence is a period of great turbulence characterized by cognitive, emotional, social and physical changes. Family environment and role of peers is extremely crucial in the development of an adolescent. Presenting here is a brief case of 15 year old boy who was referred for counseling by his parents for lack of concentration in studies. In the counseling sessions with the boy and his parents it was found that the boy was psychologically disturbed as he was teased at school by ...

  10. Giant aneurysm in 6 years old child - case report

    International Nuclear Information System (INIS)

    Sirakov, S.; Penkov, M.; Todorov, Y; Minkin, K.

    2014-01-01

    Intracranial saccular aneurysms rare in childhood is. Even among the reported series of childhood aneurysms, it is unusual to find their occurrence in children less than 7 years old. The pathogenesis of these lesions is also a matter of debate and speculations. The peak age of incidence of juvenile cerebral aneurysms appear to be 12 years, occurrence below the age of 7 being rarity. We show a case of 6 years old boy with giant aneurysm. found because of episodes of headache and vomiting. Discussion of pathogenesis for the rare pathology. After discussion of multidisciplinary team, of neuroradiologist and neurosurgeons was decided to be perform endovascular embolization, because of the better outcome for the patient. We performed endovascular treatment of the aneurysm with achieving total embolization. The patient recovery completely, and after 4 days went home. (authors) Key words: GIANT ANEURYSM. SACCULAR ANEURYSM. EMBOLIZATION. STENT ASSISTED COILING

  11. Jejunal intussusception in a 10-year-old boy with blue rubber bleb nevus syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Beluffi, Giampiero [Section of Paediatric Radiology, Department of Radiodiagnosis, IRCCS Policlinico S. Matteo, Piazzale Golgi, 2, 27100, Pavia PV (Italy); Romano, Piero; Matteotti, Chiara; Minniti, Silvio; Ceffa, Franco [Division of Paediatric Surgery, IRCCS Policlinico S. Matteo, Pavia (Italy); Morbini, Patrizia [Department of Pathology, IRCCS Policlinico S. Matteo, Pavia (Italy)

    2004-09-01

    Jejunal intussusception in a Chinese 10-year-old boy affected by the blue rubber bleb nevus syndrome is presented and discussed. The syndrome is rare, sporadically found with possible dominant inheritance, and due to a gene mutation mapped on the short arm of chromosome 9. It presents with distinctive cutaneous and gastrointestinal malformations together with possible other organ involvement. Gastrointestinal malformations tend to bleed and lead to anaemia. Infrequent complications of the gastrointestinal malformations are volvulus, intestinal infarction and intussusception. The age of the patient and the jejunal intussusception precipitated by a vascular malformation containing calcifications (which were also found in different gut segments) make this case remarkable. (orig.)

  12. Jejunal intussusception in a 10-year-old boy with blue rubber bleb nevus syndrome

    International Nuclear Information System (INIS)

    Beluffi, Giampiero; Romano, Piero; Matteotti, Chiara; Minniti, Silvio; Ceffa, Franco; Morbini, Patrizia

    2004-01-01

    Jejunal intussusception in a Chinese 10-year-old boy affected by the blue rubber bleb nevus syndrome is presented and discussed. The syndrome is rare, sporadically found with possible dominant inheritance, and due to a gene mutation mapped on the short arm of chromosome 9. It presents with distinctive cutaneous and gastrointestinal malformations together with possible other organ involvement. Gastrointestinal malformations tend to bleed and lead to anaemia. Infrequent complications of the gastrointestinal malformations are volvulus, intestinal infarction and intussusception. The age of the patient and the jejunal intussusception precipitated by a vascular malformation containing calcifications (which were also found in different gut segments) make this case remarkable. (orig.)

  13. [Relapse of bleeding ulcer in a 15 year-old boy with collagenous gastritis].

    Science.gov (United States)

    Haase, Anne-Mette; Kelsen, Jens

    2012-06-18

    Collagenous gastritis (CG) is a rare disorder. Two patient groups are known: 1) Children and young adults, presenting with anaemia and abdominal pain, and 2) adults presenting with watery diarrhoea. In the latter group, CG is frequently associated with collagenous colitis and/or coeliac disease. This case concerns a 15-year-old boy with a bleeding ulcer. The biopsies from corpus ventriculi showed a thickened subepithelial collagen band (> 10 micrometres), and the patient was diagnosed with CG. Ulcers are rarely linked to CG. CG should be considered when ulcers are found in children and young adults.

  14. Mitral valve replacement in a 12 year old boy with Marfan syndrome and severe mitral regurgitation

    Directory of Open Access Journals (Sweden)

    Md. Alauddin

    2017-02-01

    Full Text Available A 12 year old boy with Marfan syndrome associated with severe mitral regurgitation underwent successful mitral valve replacement. Careful evaluation of the cardiovascular system and specific surgical intervention help long-term survival of  patients.

  15. An 8-Year-Old Boy With Treatment-Resistant Encopresis

    NARCIS (Netherlands)

    Stein, Martin T.; Benninga, Marc A.; Felt, Barbara T.

    2017-01-01

    Paul is an 8-year-old boy with a long-standing history of encopresis and enuresis. Potty training was initiated when he was 2 years old. At this time, his mother was absent from the home for 6 weeks when she cared for her ill father in a different city. The process of teaching Paul to use the

  16. Juan: a 9-year-old Latino boy with ADHD.

    Science.gov (United States)

    DuPaul, George J; Pérez, Victor H; Kuo, Alice; Stein, Martin T

    2010-04-01

    Juan, a 9-year-old Latino male, was referred to a community clinic by his third-grade teacher for evaluation of classroom behavior problems. He is an only child and lives with both parents. At home, Juan speaks Spanish with his parents although he occasionally speaks English with his father. His father came to the U.S. from Mexico as a small child and completed the 12 grade in the U.S. Juan's mother completed 8 grade in Mexico and immigrated to the U.S. as a teenager.Juan's mother reported that he has had no significant medical problems. Her report of his behavior included an inability to focus on tasks at hand and easy distractibility. She was concerned that the principal of the school mentioned that Juan may be asked to repeat the 3 grade or change schools. In the clinic, Juan sat quietly but appeared to be daydreaming and attentive to the conversation. The pediatrician called the principal who expressed frustration with Juan's behavior. In class, he was very fidgety, did not pay attention and usually did not answer questions. He also bothered other students when they were working. The principal explained that because Juan's school was a Spanish language immersion school, there were no special education services available. If a student at the school required special education services, he or she would be transferred to another school in the same school district. An evaluation for an Individualized Education Plan (IEP) indicated that Juan had above average cognitive ability (90 percentile), with superior ability to problem solve and process information simultaneously (99 percentile). The Woodcock Johnson III (Spanish version) indicated average achievement in academic skills, with low average in reading fluency, comprehension and spelling. On the Test of Auditory-Perceptual Skills, Juan tested generally low average in all domains, and was at the 14 percentile for both auditory number and auditory word memory. On the Test of Visual-Perceptual Skills, Juan scored

  17. Enthesitis in a 16-Year-Old Boy with M694V Mutation

    Directory of Open Access Journals (Sweden)

    Syert Luidolf Nienhuis

    2016-01-01

    Full Text Available Introduction. FMF (Familial Mediterranean Fever is characterized by recurrent attacks of fever and articular pain. Enthesitis is the hallmark of pain in spondyloarthropathy. Literature suggests association of M694V mutation and enthesitis. We report a case of a 16-year-old boy with enthesitis and FMF. Case Presentation. A 16-year-old boy of Turkish origin with a history of FMF presented with localized tenderness of the heel and severe disability. MRI showed an enthesitis of the plantar fascia. Standard treatment of FMF and enthesitis was not successful. After referral to a university hospital and expert opinion of a professor in rheumatology, this enthesitis should be treated as an enthesitis related arthritis. With this treatment, our patient fully recovered 8 months after the onset of the disease symptoms. Conclusion. M694V mutation related enthesitis should be considered in FMF patients with enthesitis. We would suggest treatment for enthesitis related arthritis in similar cases. This is of clinical importance because the treatment is different from treatment of enthesitis or articular pain caused by FMF.

  18. Aggregatibacter actinomycetemcomitans osteomyelitis in a 12?year old boy: case report emphasizing the importance of tissue culture, and review of literature

    OpenAIRE

    Sharma, Ketaki; Mudgil, Poonam; Whitehall, John S.; Gosbell, Iain

    2017-01-01

    Background Aggregatibacter actinomycetemcomitans most commonly causes periodontitis but has been reported to infect heart valves, soft tissue, brain and lungs, and distal bones. Osteomyelitis distal to the jaw is rarely described. Case presentation We report an unusual and rare case of chronic osteomyelitis caused by A. actinomycetemcomitans in the toe of a paediatric patient, and review the available literature. The infection was managed with intravenous antibiotics followed by oral antibiot...

  19. [Reconstruction of the heel in a two-year-old boy after lawn mower injury].

    Science.gov (United States)

    Kraus, R; Albrecht, J; Schnettler, R; von Pichler, M

    2012-04-01

    Lawn mower injuries in children usually involve the lower extremities and can lead to serious amputation injuries. Treatment should look not only at the acute reconstruction, but also on maintaining the ability to grow. We report the case of a two-year-old boy with amputation of the heel. The boy was run over by a lawn mower. He suffered a complete loss of heel soft tissue, 30 % of the os calcis and the Achilles tendon. The one-stage reconstruction was performed by transplantation of an iliac crest graft, fascia lata to reconstruct the Achilles tendon and a microvascular latissimus dorsi flap. After one year, the functional and cosmetic result is excellent, the bone graft is healed completely and shows growth trends. The successful treatment of such a severe amputation injury requires the interdisciplinary cooperation between paediatric traumatologists, plastic surgeons, physical therapists and orthopaedic shoemaker. The result justifies the great effort. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Habit tic nail deformity - a rare presentation in an 8 year old boy.

    Science.gov (United States)

    El-Heis, S; Abadie, Al

    2016-11-15

    Habit tic nail deformity is a nail dystrophy resulting from habitual, repetitive trauma to the nail. It is usually acquired in adulthood, however, we report a case of habit tic nail deformity in an 8 year old boy. The diagnosis was made clinically with further history revealing that the boy repeatedly rubbed his thumbnails and pushed the cuticles. Emollient cream (Balneum®) was recommended twice daily and both the patient and his mother were educated on the behavioral nature of this condition. There was marked improvement at 6 months of treatment and further improvement at 12 months.We note that habit tic nail deformity is not exclusive to adults. Diagnosis can be made clinically. History and physical examination provide valuable clues and psychosocial links must be explored and addressed. Management is challenging and compliance with treatment is variable. Patient education, barrier methods, and behavioral therapy can be helpful in preventing further trauma to the nails.

  1. A diagnostic dilemma: Left-sided appendicitis in a 10 year old boy with previously undiagnosed intestinal malrotation. A case report

    Directory of Open Access Journals (Sweden)

    Ashvini Shekhar

    2015-01-01

    Conclusion: Left sided acute appendicitis is a diagnostic dilemma, thus often leading to management delays. It is pertinent to remember that malrotation of the gut is more common than previously thought, and not just a disease of infancy. It is advisable to consider imaging studies while balancing the risk-benefit-ratio of radiation exposure, especially in paediatric cases to cinch the diagnosis.

  2. Successful displacement of a traumatic submacular hemorrhage in a 13-year-old boy treated by vitrectomy, subretinal injection of tissue plasminogen activator and intravitreal air tamponade: a case report.

    Science.gov (United States)

    Doi, Shinichiro; Kimura, Shuhei; Morizane, Yuki; Shiode, Yusuke; Hosokawa, Mio; Hirano, Masayuki; Hosogi, Mika; Fujiwara, Atsushi; Miyamoto, Kazuhisa; Shiraga, Fumio

    2015-08-07

    The natural course of submacular hemorrhage resulting from traumatic choroidal rupture generally has a poor outcome unless treated. The intravitreal injection of gas only or gas with recombinant tissue plasminogen activator (rt-PA) has been reported to be effective, but has also been reported to induce severe complications such as retinal detachment and vitreous hemorrhage. Recently, we reported a safe and effective procedure for treating submacular hemorrhage due to polypoidal choroidal vasculopathy (PCV) with a low dose of rt-PA. Here we report the application of this procedure to a case of traumatic submacular hemorrhage in a 13-year-old boy, which achieved a good visual outcome. A 13-year-old Japanese boy presented with a thick submacular hemorrhage in his left eye as a result of blunt trauma from being hit by a sinker. Best-corrected visual acuity (BCVA) was assessed as only able to perceive hand motions. We carried out a vitrectomy, subretinal injection of 4,000 IU rt-PA (6.9 μg) and air tamponade. The day after surgery, most of the submacular hemorrhage had moved to the inferior periphery. One month after the surgery, we observed cataract formation, thin remnants of the submacular hemorrhage and juxtafoveal choroidal rupture. We carried out cataract surgery and injected bevacizumab intravitreally to prevent the development of choroidal neovascularization. Two months after the second surgery, the submacular hemorrhage had totally disappeared and the patient had a BCVA of 20/40. Vitrectomy, subretinal injection of rt-PA, and intravitreal air tamponade may be a promising strategy for treating traumatic submacular hemorrhage in young patients.

  3. Aggregatibacter actinomycetemcomitans osteomyelitis in a 12 year old boy: case report emphasizing the importance of tissue culture, and review of literature.

    Science.gov (United States)

    Sharma, Ketaki; Mudgil, Poonam; Whitehall, John S; Gosbell, Iain

    2017-03-14

    Aggregatibacter actinomycetemcomitans most commonly causes periodontitis but has been reported to infect heart valves, soft tissue, brain and lungs, and distal bones. Osteomyelitis distal to the jaw is rarely described. We report an unusual and rare case of chronic osteomyelitis caused by A. actinomycetemcomitans in the toe of a paediatric patient, and review the available literature. The infection was managed with intravenous antibiotics followed by oral antibiotics. This is an unusual presentation of A. actinomycetemcomitans causing chronic osteomyelitis presumed due to nidation in a minimally damaged bone, associated with bacteraemia of an oral commensal. It occurred in the toe, without obvious dental predisposition; associated with minimal clinical disturbance and with muted immune response.

  4. Disseminated herpes zoster ophthalmicus in an immunocompetent 8-year old boy.

    Science.gov (United States)

    Oladokun, Regina Eziuka; Olomukoro, Chikodili N; Owa, Adewale B

    2013-08-02

    Varicella results from a primary infection with the varicella virus while herpes zoster is caused by a reactivation of a latent infection. Dissemination of herpes zoster is uncommon in immunocompetent individuals. Reports of disseminated herpes zoster in children are even less common than in adults. An unusual case of disseminated herpes zoster ophthalmicus in an 8-year old immunocompetent black boy is presented. He had a previous primary Varicella zoster virus infection at three years of age. In the current report, he presented during an on-going chicken pox outbreak and survived with no significant complications. A breakthrough varicella virus re-infection or a reactivation is possible, both of which could present as zoster. This case emphasizes the need for prevention of varicella virus infection through universal childhood immunization and effective infection control strategies in health care settings.

  5. Disseminated herpes zoster ophthalmicus in an immunocompetent 8-year old boy

    Directory of Open Access Journals (Sweden)

    Regina Eziuka Oladokun

    2013-05-01

    Full Text Available Varicella results from a primary infection with the varicella virus while herpes zoster is caused by a reactivation of a latent infection. Dissemination of herpes zoster is uncommon in immunocompetent individuals. Reports of disseminated herpes zoster in children are even less common than in adults. An unusual case of disseminated herpes zoster ophthalmicus in an 8-year old immunocompetent black boy is presented. He had a previous primary Varicella zoster virus infection at three years of age. In the current report, he presented during an on-going chicken pox outbreak and survived with no significant complications. A breakthrough varicella virus re-infection or a reactivation is possible, both of which could present as zoster. This case emphasizes the need for prevention of varicella virus infection through universal childhood immunization and effective infection control strategies in health care settings.

  6. Relationship Between Somatotype and PHV in Iranian 7-10 Years Old Boys

    OpenAIRE

    Amir Hossein Barati; Ali Pashabadi; Mohamadreza Mahmoudkhani; Majid Nayeri

    2013-01-01

    Introduction: An important variable in investigation of agility during puberty is the age of reaching peak high velocity, which like other agility indicators is under the effect of different factors such as physical condition and type. The purpose of present research was to examine relationship between somatotype and peak high velocity (PHV) among Iranian 7-10 years old boys. Methods: Participants were 313 7-10 year-old members of Basij talent identification centers in all Iran's provinces...

  7. Computed Tomography Findings of a Patient With Severe Dysplasia of the Inner Ear and Recurrent Meningitis: A Case Report of Gusher Ear in a Five-Year Old Boy

    International Nuclear Information System (INIS)

    Alizadeh, Houman; Nasri, Fatemeh; Mehdizadeh, Mehrzad; Jamsa, Shahin

    2014-01-01

    Communication between subarachnoid and perlymphatic spaces can be due to a deficiency of lamina cribrosa (stapes gusher). Recognition of the condition may alter the course of treatment that can avoid perilymph gushing. A five-year-old boy presented with a history of congenital hearing loss and recurrent meningitis. The computed tomography (CT) of the temporal bone showed severe bilateral dysplasia in the inner ears in favor of gusher disease

  8. Missed distal tracheal foreign body in consecutive bronchoscopies in a 6-year-old boy

    Directory of Open Access Journals (Sweden)

    Oghenevware Joel Eyekpegha

    2017-01-01

    Full Text Available It is unusual but not uncommon for foreign bodies to be missed at bronchoscopy. This case report highlights the importance of the clinical history in the diagnosis of aspirated foreign bodies and the usefulness of chest imaging modalities. A 6-year-old boy presented with recurrent breathlessness and cough of 2 months. He was said to have aspirated the base cap of a pen at about the time symptoms started. He had two sessions of rigid bronchoscopy and a session of flexible bronchoscopy at three different hospitals. He had an initial rigid bronchoscopy which failed to show the foreign body (FB. A chest computerized tomographic scan demonstrated the FB, which was retrieved at combined flexible/rigid bronchoscopy. Although rigid bronchoscopy is the gold standard for managing airway foreign bodies, there remains a false negative rate for this procedure and where necessary, appropriate imaging may compliment rigid bronchoscopy, especially where there is some confusion.

  9. Interactive metronome training for a 9-year-old boy with attention and motor coordination difficulties.

    Science.gov (United States)

    Bartscherer, Melinda L; Dole, Robin L

    2005-01-01

    The purpose of this case report is to describe a new intervention, the Interactive Metronome, for improving timing and coordination. A nine-year-old boy, with difficulties in attention and developmental delay of unspecified origin underwent a seven-week training program with the Interactive Metronome. Before, during, and after training timing, accuracy was assessed with testing procedures consistent with the Interactive Metronome training protocol. Before and after training, his gross and fine motor skills were examined with the Bruininiks-Oseretsky Test of Motor Proficiency (BOTMP). The child exhibited marked change in scores on both timing accuracy and several BOTMP subtests. Additionally his mother relayed anecdotal reports of changes in behavior at home. This child's participation in a new intervention for improving timing and coordination was associated with changes in timing accuracy, gross and fine motor abilities, and parent reported behaviors. These findings warrant further study.

  10. Metastatic Parotid Myoepithelial Carcinoma in a 7-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Issam Saliba

    2012-01-01

    Full Text Available Myoepithelial carcinoma is a rare malignancy of the parotid gland that is usually seen in adults. We report the first case in children of myoepithelial carcinoma of the parotid gland with massive invasion of the facial nerve and metastasis to cervical lymph nodes. Due to its rarity, the treatment and the clinical course of this tumor are not well defined yet. We performed a total parotidectomy, a modified neck dissection, and a postoperative radiotherapy in 7-year-old boy. Sparing of the facial nerve was impossible; it was sacrificed and grafted with a sural nerve. Histopathology confirmed the diagnosis of a parotid gland carcinoma and immunohistochemical markers showed that the tumor cells express cytokeratin, epithelial membrane antigen, cytokeratin 7, smooth muscle actin, P63, CEA, and S100. This pattern of immunostaining is consistent with the diagnosis of myoepithelial carcinoma. On the postoperative tenth month he presented with a pulmonary and lumbar vertebra metastasis.

  11. Cerebral candidiasis in a 4-year-old boy after intestinal surgery.

    Science.gov (United States)

    Zhang, Shu-Cheng

    2015-03-01

    Cerebral candidiasis is a devastating disease which contributes to a high mortality. Most of the cerebral candidiasis are never microbiologically or radiologically confirmed. In this case, a 4-year-old boy who developed cerebral candidiasis was successfully rescued and presented. The diagnosis of cerebral candidiasis was established based on both microbiologic and radiologic examinations. The pathogen was revealed to be Candida albicans by cerebrospinal fluid and central venous catheter cultures, and the cerebral involvement was recorded by series head magnetic resonance imaging (MRI) with an appearance of special encephalitis demonstrated. The imaging studies played a critical role throughout the diagnosis and treatment. Familiarity with the imaging findings in the appropriate clinical setting may result in a heightened level of awareness of this infection and, consequently, in earlier diagnosis and treatment. © The Author(s) 2014.

  12. Imaging findings of Copa syndrome in a 12-year-old boy

    Energy Technology Data Exchange (ETDEWEB)

    Noorelahi, Razan; Otero, Hansel J. [George Washington University School of Medicine and Health Services, Department of Diagnostic Imaging and Radiology, Children' s National Health System, Washington, DC (United States); Perez, Geovany [George Washington University School of Medicine and Health Sciences, Pulmonary and Sleep Medicine Division, Washington, DC (United States)

    2018-02-15

    Copa syndrome is a newly described autosomal dominant autoinflammatory disease that presents as pulmonary hemosiderosis and polyarticular arthritis. Twenty-one cases from five families have been reported to date. We present chest computed tomography (CT) and temporomandibular joint magnetic resonance (MR) findings of a 12-year-old boy presenting with dyspnea on exertion, fatigue and clubbing. Additional findings included a restrictive pattern of pulmonary involvement and positive inflammatory markers and autoantibodies. Genetic testing revealed a p.W240R variant of the COPA gene confirming the diagnosis of Copa syndrome. CT of the chest showed a nonspecific interstitial pneumonia pattern distributed mainly in the lower lobes. MR of the temporomandibular joints and follow-up CT three years later are also described. (orig.)

  13. Zidovudine-induced nail pigmentation in a 12-year-old boy

    Science.gov (United States)

    Chawre, Sanjeevani M.; Pore, Shraddha M.; Nandeshwar, Manish B.; Masood, Nausheen M.

    2012-01-01

    Zidovudine is an important component of first-line antiretroviral treatment (ART) regimens used to manage pediatric HIV. Nail pigmentation with zidovudine is a well-documented occurrence in adults, especially dark-skinned individuals. But it has so far not been reported in children. Here, we report a pediatric case of zidovudine-induced nail pigmentation. A 12-year-old boy receiving ART with zidovudine, lamivudine, and nevirapine presented to dermatology OPD with complaint of diffuse bluish-brown discoloration of all fingernails. The pigmentation was noticed by the patient after 3 months of initiating zidovudine-based regimen. It first appeared in thumb nails, gradually involved all fingernails, and increased in intensity over time. Though harmless and reversible, psychological aspects of this noticeable side effect may hamper adherence to therapy and may lead to unnecessary investigations and treatment for misdiagnosis such as cyanosis or melanoma. PMID:23248416

  14. Transaldolase deficiency in a two-year-old boy with cirrhosis

    NARCIS (Netherlands)

    Wamelink, M.M.; Struijs, E.A.; Salomons, G.S.; Fowler, D.; Jakobs, C.A.J.M.; Clayton, P.T.

    2008-01-01

    Transaldolase (TALDO) deficiency is a rare inborn error of the pentose phosphate pathway. We report the clinical presentation and laboratory findings of a new patient with TALDO deficiency. The two-year-old Arabic boy presented with neonatal onset of anemia and thrombocytopenia, tubulopathy, and

  15. Cervical ankylosis following Grisel's syndrome in a 14-year-old boy with infectious mononucleosis

    International Nuclear Information System (INIS)

    Haidar, Salwa; Armstrong, Derek; Drake, James

    2005-01-01

    Non-traumatic atlanto-axial subluxation (Grisel's syndrome) is an uncommon complication of neck space infection or otolaryngologic procedures. It most frequently affects children, although it may occur in adults. We present a 14-year-old boy with Grisel's syndrome as a complication of infectious mononucleosis proceeding to cervical ankylosis. (orig.)

  16. Examining Communicative Behaviors in a 3-Year-Old Boy Who Is Blind.

    Science.gov (United States)

    Perfect, Michelle M.

    2001-01-01

    The communication patterns of a 3-year-old boy who is blind were observed during 35 videotaped classroom sessions to determine if his echolalic responses varied according to school activity and message category. Analysis revealed that, although the child was expressive with adults, he had difficulty communicating with his peers and in producing…

  17. X-Linked Recessive Form of Nephrogenic Diabetes Insipidus in A 7-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Janchevska A.

    2014-12-01

    Full Text Available Nephrogenic diabetes insipidus (NDI is caused by the inability of renal collecting duct cells to respond to arginine vasopressin (AVP/antidiuretic hormone (ADH. We present the case of a 7-year-old boy with a history of excretion of large amounts of dilute urine and polydipsia since infancy. The boy had several vomiting episodes with mild dehydration during the first 3 years of life. There was no evidence of headaches, dizziness or visual problems. He drinks between 2 and 3 L/day and has 24-hour diuresis of 2 liters, now. He has prepubertal appearance with appropriate weight [+0.85 standard deviation score (SDS] and height (+0.15 SDS for his age. His intelligence was also normal. The water deprivation test showed low urine osmolality after 8 hours of dehydration. After desmopressin administration, urine osmolality remained low. Serum osmolality was in the normal range for sex and age before and after desmopressin administration. This indicated a nephrogenic form of diabetes insipidus. Molecular analyses revealed a P286L [p.Pro(CCC286Leu(CTC] mutation in the AVPR2 gene, that was inherited from his mother. This patient is the first case with genetically confirmed X-linked inherited form of NDI in the Republic of Macedonia. Molecular analysis confirmed the clinical diagnosis and enabled genetic advice for this family.

  18. Case study of a 15-year-old boy with McCune-Albright syndrome combined with pituitary gigantism: effect of octreotide-long acting release (LAR) and cabergoline therapy.

    Science.gov (United States)

    Tajima, Toshihiro; Tsubaki, Junko; Ishizu, Katsura; Jo, Wakako; Ishi, Nobuaki; Fujieda, Kenji

    2008-07-01

    The use of octreotide-LAR and cabergoline therapy has shown great promise in adults with acromegaly; however, the experience in pediatric patients has rarely been reported. We described a clinical course of a 15-year-old boy of McCune-Albright syndrome (MAS) with pituitary gigantism. At the age of 8 years, a growth hormone (GH) and prolactin (PRL) producing pituitary adenoma was diagnosed at our hospital. He also had multiple fibrous dysplasia, so that he was diagnosed as having MAS. The tumor was partially resected, and GNAS1 gene mutation (R201C) was identified in affected tissues. We introduced octreotide to suppress GH secretion (100 mug 2/day s.c). During therapy with octreotide, IGF-1 and GH levels could not be suppressed and the patient frequently complained of nausea from octreotide treatment. Therefore, the therapy was changed to monthly injections of octreotide-LAR at the age of 12.3 years and was partially effective. However, as defect of left visual field worsened due to progressive left optic canal stenosis, he underwent second neurological decompression of the left optic nerve at 13.4 years of age. After surgery, in addition to octreotide-LAR, cabergoline (0.25 mg twice a month) was started. This regimen normalized serum levels of GH and IGF-1; however, he showed impaired glucose tolerance and gallstones at 15.7 years of age. Therefore, the dose of octreotide-LAR was reduced to 10 mg and the dose of cabergoline increased. This case demonstrated the difficulty of treating pituitary gigantism due to MAS. The use of octreotide-LAR and cabergoline should be considered even in pediatric patients; however, adverse events due to octreotide-LAR must be carefully examined.

  19. Unusual Onset of Celiac Disease and Addison's Disease in a 12-Year-Old Boy.

    Science.gov (United States)

    Miconi, Francesco; Savarese, Emanuela; Miconi, Giovanni; Cabiati, Gabriele; Rapaccini, Valentina; Principi, Nicola; Esposito, Susanna

    2017-07-29

    Celiac disease (CD) is an autoimmune disorder deriving from an aberrant adaptive immune response against gluten-containing grains in genetically predisposed subjects. In a number of patients, CD is associated with one or more other autoimmune diseases. Primary Addison's disease (AD) and CD may co-exist, although this association is relatively uncommon in children. In addition, it is not precisely defined whether a gluten-free diet influences the course of AD. A case of CD in a 12-year-old boy presenting as acute adrenal insufficiency is described here. A gluten-free diet had a significant therapeutic role in this case, wherein most of the clinical signs and symptoms of AD disappeared in a few days. In addition, the dosage of cortisol acetate, initially administered to treat the AD, was able to be rapidly reduced. This case highlights that CD can be associated with AD in children, and a gluten-free diet seems to positively influence the course of AD.

  20. Recurrent insulinoma in a 10-year-old boy with Down’s syndrome

    Directory of Open Access Journals (Sweden)

    Noman Ahmad

    2017-05-01

    Full Text Available An insulinoma is a rare tumour with an incidence of four cases per million per year in adults. The incidence in children is not established. There is limited literature available in children with insulinoma, and only one case is reported in association with Down’s syndrome in adults. Insulinoma diagnosis is frequently missed in adults as well as in children. The Whipple triad is the most striking feature although it has limited application in young children. Hypoglycaemia with elevated insulin, C-peptide and absent ketones is highly suggestive of hyperinsulinism. We present a case of 10-year-old boy with Down’s syndrome with recurrent insulinoma. He was initially misdiagnosed as having an adrenal insufficiency and developed cushingoid features and obesity secondary to hydrocortisone treatment and excessive sugar intake. The tumour was successfully localised in the head of the pancreas with an MRI and octreotide scan on first presentation. Medical treatment with diazoxide and octreotide could not achieve normal blood glucose levels. The insulinoma was laparoscopically enucleated and pathological examination confirmed a neuroendocrine tumour. Subsequently, he had complete resolution of symptoms. He had a recurrence after 2 years with frequent episodes of hypoglycaemia. The biochemical workup was suggestive of hyperinsulinism. MRI and PET scan confirmed the recurrence at the same site (head of the pancreas. He had an open laparotomy for insulinoma resection. The pathology was consistent with benign insulinoma, and subsequently, he had complete resolution of symptoms.

  1. Acute infratentorial traumatic subdural hematoma associated with a torn tentorium cerebelli in a one-year-old boy

    International Nuclear Information System (INIS)

    Vielvoye, G.J.; Peters, A.C.B.; Dulken, H. van; Rijksuniversiteit Leiden

    1982-01-01

    The case of a 1-year-old boy with an acute infratentorial subdural hematoma is presented. Surgical intervention revealed a bleeding vein at the edge of a right-sided tentorial tear. Traumatic tentorial tearing has been demonstrated previously only in neonates. Although computed tomography is the most effective method for recognition of this lesion, vertebral angiography may be mandatory for more accurate localization. (orig.)

  2. Stevens - Johnson Syndrome Induced by Combination of Lamotrigine and Valproic Acid in a 9-Year-Old Boy

    LENUS (Irish Health Repository)

    Maduemem, K

    2017-06-01

    We describe the case history of a 9-year-old boy who developed Stevens-Johnson syndrome (SJS) following concomitant use of valproic acid and lamotrigine. He presented with rash and fever several weeks after introduction of lamotrigine, having been on valproic acid for seizure disorder. SJS happens to be one of the rare adverse reactions of antiepilepsy drugs (AED). Management is mainly supportive with care escalation when necessary because of the significant morbidity.

  3. [Vomiting as main symptom: unusual presentation of a hyperthyroidism in a 12-year-old boy].

    Science.gov (United States)

    Müller-Michaels, J; Bürk, G; Andler, W

    1997-01-01

    A twelve year old boy presented with a sudden onset of recurrent nausea and vomiting. During the past six weeks he had a weight loss of 13 kg. While he was in the hospital, persistent tachycardia and a slightly elevated blood pressure were noted. The gastroenterologic, cardiologic and neuropediatric examinations were normal. To exclude the differential diagnosis of hyperthyroidism, thyroid hormones were checked. They showed clearly elevated levels of tri-iodothyronine and thyroxine, while thyrotropin was suppressed. The boy did not have a goiter. Under thyrostatic therapy his clinical condition improved quickly. Among our 20 patients with hyperthyroidism he was the only one whose main symptom was severe vomiting.

  4. Atypical rabies encephalitis in a six-year-old boy: clinical, radiological, and laboratory findings

    Directory of Open Access Journals (Sweden)

    Sunil Karande

    2015-07-01

    Full Text Available A 6-year-old boy from India developed an atypical form of rabies following a stray dog bite and as a consequence of not receiving the standard World Health Organization recommended post-exposure prophylaxis for category III wounds. Serial rising rabies virus neutralizing antibody titres in serum and cerebrospinal fluid by rapid fluorescent focus inhibition test helped confirm the diagnosis of rabies. The child has survived for 4 months since the onset of illness, albeit with neurological sequelae.

  5. Transitory spinal cord swelling in a 6-year-old boy with Guillain-Barre syndrome

    International Nuclear Information System (INIS)

    Delhaas, T.; Kamphuis, D.J.; Witkamp, T.D.

    1998-01-01

    A 6-year-old boy developed progressive motor weakness and areflexia. The clinical picture, combined with electrophysiological findings, indicated a diagnosis of Guillain-Barre syndrome (GBS). MRI on admission revealed spinal cord swelling and increased signal intensity within the cord. It is concluded that, since a degree of central nervous system involvement can occasionally be part of the spectrum of GBS, swelling of the spinal cord without contrast enhancement does not exclude a diagnosis of GBS. (orig.)

  6. Laryngeal schwannoma in an 8-year-old boy with inspiratory dyspnea.

    Science.gov (United States)

    Rognone, Elisa; Rossi, Andrea; Conte, Massimo; Nozza, Paolo; Tarantino, Vincenzo; Fibbi, Antonio; Saetti, Roberto; Cutrone, Cesare; Tortori-Donati, Paolo

    2007-10-01

    Schwannomas of the larynx are rare lesions in the pediatric age group. In this article, we report on the neuroimaging features of a schwannoma arising from the left aryepiglottic fold in an 8-year-old boy with a 6-month history of inspiratory dyspnea. Neuroimaging showed a well-defined, avoid mass originating from the left aryepiglottic fold. The lesion was removed endoscopically. Complete removal of laryngeal schwannomas is curative, and adjuvant treatment is not required.

  7. Delirium due to Scopolamine Patch in a 4-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Yang-Guang Lin

    2011-03-01

    Full Text Available The scopolamine patch is usually used to reduce postoperative nausea and vomiting associated with anesthesia and/or surgery. It is also commonly used for the prevention of motion sickness. Transdermal scopolamine patches have been used for decades and there are few reports in the literature of toxic psychosis associated with the product. Most documented cases of acute psychosis following administration of scopolamine or other anticholinergic agents have been from the adult population. Here we present a 4-year-old boy with deteriorated cognitive function and changed mental status acutely. Besides flushing skin and psychotic behaviors including bizarre actions, hallucinations, aggressive behavior, hyperactivity, and incoherent speech were also noticed. Symptoms and signs were resolved after removal of scopolamine patch and conservative management. This case is possibly one of the youngest patients to exhibit such toxic effects. We hope to relay information about common agents with anticholinergic effects to clinical practitioners and remind that drug-induced psychosis should be considered in children with acute changes in behavior.

  8. Negative Impact of Troublesome Peer Interactions and Authoritarian Parenting Style on Academic Performance of a 15 year Old Boy

    Directory of Open Access Journals (Sweden)

    Samruddhi Karnik

    2017-11-01

    Full Text Available Adolescence is a period of great turbulence characterized by cognitive, emotional, social and physical changes. Family environment and role of peers is extremely crucial in the development of an adolescent. Presenting here is a brief case of 15 year old boy who was referred for counseling by his parents for lack of concentration in studies. In the counseling sessions with the boy and his parents it was found that the boy was psychologically disturbed as he was teased at school by his peers. In addition his father had an authoritarian parenting style which was adding to his troubles resulting in low academic scores. The boy’s scores on “The Study Habits Inventory” were lower, indicating poor study habits which includes study concentration. The counsellors used an eclectic approach for the boy and his parents, to develop a healthy family environment, which improved his self-esteem and study habits.

  9. Traumatic ventricular septal defect in a 4-year-old boy after blunt chest injury

    Directory of Open Access Journals (Sweden)

    Yun Mi Kim

    2011-02-01

    Full Text Available Traumatic ventricular septal defect (VSD resulting from blunt chest injury is a very rare event. The mechanisms of traumatic VSD have been of little concern to dateuntil now, but two dominant theories have been described. In one, the rupture occurs due to acute compression of the heart; in the other, it is due to myocardial infarction of the septum. The clinical symptoms and timing of presentation are variable, so appropriate diagnosis can be difficult or delayed. Closure of traumatic VSD has been based on a combination of heart failure symptoms, hemodynamics, and defect size. Here, we present a case of a 4-year-old boy who presented with a traumatic VSD following a car accident. He showed normal cardiac structure at the time of injury, but after 8 days, his repeated echocardiography revealed a VSD. He was successfully treated by surgical closure of the VSD, and has been doing well up to the present. This report suggests that the clinician should pay great close attention to the patients injured by blunt chest trauma, keeping in mind the possibility of cardiac injury.

  10. Mimics of Duplication Cysts: Intraperitoneal Nodules in a 14-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Sara E. Ohanessian

    2015-01-01

    Full Text Available Hemangiomas are the most common primary hepatic tumors, but there are few reports of their occurrence elsewhere in the abdomen. The concurrent existence of multiple fibrous nodules of the omentum, mesentery, and porta hepatis, along with a gastric hemangioma, in a child raises the question of syndromic association. Our search of the English literature revealed only rare mentions of hemangiomas involving the stomach and mesentery or omentum. These lesions have attracted clinical attention by symptoms of obstruction, gastrointestinal bleeding, intussusception, infection, perforation, or vague abdominal pain. Although some tumors exist unnoticed for many decades and are identified only incidentally, others present emergently and require immediate surgical attention. We report the case of a 14-year-old boy who presented with symptoms similar to those for appendicitis or duplication cyst, who was found to have a torsed gastric hemangioma and multiple benign fibrous nodules in the abdomen. The presence of multiple vascular or fibrous lesions is associated with genetic syndromes that can have lifelong and reproductive repercussions; so it is imperative that these tumors be recognized by diagnosticians.

  11. Antimetropia in a 10-year-old boy with unilateral tilted disc syndrome

    Directory of Open Access Journals (Sweden)

    Makino S

    2014-05-01

    Full Text Available Shinji MakinoDepartment of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi, JapanAbstract: Antimetropia is a condition in which one eye is myopic, while the fellow eye is hyperopic. This report describes a case of antimetropia associated with unilateral tilted disc syndrome. A 10-year-old boy presented with the complaint of diminished vision for distant objects in his right eye for several months. His uncorrected distance visual acuity was 0.15 in the right eye and 1.0 in the left eye. Best corrected visual acuity was 1.0, with -6.00 D/-2.00 D 170° in the right eye and +1.50 D in the left eye. The cover test revealed right esotropia and hypertropia. Bifoveal fixation was achieved using a 14 prism diopter (PD base at 220° in the right eye. Fundus examination revealed a tilted disc with inferior staphyloma in the right eye, but no abnormal findings were observed in the left eye. In addition, the patient occasionally experienced diplopia under casual viewing conditions. A cycloplegic refraction revealed -6.00 D/-2.00 D 170° in the right eye and +1.50 D/-2.00 D 5° in the left eye. Thus, prism glasses were prescribed. While wearing the prism glasses, the patient has shown no diplopia and maintains good binocular function.Keywords: amblyopia, strabismus, anisometropia, staphyloma

  12. Unexpected course of treatment in a thirteen-year-old boy with unilateral vision disorder

    International Nuclear Information System (INIS)

    Dorobisz, A.T.; Rucinski, A.; Ujma-Czapska, B.; Grotowska, M.; Zaleska-Dorobisz, U.

    2005-01-01

    Monocular vision disorder is a characteristic symptom of brain ischemia of the second to fourth stage of Milikan's scale. Partial occipital epilepsy, where optic symptoms are usually bilateral and convulsion or automatisms appear later, is seldom the cause. In this paper the authors present a special case of a vision disorder in a 13-year-old boy in whom kinking of the internal carotid artery (ICA) was recognized in the first stage of diagnostic examination and treatment as the basic cause of the disorder. Other causes were not affirmed. Surgical angioplasty of the carotid artery was performed with the restoration of proper circulation. Despite the treatment, the symptoms persisted. In the further course of the disease, after repeated diagnostic imaging, childhood epilepsy with occipital spikes was recognized as the cause of the monocular anopsy. All the symptoms disappeared after pharmacological treatment. The surgeon must prove that the neurological symptoms are caused by kinking of the internal carotid artery and that no other etiology exists. (author)

  13. A rare case of complete second arch branchial fistula in a 7-year-old child

    OpenAIRE

    Shankar, Venkateswara Gomathi; Babu, Thirunavukkarasu Arun; Swami, Hartimath Basavanand

    2012-01-01

    Branchial fistulae are formed due to the abnormal persistence of the embryonic branchial clefts. Complete branchial fistula with internal and external opening is extremely rare. We report a rare case of complete second arch branchial fistulae in a 7-year-old boy, which was confirmed by a fistulogram. The tract was completely excised and the patient was successfully treated.

  14. A rare case of complete second arch branchial fistula in a 7-year-old child.

    Science.gov (United States)

    Shankar, Venkateswara Gomathi; Babu, Thirunavukkarasu Arun; Swami, Hartimath Basavanand

    2012-07-01

    Branchial fistulae are formed due to the abnormal persistence of the embryonic branchial clefts. Complete branchial fistula with internal and external opening is extremely rare. We report a rare case of complete second arch branchial fistulae in a 7-year-old boy, which was confirmed by a fistulogram. The tract was completely excised and the patient was successfully treated.

  15. Prophylactic thyroidectomy for asymptomatic 3-year-old boy with positive multiple endocrine neoplasia type 2A mutation (codon 634).

    Science.gov (United States)

    Jesić, Maja D; Tancić-Gajić, Milina; Jesić, Milos M; Zivaljević, Vladan; Sajić, Silvija; Vujović, Svetlana; Damjanović, Svetozar

    2014-01-01

    The multiple endocrine neoplasia type 2A (MEN 2A) syndrome, comprising medullary thyroid carcinoma (MTC), pheochromocytoma and primary hyperparathyroidism (PHPT) is most frequently caused by codon 634 activating mutations of the RET (rearranged during transfection) proto-oncogene on chromosome 10. For this codon-mutation carriers, earlier thyroidectomy (before the age of 5 years) would be advantageous in limiting the potential for the development of MTC as well as parathyroid adenomas. This is a case report of 3-year-old boy from the MEN 2A family (the boy's father and grandmother and paternal aunt) in which cysteine substitutes for phenylalanine at codon 634 in exon 11 of the RET proto-oncogene, who underwent thyroidectomy solely on the basis of genetic information. A boy had no thyromegaly, thyroidal irregularities or lymphadenopathy and no abnormality on the neck ultrasound examination. The pathology finding of thyroid gland was negative for MTC. Two years after total thyroidectomy, 5-year-old boy is healthy with permanent thyroxine replacement. His serum calcitonin level is < 2 pg/ml (normal < 13 pg/ml), has normal serum calcium and parathyroid hormone levels and negative urinary catecholamines. Long-term follow-up of this patient is required to determine whether very early thyroidectomy improves the long-term outcome of PHPT. Children with familial antecedents of MEN 2A should be genetically studied for the purpose of determining the risk of MTC and assessing the possibilities of making prophylactic thyroidectomy before the age of 5 years.

  16. CASE REPORT Thirty years old lady with nephrotic syndrome: a ...

    African Journals Online (AJOL)

    CASE REPORT. Thirty years old lady with nephrotic syndrome: a case of biopsy proven lupus nephritis in Tanzania. FRANCIS FREDRICK1,2*, PASCHAL J. RUGGAJO2,3,GYAVIIRA MAKANGA3, CHARLES K. SHIJA3, MIKAEL. AMDEMARIAM3, BELSON RUGWIZAGONGA4 and JAMES N. KITINYA4. 1Department of ...

  17. Cycling peak power in obese and lean 6- to 8-year-old girls and boys.

    Science.gov (United States)

    Aucouturier, Julien; Lazaar, Nordine; Doré, Eric; Meyer, Martine; Ratel, Sebastien; Duché, Pascale

    2007-06-01

    The purpose of this study was to investigate the possible effect of the difference in percentage body fat (%BF) and fat-free mass (FFM) on cycling peak power (CPP) in 6- to 8-year-old obese and lean untrained girls and boys. Obese (35 girls, 35 boys) and lean (35 girls, 35 boys) children were measured for obesity, %BF, calculated from skinfold measurements. FFM was calculated as body mass (BM) minus body fat. A force-velocity test on a cycle ergometer was used to measure CPP. CPP was related to anthropometric variables using standard and allometric models. CPP in absolute terms was higher in obese children than in lean children irrespective of gender. BM-related CPP was significantly lower in obese children than in lean ones, whereas no effect of obesity appeared on FFM-related CPP. Velocity at CPP (Vopt) was significantly lower and force at CPP (Fopt) was significantly higher in girls than in boys. Muscle power production was unaffected by obesity in children. Low BM-related CPP could explain the difficulty of taking up physical activities that are body-mass related in obese children. Gender difference for Vopt and Fopt shows that girls and boys may have different maturation patterns affecting CPP.

  18. Primary renal undifferentiated sarcoma as an infiltrative mass in a 12 year old boy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Hee; Kim, Myung Joon; Lee, Mi Jung [Dept. of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Se Hwa [Dept. of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-09-15

    Undifferentiated sarcomas are rare tumors not classified into any sarcoma subtype. Due to their rarity, imaging findings of undifferentiated sarcomas are poorly characterized. The purpose of this report was to present imaging findings of a pathologically confirmed undifferentiated sarcoma originated from the left kidney of a 12-year-old boy. The mass was infiltrative involving the renal pelvis. It mimicked massive hilar lymphadenopathy with a preserved renal contour visible by both ultrasonography and CT. Renal vein thrombosis was also observed. Although undifferentiated sarcomas are rare, they should be considered in differential diagnosis of infiltrative renal masses with renal pelvis invasion in children.

  19. Transitory spinal cord swelling in a 6-year-old boy with Guillain-Barre syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Delhaas, T. [Section of Child Neurology, Wilhelmina Children`s Hospital, University Hospital for Children and Youth, Utrecht (Netherlands)]|[Department of Pediatrics, University Hospital Maastricht, P0 Box 5800, 6202 AZ Maastricht (Netherlands); Kamphuis, D.J. [Section of Child Neurology, Wilhelmina Children`s Hospital, University Hospital for Children and Youth, Utrecht (Netherlands); Witkamp, T.D. [Department of Radiology, University Hospital Utrecht, Utrecht (Netherlands)

    1998-07-01

    A 6-year-old boy developed progressive motor weakness and areflexia. The clinical picture, combined with electrophysiological findings, indicated a diagnosis of Guillain-Barre syndrome (GBS). MRI on admission revealed spinal cord swelling and increased signal intensity within the cord. It is concluded that, since a degree of central nervous system involvement can occasionally be part of the spectrum of GBS, swelling of the spinal cord without contrast enhancement does not exclude a diagnosis of GBS. (orig.) With 2 figs., 8 refs.

  20. Primary renal undifferentiated sarcoma as an infiltrative mass in a 12 year old boy

    International Nuclear Information System (INIS)

    Kim, Yong Hee; Kim, Myung Joon; Lee, Mi Jung; Kim, Se Hwa

    2015-01-01

    Undifferentiated sarcomas are rare tumors not classified into any sarcoma subtype. Due to their rarity, imaging findings of undifferentiated sarcomas are poorly characterized. The purpose of this report was to present imaging findings of a pathologically confirmed undifferentiated sarcoma originated from the left kidney of a 12-year-old boy. The mass was infiltrative involving the renal pelvis. It mimicked massive hilar lymphadenopathy with a preserved renal contour visible by both ultrasonography and CT. Renal vein thrombosis was also observed. Although undifferentiated sarcomas are rare, they should be considered in differential diagnosis of infiltrative renal masses with renal pelvis invasion in children

  1. Removal of a barbed fish hook from the cornea of an 8-year-old boy.

    Science.gov (United States)

    Kemp, Pavlina S; Shah, Ankoor S; Elliott, Alexandra T; Wan, Michael J

    2017-10-01

    This video article shows the surgical removal of a three-pronged barbed fish hook from the cornea and anterior chamber of an 8-year-old boy. The advance-and-cut method is shown: the embedded barbed point of the fish hook was advanced through the cornea, its point was cut off, and the shank of the hook was withdrawn. This method was chosen due to the three-pronged configuration of the fish hook to minimize additional trauma to the eye. Other methods of fish hook removal are briefly reviewed. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  2. Unrepaired Tetralogy of Fallot with Absent Pulmonary Valve in a Mildly Symptomatic 16-Year-Old Boy.

    Science.gov (United States)

    Drogalis-Kim, Diana E; Reemtsen, Brian L; Reardon, Leigh Christopher

    2016-12-01

    Absent pulmonary valve is a rare and severe variant seen in only 3% to 6% of patients with tetralogy of Fallot. Fetuses with this combined condition who survive through birth typically need intervention in infancy or early childhood because of respiratory distress, heart failure, or failure to thrive. We describe the unusual case of a mildly symptomatic 16-year-old boy with these conditions who underwent successful primary repair. Our search of the medical literature yielded fewer than 5 cases of tetralogy of Fallot with absent pulmonary valve (or variants with an absent left pulmonary artery) and survival without repair into later adolescence or adulthood.

  3. Thyrotropin-secreting pituitary adenoma in an 11-year-old boy with type 1 autoimmune polyglandular syndrome.

    Science.gov (United States)

    Mazerkina, Nadia; Trunin, Yuri; Gorelyshev, Sergey; Golanov, Andrey; Kadashev, Boris; Shishkina, Liudmila; Rotin, Daniil; Karmanov, Maxim; Orlova, Elizabet

    2016-02-01

    Thyrotropinomas (TSHomas) are rare pituitary adenomas, particularly in childhood. We present here the case of an 11-year-old boy with type 1 autoimmune polyglandular syndrome (APS1) and TSHoma which was diagnosed by elevated thyroid - stimulating hormone and thyroid hormones levels without evident clinical signs of hyperthyroidism. He was underwent partial resection of the tumor via transsphenoidal approach and subsequently radiation therapy. Consequently, 1 year after radiotherapy, the patient developed growth hormone deficiency, three and half years after radiation became euthyroid, and five and half years after treatment - hypothyroid. This is the first case of the coexistence of these two rare endocrine diseases in one patient.

  4. 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.

  5. Primary Ewing’s Sarcoma of the Spine in a Two-Year-Old Boy

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    Ali J. Electricwala

    2016-01-01

    Full Text Available Ewing’s Sarcoma (ES is a highly malignant bone tumour. It may involve any part of the skeleton but the most frequent parts are the ilium and diaphysis of femur and tibia (Alfeeli et al., 2005; Zhu et al., 2012. Primary ES of the spine is extremely rare (Yan et al., 2011. It accounts for only 3.5 to 14.9 percent of all primary bone sarcomas. The age of presentation ranges from 12 to 24 years (median 21 years (Ferguson, 1999; Sharafuddin et al., 1992; Klimo Jr. et al., 2009. We report an unusual case of primary ES of the spine in a two-year-old boy, who presented to us with paraparesis and features of cauda equina syndrome. MRI scan showed a tumour mass arising from the pedicle of L4 vertebra invading the spinal canal. Tc-99 bone scan showed increased tracer uptake in L4 vertebra and normal tracer uptake elsewhere in the skeleton. After reaching the diagnosis of a space occupying lesion invading the lumber spinal canal, we performed a decompressive laminectomy and a biopsy was sent which confirmed the diagnosis of ES. Immunohistochemistry showed tumour cells staining positive for CD-99 (specific stain for ES. Gene testing showed an EWS-FLI 1 chimera. Surgery was followed by good improvement in motor signs. The child was then referred to a specialized oncotherapy centre for further treatment, radiation, and chemotherapy. To the best of our knowledge, we are the first to report primary ES of the spine at the age of two years.

  6. Atypical tetanus in a completely immunized 14-year-old boy.

    Science.gov (United States)

    König, Kai; Ringe, Hannelore; Dorner, Brigitte G; Diers, Alexander; Uhlenberg, Birgit; Müller, Dominik; Varnholt, Verena; Gaedicke, Gerhard

    2007-11-01

    We report the uncommon clinical course of tetanus in a completely immunized 14-year-old boy. His initial symptoms, which included a flaccid paralysis, supported a diagnosis of botulism. Preliminary mouse-test results with combined botulinum antitoxins A, B, and E, obtained from tetanus-immunized horses, backed this diagnosis. The change in his clinical course from paralysis to rigor and the negative, more specific, botulinum mouse test with isolated botulinum antitoxins A, B, and E, obtained from nonvaccinated rabbits, disproved the diagnosis of botulism. Tetanus was suspected despite complete vaccination. The final results of a positive mouse test performed with isolated tetanus antitoxin confirmed the diagnosis. Adequate treatment was begun, and the boy recovered completely.

  7. Chiropractic management using a brain-based model of care for a 15-year-old adolescent boy with migraine headaches and behavioral and learning difficulties: a case report

    Science.gov (United States)

    Kuhn, Kurt W.; Cambron, Jerrilyn

    2013-01-01

    Objective The purpose of this report is to describe chiropractic management, using a brain-based model of care, of a teen who had migraine headaches and several social and learning difficulties. Clinical features A 15-year-old adolescent boy with a chronic history of migraines and more than 10 years of learning and behavioral difficulties, including attention-deficit/hyperactivity disorder, obsessive compulsive disorder, and Tourette syndrome, presented for chiropractic care. Intervention and outcome The patient received spinal manipulation and was given home physical coordination activities that were contralateral to the side of the involved basal ganglia and ipsilateral to the involved cerebellum, along with interactive metronome training. Quantitative changes were noted in neurological soft signs, tests of variables of attention Conners’ Parent Rating Scale, the California Achievement Test, grade point, and reduction of medications. The patient reported qualitative improvements in tics, attention, reading, vision, health, relationships with his peers and his family, and self-esteem. Conclusion The patient with migraine headaches and learning difficulties responded well to the course of chiropractic care. This study suggests that there may be value in a brain-based model of care in the chiropractic management of conditions that are beyond musculoskeletal in nature. PMID:24396330

  8. Avoidant/Restrictive Food Intake Disorder in an 11-Year Old South American Boy: Medical and Cultural Challenges

    OpenAIRE

    Schermbrucker, Jonah; Kimber, Melissa; Johnson, Natasha; Kearney, Sarah; Couturier, Jennifer

    2017-01-01

    Avoidant/Restrictive Food Intake Disorder (ARFID) is new in the DSM-5, replacing the DSM-IV-TR diagnosis of Feeding Disorder of Infancy or Early Childhood. ARFID has no age criterion, and therefore addresses eating disturbances across the lifespan. This report illustrates the case of an 11-year-old boy of Colombian ancestry with ARFID and explores the role of culture in the diagnosis of ARFID. To date, literature describing this disorder is limited. ARFID is often seen in the child and adoles...

  9. TYPE IC CHOLEDOCHAL CYST PRESENTING AN EXTRAHEPATAL CHOLESTASIS IN A 3 YEAR OLD BOY

    Directory of Open Access Journals (Sweden)

    Muhammad Reza

    2015-10-01

    Full Text Available Choledochal cyst is a rare congenital dilatation of the bile ducts, mostly diagnosed in childhood. Whenappropriate resection is not performed, cholangiocarcinoma may occur in a high incidence within thesecond decade of life. This report aims to present a rare case in experience of diagnosis and managementtype IC choledochal cyst in children. We present case of a 3-year-old boy who came with jaundice anditchy skin, abdominal pain, brownish urine, pales colored of stool. Abdominal ultrasonography andcomputed tomography scan revealed type IC choledochal cyst. Patient underwent complete cyst removalsurgery and bilioenteric anastomosis through Roux-en-y hepaticojejunostomy. Excision biopsy confirmedthe diagnosis of type IC choledochal cyst. Post surgical follow up shown good physical and laboratorycondition  and  there was no  recurrence  of  symptoms. Early  surgical  procedure  through Roux-en-yhepatojejunostomy, has been performed. Long  term  follow up also  facilities good prognostic  to  thepatient. [MEDICINA 2015;46:56-60].Kista  koledokus  adalah merupakan  penyakit  saluran  empedu  bawaan  yang  jarang  dijumpai  danbanyak terdiagnosis pada saat usia anak-anak. Tindakan berupa reseksi kista adalah yang terpentingdilakukan,  jika  tidak  segera  dilakukan  maka  dapat  meningkatkan  resiko  terjadinyacholangiocarcinoma dalam usia dekade kedua penderita dalam kehidupan. Tujuan kasus ini dilaporkanuntuk menggambarkan pengalaman dalam mendiagnosis dan tata  laksana kista koledokal tipe ICyang jarang pada anak-anak. Laporan kasus ini pada anak laki-laki berumur 3 tahun dengan keluhankulit tampak kuning dan gatal, nyeri perut, urin berwarna kecoklatan, tinja yang pucat. Ultrasonografidan CT  scan abdomen memperlihatkan adanya kista koledokus. Tindakan bedah  eksisi kista dananastomosis bilioenterik dengan menggunakan tehnik hepatojejunostomi Roux-en-y. Diagnosa kistakoledokus  tipe  IC  terkonfirmasi  saat

  10. Simulation of the regularities of physical exercises learning process of boys aged 8 years old

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    O.V. Ivashchenko

    2018-02-01

    Full Text Available Purpose: to determine the peculiarities of the formation of motor skills in boys aged 8 years. Materials and methods: In study participated boys of eight years old (n=48. The study used factor experiment plans. The purpose of this experiment was to optimize the modes of education and to determine the peculiarities of the formation of motor skills in boys. Results: Discriminant analysis allowed: to determine the modes of exercise in the formation of motor skills; to answer the question as to how significantly different modes of work on the effectiveness of the formation of motor skills. Established: which of the variables most significantly affect the differentiation of classes; to which class the object belongs based on the values discriminant variables. The influence of the number of approaches, the number of repetitions in the approach and the interval of rest on the level of training for movements is revealed. Conclusions: To choose the most rational mode of exercising in the process of forming motor skills can be used the first discriminating function with an emphasis on the most informative variables.

  11. Tibial nerve intraneural ganglion cyst in a 10-year-old boy

    Energy Technology Data Exchange (ETDEWEB)

    Squires, Judy H. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati, OH (United States); Emery, Kathleen H.; Johnson, Neil [Cincinnati Children' s Hospital Medical Center, Division of Radiology, Cincinnati, OH (United States); Sorger, Joel [Cincinnati Children' s Hospital Medical Center, Division of Orthopedics, Cincinnati, OH (United States)

    2014-04-15

    Intraneural ganglion cysts are uncommon cystic lesions of peripheral nerves that are typically encountered in adults. In the lower extremity, the peroneal nerve is most frequently affected with involvement of the tibial nerve much less common. This article describes a tibial intraneural ganglion cyst in a 10-year-old boy. Although extremely rare, intraneural ganglion cysts of the tibial nerve should be considered when a nonenhancing cystic structure with intra-articular extension is identified along the course of the nerve. This report also details the unsuccessful attempt at percutaneous treatment with US-guided cyst aspiration and steroid injection, an option recently reported as a viable alternative to open surgical resection. (orig.)

  12. Chronic Recurrent Multifocal Osteomyelitis in a 9-year-old Boy

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    Abdolreza Malek

    2017-05-01

    Full Text Available Chronic recurrent multifocal osteomyelitis (CRMO is a rare aseptic, auto-inflammatory bone disorder. CRMO presents with bone pain with or without fever. The diagnosis of CRMO is a diagnosis of exclusion and should be included in the differential diagnosis of chronic inflammatory bone lesions in children. Cultures of the bone are typically sterile, antibiotic therapy does not result in clinical improvement whereas anti-inflammatory drugs improve the condition. Furthermore, biopsy should be considered in chronic and relapsing bone pain and swelling unresponsive to treatment. Herein, we present a nine-year-old boy complaining of recurrent pain in his upper and lower extremities. On examination he had mild fever and cervical lymphadenopathy. He also had experienced bone pain and weight loss in the recent month. Based on biopsy and bone scan he was finally diagnosed with CRMO. Naproxen and Pamidronate was prescribed and he was getting better and returned to normal life and activity without need to corticosteroids.

  13. An 8-year old boy with continuous spikes and waves during slow sleep presenting with positive onconeuronal antibodies.

    Science.gov (United States)

    Hu, Lin-Yan; Shi, Xiu-Yu; Feng, Chen; Wang, Jian-Wen; Yang, Guan; Lammers, Stephen H T; Yang, Xiao Fan; Ebrahimi-Fakhari, Darius; Zou, Li-Ping

    2015-03-01

    To determine the etiology of epilepsy with continuous spikes and waves during slow sleep (CSWS)/electrical status epilepticus during sleep (ESES) in an 8-year old boy with a history of neuroblastoma and opsoclonus-myoclonus. A combination of clinical characterization and follow-up, video EEG and laboratory investigations. We report the case of an 8-year old boy with a history of neuroblastoma and opsoclonus-myoclonus, who presented with intellectual disability, pharmacotherapy-resistant epilepsy and CSWS/ESES. Although the patient's neuroblastoma had been successfully treated 8 years prior to presentation and an extensive workup did not show a tumor reoccurrence, testing for onconeuronal antibodies was positive for anti-Ma2 and anti-CV2/CRMP5 antibodies. High-dose intravenous methylprednisolone and a taper of oral methylprednisolone were given, leading to a significant clinical improvement. During the taper the patient's condition and EEG manifestations deteriorated again necessitating another cycle of steroid therapy, which lead to a stable improvement. During a 6-month follow-up no CSWS/ESES was seen on EEG and anti-Ma2 and anti-CV2/CRMP5 antibodies remained undetectable. This case suggests that onconeuronal antibodies may be involved in the pathogenesis of CSWS/ESES. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  14. Prophylactic thyroidectomy for asymptomatic 3-year-old boy with positive multiple endocrine neoplasia type 2A mutation (codon 634

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    Ješić Maja D.

    2014-01-01

    Full Text Available Introduction. The multiple endocrine neoplasia type 2A (MEN 2A syndrome, comprising medullary thyroid carcinoma (MTC, pheochromocytoma and primary hyperparathyroidism (PHPT is most frequently caused by codon 634 activating mutations of the RET (rearranged during transfection proto-oncogene on chromosome 10. For this codon-mutation carriers, earlier thyroidectomy (before the age of 5 years would be advantageous in limiting the potential for the development of MTC as well as parathyroid adenomas. Case Outline. This is a case report of 3-year-old boy from the MEN 2A family (the boy’s father and grandmother and paternal aunt in which cysteine substitutes for phenylalanine at codon 634 in exon 11 of the RET proto-oncogene, who underwent thyroidectomy solely on the basis of genetic information. A boy had no thyromegaly, thyroidal irregularities or lymphadenopathy and no abnormality on the neck ultrasound examination. The pathology finding of thyroid gland was negative for MTC. Two years after total thyroidectomy, 5-year-old boy is healthy with permanent thyroxine replacement. His serum calcitonin level is <2 pg/ml (normal <13 pg/ml, has normal serum calcium and parathyroid hormone levels and negative urinary catecholamines. Long-term follow-up of this patient is required to determine whether very early thyroidectomy improves the long-term outcome of PHPT. Conclusion. Children with familial antecedents of MEN 2A should be genetically studied for the purpose of determining the risk of MTC and assessing the possibilities of making prophylactic thyroidectomy before the age of 5 years.

  15. Case report 536: Chronic tophaceous gout in a 17-year-old male

    International Nuclear Information System (INIS)

    Garagiola, D.M.; Braunstein, E.M.; Clark, S.A.; Colyer, R.A.

    1989-01-01

    We have presented a case of gout with destructive arthritis of the first metatarsophalangeal joint in a seventeen year old boy. The diagnosis was not suspected due to the patient's age and the presentation as an expanding lesion of the base of the phalanx. Renal insufficiency may have contributed to the early onset of the disease, but even in chronic renal failure secondary gout is rare. (orig./GDG)

  16. 17-Year-Old Boy with Renal Failure and the Highest Reported Creatinine in Pediatric Literature

    Directory of Open Access Journals (Sweden)

    Vimal Master Sankar Raj

    2015-01-01

    Full Text Available The prevalence of chronic kidney disease (CKD is on the rise and constitutes a major health burden across the world. Clinical presentations in early CKD are usually subtle. Awareness of the risk factors for CKD is important for early diagnosis and treatment to slow the progression of disease. We present a case report of a 17-year-old African American male who presented in a life threatening hypertensive emergency with renal failure and the highest reported serum creatinine in a pediatric patient. A brief discussion on CKD criteria, complications, and potential red flags for screening strategies is provided.

  17. Total pancreatectomy and autoislet transplant for chronic recurrent pancreatitis in a 5-year-old boy

    Directory of Open Access Journals (Sweden)

    Shaheed Merani

    2016-10-01

    Full Text Available Childhood chronic pancreatitis is a rare disorder, which can lead to a chronically debilitating condition. The etiology of recurrent hereditary pancreatitis, which previously was classified as idiopathic, has now been attributed in certain cases to specific genetic mutations including abnormalities in the PRSS gene. We describe here the use of total pancreatectomy and autoislet transplant in a 5-year-old with chronic pancreatitis. This represents the youngest patient undergoing the procedure at our institution. The early successful outcomes for this patient, both of symptom relief and glycemic control are detailed.

  18. Spontaneous resolution of pituitary apoplexy in a giant boy under 10 years old.

    Science.gov (United States)

    Chentli, Farida; Bey, Abderrahim; Belhimer, Faiza; Azzoug, Said

    2012-01-01

    Pituitary gigantism is a very rare condition; the occurrence of pituitary apoplexy in children younger than 10 years old is even rarer. The aim of our study is to report this exceptional association. A boy aged 9 years and 6 months was hospitalized for the first time in November 2011 for symptoms suggesting pituitary apoplexy. The onset of his disease was difficult to determine as his health record has been poorly maintained. On October 10, 2011, he presented to an emergency department with a sudden drop of visual acuity with diplopia and retro-orbital headaches. An ophthalmological exam found very low visual acuity (1/20) with papillary edema. An MRI of the patient's brain revealed a hemorrhagic pituitary process reaching the chiasma, which was compressed, especially on the right side. Thereafter, the patient's vision improved spontaneously. Clinical examination was normal except for gigantism (+5 SD compared to the target stature). Hormonal assessment argued for mixed secretion [growth hormone (GH) = 39 ng/mL, n ≤ 5, prolactin ( PRL) = 470 ng/mL, n gigantism: phenomenon quite exceptional and worth to be reported.

  19. Tetanus trismus in a 2 year old child: Case report

    Directory of Open Access Journals (Sweden)

    Menon Narayanankutty Sunilkumar, Vadakut Krishnan Parvathy

    2014-07-01

    Full Text Available Tetanus is still a major cause of mortality and morbidity in developing countries. It occurs in children mainly in the unimmunized, due to parental ignorance and objection to vaccination. This potentially fatal disease caused by a neurotoxin, tetanospasmin released from wounds infected with Clostridium tetani, an anaerobic gram–positive bacillus. As tetanus becomes less common, cases are likely to be misdiagnosed or go unrecognized. In this case report, we present a case of tetanus in a partially immunized 2 year old girl who presented with trismus. She was treated with the recent recommendations and adequate supportive care. Detection of tetanus at a very early stage can favor lifesaving interventions. Trismus, infected wound and partially immunized/unimmunized status of a child were the key features leading to the prompt diagnosis and early treatment.

  20. Avoidant/Restrictive Food Intake Disorder in an 11-Year Old South American Boy: Medical and Cultural Challenges.

    Science.gov (United States)

    Schermbrucker, Jonah; Kimber, Melissa; Johnson, Natasha; Kearney, Sarah; Couturier, Jennifer

    2017-07-01

    Avoidant/Restrictive Food Intake Disorder (ARFID) is new in the DSM-5, replacing the DSM-IV-TR diagnosis of Feeding Disorder of Infancy or Early Childhood. ARFID has no age criterion, and therefore addresses eating disturbances across the lifespan. This report illustrates the case of an 11-year-old boy of Colombian ancestry with ARFID and explores the role of culture in the diagnosis of ARFID. To date, literature describing this disorder is limited. ARFID is often seen in the child and adolescent population and can have significant medical consequences, including weight loss, hemodynamic instability, and growth retardation. Studies examining the potential cultural challenges of diagnosing and treating ARFID would benefit patients, as well as health professionals working in primary care, pediatrics, and psychiatry. This paper is intended to inform the reader about this multifaceted disorder, and to generate interest for future research.

  1. Collapsing glomerulopathy following anabolic steroid use in a 16-year-old boy with IgA nephropathy

    Directory of Open Access Journals (Sweden)

    S M Matthai

    2015-01-01

    Full Text Available Collapsing glomerulopathy (CG is a proliferative podocytopathy, increasingly recognized in a variety of disease conditions. We report a case of CG in a 16-year-old boy with IgA nephropathy (IgAN who presented with acute kidney injury, marked proteinuria and hypertension following a short period of anabolic steroid use. Although CG has been associated with long-term anabolic steroid use among body builders, there is no data on the effect of anabolic steroid use in persons with underlying renal disease like IgAN. We postulate that development of CG in our patient could be temporally linked to intake of body-building steroids along with a predisposing background renal disease of IgAN.

  2. Severe vitamin B₁₂ deficiency in a 15-year-old boy: presentation with haemolysis and pancytopenia.

    Science.gov (United States)

    Keskin, Ebru Yılmaz; Keskin, Mahmut

    2015-05-14

    A 15-year-old boy on a vegetarian diet presented with severe macrocytic anaemia (haemoglobin, 5.1 g/dL; mean corpuscular volume, 116 fL) in addition to leucopenia and thrombocytopaenia (pancytopenia), icterus secondary to haemolysis and splenomegaly. Laboratory investigations revealed severe vitamin B12 (cobalamin) deficiency. Following cobalamin replacement therapy, the patient reported increased well-being, including appetite and weight gain, and his icterus resolved. In the follow-up laboratory examinations, leucocyte and platelet counts in addition to serum bilirubin and lactate dehydrogenase levels normalised. At the end of 2 months, laboratory findings, including haemoglobin level, were all within the normal range. We present this case as a reminder that severe vitamin B12 deficiency may present with findings mimicking acute leukaemia (pancytopenia and splenomegaly) and findings suggestive of pseudothrombotic microangiopathy. 2015 BMJ Publishing Group Ltd.

  3. Severe vitamin B12 deficiency in a 15-year-old boy: presentation with haemolysis and pancytopenia

    Science.gov (United States)

    Keskin, Ebru Yılmaz; Keskin, Mahmut

    2015-01-01

    A 15-year-old boy on a vegetarian diet presented with severe macrocytic anaemia (haemoglobin, 5.1 g/dL; mean corpuscular volume, 116 fL) in addition to leucopenia and thrombocytopaenia (pancytopenia), icterus secondary to haemolysis and splenomegaly. Laboratory investigations revealed severe vitamin B12 (cobalamin) deficiency. Following cobalamin replacement therapy, the patient reported increased well-being, including appetite and weight gain, and his icterus resolved. In the follow-up laboratory examinations, leucocyte and platelet counts in addition to serum bilirubin and lactate dehydrogenase levels normalised. At the end of 2 months, laboratory findings, including haemoglobin level, were all within the normal range. We present this case as a reminder that severe vitamin B12 deficiency may present with findings mimicking acute leukaemia (pancytopenia and splenomegaly) and findings suggestive of pseudothrombotic microangiopathy. PMID:25976204

  4. Diagnosis and Treatment of Comorbidities of Tourette's Syndrome and Bipolar Disorder in A 10-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Peng-Wei Wang

    2009-11-01

    Full Text Available Changes in moods are one of the comorbid psychiatric manifestations that frequently occur in patients with Tourette's syndrome. The assessment of a manic episode in children with Tourette's syndrome is challenging. Furthermore, the treatment of children with comorbid mania and Tourette's syndrome has not been extensively studied. We present a 10-year-old boy who suffered from both Tourette's syndrome and mania, whose symptoms improved after using lithium and risperidone. The child was diagnosed with Tourette's syndrome at 7 years of age when he suffered from tics and experienced his first manic episode. He received monotherapy, including haloperidol, risperidone and aripiprazole, and the response was poor. When the combination of lithium and risperidone was used, the tics and mania subsided. It is important to assess individuals with Tourette's syndrome for associated bipolar disorder. The treatment of children with both disorders is a major clinical issue, and our case may serve as an example for successful treatment strategies.

  5. Retroperitoneal Angiomatoid Fibrous Histiocytoma Presenting as a Recurrent Spontaneous Retroperitoneal Hemorrhage in a 9-Year-Old Boy.

    Science.gov (United States)

    Slack, Jonathan C; Sanchez-Glanville, Carlos; Steele, MacGregor; Wong, Andrew L; Bründler, Marie-Anne

    2018-05-01

    Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumor that typically presents in children and young adults. Occurrence outside of the extremities and the head and neck region is exceedingly rare. We report the case of a 9-year-old boy who presented with recurrent retroperitoneal hemorrhage initially thought to be a manifestation of an underlying bleeding disorder. After comprehensive diagnostic work-up, including multiple negative biopsies, the patient underwent surgical resection of an extensively hemorrhagic intramuscular mass and to date remains well. Pathologic examination confirmed AFH with EWSR1 gene rearrangement. This first documented report of an AFH in a retroperitoneal location in a child highlights the diagnostic difficulties and clinical challenges of AFH arising in an atypical location.

  6. Development of urinary incontinence in a 7-year old boy after therapy with proton pump inhibitors and complete resolution of his clinicopathologic features of eosinophilic esophagitis after H2-receptor antagonist treatment: A case report

    Directory of Open Access Journals (Sweden)

    Rok Orel

    2017-06-01

    Full Text Available Background: Several diseases result in profound infltration of esophageal mucosa by eosinophilic granulocites, with gastroesophageal reflux disease (GERD, eosinophilic esophagitis (EoE and proton-pump-inhibitor-responsive esophageal eosinophilia (PPI-REE being the most prevalent. Proton-pump-inhibitor-responsive esophageal eosinophilia (PPI-REE is a newly recognized entity that must be differentiated from eosinophilic esophagitis (EoE.Case presentation: A 7-year old Slovenian male presented with a few-month history of chest pain, regurgitation and heartburn. First endoscopy was performed and revealed pronounced longitudinal furrows, and on hystology examination > 70 eosinophils per high power feld were found through the entire thickness of epithelium and in the submucosis with eosinophilic microabscess formation. Results of 24-hour pH-monitoring (without impedance monitoring excluded pathologic acid reflux. All allergy tests were negative. Te patient started treatment with proton pump inhibitors (PPIs for three times, twice with pantoprazole before the endoscopy and once with esomeprazole after it to exclude the diagnosis of GERD and PPI-REE. Urinary incontinence reappeared each time just few days after starting treatment and disappeared few days after stopping it. Therefore, urinary incontinence was considered as a plausible adverse effect of therapy with PPIs. As treatment with PPIs was not tolerated, a therapy with H2-receptor antagonists ranitidine was applied for more than 2 months followed by a second endoscopy. Both symptoms and esophageal eosinophilia completely resolved with ranitidine. The resolution of esophageal eosinophilia in PPI-REE has been attributed to proton pump independent antiinflammatory effects of PPIs. No such effects have been described in H2-receptor antagonists.Conclusions: Two unique phenomena were observed in the pediatric patient with profound esophageal eosinophilia: urinary incontinence as an adverse e

  7. Self-reported medicine use among 11- to 15-year-old girls and boys in Denmark 1988-1998

    DEFF Research Database (Denmark)

    Holstein, Bjørn E; Holme Hansen, Ebba; Due, Pernille

    2003-01-01

    AIMS: To describe the self-reported medicine use for common health complaints among 11-15-year-olds in Denmark during a ten year period, 1988-1998. The paper focuses on medicine for headache, stomach ache, cough, cold, nervousness, and difficulties in getting to sleep. METHODS: Four cross......: A large proportion of 11-15-year-olds reported medicine use during the past month. It was most common to take medicines for headache (used by 55% of 15-year-old girls and 36% of 15-year-old boys in 1998) and stomach ache (33% among 15-year-old girls in 1998). Pain reliever use was higher among girls than...... difficulties. CONCLUSION: A high proportion of 11-15-year-old girls and boys reported medicine use in relation to common health complaints. The proportion of users increased during the past decade. It is suggested that more information about medicine be built into health education programs in the future....

  8. Traumatic hemipelvectomia in one year old girl. Report of case

    Directory of Open Access Journals (Sweden)

    Fernando Medina González

    2006-01-01

    Full Text Available The trauma of pelvis is a complex condition that implies injuries of vital organs putting in risk the life of the patient. The traumatic hemipelvectomy is a extremely severe pelvic injury and is fatal almost always, caused generally to events of high energy. It causes traumatic dislocation of the sacroiliac joint and the symphysis pubis, and to the femoral vessels are avulsioned. Because survival rate it is so low it require prompt medical attention. In this pathology type dissabling and prostetic wear is very difficult. In the medical literature there is not report of any patient ho survived this type of lesion under three year's old. We report a case of traumatic hemipelvectomy in a girl of 21 months who survived a traffic accident.

  9. [Toilet training in mental retardation; approach to diurnal enuresis in a 12-year-old boy with hemiparesis].

    NARCIS (Netherlands)

    Moor, J.M.H. de; Frielink, N.; Roijen, L.E.

    2010-01-01

    A 12-year-old boy with hemiparesis, severe mental retardation, reduced mobility and behavioural problems was not yet toilet trained. He was successfully trained using a behavioural treatment. The training program was based on gradual prolongation of urine retention, the introduction of behaviour

  10. Cervical ankylosis following Grisel's syndrome in a 14-year-old boy with infectious mononucleosis

    Energy Technology Data Exchange (ETDEWEB)

    Haidar, Salwa; Armstrong, Derek [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, Ont. (Canada); Drake, James [Hospital for Sick Children, Department of Neurosurgery, Toronto (Canada)

    2005-03-01

    Non-traumatic atlanto-axial subluxation (Grisel's syndrome) is an uncommon complication of neck space infection or otolaryngologic procedures. It most frequently affects children, although it may occur in adults. We present a 14-year-old boy with Grisel's syndrome as a complication of infectious mononucleosis proceeding to cervical ankylosis. (orig.)

  11. Superior mesenteric artery aneurysm in a 9-year-old boy with classical Ehlers-Danlos syndrome

    NARCIS (Netherlands)

    de Leeuw, K.; Goorhuis, J. F.; Tielliu, I. F. J.; Symoens, S.; Malfait, F.; de Paepe, A.; van Tintelen, J. P.; Hulscher, J. B. F.

    A 9-year-old boy with the classical type of EhlersDanlos syndrome (EDS) developed a symptomatic aneurysm of the superior mesenteric artery. His EDS diagnosis had been confirmed biochemically and genetically. Vascular complications are known to be associated with the vascular type of EDS, but this is

  12. Moved to Tears: Technical Considerations and Dilemmas Encountered in Working with a 13-Year-Old Boy with Acquired Quadriplegia

    Science.gov (United States)

    Owens, Caroline

    2005-01-01

    This paper is about therapeutic work with David, a 13-year-old boy who, at the age of 5, was the victim of a hit-and-run road traffic accident resulting in quadriplegia. The circumstances leading to the accident and its sequelae reveal a particularly complex picture, which combines early emotional deprivation and trauma. Although cognitively…

  13. Chronic pancreatitis with pancreaticolithiasis and pseudocyst in a 5-year-old boy with homozygous SPINK1 mutation

    Energy Technology Data Exchange (ETDEWEB)

    Kuehn, Axel C.; Hirsch, Wolfgang [University of Leipzig, Department of Diagnostic Radiology - Pediatric Radiology, Faculty of Medicine, Leipzig (Germany); Teich, Niels; Caca, Karel [University of Leipzig, Department of Internal Medicine II - Gastroenterology / Hepatology, Faculty of Medicine, Leipzig (Germany); Limbach, Anne [University of Leipzig, Department of Pediatrics, Faculty of Medicine, Leipzig (Germany)

    2005-09-01

    We report a 5-year-old boy with a 5-month history of symptoms owing to chronic pancreatitis. Abdominal imaging revealed a large pseudocyst in the pancreatic tail and concretions in the main pancreatic duct. Successful endoscopic papillotomy and stent implantation were performed. Genetic testing showed homozygous SPINK1-N34S mutation, which is an established risk factor for chronic pancreatitis. (orig.)

  14. Chronic pancreatitis with pancreaticolithiasis and pseudocyst in a 5-year-old boy with homozygous SPINK1 mutation

    International Nuclear Information System (INIS)

    Kuehn, Axel C.; Hirsch, Wolfgang; Teich, Niels; Caca, Karel; Limbach, Anne

    2005-01-01

    We report a 5-year-old boy with a 5-month history of symptoms owing to chronic pancreatitis. Abdominal imaging revealed a large pseudocyst in the pancreatic tail and concretions in the main pancreatic duct. Successful endoscopic papillotomy and stent implantation were performed. Genetic testing showed homozygous SPINK1-N34S mutation, which is an established risk factor for chronic pancreatitis. (orig.)

  15. An 8-Year-Old Boy With Treatment-Resistant Encopresis.

    Science.gov (United States)

    Stein, Martin T; Benninga, Marc A; Felt, Barbara T

    Paul is an 8-year-old boy with a long-standing history of encopresis and enuresis. Potty training was initiated when he was 2 years old. At this time, his mother was absent from the home for 6 weeks when she cared for her ill father in a different city. The process of teaching Paul to use the bathroom was described as "inconsistent" due to multiple caretakers.Paul never successfully mastered bowel and bladder control. He continues to wet and soil his clothes on a daily basis at home and school. According to his parents, he does not accept responsibility and comments about his soiling such as, "I didn't do it; someone else must have put it there." One of Paul's teachers commented that she could tell at the beginning of the school day whether he would maintain bowel and bladder control. If he was "agitated and talkative" in the early morning, he would often soil that day.He had a pediatric gastroenterological evaluation at the age of 5 years when he was having daily episodes of stool soiling. Physical examination revealed normal anal tone, normal placement of the anus, and moderate stool in the rectal vault. An abdominal radiograph revealed moderate stool throughout the colon. He was treated with Miralax and instructed to sit on the toilet twice daily. Paul did not respond to these interventions and was diagnosed with "overflow incontinence secondary to stool withholding." When he was taking Miralax, he had a normal barium enema radiograph. He was admitted to the hospital for a cleanout with a polyethylene glycol/electrolyte solution.Although abdominal radiographs demonstrated absence of colonic stool for the following 5 months, he continued to soil his clothing. Play therapy and biofeedback did not change the chronic soiling and wetting pattern. An evaluation at the Continence Clinic resulted in a rigorous program including stooling after each meal, wearing a vibrating watch reminding him to void every 2 hours, drinking 60 ounces of water per day, tracking

  16. Omalizumab therapy in a 13-year-old boy with severe persistent asthma and concomitant eosinophilic esophagitis.

    Science.gov (United States)

    Arasi, Stefania; Costa, Stefano; Magazzù, Giuseppe; Ieni, Antonio; Crisafulli, Giuseppe; Caminiti, Lucia; Chiera, Fernanda; Vaccaro, Mario; Del Giudice, Michele Miraglia; Pajno, Giovanni Battista

    2016-03-22

    Eosinophilic esophagitis (EoE) has been defined as "asthma of the esophagus" for the large number of similarities between the two diseases. Omalizumab is an anti-Immunoglobulin E (IgE) antibody currently approved only in allergic IgE-mediated severe persistent uncontrolled asthma and in chronic spontaneous urticaria unresponsive to antihistamines, but it has been tried in other diseases, too. We present herein the case of a 13-year-old boy, affected from preschool age by severe chronic allergic asthma poorly controlled despite a generous long-term therapy, and, since he was 8 years old, by eosinophilic esophagitis, responsive to courses of strict elimination diet and semi-elemental diet, even if very burdensome for his quality of life. At the age of 11.5 years, for inadequate asthma control, he started to receive therapy with omalizumab. After the first month and for the entire duration (18 months) of omalizumab treatment, asthma was well controlled, long-term conventional therapy was gradually withdrawn and lung- function improved. Concerning EoE, after an initial clinical but not histological remission during the first few months of treatment with omalizumab, the patient experienced an exacerbation of gastrointestinal symptoms. Therefore, he started treatment with topical steroids which was effective to improve gastrointestinal symptoms. However, EoE is still steroid-dependent. Currently, he continues both treatments: omalizumab for asthma and topical steroid for EoE. This case report confirms that omalizumab is an effective treatment in patients with severe persistent, uncontrolled asthma. On the other hand, in our patient it did not produce persistent improvement neither on symptoms nor on biopsy findings of EoE. The outcome of this case might indicate different pathogenic mechanism(s) of the two diseases.

  17. Unusual Onset of Celiac Disease and Addison’s Disease in a 12-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Francesco Miconi

    2017-07-01

    Full Text Available Background: Celiac disease (CD is an autoimmune disorder deriving from an aberrant adaptive immune response against gluten-containing grains in genetically predisposed subjects. In a number of patients, CD is associated with one or more other autoimmune diseases. Primary Addison’s disease (AD and CD may co-exist, although this association is relatively uncommon in children. In addition, it is not precisely defined whether a gluten-free diet influences the course of AD. Case presentation: A case of CD in a 12-year-old boy presenting as acute adrenal insufficiency is described here. A gluten-free diet had a significant therapeutic role in this case, wherein most of the clinical signs and symptoms of AD disappeared in a few days. In addition, the dosage of cortisol acetate, initially administered to treat the AD, was able to be rapidly reduced. Conclusion: This case highlights that CD can be associated with AD in children, and a gluten-free diet seems to positively influence the course of AD.

  18. Unusual Thymic Hyperplasia Mimicking Lipomatous Tumor in an Eight-Year-Old Boy with Concomitant Pericardial Lipomatosis and Right Facial Hemihypertrophy

    International Nuclear Information System (INIS)

    Kim, Yoo Jin; Kim Woo Sun; Cheon, Jung Eun; Lim, Yun Jung; Kim, In One; Yeon, Kyung Mo; Jung, Kyeong Cheon; Byun, Sun Ju

    2011-01-01

    We report a case of thymic hyperplasia accompanied by pericardial lipomatosis and right facial hemihypertrophy in an 8-year-old boy. On imaging studies, the hyperplastic thymus had prominent curvilinear and nodular fatty areas simulating a fat-containing anterior mediastinal mass, which is an unusual finding in children. To our knowledge, this is the first report on a child with a combination of thymic hyperplasia, pericardial lipomatosis, and right facial hemihypertrophy. The radiologic findings are presented with a brief discussion.

  19. Upper Extremity Multifocal Neuropathy in a 10-Year-Old Boy Associated With NS6S Disaccharide Antibodies.

    Science.gov (United States)

    Edelman, Frederick; Naddaf, Elie; Waclawik, Andrew J

    2015-06-01

    We present a 10-year-old boy with a predominantly motor multifocal neuropathy with demyelinating and axonal changes with sensory involvement, affecting only one upper extremity. Laboratory studies revealed an elevated titer of immunoglobulin M (IgM) antibodies against the NS6S antigen. He responded to treatment with high dose intravenous immunoglobulins. Focal or multifocal immune-mediated neuropathies are not common in children and may be underdiagnosed. © The Author(s) 2014.

  20. Conjunctival papilloma caused by human papillomavirus type 11 treated with systemic interferon in a five-year-old boy.

    Science.gov (United States)

    Okan, Gökhan; Ayan, Inci; Karslioğlu, Safak; Altiok, Ender; Yenmiş, Güven; Vural, Gürcan

    2010-01-01

    Conjunctival papilloma is a benign tumor of the conjunctival mucosa. In childhood, papilloma represents 7-10% of conjunctival tumors. Human papillomavirus (HPV)-6 and HPV-11 are the major HPV types responsible for conjunctival lesions. A five-year-old boy with a two-year history of conjunctival papilloma caused by HPV type 11 treated with systemic interferon alpha is reported and the literature is reviewed.

  1. Underweight in 14 to 16 year-old girls and boys: prevalence and associations with physical activity and sedentary activities

    OpenAIRE

    Adam Kantanista; Wiesław Osiński

    2014-01-01

    Introduction and objectives. Underweight is associated with increased mortality of adults when compared to normal weight or overweight individuals. Studies of associations between underweight and physical activity levels in adolescents are sparse. The aim of this study was to determine the prevalence of underweight amongst 14 to 16 year-old girls and boys in tandem with the levels of physical activity and time spent in sedentary activities. The results were compared to those observed in norma...

  2. Symptomatic cycling Cushing disease managed by simultaneous bilateral laparoscopic adrenalectomy in a 11-year-old boy

    Directory of Open Access Journals (Sweden)

    Khalid M Al-Otaibi

    2014-01-01

    Full Text Available We report symptomatic cycling Cushing disease in a 11-year-old boy that was managed with simultaneous bilateral laparoscopic adrenalectomy. Positioning and the surgical technique have been fully described. Excellent results were achieved. Recent application of laparoscopic adrenalectomy for various adrenal pathology is highly effective and offers better results than open surgery. Post-operative recovery after laparoscopic technique is significantly shorter than the open technique.

  3. Alkaptonuria in a 6 Year Old Patient: Case Report

    Directory of Open Access Journals (Sweden)

    Vikas Sharma

    2015-11-01

    Full Text Available Alkaptonuria is a rare disorder of tyrosine catabolism. A 6 year old male child presented with history of darkish staining of the toilet commode following voiding. The urine when kept in a sterile container for a few hours turned black. Urine examination showed massive amounts of homogentisic acid. Patient was diagnosed as alkaptonuria.

  4. Posterior Nutcracker Syndrome with Left Renal Vein Duplication: A Rare Cause of Haematuria in a 12-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    J. Preza Fernandes

    2012-01-01

    Full Text Available The nutcracker syndrome (NCS is a rare cause of haematuria. It embraces an extended nonpathognomonic spectrum of symptoms that imply a difficult diagnosis. Ultimately it may be associated with substantial morbidity and even life-threatening events. We report a rare cause if a 12-year-old boy who presented with a history of frequent intermittent episodes of painless constant haematuria. The cystoscopy showed a bloody urine ejaculate from the left ureter meatus. The Doppler ultrasonography showed turbulent pattern of venous blood flow of the posterior renal vein branch behind the aorta. The abdominopelvic computer tomography (apCT revealed left renal vein (LRV duplication with a dilated retroaortic branch, entrapped between the aorta and the vertebral column, promoting the renal nutcracker syndrome. The patient was initially hospitalized and managed with oral iron supplements and continuous saline bladder irrigation, not requiring additional treatment. The child is currently asymptomatic, with haemoglobin value returning to normal and therefore proposed to conservative management with close followup. The authors present a case report of episodic haematuria caused by a rare entity—posterior nutcracker syndrome with renal vein duplication.

  5. The uses of overlap: carer-child interaction involving a nine-year-old boy with auditory neuropathy.

    Science.gov (United States)

    Anstey, Julie; Wells, Bill

    2013-01-01

    The subject of this single case study, Ricky, is a nine-year-old boy with a profound hearing loss arising from auditory neuropathy. Despite cochlear implantation at the age of two, his receptive language skills remain very restricted and his speech is unintelligible. Techniques of interactional linguistics are used to analyse recordings of Ricky and his mother during shared book reading. Both participants display competences in managing turn-taking and overlapping talk that enable them to progress the book-reading activity, to talk spontaneously on topically related matters and also to handle issues of phonetic and linguistic repair. Instances of both competitive and non-competitive overlap reveal that Ricky has access to interactionally important prosodic skills. The study thus reinforces the need, when assessing a child's potential to understand and use spoken language, to examine the child's talk from an interactional perspective. It further indicates that overlapping talk is not necessarily a problem; indeed it can be part of a solution to issues of interpersonal understanding that routinely arise in the course of talk-in-interaction.

  6. Stroke as the Sole Manifestation of Takayasu Arteritis in a 15-Year-Old Boy with Latent Tuberculosis

    Directory of Open Access Journals (Sweden)

    Espen Benjaminsen

    2016-01-01

    Full Text Available Introduction. Takayasu arteritis is a rare disease affecting the aorta and its main branches, causing arterial claudication and end-organ ischemia, including stroke. The etiology is unknown but is believed to be autoimmune. An association between Takayasu arteritis and tuberculosis has been suggested, but the possible relation is unclear. Case Presentation. A 15-year-old Somali boy was diagnosed with latent tuberculosis. He had a lesion in the right lung, and both the tuberculin skin test by the Mantoux method and Quantiferon GOLD test turned out positive. After he suffered a cerebral infarct in the right hemisphere, childhood Takayasu arteritis was diagnosed. The diagnosis was based on diagnostic imaging showing a high-grade stenosis of the origin of the right common carotid artery, an occluded common carotid artery on the left side, a circumferential thickening of the vessel walls in the right and left common carotid artery, and laboratory findings with elevated C-reactive protein. Conclusion. Takayasu arteritis is an uncommon cause of stroke. It should however be kept in mind as a cause of cerebrovascular disease, especially in the young.

  7. Staphylococcal scalded skin syndrome in a 4-year-old child: a case report.

    Science.gov (United States)

    Haasnoot, P J; De Vries, A

    2018-01-29

    Staphylococcal scalded skin syndrome is an exfoliating skin disease which primarily affects children. Differential diagnosis includes toxic epidermal necrolysis, staphylococcal scalded skin syndrome, epidermolysis bullosa, and Stevens-Johnson syndrome. Staphylococcal scalded skin syndrome primarily affects children and can cause serious morbidity. In this case report we highlight the case of a 4-year-old Caucasian boy. Diagnostic and therapeutic challenges are discussed. Differential diagnoses are considered and therapy is described and discussed. The latest treatment options are used and described. Successful results are achieved in this case due to timely and correct management. Some therapeutic options are widely used without thorough research bases. This case report highlights staphylococcal scalded skin syndrome and its treatment, and future challenges. Further research is warranted and this case report aims to further research in exfoliating skin disorders.

  8. Pancreatic cancer in an 18-year-old boy | Kitara | African Health ...

    African Journals Online (AJOL)

    old boy. Complete blood picture revealed moderate normochromic normocytic anaemia with anisocytosis. Other laboratory results including liver function tests, renal functions tests, serum amylase, fasting blood sugar level and serum ...

  9. Physical activity, stress, and metabolic risk score in 8- to 18-year-old boys.

    Science.gov (United States)

    Holmes, Megan E; Eisenmann, Joey C; Ekkekakis, Panteleimon; Gentile, Douglas

    2008-03-01

    We examined whether physical activity modifies the relationship between stress and the metabolic risk score in 8- to 18-year-old males (n = 37). Physical activity (PA) and television (TV)/videogame (VG) use were assessed via accelerometer and questionnaire, respectively. Stress was determined from self-report measures. A metabolic risk score (MRS) was created by summing age-standardized residuals for waist circumference, mean arterial pressure, glycosylated hemoglobin, and high-density lipoprotein cholesterol. Correlations between PA and MRS were low (r adolescents.

  10. Early Eruption of Maxillary Pre Molar with Turner's Hypoplasia in a 5-Year-Old Boy.

    Science.gov (United States)

    Rai, Nitya; Mathur, Shivani; Sandhu, Meera; Sachdev, Vinod

    2016-08-01

    Early eruption of permanent maxillary premolar appears to be a unique finding, at such an early chronological age. Untimely eruption of permanent maxillary premolar is discussed in a 5-year-old male patient. On intra oral examination grossly carious primary maxillary first molar (tooth number 54,64) were reported. The erupting teeth presented with a hypomineralized cusp tip. Extraction following space maintainer in 64 region was given. Pediatric dentist should consider these kinds of rarities in eruption pattern while examining a pediatric patient.

  11. [Bilateral facial nerve palsy associated with Epstein-Barr virus infection in a 3-year-old boy].

    Science.gov (United States)

    Grassin, M; Rolland, A; Leboucq, N; Roubertie, A; Rivier, F; Meyer, P

    2017-06-01

    Bilateral facial nerve palsy is a rare and sometimes difficult diagnosis. We describe a case of bilateral simultaneous facial nerve palsy associated with Epstein-Barr virus (EBV) infection in a 3-year-old boy. Several symptoms led to the diagnosis of EBV infection: the clinical situation (fever, stomachache, and throat infection), white blood cell count (5300/mm 3 with 70% lymphocyte count), seroconversion with EBV-specific antibodies, lymphocytic meningitis, and a positive blood EBV polymerase chain reaction (9.3×10 3 copies of EBV-DNA). An MRI brain scan showed bilateral gadolinium enhancement of the facial nerve. A treatment plan with IV antibiotics (ceftriaxone) and corticosteroids was implemented. Antibiotics were stopped after the diagnosis of Lyme disease was ruled out. The patient's facial weakness improved within a few weeks. Bilateral facial nerve palsy is rare and, unlike unilateral facial palsy, it is idiopathic in only 20% of cases. Therefore, it requires further investigation and examination to search for the underlying etiology. Lyme disease is the first infectious disease that should be considered in children, especially in endemic areas. An antibiotic treatment effective against Borrelia burgdorferi should be set up until the diagnosis is negated or confirmed. Further examination should include a blood test (such as immunologic testing, and serologic testing for viruses and bacterium with neurological tropism), a cerebrospinal fluid test, and an MRI brain scan to exclude any serious or curable underlying etiology. Facial bilateral nerve palsy associated with EBV is rarely described in children. Neurological complications have been reported in 7% of all EBV infections. The facial nerve is the most frequently affected of all cranial nerves. Facial palsy described in EBV infections is bilateral in 35% of all cases. The physiopathology is currently unknown. Prognosis is good most of the time. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Objectively measured physical activity and bone strength in 9-year-old boys and girls.

    Science.gov (United States)

    Sardinha, Luís B; Baptista, Fátima; Ekelund, Ulf

    2008-09-01

    The purpose of this work was to analyze the relationship between intensity and duration of physical activity and composite indices of femoral neck strength and bone-mineral content of the femoral neck, lumbar spine, and total body. Physical activity was assessed by accelerometry in 143 girls and 150 boys (mean age: 9.7 years). Measurement of bone-mineral content, femoral neck bone-mineral density, femoral neck width, hip axis length, and total body fat-free mass was performed with dual-energy radiograph absorptiometry. Compressive [(bone-mineral density x femoral neck width/weight)] and bending strength [(bone-mineral density x femoral neck width(2))/(hip axis length x weight)] express the forces that the femoral neck has to withstand in weight bearing, whereas impact strength [(bone-mineral density x femoral neck width x hip axis length)/(height x weight)] expresses the energy that the femoral neck has to absorb in an impact from standing height. Analysis of covariance (fat-free mass and age adjusted) showed differences between boys and girls of approximately 9% for compressive, 10% for bending, and 9% for impact strength. Stepwise regression analysis using time spent at sedentary, light, moderate, and vigorous physical activity as predictors revealed that vigorous physical activity explained 5% to 9% of femoral neck strength variable variance in both genders, except for bending strength in boys, and approximately 1% to 3% of total body and femoral neck bone-mineral content variance. Vigorous physical activity was then used to categorize boys and girls into quartiles. Pairwise comparison indicated that boys in the third and fourth quartiles (accumulation of >26 minutes/day) demonstrated higher compressive (11%-12%), bending (10%), and impact (14%) strength than boys in the first quartile. In girls, comparison revealed a difference between the fourth (accumulation of >25 minutes/day) and first quartiles for bending strength (11%). We did not observe any

  13. [Androgen levels, parenting styles and aggressive behavior in 5-6-year-old boys and girls].

    Science.gov (United States)

    Sánchez-Martín, José R; Azurmendi Imaz, Aitziber; Fano Ardanaz, Eduardo; Braza Lloret, Francisco; Muñoz Sánchez, José M; Carreras de Alba, María R

    2009-02-01

    Androgen levels, parenting styles and aggressive behavior in 5-6-year-old boys and girls. This study explores the relationship between androgen levels, parenting styles, and physical, verbal, and indirect aggression measures in 5-6-year-old children. 129 children (60 boys and 69 girls) were assessed in relation to their aggression levels using a peer-rating technique. Parents completed the Parenting Styles and Dimensions Questionnaire, from which the different parenting styles were obtained. Testosterone, androstenedione and dehydroepiandrosterone (DHEA) were measured using an enzymoimmunoassay technique in saliva samples. A regression analysis indicated that the directive mother-androstenedione interaction at the age of 5 was predictive of physical aggression at the age of 6. In specific terms, the results showed that, in boys with high androstenedione levels, directive maternal behavior is associated with physical aggression. The results are subsequently discussed in light of postulates related to parenting characteristic of developmental psychology and we suggest a potential link of our results with the hypothesis of maternal dominance.

  14. Underweight in 14 to 16 year-old girls and boys: prevalence and associations with physical activity and sedentary activities.

    Science.gov (United States)

    Kantanista, Adam; Osiński, Wiesław

    2014-01-01

    Underweight is associated with increased mortality of adults when compared to normal weight or overweight individuals. Studies of associations between underweight and physical activity levels in adolescents are sparse. The aim of this study was to determine the prevalence of underweight amongst 14 to 16 year-old girls and boys in tandem with the levels of physical activity and time spent in sedentary activities. The results were compared to those observed in normal weight and overweight adolescents. This study included 1702 girls and 1547 boys aged from 14 to 16 years from twelve gymnasium schools in Poznan (Poland). Based on BMI values, the participants were assigned to the following categories: a) underweight, b) normal weight, and c) overweight. The levels of physical activity, participation rates in physical education classes and the time spent in sedentary activities were determined by means of questionnaire survey. The fraction of underweight girls amounted to 11.6% and was similar to the percentage of obese girls (14.6%). The fraction of underweight boys was 7.0%, and was markedly lower than the percentage of overweight boys (17.0%). Underweight and overweight boys were characterized by significantly lower levels of physical activity compared to normal weight participants (p ≤.001). Both in girls and in boys, the prevalence of underweight and overweight was not significantly associated with the time spent in various sedentary activities. Underweight occurs in relatively high fraction of girls and boys. Underweight is associated with lower levels of physical activity in boys. The prevalence of underweight among adolescents is not associated with time spent in sedentary activities.

  15. Pre-divorce problems in 3-year-olds: a prospective study in boys and girls.

    Science.gov (United States)

    Robbers, Sylvana C C; Bartels, Meike; van Beijsterveldt, C E M Toos; Verhulst, Frank C; Huizink, Anja C; Boomsma, Dorret I

    2011-04-01

    We examined to what extent internalizing and externalizing problems at age 3 preceded and predicted parental divorce, and if divorce and the time lapse since divorce were related to internalizing and externalizing problems at age 12. Parental ratings of internalizing and externalizing problems were collected with the Child Behavior Checklist (CBCL) in a large sample (N = 6,426) of 3-year-old children. All these children were followed through the age of 12 years, at which parents completed the CBCL again, while teachers completed the Teacher's Report Form. Children whose parents divorced between age 3 and age 12 were compared with children whose families remained intact. Girls whose parents divorced between ages 3 and 12 already showed more externalizing problems at age 3 than girls whose parents stayed married. Higher levels of externalizing problems in girls at age 3 predicted later parental divorce. Parental reports indicated that 12-year-olds with divorced parents showed more internalizing and externalizing problems than children with married parents. Levels of teacher-reported problems were not different between children with married versus divorced parents. However, children whose parents divorced between ages 3 and 12 showed more teacher-rated internalizing problems at age 12 when the divorce was more recent than when the divorce was less recent. Parental ratings of both internalizing and externalizing problems at age 12 were not associated with the time lapse since divorce. Externalizing problems in girls precede and predict later parental divorce. Post-divorce problems in children vary by raters, and may depend on the time lapse since divorce.

  16. Prevalence and characteristics of cigarette smoking among 16 to 18 years old boys and girls in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Al Ghobain Mohammed

    2011-01-01

    Full Text Available Objective: To study the prevalence and characteristics of cigarette smoking among secondary school students (16- to 18-year-old boys and girls in Riyadh city, Saudi Arabia. Methods: We applied a standard two-stage, cross-sectional study design. Secondary schools for both boys and girls in Riyadh city were randomly selected using a cluster sampling method. We used the global youth tobacco survey (GYTS tool to achieve our objectives. Results: Among 1272 students (606 boys and 666 girls, the prevalence of those ever smoked cigarettes was 42.8% (55.6% of boys and 31.4% of girls. The prevalence of current smoking was 19.5% (31.2% of boys and 8.9% of girls. Despite the fact that the majority of students think smoking is harmful, most do not wish to stop smoking, and they had not tried to stop in the past year. Cigarette smoking is significantly associated with the male gender, having friends who smoke, and having parents who smoke, but is not significantly associated with the type of school attended. Conclusion: Smoking prevalence among secondary schools students in Saudi Arabia is high and alarming. There is a need to implement an education program about the risks of smoking and to include parents and friends as healthy models to prevent students from beginning to smoke.

  17. Prevalence and characteristics of cigarette smoking among 16 to 18 years old boys and girls in Saudi Arabia.

    Science.gov (United States)

    Al Ghobain, Mohammed O; Al Moamary, Mohamed S; Al Shehri, Sulieman N; Al-Hajjaj, Mohamed S

    2011-07-01

    To study the prevalence and characteristics of cigarette smoking among secondary school students (16- to 18-year-old boys and girls) in Riyadh city, Saudi Arabia. We applied a standard two-stage, cross-sectional study design. Secondary schools for both boys and girls in Riyadh city were randomly selected using a cluster sampling method. We used the global youth tobacco survey (GYTS) tool to achieve our objectives. Among 1272 students (606 boys and 666 girls), the prevalence of those ever smoked cigarettes was 42.8% (55.6% of boys and 31.4% of girls). The prevalence of current smoking was 19.5% (31.2% of boys and 8.9% of girls). Despite the fact that the majority of students think smoking is harmful, most do not wish to stop smoking, and they had not tried to stop in the past year. Cigarette smoking is significantly associated with the male gender, having friends who smoke, and having parents who smoke, but is not significantly associated with the type of school attended. Smoking prevalence among secondary schools students in Saudi Arabia is high and alarming. There is a need to implement an education program about the risks of smoking and to include parents and friends as healthy models to prevent students from beginning to smoke.

  18. A Mixed Presentation of Serotonin Syndrome vs Neuroleptic Malignant Syndrome in a 12-Year-Old Boy.

    Science.gov (United States)

    Sun, Christie; Sweet, Hannah; Minns, Alicia B; Shapiro, Desiree; Jenkins, Willough

    2018-04-24

    Neuroleptic malignant syndrome (NMS) and serotonin syndrome (SS) are serious medical conditions associated with commonly prescribed psychiatric medications. Although the mechanisms differ, they can be clinically difficult to distinguish. We report a case of a pediatric patient with complicated psychiatric history that developed features of both syndromes in the setting of polypharmacy. A 12-year-old boy with a history of developmental delay, attention-deficit hyperactivity disorder, and posttraumatic stress disorder presented to the emergency department with behavior changes consisting of delayed reactions, gait instability, drooling, and slowed movements. Ten days before presentation, his outpatient psychiatrist had made multiple medication changes including discontinuation of cyproheptadine (an appetite stimulant) and initiation of aripiprazole. On arrival, the patient was noted to be tachycardia and hypertensive for age. He was disoriented, intermittently agitated, and tremulous with increased tonicity, clonus in the lower extremities, and mydriasis. He was supportively treated with lorazepam and intravenous fluids while discontinuing potential offending agents. His course was complicated by hypertension and agitation managed with dexmedetomidine infusion and benzodiazepines. His mental status, tremors, and laboratory values began to improve over the next 2 days, and eventually transitioned to the inpatient psychiatric unit on hospital day 7. Diagnosis of NMS or SS can be difficult when there is overlap between syndromes, particularly in the setting of multiple potential offending agents or underlying developmental delay. In addition, pediatric patients may present atypically as compared with adult patients with the same condition. The use of antipsychotic medications for young children with behavioral problems has risen dramatically in the last decade, increasing their risk for developing SS or NMS.

  19. Daily portraits of five and six-year old boys: the play activity

    Directory of Open Access Journals (Sweden)

    Flavia Bignardi da Silva Nunes

    2013-08-01

    Full Text Available Introduction: Daily life experiences provide maturity along human development, and the environments in which they occur are essential for this process. These experiences help to build children’s personalities and the way they deal with the world around them. Objectives: In this study, we aimed to understand the occupational behavior of four children aged five to six years old through their mothers’ reports. Methodology: The average time spent with daily activities is described, and playing was a central theme of analysis. We analyzed the preferences, companies and emotional characteristics of the play activity. We used an Activity Clock and semi-structured interviews with the children’s mothers as data collection instruments. Results: The main results show that most of their daily life time is spent with sleep, school and play activities. They indicate that children prefer games that challenge acquisitions that are under construction. Regarding company, these children still have their mothers as a reference to the play activity, but also peers their age or a little older. Conclusion: Play has an important representation in the daily occupational lives of these children and it stands as a key life experience to acquire skills and face challenges.

  20. Aerobic Games and Playful exercises in 9-YearOld Boys: Intensity and Fitness Effects

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    Gunnar E Mathisen

    2016-04-01

    Full Text Available Previous research on exercise for pre-adolescents with the purpose of improving aerobic fitness levels has yielded contradictory results. Sufficient training intensity, frequency and duration are the crucial factors in achieving this goal; the question, however, is whether it is possible to reach sufficient intensity levels using aerobic games and playful exercises. Variety and fun are the important factors in motivating children to participate in physical exercises and sports. Therefore, the aim of the study was to investigate the effect of high intensity exercises in pre-adolescent boys, using programs consisting of fun activities and aerobic games. The findings show that the participants achieved intensity levels above 80 % of HRpeak on average in about 60 % of the total exercise time, resulting in significantly improved aerobic fitness.

  1. Therapy-related myeloid neoplasm in an 18-year-old boy with B-lymphoblastic leukemia.

    Science.gov (United States)

    Qing, Xin; Panosyan, Eduard; Yue, Changjun; Ji, Ping; Gotesman, Moran; French, Samuel; Cai, Junchao

    2017-12-01

    Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. Acute myeloid leukemia or myelodysplastic syndrome during the course of ALL is a rare entity. Some of these cases are therapy-related while the others occur due to lineage switch. The correct diagnosis relies on comparing the immunophenotypes and cytogenetic/molecular alterations of the myeloid neoplasm and the ALL. We present the clinical, pathologic and cytogenetic features of a case of an 18-year-old male with prior treatment for B-lymphoblastic leukemia (B-ALL) who developed therapy-related myeloid neoplasm (t-MN) 4-5years after his initial diagnosis of B-ALL. A 13-year-old boy with no significant past medical history presented to Harbor-UCLA Medical Center (HUMC) in November 2012 with night sweats, fevers and chills, nausea, vomiting, diarrhea, fatigue, weakness, and weight loss. Peripheral blood flow cytometric analysis disclosed B-ALL. The blasts expressed CD10, CD19, CD22 (dim), CD34, CD38, HLA-DR, and TdT, and were negative for CD20, CD13, CD33, CD117, and cytoplasmic MPO. Chromosomal analysis and a supplemental fluorescence in situ hybridization (FISH) study performed on the bone marrow aspirate showed an abnormal karyotype (47,XY,+X,del(9)(p21p21)[4]/46,XY[16]). He achieved remission after induction chemotherapy and remained in remission until March 2016 when bilateral testicular masses were noted. Biopsy of the left testicular mass showed relapsed B-ALL. Cerebrospinal fluid (CSF) contained rare TdT-positive blasts, suggestive of minimal/early involvement by B-ALL. However, there was no evidence of acute leukemia in his bone marrow at this time. He was then treated with COG protocol AALL1331 randomized to blinatumomab arm and achieved second remission. In June 2017, the patient's peripheral blood smear showed 11% circulating monoblasts. By flow cytometry, the blasts expressed CD4, CD11b, CD13, CD15, CD33, CD38, CD56, and CD64. In addition, a few TdT-positive blasts were seen in

  2. [Bipolar disorders as co-morbidity in childhood and adolescence--underdiagnosed or overinterpreted? Therapy of a 14-year-old boy with hyperkinetic conduct disorder and hypomania].

    Science.gov (United States)

    Rothermel, Boris; Poustka, Luise; Banaschewski, Tobias; Becker, Katja

    2010-03-01

    Considerable debate exists regarding differing prevalence rates of co-morbid bipolar disorder in children and adolescents with ADHD in Germany as compared to the US. Described in this case report are the assessment of and treatment procedure for a 14-year old boy with hyperkinetic conduct disorder and co-morbid hypomanic episode, as well as different possible interpretations of symptoms. Further studies of children and adolescents with ADHD and coexisting impulsive-aggressive behaviour are needed. Important in practice is a precise differentiation of symptoms with regard to co-morbid bipolar disorder.

  3. Idiopathic Facial Aseptic Granuloma in a 13-Year-Old Boy Dramatically Improved with Oral Doxycycline and Topical Metronidazole: Evidence for a Link with Childhood Rosacea

    Directory of Open Access Journals (Sweden)

    Camille Orion

    2016-07-01

    Full Text Available Idiopathic facial aseptic granuloma (IFAG is a rare, benign pediatric dermatological lesion that occurs in children between 8 months and 13 years of age. The pathogenesis of IFAG is still unclear but it is likely to be associated with granulomatous rosacea in childhood. Here we describe a case of IFAG in a 13-year-old boy who showed a dramatic response to oral doxycycline and topical metronidazole, which supports the hypothesis that IFAG may belong to the spectrum of rosacea.

  4. Clinical presentation of Churg-Strauss syndrome in children: A 12-year-old-boy with ANCA-negative Churg-Strauss syndrome.

    Science.gov (United States)

    Razenberg, Femke G E M; Heynens, Jan W C M; Jan de Vries, Geeuwke; Duijts, Liesbeth; de Jongste, Johan C; de Blic, Jacques; Rosias, Philippe P R

    2012-01-01

    Churg-Strauss syndrome is an uncommon multisystem disorder characterized by asthma, eosinophilia and vasculitis. We report on a 12-year-old boy with asthma and deterioration of his general condition, who was eventually diagnosed with an ANCA-negative Churg-Strauss syndrome. The propositus included, 50 cases of childhood Churg-Strauss syndrome have been reported. The patient characteristics and clinical characteristics of these children are summarized. The respiratory tract is most frequently involved with pulmonary infiltrates, asthma and sinusitis. Early recognition of childhood Churg-Strauss syndrome is important as delayed diagnosis can lead to severe organ involvement, and possible fatal outcome.

  5. Hypotonic hyponatremia by primary polydipsia caused brain death in a 10-year-old boy

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    A Ra Ko

    2015-09-01

    Full Text Available Hypotonic hyponatremia by primary polydipsia can cause severe neurologic complications due to cerebral edema. A 10-year-and-4-month-old boy with a psychiatric history of intellectual disability and behavioral disorders who presented with chief complaints of seizure and mental change showed severe hypotonic hyponatremia with low urine osmolality (serum sodium, 101 mmol/L; serum osmolality, 215 mOsm/kg; urine osmolality, 108 mOsm/kg. The patient had been polydipsic for a few months prior, and this had been worse in the previous few days. A diagnosis of hypotonic hyponatremia caused by primary polydipsia was made. The patient was in a coma, and developed respiratory arrest and became brain death shortly after admission, despite the treatment. The initial brain magnetic resonance imaging showed severe brain swelling with tonsillar and uncal herniation, and the patient was declared as brain death. It has been reported that antidiuretic hormone suppression is inadequate in patients with chronic polydipsia, and that this inadequate suppression of antidiuretic hormone is aggravated in patients with acute psychosis. Therefore, hyponatremia by primary polydipsia, although it is rare, can cause serious and life-threatening neurologic complications.

  6. Acute Septic Arthritis of the Knee Caused by Kingella kingae in a 5-Year-Old Cameroonian Boy

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    Nawal El Houmami

    2017-11-01

    Full Text Available Kingella kingae is an important cause of invasive infections in young children from Western countries. Although increasing reports indicate that this organism is the leading agent of bone and joint infections in early childhood, data on K. kingae infections from resource-limited settings are scarce, and none has yet been reported in Africa. We herein report the diagnostic and epidemiological investigations of the first case of K. kingae arthritis identified in a child from sub-Saharan Africa. A 5-year-old Cameroonian boy presented with a sudden painful limp which appeared in the course of a mild rhinopharyngitis. He lived in Cameroon where he had been vaccinated with BCG at birth and moved to France for holidays 4 days before consultation. There was no history of trauma and he did not have any underlying medical condition. Upon admission, he had a temperature of 36.7°C, and clinical examination revealed right-sided knee tenderness and effusion that was confirmed by ultrasound imaging. Laboratory results showed a white blood cell count of 5,700 cells/mm3, C-reactive protein level of 174 mg/L, and platelet count of 495,000 cells/mm3. He underwent an arthrocentesis and was immediately given intravenous amoxicillin-clavulanate. Conventional cultures from blood samples and synovial fluids were negative. Polymerase chain reaction (PCR assay targeting the broad-range 16S rRNA gene and real-time quantitative PCR assays targeting Mycobacterium species were negative. Surprisingly, real-time PCR assays targeting the cpn60, rtxA, and rtxB genes of K. kingae were positive. Multicolor fluorescence in situ hybridization specific for K. kingae identified the presence of numerous coccobacilli located within the synovial fluid. Finally, multilocus sequence typing analysis performed on deoxyribonucleic acid directly extracted from joint fluid disclosed a novel K. kingae sequence-type complex. This case report demonstrates that K. kingae may be considered

  7. Complications of untreated molar-incisor hypomineralization in a 12-year-old boy

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    Shubha Arehalli Bhaskar

    2012-11-01

    Full Text Available Complications arising because of untreated molar-incisor hypomineralization (MIH have received little mention in the dental literature. However, this can be an area of concern, with severe consequences in rare cases. Hence, early recognition and prompt management of MIH is essential for long-term oral health of affected individuals. This paper describes an untreated case of severe MIH that resulted in infection of facial spaces.

  8. Hydatid lung cyst in a 5-year-old boy presenting with prolonged fever

    African Journals Online (AJOL)

    Cystic echinococcosis is the larval cystic stage (echinococcal cysts) of a small taeniid-type tapeworm (Echinococcus granulosus) that may cause illness in intermediate hosts, generally herbivorous animals and people who are infected accidentally. Pulmonary hydatid cysts are typical, involving one lobe in 72% of cases, ...

  9. A foreign body within the foreskin of a 10-year-old boy

    African Journals Online (AJOL)

    inserted foreign bodies in the adult male genitalia are typically the result of autoerotic activity and occasionally require removal by a urologist. In children, the problem is extremely rare and usually accidental. We present a case in which a small ...

  10. Kawasaki disease: An unusual presentation in a 14-year old boy in ...

    African Journals Online (AJOL)

    Kawasaki disease (KD) is an acute systemic vasculitis that mostly affects children less than 5years. Occasionally, it may presents with renal involvement of varying severity. In Nigeria and most of Africa, only a few cases of KD have been reported and these were among children within the typical age group. We report an ...

  11. Mechanical Complication with Broviac Repair Kit in a 4-Year-Old Boy with MEN 2a.

    Science.gov (United States)

    Sesia, Sergio B; Haecker, Frank-Martin; Mayr, Johannes

    2009-01-01

    Background. Mechanical complications in the use of indwelling central venous catheters (CVCs) such as the Broviac catheter (BC) include kinking, occlusion, dislocation or leaking. We report on a mechanical complication after using a repair kit for the BC. Method. A 4-year old boy, suffering from multiple endocrine neoplasia type 2a (MEN 2a), intestinal aganglionosis (Hirschsprung's disease), and short bowel syndrome, required a BC for home parenteral nutrition. Result. Due to recurrent leakage of the BC, 5 subsequent repairs were necessary within seven months. During one repair a metallic tube belonging to the repair kit was found to have migrated proximally to the skin entrance level within the BC and requiring surgical removal. Conclusion. To our knowledge, this is the first report focusing on such a serious complication using a BC and its repair kit. The proximal migration of this metallic tube constitutes a distinct theoretical risk of endothoracic foreign body embolization.

  12. Biotinidase deficiency presenting as recurrent myelopathy in a 7-year-old boy and a review of the literature.

    Science.gov (United States)

    Raha, Sarbani; Udani, Vrajesh

    2011-10-01

    Biotinidase deficiency may produce variable neurologic manifestations. Brainstem and spinal cord disease comprises an uncommon presentation of biotinidase deficiency. We describe a 7-year old boy with subacute progressive quadriplegia and "sighing" respirations. Severe biotinidase deficiency was established, and the patient demonstrated complete recovery with biotin supplementation. Genetic studies revealed presence of homozygous mutation in the BTD gene [c.133C>T (p.H447Y)]. Biotinidase deficiency should be considered in the differential diagnosis for subacute, long segment myelopathy, particularly with brainstem involvement. This entity is treatable; a high index of suspicion can be life-saving. We also review the literature on biotinidase deficiency presenting as spinal cord demyelinating disease. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Excision of Epulis Granulomatosa with Diode Laser in 8 Years Old Boy

    Science.gov (United States)

    Ghadimi, Sara; Chiniforush, Nasim; Najafi, Mahsa; Amiri, Sepideh

    2015-01-01

    Introduction: Epulis granulomatosa is a lesion which grows from an extraction socket. It can be misdiagnosed with lesions of the same clinical appearance such as: foreign body or pyogenic granuloma, or as a herniation of the maxillary sinus. The most common treatment is surgical excision. Case report: The present article reports an Epulis granulomatosa which was removed with diode laser (810 nm) due to child’s fear related to traditional surgical instruments and bleeding. Results and conclusion: Lasers are useful for soft tissue surgery in modern dentistry, especially in relation to pediatric patients due to the rapid and regular wound healing without sutures. PMID:25987975

  14. Noa, a 10-Year-old Composer: A Case Study

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    Michel Hogenes

    2014-12-01

    Full Text Available The present case study aims to contribute to the knowledge of music composition as a meaningful activity in music education. An extensive amount of literature on music composition is available; however, music composition as a regular classroom activity is rarely seen in elementary schools. The effects of closely guided music composition, in which extra attention is paid to the revision of music compositions, on engagement in music education and music achievement in a single subject situation were studied using a three-step-model for music composition based on the cultural-historical activity theory. The authors conclude from this case study that executing music composition activities is possible and potentially accessible for elementary school children. The used music composition model offers classroom teachers and music specialists’ possibilities to teach music composition in elementary schools and make music composition accessible for elementary school children. The current study shows that an intense collaboration between a student, as novice, and her teacher, as more knowledgeable adult, leads to more complex compositions than was seen in classroom situations. The intense collaboration offers the teacher the opportunity to adapt to ideas, needs and interests of the student. Therefore, to offer all children in a classroom situation the assistance they need, working in small groups is suggested.

  15. Concurrent non-ketotic hyperglycinemia and propionic acidemia in an eight year old boy

    Directory of Open Access Journals (Sweden)

    Paul S. Kruszka

    2014-01-01

    Full Text Available This is the first reported case of a patient with both non-ketotic hyperglycinemia and propionic acidemia. At 2 years of age, the patient was diagnosed with non-ketotic hyperglycinemia by elevated glycine levels and mutations in the GLDC gene (paternal allele: c.1576_1577insC delT and c.1580delGinsCAA; p.S527Tfs*13, and maternal allele: c.1819G>A; p.G607S. At 8 years of age after having been placed on ketogenic diet, he became lethargic and had severe metabolic acidosis with ketonuria. Urine organic acid analysis and plasma acylcarnitine profile were consistent with propionic acidemia. He was found to have an apparently homozygous mutation in the PCCB gene: c.49C>A; p.Leu17Met. The patient was also treated with natural protein restriction, carnitine, biotin, and thiamine and had subjective and biochemical improvement.

  16. Vismodegib Therapy for Basal Cell Carcinoma in an 8-Year-Old Chinese Boy with Xeroderma Pigmentosum.

    Science.gov (United States)

    Fife, Douglas; Laitinen, Marko A; Myers, David J; Landsteiner, Pamela B

    2017-03-01

    Vismodegib is an oral inhibitor of the Hedgehog signaling pathway and has been used to treat basal cell carcinoma (BCC) in adults. This article reports clearance of a nodular BCC of the nasal tip in an 8-year-old boy with xeroderma pigmentosum (XP). BCC can pose therapeutic challenges when located in areas that are not amenable to traditional therapies such as Mohs micrographic surgery or topical agents. Vismodegib was used at a dose of 150 mg/day to treat the boy's BCC. After 4 months of therapy, we achieved complete clinical clearance. During 21 months of follow-up, the patient's nose remained clinically clear of tumor. Vismodegib was successfully used to treat a child with XP and nodular BCC. Our goal in using vismodegib was tumor regression while avoiding cosmetic and functional disfigurement. Vismodegib was effective in clinically clearing the tumor, and the patient has shown no signs of recurrence. Further studies are warranted. © 2017 Wiley Periodicals, Inc.

  17. A new device expanding operability of fingertip replantation: subzone 1 fingertip replantation assisted by non-enhanced angiography in a 2-year-old boy.

    Science.gov (United States)

    Yoshimatsu, Hidehiko; Yamamoto, Takumi; Seki, Yukio; Narushima, Mitsunaga; Iida, Takuya; Koshima, Isao

    2012-11-01

    Fingertip replantation in young children is difficult, especially in cases with amputation at subzone 1. Replantation is preferred whenever possible, but the identification of vessels of operative size can be very challenging. Non-enhanced angiography (NEA; Genial Viewer; Genial Light, Shizuoka, Japan) emits infrared light with the wavelength of 850 nm, which is exclusively absorbed by haemoglobin. The light penetrates the bones and other soft tissues, effectively visualising vessels containing blood, and the image is shown in real time on the screen of a laptop computer. We present a case in which preoperative NEA visualised vessels in the amputated fingertip, allowing a successful replantation in a 2-year-old boy. By taking the guesswork out of vessel localisation, NEA can be useful in expanding operability of replantation surgery in fingertip amputations. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Temperament and parenting antecedents of individual differences in three-year-old boys' pride and shame reactions.

    Science.gov (United States)

    Belsky, J; Domitrovich, C; Crnic, K

    1997-06-01

    To examine individual differences in pride and shame reactions of 3-year-olds and their temperamental and parenting antecedents, 110 boys were studied at ages 36 and 37 months in a "rigged" achievement situation. After being trained to complete explicitly stipulated "easy" and "difficult" tasks before a buzzer sounded, success and failure were manipulated by artificially "rigging" how much time the child had to work on these tasks. Children's facial, verbal, and postural reactions to success and failure were composited to create pride scores following success and shame scores following failure. As expected, pride reactions were greater following success on the difficult than on the easy task, and shame reactions were greater following failure on the easy than on the difficult task. Early temperament (at 12/13 months) proved unrelated to pride and shame. With respect to parenting, measurements composited across 15, 21, 27, and 33 months showed that mothers and fathers who were more positive in their parenting had children who displayed less pride, and that children whose parents (especially mothers) were more negative in their parenting evinced less shame. These counterintuitive findings are discussed in terms of differences between assessments of parenting obtained in this investigation of parenting antecedents and those obtained in other studies of parental responses in the achievement situation itself. Directions for future research are outlined.

  19. A Rare Case: Struma Ovarii in a 14-Year-Old Girl.

    Science.gov (United States)

    Iltar, Elif; Ureyen, Isin; Toptas, Tayfun; Savas, Melike; Çekiç, Sema; Uysal, Aysel

    2018-02-01

    Ovarian tumors presented with ovarian mass in childhood and adolescence are uncommon but an important part of gynecological cases. Struma ovarii is one of the rare cystic benign ovarian tumors that is observed predominantly in women who are between the ages of 40 and 60 years old. It is extremely rare in adolescents. Herein, we present a 14-year-old adolescent girl with struma ovarii who presented to the emergency room with abdominal pain.

  20. Central odontogenic fibroma (simple type) in a four year old boy: Atypical cone-beam computed tomographic appearance with periosteal reaction

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    Anbiaee, Najme; Ebrahimnejad, Hamed; Sanaei, Alireza [Dept. of , Oral and Maxillofacial Radiology, Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad (Iran, Islamic Republic of)

    2015-06-15

    Central odontogenic fibroma (COF) is a rare benign tumor that accounts for 0.1% of all odontogenic tumors. A case of COF (simple type) of the mandible in a four-year-old boy is described in this report. The patient showed asymptomatic swelling in the right inferior border of the lower jaw for one week. A panoramic radiograph showed a poorly-defined destructive unilocular radiolucent area. Cone-beam computed tomography showed expansion and perforation of the adjacent cortical bone plates. A periosteal reaction with the Codman triangle pattern was clearly visible in the buccal cortex. Since the tumor had destroyed a considerable amount of bone, surgical resection was performed. No recurrence was noted.

  1. A disseminated alveolar rhabdomyosarcoma in a 9-year-old boy disclosed by chromosomal translocation (2;13) (q35;q14)

    Science.gov (United States)

    Brichard, B; Ninane, J; Gosseye, S; Verellen-Dumoulin, C; Vermylen, C; Rodhain, J; Cornu, G

    1991-01-01

    A 9-year-old boy presented with a small subcutaneous tumor of the trunk and diffuse bone marrow involvement. The first histological diagnosis given was undifferentiated malignancy possibly of neural crest origin and chemotherapy was started immediately using vincristine, cyclophosphamide, cisplatin, and teniposide (OPEC). Complete response was achieved after four courses of chemotherapy. Histological slides were then reviewed and the final diagnosis of alveolar rhabdomyosarcoma (RMS) was retained. Moreover, chromosome analysis of malignant cells in the bone marrow revealed a translocation involving chromosomes 2 and 13:t(2;13) (q35;q14). This specific karyotype finding has been recently reported in a few cases and could be specific for alveolar RMS. The patient had a relapse 7 months after diagnosis and died 4 months later.

  2. The 48, XXXX/49,XXXXY/49,XXXX,i(Yq) mosaicism in a 3-year-old boy from a twin pregnancy.

    Science.gov (United States)

    Kaluzewski, B; Podkul, D; Zaborowska, I; Moruzgala, T; Jakubowski, L

    1977-07-26

    A 3-year-old boy from twin pregnancy with the features of marked dystrophia from birth, deficient growth, considerable retardation of physical and mental development, numerous somatic defects, suspected congenital heart disease, and hypoplastic external genitalia, is reported. The 48,XXXX/49,XXXXY/49,XXXX,i(Yq) karyotype was diagnosed. The boy's brother, normally developed, had a 46,XY karyotype. It was found on the basis of serologic findings that the brothers were dizygotic twins.

  3. Diode laser versus scalpel in the treatment of hereditary gingival fibromatosis in a 6-year old boy

    Directory of Open Access Journals (Sweden)

    Samia Aboujaoude

    2016-11-01

    Full Text Available Hereditary gingival fibromatosis (HGF is a rare disease characterized by a benign enlargement of the gingiva involving both the mandible and the maxilla. This case is about a 6-year-old child with non syndromic HGF showing a severe gingival enlargement covering almost all surfaces of the teeth, in both arches, hence causing major aesthetic, phonetic and masticatory problems. The aim of the present article is to compare the outcomes of two therapeutical approaches: i classical surgical removal with scalpel; and ii diode laser resection. Compared to the surgical approach, the clinical results show that the main advantages of the diode laser technique are a better visibility during the intervention, minimal postoperative discomfort combined to a better gingival recontouring. However, the time consumption and the high cost of the laser equipment remain the main disadvantages of the systematic use of this technique.

  4. Salivary cortisol and testosterone responses to resistance and plyometric exercise in 12- to 14-year-old boys.

    Science.gov (United States)

    Klentrou, Panagiota; Giannopoulou, Angeliki; McKinlay, Brandon J; Wallace, Phillip; Muir, Cameron; Falk, Bareket; Mack, Diane

    2016-07-01

    This study examined changes in salivary testosterone and cortisol following resistance and plyometric exercise protocols in active boys. In a crossover experimental design, 26 peri-pubertal (12- to 14-year-old) soccer players performed 2 exercise trials in random order, on separate evenings, 1 week apart. Each trial included a 30 min control session followed by 30 min of either resistance or plyometric exercise. Saliva was collected at baseline, post-control (i.e., pre-exercise), and 5 and 30 min post-exercise. There were no significant differences in the baseline hormone concentrations between trials or between weeks (p > 0.05). A significant effect for time was found for testosterone (p = 0.02, [Formula: see text] = 0.14), which increased from pre-exercise to 5 min post-exercise in both the resistance (27% ± 5%) and plyometric (12% ± 6%) protocols. Cortisol decreased to a similar extent in both trials (p = 0.009, [Formula: see text] = 0.19) from baseline to post-control and then to 5 min post-exercise, following its typical circadian decrease in the evening hours. However, a significant protocol-by-time interaction was observed for cortisol, which increased 30 min after the plyometrics (+31% ± 12%) but continued to decrease following the resistance protocol (-21% ± 5%). Our results suggest that in young male athletes, multiple modes of exercise can lead to a transient anabolic state, thus maximizing the beneficial effects on growth and development, when exercise is performed in the evening hours.

  5. "Pussy Cat, Pussy Cat, Where Have You Been?" An Account of Intensive Psychotherapy with a Seven-Year-Old Boy in a Special School

    Science.gov (United States)

    Robertson, Kate

    2008-01-01

    This paper gives an account of the developments in the intensive psychotherapy of a seven-year-old boy with global development delay. It also describes the adaptations to technique and the changes in the setting that were required to support the work, which was undertaken in a special school. The importance of the regularity of sessions in helping…

  6. Clinical presentation of Churg-Strauss syndrome in children. : A 12-year-old-boy with ANCA-negative Churg-Strauss syndrome.

    NARCIS (Netherlands)

    F.G.E.M. Razenberg (Femke); J.W.C.M. Heynens (Jan); G. Jan de Vries (Geeuwke); L. Duijts (Liesbeth); J.C. de Jongste (Johan); J. de Blic (Jacques); P.P.R. Rosias (Philippe)

    2012-01-01

    textabstractChurg-Strauss syndrome is an uncommon multisystem disorder characterized by asthma, eosinophilia and vasculitis. We report on a 12-year-old boy with asthma and deterioration of his general condition, who was eventually diagnosed with an ANCA-negative Churg-Strauss syndrome. The

  7. Perceived parental control of food intake is related to external, restrained and emotional eating in 7–12-year-old boys and girls

    NARCIS (Netherlands)

    Strien, T. van; Bazelier, F.G.

    2007-01-01

    This study examined the prevalence of external, restrained and emotional eating and the relationship of these disturbed types of eating behaviours with perceived parental control of food intake (pressure to eat and restriction) in a group of 7- to 12-year-old boys and girls (n=596). External eating

  8. Depressive symptoms as a side effect of the sustained release form of methylphenidate in a 7-year-old boy with attention-deficit hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Lakić Aneta

    2012-01-01

    Full Text Available Introduction. Hyperkinetic disorder or attention-deficit hyperactivity disorder (ADHD is a clinical entity consisting of a cluster of symptoms including hyperactivity, attention disorder and impulse control disorder group. In the context of ADHD etiology we may say that genetic, clinical and imaging studies point out a disruption of the brain dopamine system, which is corroborated by the clinical effectiveness of stimulant drugs, which increase extracellular dopamine in the brain. Basically, it is a biological and not psychological disorder, which is important both for the comprehension and therapeutical approach to this problem. Today, the best recommended approach regarding children with ADHD is a combination of two therapeutic modalities: pharmacotherapy and behavioral treatment. The first-choice drugs for this disorder belong to the group of sympathomimetics - psychostimulants and atomoxetine (more recently. As the firstchoice therapy, methylphenydate in sustained release form has numerous advantages. Like all drugs, methylphenidate has its unwanted side effects. Most common are: loss of appetite, weight loss, sleeping disorders, irritability, headache. These side effects are well-known and documented in the literature. By analysing the available literature we have found cases of psychiatric side effects such as: psychosis, mania, visual hallucinations, agitation, suicidal ideas. We have not found examples of ADHD in children who use increased dosage of sustained release of methylphenidate leading to depressive symptomatology. On the other side, methylphenidate may be prescribed for off-label use in treatmentresistant cases of depression. Case report. The case of a 7- year-old boy diagnosed with ADHD was on a minimal dose of sustained release form of methylphenidate. After initial titration of the drug, i.e. after raising the dose to the next level the boy developed clinical signs of depression. The treatment was ceased and depressive

  9. Uncorrected tetralogy of fallot in a 47 year old Nigerian man: a case ...

    African Journals Online (AJOL)

    This has been attributed to relatively small degrees of left ventricular outflow tract (LVOT) obstruction and/or presence of congenital aorto-pulmonary shunts. Very few cases of uncorrected TOF in adults have been reported in Africa. We report this case of uncorrected TOF in a 47 year old Nigerian man to highlight this rare ...

  10. Childhood Trauma and Multiple Personality Disorder: The Case of a 9-Year-Old Girl.

    Science.gov (United States)

    LaPorta, Lauren D.

    1992-01-01

    This paper reports the case of a nine-year-old female victim of sexual abuse, evaluated and diagnosed with multiple personality disorder over a six-month period. Included is a description of the child's presentation with historical and developmental data. A discussion of the dynamic and predisposing features of the case follows, along with…

  11. Cervical nodular fasciitis in a 10-year-old girl: a case report of a rare ...

    African Journals Online (AJOL)

    Thus, as clinical and morphologic characteristics are similar to those of malignant tumours, this entity is often misdiagnosed, with a few cases described in the literature. We present a case of nodular fasciitis involving the retropharynx and hypopharynx of a 10-year-old girl and discuss the importance of considering this rare ...

  12. Gasoline Abuse in a 10-Year-Old Child with Mental Retardation: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohit Joshi

    2015-01-01

    Full Text Available Inahalant abuse is of increasing interest in India. The age of onset is typically during adolescence. Gasoline inhalant use is rarely reported in adolescents with intellectual deficit. We report a case of petrol dependence in a 10-year-old child with mental retardation. Possible effect of petrol huffing on behavior and cognition is discussed.

  13. Ovarian echinococcosis in a 4-year old girl - case report | Stanev ...

    African Journals Online (AJOL)

    Hydatid disease of the genital organs is very rare with an incidence of 0.2%. This disease has no specific symptoms and findings. It is usually diagnosed intraoperatively. We present a case of a four-year old girl with ovarian echinococcosis, who had earlier been operated on in the Clinic of Pediatric Surgery University ...

  14. Early treatment of simphysis mandible fracture in children 12 years old using Erich arch bar (case report

    Directory of Open Access Journals (Sweden)

    Syahril Samad

    2016-06-01

    Full Text Available Incidence rate of symphysis mandible fracture in children was about 15 – 20%. Boys are effected twice as frequently as girls. The pattern of craniomaxillofacial fractures seen in children varies with evolving skeletal anatomy and socioenvironmental factors. The treatment of pediatric maxillofacial fractures is due to physiological, developmental, and anatomical characteristic of children. Management of pediatric mandible fracture by anatomic reduction is combine with stabilization adequate to maintain it until bone union has occured. This case report is aimed to explain about the management of simphysis mandible fracture in pediatric using erich arch bar. A 12 years old boy has fracture in mandible due to accident with mechanisme the chin hit the touching motorcyle tank. Clinically, was a deformity at the anterior of mandible and malocclusion has occured. Patient also complaint a  pain with swelling and bleeding at the regio of fracture and lip. Suturing was done  in wound area intra and extra oral, followed by application of arch bar in maxilla and mandible. Control at the third day was found a vague fracture line in panoramic radiograph. Management of emergency trauma in oral and maxillofacial surgery was based on principle of ATLS was done in this case. Following treatment was application of erich arch bar for mobility reducing the fracture of mandible symphisis. Management of mandibular symphisis fracture in 12 years old children with full eruption of teeth has been given a good healing  due to the teeth  was act to develop retention and stabilize the erich arch bar. Management of pediatric simphysis mandible fracture for 12 years old children with full eruption of teeth using erich bar revealed a healed fracture.

  15. [YEL-AND meningoencephalitis in a 4-year-old boy consecutive to a yellow-fever vaccine].

    Science.gov (United States)

    Gerin, M; Wroblewski, I; Bost-Bru, C; N'guyen, M-A; Debillon, T

    2014-04-01

    Yellow fever is a vector-borne disease transmitted by an endemic mosquito in sub-Saharan Africa and tropical South America. It causes fever and possibly liver and renal failure with hemorrhagic signs, which may be fatal. The yellow-fever vaccine is an attenuated vaccine that is recommended for all travelers over the age of 9 months in high-risk areas. Adverse effects have been reported: minor symptoms (such as viral syndrome), hypersensitivity reactions, and major symptoms such as viscerotropic disease (YEL-AVD) and neurotropic disease (YEL-AND). The yellow-fever vaccine-associated autoimmune disease with central nervous system involvement (such as acute disseminated encephalomyelitis) associates fever and headaches, neurologic dysfunction, seizures, cerebrospinal fluid (CSF) pleocytosis, and elevated protein, with neuroimaging consistent with multifocal areas of demyelization. The presence of antibodies or virus in CSF, within 1-30 days following vaccination, and the exclusion of other causes is necessary for diagnosis. We describe herein the case of a 4-year-old child who presented with severe encephalitis consecutive to a yellow-fever vaccine, with favorable progression. Diagnosis is based on the chronology of clinical and paraclinical signs and the presence of yellow-fever-specific antibodies in CSF. The treatment consists of symptomatic treatment and immunoglobulin injection. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  16. Ovarian mucinous cystadenocarcinoma in 17-year-old girl : a case report

    International Nuclear Information System (INIS)

    Lee, Jong Koo; Ko, Jae Kook; Moon, Hee Jung; Kim, Mi Young; Yu, Hyun; Shin, Hyun Ja; Seo, Kung Yong; Kim, Jeong Rye

    1997-01-01

    Malignant epithelial neoplasm usually occurs in postmenopausal women, with less than 10% of cases occurring in women under the age of 20. In patients below this age, the majority of ovarian tumors are of germ cell origin and malignant ovarian epithelial tumors are uncommon. We report US and CT imaging in a case of mucinous cystadenocarcinoma in a 17-year-old nullipara who complained of amenorrhea for 45 days and a palpable mass

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

    Directory of Open Access Journals (Sweden)

    Emily Adams-Piper

    2016-01-01

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

  18. Ovarian mucinous cystadenocarcinoma in 17-year-old girl : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Koo; Ko, Jae Kook; Moon, Hee Jung; Kim, Mi Young; Yu, Hyun; Shin, Hyun Ja; Seo, Kung Yong; Kim, Jeong Rye [Korea Veterans' Hospital, Seoul (Korea, Republic of)

    1997-08-01

    Malignant epithelial neoplasm usually occurs in postmenopausal women, with less than 10% of cases occurring in women under the age of 20. In patients below this age, the majority of ovarian tumors are of germ cell origin and malignant ovarian epithelial tumors are uncommon. We report US and CT imaging in a case of mucinous cystadenocarcinoma in a 17-year-old nullipara who complained of amenorrhea for 45 days and a palpable mass.

  19. Waardenburg Syndrome in an 8 Year Old African Child: Case Report

    OpenAIRE

    V. Odogu; I. O. Chukwuka; N. Chinawa

    2017-01-01

    Aim: Waardenburg syndrome is a very rare condition, inherited autosomally with genetic heterogeneity and characterized by deafness, hair discoloration, iris discoloration and eyelid changes. Case Report: We report a case of an 8 year old female child with a history of a striking difference between the eyes since birth. Ocular examination revealed slightly widened medial canthal distances and hypertelorism. There was a lateral displacement of the right inner canthi [Dystopia Canthorum]. T...

  20. Self-reported medicine use among 11- to 15-year-old girls and boys in Denmark 1988-1998

    DEFF Research Database (Denmark)

    Holstein, Bjørn E; Holme Hansen, Ebba; Due, Pernille

    2003-01-01

    To describe the self-reported medicine use for common health complaints among 11-15-year-olds in Denmark during a ten year period, 1988-1998. The paper focuses on medicine for headache, stomach ache, cough, cold, nervousness, and difficulties in getting to sleep.......To describe the self-reported medicine use for common health complaints among 11-15-year-olds in Denmark during a ten year period, 1988-1998. The paper focuses on medicine for headache, stomach ache, cough, cold, nervousness, and difficulties in getting to sleep....

  1. Self-reported medicine use among 11-to 15-year-old girls and boys in Denmark 1988-1998

    DEFF Research Database (Denmark)

    Holstein, BE; Hansen, EH; Due, P

    2003-01-01

    To describe the self-reported medicine use for common health complaints among 11-15-year-olds in Denmark during a ten year period, 1988-1998. The paper focuses on medicine for headache, stomach ache, cough, cold, nervousness, and difficulties in getting to sleep.......To describe the self-reported medicine use for common health complaints among 11-15-year-olds in Denmark during a ten year period, 1988-1998. The paper focuses on medicine for headache, stomach ache, cough, cold, nervousness, and difficulties in getting to sleep....

  2. Acute effects of active gaming on ad libitum energy intake and appetite sensations of 8–11-year-old boys

    OpenAIRE

    Allsop, Susan; Dodd-Reynolds, Caroline; Green, Benjamin; Debuse, Dorothée; Rumbold, Penny

    2015-01-01

    The present study examined the acute effects of active gaming on energy intake (EI) and appetite responses in 8–11 year-old boys in a schoolbased setting. Using a randomised cross-over design, twenty-one boys completed four individual 90-min gaming bouts, each separated by 1 week. The gaming bouts were (1) seated gaming, no food or drink; (2) active gaming, no food or drink; (3) seated gaming with food and drink offered ad libitum; and (4) active gaming with food and drink offered ad libitum....

  3. Comparison of short-term energy intake and appetite responses to active and seated video gaming, in 8-11-year-old boys.

    OpenAIRE

    Allsop, Susan; Green, Benjamin; Dodd-Reynolds, Caroline; Barry, Gillian; Rumbold, Penny

    2016-01-01

    The acute effects of active and seated video gaming on energy intake (EI), blood glucose, plasma glucagon-like peptide-1 (GLP-17-36) and subjective appetite (hunger, prospective food consumption and fullness) were examined in 8-11-year-old boys. In a randomised, crossover manner, twenty-two boys completed one 90-min active and one 90-min seated video gaming trial during which food and drinks were provided ad libitum. EI, plasma GLP-17-36, blood glucose and subjective appetite were measured du...

  4. Splenic artery pseudoaneurysm due to acute pancreatitis in a 6-year-old boy with acute lymphoblastic leukaemia treated with L-aspariginase

    DEFF Research Database (Denmark)

    Larsen, Cæcilie Crawley; Laursen, Christian B; Dalby, Kasper

    2014-01-01

    Acute pancreatitis is a rare phenomenon in children but its incidence seems to be increasing. In children, it is generally caused due to systemic illness, biliary disease, trauma, idiopathy and side effects of medicines like L-aspariginase. Acute pancreatitis is difficult to diagnose in children ...... pseudoaneurysm due to acute pancreatitis in a 6-year-old boy with acute lymphoblastic leukaemia treated with L-aspariginase. He presented with fever, irritability and pain in his left groin region....

  5. The effect of whole-body vibration and resistance training on muscle strength in a 13-year-old boy with m. biceps femoris lesion and posttraumatic calcification

    Directory of Open Access Journals (Sweden)

    Pantović Milan

    2015-01-01

    Full Text Available Introduction. Skeletal muscle atrophy is a common adaptation after major muscle lesion of m. biceps femoris that results in numerous health-sport related complications. Resistance strength training and whole-body vibration (WBV have been recognized as an effective tool, which attenuates atrophy and evokes hypertrophy. Case report. We presented a 13-year-old boy with a lesion of m. biceps femoris and posttraumatic calcification sustained in soccer training session 6 month prior participation in this study. The patient underwent training 3 times a week for 7 weeks, including unilateral progressive WBV + resistance training (RT of the right hamstrings muscle group using WBV and weights. Hamstrings muscle strength was measured using a Cybex isokinetic dynamometer. At the end of week 4, the patient peak torque value of the involved leg increased from 39% body weight (BW to 72% BW and bilateral deficit decreased from -64% to -35%; at the end of week 7 the participant’s peak torque value of the involved leg increased from 72% BW to 98% BW and bilateral deficit decreased from -35% to -3%, respectively. Conclusion. Unilateral WBV + RT protocol evokes strength increase in the hamstrings muscle group. This case study suggests that adding WBV, as well as the RT program have to be considered in the total management of strength disbalance. Further studies are needed to verify the efficiency of WBV + RT protocol over the classic physical therapy exercise program.

  6. Incidental Radiographic Discovery of a Screw in a Primary Molar: An Unusual Case Report in a 6 Year Old Child

    Directory of Open Access Journals (Sweden)

    Farhin Katge

    2013-01-01

    Full Text Available Dentists often find foreign bodies in the primary dentition of children who habitually place objects in their mouths. The objects are frequently embedded in exposures that result from carious or traumatic lesions or from endodontic procedures that have been left open for drainage. Such bodies are often detected on routine radiographs and, less frequently, during clinical examination. We report a case of a 6-year-old boy who had inadvertently embedded a screw in his mandibular right first primary molar and had forgotten about it until it became symptomatic. The screw was impacted in the exposed pulp chamber due to a large carious lesion in the affected molar. This case report considers the possible medical and dental consequences of placing foreign bodies in the mouth.

  7. Successful Pregnancy Outcome in Recurrent Ovarian Cancer in a 26 Year Old: A Case Report

    Directory of Open Access Journals (Sweden)

    Savita Rani Singhal

    2018-06-01

    Full Text Available Objective: To report a case of Successful Pregnancy Outcome in Recurrent Ovarian Cancer in a 26 year Old. Case Report: A 26 years old primigravida presented in antenatal clinic at 23 weeks of pregnancy with recurrence of ovarian cancer of mucinous type. Following refusal of surgical management, two courses of single dose carboplatin was administered. However, before third cycle of chemotherapy could be administered ,there was deranged liver functions tests, following which elective Cesarean section with staging laparotomy was planned at 34 weeks for breech presentation with oligohydramnios. A live healthy baby girl 2.3kg was delivered. Total abdominal hysterectomy with right salpingo-oopherectomy, infracolic omentectomy, appendectomy was done. The final diagnosis was recurrent mucinous ovarian adenocarcinoma. Postoperatively, she was given six cycles of chemotherapy (carboplatin and paclitaxel. Conclusion: Chemotherapy and surgery, both are safe beyond first trimester and multidisciplinary treatment must be planned after taking into account the wishes of couple.

  8. Case report. Neurosyphilis Masquerading as Stroke in an 84-year-old

    Directory of Open Access Journals (Sweden)

    Bologa Cristina

    2017-04-01

    Full Text Available The case of an 84 years old woman with uncharacteristic neurologic and cognitive symptoms, suspected of ischemic stroke is presented. Following an extensive assessment in the departments of neurology and internal medicine, the unusual aetiology of stroke was identified as meningovascular neurosyphilis. The patient fully recovered after antibiotic therapy. To our knowledge, this the eldest patient with tertiary neurosyphilis reported in the literature.

  9. A case of polyserositis in a 56-year-old female patient

    Directory of Open Access Journals (Sweden)

    Aratrika T Das

    2016-01-01

    Full Text Available Polyserositis is defined as general inflammation of serous membranes associated with serous effusion due to many causes. In this case, we report polyserositis as a complication of connective tissue disorder. A 56-year-old female with a history of hypertension, hypothyroidism, and bipolar disorder having dyspnea along with pleural effusion which was repeatedly tapped and treated on suspicion of tuberculosis. She became better on steroid treatment and her respiratory distress resolved.

  10. Growth trends in boys and girls (10-17 years-old) from autonomous region of Madeira, Portugal between 1996-1998 and 2007-2009.

    Science.gov (United States)

    Sousa, B; Oliveira, B M P M; de Almeida, M D V

    2012-01-01

    Growth trends have never been studied in adolescents of the Autonomous Region of Madeira, Portugal. To analyse growth trends in weight, height, body mass index (BMI), waist circumference (WC), mid-upper arm circumference (MUAC) and triceps skin-fold thickness (TST) of adolescents (10-17 years old) of the Autonomous Region of Madeira between 1996-1998 and 2007-2009. A cross-sectional study was carried out between 2007-2009, including 4314 adolescents, 2237 girls and 2077 boys (10-17 years old). To study secular growth trends, data were compared with a sample from 1996-1998, comparing the means for each anthropometric variable by age and sex using the independent-sample t-test. An average increase was found in weight of 5.8 kg in boys and 6.3 kg in girls; in height of 3.0 cm in boys and 3.7 cm in girls; in BMI of 1.5 kg/m(2) in boys and 1.7 kg/m(2) in girls; in WC a difference of 5.6 cm and 4.9 cm for boys and girls, respectively, and for MUAC a difference of 2.7 cm in boys and 2.0 cm in girls. No differences were found in TST in boys, but in girls an increase of 1.2 mm was observed. A general increase in anthropometric measurements, more marked in weight, BMI, WC and MUAC and at younger ages, was observed.

  11. Central lactic acidosis, hyperventilation, and respiratory alkalosis: leading clinical features in a 3-year-old boy with malignant meningeal melanoma.

    Science.gov (United States)

    Blüher, Susann; Schulz, Manuela; Bierbach, Uta; Meixensberger, Jürgen; Tröbs, Ralf-Bodo; Hirsch, Wolfgang; Schober, Ralf; Kiess, Wieland; Siekmeyer, Werner

    2008-04-01

    Meningeal tumors are extremely rare in children and are diagnostically as well as therapeutically challenging. Among the least common types of malignancies in childhood is malignant melanoma, counting for less than 1% of pediatric tumors. Due to the rarity and the wide spectrum of appearance, initial clinical features may be misleading. A 3-year-old boy was referred to our hospital with symptoms of hyperventilation, dyspnoea, tachycardia, respiratory alkalosis, inarticulate speech, and fatigue. Measurement of pH in cerebrospinal fluid (CSF) yielded central lactic acidosis despite alkalosis in peripheral blood. Diagnostic imaging procedures as well as histology and immunohistochemistry revealed the diagnosis of a malignant meningeal melanoma. We hypothesize that central lactate production of the tumor nests might have induced central acidification, thus inducing hyperventilation by stimulation of central chemoreceptors. This case is a model example of the key role of central pH as an inducer/suppressor of ventilation in humans and illustrates the critical importance of central pH for regulating both ventilation and acid-base homeostasis. Thus, pH of CSF should be measured whenever a malignant brain tumor is suspected.

  12. Be careful of lies: a six-year-old boy with respiratory distress and decreased level of consciousness.

    OpenAIRE

    Behdad Gharib; Hossein Farshadmoghadam; Firozeh Hosseini; Bahareh Yaghmaie

    2014-01-01

    We reports a six-year-old child with autistic disorder and methadone intoxication. Developmental disorders may mislead the caretakers and doctors to interpret the clinical manifestation and behavioral changes of these patients. Methadone indigestion can be fatal in children even in a tiny amount and cardiac monitoring should be performed at least for the first 24 hours. The pervasive prescription of methadone for detoxification programs and its extensive availability at homes of the addicted ...

  13. Psychosocial and demographic predictors of fruit, juice and vegetable consumption among 11-14-year-old Boy Scouts

    Science.gov (United States)

    Psychosocial and demographic correlates of fruit, juice, and vegetable (FJV) consumption were investigated to guide how to increase FJV intake. Experimental design consisted of hierarchical multiple regression analysis of FJV consumption on demographics and psychosocial variables. Subjects were boys...

  14. Be careful of lies: a six-year-old boy with respiratory distress and decreased level of consciousness.

    Directory of Open Access Journals (Sweden)

    Behdad Gharib

    2014-06-01

    Full Text Available We reports a six-year-old child with autistic disorder and methadone intoxication. Developmental disorders may mislead the caretakers and doctors to interpret the clinical manifestation and behavioral changes of these patients. Methadone indigestion can be fatal in children even in a tiny amount and cardiac monitoring should be performed at least for the first 24 hours. The pervasive prescription of methadone for detoxification programs and its extensive availability at homes of the addicted parents should point parents, doctors and media to pay more attention to provide safe-home environment for children.

  15. Be careful of lies: a six-year-old boy with respiratory distress and decreased level of consciousness.

    Science.gov (United States)

    Gharib, Behdad; Farshadmoghadam, Hossein; Hosseini, Firozeh; Yaghmaie, Bahareh

    2014-01-01

    We reports a six-year-old child with autistic disorder and methadone intoxication. Developmental disorders may mislead the caretakers and doctors to interpret the clinical manifestation and behavioral changes of these patients. Methadone indigestion can be fatal in children even in a tiny amount and cardiac monitoring should be performed at least for the first 24 hours. The pervasive prescription of methadone for detoxification programs and its extensive availability at homes of the addicted parents should point parents, doctors and media to pay more attention to provide safe-home environment for children. 

  16. [Dipylidium caninum infection in a 2 year old infant: case report and literature review].

    Science.gov (United States)

    Neira O, Patricia; Jofré M, Leonor; Muñoz S, Nelson

    2008-12-01

    Dipylidiasis is a zoonotic parasitic infection caused by the dog tapeworm Dipylidium caninum; it affects both feline and canine species and accidentally, humans. In Chile, as well as in other countries, it is an uncommon infection. A case of a 2 year old child from Casablanca, (a city located in the Valparaíso Region), with an infection by D. caninum, is presented. Clinical manifestations are reviewed, as well as epidemiology in domestic and wild animals, cases among the published national literature and its treatment and prevention strategies.

  17. Spontaneous Mediastinitis in a Ten-year-old Girl: A Case Report

    International Nuclear Information System (INIS)

    Cho, Kyung Eun; Kim, Ji Hong; Yoon, Choon Sik; Lee, Mi Jung; Kim, Myung Joon

    2011-01-01

    Acute suppurative mediastinitis is an uncommon, life threatening condition with a mortality rate of up to 40%. It is mainly caused by esophageal perforation or post-operative complications, and acute mediastinitis not caused by trauma or surgery is rare. To the best of our knowledge, no cases of spontaneous mediastinal abscess in children have been reported in the English medical literature. We report here on a case of an acute mediastinal abscess in a ten-year-old girl and there was no demonstrable clinical or radiologic etiology for infection

  18. Spontaneous Mediastinitis in a Ten-year-old Girl: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Kyung Eun; Kim, Ji Hong; Yoon, Choon Sik [Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Mi Jung; Kim, Myung Joon [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-01-15

    Acute suppurative mediastinitis is an uncommon, life threatening condition with a mortality rate of up to 40%. It is mainly caused by esophageal perforation or post-operative complications, and acute mediastinitis not caused by trauma or surgery is rare. To the best of our knowledge, no cases of spontaneous mediastinal abscess in children have been reported in the English medical literature. We report here on a case of an acute mediastinal abscess in a ten-year-old girl and there was no demonstrable clinical or radiologic etiology for infection

  19. Nutritional status and food consumption in 10-11 year old Dutch boys (Dutch Nutrition Surveillance System)

    NARCIS (Netherlands)

    Poppel, G.van.; Schneijder, P.; Löwik, M.R.H.; Schrijver, J.; Kok, F.J.

    1991-01-01

    As part of the Dutch Nutrition Surveillance System, cardiovascular risk factors and food consumption (24 h recall) as well as haematological, Fe and vitamin status (A, B6, C) were assessed in 126 Dutch boys aged 10-11 years (response 71%). Body mass index (BMI) and the sum of four skinfolds were

  20. The effect of a 12 week plyometric and soccer training on the cardiac structure and function among the 13-15 years old boys

    Directory of Open Access Journals (Sweden)

    Bakhtiar Tartibian

    2017-04-01

    Full Text Available Background: Exercise plays an important role in improving cardiovascular function. Due to the increasing tendency of children to the soccer the purpose of this investigation was to examine the effects of a 12 week plyometric and soccer training on the cardiac structure and function of healthy 13-15 years old boys. Materials and Methods: This quasi- experimental study was conducted with a pre-test and post-test design. The participants (n=20 were selected among the non-athletic healthy boys (13-15 years from Miyaneh (East Azerbaijan, Iran. After taking informed consent the participants were voluntarily participated in two equal Training and Control groups. The participants in the Exercise group performed a 12 week plyometric and soccer training. Under basic conditions and after a 12 week follow-up using the echocardiography both groups were examined for left ventricular end-diastolic dimension (LVEDD, left ventricular end-systolic dimension (LVESD, left ventricular end diastolic posterior wall dimension¬ (LVPWd, inter-ventricular septal end diastolic dimension (IVSd, stroke volume (SV, ejection fraction (EF and cardiac output (CO. Results: After a 12 week training program the LVEDD, LVPWd and SV were significantly increased (P<0.05. The EF in the Exercise group had no increase. Moreover, LVESD and IVSd were similar in both groups. Conclusion: A twelve week plyometric and soccer training in 13-15 years old boys result in significant changes in some cardiac structural and functional indexes.

  1. Weil’s disease in a 36 years old female: a case report

    Science.gov (United States)

    Rozalena, S.; Handayani, L.; Arman, A.; Permata, M.; Hudari, H.

    2018-03-01

    Leptospirosis is an acute zoonotic infection, itis caused by spirochetes of the genus Leptospira, has extensive vasculitis characterizes, can usually be transmitted indirectly, per contaminated water, rarely directly, and through contact with infected animals. Leptospira bacteria commonly enter the body through the damaged skin or mucous membranes. The clinical syndromes may vary from a subclinical infection and mild febrile condition to severe clinical symptoms with jaundice and renal failure. It is the case report from a woman 36 years old with leptospirosis (Weil’s disease) whose clinical manifestations included: icterus, renal failure, hemorrhagic syndrome and disturbances of consciousness. After the use of antibiotics, symptomatic and substitution therapy, all symptoms resolved completely.

  2. Sjögren's syndrome in a 25-year-old female: A case study

    Directory of Open Access Journals (Sweden)

    Bacem A.E.O. Khalele

    2016-12-01

    Full Text Available Sjögren syndrome (SS is an autoimmune epithelitis characterized by lymphocytic glandular infiltration and various extraglandular manifestations. SS is usually encountered in middle-aged females (>50 years. Immunological, viral, hereditary, environmental and hormonal etiologic factors are controversially proposed with regard to the pathogenesis of SS with no upper hand given. The present study reports an atypical case of SS in a 25-year-old female who was closely followed up for three years. Being pregnant in 2015, SS ran a total remission course but did relapse more aggressively after delivery. Immunologically implicating, the possible interpretation, which may account for such a pathological fluctuation, is also tackled.

  3. Paget-Schroetter Syndrome in 52-Year-Old Male: An Interesting Case Report

    Directory of Open Access Journals (Sweden)

    Nik Kosai

    2017-04-01

    Full Text Available Paget-Schroetter syndrome is a form of upper limb deep venous thrombosis and it is commonly seen in young individuals. Paget-Schroetter syndrome is a rare condition and diagnosis becomes more difficult if it occurs in old individuals. There is no clear consensus regarding the exact treatment of Paget's Schroetter syndrome. A high grade of suspicion with early diagnosis and treatment is needed. We here describe the case of Paget-Schroetter syndrome in a 52-year-old male and discuss the important clinical features and treatment modalities.

  4. Clear cell adenocarcinoma of the ulterine cervix in a 15 year old girl: A case report

    International Nuclear Information System (INIS)

    Choi, Seung Joon; Kim, Jee Eun; KIm, Hyung Sik; Choi, Hye Young

    2013-01-01

    Cervical cancer is rare in the pediatric population. In cases of cervical cancer, adenocarcinoma is predominantly reported. Clear cell adenocarcinoma (CCAC) of the uterine cervix is a very rare tumor and accounts for only 4% of all adenocarcinomas of the uterine cervix. Risk factors and pathogenesis of this disease are not exactly revealed. The intrauterine exposure to diethylstilbestrol (DES) and associated non-steroidal estrogen during pregnancy before 18 weeks is the only known risk factor. This study reports the imaging finding of primary uterine cervical tumor in a 15-year-old girl, who was finally diagnosed with CCAC, with no maternal history of DES exposure in utero.

  5. [A rare case report of laryngeal leech infestation in a 70-year-old man].

    Science.gov (United States)

    Anajar, Said; Tatari, Mohammed; Hassnaoui, Jawad; Abada, Reda; Rouadi, Sami; Roubal, Mohammed; Mahtar, Mohammed

    2017-01-01

    Foreign bodies in the upper respiratory tract are one of the most difficult otolaryngological emergencies; leeches are a very rare foreign bodies in the world. We report the case of a 70-year-old man with no past medical history presenting with laryngeal dyspnea associated with low abundant paroxysmal hemoptysis. The patient underwent nasofibroscopy showing the presence of a living and mobile organism at the subglottic level evoking a leech. Extraction was carried out under local anesthesia using laryngoscope and Magill forceps. The presence of a leech as a foreign body in the upper respiratory tract should be suspected in patients with a recent history of consumption of non-potable water.

  6. Toddler's Paralysis: An Acute Case of Leg Stiffening in a Previously Healthy 2-Year-Old.

    Science.gov (United States)

    Kahne, Kimberly Renee; Tay, Ee Tein

    2018-05-14

    Vegetarian and vegan diets are gaining popularity in the United States. Although appropriately planned vegetarian diets, including vegan diets, are healthful and nutritionally adequate and may provide health benefits in the prevention and treatment of certain diseases, not all families are aware of the nutritional supplements that may be required for their children. We describe a case of a 2-year-old previously healthy child consuming a vegan diet who presented to the pediatric emergency department with an acute inability to move her legs. Ionized calcium was found to be 0.89 mmol/L, and symptoms completely resolved within 2 hours of calcium gluconate infusion.

  7. Clear cell adenocarcinoma of the ulterine cervix in a 15 year old girl: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seung Joon; Kim, Jee Eun; KIm, Hyung Sik; Choi, Hye Young [Dept. of Radiology, Gachon University Gil Hospital, Incheon (Korea, Republic of)

    2013-10-15

    Cervical cancer is rare in the pediatric population. In cases of cervical cancer, adenocarcinoma is predominantly reported. Clear cell adenocarcinoma (CCAC) of the uterine cervix is a very rare tumor and accounts for only 4% of all adenocarcinomas of the uterine cervix. Risk factors and pathogenesis of this disease are not exactly revealed. The intrauterine exposure to diethylstilbestrol (DES) and associated non-steroidal estrogen during pregnancy before 18 weeks is the only known risk factor. This study reports the imaging finding of primary uterine cervical tumor in a 15-year-old girl, who was finally diagnosed with CCAC, with no maternal history of DES exposure in utero.

  8. A Rare Case of Primary Meningococcal Myopericarditis in a 71-Year-Old Male

    Directory of Open Access Journals (Sweden)

    Odilia I. Woudstra

    2016-01-01

    Full Text Available We describe a case of primary meningococcal C pericarditis with myocardial involvement in a 71-year-old male that is thus far the oldest patient with isolated meningococcal pericardial disease and only the third patient with primary meningococcal myopericarditis described in English literature. Our patient was successfully treated by full sternotomy and surgical drainage combined with intravenous ceftriaxone. Mild symptoms unresponsive to anti-inflammatory treatment and leukocytosis may guide clinicians towards the correct diagnosis. It is important to recognize this cause of pericarditis as the relatively mild clinical presentation may rapidly progress into tamponade and right-sided heart failure.

  9. Central retinal artery occlusion in the 9 years old girl (Clinical case report

    Directory of Open Access Journals (Sweden)

    E. Yu. Markova

    2013-01-01

    Full Text Available 9 years old girl was admitted to the Ophthalmological Department of Morozov Pediatric City Clinical Hospital with sudden persistent painless loss of vision of the left eye. Other organs and systems were without any changes. After ophthalmological examination (OS — white edema of central and peripapillar retina, a cherry red spot at the fovea the diagnosis of central retinal artery occlusion OS was formed, and treatment was started immediately. CRAO practically does not occur in pediatric ophthalmological practice. Therefore this clinical case can be of interest to clinicians and pediatric ophthalmologists.

  10. Central retinal artery occlusion in the 9 years old girl (Clinical case report

    Directory of Open Access Journals (Sweden)

    E. Yu. Markova

    2014-07-01

    Full Text Available 9 years old girl was admitted to the Ophthalmological Department of Morozov Pediatric City Clinical Hospital with sudden persistent painless loss of vision of the left eye. Other organs and systems were without any changes. After ophthalmological examination (OS — white edema of central and peripapillar retina, a cherry red spot at the fovea the diagnosis of central retinal artery occlusion OS was formed, and treatment was started immediately. CRAO practically does not occur in pediatric ophthalmological practice. Therefore this clinical case can be of interest to clinicians and pediatric ophthalmologists.

  11. Primary Disseminated Hydatid Cysts in a 14-Year-Old Girl: A Case Report

    Directory of Open Access Journals (Sweden)

    Nazanin Fallah

    2018-01-01

    Full Text Available Hydatid cysts in humans usually located in the liver or lungs primarily and some case in the other organs. Sometimes, because the trauma or medical manipulating, the cyst may be rupture and protoscoleces spillage resulted in secondary hydatid cyst. Primary dissemination of cyst to multiple organs is a rare phenomenon. Herein, we reported a 14-year-old teenage female patient with symptoms of abdominal pain with an unusual ultrasonographic and computed tomographic presentation mimicking polycystic ovarian syndrome PCOS. Due to numerous masses in the retrovesical region, she was admitted for surgical treatment in the gynecology ward, and after laparotomy, more than 50 cysts removed her internal organs.

  12. Tuberculous Dactylitis in a 20 Year Old – A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Shefali Goyal

    2017-10-01

    Full Text Available Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis and manifested by formation of tubercles and caseous necrosis in tissues. Tuberculous spondylitis is the most typical form of disease in the musculoskeletal system. Tubercular dactylitis is the tuberculous infection of metacarpal, metatarsal and phalanges and is uncommon. Tuberculous granuloma results in spindle shaped expansion of the short tubular bones, so it is also called as Spina Ventosa (Spina=thorn, Ventosa=full of air. We present a case of 20 year old female with an isolated swelling in the right thumb of 3 months duration.

  13. Colorectal carcinoma in a ten-year-old girl: A case report

    Directory of Open Access Journals (Sweden)

    Sarbani Chattopadhyay

    2012-01-01

    Full Text Available Colorectal carcinoma is very rare in childhood. In this case report, we depict a ten-year-old girl who presented with features of intestinal obstruction which turned out to be due to poorly differentiated mucin secreting adenocarcinoma of descending colon. Only increased awareness of this malignancy in this age-group and a high index of suspicion can help when a child complains of persistent pain of abdomen, altered bowel habits or rectal bleeding, and may provide diagnosis at an earlier stage, thereby improving the prognosis.

  14. Fournier’s Gangrene in a Two Year Old Child: A Case Report

    Science.gov (United States)

    Bains, Satinder Pal Singh; Singh, Vikram; Jain, Amit; Arry, Vivek

    2014-01-01

    Necrotizing fasciitis of the perineum and external genitalia is a life-threatening infective gangrene, primarily seen in adults. It may be seen at any age but it is relatively uncommon in children. Here, we report a case of Fournier’s gangrene in a two year old male child who was treated aggressively with broad spectrum antibiotics and early surgical debridement with hemodynamic stabilization. Even though no obvious precipitating cause was identified, hygiene was thought to be the inciting factor. Early surgical debridement with appropriate antibiotics and aggressive supportive care gave good results. PMID:25302233

  15. ANAESTHETIC MANAGEMENT OF BOCHDALEK HERNIA IN A 72-YEAR-OLD PATIENT- A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Basheer Ahmed Khan

    2017-05-01

    Full Text Available PRESENTATION OF CASE A 72-year-old female was admitted to the hospital with the complaints of difficulty in breathing and chest discomfort after food intake since 7 months. She also complained of reflux vomiting after a regular meal for the same duration. Other complaints included weight loss, cough after taking even water and recurrent upper respiratory tract infection. DIFFERENTIAL DIAGNOSIS Chest x-ray PA view shows elevated diaphragm on the left side. At this point, our differential diagnosis included hiatal hernia (fundic gas shadow, left lower lobe abscess (air fluid level and infected bulla (air fluid level.

  16. Ward's area location, physical activity, and body composition in 8- and 9-year-old boys and girls.

    Science.gov (United States)

    Cardadeiro, Graça; Baptista, Fátima; Zymbal, Vera; Rodrigues, Luís A; Sardinha, Luís B

    2010-11-01

    Bone strength is the result of its material composition and structural design, particularly bone mass distribution. The purpose of this study was to analyze femoral neck bone mass distribution by Ward's area location and its relationship with physical activity (PA) and body composition in children 8 and 9 years of age. The proximal femur shape was defined by geometric morphometric analysis in 88 participants (48 boys and 40 girls). Using dual-energy X-ray absorptiometry (DXA) images, 18 landmarks were digitized to define the proximal femur shape and to identify Ward's area position. Body weight, lean and fat mass, and bone mineral were assessed by DXA, PA by accelerometry, and bone age by the Tanner-Whitehouse III method. Warps analysis with Thin-Plate Spline software showed that the first axis explained 63% of proximal femur shape variation in boys and 58% in girls. Most of this variation was associated with differences in Ward's area location, from the central zone to the superior aspect of the femoral neck in both genders. Regression analysis demonstrated that body composition explained 4% to 7% of the proximal femur shape variation in girls. In boys, body composition variables explained a similar amount of variance, but moderate plus vigorous PA (MVPA) also accounted for 6% of proximal femur shape variation. In conclusion, proximal femur shape variation in children ages 8 and 9 was due mainly to differences in Ward's area position determined, in part, by body composition in both genders and by MVPA in boys. These variables were positively associated with a central Ward's area and thus with a more balanced femoral neck bone mass distribution. © 2010 American Society for Bone and Mineral Research.

  17. Gorlin-Goltz Syndrome: A Rare Case Report of a 11-Year-Old Child.

    Science.gov (United States)

    Tandon, Sandeep; Chauhan, Yashwant; Sharma, Meenakshi; Jain, Manish

    2016-01-01

    Gorlin-Goltz Syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS), is an autosomal dominant trait caused due to mutations in the patched tumor suppressor gene (PTCH) gene found on the long arm of chromosome 9. The syndrome is characterized by the presence of odontogenic keratocysts (OKCs), basal cell carcinomas, and skeletal malformations. Early diagnosis of the syndrome can be done by pedodontist as OKC is one of the early manifestations of the syndrome. Early diagnosis and treatment is important for long-term prognosis of the syndrome by reducing the severity of cutaneous carcinomas and deformities due to jaw cyst. The present case describes an 11-year-old patient with some typical features of NBCCS, which were diagnosed through its oral and maxillofacial manifestations. This case emphasizes the importance of pedodontist in early recognition of the syndrome. Tandon S, Chauhan Y, Sharma M, Jain M. Gorlin-Goltz Syndrome: A Rare Case Report of a 11-Year-Old Child. Int J Clin Pediatr Dent 2016;9(3):264-268.

  18. Five-year follow-up of a 13-year-old boy with a pituitary adenoma causing gigantism--effect of octreotide therapy.

    Science.gov (United States)

    Schoof, Ellen; Dörr, Helmuth G; Kiess, Wieland; Lüdecke, Dieter K; Freitag, Eduard; Zindel, Volker; Rascher, Wolfgang; Dötsch, Jörg

    2004-01-01

    In children, there is little experience with octreotide therapy for pituitary tumors, especially growth hormone (GH) producing adenomas. We report on a 13-year-old boy with gigantism due to a GH-producing pituitary adenoma caused by a Gsalpha mutation on the basis of McCune-Albright syndrome. At the age of 6.5 years a GH- and prolactin-producing pituitary adenoma was diagnosed. The adenoma was surgically removed. Immediately thereafter, the small adenoma residuum was treated with octreotide (2 x 100 microg/day s.c.). During therapy with octreotide, the growth rate dropped to normal values; however, rose again after 2 years of treatment. The insulin-like growth factor I (IGF-I) levels remained above the 95th percentile, the GH level mostly >2 microg/l. After 5 years of octreotide therapy, GH (6.9 microg/l), IGF-I (620 microg/l), IGF-binding protein 3 (5.4 mg/l), and prolactin (17.0 ng/ml) levels were still elevated. The growth velocity was +2.4 SDS (standard deviation score), the pubertal status was mature, and the bone age was 14.3 years (prospective final height 208 cm). A magnetic resonance imaging scan showed an unchanged residual 4-mm rim of adenoma at the pituitary site. Side effects from octreotide therapy were not reported by the patient or his family. The therapy was changed to the long-acting release octreotide analog octreotide-LAR. After 1 year of treatment with octreotide-LAR, the GH level was 1.0 microg/l, and the prospective final height dropped by 10 cm. This case demonstrates that combined surgical and medical treatment can influence the prognosis of childhood gigantism; however, the prognosis of this rare condition remains uncertain. Copyright 2004 S. Karger AG, Basel

  19. Case report of narcolepsy in a six-year-old child initially misdiagnosed as atypical epilepsy.

    Science.gov (United States)

    Zhou, Jinquan; Zhang, Xi; Dong, Zaiwen

    2014-08-01

    This report describes a case of first-onset narcolepsy in a six-year-old female that was misdiagnosed as atypical epilepsy and other diagnoses at eight different hospitals over a period of 10 months before the correct diagnosis was made. The diagnosis of narcolepsy is more difficult in children because very few of them experience all four cardinal symptoms of narcolepsy - paroxysmal sleep, cataplexy, hypnagogic hallucination, and sleep paralysis - and they often have a more prolonged onset and diverse symptoms. To decrease the time lag between initial presentation and accurate diagnosis, we recommend that in all cases in which children report excessive sleep of unknown etiology - regardless of the associated symptoms - that sleep monitoring and sleep latency tests be conducted to rule out the possibility of narcolepsy. The case highlights the wide variety of presentations of uncommon psychiatric conditions, particularly in children, and the need for clinicians to be aware of the atypical presentations of these conditions when collecting medical histories.

  20. [Teenagers' views and needs on sexual and emotional education. Survey among 15- to 16-year-old boys and girls].

    Science.gov (United States)

    Verdure, F; Rouquette, A; Delori, M; Aspeele, F; Fanello, S

    2010-03-01

    Teenagers have very particular needs and their healthcare must be adapted to these needs. Despite all the modern means of communication and education, problems related to sex and sexuality have an effect on their well-being. Sex education has improved in the last 40 years, but what is today's situation? In the Maine-et-Loire region of France, approximately 100 15- to 16-year-olds responded to a questionnaire, giving their views on the nature and quality of the sexual and emotional education they received. It appears that it falls very short of the legal requirements and that it is often inappropriate to the needs of young people. To improve sexual prevention, it is necessary to start early to provide sexual and emotional education and to increase the opportunities and the diversity of speakers presenting themes of importance to young people. The speaker should preferably be young and use lively means of communication and role-plays to normalize sex education. The most important aspects are respecting this young population as well as opening and maintaining communication with them, which will help them make better choices toward a better future. Promoting sex education is part of a global approach to healthy lifestyles and requires a national strategy, cooperation between the interested parties, and an adequate budget. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  1. Parental education, body mass index and prevalence of obesity among 14-year-old boys between 1987 and 1997 in Wroclaw, Poland

    International Nuclear Information System (INIS)

    Koziel, Slawomir; Kolodziej, Halina; Ulijaszek, Stanley J.

    2000-01-01

    The main aim of this study was to examine changes in relative weight and prevalence of obesity across a ten-year period among 14-year-old boys according to parental education level. Data from two surveys, carried out in 1987 and 1997, of boys attending the 7th grade of primary schools in Wroclaw were used in the analysis. The heights and weights of 3165 boys aged 14 years selected from cohort of 6969 7th and 8th grade boys from all primary schools of the city Wroclaw were used. The data of the second sample of 14-year-old boys (n = 1014) were obtained from a health examination study carried out in the Silesian Centre for Preventive Medicine, 'DOLMED', in Wroclaw in 1997. All boys attended the 7th grade of 34 randomly selected primary schools from a total of 129 schools in the city of Wroclaw. Social status was assessed on the basis of parental education level scored to four categories: university, secondary school, trade school, and elementary school. The prevalence of overweight and obesity was defined as the percentage of children above the 85th and 95th percentiles of the body mass index (BMI), the means of which were 21.27 and 23.75 kg/m 2 respectively. Prevalence of overweight among boys is slightly lower in the 1997 sample, whereas the prevalence of obesity shows the opposite trend and is higher by more than one percent in comparison with the 1987 sample. Similar trends of declining medians and increasing variance are observed in all educational groups. The differences in medians between the two samples within educational groups did not achieve statistical significance for the groups with parents with education at elementary level and fathers with university education. There is a trend toward increasing prevalence of obesity across the decade considered, according to father's education level. With respect to mother's education levels, the most dramatic changes in BMI and obesity occurred in the elementary education group, where the percentage of obese

  2. Differences in the speech of 10- to 13-year-old boys from divorced and nondivorced families against the background of emotional attachment.

    Science.gov (United States)

    Böhm, Birgit

    2004-01-01

    In Germany, an increasing number of children live with one parent alone and have to cope with the separation or divorce of their parents. Emotional drawbacks have frequently been hypothesized for these children. Thus, we studied if such experiences are reflected in speech behavior. Twenty-eight 10- to 13-year-old boys from separated parents (physical separation of the parents was 2 years before the investigation) were compared with 26 boys from parents living together in an interview focusing on attachment-related themes and everyday situations. The interviews were analyzed with regard to coherence of speech, coping with emotional problems, reflectivity, child representation of both parents, and verbal and nonverbal expression of feelings. Boys from separated parents had incoherent speech, difficulties in coping with emotional problems, a poorer reflectivity (thinking about their own mental states and those of others), they represented neither parent supportively and did not show their feelings openly. These results can be traced back to an insecure attachment representation of the boys with separated parents. Copyright 2004 S. Karger AG, Basel

  3. Spontaneous splenic artery aneurysm rupture in a 38-year old female: a case report.

    Science.gov (United States)

    Koutserimpas, C; Papachristou, E; Nikitakis, N; Zannes, N; Tellos, A; Velimezis, G

    2017-01-01

    Splenic artery aneurysm (SAA) is a rare and extremely difficult diagnosis. A rare case of a ruptured SAA in a 38-year old female, firstly treated with endovascular embolization and then with splenectomy, is presented. A 38-year old female presented to the emergency department with epigastric pain and fainting episodes. Direct catheter angiography revealed a ruptured SAA and distal, as well as proximal coil embolization was performed. Due to abdominal compartment syndrome the patient underwent open surgery with splenic artery ligation and splenectomy. Postoperative she showed signs of sepsis and was treated with i.v. fluids, steroids, packed red blood cells, platelets, fresh frozen plasma and antimicrobial treatment. Additionally, a multidrug resistant Acinetobacter baumanni was yielded from the urine culture. She had a satisfactory recovery. She is followed up a total of 5 years with no signs of overwhelming post-splenectomy infection syndrome. Direct catheter angiography is a very helpful option in diagnosis, as well as treatment, but a close monitoring after embolization is essential. Furthermore, post-splenectomy sepsis is a severe disease with high mortality rates that requires immediate appropriate treatment.

  4. Psycho-social and environmental correlates of location-specific physical activity among 9- and 15- year-old Norwegian boys and girls: the European Youth Heart Study

    Directory of Open Access Journals (Sweden)

    Anderssen Sigmund A

    2006-09-01

    Full Text Available Abstract Objective Little is known about the existence of independent location- or context specific forms of physical activity. This study sought to identify location-specific forms of physical activity in a sample of 9 and 15 years-olds Norwegian boys and girls, and examined their associations to psycho-social and environmental factors. Methods A cross-sectional study of 9 and 15-year-olds (N = 760; 379 boys and 381 girls was conducted in which participants responded to a computer-based questionnaire (PEACH tapping potentially location specific forms of physical activity as well as psycho-social and environmental correlates. Results Exploratory factor analysis indicated that the nine and fifteen year-olds self-reported their physical activity as located in three separate and specific contexts: a school commuting, b informal games play at school and c organized sport, structured exercise and games play in leisure time. Dependent of location, psycho-social and environmental correlates explained between 15 and 55 percent of the variance in physical activity. The impact of peer support, enjoyment and perceived competence in physical activity generalized across the three locations. Enjoyment of physical education classes, parental support and teacher support, in contrast, confined to particular location-specific forms of physical activity. Generally, behavioural beliefs and environmental factors represented marginal correlates of all location-specific forms of activity. Conclusion Young peoples' physical activity was identified as taking place in multiply genuine locations, and the psychosocial correlates of their physical activity seem to some extent to be location specific. Results may inform intervention efforts suggesting that targeting specific sets of psycho-social factors may prove efficient across physical activity locations, gender and age groups. Others, in contrast may prove effective in facilitating location specific physical activity

  5. Remission without insulin therapy on gluten-free diet in a 6-year old boy with type 1 diabetes mellitus

    DEFF Research Database (Denmark)

    Sildorf, Stine Møller; Fredheim, Siri; Svensson, Jannet

    2012-01-01

    A 5-year and 10-month old boy was diagnosed with classical type 1 diabetes mellitus (T1DM) without celiac disease. He started on a gluten-free diet after 2–3 week without need of insulin treatment. At the initiation of gluten-free diet, HbA1c was 7.8% and was stabilised at 5.8%–6.0% without insulin...... therapy. Fasting blood glucose was maintained at 4.0–5.0 mmol/l. At 16 months after diagnosis the fasting blood glucose was 4.1 mmol/l and after 20 months he is still without daily insulin therapy. There was no alteration in glutamic acid decarboxylase positivity. The gluten-free diet was safe and without...... side effects. The authors propose that the gluten-free diet has prolonged remission in this patient with T1DM and that further trials are indicated....

  6. Conservative Management of Duodenal Perforation with Toothpick in a 9- Year Old Girl; a Case Report

    Directory of Open Access Journals (Sweden)

    Shahsanam Gheibi

    2016-10-01

    Full Text Available Background Foreign body ingestion is a relatively common in children. Most ingested foreign bodies spontaneously pass out of the body via the gastrointestinal (GI system but sharp materials may perforate the GI tract and need to surgical intervention. Case Presentation  The patient was a 9-year-old girl with progressive abdominal pain for one month and admitted with acute abdomen impression. She underwent esogastroduodenoscopy (EGD due to severe epigastric tenderness. Upper GI endoscopy revealed duodenal ulceration and perforation by a toothpick while she had no history of foreign body ingestion. Toothpick was removed by endoscopy. She was successfully managed conservatively and had no abdominal pain during the one month follow-up period. Conclusion We recommend the endoscopic approach as the preferable method for the extraction of duodenal foreign bodies in children, even in the case of intestinal perforation.

  7. Mandibular Arteriovenous Malformation in an 8-year-old Child: A Case Report.

    Science.gov (United States)

    Rudagi, B M; Patil, Sudha; Hammannavar, Reshma; Jaiswal, Tejus

    2016-01-01

    Arteriovenous (AV) malformation is a congenital vascular anomaly in which there is an abnormal connection between the arterial and venous system resulting from developmental arrest during embryogenesis. In children, they are rare and potentially life-threatening. In the present case, an 8-year-old male patient presented with a simple gingival swelling associated with mobility of the corresponding teeth, which appeared relatively simple to excise but had an AV malformation associated with it. Timely diagnosis and investigations revealed its presence and hence prevented a catastrophy from occurring. Conventional method of surgical ligation of the external carotid artery was done as an emergency procedure and surgical resection was done without compromising the associated anatomic structures. This procedure helped control the bleeding as well as achieved an uneventful healing. This case report intends to create an awareness among Pediatric Dentists regarding the condition and thereby preventing an uncontrolled and unmanageable hemorrhage occurring in the Dental Office.

  8. Erasmus Syndrome in a 42-Year-Old Male: A Rare Case Report.

    Science.gov (United States)

    Chakrabarti, Subrata; Pan, Koushik

    2015-05-01

    Erasmus syndrome is a rare entity in which systemic sclerosis develops following exposure to silica with or without silicosis. Few case reports are available in literature. We report here a case of Erasmus syndrome in a 42-year-old manual labourer. The patient presented with arthralgia, Raynoud's phenomenon, skin tightening and microstomia along with features of Interstitial Lung Disease (ILD) and pulmonary arterial hypertension. Evidence of Interstitial Lung Disease (ILD) with mediastinal lymphadenopathy as well as pulmonary arterial hypertension with vascular reactivity was found in appropriate investigations. Serological markers of systemic sclerosis were strongly positive. After a diagnosis of Erasmus syndrome was made, a combination of drugs including Prednisone, Cyclophosphamide and Nifedipine was instituted this led to moderate improvement in his symptoms over 6 months.

  9. Comparison of short-term energy intake and appetite responses to active and seated video gaming, in 8-11-year-old boys.

    Science.gov (United States)

    Allsop, Susan; Green, Benjamin P; Dodd-Reynolds, Caroline J; Barry, Gillian; Rumbold, Penny L S

    2016-03-28

    The acute effects of active and seated video gaming on energy intake (EI), blood glucose, plasma glucagon-like peptide-1 (GLP-17-36) and subjective appetite (hunger, prospective food consumption and fullness) were examined in 8-11-year-old boys. In a randomised, crossover manner, twenty-two boys completed one 90-min active and one 90-min seated video gaming trial during which food and drinks were provided ad libitum. EI, plasma GLP-17-36, blood glucose and subjective appetite were measured during and following both trials. Time-averaged AUC blood glucose was increased (P=0·037); however, EI was lower during active video gaming (1·63 (sem 0·26) MJ) compared with seated video gaming (2·65 (sem 0·32) MJ) (P=0·000). In a post-gaming test meal 1 h later, there were no significant differences in EI between the active and seated gaming trials. Although estimated energy expenditure was significantly higher during active video gaming, there was still no compensation for the lower EI. At cessation of the trials, relative EI (REI) was significantly lower following active video gaming (2·06 (sem 0·30) MJ) v. seated video gaming (3·34 (sem 0·35) MJ) (P=0·000). No significant differences were detected in time-averaged AUC GLP-17-36 or subjective appetite. At cessation of the active video gaming trial, EI and REI were significantly less than for seated video gaming. In spite of this, the REI established for active video gaming was a considerable amount when considering the total daily estimated average requirement for 8-11-year-old boys in the UK (7·70 MJ).

  10. Pyogenic granuloma associated with bone loss in an eight year old child: A case report

    Directory of Open Access Journals (Sweden)

    Shenoy S

    2006-01-01

    Full Text Available Soft tissue enlargements of the oral cavity often present a diagnostic challenge because a diverse group of pathologic processes can produce such lesions. An enlargement may represent a variation of normal anatomic structures, inflammation, cysts, developmental anomalies and neoplasm. Within these lesions is a group of reactive hyperplasias, which develop in response to a chronic, recurring tissue injury that stimulates an exuberant or excessive tissue repair response. The pyogenic granuloma is a reactive enlargement that is an inflammatory response to local irritation such as calculus, a fractured tooth, rough dental restoration and foreign materials. This article aims to present a case of pyogenic granuloma in 8 year old child patient associated with resorption of bone in relation to the tooth.

  11. A case of radiation-induced squamous cell carcinoma of an 87-year-old physician

    International Nuclear Information System (INIS)

    Tanaka, Eiichiro; Takatsuka, Sumiko; Takenouchi, Tatsuya

    2005-01-01

    We reported a case of radiation-induced squamous cell carcinoma on the bilateral middle finger of an 87-year-old physician. He had exposed his hands to radiation without defense when he took an X-ray photograph. Squamous papules and ulcers occurred on both of his hands 10-years ago. The ulcer on the right middle finger enlarged rapidly after a one-month duration. A biopsy specimen showing squamous cell carcinoma derived from chronic radiation dermatitis, and disarticulation at the proximal interpharyngeal joint (PIP) joint of the right middle finger was performed. Six month later, hyperkeratotic tumor newly occurred on the opposite middle finger, and were operated on in the same way. The remaining lesions of chronic radiation dermatitis were treated by topical bleomycin hydrochloride. Since medical workers carelessly exposed their skin to radiation several decades ago, attention to late occurrence of radiation-induced skin cancer is needed. (author)

  12. A case of ocular thelaziasis in a 2.5 years old Holstein heifer

    Directory of Open Access Journals (Sweden)

    Mousa Daradka

    2014-09-01

    Full Text Available A 2.5-years-old, Holstein lactating dairy cow was presented to the Veterinary Health Center with severe conjunctivitis and exuberant granulation tissue formation of the left eye. Upon close examination of the eye, a 2-cm long slender-shaped nematode was found in the conjunctival sac. The nematode was examined by a veterinary parasitologist and determined to be Thelazia species. The exuberant granulation tissue was surgically removed and a total of 0.5 mL of 1% levamisole was injected subconjunctivally. Levamesole was also injected subcutaneously at a dose of 10 mg/kg of body weight and repeated after 15 days. The cow made a complete recovery within 25 days following treatment. This is the first case report of ocular thelaziasis in dairy cattle in Jordan.

  13. Anesthesia Management for Pheochromocytoma Removal in a 17-Year-Old Girl: Case Report

    Directory of Open Access Journals (Sweden)

    Gulsen Keskin

    2018-03-01

    Full Text Available A rare tumor of the chromaffin tissue, pheochromocytoma is characterized by increased secretion of catecholamines. Pediatric cases represent only 5% of all pheochromocytomas. In this report, we presented anesthesia management of a 17-year-old girl who would undergo right suprarenal mass excision due to pheochromocytoma accompanied with familial Mediterranean fever (FMF. Preoperative blood pressure control was achieved with phenoxybenzamine. General anesthesia was established with thiopental, vecuronium, fentanyl, and sevoflurane. Sodium nitroprusside and phentolamine was used for perioperative blood pressure control. Tramadol and diclofenac were administered for postoperative pain. The patient was discharged after a good preoperative preparation and perioperative management with uneventful treatment period. [J Contemp Med 2018; 8(1.000: 70-73

  14. PFAPA syndrome in a 2-year-old girl: a case report and literature review

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    Jakub Haracz

    2018-03-01

    Full Text Available PFAPA syndrome is the most common periodic fever syndrome in our geographic zone. It usually develops in children under 5 years of age and is classified as an autoinflammatory disease. PFAPA syndrome is characterised by episodes of high fever (>39°C accompanied by aphthous stomatitis, pharyngitis, and cervical lymphadenopathy, which occur cyclically at 25–35-day intervals and last between 3 and 6 days. Patients experience no symptoms between these episodes. The disease resolves with age. The cause of PFAPA and the predisposing factors remain unknown. The paper presents a clinical case of a 2-year-old girl diagnosed in the Department of Paediatric Pulmonology and Rheumatology of the Medical University of Lublin due to recurrent fever episodes. After exclusion of other causes, PFAPA syndrome was diagnosed. Corticosteroid treatment was used and good therapeutic response was achieved. The paper also presents a literature review on the current diagnosis and treatment modalities in PFAPA.

  15. A Rare Case of Splenic Torsion with Sigmoid Volvulus in a 14-Year-Old Girl.

    Science.gov (United States)

    Ahmadi, Hamid; Tehrani, Mahdieh Mohammad Khan

    2016-01-01

    Wandering spleen is an uncommon entity in adults and has been described only rarely with sigmoid volvulus, that rarely affects children and adolescents. It is usually described in adults.Wandering spleen characterized by the abnormal location of the spleen, caused by incomplete fusion of the four primary splenic ligaments, allowing the spleen to be mobile within the abdomen.The wandering spleen can lead to torsion and subsequent splenic infarction or rupture. Clinical suspicion plus urgent investigation and intervention are important. We present a rare clinical case of acute abdomen due to torsion of wandering spleen and volvulus of sigmoid in a 14-year-old girl presented with painful periumbilical mass. Detorsion of sigmoid occurred while undergoing exploratory laparotomy and splenectomy was performed. The possibility of torsion and its complication like gastric, pancreas tail and colon volvulus should be kept in mind in the differential diagnosis of the acute abdomen to avoid serious complications.

  16. A Rare Case of Splenic Torsion with Sigmoid Volvulus in a 14-Year-Old Girl

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    Hamid Ahmadi

    2016-01-01

    Full Text Available Wandering spleen is an uncommon entity in adults and has been described only rarely with sigmoid volvulus, that rarely affects children and adolescents. It is usually described in adults.Wandering spleen characterized by the abnormal location of the spleen, caused by incomplete fusion of the four primary splenic ligaments, allowing the spleen to be mobile within the abdomen.The wandering spleen can lead to torsion and subsequent splenic infarction or rupture. Clinical suspicion plus urgent investigation and intervention are important. We present a rare clinical case of acute abdomen due to torsion of wandering spleen and volvulus of sigmoid in a 14-year-old girl presented with painful periumbilical mass. Detorsion of sigmoid occurred while undergoing exploratory laparotomy and splenectomy was performed. The possibility of torsion and its complication like gastric, pancreas tail and colon volvulus should be kept in mind in the differential diagnosis of the acute abdomen to avoid serious complications.

  17. Torpedo maculopathy with an anisometropic amblyopia in a 5-year-old Caucasian girl: case report

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    Marco Dutra-Medeiros

    2013-08-01

    Full Text Available The aim of this study is to report a clinical case of asymptomatic female Caucasian children with torpedo maculopathy. A 5-year-old girl was referred to our clinic for routine evaluation. The ophthalmic examination revealed best-corrected visual acuity of 20/20 in both eyes, without any changes in the biomicroscopy. Fundus examination showed normal findings in one eye, whereas in the contralateral eye it disclosed, in the temporal sector of the macular region, a whitish, atrophic, oval chorioretinal lesion with clearly defined margins. Posterior evaluations documented the stability of the lesion. Torpedo maculopathy diagnosis is based on its characteristic shape and peculiar location. The differential diagnosis has to be estabilished versus choroidal lesions (melanoma and nevus, congenital or iatrogenic hyperplasia of the retinal pigment epithelium (RPE and particularly versus the congenital pigmented lesions associated with Gardner's syndrome.

  18. Myxedema coma in a 74 year old man: case report and narrative review

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    Idania Teresa Mora López

    2013-05-01

    Full Text Available The follicular cells of the thyroid gland produce thyroxine and triiodothyronine hormones, as regulated by the thyrotropic hormone of the anterior pituitary, also called thyroid stimulating hormone. Myxedema coma is defined as profound hypothyroidism characterized by impairment of consciousness ranging from lethargy to stupor and coma, associated with hypothermia, hypoglycemia, seizures, hypotension, and manifestations of uncompensated hypothyroidism. The condition can be prevented if diagnosis of primary hypothyroidism is established and thyroid hormone replacement therapy is instituted. It is considered a medical emergency with high mortality rates, where environmental factors such as cold, severe infections and drug poisoning are important triggering factors. We report the case of a 74 year old male adult with no history of thyroid disease who was admitted to the Internal Medicine Ward of the “Enrique Cabrera” Hospital, Havana, Cuba, in December 2011, with clinical and laboratory signs of thyroid hypofunction. Myxedema coma was confirmed and patient course was untoward.

  19. A Rare Case Report of Mandible Osteosarcoma in an 8-Year-Old Child

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    Atena Shiva

    2017-09-01

    Full Text Available Introduction: Osteosarcoma of jaw bones is the most common primary malignant bone tumor arising from mesenchymal cells capable of producing steoid; this disorder predominantly occurs in the long bones and rarely involves the maxillofacial region.  Normally, this disease presents in the third and fourth decades of life, is slightly more common in men than women, and affects the mandible and maxilla in the same proportion. Case report: An 8-year-old girl was referred to an oral and maxillofacial surgeon due to tumoral lesions in the posterior mandible in Sari, Iran. After the surgery, histopathological examination of the tumoral lesions revealed fibroblastic osteosarcoma. Further, immunohistochemical markers were evaluated, results of which approved final diagnosis of mandible osteosarcoma. Conclusion: Given that osteosarcoma of jaw bones share the same clinical manifestations with benign lesions, misdiagnosis is highly common and diagnosis is challenging for dentists. Accurate diagnosis and early referral are critical in prognosis and survival of patients.

  20. Exertional Rhabdomyolysis in a 21-Year-Old Healthy Woman: A Case Report.

    Science.gov (United States)

    McKay, Brianna D; Yeo, Noelle M; Jenkins, Nathaniel D M; Miramonti, Amelia A; Cramer, Joel T

    2017-05-01

    McKay, BD, Yeo, NM, Jenkins, NDM, Miramonti, AA, and Cramer, JT. Exertional rhabdomyolysis in a 21-year-old healthy woman: a case report. J Strength Cond Res 31(5): 1403-1410, 2017-The optimal resistance training program to elicit muscle hypertrophy has been recently debated and researched. Although 3 sets of 10 repetitions at 70-80% of the 1 repetition maximum (1RM) are widely recommended, recent studies have shown that low-load (∼30% 1RM) high-repetition (3 sets of 30-40 repetitions) resistance training can elicit similar muscular hypertrophy. Incidentally, this type of resistance training has gained popularity. In the process of testing this hypothesis in a research study in our laboratory, a subject was diagnosed with exertional rhabdomyolysis after completing a resistance training session that involved 3 sets to failure at 30% 1RM. Reviewed were the events leading up to and throughout the diagnosis of exertional rhabdomyolysis in a healthy recreationally-trained 21-year-old woman who was enrolled in a study that compared the acute effects of high-load low-repetition vs. low-load high-repetition resistance training. The subject completed a total of 143 repetitions of the bilateral dumbbell biceps curl exercise. Three days after exercise, she reported excessive muscle soreness and swelling and sought medical attention. She was briefly hospitalized and then discharged with instructions to take acetaminophen for soreness, drink plenty of water, rest, and monitor her creatine kinase (CK) concentrations. Changes in the subject's CK concentrations, ultrasound-determined muscle thickness, and echo intensity monitored over a 14-day period are reported. This case illustrates the potential risk of developing exertional rhabdomyolysis after a low-load high-repetition resistance training session in healthy, young, recreationally-trained women. The fact that exertional rhabdomyolysis is a possible outcome may warrant caution when prescribing this type of resistance

  1. Addison's disease presenting with idiopathic intracranial hypertension in 24-year-old woman: a case report

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    Moore Peter

    2010-02-01

    Full Text Available Abstract Introduction Idiopathic intracranial hypertension can rarely be associated with an underlying endocrine disorder such as Cushing's syndrome, hyperthyroidism, or with administration of thyroxine or growth hormone. Though cases of idiopathic intracranial hypertension associated with Addison's disease in children have been reported, there is only one documented case report of this association in adults. We describe a case of an acute adrenal insufficiency precipitated by idiopathic intracranial hypertension in a Caucasian female. Case presentation A 24-year-old Caucasian woman was acutely unwell with a background of several months of generalised fatigue and intermittent headaches. She had unremarkable neurological and systemic examination with a normal computerised tomography and magnetic resonance imaging of the brain. Normal cerebrospinal fluid but increased opening pressure at lumbar puncture suggested intracranial hypertension. A flat short synacthen test and raised level of adrenocorticotrophic hormone were consistent with primary adrenal failure. Conclusion Addison's disease can remain unrecognised until precipitated by acute stress. This case suggests that idiopathic intracranial hypertension can rarely be associated with Addison's disease and present as an acute illness. Idiopathic intracranial hypertension is possibly related to an increase in the levels of arginine vasopressin peptide in serum and cerebrospinal fluid secondary to a glucocorticoid deficient state.

  2. Sacrococcygeal chordoma in a 9-year-old boy Cordoma sacrococígeo em um menino de 9 anos de idade

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    Lúcia de Noronha

    1995-09-01

    Full Text Available A case of sacrococcygeal chordoma in a 9-year-old boy is presented. The symptoms at presentation were pain in both legs and sacrococcygeal region for the last two years that increased in the last four weeks irradiating mainly to the left leg. X-ray and CT scan examinations of the lumbar region revealed an expansive process in the coccygeal region with multiple calcifications and a partially eroded coccyx. There was no invasion of the retroperitoneum and regional lymph nodes. A biopsy was performed and showed cords and nests of cells with large cytoplasm, sometimes vacuolated, nuclei with moderate pleomorphism and clumped chromatin. Immunohistochemistry with avidin-biotin peroxidase technique showed positivity for CK, S-100 protein, CEA, vimentin and to EMA. Chordomas are a distinctly uncommon neoplasm in the first two decades of life, specially in the sacrococcygeal region. They have an aggressive behavior. Treatment of choice is complete resection.Os autores apresentam um caso de cordoma sacroccígeo em um menino de 9 anos de idade. O paciente foi admitido no hospital com história de dor na região sacral e nos membros inferiores com dois anos de evolução, piorando nas últimas quatro semanas. O exame físico revelou atrofia muscular moderada em ambos os membros inferiores, diminuição do reflexo patelar e presença do sinal de Lasègue à esquerda. Os exames de imagem da região lombar mostraram um processo expansivo na região sacrococcígea com erosão parcial do coccix e focos de calcificação, sem evidência de metástases para linfonodos regionais. Foi realizada biópsia diagnóstica que mostrou neoplasia formada por cordões e ninhos de células de citoplasma amplo, por vezes vacuolado, com núcleos moderadamente pleomórficos com cromatina grumosa. O estudo imuno-histoquímico revelou positividade para CK, proteína S-100, CEA, vimentina e EMA. Cordomas são tumores raros que representam em torno de 2% de todas as neoplasias

  3. Epithelioid hemangioendothelioma of the liver with metastatic coeliac lymph nodes in an 11-year-old boy

    International Nuclear Information System (INIS)

    Ines, David da; Petitcolin, Virginie; Garcier, Jean-Marc; Joubert-Zakeyh, Juliette; Demeocq, Francois

    2010-01-01

    Epithelioid hemangioendothelioma of the liver is a very rare vascular tumour in children with intermediate malignant potential. We present a case in which the typical imaging appearances of coalescent peripheral hepatic masses with capsular retraction contributed to the diagnosis. A positron emission tomography-CT (PET-CT) procedure was performed in staging the disease with a strong suspicion of coeliac nodal involvement confirmed after laparotomy and histological analysis. Our case is unique because of the rarity of the disease, the young age of the child, and proven nodal metastases at initial diagnosis. The use of PET-CT allows better staging at initial diagnosis and thus better management with improved follow-up in these patients. (orig.)

  4. Spontaneous traumatic macular hole closure in a 50-year-old woman: a case report

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    Rotsos Tryfon

    2011-07-01

    Full Text Available Abstract Introduction Traumatic macular holes (TMH are well-known complications of ocular contusion injury. Spontaneous closure occurs in approximately 50% of cases, but rarely after the age of thirty. We report a case of spontaneous closure of a full thickness macular hole due to a blunt trauma and we suggest possible mechanisms for this closure. Case presentation A 50-year-old Greek woman was referred with a history of reduced best-corrected visual acuity after blunt trauma to her right eye. Diagnosis was based on fundoscopic, optical coherence tomography as well as fluorescein angiography findings with follow-up visits at two days, 20 days and five months. Fundoscopy revealed a full-thickness TMH with a minor sub-retinal hemorrhage and posterior vitreous detachment. The presence of a coagulum in the TMH base was observed. Subsequently, TMH closure was observed. Conclusion The clot in the TMH base, potentially a hemorrhage by-product containing a significant quantity of platelets, may have simulated the clot observed after autologous serum use, thus facilitating a similar effect. This may have stimulated glial cell migration and proliferation, thus contributing to spontaneous hole closure.

  5. The Brugada Syndrome Unmasked by Fever in a Two-Year-Old Child: Case Report

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    Ghandi

    2016-02-01

    Full Text Available Introduction Brugada syndrome (BrS is an autosomal-dominant inherited cardiac arrhythmia that occurs due to sodium channelopathy and increases sudden cardiac death due to episodes of polymorphic ventricular tachyarrhythmia. It is characterized by ST-segment elevation in the right precordial leads and right bundle branch block (RBBB pattern. We herewith present a case of Brugada syndrome with an unusual presentation. Case Presentation A 2.5-year-old girl with a history of quadriplegic cerebral palsy was admitted due to aspiration pneumonia. Cardiovascular examination and echocardiography was normal. She had a history of surgery for gastro esophageal reflux disease and was under treatment with pantoprazole. Electrocardiogram revealed ST-segment elevation in the right precordial leads (V1 - V3. The patient died during hospitalization due to cardiac arrest before any intervention. Conclusions The most important feature of Brugada syndrome is clinically suspicion. Therefore it should be considered in cases with uncontrolled seizures, stroke, refractory seizures, recurrent syncope, repeated attacks VT and conduct disorders like RBBB in the absence of structural cardiac and metabolic disorders.

  6. Glandular odontogenic cyst mimicking ameloblastoma in a 78 year old female: A case report

    International Nuclear Information System (INIS)

    Lee, Byung Do; Lee, Wan; Kwon, Kyung Hwan; Choi, Moon Ki; Choi, Eun Joo; Yoon, Jung Hoon

    2014-01-01

    Glandular odontogenic cyst (GOC) is a rare, potentially aggressive jaw lesion. The common radiographic features include a well-defined radiolucency with distinct borders, presenting a uni- or multilocular appearance. A cystic lesion in the posterior mandible of a 78-year-old female was incidentally found. Radiographs showed a unilocular lesion with a scalloped margin, external root resorption of the adjacent tooth, and cortical perforation. This lesion had changed from a small ovoid shape to a more expanded lesion in a period of four years. The small lesion showed unilocularity with a smooth margin and a well-defined border, but the expanded lesion produced cortical perforation and a lobulated margin. The provisional diagnosis was an ameloblastoma, whereas the histopathological examination revealed a GOC. This was a quite rare case, given that this radiographic change was observed in the posterior mandible of an elderly female. This case showed that a GOC can grow even in people in their seventies, changing from the unilocular form to an expanded, lobulated lesion. Here, we report a case of GOC with characteristic radiographic features.

  7. Glandular odontogenic cyst mimicking ameloblastoma in a 78 year old female: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Do; Lee, Wan; Kwon, Kyung Hwan; Choi, Moon Ki; Choi, Eun Joo [College of Dentistry, Wonkwang University, Iksan (Korea, Republic of); Yoon, Jung Hoon [Dept. of Oral and Maxillofacial Pathology, College of Dentistry, Daejeon Dental Hospital, Wonkwang University, Daejeon (Korea, Republic of)

    2014-09-15

    Glandular odontogenic cyst (GOC) is a rare, potentially aggressive jaw lesion. The common radiographic features include a well-defined radiolucency with distinct borders, presenting a uni- or multilocular appearance. A cystic lesion in the posterior mandible of a 78-year-old female was incidentally found. Radiographs showed a unilocular lesion with a scalloped margin, external root resorption of the adjacent tooth, and cortical perforation. This lesion had changed from a small ovoid shape to a more expanded lesion in a period of four years. The small lesion showed unilocularity with a smooth margin and a well-defined border, but the expanded lesion produced cortical perforation and a lobulated margin. The provisional diagnosis was an ameloblastoma, whereas the histopathological examination revealed a GOC. This was a quite rare case, given that this radiographic change was observed in the posterior mandible of an elderly female. This case showed that a GOC can grow even in people in their seventies, changing from the unilocular form to an expanded, lobulated lesion. Here, we report a case of GOC with characteristic radiographic features.

  8. CARDIORESPIRATORY FITNESS, ACTIVITY LEVEL, HEALTH-RELATED ANTHROPOMETRIC VARIABLES, SEDENTARY BEHAVIOUR AND SOCIOECONOMIC STATUS IN A SAMPLE OF IRANIAN 7-11 YEAR OLD BOYS

    Directory of Open Access Journals (Sweden)

    Samad Esmaeilzadeh

    2013-01-01

    Full Text Available The purpose of this study was to evaluate cardiorespiratory fitness (CRF, activity level, some health-related anthropometric variables, sedentary behaviour and socioeconomic status (SES of 7-11 year old boys in the city of Ardabil, Iran. Of 21 253 school boys aged 7-11 years, 766 participated in this study using the cluster sampling method. Subjects underwent standard anthropometry. One-mile test was used to evaluate ·VO2max. BMI cut-off points were used to identify weight status. Child’s TV watching and video playing daily time (TVVPT was taken for sedentary behaviour evaluation. SES and activity level were measured by standard questionnaires. Of all participants, 8.9�0(N=68 of students had CRF lower than normal and 58.6�0(N=449 of them had inadequate physical activity. There was a significant adverse relationship between ·VO2max and body mass index (BMI, waist to height ratio (WHtR, waist circumference (WC, and fat mass (FM (p<0.05. A significant direct association between SES and both FM and TVVPT was observed (p<0.05. Significantly lower physical activity and ·VO2max, and higher TVVPT were observed in the obese boys than their counterparts (p<0.05. The results of this study indicated a significant relationship between CRF and physical activity, and health-related anthropometric variables in a selected sample of 7-11 year boys. Moreover, the obese subjects had not only lower physical activity but also longer sedentary behaviour time than their counterparts.

  9. Lymphomatoid papulosis with pseudocarcinomatous hyperplasia in a 7-year-old girl: a case report.

    Science.gov (United States)

    Xiong, Jingshu; Ma, Yiping; Chen, Hao; Xu, Xiulian; Sun, Jianfang

    2016-05-01

    Lymphomatoid papulosis (LyP) belongs to the group of cutaneous CD30+ lymphoproliferative disorders. Pseudocarcinomatous hyperplasia has rarely been reported in patients with LyP. In this report, we describe a case of LyP presenting as pseudocarcinomatous hyperplasia. The patient was a 7-year-old girl who presented with a recurrent papulonodular eruption on her face and trunk for 2 months. Histopathologic examination revealed an irregular growth of hyperkeratotic epidermis into the whole dermal layer with marked nests of squamous cells in the background of diffuse atypical lymphoid cells, eosinophils and neutrophils. The large atypical cells were positive for CD30 and CD3, but negative for CD4, CD5, CD8, CD20 and CD56. A TCR-γ clone was identified by polymerase chain reaction (PCR). The correct diagnosis in cases of LyP with overlying pseudocarcinomatous epithelial hyperplasia can be very difficult both clinically and histopathologically. Clinical and histopathologic characteristics should be integrated to avoid an erroneous diagnosis of squamous cell carcinoma or keratoacanthoma. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Sleep-Related Orgasms in a 57-Year-Old Woman: A Case Report.

    Science.gov (United States)

    Irfan, Muna; Schenck, Carlos H

    2018-01-15

    We report a case of problematic spontaneous orgasms during sleep in a 57-year-old woman who also complained of hypnic jerks and symptoms of exploding head syndrome. To our knowledge, this is the first case report in the English language literature of problematic spontaneous orgasms during sleep. She had a complex medical and psychiatric history, and was taking oxycontin, venlafaxine, amitriptyline, and lurasidone. Prolonged video electroencephalogram monitoring did not record any ictal or interictal electroencephalogram discharges, and nocturnal video polysomnography monitoring did not record any behavioral or orgasmic event. Periodic limb movement index was zero events/h. Severe central sleep apnea was detected with apnea-hypopnea index = 130 events/h, but she could not tolerate positive airway pressure titration. Sleep architecture was disturbed, with 96.4% of sleep spent in stage N2 sleep. Bedtime clonazepam therapy (1.5 mg) was effective in suppressing the sleep-related orgasms and hypnic jerks. © 2018 American Academy of Sleep Medicine

  11. Incontinentia pigmenti presenting as hypodontia in a 3-year-old girl: a case report

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    Kitakawa Dárcio

    2009-11-01

    Full Text Available Abstract Introduction Incontinentia pigmenti or Bloch-Sulzberger syndrome is a rare X-linked dominant disease that mainly affects the skin, eyes, hair, central nervous system and teeth. The disease is predominant among women. Although dermatologic manifestations are among the most important aspects for the diagnosis of the syndrome, they are less damaging to the patient and do not require treatment. However, oral involvement characterized by hypodontia of deciduous and permanent teeth is important for the diagnosis and treatment of the patient. Case presentation We report the case of a 3-year-old girl with ophthalmologic and neurologic disturbances, cutaneous manifestations and hypodontia. Since the patient did not present more damaging manifestations such as neurologic and/or ophthalmologic problems, her most severe complications were related to dental anomalies. The importance of integrated dental treatment, which combines pediatric dentistry, orthodontics and conventional prosthesis, is emphasized. Conclusion Hypodontia is a frequent finding in incontinentia pigmenti, and dentists should be aware of this condition in order to help with the diagnosis.

  12. Case report on xeroderma pigmentosum with squamous cell carcinoma in a ten year old child

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    Uday Kumar Sonnappa

    2018-04-01

    Full Text Available Xeroderma pigmentosum (XPis a rare inherited skin disorder characterized by a heightened sensitivity to the DNA damaging effects of ultraviolet radiation (UV. The main source of UV is the sun. The symptoms of XP can be seen in any sun-exposed area of the body. The effects are greatest on the skin, the eyelids and the surface of the eyes but the tip of the tongue may also be damaged. In addition, approximately 25% of XP patients also develop abnormalities of the nervous system manifesting as progressive neuro-degeneration with hearing loss. People with XP have a 10,000-fold increased risk for developing skin cancer including basal cell carcinoma, squamous cell carcinoma and melanoma. They also have a 2000-fold increased risk for cancer of the eye and surrounding ocular tissues. These symptoms appear early in life, typically before age 10 years. This case is being presented to highlight the rarity of a case of xeroderma pigmentosum with squamous cell carcinoma in a ten year old child.

  13. Acute effects of active gaming on ad libitum energy intake and appetite sensations of 8-11-year-old boys.

    Science.gov (United States)

    Allsop, Susan; Dodd-Reynolds, Caroline J; Green, Benjamin P; Debuse, Dorothée; Rumbold, Penny L S

    2015-12-28

    The present study examined the acute effects of active gaming on energy intake (EI) and appetite responses in 8-11-year-old boys in a school-based setting. Using a randomised cross-over design, twenty-one boys completed four individual 90-min gaming bouts, each separated by 1 week. The gaming bouts were (1) seated gaming, no food or drink; (2) active gaming, no food or drink; (3) seated gaming with food and drink offered ad libitum; and (4) active gaming with food and drink offered ad libitum. In the two gaming bouts during which foods and drinks were offered, EI was measured. Appetite sensations - hunger, prospective food consumption and fullness - were recorded using visual analogue scales during all gaming bouts at 30-min intervals and at two 15-min intervals post gaming. In the two bouts with food and drink, no significant differences were found in acute EI (MJ) (P=0·238). Significant differences were detected in appetite sensations for hunger, prospective food consumption and fullness between the four gaming bouts at various time points. The relative EI calculated for the two gaming bouts with food and drink (active gaming 1·42 (sem 0·28) MJ; seated gaming 2·12 (sem 0·25) MJ) was not statistically different. Acute EI in response to active gaming was no different from seated gaming, and appetite sensations were influenced by whether food was made available during the 90-min gaming bouts.

  14. Low fundamental movement skill proficiency is associated with high BMI and body fatness in girls but not boys aged 6-11 years old.

    Science.gov (United States)

    Duncan, Michael J; Bryant, Elizabeth; Stodden, David

    2017-11-01

    This study examined differences in children's body mass index (BMI) and body fatness (BF%) as a function of gender and fundamental movement skill (FMS) proficiency. Following ethics approval and parental consent, 248, 6-11 year-old children (112 boys, 136 girls) underwent assessment of 7 FMS: sprint run, side gallop, hop, kick, catch, throw and vertical jump. FMS tertiles ("high", "medium" or "low" FMS) were created based on the summed components of the FMS. Skinfold measures were used to calculate BF%. Physical activity (PA) was assessed using pedometry and maturation predicted using anthropometry. Data were analysed using a 2 (Gender) × 3 (FMS tertile) ways analysis of covariance (ANCOVA), controlling for age, maturation and PA. Age (P = .001) and maturation (P = .006) were associated with BMI. Girls classified as high FMS proficiency had significantly lower BMI compared to girls with low and medium FMS proficiency. Age (P = .0001) and maturation (P = .007) were associated with BF%. BF% was also higher for girls with low FMS compared to those with medium and high FMS. BF% and BMI were not different across FMS tertile in boys. Such findings suggest focusing on FMS may be especially important for healthy weight, particularly in girls.

  15. Iris concavity, corneal biomechanics, and their correlations with ocular biometry in a cohort of 10- to 12-year-old UK school boys: baseline data.

    Science.gov (United States)

    Shah, Ameet; Low, Sancy; Garway-Heath, David F; Foster, Paul J; Barton, Keith

    2014-04-17

    Pigment dispersion syndrome is associated with iris concavity. This study investigated the prevalence of iris concavity, defined as a measurement of ≤-0.1 mm, in a cohort of 10- to 12-year-old boys, and explored the relationship between iris curvature and anterior segment biometry. Associations with corneal biomechanical parameters also were explored. A cohort of school boys (n = 96) was recruited from a local school. Anterior segment optical coherence tomography (AS-OCT) was performed under accommodative and nonaccommodative conditions, and iris curvature quantified. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured with the ocular response analyzer (ORA). Noncontact axial biometry was performed using laser interferometry. The prevalence of iris concavity was 24% on distance fixation, increasing to 65% on accommodation. Variables significantly associated with nonaccommodating iris curvature were lens vault (P = 0.02) and mean keratometry (P = 0.02). For both variables acting jointly, R(2) = 0.30. Variables associated significantly with accommodating iris curvature were anterior chamber depth (P = 0.009), lens vault (P = 0.049), and mean scleral spur angle (P Iris concavity was a common finding in this cohort and related to anterior segment biometric parameters. Further work is required to clarify whether anatomical differences exist between iris concavity seen in the adolescent eye and that found in adults with pigment dispersion syndrome. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  16. The impact of exercise therapy on the musculoskeletal abnormalities of blind boy students of 12- 18 years old at Tehran Mohebbi blind school

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    Habib Allah Jadidi

    2009-08-01

    Full Text Available Introduction: The purpose of this study was to examine the 13 musculoskeletal abnormalities (fronthead, lateral bending head, shoulder dropping, scoliosis, kyphosis, lumbar lordosis, flat back,pelvicobliguity, genu varum, x.leg, flat foot, pes cavus, and hallux valgus after a period of exercisetherapy on the blind boy students without secondary disability.Materials and Methods: In this semi-experimental research, 60 boy students were included fromsecondary and high school (12-18 years old including 34 congenital blind and 26 semi blind. Theywere selected among 135 students at Tehran Mohebbi blind school. They were tested by measurementtools (symetrigraph, antropometer, and podioscope. After examining the results by the New York test,the students who were diagnosed with one or more musculoskeletal abnormalities took part in fourmonth’sexercises with 3 sessions at weak. The results were registered after the end of the exerciseprogram and administered secondary exam. The data before and after the exam were analyzed.Results: 80 percents of the blind students at pre-exam had musculoskeletal abnormalities which aredecreased to 45 percent after exercises. There were significant differences on the rate of recovery at 11abnormalities (Exact – Sign = 0 < 0/05 and there were not significant differences at pelvicobliguityand x.leg abnormalities (Exact – Sign = 1 < 0/05.Conclusion: the research findings emphasized on the validation and important of exercise therapyon musculoskeletal abnormalities.

  17. Twenty-one year old female with an iris tumor: a case report

    International Nuclear Information System (INIS)

    Zettinig, G.; Kurtaran, A.; Dudczak, R.; Maca, S.; Barisani, T.; Horvat, R.

    2002-01-01

    Full text: A 21-year-old female with multiple granulomas an the right iris with concomitant therapy refractive panuveitis was referred to the Department of Ophthalmology to exclude an ocular malignancy. The patient had a history of minimal change glomerulonephritis and cutaneous granulomas at the age of six years that were successfully treated with cyclophosphamide. Her visual acuity initially already reduced to 30 % decreased rapidly to 'counting fingers'. A clinical work-up including chest x-ray, spiral computed tomography of the lungs and a detailed serological examination including angiotensin converting enzyme showed no evidence of infection or neoplasia. Planar scintigraphy 24 hours after administration of 185 MBq Gallium-67 citrate demonstrated an intense tracer accumulation in both lacrimal glands. Salivary gland uptake was normal and there was only a faint accumulation in the mediastinum interpreted as normal. A biopsy of the right iris revealed a granulomatous non caseating inflammation diagnosed as sarcoidosis. A systemic combination treatment with prednisolone and methotrexate for 4 months could not control the inflammation. After therapy was changed to cyclosporine the inflammation decreased and visual acuity decreased to 60 %. Neither a 'lambda sign' (characteristic uptake of Ga-67 in intrathoracic lymph nodes resembling the Greek letter lambda) nor a typical 'panda sign' (bilateral salivary and lacrimal gland uptake of Ga-67) commonly present in sarcoidosis were seen in our patient. This case demonstrates that in individual patients with sarcoidosis, lacrimal gland uptake of Ga-67 may be the only significant noninvasive finding. (author)

  18. A 17 year-old girl with a demyelinating disease requiring mechanical ventilation: a case report

    Directory of Open Access Journals (Sweden)

    Katsenos Chrysostomos

    2013-01-01

    Full Text Available Abstract Background Demyelinating diseases cause destruction of the myelin sheath, while axons are relatively spared. Pathologically, demyelination can be the result of an inflammatory process, viral infection, acquired metabolic derangement and ischemic insult. Three diseases that can cause inflammatory demyelination of the CNS are: Multiple sclerosis (MS, Acute disseminated encephalomyelitis (ADEM and Acute hemorrhagic leucoencephalitis. Differentiation is not always easy and there is considerable overlaping. Data about adults with acute demyelination requiring ICU admission is limited. Case presentation A 17 year old Greek female was hospitalised in the ICU because of acute respiratory failure requiring mechanical ventilation. She had a history of febrile disease one month before, acute onset of paraplegia, diplopia, progressive arm weakness and dyspnea. Her consciousness was not impaired. A demyelinating central nervous system (CNS disease, possibly post infectious encephalomyelitis (ADEM was the underlying condition. The MRI of the brain disclosed diffused expanded cerebral lesions involving the optic nerve, basal ganglia cerebellum, pons and medulla oblongata. There was also extended involvement of the cervical and thoracic part of the spinal cord. CSF leukocyte count was elevated with lymphocyte predominance. The patient required mechanical ventilation for two months. Then she was transferred to a rehabilitation centre. Three years later she remains paraplegic. Since then she has not suffered any other demyelination attack. Conclusions Demyelinating diseases can cause acute respiratory failure when the spinal cord is affected. Severe forms of these diseases, making necessary ICU admission, is less frequently reported. Intensivists should be aware of the features of these rare diseases.

  19. Acute unintentional intoxication with paraffin in a 25-year old patient - clinical case report.

    Science.gov (United States)

    Chibishev, Andon; Simonovska, Natasa

    2014-08-01

    "Fire-breathing" or "fire-eating" is a special kind of street art where the acts are always stunning, spectacular and amazing. People exhibiting this kind of show are professionals, not rare amateurs, who use different kind of fuels, usually hydrocarbons, in order to produce a pillar of fire. Intoxications caused by ingestion or inhalation of liquid paraffin, used as a fuel while performing, are numerous and various. We present a clinical case report of a 25-year old, previously healthy, amateur "fire-breather". During October, 2010 this young men arrived at the Emergency Unit of the University Clinic for toxicology and Urgent Internal Medicine in a severe clinical condition, after his unsuccessful attempt to perform real "fire-breathing". He had fever, strong headaches, mild abdominal and chest pain and he also had difficulties breathing and persistent dry cough. The patient was extremely dyspneic with peripheral cyanosis and shortness of breath. "Fire-breathers" must be viewed as a population at risk of paraffin-induced pneumonia, which has low mortality rate, but still is related with numerous and various chronic complications. Our patient was first in a life threatening, extremely serious clinical condition which was urgently treated with appropriate vigorous and effective therapy. This therapeutic protocol led to successful full recovery of these young men, who luckily didn't exhibit any chronic complications. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  20. Twelve Weeks of Plyometric Training Improves Motor Performance of 7- to 9-Year-Old Boys Who Were Overweight/Obese: A Randomized Controlled Intervention.

    Science.gov (United States)

    Nobre, Gabriela G; de Almeida, Marcelus B; Nobre, Isabele G; Dos Santos, Fernanda K; Brinco, Raphael A; Arruda-Lima, Thalison R; de-Vasconcelos, Kenya L; de-Lima, Jociellen G; Borba-Neto, Manoel E; Damasceno-Rodrigues, Emmanuel M; Santos-Silva, Steve M; Leandro, Carol G; Moura-Dos-Santos, Marcos A

    2017-08-01

    Nobre, GG, de Almeida, MB, Nobre, IG, dos Santos, FK, Brinco, RA, Arruda-Lima, TR, de-Vasconcelos, KL, de-Lima, JG, Borba-Neto, ME, Damasceno-Rodrigues, EM, Santos-Silva, SM, Leandro, CG, and Moura-dos-Santos, MA. Twelve weeks of plyometric training improves motor performance of 7- to 9-year-old boys who were overweight/obese: a randomized controlled intervention. J Strength Cond Res 31(8): 2091-2099, 2017-The prevalence of childhood overweight/obesity has increased, and physical training at school may to be effective to combat this scenario. We analyzed the effects of a protocol of plyometric training on body composition and motor performance of boys who were overweight/obese aged 7-9 years. The sample was randomly assigned into 2 groups: plyometric training group (T, n = 40) and control group (C, n = 19). Training consisted of 20 min·d (twice a week, during 12 weeks) of lower extremity plyometric exercise. Health-related physical fitness was measured by handgrip strength, standing long jump (SLJ), curl-ups, sit and reach, square test, running speed, and mile run test. Gross motor coordination was evaluated by means of the Körperkoordinations-test für Kinder (KTK) tests. Baseline and postintervention differences were investigated, and effect size was estimated through Cohen's d coefficient. Both groups showed increased body weight, height, and sitting height after intervention with a negligible effect size. Only T group showed increased fat-free mass (p = 0.011) compared with baseline values with small effect size. Plyometric training improved handgrip strength (d = 0.23), sit and reach (d = 0.18), curl-ups (d = 0.39), SLJ (d = 0.80), agility (d = 0.48), and time in the mile run test (d = 0.38). For gross motor coordination results, T group showed better performance in all tests after plyometric training with moderate/large effect size. Thus, 12 weeks of PT improved health-related physical fitness components and motor coordination acquisition of 7- to 9-year-old

  1. Post-traumatic nonunion of the clavicle in a 4-year-old boy and the importance of vitamin D level testing.

    Science.gov (United States)

    Duplantier, Neil L; Waldron, Sean

    2016-01-01

    Clavicle fractures in children are common and usually go on to achieve solid union with closed treatment. A limited number of pediatric clavicle fracture nonunion cases have been reported in the literature, none of which were directly associated with hypovitaminosis D. We report the youngest case to our knowledge in a 4-year-old vitamin D-deficient male with a 6-month-old right midshaft clavicle fracture nonunion that was treated successfully with vitamin D supplementation, followed by open reduction and internal fixation with autologus iliac crest bone grafting.

  2. Evaluation of dietary intake of vitamins and minerals in 13-15-years-old boys from a sport school in Warsaw.

    Science.gov (United States)

    Szczepańska, Beata; Malczewska-Lenczowska, Jadwiga; Wajszczyk, Bożena

    2016-01-01

    Insufficient intake of vitamins and minerals, in teenagers engaged in physical activity increases the risk of health disorders. The aim of this study was to evaluate selected vitamins and minerals intake in 13-15-year-old boys from sport school. The study of dietary intake was conducted among 44 boys from the School of Sport Championship (SSC). Nutritional data was collected using 24-hour recall for 3 days of week. Daily intake of minerals: sodium, potassium, calcium, phosphorus, magnesium, iron, zinc, copper, iodine and vitamins: A, E, D, B1, B2, B6, B12, C, folate and niacin was estimated. The probability of insufficient intake of nutrients in relation to the standard levels: Estimated Average Requirement (EAR) or Adequate Intake (AI) as well as excessive intake of them in relation to the Tolerable Upper Intake Level (UL) were assessed. The highest percentage of insufficient intake concerned vitamin D (100%), potassium (69%), folate (53%), and calcium (50%), slightly lower of magnesium (27%), vitamins C (24%) and E (15%). The risk of inadequate intake of other minerals: sodium, copper, iron, zinc, phosphorus, iodine and vitamins: B6, B1, B2, A, B12, niacin, was relatively lower and amounted from 0.3% to 5.4%. The disturbingly high probability of exceeding the UL for sodium (99.5%) was observed. A significant disproportion between the mean intake and the percentage of inadequate diets indicates a large diversity in the intake of vitamins and minerals in the group of studied boys, what was the reason of unbalanced diet. The insufficient intake concerns especially vitamin D, potassium, folate, calcium and a lesser extent magnesium, vitamins C and E. Sodium intake was disturbingly high. In order to avoid nutritional mistakes in the future education on the rational nutrition among students, their parents, and teachers is necessary.

  3. Case Report of a 21-Year-Old Man With Epidermolysis Bullosa Acquisita.

    Science.gov (United States)

    Cyr, Janelle; Liu, Annie; Ghazarian, Danny; Siddha, Sanjay

    Epidermolysis bullosa acquisita (EBA) is a rare acquired type of mechanobullous disease affecting the dermal-epidermal junction (DEJ) of trauma prone acral surfaces. It manifests as tense vesicles, bullae, and milia and typically heals as atrophic hypo- or hyperpigmented scars. Classic noninflammatory mechanobullous EBA typically presents at a mean age of 48 years. A 21-year-old man presented with a 2-year history of nonpainful papular-vesicular lesions on his hands, knees, and toes after minor trauma to these areas. Physical exam revealed postinflammatory hypopigmented scarring and milia to the bilateral dorsal hands and bilateral extensor elbows and knees, with tense blisters on the dorsal hand and patella regions. Direct immunofluorescence revealed strong linear IgG and IgM with weak focal positivity for IgA and C3 at the DEJ. Blood work revealed an increased diffuse gamma region of 71 g/L (6-13 g/L) on serum protein electrophoresis. Pathology showed a fibrotic underlying dermis, with subepidermal bullae and separation and no significant inflammation. The patient was started on colchicine. This case showcases an unusual early age of presentation for mechanobullous EBA and illustrates the importance of interpreting pathology in the context of clinical findings and maintaining a high index of suspicion for EBA in younger patients who present with classic findings. This case is unique as it is the first report of an association between EBA and polyclonal gammopathy and could be suggestive of chronic inflammation, which would fit with our patient's chronic history of EBA.

  4. Fibroadenoma in Axillary Supernumerary Breast in a 17-Year-Old Girl: Case Report.

    Science.gov (United States)

    Surd, Adrian; Mironescu, Aurel; Gocan, Horatiu

    2016-10-01

    Supernumerary breast or polymastia is a well documented anomaly of the breast, and commonly presents along the embryonic milk line extending between the axilla and groin. However, cases of polymastia have been recorded in the face, vulva, and perineum. The clinical significance of these anomalies include their susceptibility to inflammatory and malignant changes, and their association with other congenital anomalies of the urinary and cardiovascular systems. In this article we report a case of fibroadenoma that developed in the supernumerary breast of the right axilla in a 17-year-old girl. It is uncommon to find such palpable masses in young patients. Clinical and sonographic examination of both breasts revealed no abnormalities and no lymph nodes were detected in the axillae or the neck. No associated urologic or cardiovascular abnormalities were found, and the histopathological examination of the excisional biopsy samples showed a well-defined, capsulated intracanalicular type of fibroadenoma similar to that of eutopic mammary tissue. In this report, we describe a rare case of fibroadenoma in an accessory breast in a young woman. There are a fewer than 40 reports in the world about this subject, of which differential diagnoses include: cancer in axillary supernumerary breast, hidradenitis, axillary lymphadenomegaly, lipomas, anexial cutaneous neoplasia, cysts, and phylloides tumor. The combination of clinical examination, ultrasound, and cytology leads to adequate treatment, especially surgical. The diagnosis could be confused because of findings from cytology. In this case, because of the clinical and sonographic findings and multiple differential diagnosis, only the histopathological study was used to confirm the diagnosis. Despite its high sensitivity, cytology has low specificity and could create false positive results. However, atypical lesions can be seen in fibroadenomas, especially in younger patients, pregnant patients, and in patients who use hormonal

  5. Case Report: Acute Fatty Liver Of Pregnancy In A 30-year Old ...

    African Journals Online (AJOL)

    Acute fatty liver of pregnancy is an uncommon, potentially fatal disorder that usually occurs in the third trimester of pregnancy or in the early post partum. We present here a 30-year-old Nigerian primigravida with acute fatty liver of pregnancy. She was successfully managed and discharged. Keywords: Acute fatty liver of ...

  6. Situs Inversus in A 53 Year Old Man: A Case Report | Uchenna ...

    African Journals Online (AJOL)

    Result: A 53 year old man was referred to the cardiology clinic from the general outpatient department on account of an abnormal ECG. On examination his apex could not be located on the left and was subsequently located on the right 5th intercostal space mid-clavicular line. Examination of the abdomen revealed an ...

  7. The Effects of "Handwriting without Tears®" on the Handwriting Skills of Appropriate Size, Form, and Tool for a Four Year-Old Boy with a Developmental Delay

    Science.gov (United States)

    Meyers, Colleen; McLaughlin, T. F.; Derby, Mark; Weber, Kimberly P.; Robison, Milena

    2015-01-01

    The ability to write one's own name legibly is a critical lifelong skill for academic success. The purpose of the present study was to evaluate the effects of the Handwriting Without Tears® program on teaching a four year-old how to write his first name using proper size, form, and tool. The participant was a four year-old boy in a self-contained…

  8. Vancomycin-induced thrombocytopenia in a 60-year-old man: a case report

    Directory of Open Access Journals (Sweden)

    Shah Ravish A

    2009-06-01

    Full Text Available Abstract Introduction Vancomycin, a glycopeptide antibiotic, is used to treat resistant gram-positive infections. There has been a 10- to 20-fold increase in its use over the past 25 years. Although ototoxicity and nephrotoxicity are well known side effects of vancomycin, it can also induce platelet reactive antibodies leading to life-threatening thrombocytopenia. Vancomycin is often clinically overlooked as a cause of thrombocytopenia, especially in a scenario of sepsis or when there is use of heparin. We report a proven case of vancomycin-induced thrombocytopenia and its reversal after discontinuation of vancomycin. Case presentation A 60-year-old man with a history of hypertension, congestive heart failure and dyslipidemia was admitted for a right shoulder rotator cuff tear. He underwent right-shoulder arthroscopy and rotator cuff repair. About three weeks later, he developed pain, swelling and purulent drainage from his right shoulder. Arthroscopic irrigation and drainage was then performed. Intraoperative fluid revealed the presence of Methicillin susceptible Staphylococcus aureus, vancomycin-sensitive Enterococcus spp. and Serratia marcescens. The patient had no known allergies. After reviewing his antimicrobial susceptibility, he was started on vancomycin 1500 mgs intravenously every 12 hours (to treat both Staphylococcus aureus and Enterococcus spp and ciprofloxacin 750 mgs by oral induction every 12 hours. The patient's condition improved following antibiotic treatment. He was discharged and allowed to go home on IV vancomycin and oral ciprofloxacin. The patient's platelet count on the day of starting vancomycin therapy was 253 × 103/mm3. At weeks one, two and three, the counts were 231 × 103/mm3, 272 × 103/mm and 6 × 103/mm3, respectively. The patient was admitted for further work-up of the thrombocytopenia. He was later shown to have vancomycin-induced platelet-reactive antibodies, causing significant thrombocytopenia, and then

  9. [Primary prevention of cardiovascular diseases: long term results of five year long preventive intervention in 12-year old boys (ten year prospective study)].

    Science.gov (United States)

    Rozanov, V B; Aleksandov, A A; Shugaeva, E N; Perova, N V; Maslennikova, G Ia; Smirnova, S G; Olfer'ev, A M

    2007-01-01

    In a longitudinal cohort (prevention group, n=213, comparison group, n=163) of 10-year prospective follow-up we addressed efficacy of 5-year-long multifactor preventive intervention, conducted in a sample of population of 12 year old boys. Preventive intervention was carried out both at populational level and among persons with risk factors of development of cardiovascular diseases with the use of group, individual, and partly family approaches, and was directed at rationalization of nutrition, elevation of physical activity and prevention of harmful habits. During first 3 years of prevention we succeeded to achieve stable statistically significant lowering of mean levels of total cholesterol, low density lipoprotein cholesterol, triglycerides, and atherogeneity index, as well as to affect fatty component of body mass (skinfold thickness). Long term effect of 5-year long preventive intervention manifested as significantly lower level of systolic blood pressure, lower prevalence of low levels of high density lipoprotein cholesterol, smaller increment of low density lipoprotein cholesterol and index of atherogeneity in the prevention group. These results evidence that prevention of main factors of risk of development of cardiovascular diseases (obesity, arterial hypertension, disorders of lipid composition of the blood, and low physical activity) in child and adolescent age in the period of active growth and development is feasible, effective, safe and is able to lead to decrease of levels of these factors in adults, but should last uninterruptedly until formation of stable habits of healthy life style.

  10. [Case report: electroconvulsive therapy in a 33-year-old man with hysterical quadriplegia].

    Science.gov (United States)

    Gaillard, A; Gaillard, R; Mouaffak, F; Radtchenko, A; Lôo, H

    2012-02-01

    Conversion disorder refers to the occurrence of neurological-like symptoms or deficits that are neither intentionally produced nor simulated. While it cannot be explained by an organic disease, it is often related to psychological events. We report the case of a 33-year-old patient with a fluctuating hysterical tetraplegia, which had started three years earlier. After the failure or the exhaustion of several biological (psychotropic medication, transcranial magnetic stimulation) and psychotherapeutic strategies, treatment with electroconvulsive therapy (ECT) was conducted. A total of thirty-five ECT sessions were performed. Whereas the patient's clinical state was initially characterized by a complete quadriplegia and an uncontrollable muscular hypertonia, we noted that the ECT sessions were associated with a slow, though remarkable, progress. At first, the sessions were followed by moments of altered consciousness during which the patient would be relaxed and could make simple movements. Secondarily, not only was our patient able to consciously move his four limbs, but he was also able to walk. However, those improvements remained partial and fluctuating, sometimes allowing the symptom to return temporarily secondary to frustrations or annoyances. Finally, our patient relapsed. Nevertheless, his clinical state presently remains better than that in which we first knew him. The treatment of conversion disorders has been the subject of few studies and predominantly remains symptomatic. Its main goals are: to lessen secondary gains impact by adopting a neutral behaviour towards the symptom and by encouraging physical rehabilitation; to lower the symptom by allowing the patient to understand the normal functioning of the diseased organ, and; to help the patient to deal with stressful situations. There is no evidence that hypnosis is superior to medical and other psychotherapeutic approaches. Pharmacological treatments may be helpful in the case of anxiety, impulsivity

  11. Cleidocranial dysplasia in a 15-month-old boy and a 14-year-old girl: clinical and radiological presentation; Dysplazja obojczykowo-czaszkowa u 15-miesiecznego chlopca i 14-letniej dziewczynki - prezentacja kliniczna i obraz radiologiczny

    Energy Technology Data Exchange (ETDEWEB)

    Gizewska, M; Walczak, M; Bich, W [II Klinika Chorob Dzieci Pomorskiej Akademii Medycznej, Szczecin (Poland); Walecka, A [Zaklad Diagnostyki Obrazowej i Radiologii Interwencyjnej Pomorskiej Akademii Medycznej, Szczecin (Poland); Rosinska, Z [Oddzial Noworodkow, Patologii i Intensywnej Terapii, SPS ' ' Zdroje ' ' , Szczecin (Poland); Doniec-Zawidzka, I [Katedra i Zaklad Ortodoncji Pomorskiej Akademii Medycznej, Szczecin (Poland)

    2005-07-01

    Cleidocranial dysplasia (CCD) is a rare, autosomal dominant skeletal dysplasia with a relatively mild course. The most characteristic symptoms are clavicle hypoplasia or aplasia, abnormalities in the skull ossification, and a variety of dental pathologies. The clinical course and radiological presentation of two cases (a 15-month-old boy and a 14-year-old girl) of CCD are presented. Among the characteristic phenotype features the patients demonstrated were abnormalities in the skull formation, with wide sutures and large, delayed closure of the fontanelles, additional Wormian bones, and significant dental abnormalities, in both cases with delayed eruption of teeth and, in the girl, intensive caries, cross bite, and impacted teeth. The boy presented hypoplasia of the clavicles, while aplastic clavicles were confirmed in the girl. In both cases clavicle defects resulted in descended shoulders with abnormal movement faculty. Metacarpal and phalangeal defects were also found in both children as well as abnormalities in pelvic structure, with wide pubic symphysis and vertical arrangement of the pelvic bones in the girl. CCD is a skeletal dysplasia with characteristic clinical and radiological presentation. Although the course of the disorder is relatively mild, early orthopedic, dental, and orthodontic care, as well as rehabilitation, are essential in limiting complications resulting from the congenital malformation of the skeletal system. (author)

  12. Dysplasia Epiphysealis Hemimelica (Trevor Syndrome of Talus in a 21-Year Old Woman; Case Report

    Directory of Open Access Journals (Sweden)

    Amir R Sdeghifar

    2014-03-01

    Full Text Available Dysplasia epiphysealis hemimelica is a rare nonhereditary epiphyseal disease that mimics synovial chondromatosis and osteochondroma of the joints. The disease mainly involves long bones of the lower extremities and tarsal bones. Herein we report 21-year old woman who presented with pain and limited range of ankle motion, who underwent surgical excision of talus exostosis after preoperative imaging and careful planning. after that she was discharged and her problem improved and she have no problem in three year follow up .pathologic examination of specimen confirm the diagnosis.

  13. 74 Year-Old-Man With Pneumopericardium Due to Blunt Chest Trauma: Case Report

    Directory of Open Access Journals (Sweden)

    Alper Avcı

    2008-12-01

    Full Text Available Pneumopericardium is the presence of air in the pericardial space. It may be seen in the context with severe blunt chest trauma. Usually, pneumopericardium is self-limiting and requiring no specific therapy. However, a continuous monitoring of the electrocardiography and the blood pressure is necessary at an intermediate care unit. We report a 74 year-old-man had been presented with Pneumopericardium, after a car striking. He had bilateral pneumohematothoraces, pneumomediastinum and bilateral multiple rib fractures. Pneumopericardium was diasappeared without surgical management like written in english literature. Frequent cardiac and vital signs monitoring and general support treatment were successful in our treatment.

  14. Total Colonic Volvulus Followed by Mesenteroaxial Gastric Volvulus in a 24-year-old Female: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Kyung; Lee, Jong Beum; Kim, Gi Hyeon; Lee, Hwa Yeon; Kim, Yang Soo; Song, In Sup [Chung-Ang University Hospital, Seoul (Korea, Republic of)

    2010-08-15

    A very rare case of multi-organ volvulus, serially involving the spleen, colon and stomach, is presented in a 24-year-old female patient with Down syndrome. This case is of interest because of the three different types of volvulus or torsion that occurred serially over thirteen years in the same patient. We report the imaging findings and suggest possible pathogenesis by a review of the operation record and literature.

  15. Total Colonic Volvulus Followed by Mesenteroaxial Gastric Volvulus in a 24-year-old Female: A Case Report

    International Nuclear Information System (INIS)

    Kim, Mi Kyung; Lee, Jong Beum; Kim, Gi Hyeon; Lee, Hwa Yeon; Kim, Yang Soo; Song, In Sup

    2010-01-01

    A very rare case of multi-organ volvulus, serially involving the spleen, colon and stomach, is presented in a 24-year-old female patient with Down syndrome. This case is of interest because of the three different types of volvulus or torsion that occurred serially over thirteen years in the same patient. We report the imaging findings and suggest possible pathogenesis by a review of the operation record and literature

  16. A case of premature ovarian failure (POF) in a 31-year-old woman with a 47,XXX karyotype.

    Science.gov (United States)

    Skałba, Piotr; Cygal, Anna; Gierzyńska, Zuzanna

    2010-01-01

    A case of POF in a 31-year-old woman with karyotype 47,XXX. The aim of the study was to discuss a case of POF in a 31-year-old patient with polysomy 47,XXX. The described karyotype is not usually associated with this characteristic physical phenotype. In some rare cases, menstrual disorders, sterility, secondary amenorrhoea, premature menopause, and low intelligence are found. Our observations revealed the necessity for cytogenetic examination in all women at reproductive age with symptoms of premature ovarian failure. According to the data found in literature, patients with POF and karyotype disorders belong to the risk group of premature death, mostly for cardiological reasons. Raising patient awareness about the risk may have a positive effect on quality of life and regularity of check-ups.

  17. Malignant phyllodes tumor in an 11-year-old girl with fatal clinical outcome. A case report.

    Science.gov (United States)

    Hassan, Sidra; Ud Din, Nasir; Kayani, Naila

    2016-01-27

    Phyllodes tumors are rare biphasic tumors occur predominantly in middle aged women. Malignant phyllodes tumor in children is very rare. To report a case of malignant phyllodes tumor in a pre-menarchal girl. H&E slides of the case were reviewed and follow up was obtained. The patient was 11-year-old girl who noticed a lump in her right breast 1 year back which grew rapidly in size. Wide local excision of the mass was done and histopathology revealed a malignant phyllodes tumor. Patient underwent mastectomy one month later due to recurrence. Two years later, she presented with dyspnea and chest pain. CT showed lung metastasis. The patient died of disease 1 year later due to widespread metastasis in liver and bone. We report a case of malignant phyllodes tumor in an 11-year-old girl, which behaved aggressively and patient died of disease due to widespread metastases 3 years after diagnosis.

  18. A Case of Male Osteoporosis: A 37-Year-Old Man with Multiple Vertebral Compression Fractures

    Directory of Open Access Journals (Sweden)

    Suhaib Radi

    2017-01-01

    Full Text Available While the contributing role of testosterone to bone health is rather modest compared to other factors such as estradiol levels, male hypogonadism is associated with low bone mass and fragility fractures. Along with stimulating physical puberty by achieving virilization and a normal muscle mass and improving psychosocial wellbeing, the goals of testosterone replacement therapy in male hypogonadism also include attainment of age-specific bone mineral density. We report on a 37-year-old man who presented with multiple vertebral compression fractures several years following termination of testosterone replacement therapy for presumed constitutional delay in growth and puberty. Here, we discuss the management of congenital hypogonadotropic hypogonadism with hyposmia (Kallmann syndrome, with which the patient was ultimately diagnosed, the role of androgens in the acquisition of bone mass during puberty and its maintenance thereafter, and outline specific management strategies for patients with hypogonadism and high risk for fragility fractures.

  19. Acute Urinary Retention in A Three Years Old Girl: Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Homayoon Tabesh

    2009-08-01

    Full Text Available Urinary retention,a rare childhood problem which is most commonly caused by urinary tract infection. However,neurological neoplasm must also be considered in differential diagnosis.We report here a 3 year old girlthat was referred to the pediatrics department of Kashan University of Medical Sciences (KAUMS with a history of urinary retention for10 days.By insertion of a Foley catheter specimens obtained for urinalysis and culture, and also antibiotics were administered,but no clinical improvement encountered and the patient developed lower limbs weakness.Magnetic resonance imaging of the spine revealed an intramedullary mass lesion at located in T10 to T12.Gradual improvement appeared after surgical excision of an   infected epidermoid cyst and completion of the course of antibiotics.

  20. Prosthodontic Rehabilitation of Hereditary Ectodermal Dysplasia in an 11-Year-Old Patient with Flexible Denture: A Case Report

    Directory of Open Access Journals (Sweden)

    Neha Jain

    2012-01-01

    Full Text Available Hereditary ectodermal dysplasia is a rare group of inherited disorders characterized by aplasia or dysplasia of two or more tissues of ectodermal origin such as hair, nails, teeth, and skin. The dental characteristics of this syndrome include anodontia or hypodontia of the primary and/or permanent teeth, hypoplastic conical teeth, and underdevelopment of the alveolar ridges. The options for a definitive treatment plan include fixed, removable or implant-supported prostheses, singly or in combination. This clinical report describes the prosthetic rehabilitation of an 11-year-old boy with hereditary ectodermal dysplasia. Maxillary flexible removable partial denture and mandibular conventional complete denture were fabricated to establish an acceptable masticatory function, speech, and esthetics for the patient.

  1. A rare case of localised pigmented villonodular synovitis in the knee of a 24-year-old female soccer player

    DEFF Research Database (Denmark)

    Falster, Casper; Stockmann Poulsen, Simon; Joergensen, Uffe

    2017-01-01

    Localised pigmented villonodular synovitis (PVNS) of the knee is a rare diagnosis, with clinical signs and symptoms mimicking meniscal damage or other common knee injuries. We report the case of a 24-year-old female soccer player, seeking treatment after 7 months of persisting knee pain...... analyses confirmed the diagnosis of localised PVNS. The patient was subsequently free of symptoms with no signs of recurrence on MRI and had resumed soccer practice at the 1-year follow-up appointment....

  2. A case report on gastric volvulus of a 17 years old boy from Bangladesh

    Directory of Open Access Journals (Sweden)

    M. Tasdik Hasan

    2017-01-01

    Conclusion: It should be suspected in congenital abnormalities of diaphragm and associate with many other congenital abnormalities like ectopic kidney. Early surgical repair remains the treatment of choice.

  3. AVN OF BILATERAL HIP IN 36 YEAR OLD MALE PATIENT TREATED CONSERVATIVELY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Prashanth

    2015-04-01

    Full Text Available CLINICAL D ETAILS: History: A 36 year old patient with bilateral hip pain and limp of nine months gradually progressed to rest pain with inability to squat and low back pain. EXAMINATION: Bilateral hip joint line tenderness (left>right. Left hip restriction of movements, wasting with abduction deformity. INVESTIGATIONS: X - ray showed increased density (left>right in subchondral region of head , >50% segmental collapse in left hip, regional osteoporosis. Blood investigations showed high triglyceride , uric acid with anaemia. MANAGEMENT: Traction and physiotherapy with Zolendronic acid 5mg i.v. infusion, balanced diet, calcium, iron and methylcobalamine supplementation. RESULTS: X - rays revealed improvement in osteoporosis and disappearance of acetabula r osreophyte, rebuilding of vertical trabaculae. MRI on 14 th month showed revascularization of trabaculae with maintenance of articular cartilage without hyper intensity in T2 images. Triglycerides and uric acid level normalized. DISCUSSION: AVN Hip is the result of vascular insult due to many causes. In this patient contributing factors are non - vegetarian diet, tobacco chewing , hypertriglyceridemia, hyperurecimia. All these resulted in endothelial damage of vessels. CONCLUSION: AVN of femoral head grade 2 and 3 managed conservatively with physiotherapy, dietary modification and bisphosphonates gave good results as assessed with Harris hip score

  4. Use of Hippotherapy With a Boy After Traumatic Brain Injury: A Case Study.

    Science.gov (United States)

    Erdman, Ellen A; Pierce, Samuel R

    2016-01-01

    The purpose of this case report was to describe the use of hippotherapy with a boy who sustained a brain injury. A 13-year-old boy, 6 months after traumatic brain injury received 12 physical therapy sessions, which included hippotherapy. Improvements were noted in balance, strength, gross motor skills, gait speed, functional mobility, and reported participation. Hippotherapy used with a 13-year-old boy after traumatic brain injury may have had a positive effect in the body structure, activity, and participation domains.

  5. Making sense of gender from digital game play in three-year-old children’s everyday lives: An ethnographic case study

    Directory of Open Access Journals (Sweden)

    Youn Jung Huh

    2015-06-01

    Full Text Available This study explores very young children performing and talking about game characters in their everyday life. In this study, young children’s digital game play is considered as a hybrid and complex site for the children to meet popular culture and their everyday family experiences. This article represents a case study of six three-year-old children and their families, which combines ethnographic methods (spending time with the families, being a participant observer and critical perspectives analysis with Bakhtinian perspectives to construct analyses that have the potential to understand how young children make sense of their everyday roles as a boy or a girl through their game play. This study shows that young children do not directly receive ideological messages from the game media, but they make sense of the messages by decoding and interpreting the game media based on their own theories of everyday life.

  6. Spontaneous bilateral subclavian vein thrombosis in a 40-year-old man: A case report.

    Science.gov (United States)

    Huang, Chun-Yen; Wu, Yen-Hung; Yeh, I-Jeng; Chen, Yun-Yi; Kung, Fung-Ya

    2018-04-01

    Paget-Schroetter syndrome (PSS) is an uncommon condition that refers to primary (spontaneous) thrombosis of the deep veins that drain the upper extremities because of anatomical anomalies or repetitive strenuous arm activity. Bilateral spontaneous upper extremity deep-vein thrombosis (UEDVT) is an extremely rare phenomenon in adults, which may be misdiagnosed by physicians in acute settings. A 40-year-old man presented to our emergency department because of progressive left upper arm swelling for 1 day. He denied fever, chest pain, dyspnea, trauma, or any other systemic disease before. The swollen left arm also had no local heat or redness with normal radius pulsation. He was a laborer who lifted heavy objects. Blood examination included tests for complete blood count, renal function, liver function, blood coagulation profile, cardiac enzyme levels, and D-dimer level. Results showed that the white blood cell count, renal and liver functions, and cardiac enzyme levels were all within their normal ranges, except for the elevated D-dimer level (1.93 mg/L). Chest radiography and electrocardiography were performed with nonspecific findings. Subsequently, computed tomographic angiography was recommended for the suspected deep-vein thrombosis. The report showed venous thrombosis involving the bilateral subclavian and internal jugular veins. Heparin and enoxaparin were prescribed for this patient, with loading and maintenance doses. He was then admitted to our cardiovascular ward for further treatment. The patient was discharged 9 days later in a stable condition. Emergency physicians should consider the rare condition of UEDVT when a healthy patient presents with acute arm swelling. Patient history taking should be thorough, especially concerning the risk factors of secondary causes and possible frequent vigorous heavy lifting and overhead motion. Without secondary risk factors, primary upper deep-vein thrombosis might be suspected. Further laboratory tests and imaging

  7. Nitrous Oxide Abuse and Vitamin B12 Action in a 20-Year-Old Woman: A Case Report.

    Science.gov (United States)

    Duque, Miriam Andrea; Kresak, Jesse L; Falchook, Adam; Harris, Neil S

    2015-01-01

    Herein, we report a case of a 20-year-old (ethnicity not reported) woman with a history of nitrous oxide abuse and clinical symptoms consistent with spinal cord subacute combined degeneration with associated low serum concentrations of vitamin B12, elevated methylmalonic acid levels, and radiologic evidence of demyelination of the dorsal region of the spinal column. The health of the patient improved dramatically with B12 supplementation. In this case, we discuss the interaction of nitrous oxide with the enzymatic pathways involved in the biochemistry of vitamin B12. Copyright© by the American Society for Clinical Pathology (ASCP).

  8. Rare case of primary spinal ependymomatosis occurring in a 26-year-old man: a case report

    Directory of Open Access Journals (Sweden)

    Kaliaperumal Chandrasekaran

    2009-10-01

    Full Text Available Abstract Introduction The authors report a rare case of primary spinal ependymomatosis in a young adult man. Multiple primary ependymomatous lesions were seen on magnetic resonance imaging and no anaplasia was identified on the surgical-pathological analysis. The aetio-pathological mechanism and surgical significance of this rare occurrence is discussed. Case presentation A 26-year-old man of Polish origin presented with a ten-day history of pain in the left leg and lower back. This was followed by difficulty in urinating and a decrease in sensation in both legs. Examination revealed pyramidal signs and mild weakness in both lower limbs. He had early sphincter involvement requiring catheterization. Magnetic resonance imaging of the brain was normal. However, that of the spinal cord revealed multiple intradural spinal lesions, both intra- and extramedullary, extending from the cervical cord down to the cauda equina roots. T12-L1 laminectomy was performed. Multiple intradural, extra- and intra-medullary tumors were seen. After the operation, the patient deteriorated with a sensory level at T4. Post-operative cranio-spinal radiotherapy was administered but there was no clinical improvement in the lower limbs. Conclusion Primary spinal ependymomatosis is a rare phenomenon involving multiple spinal segments in the absence of a primary intracranial tumor. Radical excision is unrealistic in this condition. Biopsy followed by radiotherapy is the preferred method of treatment.

  9. Disseminated Histoplasmosis in a 13-year-old girl: A case report ...

    African Journals Online (AJOL)

    Background: Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immunecompromised individuals such as those with acquired immuno-deficiency syndrome. Objective: To describe a case of disseminated histoplasmosis in an adolescent girl. Method: We report a case of disseminated ...

  10. Disseminated Histoplasmosis in a 13-year-old girl: a case report

    African Journals Online (AJOL)

    EB

    Abstract. Background: Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immune- compromised individuals such as those with acquired immuno-deficiency syndrome. Objective: To describe a case of disseminated histoplasmosis in an adolescent girl. Method: We report a case of ...

  11. PNET Ewing's sarcoma: a case report of a 8-year-old child presenting with PNET Ewing sarcoma

    International Nuclear Information System (INIS)

    Bauskar, Pratibha; Bhalavat, Rajendra; Chandra, Manish; Bauskar, Dipak

    2016-01-01

    PNET (Primitive Neuro-Ectodermal) mostly present in younger children. PNET Ewing sarcoma Ewing's sarcomas are rare, aggressive tumors, growth from undeveloped brain cells, with a tendency towards recurrence. We report the case of a 8-year-old girl who presented with a one year history of pain in her lower neck region with single episode of un-consciousness associate with left side upper and lower limb weakness. Magnetic resonance imaging demonstrated an abnormal marrow changes involving C5 vertebra and involvement of posterior elements showing expansive changes. Biopsy showed malignant small round cell tumor identifying as PNET Ewing sarcoma. Laminectomy and Decompression of cervical tumor. (author)

  12. Therapy for Ewing´s Family of Tumours in adults - a case report of 53 years old patient

    International Nuclear Information System (INIS)

    Adamkova Krakorova, D.; Tomasek, J.; Tucek, S.; Janicek, P.; Cerny, J.

    2011-01-01

    Ewing's sarcoma, a highly malignant primary bone tumour, is most frequently observed in children and adolescents, aged 4 - 15 years. 90 % of patients are younger than 20 years. Ewing's sarcomas are rare in patients over the age of 40 years. Prognosis is poor, with 5-year overall survival of 55 % to 70 % in localized and not exceeding 20 % in primarily metastatic disease. Patients with primary bone cancers should be evaluated by a multidisciplinary team with demonstrated expertise in the management of such patients. We introduce you a curiose case report of 53 years old patient. (author)

  13. Idiopathic Perforation of the Sigmoid Colon in a 2.5 Years Old Girl: A Case Report

    Directory of Open Access Journals (Sweden)

    Sanaz Mehrabani

    2017-09-01

    Full Text Available Idiopathic colon perforation is rare in children. It is more common at the extremes of age. Splenic flextures, ileocecal and lower sigmoid regions are the most common sites of perforation. Delay in proper management of this condition is associated with high mortality and morbidity rate. We report on the case of a 2.5 years old girl who presented with fever, diarrhea, nausea and vomiting and progressive abdominal distention.Finally, she underwent an exploratory laparotomy for suspected peritonitis because of the patient's worsening condition. An area of perforation was found in the sigmoid colon that segmental resection and an end double barrel colostomy was done.

  14. Diagnosis and management of nonsyndromic hereditary gingival fibromatosis in a 13 year old girl: Report of a rare case

    Directory of Open Access Journals (Sweden)

    Lata Goyal

    2012-01-01

    Full Text Available Hereditary gingival fibromatosis is a rare condition characterized by various degree of gingival overgrowth. It usually develops as an isolated disorder but can manifest with multisystem syndrome. We are here presenting a case of a 13-year-old girl who presented with severe enlargement of gingiva covering all most the entire crown involving both maxillary and mandibular arches. Differential diagnosis includes drug-induced and idiopathic gingival enlargement. Excess gingival tissue was removed by full mouth gingivectomy and sent for histopathological examination. Postoperative course was uneventful and patient′s esthetics improved significantly. A 12 month postoperative period shows no recurrence.

  15. Bilateral fibrous dysplasia of the mandible in a 7-year-old male patient-A rare case

    Directory of Open Access Journals (Sweden)

    Chandar V

    2010-06-01

    Full Text Available Fibrous dysplasia is a disturbance of bone metabolism that is classified as a benign fibro-osseous lesion. Fibrous connective tissue, containing abnormal bone, replaces normal bone. The etiology of fibrous dysplasia is unknown. The radiographic appearance of the irregularly shaped trabeculae aids in the differential diagnosis. Occurring most commonly in the second decade of life, the lesions of fibrous dysplasia can be surgically recontoured for esthetic or functional purposes once they become dormant. Here, we report a case of bilateral fibrous dysplasia in a 7 year old male patient and its diagnostic work-up.

  16. Genital sanguineous discharge in prepuberty: a case of mullerian papilloma of vagina in a nine-year-old girl.

    Science.gov (United States)

    Tumini, Stefano; Carinci, Silvia; Anzellotti, Maria Teresa; Chiesa, Pier Luigi Lelli; Rossi, Carlo; Stuppia, Liborio; Bertelloni, Silvano; Chiarelli, Francesco

    2010-08-01

    Vaginal bleeding in prepuberty is an alarming symptom that must be carefully investigated. Among quite common causes of genital sanguineous discharge, there are rarer conditions responsible for bleeding at this age like Mullerian papilloma of the genital tract. In this report, we describe a case of Mullerian papilloma of the vagina in a 9-year-old girl. We believe in the importance of a correct clinical setting and histological definition to avoid wrong diagnosis and consequent inadequate treatments. Mullerian papilloma, a benign tumor, can in fact be treated only with local excision.

  17. Giant insulinoma in a 15-year-old man: A case report

    Directory of Open Access Journals (Sweden)

    Vasin Vasikasin

    2016-01-01

    Conclusion: We report the youngest case of a giant insulinoma. Despite the size of the tumor, the pathological report confirmed the benign characteristics. However, long-term follow-up is still essential to detect recurrence in the future.

  18. False-positive “halo” sign on testicular scintigraphy in a 5-year-old boy with epididymitis and hydrocele

    International Nuclear Information System (INIS)

    Santhosh, Sampath; Guha, Poonam; Bhattacharya, Anish; Bawa, Monika; Mittal, Bhagwant Rai

    2011-01-01

    Scintigraphic differentiation between acute torsion, hydrocele and testicular or scrotal abscess can be difficult. Doppler sonography may provide useful complimentary information toward diagnosis. The authors describe a 5-year-old child where epididymitis with hydrocele was misdiagnosed as testicular torsion on scrotal scintigraphy

  19. Case report of Lewy body disease mimicking Creutzfeldt-Jakob disease in a 44-year-old man.

    Science.gov (United States)

    Saint-Aubert, Laure; Pariente, Jérémie; Dumas, Herve; Payoux, Pierre; Brandel, Jean-Philippe; Puel, Michèle; Vital, Anne; Guedj, Eric; Lesage, Suzanne; Peoc'h, Katell; Brefel Courbon, Christine; Ory Magne, Fabienne

    2016-07-30

    Few patients are reported with dementia with Lewy bodies before fifty years-old, which may partly reflect the difficulty of accurate diagnosis in young population. We report the case of a 44-year-old male with pathologically confirmed sporadic dementia with Lewy bodies, who did not fulfil the revised clinical criteria for this disease. We document this atypical case with clinical and cognitive evaluation, imaging, biochemistry, genetics and pathology investigations. Creutzfeldt-Jakob disease was first suspected in this patient with no previous medical history, who developed acute and rapid cognitive impairment, L-dopa-non-responsive parkinsonism, and delusion. Positive 14-3-3 protein was initially detected in cerebrospinal fluid and until the late stages of the disease. Severe atrophy with no diffusion hypersignal was found on structural MRI as well as an extensive hypometabolism on (18)F-FDG-PET, in comparison to age-matched healthy volunteers. Genetic investigation found no alpha-synuclein gene mutation. The patient died within 5 years, and post-mortem examination found numerous Lewy bodies and Lewy neurites consistent with pure Lewy body disease. This comprehensively described case illustrates that dementia with Lewy bodies can occur in young patients with atypical clinical presentation. Biochemistry and neuroimaging investigations can sometimes be insufficient to allow accurate diagnostic. More specific markers to support such diagnosis are needed.

  20. Conservative management of idiopathic anterior atlantoaxial subluxation without neurological deficits in an 83-year-old female: A case report.

    Science.gov (United States)

    Marchand, Andrée-Anne; Wong, Jessica J

    2014-03-01

    Atlantoaxial subluxation that is not related to traumatic, congenital, or rheumatological conditions is rare and can be a diagnostic challenge. This case report details a case of anterior atlantoaxial subluxation in an 83-year-old female without history of trauma, congenital, or rheumatological conditions. She presented to the chiropractor with insidious neck pain and headaches, without neurological deficits. Radiographs revealed a widened atlantodental space (measuring 6 mm) indicating anterior atlantoaxial subluxation and potential sagittal atlantoaxial instability. Prompt detection and appropriate conservative management resulted in favourable long-term outcome at 13-months follow-up. Conservative management included education, mobilizations, soft tissue therapy, monitoring for neurological progression, and co-management with the family physician. The purpose of this case report is to heighten awareness of the clinical presentation of idiopathic anterior atlantoaxial subluxation without neurological deficits. Discussion will focus on the incidence, mechanism, clinical presentation, and conservative management of a complex case of anterior atlantoaxial subluxation.

  1. Torsion of normal adnexa in a 31-year-old woman: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Nao Wakui

    2018-01-01

    Full Text Available It is known that a large ovarian cyst will likely cause torsion. However, normal adnexal torsion is rare and occurs in premenarchal girls in most cases. This is a case of a reproductive woman. A 31-year-old woman suffering from acute abdominal pain in the lower and right side consulted her gynecologist. The next day she had a computed tomography performed and was suspected of ovarian torsion. She did not have fever, nausea, or leukocytosis, but her abdominal pain persisted. Diagnostic laparoscopy was performed and showed torsion of the right fallopian tube, which was swollen and looked like a hydrosalpinx with a normal ovary. We did detorsion and excision of the right tube. However, pathological findings showed that the right tube was not a hydrosalpinx but was swollen due to blood stasis. We determined that this case was torsion of normal adnexa. In such cases, diagnostic laparoscopy is very effective.

  2. Alagille syndrome in an eleven year old Nigerian child – A case report

    African Journals Online (AJOL)

    2016-11-08

    Nov 8, 2016 ... is associated with cardiac, hepatic, skeletal, ocular, renal and facial abnormalities ... important pathway by which cells can signal to each other. The Jagged-1 ... tion for liver transplant.13 The first reported case in. Nigeria was by ... Her pregnancy and delivery was supervised and mother well except for a ...

  3. Achalasia of the Cardia in a 21 Year old Pregnant Lady: A Case ...

    African Journals Online (AJOL)

    Achalasia of the cardia is a motor disorder of the lower oesophagus of unknown aetiology. It is characterized by persistent dysphagia in 82 – 100% of patients. We describe a rare case of dysphagia due to Achalasia cardia in a pregnant lady in her third trimester. Tanzania Medical Journal Vol. 23 (2) 2008: pp. 31-32.

  4. Portal biliopathy in a 13-year-old Asian girl: A case report and ...

    African Journals Online (AJOL)

    Portal biliopathy (PB) is a term used to describe biliary ductal and gallbladder wall abnormalities seen in patients with portal hypertension. The pathogenesis of PB is not well known. It has been postulated that external pressure of portal cavernoma and/ or ischemia may play a role. We report a case of a patient with PB ...

  5. Case report: 16-Year-old male with autistic disorder with preoccupation with female feet.

    Science.gov (United States)

    Early, Maureen C; Erickson, Craig A; Wink, Logan K; McDougle, Christopher J; Scott, Eric L

    2012-06-01

    This paper highlights clinical challenges faced when diagnosing and then treating an individual presenting to a child and adolescent psychiatry clinic because of unwelcome comments he made to female peers about their feet. Novel use of exposure therapy helped him effectively decrease his comments from 1 to 2 times per month to once every 6 months. Conceptualizing this case as the individual's failed attempts toward relationships with females instead of sexual harassment led to diminution of problematic behavior. Implications for diagnosis and treatment of individuals with Autistic Disorder displaying problematic behaviors are presented.

  6. Muscle dysmorphia symptomatology and extreme drive for muscularity in a 23-year-old woman: a case study.

    Science.gov (United States)

    Leone, James E

    2009-05-01

    We describe a 23-year-old woman with muscle dysmorphia symptomatology and extreme drive for muscularity. In addition to structured case study interviews, 3 questionnaires and a series of semistructured interview questions were administered for elaboration on key issues. The case studies allowed for triangulation of data garnered from the questionnaires. Responses revealed high scores for drive for muscularity, moderate scores for the Adonis complex, and high scores for symptoms of muscle dysmorphia. Muscle dysmorphia and drive for muscularity are more prevalent in men; however, unique cases such as this need to be further explored both empirically and theoretically. Cross-cultural references are needed to assess the overall impact of global social influences. Instruments measuring muscle dysmorphia need to be devised and validated for women as well as men. The strength and conditioning professional needs to be both aware and vigilant in helping people affected with psychosomatic disorders such as muscle dysmorphia or exercise addiction.

  7. Second trimester hepatic rupture in a 35 year old nulliparous woman with HELLP syndrome: a case report.

    LENUS (Irish Health Repository)

    Kelly, J

    2009-01-01

    The HELLP syndrome (haemolysis, elevated liver blood tests and low platelets) is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10-20% of cases with severe preeclampsia. Hepatic capsular rupture is a rare yet dramatic complication of HELLP syndrome. The majority of cases occur in multiparous women over the age of 30. Classically it presents with acute onset right upper quadrant pain in the presence of constitutional symptoms such as vomiting and pyrexia. However, symptoms and signs are usually non specific. Spontaneous hepatic rupture can be preceded by signs of hypovolaemic shock; yet the diagnosis is infrequently made prior to emergent laparotomy. We present the case of a 35 year old nulliparous woman with a second trimester gestational hepatic rupture associated with HELLP syndrome. We briefly discuss the aetiology, diagnostic difficulties and treatment options associated with this rare presentation.

  8. Endogenous Cushing’s Syndrome with Precocious Puberty in an 8-Year-Old Boy due to a Large Unilateral Adrenal Adenoma

    Directory of Open Access Journals (Sweden)

    Muhammad Rajib Hossain

    2013-01-01

    Full Text Available Adrenocortical tumors (ACTs causing Cushing’s syndrome are extremely rare in children and adolescents. Bilateral macronodular adrenocortical disease which is a component of the McCune-Albright syndrome is the most common cause of endogenous Cushing’s syndrome. We report the case of a boy with Cushing’s syndrome who presented with obesity and growth retardation. The child was hypertensive. The biochemical evaluation revealed that his serum cortisol levels were 25.80 g/dL, with a concomitant plasma ACTH level of 10.0 pg/mL and nonsuppressed serum cortisol on high-dose dexamethasone suppression test (HDDST to be 20.38 g/dL. Computed tomography of the abdomen demonstrated a 8 × 6 × 5 cm left adrenal mass with internal calcifications. Following preoperative stabilization, laparotomy was carried out which revealed a lobulated left adrenal mass with intact capsule weighing 120 grams. Histopathological examination revealed a benign cortical neoplastic lesion, suggestive of adrenal adenoma; composed of large polygonal cells with centrally placed nuclei and prominent nucleoli without capsular and vascular invasion. On the seventh postoperative day, cortisol levels were within normal range indicating biochemical remission of Cushing’s syndrome. On followup after three months, the patient showed significant clinical improvement and had lost moderate amount of weight and adrenal imaging was found to be normal.

  9. Atrial septal defect as a cause of chronic cough and recurrent infections in a 4-year-old boy

    Directory of Open Access Journals (Sweden)

    Piotr Fuss

    2017-09-01

    Full Text Available Recurrent infections of the respiratory system among children are the most common reason for ambulatory treatment and one of the main causes of hospitalisation. Out of many factors that can be potentially responsible for the recurrent infections in children it is necessary to consider the ones that are connected with the immaturity of the immune system of a child and ones that can disturb the proper functioning of this system. It seems that the most important observations are those pointing at links between recurrent infections of the respiratory tract and the allergic process. The present article describes a case of a boy with recurrent respiratory infections, who was diagnosed towards immune system malfunction and allergies. An echocardiographic examination revealed a major defect of the interatrial septum. This  heart condition was treated with cardiac surgery as a result of which infections occur less frequently and do not require the hospitalisation of the patient.

  10. Secondary hypertension due to isolated interrupted aortic arch in a 45-year-old person: A case report.

    Science.gov (United States)

    Zhou, Jian Mei; Liu, Xin Wen; Yang, Yi; Wang, Bo Zhong; Wang, Jian An

    2017-12-01

    Though it is rare, isolated interrupted aortic arch (IAA) could lead to hypertension. Surgical repair is the only effective curative method to treat IAA conditions and patients with IAA can hardly survive to adulthood with medication alone. We report an IAA case that of a 45-year-old male patient who survived for 45 years without surgical treatment. A 45-year-old man was referred to the hospital presenting with abnormal blood pressure level. Both computed tomography angiogram (CTA) and angiography revealed IAA. The patient was diagnosed as IAA based on computed tomography angiogram (CTA) and angiography. The patient's blood pressure was severely high and refractory. He refused surgical treatment and accepted antihypertensive medication for 10 days. The patient's office blood pressure level was abnormal, fluctuating between 140/90 and 160/100 mm Hg, but 24-hour ambulatory blood pressure monitoring showed normal level. Hypertension due to IAA could be controlled with medications, even surgery is not performed. The discrepancy between ambulatory and office blood pressure levels may be due to the white coat effect.

  11. Ameloblastic Fibroodontoma: Uncommon Case Presentation in a 6-Year-Old Child with Review of the Literature

    Directory of Open Access Journals (Sweden)

    Anshad Mohamed Abdulla

    2017-01-01

    Full Text Available Ameloblastic fibroodontoma is a benign mixed odontogenic neoplasm considered in patients with asymptomatic swelling and unerupted teeth that exhibit histologic features between ameloblastic fibroma and complex odontoma. Radiographically, this lesion appears as radiolucency admixed with focal radio opaque masses of irregular shapes and sizes. This lesion is confirmed by the presence of proliferating odontogenic epithelium, ectomesenchyme, and dental hard tissue formation on pathological analysis supplementing clinical and radiographic findings. As this tumour is less commonly seen in routine clinical practice, ameloblastic fibroodontoma with detailed orofacial features and periodic approach to its diagnosis is discussed. This paper reports a case of ameloblastic fibroodontoma of the mandible in a 6-year-old male patient with an uncommon case presentation and review of the literature.

  12. Cerebral germinoma revealed through a polydipsic polyuric syndrome in a 10-year-old girl: case report

    Directory of Open Access Journals (Sweden)

    Van Lierde

    2017-10-01

    Full Text Available Cerebral germinoma is rare. Although the imaging of the germinoma is very evocative, it’s very polymorphic clinical expression is at the origin of misguided diagnosis, as illustrated in our case. We report the case of a 10-year-old girl with diabetes insipidus evolving for 12 months associated with a decrease in visual acuity. Brain MRI (Magnetic Resonance Imaging revealed a tumor process in the suprasellar region. The stereotaxic biopsy of the tumor confirmed the diagnosis of the hypothalamic germinoma, which allowed the patient to be treated by radiotherapy and chemotherapy. The incidence of cerebral germinoma, its clinical (principally diabetes insipidus and radiological features as well as therapeutic strategies are discussed hereby.

  13. Non-traumatic myositis ossificans mimicking a malignant neoplasm in an 83-year-old woman: a case report

    Directory of Open Access Journals (Sweden)

    Nishio Jun

    2010-08-01

    Full Text Available Abstract Introduction Myositis ossificans is a benign, self-limiting condition that usually affects young, athletically active men. To the best of our knowledge, this case report describes the oldest recorded patient with myositis ossificans. Case presentation Our patient was an 83-year-old Japanese woman who presented with a one week history of a palpable mass in the left thigh. She had a history of surgery for transverse colon cancer and lung cancer at the ages of 73 and 80, respectively. Clinical and radiological examinations suggested a malignant neoplasm such as metastatic carcinoma or extraskeletal osteosarcoma. A diagnosis of myositis ossificans was made by core needle biopsy. Our patient was asymptomatic and had no recurrence at one year follow-up. Conclusion Clinicians should consider myositis ossificans as a possible diagnosis for a soft tissue mass in the limb of an older patient, thereby avoiding unnecessarily aggressive therapy.

  14. Situs Inversus with Levocardia and Congenitally Corrected Transposition of Great Vessels in a 35 year old Male: A Case report.

    Science.gov (United States)

    Ghorbnazadeh, Atefeh; Zirak, Nahid; Fazlinezhad, Afsoon; Moenipour, Aliasghar; Manshadi, Hamid Hoseinikhah; Teshnizi, Mohammad Abbasi

    2017-01-01

    Situs inversus with levocardia and congenitally corrected transposition of the great arteries represents a relatively very rare congenital condition and most patients are diagnosed in infancy or early age. This case report describes a 35-year old man with congenitally corrected transposition of the great arteries which presented with a five month history of exertional dyspnea. A diagnosis was confirmed by transesophageal echocardiogram, showing situs inversus, levocardia, atrioventricular and ventriculoarterial discordance. He underwent physiologic repair, and was discharged thirty five days after the operation, in a good general condition. Although management of the corrected transposition of the great arteries patients remains controversial, the recommendation is that physiologic repair may be the procedure of choice for some patients, particularly complicated cases.

  15. Microinvasive carcinoma of the uterine cervix in a 14-year-old adolescent: case report and literature review

    Directory of Open Access Journals (Sweden)

    Carla Vitola Gonçalves

    Full Text Available CONTEXT: Cancer of the uterine cervix is rare during adolescence. The reported rates are 0/100,000 adolescents aged 10 to 19 years and 1.7/100,000 women aged 20 to 24 years. However, several studies have shown increasing incidence of preneoplastic lesions at increasingly early ages. CASE REPORT: This paper reports a case of microinvasive carcinoma of the uterine cervix in a 14-year-old patient with menarche at 10 years of age and first coitus at 12 years of age. The objective of the present report was to alert gynecologists and pediatricians regarding the need for cervical carcinoma prevention among sexually active adolescents, based on educational programs that explain the purpose of colpocytological examinations and encourage their use, along with condom use and limitation of the number of sexual partners.

  16. An 11-Year-Old Girl Presenting with Chronic Knee Pain: A Case Report with Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    Muhammad Kamal Maj

    2010-01-01

    Full Text Available Discoid meniscus is the commonest anatomical aberration of the knee joint, among rare cases such as bilateral separated lateral meniscus, accessory lateral meniscus, partial deficiency of the lateral meniscus and double-layered lateral meniscus. An 11-year- old girl presented with history of chronic pain in her right knee for the last 6 months. The problem disturbed her involvement in the sport activities at school. Clinical examination revealed a clicking sensation on knee extension with lateral joint line tenderness. Magnetic resonance imaging (MRI of her right knee showed torn posterior horn of lateral meniscus. Arthroscopy examination revealed a discoid meniscus with absence posterior horn. Posterior horn deficient discoid meniscus is a rare form of a congenital meniscus anomaly. We as clinicians believe that the abnormal shaped meniscus may pose a diagnostic challenge clinically and radiologically. Presentation of this case may be beneficial for orthopaedicians in their daily clinical practice.

  17. A Boy with a Mild Case of Cornelia de Lange Syndrome with Above Average Intelligence.

    Science.gov (United States)

    Lacassie, Yves; Bobadilla, Olga; Cambias, Ron D., Jr.

    1997-01-01

    Describes the characteristics of an 11-year-old boy who represents the only documented case of an individual with Cornelia de Lange syndrome who also has above average cognitive functioning. Major diagnostic criteria for de Lange syndrome and comparisons with other severe and mild cases are discussed. (Author/CR)

  18. Physical activity decreased by a quarter in the 11- to 12-year-old Swedish boys between 2000 and 2013 but was stable in girls: a smartphone effect?

    Science.gov (United States)

    Raustorp, Anders; Pagels, Peter; Fröberg, Andreas; Boldemann, Cecilia

    2015-08-01

    This study explored physical activity, body mass index (BMI) and overweight and obesity from 2000 to 2013 using a convenience sample of second- and fifth-grade Swedish schoolchildren aged 8-9 years and 11-12 years, respectively. We examined cross-sectional cohorts of 126 second-grade children in 2000, 84 in 2006 and 44 in 2013 and 105 fifth-grade children in 2000 and 38 in 2013. No fifth graders were available in 2006. Physical activity data were collected based on pedometer readings over four consecutive weekdays, and height and weight were measured. Identical instruments and procedures were used in all three years. There was an increase in physical activity in second-grade girls from 2000 to 2006 (p boys and fifth-grade girls were stable throughout the study period. Fifth-grade boys decreased significantly (24%) from 16 670 to 12 704 steps per day (p physical activity differed between boys and girls. Second-grade boys and fifth-grade girls were stable throughout, whereas second-grade girls increased from 2000 to 2006 before stabilising. Fifth-grade boys showed a significant 24% reduction from 2000 to 2013. Changes in recess and leisure time habits, such as smartphone use, may have influenced the result. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  19. Palliative care in the home: a case study of secondary histiocytic sarcoma in a 3-year-old child

    Directory of Open Access Journals (Sweden)

    Zuzana Karabová

    2013-12-01

    Full Text Available This article describes the medical, psychological, and social challenges encountered during home-based, family-centred palliative care of a 3-year-old female with secondary histiocytic sarcoma diagnosed during treatment for T-cell acute lymphoblastic leukaemia. Histiocytic sarcoma is an exceedingly rare cancer in adults, but even less frequent and highly aggressive when presenting as a secondary cancer in children. Comprehensive, multidisciplinary paediatric hospice care services are not widely available across Slovakia,thus limiting the number of patients and families offered such highly specialized end-of-life care. This case study illustrates the primary benefits for the child and family of such a program as well as the impact on the medical and nursing professionals working in the fi eld of paediatric haematology-oncology.

  20. Torsion of a Wandering Spleen in a 24 Years Old Female: a Case Report and Review of Literature

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    KavianiFar Kamran

    2009-09-01

    Full Text Available Wandering spleen is a rare condition characterized by increased splenic mobility due to the absence or laxity of its suspensory ligaments that may present as acute abdomen when it is twisted on its pedicle. Herein we report a case of torsion of a wandering spleen in a 24- year-old female patient without any history of trauma. The patient was admitted to emergency ward at February 2008 with clinical findings of acute abdomen. Laparotomy was performed and the infarcted spleen was removed. Although wandering spleen is a rare clinical entity, the possibility of torsion should be kept in mind in the differential diagnosis of acute abdomen to avoid serious complications.

  1. When a 520 million-year-old Chengjiang fossil meets a modern micro-CT--a case study.

    Science.gov (United States)

    Liu, Yu; Scholtz, Gerhard; Hou, Xianguang

    2015-08-04

    The 520 million-year-old Chengjiang biota of China (UNESCO World Heritage) presents the earliest known evidence of the so-called Cambrian Explosion. Studies, however, have mainly been limited to the information exposed on the surface of the slabs. Thus far, structures preserved inside the slabs were accessed by careful removal of the matrix, in many cases with the unfortunate sacrifice of some "less important" structures, which destroys elements of exceptionally preserved specimens. Here, we show for the first time that microtomography (micro-CT) can reveal structures situated inside a Chengjiang fossil slab without causing any damage. In the present study a trilobitomorph arthropod (Xandarella spectaculum) can be reliably identified only with the application of micro-CT. We propose that this technique is an important tool for studying three-dimensionally preserved Chengjiang fossils and, most likely, also those from other biota with a comparable type of preservation, specifically similar iron concentrations.

  2. When a 520 million-year-old Chengjiang fossil meets a modern micro-CT – a case study

    Science.gov (United States)

    Liu, Yu; Scholtz, Gerhard; Hou, Xianguang

    2015-01-01

    The 520 million-year-old Chengjiang biota of China (UNESCO World Heritage) presents the earliest known evidence of the so-called Cambrian Explosion. Studies, however, have mainly been limited to the information exposed on the surface of the slabs. Thus far, structures preserved inside the slabs were accessed by careful removal of the matrix, in many cases with the unfortunate sacrifice of some “less important” structures, which destroys elements of exceptionally preserved specimens. Here, we show for the first time that microtomography (micro-CT) can reveal structures situated inside a Chengjiang fossil slab without causing any damage. In the present study a trilobitomorph arthropod (Xandarella spectaculum) can be reliably identified only with the application of micro-CT. We propose that this technique is an important tool for studying three-dimensionally preserved Chengjiang fossils and, most likely, also those from other biota with a comparable type of preservation, specifically similar iron concentrations. PMID:26238773

  3. A case of diagnostic difficulties of perirenal tumor in a 1-year-old child with renovascular hypertension

    International Nuclear Information System (INIS)

    Uliasz, M.; Romaniuk-Doroszewska, A.; Klepacka, T.; Madzik, J.

    2005-01-01

    Systemic hypertension is less common in children than in adults, but the incidence of hypertension In children is approximately 1 - 5%. Hypertension in younger children is usually indicative of an underlying disease process (secondary hypertension). In children, approximately 5 - 25% of secondary hypertension is attributable to renovascular disease. The authors present the case of a 1-year-old child with perirenal tumor and renovascular hypertension. This caused clinical and diagnostic difficulties. Renal vessel malformation is a very uncommon congenital anomaly. It can be a cause of renovascular hypertension. Diagnosis was based on tests in the following order: USG, CT, MR, CT-angiography, and histopathology. Surgical treatment and nephrectomy was necessary; renal arteries were involved. (author)

  4. A case of selective mutism in an 8-year-old girl with thalassaemia major after bone marrow transplantation.

    Science.gov (United States)

    Plener, P L; Gatz, S A; Schuetz, C; Ludolph, A G; Kölch, M

    2012-01-01

    Selective mutism is rare with a prevalence below 1% in the general population, but a higher prevalence in populations at risk (children with speech retardation, migration). Evidence for treatment strategies is hardly available. This case report provides information on the treatment of selective mutism in an 8-year-old girl with preexisting thalassaemia major. As medications she received penicillin prophylaxis (500000 IE/d) and deferasirox (Exjade; 20-25mg/kg/d), an iron chelator. The preexisting somatic disease and treatment complicated the treatment, as there are no data about pharmacological combination therapy. Psychotherapy in day treatment, supported by the use of the SSRI fluoxetine (10 mg), led to a decrease in the selective mutism score from 33 to 12 points, GAF improved by 21 points. Mean levels of fluoxetine plus norfluoxetine were 287.8 ng/ml without significant level fluctuations. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Catatonia, neuroleptic malignant syndrome, and cotard syndrome in a 22-year-old woman: a case report.

    Science.gov (United States)

    Weiss, C; Santander, J; Torres, R

    2013-01-01

    The following case study describes a 22-year-old woman with depression and symptoms of psychosis who developed neuroleptic malignant syndrome after using Risperidone, thus requiring life support equipment and Bromocriptine, later recovering after seven days. From a psychiatric and neurological point of view, however, the persistence of catatonic syndrome and Cotard syndrome delusions was observed, based on assertions such as "I do not have a heart," "my heart is not beating," "I can not breathe," "I am breaking apart," "I have no head" (ideas of negation) and statements about the patient being responsible for the "death of the whole world" (ideas of enormity). Brain NMR revealed leukoencephalopathy, interpreted as scar lesions caused by perinatal neurological damage, after discarding other pathologies. The patient responded well to electroconvulsive therapy after 11 sessions. Organic vulnerability to these syndromes, as well as their coexistence and clinical differentiation is discussed in the light of the data observed.

  6. From Benign to Malign in a Case of Cervical Adenopathy in a 17-Year-Old Adolescent: Diagnostic Traps

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    Simona Dumitra

    2016-01-01

    Full Text Available Distinguishing between benign and malign adenopathies remains a challenge and could represent a source of error in a diagnosis. We report a case of right laterocervical adenopathy in a 17-year-old teenager admitted to hospital with an episode of fever associated with dysphagia, congested pharynx, and pultaceous deposits. Initially the adenopathy was considered to be secondary to a coinfection with Streptococcus B-hemolytic and Epstein-Barr virus, as suggested by the positive bacteriological and serological tests. The onset of the adenopathy before the episode and the ultrasound modifications raised the suspicion of a malignancy, later confirmed by the histopathologic examination of the lymph node excision. The final diagnosis was nodal metastasis of an undifferentiated lymphoepithelial carcinoma with an ENT starting point. Currently, the adolescent is hospitalised in the ENT ward, where the pharynx carcinoma with nodal metastasis was confirmed. Sometimes the infectious context can mask or unmask a malign chronic disease with insidious evolution.

  7. A 7-year-old with indurated skin and unilateral progressive joint immobility: A case of stiff skin syndrome.

    Science.gov (United States)

    Ogunmakin, Kehinde; Vangipuram, Ramya; Sturgeon, Ashley; Shimizu, Ikue

    2015-09-17

    Stiff skin syndrome is a rare sclerotic condition that presents during infancy or early childhood. It has an insidious chronic course and may lead to significant co-morbidity and reduced quality of life. Often, affected individuals experience impaired ambulation and immobilization related to joint involvement. Clinically, it may resemble other sclerotic diseases, so histopathological evaluation is necessary to establish a diagnosis. As it is a condition with limited treatment options, prompt diagnosis and early initiation of physical therapy is crucial to prevent joint restriction and maintain quality of life. We describe a case of a 7-year-old with stiff skin syndrome, and review the literature to discuss the clinical presentation, histological findings, and management of this condition.

  8. Celiac disease and fulminant T lymphoma detected too late in a 35-year-old female patient: Case report

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    Marinko Marušić

    2011-08-01

    Full Text Available Celiac disease is the most common chronic gastroenterological autoimmune disease characterized by gluten intolerance. The diagnosis of celiac disease and enteropathy-associated T cell lymphoma is often made when it is too late.Case report describes a 35-year-old female patient managed for one year under the diagnosis of inflammatory bowel disease and admitted to our hospital for exacerbation of the underlying disease. However, inflammatory bowel disease was ruled out by diagnostic work-up, while the clinical picture and the findings obtained raised suspicion of lymphoma. The patient’s condition was additionally complicated by fulminant course of the disease and ileus.Conclusion:Early diagnosis and appropriate treatment of the disease, and follow up of family members are crucial to prevent intestinal lymphoma development.

  9. The use of medicinal leeches in fingertip replantation without venous anastomosis - case report of a 4-year-old patient.

    Science.gov (United States)

    Streit, L; Dvořák, Z; Novák, O; Stiborová, S; Veselý, J

    2014-01-01

    Replantation of amputated fingertip is a technical challenge to the microsurgeons. The success rate depends directly on the availability and the size of preserved vessels and on the degree of their damage. In distal digital amputations, veins are usually not easily recovered or even absent, and thus high number of replantation procedures fails because of the venous congestion. The use of medicinal leeches is a treatment option for venous congestion of replanted fingers. A case report of a 4-year-old patient after fingertip replantation without venous anastomosis when temporary venous drainage was provided by an application of medicinal leeches is reported together with literature review. We observed an unusually short duration of venous congestion (48 hours) and there was no need of blood transfusion.

  10. Identifying with Science: A case study of two 13-year-old `high achieving working class' British Asian girls

    Science.gov (United States)

    Wong, Billy

    2012-01-01

    This paper provides an in-depth, 'case study' style analysis of the experiences of two 13-year-old British Asian girls from a larger qualitative study investigating minority ethnic students' aspirations in science. Through the lens of identity as performativity and Bourdieu's notions of habitus and capital, the ways in which two girls engage with the field of science is examined. Samantha is British Indian and Fay is British Bangladeshi and they are both 'top set' students in science, but only one aspired to study triple science, while the other desired to be 'famous'. The experiences of the two girls are explicated in this paper, teasing out their experiences and constructions of science. It is argued that cultural discourses of family, peers and teacher expectations can shape students' perceptions of science and education.

  11. Giant serous cystadenoma arising from an accessory ovary in a morbidly obese 11-year-old girl: a case report

    Directory of Open Access Journals (Sweden)

    Sharatz Steven M

    2008-01-01

    Full Text Available Abstract Introduction Ectopic ovarian tissue is an unusual entity, especially if it is an isolated finding thought to be of embryological origin. Case presentation An 11-year-old, morbidly obese female presented with left flank pain, nausea, and irregular menses. Various diagnostic procedures suggested a large ovarian cyst, and surgical resection was performed. Conclusion Histologically, the resected mass was not of tubal origin as suspected, but a serous cystadenoma arising from ovarian tissue. The patient's two normal, eutopic ovaries were completely uninvolved and unaffected. A tumor arising from ectopic ovarian tissue of embryological origin seems the most likely explanation. We suggest refining the descriptive nomenclature so as to more precisely characterize the various presentations of ovarian ectopia.

  12. Acute kidney injury and cholestasis associated with Kawasaki disease in a 9-year-old: Case report.

    Science.gov (United States)

    Martínez Vázquez, José Allan; Sánchez García, Carlos; Rodríguez Muñoz, Lorena; Martínez Ramírez, Rogelio Osvaldo

    2017-12-15

    Kawasaki disease (KD) is a systemic vasculitis frequent in children younger than 5 years of age. It involves coronary arteries and other medium-sized vessels. There also exists evidence of inflammatory and proliferative changes affecting the biliary tract and lymphocyte infiltration of the renal interstitial. We describe the case of a 9-year-old girl who developed high-grade fever, bilateral non-purulent conjunctivitis, «strawberry» tongue, desquamation of the fingers and toes, cholestatic syndrome, edema and elevated serum creatinine. KD is a diagnostic challenge for the pediatrician. In every patient with high-grade fever, cholestasis and acute kidney injury, KD should be included in the differential diagnosis, even though more research is necessary to evaluate this atypical association. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  13. Phosphaturic mesenchymal tumor of the brain without tumor-induced osteomalacia in an 8-year-old girl: case report.

    Science.gov (United States)

    Ellis, Mark B; Gridley, Daniel; Lal, Suresh; Nair, Geetha R; Feiz-Erfan, Iman

    2016-05-01

    Phosphaturic mesenchymal tumor (mixed connective tissue variant) (PMT-MCT) are tumors that may cause tumor-induced osteomalacia and rarely appear intracranially. The authors describe the case of an 8-year-old girl who was found to have PMT-MCT with involvement of the cerebellar hemisphere and a small tumor pedicle breaching the dura mater and involving the skull. This was removed surgically in gross-total fashion without further complication. Histologically the tumor was confirmed to be a PMT-MCT. There was no evidence of tumor-induced osteomalacia. At the 42-month follow-up, the patient is doing well, has no abnormalities, and is free of recurrence. PMT-MCTs are rare tumors that may involve the brain parenchyma. A gross-total resection may be effective to cure these lesions.

  14. Neotropical echinococcosis caused by Echinococcus vogeli in a 6-year-old child: the second case report in humans in French Guiana.

    Science.gov (United States)

    Debourgogne, Anne; Blanchet, Denis; Fior, Angela; Umhang, Gérald; Simon, Stéphane; Aznar, Christine

    2017-02-01

    Human polycystic echinococcosis is a parasitic infection caused by the larval stage of Echinococcus vogeli which occurs in rural areas of Central and South America. Abdominal echinococcosis caused by E. vogeli is reported for the first time in a child, a 6-year-old boy in French Guiana. The diagnosis was made by histological and molecular techniques. In tropical regions, this neglected disease must be considered even in children.

  15. Prosthetic rehabilitation in a four-year-old child with severe early childhood caries: a case report.

    Science.gov (United States)

    Parisotto, Thaís Manzano; de Souza-E-Silva, Cintia Maria; Steiner-Oliveira, Carolina; Nobre-dos-Santos, Marinês; Gavião, Maria Beatriz Duarte

    2009-03-01

    The purpose of this case report was to describe the oral rehabilitation of a 4-year-old girl presenting early childhood caries (ECC). ECC is highly prevalent in developing countries and its severity increases with age. This disease implies serious consequences for the development of the stomatognathic system and for the child's quality of life. As young children are usually anxious about dental treatment, their level of co-operation is limited, leading to a challenging situation. A 4-year-old girl was brought by her mother for dental treatment with the complaint of pain. The clinical examination revealed extensive carious coronary destructions. After preventive and curative measures, the oral rehabilitation was performed; it included the use of stainless steel crowns, resin filled celluloid crowns with previous cementation of glass post pins when necessary, an amalgam restoration, orthodontic treatment, and a partial removable prosthesis. The child has been monitored in the Pediatric Dentistry Clinic at 4-monthly intervals. The oral rehabilitation was able to reestablish the oral health in the primary arches mutilated by early childhood caries. This is important for the establishment of an adequate mixed and permanent dentition, for proper facial and maxillary growth, and to the child's psychological and social development. The full management, including preventive, psychological, and curative measures of a young child with severe ECC was found successful after 8 months of follow up. This result can encourage the clinicians to seek a cost-effective technique such as stainless steel crowns, resin filled celluloid crowns, and partial removable prosthesis to reestablish the oral functions and improve the child's psycho-social development.

  16. Dynamic of changes in health of 10-11 years old gymnasium boys under influence of comprehensive education’s load

    Directory of Open Access Journals (Sweden)

    E.M. Proskurov

    2015-07-01

    Full Text Available Purpose: determination of somatic health, physical condition, physical and mental workability changes of pupils under influence of comprehensive education loads at the end of first academic semester. Material: in the research 140 pupils of 10-11 years old age, related to main health group, participated. Results: we found that the reason of children’ health’s worsening appears at the account of increasing of intellectual pressure. This pressure can not be overcome by means of physical education, oriented on recreation and perfection of pupils’ organisms. Absence of gradual relaxation of mental loads (periods of recreation and test after different intellectual tensions results in sharpening of overtiredness at the end of first academic semester. This overtiredness negatively influences on pupils’ general health. Conclusions: responses of children’s organisms to irritators of comprehensive education’s pressure are accompanied by worsening of a number of functional indicators, which have no age distinctions.

  17. Retroperitoneal necrotizing fasciitis presenting with peritonism in a 33-year-old Nepalese man: a case report

    Directory of Open Access Journals (Sweden)

    Giri Smith

    2012-02-01

    Full Text Available Abstract Introduction Retroperitoneal necrotizing fasciitis is a rare, fulminant, and potentially lethal complication of intra-abdominal suppuration. A retroperitoneal origin is very rare and very few cases have been reported in the literature. To the best of our knowledge, this case is only the fourth case reported of successful management following retroperitoneal necrotizing fasciitis. Case presentation A 33-year-old Tamang man presented to our facility with a history of five days of fever and vomiting and eight days of severe left loin pain. On examination, he had features of peritonism. A laparotomy was performed, revealing extensive necrotizing fasciitis of the retroperitoneum extending to the anterior abdominal wall. Our patient survived following extensive debridement of the necrotic tissues and supportive care. Conclusions Retroperitoneal necrotizing fasciitis can rarely present with features of peritonism, and hence should be included as a possible differential diagnosis for anyone presenting with peritonism. Although a fatal condition, early intervention and aggressive management can save the life of a patient.

  18. Plexiform neurofibroma causing an ossifying subperiosteal haematoma: a rare case in the tibia of an 11-year-old girl

    International Nuclear Information System (INIS)

    Lavell, Anton; Jones, Christopher W.; Wong, Daniel; Counsel, Peter; Carey-Smith, Richard

    2017-01-01

    Ossifying subperiosteal haematoma is an exceedingly rare manifestation of Neurofibromatosis type 1 (NF-1). We report an interesting case of plexiform neurofibroma causing a rapidly growing tibial mass as a result of subperiosteal haemorrhage, in an 11-year-old girl with previously undiagnosed NF-1. This reflects a precursor of the more mature periosteal ossification seen in cases traditionally termed ''subperiosteal cysts''. A previously well young girl was referred by her general practitioner with an increasingly large, mildly tender, soft lump on the anterior aspect of her right tibia. Plain radiographs demonstrated soft tissue thickening overlying the anterior tibia, without appreciable periosteal ossification. Magnetic resonance imaging (MRI) illustrated a single central fluid-fluid level and periosteal elevation with saucerisation of the anterior tibial cortex and mild surrounding oedema. Histopathology revealed a large plexiform neurofibroma. Interestingly, this was associated with haemorrhagic change and a peripheral rim of florid reactive new bone formation. This unusual presentation was discussed at a multidisciplinary bone and soft tissue tumour meeting, where in combination with the clinical history of cafe au lait spots and positive family history, a consensus diagnosis of NF-1 was made. To date, there have only been limited case reports of this rare pathological process. In summary, this case report accounts an acute presentation of this rare osseous manifestation of NF-1, being the first to clearly demonstrate a timeline of subperiosteal haematoma with subsequent subperiosteal bone proliferation. The clinical reasoning and radiological features for such a presentation are also described. (orig.)

  19. Spinal meningeal melanocytoma in a 5-year-old child: a case report and review of literature.

    Science.gov (United States)

    Salah El-Din, Ahmed M; Aboul-Ela, Hashem M; Alsawy, Mohamed F; Koheil, Ahmed; Ashry, Ahmed H

    2018-01-01

    Meningeal melanocytoma is considered a rare lesion arising from leptomeningeal melanocytes. Nearly two thirds of meningeal melanocytomas were reported in the intracranial compartment and the remaining one third in the spine. Spinal melanocytomas can be extradural or intradural, with extradural variant being more common, and the majority of cases have been single reports. A 5-year-old male presented with a 4-month history of non-radiating low back pain persistent at rest, with otherwise non-remarkable medical history. The patient was neurologically intact with no deficits. Preoperatively, routine laboratory investigations were non-remarkable. MRI imaging was done and showed a lesion at the level of T11 to L4, hyperintense on T1 and hypointense on T2 with homogenous contrast enhancement. Intraoperatively, the lesion was hemorrhagic, brownish, and rubbery in consistency attached to the ventral dura. Microscopic picture revealed dense cytoplasmic brown melanin pigments, with no significant mitoses or nuclear atypia. What is unique about our case is the age of the patient (5 years). To the best of our knowledge, after reviewing the literature, this is the youngest case to be reported. SMM is an extremely rare tumor with a benign course. Complete surgical excision should be attempted. Age of presentation may be as young as in our case and the diagnosis of such a tumor should never be excluded in this early age group with persistent low back ache.

  20. Knowing right from wrong, but just not always feeling it: relations among callous-unemotional traits, psychopathological symptoms, and cognitive and affective morality judgments in 8- to 12-year-old boys.

    Science.gov (United States)

    Feilhauer, Johanna; Cima, Maaike; Benjamins, Caroline; Muris, Peter

    2013-12-01

    The present research expands our understanding of cognitive and affective morality by exploring associations with callous-unemotional (CU) traits and externalizing symptoms. Participants were 46 8- to 12-year-old boys from the community who completed the Affective Morality Index, the Youth Self-Report, and the Inventory of Callous-Unemotional Traits. A pattern of results was found indicating that in particular the combination of high CU traits and high externalizing symptoms was associated with lack of affective morality, and an increased perceived likelihood of recommitting antisocial acts (recidivism). The implications of these findings and suggestions for future research are discussed.

  1. Do descriptive norms related to parents and friends predict fruit and vegetable intake similarly among 11-year-old girls and boys?

    Science.gov (United States)

    Lehto, Elviira; Ray, Carola; Haukkala, Ari; Yngve, Agneta; Thorsdottir, Inga; Roos, Eva

    2016-01-14

    We examined whether there are sex differences in children's fruit and vegetable (FV) intake and in descriptive norms (i.e. perceived FV intake) related to parents and friends. We also studied whether friends' impact is as important as that of parents on children's FV intake. Data from the PRO GREENS project in Finland were obtained from 424 children at the age 11 years at baseline. At baseline, 2009 children filled in a questionnaire about descriptive norms conceptualised as perceived FV intake of their parents and friends. They also filled in a validated FFQ that assessed their FV intake both at baseline and in the follow-up in 2010. The associations were examined with multi-level regression analyses with multi-group comparisons. Girls reported higher perceived FV intake of friends and higher own fruit intake at baseline, compared with boys, and higher vegetable intake both at baseline and in the follow-up. Perceived FV intake of parents and friends was positively associated with both girls' and boys' FV intake in both study years. The impact of perceived fruit intake of the mother was stronger among boys. The change in children's FV intake was affected only by perceived FV intake of father and friends. No large sex differences in descriptive norms were found, but the impact of friends on children's FV intake can generally be considered as important as that of parents. Future interventions could benefit from taking into account friends' impact as role models on children's FV intake.

  2. Case Report: 84 year-old woman with alien hand syndrome [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Ihtesham Aatif Qureshi

    2016-07-01

    Full Text Available Background: Alien hand syndrome [AHS] is a rare and ill-defined neurological disorder. It produces complex, goal-directed motion of one hand that is involuntarily instigated. This syndrome characteristically arises after brain trauma, brain surgery, stroke or encephalitis. We describe a case of AHS in a patient who had a previous episode of subarachnoid hemorrhage affecting the left frontal lobe and corpus callosum. Case presentation: An 84-year-old woman presented to the emergency department complaining of headaches and several episodes of her left arm moving as if it was groping around trying to grab at her own body. A computed tomography scan of the head demonstrated an acute left superior frontal hemorrhage with compression of the corpus callosum. Transcranial Doppler report showed no significant abnormality in the insonated vessels. After being stabilized for the acute bleed, she was treated with clonazepam 0.5 mgat night for the uncontrolled hand movements. Her movements resolved by her next month follow up. The diagnosis of AHS was made based on her clinical presentation, characterization of the movement and localization correlating with findings in neuroimaging. Conclusion: We document a rare neurologic disorder seen in patients presenting with a history of previous strokes and a typical description of involuntary and unintentional, uncontrolled unilateral arm movements with repetitive grasping. The present case has a combination of frontal and callosal lesions.  These findings appear to support a potential destruction leading to the rare syndrome.

  3. Second trimester hepatic rupture in a 35 year old nulliparous woman with HELLP syndrome: a case report

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    O'Brien N

    2009-06-01

    Full Text Available Abstract The HELLP syndrome (haemolysis, elevated liver blood tests and low platelets is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10–20% of cases with severe preeclampsia. Hepatic capsular rupture is a rare yet dramatic complication of HELLP syndrome. The majority of cases occur in multiparous women over the age of 30. Classically it presents with acute onset right upper quadrant pain in the presence of constitutional symptoms such as vomiting and pyrexia. However, symptoms and signs are usually non specific. Spontaneous hepatic rupture can be preceded by signs of hypovolaemic shock; yet the diagnosis is infrequently made prior to emergent laparotomy. We present the case of a 35 year old nulliparous woman with a second trimester gestational hepatic rupture associated with HELLP syndrome. We briefly discuss the aetiology, diagnostic difficulties and treatment options associated with this rare presentation.

  4. 36-Year-Old Female with Catastrophic Antiphospholipid Syndrome Treated with Eculizumab: A Case Report and Review of Literature

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    Marianna Strakhan

    2014-01-01

    Full Text Available Catastrophic antiphospholipid syndrome (CAPS is a rare but potentially life-threatening condition characterized by diffuse vascular thrombosis, leading to multiple organ failure developing over a short period of time in the presence of positive antiphospholipid antibodies (aPL. CAPS is a severe form of antiphospholipid syndrome, developing in about 1% of cases of classic antiphospholipid syndrome, manifesting as microangiopathy, affecting small vessels of multiple organs. It is acute in onset, with majority of cases developing thrombocytopenia and less frequently hemolytic anemia and disseminated intravascular coagulation. Lupus anticoagulant and anticardiolipin antibodies have been reported as predominant antibodies associated with CAPS. Treatment options often utilized in CAPS include anticoagulation, steroids, plasma exchange, cyclophosphamide therapy, and intravenous immunoglobulin therapy. Even though the reported incidence of this condition is considered to be low, the mortality rate is approaching 50%. The high rate of mortality should warrant greater awareness among clinicians for timely diagnosis and treatment of this life-threatening condition. Studies have shown that complement activation plays a key role in the pathogenesis of aPL mediated thrombosis in CAPS. We report a case of a 36-year-old female admitted with clinical and laboratory findings consistent with CAPS successfully treated with eculizumab, a terminal complement inhibitor.

  5. Intake of total dietary sugar and fibre is associated with insulin resistance among Danish 8-10- and 14-16-year-old girls but not boys. European Youth Heart Studies I and II

    DEFF Research Database (Denmark)

    Kynde, Iben; Johnsen, Nina Føns; Wedderkopp, Niels

    2010-01-01

    Objective: To examine the dietary intake of total sugar, added sugar, non-added sugar and starch as well as dietary fibre and glycaemic index (GI) and their respective associations with insulin resistance. Design: Mixed linear models were used to study both cross-sectional and prospective...... associations between carbohydrate components and insulin resistance separately in girls and boys. Diet was assessed by a single 24 h recall interview and insulin resistance was calculated using the homoestasis model assessment (HOMA). Setting: The Danish part of the European Youth Heart Studies (EYHS) I and II....... Subjects: Girls and boys at 8–10 and 14–16 years from EYHS I (n 651) and 8–10-year olds from baseline followed up 6 years later in EYHS II (n 233). Results: Among girls, a difference in dietary total sugar of 43 g/MJ was associated with a 1 SD difference of HOMA and a difference in dietary fibre of 28g...

  6. A case of mumps orchitis and pancreatitis in 25 years old man hospitalized in Clinic of infectious diseases - Varna

    Directory of Open Access Journals (Sweden)

    Bliznakova Dimitrichka

    2016-01-01

    Full Text Available Introduction: Mumps is an acute infectious disease caused by mumps virus. The main pathologic feature is serofibrinous inflammation of the salivary glands, resulting in their swelling. In pre-puberty children the course of illness is usually benign, and approximately one third of the cases remain subclinical. Extrasalivary gland involvement, such as orchitis, meningitis, pancreatitis is possible. The inflammation of pancreas takes an auspicious course and lasting sequels, such as diabetes mellitus or pancreatic cancer, do not occur. Orchitis occurs in 15-40% of postpubertal males with mumps, and without treatment 30-50% of them develop testicular atrophy, which is associated with male infertility. The testicular atrophy after recovery from mumps orchitis is linked as a predisposing factor for testicular cancer. Objective: To present a case report of patient with multi-organ localization of mumps virus and to analyze the severity of the specific organ form of the disease. Case report: We present a case report of mumps, in combination with mumps orchitis and mumps pancreatitis in 25 years old man, hospitalized in the Clinic of infectious diseases - Varna. Diagnosis was established on the basis of clinical features of disease, epidemiological, biochemical and serological data, realized through the relevant laboratories in the St. Marina Hospital - Varna. Results: In the presented case, the disease started as a moderate form of mumps affecting both parotid glands, and 3 days after the onset of the symptoms, pancreatitis and orchitis occurred. Conclusion: multi-organ involvement in the clinical course of mumps, taking its with is usual manifestation of the disease. In spite of the multiple organ involvement in this case, the patient recovered without lasting sequels.

  7. A 35-year-old woman presenting with an unusual post-traumatic leiomyoma of the nipple: a case report.

    Science.gov (United States)

    Pavlidis, Leonidas; Vakirlis, Efstratios; Spyropoulou, Georgia-Alexandra; Pramateftakis, Manousos Georgios; Dionyssiou, Dimitris; Demiri, Efterpi

    2013-02-19

    Leiomyoma of the mammary papilla is one of the most uncommon nipple tumors with only 50 cases reported in the literature until now. To the best of our knowledge we present the first report of a nipple leiomyoma that originated from a traumatic abrasion caused by breastfeeding. A 35-year-old healthy Caucasian female with a cauliflower-like tender and pink nodular mass that was approximately 10mm in diameter presented to our out-patients department. The patient suggested that the mass originated from a traumatic abrasion caused by breastfeeding three years ago and it has been slowly growing ever since.An excision biopsy was performed. The histological and immunohistochemical examination confirmed the diagnosis of leiomyoma. There were no postoperative complications or any sign of local recurrence four years postoperatively. Leiomyoma of the mammary papilla is a rare benign neoplasm that usually appears as a solid tender nodule. Differential diagnosis comprises breast carcinoma, leiomyosarcoma and myoid hamartoma. The recommended treatment is complete excision of the tumor with histologically confirmed tumor-free margins otherwise recurrence is possible. A detailed history of the patient's disease can reveal the original etiology. This is an original case report that will have particular interest to plastic surgeons, dermatologists, and pathologists. The pathogenetic mechanism was trauma of the nipple. According to our review of the literature this particular information has never been reported and we think that it may advance our knowledge of this very infrequent tumor.

  8. Hypophosphatemia Dependent Rickets with Failure to Thrive (FTT in a 4- Years Old Child: a Case Report

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    Fereshteh Ghaljaei

    2017-02-01

    Full Text Available BackgroundRickets is a disorder due to impaired metabolism of bone mineralization which caused by low concentrations of extra-cellular calcium or phosphate. In children, hypophosphatemic rickets (HR happen malabsorption of phosphate and increasing of renal tubular loss.Case Presentation We present the case of a 4-year-old girl who had medical history of HR with failure to thrive (FTT. Child hospitalized several times due to osteomalacia and leg fractures. In physical examinations, there were obvious signs of rickets such as bow legs and hands, deviations of the wrist and chest pigeon. The results of blood tests showed low level of Phosphorus; but the level of calcium was normal. Radiography showed deformity of wrists and hands. ConclusionHR should be considered as one of the childhood disorders which impairs metabolism of bone mineralization and cause osteomalacia and bones fractures. If HR undiagnosed and remedies poor during childhood, in older ages would reveal automatic fractures and mineralization defects.

  9. The horror of unsafe abortion: case report of a life threatening complication in a 29-year old woman.

    Science.gov (United States)

    Naqvi, Kaniz Zehra; Edhi, Muhammad Muzzammil

    2013-10-16

    Every year 42 million women with unintended pregnancies choose abortion, and fifty percent of these procedures, 20 million are unsafe. An unsafe abortion is defined as a procedure for terminating an unintended pregnancy carried out either by person lacking the necessary skills or in an environment that does not conform to minimal medical standards or both.Pakistan is the one of the six countries where more than 50% of the world's all maternal deaths occur. It is estimated that 890,000 induced abortions are performed annually in Pakistan, and estimate an annual abortion rate of 29 per 1000 women aged 15-49. Here we present a case report of a 29-year old woman who underwent an unsafe abortion for unintended pregnancy resulting in uterine perforation. The unskilled provider pulled out her bowel through vagina after perforating the uterus, as a result she lost major portion of her small intestine resulting in short bowel syndrome. The law of Pakistan only allows abortion during early stages of pregnancy for purpose of saving the life of a mother but does not cater for cases of rape, incest and fetal abnormalities or social reasons.Only legalization of abortion is not sufficient, preventing unintended pregnancy should be the priority of all the nations and for this reason contraception should be widely accessible.Practitioners need to become better trained in safer abortion methods and be to able transfer the patient to health facility when complications occur.

  10. "Intermetamorphic" developmental stages in 150 million-year-old achelatan lobsters--The case of the species tenera Oppel, 1862.

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    Haug, Joachim T; Haug, Carolin

    2016-03-01

    We re-investigated the fossil species tenera Oppel, 1862, an achelatan lobster (traditionally named Palinurina tenera) found in 150 million years old limestones of southern Germany. All known specimens attributed to this species show a mixture of characters, which in modern forms occur either in larvae or post-larval juveniles. Hence these specimens provide insight into a phase in ontogeny that is no longer present in the developmental sequence of any modern achelatan lobster, as the latter ones skip this phase and replace it by a drastic metamorphosis. Comparable cases have been described earlier, yet did only comprise single stages or two successive ones at most. In the here described case four developmental stages are preserved. The reconstructed ontogeny of tenera therefore represents the currently best known sequence of an early achelatan lobster that covers this specific intermediate phase. The largest known stage most likely still represents an immature of a yet undiscovered adult. These findings support the interpretation that early achelatan lobsters developed in a more gradual ontogenetic sequence than modern forms. It furthermore demonstrates that it was even more gradual than anticipated previously. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Ultrasonography and radiography to identify early post traumatic myosistis ossificans in an 18-year-old male: a case report.

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    Yochum, Alicia M; Reckelhoff, Kenneth; Kaeser, Martha; Kettner, Norman W

    2014-06-01

    The purpose of this case report is to describe a patient with post traumatic myositis ossificans (PTMO) of the anterior thigh following blunt trauma and discuss the incidence, clinical presentation, management, and imaging findings. An 18-year-old male presented to a chiropractic clinic with a chief complaint of left knee pain and reduced range of motion after an impact injury to his left anterior thigh during hurdling 6 weeks earlier. Immediately after the injury, he presented to the emergency department where radiography of the left knee was negative and he was diagnosed with a muscle sprain. Follow-up radiography and ultrasonography of the left knee in a chiropractic radiology department revealed ossification consistent with PTMO within his vastus intermedius. The patient underwent a course of rehabilitation for 2 months including ice, class IV cold laser and vibration applied to his anterior thigh, and myofascial release of his quadriceps musculature with targeted and progressive rehabilitative exercises. His left knee pain resolved within 2 weeks of care. He resumed sports participation (American football) pain-free, while wearing protective padding over the affected thigh, 1 month after presentation, which was approximately 2 1/2 months following his injury. This case demonstrates that ultrasonography may have the capability to detect early phases of PTMO approximately 2 weeks prior to radiographic evidence and to monitor progression throughout its course.

  12. A prepubertal giant juvenile fibroadenoma in a 12-year-old girl: Case report and brief literature review

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    Aris Giannos

    Full Text Available Introduction: Giant juvenile fibroadenomas represent only the 0.5% of all fibroadenomas, constituting a rare condition in adolescence. In prepuberty, the presence of this condition is extremely rare. Presentation of case: We describe a rare case of a 12- year-old Caucasian girl who presented to our Hospital complaining of a palpable mass with rapid enlargement in her right breast that she had first noticed 3 months ago. Her menarche hadn’t occurred yet. Discussion: Physical examination showed a giant mass of 15 × 13 cm in the right breast. The patient was further evaluated via ultrasonography showing a sole large lesion of 13 × 12 cm in the right breast. A surgical procedure under general anesthesia was performed. Histopathological findings after the surgical excision were suggestive of giant juvenile fibroadenoma. The patient has a normal breast development over a period of 9 month follow up. Conclusion: Giant juvenile fibroadenomas should be included in differential diagnosis of a breast mass in prepubertal girls despite the fact that they are very rare in prepuberty, tend to appear later during adolescence and their prevalence is lower in Caucasians. The remarkable size and the rapid growth of the lesion should not be ruled out in the diagnostic process of an adolescent breast. Keywords: Fibroadenoma, Giant juvenile fibroadenoma, Adolescence, Breast, Prepuberty

  13. Diagnosis and imaging characteristics of a juvenile fibroadenoma in a 2–year-old patient: a case report

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    Stefanie Woodard, DO

    2018-02-01

    Full Text Available Fibroadenomas are abundantly reported in the literature with several papers documenting the natural progression and clinical outcomes of thousands of cases. Juvenile fibroadenomas (also called cellular fibroadenomas are frequently characterized by rapid growth, often described as 5-10 cm in size. They constitute approximately 7%-8% of fibroadenomas. They often measure greater than 5 cm. Pathologically, they show similar features to fibroadenomas but can resemble phyllodes. There have been few documented cases of breast masses in early childhood. Furthermore, there are scant radiology publications focused on the imaging features of juvenile fibroadenomas in patients younger than 5 years old. Our patient presented at 2 years of age with a unilateral right breast mass. Two ultrasound examinations were completed over a period of 5 months, and a magnetic resonance imaging was performed prior to surgical intervention. Eventual surgical excision yielded a final pathologic diagnosis of juvenile fibroadenoma. In this report, we will discuss the imaging and pathology of juvenile fibroadenomas, and we will address important differential considerations both from a pathologic and radiologic standpoint.

  14. A 37-year-old woman presenting with impaired visual function during antituberculosis drug therapy: a case report

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    Ayanniyi Abdulkabir A

    2011-07-01

    Full Text Available Abstract Introduction Combination antituberculosis drug therapy remains the mainstay of treating tuberculosis. Unfortunately, antituberculosis drugs produce side effects including (toxic impaired visual function, which may be irreversible. We report a case of antituberculosis-drug-induced impaired visual function that was reversed following early detection and attention. Case presentation A 37-year-old Yoruba woman, weighing 48 kg, presented to our facility with impaired visual functions and mild sensory polyneuropathy in about the fourth month of antituberculosis treatment. Her therapy comprised ethambutol 825 mg, isoniazid 225 mg, rifampicin 450 mg, and pyrazinamide 1200 mg. Her visual acuity was 6/60 in her right eye and 1/60 in her left eye. She had sluggish pupils, red-green dyschromatopsia, hyperemic optic discs and central visual field defects. Her intraocular pressure was 14 mmHg. Her liver and kidney functions were essentially normal. Screening for human immunodeficiency virus was not reactive. Her impaired visual function improved following prompt diagnosis and attention, including the discontinuation of medication. Conclusions The ethambutol and isoniazid in antituberculosis medication are notorious for causing impaired visual function. The diagnosis of ocular toxicity from antituberculosis drugs should never be delayed, and should be possible with the patient's history and simple but basic eye examinations and tests. Tight weight-based antituberculosis therapy, routine peri-therapy visual function monitoring towards early detection of impaired function, and prompt attention will reduce avoidable ocular morbidity.

  15. Uncommon Infections in Children Suggest Underlying Immunodeficiency: A Case of Infective Endocarditis in a 3-Year-Old Male

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    Aisha Shakoor

    2018-01-01

    Full Text Available Infective endocarditis (IE results from bacterial or fungal infection and is associated with significant morbidity and mortality. Several known risk factors exist for endocarditis, and 90% of pediatric cases have an underlying structural or congenital heart disease or prosthetic heart valve. Literature on IE in previously healthy children is relatively sparse, and the pathogenesis and underlying risk factors remain mostly unknown. Our patient was a 3-year-old male with a unique presentation of IE. His lack of structural and congenital risk factors for endocarditis prompted further workup, and labs were consistent with insufficient immunoglobulin, suggesting a primary immunodeficiency (PAD. PAD presents as heightened susceptibility to infections, commonly seen as recurrent pneumonia, meningitis, septic arthritis, and otitis media. Pediatric patients commonly have infections, yet as many as in 1 in 2000 patients have PAD. Our case emphasizes the potential need for further investigation into PAD in a young patient with no known risk factors who develops an uncommon infection such as IE.

  16. A Rare Case of Charcot-Mari-Tooth Disease Type 2S in a 20-year-old Man

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    Natalia A. Shnayder

    2017-12-01

    Full Text Available Charcot-Marie-Tooth disease type 2 (CMT2S is rare form of Charcot-Marie-Tooth disease (CMT that is characterized by a mutation in the IGHMBP2 gene. This gene encodes a helicase superfamily member that binds a specific DNA sequence from the region of the immunoglobulin mu chain switch. Mutation of this gene leads to spinal muscle atrophy with respiratory distress type 1 and CMT2S. This case report presents a 20-year-old male with genetically confirmed CMT2S having clinical respiratory involvement and symmetrically involved lower extremities. DNA sequencing revealed a previously unknown heterozygous mutation in the exone 2 of the IGHMBP2 gene leading to the replacement of the amino acid in the 46 position of the protein (chr11q13.3: 68673587 G>C. These atypical features widen the clinical spectrum of CMT2S. In describing this clinical case, we also improve diagnostic management and try to increase the alertness of various doctors towards neuromuscular diseases, including CMT.

  17. Plexiform neurofibroma causing an ossifying subperiosteal haematoma: a rare case in the tibia of an 11-year-old girl

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    Lavell, Anton [Fiona Stanley Hospital, Department of Radiology, Murdoch, WA (Australia); Jones, Christopher W. [Perth Orthopaedic Institute, Nedlands, WA (Australia); Sir Charles Gairdner Hospital, Department of Orthopaedic Surgery, Nedlands, WA (Australia); Princess Margaret Hospital, Subiaco, WA (Australia); Wong, Daniel [PathWest, QEII Medical Centre, Anatomical Pathology, Nedlands, WA (Australia); Counsel, Peter [Princess Margaret Hospital, Department of Radiology, Subiaco, WA (Australia); Perth Radiological Clinic, Mirrabooka, WA (Australia); Carey-Smith, Richard [Sir Charles Gairdner Hospital, Department of Orthopaedic Surgery, Nedlands, WA (Australia); Princess Margaret Hospital, Subiaco, WA (Australia)

    2017-10-15

    Ossifying subperiosteal haematoma is an exceedingly rare manifestation of Neurofibromatosis type 1 (NF-1). We report an interesting case of plexiform neurofibroma causing a rapidly growing tibial mass as a result of subperiosteal haemorrhage, in an 11-year-old girl with previously undiagnosed NF-1. This reflects a precursor of the more mature periosteal ossification seen in cases traditionally termed ''subperiosteal cysts''. A previously well young girl was referred by her general practitioner with an increasingly large, mildly tender, soft lump on the anterior aspect of her right tibia. Plain radiographs demonstrated soft tissue thickening overlying the anterior tibia, without appreciable periosteal ossification. Magnetic resonance imaging (MRI) illustrated a single central fluid-fluid level and periosteal elevation with saucerisation of the anterior tibial cortex and mild surrounding oedema. Histopathology revealed a large plexiform neurofibroma. Interestingly, this was associated with haemorrhagic change and a peripheral rim of florid reactive new bone formation. This unusual presentation was discussed at a multidisciplinary bone and soft tissue tumour meeting, where in combination with the clinical history of cafe au lait spots and positive family history, a consensus diagnosis of NF-1 was made. To date, there have only been limited case reports of this rare pathological process. In summary, this case report accounts an acute presentation of this rare osseous manifestation of NF-1, being the first to clearly demonstrate a timeline of subperiosteal haematoma with subsequent subperiosteal bone proliferation. The clinical reasoning and radiological features for such a presentation are also described. (orig.)

  18. Selective mutism due to a dog bite trauma in a 4-year-old girl: a case report

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    Anyfantakis Dimitrios

    2009-11-01

    Full Text Available Abstract Introduction A child experiencing an event of threatening or catastrophic nature may experience considerable post-traumatic psychological distress. Dog bites present an important public health problem and are a frequent cause of physical trauma in children. Physicians who manage paediatric trauma may not be vigilant of the high risk of psychological stress in children exposed to a physical injury. Case presentation A 4-year-old white girl of Greek origin, with a dog-bite related trauma was admitted to the University Hospital of Crete, Greece, for surgical repair and intravenous antibiotic therapy due to extensive lesions. Exposure to the traumatic event triggered the onset of an unusual psychological response, selective mutism and acute post-traumatic stress disorder. Conclusion There is limited literature discussing the psychological effect of dog bites in children. Parents and physicians involved in pediatric physical trauma need to be more familiar with post-traumatic behavioral reactions. Awareness of the potential development of such reactions may result in early detection and effective management of children at risk.

  19. Selective mutism due to a dog bite trauma in a 4-year-old girl: a case report

    Science.gov (United States)

    2009-01-01

    Introduction A child experiencing an event of threatening or catastrophic nature may experience considerable post-traumatic psychological distress. Dog bites present an important public health problem and are a frequent cause of physical trauma in children. Physicians who manage paediatric trauma may not be vigilant of the high risk of psychological stress in children exposed to a physical injury. Case presentation A 4-year-old white girl of Greek origin, with a dog-bite related trauma was admitted to the University Hospital of Crete, Greece, for surgical repair and intravenous antibiotic therapy due to extensive lesions. Exposure to the traumatic event triggered the onset of an unusual psychological response, selective mutism and acute post-traumatic stress disorder. Conclusion There is limited literature discussing the psychological effect of dog bites in children. Parents and physicians involved in pediatric physical trauma need to be more familiar with post-traumatic behavioral reactions. Awareness of the potential development of such reactions may result in early detection and effective management of children at risk. PMID:19946578

  20. Catatonia, Neuroleptic Malignant Syndrome, and Cotard Syndrome in a 22-Year-Old Woman: A Case Report

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    C. Weiss

    2013-01-01

    Full Text Available The following case study describes a 22-year-old woman with depression and symptoms of psychosis who developed neuroleptic malignant syndrome after using Risperidone, thus requiring life support equipment and Bromocriptine, later recovering after seven days. From a psychiatric and neurological point of view, however, the persistence of catatonic syndrome and Cotard syndrome delusions was observed, based on assertions such as “I do not have a heart,” “my heart is not beating,” “I can not breathe,” “I am breaking apart,” “I have no head” (ideas of negation and statements about the patient being responsible for the “death of the whole world” (ideas of enormity. Brain NMR revealed leukoencephalopathy, interpreted as scar lesions caused by perinatal neurological damage, after discarding other pathologies. The patient responded well to electroconvulsive therapy after 11 sessions. Organic vulnerability to these syndromes, as well as their coexistence and clinical differentiation is discussed in the light of the data observed.

  1. An Unusual Case of Abdominal Pain and Hyponatremia in a 16-Year-Old Girl With Disordered Eating.

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    Hunter, Grace; Blankenburg, Rebecca; Andrews, Jennifer; Stevenson, Terrell

    2018-01-01

    A previously healthy 16-year-old girl presented to the emergency department with 1 week of severe, diffuse abdominal pain and constipation, as well as several episodes of nonbloody, nonbilious emesis. Her symptoms began several days after she decreased her caloric intake in an attempt to lose weight. She had been drinking 48 to 60 oz of water per day for several days before admission in an attempt to ameliorate her constipation. She also admits to drinking alcohol the night before her pain began. She had visited several other emergency departments before her presentation to our hospital, and she had been sent home on a bowel regimen without amelioration of her symptoms. On arrival to our emergency department, she described severe diffuse abdominal pain. Her abdomen was tender to palpation throughout but soft with no rebound tenderness or peritoneal signs. The remainder of her physical examination yielded normal results. She was found to have hyponatremia with a sodium level of 122 and no neurologic sequelae. Abdominal radiograph showed moderate constipation but her abdominal pain continued even after bowel cleanout. The home, education, activities, drugs, sex, suicide, and safety assessment revealed several stressors, including a recent suicide in the family and a history of disordered eating and anxiety. Here, we present her case, diagnostic evaluation, ultimate diagnosis, and complications. Copyright © 2018 by the American Academy of Pediatrics.

  2. Unusual cause of a painful right testicle in a 16-year-old man: a case report

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    Riaz Amjid A

    2011-01-01

    Full Text Available Abstract Introduction Urgent surgical exploration of the scrotum of a child or teenager who presents with a painful and swollen testicle is paramount if testicular torsion is not to be missed. It is extremely rare for a non-scrotal pathology to present with acute scrotal signs. Here we present such a rare case and emphasize the importance of being aware of this potential clinical pitfall. Case presentation A 16-year-old Caucasian man presented as a surgical emergency with a five to six hour history of a painful, red, and swollen right hemiscrotum. He also complained of vague lower abdominal pain, vomiting, and watery diarrhea. He had a temperature of 38.5°C and a tender, red, and swollen right hemiscrotum. The right testicle appeared elevated. He was mildly tender in his central and upper abdomen and less so in the lower abdomen. No convincing localizing abdominal signs were noted. He had an increased white cell count (15 × 109/L and C-reactive protein (CRP; 300 mg/L. Urgent right hemiscrotal exploration revealed about 5 ml of pus in the tunica vaginalis and a normal testicle. A right iliac fossa incision identified the cause: a perforated retrocecal appendix. Appendectomy was performed, and both the abdomen and scrotum washed copiously with saline before closure. The patient made an uneventful recovery. Conclusion Acute appendicitis presenting with scrotal signs due to a patent processus vaginalis is an extremely rare clinical entity. To date, fewer than five such cases have been reported in the medical literature. It is, therefore, extremely important to be aware of this unusual clinical scenario, as only a high index of suspicion will enable prompt, successful management of both the appendicitis and the scrotal abscess.

  3. Epilepsy surgery in the elderly: an unusual case of a 75-year-old man with recurrent status epilepticus.

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    Tellez-Zenteno, Jose F; Sadanand, Venkatraman; Riesberry, Martha; Robinson, Christopher A; Ogieglo, Lissa; Masiowski, Paul; Vrbancic, Mirna

    2009-06-01

    Epilepsy surgery is increasingly well-supported as an effective treatment for patients with intractable epilepsy. It is most often performed on younger patients and the safety and efficacy of epilepsy surgery in elderly patients are not frequently described. We report a case of a 75-year-old right-handed man who underwent a left fronto-temporal craniotomy for resection of a suprasellar meningioma in 2002. Immediately following hospital discharge, he began to experience complex partial seizures. He continued to have frequent seizures despite treatment with multiple combinations of antiepileptic medications. He presented with status epilepticus every two or three months, and required long periods of hospitalization on each occasion for post-ictal confusion and aphasia. Scalp EEG showed continuous spikes and polyspikes and persistent slowing in the left temporal area, as well as spikes in the left frontal area. EEG telemetry recorded multiple seizures, all with a clear focus in the left temporal area. MRI scan showed an area of encephalomalacia in the left temporal lobe, as well as post-surgical changes in the left frontal area. Neuropsychological testing showed bilateral memory impairment with no significant cognitive decline expected after unilateral temporal lobe resection. A left anteromesial temporal lobectomy was performed with intraoperative electrocorticography. Since surgery, the patient was not seizure-free (Engel class II-b), but had no further episodes of status epilepticus in one year and two months of follow-up. This is one of the oldest patients reported in the literature with epilepsy surgery and supports the possibility of epilepsy surgery in elderly patients for particular cases. In addition, few cases with such a malignant evolution of temporal lobe epilepsy have been described in this age group.

  4. Acquired hemophilia as the cause of life-threatening hemorrhage in a 94-year-old man: a case report

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    Blanchard Elizabeth

    2010-07-01

    Full Text Available Abstract Introduction Acquired factor VIII deficiency is a rare entity that can lead to severe and life-threatening bleeding. We describe a case of severe bleeding from the tongue secondary to acquired hemophilia and discuss treatment options, including aminocaproic acid and recombinant factor VIII, which have not been widely reported in the literature for the management of such patients. Case presentation A 94-year-old Caucasian man presented to our institution with diffuse bruising and extensive bleeding from the tongue secondary to mechanical trauma. He had no prior history of bleeding and his medical history was unremarkable except for dementia and hypertension. Coagulation studies revealed a prolonged activated partial thromboplastin time and a mixing study was consistent with the presence of an inhibitor. Quantitative assays revealed a reduced level of factor VIII activity (1% and the presence of a factor VIII inhibitor, measured at seven Bethesda units, in the serum. Oral prednisone therapy (60mg/day was given. He also received intravenous aminocaproic acid and human concentrate of factor VIII (Humate-P and topical anti-thrombolytic agents (100 units of topical thrombin cream. His hospital course was prolonged because of persistent bleeding and the development of profuse melena. He required eight units of packed red blood cells for transfusion. Hospitalization was also complicated by bradycardia of unclear etiology, which started after infusion of aminocaproic acid. His activated partial thromboplastin time gradually normalized. He was discharged to a rehabilitation facility three weeks later with improving symptoms, stable hematocrit and resolving bruises. Conclusions Clinicians should suspect a diagnosis of acquired hemophilia in older patients with unexplained persistent and profound bleeding from uncommon soft tissues, including the tongue. Use of factor VIII (Humate-P and aminocaproic acid can be useful in this coagulopathy but

  5. Levels of physical activity and sedentary time among 10- to 12-year-old boys and girls across 5 European countries using accelerometers: an observational study within the ENERGY-project.

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    Verloigne, Maïté; Van Lippevelde, Wendy; Maes, Lea; Yıldırım, Mine; Chinapaw, Mai; Manios, Yannis; Androutsos, Odysseas; Kovács, Eva; Bringolf-Isler, Bettina; Brug, Johannes; De Bourdeaudhuij, Ilse

    2012-03-31

    The study aim was to objectively assess levels of sedentary time, light, moderate and vigorous physical activity (PA) among 10-12 year olds across five European countries and to examine differences in sedentary time and PA according to gender and country. 686 children (mean age = 11.6 ± 0.8 years, 53% girls, mean BMI = 19.0 ± 3.4 kg/m(2)) from Belgium, Greece, Hungary, the Netherlands and Switzerland wore Actigraph accelerometers and had at least 2 weekdays with minimum 10 h-wearing time and 1 weekend day with minimum 8 h-wearing time. Data were analyzed using multivariate analyses of covariance. Girls spent significantly more time sedentary (500 minutes/day) than boys (474 minutes/day) and significantly less time in light (267 minutes/day) and moderate-to-vigorous PA (32 minutes/day) than boys (284 minutes/day; 43 minutes/day respectively; p girls and 16.8% of the boys met moderate-to-vigorous PA recommendations of at least 60 minutes/day. Greek boys were more sedentary (510 minutes/day; all at p boys. Dutch girls were less sedentary (457 minutes/day; all at p girls. Swiss girls displayed more moderate-to-vigorous PA (43 minutes/day; at p girls. Large proportions of children across different European countries did not meet PA recommendations and spent a lot of time sedentary. Mean time spent in moderate-to-vigorous PA was significantly lower than the recommended 60 minutes. Obesity prevention programmes focusing on both decreasing sedentary time and increasing light, moderate and vigorous PA are needed for European children, particularly girls.

  6. Atrial myxoma presenting with orthostatic hypotension in an 84-year-old Hispanic man: a case report

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    Halstead Michael

    2009-12-01

    Full Text Available Abstract Introduction Left atrial myxomas remain the most common benign primary cardiac tumors, and these cardiac growths can masquerade as mitral stenosis, infective endocarditis and collagen vascular disease. Atrial myxomas are found in approximately 14-20% of the population and can lead to embolization, intercardiac obstructions, conduction disturbances and lethal valve obstructions. Case presentation An 84-year-old Hispanic man presented with complaints of dizziness upon standing, and with no prior history of heart murmurs, syncope, shortness of breath, or chest pain. Physical examination revealed evidence of orthostatic hypotension and a soft grade 1/6 systolic murmur at the left sternal border. A transthoracic echocardiogram revealed a large atrial myxoma occupying the majority of the left atrium, with the posterior border of the large atrial mass defined by eccentric mitral regurgitation identified during cardiac catheterization. Left atrial myxoma excision was performed, revealing a 7 × 6.5 × 4.5 cm atrial tumor attached to a 4 × 3 × 2 cm stalk of atrial septal tissue. Conclusion This patient didn't present with the common symptoms associated with an atrial myxoma, which may include chest pain, dyspnea, orthopnea, peripheral embolism or syncope. Two-dimensional echocardiography provides substantial advantages in detecting intracardiac tumors. We recommend a two-dimensional echocardiogram in the workup of orthostatic hypotension of unknown etiology after the common causes such as autonomic disorders, dehydration, and vasodilative dysfunctions have been ruled out. By illustrating this correlation between orthostasis and an atrial myxoma, we hope to facilitate earlier identification of these intracardiac growths.

  7. Self-Reported Physical Activity is Not a Valid Method for Measuring Physical Activity in 15-Year-Old South African Boys and Girls

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    Makama Andries Monyeki

    2018-06-01

    Full Text Available Physical activity plays an important role in the prevention of chronic lifestyle-related diseases. The development of valid instruments for the assessment of physical activity remains a challenge in field studies. The purpose of the present study was therefore to determine the level of agreement between physical activity objectively measured by the ActiHeart® (Cambridge Neurotechnology Ltd, Cambridge, UK device and subjectively reported physical activity by means of the International Physical Activity Questionnaire Short Form (IPAQ-SF among adolescents attending schools in the Tlokwe Local Municipality, South Africa. A cross-sectional study design was used with a total of 63 boys and 45 girls aged 15 years who took part in the Physical Activity and Health Longitudinal Study (PHALS. Stature and weight were measured according to standard International Society for the Advancement of Kinanthropometry (ISAK protocols. Objective physical activity (PA was measured by a combined heart rate and accelerometer device (ActiHeart® for seven consecutive days. Time spent in moderate-to-vigorous intensity physical activity (MVPA was assessed. Subjective physical activity was assessed with the self-reported IPAQ-SF. Objective PA indicated that 93% of the participants were inactive and only 6% were highly active. The IPAQ-SF showed that 24% were inactive, with 57% active. A non-significant correlation (r = 0.11; p = 0.29 between the ActiHeart® measure of activity energy expenditure (AEE and total physical activity (IPAQ-SF was observed. The Bland–Altman plot showed no agreement between the two measurement instruments and also a variation in the level of equivalence. When Cohen’s kappa (κ was run to determine the agreement between the two measurement instruments for estimated physical activity, a poor agreement (κ = 0.011, p < 0.005 between the two was found. The poor level of agreement between the objective measure of physical activity (ActiHeart® and

  8. Acute primary mesenteroaxial gastric volvulus in a 6 years old child; the contribution of ultrasonographic findings to the prompt diagnosis (a case report and review of the literature).

    Science.gov (United States)

    Patoulias, Dimitrios; Rafailidis, Vasileios; Kalogirou, Maria; Farmakis, Konstantinos; Rafailidis, Dimitrios; Patoulias, Ioannis

    2017-01-01

    The aim of the present case study is to raise concern on the proper diagnostic approach of acute gastric volvulus (AGV) cases, in which, the key issue is the timely diagnosis and the prompt therapeutic intervention. After thorough and systematic research of the current literature, it is concluded that early diagnosis remains challenging, while there is no relevant publication with emphasis on the contribution of ultrasonography to the diagnostic documentation of AGV. A 6 years old boy was admitted to our Department due to repeatedly non bilious vomiting and food refusal during the last 72 hours before admission. Physical examination revealed the presence of a spherical, painful mass in the epigastrium, which did not recede a er placement of a nasogastric tube. Abdominal radiography showed the presence of a large gastric air bubble. Ultrasonography highlighted a distended and fluid-filled stomach, which was displaced in a cephalic position compared to esophagus and a pylorus pointing downward, in a cranial caudal orientation. Following barium meal examination confirmed the diagnosis of gastric volvulus. Patient underwent an urgent exploratory laparotomy, revealing the presence of acute mesenteroaxial gastric volvulus with a serosal ecchymosis in the major arc. After restoration of the gastric volvulus, thorough intraoperative investigation on the existence of a subject cause followed. Presence of relaxation of stomach's ligaments was finally documented. Fixation of the stomach' fundus to the diaphragm and anterior gastropexy were then conducted. Postoperative period was uneventful and the patient was discharged home on the 4th postoperative day. In conclusion, we believe that ultrasonography plays a significant role in the diagnostic approach of acute gastric volvulus, as it has the potential to detect findings suggestive of the diagnosis. Once the diagnosis is suspected on ultrasonography, contrast series should be performed, without further delay, in order to con

  9. Life-threatening MRSA sepsis with bilateral pneumonia, osteomyelitis, and septic arthritis of the knee in a previously healthy 13-year-old boy

    DEFF Research Database (Denmark)

    Hardgrib, Nina; Wang, Michala; Jurik, Anne Grethe

    2016-01-01

    The incidence and severity of methicillin resistant Staphylococcus aureus (MRSA) infections are increasing and cause high mortality and morbidity. We describe the first pediatric case in Scandinavia with Panton-Valentine leucocidin (PVL) positive MRSA septicemia who developed bilateral pneumonia...... and antimicrobial combination therapy. The outcome was a healthy patient without sequelae, a favorable course unlike those previously described in the literature. This case underlines the necessity of a close interdisciplinary cooperation in children with severe MRSA infection encompassing pneumonia, septic...

  10. An Atypical Eating Disorder with Crohn's Disease in a Fifteen-Year-Old Male: A Case Study.

    Science.gov (United States)

    Holaday, Margot; And Others

    1994-01-01

    Discusses how 6 months after psychological intervention for an eating disorder, a 15-year-old male was diagnosed with Crohn's disease, a chronic inflammatory bowel disease. Addresses need for additional training for those from traditional school and counseling psychology programs. Advocates a team approach and consultations. (RJM)

  11. Kikuchi Disease Presented with External Iliac Lymphadenitis in a 7-year-old Girl: A Case Report

    International Nuclear Information System (INIS)

    Kim, Young Tong; Yoo, Kyung Hee; Cho, Hyun Deuk; Oh, Mee Hye; Shin, Hyeong Cheol

    2010-01-01

    Kikuchi disease of the iliac lymph node is rare, and even more rare is lymphadenitis with abdominal pain caused by Kikuchi disease. We report the US and CT findings of Kikuchi disease of the external iliac node in a 7 year-old-girl who complained of fever and abdominal pain in the left lower quadrant

  12. Uncovering Young Children's Transformative Digital Game Play through the Exploration of Three-Year-Old Children's Cases

    Science.gov (United States)

    Huh, Youn Jung

    2017-01-01

    In contrast to studies focusing on digital games as learning tools, this study shows how young children use digital games as a means of facilitating spontaneous play in their everyday lives. This article highlights how 4 three-year-old children's play with digital games revealed their ability to create new forms of play by mixing their digital…

  13. Effects of thinning on aboveground carbon sequestration by a 45-year-old eastern white pine plantation: A case study

    Science.gov (United States)

    W. Henry McNab

    2012-01-01

    Aboveground carbon sequestration by a 45-year-old plantation of eastern white pines was determined in response to thinning to three levels of residual basal area: (1) Control (no thinning), (2) light thinning to 120 feet2/acre and (3) heavy thinning to 80 feet2/acre. After 11 years carbon stocks were lowest on the heavily...

  14. Associations of physical activity and sedentary time with weight and weight status among 10- to 12-year-old boys and girls in Europe: a cluster analysis within the ENERGY project.

    Science.gov (United States)

    De Bourdeaudhuij, I; Verloigne, M; Maes, L; Van Lippevelde, W; Chinapaw, M J M; Te Velde, S J; Manios, Y; Androutsos, O; Kovacs, E; Dössegger, A; Brug, J

    2013-10-01

    Moderate-to-vigorous physical activity (MVPA) plays an important role in childhood overweight prevention. Sedentary time appears to be independently associated with overweight, but most research has been done in adults. The objective of this study were to identify subgroups of children based on their MVPA and sedentary time, and explore differences in body mass index (BMI), waist circumference and overweight prevalence between among these subgroups. A sample of 766 10- to 12-year-old children (52.9% girls, 11.6 ± 0.8 years) were recruited from Hungary (n = 158), Belgium (n = 111), the Netherlands (n = 113), Greece (n = 169) and Switzerland (n = 215). Children wore an accelerometer to measure MVPA and sedentary time. Cluster analysis revealed four clusters in both gender groups showing an unhealthy pattern (low MVPA/high sedentary time), a healthy pattern (high MVPA/low sedentary time), a low mixed pattern (low MVPA/low sedentary time) and a moderate to high mixed pattern (moderate to high MVPA/moderate sedentary time). In girls, the high MVPA/low sedentary time cluster had a significantly lower BMI (P ≤ 0.05), a lower waist circumference (P ≤ 0.01) and the lowest percentage of overweight (P ≤ 0.10) compared with the other three clusters. In boys, both clusters with higher activity levels had a significantly lower BMI (P ≤ 0.001) and waist circumference (P ≤ 0.001) than the two low activity clusters, independent of sedentary time. Engagement in more MVPA and less sedentary time is associated with a more favourable weight status among 10- to 12-year-old girls. Among boys, MVPA seems most important for weight status, while sedentary time appears to be less relevant. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

  15. Ultrasonographically supported removal of foreign bodies of the eye lid and parapharyngeal space in a 13-year-old boy subjected to shot injuries in early childhood

    Directory of Open Access Journals (Sweden)

    Friedrich, Reinhard E.

    2013-11-01

    Full Text Available Background: B-scan ultrasonography is widely used in diagnostics of head and neck pathologies. Ultrasonography can be applied intraoperatively to identify foreign materials. Case report: This case report describes the ultrasonographic identification of foreign bodies of the eye lid and parapharyngeal space in an adolescent who was injured several years ago, obviously a victim of domestic violence. B-scan ultrasonography (small part transducer, emission frequency: 7.5 MHz proved to be a reliable tool to locate the foreign bodies. Ultrasound imaging facilitated the decision-making of the surgical approach and thus reduced the surgical exploration time. Discussion: B-scan ultrasonography is a valuable tool in oral and maxillofacial surgery. The use of B-scan ultrasonography in the head neck region requires the capacity of the surgeon to fuse the ultrasonographic picture with the topography of the head and neck. The advantages and limitations of B-scan ultrasonography in the head and neck region concerning foreign body identification are briefly discussed.

  16. Family-Based Treatment of a 17-Year-Old Twin Presenting with Emerging Anorexia Nervosa: A Case Study Using the "Maudsley Method"

    Science.gov (United States)

    Loeb, Katharine L.; Hirsch, Alicia M.; Greif, Rebecca; Hildebrandt, Thomas B.

    2009-01-01

    This article describes the successful application of family-based treatment (FBT) for a 17-year-old identical twin presenting with a 4-month history of clinically significant symptoms of anorexia nervosa (AN). FBT is a manualized treatment that has been studied in randomized controlled trials for adolescents with AN. This case study illustrates…

  17. Co-existence of Chiari malformation type I and Epstein-Barr virus meningoencephalitis in a 3-year-old child: case report and review of the literature

    International Nuclear Information System (INIS)

    Solomou, E.K.; Kotsarini, C.; Badra, F.A.; Krepis, A.; Papanastasiou, D.; Patriarcheas, G.

    2005-01-01

    In the present report we describe an unusual case of a 3-year-old girl who was admitted to our hospital with Epstein-Barr virus meningoencephalitis. Brain magnetic resonance imaging revealed diffuse abnormalities in white matter and Chiari I malformation with cervical and thoracic hydro-syringomyelia. (orig.)

  18. [The necessity and possibility of developing skills in daily living activities in children attending a special kindergarten for the physically handicapped--demonstrated by means of a five-year-old boy suffering from spastic hemiparesis (author's transl)].

    Science.gov (United States)

    Burgheim-Raguss, B

    1980-02-01

    Within the framework of an empirical study carried out in a special kindergarten it was attempted to answer the question whether it is necessary and possible in such an institution to develop the children's skills in daily living activities. A six month systematic programme was set up for a five-year-old boy suffering from spastic hemiparesis which was designed to develop his skills in personal hygiene, and general behaviour in the kitchen area. In preparing the programme each of the two fields was first treated separately in detail, then the common factors taken into account. The programm's subdivision into an ultimate goal and two partial goals assisted the implementation of the eighteen training steps. A comparision of the knowledge of, and skills in, the two fields before and after the training showed that they had increased both in quantity and quality. As the boy still showed a headway over his peers - comparable in their disabilities - three years after completion of the programme as far as independence was concerned, it can be said that special training in daily living activities can and must be carried out in a special kindergarten for physically handicapped children provided the training is based on a specialized and fully structured programme.

  19. Rare case of primary spinal ependymomatosis occurring in a 26-year-old man: a case report.

    LENUS (Irish Health Repository)

    Kaliaperumal, Chandrasekaran

    2009-01-01

    The authors report a rare case of primary spinal ependymomatosis in a young adult man. Multiple primary ependymomatous lesions were seen on magnetic resonance imaging and no anaplasia was identified on the surgical-pathological analysis. The aetio-pathological mechanism and surgical significance of this rare occurrence is discussed.

  20. [Penetrating orbitocranial injury: a review of the literature and a case report of injury by a watercolor brush in a 3-year-old child].

    Science.gov (United States)

    Rzaev, D A; Danilin, V E; Letyagin, G V; Istomina, T K; Chishchina, N V

    We present a rare case of orbitocranial penetrating injury by a watercolor brush in a 3-year-old child. Injuries of this localization can affect important orbital structures (eyeball, blood vessels, nerves, muscles) and cause severe intracranial damages. In some cases, diagnosis of these injuries in children may be difficult due to the lack of marked clinical manifestations. The presented clinical case illustrates the approaches for choosing methods for diagnosis of injury in childhood and subsequent treatment options.

  1. Giant serous cystadenoma arising from an accessory ovary in a morbidly obese 11-year-old girl: a case report.

    Science.gov (United States)

    Sharatz, Steven M; Treviño, Taína A; Rodriguez, Luís; West, Jared H

    2008-01-18

    Ectopic ovarian tissue is an unusual entity, especially if it is an isolated finding thought to be of embryological origin. An 11-year-old, morbidly obese female presented with left flank pain, nausea, and irregular menses. Various diagnostic procedures suggested a large ovarian cyst, and surgical resection was performed. Histologically, the resected mass was not of tubal origin as suspected, but a serous cystadenoma arising from ovarian tissue. The patient's two normal, eutopic ovaries were completely uninvolved and unaffected. A tumor arising from ectopic ovarian tissue of embryological origin seems the most likely explanation. We suggest refining the descriptive nomenclature so as to more precisely characterize the various presentations of ovarian ectopia.

  2. A comprehensive special educational diagnostic assessment of five-year-old children with developmental coordination disorder (case studies

    Directory of Open Access Journals (Sweden)

    Tjasa Filipcic

    2016-07-01

    Full Text Available Developmental coordination disorder (DCD is a neurodevelopmental disorder which affects different areas of an individual's everyday living and learning. Children with DCD are often diagnosed late, at school age, when difficulties with writing, organization and executive functions arise, even though one could have seen signs of probable DCD very early in childhood. The aim of this study was to further assess five-year-old, preschool children recognized as children with DCD, and develop a model for a comprehensive special educational diagnostic assessment of abilities and skills in five-year-old children with DCD. The comprehensive diagnostic assessment comprised observations and assessments of children’s everyday skills in their kindergartens. It also included semi-structured interviews with children, their parents and their preschool teachers. Further, children’s skills and abilities in all developmental domains (sensory and motor skills, cognitive abilities, social and emotional development, speech and language development, including emerging literacy skills, and early maths skills were assessed. A qualitative analysis was undertaken to compare individual children’s comprehensive assessments. The developed model included both the strengths and weaknesses of the assessed children.

  3. Retroviral rebound syndrome after treatment discontinuation in a 15 year old girl with HIV attracted through mother-to-child transmission: case report

    OpenAIRE

    Gisslén Magnus; Friman Vanda

    2007-01-01

    Abstract A case of a 15 year old girl with retroviral rebound syndrome after discontinuation of highly active antiretroviral treatment (HAART) due to side effects is presented. The patient was transmitted with HIV at birth by her mother. She had recovered from severe AIDS after HAART was initiated five years earlier. This is the first case reported in the literature of retroviral rebound syndrome in a vertically transmitted HIV-infected patient.

  4. Atypical teratoid rhabdoid tumor in a 65-year-old man presenting with disseminated leptomeningeal disease: A case report and review of the literature.

    Science.gov (United States)

    Babi, Marc-Alain; Fecci, Peter; Luedke, Matthew; Pineda, Olinda; O'Keefe, Yasmin Ali

    2018-01-01

    Central nervous system atypical teratoid rhabdoid tumors are very rare aggressive tumor of childhood, primarily occurring at age of less than 3 years old. The prognosis of these tumors is very poor, with a reported median survival of 6-12 months in most cases. Treatment typically consists of aggressive chemotherapy and radiotherapy. We present the case of a 65-year-old man who presented with progressive encephalopathy and change in personality over 3 months period. The patient had further accelerated decline over 3 weeks. The diagnosis of atypical teratoid rhabdoid tumor initially remained elusive despite very extensive workup, but was eventually confirmed via open brain biopsy. To the best of our knowledge, this is the oldest reported case of atypical teratoid rhabdoid tumor in the literature. We further extend the spectrum of this rare disease.

  5. A case of thyrotoxic periodic paralysis as initial manifestation of Graves' disease in a 16-year-old Korean adolescent

    Directory of Open Access Journals (Sweden)

    Se Yong Jung

    2014-09-01

    Full Text Available Thyrotoxic periodic paralysis (TPP is a rare complication of hyperthyroidism, with recurrent muscle paralysis and hypokalemia that are caused by an intracellular shift of potassium. TPP is relatively common in Asian males, but is extremely rare in children and adolescents, even for those of Asian descent. We describe a 16-year-old Korean adolescent presenting with a two-week history of episodic leg weakness in the morning. He showed sinus tachycardia, lower leg weakness, and hypokalemia. Thyroid function test showed hyperthyroidism, and thyroid ultrasonography revealed a diffuse enlarged thyroid with increased vascularity, consistent with Graves' disease. He was treated with β-adrenergic blocker and antithyroid drugs. He has been symptom free for one year, as his hyperthyroidism has been controlled well with antithyroid drugs. TPP should be considered in children and adolescents with acute paralysis of the lower extremities and hypokalemia.

  6. WHO Grade 2 Neuroendocrine Tumor in a 15-Year-Old Male: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Eric Johannesen

    2014-01-01

    Full Text Available Neuroendocrine tumors, distinguished from adenocarcinomas by their neuroendocrine differentiation, are the most common pediatric epithelial malignancy that most often occurs in the appendix. In 2010, the WHO classified neuroendocrine neoplasms into three grades based on morphology, mitotic count, and Ki67 proliferation index. A 15-year-old male with a history of anemia and failure to thrive was diagnosed with a well-differentiated neuroendocrine tumor in the jejunum that invaded into the subserosal soft tissue and metastasized to four lymph nodes. Pediatric neuroendocrine tumors frequently arise within hereditary tumor syndromes with pancreatic neuroendocrine tumors being the most common. Several studies also indicate an elevated risk of small intestinal neuroendocrine tumors in which children born to a parent with a history of neuroendocrine tumors in the small intestine have a significant increased risk of developing one.

  7. Unexpected subthreshold autism spectrum in a 25-year-old male stalker hospitalized for delusional disorder: a case report.

    Science.gov (United States)

    Dell'Osso, Liliana; Dalle Luche, Riccardo; Cerliani, Corrado; Bertelloni, Carlo Antonio; Gesi, Camilla; Carmassi, Claudia

    2015-08-01

    This paper highlights the clinical challenges faced when assessing patients with stalking behaviors with psychotic disorders, suggesting the need for an accurate assessment of adult autism spectrum symptoms. A 25-year-old man with a diagnosis of delusional disorder, erotomanic type, was hospitalized for acute psychotic symptoms occurred in the framework of a repeated stalking behavior towards his ex girlfriend. When assessed for adult autism spectrum symptoms upon an accurate clinical evaluation, he reported elevated scores in the mentalizing deficit and social anxiety domains by means of the 14 item Ritvo Autism and Asperger Diagnostic Scale (RAADS-14). Authors discuss a possible role of adult (subthreshold) autism spectrum symptoms, generally disregarded in adult psychiatry, on the type of psychotic features and stalking behavior developed that may help for appropriate diagnosis and treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Anti-Ma2-encephalitis in a 2 year-old child: A newly diagnosed case and literature review.

    Science.gov (United States)

    Mrabet, Saloua; Ben Achour, Nedia; Kraoua, Ichraf; Benrhouma, Hanène; Klaa, Hedia; Rouissi, Aida; Ben Ahmed, Malika; Ben Youssef Turki, Ilhem

    2015-11-01

    Anti-Ma2-associated encephalitis is a rare paraneoplastic neurological syndrome characterized by isolated or combined limbic, diencephalic, or brainstem dysfunction. It is rarely reported in children. We describe the clinical data of a 2-year-old girl referred to our department for refractory focal seizures associated with fever, followed by behavioural changes, speech disturbances and confusional episodes. Brain magnetic resonance imaging (MRI) showed left temporoparietal brain involvement. Haematological, biochemical and infectious evaluations were unremarkable. Autoimmune encephalitis was suspected. Paraneoplastic antibodies tests showed positive results for anti-Ma2 antibodies. Screening for underlying tumour was negative. Immunomodulatory treatment was administrated. The patient showed improvement of vigilance and behaviour. However, she kept refractory epilepsy. Although poor response to immunotherapy, early diagnosis and appropriate treatment of this disorder may prevent irreversible sequelae. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  9. Nasal Extranodal Natural Killer/T Cell Lymphoma in a 69-Year Old Female: A Case Report

    Directory of Open Access Journals (Sweden)

    Duygu Mert, Mehmet Sinan Dal, Fazilet Duygu

    2016-09-01

    Full Text Available Mature natural killer /T-cell (NK/T-cell lymphomas are a rarely occurring subgroup of Non Hodgkin Lymphomas (NHL. A large majority of NK/T cell lymphomas are extranodal. Nasal type is the most common one. As clinical symptoms are usually nasal obstruction associated with mass lesion and epistaxis in extranodal NK/T cell lymphomas. Their diagnosis is usually delayed when the disease is advanced, it may have serious consequences. The aim of the present article was to present the clinical, radiological and histopathological findings of a 69-year old female patient who had refractory ulcerated wound on left side of nose and followed for soft tissue infection. It was diagnosed with extranodal NK/T cell lymphoma after deep biopsy was obtained from the lesion and to discuss this rare disease in view of literature data. J Microbiol Infect Dis 2016;6(3: 140-144

  10. Surgical pitfalls in patients with Ehlers–Danlos type IV: A case of spontaneous sigmoid perforation in a 17-year-old male

    Directory of Open Access Journals (Sweden)

    Kai Lyn Ng

    2011-07-01

    Full Text Available Ehlers–Danlos syndrome (EDS is a group of well described connective tissue disorders in which collagen production is impaired. The surgical management of affected individuals remains challenging, with no general consensus. We report a case of spontaneous sigmoid perforation in a 17-year-old Eurasian male, in whom we subsequently established the diagnosis of EDS type IV (EDS-IV. We review the literature to discuss the clinical features and diagnosis, and the recommended therapeutic management.

  11. Family-Based Treatment of a 17-Year-Old Twin Presenting with Emerging Anorexia Nervosa: A Case Study Using the “Maudsley Method”

    OpenAIRE

    Loeb, Katharine L.; Hirsch, Alicia M.; Greif, Rebecca; Hildebrandt, Thomas B.

    2009-01-01

    This paper describes the successful application of family-based treatment (FBT) for a 17-year-old identical twin presenting with a four-month history of clinically significant symptoms of anorexia nervosa (AN). FBT is a manualized treatment that has been studied in randomized controlled trials for adolescents with AN. This case study illustrates the administration of this evidence-based intervention in a clinical setting, highlighting how the best available research was used to make clinical ...

  12. An 18-year-old patient with Prader-Willi syndrome: a case report on dental management under sedation and general anesthesia

    OpenAIRE

    Song, Ki Un; Nam, Ok Hyung; Kim, Mi Sun; Choi, Sung Chul; Lee, Hyo-Seol

    2015-01-01

    Prader-Willi syndrome (PWS) is a rare genetic disorder reported rarely in dentistry. Dental practitioners should know the features of PWS because affected patients have a variety of dental symptoms. The current report describes a case of PWS. An 18-year-old male patient presented with traumatic injuries. Initial emergency treatments were performed under sedation, and further treatments were conducted under general anesthesia. After adequate healing, periodic follow-up and dietary management a...

  13. Rupture of the Distal Biceps Tendon Combined with a Supinator Muscle Tear in a 51-Year-Old Woman: A Case Report

    OpenAIRE

    Nayyar, Samir; Quirno, Martin; Hasan, Saqib; Rybak, Leon; Meislin, Robert J.

    2011-01-01

    Distal biceps tendon rupture is a relatively uncommon occurrence in the general female population, and to our knowledge, has not been reported in association with a supinator muscle tear. We report a case of 51-year-old woman who experienced sharp pain in her forearm and elbow after lifting a heavy object. History and physical examination raised suspicion for a distal biceps tendon rupture. MRI imaging determined a combined distal biceps tendon tear with a supinator muscle tear with subsequen...

  14. Cephalometric analysis of hard and soft tissues in a 12-year-old syndromic child: A case report and update on dentofacial features of Crouzon syndrome

    Directory of Open Access Journals (Sweden)

    K Nagaraju

    2011-01-01

    Full Text Available Crouzon syndrome or craniofacial dysostosis is a rare syndrome characterized by craniosynostosis, midfacial hypoplasia and exophthalmia. The abnormalities found in this syndrome change too much from case to case depending on the suture fusion order. We report a case of a 12 year old child and a mother showing variations in the dentofacial tissues clinically and radiographically. Subsequently, the application of digital software [Dolphin Imaging 11] enabled us to solve out the case as Crouzon syndrome by analyzing the skeletal and soft tissue alterations. An update of the effects of this syndrome on various systems and dentofacial features with emphasis on tooth abnormalities is documented.

  15. [Competitive sports and dilated cardiomyopathy: the case of a 32-year-old soccer player with ventricular tachycardia].

    Science.gov (United States)

    Scharhag, J; Meyer, T; Görge, G; Kindermann, W

    2003-01-24

    A 32-year-old competitive soccer player presented with palpitations he had felt for 4 weeks during maximal activity (soccer training and match). The physical examination and an exercise electrocardiogram were carried out by his general practitioner up to 19 s at 350 W and a heart rate of 147/min without showing any abnormalities. All blood parameters revealed no signs of illness. During treadmill exercise at a heart rate of 181/min, a non-sustained ventricular tachycardia was induced. Echocardiography showed a dilated left ventricle with an enddiastolic diameter of 70 mm and low fractional shortening (28 %). Cardiac catheterization demonstrated a diminished left ventricular ejection fraction (38 %) and an enlarged enddiastolic volume (199 ml) without signs of coronary artery disease. Electrophysiologic testing induced a non-sustained ventricular tachycardia. The echocardiographic and angiographic results indicated a dilated cardiomyopathy. Competitive sports activities were stopped and treatment with a beta-blocker (metoprolol) and an ACE-antagonist (ramipril) was started. In young male and female athletes, the possibility of severe cardiac abnormalities have to be considered even in the presence of good physical fitness and performance. To reach a high sensitivity for diagnostic ergometry, the work-load must reach the maximal capacity of the cardio-pulmonary system. Differences in the exercise performance of athletes and untrained subjects have to be considered.

  16. A Peripheral Ameloblastic Fibro-Odontoma in a 3-Year-Old Girl: Case Report, Immunohistochemical Analysis, and Literature Review

    Directory of Open Access Journals (Sweden)

    Yi-Chun Lin

    2014-01-01

    Full Text Available Ameloblastic fibro-odontoma (AFO predominantly occurs in the jaw bones of children and young adults. Extraosseous AFO is extremely rare. We describe a peripheral ameloblastic fibro-odontoma in the maxillary gingiva of a 3-year-old girl. The clinical appearance resembled fiery red reactive gingival lesions. The histopathological examination of the excised lesion showed small islands and cords of odontogenic epithelium with cellular myxoid stroma in the subepithelial tissue. The mass contained calcified material and an enamel-like deposit. Many small blood vessels appeared in the connective tissue surrounding the odontogenic epithelium. The immunohistochemical assays showed strong reactivity for amelogenin, β-catenin, CD44, and CD31 in the tissue sections. There was no recurrence after the 1-year follow-up. Because this lesion clinically resembles other nonneoplastic lesions and is very rare in gingiva, establishing a correct diagnosis is achieved only based on specific histological characteristics. Conservative excision of the tumor is the treatment of choice.

  17. Bone dysplasia with optic atrophy, vascular malformation and seizures in a 14-year-old girl - a case report

    International Nuclear Information System (INIS)

    Kuleta-Bosak, E.; Kluczewska, E.; Gibinska, E.; Jamroz, E.; Augustyn, D.; Gluszkiewicz, E.

    2007-01-01

    The heritable skeletal dysplasias or osteochondrodysplasias are a large heterogeneous group of disorders associated with abnormal shape, growth, or integrity of bones. Osteopetrosis is a collective term for a range of sclerosing bone diseases with various degree of defective remodeling. Increased bone density is the predominant radiologic feature. The skull is often involved with basal sclerosis and the sinuses are obliterated. The most serious consequences of the osteopetroses are seen in the nervous system. Because of perturbed remodeling of the skull bones, many aspects of the brain and cranial nerve function are endangered. Cranial nerves, blood vessels and the spinal cord may be compressed by progressive occlusion of cranial foramina. Carious, misplaced teeth, dysplastic fingernails, tendency to pathologic fractures are the other clinical manifestations. The authors present a 14-year-old girl with dysmorphic features, optic atrophy, CNS vessel malformation, pathologic fractures and seizures. The girl had a wide range of clinical and radiographic symptoms of bone dysplasias together with a giant left internal carotid artery aneurysm and epilepsy. On the basis of clinical and radiological features, a disease belonging to the group of skeletal dysplasias was recognized in our patient. The configuration of the presented symptoms does not allow at the moment strict classification to hitherto determined forms of dysplasia. This leads to the necessity of extending diagnostics, especially by molecular tests, and further long-lasting observations, which perhaps would allow classification of the presented syndrome to one of the known groups, or determination of a new clinical entity. (author)

  18. Inflammatory Myofibroblastic Tumor Presenting with Diabetes Insipidus in an Eight-Year-Old Boy: A Case Report.

    Science.gov (United States)

    Sarı, Erkan; Ataş, Erman; Bulut, Engin Burak; Sarı, Sebahattin; Akın, Onur; Saldır, Mehmet; Karslıoğlu, Yıldırım; Yeşilkaya, Ediz

    2015-12-01

    Inflammatory myofibroblastic tumors (IMT) develop as a non-neoplastic proliferation of myofibroblasts in a myxoid to collagenous stroma admixed with inflammatory cells. The symptoms depend on the specific location of the tumor, which can be anywhere, but is particularly in the respiratory system. Thus, patients with IMT can present with a variety of findings. A pediatric patient with IMT who presented with cough, breathlessness, polyuria-polydipsia, and convulsions is described in this report.

  19. A Unique Case of Primary Ewing’s Sarcoma of the Cervical Spine in a 53-Year-Old Male: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Marshall T. Holland

    2015-01-01

    Full Text Available Extraskeletal Ewing’s sarcoma (EES is a rare presentation, representing only 15% of all primary Ewing’s sarcoma cases. Even more uncommon is EES presenting as a primary focus in the spinal canal. These rapidly growing tumors often present with focal neurological symptoms of myelopathy or radiculopathy. There are no classic characteristic imaging findings and thus the physician must keep a high index of clinical suspicion. Diagnosis can only be definitively made by histopathological studies. In this report, we discuss a primary cervical spine EES in a 53-year-old man who presented with a two-month history of left upper extremity pain and acute onset of weakness. Imaging revealed a cervical spinal canal mass. After undergoing cervical decompression, histopathological examination confirmed a diagnosis of Ewing’s sarcoma. A literature search revealed fewer than 25 reported cases of primary cervical spine EES published in the past 15 years and only one report demonstrating this pathology in a patient older than 30 years of age age=38. Given the low incidence of this pathology presenting in this age group and the lack of treatment guidelines, each patient’s plan should be considered on a case-by-case basis until further studies are performed to determine optimal evidence based treatment.

  20. Retiform Sertoli-Leydig Cell Tumor in a 38-Year-Old Woman: A Case Report, Retrospective Review, and Review of Current Literature

    Directory of Open Access Journals (Sweden)

    Laura C. Nwogu

    2017-01-01

    Full Text Available Ovarian sex cord-stromal tumors arise from the stromal cells that surround and support the oocytes. Sertoli-Leydig cell tumors belong to this category of ovarian neoplasms. We present the case of a 38-year-old woman who was found to have a right ovarian mass. The mass was resected and diagnosed as Stage I Sertoli-Leydig cell tumor, retiform variant, following histopathologic and immunohistochemical examination. This case is unusual given the rarity of the retiform variant of Sertoli-Leydig cell tumor and the atypically older age of 38 years at presentation.

  1. A Case Study of Deep Vein Thrombosis of the Right Internal Jugular Vein in a Healthy 21-Year-Old Male

    Directory of Open Access Journals (Sweden)

    Javier Corral

    2016-01-01

    Full Text Available We are reporting a case of a healthy 21-year-old male, with no significant past medical history, who was found to have an incidental nonocclusive deep vein thrombosis in the right internal jugular vein detected on a head MRI previously ordered for work-up of headaches. A follow-up upper extremity venous Doppler ultrasound confirmed the presence of a partially occlusive deep vein thrombosis in the right jugular vein. The case presented is unique for the reason that the patient is young and has no prior risk factor, personal or familial, for venous thrombosis except for associated polycythemia on clinical presentation.

  2. Double-Layered Lateral Meniscus in an 8-Year-Old Child: Report of a Rare Case

    OpenAIRE

    Araki, Susumu; Kubo, Mitsuhiko; Kumagai, Kosuke; Imai, Shinji

    2016-01-01

    Reports of congenital abnormalities of the lateral meniscus include discoid meniscus, accessory meniscus, double-layered meniscus, and ring-shaped meniscus. Particularly, only a few cases of double-layered meniscus have been reported. We report a case of double-layered lateral meniscus, in which an additional semicircular meniscus was observed under the normal lateral meniscus. The accessory hemimeniscus was resected by means of arthroscopic surgery. This case demonstrates an interesting and ...

  3. 3-Dimensional computed tomography imaging of the ring-sling complex with non-operative survival case in a 10-year-old female

    OpenAIRE

    Fukuda, Hironobu; Imataka, George; Drago, Fabrizio; Maeda, Kosaku; Yoshihara, Shigemi

    2017-01-01

    We report a case of a 10-year-old female patient who survived ring-sling complex without surgery. The patient had congenital wheezing from the neonatal period and was treated after a tentative diagnosis of infantile asthma. The patient suffered from allergy and was hospitalized several times due to severe wheezing, and when she was 22 months old, she was diagnosed with ring-sling complex. We used a segmental 4 mm internal diameter of the trachea for 3-dimensional computed tomography (3D-CT). ...

  4. Enterobius vermicularis: an unusual cause of recurrent urinary tract infestation in a 7-year-old girl: case report and review of the literature.

    Science.gov (United States)

    Patel, Bhupeshwari; Sharma, Tanya; Bhatt, Girish Chandra; Dhingra Bhan, Bhavna

    2015-04-01

    Enterobius vermicularis, the pinworm, is one of the most prevalent intestinal parasites in the world. Ectopic infestations in the genital or urinary tracts rarely occur and chronic enterobiasis of the urinary tract has rarely been reported. Here we present such a case in a 7-year-old girl presenting with fever, pain in the abdomen, vomiting and burning micturition. Ultrasonography and micturating cystourethrogram (MCU) studies were normal. The ova were demonstrated from both the patient's urine and stool specimen. This child was treated successfully with Albendazole and Ivermectin. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  5. Cine phase-contrast MR to assess portal blood flow in a 10-year-old girl with abdominal aortic coarctation: a case report

    International Nuclear Information System (INIS)

    Clark, T.W.I.; Culham, J.A.G.

    1998-01-01

    We report the case of a 10-year-old girl with repaired abdominal aortic coarctation in whom chronic mesenteric ischemia was clinically suspected. Cine phase-contrast magnetic resonance (MR) was used to determine the difference between fasting and postprandial portal blood flow. Fasting flow rates in the portal vein were normal. After a meal, blood flow in the portal vein increased 226 % over the fasting state, showing normal augmentation. To the best of our knowledge, this is the first application of this technique to a pediatric setting. (orig.)

  6. Rupture of the Distal Biceps Tendon Combined with a Supinator Muscle Tear in a 51-Year-Old Woman: A Case Report

    Directory of Open Access Journals (Sweden)

    Samir Nayyar

    2011-01-01

    Full Text Available Distal biceps tendon rupture is a relatively uncommon occurrence in the general female population, and to our knowledge, has not been reported in association with a supinator muscle tear. We report a case of 51-year-old woman who experienced sharp pain in her forearm and elbow after lifting a heavy object. History and physical examination raised suspicion for a distal biceps tendon rupture. MRI imaging determined a combined distal biceps tendon tear with a supinator muscle tear with subsequent confirmation at surgery. Surgical repair was performed for the distal biceps tendon only through a single incision approach using the Endobutton technique.

  7. An 18-year-old patient with Prader-Willi syndrome: a case report on dental management under sedation and general anesthesia.

    Science.gov (United States)

    Song, Ki Un; Nam, Ok Hyung; Kim, Mi Sun; Choi, Sung Chul; Lee, Hyo-Seol

    2015-12-01

    Prader-Willi syndrome (PWS) is a rare genetic disorder reported rarely in dentistry. Dental practitioners should know the features of PWS because affected patients have a variety of dental symptoms. The current report describes a case of PWS. An 18-year-old male patient presented with traumatic injuries. Initial emergency treatments were performed under sedation, and further treatments were conducted under general anesthesia. After adequate healing, periodic follow-up and dietary management according to the patient's age and nutritional phase were recommended. Dental management of PWS patients consists of active preventive measures in addition to dietary consultation according to age and nutritional phase.

  8. Coprophagia in an 8-Year-Old Hospitalized Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Aleksandra Bacewicz

    2017-01-01

    Full Text Available Consult-liaison psychiatrists often encounter difficult clinical scenarios. We present a pediatric case of presumptive coprophagia. After a negative medical work-up, the pediatrics team asked psychiatry to assist them in managing this relatively rare disorder in the hospital setting. Little is known about the etiology and treatment of coprophagia in the pediatric population. Using the case as a catalyst, we discuss what is known about this disorder as well as treatment strategies in the hospital setting.

  9. Traumatic posterior dislocation of the hip in a 3-year-old child.

    LENUS (Irish Health Repository)

    Forde, James C

    2012-02-01

    We report the case of a traumatic posterior dislocation of the hip in a 3-year-old boy. After a fall in the garden, the boy was brought to our emergency department where an x-ray confirmed a posterior dislocation of his right hip. A successful prompt reduction was performed in the operating room under general anesthesia. This uncommon injury represents an orthopedic emergency and requires prompt reduction to lessen the risk of complications including avascular necrosis of the femoral head.

  10. A Case Report of Salmonella muenchen Enteritis Causing Rhabdomyolysis and Myocarditis in a Previously Healthy 26-Year-Old Man.

    Science.gov (United States)

    Chapple, Will; Martell, Jon; Wilson, Joy S; Matsuura, Don T

    2017-04-01

    This case report examines an unusual presentation of a non-typhoidal Salmonella serovar with limited prevalence in the literature. This is the first case report to associate specifically the Salmonella muenchen serovar with rhabdomyolysis and myocarditis. This case report reviews the diagnostic criteria for myocarditis and explores the diagnostic dilemma of troponin elevation in the setting of rhabdomyolysis. It demonstrates that Salmonella muenchen has the ability to present in a broad range of individuals with complications extending beyond classical gastrointestinal symptoms. This report also concludes that diagnosis of the many possible complications from non-typhoidal Salmonella infections can be difficult due to patient comorbidities, variability in the severity of the illnesses, laboratory test limitations, and imaging limitations. When a patient presents with elevated troponins in the setting of rhabdomyolysis a careful workup should be done to evaluate for ischemic causes, myocarditis, or false elevation secondary to rhabdomyolysis.

  11. Sialolipoma of parotid gland in a 1-year-old male child: A case report and review of literature.

    Science.gov (United States)

    Arakeri, Surekha Ulhas; Banga, Shilpi

    2018-01-01

    Sialolipoma is a recently described rare histological variant of lipoma, characterized by well-demarcated proliferation of mature adipocytes with secondary entrapment of salivary gland elements. Less than forty cases of sialolipoma have been reported in English literature. This tumor has been reported both in major and minor salivary glands, with the parotid gland being the most common site. Age incidence in this tumor varies from 0 month to 84 years. However, the occurrence of this tumor in an infant is very rare. In the published literature, the size of this tumor varied from 1 to 7 cm. In the present case, the tumor size was >7 cm. To the best of our knowledge, congenital sialolipoma >7 cm has been rarely reported earlier. Hence, this case is presented because of its rarity and unusual gross appearance.

  12. Case report: a 70-year-old man with undiagnosed factor VII deficiency presented with acute ischemic stroke.

    Science.gov (United States)

    Ip, Hing-Lung; Chan, Anne Yin-Yan; Ng, Kit-Chung; Soo, Yannie Oi-Yan; Wong, Lawrence Ka-Sing

    2013-11-01

    Factor VII deficiency is an uncommon coagulation disorder that patient usually presents with bleeding diathesis, but thrombotic event has been reported. We report a case of unusual clinical presentation in a patient with undiagnosed factor VII deficiency who presented with acute ischemic stroke. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. A 30-Year-Old Man with Three Primary Malignancies: A Case of Constitutional Mismatch Repair Deficiency

    OpenAIRE

    Rengifo-Cam, William; Jasperson, Kory; Garrido-Laguna, Ignacio; Colman, Howard; Scaife, Courtney; Samowitz, Wade; Samadder, N. Jewel

    2017-01-01

    Constitutional mismatch repair deficiency (CMMRD) is a devastating cancer predisposition syndrome for which clinical manifestations, genetic screening, and cancer prevention strategies are limited. We report a case of CMMRD presenting with metachronous colorectal cancer and brain cancer. Oncologists and gastroenterologists should be aware of the CMMRD syndrome as a rare cause of very early-onset colorectal cancer.

  14. A 30-Year-Old Man with Three Primary Malignancies: A Case of Constitutional Mismatch Repair Deficiency.

    Science.gov (United States)

    Rengifo-Cam, William; Jasperson, Kory; Garrido-Laguna, Ignacio; Colman, Howard; Scaife, Courtney; Samowitz, Wade; Samadder, N Jewel

    2017-01-01

    Constitutional mismatch repair deficiency (CMMRD) is a devastating cancer predisposition syndrome for which clinical manifestations, genetic screening, and cancer prevention strategies are limited. We report a case of CMMRD presenting with metachronous colorectal cancer and brain cancer. Oncologists and gastroenterologists should be aware of the CMMRD syndrome as a rare cause of very early-onset colorectal cancer.

  15. Ovarian serous cystadenoma with ectopic adrenal tissue in a 65-year-old patient: A case report

    Directory of Open Access Journals (Sweden)

    Çağdaş Şahin

    2017-01-01

    Conclusion: Ectopic adrenal tissues are generally asymptomatic and revealed incidentally during surgery; however some cases have demonstrated the risk of neoplastic transformation. Therefore, surgeons must be aware of this rare entity that bears the risk of malignancy, and should surgically remove all suspicious lesions.

  16. Observable Flow Experience in a Two-Year-Old Japanese Child's Violin Playing

    Science.gov (United States)

    Akutsu, Taichi

    2018-01-01

    This study investigated the flow experience of Jiro, a 2-year-old Japanese boy, regarding his violin playing in a social context. In this study, Jiro's violin playing was videotaped at home and during musical sessions for young children and families, guided by the author as a violinist-teacher-researcher. The method adopted a single case study…

  17. Anaphylactoid Purpura Manifested after Acute Gastroenteritis with Severe Dehydration in an 8-Year-Old Male Child: A Case Report.

    Science.gov (United States)

    Thakkar, Umang G; Vanikar, Aruna V; Trivedi, Hargovind L

    2015-12-01

    Anaphylactoid purpura, also known as Henoch-Schönleinpurpura (HSP), is an IgA-mediated vasculitis that tends to be a benign disease of childhood. Up to 50% of cases are preceded by an upper tract respiratory infection caused by group-A beta-hemolytic streptococcus and present with the common tetrad of abdominal pain, arthritis, purpuric rash, and renal involvement. The majority of patients recover completely. Here we document a rare case of anaphylactoid purpura which manifested with skin lesions in the form of palpable purpura following about of acute gastroenteritis with severe dehydration; it was treated with a short regimen of steroid therapy, which resulted in the complete remission of the disease. We conclude that prompt diagnosis and multidisciplinary intervention will lead to appropriate management-consisting of the installation of early short-course steroid therapy and thus, prevent further complications and the recurrence of the disease.

  18. A case report of spontaneous rupture of a renal angiomyolipoma in a post-partum 21-year-old patient.

    Science.gov (United States)

    Lucky, Marc A; Shingler, Simon N; Stephenson, Richard N

    2009-10-01

    Renal angiomyolipomas (AML) are benign tumours containing vascular, smooth muscle and fatty elements. The majority of renal AML run an asymptomatic, benign course. The main associated complication is that of retro-peritoneal or intra-tumoural haemorrhage. Treatment options include conservative management versus interventional procedures such as total or partial nephrectomy, cryotherapy or embolization. We describe a case of symptomatic, spontaneous rupture of AML in the immediate post-partum period of a patient treated under our care. This case highlights the presentation in the form of an acute abdomen in the immediate post-partum period. This is important as acute abdomen following delivery can be attributed to a number of other causes. It also demonstrates that further complications of renal angiomyolipoma rupture can arise, emphasising the importance of post treatment vigilance for signs of infection, further haemorrhage and post embolic events.

  19. [Perthes syndrome secondary to an asthma attack: A case report in a 15-year-old child].

    Science.gov (United States)

    El Amraoui, W; El Koraichi, A; Bentalha, A; El Kettani, S E

    2016-12-01

    Perthes syndrome, or traumatic asphyxia syndrome, is a rare clinical entity, associating cyanosis, cervicofacial petechiae and subconjunctival hemorrhage. It is usually secondary to chest trauma, but can occur in any situation of abrupt rise in intrathoracic pressure with closed glottis. In this paper, we present a case of Perthes syndrome that triggered an asthma attack for a child during surgery. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. Questionnaire-based case finding of celiac disease in a population of 8- to 9-year-old children

    DEFF Research Database (Denmark)

    Toftedal, Peter; Hansen, Dorte Gilså; Nielsen, Christian

    2010-01-01

    OBJECTIVE: Antibody screenings and diagnosis of celiac disease (CD) among children with type 1 diabetes have suggested that a considerable proportion of children with CD may, in fact, have preclinical (undiagnosed) symptoms. We aimed to test if a questionnaire would lead to significant case finding...... the questionnaire to the families of all children in the study population who resided in the County of Funen, Denmark. In total, 7029 respondents returned the questionnaire (70%); among them, 2835 children had 1 or more symptoms. These children were invited for a blood test to determine their human serum...

  1. Intestinal mass in a one year old child: An unusual presentation of Strongyloides stercolaris infection. Case report

    Directory of Open Access Journals (Sweden)

    Silvia Aragon, MD

    2017-05-01

    Full Text Available Intestinal strongyloidiasis is a common disease in the world. In children, the worldwide prevalence rates ranged from 0.6% to 5.3% [1]. In Colombia studies report a prevalence of 1.3% in children, although it may be higher [2]. The most frequent symptoms are abdominal pain, diarrhea and weight loss. However, on rare occasions the infection can cause duodenal obstruction, pyloric hypertrophy and colonic mass. This article reports the first case of a toddler who presented with a mass in the cecum as a manifestation of Strongyloides stercolaris infection, which required surgical resection as it was initially believed to be a Burkitt lymphoma.

  2. Incisional hernia as an unusual cause of hepatic encephalopathy in a 62-year-old man with cirrhosis: a case report

    Directory of Open Access Journals (Sweden)

    Ustaoglu Muge

    2009-09-01

    Full Text Available Abstract Introduction Hepatic encephalopathy may be initiated by many factors such as gastrointestinal bleeding, infections, fluid and electrolyte disturbances. Hypokalemia is one of the most commonly encountered electrolyte abnormalities causing hepatic encephalopathy in patients with cirrhosis. Case presentation We present the case of a 62-year-old Caucasian man with decompensated liver cirrhosis having multiple episodes of hepatic encephalopathy precipitated by vomiting. He had an incisional hernia at the right lumbar region. A barium contrast study of the small intestine and magnetic resonance imaging showed that the hernial sac included gastric antrum and bowel. We observed that hepatic encephalopathy coincided with hypokalemia as a result of a large volume of vomiting triggered by the collapsed hernial sac. Hepatic encephalopathy was resolved by administration of intravenous potassium. Conclusion This case illustrates that a hernia causing a large volume of vomiting may be a precipitant factor in the development of hepatic encephalopathy.

  3. Case Record of a Teaching Hospital in Karaj; A 35-Year Old Man With Taenia saginata Infection Treated With Niclosamide

    Directory of Open Access Journals (Sweden)

    Aliehsan Heidari

    2016-11-01

    Full Text Available Taeniasaginata can cause severe health and economic problems particularly in endemic areas. The disease cause by this cestode is related to poor sanitary conditions, inadequate hygiene, open defecation, inadequately cooked beef and poverty. A 35 years man found yellowish white tapeworm proglottids moving in his feces and consulted to the Department of Emergency, ShahidRajaei hospital, Karaj, Iran. He complained of lower abdominal discomfort, anal itching and moving something in the stomach. He was given wrong prescription. The patients had the history of eating undercooked beef. We report one case of T. saginata infection based on adult tapeworm recovery from the patients. The specific identification of the worm was based on based on standard procedures. Three months after expelling the tapeworm, the man felt better and returned to his normal life.

  4. A case of myxedema coma presenting as a brain stem infarct in a 74-year-old Korean woman.

    Science.gov (United States)

    Ahn, Ji Yun; Kwon, Hyuk-Sool; Ahn, Hee Chol; Sohn, You Dong

    2010-09-01

    Myxedema coma is the extreme form of untreated hypothyroidism. In reality, few patients present comatose with severe myxedema. We describe a patient with myxedema coma which was initially misdiagnosed as a brain stem infarct. She presented to the hospital with alteration of the mental status, generalized edema, hypothermia, hypoventilation, and hypotension. Initially her brain stem reflexes were absent. After respiratory and circulatory support, her neurologic status was not improved soon. The diagnosis of myxedema coma was often missed or delayed due to various clinical findings and concomitant medical condition and precipitating factors. It is more difficult to diagnose when a patient has no medical history of hypothyroidism. A high index of clinical suspicion can make a timely diagnosis and initiate appropriate treatment. We report this case to alert clinicians considering diagnosis of myxedema coma in patients with severe decompensated metabolic state including mental change.

  5. A rare case of acute intermittent porphyria with ichthyosis vulgaris in a young boy

    Directory of Open Access Journals (Sweden)

    Garima Agrawal Varshney

    2018-01-01

    Full Text Available Acute intermittent porphyria (AIP and ichthyosis vulgaris both are autosomal dominant disorders with incomplete penetrance caused by the deficiency of porphobilinogen deaminase enzyme and filaggrin protein, respectively. We report a rare case of a 9-year-old boy having two genetic diseases with an unclear association. An acute attack of AIP is characterized by gastrointestinal symptoms and neuropsychiatric manifestations. Although rare in the first decade of life, the presence of reddish urine with a typical presentation such as abdominal pain, hypertension, seizure, and paresthesias lead us to the diagnosis of AIP. The precipitating factor in the present case was prolonged fasting in Ramadan.

  6. Marjolin's ulcer in a 20 years old split thickness skin graft on the knee-A case report.

    Science.gov (United States)

    Saltvig, Iselin; Matzen, Steen H

    2018-01-01

    Marjolin's Ulcer (MU) is a rare cutaneous neoplasm arising in cikatrical tissue. Due to its typical clinical presentation as a non-healing lesion in scar tissue, the diagnosis can be delayed and even overlooked. We present the case of an elderly woman who developed an ulcerated, exophytic lesion in a split thickness skin graft (STSG) on the lateral aspect of the left knee. Histology showed a radically excised highly differentiated squamous cell carcinoma (SCC) with keratine pearls and a component of basocellular carcinoma (BCC). The histological picture combined with the location and long time interval since the primary surgery made the diagnosis of MU highly likely. Considering the risk of metastasis and mortality it is important to recognize the diagnosis and initiate adequate treatment. The diagnosis of MU is clinical and confirmed by pathology. The typical long delay from the primary lesion to the malignant transformation might occlude the diagnosis. As such, a thorough anamnesis is essential in a non- healing ulcerated lesion in a cikatrical area to adequately diagnose and treat the condition. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Home Air Quality And Case Of Pneumonia In Children Under Five Years Old ((In Community Health Center of South Cimahi and Leuwi Gajah, City of Cimahi

    Directory of Open Access Journals (Sweden)

    Rilla Fahimah

    2014-04-01

    Full Text Available Pneumonia is the number one deadliest disease in the world with the prevalence of 44%. In Indonesia, pneumonia in to odler is the leading cause of death, after diarrhea, with proportion 15,5%. Pneumonia is a disease caused by a virus and bacteria influenced by physical and chemical contaminants. The purpose of this study is to analyze indoor air quality with the incidence of pneumonia in children under five years old with cross sectional method. The population in this study is the population living in the region of South Cimahi Public Health Center and Leuwi Gajah Public Health Center. The criteria of selection for the region are: region with the highest population, high pneumonia cases (in the red and yellow area, a coal-fired industrial area, and located near the toll Purbaleunyi. The sample of this research are respondents who live in the region of South Cimahi Public Health Center and Leuwi Gajah Public Health Center with inclusion criteria length of stay ≥1 year with a child under five years old. Significant correlation occur between PM10 and PM2,5 (p 0.05 with pneumonia. Dominant factors that cause pneumonia in infants is PM10 (p 0.036 with a value of OR 4.09 after controlled PM2,5 (p 0.142; OR 2.78, the number of bacteria (p 0.004; OR 0.17 and ventilation the house (p 0.395; OR 0.58.

  8. Treatment of giant and large fusiform middle cerebral artery aneurysms with excision and interposition radial artery graft in a 4-year-old child: case report.

    Science.gov (United States)

    Mrak, Goran; Paladino, Josip; Stambolija, Vasilije; Nemir, Jakob; Sekhar, Laligam N

    2014-03-01

    We report an unusual case of complex giant and large fusiform aneurysms not amenable for clipping or coiling in a 4-year-old child managed with aneurysm resection and radial artery interposition graft. A 4-year-old child presented with repeated severe headache and vomiting. Computed tomography, magnetic resonance imaging, and magnetic resonance angiography and digital subtraction angiography showed a giant fusiform aneurysm on the right middle cerebral artery (MCA). Because of the complex shape, endovascular treatment or clip reconstruction was not possible, and a bypass procedure was planned. Right frontotemporal craniotomy and orbitotomy was performed. Two aneurysms involving the M1 segment of the MCA were found in line, 1 giant, and the other large in size. The aneurysms were resected and treated with short radial artery interposition graft, which was narrower than the proximal or distal MCA. The child recovered normally, and the bypass was patent after 1 year. Large fusiform MCA aneurysms may be difficult to treat, but there are treatment options that include a bypass procedure. Resection and short interposition radial artery graft is an excellent but rare treatment option in a very young child. This was a very successful treatment in this child.

  9. Surgical treatment for old subaxial cervical dislocation with bilateral locked facets in a 3-year-old girl: A case report.

    Science.gov (United States)

    Li, Cheng; Li, Lei; Duan, Jingzhu; Zhang, Lijun; Liu, Zhenjiang

    2018-05-01

    This study aimed to describe the case of a 3-year-old girl with old bilateral facet dislocation on cervical vertebrae 6 and 7, who had spinal cord transection, received surgical treatment, and achieved a relative satisfactory therapeutic effect. A 3-year-old girl was urgently transferred to the hospital after a car accident. DIAGNOSES:: she was diagnosed with splenic rupture, intracranial hemorrhage, cervical dislocation, spinal transection, and Monteggia fracture of the left upper limb. The girl underwent emergency splenectomy and was transferred to the intensive care unit of the hospital 15 days later. One-stage anterior-posterior approach surgery (anterior discectomy, posterior laminectomy, and pedicle screw fixation) was performed when the patient stabilized after 45-day symptomatic treatment. The operation was uneventful. The reduction of lower cervical dislocation was satisfactory, with sufficient spinal cord decompression. The internal fixation position was good, and the spinal sequence was well restored. The girl was discharged 2 weeks later after the operation and followed up for 2 years. The major nerve function of both upper limbs was recovered, with no obvious retardation of the growth of immature spine. A satisfactory therapeutic effect was achieved for a pediatric old subaxial cervical dislocation with bilateral locked facets using anterior discectomy, posterior laminectomy, and pedicle screw fixation. The posterior pedicle screw fixation provided a good three-dimensional stability of the spine, with reduced risk and complications caused by anterior internal fixation. The growth of immature spine was not obviously affected during the 2-year follow-up.

  10. "Whisking of ugly tissue"… A surgical management of gingival fibromatosis in a 15-year-old girl: A rare case report

    Directory of Open Access Journals (Sweden)

    Srinivasa Tenkasale Siddeshappa

    2015-01-01

    Full Text Available Gingival fibromatosis is a condition characterized by a slow, progressive increase in the gingival tissue that develops as either an isolated disorder or as part of the clinical characteristics of diverse syndrome. The present case report describes a rare case of gingival fibromatosis and its management using scalpel in combination with electrosurgery. A 15-year-old girl patient presented with a chief complaint of gingival overgrowth covering all the surfaces upper and lower teeth. The growth was excised with periodontal knife in combination with electrosurgery under local anesthesia. After 1-year of follow-up, healing was uneventful with no recurrence. Combined technique for the removal of gingival overgrowth represents a unique treatment approach where minimal postoperative bleeding and discomfort were observed.

  11. Aesthetically and functionally satisfying reconstruction of an Achilles tendon and overlying skin defect in a 15 year old girl: a case report.

    Science.gov (United States)

    Wurzer, Paul; Eberl, Robert; Kamolz, Lars-Peter; Parvizi, Daryousch; Rappl, Thomas; Spendel, Stephan

    2015-03-01

    Achilles tendon and overlying soft tissue reconstruction presents an interdisciplinary challenge. In the literature many possible procedures are described, but each reconstruction in this region has its specific demands. Single stage reconstruction is normally pursued, but it is not always the best procedure for the patient, either aesthetically or functionally. We present a case of a 15 year old girl who suffered a soft tissue defect of 10cm×6cm in size at the area of the Achilles tendon due to a contact burn by an exhaust pipe during a motorcycle accident. For this case, reconstruction of the soft tissue defect using a free temporoparietal fascial flap (TPFF) and a full-thickness skin autograft was the best means to provide a satisfying result for both the patient and the surgeon. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  12. Emotional Development: 1 Year Olds

    Science.gov (United States)

    ... Toddler Fitness Nutrition Toilet Training Preschool Gradeschool Teen Young Adult Healthy Children > Ages & Stages > Toddler > Emotional Development: 1 Year Olds Ages & Stages Listen Español Text ...

  13. A Multidisciplinary Approach to a Seven Year-Old Patient with Incontinentia Pigmenti: A Case Report and Five-Year Follow Up

    Directory of Open Access Journals (Sweden)

    Rezvan Rafatjou

    2016-11-01

    Full Text Available Incontinentia pigmenti is a rare inherited disorder involving abnormalities of the skin, hair, eyes, musculoskeletal system, central nervous system, and the teeth. Dental abnormalities are the most common manifestations of this disorder. The purpose of this case report was to present the clinical and radiological findings of a seven-year-old girl as well as the results of her five-year follow up. The patient showed faded linear pigmented macular lesions on the trunk and on upper and lower limbs. Dental examination was notable for conical and peg-shaped anterior teeth as well as delayed eruption of primary and permanent teeth. In addition to conservative treatments, prosthetic treatments such as interim removable partial dentures were indicated for the patient.Keywords: Incontinentia Pigmenti; Dental Prosthesis; Genetic Diseases, Inborn 

  14. Zespół Noonan u 8-letniej pacjentki – opis przypadku = 8 - year - old patient with Noonan syndrome - case report

    Directory of Open Access Journals (Sweden)

    Aleksandra Grabiec

    2016-12-01

    Kierownik: dr hab. n. med. prof. nadzw. Anna Janas-Naze               Adres do korespondencji: Aleksandra Szczepkowska Zakład Chirurgii Stomatologicznej UM w Łodzi 92-213 Łódź, ul. Pomorska 251 e-mail: aleksandra.szczepkowska@gmail.com tel. 42 675 75 71           Praca finansowana przez Uniwersytet Medyczny w Łodzi w ramach działalności statutowej nr 503/2-163-01/503-21-001       Streszczenie: W poniższej pracy opisano przypadek zespołu Noonan u 8- letniej dziewczynki.   Słowa kluczowe: zespół Noonan, rzadkie choroby genetyczne, znieczulenia ogólne     Abstract: The article presents the case of 7 year old girl with Noonan syndrome.   Key words: Noonan syndrome, rare genetic diseases, general anesthesia

  15. Case report of oral cavity infestation in a 3-year old jackass with Limnatis nilotica from Ilam province, west of Iran

    Directory of Open Access Journals (Sweden)

    Mahmoud Bahmani

    2014-06-01

    Full Text Available Leeches (phylum: Annelida, class: hirudinea could infest wide range of livestock such as cow, buffalo, sheep, goat, horse, mule, ass, dog, pig and even human. In November 2013, a 3-year old jackass from Dehloran county, Ilam province, Iran, was infected through his mouth due to drinking spring water. Symptoms including stress, anxiety and tachycardia were seen. After examining oral cavity of jackass, a leech was observed in upper gum. The leech was measured after separation which was three inches in length. The leech was adult which has dark green with orange lines, and it was identified as Limnatis nilotica species. It seems that using spring, subterranean water, pond etc. is the main causes of livestock infestation with leech. Ranchers could be recommended to decontaminate leech waters to prevent further leech infestation cases.

  16. Acute simultaneous bilateral avulsion fractures of the tibial tubercles in a 15-year-old male hurler: case report and literature review.

    LENUS (Irish Health Repository)

    Hanley, C

    2012-02-01

    BACKGROUND: Avulsion fractures of the tibial tubercle are an unusual injury pattern generally occurring in the adolescent male during sporting activities. Bilateral simultaneous fractures are extremely rare. They are often associated with other underlying orthopaedic pathology. AIMS: We present a case of bilateral tibial tubercle avulsions occurring in a 15 year-old male hurler. We describe the management and necessary investigations required for this type of trauma and present a literature review on this rarely encountered injury. CONCLUSION: Although this type of atypical fracture pattern is associated with high energy trauma and other underlying pathology, we have shown that once treated, the patient can expect to make a prompt return to sporting activities with no significant long-term functional deficit.

  17. Surgical Repair of an Impalement Genital Injury from an Inline Skating Accident in a 7-Year-Old Prepubertal Girl: A Case Report.

    Science.gov (United States)

    Csorba, Roland; Engel, Joerg B; Wieg, Christian

    2017-02-01

    In girls who present with vaginal trauma, sexual abuse is often the primary diagnosis. The differential diagnosis must include patterns and the mechanism of injury that differentiate accidental injuries from inflicted trauma. A 7-year-old prepubertal girl presented to the emergency department with genital bleeding after a serious accidental impaling injury from inline skating. After rapid abduction of the legs and a fall onto the blade of an inline skate this child incurred an impaling genital injury consistent with an accidental mechanism. The dramatic genital injuries when repaired healed with almost imperceptible residual evidence of previous trauma. To our knowledge, this case report represents the first in the medical literature of an impaling vaginal trauma from an inline skate and describes its clinical and surgical management. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  18. Extrarenal retroperitoneal Wilms' tumor with subsequent pulmonary and peritoneal metastasis in a 4 year-old girl: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Jinyoung Park

    2016-05-01

    Full Text Available This report describes an extremely rare case of extrarenal Wilms' tumor in a 4 year-old girl who presented with abdominal mass and pain. Computed tomography (CT scanning revealed a well-defined mass lesion measuring 10 cm on the right side of her lower abdomen and pelvic cavity. The mass was surgically removed. Histologically, the tumor showed a triphasic pattern, consisting of stromal, epithelial and blastemal components. Immunohistochemistry showed that the tumor was positive for cytokeratin, vimentin and CD99. The histopathological diagnosis was extrarenal Wilms' tumor arising in the retroperitoneum and inguinal canal. The patient was administered adjuvant chemoradiotherapy due to subsequent pulmonary and peritoneal metastases. Follow-up 4 years later showed that she was doing well, with no recurrence of the tumor.

  19. Case Report: Laparoscopic Approach for Orchiopexy in a 26-Year-Old Man with Accidentally Discovered Persistent Müllerian Duct Syndrome and Bilateral Undescended Testis.

    Science.gov (United States)

    Noureldin, Mohamed Essam; Tawfik, Ahmed Mohamed; Shaker, Hassan S

    2018-01-01

    Background: Persistent Müllerian duct syndrome (PMDS) is not a common form of disorder of sex development in which Müllerian duct derivatives (fallopian tubes, uterus, and the proximal vagina) are present in an otherwise normally differentiated 46 XY male. In most of cases, the challenge comes in the procedure of orchiopexy. Case Presentation: We report a case of a 26-year-old man with PMDS. It was accidentally discovered when the patient presented to our outpatient clinic concerning about his empty scrotum as a premarital check. Diagnostic laparoscopy discovered Mullerian remnants in the form of uterus, cervix, and fallopian tubes with two attached testes to the fallopian tubes. Staged laparoscopic orchiopexy was done. We discuss the presentation, the management of this case in the literature, and our intervention. Conclusion: PMDS is not a common condition. Several concerns present in the management of these cases. Malignant transformation of the testis is the main risk facing those patients. Few literature studies discussed the risk of changing of these remnants into malignant tissue. Thus discussion with the patient, tissue histopathology, expert opinions, and literature review are the main clues in management of such cases.

  20. Pulmonary sclerosing hemangioma in a 21-year-old male with metastatic hereditary non-polyposis colorectal cancer: Report of a case

    Directory of Open Access Journals (Sweden)

    Angele Martin K

    2011-06-01

    Full Text Available Abstract Background Pulmonary sclerosing hemangioma (SH is a rare tumor of the lung predominantly affecting Asian women in their fifth decade of life. SH is thought to evolve from primitive respiratory epithelium and mostly shows benign biological behavior; however, cases of lymph node metastases, local recurrence and multiple lesions have been described. Case Presentation We report the case of a 21-year-old Caucasian male with a history of locally advanced and metastatic rectal carcinoma (UICC IV; pT4, pN1, M1(hep that was eventually identified as having hereditary non-polyposis colorectal cancer (HNPCC, Lynch syndrome. After neoadjuvant chemotherapy followed by low anterior resection, adjuvant chemotherapy and metachronous partial hepatectomy, he was admitted for treatment of newly diagnosed bilateral pulmonary metastases. Thoracic computed tomography showed a homogenous, sharply marked nodule in the left lower lobe. We decided in favor of atypical resection followed by systematic lymphadenectomy. Histopathological analysis revealed the diagnosis of SH. Conclusions Cases have been published with familial adenomatous polyposis (FAP and simultaneous SH. FAP, Gardner syndrome and Li-Fraumeni syndrome, however, had been ruled out in the present case. To the best of our knowledge, this is the first report describing SH associated with Lynch syndrome.