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Sample records for year-old male patient

  1. Peroral Endoscopic Myotomy for the Treatment of Achalasia in a 10-Year-Old Male Patient

    PubMed Central

    Filser, Jörg; Dick, Anke; Meyer, Thomas; Germer, Christoph-Thomas; von Rahden, Burkard H.A.

    2014-01-01

    Peroral endoscopic myotomy (POEM) is a new endoscopic treatment for achalasia with very good short-term results in adults. Data about POEM in pediatric patients are missing. We present the case of a 10-year-old male patient with type I (classic) achalasia, successfully treated with POEM. The procedure was accomplished in a similar fashion to the technique used in adults. Short-term results were fine, with a complete control of dysphagia and absence of reflux. We suggest that POEM is a suitable option in pediatric patients—similar to adults—but long-term results must be awaited. PMID:26171309

  2. Localized lipomatosis of the perineum in a 58-year-old male patient – case report

    PubMed Central

    Ndhlovu, Mathias; Amr, Amro; Schoeller, Thomas; Werdin, Frank

    2015-01-01

    Abstract Lipomatosis of the perineum is an extremely rare condition. We report a localized hypertrophy of adipose tissue of the perineum in a 58-year-old man. The cause of enlargement could not be revealed. Nonetheless, preoperative workup and exclusion of possible malign tumors is essential.

  3. Surgical treatment of temporomandibular disorder in a 24-year-old male patient with ganglion cyst.

    PubMed

    Zheng, Zhi Wei; Shao, Xia; Yang, Chi; Fang, Yi Ming

    2015-03-01

    Ganglion cysts are common pseudocystic masses, whereas those arising from the temporomandibular joint (TMJ) are rare entities. We report a case of ganglion cyst of the right TMJ with symptomatic bilateral TMJ internal derangement in a 24-year-old man. Disk repositioning using bone anchors and excision of the ganglion cyst were performed. A unique characteristic of inflammatory infiltrates was revealed in the specimen, and the relationship between these 2 distinct entities and probable pathogenesis of infectious involvement are discussed. PMID:25643336

  4. Low-tech rehabilitation and management of a 64 year old male patient with acute idiopathic onset of costochondritis

    PubMed Central

    Hudes, Karen

    2008-01-01

    Objective This study was conducted to discuss the treatment and management of a patient presenting with acute idiopathic costochondritis. Case 64 year old male patient presenting with acute anterior chest pain of one week duration. Treatment High-velocity low-amplitude thrust manipulation was used to the zygapophyseal joints of the thoracic spine, costotransverse, and costochondral joints involved. Acupuncture, ischemic compression, cross fibre friction massage techniques, and cryotherapy were utilized on the local area of pain. Specific exercise prescription (low tech rehabilitation) was also utilized. Improvement of pain reported on the Visual Analog Scale was noted with a complete resolution of the condition at the conclusion of treatment. No recurrences were reported on an eleven month follow up of the patient. Conclusion Conservative management, including manipulation and exercise prescription, may be beneficial in the treatment of benign costochondritis. PMID:19066696

  5. Large hepatic adenoma in a 21-year-old male

    PubMed Central

    Martinez-Mier, Gustavo; Enriquez De los Santos, Horacio; Grube-Pagola, Peter

    2013-01-01

    Hepatic adenoma is an uncommon benign lesion of the liver that occurs more frequently in women in their third and fourth decades. The female/male ratio is up to 11:1. Hepatic adenomas may be single or multiple occasionally reaching sizes up to 20 cm. They are non-cancerous lesions, however they can become malignant. We present a 21-year-old male patient with no medical history who presented with abdominal pain, a palpable abdominal mass, abnormal liver function tests and a 14 kg weight loss in a 2-year period. A CT scan was performed with a 17 cm tumour compressing intrahepatic bile ducts. The patient underwent a right hepatectomy with no complications. Histopathological analysis of the tumour revealed a hepatic adenoma with central necrosis. The patient is asymptomatic at 1-year follow-up. PMID:24306431

  6. Thyrotoxic Dysphagia in an 82-year-old male.

    PubMed

    Parperis, Konstantinos; Dadu, Ramona; Hoq, Sheikh; Argento, Vivian

    2011-01-01

    Dysphagia is a common problem in elderly patients and a rare manifestation of Graves' disease. We report a case of an 82-year-old male who presented with a 4-week history of dysphagia and weight loss. Workup for his dysphagia with upper endoscopy, MRI brain, electromyography, acetyl-cholinesterase receptor antibodies, and voltage-gated calcium channel antibodies were negative. Modified Barium swallow test showed oropharyngeal dysphagia. Thyroid function tests that revealed hyperthyroidism and antibodies to TSH-receptor were positive. Based on the above findings, we considered Graves' disease as the most likely diagnosis. Patient was treated with methimazole and beta-blockers and subsequently his dysphagia resolved. This paper highlights the importance to clinicians of considering thyrotoxicosis as possible diagnosis in an elderly patient presenting with unexplained dysphagia. PMID:21317989

  7. Interstitial Lung Disease in Werner Syndrome: A Case Report of a 55-Year-Old Male Patient

    PubMed Central

    Goletto, Tiphaine; Crockett, Flora; Aractingi, Selim; Toper, Cecile; Senet, Patricia; Cadranel, Jacques; Naccache, Jean-Marc

    2015-01-01

    Werner syndrome (WS) is a progeroid or premature aging syndrome characterized by early onset of age-related pathologies and cancer. The average life expectancy of affected people is 52.8 years and tends to increase. The major causes of death are malignancy and myocardial infarction. Increased telomere attrition and decay are thought to play a causative role in the clinical and pathological manifestations of the disease. Although telomere length, with or without germline mutation, is known to be associated with interstitial lung disease, the latter is not associated with WS. To the best of our knowledge, we report the first case describing a WS patient with fatal ILD. This case suggests that older patients with WS could develop ILD. Clinical outcome of WS patients may thus be improved by counselling them regarding smoking cessation or other exposure and by proposing antifibrotic therapy. PMID:26788395

  8. A Case of Early Ocular Manifestation of Maculopathy in a 37 year Old Male Patient of CLL.

    PubMed

    Mehdi, Syed Riaz; Tandon, Nishi; Khan, Sufia Ahmad; Ahmad, Sharique

    2014-09-01

    B cell chronic lymphocytic leukemia (CLL) also called chronic lymphocytic leukemia is a disease of elderly, but in rare cases it can occur in young adults. Majority of patients present with no specific symptoms, and CLL is suspected on the basis of high total and relative lymphocyte counts, discovered on routine blood examination. This patient was referred from medicine outpatient in our institute, Era's Lucknow Medical College & Hospital for routine complete blood count. His total leukocyte count came out to be alarmingly high. The general blood picture and bone marrow examinations were consistent with CLL. On immunophenotyping CD5 and CD23 were positive. His cervical lymph nodes biopsy was reported as a case of CLL/small lymphocytic lymphoma. On his complaint of hazy vision his funduscopy revealed maculopathy. This makes our case a unique and rare one, as maculopathy in a young patient of CLL has not yet been reported from India. PMID:25332614

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

    PubMed Central

    Sharma, Vikas; Nerli, Rajendra B.; Magdum, Prasad V.; Mudegoudra, Abhijith; Hiremath, Murigendra B.

    2015-01-01

    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. PMID:26793547

  10. Finger Fractures as an Early Manifestation of Primary Hyperparathyroidism Among Young Patients: A Case Report of a 30-Year-Old Male With Recurrent Osteoporotic Fractures.

    PubMed

    Ozaki, Akihiko; Tanimoto, Tetsuya; Yamagishi, Eiki; Sato, Shunsuke; Tsukada, Manabu; Sawano, Toyoaki; Leppold, Claire; Tsuda, Kenji; Asakura, Takanori; Tsubokura, Masaharu; Kato, Shigeaki; Kami, Masahiro; Ohira, Hiromichi

    2016-05-01

    Osteoporosis and osteoporotic fractures represent a substantial health burden, and predominantly affect the elderly. Younger generations may also develop these conditions because of various predisposing conditions, including primary hyperparathyroidism. However, little information is available regarding early skeletal manifestations of primary hyperparathyroidism.A 30-year-old Japanese male presented with pain in his left wrist, and was diagnosed with a distal radius fracture. During surgery, we noticed decreased bone strength of the fracture site. Further investigation found osteoporosis and primary hyperparathyroidism owing to a solitary parathyroid adenoma, which was resected without significant complications. History revealed that the patient suffered a metacarpal bone fracture of his right fifth bone 6 months earlier. Although serial x-rays at that time had shown rapidly developed cortical bone erosion around the fractured finger, the possibility of primary hyperparathyroidism was overlooked because of poor awareness of the condition, leading to a 6-month delay in the diagnosis of primary hyperparathyroidism.Clinicians should be aware that finger fractures may be an early skeletal manifestation of primary hyperparathyroidism that can help achieve a prompt diagnosis of the condition, especially when they occur in young adults in the absence of major trauma. PMID:27196476

  11. A 9-year-old male with hypertension.

    PubMed

    Poole, Nicole; Schwab, Joel; Hageman, Joseph

    2015-01-01

    Blood pressure screening is an important component of the pediatric outpatient visit. The following case describes a 9-year-old male with a medical history significant for prematurity, obesity, asthma, and secondary nighttime enuresis who was admitted to our institution with hypertensive urgency. His blood pressure on presentation was 166/122 mm Hg, and he was clinically asymptomatic. There is a strong family history of hypertension, renal disease, and brain cancer. During his admission, his blood pressures were medically managed. He received a comprehensive diagnostic investigation of possible primary or secondary causes of hypertension, including consultation with nephrology, endocrinology, and ophthalmology subspecialty teams. The etiology of the hypertension was determined, and he was subsequently treated for a rare and life-threatening disease. This case highlights the importance of the close surveillance of children with hypertension. PMID:25621628

  12. Inflammatory cap polyposis in a 42-year-old male

    PubMed Central

    Mason, Meredith; Faizi, Syed Adeel; Fischer, Edgar; Rajput, Ashwani

    2013-01-01

    INTRODUCTION Inflammatory cap polyposis (CP) is an uncommon, non-malignant condition whose pathogenesis is poorly understood. Initial presentation of CP may mimic other gastrointestinal conditions like inflammatory bowel disease, pseudomembranous colitis, irritable bowel syndrome, and colon cancer. PRESENTATION OF CASE A 42-year-old male presented with symptoms of constipation, abdominal pain and weight loss, which were suggestive of a malignancy. DISCUSSION Since the symptoms of CP resemble closely those of other gastrointestinal diseases, particularly colon cancer, making the initial diagnosis can be challenging and it is often delayed. The mainstay of initial treatment is conservative, however symptomatic and complicated cases require prompt surgical intervention with close clinical follow-up. CONCLUSION We chose to report this case because it represents a rare and unique disease process that may masquerade as a colon cancer. It is important for surgeons to be aware of this non-malignant condition since inadequate surgery usually results in recurrence. PMID:23416507

  13. Iridocorneal Endothelial Syndrome in a 14-Year-Old Male.

    PubMed

    Aponte, Elisabeth P; Ball, David C; Alward, Wallace L M

    2016-02-01

    The iridocorneal endothelial syndrome is a rare cause of unilateral glaucoma that is almost never seen in children. We report a case of iridocorneal endothelial in a 14-year-old boy who did not yet have ocular hypertension or glaucoma. PMID:26035422

  14. Delayed diagnosis of endobronchial mucoepidermoid carcinoma in a 29-year-old male.

    PubMed

    Jain, Akanksha; Madan, Neha Kawatra; Arava, Sudheer; Pandey, Durgatosh; Madan, Karan

    2016-01-01

    Mucoepidermoid carcinoma (MEC) is an uncommon primary lung tumor. It usually involves large airways and presents clinically and radiologically with nonspecific features. Because of nonspecific presentation diagnosis is frequently delayed. We report the case of a 29-year-old male patient wherein a clinico-radiological consideration of tuberculosis (TB) led to a prolonged treatment with anti-TB medications without response. Flexible bronchoscopic biopsy confirmed the diagnosis of MEC following that the patient underwent curative surgical resection. PMID:27186000

  15. Delayed diagnosis of endobronchial mucoepidermoid carcinoma in a 29-year-old male

    PubMed Central

    Jain, Akanksha; Madan, Neha Kawatra; Arava, Sudheer; Pandey, Durgatosh; Madan, Karan

    2016-01-01

    Mucoepidermoid carcinoma (MEC) is an uncommon primary lung tumor. It usually involves large airways and presents clinically and radiologically with nonspecific features. Because of nonspecific presentation diagnosis is frequently delayed. We report the case of a 29-year-old male patient wherein a clinico-radiological consideration of tuberculosis (TB) led to a prolonged treatment with anti-TB medications without response. Flexible bronchoscopic biopsy confirmed the diagnosis of MEC following that the patient underwent curative surgical resection. PMID:27186000

  16. Transient Unexplained Shock in 30-year-old Trauma Patient.

    PubMed

    Rahmani, Farzad; Ebrahimi Bakhtavar, Hanieh; Shahsavari Nia, Kavous; Mohammadi, Neda

    2014-01-01

    Shock as an inadequate tissue perfusion is one of the frequent causes of death in trauma patients. In this context, there are various reasons for hemodynamic instability and shock including hypovolemic (hemorrhagic), obstructive (cardiac tamponade, tension pneumothorax), cardiogenic, neurogenic, and rarely septic. In the present report, a 30-year-old trauma patient with full clinical signs and symptoms of shock referred while had unknown origin; it was finally recognized as anaphylactic shock. PMID:26495357

  17. Anomalous Left Anterior Descending Coronary Artery Arising from Pulmonary Artery in a 63 Year-old Male Patient: Case Report and Literature Review

    PubMed Central

    Ismail, Montasser Y.; Nassar, Mohammed I.; Hamad, Mohammed A.

    2015-01-01

    To present a case of a rare congenital coronary anomaly in an adult patient, which was not reported before in Palestine, review the literature, and compare with previously reported cases. PMID:27326352

  18. Incidental Diagnosis of Bladder Cancer in a 17-year-old Patient.

    PubMed

    Facio, Fernando Nestor; Facio, Maria Fernanda W; Spessoto, Luis Cesar F; Gatti, Marcio; Ferraz Arruda, Pedro F; Ferraz Arruda, Jose G; Gabriotti, Luis Francisco B; Polotto, Pedro Paulo Silva L

    2015-07-01

    Bladder cancer is the fourth most common type of cancer among males and the ninth most common cause of cancer death. Bladder cancer can occur at any age. This paper reports the incidental diagnosis of bladder cancer in a 17-year-old female patient. Data on bladder cancer at this age are uncommon in the literature. PMID:26793515

  19. [Fascicular ventricular tachycardia in a 49-year-old patient].

    PubMed

    Bellmann, Barbara; Nagel, Patrick; Tscholl, Verena; Roser, Mattias; Rillig, Andreas

    2016-06-01

    We report a 49-year-old patient who presented with tachycardia in our emergency room. The 12-lead ECG showed a wide complex tachycardia with a heart rate of 234 beats per minute. After structural heart disease was excluded via echocardiography, coronary angiography and magnetic resonance imaging, an electrophysiological study was performed. During programmed ventricular stimulation, a fascicular tachycardia was induced, which was successfully treated by radiofrequency ablation. Fascicular ventricular tachycardia is a rare tachycardia that occurs in patients without structural heart disease. Radiofrequency ablation can be performed safely and shows a high success rate. Differential diagnoses of fascicular ventricular tachycardias are substrate-based ventricular tachycardia and supraventricular tachycardia. PMID:27193769

  20. [65-year old female patient with persistent hypercalcemia].

    PubMed

    Wiedmann, M; Kassahun, W; Deckert, F; Tröltzsch, M; Sturmvoll, M; Führer, D

    2007-12-01

    A 65-year old patient presented with newly diagnosed hypercalcemia and elevated parathyroid hormone levels. Exploration of parathyroid glands was performed under the diagnosis of primary hyperparathyroidism and was combined with thyreoidectomy due to concomittant multinodular goiter. However, no parathyroid adenoma was identified despite careful exploration. Therefore, the operation was terminated and an ectopic adenoma was suspected. A (99m)Tc-sestamibi scintigraphy with SPECT, neck ultrasound, neck CT scan with contrast media and selective venous sampling were performed for further localization of the adenoma. A single adenoma localized in the submandibular area of the left jaw was suspected and confirmed during surgical reexploration. Postoperatively, parathyroid hormone levels were below detection level and the patient required short-term calcium supplementation for symptomatic hypocalcemia. PMID:17965847

  1. Colosplenopleural fistula: An unusual colonic fistula in a 44-year-old male with Crohn's disease

    PubMed Central

    Winter, Michael W.; Lee, Steven

    2015-01-01

    A 44-year-old male with a history of well-controlled human immunodeficiency virus disease and Crohn's disease presented with fever, cough, and left-sided chest pain with radiation to his back. His medical history was notable for a medically managed spontaneous microperforation of the colon at the splenic flexure 30 months prior, and recurrent left-lower-lobe pneumonia with empyema and a splenic abscess within the past 24 months. CT demonstrated a complex left pleural fluid collection with fistulous connection through the spleen and into the large bowel. The patient tolerated a diverting loop ileostomy without complications and was discharged home with plans for resection of the fistulous tract and splenectomy in several months.

  2. Influenza Vaccine-Induced CNS Demyelination in a 50-Year-Old Male

    PubMed Central

    Sacheli, Aaron; Bauer, Raymond

    2014-01-01

    Patient: Male, 50 Final Diagnosis: Acute post-vaccination CNS demyelinating disorder Symptoms: Blurred vision • hemiparesis • hemiplegia • hypertonia • itching • paresthesia Medication: — Clinical Procedure: MRI Specialty: Neurology Objective: Rare disease Background: There are several categories of primary inflammatory demyelinating disorders, which comprise clinically similar neurologic sequelae. Of interest, clinically isolated syndrome (CIS) and acute disseminated encephalomyelitis (ADEM) are 2 demyelinating conditions of the central nervous system (CNS), whose clinical similarity pose a significant challenge to definitive diagnosis. Yet, both remain important clinical considerations in patients with neurologic signs and symptoms in the context of recent vaccination. Case Report: We report a case of a 50-year-old Caucasian male with a course of progressive, focal, neurologic deficits within 24 h after receiving the influenza vaccine. Subsequent work-up revealed the possibility of an acute central nervous system (CNS) demyelinating episode secondary to the influenza vaccine, best described as either CIS or ADEM. Conclusions: Case reports of CNS demyelination following vaccinations have been previously noted, most often occurring in the context of recent influenza vaccination. This report serves to document a case of CNS demyelination occurring 24 h after influenza vaccination in a middle-aged patient, and will describe some salient features regarding the differential diagnosis of CIS and ADEM, as well as their potential management. PMID:25175754

  3. Long-term survival of full trisomy 13 in a 14 year old male: a case report.

    PubMed

    Imataka, G; Hagisawa, S; Nitta, A; Hirabayashi, H; Suzumura, H; Arisaka, O

    2016-03-01

    Long term survival for the cases of trisomy 13 into over a first decade is very rare. We reported here the case of a 14-year-old male karyotype with full type of trisomy 13. In this clinical phenomenon, the case had typical facial, finger and limb anomalies for trisomy 13. Arterial septal defect and patent ductus arteriosus were recognized using ultrasonography after birth. Major cerebral malformation such as holoprosencephaly or cerebellar hypoplasia were also not revealed. After 5 months of his age, artificial ventilation therapy for dyspnea associated with laryngomalacia was required. A tracheotomy was performed at 6 months of his age. After 12 years old, intractable partial epilepsy was recognized. For his partial seizures, a treatment with a combination of two anti-epileptic drugs, valproic acid and levetiracetam, were advised. Now he is alive for 14-years-old and he is the 4th longest surviving patient with full karyotype of trisomy 13. PMID:27010151

  4. Pyogenic liver abscess caused by Fusobacterium in a 21-year-old immunocompetent male.

    PubMed

    Ahmed, Zohair; Bansal, Saurabh K; Dhillon, Sonu

    2015-03-28

    A 21-year-old male with no significant past medical history, presented with right upper quadrant (RUQ) abdominal pain along with fevers and chills. Lab work revealed leukocytosis, anemia, and slightly elevated alkaline phosphatase. Viral serology for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus were negative and he was immunocompetent. Computed tomography imaging revealed hepatic abscesses, the largest measuring 9.5 cm. Empiric antibiotics were started and percutaneous drains were placed in the abscesses. Anaerobic cultures from the abscesses grew Fusobacterium nucleatum. This is a gram negative anaerobic bacteria; a normal flora of the oral cavity. Fusobacterium is most commonly seen in Lemiere's disease, which is translocation of oral bacteria to the internal jugular vein causing a thrombophlebitis and subsequent spread of abscesses. Our patient did not have Lemiere's, and is the first case described of fusobacterium pyogenic liver abscess in a young immunocompetent male with good oral hygiene. This case was complicated by sepsis, empyema, and subsequent abscesses located outside the liver. These abscesses' have the propensity to flare abruptly and can be fatal. This case not only illustrates fusobacterium as a rare entity for pyogenic liver abscess, but also the need for urgent diagnosis and treatment. It is incumbent on physicians to diagnose and drain any suspicious hepatic lesions. While uncommon, such infections may develop without any overt source and can progress rapidly. Prompt drainage with antibiotic therapy remains the cornerstone of therapy. PMID:25834342

  5. Pyogenic liver abscess caused by Fusobacterium in a 21-year-old immunocompetent male

    PubMed Central

    Ahmed, Zohair; Bansal, Saurabh K; Dhillon, Sonu

    2015-01-01

    A 21-year-old male with no significant past medical history, presented with right upper quadrant (RUQ) abdominal pain along with fevers and chills. Lab work revealed leukocytosis, anemia, and slightly elevated alkaline phosphatase. Viral serology for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus were negative and he was immunocompetent. Computed tomography imaging revealed hepatic abscesses, the largest measuring 9.5 cm. Empiric antibiotics were started and percutaneous drains were placed in the abscesses. Anaerobic cultures from the abscesses grew Fusobacterium nucleatum. This is a gram negative anaerobic bacteria; a normal flora of the oral cavity. Fusobacterium is most commonly seen in Lemiere’s disease, which is translocation of oral bacteria to the internal jugular vein causing a thrombophlebitis and subsequent spread of abscesses. Our patient did not have Lemiere’s, and is the first case described of fusobacterium pyogenic liver abscess in a young immunocompetent male with good oral hygiene. This case was complicated by sepsis, empyema, and subsequent abscesses located outside the liver. These abscesses’ have the propensity to flare abruptly and can be fatal. This case not only illustrates fusobacterium as a rare entity for pyogenic liver abscess, but also the need for urgent diagnosis and treatment. It is incumbent on physicians to diagnose and drain any suspicious hepatic lesions. While uncommon, such infections may develop without any overt source and can progress rapidly. Prompt drainage with antibiotic therapy remains the cornerstone of therapy. PMID:25834342

  6. [Methanol poisoning in a 61-year old male with recently diagnosed diabetes--a case report].

    PubMed

    Szponar, Jarosław; Górska, Agnieszka; Majewska, Magdalena; Tchórz, Michał; Drelich, Grzegorz

    2011-01-01

    The aim of this paper is to present a case of a 61-year-old male transferred to the Regional Center of Clinical Toxicology from the Department of Endocrinology with suspected methanol poisoning. The patient presented symptoms of diabetes with extreme hyperglycemia >1600 mg/dl and nonketotic hyperosmolar coma. Laboratory tests showed metabolic/respiratory acidosis, methanol 80 mg/dl, ethanol 0.47 g/l, creatinine 3.5 mg/dl, urea 140 mg/dl, lactic acid 4.11 mmol/l, myoglobin >1000 ng/ml, HbA1C >14.5%. During a few days prior to the hospitalization the patient was drinking a great amount of fruit juices and milk (a dozen or so litres per twenty four hours). The eventuality of metabolizing glucose and aspartame into methanol is known from professional literature. The possibility of excessive consumption of aspartame and its metabolites causing methanol poisoning in the presented patient was considered. PMID:22010455

  7. A 26-year-old male with mesothelioma due to asbestos exposure.

    PubMed

    Zarogoulidis, P; Orfanidis, M; Constadinidis, T C; Eleutheriadou, E; Kontakiotis, T; Kerenidi, T; Sakkas, L; Courcoutsakis, N; Zarogoulidis, K

    2011-01-01

    Mesothelioma is a malignancy with poor prognosis, with an average 5-year survival rate being less than 9%. This type of cancer is almost exclusively caused by exposure to asbestos. A long exposure can cause mesothelioma and so can short ones, as each exposure is cumulative. We report a case of a 26-year-old male who was exposed to asbestos during his primary school years from the age of 6 to 12. Although the tumor mainly affects older men who in their youth were occupationally exposed to asbestos, malignant mesothelioma can also occur in young adults. A medical history was carefully taken and asbestos exposure was immediately mentioned by the patient. We conducted biopsy on the right supraclavicular lymph node. The patient was not a candidate for surgery, and chemotherapy treatment was initiated. While patient's chemotherapy is still ongoing, no other similar cases of students or teachers have been traced up to date from his school. The school building was demolished in January 2009. PMID:21776278

  8. A 26-Year-Old Male with Mesothelioma Due to Asbestos Exposure

    PubMed Central

    Zarogoulidis, P.; Orfanidis, M.; Constadinidis, T. C.; Eleutheriadou, E.; Kontakiotis, T.; Kerenidi, T.; Sakkas, L.; Courcoutsakis, N.; Zarogoulidis, K.

    2011-01-01

    Mesothelioma is a malignancy with poor prognosis, with an average 5-year survival rate being less than 9%. This type of cancer is almost exclusively caused by exposure to asbestos. A long exposure can cause mesothelioma and so can short ones, as each exposure is cumulative. We report a case of a 26-year-old male who was exposed to asbestos during his primary school years from the age of 6 to 12. Although the tumor mainly affects older men who in their youth were occupationally exposed to asbestos, malignant mesothelioma can also occur in young adults. A medical history was carefully taken and asbestos exposure was immediately mentioned by the patient. We conducted biopsy on the right supraclavicular lymph node. The patient was not a candidate for surgery, and chemotherapy treatment was initiated. While patient's chemotherapy is still ongoing, no other similar cases of students or teachers have been traced up to date from his school. The school building was demolished in January 2009. PMID:21776278

  9. Tanycytic ependymoma in a 76-year-old Puerto Rican male.

    PubMed

    Ortiz, Yvis del Mar; Pérez Berenguer, Juan L; Mercado Acosta, Juan; Polo, Mario; de Jesús-Garces, Orlando; Vega, Irving E

    2014-01-01

    Ependymoma is a slowly growing tumor in children and young adults originating from the wall of the ventricles or from the spinal canal that is composed of neoplastic ependymal cells. Tanycytic ependymoma is a rare variant of ependymoma usually arising in the intra medullary spine. The World Health Organization classifies the tanycytic ependymoma as a grade II tumor. The diagnosis of tanycytic ependymoma is challenging since the morphology of the lesions resemble those found in schwannoma and astrocytomas. In the present study, we show a case of a 76 years old male with a progressive paraparesis for 8 years, due to a spinal tumor. Radiological and histological studies were used to classify the tumor as tanycytic ependymoma. Therefore, it is important to be aware of tanycytic ependymoma and its immunohistochemistry profile in older patients, especially within the Caribbean Hispanic population. To our knowledge this is the oldest patient known to have this rare tumor and the first case reported in Puerto Rico. PMID:25550817

  10. Niemann-Pick Disease Type B in a 21 Year Old Male.

    PubMed

    Haque, M A; Miah, M Z

    2016-04-01

    Niemann-pick disease is a group of autosomal recessive disorder of lipid storage with progressive accumulation of sphingomyelin and other lipids in the lysosomes of various tissues. We are reporting a 21 year old male who had hepatosplenomegaly, cherry red macula and normal cognitive function. Bone marrow biopsy showed plenty of foam cells and sphingomyelinase level was low, thus conforming our diagnosis. Survival into adulthood and absence of gross neurological involvement suggests Niemann-Pick disease type B. PMID:27277377

  11. [28-year-old patient with iron deficiency anemia].

    PubMed

    Pavlov, N; Strebel, B M; Brill, A - K; Schmidtko, J; Cottagnoud, P; Stucki, A N

    2013-02-13

    We report the case of a 28-years-old woman with Turner's syndrome and iron deficiency anaemia. The faecal occult blood test was intermittently positive whereas earlier upper and lower endoscopy revealed no source of bleeding. Capsule endoscopy showed multiple vascular malformations on the jejunum and ileum. Our case report emphasizes the importance of capsule endoscopy in the localising occult bleedings in the small bowel. We discuss the different diagnostic modalities and possible treatments. PMID:23399608

  12. A 33-year-old male patient with paternal derived duplication of 14q11.2-14q22.1~22.3: clinical course, phenotypic and genotypic findings.

    PubMed

    Wannenmacher, Bardo; Mitter, Diana; Kießling, Franziska; Liehr, Thomas; Weise, Anja; Siekmeyer, Manuela; Kiess, Wieland

    2016-05-01

    We report on a 33-year-old patient with mosaic interstitial duplication on chromosome 14q11.2-14q22.1~22.3 with severe physical and mental retardation and multiple dysmorphisms. This patient was admitted to our pediatric hospital due to severe dehydration and malnutrition as a result of food refusal. It is an actual phenomenon that patients with severe inborn clinical problems nowadays survive due to progress and care of modern medicine. Nevertheless, transition from pediatric care to adult medicine seems to remain a challenging problem. We demonstrate the clinical course as well as clinical and genetic findings of this adult patient. Comparisons are made to previously reported cases with mosaic trisomy 14 involving a proximal interstitial duplication on the long arm of chromosome 14. PMID:26824977

  13. Meniscal allograft transplant in a 16-year-old male soccer player: A case report

    PubMed Central

    Menta, Roger; Howitt, Scott

    2014-01-01

    Meniscal allograft transplantation (MAT) is a relatively new procedure that has gained popularity in the last couple of decades as a possible alternative to a meniscectomy to provide significant pain relief, improve function, and prevent the early onset of degenerative joint disease (DJD). As of present, evidence is limited and conflicting on the success of such procedures. In this case, a 16-year old male athlete underwent numerous surgical procedures to correct a left anterior cruciate ligament (ACL) rupture with associated medial and lateral meniscal damage that occurred as a result of a non-contact mechanism of injury. Following multiple procedures, including repair of both menisci and follow-up partial meniscectomy of the lateral meniscus, the patient continued to experience symptoms on the left lateral knee, making him a candidate for MAT. This case is used to highlight what a MAT is, what makes someone a candidate for this type of procedure, the current evidence surrounding the success of this intervention, and some rehabilitation considerations following surgery. The role of chiropractors and primary clinicians is to ensure that young athletes undergo early intervention to offset any degenerative changes that would be associated with sustained meniscal lesions. PMID:25550669

  14. Meniscal allograft transplant in a 16-year-old male soccer player: A case report.

    PubMed

    Menta, Roger; Howitt, Scott

    2014-12-01

    Meniscal allograft transplantation (MAT) is a relatively new procedure that has gained popularity in the last couple of decades as a possible alternative to a meniscectomy to provide significant pain relief, improve function, and prevent the early onset of degenerative joint disease (DJD). As of present, evidence is limited and conflicting on the success of such procedures. In this case, a 16-year old male athlete underwent numerous surgical procedures to correct a left anterior cruciate ligament (ACL) rupture with associated medial and lateral meniscal damage that occurred as a result of a non-contact mechanism of injury. Following multiple procedures, including repair of both menisci and follow-up partial meniscectomy of the lateral meniscus, the patient continued to experience symptoms on the left lateral knee, making him a candidate for MAT. This case is used to highlight what a MAT is, what makes someone a candidate for this type of procedure, the current evidence surrounding the success of this intervention, and some rehabilitation considerations following surgery. The role of chiropractors and primary clinicians is to ensure that young athletes undergo early intervention to offset any degenerative changes that would be associated with sustained meniscal lesions. PMID:25550669

  15. Juvenile Osteochondritis Dissecans in a 13-year-old male athlete: A case report

    PubMed Central

    D’Angelo, Kevin; Kim, Peter; Murnaghan, M. Lucas

    2014-01-01

    Objective: To present the clinical management of juvenile osteochondritis dissecans (OCD) of the knee and highlight the importance of a timely diagnosis to optimize the time needed for less invasive, non-operative therapy. Clinical Features: A 13-year-old provincial level male soccer player presenting with recurrent anterior knee pain despite ongoing manual therapy. Intervention and Outcome: A multidisciplinary, non-operative treatment approach was utilized to promote natural healing of the osteochondral lesion. The plan of management consisted of patient education, activity modification, manual therapy, passive modalities and rehabilitation, while being overseen by an orthopaedic surgeon. Conclusions: Considering the serious consequences of misdiagnosing osteochondritis dissecans, such as the potential for future joint instability and accelerated joint degeneration, a high degree of suspicion should be considered with young individuals presenting with nonspecific, recurrent knee pain. A narrative review of the literature is provided to allow practitioners to apply current best practices to appropriately manage juvenile OCD and become more cognizant of the common knee differential diagnoses in the young athletic population. PMID:25550663

  16. A 27-Year-Old Patient Fulfilling the Diagnostic Criteria of Both CMML and JMML

    PubMed Central

    Manzoor, Mohmmed U.; AlMishari, Mai A.; Ibrahim, Mamoun H.

    2016-01-01

    Chronic myelomonocytic leukaemia (CMML) and juvenile myelomonocytic leukaemia (JMML) are two disease entities that come under the myelodysplastic/myeloproliferative neoplasms category. Each of the two conditions has its own diagnostic criteria. In addition, they have different ages of presentation; while CMML is typically a disease of the elderly, JMML is a disease of young children. Here we are presenting the case of a 27-year-old male patient who, at the time of diagnosis, fulfilled the diagnostic criteria of both diseases. In addition he had radiological changes of type 1 neurofibromatosis. Possible explanations of the patient case have been discussed. PMID:27034866

  17. Histiocytic Sarcoma Originating in the Lung in a 16-Year-Old Male.

    PubMed

    Tomita, Sakura; Ogura, Go; Inomoto, Chie; Kajiwara, Hiroshi; Masuda, Ryota; Iwazaki, Masayuki; Kojima, Masaru; Nakamura, Naoya

    2015-01-01

    We report a 16-year-old male with histiocytic sarcoma (HS) originating in the lung. Partial resection of the lung was performed for a 3-cm mass with a clear boundary detected in the right inferior pulmonary lobe on a health checkup. Histologically, the tumor infiltrated into the surrounding tissue, and was comprised of spindle cells, mainly, and foam cells accompanied by mild nuclear atypia. The tumor cells were immunohistochemically positive for CD68 and CD163, indicating histiocytic lineage and the MIB-1-positive rate was low. Spindle cell morphology of HS is quite rare and only 3 cases of pulmonary HS have previously been reported. PMID:26106007

  18. Trapped lung secondary to cardiomegaly in a 78 year-old male with congestive heart failure

    PubMed Central

    Amabile, Amy H.; Moffatt-Bruce, Susan D.; DePhilip, Robert M.

    2016-01-01

    Although the etiologies of both trapped lung and cardiomegaly are well-established, co-presentation of the two conditions, and possible interactions between them, are much rarer. Here we describe the case of 78 year-old male found to have both cardiomegaly and trapped lung, with a cause of death of congestive heart failure and subsequent cardiac arrest. This case prompted consideration of possible interactions between the two conditions. Issues related to decision-making for imaging and clinical interventions are also discussed. PMID:27054087

  19. Trapped lung secondary to cardiomegaly in a 78 year-old male with congestive heart failure.

    PubMed

    Amabile, Amy H; Moffatt-Bruce, Susan D; DePhilip, Robert M

    2016-01-01

    Although the etiologies of both trapped lung and cardiomegaly are well-established, co-presentation of the two conditions, and possible interactions between them, are much rarer. Here we describe the case of 78 year-old male found to have both cardiomegaly and trapped lung, with a cause of death of congestive heart failure and subsequent cardiac arrest. This case prompted consideration of possible interactions between the two conditions. Issues related to decision-making for imaging and clinical interventions are also discussed. PMID:27054087

  20. Heel pain due to psoriatic arthritis in a 50 year old recreational male athlete: case report

    PubMed Central

    Yedon, Dominique Forand; Howitt, Scott

    2011-01-01

    Heel pain is a common presentation in a sports injury practice, with a list of common differentials including achilles tendinopathy and retrocalcaneal bursitis. However, seronegative arthritis can also cause enthesopathies that produce heel pain and should be considered in a differential diagnosis list. In this case, a 50 year old recreationally active male presented with non-traumatic insidious heel pain and without history of any skin conditions or any other symptoms of seronegative spondyloarthritis. Clinical suspicion led to laboratory testing and radiographs/bone scan which yielded the diagnosis of psoriatic arthritis. PMID:22131565

  1. Cytogenetic and clinical features of a 13 year old male with trisomy 8

    PubMed Central

    Balkan, Mahmut; Fidanboy, Mehmet; Özmen, Cihan; Özbek, M. Nuri; Otçu, Selçuk; Kapı, Emin; Budak, Turgay

    2012-01-01

    Trisomy 8 is a relatively rare chromosomal abnormality. The majority of cases present with the mosaic form. Regular trisomy 8 is usually lethal and frequently results in miscarriage, while those with “trisomy 8 mosaicism” are more likely to survive. We report clinical observations and cytogenetic studies of a 13-year-old male with regular trisomy 8 and compared with those of other known cases of trisomy 8. The most discriminating findings for this condition are skeletal anomalies, restricted articular function, and speech problems. Our results are in agreement with those of previous studies for trisomy 8.

  2. A 52-Year-Old Male with Bilaterally Duplicated Collecting Systems with Obstructing Ureteral Stones: A Case Report

    PubMed Central

    Scantling, Dane; Ross, Curtis; Altman, Howard

    2013-01-01

    Collecting system duplication is marked by a variety of clinical syndromes. Bilateral and obstructed duplicated systems, particularly with asymmetric levels of duplication, are rare and typically due to ureteric bud development anomalies. The infrequency with which this condition exists makes it a formidable challenge for physicians and patients. To our knowledge, we present the first case report of bilateral obstruction of bilaterally duplicated collecting systems. In our case, a 52-year-old male complaining of low back pain, constipation, urinary urgency and hematuria was found to have bilateral obstructing stones as well as asymmetrical bilateral collecting system duplication. We discuss the natural history of this condition, its consequences and identification. PMID:24917767

  3. Tuberculosis of symphysis pubis in a 17 year old male: a rare case presentation and review of literature.

    PubMed

    Bali, Kamal; Kumar, Vishal; Patel, Sandeep; Mootha, Aditya K

    2010-01-01

    Tuberculosis of symphysis pubis is a rare condition with hardly any report of such cases in the last decade. It is necessary to distinguish the entity from more common ones like Osteitis pubis and Osteomyelitis of pubis symphysis by urgent means in order to start the treatment early and thereby minimize morbidity and prevent complications. A rare case of tuberculosis of symphysis pubis in a 17 year old male is described. A high index of suspicion along with an extensive workup including 3-phase bone scan and fine needle aspiration led to the diagnosis. The patient had an excellent outcome following a complete course of multidrug chemotherapy for tuberculosis. PMID:20799960

  4. A 5-year-old male child with late infantile metachromatic leukodystrophy: a case report.

    PubMed

    Mahmood, Afreen; Chacham, Swathi; Reddy, Uppin Narayan; Rao, Jillalla Narsing; Rao, S Pratap

    2015-03-01

    Metachromatic leukodystrophy is a rare disorder of myelin metabolism. This degenerative disorder results from the accumulation of cerebroside sulfatide within the myelin sheath of central and peripheral nervous system, due to deficiency of aryl sulfatase A enzyme. We report a 5-year-old male child, who presented with regression of milestones, recurrent seizures and spasticity from second year of life. Initially neurodegenerative disorder was considered and the case was investigated with neuroimaging and enzyme levels. Computed tomography (CT) of the brain showed hypodensities in the corpus callosum and bilateral periventricular and deep cerebral white matter suggestive of neurodegenerative disorder. Subsequently, magnetic resonance imaging (MRI) of the brain was done, which showed symmetrical hyperintensities in the periventricular white matter with classical sparing of subcortical "U" fibers. The β-galactosidase enzyme activity was normal; however, the activity of aryl sulfatase A enzyme was undetectable, confirming the diagnosis of late infantile variant of metachromatic leukodystrophy. PMID:25117420

  5. Colonic Spirochetosis in a 60-Year-Old Immunocompetent Patient

    PubMed Central

    Ngwa, Taiwo; Peng, Jennifer L.; Choi, Euna; Tayarachakul, Sucharat; Liangpunsakul, Suthat

    2016-01-01

    Spirochetes, a genetically and morphologically distinct group of bacteria, are thin, spiral-shaped, and highly motile. They are known causes of several human diseases such as syphilis, Lyme disease, relapsing fever, and leptospirosis. We report a case of colonic spirochetosis in a healthy patient presenting for surveillance colonoscopy. The diagnosis of intestinal spirochetosis was made accidentally during the histological examination of colonic polyps, which were removed during colonoscopy. We also performed an extensive review on intestinal spirochetosis with a focus on clinical presentation and outcomes of reported cases from the past two decades. PMID:27570780

  6. Lyme disease: a case report of a 17-year-old male with fatal Lyme carditis.

    PubMed

    Yoon, Esther C; Vail, Eric; Kleinman, George; Lento, Patrick A; Li, Simon; Wang, Guiqing; Limberger, Ronald; Fallon, John T

    2015-01-01

    Lyme disease is a systemic infection commonly found in the northeastern, mid-Atlantic, and north-central regions of the United States. Of the many systemic manifestations of Lyme disease, cardiac involvement is uncommon and rarely causes mortality. We describe a case of a 17-year-old adolescent who died unexpectedly after a 3-week viral-like syndrome. Postmortem examination was remarkable for diffuse pancarditis characterized by extensive infiltrates of lymphocytes and focal interstitial fibrosis. In the cardiac tissue, Borrelia burgdorferi was identified via special stains, immunohistochemistry, and polymerase chain reaction. The findings support B. burgdorferi as the causative agent for his fulminant carditis and that the patient suffered fatal Lyme carditis. Usually, Lyme carditis is associated with conduction disturbances and is a treatable condition. Nevertheless, few cases of mortality have been reported in the literature. Here, we report a rare example of fatal Lyme carditis in an unsuspected patient. PMID:25864163

  7. Unilateral hemothorax in a 46 year old South Indian male due to a giant arteriovenous hemodialysis fistula: a case report.

    PubMed

    Salim, Shihas; Ganeshram, Prasanthi; Patel, Amish Dilip; Kumar, Anita A; Vemuri, Divya; Jeyachandran, Vijay; Rajamanickam, Deepan; Shantha, Ghanshyam Palamaner Subash

    2008-01-01

    In a patient undergoing regular hemodialysis through an arteriovenous fistula access, pleural effusion is a known long term complication. However, a unilateral hemothorax is relatively uncommon. Here we report a 46 year old male, end-stage renal disease patient, on maintenance hemodialysis, who presented with a giant brachiocephalic AV fistula in his left arm and progressive breathlessness. Radiological imaging revealed a left sided pleural effusion. Ultrasound guided aspiration revealed a hemorrhagic pleural fluid. A Doppler study of the fistula revealed a high velocity blood flow through the fistula, thereby establishing the cause of the unilateral hemothorax. Ligation of the fistula resulted in complete resolution of the hemothorax. The other possible causes for hemothorax in a dialysis patient are also discussed in this case report. PMID:18840271

  8. Xanthogranulomatous Adrenalitis: A Case Report of a Diabetic, 55-Year-Old Male.

    PubMed

    Reed, Caitlyn Trotter; Adams, Kristen; Shenoy, Veena

    2015-09-01

    We report a rare case of xanthogranulomatous adrenalitis in a 55-year-old man. The patient presented to the hospital with fever, nausea, and right flank pain. His medical history was significant for diabetes and an adrenal mass that was detected 6 years prior to presentation during a computed tomography (CT) scan for trauma secondary to a motor vehicle collision. The mass was thought to be a myelolipoma. Magnetic resonance imaging (MRI) revealed a 12-cm right adrenal mass that was considered suspicious for carcinoma, which was surgically excised and cultured intraoperatively. The cultures subsequently grew methicillin-resistant Staphylococcus aureus (MRSA). Grossly, the adrenal mass was an encapsulated, necrotic lesion with surrounding areas of fat necrosis. On histologic examination, the tissue showed sheets of histiocytes, lymphocytes, and plasma cells diffusely involving the adrenal gland along with bright yellow lipofuscin crystals in a background of necrosis and fibrosis. PMID:26044256

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

    PubMed Central

    Pan, Koushik

    2015-01-01

    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. PMID:26155508

  10. Acute Myocardial Infarction in a 26-Year-Old Patient With Familial Hypercholesteremia.

    PubMed

    Miyayama, Takeshi; Miura, Shin-Ichiro; Komaki, Tomo; Kuwano, Takashi; Morii, Joji; Nishikawa, Hiroaki; Saku, Keijiro

    2016-07-01

    A 26-year-old male suffered sustained chest pain. Electrocardiogram showed ST-segment elevation in the anteroseptal wall and reciprocal ST-segment change in the inferior wall. The troponin-I level and the white blood cell count were elevated. We gave a diagnosis of acute myocardial infarction. He underwent urgent coronary angiography, which revealed 90% diffuse stenosis in the middle right coronary artery and total occlusion in the proximal left anterior descending coronary artery (LAD). Since the electrocardiogram indicated that the culprit lesion was in the proximal LAD, we performed percutaneous coronary intervention. The coronary flow in the LAD was classified as thrombolysis in myocardial infarction trial 3. His coronary risk factors were obesity, smoking, family history, hypertension and diabetes, in addition to heterozygous familial hypercholesteremia (FH). Herein, we describe the case of a young patient with acute anteroseptal myocardial infarction and discuss the potential importance of controlling cholesterol levels in FH. PMID:27298669

  11. Acute Myocardial Infarction in a 26-Year-Old Patient With Familial Hypercholesteremia

    PubMed Central

    Miyayama, Takeshi; Miura, Shin-ichiro; Komaki, Tomo; Kuwano, Takashi; Morii, Joji; Nishikawa, Hiroaki; Saku, Keijiro

    2016-01-01

    A 26-year-old male suffered sustained chest pain. Electrocardiogram showed ST-segment elevation in the anteroseptal wall and reciprocal ST-segment change in the inferior wall. The troponin-I level and the white blood cell count were elevated. We gave a diagnosis of acute myocardial infarction. He underwent urgent coronary angiography, which revealed 90% diffuse stenosis in the middle right coronary artery and total occlusion in the proximal left anterior descending coronary artery (LAD). Since the electrocardiogram indicated that the culprit lesion was in the proximal LAD, we performed percutaneous coronary intervention. The coronary flow in the LAD was classified as thrombolysis in myocardial infarction trial 3. His coronary risk factors were obesity, smoking, family history, hypertension and diabetes, in addition to heterozygous familial hypercholesteremia (FH). Herein, we describe the case of a young patient with acute anteroseptal myocardial infarction and discuss the potential importance of controlling cholesterol levels in FH. PMID:27298669

  12. Primary non-Hodgkin's lymphoma of gingiva in a 28-year-old HIV-positive patient

    PubMed Central

    Basavaraj, K. F.; Ramalingam, Karthikeyan; Sarkar, Amitabha; Muddaiah, Savitha

    2012-01-01

    Non-Hodgkin's lymphoma (NHL) is seldom seen in the oral cavity, and has been reported with some frequency in HIV-positive patients. Oral HIV-related lymphomas exhibit an aggressive course and can mimic other oral tumors and infections that make early recognition and diagnosis difficult. This paper presents a case of NHL on the gingiva of a 28-year-old HIV-positive male patient. PMID:23225984

  13. Pancytopenia in a 70-Year-Old African-American Male: An Unusual Presentation of a Rare Disease

    PubMed Central

    Mirrakhimov, Aibek E.; Ali, Alaa M.; Anusim, Nwabundo; Kwatra, Shawn G.; Zdunek, Teresita; Gilman, Alan D.

    2014-01-01

    Hairy cell leukemia is a rare lymphoid neoplasm arising from mature B-lymphocytes. Clinically, the disease presents with splenomegaly and abdominal discomfort, frequent infections, fatigue and bleeding because of related cytopenias. Bone marrow biopsy is essential for diagnosis. Below we describe a case of a 70-year-old African-American male who presented to our hematology clinic complaining of fatigue. Clinical exam and computed tomography imaging did not reveal splenic enlargement. Blood work-up revealed pancytopenia and bone marrow was diagnostic for hairy cell leukemia.The patient was started on cladribine, with gradual improvement of his symptoms and blood count abnormalities. Therefore, it is essential to keep hairy cell leukemia in the differential of pancytopenia even in the absence of a splenomegaly. PMID:24782931

  14. A 15-Year-Old Male Baseball Player With a Mass in the Brachialis Muscle.

    PubMed

    Golub, Ivan J; Garcia, Roberto A; Wittig, James C

    2016-05-01

    A 15-year-old boy presented with a mass in his right arm after suffering a minor injury playing baseball. He had been diagnosed with a hematoma. There was no other outstanding medical/surgical history. Magnetic resonance images showed a heterogeneous mass arising from the brachialis muscle that mainly enhanced peripherally with extremely scant internal nodular enhancement. Core needle biopsy cells were positive for CD31 and CD34, markers for atypical endothelial cells, as well as MIB-1 and p53. The final diagnosis was an angiosarcoma of the brachialis muscle. Pediatric angiosarcoma, particularly within deep tissue, is exceedingly rare. Histological and immunohistochemical modalities led to the diagnosis. Magnetic resonance images suggested a mass with a large cystic/hemorrhagic space that could have been misconstrued as a hematoma had there been absolutely no nodular or septal enhancement. The patient underwent neoadjuvant chemotherapy and radiation before undergoing limb-sparing surgery that included resection of the mass with the brachialis muscle and short head of the biceps muscle. Neoadjuvant treatment was deemed successful due to a drastic reduction in the size of the tumor and 95% tumor necrosis. The patient was disease free 2 years postoperatively. There had been no local/systemic recurrences. He was pain free, had normal elbow function, and had returned to playing baseball. It is important to be extremely suspicious when a patient presents with a hemorrhagic, painless, enlarging mass after sustaining minor trauma. A careful and meticulous biopsy must be completed to achieve the correct diagnosis. Magnetic resonance imaging with gadolinium is recommended for evaluation because these masses can be often misinterpreted as hematomas. [Orthopedics. 2016; 39(3):e545-e548.]. PMID:27045482

  15. [Prevalence of anti-HAV antibodies (hepatitis A virus) in 18-year-old males from the Florence area].

    PubMed

    Calabri, G B; Santini, M G; Genovese, F; Bambi, F; Salvi, G; Calabri, G

    1999-01-01

    In 1998 sera from 430 18 year old male subjects living in "Florentina area" have been tested for anti-hepatitis A virus (HAV) antibodies. 27 out of 430, (6.2%), study samples were found to be positive. Our results confirm the low circulation rate of HAV in Florence area. PMID:10963011

  16. An Atypical Eating Disorder with Crohn's Disease in a Fifteen-Year-Old Male: A Case Study.

    ERIC Educational Resources Information Center

    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)

  17. Four-Year-Olds' Beliefs about How Others Regard Males and Females

    ERIC Educational Resources Information Center

    Halim, May Ling; Ruble, Diane N.; Tamis-LeMonda, Catherine S.

    2013-01-01

    Children's awareness of how others evaluate their gender could influence their behaviours and well-being, yet little is known about when this awareness develops and what influences its emergence. The current study investigated culturally diverse 4-year-olds' ("N" = 240) public regard for gender groups and whether exposure to…

  18. Running Training, Instruction on Running Technique, and Running Economy in 10-year-old Males.

    ERIC Educational Resources Information Center

    Petray, Clayre K.; Krahenbuhl, Gary S.

    1985-01-01

    This study attempted to determine the effects of running training, instruction on running techniques, or a combination of instruction and training on the running economy of 10-year-old children. No significant alterations in running economy or technique were produced as a result of the various regimens. (Author/MT)

  19. Differential diagnosis and early management of rapidly progressing hip pain in a 59-year-old male

    PubMed Central

    Wright, Alexis; O'Hearn, Michael A.

    2012-01-01

    Objective and importance Rapidly progressing degeneration of the hip joint is an uncommon condition presenting to physical therapy. Differential diagnosis can often be difficult, as clinical and radiographic findings do not always coincide leaving clinicians with difficult decision making regarding course of treatment. The purpose of this case report was to describe the differential diagnosis and early management of a patient with rapidly progressing hip pain. Clinical presentation A 59-year-old male with a complicated medical history was referred with a diagnosis of severe bilateral hip osteoarthritis. Clinical presentation of insidious onset, severe bilateral groin and anterior thigh pain with rapid progression of functional decline lead to the differential diagnosis of bilateral avascular necrosis. Intervention The patient received seven manual physical therapy sessions over the course of one month. Conclusion During this time, the patient’s Lower Extremity Functional Scale score worsened from 33 to 21. The persistence of the patient’s painful symptoms and continued functional decline helped determine cessation of manual therapy and referral back to his GP for further diagnostic testing and eventual correct diagnosis. This case highlights the importance of monitoring patient prognosis using outcome measures leading to a change in patient management strategies. PMID:23633889

  20. Treatment of Metastatic Colorectal Cancer Patients ≥75 Years Old in Clinical Practice: A Multicenter Analysis

    PubMed Central

    Grande, Roberta; Natoli, Clara; Ciancola, Fabrizio; Gemma, Donatello; Pellegrino, Arianna; Pavese, Ida; Garufi, Carlo; Di Lauro, Luigi; Corsi, Domenico; Signorelli, Diego; Sperduti, Isabella; Cortese, Giada; Risi, Emanuela; Morano, Federica; Sergi, Domenico; Signorelli, Carlo; Ruggeri, Enzo Maria; Zampa, Germano; Russano, Marco; Gamucci, Teresa

    2016-01-01

    elderly patients, confirmed at multivariate analysis, included patients with age >80 years old or with a poor performance status (respectively p<0.0001 and p<0.0001). KRAS analysis deserve further evaluation. PMID:27442239

  1. Cytomorphology of lung metastasis of pure choriocarcinoma of testis in a 58-year-old male.

    PubMed

    Puri, Shailja; Sood, Shivani; Mohindroo, Shobha; Kaushal, Vijay

    2015-01-01

    Choriocarcinoma is malignancy arising from the trophoblastic tissue. Pure choriocarcinoma is rare in testis. Choriocarcinoma of testis is more commonly associated with other germ cell tumors. The usual age of presentation is 2nd-3rd decade. Distant metastasis is known to occur in choriocarcinoma. We present a rare case of testicular pure choriocarcinoma in a male patient. The patient was treated with orchidectomy, lymphadenectomy, and chemotherapy. Three months later the patient presented with hemoptysis and a lung mass. The aspiration cytology of the lung mass revealed metastatic deposits of syncytiotrophoblastic and cytiotrophoblastic cells. We are reporting this case due to its rarity, rare age of presentation, and characteristic cytology at metastatic focus. PMID:26881635

  2. Increasing incidence of colon cancer in patients <50 years old: a new entity?

    PubMed Central

    Esebidis, Agis

    2016-01-01

    Colorectal cancer (CRC) is the third most common cancer type in humans, the fourth most common cause of death because of cancer, and the second most common cancer type in terms of the number of individuals living with cancer 5 years after diagnosis worldwide, almost 694,000 people die from CRC annually. As it is expected is more frequent in older patients (patients older than 70 years old than in young patients (patients younger than 40 years old). The incidence of CRC in young adults is rising the last years and this fact arises the question; is this coincidence or is young adult CRC a real epidemy. In our current commentary we try and elucidate based on current data whether disease on young individuals is a new entity.

  3. Acquired Brachial Cutaneous Dyschromatosis in a 60-Year-Old Male: A Case Report and Review of the Literature

    PubMed Central

    Foering, Kristen

    2014-01-01

    Acquired brachial cutaneous dyschromatosis is an acquired pigmentary disorder that has been described in only 20 patients but likely affects many more. This case of a man with acquired brachial cutaneous dyschromatosis is unique as most reports are in women. We report the case of a 60-year-old male who presents with an asymptomatic eruption characterized by hyperpigmented and telangiectatic macules coalescing into patches on the bilateral extensor aspects of the forearms which is consistent clinically and histopathologically with acquired brachial cutaneous dyschromatosis. Given its presence in patients with clinical evidence of chronic sun exposure and its histopathological finding of solar elastosis, acquired brachial cutaneous dyschromatosis is likely a disorder caused by cumulative UV damage. However, a possible association between angiotensin-converting enzyme inhibitors and acquired brachial cutaneous dyschromatosis exists. Further investigation is needed to elucidate both the pathogenesis of the disorder and forms of effective management. Treatment of the disorder should begin with current established treatments for disorders of dyspigmentation. PMID:25610668

  4. Idiopathic Bilateral Adrenal Hemorrhage in a 63-Year-Old Male: A Case Report and Review of the Literature

    PubMed Central

    Bodukam, Vijay Kumar; Thakur, Kshitij; Singh, Amandeep; Jenkins, Donald; Bahl, Jaya

    2015-01-01

    Adrenal hemorrhage is a largely uncommon condition typically caused by a number of factors including infection, MI, CHF, anticoagulants, trauma, surgery, and antiphospholipid syndrome. Yet, idiopathic bilateral hemorrhage is rare. The authors present a case of a 63-year-old male who presented with abdominal pain that was eventually diagnosed as bilateral adrenal hemorrhages due to an unknown origin. Abdominal CT revealed normal adrenal glands without enlargement, but an MRI displayed enlargement due to hemorrhage in both adrenals. There was no known cause; the patient had not suffered from an acute infection and was not on anticoagulants, and the patient's history did not reveal any of the other known causative factors. The case underscores the importance of keeping bilateral adrenal hemorrhages on the list of differentials even when a cause is not immediately clear. It also raises the question of whether CT is the most sensitive test in the diagnosis of adrenal hemorrhage and whether the diagnostic approach should place greater weight on MRI. The case highlights the need for prompt therapy with steroids once bilateral hemorrhage is suspected to avert the development or progression of adrenal insufficiency. PMID:25973281

  5. [Case report: 40-year-old patient with massive bleeding undergoing cesarean section].

    PubMed

    Thomas, Rainer; Thal, Serge

    2016-05-01

    We report a case of a 40-year-old patient suffering major bleeding when undergoing cesarean section for delivery with placenta previa. After surgery the patient suffered from severe bleeding several times and again underwent surgery with abdominal packing. After an abdominal compartment syndrome and an ARDS a post transfusion purpura was found to be the cause of the repeated bleeding and could successfully be treated with a cycle of plasmapheresis. PMID:27213602

  6. [Giant simple hepatic cysts as dyspnea symptom in a 93-year-old patient].

    PubMed

    Macho Pérez, O; Gómez Pavón, J; Núñez González, A; Narvaiza Grau, L; Albéniz Aguiriano, L

    2007-03-01

    Giant simple hepatic cysts is generally asymptomatic in the 3% of cases of adult patients. We present a woman case of 93 years old who was diagnoses of giant simple hepatic cyst presented as dysnea. The management of this patient was with percutaneous aspiration and fenol alcohol. It made a review of cystic lesions of the liver and of simple hepatic cysts management. PMID:17590136

  7. Elderly victim: an unusual autoerotic fatality involving an 87-year-old male.

    PubMed

    Sauvageau, Anny; Geberth, Vernon J

    2009-01-01

    The average age of autoerotic victims is in the early thirties. Elderly victims of more than 65 years of age are uncommon, consisting of less than 1% of cases. The following case represents the oldest victim ever reported: a 87-year-old man found hanging by a belt in his living room. The body of the deceased was completely naked, with a complex bondage system of ropes. In the victim's bedroom closet, a suitcase contained similar ropes and belts suggesting prior autoerotic activity. Semen was also found at the scene. PMID:19507074

  8. Asymptomatic Left Ventricular Myxoma in a 12-Year-Old Male.

    PubMed

    Chlebowski, Meghan; O'Brien, James; Hertzenberg, Casey; Wagner, Jonathan

    2016-06-01

    Cardiac myxoma is the most common cardiac tumor in patients of all ages; the majority are encountered as single left atrial tumors. Left ventricular myxomas are exceedingly rare, having been recorded in a small number of case reports involving children worldwide. We report a case of a left ventricular myxoma with left ventricular outflow tract obstruction in a previously healthy, asymptomatic adolescent black male. Transthoracic echocardiograms revealed a single, large (2.5 × 5-cm), lobulated, mobile mass within the left ventricular cavity that oscillated into the outflow tract, thereby causing moderate obstruction during systole. Advanced images delineated the location and tissue composition of the mass, characterizing it as a myxoma. Complete surgical excision of the mass was accomplished via aortotomy. Gross examination and histology confirmed the diagnosis of myxoma. PMID:27303249

  9. Asymptomatic Left Ventricular Myxoma in a 12-Year-Old Male

    PubMed Central

    O'Brien, James; Hertzenberg, Casey; Wagner, Jonathan

    2016-01-01

    Cardiac myxoma is the most common cardiac tumor in patients of all ages; the majority are encountered as single left atrial tumors. Left ventricular myxomas are exceedingly rare, having been recorded in a small number of case reports involving children worldwide. We report a case of a left ventricular myxoma with left ventricular outflow tract obstruction in a previously healthy, asymptomatic adolescent black male. Transthoracic echocardiograms revealed a single, large (2.5 × 5-cm), lobulated, mobile mass within the left ventricular cavity that oscillated into the outflow tract, thereby causing moderate obstruction during systole. Advanced images delineated the location and tissue composition of the mass, characterizing it as a myxoma. Complete surgical excision of the mass was accomplished via aortotomy. Gross examination and histology confirmed the diagnosis of myxoma. PMID:27303249

  10. [Cerebral trunk abscess due to Neisseria meningitidis in a 28-year-old immunocompetent patient].

    PubMed

    Faisant, C; Cochin, J P; Rapoport, N; Evreux, F; Vaschalde, Y

    2012-03-01

    Meningococcal disease can manifest in very different clinical situations. Meningococcal meningitis and fulminant meningococcemia (or purpura fulminans) are the most common forms of these infections, but many other manifestations can be seen including septic arthritis, pericarditis, pleurisy and conjunctivitis. Brain abscesses have also been described; they are a rare complication of meningococcal disease. We report the case of a 28-year-old immunocompetent patient who developed meningococcal infection associated with brain abscesses and oligo-arthritis. PMID:22284670

  11. Papulonodular secondary syphilis in a 52-year-old non-HIV heterosexual patient.

    PubMed

    Breznik, V; Potočnik, M; Miljković, J

    2010-12-01

    There has been a recent increase in the incidence of syphilis in Slovenia, similar to other countries. Secondary syphilis can manifest with various clinical and histopathological presentations. We report the case of a 52-year-old patient that presented with nonpruritic nodular lesions on the face, trunk, and insteps that clinically mimicked lymphoma or sarcoidosis. Histopathological findings showed granulomatous inflammation. The serology revealed positive non-treponemal and treponemal tests. Treatment with benzathine penicillin G was successful. PMID:21390478

  12. A treatable metabolic cause of encephalopathy: cobalamin C deficiency in an 8-year-old male.

    PubMed

    Krueger, Jena M; Piantino, Juan; Smith, Craig M; Angle, Brad; Venkatesan, Charu; Wainwright, Mark S

    2015-01-01

    Neurologic regression in a previously healthy child may be caused by metabolic or neurodegenerative disorders, many of which have no definitive treatment. We report a case of a previously healthy 8-year-old boy who presented with a month-long history of waxing and waning encephalopathy and acute regression, followed by seizures. Evaluation for a metabolic disorder revealed methylmalonic acidemia and hyperhomocysteinemia of the cobalamin C type due to a single, presumed homozygous pathogenic c.394 C>T mutation in the MMACHC gene. With the appropriate diet restrictions and vitamin replacement, he improved significantly and returned to his premorbid level of behavior. This case illustrates an unusual presentation of a treatable metabolic disorder and highlights the need to consider cobalamin defects in the differential diagnosis of healthy children with neurologic regression. PMID:25511120

  13. [Anesthetic Management of a 69-year-old Patient with Eisenmenger Syndrome for Abdominoperineal Resection].

    PubMed

    Tamii, Toru; Yoshida, Akiko; Ito, Yosuke; Nagaya, Kei

    2016-06-01

    Although life expectancy of the patients with Eisenmenger syndrome (ES) is currently reported to be lower than 40 years, life span of the patients with ES may be extended because of development of medical care. According to recently reported middle-aged patients with ES undergoing non-cardiac surgeries, per-operative mortality and morbidity of the patients with ES undergoing non-cardiac surgeries may be lower than previously thought, and even elderly patients may be able to undergo major surgeries such as laparotomies for cancers. We described the anesthetic management of a 69-year-old patient with ES who had undergone abdominoperineal resection. In the anesthetic management it is important to maintain adequate blood volumne and systemic vascular resistance and this avoids increases of right-to-left shunt. Perioperative monitoring of pulmonary arterial pressure was useful for hemodynamic management. Good pain control and management of body temperature were also needed for a perioperative course with no adverse events. The appropriate anesthetic management of the 69-year-old patient with ES for abdominoperineal resection resulted in the successful perioperative course. PMID:27483658

  14. [Coexistence of Crohn disease and Wegener granulomatosis in a 15-year-old patient].

    PubMed

    Sieczkowska, Agnieszka; Lewandowski, Piotr; Szumera, Małgorzata; Kamińska, Barbara

    2011-01-01

    Crohn disease is being diagnosed more and more frequently in children and teenagers. Clinical symptoms are mainly related to the gastrointestinal tract, however there are many reports in the literature about the coexistence of Crohn disease with other autoimmunological disorders such as celiac disease, autoimmune hypothyroidism, systemic lupus erythematosus and Wegener granulomatosis. We report a 15-year-old patient with Crohn disease who also developed Wegener granulomatosis. The presented case illustrates the difficulties in establishing the diagnosis when symptoms of the original disease are superimposed on symptoms of a different disorder. PMID:22516704

  15. [A 39-year-old patient with maculopapular rash, recurrent fever, and arthralgia].

    PubMed

    Freund, V; Budihardja, D; Nilles, M; Mayser, P

    2009-07-01

    Adult-onset Still's disease is a rare disorder of unknown etiology. We report the case of a 39-year-old patient who showed the characteristic symptoms: recurrent attacks of fever, arthralgia, maculopapular rash, sore throat, and lymphadenopathy. After the possibility of an infectious or paraneoplastic process was excluded and the laboratory findings were evaluated (increased C-reactive protein, liver values, and ferritin level), the diagnosis was established according to the criteria of Yamaguchi. Therapy with steroids and nonsteroidal anti-inflammatory drugs was started successfully. PMID:19543861

  16. [The coexistence of a para hisian accessory pathway and a complete atrioventricular block in a 32 years old patient].

    PubMed

    Petipe Kappe, C; Halimi, F; Leclercq, J-F

    2015-02-01

    The present case report describes a 32-year-old patient with complete atrioventricular block coexisting with a permanent ventricular preexcitation. The patient ended up with pacemaker implantation without requiring ablation of accessory pathway. PMID:23806864

  17. Noninvasive assessment of cardiomyopathy in normotensive diabetic patients between 20 and 50 years old

    SciTech Connect

    Bouchard, A.; Sanz, N.; Botvinick, E.H.; Phillips, N.; Heilbron, D.; Byrd, B.F. 3d.; Karam, J.H.; Schiller, N.B. )

    1989-08-01

    To further the understanding of diabetic heart disease, we tested the hypothesis that an asymptomatic group of normotensive diabetic patients between 20 and 50 years old had a restrictive cardiomyopathy independent of clinically significant coronary artery disease. Quantitative two-dimensional echocardiography and stress myocardial perfusion scintigraphy were performed to detect and characterize the cardiac abnormalities in this study group comprising 88 patients with rigorously classified diabetes and 65 volunteer control subjects. Diabetic patients were shown to have a mildly reduced left ventricular end-diastolic volume index: 50.1 +/- 8.2 and 52.1 +/- 14.7 mL/m2 for patients with type I and type II diabetes, respectively, versus 58.9 +/- 11.7 mL/m2 for control subjects. The left ventricular diastolic filling was also impaired in diabetic patients as reflected by a lower atrial emptying index: 0.73 +/- 0.24 and 0.76 +/- 0.3 for type I and type II diabetics, respectively, compared with 1.14 +/- 0.24 for control subjects. Exercise tolerance was normal in subjects with type I diabetes and slightly reduced in subjects with type II diabetes. Only one patient developed regional ischemia on thallium exercise testing. Using a comprehensive, noninvasive approach, we have shown that asymptomatic normotensive patients with type I or type II diabetes who were between 20 and 50 years old had a restrictive cardiomyopathy characterized by mildly reduced left ventricular end-diastolic volume and altered left ventricular compliance independent of critical coronary artery disease.

  18. Acute Splenic Sequestration Crisis in a 70-Year-Old Patient With Hemoglobin SC Disease.

    PubMed

    Squiers, John J; Edwards, Anthony G; Parra, Alberto; Hofmann, Sandra L

    2016-01-01

    A 70-year-old African American female with a past medical history significant for chronic bilateral shoulder pain and reported sickle cell trait presented with acute-onset bilateral thoracolumbar pain radiating to her left arm. Two days after admission, Hematology was consulted for severely worsening microcytic anemia and thrombocytopenia. Examination of the patient's peripheral blood smear from admission revealed no cell sickling, spherocytes, or schistocytes. Some targeting was noted. A Coombs test was negative. The patient was eventually transferred to the medical intensive care unit in respiratory distress. Hemoglobin electrophoresis confirmed a diagnosis of hemoglobin SC disease. A diagnosis of acute splenic sequestration crisis complicated by acute chest syndrome was crystallized, and red blood cell exchange transfusion was performed. Further research is necessary to fully elucidate the pathophysiology behind acute splenic sequestration crisis, and the role of splenectomy to treat hemoglobin SC disease patients should be better defined. PMID:27047980

  19. Traumatic bilateral posterior hip dislocation in 10 year old male child.

    PubMed

    Garg, Vipul; Singh, Ajay Pal; Singh, Arun Pal; Bajaj, P S

    2014-09-01

    Traumatic bilateral posterior hip dislocation in skeletally immature patient is reported very less in literature. We report a 10 yr old boy presented to us following farmyard injury with bilateral posterior hip dislocation, which was reduced manually under sedation with uneventful follow-up and complete hip range of motion at 2 year. PMID:25983489

  20. Mature Ovarian Teratoma with Carcinoid Tumor in a 28-Year-Old Patient

    PubMed Central

    Petousis, Stamatios; Kalogiannidis, Ioannis; Margioula-Siarkou, Chrysoula; Traianos, Alexandros; Miliaras, Dimosthenis; Kamparoudis, Apostolos; Mamopoulos, Apostolos; Rousso, David

    2013-01-01

    Introduction. Coexistence of carcinoid tumor inside a mature cystic teratoma is an extremely rare phenomenon, especially in young women. We present the case of a 28-year-old woman diagnosed with a right ovarian carcinoid and treated uneventfully with conservative surgical approach. Case Report. A 28-year-old woman, gravid 0, parity 0, presented to our department for her annual gynecological examination and Pap smear test. During her examination, a mobile cystic mass was detected in the right lower abdomen. Ultrasound indicated a right ovarian mass 10.5 × 6.3 cm, confirmed by CT scan. Further investigation revealed AFP levels (1539 ng/mL). The ovarian mass was excised by laparoscopy, leaving intact the remaining right ovary. Frozen sections showed a mature cystic teratoma. However, paraffin sections revealed the presence of a small carcinoid within the teratoma's gastric-type mucosa. The patient was set to a close followup. Nine months postoperatively, ultrasound pelvis imaging and CT scan of the abdomen as well as serum tumor markers have shown no evidence of recurrence disease. Conclusion. Despite the weak evidence, fertility spare surgical approach for women wanting to preserve their genital tract might be a reasonable option. PMID:23984130

  1. Tuberculous Empyema Necessitatis in a 40-Year-Old Immunocompetent Male

    PubMed Central

    Babamahmoodi, Farhang; Sheikholeslami, Roya; Ahangarkani, Fatemeh

    2016-01-01

    Empyema necessitans (EN) is a kind of empyema that diffuses to extrapleural space and can involve chest pain. Tuberculosis (TB) is the most common cause of EN. This disease can be found in both immunocompromised and immunocompetent individuals but is usually seen in the immunocompromised individuals. Because of long duration and ambiguous symptoms of the disease, diagnosis can be hard. The disease can be treated both medically and surgically. Missing the disease can lead to undesirable effects on patient's condition and health care setting. This problem can be seen in endemic area in which controlling of TB is hard. Report of the disease in local health care center for desirable treatment and health maintenance is necessary. We explained a rare case of pulmonary TB in a patient that was healthy in other fields and just showed the minimum systemic symptoms. The patient came with a mass in lower part of back of chest cage, with a mild pain. The imaging survey showed EN. Smear and Ziehl-Neelsen stains from subcutaneous aspiration were positive for TB. This case showed importance of clinical view and awareness of this silent but serious disease in endemic area especially for TB. PMID:27555974

  2. Wilms' tumor in a 51-year-old patient: An extremely rare case and review of the literature

    PubMed Central

    HU, JIA; JIN, LU; HE, TAO; LI, YIFAN; ZHAO, YANG; DING, YU; LI, XIANXIN; LIU, YUNCHU; GUI, YAOTING; MAO, XIANGMING; LAI, YONGQING; NI, LIANGCHAO

    2016-01-01

    Wilms tumor or nephroblastoma is a common kidney malignant tumor in childhood, accounting for ~5% of all pediatric tumors. At present, reports on Wilms' tumor occurring in adults, particularly at ages >30 years, are extremely rare. The majority of the cases of adult Wilms' tumor are closely associated with chemotherapy. Furthermore, in rare cases, Wilms' tumor is characterized by three classic types of cells, namely blastemal, stromal and epithelial cells. We herein report a case of Wilms' tumor with three classic types of cells on histological examination in a 51 year-old male patient who had received prior chemotherapy. The patient promptly underwent radical nephrectomy and remains alive. A review of previously presented cases of adult Wilms' tumor from PubMed database was also performed. PMID:27313862

  3. Acute Splenic Sequestration Crisis in a 70-Year-Old Patient With Hemoglobin SC Disease

    PubMed Central

    Squiers, John J.; Edwards, Anthony G.; Parra, Alberto; Hofmann, Sandra L.

    2016-01-01

    A 70-year-old African American female with a past medical history significant for chronic bilateral shoulder pain and reported sickle cell trait presented with acute-onset bilateral thoracolumbar pain radiating to her left arm. Two days after admission, Hematology was consulted for severely worsening microcytic anemia and thrombocytopenia. Examination of the patient’s peripheral blood smear from admission revealed no cell sickling, spherocytes, or schistocytes. Some targeting was noted. A Coombs test was negative. The patient was eventually transferred to the medical intensive care unit in respiratory distress. Hemoglobin electrophoresis confirmed a diagnosis of hemoglobin SC disease. A diagnosis of acute splenic sequestration crisis complicated by acute chest syndrome was crystallized, and red blood cell exchange transfusion was performed. Further research is necessary to fully elucidate the pathophysiology behind acute splenic sequestration crisis, and the role of splenectomy to treat hemoglobin SC disease patients should be better defined. PMID:27047980

  4. Successful Pregnancy in a 31-Year-Old Peritoneal Dialysis Patient with Bilateral Nephrectomy

    PubMed Central

    Nazer, Ahmed; AlOmar, Osama; Al-Badawi, Ismail A.

    2013-01-01

    Frequency of pregnancy among childbearing age women with end-stage renal disease (ESRD) undergoing long-term periodic dialysis ranges from 1% to 7%. Although pregnancy in dialysis women with ESRD is considered a largely high-risk pregnancy, occurrence of successful pregnancy is not impossible with success rates approaching 70%. Rates of successful pregnancy are greatly impacted by early pregnancy diagnosis and preserved residual renal functions. Herein, to the best of our knowledge, we report the first case of successful pregnancy (despite late diagnosis at 14 weeks of gestation) in a 31-year-old peritoneal dialysis patient with bilateral nephrectomy and no whatsoever preserved residual renal function. Moreover, a literature review on pregnancy in dialysis patients is presented. PMID:24198990

  5. Successful pregnancy in a 31-year-old peritoneal dialysis patient with bilateral nephrectomy.

    PubMed

    Abu-Zaid, Ahmed; Nazer, Ahmed; Alomar, Osama; Al-Badawi, Ismail A

    2013-01-01

    Frequency of pregnancy among childbearing age women with end-stage renal disease (ESRD) undergoing long-term periodic dialysis ranges from 1% to 7%. Although pregnancy in dialysis women with ESRD is considered a largely high-risk pregnancy, occurrence of successful pregnancy is not impossible with success rates approaching 70%. Rates of successful pregnancy are greatly impacted by early pregnancy diagnosis and preserved residual renal functions. Herein, to the best of our knowledge, we report the first case of successful pregnancy (despite late diagnosis at 14 weeks of gestation) in a 31-year-old peritoneal dialysis patient with bilateral nephrectomy and no whatsoever preserved residual renal function. Moreover, a literature review on pregnancy in dialysis patients is presented. PMID:24198990

  6. A 3 Year-Old Male Child Ingested Approximately 750 Grams of Elemental Mercury

    PubMed Central

    Uysalol, Metin; Parlakgül, Güneş; Yılmaz, Yasin; Çıtak, Agop; Uzel, Nedret

    2016-01-01

    Background: The oral ingestion of elemental mercury is unlikely to cause systemic toxicity, as it is poorly absorbed through the gastrointestinal system. However, abnormal gastrointestinal function or anatomy may allow elemental mercury into the bloodstream and the peritoneal space. Systemic effects of massive oral intake of mercury have rarely been reported. Case Report: In this paper, we are presenting the highest single oral intake of elemental mercury by a child aged 3 years. A Libyan boy aged 3 years ingested approximately 750 grams of elemental mercury and was still asymptomatic. Conclusion: The patient had no existing disease or abnormal gastrointestinal function or anatomy. The physical examination was normal. His serum mercury level was 91 µg/L (normal: <5 µg/L), and he showed no clinical manifestations. Exposure to mercury in children through different circumstances remains a likely occurrence. PMID:27606146

  7. Acute myocardial infarction in a 56-year-old female patient treated with sulfasalazine.

    PubMed

    Daoulah, Amin; Alqahtani, Awad A R; Ocheltree, Sara R; Alhabib, Abdulkarim; Ocheltree, Ali R

    2012-05-01

    Drug rash, eosinophilia, and systemic symptoms (DRESS) syndrome represents one pattern of the cutaneous involvement in type IV hypersensitivity reaction to drugs. It is a severe, delayed, idiosyncratic reaction presented as rash with fever, lymphadenopathy, and visceral involvement. There are several reported cases of sulfasalazine-induced DRESS syndrome, but myocardial involvement was rare. High index of suspicion is needed in every patient receiving these drugs for prompt diagnosis and early management. We report a case of a 56-year-old woman treated with sulfasalazine for ankylosing spondylitis for 3 weeks, which was discontinued after development of DRESS syndrome. Despite treating her with high dose of steroid and cyclosporine, her symptoms persisted, and ultimately, she developed toxic myocarditis with a misleading presentation of acute ST-elevated myocardial infarction. The diagnosis was made based on postmortem histopathologic finding. PMID:21514761

  8. Possible Hepatotoxicity Associated With Intravenous Acetaminophen in a 36-Year-Old Female Patient

    PubMed Central

    Lee, Philip J.; Shen, Mark; Wang, Shan; Spiegler, Peter; Caraccio, Thomas; DeMuro, Jonas P.; Malone, Brian

    2015-01-01

    We present a case of a 36-year-old female who came into the emergency department with right-side abdominal pain. She went to the operating room for a diagnostic laparoscopy and appendectomy. She received intravenous (IV) acetaminophen every six hours both preoperatively and postoperatively for pain control. The patient’s aspartate aminotransferase and alanine aminotransferase levels were elevated and peaked at 4,833 and 6,600 IU/L, respectively, from baselines of 14 and 15, respectively, while she was receiving 16 doses of IV acetaminophen. The patient was transferred to a regional liver transplant center for evaluation for a transplant. She was treated with IV N-acetylcysteine and discharged with a normal liver-function test without a transplant. This case report supports the possibility of hepatotoxicity associated with IV acetaminophen. PMID:25673962

  9. Chiropractic management of a 30-year-old patient with Parsonage-Turner syndrome

    PubMed Central

    Charles, Eugene

    2011-01-01

    Objectives The purpose of this case report is to describe the chiropractic management of a patient presenting with right arm paralysis and a diagnosis of Parsonage-Turner syndrome. Clinical Features After receiving nerve entrapment release surgery, a 30-year-old man presented with a right arm contracture, atrophy, and weakness with general paralysis of the forearm and index finger of 6 weeks' duration. Intervention and Outcome The patient was provided chiropractic care that included high-velocity/low-amplitude spinal manipulation based upon applied kinesiology manual muscle testing, soft tissue trigger point therapy, exercises, and stretches. The patient demonstrated improvement in range of motion after the first treatment session. By the eighth treatment, he was able to fully straighten his arm. Three years later, the patient reported that he was able to do mountain climbing and that his arm was fully functional and pain-free. Conclusion For this patient, chiropractic care seemed to be successful in relieving his right arm paralysis and restoring normal arm movement. PMID:22654689

  10. Takotsubo Cardiomyopathy in a 22-Year-Old Single-Ventricle Patient

    PubMed Central

    Aboulhosn, Jamil; Reardon, Leigh C.

    2016-01-01

    We report a highly unusual case of a 22-year-old woman with single-ventricle anatomy and a history of Fontan palliation who developed takotsubo cardiomyopathy. To our knowledge, takotsubo cardiomyopathy has not previously been described in a patient with single-ventricle anatomy, or more generally in any patient with congenital heart disease. The patient presented at our clinic for urgent examination after a 2-day history of chest pain that had begun upon the death of her dog. Invasive evaluation was refused by the patient; instead, she underwent electrocardiogram-gated coronary computed tomographic angiography, to rule out obstructive coronary disease. A physician who suspects takotsubo cardiomyopathy in a patient should look for new-onset chest pain and dyspnea coupled with these features: immediate onset of segmental akinesia in the midventricular or apical aspects of the heart, elevation of brain natriuretic peptide level 12 to 24 hours after onset of akinesia, elevation of troponin level 24 to 48 hours after onset, and disappearance of the segmental akinesia a few days after onset. PMID:27047288

  11. The Incidence of Problem Gambling in a Representative Cohort of Swedish Female and Male 16-24 Year-Olds by Socio-demographic Characteristics, in Comparison with 25-44 Year-Olds.

    PubMed

    Fröberg, Frida; Rosendahl, Ingvar K; Abbott, Max; Romild, Ulla; Tengström, Anders; Hallqvist, Johan

    2015-09-01

    We aimed to estimate the incidence of a first episode of problem gambling among Swedish 16-24 year-olds by demographic and socio-economic characteristics, and to compare the incidence between 16-24 and 25-44 year-olds, and between young women and men. Other aims were to estimate the proportions of recovery and incidence in recurrent problem gambling, and prevalence of problem gambling among 16-44 year-olds in Sweden. We selected 4,358 participants aged 16-44 from the nationally representative Swedish Longitudinal Gambling Study in 2008/2009 and 2009/2010. The primary outcome measure was a first episode of problem gambling during 12 months before the follow-up as measured by the Problem Gambling Severity Index among participants without a history of problem gambling at baseline. The incidence proportion of a first episode of problem gambling among 16-24 year-olds was 2.26% (95% confidence interval 1.52-3.36); three times lower among females (1.14; 0.42-3.07%) than males (3.32; 2.19-5.01%). Young age and household financial problems were associated with first episode problem gambling among young women. Among 25-44 year-olds, the incidence proportion of a first episode of problem gambling was 0.81% (0.41-1.56). Recovery from problem gambling was high, in particular among females. Individual transitions from problem gambling to recovery and to recurrent problem gambling, between baseline and follow-up, were common regardless of age. This study adds further evidence to research suggesting that there is a high mobility in and out of problem gambling over time on an individual level. The high incidence of first episode problem gambling among youth in Sweden stresses the importance of prevention of problem gambling at an early age. PMID:24590609

  12. Rhabdomyolysis and Cardiomyopathy in a 20-Year-Old Patient with CPT II Deficiency

    PubMed Central

    Vavlukis, M.; Eftimov, A.; Zafirovska, P.; Caparovska, E.; Pocesta, B.; Kedev, S.; Dimovski, A. J.

    2014-01-01

    Aim. To raise the awareness of adult-onset carnitite palmitoyltransferase II deficiency (CPT II) by describing clinical, biochemical, and genetic features of the disease occurring in early adulthood. Method. Review of the case characteristics and literature review. Results. We report on a 20-year-old man presenting with dyspnea, fatigue, fever, and myoglobinuria. This was the second episode with such symptoms (the previous one being three years earlier). The symptoms occurred after intense physical work, followed by a viral infection resulting in fever treated with NSAIDs. Massive rhabdomyolysis was diagnosed, resulting in acute renal failure necessitating plasmapheresis and hemodialysis, acute hepatic lesion, and respiratory insufficiency. Additionally, our patient had cardiomyopathy with volume overload. After a detailed workup, CPT II deficiency was suspected. We did a sequencing analysis for exons 1, 3, and 4 of the CPT II gene and found that the patient was homozygote for Ser 113 Leu mutation in exon 3 of the CPT II gene. The patient recovery was complete except for the cardiomiopathy with mildly impaired systolic function. Conclusion. Whenever a patient suffers recurrent episodes of myalgia, followed by myoglobinuria due to rhabdomyolysis, we should always consider the possibility of this rare condition. The definitive diagnose of this condition is achieved by genetic testing. PMID:24563797

  13. Cat scratch disease in 9-year-old patient - a case report.

    PubMed

    Świątkowski, Wojciech; Rahnama, Mansur; Strzelczyk, Katarzyna; Baszak, Jakub; Sierocińska-Sawa, Jadwiga

    2016-03-01

    Cat scratch disease (CSD) - bartonellosis, is zoonosis caused by the intracellular gram negativebacterium Bartonellahenselae or Bartonellaquintana. The pathogens of this disease enter the human body usually as a consequence of a bite or scratch by young cats which are the natural source of such bacteria. The illness proceeds asymptomatically or with topical symptoms of infection such as a lump, spot or blister. Within 14 days a high fever and topical lymphadenopathy are observed. Lymph nodes are sore and start suppurating. In half of patients, these symptoms may resemble malignancy, and in single cases there are symptoms associated with the musculoskeletal system, such as: osteitis, arthitis and myositis. In paper presented case of 9 year-old girl patients, treated in Oral Surgery Unit due to odema and lymphadenopathy in right submandibular space. Primary surgical treatment of deciduous teeth was conducted without recovery. In few months follow-up, biopsy of lymph node of submandibular group was taken and provisional diagnosis of cat scratch disease was set. Patient was referred to the Infectious Diseases Unit where serological test confirmed cat scratch disease, and pharmacological treatment was conducted with success and recovery of young patient. PMID:27213258

  14. Tongue squamous cell carcinoma as a possible distinct entity in patients under 40 years old

    PubMed Central

    FANG, QI-GEN; SHI, SHUANG; LIU, FA-YU; SUN, CHANG-FU

    2014-01-01

    Much controversy exists in the published literature regarding the clinical course and prognosis of tongue squamous cell carcinoma (SCC) in young patients. The aim of the current study was to evaluate the clinical results of tongue SCC in young patients. A total of 176 patients were included in this retrospective study. The patients were divided into two groups (young and old) according to an age cut-off of 40 years. The χ2 test and Kaplan-Meier method were used to analyze the variables. In total, 15 patients were <40 years old and placed into the young group, with five-year recurrence-free survival (RFS) and disease-specific survival (DSS) rates of 30 and 63%, respectively, compared with 47 and 62%, respectively, in the old group. No significant differences were identified between the RFS and DSS rates of the two groups, however, the young patients exhibited a different failure pattern. Overall, nine out of 10 recurrences in the young group occurred at a primary site compared with 18 out of 70 in the old group (P<0.001). Univariate analysis revealed that gender and differentiation were associated with recurrence and neck nodal involvement. In addition, poor differentiation was found to significantly decrease the DSS time. However, the prognosis of tongue SCC in the young patient group did not appear to differ from that of the old patient group. Furthermore, in the young patient group, local recurrence was the most common failure pattern and tumor differentiation was the most important prognostic factor. PMID:24932296

  15. A 45-Year-Old Undiagnosed Cirrhotic Patient with Hepatopulmonary Syndrome as First Presentation: A Case Report

    PubMed Central

    Dhoble, Chetan; Saoji, Neelima; Jeswani, Jitesh; Rios, Rosa

    2015-01-01

    Patient: Male, 45 Final Diagnosis: Hepatopulmonary syndrome Symptoms: Dyspnea • edema of feet Medication: — Clinical Procedure: None Specialty: Gastroenterology and Hepatology Objective: Unusual clinical course Background: Hepatopulmonary syndrome (HPS) is a pulmonary complication characterized by a triad of chronic liver disease, arterial hypoxemia, and pulmonary vascular dilations. Agitated saline contrast echocardiography is a simple inexpensive criterion standard procedure for confirming the diagnosis of HPS. Case Report: Here, we discuss a case of a 45-year-old male Indian patient with no medical history who presented to our hospital with exertional dyspnea, hypoxia, and classical signs of HPS. A diagnosis of cirrhosis was made on the basis of history, liver enzymes, and ultrasound, while HPS was diagnosed using transthoracic echocardiography with agitated saline. Conclusions: HPS, although a complication of cirrhosis, can be the initial presentation in undiagnosed cirrhotic patients. Thus, it is important to include HPS in differentials when dealing with cases of progressive dyspnea. Also, the possibility of a liver disease etiology should be explored in patients with unexplained hypoxemia. PMID:26489790

  16. Congenital insensitivity to pain with anhidrosis: a case report of a 33-year-old patient.

    PubMed

    Kosmidis, Ilias; Krallis, Panagiotis; Tsiamasfirou, Damiani; Filiopoulos, Konstantinos

    2013-01-01

    Congenital insensitivity to pain with anhidrosis is a type IV hereditary sensory and autonomic neuropathy, presenting early in life. This disorder results from defective neural crest differentiation with loss of the first-order afferent system, which is responsible for sensations of pain and temperature; a neuronal loss in the sympathetic ganglia is also present. A case of a 33-year-old patient with congenital insensitivity to pain with anhidrosis is presented. From the time of birth, he did not sweat and did not respond to painful stimuli, although unexplained bouts of fever were often observed in infancy; an extensive workup during childhood helped establish the diagnosis. Throughout childhood and adulthood, the patient presented multiple infections and fractures in various sites of his body, growth disturbances, and avascular necrosis, and Charcot arthropathies and joint dislocations mainly affected his elbow and hip joint. At the final follow-up, at the age of 33 years, he was found to be obese, with a limited social life. A Charcot elbow restricted the activity of his left upper limb, and the dislocated hips combined with the instability of the ankle joints limited the ambulation distance. A specific treatment protocol has not been established in the literature; the main principles that can be applied in patients with normal intelligence include training programs to prevent self-mutilation and accidental injuries and an early diagnosis and treatment of the infections. PMID:22422007

  17. Unexpected subthreshold autism spectrum in a 25-year-old male stalker hospitalized for delusional disorder: a case report.

    PubMed

    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. PMID:26031384

  18. Thyrotoxicosis after a massive levothyroxine ingestion in a 3-year-old patient.

    PubMed

    Hays, Hannah L; Jolliff, Heath A; Casavant, Marcel J

    2013-11-01

    Most children with exploratory levothyroxine ingestions remain asymptomatic or suffer only minor effects, and most patients can be managed in the home or with supportive care in the hospital. We present a case of a 3-year-old girl who was found after a witnessed massive ingestion of levothyroxine. The patient was initially seen in an emergency department and discharged in stable condition, only to return 4 days after ingestion with thyrotoxicosis, hypertension, tachycardia, 24 hours of persistent vomiting, and clinical and laboratory evidence of dehydration. On the day of hospital admission, her thyroid-stimulating hormone was 0.018 µIU/mL (reference range, 0.6-4.5 µIU/mL); free T4 (tetraiodothyronine) was greater than 6.0 ng/dL (reference range, 0.7-2.1 ng/dL); and T3 (triiodothyronine) total was 494 ng/dL (reference range, 100-200 ng/dL). During a 3-day hospital admission, she was managed with supportive care, including intravenous fluid rehydration and antiemetics, and was ultimately discharged in good condition. The patient was followed up until 2 months after ingestion and remained asymptomatic. Although most exploratory levothyroxine ingestions suffer little to no clinical effects, serious symptoms can occur. Because serious symptoms can occur in a delayed fashion, it is important for clinicians to give proper anticipatory guidance regarding home symptom monitoring, follow-up, and reasons to return to the emergency department when patients present for medical evaluation. PMID:24196094

  19. Acne scars in 18-year-old male adolescents: a population-based study of prevalence and associated factors*

    PubMed Central

    Lauermann, Fernanda Tcatch; de Almeida Jr., Hiram Larangeira; Duquia, Rodrigo Pereira; de Souza, Paulo Ricardo Martins; Breunig, Juliano de Avelar

    2016-01-01

    Background Acne vulgaris is a pilosebaceous follicle disorder affecting over 85% of adolescents to some degree. It frequently causes psychological distress that may persist into adulthood due to scarring. Little information about post-acne scarring epidemiology is available. Objectives To describe prevalence, distribution patterns and associated factors of acne scarring in young males, drawing on a representative population sample from a southern Brazilian city. Methods A cross-sectional study was undertaken during presentation for military service, which is compulsory for all 18-year-old males. A questionnaire was applied, covering topics like diet, smoking habits, ethnicity, family structure, socio-economic level, as well as specific questions about active acne and resulting scars. Dermatologists conducted the clinical examination. Results A total of 2,201 male adolescents were interviewed and examined. The overall prevalence of acne scarring was 22%. The malar region was the most frequently involved, present in 80% of affected individuals, followed by the frontal region (31.5%), back (17%), anterior chest (8.2%) and mentonian region (6.4%). Correlation between the intensity of clinical acne and the presence of scars was found, but no association was observed with educational level, smoking, ethnicity, obesity or socio-economic status. Conclusions There is a high prevalence of acne scars among this population. This is the first study to ascertain a correlation between acne scarring and factors such as socio-economic status and educational level. The direct relation between acne severity and scarring indicates that prompt and effective treatment is the best way to reduce scarring. PMID:27438194

  20. A Comparative Analysis Regarding Factors Related to 13- to 18-Year-Old African American Male Adolescents in Special Education and the Justice System

    ERIC Educational Resources Information Center

    Phipps, Jonathan Lanier

    2013-01-01

    This study was focused on the identification of selected risk factors seemingly present among African American male adolescents 13 to 18 years old who were participants in special education programs at their schools. Many of these male adolescents were also found to participate in the juvenile justice system under what was characterized as…

  1. Searching for patent foramen ovale in a 44-year-old female patient after ischemic stroke – diagnostic problems

    PubMed Central

    Kralisz, Paweł; Bachórzewska-Gajewska, Hanna; Dobrzycki, Sławomir

    2016-01-01

    Patent foramen ovale (PFO) is associated with the occurrence of cryptogenic strokes in young patients. Transesophageal echocardiography with contrast is the established standard in PFO diagnostics. We present the case of a 44-year-old female patient after ischemic stroke, in whom PFO was not detected by echocardiography; the defect was ultimately diagnosed by right heart catheterization. PMID:27516797

  2. Searching for patent foramen ovale in a 44-year-old female patient after ischemic stroke - diagnostic problems.

    PubMed

    Zalewska-Adamiec, Małgorzata; Kralisz, Paweł; Bachórzewska-Gajewska, Hanna; Dobrzycki, Sławomir

    2016-06-01

    Patent foramen ovale (PFO) is associated with the occurrence of cryptogenic strokes in young patients. Transesophageal echocardiography with contrast is the established standard in PFO diagnostics. We present the case of a 44-year-old female patient after ischemic stroke, in whom PFO was not detected by echocardiography; the defect was ultimately diagnosed by right heart catheterization. PMID:27516797

  3. [57-year-old patient with hypopituitarism and coexisting autommune hypothyroidism polyglandular syndrome--a case report].

    PubMed

    Czech-Brożek, Klaudyna; Kuźmińska, Maria; Molczyk-Niedźwiecka, Anna

    2015-01-01

    A case of 57-year-old patient with hypopituitarism multihormonal whose symptoms occurred after the last birth history of 16 years ago. Completed studies revealed other irregularities on the basis of which ultimately diagnosed with hypothyroidism polyglandular syndrome patients. PMID:26827563

  4. Distal Partial Trisomy 15q26 and Partial Monosomy 16p13.3 in a 36-Year-Old Male with Clinical Features of Both Chromosomal Abnormalities.

    PubMed

    Cox, Devin M; Butler, Merlin G

    2015-01-01

    We report a 36-year-old Caucasian male identified with distal partial trisomy 15q and partial monosomy 16p from an unbalanced chromosome translocation detected by microarray and FISH analysis. He had a history of developmental delay and intellectual disability, chronic anemia, tall and slender stature, thoracic scoliosis and lumbar lordosis, and dysmorphic features. The distal partial trisomy 15q included the insulin-like growth factor 1 receptor gene involved with growth, while genes in the distal partial monosomy 16p region are involved with alpha hemoglobin production, intellectual disability, dysmorphic features, and acromegaly. The chromosome derivative found in our patient contains genes known to play a role in his phenotype. PMID:25871641

  5. Prediction of Ambulatory Status After Hip Fracture Surgery in Patients Over 60 Years Old

    PubMed Central

    2016-01-01

    Objective To predict ambulatory capacity, 1 month after physical therapy following hip fracture surgery. Methods A retrospective chart review was carried out. Patients more than 60 years old, who underwent hip fracture surgery and received physical therapies, were selected (n=548). Age, gender, presence of cognitive dysfunction, combined medical diseases, combined fractures, previous history of hip surgery, prefracture ambulatory capacity, days from the fracture to surgery, type of fracture, type of surgery, presence of postoperative complications, days from the surgery to physical therapy, and total admission period, were collected. Prefracture ambulatory capacity and postoperative ambulatory capacity were classified into non-ambulatory status (NA), ambulation with assistive device (AA), and independent-ambulation without any assistive device (IA). Multiple-logistic regression analysis was performed for the prediction of postoperative ambulatory capacity. Results Age (odds ratio [OR]=0.94 for IA and 0.96 for IA or AA), gender (OR=1.64 for IA and 0.98 for IA or AA), prefracture ambulatory capacity (OR of IA=19.17 for IA; OR of IA=16.72 for IA or AA; OR of AA=1.26 for IA, OR of AA=9.46 for IA or AA), and combined medical disease (OR=2.02) were found to be the factors related to postoperative ambulatory capacity and the prediction model was set up using these four factors. Conclusion Using this model, we can predict the ambulatory capacity following hip fracture surgery. Further prospective studies should be constructed to improve postoperative ambulatory capacity. PMID:27606273

  6. Assessment of Mandibular Movements in 10 to 15 Year-old Patients With and Without Temporomandibular Disorders.

    PubMed

    Cortese, Silvina G; Biondi, Ana M; Fridman, Diana E; Guitelman, Ingrid; Farah, Catalina L

    2015-12-01

    The aim of this study was to establish reference values for mandibular movements in 10- to 15-year-olds without dysfunction and compare these values to those in patients of the same age with tempromandibular disorders (TMD) and those found previously in a group of children younger than 11 years old without TMD. Children of both genders who visited the Department of Comprehensive Pediatric Dentistry at Buenos Aires University in 2013 and whose parents or guardians provided consent were evaluated using TMD/RDC by standardized pediatric dentists (Kappa 0.88). Three groups were formed according to diagnostic summary: Group C, without TMD; Group Ia, with myofascial pain, and Group Ib, pain with limited mouth opening. The following variables were analyzed: age, gender and mandibular movements. The sample included 169 patients aged 12.5±1.76 years, of whom 62.36% did not have TMD (C) while 37.27% were diagnosed with muscle disorder (29.58% Ia and 7.69% Ib). For Group C, the following values (in mm) were recorded: maximal unassisted opening: 48.28±6.14; right lateral movement 8.78±2.50; left lateral movement: 9.60±2.64; protrusion: 4.94±2.58 and overbite: 2.98 ± 2.5, with no variation associated to sex, but with differences in the values recorded for all movements compared to those obtained for mixed dentition (p=0.0001). Analysis of mean values for mandibular movements in all 3 groups only revealed differences for maximal unassisted opening (p= 0.0317). With relation to gender, TMD was more frequent in females, with significant differences between Groups C and Ia (p=0.019). In males without dysfunction, average maximal opening was 48.28±6.14mm, with lower values in patients with TMD. Mandibular movements in pediatric patients without TMD showed significant differences according to dentition type and age. PMID:27095624

  7. [Abdominal CSF pseudocyst recurrence in a 14-year-old patient with ventricular-peritoneal shunt].

    PubMed

    Laurent, P; Hennecker, J-L; Schillaci, A; Scordidis, V

    2014-08-01

    Abdominal cerebrospinal fluid (CSF) pseudocyst is a rare complication of ventricular-peritoneal shunt (VPS) but needs to be considered in every patient with abdominal complaints or signs of intracranial hypertension (IH). The pathogenesis of pseudocysts remains unclear. Diverse predisposing factors have been proposed such as previous abdominal surgeries, multiple VPS revisions, infections, history of necrotizing enterocolitis, and nonspecific inflammatory processes. We report the case of a 14-year-old patient, known to have a VPS as intraventricular hemorrhage treatment, presenting cephalalgia, vomiting, apathy, and an indurate abdominal mass without fever. The first abdominal CSF pseudocyst diagnosis had been established 3 months earlier. Abdominal ultrasounds confirmed a large homogeneous cyst with the shunt tip within the pseudocyst. Cerebral CT revealed an increased ventricular size. An exploratory laparotomy with cyst aspiration, lysis of adhesions, excision of cystic walls, and repositioning of the peritoneal catheter was performed. No antibiotics were initiated given that the cultures were negative. Ultrasonography proved to be the method of choice in the diagnosis of VPS abdominal complications, especially CSF pseudocyst. CT can also reliably confirm the pseudocyst. In case of IH signs, a cerebral CT scan can be performed to evaluate the ventricular distension and to check the shunt position. Various methods to process the cyst have been described in the medical literature, but the recurrence rate remains elevated (25-100%). Then the probability of an infection without any clinical sign has to be considered. In case of suspected infection, the VPS is removed and replaced by an external ventricular drain. Antibiotics are started and adjusted to the results of the CSF culture. If there is no direct sign of infection, only the distal catheter is externalized and antibiotics are introduced until infection is treated. Depending on the peritoneal absorption state

  8. Severe Quetiapine Withdrawal Syndrome with Nausea and Vomiting in a 65-year-old Patient with Psychotic Depression.

    PubMed

    Koch, Horst J

    2015-01-01

    A 65-year old patient suffering from severe psychotic depression obtained quetiapine for roughly one year. Several attempts to discontinue quetiapine by tapering the dose provoked severe withdrawal symptoms with nausea and vomitus. Pretreatment with domperidone largely prevented withdrawal so that he finally could successfully discontinue quetiapine administration. PMID:26242495

  9. Pathologic fracture of the distal radius in a 25-year-old patient with a large unicameral bone cyst

    PubMed Central

    2014-01-01

    Background Distal radius fractures (DRF) are often referred to as osteoporosis indicator fractures as their incidence increases from age 45. In the group of young adults, distal radius fractures normally result from high-energy trauma. Wrist fractures in young patients without adequate trauma thus raise suspicion of a pathologic fracture. In this report we present the case of a fractured unicameral bone cyst (UBC) at the distal radius in a young adult. To the author’s best knowledge, this is the first detailed report in an UBC at the distal radius causing a pathologic DRF in an adult patient. Case presentation A 25-year-old otherwise healthy male presented to our Emergency Department after a simple fall on his right outstretched hand. Extended diagnostics revealed a pathologic, dorsally displaced, intra-articular distal radius fracture secondary to a unicameral bone cyst occupying almost the whole metaphysis of the distal radius. To stabilize the fracture, a combined dorsal and volar approach was used for open reduction and internal fixation. A tissue specimen for histopathological examination was gathered and the lesion was filled with an autologous bone graft harvested from the ipsilateral femur using a reamer-irrigator-aspirator (RIA) system. Following one revision surgery due to an intra-articular step-off, the patient recovered without further complications. Conclusions Pathologic fractures in young patients caused by unicameral bone cysts require extended diagnostics and adequate treatment. A single step surgical treatment is reasonable if fracture and bone cyst are treated appropriately. Arthroscopically assisted fracture repair may be considered in intra-articular fractures or whenever co-pathologies of the carpus are suspected. PMID:24925068

  10. Unusual finding of a mediastinal T-cell lymphoma in a 13-year-old patient - a case report.

    PubMed

    Bălănescu, Radu Ninel; Bălănescu, Laura; Cordoş, Ioan; Sfrijan, Doiniţa; Pop, Florinel; CaragaŢă, Florentina-Ruxandra; Mălăescu, Gheorghe Dan

    2015-01-01

    T-cell lymphoblastic lymphoma is an aggressive malignancy that represents 85% of all lymphoblastic lymphomas. It usually occurs in late childhood, adolescence and young adulthood with a 2:1 male preponderance and it presents with pleural effusion and respiratory symptoms and in rare cases vena cava syndrome can be encountered. We present the case of a 13-year-old patient who was referred to our clinic from a local hospital where he was diagnosed with a mediastinal tumor. The patient presented with thoracic pain, fever, coughing and fatigability for a month prior to admission, after having underwent surgery for abdominal pain (appendectomy). On admission to our hospital, a thoracic computed tomography (CT) scan was performed and showed the presence of an anterior mediastinal mass measuring 109/76/140 mm, well defined, which came in close contact with the superior vena cava, the ascending aorta and the pulmonary artery, right pleural effusion and a collapsed lung on the right side. The decision was taken to perform a tumor biopsy and a right pleural drain was placed. The patient's post-operative evolution was favorable with the remission of the respiratory symptoms. The histopathological result showed the presence of T-cell lymphoblastic lymphoma and the patient was then transferred to the oncology ward where he underwent chemotherapeutic treatment, with a favorable outcome. T-cell lymphoblastic lymphoma is an aggressive type of lymphoma and it is usually hard to diagnose considering the fact that the symptoms are often vague. It is essential to establish the diagnosis without delay and start appropriate chemotherapeutic treatment. PMID:26743307

  11. Males Have Greater "g": Sex Differences in General Mental Ability from 100,000 17- to 18-Year-Olds on the Scholastic Assessment Test

    ERIC Educational Resources Information Center

    Jackson, Douglas N.; Rushton, J. Philippe

    2006-01-01

    In this study we found that 17- to 18-year old males averaged 3.63 IQ points higher than did their female counterparts on the 1991 Scholastic Assessment Test (SAT). We analysed 145 item responses from 46,509 males and 56,007 females (total N = 102,516) using a principal components procedure. We found (1) the "g" factor underlies both the SAT…

  12. Isolated infrarenal abdominal aorta aneurysm in a 42-year-old patient with Marfan’s syndrome: Case report

    PubMed Central

    Hajji, Rita; Zrihni, Youssef; Zaghloul, Rachid; Zizi, Othman; Bouarhroum, Abdellatif

    2013-01-01

    Marfan’s syndrome is an autosomal dominant disorder of connective tissue characterized by a large number of possible mutations and by heterogeneity of clinical presentation primarily in skeletal, ocular and cardiovascular organ systems. Cardiovascular complications of the disease are responsible for high mortality. The case of a 42-year-old patient with a progressive advanced abdominal aorta dilatation visualized on computed tomography images is presented. Pathogenesis, diagnosis and management of patients with Marfan’s syndrome are also discussed. PMID:27489631

  13. The successful use of extracorporeal photopheresis in a 12-year-old patient with refractory epidermolysis bullosa acquisita.

    PubMed

    Liszewski, Walter; Omland, Silje Haukali; Gniadecki, Robert

    2015-01-01

    Epidermolysis bullosa acquisita is a rare autoimmune bullous disease of the mucosa and skin characterized by the presence of anti-collagen VII antibodies at the dermoepidermal junction. Most patients respond to immunosuppressive or antiinflammatory agents, although patients whose condition is refractory to these therapies will require more aggressive treatment. We present a 12-year-old girl with refractory epidermolysis bullosa acquisita who responded to extracorporeal photopheresis. PMID:25639865

  14. [A 77-year-old patient with suspected left atrial tumor].

    PubMed

    Bandorski, D; Hönscher, R; Ibing, R; Rieker, W

    2004-09-01

    A 77-year-old female presented with a suspected cardiac tumor and thrombosis of both legs diagnosed by phlebography with pulmonary embolism of both sides. In transthoracic echocardiography, transesophageal echocardiography, and CT no intracardial tumor was seen. There was a hiatal hernia which compressed the left atrium from outside. As echocardiographic criteria of hiatal hernia described by D'Cruz we found the left atrium filled with a solid mass and variation of compression of the left atrium depending on breathing. Because of the low incidence of cardiac tumors, differential diagnosis should be done if a cardiac tumor is suspected. A hiatal hernia should always be taken into consideration. PMID:15340697

  15. Meckel's diverticulum with intussusception in a 5-year-old patient with Down's syndrome.

    PubMed

    Anwar, Mohammed Omer; Ahmed, Hamza Ibn; Al Hindi, Saeed; Al Omran, Yasser

    2014-01-01

    Meckel's diverticulum is understood to be the commonest congenital malformation within the gastrointestinal tract with a prevalence of 2%, as found on autopsy studies. Although many cases are asymptomatic, complications can occur including haemorrhage, diverticulitis, chronic ulceration and intestinal obstruction. Intussusception is also a complication, but extremely rare. We present a rare case of Meckel's diverticulum causing intussusception, which was surgically resolved, in a 5-year-old girl. Our aim through this case report is to generate greater awareness of this complication and to provide some potential guidance towards its treatment. PMID:25540213

  16. Unicystic ameloblastoma in 3 year old paediatric patient – A rare entity

    PubMed Central

    Kumar, Priya; Urs, Aadithya B.; Augustine, Jeyaseelan

    2013-01-01

    Unicystic ameloblastoma (UA) is a benign epithelial odontogenic tumor of the jaws that commonly occurs in 2nd and 3rd decade of life. In fact, this entity is rare in children under 12 years of age. It is characterised as a distinct variant of ameloblastoma, exhibiting a less aggressive behaviour and a lower rate of recurrence than solid conventional ameloblastoma. There are very few reported cases of UA occurring in children below five years of age. The purpose of this case report is to describe a case of UA involving the crown of an unerupted maxillary second premolar in a 3 year old girl. The pathogenesis, clinical appearance, radiographic presentation, histological findings and management of the tumour have also been discussed. PMID:24455052

  17. Ovarian hemangioma occurring synchronously with contralateral mature cystic teratoma in an 81-year-old patient

    PubMed Central

    2010-01-01

    Purpose Ovarian hemangiomas are seen rarely. We present a case of an ovarian hemangioma occurring synchronously with contralateral mature cystic teratoma. Case history An 81-year-old woman presented with hypertension and hyponatremia. In ultrasonographic evaluation a pelvic mass was found located at the left ovary. Histologically, a mature cystic teratoma measuring 9.5 × 9 × 8 cm was seen in left ovary. In the right ovary an incidental vascular lesion measuring 3.5 × 1.5 × 1 cm was observed. Final histopathological examination of this lesion demonstrated a hemangioma of cavernous type. Conclusion To the best of our knowledge, this is the first ovarian hemangioma case occurring synchronously with contralateral mature cystic teratoma. PMID:20846106

  18. [Aseptic, simultaneous and bilateral mobilisation due to an acetabular shell fracture in a 43 year-old patient].

    PubMed

    Ceretti, M; Fanelli, M; Pappalardo, S

    2014-01-01

    The acetabular shell mobilization is the main long-term complication in total hip replacement. Metal-back fracture has also to be considered among the possible causes of shell mobilization. A case is presented of bilateral acetabular shell mobilization due to the trabecular covering de-soldering from the metal-back in a 43 year-old patient, 13-14 years after the first surgery. PMID:24360788

  19. Acute disseminated intravascular coagulation following surgical resection of a myeloid sarcoma in a 57-year-old male

    PubMed Central

    Paul, Rohan; Morgan, David; Levitt, Michael; Baker, Ross

    2012-01-01

    Myeloid sarcoma is a rare extramedullary tumour consisting of immature myeloid cells. It can arise at any anatomical location and often develops in the bowel. This report describes a case of severe acute disseminated intravascular coagulation (DIC) with multi-organ failure occurring in a 57-year-old man with chronic myelomonocytic leukaemia during bowel resection for newly diagnosed adenocarcinoma of the sigmoid colon. Histopa thology however revealed a differentiating myeloid sarcoma encompassing a well-differentiated adenocarcinoma. This is the first documented case of acute DIC to be triggered following surgical manipulation of myeloid sarcoma. PMID:24765456

  20. Adenoid cystic carcinoma of the submandibular gland with rare metastasis to the sternum in a 52-year-old male

    PubMed Central

    Alshammari, Abdullah; Eldeib, Omar Jamal; Eldeib, Ahmed Jamal; Saleh, Waleed

    2016-01-01

    Adenoid cystic carcinoma (ACC) is a rare tumor, described as being one of the most biologically destructive tumors of the head and neck. It is the most common malignancy that affects the minor salivary glands. Lung and bones are the most common regions of ACC distant metastasis. To the best of our knowledge, herein, we report the first ever case of latent isolated sternal metastasis from ACC in a 52-year-old gentleman, who was diagnosed to have ACC of the submandibular gland, excised 10 years ago. PMID:26933463

  1. A rare case of Kearns–Sayre syndrome in a 17-year-old Venezuelan male with bilateral ptosis as the initial presentation

    PubMed Central

    Leal, Mayela; Dhoble, Chetan; Lee, Julie; Lopez, Deinymar; Menéndez, Laura Simonne

    2016-01-01

    Kearns–Sayre syndrome (KSS) was first described in 1958 as ‘a rare neuromuscular disorder defined by a characteristic triad of progressive external ophthalmoplegia, pigmentary retinopathy, atrioventricular block and cerebellar ataxia’. The prevalence rate of KSS is ∼1–3 per 100 000 individuals. Here, we report a rare case of a 17-year-old Venezuelan male with KSS. PMID:26949540

  2. Presentation of case: Bladder cancer in an 18 year old female patient

    PubMed Central

    Sheehan, Lisa; Anwar, Adeel; Kommu, Sashi

    2014-01-01

    Introduction Bladder cancers are not very common in the young population below 20 years of age, especially in those who have not been exposed to chemotherapy, bladder augmentation surgery and other known risk factors. By highlighting this case we hope to raise awareness in the medical community, that the symptom of visible haematuria can potentially be due to a bladder malignancy and therefore this should be thoroughly investigated. Presentation of case An 18-year-old female presented with intermittent macroscopic haematuria and non-specific abdominal pain. Physical examination and routine blood tests were normal. An ultrasound scan initially showed a bladder wall lesion, which a flexible cystoscopy confirmed. Histology revealed grade 2 papillary transitional cell carcinoma of the bladder with no invasion into the lamina propria (G2pTa TCCB). Discussion We recognise through our literature review that paediatric bladder cancers are not commonly reported in the UK. In our paper we highlight the relevant major studies that have been carried out world-wide, the reported incidence so far and gaps in the evidence base. Conclusion Despite the dearth of data about paediatric bladder malignancies there is enough case-based evidence, from world-wide sources, to support that bladder cancer must be suspected in the event of macroscopic haematuria. Ultrasound and cystoscopy are the standard diagnostic tools for bladder tumours. Endoscopic resection of the tumour followed up by interval ultrasound scans and flexible cystoscopy checks remain the mainstay of treatment hitherto. PMID:25574770

  3. Thyroid lipomatosis in a 36-year-old patient with rheumatoid arthritis and a kidney transplant

    PubMed Central

    Bell, Soledad; del Valle Jaen, Ana; Russo Picasso, María Fabiana

    2016-01-01

    Summary Thyroid lipomatosis is a rare disease, as a total of 20 cases have been described in the literature. It is characterized by diffuse infiltration of the stroma by mature adipose tissue and by progressive growth that produces different degrees of compressive symptoms. Our aim is to present the case of a 36-year-old woman who consulted because of dyspnea caused by a multinodular goiter. She underwent surgery with the presumptive diagnosis of a malignant neoplasia, but the pathological examination of the surgical specimen established the diagnosis of thyroid lipomatosis. Learning points Thyroid lipomatosis is a rare, benign disease characterized by diffuse infiltration of the stroma by mature adipose tissue.The pathophysiology of diffuse proliferation of adipose tissue in the thyroid gland is unclear.Thyroid lipomatosis is clinically manifested by a progressive enlargement of the thyroid that can involve the airway and/or upper gastrointestinal tract, producing dyspnea, dysphagia, and changes in the voice.Given the rapid growth of the lesion, the two main differential diagnoses are anaplastic carcinoma and thyroid lymphoma.Imaging studies may suggest a differential diagnosis, but a definitive diagnosis generally requires histopathological confirmation after a thyroidectomy. PMID:27252862

  4. BONY AVULSION INJURY OF THE PECTORALIS MAJOR IN A 19 YEAR-OLD MALE JUDO ATHLETE: A CASE REPORT

    PubMed Central

    Westrick, Richard B.; Owens, Brett D.; Johnson, Michael R.

    2013-01-01

    Background and Purpose: Bony avulsion of the pectoralis major muscle is a rare but potentially devastating injury for athletes. Pectoralis major rupture typically occurs in 20 to 39 year‐old males. The shoulder region is one of the most frequently injured areas in Judo athletes. The purpose of this case report is to describe diagnosis and treatment following a pectoralis major bony avulsion due to an atypical mechanism of injury in a young Judo athlete. Case Description: A 19‐year‐old military cadet and competitive judo athlete reported to a direct‐access sports physical therapy clinic 7 weeks after incurring a shoulder injury during a judo match. He complained of shoulder pain and weakness with the inability to perform pushups. He presented with horizontal adduction weakness and visible discontinuity of the pectoralis muscle with resisted adduction. Outcomes: Radiographs demonstrated a bony avulsion of the pectoralis major from its humeral attachment. The patient underwent surgical repair of the lesion the next week and was able to resume most military cadet activities within 5 months post‐operation. Discussion: Bony avulsions are exceptionally rare injuries, and are even more uncommon in athletes under the age of 20. It is important for clinicians to perform a thorough history and physical examination in order to avoid missing this diagnosis. Surgery is likely the best option for a young athletic population; while conservative management may be optimal for the older, inactive population. Level of Evidence: 4 PMID:24377072

  5. Hypercalcemia and diffuse osteolytic lesions in a 45-year-old patient with myeloid sarcoma with megakaryocytic differentiation

    PubMed Central

    Goud, Aditya; Abdelqader, Abdelhai; Dahagam, Chanukya; Jabaji, Ramez; Kumar, Pallavi; Aboulafia, Albert; Selinger, Stephen

    2016-01-01

    Acute megakaryocytic leukemia is a rare form of acute myeloid leukemia that carries a poor prognosis. As most cases of osteolytic lesions are due to plasma cell and myeloid malignancies, maintaining a broad differential directly influences clinical course. We document a 45-year-old patient with progressive constitutional symptoms, osteolytic bone lesions in the setting of hypercalcemia, who developed acutely worsening pancytopenia. The diagnosis of myeloid sarcoma with megakaryocytic differentiation was made after obtaining tissue from osteolytic bone that stained strong for CD34. Immunohistochemical testing underscores the importance of how serologic and urine testing remains limited and can delay early diagnosis in this disease. PMID:27124159

  6. Sinus venosus atrial septal defect presenting with brain abscesses in a 77-year-old immunocompetent patient.

    PubMed

    Alhamshari, Yaser S M; Punjabi, Chitra; Pressman, Gregg S; Govil, Anita

    2015-01-01

    We present a case of 77-year-old immunocompetent patient who initially presented with vertigo, nausea and vomiting, with symptoms later progressing to headaches and increased lethargy. Brain MRI revealed ring-enhancing lesions typical of abscesses in the right cerebellum. Transoesophageal echocardiogram (TEE) was performed to look for the source of his abscesses, and uncovered a sinus venosus type atrial septal defect. Cardiac CT was carried out; the patient was found to have a sinus venosus atrial septal defect with partial anomalous pulmonary venous return. Moreover, dental examination showed multiple dental caries with poor oral hygiene. The patient was started on intravenous empiric antibiotics and steroids. Subsequent brain imaging showed almost complete resolution of the abscesses. The patient's symptoms started to improve, and he was eventually sent to an intensive rehabilitation centre with future plans to surgically correct his congenital heart disease to prevent further complications. PMID:26475881

  7. [Feasibility and importance of self-monitoring in patients over 75 years old].

    PubMed

    Bortolotto, L A; Henry, O; Hanon, O; Sikias, P; Girerd, X

    1999-08-01

    The feasibility of self-measurement (SM) of the blood pressure (BP) is well demonstrated in hypertensive patients (pts) but, in elderly pts physical and intellectual limitations can restrict the use of SM. The aim was to evaluate the feasibility of SM as a function of autonomic psychomotricity in pts aged more than 75 years and to estimate the reproducibility of SM in comparison with office's measurements (OM). We initially proposed the use of SM devices of BP to 53 pts aged > 75 years. One-third of pts refused to participate in the study. In 32 pts we did a mini-mental-state score (MMS) and an evaluation of autonomic functions (IADL). Two patients with a MMS < 20 were excluded. The OM of BP was done in sitting position with a mercury sphygmomanometer (4 measures) and the SM by a Omron device during 5 consecutive days (3 measures morning and night). Eighteen (60%) pts did more or equal to 15 measures (good measurer) and 12 less than 15 (bad measurer). The pts of the group "good measurer" were significantly younger, were all hypertensive treated patients and had a higher MMS and a lower IADL than those of the group "bad measurer". Considering the differences (OM-SM), 55% of patients showed values superior to 10 mmHg for systolic blood pressure, and 64% of subjects had values superior to 5 mmHg for diastolic blood pressure. We conclude that the SM is acceptable by patients older than 75 years and that feasibility is optimal in those patients where the autonomic and cognitive functions are preserved and when the patient is hypertensive. Also, as the concordance between OM and SM of patients older than 75 years is below 50%, diagnostic and therapeutic decisions based on OM is hazardous in these patients. PMID:10486683

  8. Patient Perspectives on Online Health Information and Communication With Doctors: A Qualitative Study of Patients 50 Years Old and Over

    PubMed Central

    2015-01-01

    Background As health care systems around the world shift toward models that emphasize self-care management, there is increasing pressure for patients to obtain health information online. It is critical that patients are able to identify potential problems with using the Internet to diagnose and treat a health issue and that they feel comfortable communicating with their doctor about the health information they acquire from the Internet. Objective Our aim was to examine patient-identified (1) problems with using the Internet to identify and treat a health issue, (2) barriers to communication with a doctor about online health information seeking, and (3) facilitators of communication with a doctor about patient searches for health information on the Internet. Methods For this qualitative exploratory study, semistructured interviews were conducted with a sample of 56 adults age 50 years old and over. General concerns regarding use of the Internet to diagnose and treat a health issue were examined separately for participants based on whether they had ever discussed health information obtained through the Internet with a doctor. Discussions about barriers to and facilitators of communication about patient searches for health information on the Internet with a doctor were analyzed using thematic analysis. Results Six higher-level general concerns emerged: (1) limitations in own ability, (2) credibility/limitations of online information, (3) anxiety, (4) time consumption, (5) conflict, and (6) non-physical harm. The most prevalent concern raised by participants who communicated with a doctor about their online health information seeking related to the credibility or limitations in online information. Participants who had never communicated with a doctor about their online health information seeking most commonly reported concerns about non-physical harm. Four barriers to communication emerged: (1) concerns about embarrassment, (2) concerns that the doctor doesn’t want

  9. [Tertiary syphilis of the pancreas and liver in 82-year-old patient: case study].

    PubMed

    Denisova, T L; Tiul'tiaeva, L A; Lipatova, T E; Bakulev, A L; Alipova, L N; Apanasevich, A V; Bezrodnaia, L A; Borisova, E A

    2013-01-01

    It has been described a clinical case of late diagnosis of syphilis of the pancreas and liver of elderly patients. Two years before that it was wrongly diagnosed with cancer of the pancreas with liver metastases, and the patient was operated on with the imposition of cholecystostomy. It was conducted appropriate therapy and reconstructive surgery after verification of the diagnosis of syphilis of the pancreas and liver. PMID:24772875

  10. Bee sting envenomation resulting in gross haematuria in an eight-year-old Nigerian male with sickle cell anaemia: A case report

    PubMed Central

    Odinaka, Kelechi Kenneth; Achigbu, Kingsley; Ike, Ifeanyi; Iregbu, Francis

    2015-01-01

    Gross haematuria is an unusual complication of Honey bee stings. Herein, we report a rare case of gross haematuria following multiple honeybees stings in an 8-year-old Nigerian child with sickle cell anaemia. The patient had evidence of massive intravascular haemolysis and was transfused with a unit of fresh whole blood. However, he died within 36 hours on admission despite medical intervention. PMID:25657498

  11. Alumina-alumina hip replacement in patients younger than 50 years old.

    PubMed

    Sedel, L; Nizard, R S; Kerboull, L; Witvoet, J

    1994-01-01

    From April 1977 to December 1990, 131 total hip arthroplasties were performed on 113 patients younger than 50 years of age (median, 41 years); 64 were men and 49 women. The majority were active people. Sixty-six hips had no previous operations, and 33 had at least one previous arthroplasty. The femoral component was a cemented collared titanium alloy stem, and alumina socket was cemented for 99 hips and press-fit for 32. The mean follow-up period was five years, with 32 hips followed for more than ten years. Revision arthroplasty was considered as a failure. Survivorship analysis depicted a 97.5% rate of survival at five years, an 89.4% rate at ten years, and an 86.2% at 11 years. Nine revisions were performed: one experienced a femoral head rupture after three years, one had bipolar loosening, one experienced femoral cystic formation, and six were revised for acetabular cup loosening, all from the cemented group. Two revisions occurred on the same patient. No stem revision was necessary before ten years. Only one of these revisions was required in patients aged 40 or younger (64 patients). Alumina-alumina friction is an extremely interesting phenomenon in young patients, and could be related to the low wear debris production. PMID:8118972

  12. [Features of elderly patients over 75 years old with gastric cancer and surgical strategy].

    PubMed

    Chen, Lin; Cui, Jianxin

    2016-05-25

    The new cases and mortality of gastric cancer in the population aged over 75 years account for 21% and 30% of the cases in the whole population respectively. These elderly patients with gastric cancer are characteristic of nonspecific clinical manifestations, high proportion of upper gastric carcinoma, larger tumor size, advanced TNM stage, concomitant diseases, poor body function and high risk of complications. Specialists should pay more attention to the diagnosis and treatment of these patients. Comprehensive and systemic assessment should be performed, and concomitant diseases should be treated. Accurate preoperative staging should be accessed by EUS and CT. Individualized treatment according to the principle of precise surgery and enhanced recovery after surgery (ERAS) should be performed as follows. For early gastric cancer with low risk of lymph node metastasis, endoscopic submucosal dissection(ESD) is recommended for expanded indications. For resectable advanced gastric cancer, "downsizing" surgery obtaining ≥4 cm incisal margin is recommended, which must be based on accurate preoperative stage. And gasless laproscopy is applicable for these patients. For unresectable advanced gastric cancer, conversion therapy is not the priority unless patients with high response rate. Palliative chemotherapy, immunotherapy and best supportive care should be applied in turn. ERAS techniques application in elderly patients with gastric cancer requires careful selection. PMID:27215511

  13. Sudden elevation of liver enzymes in a 64-year-old patient: a case report

    PubMed Central

    2009-01-01

    Eradication of Helicobacter pylori usually consists of a 7-day course of triple therapy including metronidazole or amoxicillin plus clarithromycin plus a proton pump inhibitor. We report about a rare adverse event of Hp eradication in a patient with moderate chronic and moderate active pangastritis. Shortly after the end of treatment cholestatic hepatitis occurred which was most likely related to clarithromycin, perhaps enhanced by amoxicillin. Since liver dysfunction was self-limited, no further treatment was required. In summary, clinicians should be aware about the presented rare adverse event of Helicobacter pylori eradication treatment for a close monitoring of those patients and rapid management of acute liver failure. PMID:19946449

  14. Operative management of traumatic cervical spine distraction and complete cord transection in a 3-year-old patient.

    PubMed

    Davern, Monica Salazar; Garg, Sumeet; Hankinson, Todd C

    2015-02-01

    This report describes the presentation and operative treatment of a 3-year-old boy who survived a motor vehicle accident that resulted in a C6-7 distraction injury, complete avulsion of the spinal cord, and gross spinal instability. Only 5%-10% of all spinal cord and vertebral column injuries occur in children. Survival after such an injury is exceptionally rare in very young patients and is associated with severe neurological deficits. The authors discuss the substantial ethical challenges involved in the care of a patient with this injury. To their knowledge, only two other cases of survival have been reported in pediatric patients following motor vehicle trauma resulting in complete injury to the lower cervical spinal cord. PMID:25415253

  15. Laparoscopic repair of Morgagni hernia and cholecystectomy in a 40-year-old male with Down's sindrome. Report of a case.

    PubMed

    De Paolis, P; Mazza, L; Maglione, V; Fronda, G R

    2007-06-01

    Morgagni-Larrey hernia (MH) is an unusual diaphragmatic hernia of the retrosternal region. Few cases of MH, treated laparoscopically, associated with Down's syndrome (DS) have been reported in literature. On October 2004, a DS 40-year-old male was admitted to our Department with mild abdominal pain and nausea. Hematochemical tests were within the normal range. Ultrasonography showed biliary sludge and multiple gallstones. Chest X-ray revealed a right-sided paracardiac mass that appeared as MH after a thoraco-abdominal computed tomography (CT). Four trocars were placed as a routinary cholecystectomy. Abdominal exploration confirmed the presence of a voluminous hernia through a wide diaphragmatic defect (12 cm) on the left side of the falciform ligament, containing the last 20 cm ileal loops and right colon with the third lateral of transverse. After retrograde cholecystectomy and reduction of the herniated ileo-colonic tract from multiple adherences, the defect was repaired with an interrupted 2/0 silk suture and then a running 2/0 polypropylene suture. Postoperative course was complicated by pulmonary edema but subsequently the patient was discharged without further complications and has no recurrence after 2 years. In conclusion, surgery is necessary for symptomatic MH and to prevent possible severe complications. We preferred laparoscopy for the reduced morbidity compared to laparotomy, even if in our case the postoperative course was not uneventful. There are still few comparative data about the modality of closure of the defect between primary repair with nonabsorbable suture material, in case of small defects, or continuous monofilament suture or prosthesis in case of large defects. PMID:17519846

  16. [Multiple smooth colon stenosis in 76-year-old female patient].

    PubMed

    Muehlenberg, K; Dietl, O; Piso, P; Pech, O

    2015-10-01

    Differential diagnostic aspects of colon stenoses are discussed using the example case of a female patient presenting with multilocular colon metastases, who had lobular breast cancer 9 years previously. Typical is linitis plastica, which can indicate tumorous infiltration not only of the stomach, but also of the large intestine. Other endoscopic imaging and histological studies may, however, fail. The pathologist requires the anamnestic data relating to the breast cancer for exact assignment of the tumorous infiltration. PMID:26349909

  17. The Association of Irritability and Impulsivity with Suicidal Ideation Among 15- to 20-Year-Old Males

    ERIC Educational Resources Information Center

    Conner, Kenneth R.; Meldrum, Sean; Wieczorek, William F.; Duberstein, Paul R.; Welte, John W.

    2004-01-01

    Information on the association of impulsivity and measures of aggression with suicidal ideation in adolescents and young adults is limited. Data were gathered from a community sample of 625 adolescent and young adult males. Analyses were based on multivariate generalized estimating equations. Impulsivity and irritability were associated strongly…

  18. A 23-year-old patient with secondary tumoral calcinosis: Regression after subtotal parathyroidectomy

    PubMed Central

    Niemann, Katharina E.; Kröpil, Feride; Hoffmann, Martin F.; Coulibaly, Marlon O.; Schildhauer, Thomas A.

    2016-01-01

    Introduction Tumoral calcinosis (TC) is a rare disorder defined by hyperphosphatemia and ectopic calcifications in various locations. The most common form of TC is associated with disorders such as renal insufficiency, hyperparathyroidism, or hypervitaminosis D. The primary (hereditary) TC is caused by inactivating mutations in either the fibroblast growth factor 23 (FGF23), the GalNAc transferase 3 (GALNT3) or the KLOTHO (KL) gene. Presentation of case We report here a case of secondary TC in end-stage renal disease. The patient was on regular hemodialysis and presented with severe painful soft-tissue calcifications around her left hip and shoulder that had been increasing over the last two years. Initially, she was treated with dietary phosphate restriction and phosphate binders. Because of high phosphate blood levels, which were not yet managed with dialysis and medical therapy, a subtotal parathyroidectomy (sP) was performed. This approach demonstrated significant response. Three months after surgery a rapid regression of the tumors was observed. Disscusion Regardless of the etiology, the two types of TC do not differ in their radiologic or histopathologic presentations but need to be diagnosed correctly to initiate targeted and effective treatment. Considering the primary TC, primary treatment is early and complete surgical excision. In case of secondary TC surgical excision of the tumoral masses should be avoid because of extensive complications. These patients benefit from sP. Conclusion After initial conservative therapy chronic kidney disease patients with TC might benefit from sP to avoid prolonged suffering and potential mutilations. PMID:27088846

  19. Colonic Spirochetosis in a 60-Year-Old Immunocompetent Patient: Case Report and Review.

    PubMed

    Ngwa, Taiwo; Peng, Jennifer L; Choi, Euna; Tayarachakul, Sucharat; Liangpunsakul, Suthat

    2016-01-01

    Spirochetes, a genetically and morphologically distinct group of bacteria, are thin, spiral-shaped, and highly motile. They are known causes of several human diseases such as syphilis, Lyme disease, relapsing fever, and leptospirosis. We report a case of colonic spirochetosis in a healthy patient presenting for surveillance colonoscopy. The diagnosis of intestinal spirochetosis was made accidentally during the histological examination of colonic polyps, which were removed during colonoscopy. We also performed an extensive review on intestinal spirochetosis with a focus on clinical presentation and outcomes of reported cases from the past two decades. PMID:27570780

  20. Whose information is it anyway? Informing a 12-year-old patient of her terminal prognosis

    PubMed Central

    Goldie, J; Schwartz, L; Morrison, J

    2005-01-01

    Design: A cohort study of students entering Glasgow University's new medical curriculum in October 1996. Methods: Students' responses obtained before year 1 and at the end of years 1, 3, and 5 to the "childhood leukaemia" vignette of the Ethics in Health Care Survey Instrument (EHCI) were examined quantitatively and qualitatively. Analysis of the students' multichoice answers enabled measurement of the movement towards professional consensus opinion. An analysis of their written justifications for their answers helped to determine whether their reasoning was consistent with professional consensus and enabled measurement of changes in knowledge content and recognition of the values inherent in the vignette. Themes on the students' reasoning behind their decision to tell the patient or not were also identified. Results: Unlike other vignettes of the EHCI in which autonomy was a main theme, few students chose the consensus answer before year 1 and there was no significant movement towards consensus at any point during the course. In defence of their decision to withhold information, the students expressed strong paternalistic opinions. The patient's age was seen as a barrier to respecting her autonomy. Conclusions: It is important to identify students' perceptions on entry to medical school. Transformative learning theory may provide the basis for an approach to foster doctors who consider the rights of young people. Small-group teaching is most conducive to this approach. The importance of positive role modelling is also emphasised. PMID:15994366

  1. Dietary and Lifestyle Changes in the Treatment of a 23-Year-Old Female Patient With Migraine

    PubMed Central

    Martin, Brett R.; Seaman, David R.

    2015-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a patient with atypical migraine headache. Clinical Features A 23-year-old woman experienced migraines for 3 months. She had no previous history of migraines and was unresponsive to pharmaceutical and musculoskeletal therapies. The migraine headaches could not be classified according to the common categories associated with migraines. She had a change in diet due to severe gastroesophageal reflux causing her to reduce or avoid consuming foods. She also had a history of smoking and alcohol consumption. Intervention and Outcome Dietary and lifestyle changes were recommended in conjunction with the administration of a multivitamin, magnesium oxide, and Ulmus rubra. Her migraine headaches improved with the resolution of her gastroesophageal reflux symptoms. Conclusion This patient with atypical migraines and a history of poor dietary and lifestyle choices improved using nutritional changes and supplementing with a multivitamin and magnesium oxide. PMID:26778934

  2. Immunogenicity of the quadrivalent human papillomavirus (type 6/11/16/18) vaccine in males 16 to 26 years old.

    PubMed

    Hillman, Richard J; Giuliano, Anna R; Palefsky, Joel M; Goldstone, Stephen; Moreira, Edson D; Vardas, Eftyhia; Aranda, Carlos; Jessen, Heiko; Ferris, Daron G; Coutlee, Francois; Marshall, J Brooke; Vuocolo, Scott; Haupt, Richard M; Guris, Dalya; Garner, Elizabeth I O

    2012-02-01

    Human papillomavirus (HPV) infection can lead to significant disease in males, including anogenital warts, intraepithelial neoplasias, and several types of oral and anogenital cancers. The quadrivalent HPV (type 6/11/16/18) L1 virus-like particle (VLP) vaccine (qHPV vaccine; Gardasil) has recently been demonstrated to prevent persistent infection and associated disease related to vaccine HPV types in males. We report the overall immunogenicity results from a trial of the quadrivalent HPV vaccine in males. Overall, 3,463 heterosexual men and 602 men who had sex with men were enrolled into a randomized, placebo-controlled, double-blind safety, immunogenicity, and efficacy study. Serum samples were collected prior to vaccination at day 1 and at months 7, 24, and 36 postvaccination. Immunogenicity was evaluated with a multiplex, competitive Luminex immunoassay. Almost all subjects (97.4 to 99.2%) seroconverted for vaccine HPV types by month 7. At month 36, 88.9%, 94.0%, 97.9%, and 57.0% of subjects were still seropositive for HPV-6, -11, -16, and -18, respectively. For all vaccine HPV types, black subjects had significantly higher antibody titers at month 7 than did both Caucasian and Asian subjects. An anamnestic antibody response was seen in men seropositive before vaccination. The vaccine was highly immunogenic in males 16 to 23 years of age; responses were comparable to those observed in women. Furthermore, the immune responses were consistent with the established efficacy of the vaccine in the prevention of incident and persistent HPV infection, anogenital warts, and anal intraepithelial neoplasia. PMID:22155768

  3. Condom use behaviours among 18–24 year-old urban African American males: a qualitative study

    PubMed Central

    KENNEDY, S. B.; NOLEN, S.; APPLEWHITE, J.; WAITERS, E.; VANDERHOFF, J.

    2007-01-01

    The purpose of this pilot project was to develop, administer and assess a brief male-focused and behavioural-driven condom promotion programme for young adult African American males in an urban setting. To achieve the aims of this study, linkages with local community centres were initially fostered and both quantitative and qualitative research methods were employed. Based on relevant tenets of the social cognitive theory and the stages of change model, a series of focus groups were conducted among the target population, recruited from non-traditional urban settings, to identify and further explore their perceived condom use barriers and facilitators in order to support programme development. Specifically, the topical items addressed those young men’s perceptions of sexuality and condom use within three broad contexts: general sexual behaviours, condom use behaviours, and the relationship between condoms and substance use. The focus group discussions were audiotaped and the transcribed data summarized and analysed based on those thematic topics. The findings revealed that significant myths, misconceptions and knowledge gaps exist regarding HIV/STD-related prevention, condom promotion and substance use. The findings imply that there is a critical need to develop target group suitable condom promotion programmes in order to successfully promote, foster and sustain condom use among high-risk populations. PMID:17852001

  4. Diced Cartilage Graft for Revision Rhinoplasty in a 64-year-old Cleft Patient: A Case Report

    PubMed Central

    Lin, Susie; Hsiao, Yen-Chang; Chen, Philip Kuo-Ting; Chen, Jyh-Ping

    2016-01-01

    Summary: Pure diced cartilage graft has been the technique of choice for revision rhinoplasty in cleft patients since 2003 at our center. This technique has several advantages over the traditional en bloc cartilage onlay graft including minimal risk of warping, its technical simplicity, and the ability to adjust the shape of the graft with manual massage for up to 3 weeks postoperatively. Calcification of the costal cartilage, however, poses a real concern for surgeons. In this case report, we are presenting a 64-year-old woman with a right unilateral complete cleft lip and palate deformity who presented to our clinic for secondary revision. Central-pattern rib calcification was encountered during the operation. Outcomes, details of the operation, and potential limitations of this technique are discussed in this case report. PMID:27536492

  5. Diced Cartilage Graft for Revision Rhinoplasty in a 64-year-old Cleft Patient: A Case Report.

    PubMed

    Lin, Susie; Hsiao, Yen-Chang; Chang, Chun-Shin; Chen, Philip Kuo-Ting; Chen, Jyh-Ping

    2016-07-01

    Pure diced cartilage graft has been the technique of choice for revision rhinoplasty in cleft patients since 2003 at our center. This technique has several advantages over the traditional en bloc cartilage onlay graft including minimal risk of warping, its technical simplicity, and the ability to adjust the shape of the graft with manual massage for up to 3 weeks postoperatively. Calcification of the costal cartilage, however, poses a real concern for surgeons. In this case report, we are presenting a 64-year-old woman with a right unilateral complete cleft lip and palate deformity who presented to our clinic for secondary revision. Central-pattern rib calcification was encountered during the operation. Outcomes, details of the operation, and potential limitations of this technique are discussed in this case report. PMID:27536492

  6. Safety and efficacy of treatment with liposomal amphotericin B in elderly patients at least 65 years old with hematological diseases.

    PubMed

    Ueda, Satomi; Miyamoto, Shunichi; Kaida, Kosuke; Chizuka, Aki; Kojima, Rie; Takano, Junichiro; Ogasawara, Toshie; Miyamoto, Ko; Miyakoshi, Shigesaburo; Kanda, Yoshinobu

    2016-05-01

    The safety and efficacy of treatment with liposomal amphotericin B (L-AMB) in elderly patients has not been clarified, especially in Japanese patients. Therefore, we retrospectively analyzed 33 elderly patients with hematological diseases of at least 65 years old who received L-AMB between 2009 and 2012. Their clinical outcomes were compared to those of 21 patients who were younger than 65 years. L-AMB was administered for empirical therapy (n = 2) or target therapy for possible (n = 14) or probable/proven (n = 17) invasive fungal infection. There was no discontinuation of L-AMB due to adverse events. More than 2-fold increases from the baseline Cre, AST, and ALT values were observed in 21.2%, 39.4%, and 45.5% of the older group and 38.1%, 61.9%, and 52.4% of the younger group, respectively. The concurrent use of nephrotoxic antibiotics was the only risk factor for the development of a 2-fold increase in the serum Cre level. The duration of L-AMB was significantly longer in patients who developed grade III-IV hypokalemia. A partial or complete response was observed in 54.8% and 62.5% of the elderly and younger groups, respectively. In conclusion, L-AMB therapy appeared to be acceptably safe as empirical therapy or treatment for invasive fungal infection. PMID:26908230

  7. Type and location of findings in dental panoramic tomographs in 7-12-year-old orthodontic patients.

    PubMed

    Pakbaznejad Esmaeili, Elmira; Ekholm, Marja; Haukka, Jari; Waltimo-Sirén, Janna

    2016-05-01

    Objective The Radiation and Nuclear Safety Authority in Finland has paid attention to the large numbers of dental panoramic tomographs (DPTs), particularly in 7-12-year-old children. The majority of these radiographs are taken for orthodontic reasons. Because of the high radiosensitivity of children, the size of the irradiated field should be carefully chosen to yield the necessary diagnostic information at the lowest possible dose. The purpose of the present study was, therefore, to assess the outcome of DPTs within this age group in terms of type and location of pathological findings. It was also hypothesized that DPTs of orthodontic patients rarely display unrestored caries. Materials and methods Four hundred and forty-one DPTs, taken of 7-12-year-old children in 2010-2014, were randomly sampled. The 413 of them (94%) that had been taken for orthodontic reasons were analysed. Results All pathologic findings were restricted to the tooth-bearing area and there was no pathology in the bone structure or any incidental findings in the region of temporomandibular joint. Unlike hypothesized, 27% of the orthodontic DPTs showed caries in deciduous teeth and 16% in permanent teeth. A sub-sample of 229 DPTs, analysed for developmental dental and occlusal problems, most commonly displayed crowding (50%), positional anomalies and local problems with tooth eruption (32%), as well as hyperodontia (15%). Conclusion Inclusion of only the actual area of interest in the image field should be considered case-specifically as a means to reduce the radiation dose. PMID:26634313

  8. Primary mixed malignant tumor of bone in an 18-year-old male: Report of a case with radiologic-pathologic correlation

    PubMed Central

    Courtier, Jesse; Robbins, Elizabeth; Soares, Bruno; Horvai, Andrew; Mackenzie, John D.

    2012-01-01

    We report a case of primary malignant mixed tumor (MMT) of bone in an 18-year-old boy with X-ray, CT, MR, scintigraphic, FDG PET, and pathologic correlation. Primary MMT of bone is a highly aggressive tumor and presents both a diagnostic and clinical treatment challenge. This tumor is extremely rare and to the best of our knowledge, this is the first report of the diagnostic imaging findings for primary MMT arising from bone in a patient of this age group. PMID:26909264

  9. A Process of Multidisciplinary Team Communication to Individualize Stroke Rehabilitation of an 84-Year-Old Stroke Patient.

    PubMed

    Hiragami, Fukumi; Hiragami, Shogo; Suzuki, Yasuo

    2016-01-01

    Previously, we have used a multidisciplinary team (MDT) approach to individualize rehabilitation of very old stroke patients as a means to establish intervention points for addressing impaired activities of daily living (ADL). However, this previous study was limited because of a lack in describing the communication process over time. This case study characterized the MDT communication process in the rehabilitation of an 84-year-old patient over the course of 15 weeks. The MDT consisted of 3 nurses, 1 doctor, 6 therapists, and the patient/families. Meetings (15 minutes each) were held at 4, 6, 8, and 15 weeks following the patient's admission. To individualize the rehabilitation, the communication process involved gaining knowledge about ADL impairments, sharing assessments, providing treatment options, and reflecting on desired treatment outcomes-a process termed KATR. The knowledge, assessment, treatment, and reflection (KATR) process established intervention points focusing on specific ADL impairments. The team members focused the interventions on the impaired ADL identified in the KATR process, and individualized rehabilitation was generated from the MDT information-sharing knowledge. In the initial meeting (Week 4), intervention points derived from the KATR process focused on rehabilitation of self-care impairments. These impairments improved by Week 15. By the last meeting, the MDT intervention points focused on mobility impairments. Having an organized communication process (i.e., KATR) facilitates individualization of rehabilitation without lengthy and frequent MDT meetings and enhances the quality of rehabilitation after a stroke. PMID:27298136

  10. Anaphylactoid Purpura Manifested after Acute Gastroenteritis with Severe Dehydration in an 8-Year-Old Male Child: A Case Report.

    PubMed

    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. PMID:26602584

  11. Quantification of biological tissue and construction of patient equivalent phantom (skull and chest) for infants (1-5 years old)

    NASA Astrophysics Data System (ADS)

    Alves, A. F.; Pina, D. R.; Bacchim Neto, F. A.; Ribeiro, S. M.; Miranda, J. R. A.

    2014-03-01

    Our main purpose in this study was to quantify biological tissue in computed tomography (CT) examinations with the aim of developing a skull and a chest patient equivalent phantom (PEP), both specific to infants, aged between 1 and 5 years old. This type of phantom is widely used in the development of optimization procedures for radiographic techniques, especially in computed radiography (CR) systems. In order to classify and quantify the biological tissue, we used a computational algorithm developed in Matlab ®. The algorithm performed a histogram of each CT slice followed by a Gaussian fitting of each tissue type. The algorithm determined the mean thickness for the biological tissues (bone, soft, fat, and lung) and also converted them into the corresponding thicknesses of the simulator material (aluminum, PMMA, and air). We retrospectively analyzed 148 CT examinations of infant patients, 56 for skull exams and 92 were for chest. The results provided sufficient data to construct a phantom to simulate the infant chest and skull in the posterior-anterior or anterior-posterior (PA/AP) view. Both patient equivalent phantoms developed in this study can be used to assess physical variables such as noise power spectrum (NPS) and signal to noise ratio (SNR) or perform dosimetric control specific to pediatric protocols.

  12. Changes in Caries Risk and Activity of a 9-Year-Old Patient with Niemann-Pick Disease Type C

    PubMed Central

    Mesquita-Guimarães, Késsia Suênia Fidelis; De Rossi, Andiara; Freitas, Aldevina Campos; Nelson-Filho, Paulo; da Silva, Raquel Assed; de Queiroz, Alexandra Mussolino

    2015-01-01

    Objective. This case report describes the changes in caries risk and activity and dental treatment of a 9-year-old patient who presented with signs and symptoms of Niemann-Pick disease type C (NPC). Treatment. The preventive dental treatment included instructions to caregivers for oral hygiene and diet. A calcium hydroxide pulpotomy and restorative dental treatments were performed in a dental office with desensitization techniques and behavioral management. The patient was attended every 3 months for the control of dental plaque biofilm, for topical fluoride application, and for observing the pulpotomized tooth. Results. The bacterial plaque biofilm was being adequately controlled by the caregiver. After 2 years, the clinical and radiographic examination of the pulpotomized tooth showed the absence of internal root resorption and bone rarefaction, and clinical examination showed tooth sensitivity, dental pain, and gingival swelling. Conclusion. The pulpotomy prevented clinical and radiographic success. Dentists must be aware of and be able to identify systemic and local aspects associated with caries risk of children with NPC disease. Furthermore, dentists must employ stringent preventive measures and provide instructions to caregivers to reduce caries risk. PMID:25685563

  13. Changes in caries risk and activity of a 9-year-old patient with niemann-pick disease type C.

    PubMed

    Mesquita-Guimarães, Késsia Suênia Fidelis; De Rossi, Andiara; Freitas, Aldevina Campos; Nelson-Filho, Paulo; da Silva, Raquel Assed; de Queiroz, Alexandra Mussolino

    2015-01-01

    Objective. This case report describes the changes in caries risk and activity and dental treatment of a 9-year-old patient who presented with signs and symptoms of Niemann-Pick disease type C (NPC). Treatment. The preventive dental treatment included instructions to caregivers for oral hygiene and diet. A calcium hydroxide pulpotomy and restorative dental treatments were performed in a dental office with desensitization techniques and behavioral management. The patient was attended every 3 months for the control of dental plaque biofilm, for topical fluoride application, and for observing the pulpotomized tooth. Results. The bacterial plaque biofilm was being adequately controlled by the caregiver. After 2 years, the clinical and radiographic examination of the pulpotomized tooth showed the absence of internal root resorption and bone rarefaction, and clinical examination showed tooth sensitivity, dental pain, and gingival swelling. Conclusion. The pulpotomy prevented clinical and radiographic success. Dentists must be aware of and be able to identify systemic and local aspects associated with caries risk of children with NPC disease. Furthermore, dentists must employ stringent preventive measures and provide instructions to caregivers to reduce caries risk. PMID:25685563

  14. Minimal change nephrotic syndrome in an 82 year old patient following a tetanus-diphteria-poliomyelitis-vaccination

    PubMed Central

    2009-01-01

    Background The most common cause of idiopathic nephrotic syndrome in children and younger adults is the minimal change nephrotic syndrome (MCNS). In the elderly MCNS is relatively uncommon. Over the last decade some reports suggest a rare but possible association with the administration of various vaccines. Case presentation A 82-year old Caucasian female presented with pronounced nephrotic syndrome (proteinuria of 7.1 g/d, hypoproteinemia of 47 g/l). About six weeks prior to admission, she had received a combination vaccination for tetanus, diphtheria and poliomyelitis as a booster-vaccination from her general practitioner. The renal biopsy revealed typical minimal change lesions. She responded well to the initiated steroid treatment. As through physical examination as well as extensive laboratory and imaging studies did neither find any evidence for malignancies nor infections we suggest that the minimal change nephrotic syndrome in this patient might be related to the activation of the immune system triggered by the vaccination. Conclusion Our case as well as previous anecdotal reports suggests that vaccination and the resulting stimulations of the immune system might cause MCNS and other severe immune-reactions. Increased awareness in that regard might help to expand the database of those cases. PMID:19656382

  15. Orofacial granulomatosis affecting lip and gingiva in a 15-year-old patient: A rare case report

    PubMed Central

    Bansal, Monika; Singh, Nootan; Patne, Shashikant; Singh, Satyendra Kumar

    2015-01-01

    Orofacial granulomatosis (OFG) is a rare disorder affecting the orofacial region, and clinically characterized by diffuse, nontender, soft to firm, painless swelling restricted to one or both lips and intraoral sites such as tongue, gingiva and buccal mucosa. Histologically, OFG is characterized by noncaseating granulomatous inflammation. The early diagnosis of OFG is essential for the better prognosis of the lesion. Delay in diagnosis of OFG results into formation of indurated and permanent swelling of the lip that not only compromises esthetic appearance but also causes impairment in function such as speaking and eating. Early diagnosis of OFG is challenging to the health care professionals due to clinical and histological resemblance to other chronic granulomatous disorders. Thus, dentists may act as a first person to diagnose the lesion and play an important role in the multidisciplinary treatment of granulomatous disorders. Here, we present a case of OFG affecting lips and gingiva in a 15-year-old patient without any identifiable systemic or local causes. PMID:25821385

  16. A case of an 18-year-old male rugby union forward with a C5/C6 central disc herniation.

    PubMed

    Broughton, Henare Renata

    2009-01-01

    The patient was an 18-year-old front row forward rugby player who had a history of episodic neck pain for over 2 years following playing games of rugby. The initial event of April 2005 for which the symptoms manifested was a scrum collapse; he continued playing until a front-on tackle occurred when the symptoms dictated that he leave the field and be taken to the local hospital. A diagnosis of a cervical sprain was made and conservative management ensued. During the selections held on January 2008, a medical assessment was made and an MRI found that he had a central disc herniation at C5/C6. He was referred to a spinal orthopaedic surgeon for further treatment. The risks to cervical spinal injuries are illustrated in this case, in a scrum and in the tackle. The prevention of such an injury is discussed. PMID:21686741

  17. Robot-assisted laparoscopic prostatectomy in a 68-year-old patient with previous heart transplantation and pelvic irradiation.

    PubMed

    Axcrona, Karol; Vlatkovic, Ljiljana; Hovland, Jarl; Brennhovd, Bjørn; Kongsgaard, Ulf; Giercksky, Karl-Erik

    2012-03-01

    We report the case of a 68-year-old man who had previously undergone heart transplantation and pelvic irradiation for Hodgkin's lymphoma and who was under active surveillance for prostate cancer. In response to his increased prostate-specific antigen levels and elevated Gleason score, he was offered robot-assisted laparoscopic prostatectomy. PMID:22408687

  18. Combined mitral valve replacement associated with the Bentall procedure, diaphragmatic hernia repair and reconstruction of the pectus excavatum in a 26-year-old patient with Marfan syndrome

    PubMed Central

    Stępiński, Piotr; Aboul-Hassan, Sleiman Sebastian; Szymańska, Anna; Marczak, Jakub; Cichoń, Romuald

    2016-01-01

    A 26-year-old man with Marfan syndrome was admitted as an emergency patient with ascending aorta aneurysm, severe mitral and aortic regurgitation, diaphragmatic hernia and pectus excavatum. After completion of diagnostics a combined surgical procedure was performed. PMID:27516786

  19. Non-Contrast-Enhanced Whole-Body Magnetic Resonance Imaging in the General Population: The Incidence of Abnormal Findings in Patients 50 Years Old and Younger Compared to Older Subjects

    PubMed Central

    Cieszanowski, Andrzej; Maj, Edyta; Kulisiewicz, Piotr; Grudzinski, Ireneusz P.; Jakoniuk-Glodala, Karolina; Chlipala-Nitek, Irena; Kaczynski, Bartosz; Rowinski, Olgierd

    2014-01-01

    Purpose To assess and compare the incidence of abnormal findings detected during non-contrast-enhanced whole-body magnetic resonance imaging (WB-MRI) in the general population in two age groups: (1) 50 years old and younger; and (2) over 50 years old. Materials and Methods The analysis included 666 non-contrast-enhanced WB-MRIs performed on a 1.5-T scanner between December 2009 and June 2013 in a private hospital in 451 patients 50 years old and younger and 215 patients over 50 years old. The following images were obtained: T2-STIR (whole body-coronal plane), T2-STIR (whole spine-sagittal), T2-TSE with fat-saturation (neck and trunk-axial), T2-FLAIR (head-axial), 3D T1-GRE (thorax-coronal, axial), T2-TSE (abdomen-axial), chemical shift (abdomen-axial). Detected abnormalities were classified as: insignificant (type I), potentially significant, requiring medical attention (type II), significant, requiring treatment (type III). Results There were 3375 incidental findings depicted in 659 (98.9%) subjects: 2997 type I lesions (88.8%), 363 type II lesions (10.8%) and 15 type III lesions (0.4%), including malignant or possibly malignant lesions in seven subjects. The most differences in the prevalence of abnormalities on WB-MRI between patients 50 years old and younger and over 50 years old concerned: brain infarction (22.2%, 45.0% respectively), thyroid cysts/nodules (8.7%, 18.8%), pulmonary nodules (5.0%, 16.2%), significant degenerative disease of the spine (23.3%, 44.5%), extra-spinal degenerative disease (22.4%, 61.1%), hepatic steatosis (15.8%, 24.9%), liver cysts/hemangiomas (24%, 34.5%), renal cysts (16.9%, 40.6%), prostate enlargement (5.1% of males, 34.2% of males), uterine fibroids (16.3% of females, 37.9% of females). Conclusions Incidental findings were detected in almost all of the subjects. WB-MRI demonstrated that the prevalence of the vast majority of abnormalities increases with age. PMID:25259581

  20. Is there benefit in optimising heart failure treatment in over-80 year-old patients? (HF-80 study): study protocol for a randomized controlled trial

    PubMed Central

    2012-01-01

    Background An aging population and better management of various heart diseases explain the exponential growth in incidence and prevalence of chronic heart failure, with poor prognosis and heavy health costs. Medical management is codified in international guidelines. The management of heart failure in over-80 year-old patients follows these guidelines, but no clinical trials have been able to confirm benefit. Moreover, registries show down-prescription of heart failure treatments in the elderly and over-80s. Methods/Design We present the design of the HF-80 ("Is there benefit in optimising heart failure treatment in over-80 year-old patients?") study, which is a prospective randomised open-label clinical trial with blinded end-points, designed to evaluate the effect of optimising management by adhering to guidelines in over-80 year-old heart failure patients. Patients over 80 years of age admitted with acute heart failure will be included. The primary endpoint is to assess quality of life at 6 months on the Minnesota questionnaire. The secondary endpoints are to assess the effect of optimised management on quality of life, mortality, readmission for acute heart failure, cardiac fibrosis and economic data at 12 months. 80 patients will be included, divided into 2 groups: group A, with usual heart failure management by general practitioners; and group B, with optimised management based on international guidelines. Discussion It is necessary to assess the benefit of guidelines in over-80 year-old heart failure patients because of the fragility of this population and the elevated risk of iatrogenic complications. Trial Registration Clinical trials.gov number: NCT01437371. PMID:22394464

  1. A Comparative Analysis of Selected Variables of 12-to-15 Year Old Males in Special Education and the Juvenile Justice System

    ERIC Educational Resources Information Center

    Sinclair-Blake, Leslie C.

    2010-01-01

    This study identified and compared selected variables of 12-15-year-old African American young men in special education programs and the juvenile justice system. A majority of African American young men who are placed in special education programs are also involved with the juvenile justice system. Through personal observations, interviews with…

  2. The Combined use of Diode LASER & Conscious Sedation in the Excision of Pyogenic Granuloma in A Nine-Year-Old Patient

    PubMed Central

    Gokhale, Shankar T; Naik, N. Sathyajith; Singh, Akanksha; Bhattacharya, Deepankar

    2015-01-01

    This case report is to comprehensively review N2O/ O2 inhalational sedation in the context of conscious sedation for treating a nine-year-old patient with pyogenic granuloma. The excision was carried out by the use of diode laser. The six month postoperative follow up showed complete resolution of the lesion and increased patient acceptance for the future treatment. The use of laser minimizes the pain during the surgery and postoperatively and suturing was not required. Therefore this case report emphasizes the use of combined treatment modalities to increase patient comfort and to obtain a better function and aesthetics of the oral cavity. PMID:26816994

  3. Central Nervous System Lymphoma in a 3-Year-Old Male Suffering from a Severe Juvenile Xanthogranuloma – the Usefulness of Perfusion Weighted Imaging and Diffusion Weighted Imaging in the Diagnostics of Pediatric Brain Tumors

    PubMed Central

    Neska-Matuszewska, Małgorzata; Zimny, Anna; Kałwak, Krzysztof; Sąsiadek, Marek J.

    2015-01-01

    Summary Background Primary Central Nervous System Lymphomas (PCNSLs) are rare, malignant brain tumors derived from lymphocytes B. Juvenile xanthogranuloma (JXG) is a non-Langerhans histiocytic cell disorder in children which mostly affects the skin. Rare fatalities have been reported in extracutaneous manifestation. Brain magnetic resonance imaging (MRI) is a method of choice in the diagnostics of all neoplastic CNS lesions. Perfusion weighted imaging (PWI) and diffusion weighted imaging (DWI) allow for more detailed analysis of brain tumors including the rate of neoangiogenesis and cellularity. We presented a pediatric patient suffering from JXG with CNS involvement and the role of brain MRI including DWI and PWI in the evaluation of brain focal lesions. Case Report A 3-year-old male with severe JXG underwent two stem cell transplantations with a development of neurological complications. The patient underwent emergency CT and MRI which revealed a non-specific enhancing focal brain lesion. In DWI it showed restricted diffusion while PWI revealed low values of rCBV and the signal intensity curve returning above the baseline level. Advanced MRI techniques such as DWI and PWI suggested PCNSL. Stereotactic biopsy confirmed PCNSL due to Ebstein-Barr virus reactivation. Conclusions The use of advanced MRI sequences is important to differentiate brain lesions in pediatric patients. The use of PWI and DWI facilitated the diagnosis of PCNSL. It is important to remember that PCNSLs show a very typical pattern of changes visualized with MRI such as: usually strong homogenous enhancement, restricted diffusion and low perfusion. PMID:25624957

  4. Successful tongue cancer surgery under general anesthesia in a 99-year-old patient in Okinawa, Japan: A case report and review of the literature

    PubMed Central

    Maruyama, Tessho; Nakasone, Toshiyuki; Matayoshi, Akira; Arasaki, Akira

    2016-01-01

    As advances in the medical field have resulted in increased life expectancy, performing surgery under general anesthesia in elderly patients has become an important issue. A 99-year-old Okinawan female was admitted to the hospital presenting with pain in the tongue. Following physical examination, a clinical diagnosis of early stage tongue cancer (T2N0Mx) was confirmed. Early stage tongue cancer is particularly easy to access for surgical resection. By contrast, later stages of tongue cancer are associated with pain, dysphagia and throat obstruction. The patient and their family agreed to surgery due to the worsening pain associated with the tumor and gave informed consent for surgery. Following consultation with a cardiologist and an anesthesiologist, the tongue tumor was surgically resected under general anesthesia. Subsequent to surgery, the patient experienced pain relief and was discharged from the hospital on day 14 post-surgery. The patient was able to maintain the same quality of life, and lived for 5 years and 2 months longer without evidence of disease, surviving to the age of 104 years old. The present case demonstrates that surgery under general anesthesia may be appropriate in patients of an advanced age, with a treatment plan that should ideally be based on careful assessment of the wishes of the patient and their family, medical risks, and benefits and economic costs of alternative treatments, in addition to consideration of the patient's culture. PMID:27588116

  5. Almotriptan in the acute treatment of migraine in patients 11-17 years old: an open-label pilot study of efficacy and safety.

    PubMed

    Charles, James A

    2006-04-01

    The objective was to investigate the safety and efficacy of almotriptan in patients aged 11-17 years old with acute migraine. Fifteen patients aged 11-17 with a history of migraine with or without aura were treated with almotriptan. Reduction in headache severity, disability and adverse effects were studied. Almotriptan in doses ranging from 6.25 to 12.5 mg was well tolerated. There were virtually no adverse effects except for one case of transient mild stiffness. Of the 15 patients, only 2 demonstrated no efficacy without adverse effects. In the other 13 patients, not only was almotriptan effective, but again, no significant adverse effects were reported. Almotriptan is probably safe and effective in patients aged 11-17. This small open-label pilot study should support the feasibility of a large randomised controlled study to demonstrate tolerability and efficacy of almotriptan in children and adolescents with episodic migraine. PMID:16688412

  6. The Result of In Situ Pinning for Valgus Impacted Femoral Neck Fractures of Patients over 70 Years Old

    PubMed Central

    Kim, Yoon-Chung; Lee, Joo-Yup; Oh, Seungbae

    2014-01-01

    Purpose We aimed to evaluate the outcome of fixation with cannulated screws for valgus impacted femoral neck fractures in patients over 70 years of age. Materials and Methods We reviewed the outcome in 33 patients older than 70 years with valgus impacted femoral neck fractures who were treated with cannulated screws fixation from May 2007 to December 2010. These patients were followed for at least a year. We assessed the fixation failure rate, body mass index (BMI), bone mineral density (BMD) of proximal femur, distance between screw tip and joint, number of screws and time from fracture to operation. Results We identified six patients (18.2%) with failure. Two patients with subtrochanteric fractures through the screw insertion site and another patient with osteonecrosis were excluded from the fixation failure group. No difference was found in age, BMI, BMD of proximal femur, distance between screw tip and joint, number of screws and time from fracture to operation between failure and non-failure groups. Conclusion The failure rate of cannualted screw fixation for valgus impacted femoral neck fractures in the elderly patients was not low. Risk of failure should be considered in the management of these patients and accurate assessment for fracture type should be performed using computed tomogram and clinical evaluation.

  7. Umbilical Cord Blood Transplantation Outcomes in Acute Myelogenous Leukemia/Myelodysplastic Syndromes Patients ≥70 Years Old

    PubMed Central

    Sandhu, Karamjeet S; Brunstein, Claudio; DeFor, Todd; Bejanyan, Nelli; Arora, Mukta; Warlick, Erica; Weisdorf, Daniel; Ustun, Celalettin

    2016-01-01

    The maximum age of patients receiving allogeneic hematopoietic stem cell transplantation (alloHCT) has been moving up over time. However, the availability of a suitable HLA-matched sibling donor may limit access of this patient population to alloHCT. We retrospectively investigated the outcomes of umbilical cord blood transplantation (UCBT) after reduced-intensity conditioning regimens in patients aged ≥70 years with myelodysplastic syndrome (MDS) and acute myelogenous leukemia (AML) between 2010 and 2014. During this period 70 patients with AML/MDS were referred to our center for alloHCT consideration. Twenty-two patients (33%) received alloHCT: 10 UCBT, 9 HLA full-matched sibling donor transplantation, 2 haploidentical alloHCT, and 1 unrelated donor alloHCT. In UCBT, cumulative incidences of nonrelapse mortality and relapse were 20% and 30% at 2 years, respectively. The cumulative incidence of acute graft-versus-host disease (GVHD) at day +100 and chronic GVHD at 2 years was 10%. Seven patients had viral reactivation/infections. Rates of overall survival and disease-free survival were 60% and 50% at 2 years, respectively. Moreover, these outcomes seemed to be similar to that of patients aged 60 to 69 years receiving UCBT (n = 60) and patients aged ≥70 years receiving HLA full-matched sibling donor transplantation (n = 9). These results suggest that UCBT is feasible in selected AML/MDS patients aged ≥70 years. In fact, UCBT shortens the required time for an unrelated donor search and thus increases the chance of proceeding with alloHCT, which might contribute to higher rates of alloHCT in the referral group. Outcomes of UCBT are promising; however, larger studies with a longer follow-up are needed. PMID:26415559

  8. Delayed presentation of a heteropagus (parasitic) twin: a case report of a 17-year-old patient.

    PubMed

    Gokcen, Eric C; Wamisho, Biruk L

    2015-11-01

    Conjoined twins are rare, but well-described, anomalies. The heteropagus (parasitic) variant, in which there is a fully functioning autosite and a partially formed parasite, is even more rare. Typically, patients with this condition are discovered and treated as neonates or infants. We present an unusual case of an ischiopagus patient presenting at 17 years of age, which appears to be the oldest recorded presentation for surgery of a heteropagus twin in the English literature. The patient had two additional developed lower extremities along with two additional rudimentary upper extremities. The challenges and lessons learned from this rare and complex surgery are discussed. PMID:25647563

  9. FH Tulsa-1 and -2: Two unique alleles for familial hypercholesterolemia presenting in an affected two-year-old African-American male

    SciTech Connect

    Blackett, P.R.; Altmiller, D.H.; Jelley, D.; Wilson, D.P.

    1995-11-20

    A two-year-old African American boy presented with cutaneous xanthomata and extreme hypercholesterolemia. Subsequent studies revealed that the LDL-cholesterol was 1,001 mg/dl and apoB 507 mg/dl. LDL-receptor activity was almost undetectable, which is compatible with the finding of two newly described defective alleles on exon 4 of the LDL-receptor gene coding for part of the ligand-binding domain. One allele contained a 21 base-pair insertion from codon 200 to 207 whereas the other had a point mutation at codon 207. The rarity of genes for FH reported in individuals of African ancestry is discussed. 16 refs., 2 figs., 2 tabs.

  10. Twenty-one-year-old male with congenital anomalies, obstructive uropathy and chronic renal failure: is this a case of Townes Brocks syndrome?

    PubMed

    Unuigbe, E I; Azubike, C A; Okaka, E I; Osarenkhoe, J O; Onuora, V C

    2007-03-01

    Townes Brocks syndrome is an autosomal dominant multiple malformations syndrome comprising of ear anomalies/hearing loss, limb defects, anal, genitourinary, eye, spine anomalies, heart defects and sometimes mental retardation. This report presents the case of a 21-year-old secondary school leaver as a likely case of Townes-Brocks syndrome. He was born with congenital abnormalities consisting of fixed flexion deformities of hands, wrist and elbows, urethral meatal stenosis, scoliosis and aortic stenosis. He was diagnosed with obstructive uropathy at the age of 19 years and subsequently developed chronic renal failure. The report aims to highlight the need for early recognition of potentially preventable conditions, which, if left unattended to, can lead to unnecessary fatality. PMID:17668723

  11. [Septic shock in 23 year old female patient after surgical correction of the nasal septum effectively treated in the intensive care unit].

    PubMed

    Greberski, Krzysztof; Kilanowska, Magdalena; Bugajski, Paweł; Rzymski, Stanisław; Jarząbek, Radosław; Kalawski, Ryszard

    2015-12-01

    A female patient 23 years old was admitted to the medical intensive care unit due to sudden loss of consciousness and seizures. At the time of admition observed lack of consciousness, seizures and severe critical condition was observed. Meningitis and septic shock were diagnosed. Based on computed tomography performed on the first day--inflammation of the sinuses soft tissues was diagnosed. Suspected cause of infection was performed 6 weeks earlier surgical correction of the nasal septum. In the next stage of treatment on the seventh day after admission the functional endoscopic sinus surgery was performed. Due to massive tissue hypoperfusion the necrosis in the skin of the lower limbs occurred. Due to the lack of effectiveness antimicrobial therapy use of intravenous ceftaroline was administrated. Effective treatment allowed in day 11 to wean the patient from the ventilator. At the day 26 the patient was transferred to a hospital in the place of residence. PMID:26802691

  12. Isolated coronary artery bypass grafting in extracorporeal circulation in patients over 65 years old – does age still matter?

    PubMed Central

    Walczak, Andrzej; Ostrowski, Stanisław; Wrona, Ewa; Bartczak, Karol; Jaszewski, Ryszard

    2014-01-01

    Introduction Coronary artery bypass grafting (CABG) is conducted more and more commonly in patients in advanced age. Aim of the study To analyze the influence of age and concurrent risk factors on the complications and early mortality after CABG. Material and methods Medical records of 2194 patients were analyzed retrospectively. A group of 1303 patients who had undergone isolated CABG was selected. 106 (4.8%) patients were excluded due to missing data in their medical records. The remaining 1197 patients were divided into two subgroups by age: 1st group < 65 years (n = 662; 55.3%); 2nd group ≥ 65 years (n = 535; 44.7%). Results The total 30-day mortality was 3.93% and was six times higher in the older group (1.21 vs. 7.29%; p < 0.001). Complications were observed in 176 (14.70%) patients, more often in the older group (10.42% vs. 20.0%; p < 0.001). In this group all kinds of complications were noted more often and in particular: postoperative myocardial infarction (1.96% vs. 5.42%; p = 0.001), respiratory dysfunction (1.36% vs. 4.11%; p = 0.005), neurological complications (1.81% vs. 3.74%; p = 0.04) and multi-organ dysfunction syndrome (0.30% vs. 1.68%, p = 0.03). The older patients required longer time under mechanical ventilation (24.0 ± 27.9 vs. 37.0 ± 74.1 hours; p = 0.004) and stayed longer in the intensive care unit: 2.5 ± 3.0 vs. 4.1 ± 7.84 days; p < 0.001. Independent predictors of death were: female sex [OR (95% CI) = 2.4 (1.2-4.5)], age ≥ 65 years [OR = 4.9 (2.1-11.1)], eGFR < 60 mL/min/1.73 m2 [OR = 2.2 (1.0-4.7)], time at extracorporeal circulation > 72 minutes [OR = 5.5 (2.7-10.9)] and left main stem stenosis (> 50%) [OR = 2.4 (1.3-4.6)]. Conclusions Age still significantly influences postoperative complications and mortality after isolated CABG. PMID:26336419

  13. Blocking the rectus sheath guided by ultrasound in an 8-year-old patient with cystic fibrosis: reporting a case

    PubMed Central

    Encarnación-Martínez, Juan; Barberá-Alacreu, Manuel

    2015-01-01

    Cystic fibrosis (CF) is a severe disease that is transmitted with an autosomal recessive inheritance pattern, and is the commonest disease among Caucasian populations (1/2,500). There are many clinical manifestations that derive from its multiorgan dysfunctions, mainly in the respiratory and digestive tract. In addition, lung disease injury is principally responsible for morbidity and mortality in CF patients. Blocking the rectus sheath, first described by Schleich in 1899, is a loco-regional technique that provides adequate analgesia in those surgical procedures with midline or umbilical incisions. PMID:26733116

  14. 3-D Storybook: Effects on Surgical Knowledge and Anxiety Among Four- to Six-Year-Old Surgical Patients.

    PubMed

    Macindo, John Rey B; Macabuag, Katherine R; Macadangdang, Carlo Miguel P; Macaranas, Margaux Valerie S; Macarilay, Marianne Jezelle Jem T; Madriñan, Natasha Nikki M; Villarama, Rouena S

    2015-07-01

    Inadequate surgical knowledge potentiates anxiety; however, no methodology simultaneously addresses anxiety and surgical knowledge. Our quasi-experimental study determined the effectiveness of a three-dimensional (3-D) storybook in increasing surgical knowledge and decreasing anxiety among young children scheduled for planned or required major surgeries. We studied 20 randomly assigned participants who received either the 3-D storybook or traditional health teaching. A presurgical knowledge questionnaire and modified Yale Preoperative Anxiety Scale assessed surgical knowledge and anxiety. Data were analyzed with one-way and repeated-measures multivariate analysis of variance. Results showed that both groups had higher knowledge scores (F = 8.94; P = .008) and lower anxiety scores (F = 5.13; P = .036) after the intervention. The children who received information from the 3-D storybook exhibited a significantly higher posttest knowledge score (F = 11.71; P = .003) and lower anxiety score (F = 10.05; P = .005) than the traditionally educated group of children. The 3-D storybook effectively increased surgical knowledge and decreased anxiety and could be used as an alternative method to prepare pediatric surgical patients. PMID:26119618

  15. Characterization of Fibromyalgia Symptoms in Patients 55 to 95 Years Old: a Longitudinal Study Showing Symptom Persistence with Suboptimal Treatment

    PubMed Central

    Jacobson, Sandra A.; Simpson, Rachel G.; Lubahn, Cheri; Hu, Chengcheng; Belden, Christine M.; Davis, Kathryn J.; Nicholson, Lisa R.; Long, Kathy E.; Osredkar, Tracy; Lorton, Dianne

    2014-01-01

    BACKGROUND Fibromyalgia (FM) has been understudied in the elderly population, a group with particular vulnerabilities to pain, reduced mobility, and sleep disruption. AIMS To characterize FM symptoms and treatments in a cohort of older subjects examined over time to determine the extent to which current, community-based treatment for older FM patients is in accord with published guidelines, and effective in reducing symptoms. METHODS A longitudinal, observational study of 51 subjects with FM (range 55 to 95 years) and 81 control subjects (58 to 95 years) performed at Banner Sun Health Research Institute in Sun City, AZ. Serial history and examination data were obtained over a 6-year period. FM data included medical history, medications, physical examination, tender point examination, neuropsychological testing, sleep and pain ratings, the Physical Function Subscale of the Fibromyalgia Impact Questionnaire, and other standardized scales to evaluate depression and other psychiatric symptoms, and cognitive and functional impairment. RESULTS Pain and stiffness that interfered with physical activity, sleep, and mood were reported by 80% or more of subjects. Over time, pain involved an increasing number of body areas. Over half of subjects were treated with NSAIDs, one-quarter with opioids, and one-quarter with estrogen. Few were treated with dual-acting antidepressants or pregabalin. DISCUSSION In this cohort of elders with suboptimally treated FM, substantial persistence of symptoms was seen over time. In general, recommended treatments were either not used or not tolerated. CONCLUSIONS Age-appropriate treatments as well as education of primary care providers are needed to improve treatment of FM in the older population. PMID:24859821

  16. Emotional Development: 2 Year Olds

    MedlinePlus

    ... Español Text Size Email Print Share Emotional Development: 2 Year Olds Page Content Article Body It’s so ... to follow the ups and downs of a two-year-old. One moment he’s beaming and friendly; ...

  17. Clinical usefulness of fine needle aspiration cytology in patients less than 20 years old: a 10-year experience at a single institution

    PubMed Central

    Kim, Sunzoo; Jang, Eun Jeong; Jeong, Ji Yun; Park, Ji Young

    2013-01-01

    The purpose of this study was to identify the spectrum of cytological diagnoses and evaluate the diagnostic effectiveness of fine needle aspiration cytology (FNA) in patients less than 20 years old. The subjects were selected by retrospectively reviewing records from 1999 to 2009. Selected patients less than 20 years old underwent FNA. Cytological and histological slides of samples from the subjects were reviewed. Our study included a total of 909 subjects with a mean age of 14.6 years. The majority of the FNA samples were taken from lymph nodes (n = 448, 49.3%), with the remaining aspirates obtained from the thyroid gland (n = 247, 27.2%), soft tissues of head and neck masses (n = 106, 11.7%), salivary glands (n = 75, 8.3%), breasts (n = 18, 1.9%), skins (n = 9, 1.0%) and soft tissues of extremity (n = 6, 0.7%). The majority (87.6%, n = 796) of the FNA samples were categorized as ‘benign’, with the remaining designated as ‘atypical lesion’ (n = 18, 2.0%), ‘malignant’ (n = 24, 2.6%), or ‘inadequate specimen’ (n = 71, 7.8%). FNA accuracy was 92% for diagnosing cancer. Specificity and sensitivity were 99% and 63%, respectively. Our study first revealed that FNA has a high specificity for diagnosing cancer in various anatomical locations in young patients and can be confidently used as an effective tool for diagnosing malignancies in young individuals with a clinically suspicious lesion. PMID:24294385

  18. Spontaneous, Postpartum Coronary Artery Dissection and Cardiogenic Shock with Extracorporeal Membrane Oxygenation Assisted Recovery in a 30-Year-Old Patient

    PubMed Central

    Weis, Ricardo A.; Cubillo, Efrain I.; Chapital, Alyssa B.

    2016-01-01

    Coronary artery dissection is an infrequent cause of acute coronary syndrome in the general population. There is, however, a greater incidence of spontaneous coronary artery dissection (SCAD) in young women, especially in the peripartum period. However, the majority of cases have favorable outcomes with medical management or percutaneous coronary intervention; coronary artery bypass grafting (CABG) and transplantation are utilized in severe cases. This case is a one of a 30-year-old postpartum female with multivessel SCAD requiring CABG with subsequent biventricular failure and inability to wean from bypass. We believe this is the first reported case in which venoarterial extracorporeal membrane oxygenation (VA-ECMO) was used in the management of biventricular heart failure in a postpartum patient with SCAD. PMID:27127660

  19. Type I enteropathy-associated T-cell lymphoma in the colon of a 29-year-old patient and a brief literature review

    PubMed Central

    Zhang, Jiu-Cong; Wang, Yong; Wang, Xiu-Feng; Zhang, Fang-Xin

    2016-01-01

    Enteropathy-associated T-cell lymphoma (EATL) is a rare gastrointestinal non-Hodgkin’s lymphoma, originating from intraepithelial T-lymphocyte, which is specifically associated with celiac disease. EATL most commonly presents in the sixth and seventh decades of life. We report a unique case of type I EATL in the colon with liver metastasis, which was presented with nonspecific radiological findings and at a very young age (29 years old) compared with previously published data. We suggest that EATL should be regarded as part of differential diagnosis in any patient presenting with abdominal pain, diarrhea, weight loss, and malabsorption because delay in treatment can result in an irreversible clinical outcome. PMID:26955284

  20. Estimates of genetic parameters for 320-day pelvic measurements of males and females and calving ease of 2-year-old females.

    PubMed

    Kriese, L A; Van Vleck, L D; Gregory, K E; Boldman, K G; Cundiff, L V; Koch, R M

    1994-08-01

    Records from 12 breed groups collected from 1983 to 1991, included in the Germ Plasm Utilization project at the U.S. Meat Animal Research Center, were analyzed separately by breed group and combined to estimate heritabilities and genetic correlations for 320-d male and female pelvic width, height, and area, and for 320-d male pelvic and female 2-yr-old calving ease. Calving ease was analyzed as a trait of the dam using 1) actual and 2) binary scale calving ease scores with a covariate of calf birth weight. A bivariate animal model and derivative-free REML incorporating sparse matrix techniques were used. When breed groups were analyzed separately, heritability estimates of male and female 320-d pelvic traits varied by breed group and sex. Average genetic correlations between male and female 320-d pelvic width, pelvic height, and pelvic area were large and positive. When breed groups were combined (n = 26,071), heritability estimates for 320-d pelvic traits were moderate in size. Genetic correlations of .68, .48, and .61, between male and female 320-d pelvic width, height, and area, respectively, suggest male and female pelvic traits are largely under the same genetic control but are correlated traits rather than the same trait. Heritability estimates for actual calving ease in 2-yr-olds ranged from .00 to .49 in separate breed group analyses, and from .00 to .37 for binary measures. When breed groups were combined, heritability was .11 for actual calving ease and was .09 on the binary scale.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7982822

  1. Total laparoscopic pylorus-preserving pancreatoduodenectomy in an 89-year-old man: A case report and review of a single institute's experience in elderly patients

    PubMed Central

    LI, HONGYU; PENG, BING

    2016-01-01

    Total laparoscopic pylorus-preserving pancreatoduodenectomy (tLPPPD) has been demonstrated to be a safe and feasible surgery for pancreatic malignant diseases located in the head or uncinate process, with the advantages including minimal invasion, lower blood loss and a shorter hospital stay, compared with traditional open pancreatoduodenonectomy. Elderly patients theoretically have a lower capability to tolerate complex surgeries. The impairment of heart and pulmonary reserve function often leads to a high risk of post-operative cardiopulmonary complications. The present study reports a case of tLPPPD that was successfully performed in an 89-year-old man. No fatal complications developed. The post-operative pathological result revealed a diagnosis of pancreatic uncinate adenocarcinoma (T2N0M0, stage IB). After 1 year of follow-up, the patient remained alive without tumor recurrence or metastasis. The present study also discusses the associated literature and concludes that tLPPPD is a safe and feasible procedure in selective elderly patients. Use of this technique may expand the number of patients who can undergo surgery and provide benefits to these patients. PMID:27073538

  2. Social Development:: 2 Year Olds

    MedlinePlus

    ... Español Text Size Email Print Share Social Development: 2 Year Olds Page Content Article Body By nature, ... probably are acting the same way. At age two, children view the world almost exclusively through their ...

  3. Emotional Development: 1 Year Olds

    MedlinePlus

    ... Español Text Size Email Print Share Emotional Development: 1 Year Olds Page Content Article Body Throughout her ... for shelter. She may seem to change from one moment to the next, or she may seem ...

  4. Language Development: 2 Year Olds

    MedlinePlus

    ... Stages Listen Español Text Size Email Print Share Language Development: 2 Year Olds Page Content Article Body ... Pay attention to how he also is using language to describe ideas and information and to express ...

  5. Social Development: 1 Year Olds

    MedlinePlus

    ... Stages Prenatal Baby Toddler Fitness Nutrition Toilet Training Preschool Gradeschool Teen Young Adult Healthy Children > Ages & Stages > Toddler > Social Development: 1 Year Olds Ages & Stages Listen Español ...

  6. Successful treatment of a 14-year-old patient with intestinal malrotation with laparoscopic Ladd procedure: case report and literature review

    PubMed Central

    2013-01-01

    Midgut malrotation is an anomaly of intestinal rotation that occurs during fetal development and usually presents in the neonatal period. We present a rare case of malrotation in a 14-year-old patient who presented with cramping, generalized right abdominal pain, and vomiting for a duration of one day. A computed tomography abdominal scan and upper gastrointestinal contrast studies showed malrotation of the small bowel without volvulus. Laparoscopy revealed typical Ladd’s bands and a distended flabby third and fourth duodenal portion extrinsically obstructing the misplaced duodeno-jejunal junction. The Ladd procedure, including widening of the mesenteric base and appendectomy, was performed. Symptoms completely resolved in a half-year follow up period. Patients with midgut malrotation may present with vague abdominal pain, intestinal obstruction, or intestinal ischemia. The laparoscopic Ladd procedure is feasible and safe, and it appears to be as effective as the standard open Ladd procedure in the diagnosis and treatment of teenage or adult patients with intestinal malrotation. PMID:23684081

  7. Multiple endocrine neoplasia type 2a and germ line C634G RET mutation diagnosed in an 80-year-old patient.

    PubMed

    Sanz, C; Vezzosi, D; Pigny, P; Bennet, A; Caron, P

    2009-04-01

    An 80-year-old man presented with progressive fatigue. Blood tests showed that serum calcium was increased (2.93 mmol/l, normal range 2.20-2.55 mmol/l) and serum concentration of intact parathyroid hormone (iPTH) inappropriately high (198 pg/ml, normal range 15-85 pg/ml). Neck ultrasonography and Tc-MIBI scintigraphy revealed a right parathyroid adenoma and a multinodular goiter. Serum calcitonin was significantly increased (220 pg/ml, normal range<10 pg/ml). Concomitantly, a chest-abdominal computed tomography was performed and revealed a 22 mm right adrenal incidentaloma. The urinary catecholamines and metabolites were two-fold above the upper limit of normal. After right adrenalectomy which confirmed the diagnosis of pheochromocytoma, the patient underwent total thyroidectomy with dissection of the central lymph node compartment and right parathyroidectomy. On histopathologic examination, both thyroid lobes presented 13 foci of MTC without lymph node metastasis and the parathyroid gland presented a benign adenoma without hyperplasia. The patient underwent screening and genetic testing revealing a germ line C634 G RET mutation. The diagnosis of Men2a at the age of 80 years and the absence of lymph node metastasis of the multiple MTC in a carrier of C634G mutation were unusual and argued for the possible role of genetic modifier(s) in this MEN 2a patient. PMID:19201392

  8. A Quantitative Study on the Condom-Use Behaviors of Eighteen- to Twenty-Four-Year-Old Urban African American Males

    PubMed Central

    KENNEDY, STEPHEN B.; NOLEN, SHERRY; APPLEWHITE, JEFFREY; PAN, ZHENFENG; SHAMBLEN, STEPHEN; VANDERHOFF, KENNETH J.

    2007-01-01

    This research study sought to develop, pilot test, and assess a brief male-centered condom promotion program for urban young adult African American males. For study implementation, both qualitative and quantitative research methods were used, and the project was guided by tenets of two common but integrated theoretical frameworks in HIV/sexually transmitted disease (STD) prevention research: the social cognitive theory and the stages of change model. The purpose of the qualitative component was to identify and explore condom-use barriers and facilitators while that of the quantitative component was to identify the prevalence of condom-related behaviors and the feasibility of program administration. After recruitment of study participants from hang-out spots and street intercepts, study participants were self-administered a baseline survey regarding their perceived condom-use behaviors prior to random assignment to program conditions (a condom promotion program and an attention-matched comparison condition). In this paper, we report the findings from the analyses of the quantitative baseline survey data. While the occurrence of HIV/STD-related risk behaviors were highly prevalent among this population; importantly, regression analyses revealed that sexual debut, favorable attitudes toward condom use, social or personal connectedness to HIV/STDs, health beliefs, perceived susceptibility, unprotected sexual encounters, and refusal skills were predictive of retrospective (i.e., prior 30 days) condom use while positive reasons (pros) to use condoms, condom-use beliefs, condom-carrying, health belief, unprotected sexual encounters and refusal skills were also predictive of prospective (i.e., future 30 days) condom-use intentions. The implications and limitations of this study are described and recommendations provided for program development. PMID:17518523

  9. Focal Epithelial Hyperplasia (Heck’s Disease) in a 57-Year-Old Brazilian Patient: A Case Report and Literature Review

    PubMed Central

    de Castro, Luciano Alberto; de Castro, Joao Gabriel Leite; da Cruz, Alexandre Duarte Lopes; Barbosa, Bruno Henrique de Sousa; de Spindula-Filho, Jose Vieira; Costa, Mauricio Barcelos

    2016-01-01

    Focal epithelial hyperplasia (FEH), or Heck’s disease, is a rare disease of the oral mucosa associated with infection by some subtypes of human papilloma virus, especially subtypes 13 or 32. The disease is predominantly found in children and adolescents with indigenous heritage, but other ethnic groups can be affected worldwide. To the best of the authors’ knowledge, it has not been reported in Brazil’s elderly population. This article describes a case of FEH in a 57-year-old Brazilian patient presenting since childhood, with multiple lesions in the lips, buccal mucosa and tongue. The solitary tongue lesion underwent excisional biopsy and the histopathological analysis showed parakeratosis, acanthosis, rete pegs with a club-shaped appearance, koilocytosis and the presence of mitosoid cells. These microscopic findings in conjunction with clinical presentation were sufficient to establish the accurate diagnosis of FEH. Polymerase chain reaction (PCR) was performed, but no one human papillomavirus (HPV) subtype could be identified. Clinicians must be aware of this rare oral disease, which can even affect elderly patients, as we described here. Treatment may be indicated in selected cases due to esthetic and/or functional problems. PMID:26985258

  10. A Rare Case of Aggressive Fibromatosis Infiltrating Dorsal Muscles in a 6-Year-Old Patient – CT, MRI and Elastography Evaluation

    PubMed Central

    Pawluś, Aleksander; Szymańska, Kinga; Kaczorowski, Krzysztof; Sokołowska-Dąbek, Dąbrówka; Olchowy, Cyprian; Markiewicz, Bartosz D.; Zaleska-Dorobisz, Urszula

    2015-01-01

    Summary Background The term fibromatosis or desmoid tumor refers to a group of benign fibrous growths without metastatic potential but with a significant risk of local recurrence. These lesions typically present infiltrative growth pattern with local invasion of adjacent tissues. This tendency is the reason for a relatively high rate of local recurrence, even after surgical removal. Fibromatosis is a very rare condition in general population but occurs more frequently in one of the familial cancer predispositions known as familial adenomatous polyposis (FAP) or Gardner syndrome. There are two main groups of fibromatosis: superficial (small, slow-growing lesions) and deep, also known as aggressive fibromatosis (large, rapid-growing lesions). Case Report We report a case of a 6-year-old boy suffering from an aggressive form of fibromatosis. The patient developed a large pathological mass extending from the neck to the loins. After incisional biopsy and histpoathological examination of the sample, a diagnosis of aggressive fibromatosis was established. During the whole diagnostic process, different imaging techniques including CT, MRI and sonoelastography were used. As the surgical treatment was not possible, the patient was finally qualified for chemotherapy. Conclusions Eventual diagnosis of aggressive fibromatosis is based on histopathological examination. However, it is an important condition that should be included in differential diagnosis of soft-tissue masses found in diagnostic imaging. Radiologists should be careful especially in defining the margins of infiltration in case of potential surgical treatment. PMID:25866593

  11. 70-year old female patient with mismatch between hematocrit and hemoglobin values: the effects of cold agglutinin on complete blood count

    PubMed Central

    Ercan, Şerif; Çalışkan, Mustafa; Koptur, Erhan

    2014-01-01

    Introduction: There are a number of pre-analytical and analytical factors, which cause false results in the complete blood count. The present case identifies cold agglutinins as the cause for the mismatch between hematocrit and hemoglobin values. Materials and methods: 70-year old female patient had a history of cerebrovascular diseases and rheumatoid arthritis. During routine laboratory examination, the patient had normal leukocyte and platelet counts; however, the hemoglobin (Hb: 105 g/L) and hematocrit (HCT: 0.214 L/L) results were discordant. Hemolysis, lipemia and cold agglutinin were evaluated as possible reasons for the mismatch between hematocrit and hemoglobin values. Results: First blood sample was slightly hemolysed. Redrawn sample without hemolysis or lipemia was analyzed but the mismatch became even more distinct (Hb: 104 g/L and HCT: 0.08 L/L). In this sample, the titration of the cold agglutinin was determined and found to be positive at 1:64 dilution ratios. After an incubation of the sample at 37°C for 2 hours, reversibility of agglutination was observed. Conclusion: We conclude that cold agglutinins may interfere with the analysis of erythrocyte and erythrocyte-related parameters (HCT, MCV, MCH and MCHC); however, Hb, leukocyte and platelet counts are not affected. PMID:25351358

  12. Anterior Reconstruction of C2-C3 Bodies in a 6-Year-Old Patient with a Huge Osteoblastoma: A Novel Technique.

    PubMed

    Haghnegahdar, Ali; Sedighi, Mahsa

    2016-02-01

    Study Design Case report. Objective We report the youngest child diagnosed with upper cervical osteoblastoma and the first case operated on with our novel surgical approach. Methods Our patient underwent a two-stage surgery. During the first operation via a posterior approach, a subtotal resection of a C2 bony mass was performed. C3 was also subtotally resected due to tumor extension. Posterior fixation of C1-C5 was performed by C1 sublaminar hooks and C4 and C5 lateral mass screws. Ten days later, a total resection of the residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath). Reconstruction of C1-C3 was performed with C1 anterior sublaminar wiring and an expandable titanium cage. Results Successful reconstruction of C2-C3 vertebral bodies was achieved. At 2-year follow-up, the child was symptom-free. Imaging studies revealed no recurrence of tumor or instability. Conclusion A novel technique for reconstruction of C2-C3 vertebral bodies is demonstrated for the youngest case (a 6-year-old boy) of osteoblastoma in the literature. We recommend this approach for cervical spine reconstruction in patients who have an intact C1 arc and resected lower bodies. PMID:26835212

  13. Hepatitis B surface antigenemia following recombinant Engerix B hepatitis B vaccine in an 81-year-old ESRD patient on hemodialysis.

    PubMed

    Onuigbo, Macaulay A C; Nesbit, Ashley; Weisenbeck, Jacquelyn; Hurlburt, Jill

    2010-05-01

    The first cases of transient hepatitis B surface antigenemia (HBsAg) in adults following hepatitis B virus (HBV) immunization were reported in the 1990s. HBV immunization is mandatory for all hemodialysis (HD) patients. Ly et al. who demonstrated transient HBsAg in eight out of nine HD patients following HBV vaccine concluded that HD patients should not be screened for HBV within a week of HBV immunization and that positive HBsAg within a month of HBV immunization must be interpreted with caution. We present an 81-year-old woman on HD, who needed a booster Recombivax (Merck, Whitehouse Station, NJ, USA) vaccine after remaining hepatitis B surface antibody (HBsAb) negative from previous vaccinations. The HD Unit had switched to Engerix B (GlaxoSmithKline, Atlanta, GA, USA) HBV vaccine. Two days after the first Engerix B vaccine, HBsAg was detected. She was asymptomatic; ALT was 25 U/L. Repeat testing for HBsAg, HBsAb, hepatitis B E antigen (HB E Ag), and hepatitis B DNA (HB DNA), a week later, all returned negative. Previous reports of transient HBsAg following HBV vaccines were after Engerix B vaccination. Our patient is unusual since she had received both brands of HBV vaccines, sequentially, at different times. Twice, HBsAg tests completed as early as 5 days following Recombivax vaccine were negative. We submit that positive HBsAg tests are more likely following Engerix B vaccines. We reemphasize previous recommendations that patients should not be screened for HBsAg < 4 weeks following HBV immunization. This is particularly important in HD units where hepatitis B screening is carried out routinely all year round and hepatitis B vaccinations are commonplace. Very strict schedules must be adopted to avoid false positive HBsAg tests. PMID:20446799

  14. A 30-year-old female Behçet’s disease patient with recurrent pleural and pericardial effusion and elevated adenosine deaminase levels: case report

    PubMed Central

    Choi, Joon Young; Kim, Sung-Hwan; Kwok, Seung-Ki; Jung, Jung Im; Lee, Kyo-Young; Kim, Tae-Jung

    2016-01-01

    Behçet’s disease is a systemic disease which may involve various organs. We describe a case of a patient diagnosed as pleuropericardial involvement of Behçet’s disease. A 30-year-old woman visited our clinic presented with left pleuritic chest pain for s days. She had been diagnosed as Behçet’s disease and admitted to our clinic due to pericardial and pleural effusion repeatedly in past two years. In the previous studies, effusion analysis revealed to be lympho-dominant exudate with high adenosine deaminase level. Acid-fast bacilli (AFB) culture and polymerase chain reaction (PCR) for mycobacterial tuberculosis (M.TB) were negative in the pericardial tissue, and pathologic finding showed mild endothelitis with micro-thrombi formation in the lumen. The patient had been treated with antituberculous medication for a year. In the current admission, chest computed tomography (CT) again showed left pleural effusion without other significant lesion. Pleural fluid analysis was similar with the previous study. Video-assisted thoracoscopic pleural biopsy was performed to obtain the definite diagnosis. Pathology confirmed the diagnosis as pleuropericardial involvement of Behçet’s disease, and we treated the patient with oral steroid in the out-patient department. Pleuropericardial involvement of Behçet’s disease may mimic TB pleurisy or pericarditis due to high adenosine deaminase (ADA) level in effusion analysis. Clinicians should keep in mind that Behçet’s disease may manifest as pleural or pericardial effusion, and pathologic confirmation could be helpful for the definite diagnosis. PMID:27499994

  15. Primary Mixed Adenoneuroendocrine Carcinoma of the Gallbladder in a 55-Year-Old Female Patient: A Case Report and Review of the Literature.

    PubMed

    Acosta, Andrés Martin; Hamedani, Farid Saei; Kajdacsy-Balla, Andre; Wiley, Elizabeth Louise

    2015-08-01

    Mixed adenoneuroendocrine carcinomas (MANECs) of the biliary tract are rare tumors, and to date only a few cases arising in the gallbladder have been reported. Their histogenesis is a matter of debate, since the biliary tract normally lacks neuroendocrine cells. However, the immunohistochemical identification of nonneoplastic neuroendocrine cells in both biliary adenocarcinomas and intestinal metaplasia has been documented. Here we report a case of a 55-year-old female patient presenting with right upper quadrant pain, cholelithiasis, and a gallbladder mass identified after cholecystectomy. The histopathologic examination showed a MANEC, composed of an intestinal-type adenocarcinoma and a large cell neuroendocrine carcinoma, arising in a background of enteric metaplasia with extensive high-grade dysplasia. Moreover, we report the presence of focal pancreatic intraepithelial neoplasia-like epithelial lesions, which has not been described for these tumors yet. The histopathologic features of this case provide further support for the theory that MANECs arise following a metaplasia-dysplasia-carcinoma pathway. PMID:25838330

  16. Motor Proficiency Predicts Cognitive Ability in Four-Year-Olds

    ERIC Educational Resources Information Center

    Hernandez, Amanda Martinez; Caçola, Priscila

    2015-01-01

    Research has shown links between motor proficiency and cognition in school-age children, however, few have explored earlier ages. We aimed to determine the association between motor proficiency and cognitive ability in four-year-olds. Motor and cognitive skills were examined in 32 (15 males, 17 females) four-year-olds (±5.59 months) using the…

  17. [CMV-associated gastric ulcer in an immunocompetent male patient].

    PubMed

    Kastenbauer, U; Ließ, H; Kremer, M

    2016-07-01

    This article reports the case of a 45-year-old male immunocompetent patient who presented with acute epigastric pain and vomiting. Diagnostic tests confirmed a recent cytomegalovirus (CMV) infection as a contributory cause of a florid gastric ulcer. Primary CMV infections affecting the upper gastrointestinal tract are rare in immunocompetent adults. In this case treatment with a proton pump inhibitor and eradication of concomitant Helicobacter pylori colonization led to a full recovery. Anti-CMV treatment was not necessary. PMID:27080250

  18. 3-D printout of a DICOM file to aid surgical planning in a 6 year old patient with a large scapular osteochondroma complicating congenital diaphyseal aclasia.

    PubMed

    Tam, Matthew D; Laycock, Stephen D; Bell, Duncan; Chojnowski, Adrian

    2012-01-01

    A 6 year old girl presented with a large osteochondroma arising from the scapula. Radiographs, CT and MRI were performed to assess the lesion and to determine whether the lesion could be safely resected. A model of the scapula was created by post-processing the DICOM file and using a 3-D printer. The CT images were segmented and the images were then manually edited using a graphics tablet, and then an STL-file was generated and a 3-D plaster model printed. The model allowed better anatomical understanding of the lesion and helped plan surgical management. PMID:22690278

  19. Long- and short-term outcomes of ERCP for bile duct stones in patients over 80 years old compared to younger patients: a propensity score analysis

    PubMed Central

    Kanamori, Akira; Kiriyama, Seiki; Tanikawa, Makoto; Hisanaga, Yasuhiro; Toyoda, Hidenori; Tada, Toshifumi; Kitabatake, Syusuke; Kaneoka, Yuji; Maeda, Atsuyuki; Kumada, Takashi

    2016-01-01

    Backgrounds and study aims: Endoscopic sphincterotomy (ES) is widely accepted as first-line therapy for bile duct stones (BDS). The major long-term pancreaticobiliary complication is BDS recurrence. Whether cholecystectomy should be performed after ES, especially in elderly patients, remains controversial. The aim of this study is to investigate the short-term and long-term outcomes after therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for BDS and to analyze risk factors for pancreaticobiliary complications. We also compared long-term outcomes in patients older and younger than age 80. Patients and methods: A total of 1210 patients who underwent therapeutic ERCP for BDS were retrospectively reviewed to identify risk factors for pancreaticobiliary complications. We divided these patients into two groups: Group Y (< 80 years; 960 patients) and Group O (≥ 80 years; 250 patients). There were 192 matched pairs in the propensity score analysis. Results: The incidence of pancreaticobiliary complications was 13.1 % (126/960) in Group Y and 20.4 % (51/250) in Group O (P < 0.00001). Multivariate analysis showed that a gallbladder left in situ with stones was a significant independent risk factor (hazard ratio, 2.81; 95 % confidence interval, 1.62 – 4,89; P = 0.0002). There were no significant differences in the incidence of pancreaticobiliary complications between the propensity score-matched groups. Conclusions: A gallbladder in situ with stones was the only significant risk factor for pancreaticobiliary complications after treatment for BDS. Age per se should not be the major factor when deciding on treatment that minimizes the occurrence of pancreaticobiliary disease. PMID:26793790

  20. Parotid sialolithiasis in a two-year-old boy

    PubMed Central

    Kim, Do Hoon; Song, Woo Sun; Kim, Yeong Jin

    2013-01-01

    Sialolithiasis is caused by the obstruction of a salivary gland or its excretory duct by the formation of calcareous concretions or sialoliths; this results in salivary ectasia and provokes subsequent dilation of the salivary gland. Sialolithiasis is relatively common, accounting for 30% of salivary diseases; however, it is rarely observed in childhood. This case report describes a 2-year-old male patient who complained of a painful swelling over the right cheek, and presented with palpable stones and pus discharge from the orifice of the right Stensen's duct. Computerized tomography of the neck confirmed the diagnosis, and the patient received intravenous empiric antibiotics combined with intraoral sialolithotomy. We also provide a review of the spectrum of concepts regarding the pathogenesis, diagnosis, and treatment of sialolithiasis. PMID:24244214

  1. Birdshot chorioretinopathy in a male patient with facioscapulohumeral muscular dystrophy.

    PubMed

    Papavasileiou, Evangelia; Lobo, Ann-Marie

    2015-01-01

    We report a case of birdshot chorioretinopathy (BSCR) in a patient with facioscapulohumeral muscular dystrophy (FSHD). A 40-year-old male with history of facioscapulohumeral muscular dystrophy with significant facial diplegia and lagophthalmos presents for an evaluation of bilateral choroiditis with vasculitis and optic disc edema. Clinical examination included fundus and autofluorescence photographs, fluorescein angiography, and optical coherence tomography. To our knowledge, this patient represents the first reported case of birdshot chorioretinopathy with facioscapulohumeral muscular dystrophy. Patients with FSHD can present with ocular findings and should be screened with dilated fundus examinations for retinal vascular changes and posterior uveitis. PMID:25861398

  2. Group-A-streptococcal meningitis in a 7-year-old child – a rare pathogen in a non-immune compromised patient

    PubMed Central

    van Zitteren, Leonarda Maria (LM); Arents, Niek LA; Halbertsma, Feico

    2011-01-01

    A case is presented of meningitis in a 7-year-old female child caused by Group A streptococcus (GAS), a rare bacterial cause of meningitis, with a high rate of morbidity (46%) and mortality (10%). GAS is susceptible for empiric antibiotic therapy aimed at the most prevalent pathogens of meningitis. As GAS meningitis is typically associated with ear-nose-throat (ENT) infections, specific search for a reservoir is advised. Bacterial typification often demonstrates M-protein gene sequence type (EMM type) 1.0 associated with upper respiratory tract infections and also severe, invasive GAS infections. Follow-up investigation including neurologic developmental status and audiologic testing is necessary. Although GAS is a very uncommon cause of acute bacterial meningitis in children, high morbidity and mortality have been reported. Being associated with ENT infections, a search for a GAS reservoir is proposed. GASs are susceptible for common empiric antibiotic therapies in meningitis. Follow-up investigation is necessary. PMID:22674699

  3. Cognitive Development: Two-Year-Old

    MedlinePlus

    ... Español Text Size Email Print Share Cognitive Development: Two-Year-Old Page Content Article Body Think back ... touching, looking, manipulating, and listening. Now, as a two-year-old, the learning process has become more ...

  4. Bladder leiomyoma in male patient presenting with renal oncocytoma: Are the two conditions related?

    PubMed Central

    Almouhissen, Turky; Badr, Hattan; Alessa, Noor; Nassir, Anmar

    2016-01-01

    A 64-year-old male patient with a large pelvic mass and a right renal mass was referred to our facility. The patient underwent a right radical nephrectomy and pelvic mass excision. A histopathological examination led to a diagnosis of renal oncocytoma and urinary bladder leiomyoma. PMID:27453673

  5. Atraumatic Bilateral Neglected Anterior Shoulder Dislocation: Case Report of a Jehovah’s Witness 28-Year-Old Male Affected by Iron-Deficiency Anemia and Treated with Bilateral Latarjet Procedure

    PubMed Central

    Poggetti, Andrea; Castellini, Iacopo; Neri, Elisabetta; Marchettil, Stefano; Lisanti, Michele

    2015-01-01

    Introduction: Neglected bilateral anterior shoulder dislocation is a very rare condition, often related to seizures or major trauma. Open reduction is recommended whenever Hill-Sachs lesion is >25% of the joint and the dislocation is elder than 3 weeks. Case Report: We describe a case report of a 28-year-old man left handed Jehovah’s Witness laborer assessed 12 weeks after bilateral anterior shoulder dislocation. The patient was evaluated with clinical examination, and it was observed an asymptomatic intrarotation of both shoulders with a mild left circumflex nerve deficit. He was able to perform flexion and abduction of both arms up to 60° and 10° of extrarotation. Pre-operative constant scores were 49 in left and 55 in right shoulder, pre-operative disabilities of the arm, shoulder, and hand (DASH) scores were 57 in left and 53 in right shoulder, and visual analogue scales (VAS) was 2. Radiological examination were bilateral anteroposterior shoulder X-rays and computer tomography scan. The surgeon treated both shoulder (not simultaneously) by open reduction and Bristow-Latarjet coracoids transfer procedure. A 1 year after operations, left flexion was 180° while right was 160, bilateral abduction was 180. He was able to return to his pre-injury activities, the constant score was 89 left and 83 right, DASH score was 17 left and 13 right and VAS was 0. Conclusion: Atraumatic bilateral neglected anterior shoulder dislocation can be treated with open Bristow-Latarjet procedure to provide a stable glenohumeral joint in laborer patient and permit a return to the pre-injury activities, to create a greater extension of the glenoid arc and to avoid future dislocation. PMID:27299079

  6. Pulmonary hernia in a two-year-old child.

    PubMed

    Fine, Jenna; Walters, Bryan S; Agnoni, Alysia A; Coppola, Christopher P; Scorpio, Ronald J; Kennedy, Alfred P

    2014-01-01

    Pulmonary hernia, also known as lung herniation or intercostal herniation, is best explained as the lung parenchyma protruding beyond the confines of the thoracic wall. This rare finding can be classified as congenital or acquired. Acquired pulmonary herniations are often the complication of blunt or penetrating trauma to the chest wall. This report describes a two-year-old male who fell onto a rigid post, striking his left lower chest. Imaging studies demonstrated a small pneumothorax as well as pulmonary herniation. The patient underwent a diagnostic thoracoscopy and repair of a pulmonary hernia within the 7th intercostal space without complication. In this case report, we aim to add to the limited body of existing literature on the surgical management of pulmonary hernias. PMID:25328752

  7. Pulmonary Hernia in a Two-Year-Old Child

    PubMed Central

    Walters, Bryan S.; Agnoni, Alysia A.; Coppola, Christopher P.; Scorpio, Ronald J.; Kennedy, Alfred P.

    2014-01-01

    Pulmonary hernia, also known as lung herniation or intercostal herniation, is best explained as the lung parenchyma protruding beyond the confines of the thoracic wall. This rare finding can be classified as congenital or acquired. Acquired pulmonary herniations are often the complication of blunt or penetrating trauma to the chest wall. This report describes a two-year-old male who fell onto a rigid post, striking his left lower chest. Imaging studies demonstrated a small pneumothorax as well as pulmonary herniation. The patient underwent a diagnostic thoracoscopy and repair of a pulmonary hernia within the 7th intercostal space without complication. In this case report, we aim to add to the limited body of existing literature on the surgical management of pulmonary hernias. PMID:25328752

  8. Severe hypercholesterolemia and liver disease in a 3-year old.

    PubMed

    Patel, Amol M; Brautbar, Ariel; Desai, Nirav K; Wilson, Don P

    2016-01-01

    Lipoprotein-X, which is composed of phospholipids and non-esterified cholesterol, is an abnormal lipoprotein with a density range similar to LDL-C. The two most common ways which lipoprotein-X accumulates is from reflux of bile salts into plasma or deficiency in lecithin cholesterol acyltransferase. This is a case of severe hypercholesterolemia and liver disease in a 3- year old male that presented with pruritus, pale stool, scleral ictus, and abdominal distention. He was diagnosed with primary sclerosing cholangitis which was confirmed by liver biopsy. Our patient was treated with steroids and immunomodulator therapy which was associated with significant reduction in cholestasis and LDL-C levels. Lipoprotein-X has several properties that make it anti-atherogenic, which raises the question if treatment for hypercholesterolemia should be initiated. PMID:27206954

  9. Thyroidectomy in a two-year old for graves’ disease

    PubMed Central

    Shakhsheer, Baddr A; Bordini, Brian; Abdulrasool, Layth; Grogan, Raymon; Kaplan, Edwin

    2015-01-01

    Introduction The most common cause of hyperthyroidism in children is graves’ disease – an autoimmune disorder in which antibodies stimulate the thyrotropin receptor to signal growth thyroid gland by increasing thyroid hormone synthesis and release. It can be treated with medical therapy, radioactive iodine, or surgery. Presentation of case JD was a two year old male who presented with severe diarrhea and diffuse neck enlargement. Laboratory work up was consistent with graves’ disease. Discussion Despite maximal outpatient and inpatient treatment with methimazole, atenolol, prednisone, and SSKI, he suffered persistent thyrotoxicosis. He underwent near-total thyroidectomy without complication. Conclusion This case is notable as it may represent the youngest patient in the literature who has undergone thyroidectomy for graves’ disease. PMID:25661638

  10. Form and Functions of "Slut Bashing" in Male Identity Constructions in 15-Year-Olds: "I Know It May Sound Mean to Say This, but We Couldn't Really Care Less about Her Anyway"

    ERIC Educational Resources Information Center

    Bamberg, Michael

    2004-01-01

    In this article I discuss an excerpt from a group discussion between five 15-year-old boys who, in the presence of an adult moderator, engaged in the act of "slut bashing" while telling a minimal story about an incident of female promiscuity. The analysis proceeds microanalytically in a three-step procedure that details the positions taken by the…

  11. Multimodal Imaging after Sudden Cardiac Arrest in an 18-Year-Old Athlete

    PubMed Central

    Rehman, Mobeen Ur; Atalay, Michael K.; Broderick, Ryan J.

    2015-01-01

    We report the case of a previously healthy 18-year-old male athlete who twice presented with sudden cardiac arrest. Our use of electrocardiography, echocardiography, cardiac magnetic resonance, coronary angiography, coronary computed tomographic angiography, and nuclear stress testing enabled the diagnoses of apical hypertrophic cardiomyopathy and anomalous origin of the right coronary artery. We discuss the patient's treatment and note the useful role of multiple cardiovascular imaging methods in cases of sudden cardiac arrest. PMID:26664308

  12. Multimodal Imaging after Sudden Cardiac Arrest in an 18-Year-Old Athlete.

    PubMed

    Afari, Maxwell E; Rehman, Mobeen Ur; Atalay, Michael K; Broderick, Ryan J

    2015-12-01

    We report the case of a previously healthy 18-year-old male athlete who twice presented with sudden cardiac arrest. Our use of electrocardiography, echocardiography, cardiac magnetic resonance, coronary angiography, coronary computed tomographic angiography, and nuclear stress testing enabled the diagnoses of apical hypertrophic cardiomyopathy and anomalous origin of the right coronary artery. We discuss the patient's treatment and note the useful role of multiple cardiovascular imaging methods in cases of sudden cardiac arrest. PMID:26664308

  13. Fatal Case of Brucellosis Misdiagnosed in Early Stages of Brucella suis Infection in a 46-Year-Old Patient with Marfan Syndrome

    PubMed Central

    Carrington, M.; Choe, U.; Ubillos, S.; Stanek, D.; Campbell, M.; Wansbrough, L.; Lee, P.; Churchwell, G.; Rosas, K.; Zaki, S. R.; Drew, C.; Paddock, C. D.; DeLeon-Carnes, M.; Guerra, M.; Hoffmaster, A. R.; Tiller, R. V.

    2012-01-01

    We report a fatal case of Brucella suis endocarditis initially misdiagnosed by automated identification systems as Ochrobactrum anthropi infection in a patient with a history of Marfan syndrome and recreational feral swine hunting. This report emphasizes the need to consider brucellosis as a part of the differential diagnosis of acute febrile illness, particularly in patients with known risk of exposure. PMID:22495564

  14. Ceramic-on-Ceramic Total Hip Arthroplasty in a Twelve-Year-Old Patient: Case Report with a 27-Year Follow-Up.

    PubMed

    Save, Ameya V; Varthi, Arya; Talusan, Paul G; Gala, Raj; Nelson, Stephen; Keggi, Kristaps J

    2016-01-01

    Total hip arthroplasty in the juvenile patient with a severely diseasedjoint can provide long-term pain relief and improvement in function. We present a patient with juvenile rheumatoid arthritis who underwent a Mittelmeier ceramic-on-ceramic total hip arthroplasty at age 12 in 1986. The implant provided the patient with a functioning hip for 24 years, but subsequently required revision due to femoral component loosening. This case report represents the longest reported clinical follow-up of noncemented, ceramic-on-ceramic total hip arthroplasty in a juvenile patient and depicts an excellent outcome at 27 years. Our case is also unique in that the Mittelmeier ceramic acetabulum was left in place during revision surgery. In this report, we also describe the senior author's choice of the Mittelmeier hip prosthesis within its historical context and provide a brief review of the literature as it relates to total hip arthroplasty in the juvenile patient. PMID:27509640

  15. Two-Years-Old Social Competence.

    ERIC Educational Resources Information Center

    Adcock, Don; Segal, Marilyn

    This guide for parents discusses social competence in 2-year-old children, drawing upon anecdotal data to provide a sampling of 2-year-old children's social behavior and their parents' child rearing techniques. The data were collected from questionnaires, telephone interviews, and home visits in a 12-month study of the interactions of 86…

  16. How Grammatical Are 3-Year-Olds?

    ERIC Educational Resources Information Center

    Eisenberg, Sarita L.; Guo, Ling-Yu; Germezia, Mor

    2012-01-01

    Purpose: This study investigated the level of grammatical accuracy in typically developing 3-year-olds and the types of errors they produce. Method: Twenty-two 3-year-olds participated in a picture description task. The percentage of grammatical utterances was computed and error types were analyzed. Results: The mean level of grammatical accuracy…

  17. Early and long-term results of cardiosurgical treatment of coronary artery disease and aortic stenosis in patients over 80 years old

    PubMed Central

    Buczkowski, Piotr; Perek, Bartłomiej; Katyńska, Izabela; Jemielity, Marek

    2014-01-01

    Background In recent years, patients over 80 years of age have been a growing group of individuals referred to cardiac surgeons. They pose a serious challenge and usually require a multidisciplinary approach. Aim The aim of this study was to evaluate the early and late outcomes of cardiosurgical treatment of patients over 80 years of age suffering from coronary artery disease and aortic stenosis. Material and methods The study involved 96 patients aged over 80 years treated between January, 2004 and December, 2012. The mortality and morbidity in the early postoperative period, as well as throughout the follow-up period, were analyzed. Results The majority of patients underwent isolated coronary artery bypass grafting (CABG) (58.3%; Group I), while 29.2% of them underwent an isolated aortic valve replacement (AVR) (Group II). Combined procedures (CABG + AVR) were carried out in 12.5% of patients (Group III). The mean operational risk calculated according to the logistic EuroSCORE was 11.6%, 11.9%, and 9.5%, respectively in Group I, Group II and in Group III. In the early postoperative period, 4 patients died (all from Group I). The 30-day mortality rate was 4.2% and the morbidity rate was 56.3%. During the post-discharge follow-up period that lasted from 1 to 100 months, 4 patients died (2 from Group I and 2 from Group III). The 2-year probability of survival was 91.9 ± 3.0%. During the last follow-up clinical assessment, half of the patients were asymptomatic. Conclusions The perioperative mortality of the patients is acceptably and markedly lower than that predicted by the logistic EuroSCORE calculator. However, the complication rate, particularly in the early postoperative period, is relatively high. PMID:26336430

  18. Eisenmenger syndrome: a case of survival after ventricular tachycardia due to inferior myocardial infarction in a 48-year-old patient with congenital large ventricular septal defect.

    PubMed

    Passarani, Simonetta; Vignati, Gabriele; Einaudi, Arturo

    2004-06-01

    Eisenmenger syndrome is the most common consequence of congenital cyanotic heart disease seen in adults; survival to the fifth decade of life is rare. Death is very difficult to predict: it is related to sudden cardiac ventricular arrhythmia, massive hemoptysis and right heart failure. In this paper, a patient with ventricular septal defect and Eisenmenger reaction is described. The patient was relatively well until 48 years of age, when she underwent surgery because of a cerebral abscess without cerebral complications but with some deterioration of her cardiac function. After discharge, the patient was readmitted to the hospital because the electrocardiogram showed persistent ST inferior elevation. Echocardiography demonstrated poor contractility and inferior akinesia. Sudden ventricular tachycardia occurred and the patient became unconscious. She was successfully resuscitated and, following a period of ventilation, the hemodynamics stabilized and she was discharged 17 days later. She remained well two years later. PMID:15229766

  19. Not 2 old 2 TXT: there is potential to use email and SMS text message healthcare reminders for rheumatology patients up to 65 years old.

    PubMed

    Hughes, Lyndsay D; Done, John; Young, Adam

    2011-12-01

    Short message service (SMS) and email reminders have the potential to improve adherence to appointments and medication taking. Within the UK, information and communication technology (ICT) is widely used with a very high proportion of people having access to the internet and mobile phones. Little is known about ICT use by older adults and those with chronic illness. A feasibility survey was carried out with 112 rheumatology patients in Hertfordshire, UK to determine their current use of the internet, email and SMS and their willingness to receive electronic reminders in the future. A high proportion of patients up to age 65 are successfully using ICT despite older age or functional disability caused by rheumatic disease. Forty-four percent would be willing to receive an electronic appointment reminder and 25% a medication reminder. The results suggest that reminders would be welcomed by some patients and extensive patient training would not be needed before implementation. PMID:22193827

  20. Implantable cardioverter-defibrillator therapy in a 34-year-old patient with eating disorders and after the third sudden cardiac arrest.

    PubMed

    Piotrowicz, Ewa; Orzechowski, Piotr; Bilinska, Maria; Przybylski, Andrzej; Szumowski, Lukasz; Piotrowicz, Ryszard

    2015-03-01

    Eating disorders (ED) such as anorexia nervosa and bulimia are psychiatric diseases associated with the highest mortality rate of any other psychiatric disorders. More recently, long-term outcome studies with follow-up of over 20 years report a mortality of between 15% and 18% (Casiero and Frishman, Cardiol Rev 14(5), 227, 2006). The sudden death secondary to arrhythmias is often the cause of death in these patients (Casiero and Frishman, Cardiol Rev 14(5), 227, 2006). A case of life-threatening ventricular arrhythmia (VA) in a patient with ED is presented. Clinical records (cardiologic, psychiatric), electrocardiograms, echocardiogram, coronary angiogram, cardiac magnetic resonance, and endocrine diagnostics were performed. Finally a cardioverter-defibrillator (ICD) was implanted in the patient after her third cardiac arrest. An optimal approach to antiarrhythmic therapy in such patients is a real challenge for a cardiologist. PMID:24535846

  1. Euglycemic Diabetic Ketoacidosis in a 27 year-old female patient with type-1-Diabetes treated with sodium-glucose cotransporter-2 (SGLT2) inhibitor Canagliflozin.

    PubMed

    Bader, Nimrah; Mirza, Lubna

    2016-01-01

    We are reporting a timely case of atypical euglycemic diabetic ketoacidosis in a type 1 diabetic patient treated with sodium-glucose cotransporter-2 (SGLT-2) inhibitor canagliflozin. The clinical history, physical examination findings and laboratory values are described. Other causes of acidosis such as salicylate toxicity or alcohol intoxication were excluded. Ketoacidosis resolved after increasing dextrose and insulin doses supporting the hypothesis that SGLT-2 inhibitors may lead to hypoinsulinemia. Euglycemic ketoacidosis did not recur in our patient after discontinuing canagliflozin. We recommend reserving SGLT2 inhibitor therapy to type 2 diabetics, discontinuing medication and treating patients presenting with ketoacidosis due to SGLT-2 inhibitors with higher concentrations of dextrose with appropriate doses of insulin to help resolve acidosis. PMID:27375734

  2. An ethical dilemma: malignant melanoma in a 51-year-old patient awaiting simultaneous kidney and pancreas transplantation for type 1 diabetes.

    PubMed

    Kirby, L C; Banerjee, A; Augustine, T; Douglas, J F

    2016-07-01

    Malignant melanoma is a high-risk skin cancer that, in potential transplant recipients, is considered a substantial contraindication to solid organ transplantation due to significant risk of recurrence with immunosuppression. Current guidelines stipulate waiting between 3 and 10 years after melanoma diagnosis. However, in young patients with end-stage organ failure and malignant melanoma, complex ethical and moral issues arise. Assessment of the true risk associated with transplantation in these patients is difficult due to lack of prospective data, but an autonomous patient can make a decision that clinicians may perceive to be high risk. The national and worldwide shortage of available organs also has to be incorporated into the decision to maximize the net benefit and minimize the risk of graft failure and mortality. The incidence of malignant melanoma worldwide is increasing faster than that of any other cancer and continues to pose ethically challenging decisions for transplant specialists evaluating recipients for solid organ transplantation. PMID:27484276

  3. Euglycemic Diabetic Ketoacidosis in a 27 year-old female patient with type-1-Diabetes treated with sodium-glucose cotransporter-2 (SGLT2) inhibitor Canagliflozin

    PubMed Central

    Bader, Nimrah; Mirza, Lubna

    2016-01-01

    We are reporting a timely case of atypical euglycemic diabetic ketoacidosis in a type 1 diabetic patient treated with sodium-glucose cotransporter-2 (SGLT-2) inhibitor canagliflozin. The clinical history, physical examination findings and laboratory values are described. Other causes of acidosis such as salicylate toxicity or alcohol intoxication were excluded. Ketoacidosis resolved after increasing dextrose and insulin doses supporting the hypothesis that SGLT-2 inhibitors may lead to hypoinsulinemia. Euglycemic ketoacidosis did not recur in our patient after discontinuing canagliflozin. We recommend reserving SGLT2 inhibitor therapy to type 2 diabetics, discontinuing medication and treating patients presenting with ketoacidosis due to SGLT-2 inhibitors with higher concentrations of dextrose with appropriate doses of insulin to help resolve acidosis. PMID:27375734

  4. Therapeutic expectations: Dentistry relies less on dental plaque as a major etiological factor OR On the dental needs of young orthodontic patients (12-20 years old)

    PubMed Central

    Consolaro, Alberto; Nardoni, Daniele Nóbrega; Capelozza, Leopoldino; Franco, Paulo Henrique X.; Cappellozza, José Antônio Z.

    2016-01-01

    In Brazilian cities and states governed efficiently with wealth ethically administered, carious and periodontal diseases have prevalence rates similar to those found in socially developed European countries. This shift in reality, noticed over the last 15 years, reflects on changes in the etiological factors related to patients' major expectations and needs - especially young and orthodontic patients - which turn out to be a result of dental trauma, malocclusion, facial aspect, dental agenesis and iatrogenesis. Under such conditions, patients begin to appreciate the value of tooth position, color and shape, their smile and function: details become relevant. Carious and periodontal diseases remain an issue, not only from a preventive prospect, but also from a curative one. Nevertheless, it should be noted that changes and development are inevitable, and we should be prepared to contribute to the wellbeing of people, particularly regarding their novel needs and expectations. PMID:27007757

  5. Physical Therapy Management of Complex Regional Pain Syndrome I in a 14-Year-Old Patient Using Strain Counterstrain: A Case Report

    PubMed Central

    Collins, Cristiana Kahl

    2007-01-01

    This report describes the examination, intervention, and outcomes for a patient with Complex Regional Pain Syndrome I (CRPS I) treated with Strain Counterstrain (SCS). The patient was diagnosed with CRPS I following a Grade II ankle sprain. Treatment consisted of SCS once per week for six months with one additional session each week in Months 4 through 6 for strengthening, endurance, and gait training. A re-examination was performed monthly. A clinically significant decrease of 2 points in overall pain as measured with a numeric pain rating scale (NPRS) occurred as of Month 2; a 2-point decrease in tenderness on 10 of 13 SCS tender points also measured with an NPRS was documented as early as Month 1. Throughout the treatment period, an increase in function was noted by way of patient report and objective tests and measures. Gait improved with regard to cadence, use of an assistive device, and weight-bearing status. Single limb stance on the involved leg increased from 0 (s) to 40 (s) over the course of treatment and ankle active range of motion as measured with a goniometer and muscle strength as measured with manual muscle tests both returned to normal values. CRPS I remains a poorly understood and difficult-to-treat chronic syndrome. By way of its proposed effects on the neuromuscular system and facilitated segments, SCS may be an additional effective treatment tool in the management of some patients diagnosed with CRPS I. PMID:19066641

  6. A prospective study of reduced-dose three-course CHOP followed by involved-field radiotherapy for patients 70 years old or more with localized aggressive non-Hodgkin's lymphoma

    SciTech Connect

    Shikama, Naoto . E-mail: shikama@hsp.md.shinshu-u.ac.jp; Oguchi, Masahiko; Isobe, Koichi; Nakamura, Katsumasa; Tamaki, Yoshio; Hasegawa, Masatoshi; Kodaira, Takeshi; Sasaki, Shigeru; Kagami, Yoshikazu

    2006-09-01

    Purpose: We conducted a multicenter prospective study to evaluate the efficacy and safety of reduced-dose three-course CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) followed by involved-field radiotherapy for elderly patients with localized aggressive non-Hodgkin's lymphoma. The primary endpoint was compliance with the combined modality. Methods and Materials: This study included untreated patients, {>=}70 years old, with diffuse aggressive lymphoma, Stage IA or contiguous nonbulky Stage IIA. 80%-CHOP (cyclophosphamide 600 mg/m{sup 2}, doxorubicin 40 mg/m{sup 2}, vincristine 1.1 mg/m{sup 2}, and prednisolone at 80 mg/day for 5 days) was repeated every 3 weeks. After three cycles of chemotherapy, involved-field radiotherapy was performed with a radiation dose of 30-50 Gy in 15-28 fractions. Results: Twenty-four patients with a median age of 75 years (range, 70-84 years) were enrolled. The compliance rate of the protocol study was 87.5% (95% confidence interval [CI], 67.6-97.3). Three patients received only two cycles of chemotherapy because of toxicity or second neoplasm. There were no deaths caused by severe toxicity. The 3-year progression-free and overall survival rates were 83.1% (95% CI, 75.4-90.8) and 82.9% (95% CI, 75.1-90.6), respectively. Conclusion: Three-course 80%-CHOP followed by involved-field radiotherapy may be safe for administration to elderly patients over 70 years old. The next step is to evaluate three-course 80%-CHOP and rituximab followed by radiotherapy in elderly patients with localized disease.

  7. Malignant melanoma of the nasal septum, a rare tumor, occurring in a 54-year-old patient after hereditary retinoblastoma treatment.

    PubMed

    Djiguimdé, Windinmanégdé Pierre; Diomandé, Ibrahim Abib; Bonnin, Nicolas; Saroul, Nicolas; Touré, Abdoulaye; Sanou, Jérôme; Sankara, Paté; Russier, Marc; Gilain, Laurent; Ahnoux-Zabsonré, Ahgbatouhabéba; Meda, Nonfounikoun; Bacin, Franck

    2016-01-01

    The authors report a case of a malignant melanoma of the nasal cavity that is a rare tumor and very aggressive, constituting 1% of all melanomas. It appeared in a patient 54 years after he was treated for a hereditary retinoblastoma. Its symptoms are nonspecific, and often marked by epistaxis. Its diagnosis is histological, supported by immunohistochemistry. Its prognosis is often unfavorable, and characterized by the occurrence of metastases and recurrences. Because of the risk of secondary cancer that exists in any survivor of hereditary retinoblastoma, we must think of possible mucosal melanoma of the nasal sinus in these patients in cases of chronic epistaxis. The prognosis of this tumor depends on its early diagnosis and surgical treatment. PMID:26929670

  8. Malignant melanoma of the nasal septum, a rare tumor, occurring in a 54-year-old patient after hereditary retinoblastoma treatment

    PubMed Central

    Djiguimdé, Windinmanégdé Pierre; Diomandé, Ibrahim Abib; Bonnin, Nicolas; Saroul, Nicolas; Touré, Abdoulaye; Sanou, Jérôme; Sankara, Paté; Russier, Marc; Gilain, Laurent; Ahnoux-Zabsonré, Ahgbatouhabéba; Meda, Nonfounikoun; Bacin, Franck

    2016-01-01

    The authors report a case of a malignant melanoma of the nasal cavity that is a rare tumor and very aggressive, constituting 1% of all melanomas. It appeared in a patient 54 years after he was treated for a hereditary retinoblastoma. Its symptoms are nonspecific, and often marked by epistaxis. Its diagnosis is histological, supported by immunohistochemistry. Its prognosis is often unfavorable, and characterized by the occurrence of metastases and recurrences. Because of the risk of secondary cancer that exists in any survivor of hereditary retinoblastoma, we must think of possible mucosal melanoma of the nasal sinus in these patients in cases of chronic epistaxis. The prognosis of this tumor depends on its early diagnosis and surgical treatment. PMID:26929670

  9. Acute lower respiratory infections in ≥5 year -old hospitalized patients in Cambodia, a low-income tropical country: clinical characteristics and pathogenic etiology

    PubMed Central

    2013-01-01

    Background Few data exist on viral and bacterial etiology of acute lower respiratory infections (ALRI) in ≥5 year –old persons in the tropics. Methods We conducted active surveillance of community-acquired ALRI in two hospitals in Cambodia, a low-income tropical country. Patients were tested for acid-fast bacilli (AFB) by direct sputum examination, other bacteria by blood and/or sputum cultures, and respiratory viruses using molecular techniques on nasopharyngeal/throat swabs. Pulmonologists reviewed clinical/laboratory data and interpreted chest X-rays (CXR) to confirm ALRI. Results Between April 2007 - December 2009, 1,904 patients aged ≥5 years were admitted with acute pneumonia (50.4%), lung sequelae-associated ALRI (24.3%), isolated pleural effusions (8.9%) or normal CXR-related ALRI (17.1%); 61 (3.2%) died during hospitalization. The two former diagnoses were predominantly due to bacterial etiologies while viral detection was more frequent in the two latter diagnoses. AFB-positive accounted for 25.6% of acute pneumonia. Of the positive cultures (16.8%), abscess-prone Gram-negative bacteria (39.6%) and Haemophilus influenzae (38.0%) were most frequent, followed by Streptococcus pneumoniae (17.7%). Of the identified viruses, the three most common viruses included rhinoviruses (49.5%), respiratory syncytial virus (17.7%) and influenza viruses (12.1%) regardless of the diagnostic groups. Wheezing was associated with viral identification (31.9% vs. 13.8%, p < 0.001) independent of age and time-to-admission. Conclusions High frequency of H. influenzae and S. pneumoniae infections support the need for introduction of the respective vaccines in the national immunization program. Tuberculosis was frequent in patients with acute pneumonia, requiring further investigation. The relationship between respiratory viruses and wheezing merits further studies. PMID:23432906

  10. Delirium Accompanied by Cholinergic Deficiency and Organ Failure in a 73-Year-Old Critically Ill Patient: Physostigmine as a Therapeutic Option

    PubMed Central

    Zujalovic, Benedikt; Barth, Eberhard

    2015-01-01

    Delirium is a common problem in ICU patients, resulting in prolonged ICU stay and increased mortality. A cholinergic deficiency in the central nervous system is supposed to be a relevant pathophysiologic process in delirium. Acetylcholine is a major transmitter of the parasympathetic nervous system influencing several organs (e.g., heart and kidneys) and the inflammatory response too. This perception might explain that delirium is not an individual symptom, but rather a part of a symptom complex with various disorders of the whole organism. The cholinergic deficiency could not be quantified up to now. Using the possibility of bedside determination of the acetylcholinesterase activity (AChE activity), we assumed to objectify the cholinergic homeostasis within minutes. As reported here, the postoperative delirium was accompanied by a massive hemodynamic and renal deterioration of unclear genesis. We identified the altered AChE activity as a plausible pathophysiological mechanism. The pharmacological intervention with the indirect parasympathomimetic physostigmine led to a quick and lasting improvement of the patient's cognitive, hemodynamic, and renal status. In summary, severe delirium is not always an attendant phenomenon of critical illness. It might be causal for multiple organ deterioration if it is based on cholinergic deficiency and has to be treated at his pathophysiological roots whenever possible. PMID:26550498

  11. [13-Year old boy with abdominal pain].

    PubMed

    Thomassen, Irene; Klinkhamer, Paul J J M; van de Poll, Marcel C G

    2012-01-01

    A 13-year old boy presents with pain in the lower right abdomen, showing clinical signs of appendicitis. During McBurney' incision an appendix sana was seen. Histologic examination showed penetrating enterobiasis. This was treated with mebendazol. PMID:22551758

  12. Cognitive Development: One-Year-Old

    MedlinePlus

    ... Español Text Size Email Print Share Cognitive Development: One-Year-Old Page Content Article Body As you ... range of activities, and she’ll select the ones that are challenging but not completely beyond her ...

  13. First Report of Respiratory Syncytial Virus and Human Metapneumovirus Co-Infection in a 2-Year-Old Kawasaki Patient in Iran

    PubMed Central

    Shatizadeh Malekshahi, S; Mokhtari Azad, T; Shahmahmoodi, Sh; Yavarian, J; Rezaei, F; Naseri, M

    2010-01-01

    Background: Respiratory virus infections in children are a leading cause of morbidity and mortality worldwide. Methods: A total of 897 clinical specimens were collected from February 2007 to January 2008 and transported to the National Influenza Center. Two hundred and two samples belonged to children under the age of six from 897 specimens, described above, were selected. Then they were tested for influenza virus types and subtypes by real time PCR assay subsequently, the specimens were tested for RSV and hMPV by hemi-nested multiplex PCR and parainfluenza viruses type 1–4 by hemi-nested multiplex PCR and adenovirus by hemi-nested PCR. Results: The throat swab was taken from the Kawasaki case with the history of chicken’s contact. The specimen was tested for all influenza subtypes especially H5N1 and the results were negative. Meanwhile PCR was done for screening of other respiratory viruses that results came out positive for RSV and hMPV. Conclusion: In the present study, we demonstrated the possibility to detect dual infection caused by RSV and hMPV, but because of the extravagant pattern of this case, more investigation is suggested specially on Kawasaki patients. PMID:23113048

  14. Primary cancer of the anterior urethra in a male patient

    PubMed Central

    Wolski, Zbigniew; Warsiński, Patryk

    2011-01-01

    We present a 76-year-old male patient, who was diagnosed with transitional cell carcinoma (TCC) of the distal part of the urethra. Transurethral resection of the tumor (TURT) of the urethra was conducted. After establishing local relapse, surgical removal of the distal part of the urethra was proposed to the patient. Due to no consent for an open surgery, another electroresection of the tumor was performed. When the second relapse occurred, the patient provided his consent for surgical removal of the part of the urethra with anastomosis of the remaining part of the urethra with the skin from the abdominal part of the penis. Postsurgical observation did not reveal any local relapse. PMID:24578911

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

    PubMed

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

    2015-01-01

    Disulfiram is the aversive therapeutic agent which has been used to treat alcohol dependence more than 50 years. It causes the complications like neurological toxicity, postural hypotension, circulatory collapse, mental confusion, etc. The aim of our study was to report a rare case of disulfiram-induced seizures in a patient of alcohol dependence syndrome. This case study is about a 35-year-old male patient who had one episode of seizures during treatment with disulfiram. PMID:26600588

  16. Phacomatosis pigmentokeratotica (Happle) in a 23-year-old man.

    PubMed

    Wollenberg, Andreas; Butnaru, Cristina; Oppel, Tilmann

    2002-01-01

    Phacomatosis pigmentokeratotica is a rare but highly characteristic disease defined by the occurrence of an organoid naevus with sebaceous differentiation, a speckled-lentiginous naevus and other associated anomalies. It is probably caused by the twin-spot phenomenon. We report on a 23-year-old male electrician with 10 irregularly shaped, sharply demarcated, brownish-yellow papillomatous plaques following Blaschko's lines, as well as 6 large, sharply demarcated, round to oval, slightly greyish macules with pewit-egg-like dots, involving both buttocks, the right thigh, the right knee, the right pectoral region and the upper back. A moderate hyperhidrosis of the palms, soles and axillae was noted. All routine blood tests and laboratory findings, including chest X-ray, ECG, abdominal ultrasound, ocular and neural examination were unrevealing. Phacomatosis pigmentokeratotica may be associated with dysaesthesia, segmental hyperhidrosis, mild mental retardation, epileptic seizures, deafness, ptosis, strabismus or muscular weakness. In our patient, only slight hyperhidrosis was present, whereas all other associated anomalies could be excluded. PMID:12013201

  17. Fertility-sparing management and obstetric outcomes in a 20-year-old patient with a Sertoli-Leydig cell tumor of the ovary: A case report and review of the literature

    PubMed Central

    Stavrakis, Thomas; Kalogiannidis, Ioannis; Petousis, Stamatios; Tsompanidou, Chrisoula; Delkos, Dimitris; Prapas, Nikolaos; Rousso, David

    2016-01-01

    Sertoli-Leydig cell tumors (SLCTs) are an uncommon subtype of sex-cord stromal tumors of the ovary, which most commonly arise in women of reproductive age, creating an issue with regard to the preservation of fertility. The clinical manifestation of SLCTs varies widely, ranging from an asymptomatic clinical profile to extreme virilization. Correct diagnosis of SLCT is crucial and is primarily based on histopathological results. The current study presents the case of a 20-year-old woman who underwent unilateral salpingo-oophorectomy and adjuvant chemotherapy due to the diagnosis of an SLCT of the left ovary. Almost 2 years after the initial surgery, during the follow-up period, the patient conceived normally. Pregnancy was uneventful and the patient vaginally delivered a healthy infant at 38 weeks of gestation. A total of 1 year after delivery (3 years after the initial diagnosis), follow-up of the patient did not reveal any disease recurrence. In conclusion, SLCTs may be adequately treated by fertility-sparing surgery and chemotherapy in young women who wish to preserve their fertility. Natural conception, an uncomplicated pregnancy and a vaginal delivery are possible. PMID:27446397

  18. Hypogonadism in male cancer patients.

    PubMed

    Burney, Basil O; Garcia, Jose M

    2012-09-01

    Prevalence of hypogonadism in men with cancer has been reported between 40% and 90%, which is significantly higher than in the general population. Hypogonadism is likely to affect the quality of life in these patients by contributing to non-specific symptoms, including decreased energy, anorexia, sarcopenia, weight loss, depression, insomnia, fatigue, weakness, and sexual dysfunction. Pathogenesis of hypogonadism in cancer patients is thought to be multi-factorial. Inflammation may play an important role, but leptin, opioids, ghrelin, and high-dose chemotherapy through different mechanisms have all been implicated as the cause. Hypogonadism is also associated with poor survival in cancer patients. Data looking into the treatment of hypogonadal male cancer patients with testosterone are limited. However, improvements in body weight, muscle strength, lean body mass, and quality of life have been shown in hypogonadal men with other chronic diseases on testosterone replacement therapy. Prospective and interventional trials are needed to test the efficacy and safety of testosterone treatment in improving quality of life of these patients. PMID:22528986

  19. Thirteen for Thirteen-Year-Olds

    ERIC Educational Resources Information Center

    Instructor, 2011

    2011-01-01

    What does it take to reach a middle school reader? Literacy expert Laura Robb recently shared her top strategies in a webcast for Scholastic fans. This article presents Robb's 13 strategies for thirteen-year-olds. These are: (1) Respect students' search for self; (2) Embrace blogging; (3) Send texts in class; (4) Take words apart; (5) Build…

  20. [Necrophilia in a 17 year old girl].

    PubMed

    Foerster, K; Foerster, G; Roth, E

    1976-01-01

    Case report of true necrophilia in a seventeen-year-old girl, which is the first description of such a behaviour in a woman. The possible development of the abnormal behaviour is discussed. A complete theory of necrophilia semms to be not yet possible because of the few cases described. PMID:981988

  1. Intonation Comprehension in Ten-Year-Olds.

    ERIC Educational Resources Information Center

    Cruttenden, Alan

    1985-01-01

    Investigates the comprehension of nine intonational contrasts in ten-year-olds and adults. Overall performance on the tasks was much lower among the children than among the adults. Results indicate that hypotheses concerning the chronological order of development of meanings dependent on groupings, nucleus placements, and tones are too simplistic.…

  2. [Schooling for Four Year Olds in California.

    ERIC Educational Resources Information Center

    Olenick, Michael

    The California State Department of Education provides part-day comprehensive development programs for 3- to 5-year-olds from low income families. The programs include educational development, health services, social services, nutrition services, parent education and participation, evaluation, and staff development. The state requires that all…

  3. Hypopigmented mycosis fungoides in a 10-year-old boy.

    PubMed

    Manzur, A; Zaidi, S T H

    2006-01-01

    Cutaneous T-cell lymphoma (CTCL) presenting with hypopigmented lesions is an uncommon clinical variant of the disease, usually described in dark-skinned patients. We report a case of hypopigmented CTCL in a 10-year-old boy. The disease has responded favorably to narrowband UVB therapy. This case illustrates the importance of clinical suspicion for mycosis fungoides in patients with widespread hypopigmentation. PMID:17083901

  4. Giant appendix or an appendiceal mucocele? Case report of an 11-year-old child

    PubMed Central

    Nad, Marta; Kiraly, Adrienn; Bali, Ottilia; Rashed, Adel; Vizsy, Laszlo

    2014-01-01

    We present an 11-year-old male child with an enormous appendix that was regarded as an appendiceal mucocele. The disorder is very rare and usually appears in middle aged patients. It is a clinical diagnosis. It could cause a variety of symptoms, especially, acute appendicitis and unidentified lesion in the right iliac fossa. According to the reasons, it could be just a curiosity without any relevancy or the sign of a malignant lesion with bad prognostic factors. The histopathological findings prove the origin. PMID:25598994

  5. A case of Fournier’s gangrene in a young immunocompetent male patient resulting from a delayed diagnosis of appendicitis

    PubMed Central

    Wanis, Michael; Nafie, Shady; Mellon, John Kilian

    2016-01-01

    We discuss the case of a 28-year-old male patient presenting to our department with an atypical history of acute scrotal swelling on a background of abdominal pain. He was diagnosed with a perforated appendicitis and Fournier’s gangrene. PMID:27106611

  6. A case of Fournier's gangrene in a young immunocompetent male patient resulting from a delayed diagnosis of appendicitis.

    PubMed

    Wanis, Michael; Nafie, Shady; Mellon, John Kilian

    2016-01-01

    We discuss the case of a 28-year-old male patient presenting to our department with an atypical history of acute scrotal swelling on a background of abdominal pain. He was diagnosed with a perforated appendicitis and Fournier's gangrene. PMID:27106611

  7. Treatment of a TIPS-Biliary Fistula by Stent-Graft in a 9-Year-Old Boy

    SciTech Connect

    Boyvat, Fatih; Cekirge, Saruhan; Balkanci, Ferhun; Besim, Aytekin

    1999-01-15

    We report a 9-year-old male cirrhotic patient with acute occlusion of a transjugular intrahepatic portosystemic shunt (TIPS) due to a biliary-to-TIPS fistula which occurred 9 hr after the TIPS procedure. Immediate TIPS revision was performed and the fistula was treated by placement of an endoluminal stent-graft. At 12-month follow-up color Doppler examination demonstrated a patent shunt.

  8. Femoroacetabular impingement: A classic case of cam-type impingement in a 21-year-old soldier

    PubMed Central

    Royston, Eric; Bush, Lisabeth

    2015-01-01

    We describe a case of femoroacetabular impingement (FAI) in a 21-year-old male U.S. Army Private. Pre-operative radiographs demonstrated a dysplastic bump at the right head-neck junction. The patient underwent arthroscopy and resection of the bump, resulting in a improved contour of the femoral head-neck junction. After standard recovery, he is now able to ambulate and flex his right hip without pain and has returned to full duty. PMID:27186247

  9. Bilateral breast uptake of radioiodine in a male patient with gynecomastia: A case report.

    PubMed

    Uslu, Lebriz; Ozbayrak, Mustafa; Vatankulu, Betul; Sonmezoglu, Kerim

    2015-01-01

    A 56-year-old male patient with papillary thyroid carcinoma was given radioiodine for the treatment of persistent disease. Post radioiodine whole body scan revealed uptake at the thyroidal region and bilateral uptake at the upper thoracic region. Single photon emission computed tomography/computed tomography (SPECT/CT) confirmed uptake at the left thyroid lobe, and additional symmetrical mammary gland uptake was observed at both breasts. The patient had obesity-related gynecomastia, but he did not have any history of breast cancer, mastitis, hyperprolactinemia, or galactorrhea. Although breast uptake of radioiodine is a common finding in postpartum or lactating women, it is uncommon in male patients. To our knowledge, this is the first case of a male patient with breast uptake of radioiodine documented with SPECT/CT. SPECT/CT is useful in male patients in the differentiation of benign breast uptake with lung metastases or axillary metastases of thyroid cancer. PMID:26430322

  10. Primary Nasal Tuberculosis in a 10-Year-Old Girl

    PubMed Central

    Özer, Murat; Özsurekçi, Yasemin; Cengiz, Ali Bülent; Özçelik, Uğur; Yalçın, Ebru; Gököz, Özay

    2016-01-01

    Nasal tuberculosis is a rare clinical entity which mainly presents in elderly people. Nasal tuberculosis has always been considered to be secondary to tuberculosis of the lungs, and in rare instances it is a primary infection, usually when mycobacteria are inhaled. We describe the case of a 10-year-old girl who was successfully treated for primary nasal tuberculosis. This patient is one of the very few children who have been reported to have primary nasal tuberculosis. PMID:27366187

  11. Obsessive Compulsive Disorder in a 4-Year-Old Child

    PubMed Central

    Kulkarni, Harish; Sudarshan, C. Y.

    2015-01-01

    Obsessive-compulsive disorder (OCD) is a very distressing disorder for both patient and caregiver. Usual onset of the disorder is in late second or early third decade of life. It is diagnosed in children but rarely before 5 years. A case of OCD in a 4-year-old girl is reported here. Diagnostic and therapeutic dilemmas in such a situation are discussed. PMID:25969614

  12. Clarithromycin induced psoriasis in a 37-year old man.

    PubMed

    Zaiem, Ahmed; Mebazaa, Amel; Lakhoua, Ghozlane; Badri, Talel; Sahnoun, Rym; Kastalli, Sarrah; Daghfous, Riadh; El Aidli, Sihem

    2014-03-01

    Many drugs may induce psoriatic lesions or exacerbate preexisting psoriasis. We report an exceptional case of psoriasis vulgaris probably induced by clarithromycin. A 37-year-old man was prescribed for pharyngitis clarithromycin 500mg twice a day. On the third day of treatment, he presented a non pruriginous erythemato-squamous eruption, of trunk and limbs. Skin biopsy showed a typical aspect of psoriasis vulgaris. The drug was interrupted and the patient was treated by topical corticoids with rapid improvement. PMID:24410388

  13. Chiropractic Management of an 81-Year-Old Man With Parkinson Disease Signs and Symptoms

    PubMed Central

    Bova, Joesph; Sergent, Adam

    2014-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a patient with Parkinson disease. Clinical features An 81-year-old male with a 12-year history of Parkinson disease sought chiropractic care. He had a stooped posture and a shuffling gait. He was not able to ambulate comfortably without the guidance of his walker. The patient had a resting tremor, most notably in his right hand. Outcome measures were documented using the Parkinson’s Disease Questionaire-39 (PDQ-39) and patient subjective reports. Intervention and outcome The patient was treated with blue-lensed glasses, vibration stimulation therapy, spinal manipulation, and eye-movement exercises. Within the first week of treatment, there was a reduction in symptoms, improvement in ambulation, and tremor. Conclusion For this particular patient, the use of alternative treatment procedures appeared to help his Parkinson disease signs and symptoms. PMID:25685120

  14. Disease Burden Due to Herpes Zoster among Population Aged ≥50 Years Old in China: A Community Based Retrospective Survey

    PubMed Central

    Yin, Dapeng; Liu, Yanmin; Huang, Zhuoying; Xu, Jianfang; Ma, Yujie; Tu, Qiufeng; Li, Qi; Wang, Huaqing

    2016-01-01

    Objective To understand the disease burden due to Herpes Zoster (HZ) among people aged ≥50 years old in China and provide baseline data for future similar studies, and provide evidence for development of herpes zoster vaccination strategy. Methods Retrospective cohort study was conducted in 4 townships and one community. A questionnaire was used to collect information on incidence and cost of HZ among people aged ≥ 50 years old. Results The cumulative incidence rate was 22.6/1,000 among people aged ≥ 50 years old. The average annual incidence rate of HZ was 3.43/1,000 among people aged ≥ 50 years old in 2010–2012. Cumulative incidence and average annual incidence rate increased with age: the cumulative incidence of HZ among people aged ≥ 80 years old was 3.34 times of that among 50- years old (52.3/1000vs15.7/1,000); average annual incidence rate rises from 2.66/1,000 among 50- years old to 8.55/1,000 among 80- year old. Cumulative incidence and average annual incidence rate for females were higher than that for males (cumulative incidence, 26.5/1000vs18.7/1,000; annual incidence rate, 3.95/1000vs2.89/1,000). Cumulative incidence and average annual incidence rate in urban were higher than in rural (cumulative incidence, 39.5/1000vs 17.2/1,000; annual incidence rate, 7.65/1000vs2.06/1,000). The hospitalization rate of HZ was 4.53%. And with the increase of age, the rate has an increasing trend. HZ costs 945,709.5 RMB in total, corresponding to 840.6 RMB per patient with a median cost of 385 RMB (interquartile range 171.7–795.6). Factors associated with cost included the first onset year, area, whether hospitalized and whether sequelae left. Conclusion Incidence rate, complications, hospitalization rate and average cost of HZ increase with age. We recommend that the HZ vaccinations should target people aged ≥50 years old if Zoster vaccine is licensed in China. PMID:27055179

  15. Fasciolopsiasis in a five year old girl.

    PubMed

    Naher, B S; Shahid, A T; Khan, K A; Nargis, S; Hoque, M M

    2013-04-01

    A 5 year old girl hailing from Keraniganj, presented with the complaints of fever, periumbilical pain and vomiting. In vomitus, Fasciolopsis buski worm in adult form was identified by naked eye examination. In stool, ova of Fasciolopsis buski were also observed under microscope. Clinically she was pale and had hepatomegaly. Microcytic hypochromic anaemia with normal liver function test was found on lab investigation. She was diagnosed as a case of Fasciolopsiasis and treated with Praziquantel and on follow up visit she was found to be free of symptom. PMID:23715369

  16. Development of 5- and 10-year-old pediatric phantoms based on polygon mesh surfaces

    SciTech Connect

    Melo Lima, V. J. de; Cassola, V. F.; Kramer, R.; Oliveira Lira, C. A. B. de; Khoury, H. J.; Vieira, J. W.

    2011-08-15

    Purpose: The purpose of this study is the development of reference pediatric phantoms for 5- and 10-year-old children to be used for the calculation of organ and tissue equivalent doses in radiation protection. Methods: The study proposes a method for developing anatomically highly sophisticated pediatric phantoms without using medical images. The 5- and 10-year-old male and female phantoms presented here were developed using 3D modeling software applied to anatomical information taken from atlases and textbooks. The method uses polygon mesh surfaces to model body contours, the shape of organs as well as their positions, and orientations in the human body. Organ and tissue masses comply with the corresponding data given by the International Commission on Radiological Protection (ICRP) for the 5- and 10-year-old reference children. Bones were segmented into cortical bone, spongiosa, medullary marrow, and cartilage to allow for the use of micro computer tomographic ({mu}CT) images of trabecular bone for skeletal dosimetry. Results: The four phantoms, a male and a female for each age, and their organs are presented in 3D images and their organ and tissue masses in tables which show the compliance of the ICRP reference values. Dosimetric data, calculated for the reference pediatric phantoms by Monte Carlo methods were compared with corresponding data from adult mesh phantoms and pediatric stylized phantoms. The comparisons show reasonable agreement if the anatomical differences between the phantoms are properly taken into account. Conclusions: Pediatric phantoms were developed without using medical images of patients or volunteers for the first time. The models are reference phantoms, suitable for regulatory dosimetry, however, the 3D modeling method can also be applied to medical images to develop patient-specific phantoms.

  17. Endometrial adenocarcinoma in a 13-year-old girl

    PubMed Central

    Kim, Sung Mee; Shin, So Jin; Bae, Jin Gon; Kwon, Kun Young

    2016-01-01

    Endometrial cancer is the third most common gynecologic cancer in the Korea and occurs mainly in menopausal women. Although it can develop in young premenopausal women cancer as well, an attack in the adolescent girl is very rare. A 13-year-old girl visited gynecology department with the complaint of abnormal uterine bleeding. An endometrial biopsy revealed FIGO (International Federation of Gynecology and Obstetrics) grade II endometrial adenocarcinoma. In the treatment of endometrial cancer, conservative management should be considered if the patient is nulliparous or wants the fertility preservation. Therefore, we decided to perform a hormonal therapy and a follow-up endometrial biopsy after progestin administration for eight months revealed no residual tumor. We report a case of endometrial cancer occurred in a 13-year-old girl with a brief review of the literature. PMID:27004208

  18. Endometrial adenocarcinoma in a 13-year-old girl.

    PubMed

    Kim, Sung Mee; Shin, So Jin; Bae, Jin Gon; Kwon, Kun Young; Rhee, Jeong Ho

    2016-03-01

    Endometrial cancer is the third most common gynecologic cancer in the Korea and occurs mainly in menopausal women. Although it can develop in young premenopausal women cancer as well, an attack in the adolescent girl is very rare. A 13-year-old girl visited gynecology department with the complaint of abnormal uterine bleeding. An endometrial biopsy revealed FIGO (International Federation of Gynecology and Obstetrics) grade II endometrial adenocarcinoma. In the treatment of endometrial cancer, conservative management should be considered if the patient is nulliparous or wants the fertility preservation. Therefore, we decided to perform a hormonal therapy and a follow-up endometrial biopsy after progestin administration for eight months revealed no residual tumor. We report a case of endometrial cancer occurred in a 13-year-old girl with a brief review of the literature. PMID:27004208

  19. [Successful preclinical thoracotomy in a 17-year-old man].

    PubMed

    Puchwein, P; Prenner, G; Fell, B; Sereinigg, M; Gumpert, R

    2014-09-01

    We report the case of a 17-year-old man who sustained multiple stab wounds after a knife attack. After arrival of the emergency medical team the patient suffered a cardiac arrest caused by cardiac tamponade. After emergency thoracotomy and open heart massage the patient developed ROSC and could be discharged 13 days later without neurological deficits. Prehospital thoracotomy is rarely performed in Austria but is the only realistic chance for survival in cases of hematopericardium and tamponade. Better training of emergency physicians in Austria concerning surgical resuscitation could increase survival rates especially after penetrating thoracic trauma. PMID:23884562

  20. Fifty-five-year-old man with chronic yeast infections

    PubMed Central

    Schroeder, Nikhila; Palacios, Thamiris; Rosen, Lindsey B.; Martinez, Bianca; Browne, Sarah; Borish, Larry

    2014-01-01

    As immunologists, we are frequently asked to evaluate patients with recurrent infections. These infections can provide us with clues regarding what pathways might be aberrant in a given patient, e.g., specific pyogenic bacteria with Toll-like receptor problems, atypical mycobacteria with interferon gamma receptor autoantibodies, and Candida/staphylococcal infections with cellular immune abnormalities. We present a 55-year-old man who presented to our immunology clinic with onychodystrophy of the toenails and fingernails and recurrent oral–esophageal candidiasis. The differential diagnosis for recurrent yeast infections is complex and includes usual suspects as well as some that are not as straightforward. PMID:25295810

  1. Gender Dysphoria in a 62-Year-Old Genetic Female With Congenital Adrenal Hyperplasia.

    PubMed

    Silveira, Mariana Telles; Knobloch, Felícia; Silva Janovsky, Carolina C P; Kater, Claudio E

    2016-10-01

    We report a case of gender dysphoria (GD) in a 62-year-old genetic female patient, raising the pros and cons of performing corrective surgery later in life. This 46,XX DSD patient was registered and reared as a girl; CAH was diagnosed late in childhood. Poor adherence to treatment and lack of proper psychological management contributed to evident GD. Living for years as a male, the patient applied for a legitimate male identification document in his late 50s; thereafter, he requested a sex-reassignment surgery "to disguise his female body upon his death." We informed the patient and family about surgery hazards, while analytical therapy allowed the group to evaluate the actual wish for surgery. When the wish was brought up, the role of death urged the group to rethink the course of treatment. During the process, it became clear that the patient's desire for surgery, more than a wish for changing the genitalia, expressed an impulse related to issues of endorsement and acceptance of his male identity. This report raises interesting questions about sexuality in a social context and prompts the idea that sexuality is broader than sex itself, raising new questions on the psychological risks faced when considering a body change after years of living with a disorder of sex development. PMID:27270635

  2. [Dermatobia hominis infection in a 3-year-old child].

    PubMed

    Meissner, M; Kippenberger, S; Valesky, E M; Kaufmann, R

    2012-04-01

    In the context of increasing travel to the tropics, outpatient services are more frequently confronted with non-domestic diseases in Europe. A 3-year old child presented with a painful tumor of the scalp. After incision of the furuncle-like lesion, we extracted a larva of the botfly Dermatobia hominis. Botflies are mainly encountered in Central and South America; they should be considered if patients demonstrate a furuncle-like lesion and have returned from a holiday in these endemic regions. PMID:22068935

  3. Cervical hibernoma in a two year old boy.

    PubMed

    Khattala, Khalid; Elmadi, Aziz; Bouamama, Hanane; Rami, Mohamed; Bouabdallah, Youssef

    2013-01-01

    Hibernomas are uncommon benign soft tissue tumours mimicking brown fat. They are mostly seen in the fourth and fifth decades of life. Only few cases in the cervical area have been reported. Because of its rarity in pediatrics and difficult diagnosis, we report a tow year-old patient with a cervical tumor. Ultrasound and computed tomography exams showed an infiltrative, with hypervascular and lipomatous features. After tumor excision, histopathological exam confirmed the diagnosis of hibernoma or brown fat tumor. This presentation describes the characteristics of this type of tumor, rare in children. PMID:24570788

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

    PubMed

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

    2015-02-01

    Snake bites are rare events in Germany and are not life-threatening with usually only mild clinical symptoms. The most widespread venomous snake is the common European adder (Vipera berus). Here we present the case of a 53-year-old woman who was bitten by a common adder. Although the patient was initially in stable condition she developed edematous swelling of the complete lower limb, subcutaneous bleeding, and rhabdomyolysis. The aim of this report is to raise awareness that even in a central European country like Germany snake bites with a life-threatening course can occur and need immediate attention and medical care. PMID:25617003

  5. [Massive ovarian edema in a 13-year-old girl].

    PubMed

    Sailer, V; Huss, S; Wardelmann, E; Müller, A M

    2013-11-01

    Massive ovarian edema is a rare tumor-like condition found in young women resulting from accumulation of fluid mostly due to partial or intermittent torsion of the ovary or secondary, to a preexisting ovarian lesion. We report a case of a 13-year-old girl presenting with an ovarian mass measuring 16 cm. CA-12-5 levels were slightly elevated. Concerns regarding underlying malignancy led to salpingo-oophorectomy. Pathological evaluation revealed a massive ovarian edema and multiple thromboses of ovarian veins. Differentiating massive ovarian edema from malignant ovarian tumor is crucial to prevent patients from undergoing unnecessary surgery. PMID:23649810

  6. Blowout fracture in a 3-year-old.

    PubMed

    Pluijmers, Britt I; Koudstaal, Maarten J; Paridaens, Dion; van der Wal, Karel G H

    2013-06-01

    A 3-year-old patient was referred to the oral and maxillofacial department with a fracture of the orbital floor. Due to the lack of clinical symptoms, a conservative approach was chosen. After 3 weeks, an enophthalmos developed. The orbital floor reconstruction was successfully performed through a transconjunctival approach. This case highlights the rarity of pure blowout fractures in young children. The specific presentation and diagnostics of orbital floor fractures in children and the related surgical planning and intervention are discussed. PMID:24436749

  7. Pulmonary nocardiosis in a 3-year-old child

    PubMed Central

    Holdaway, M. D.; Kennedy, J.; Ashcroft, T.; Kay-Butler, J. J.

    1967-01-01

    Until 1960, 179 cases of infection with Nocardia asteroides had been described in the world literature. Seventeen cases in children were reported by 1963. The organism is a common saprophyte in nature with probably a world-wide distribution. Infection can be primary but is more common in patients with underlying malignancy, auto-immune disease or preceding tuberculosis. Sulphonamides, particularly sulphadiazine, are the drugs of choice in treatment; the value of antibiotics is less clearly established. The indications for surgical treatment have not yet been defined. We record a further case of primary pulmonary nocardiosis in a 3-year-old child. Images PMID:6035802

  8. Multiple Radiolucencies of the Jaws in a 6 Year Old.

    PubMed

    Hansford, John T; Kelsch, Robert D; Wiltz, Mauricio

    2015-11-01

    Radiolucencies of the jaws are a common finding. Mostly, they are isolated findings associated with inflammatory processes and consistent with inflammatory periapical disease, such as periapical cysts and periapical granulomas. If associated with the crowns of unerupted teeth, they may represent dentigerous cysts. However, occasionally, larger lytic/radiolucent lesions are identified; even more infrequently, these radiographic findings may be multiple and concurrent. The purpose of this report is to present the case of a 6-year-old female patient with no known concomitant syndrome who presented with multiple intraoral swellings and to discuss the treatment of multiple, bilateral mandibular and maxillary radiolucencies. PMID:26749783

  9. Blowout Fracture in a 3-Year-Old

    PubMed Central

    Pluijmers, Britt I.; Koudstaal, Maarten J.; Paridaens, Dion; van der Wal, Karel G.H.

    2013-01-01

    A 3-year-old patient was referred to the oral and maxillofacial department with a fracture of the orbital floor. Due to the lack of clinical symptoms, a conservative approach was chosen. After 3 weeks, an enophthalmos developed. The orbital floor reconstruction was successfully performed through a transconjunctival approach. This case highlights the rarity of pure blowout fractures in young children. The specific presentation and diagnostics of orbital floor fractures in children and the related surgical planning and intervention are discussed. PMID:24436749

  10. Granuloma inguinale in a 51-year-old man.

    PubMed

    Ornelas, Jennifer; Kiuru, Maija; Konia, Thomas; Larsen, Larissa

    2016-01-01

    Granuloma inguinale, or Donovanosis, is a rare, sexually transmitted ulcerative disease primarily affecting the genital area. In this report, we present a case of a 50-year-old man that was diagnosed with granuloma inguinale after a 2-month history of a penile ulcer. Histological analysis demonstrated the presence of Donovan bodies within macrophages, confirming the diagnosis. He was subsequently treated with trimethoprim/sulfamethoxazole with improvement in the ulcer. This case serves as a reminder to clinicians that although granuloma inguinale is rarely encountered in the US, it should still be suspected in patients with non-healing penile ulcers. PMID:27617463

  11. Spontaneous Coronary Artery Dissection in a Male Patient with Takayasu's Arteritis and Antiphospholipid Antibody Syndrome

    PubMed Central

    Gerede, Demet Menekşe; Yüksel, Bağdagül; Tutar, Eralp; Küçükşahin, Orhan; Uzun, Çağlar; Atasoy, Kayhan Çetin; Düzgün, Nurşen; Bengisun, Uğur

    2013-01-01

    We present a case of a 34-year-old male who presented to the emergency ward with fever and abdominal pain. The diagnosis of Takayasu's arteritis and also antiphospholipid syndrome was made during an imaging workup of deep-vein thrombosis. A spontaneous coronary artery dissection was revealed in coronary CT angiography requested for chest pain and dyspnea. The patient was treated medically and discharged on close followup. The concurrence of spontaneous coronary artery dissection with antiphospholipid syndrome and Takayasu's arteritis has not been reported in the previous literature. The possibility of a spontaneous coronary artery dissection should be considered in patients presenting with both diseases. PMID:23956914

  12. Spontaneous Coronary Artery Dissection in a Male Patient with Takayasu's Arteritis and Antiphospholipid Antibody Syndrome.

    PubMed

    Gerede, Demet Menekşe; Yüksel, Bağdagül; Tutar, Eralp; Küçükşahin, Orhan; Uzun, Cağlar; Atasoy, Kayhan Çetin; Düzgün, Nurşen; Bengisun, Uğur

    2013-01-01

    We present a case of a 34-year-old male who presented to the emergency ward with fever and abdominal pain. The diagnosis of Takayasu's arteritis and also antiphospholipid syndrome was made during an imaging workup of deep-vein thrombosis. A spontaneous coronary artery dissection was revealed in coronary CT angiography requested for chest pain and dyspnea. The patient was treated medically and discharged on close followup. The concurrence of spontaneous coronary artery dissection with antiphospholipid syndrome and Takayasu's arteritis has not been reported in the previous literature. The possibility of a spontaneous coronary artery dissection should be considered in patients presenting with both diseases. PMID:23956914

  13. A 36-year-old man with vomiting, pain abdomen, significant weight loss, hyponatremia, and hypoglycemia.

    PubMed

    Mutreja, Deepti; Sivasami, Kartik; Tewari, Vanmalini; Nandi, Bhaskar; Nair, G Lakhsmi; Patil, Sunita D

    2015-01-01

    Diagnosis of Strongyloides stercoralis hyperinfection can be a challenge. The key to a timely diagnosis is to have a high index of suspicion. We present a rare case of a 36-year-old human immunodeficiency virus negative male patient, who was on multidrug therapy for lepromatous leprosy and was treated for type 2 lepra reactions with steroids in the past. The patient presented with vomiting and pain abdomen, persistent hyponatremia, and terminal hypoglycemia. He had features of malnutrition and had a rapid downhill course following admission. A diagnosis of S. stercoralis hyperinfection with sepsis and multiorgan failure, adrenal hemorrhage, and syndrome of inappropriate antidiuretic hormone secretion was established on a postmortem examination. PMID:26549076

  14. Growth and Your 13-to 18-Year-Old

    MedlinePlus

    ... Years Understanding Puberty Your Child's Checkup: 17 Years Female Reproductive System Fitness and Your 13- to 18-Year-Old ... 18-Year-Old Your Daughter's First Gynecology Visit Female Reproductive System What's the Right Weight for My Height? When ...

  15. Asymptomatic gonorrhoea in a male patient.

    PubMed Central

    Chattopadhyay, B.; Teli, J. C.

    1984-01-01

    A case of asymptomatic gonorrhoea in a male patient is described. Failure to isolate Neisseria gonorrhoea from his wife possibly demonstrates inhibitory effect of Candida albicans in vivo on the former organism. PMID:6436805

  16. Clinical Features and Treatment Outcomes of Primary Immune Thrombocytopenic Purpura in Hospitalized Children Under 2-Years Old

    PubMed Central

    Farhangi, H; Ghasemi, A; Banihashem, A; Badiei, Z; Jarahi, L; Eslami, G; Langaee, T

    2016-01-01

    Background Immune thrombocytopenic purpura (ITP) is the most prevalent cause of thrombocytopenia in children. Despite the importance of ITP in children under 2-years old, only a few publications are available in the literature.ITP usually presents itself as isolated thrombocytopenia and mucocutaneous bleeding. Materials and Methods This study was conducted on 187 under 2-year-old children diagnosed with ITP and treated at Dr. Sheikh Hospital from 2004 to 2011.In this retrospective study, clinical symptoms, laboratory findings, history of viral infections, vaccination history, and treatment efficacy in children under 2-years old with ITP were investigated.Patients were followed for one year after being discharged from the hospital. Results The risk of the disease developing into chronic form was higher in older children (0.001). ITP in children under 3-months old was significantly associated with vaccination (p=0.007). There was no significant differences between male and female patients in regards to newly diagnosed ITP, persistent, and chronic disease status (p = 0.21). No significant difference in bleeding symptoms was observed between patients under 3-months old and 3 to 24-months old (p=0.18). Conclusion Infantile ITP respond favorably to treatment. The risk of the disease developing into chronic form is higher in 3-to-24-month-old children compared to under-three-month olds. PMID:27222699

  17. [A 77-year-old woman with myoclonus and epilepsy].

    PubMed

    Yokochi, M; Takaoka, S; Kawano, H; Mori, H; Shirai, T; Imai, H; Mizuno, Y

    1993-12-01

    We present a 77-year-old woman with myoclonus and epilepsy. She was well until 35 years of age, when she noted an onset of trembling of the legs upon standing. Her symptom slowly progressed, and she felt a difficulty in standing when she was 39-year-old. She had a major motor seizure without an apparent focal onset when she was 46-year-old. She also developed tremor in her hands, and she felt difficulty in holding a glass filled with water. She was admitted to our service for the first time in 1965 when she was 51-year-old. She showed wide-based ataxic gait with truncal titubation. In finger to nose test, myoclonic jerks were induced in the upper extremities. Otherwise neurological examination was unremarkable. She was treated with primidone and phenobarbital, and was discharged for out patient follow up. Her symptoms slowly progressed, and gait and station became more difficult. Mentally she was sound. Three months prior to the present admission, she developed more difficulty in gait, and decrease in food intake. On the 14th of September in 1991, she was seen by a local physician who found an abnormal shadow in her chest X-ray, and she was admitted to our service for further work-up on September 18, 1991. On admission, the patient was a chronically ill and emaciated woman. Her blood pressure was 140/84 mmHg, heart rate 115/minutes and regular, and the body temperature 36.9 degrees C. The palpebral conjunctivae were anemic. No cervical adenopathy was noted. The lung fields were clear, and no heart murmur was audible. The abdomen was soft, and no organomegaly was present. On neurologic examination, she looked somnolent with disorientation to time and place. Her memory was poor, and she could not do well serial 7s. The disc was flat and the ocular movements appeared intact. Other cranial nerves were also unremarkable. She showed diffuse muscle wasting. She was unable to stand or walk. Maintaining the sitting position was also difficult. She was able to raise her arms

  18. Prophylactic gastrectomy in a 16-year-old.

    PubMed

    Wickremeratne, Tehara; Lee, Cheng Hiang; Kirk, Judy; Charlton, Amanda; Thomas, Gordon; Gaskin, Kevin J

    2014-03-01

    We performed a total gastrectomy in a 16-year-old asymptomatic CDH1 gene mutation carrier in whom two prior gastroscopies with biopsies were normal. The patient's mother died aged 39 years and her aunt died aged 21 years of gastric cancer. A germline CDH1 mutation (associated with hereditary diffuse gastric cancer) was initially identified in her mother at diagnosis and was later identified by predictive testing in this patient. Our patient is the youngest CDH1 carrier to date to have a prophylactic gastrectomy, and is several years below the age at which existing guidelines recommend consideration of gastrectomy. Multiple foci of early-stage carcinoma were found in her gastrectomy specimen. Given the family history of advanced gastric cancer in the late second decade, the unpredictable time course to development of advanced gastric cancer, and the futility of gastroscopic surveillance, we recommend consideration of prophylactic gastrectomy in adolescent asymptomatic CDH1 mutation carriers on an individual basis. PMID:24240619

  19. Lymphoblast-derived integration-free iPS cell line from a 65-year-old Alzheimer's disease patient expressing the TREM2 p.R47H variant.

    PubMed

    Schröter, Friederike; Sleegers, Kristel; Cuyvers, Elise; Bohndorf, Martina; Wruck, Wasco; Van Broeckhoven, Christine; Adjaye, James

    2016-01-01

    Human lymphoblast cells from a male patient diagnosed with Alzheimer's disease (AD) expressing the TREM2 p.R47H variant were used to generate integration-free induced pluripotent stem (iPS) cells employing episomal plasmids expressing OCT4, SOX2, NANOG, LIN28, c-MYC and L-MYC. The iPS cells retained the TREM2 mutation, and were defined as pluripotent based on (i) expression of pluripotent-associated markers, (ii) embryoid body-based differentiation into cell types representative of the three germ layers and (iii) the similarity between the transcriptomes of the iPS cell line and the human embryonic stem cell line H1 with a Pearson correlation of 0.966. PMID:27345793

  20. [Sudden death of a 16-year-old girl with WPW syndrome: a case report].

    PubMed

    Wöllner, Kirsten; Doberentz, Elke; Madea, Burkhard

    2015-01-01

    The Wolff-Parkinson-White syndrome is a usually benign heart disease with accessory pathways. Circling excitations arise between atria and ventricles which can lead to cardiac arrhythmias. Cases of sudden cardiac death are rare (0.2 %). Risk factors for sudden cardiac death in patients with WPW syndrome are old age, several accessory pathways, male sex and previous syncopes. A 16-year-old girl was found lying dead in her bed. The evening before, she didn't feel well and complained about abdominal pain. The girl had known epilepsy and Wolff- Parkinson-White syndrome. The macroscopic and histological findings are presented and discussed with reference to the pertinent literature. PMID:26419085

  1. Challenges of banding jejunal varices in an 8-year-old child

    PubMed Central

    Belsha, Dalia; Thomson, Mike

    2015-01-01

    Endoscoic variceal ligation (EVL) by the application of bands on small bowel varices is a relatively rare procedure in gastroenterology and hepatology. There are no previously reported paediatric cases of EVL for jejunal varices. We report a case of an eight-year-old male patient with a complex surgical background leading to jejunal varices and short bowel syndrome, presenting with obscure but profound acute gastrointestinal bleeding. Wireless capsule endoscopy and double balloon enteroscopy (DBE) confirmed jejunal varices as the source of bleeding. The commercially available variceal banding devices are not long enough to be used either with DBE or with push enteroscopes. With the use of an operating gastroscope, four bands were placed successfully on the afferent and efferent ends of the leads of the 2 of the varices. Initial hemostasis was achieved with obliteration of the varices after three separate applications. This case illustrates the feasibility of achieving initial hemostasis in the pediatric population. PMID:26722617

  2. Challenges of banding jejunal varices in an 8-year-old child.

    PubMed

    Belsha, Dalia; Thomson, Mike

    2015-12-25

    Endoscoic variceal ligation (EVL) by the application of bands on small bowel varices is a relatively rare procedure in gastroenterology and hepatology. There are no previously reported paediatric cases of EVL for jejunal varices. We report a case of an eight-year-old male patient with a complex surgical background leading to jejunal varices and short bowel syndrome, presenting with obscure but profound acute gastrointestinal bleeding. Wireless capsule endoscopy and double balloon enteroscopy (DBE) confirmed jejunal varices as the source of bleeding. The commercially available variceal banding devices are not long enough to be used either with DBE or with push enteroscopes. With the use of an operating gastroscope, four bands were placed successfully on the afferent and efferent ends of the leads of the 2 of the varices. Initial hemostasis was achieved with obliteration of the varices after three separate applications. This case illustrates the feasibility of achieving initial hemostasis in the pediatric population. PMID:26722617

  3. Antiretroviral treatment induced catatonia in 16-year-old boy.

    PubMed

    Lingeswaran, Anand

    2014-01-01

    We present a 16-year-old boy, who had presented to us with catatonic features of mutism, withdrawal, passive negativism, grimacing, gesturing, echopraxia, and excitement of 5 days duration while taking antiretroviral therapy (ART) for a period of 2 years. He had history of birth asphyxia and acquired HIV infection from his father when the same syringe and needle was used on both of them in a medical setting where the father and son had consulted for treatment of pyrexia of unknown origin. He was the eldest of a three children family in which the biologic father had acquired HIV through extramarital sexual contact with HIV-infected sex workers but was unaware of his HIV positive status till our patient, the 16-year-old was admitted and treated for pulmonary tuberculosis at 14 years of age. The boy's mother had only acquired HIV after having three children with the HIV-positive husband, thus leaving the other two children HIV negative. The catatonia completely resolved within 2 days after the ART was withheld, and risperidone 1 mg twice a day was prescribed. This case highlights the risks of ART and breach of universal precautions. PMID:25624940

  4. A 62-year-old man with dyspnea

    PubMed Central

    Baqir, Misbah; Ryu, Jay H.; Sorenson, Eric J.; Olson, Eric J.

    2016-01-01

    We describe the case of a 62-year-old man who presented with shortness of breath that had progressed over several years. He had a history of a paralyzed right hemidiaphragm for at least the previous 10 years. He also reported weakness in his proximal legs and daytime sleepiness. On examination, he was found to have thoracoabdominal paradox when in supine position. Pulmonary function testing revealed severe restriction; arterial blood gas showed chronic respiratory acidosis. Electromyography showed chronic phrenic neuropathy bilaterally, with mild proximal myopathy. Serum aldolase level was mildly elevated, but serologic tests for connective tissue disorders were within reference range. After extensive clinical investigations, the patient was found to have severely reduced acid α-glucosidase. Genetic analysis confirmed the diagnosis of adult-onset Pompe disease. The patient started treatment with bilevel positive airway pressure titrated during polysomnography, and acid α-glucosidase enzyme replacement was recommended. PMID:27141434

  5. Choline associated hypersexuality in a 79-year-old man.

    PubMed

    Calabrò, Rocco Salvatore; Cordici, Francesco; Genovese, Carmelo; Bramanti, Placido

    2014-01-01

    Hypersexuality, also referred to as sexually inappropriate behavior and sexual disinhibition, involves persistent, uninhibited sexual behaviors directed at oneself or at others, sometimes associated with neurodegenerative disorders. Choline is a water-soluble essential nutrient, used as a dietary supplement in different diseases. This report was aimed at considering choline intake as a possible cause of iatrogenic hypersexuality. After an evaluation, a 79-year-old man affected by memory loss was diagnosed with mild cognitive impairment and treated with oral choline. After 6 weeks of regular choline assumption, the patient showed a pathological increase in libido with sexual urges. As choline was withdrawn, the hypersexuality disappeared within 5 days. Since hypersexuality may be an underreported and overlooked adverse effect of drugs and dietary supplements acting on the cholinergic pathway, this should be considered when treating and counselling patients with inappropriate sexual behavior. PMID:23733158

  6. Epicardial Tachosil Patch Repair of Ventricular Rupture in a 90-Year-Old After Mitral Valve Replacement.

    PubMed

    Feng, William; Coady, Michael

    2016-06-01

    We report our experience with emergent treatment of ventricular rupture following a mitral valve replacement in a 90 year-old male. The repair was performed using a Tachosil patch (Baxter Health Care Corporation, Westlake Village, California), a fibrin sealant coated on an equine collagen sponge, and BioGlue (Cryolife, Kenneson, GA) and bovine pericardium (Edwards Lifesciences, Irvine, CA). Aside from early ventricular dysfunction requiring a low-dose dopamine infusion, this patient's recovery was uneventful. Follow-up echocardiograms demonstrated no gross anatomic abnormality at the repair site, and steady improvement in his ventricular function. PMID:27211944

  7. Male patients presenting with rapidly progressive puberty associated with malignant tumors

    PubMed Central

    Kim, Soo Jung; Ko, A Ra; Jung, Mo Kyung; Kim, Ki Eun; Chae, Hyun Wook; Kim, Duk Hee; Kim, Ho-Seong

    2016-01-01

    In males, precocious puberty (PP) is defined as the development of secondary sexual characteristics before age 9 years. PP is usually idiopathic; though, organic abnormalities including tumors are more frequently found in male patients with PP. However, advanced puberty in male also can be an important clinical manifestation in tumors. We report 2 cases of rapidly progressive puberty in males, each associated with a germ-cell tumor. First, an 11-year-old boy presented with mild fever and weight loss for 1 month. Physical examination revealed a pubertal stage of G3P3 with 10-mL testes. Investigations revealed advanced bone age (16 years) with elevated basal luteinizing hormone and testosterone levels. An anterior mediastinal tumor was identified by chest radiography and computed tomography, and elevated α-fetoprotein (AFP) and β-human chorionic gonadotropin (β-hCG) levels were noted. Histopathologic analysis confirmed a yolk-sac tumor. Second, a 12-year-old boy presented with diplopia, polydipsia, and polyuria for 4 months. Physical examination revealed a pubertal stage of G3P3 with 8-mL testes. Bone age was advanced (16 years) and laboratory tests indicated panhypopituitarism with elevated testosterone level. A mixed germ-cell tumor was diagnosed with elevated AFP and β-hCG levels. Of course, these patients also have other symptoms of suspecting tumors, however, rapidly progressive puberty can be the more earlier screening sign of tumors. Therefore, in male patients with accelerated or advanced puberty, malignancy should be considered, with evaluation of tumor markers. In addition, advanced puberty in male should be recognized more widely as a unique sign of neoplasm. PMID:27104181

  8. Systemic lupus erythematosus in 50 year olds.

    PubMed Central

    Domenech, I.; Aydintug, O.; Cervera, R.; Khamashta, M.; Jedryka-Goral, A.; Vianna, J. L.; Hughes, G. R.

    1992-01-01

    We compared the clinical and serological characteristics of 15 patients with onset of systemic lupus erythematosus after the age of 50 with those of 232 younger patients. The sex distribution was similar in both groups. All 15 patients were Caucasian. Autoimmune thyroiditis was found in 20% of the elderly patients. Initial manifestations, which presented more frequently in the older group, included thrombocytopenia (P < 0.05), sicca syndrome (P < 0.01) and cardiomyopathy (P < 0.005), whereas butterfly rash (P < 0.05) presented more frequently in the younger group. Analysis of cumulative clinical symptoms showed that butterfly rash (P < 0.05) and livedo reticularis (P < 0.05) were less frequent in the elderly. However, this group presented a significantly increased incidence of sicca syndrome (P < 0.005) and cardiomyopathy (P < 0.005). Antibodies to double-stranded DNA tended to occur less frequently in older patients (P < 0.05). PMID:1437923

  9. 28. Graffiti in north cells: '20 years old 4315 CD ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    28. Graffiti in north cells: '20 years old 4315 C-D Mamoru Yoshimoto 5/24/45 180 days Kumamoto'; '18 ' ' years old 1406-A Haruo Yokoi 6/17/45 270 days Nagoya'; '31 ' ' years old 5604-B Masaki Nishii 5/24/45 180 days Kumamoto'; '19 ' ' years old 1806-B Masaharu Yoshida 5/24/45 180 days Hiroshima'; 135mm lens with electronic flash illumination. - Tule Lake Project Jail, Post Mile 44.85, State Route 139, Newell, Modoc County, CA

  10. [Circumscript myositis ossificans in a four-year-old boy].

    PubMed

    Cabello García, D; Rodríguez Fernández, A; Gómez Río, M; Moreno, M J; Rebollo Aguirre, A C; Martín Castro, A; Llamas Elvira, J M

    2008-01-01

    We present the case of a 4 year old boy with no previous personal or family history of interest, who attended the Paediatric Department of our hospital after a physical examination revealed a painful induration in the left arm which had increased in size; imaging tests were consistent with a calcified mass in soft tissues, without cortical involvement, suspected of being malignant. Two-phase bone scintigraphy was requested in which a soft tissue lesion, not suggestive of malignancy, was detected. The biopsy was negative for malignant cells. However, in view of the progressive increase in size of the lesion, FDG positron emission tomography (FDG-PET) was performed, showing a hypermetabolic mass consistent with malignancy in the left arm, for which the patient underwent surgery for suspected possible parosteal osteosarcoma. PMID:18817666

  11. SCHMIDT'S SYNDROME IN A 32 YEARS OLD FEMALE.

    PubMed

    Khattak, Abdul Latif; Khatak, Abdul Latif; Ali, Waqar; Saleem, Salman; Nayyer, Zameer Ahmad; Idris, Muhammad; Idrees, Mohammad; Khan, Naseer Ahmad; Ahmad, Nayyer; Pasha, Waseem

    2015-01-01

    In polyglandular autoimmune (PGA) syndromes, there is immune dysfunction of two or more endocrine glands. Immunity mediated disorders of non-endocrine organs may also be seen. These syndromes are of two main types: type I and type II. We are reporting this case of a 32 years old lady who presented initially with hypothyroidism for many years and received thyroid replacement therapy. After that she was married and had children. After an interval of about seven years of the initial diagnosis of hypothyroidism, she was hospitalized in first trimester of pregnancy for severe vertigo, syncopal episodes and hypotension. She responded well to intravenous fluids and steroids. Further endocrine related, investigations revealed Addison's disease and the above episode were retrospectively diagnosed as Addisonian crisis. Thus the patient was diagnosed as Schmidt's Syndrome (Autoimmune polyendocrine syndrome type 2) since 2009. PMID:26411141

  12. Pyomyositis in a 5-year-old child.

    PubMed

    Romeo, S; Sunshine, S

    2000-07-01

    We present a case of pyomyositis in an otherwise healthy 5-year-old child that underscores the potential for serious, life-threatening complications. Pyomyositis of the gluteal, psoas, and iliacus muscles was associated with osteomyelitis, septic arthritis, a large inferior vena cava thrombus, septic pulmonary emboli, and eventual pneumonia. Primary pyomyositis is a purulent infection of striated muscle thought to be caused by seeding from a transient bacteremia. The focal infection typically forms an abscess that generally responds to intravenous antibiotics and occasionally requires adjunctive computed tomography-guided aspiration and drainage. This localized infectious process rarely produces further sequelae unless treatment is delayed. Pyomyositis is rare in healthy individuals and requires a high clinical suspicion in patients who present with fever, leukocytosis, and localized pain. PMID:10910315

  13. A 35-year old woman with productive cough and breathlessness.

    PubMed

    Kalai, Umasankar; Hadda, Vijay; Madan, Karan; Arava, Sudheer; Ali, Firdaus; Jain, Neetu; Mohan, Anant

    2015-01-01

    A 35-year-old lady was seen in the outpatient clinic owing to fever, cough with mucopurulent expectoration, and breathlessness for the duration of 1 month. She had history of similar episodes treated with antibiotics four times during last 2 years. There was no history of recurrent sinusitis, diarrhea, and skin or soft tissue infection. She had no history of diabetes mellitus or steroid intake. She denied any history of facial trauma or dental infection in the past. There was no history of tuberculosis in her or in the family. Radiograph and CT scan of the chest revealed right upper lobe consolidation. Flexible fibreoptic bronchoscopy revealed multiple nodules at opening of right upper lobe bronchus. This clinicopathological conference describes the details of differential diagnoses, difficulties in achieving the final diagnosis and management of such patient. PMID:26664183

  14. Review of the Literature: Organ of Giraldes Epididymal Appendage Presenting as a Painless Scrotal Mass in a 19-Year-Old Male—A Rare Urologic Entity

    PubMed Central

    Dalati, Mohamad-Fadi; Oliveira-e-Silva, Tania; Entezari, Kim

    2015-01-01

    An incidental finding of a testicular mass in young male population is always a case of great concern for the patient and controversy for the physician. Differential diagnosis ranges from acute scrotum (notably testicular torsion), to acute inflammation and infection, all the way to testicular tumors. We present a case of an incidental finding of a painless testicular solid mass in a 19-year-old male patient, with an end pathological result of paradidymis (organ of Giraldes) following orchiectomy. To the best of our knowledge, this is the first case of its kind to be reported in the literature. PMID:26576317

  15. Malignant lymphoma of the breast in a male patient: ultrasound imaging features.

    PubMed

    Ikeda, Tatsuhiko; Bando, Hiroko; Iguchi, Akiko; Tanaka, Yuko; Tohno, Eriko; Hara, Hisato

    2015-03-01

    Non-Hodgkin lymphoma (NHL) of the breast is a rare disease. Herein, we report a rare case of secondary involvement of the breast by NHL in a male patient and the ultrasound imaging findings. A 70-year-old man noticed an induration of the subareolar region of the right breast. He had been diagnosed as having mantle cell lymphoma 5 years before and treated with several series of chemoradiotherapy. On supine examination, palpation revealed bilateral breast enlargement, but detection of a lump was difficult. Ultrasonography showed a hypoechoic non-mass image-forming lesion in the subareolar region of the right breast. The final pathological diagnosis was recurrence of mantle cell lymphoma in the right breast. The diagnosis of malignant lymphoma of the breast by imaging modalities is difficult because there are no specific features. Breast lymphoma should be included with gynecomastia and breast cancer in the differential diagnosis of male patients with breast enlargement. PMID:22396322

  16. Personal and Social Correlates of the "Closed Mind" among 16-Year-Old Adolescents in England.

    ERIC Educational Resources Information Center

    Francis, Leslie J.

    1997-01-01

    Compares what is known about key personal and social correlates of scores on Rokeach dogmatism scales with findings from a new study of English 16-year-old pupils. Demonstrates that higher dogmatism scores are associated with lower IQ scores, lower social-class backgrounds, higher neuroticism scores, higher lie-scale scores, and being male. (DSK)

  17. Ectopic Ureteral Insertion into the Seminal Vesicle Causing Recurrent Epididymitis in a 24-Year-Old

    PubMed Central

    Marien, Tracy; Herrell, Stanley Duke

    2015-01-01

    Abstract A 24-year-old male was found to have recurrent epididymitis secondary to ectopic ureteral insertion to the seminal vesicle. His ipsilateral kidney was atrophic and ectopic in the pelvis, suggesting a complex failure of embryological development. He was successfully treated with robot-assisted laparoscopic nephroureterectomy.

  18. Dental Management of a 14-Year-Old with Cockayne Syndrome under General Anesthesia

    PubMed Central

    Gaddam, Divya; Thakur, Mukesh Singh; Krothapalli, Niranjani; Kaniti, Saujanya

    2014-01-01

    Cockayne's syndrome is a rare, autosomal recessive disorder characterized clinically by cachectic dwarfism, cutaneous photosensitivity, loss of adipose tissue, mental retardation, skeletal and neurological abnormalities, and pigmentary degeneration of the retina. Dental caries is a common finding. Dental rehabilitation of a 14-year-old male with Cockayne's syndrome is presented. PMID:25574402

  19. Temporal Generalization in 3- to 8-Year-Old Children.

    ERIC Educational Resources Information Center

    Droit-Volet, Sylvie; Clement, Angelique; Wearden, John

    2001-01-01

    Tested 3-, 5-, and 8-year-olds on temporal generalization with visual stimuli. Found increasing sharpness of generalization gradient with increasing age, and change from symmetrical to adult-like asymmetrical generalization gradients among 8-year-olds. Theoretical models attributed changes to increasing precision of the reference memory with…

  20. Growth and Your 2- to 3-Year-Old

    MedlinePlus

    ... to Know About Zika & Pregnancy Growth and Your 2- to 3-Year-Old KidsHealth > For Parents > Growth and Your 2- to 3-Year-Old Print A A A ... 4 pounds (1.8 kilograms) and grow about 2 to 3 inches (5 to 8 centimeters). They' ...

  1. Medical Care and Your 1- to 2-Year-Old

    MedlinePlus

    ... Zika & Pregnancy Medical Care and Your 1- to 2-Year-Old KidsHealth > For Parents > Medical Care and Your 1- to 2-Year-Old Print A A A Text Size ... Following simple instructions? Saying a few words? Combining two words by age 2? The doctor may ask ...

  2. Puzzlemaking and Part-Whole Perception of Two-Year-Old and Four-Year-Old Children

    ERIC Educational Resources Information Center

    Montford, Emily I. Purvis; Readdick, Christine A.

    2008-01-01

    The relationship between preschoolers' puzzlemaking strategies and part-whole perception was investigated in the present study. Forty-eight two year olds and 48 four year olds were randomly selected from eight licensed childcare centers. Puzzlemaking strategies (image, form, color, and trial and error) were measured by performance in the…

  3. Myxoid chondrosarcoma of the mandible in a 22-year-old man: A case report

    PubMed Central

    Chen, Ying; Zhang, Ying

    2016-01-01

    This study describes a case of myxoid chondrosarcoma of the mandible in a 22-year-old male patient. A tumour in the buccal gingiva of the lower left premolar region had been identified 2 years earlier. Whole-jaw panoramic radiographs showed a hypodense shadow in the mesiodistal area near the roots of teeth 34 and 35. A maxillofacial computed tomography scan revealed a mass in the lower left premolar soft tissue, with a shadow indicating bone destruction, a clear boundary and uniform density. The preliminary diagnosis at the outpatient department was 34–35 epulis. The patient underwent surgery for 34–35 gingival tumour resection, 34 and 35 extraction, and 34 and 35 immediate implantation. The postoperative pathological examination revealed a cellular type extraskeletal myxoid chondrosarcoma of the lower left mandible. Under general anaesthesia, the patient underwent lower left mandibular block and segmental resection, submandibular triangle dissection and vessel disassociation, and musculocutaneous flap repair in the oral and maxillofacial defect area. After 9 months of follow-up, the patient had no complaints of discomfort, and tumour recurrence was not observed on imaging examinations. PMID:27602220

  4. [Asymptomatic 32 year old female smoker with persistent polyclonal lymphocytosis].

    PubMed

    Chapuy, B; Wulf, G; Tessen, H W; Griesinger, F; Trümper, L; Schroers, R

    2007-03-01

    A 32 year old female smoker (20 pack years) presented with an asymptomatic lymphocytosis of 13,000/nl and splenomegaly. The patient's blood smear showed an absolute lymphocytosis with 65% atypical lymphocytes. A total of 1% of the lymphocytes were bilobulated. Bone marrow histology and immunphenotyping of blood and bone marrow excluded leukemia and non-Hodgkin's lymphoma. IgH-CDR-3 PCR analysis revealed a polyclonal pattern. In summary, a persistent polyclonal B-cell-lymphocytosis (PPBL) was diagnosed. The exact etiology of PPBL is still unclear, however, it is associated with a polyclonal raise in the lymphocyte count of CD27+IgD+-memory-B-lymphocytes due to a defect in apoptosis signaling and leukocyte homing to secondary lymphoid tissues. An association with cigarette smoking is obvious since all patients are smokers. From all published cases, only two developed a malignancy with an uncertain association with PPBL. We have been monitoring our patient for 6.5 years without any evidence of the development of a lymphoma. PMID:17287965

  5. Unexplained weight loss in an 80-year-old woman.

    PubMed

    Taylor, Imogen Aleksandra; Gill, Isaac; Harripaul, Azad

    2015-01-01

    An 80-year-old woman presented with long-standing history of weight loss and malnutrition, which had caused her to become reliant on the use of a wheelchair. Her symptoms were initially attributed to her medical comorbidities, however, during admission it became apparent that she had been suffering from depression and had gone on to develop an eating disorder. Eating disorders are most common in young adults but can affect all age groups, including the elderly population. The diagnosis is rarely considered in such patients and easily overlooked, especially when in the presence of chronic conditions and cognitive decline. A pre-existing psychiatric issue, most often depression, may also be present in this age group. There are no current treatment methods targeting patients in this population, who may not respond as effectively to the available strategies directed at young adults. It is important to always consider an eating disorder as a contributor or direct cause of unexplained weight loss in elderly patients. PMID:25618876

  6. ST segment depression in asymptomatic male patient with normal coronary arteries.

    PubMed

    Mitu, O; Mitu, F; Leon, Maria Magdalena; Roca, M; Graur, Mariana

    2015-01-01

    ST segment depression and T waves inversion are electrocardiographic (ECG) repolarization abnormalities often encountered in clinical medical practice that have been proved to predict future cardiovascular events. We present the case of a 62-year-old male patient, asymptomatic, with ST segment depression and inverted T waves discovered incidentally on resting ECG. Echocardiographic and laboratory examinations ruled out multiple causes of ECG abnormalities. Suspecting a silent myocardial ischemia, an ECG exercise stress test was performed; it revealed pseudo normalization of T waves during exercise and early recovery phase. Being inconclusive, a coronary CT was the final election test; it showed normal coronary arteries with no stenosis, the patient being scheduled for regular follow-up. The possible causes of ST segment depression are reviewed since it is important that early cardiovascular signs especially in asymptomatic patients to be prevented and detected. PMID:25970951

  7. Breast mass in a 69-year-old woman

    SciTech Connect

    Hermann, G.; Schwartz, I.S.; Slater, G.

    1986-02-21

    A 69-year-old woman was initially seen with constant abdominal pain in the epigastrium and right upper quadrant, with nausea and vomiting of three days' duration. On examination, moderate tenderness and guarding in the right upper quadrant of the abdomen were noted. A leukocytosis of 11,000/cu mm, with a mild shift to the left, was present. Findings from a sonogram and hepatobiliary scan were consistent with a diagnosis of acute cholecystitis for which intravenous (IV) antibiotic therapy was instituted. Results of radiological studies performed on the second hospital day showed a small-bowel obstruction. On surgical exploration, a gangrenous segment of the terminal ileum was resected and an end-to-end anastomosis was performed. The resected bowel demonstrated hemorrhagic infarction with evidence of focal organizing venous thrombosis in the mesentery. The patient was initially started on a regimen of IV heparin and then switched to oral coumarin. On the fourth day of coumarin therapy, massive swelling, tenderness, and erythema were noted to involve the entire right breast. Six months later, the patient was readmitted because of an acute pulmonary embolism. A residual 4x5-cm mass was present in the central portion of the right breast. The overlying skin was slightly retracted. Mammography showed an extensive masslike density behind the right nipple, with evidence of periareolar retraction. Coumarin-induced mammary necrosis was diagnosed.

  8. A 37-year-old mechanic with multiple chemical sensitivities.

    PubMed Central

    Kipen, H M; Fiedler, N

    2000-01-01

    A 37-year-old heating, ventilation, and air-conditioning mechanic developed respiratory, musculoskeletal, and central nervous system symptoms associated with a variety of odorous environmental chemicals. Organic disease was not evident, but the patient was distressed by these symptoms and was at risk for becoming disabled by them. His symptoms fit broadly into the condition recognized as multiple chemical sensitivity. Multiple chemical sensitivity is a diagnostic term for a group of symptoms without demonstrated organic basis. The symptoms are characteristic of dysfunction in multiple organ systems, they increase and decrease according to exposure to low levels of chemical agents in the patient's environment, and they sometimes occur after a distinct environmental change or insult such as an industrial accident or remodeling. Although traditional medical organizations have not agreed on a definition for this syndrome, it is being increasingly recognized and makes up an increasing percentage of the caseload at occupational and environmental medicine clinics. Although there is often dispute about whether the symptoms have a functional or organic basis, an informed approach to evaluation, diagnosis, and management and a careful assessment of impairment, disability, and work relatedness are necessary. Careful exclusion of organic causes is critical, and this should be followed by a judicious approach to coping with symptoms. PMID:10753098

  9. October 2002: 27-year-old female with epilepsy.

    PubMed

    Mourelatos, Zissimos; McGarvey, Michael; French, Jacqueline A; Wells, Gregg

    2003-04-01

    The October 2002 Case of the Month (COM). The patient was a 27-year-old woman with a history of partial complex seizures at age 7. At age 20 her seizures changed in character and became progressively worse. Neuroimaging studies showed atrophy of the right hemisphere and contralateral cerebellar atrophy. Following a biopsy, she was scheduled for a surgical procedure, but unfortunately she expired at home during her sleep a week later. Examination of the brain confirmed the hemi-atrophy of the right cerebral hemisphere and left cerebellum. Microscopic examination showed severe gliosis and perivascular lymphocytic infiltrates in many areas. A diagnosis of Rasmussen's encephalitis was made. Rasmussen's encephalitis is a chronic neurological disorder, first described in 1958. The active neurological decline lasts from 1 to 20 years and the patients then remain stable with a fixed neurological deficit and residual seizures. Pathological examination shows a chronic encephalitis confined to one hemisphere. In the active phase, neuronophagia, activated microglial cells (rod cells), microglial nodules, and perivascular lymphocytic infiltrates, are present. In the more chronic phase neuronal loss and gliosis predominate. The etiology of Rasmussen's encephalitis is unknown but viral infection and autoimmunity have been implicated. The treatment of choice is functionally complete hemispherectomy with complete disconnection of the frontal and occipital lobes. PMID:12744477

  10. Administration of high-dose interleukin-2 in a 2-year-old with metastatic melanoma.

    PubMed

    Bernhardt, M Brooke; Hicks, M John; Pappo, Alberto S

    2009-12-15

    Malignant melanoma is rare in pediatrics, and therapies for patients with disseminated disease have not been well studied. This report describes our experience with the use of high-dose interleukin 2 (aldesleukin, IL-2) in a 2-year-old child with metastatic melanoma and describes our approach for the administration of this agent to young patients. PMID:19731326

  11. Complex Motor Learning in Four-Year-Olds

    ERIC Educational Resources Information Center

    Leithwood, K. A.; Fowler, W.

    1971-01-01

    The effects of 4 months of gymnostic training upon complex and simple gross motor abilities and general cognitive and psychosocial functioning in 4-year-olds were compared with the effects of music training and no treatment. (WY)

  12. CPR - child 1 to 8 years old - slideshow

    MedlinePlus

    ... medlineplus.gov/ency/presentations/100215.htm CPR - child 1 to 8 years old - series—Check for responsiveness ... this page, please enable JavaScript. Go to slide 1 out of 3 Go to slide 2 out ...

  13. A Gunpowder Tattoo in a 6-Year-Old Girl.

    PubMed

    Bernstein, Seth; Barros, Brittany; Zaenglein, Andrea L

    2016-05-01

    Gunpowder tattoos result from explosion and subsequent traumatic implantation of pigmented granules into varying layers of the skin. This report details the case of a 6-year-old with a gunpowder tattoo on the face. PMID:27040733

  14. Borderline phylloides tumor in an 11-year-old girl.

    PubMed

    Selamzade, M; Gidener, C; Koyuncuoglu, M; Mevsim, A

    1999-07-01

    Phylloides tumor is an uncommon breast tumor in children. Only a few cases have been reported in the literature. A case of borderline phylloides tumor in an 11-year-old girl is described. PMID:10415310

  15. Intracystic Papillary Carcinoma of the Breast in a Male Patient

    PubMed Central

    Hu, Zishuo Ian; Liu, Chengbao; Fisher, Paul R.; Cohen, Jules A.

    2016-01-01

    We report a case of intracystic papillary carcinoma of the right breast in a 59-year old man presenting with bloody nipple discharge for 1 week prior to presentation. Mammography, ultrasonography, and core needle aspiration were consistent with intracystic papillary carcinoma. The patient underwent right simple mastectomy. Pathology was also consistent with low grade intracystic papillary carcinoma. The 21-gene assay revealed a recurrence score of 0, corresponding to a 3% risk of distant recurrence at 10 years. A patient did not receive chemotherapy or post-mastectomy radiotherapy. The patient was placed on tamoxifen and has been free of disease to date. PMID:27134706

  16. Primary Mature Cystıc Teratoma Mimickıng an Adrenal Mass in an Adult Male Patient

    PubMed Central

    Ener, Kemal; Aldemir, Mustafa; Isik, Evren; Irkkan, Cigdem; Kayigil, Onder

    2014-01-01

    Teratomas are bizarre neoplasms derived from embryonic tissues that are typically found only in the gonadal and sacrococcygeal regions of adults. Primary retroperitoneal teratomas are rare and present challenging management options. We report a case of a unilateral primary retroperitoneal mature cystic teratoma mimicking an adrenal mass in a 54-year-old male patient. Complete resection of the adrenal mass was performed by the flank approach by using the 11th rib resection. Because of the risk of malignancy, follow-up radiographic studies were performed to ensure the oncologic efficacy of resection. The patient has been free of recurrence for longer than 12 months. PMID:24578814

  17. Unusual presentation of dermatofibrosarcoma protuberans in a male patient's breast: a case report and review of the literature.

    PubMed

    Al Tarakji, Mohannad; Toro, Adriana; Di Carlo, Isidoro; Junejo, Kulsoon

    2015-01-01

    We herein present a case report and literature review of dermatofibrosarcoma protuberans in the breast of a male patient. A 27-year-old man presented with a painless lump in his right breast with areas of bluish skin discoloration. The diagnostic work-up comprised clinical examination, ultrasonography, core biopsy, mammography, and magnetic resonance imaging. After surgical excision, the preoperative diagnosis of dermatofibrosarcoma protuberans was proven by pathological examination and immunohistochemistry. The patient was still free of recurrence 1 year after surgical excision. This extremely rare case is, to the best of our knowledge, the fifth such case reported in the literature. PMID:25896773

  18. A large pseudoaneurysm of the left cardiac ventricle in a 57-year-old patient after urgent coronary artery bypass grafting and surgical mitral valve replacement due to acute myocardial infarction.

    PubMed

    Wieczorek, Joanna; Mizia-Stec, Katarzyna; Rybicka-Musialik, Anna; Janusiewicz, Piotr; Malinowski, Marcin; Deja, Marek A

    2014-12-01

    We present a rare case of a left ventricular pseudoaneurysm in a patient after inferior wall myocardial infarction. The infarction was complicated with acute mitral insufficiency, pulmonary edema, and cardiogenic shock. Urgent surgical mitral valve replacement and coronary artery bypass grafting were performed. After several months, the patient was hospitalized again because of deterioration of exercise tolerance and symptoms of acute congestive heart failure. A large pseudoaneurysm of the left ventricle was recognized and successfully treated surgically. PMID:26336464

  19. A large pseudoaneurysm of the left cardiac ventricle in a 57-year-old patient after urgent coronary artery bypass grafting and surgical mitral valve replacement due to acute myocardial infarction

    PubMed Central

    Mizia-Stec, Katarzyna; Rybicka-Musialik, Anna; Janusiewicz, Piotr; Malinowski, Marcin; Deja, Marek A.

    2014-01-01

    We present a rare case of a left ventricular pseudoaneurysm in a patient after inferior wall myocardial infarction. The infarction was complicated with acute mitral insufficiency, pulmonary edema, and cardiogenic shock. Urgent surgical mitral valve replacement and coronary artery bypass grafting were performed. After several months, the patient was hospitalized again because of deterioration of exercise tolerance and symptoms of acute congestive heart failure. A large pseudoaneurysm of the left ventricle was recognized and successfully treated surgically. PMID:26336464

  20. Cosmetic clitoridectomy in a 33-year-old woman.

    PubMed

    Veale, David; Daniels, Joe

    2012-06-01

    The Female Genital Mutilation Act (2003) in England allows for mental health exceptions for cosmetic surgery resulting from perceived abnormality. Similar legislation exists in other countries. There are no reported cases of clitoridectomy for cosmetic reasons or any discussion in the literature of mental health exceptions to the Act. This is a single case report on a 33-year-old married, heterosexual woman who had already had a cosmetic labiaplasty and was seeking a clitoridectomy for aesthetic reasons. At assessment, there were no psychiatric contra-indications or unrealistic expectations and the patient proceeded with a clitoridectomy. At 9 and 22 months follow-up, she was reassessed and was very pleased with the outcome. There were improvements in the satisfaction with her genital appearance, sexual satisfaction, and quality of life related to body image. Assessments for cosmetic clitoridectomy will continue to be rare, but this case may provide some guidance for practitioners who are confronted with such requests for body modification. However there remains only limited understanding of the motivation for such a request. PMID:21837517

  1. A 47-year-old returning traveler with shock.

    PubMed

    Soni, Hardik; Gandhi, Viral; Varma, Sohan; Kaur, Deepinder; Epelbaum, Oleg

    2015-01-01

    A 47-year-old man with no significant past medical history, originally from Indonesia, was brought to the ED of an urban US medical center after being found collapsed on the sidewalk in respiratory distress and with an altered sensorium. Upon arrival to the ED, he was tachypneic, with increased work of breathing and an oxygen saturation of 88% on 100% nonrebreather mask, so he was immediately intubated. Following intubation, he became profoundly hypotensive, requiring aggressive crystalloid resuscitation and vasopressor support. Broad-spectrum antimicrobials were administered, including ceftriaxone, vancomycin, levofloxacin, and oseltamivir. Further history elicited subsequently from family members revealed that the patient had returned from a 2-week vacation in Indonesia 6 days prior to presentation. According to relatives, he appeared to be in his usual state of health upon his return and was not seen by anyone thereafter, but in the interim he reportedly had an episode of epistaxis, and text messages received from him became progressively more bizarre. PMID:25560874

  2. Wandering spleen with gastric volvulus and intestinal non-rotation in an adult male patient.

    PubMed

    Ooka, Minako; Kohda, Eiichi; Iizuka, Yuo; Nagamoto, Masashi; Ishii, Tomotaka; Saida, Yoshihisa; Shimizu, Norikazu; Gomi, Tatsuya

    2013-01-01

    We report an extremely rare case of wandering spleen (WS) complicated with gastric volvulus and intestinal non-rotation in a male adult. A 22-year-old man who had been previously treated for Wilson disease was admitted with severe abdominal pain. Radiological findings showed WS in the midline of the pelvic area. The stomach was mesenteroaxially twisted and intestinal non-rotation was observed. Radiology results did not show any evidence of splenic or gastrointestinal (GI) infarction. Elective emergency laparoscopy confirmed WS and intestinal non-rotation; however, gastric volvulus was not observed. It was suspected that the stomach had untwisted when gastric and laparoscopic tubes were inserted. Surgery is strongly recommended for WS because of the high risk of serious complications; however, some asymptomatic adult patients are still treated conservatively, such as the patient in this study. The present case is reported with reference to the literature. PMID:24349711

  3. Wandering spleen with gastric volvulus and intestinal non-rotation in an adult male patient

    PubMed Central

    Kohda, Eiichi; Iizuka, Yuo; Nagamoto, Masashi; Ishii, Tomotaka; Saida, Yoshihisa; Shimizu, Norikazu; Gomi, Tatsuya

    2013-01-01

    We report an extremely rare case of wandering spleen (WS) complicated with gastric volvulus and intestinal non-rotation in a male adult. A 22-year-old man who had been previously treated for Wilson disease was admitted with severe abdominal pain. Radiological findings showed WS in the midline of the pelvic area. The stomach was mesenteroaxially twisted and intestinal non-rotation was observed. Radiology results did not show any evidence of splenic or gastrointestinal (GI) infarction. Elective emergency laparoscopy confirmed WS and intestinal non-rotation; however, gastric volvulus was not observed. It was suspected that the stomach had untwisted when gastric and laparoscopic tubes were inserted. Surgery is strongly recommended for WS because of the high risk of serious complications; however, some asymptomatic adult patients are still treated conservatively, such as the patient in this study. The present case is reported with reference to the literature. PMID:24349711

  4. A case of accessory mammary cancer in a male patient and a literature review.

    PubMed

    Gao, Y G; Zhang, S H; Wang, Y

    2014-01-01

    A 68-year-old Chinese male patient was referred to the present hospital because of a right axillary lump in May 2011. Physical examination showed a rigid movable mass measuring 35 mm in diameter in the right axilla. No mass was palpable in either breast. Mammograms were normal. Physical and imaging examination of the head and neck region, lung, and upper and lower gastrointestinal tract also revealed no evidence of a primary tumor. Ultrasonography and resonance imaging (MRI) revealed no evidence of tumors in the bilateral mammary glands. Fine needle histological biopsy for suspected malignancy was performed, and the patient underwent tumor resection with axillary lymph node dissection on Jun 2011. Moderately differentiated adenocarcinoma in ectopic breast tissue was diagnosed based on the pathologic result, the tumor was immunohistochemically positive for ER, PR, and HER-2. PMID:25118491

  5. Draft Genome Sequence of Corynebacterium striatum 1961 BR-RJ/09, a Multidrug-Susceptible Strain Isolated from the Urine of a Hospitalized 37-Year-Old Female Patient

    PubMed Central

    Guimarães, Luis C.; Santos, Carolina S.; Veras, Adonney A. O.; Carneiro, Adriana R.; Soares, Siomar C.; Ramos, Juliana N.; Souza, Cassius; Vieira, Veronica V.; Hirata, Raphael; Azevedo, Vasco; Pacheco, Luis G. C.; Silva, Artur

    2015-01-01

    Corynebacterium striatum commonly colonizes the normal skin and nasopharyngeal tract of humans; however, this potentially pathogenic bacterium has been identified as the causative agent of several nosocomial infections. The current study describes the draft genome of strain 1961 BR-RJ/09, isolated from the urine of a hospitalized patient from Brazil. PMID:26251495

  6. Epithelial Dysplasia in Ameloblastic Fibrosarcoma Arising from Recurrent Ameloblastic Fibroma in a 26-Year-Old Iranian Man

    PubMed Central

    Mohsenifar, Zhaleh; Behrad, Samira; Abbas, Fatemeh Mashhadi

    2015-01-01

    Patient: Male, 26 Final Diagnosis: Ameloblastic fibrosarcoma Symptoms: Swelling Medication: — Clinical Procedure: Hemimandibulectomy Specialty: Dentistry Objective: Rare disease Background: Ameloblastic fibrosarcoma (AFS) is a rare malignant odontogenic tumor with a mesenchymal component, showing sarcomatous features and epithelial nests resembling ameloblastic fibroma (AF). Case Report: We report a case of AFS showing epithelial dysplasia arising in a recurrent AF in the left mandible after 3 years in a 26-year-old man, which is regarded as an uncommon histopathologic finding in AFS. We also emphasize the comprehensive clinical, radiographic, and histopathologic evaluation, and immunohistochemical staining of this patient. Conclusions: We conclude that it is important to consider malignancy alternations in the epithelial component of AFS, along with that of the mesenchymal component, to provide a proper diagnosis and treatment of recurrent AF. PMID:26289384

  7. Postobstructive Pulmonary Edema following Tonsillectomy/Adenoidectomy in a 2-Year-Old with Poland-Moebius Syndrome

    PubMed Central

    Powell, Tanisha; Sharma, Nirupma; McKie, Kathleen T.

    2016-01-01

    A 2-year-old male with Poland-Moebius syndrome was transferred from a local hospital to the Pediatric ICU at Children's Hospital of Georgia for suspected postobstructive pulmonary edema (POPE) after tonsillectomy/adenoidectomy (T&A). The patient's respiratory status ultimately declined and he developed respiratory failure. Imaging suggested pulmonary edema as well as a left-sided pneumonia. Echocardiogram showed pulmonary hypertension and airway exam via direct fiberoptic bronchoscopy revealed tracheomalacia and bronchomalacia. He developed acute respiratory distress syndrome (ARDS) and remained intubated for ten days. This case highlights the association between congenital upper body abnormalities with cranial nerve dysfunction and the development of POPE with delayed resolution of symptoms. Patients with upper body abnormalities as above are at great risk of postoperative complications and should therefore be managed in a tertiary-care facility. PMID:26942029

  8. Primary Sjögren syndrome in a 2-year-old patient: role of the dentist in diagnosis and dental management with a 6-year follow-up.

    PubMed

    De Oliveira, Marcio Augusto; De Rezende, Nathalie Pepe Medeiros; Maia, Célia Márcia Fernandes; Gallottini, Marina

    2011-11-01

    BACKGROUND. Primary Sjögren syndrome is a rare autoimmune disease, especially in children, mainly affecting girls (77%), and usually diagnosed around 10 years of age. Diagnosis during childhood is difficult, especially because of the diversity of the clinical presentation and difficulty obtaining reliable history data, accounting for a higher frequency of underdiagnosed cases. Differential conditions should be considered, especially the ones that promote xerostomia, such as diabetes, ectodermal dysplasia, rheumatoid arthritis, scleroderma, systemic lupus erythematosus, sarcoidosis, lymphoma, HIV and HTLV infection. Conditions associated with parotid enlargement should also be excluded, including juvenile recurrent parotitis (JRP), sialadenosis, sarcoidosis, lymphoma, infectious parotitis caused by streptococcal and staphylococcal infections, viral infections (paramyxovirus, Epstein-Barr virus, cytomegalovirus, and parvovirus), and diffuse infiltrative lymphocytosis syndrome (associated with HIV infection), and rare congenital conditions, such as polycystic parotid disease. CASE REPORT. A paediatric female patient was referred to our clinic for dental treatment complaining about dry mouth, oral discomfort, and dysphagia. The patient presented five of the required criteria to establish the diagnosis of pSS, including ocular symptoms, oral symptoms, evidence of keratoconjunctivitis sicca, focal sialadenitis confirmed by minor salivary gland biopsy, and evidence of major salivary gland involvement. Our patient did not have positive SS-A and SS-B autoantibodies. According to the literature, about 29% of individuals with pSS can present seronegativity for SS-A (anti-Ro) antibodies and about 33% can present seronegativity for SS-B (anti-La) antibodies. CONCLUSION. To the best of our knowledge, this is the youngest patient reported in the scientific English literature with pSS. Primary Sjögren syndrome has a wide clinical and immunologic spectrum and may progress with

  9. [Acute kidney failure and renal replacement therapy after colonoscopy in a 63-year-old woman].

    PubMed

    Bös, D

    2015-11-01

    A 63-year-old woman presented with intestinal disorder, alternating between obstipation and diarrhoea. Sodium phosphate/diphosphate (Fleet®) was used in preparation for colonoscopy. Within 24 h the patient developed severe hyperphosphatemia and oliguric acute kidney failure with the need of renal replacement therapy. This case illustrates the rare event of phosphate nephropathy after colonoscopy. PMID:26482077

  10. Spontaneous bilateral anterior lens dislocation in an 8-year-old girl.

    PubMed

    Ismail, Shatriah; Khairy-Shamel, Sonny-Teo; Hussein, Adil; Shaharuddin, Bakiah; Embong, Zunaina; Ibrahim, Mohtar

    2010-01-01

    The authors describe recurrent lens dislocation into the anterior chamber in a young girl with homocystinuria. The patient's 12-year-old sister died after a cerebrovascular accident caused by the same disease. This report highlights the importance of early dietary restrictions and treatment. PMID:20349906

  11. Cervical necrotizing fasciitis caused by Serratia marcescens in a 2 year old.

    PubMed

    Newton, Christopher L; deLEMOS, David; Abramo, Thomas J; Murrey, Allen; Noell, Courtney

    2002-12-01

    We report an unusual, life-threatening complication of producing fulminant cervical necrotizing fasciitis in a previously healthy 2-year-old girl. We reviewed the literature for necrotizing fasciitis in children and its morbidity, mortality, and treatment. This case illustrates the necessity of prompt recognition and aggressive management in patients presenting with cervical necrotizing fasciitis. PMID:12488837

  12. Myeloradicular Form of Neuroschistosomiasis in a Six-Year-Old Boy Infected With Schistosoma mansoni.

    PubMed

    Salgado, João Victor; Salgado, Izabel Athayde da Silva Cruz; Braga Júnior, Leônidas Lopes; Serra, Silane Calland Marques; Barros, Verbena Maria de Carvalho; Silva, Maria José Alves; Monteiro-Neto, Valério

    2015-12-01

    Neuroschistosomiasis is a severe disease caused by the presence of Schistosoma eggs and/or adult worms in the central nervous system. Schistosomal transverse myelitis represents a rare clinical form with nonspecific clinical findings, and it is thus underdiagnosed, especially in children. In this report, we describe a 6-year-old patient with the myeloradicular form of neuroschistosomiasis. PMID:26780026

  13. Fifty-six-year-old man with anaphylaxis: A novel delayed food hypersensitivity reaction.

    PubMed

    Wagner, Kendall D; Bell, Matthew C; Pesek, Robert D; Kennedy, Joshua L

    2015-11-01

    Anaphylaxis and urticaria are commonly seen in both primary care and allergy clinics. Foods, drugs, and insects are frequent culprits for immediate reactions; however, the trigger for recurring and/or chronic episodes is often unclear. We present a 56-year-old male with recurrent symptoms of urticaria, angioedema, and anaphylaxis found to be triggered by sensitization to galactose-alpha 1, 3-galactose (alpha-gal), a novel food allergen. PMID:26625604

  14. A 75-year old man complaining of flank pain and obstructive urinary symptoms: a case report.

    PubMed

    Mohseni, Mohammad-Ghasem; Hamidi, Morteza; Salavati, Alborz; Rangzan, Nazir; Kowsari, Farid

    2011-01-01

    Benign renal cystic adenoma with out malignant features is a very rare entity. A 75 year old male with obstructive Lower tract symptoms and vague flank pain was admitted and planned for nephrectomy of non functional kidney -due to long term nephrolithiasis- intra operative finding was a cystic hydronephrotic kidney filled by thick mucous secretions which turned out to be a cyst adenoma of kidney with no malignant features. PMID:21960085

  15. Efficacy of topical azathioprine and betamethasone versus betamethasone-only emollient cream in 2-18 years old patients with moderate-to-severe atopic dermatitis: A randomized controlled trial

    PubMed Central

    Iraji, Fariba; Farhadi, Sadaf; Faghihi, Gita; Mokhtari, Fatemeh; Basiri, Akram; Jafari-Koshki, Tohid; Nilforoushzadeh, Mohammad Ali

    2015-01-01

    Background: Atopic dermatitis is a chronic skin disease with increasing prevalence worldwide and a considerable burden especially among children. To circumvent the problems related to oral azathioprine (AZT) we aimed to evaluate its topical variant and assess its efficacy in patients aged 2–18. Materials and Methods: In a single-blind trial, we randomized the patients into two groups, one treated with topical emollient containing AZT and betamethasone (BM), and the other treated solely with topical emollient of BM. The treatments were administered twice a day for 8 weeks in both groups. The efficacy, recurrence, and the presence of side effects were evaluated using SPSS 20. Results: The amount of reduction in severity scoring for atopic dermatitis (SCORAD) score was significantly greater in the group treated with the topical AZT (P = 0.024). Incidentally, there were no difference between two treatments in difference in proportions of recurrence and adverse effects as well as SCORAD reduction in subgroups of sex and age (all P > 0.05). Conclusions: Our results showed the superiority of topical AZT over BM with a low recurrence and adverse effects. No expectation of severe side effects, like those of oral AZT, is the major advantage of topical AZT. The sample size was an issue in uncovering the value of AZT in the subgroups. Conducting prolonged studies of quality-of-life and comparing the topical AZT potency relative to the common alternatives are recommended areas of future work. PMID:26623403

  16. [A 73-year-old woman with familial Parkinson's disease].

    PubMed

    Takanashi, M; Urabe, T; Ohta, S; Hamano, Y; Mori, H; Shirai, T; Kondo, T; Mizuno, Y

    1999-12-01

    We report a 73-year-old Japanese woman with familial Parkinson's disease. The patient was well until her 67 years of the age, when she noted rest tremor in her right hand. Soon after her gait became short stepped. She visited our clinic on October 6, 1992 when she was 68 years old. She was alert and well oriented without dementia. She showed masked face, small voice, small stepped gait, retropulsion, resting tremor in her right hand, rigidity in the neck, and bradykinesia. She was treated with 400 mg/day of levodopa-carbidopa, which improved her symptoms, however, she developed wearing off phenomenon 3 years after the initiation of levodopa treatment. On August 26, 1998, she developed abdominal pain, diarrhea, and vomiting. She was admitted to another hospital, where abdominal plain x-ray revealed an evidence of intestinal obstruction (ileus). She was treated with nasogastric suction and intravenous fluid. Her condition did not improve and she was transferred to our hospital on August 29, 1998. Her family history revealed no consanguineous marriage. She had two elder brothers and three elder sisters. One of her brothers had been diagnosed as Parkinson's disease. Her husband also suffered from Parkinson's disease, however, her parents apparently did not have Parkinson's disease. On admission, she appeared to be drowsy. Her blood pressure was 102/70 mmHg, body temperature 36.2 degrees C. The lungs were clear and no cardiac murmur was present. Abdomen was flat and bowel sound was audible. No abnormal mass was palpable. Neurologic examination revealed mild consciousness disturbance, masked face, and small voice. No motor paralysis was noted. Muscle tone was hypotonic. No abnormal involuntary movement was noted. Abnormal laboratory findings on admission were as follows; WBC 11,300/microliter, amylase 1,373 IU/l, CK 446 IU/l, BUN 50 mg/dl, creatinine 1.17 mg/dl, CRP 22.7 mg/ dl, Na 134 mEq/l, K 3.1 mEq/l, and Cl 81 mEq/l. A chest x-ray film revealed pneumonic shadows in

  17. Can bilingual two-year-olds code-switch?

    PubMed

    Lanza, E

    1992-10-01

    Sociolinguists have investigated language mixing as code-switching in the speech of bilingual children three years old and older. Language mixing by bilingual two-year-olds, however, has generally been interpreted in the child language literature as a sign of the child's lack of language differentiation. The present study applies perspectives from sociolinguistics to investigate the language mixing of a bilingual two-year-old acquiring Norwegian and English simultaneously in Norway. Monthly recordings of the child's spontaneous speech in interactions with her parents were made from the age of 2;0 to 2;7. An investigation into the formal aspects of the child's mixing and the context of the mixing reveals that she does differentiate her language use in contextually sensitive ways, hence that she can code-switch. This investigation stresses the need to examine more carefully the roles of dominance and context in the language mixing of young bilingual children. PMID:1429952

  18. A 15-year-old boy with snoring and molar tooth sign.

    PubMed

    El-Kersh, Karim; Senthilvel, Egambaram

    2015-04-01

    A 15-year-old boy presented for evaluation of snoring and sleep-disordered breathing. The parents noted that the patient snored every night and that he had episodes when he stopped breathing, ending with gasping for air. He had no history of sleep walking, night terrors, tongue biting, or seizures. The patient had two healthy siblings, but he had a history of intellectual disability and developmental delay. The patient had a history of adenotonsillectomy. PMID:25846539

  19. Atypical eating disorder in a male patient.

    PubMed

    Bailer, U; De Zwaan, M; Kasper, S

    1999-01-01

    In the literature there is evidence that a substantial proportion of patients with bulimia nervosa can be helped by cognitive behavioural self-help manuals. As there are no specific recommendations or strategies for the treatment of males with eating disorders we were therefore especially interested in the way a man might deal with such a self-help manual. In this case the book Getting better bit(e) by bit(e) by Treasure and Schmidt (also available in German translation) was given to a young man with an atypical eating disorder (atypical anorexia nervosa according to ICD-10). The patient was offered a maximum of 16 short visits and was seen by a first-year psychiatry resident. Treatment with this self-help manual was effective and the patient succeeded in changing his former eating behaviour. The case report provides preliminary evidence that a self-help manual may be a useful addition to the range of possible interventions in the treatment of eating disorders in men. Self-help manuals are less intensive and less costly than other forms of treatment and might be the lowest-step intervention in a stepped-care approach to treatment. PMID:24941097

  20. [Ultrasound diagnosis of an abdominal aortic aneurysm in a 52 year old woman].

    PubMed

    Romero-Hernández, Juan José; Lozano-Corona, Marco Antonio; Díaz-Méndez, Macrina; Aspeitia-León, Jorge Alejandro; Hernández-Díaz, Víctor; Magaña-Cabrera, Daniel

    2012-01-01

    The abdominal aortic aneurysm (AAA) is defined as increasing the diameter of the aorta in more than 50 % of its original size and the infra-renal location is the most common (90 %). AAA disease mainly affects older men and white smokers, and has a male: female ratio of 4:1, as well the diagnosis is rare in women under age 55. Aneurysm rupture is the most common complication and cause of death in the general population, its etiology is unclear, but is commonly associated with atherosclerosis. The AAA do not exhibit rupture and it is usually asymptomatic diagnosed incidentally, however, as the aneurysm grows, appears symptoms such as back pain, abdominal or groin pain, well as palpation of a pulse mass on umbilical and supra-umbilical region. Imaging study such as ultrasound and CT scan are the mainstay of diagnosis. We present a case of 52 years old patient with no history related to the diagnosis, who presented sudden and severe abdominal pain. She was admitted to the emergency room with a diagnosis of acute cholecystitis vs. acute pancreatitis. After ultrasound and CT studies, the diagnosis was a complicated abdominal aortic aneurysm. PMID:22882988

  1. Hypohydrotic ectodermal dysplasia: an unusual presentation and management in an 11-year-old Xhosa boy.

    PubMed

    Sarvan, I; Naidoo, S; Norval, E J

    2000-01-01

    Ectodermal dysplasia (ED) is an inherited disorder in which two or more ectodermally derived structures fail to develop, or are abnormal in development. Hypohydrotic ectodermal dysplasia (HED) or Christ-Siemens-Touraine syndrome, is an X-linked recessive syndrome with an incidence of 1/10,000 to 1/100,000 births. Because of its X-linked inheritance pattern, it is more common in males. HED is characterised by hypohydrosis (diminished perspiration), hypotrichosis (decreased amount of hair) and microdontia (small teeth), hypodontia (lack of development of one or more teeth) or adontia (total lack of tooth development). These patients present diagnostic and treatment challenges because of variable oral manifestations. This report describes an 11-year-old Xhosa boy, who was referred to the University Dental Faculty by his general medical practitioner because of hypodontia. General facial features included: frontal bossing, a depressed nasal bridge, 'butterfly' pattern of eczema over the nasal bridge to the malar process of each cheek, thinned out hair, loss of vertical dimension of face and dry skin. Intra-oral examination revealed hypodontia with peg-shaped anterior teeth and diastemas. Radiological examination revealed no developing permanent teeth or tooth buds. Diagnosis was confirmed by doing a sweat gland count. Management included oral hygiene instruction, fluoride treatments, construction of a partial lower denture and counselling about his condition with particular reference to the danger of hyperthermia and control of allergies. PMID:12608250

  2. Atypical rosacea in a male patient: case study.

    PubMed

    Debroy Kidambi, A; Tiffin, N J; Ramsay, H M

    2016-01-01

    Rosacea fulminans is a rare disorder of unknown cause, almost exclusively affecting women. There are only a few reported cases in men. The condition is characterized by the abrupt onset of pustules and nodules predominantly affecting the cheeks or chin without any systemic upset. We report the case of a 37-year-old man who presented with papulopustules, predominantly localized to his nose. Histopathological features were consistent with rosacea fulminans. The patient was managed with treatments including oral prednisolone, isotretinoin, and trimethioprim. PMID:27267199

  3. Primary biliary cirrhosis associated with Graves' disease in a male patient.

    PubMed

    Suzuki, Yuji; Ishida, Kazuyuki; Takahashi, Hiroshi; Koeda, Norihiko; Kakisaka, Keisuke; Miyamoto, Yasuhiro; Suzuki, Akiko; Takikawa, Yasuhiro

    2016-04-01

    Primary biliary cirrhosis (PBC), which predominantly affects women, has been associated with various autoimmune diseases. Although hypothyroidism accompanying PBC is well documented, the concomitance of PBC and hyperthyroidism is rare. Herein, we report the case of a 62-year-old man who was diagnosed with PBC several years after the development of Graves' disease. This is the first case of a male patient developing PBC with Graves' disease. Both serum alanine aminotransferase levels and serum thyroid hormone levels were normalized after the administration of thiamazole for Graves' disease. However, the cholestatic liver enzyme abnormalities continued, indicating that the PBC was actualized by the administration of thiamazole. After starting ursodeoxycholic acid treatment, cholestatic liver enzyme abnormalities improved. Taken together, when a cholestatic pattern of liver enzymes is observed during follow-up for Graves' disease, an association between Graves' disease and PBC should be considered as a differential diagnosis. PMID:26935935

  4. Laterality and Motor Skills in Four-Year-Olds.

    ERIC Educational Resources Information Center

    Tan, Lesley E.

    1985-01-01

    Compared four-year-old left-handed children and children lacking definite hand preference with right-handers on motor skills. Found no differences between left-handers and right-handers of either sex, but the children lacking hand preference had lower scores. Possible sex differences and implications for the education of children lacking…

  5. The Passive in 3- and 4-Year-Olds

    ERIC Educational Resources Information Center

    de Barros Pereira Rubin, Maraci Coelho

    2009-01-01

    This paper argues that analyzing the patterns of individual subject performance in tests of comprehension of passives might give insight into how little children interpret passives: 3 and 4 year-olds seem to go through a range of passive interpretation, that varies from actual comprehension to total non-comprehension. The fact that some small…

  6. "Generalist Genes" and Mathematics in 7-Year-Old Twins

    ERIC Educational Resources Information Center

    Kovas, Y.; Harlaar, N.; Petrill, S. A.; Plomin, R.

    2005-01-01

    Mathematics performance at 7 years as assessed by teachers using UK national curriculum criteria has been found to be highly heritable. For almost 3000 pairs of 7-year-old same-sex twins, we used multivariate genetic analysis to investigate the extent to which these genetic effects on mathematics performance overlap with genetic effects on reading…

  7. Triadic Interaction among Newly Acquainted 2-Year-Olds

    ERIC Educational Resources Information Center

    Ishikawa, Fumiko; Hay, Dale F.

    2006-01-01

    Are children as young as 2 years old able to interact in groups of three? The study applied the family triad model first introduced by Parke, Power, and Gottman (1979) to the case of peer interaction. In Experiment 1, the model was refined for use in studies of peer interaction and applied to an existing dataset of 16 triads of newly acquainted…

  8. [Pincoffs-Bard's syndrome in a 15-year old girl].

    PubMed

    Pakulski, C; Pankowski, J; Swiniarski, A; Król-Pakulska, E

    1996-01-01

    A case of primary stomach carcinoma (or Pincoff's-Bard syndrome) with extensive radiologic shadows on chest X-ray and clinical signs of respiratory failure has been presented. The case concerned a 15-year-old girl being diagnosed in several hospital because of pulmonary lesions. The diagnosis was made on a basis of the autopsy. PMID:9162328

  9. True or False: Do 5-Year-Olds Understand Belief?

    ERIC Educational Resources Information Center

    Fabricius, William V.; Boyer, Ty W.; Weimer, Amy A.; Carroll, Kathleen

    2010-01-01

    In 3 studies (N = 188) we tested the hypothesis that children use a perceptual access approach to reason about mental states before they understand beliefs. The perceptual access hypothesis predicts a U-shaped developmental pattern of performance in true belief tasks, in which 3-year-olds who reason about reality should succeed, 4- to 5-year-olds…

  10. The Mathematical Abilities of Dyslexic 10-Year-Olds.

    ERIC Educational Resources Information Center

    Miles, T. R.; Haslum, M. N.; Wheeler, T. J.

    2001-01-01

    Seventy-two items testing various aspects of mathematics were given to 12,131 10-year-old British children. Despite the absence of difference in intelligence level, the mean scores on the mathematics test for children with dyslexia was not only lower than that of normal achievers, but also lower than that of underachievers. (Contains references.)…

  11. Early Childhood Program Standards for Three and Four Year Olds.

    ERIC Educational Resources Information Center

    Franklin, Sandra Putnam; Lamana, Annette; Van Thiel, Lisa

    This document presents the Massachusetts Early Childhood Program Standards and Learning Guidelines for Three- and Four-Year-Olds, required for programs receiving funding through Community Partnerships for Children (CPC). The standards were developed in accord with the accreditation process of the National Association for the Education of Young…

  12. Assessing Two-Year-Olds' Knowledge of Number Agreement Morphology

    ERIC Educational Resources Information Center

    Blossom, Megan

    2013-01-01

    Previous research in the area of children's knowledge of number agreement morphology has yielded mixed results. Some researchers have found evidence for sensitivity to agreement morphology at as early as 16 months, while others report that children do not comprehend number agreement morphology until as late as five or six years old. Studies of…

  13. Moral and Faith Development in Seventeen-year Old Students.

    ERIC Educational Resources Information Center

    Gorman, Margaret

    Subjects were 50 17 year-old students from a variety of types of schools (parochial, private, public) in two New England areas were interviewed for moral and faith development according to the theories of Kohlberg and Fowler. Socioeconomic level and IQ were highly correlated with faith and moral scores. Experiences of the death of someone close…

  14. Two-Year-Olds Compute Syntactic Structure On-Line

    ERIC Educational Resources Information Center

    Bernal, Savita; Dehaene-Lambertz, Ghislaine; Millotte, Severine; Christophe, Anne

    2010-01-01

    Syntax allows human beings to build an infinite number of new sentences from a finite stock of words. Because toddlers typically utter only one or two words at a time, they have been thought to have no syntax. Using event-related potentials (ERPs), we demonstrated that 2-year-olds do compute syntactic structure when listening to spoken sentences.…

  15. Psychosis in a 15 year old hypothyroid girl: myxoedematous madness?

    PubMed

    Chalk, J N

    1991-12-01

    The case of a fifteen year old girl with sudden onset of a psychotic illness thought to be related to marked hypothyroidism is reported. Apart from the age several features of this case warrant discussion and the value of screening for thyroid disease in psychotic illnesses is highlighted. PMID:1793426

  16. Headshaking in a 10-year-old Thoroughbred mare

    PubMed Central

    2004-01-01

    Abstract A 10-year-old Thoroughbred mare was presented with a 2.5-week history of headshaking. Based on a thorough physical examination, blood analysis, and a fine needle aspirate of an enlarged thyroid gland, a tentative diagnosis of seasonal idiopathic headshaking was made. Treatment with cyproheptadine was attempted. PMID:15025153

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

    PubMed

    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. PMID:24647303

  18. Grammatical Morpheme Production in 4-Year-Old Children.

    ERIC Educational Resources Information Center

    Balason, Denise V.; Dollaghan, Christine A.

    2002-01-01

    Grammatical morpheme (GM) production was studied in 15-minute spontaneous language samples from 100 4-year-olds. Substantial variability was observed in both the frequency of obligatory contexts and in the percentages of correct usage of GM. For only one morpheme did all 100 participants contain the minimum number of 3 obligatory contexts.…

  19. Similarity Predicts Liking in 3-Year-Old Children

    ERIC Educational Resources Information Center

    Fawcett, Christine A.; Markson, Lori

    2010-01-01

    Two studies examined the influence of similarity on 3-year-old children's initial liking of their peers. Children were presented with pairs of childlike puppets who were either similar or dissimilar to them on a specified dimension and then were asked to choose one of the puppets to play with as a measure of liking. Children selected the puppet…

  20. Two-Year-Old Children Interpret Abstract, Purely Geometric Maps

    ERIC Educational Resources Information Center

    Winkler-Rhoades, Nathan; Carey, Susan C.; Spelke, Elizabeth S.

    2013-01-01

    In two experiments, 2.5-year-old children spontaneously used geometric information from 2D maps to locate objects in a 3D surface layout, without instruction or feedback. Children related maps to their corresponding layouts even though the maps differed from the layouts in size, mobility, orientation, dimensionality, and perspective, and even when…

  1. Intensity Accents in French 2 Year Olds' Speech.

    ERIC Educational Resources Information Center

    Allen, George D.

    The acoustic features and functions of accentuation in French are discussed, and features of accentuation in the speech of French 2-year-olds are explored. The four major acoustic features used to signal accentual distinctions are fundamental frequency of voicing, duration of segments and syllables, intensity of segments and syllables, and…

  2. The Structure of Executive Function in 3-Year-Olds

    ERIC Educational Resources Information Center

    Wiebe, Sandra A.; Sheffield, Tiffany; Nelson, Jennifer Mize; Clark, Caron A. C.; Chevalier, Nicolas; Espy, Kimberly Andrews

    2011-01-01

    Although the structure of executive function (EF) during adulthood is characterized by both unity and diversity, recent evidence suggests that preschool EF may be best described by a single factor. The latent structure of EF was examined in 228 3-year-olds using confirmatory factor analysis. Children completed a battery of executive tasks that…

  3. Urethral mucosa prolapse in an 18-year-old adolescent.

    PubMed

    Olumide, Akadiri; Kayode Olusegun, Ajenifuja; Babatola, Bakare

    2013-01-01

    Urethra mucosa prolapse is a benign condition in which there is a circular protrusion of the distal urethra through the external urethra meatus. It is more commonly seen in prepubertal black girls and postmenopausal white women. It is rare in the reproductive age group. This case describes the presentation and management of an 18-year-old adolescent with urethra mucosa prolapse. PMID:24109533

  4. One-Year-Olds Think Creatively, Just Like Their Parents

    ERIC Educational Resources Information Center

    Hoicka, Elena; Mowat, Rachael; Kirkwood, Joanne; Kerr, Tiffany; Carberry, Megan; Bijvoet-van den Berg, Simone

    2016-01-01

    Creativity is an essential human ability, allowing adaptation and survival. Twenty-nine 1-year-olds and their parents were tested on divergent thinking (DT), a measure of creative potential counting how many ideas one can generate. Toddlers' and parents' DT was moderately to highly correlated. Toddlers showed a wide range of DT scores, which were…

  5. Fracture of Proximal Humerus with dislocation of Glenohumeral joint in a 3 year old child: A case report

    PubMed Central

    Gupta, Rajul; Singh, Amardeep; Singh, Kunwar Kulwinder; Vohra, Rajeev

    2013-01-01

    Introduction: Though proximal humeral physeal injuries are common in children, reports of proximal humeral physeal injuries with disruption of glenohumeral joint are exceedingly rare. We here report such a case. Case Report: A three year old male patient presented to us with proximal humeral physeal separation along with glenohumeral dislocation. Under general anaesthesia, closed reduction could be achieved. Thereafter, three Kirschner wires were used to fix the physeal injury. Wires were removed at six weeks and physiotherapy was started. Good range of motion was achieved, and follow up radiographs demonstrated no evidence of growth arrest at one year. Conclusion: In spite of significant displacement in cases of proximal humeral physeal injury with glenohumeral dislocation in children, closed reduction can be achieved and should be attempted.

  6. [A 25-year-old patient with corneal infiltration].

    PubMed

    Aperlic, K; Tietz, H-J; Erhard, M; Regnath, T

    2011-05-01

    Filamentous fungal keratitis represents a serious infection of the eye. When corneal infiltrates appear, particularly in those who wear contact lenses, mycological assessment should already be performed initially so that filamentous fungal keratitis can be recognized early and treated. Keratitis caused by Fusarium responds well in most cases to topical therapy with ketoconazole or other antimycotic agents so that surgical intervention is only necessary in advanced or treatment-refractory cases. PMID:21528373

  7. A Rare Case of a 15-Year-Old Boy with Two Accessory Nipples: One in the Forearm and One in the Milk Line.

    PubMed

    Tauchen, Alexander J; Kueberuwa, Essie; Schiffman, Kenneth; Mudaliar, Kumaran M; Noland, Shelley S

    2015-01-01

    A 15-year-old male presented for evaluation of a volar forearm mass that he noticed four years before. The mass was not painful and his main concern was cosmesis. The mass was two centimeters in diameter with a pinpoint central sinus and scant drainage. After excision, the pathology report noted pilosebaceous units and smooth muscle bundles, consistent with an accessory nipple. In addition, the patient had another accessory nipple in the "milk line" on his torso. While accessory nipples and breast tissue have been reported in numerous locations throughout the body, this is the first reported case of an accessory nipple on the forearm. PMID:26783489

  8. [Association between Crohn's disease and primary sclerosing cholangitis in a 10 year old girl].

    PubMed

    Muñoz Lozón, Ana; Iglesias Blázquez, Cristina; Menéndez Arias, Cristina; Domínguez Sánchez, Patricia

    2016-06-01

    A 10 year old girl with diarrhea, abdominal pain, weight loss and fever of one month and a half of evolution. Analytical and sonographic findings raised the possibility of inflammatory bowel disease. Endoscopy and histology showed findings consistent with Crohn's disease. Treatment was initiated with mesalazine and exclusive enteral nutrition. Later corticosteroid treatment, immunosuppressive drugs and ursodeoxycholic acid were added due to cholestasis and persistent hypergammaglobulinemia. Magnetic resonance cholangiography and liver biopsy confirmed the diagnosis of concomitant primary sclerosing cholangitis. The association between Crohn's disease and primary sclerosing cholangitis is rare, predominantly in males between 20 and 40 years old and it presents a great clinical variability. The confirmation of the diagnosis requires magnetic resonance cholangiography or endoscopic retrograde cholangiopancreatography. The prognosis is poor and there is no treatment to slow the progression of the disease. PMID:27164355

  9. Are Story Preferences Sex-Linked for 2 and 3 Year Olds and for 4 and 5 Year Olds?

    ERIC Educational Resources Information Center

    Ross, Martha

    This study attempted to determine: (1) whether 2-, 3-, 4-, and 5-year-old children have sex typed story preferences; and (2) whether an attempt on the part of parents to prevent sex stereotyping would affect sex typed preferences. A review of previous research discusses measures used to determine sex linked responses and the implications of…

  10. Internet Use and Psychological Well-Being among 10-Year-Old and 11-Year-Old Children

    ERIC Educational Resources Information Center

    Devine, Paula; Lloyd, Katrina

    2012-01-01

    This paper uses data from the 2009 Kids' Life and Times Survey, involving 3657 children aged 10 or 11 years old in Northern Ireland. The survey indicated high levels of use of Internet applications, including social-networking sites and online games. Using the KIDSCREEN-27 instrument, the data indicate that the use of social-networking sites and…

  11. Resiliency: A Comparison of Construct Definitions Arising from Conversations with 9 Year Old - 12 Year Old Children and Their Teachers.

    ERIC Educational Resources Information Center

    Dryden, John; Johnson, Bruce; Howard, Sue; McGuire, Alex

    Much research has focused on the concept of resilience, which is defined as the process of, capacity for, or outcome of successful adaptation despite challenging circumstances. To examine resilience in school children, small group interviews were conducted with 9-12 year-old children (N=125) drawn from five primary schools in South Australia. The…

  12. Gender, Popularity and Notions of In/Authenticity amongst 12-Year-Old to 13-Year-Old School Girls

    ERIC Educational Resources Information Center

    Read, Barbara; Francis, Becky; Skelton, Christine

    2011-01-01

    This paper draws on data from a research project investigating gendered identities and interactions of high-achieving students in Year Eight in England (12-13 years old), particularly in relation to students' "popularity" amongst their peers. As part of this study 71 students were interviewed from nine different schools in urban, rural and small…

  13. Etiologic and clinical analysis of chronic complex anal and rectal inflammation in children less than 3 years old

    PubMed Central

    Huang, Yanlei; Zheng, Shan; Xiao, Xianmin

    2014-01-01

    Objective: To analyze the etiology and clinical diagnostic method for chronic complex anal and rectal inflammation in children less than 3 years old. Method: Seven children (5 males and 2 females; 1 year 8 months to 3 years of age at the time of physician evaluation) with chronic complex anal and rectal inflammation were enrolled between May 2008 and May 2013 at our hospital. Clinical history, results of auxiliary examinations, and empirical treatment of the children were analyzed retrospectively combined with the etiologic diagnosis. Results: Four patients were confirmed to have Crohn’s disease and one patient was confirmed to have intestinal tuberculosis; two patients were suspected to have Crohn’s disease. Anemia and low pre-albumin level were common (seven patients); serologic testing revealed four patients with elevated IgG levels and seven patients with elevated IgA levels; there were no patients with positive tuberculosis antibody titers and two patients were weakly positive for C-ANCA (one patient with Crohn’s disease and one patient intestinal tuberculosis). Colonoscopies revealed that the entire colon was affected in one patient, the left hemicolon was affected in four patients, and the sigmoid colon and rectum were affected in two patients. Two patients with Crohn’s disease and one patient with intestinal tuberculosis were diagnosed by colonoscopies in combination with histopathologic examinations. Two patients with Crohn’s disease were confirmed after empirical drug treatment, and two other patients were not definitely diagnosed. Conclusion: The possibility of Crohn’s disease or intestinal tuberculosis should be considered in the clinical diagnosis of complex chronic anal and rectal inflammation in younger children. Local surgery is sometimes unnecessary. Empirical drug treatment should be used if necessary. PMID:25550910

  14. One-Year-Olds Think Creatively, Just Like Their Parents.

    PubMed

    Hoicka, Elena; Mowat, Rachael; Kirkwood, Joanne; Kerr, Tiffany; Carberry, Megan; Bijvoet-van den Berg, Simone

    2016-07-01

    Creativity is an essential human ability, allowing adaptation and survival. Twenty-nine 1-year-olds and their parents were tested on divergent thinking (DT), a measure of creative potential counting how many ideas one can generate. Toddlers' and parents' DT was moderately to highly correlated. Toddlers showed a wide range of DT scores, which were reliable on retesting. This is the first study to show children think divergently as early as 1 year. This research also suggests 1-year-olds' DT is related to parents', opening up future research into whether this relationship is due to genetics and/or social learning at its emergence. Understanding DT at its emergence could allow for interventions while neurological development is most plastic, which could improve DT across the life span. PMID:27154630

  15. Predictive testing of eighteen year olds: counseling challenges.

    PubMed

    Gaff, Clara L; Lynch, Elly; Spencer, Lesley

    2006-08-01

    Genetic counseling of teenagers is challenging and complex. The ability to think abstractly, a sense of self and independence from family all develop during adolescence. Predictive genetic testing counseling protocols presuppose that these qualities exist, requiring the at-risk individual to consider the short and long term consequences of testing as well as their motivations. Eighteen year olds are in transition from adolescence to adulthood; eligible for predictive genetic testing, they may not yet be independent of their family or able to articulate their feelings. This paper presents case studies from the authors' clinical practice to illustrate some of the difficulties faced by genetic counselors when 18 year olds request predictive testing for Hereditary Non-Polyposis Colorectal Cancer. By reflecting upon their experiences with these young adults and their families, the authors' intention is to generate discussion about genetic counseling strategies, particularly for predictive genetic testing, that are both age-appropriate and family-sensitive. PMID:16865560

  16. A Five-Year-Old Child with Renal Hydatidosis

    PubMed Central

    Moscatelli, Guillermo; Moroni, Samanta; Freilij, Héctor; Salgueiro, Fabián; García Bournissen, Facundo; Altcheh, Jaime

    2013-01-01

    Hydatidosis is a zoonosis of worldwide distribution caused by the parasite Echinococcus granulosus. Clinical manifestations include cyst formation, most commonly in the liver (67–89%) and lungs (10–15%). Renal localizations are rare. We report a case of renal hydatidosis in a five-year-old child treated in a tertiary pediatric hospital in Argentina. After the diagnosis was made, elective surgery was performed, which led to a rapid recovery. PMID:23897992

  17. Palpitations in a 64-year-old man.

    PubMed

    Bauml, Michael A; Chung, Jaehoon; Groth, John V; Farzaneh-Far, Afshin

    2014-01-01

    A 64-year-old man presented with several weeks of intermittent irregular palpitations. He had no prior history of cardiac disease, hypertension or syncope. A 12-lead ECG revealed sinus rhythm with premature atrial and ventricular contractions and high QRS voltages consistent with LV-hypertrophy. Cardiac MR revealed asymmetrical septal hypertrophy and marked mid-myocardial hyperenhancement of the interventricular septum. PMID:24281755

  18. Splenic Epidermoid Cyst in a Five-Year-Old Child

    PubMed Central

    Garg, Bhavna; Sood, Neena; Singh, Satpal

    2016-01-01

    Splenic epidermoid cysts are rare non-parasitic true cysts affecting the spleen. We report a five-year-old child who presented with an abdominal lump associated with pain of 15 days. Ultrasonography of the abdomen showed a huge cystic lesion of obscure origin. At laprotomy a huge unilocular cyst involving upper part of spleen containing pultaceous fluid was seen and its removal necessitated splenectomy. Histopathological findings were consistent with splenic epidermoid cyst. Thus histopathology helped in elucidating the aetiology and diagnosis.

  19. Retroperitoneal necrotizing fasciitis in a 4-year-old girl.

    PubMed

    Paya, K; Hayek, B F; Rebhandl, W; Pollak, A; Horcher, E

    1998-05-01

    Necrotizing fasciitis is a rare but serious condition with a poor prognosis both in adults and in children. Retroperitoneal localization is mostly associated with fatal outcome. Early diagnosis, extensive and repeated surgical debridement, and use of antibiotics are necessary. Herein the authors report on a 4-year-old girl in whom retroperitoneal necrotizing fasciitis developed after she suffered from pyelonephritis. In this case, the outcome was favorable because of early surgical intervention, confirming the diagnosis. PMID:9607500

  20. Heart Health...Your Choice. 11-14 Year Olds.

    ERIC Educational Resources Information Center

    National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD.

    The purpose of this illustrated booklet is to teach 11-14 year old students that all healthy Americans, 2 years of age or older, should eat in a way that is low in saturated fat and cholesterol to help reduce the risk of heart disease. The guide is designed to promote changes in eating patterns, to show children how to switch to good eating…

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

    PubMed Central

    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. PMID:6880245

  2. Dietary Habits of Welsh 12-13 Year Olds

    ERIC Educational Resources Information Center

    Thomas, Non-Eleri; Cooper, Stephen-Mark; Graham, Mike; Boobier, Wyndham; Baker, Julien; Davies, Bruce

    2007-01-01

    This study examined the dietary habits of Welsh 12-13 year olds. A cohort of 84 boys and 81 girls, age 12.9 SD 0.3 years; body mass 51.3 SD 12.6kg; and stature 1.54 SD 0.08m, completed a food frequency questionnaire and seven-day food diary. Mean daily kilocalories (kcal/d), and percentages of total fat, saturated fat, carbohydrate, and protein,…

  3. Partial Response to First-Line Crizotinib in an Elderly Male Patient with ROS1 Translocation-Positive Lung Cancer

    PubMed Central

    Overbeck, Tobias R.; Schmitz, Katja; Engelke, Christoph; Sahlmann, Carsten-Oliver; Hugo, Sara; Kellner, Laura; Trümper, Lorenz; Schildhaus, Hans-Ulrich

    2016-01-01

    We report on a 90-year-old male patient with a ROS1-translocated adenocarcinoma of the lung who was treated with crizotinib as first-line therapy. After 11 months of treatment, we noticed complete metabolic response as measured by 18F-FDG-PET/CT scan and a partial response according to RECIST criteria. This patient indicates that ROS1 translocations are not restricted to young age, female gender and low stage. Furthermore, this case illustrates exemplarily that crizotinib therapy is effective and manageable even as first-line treatment in elderly patients with comorbidities. Based on our findings, we recommend to include elderly patients with advanced pulmonary adenocarcinomas in molecular screening approaches for ROS1 translocations. PMID:27065847

  4. Giant left anterior descending coronary artery aneurysm in an adult male patient with ST elevation myocardial infarction

    PubMed Central

    Sadeghi, Mohsen Mirmohammad; Jouzdani, Saeid Rezaei

    2016-01-01

    Coronary artery aneurysm is a rare clinical entity encountered incidentally 0.3–5% among patients who undergo coronary angiography. Even giant coronary artery aneurysm is much rarer with an incidence of 0.02% among all atherosclerotic cases. Due to rare occurrence and lack of controlled trials, clinical presentation, prognosis and management of giant coronary artery aneurysm are under controversies in the literature. We report a 43-year-old male patient admitted to our hospital with a typical chest pain associated with ST elevation changes in anterior chest leads and elevated cardiac enzymes. Coronary angiography of the patient revealed a large (1.5 cm × 3 cm) aneurysm of proximal left anterior descending coronary artery. We performed a successful surgical excision and coronary bypass surgery. The patient had an uncomplicated course. PMID:27021297

  5. Ten years survival with excellent outcome after living donor liver transplantation from 70 years old donor for primary hepatic neuroendocrine carcinoma: Case report

    PubMed Central

    Alekseev, Denis; Goralczyk, Armin; Lorf, Thomas; Ramadori, Giuliano; Obed, Aiman

    2011-01-01

    BACKGROUND Primary hepatic carcinoid tumors (PHCT) are rare entities; they are even rarer than extrahepatic neuroendocrine gastrointestinal tumors with only about 95 cases reported in the literature. An extrahepatic primary tumor must be excluded to confirm the diagnosis of PHCT. CASE PRESENTATION We report a case of a 42-year-old male patient with a primary hepatic neuroendocrine carcinoma, who successfully underwent living donor liver transplantation from his 70 years old mother with 10 years follow-up. Both donor and recipient are still alive and in the good health. CONCLUSION Living liver donation from elderly donors for the patients with irresectable neuroendocrine liver malignancies can be as safe as deceased donation or liver donation from young donors (age < 50). Living donation from elderly donors might significantly expand the donor pool for patients with liver neuroendocrine tumors (NET) and potentially reduce waiting list mortality. Especially young patients with irresectable NET can benefit from this option. However, case–control studies are needed to verify the advantage of living liver transplantation (LDLT) for the patients with irresectable liver NET and to define selection criteria for these patients. PMID:22288038

  6. Birth of a baby conceived from frozen oocytes of a 40-year-old woman.

    PubMed

    Parmegiani, L; Cognigni, G E; Bernardi, S; Ciampaglia, W; Pocognoli, P; Filicori, M

    2009-06-01

    The potential, limits and safety of oocyte freezing are still being explored. Female age may play a relevant role in treatment outcome. The present study is the first report of the birth and normal development of a baby conceived from frozen oocytes of a 40-year-old woman. IVF was carried out in an infertile 40-year-old woman, and seven metaphase II (MII) oocytes were obtained after ovarian stimulation. Three fresh oocytes were inseminated by intracytoplasmic sperm injection (ICSI), according to Italian law. Two embryos were transferred, but pregnancy did not occur. The four remaining MII oocytes were frozen (by slow freezing protocol) and ICSI was performed in the two oocytes surviving after thawing. Two embryos were obtained on day 2. Both embryos were transferred, resulting in a singleton pregnancy, and a healthy male baby was born. So far, the child (now 3 years old) has scored normally according to the WHO Child Growth Standards. The Denver Developmental Screening Test for psychomotor development was normal. This report demonstrates that conception and pregnancy from cryopreserved oocytes belonging to women up to 40 years of age is possible, and can yield normal children. This finding has implications for women who want to preserve their reproductive potential. PMID:19490783

  7. Trisomy 18 mosaicism in a 15-year-old boy with normal intelligence and short stature

    SciTech Connect

    1995-05-08

    We report a 15-year-old boy with mosaicism for trisomy 18 and normal intelligence. Approximately 50% of his leukocytes are trisomic. This patient represents the sixth report of an individual with trisomy 18 mosaicism and normal intelligence. Those individuals with trisomy 18 mosaicism and normal intelligence need to be advised of increased risks for offspring with chromosome abnormalities and offered the option of prenatal diagnosis for cytogenetic anomalies. 6 refs.

  8. [Acute bilateral impaired vision with central scotoma in an 11-year-old boy].

    PubMed

    Pollithy, S; Ach, T; Schaal, K B; Dithmar, S

    2012-09-01

    This article presents a case of acute bilateral impaired vision and central scotoma in an 11-year-old boy. Looking directly into a laser beam of a laser pointer for only a few seconds can cause retinal damage in the form of lesions of the retinal pigment epithelium and the photoreceptor layer, up to retinal hemorrhage. Patients often complain about impaired vision and a central scotoma of the affected eye. PMID:22740016

  9. Solitary Atypical Adenomatous Hyperplasia in a 12-Year-Old Girl

    PubMed Central

    Jin, Moran; Lee, Yang-Haeng; Kim, Bomi; Yoon, Young Chul; Wi, Jin Hong

    2016-01-01

    Atypical adenomatous hyperplasia is a premalignant lesion reflecting a focal proliferation of atypical cells. These lesions are usually observed as incidental findings in lungs that have been resected due to other conditions, such as lung cancer. We report the youngest case of atypical adenomatous hyperplasia on record in a 12-year-old girl. In this patient, the lesion was found in association with pneumothorax. PMID:27065090

  10. Complete paroxysmal atrioventricular block in a 2-year-old girl.

    PubMed

    Holst, Line M; Dixen, Ulrik; Jeppesen, Dorthe L

    2015-10-01

    We present a case of atypical syncope in a 2-year-old, otherwise healthy girl. The patient presented with three episodes of syncope without any precipitating factors and no family history of sudden unexpected death. Holter monitoring revealed 24 events of complete atrioventricular block lasting up to 6 seconds. A normal 12-lead electrocardiogram does not necessarily exclude cardiac disease, and Holter monitoring is warranted in children with atypical syncope. PMID:25428604

  11. [Secondary retroperitoneal fibrosis in a 39-year-old man after rectal cancer].

    PubMed

    Jarosch, A; Tiller, M; Rohrbach, H; Leimbach, T; Schepp, W

    2016-05-01

    A 39-year-old man had been treated for rectal cancer 6 years ago by lower anterior resection of the rectum and perioperative radiochemotherapy. Since then follow-up had been unremarkable but now the patient presented with unspecific lower abdominal pain. The cause of the pain was identified as paraneoplastic retroperitoneal fibrosis secondary to metachronous pulmonary metastases of the rectal cancer. PMID:26895316

  12. Concurrent Testicular and Bladder Cancer in a 57-year-old Man.

    PubMed

    Han, Esther; Stein, Daniel M; Shi, Dongping; Miocinovic, Ranko

    2015-09-01

    We present a rare finding of concurrent right testis non-seminomatous mixed germ cell tumor and muscle invasive urothelial carcinoma of the bladder in a 57-year-old homeless man. The socioeconomic factors and the disease presentation caused a treatment dilemma in terms of the appropriate type of neoadjuvant chemotherapy. The patient ultimately underwent upfront surgery with retroperitoneal lymph node dissection and radical cystoprostatectomy followed by adjuvant cisplatin-based chemotherapy. PMID:26793541

  13. Clinicopathological conference: A 71-year-old female with neurological deficits, chest pain, and electrocardiographic changes.

    PubMed

    Narang, Aneesh T; Alian, Andrus

    2010-10-01

    The authors present a case of a 71-year-old female who presented to the emergency department with slurred speech, left sided facial droop, and right arm and leg weakness. During her ED stay, she developed left sided chest pain and right arm numbness in the setting of EKG changes. The patient's clinical course is outlined and a discussion of the potential etiologies as well as the clinical management is provided. PMID:21040102

  14. Hemangioma of the ovary in an 81-year-old woman.

    PubMed

    Rodriguez, M A

    1979-04-01

    We have reported a case of cavernous hemangioma of the ovary in an 81-year-old woman with uterine prolapse and without ascites. Review of the literature reveals that this is the oldest patient reported. The size of the lesion is considered large at 5 cm in diameter. No associated disease or other lesions were present. The lesion was an incidental finding with no complications. PMID:432698

  15. Bilateral angiosarcoma of the breast in a fourteen-year-old child.

    PubMed

    van Geel, Albertus N; den Bakker, Michael A

    2009-01-01

    Malignant vascular tumors are rare and angiosarcomas of the breast in patients under 21 years of age are exceedingly uncommon. In this report an angiosarcoma in the breast of a 14-year-old girl is described. She died nine months after mastectomy with recurrent disease in the bones and the contralateral breast. The etiology of most primary angiosarcomas is unknown. Secondary angiosarcomas can develop after radiotherapy and chronic lymphedema. The histology of this angiosarcoma is illustrated. PMID:21139917

  16. A 74-year-old unoperated univentricular heart: the oldest reported survival.

    PubMed

    Gesuete, Valentina; Fabi, Marianna; Bonvicini, Marco

    2016-04-01

    Univentricular heart is a rare congenital heart malformation. Nowadays prognosis is considered to be strictly linked to surgical intervention, and survival into late adulthood is unusual. In some patients native haemodynamic circulation balances pulmonary and systemic blood flow, allowing long-term survival without the need for surgery. We report the case of a 74-year-old man with a univentricular heart in natural history, and we discuss the factors that might contribute to his extraordinary long-term survival. PMID:26508431

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

    PubMed Central

    Rayment, Jonathan H.; Narang, Indra

    2016-01-01

    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.

  18. Acute Abdominal Pain Caused by an Infected Mesenteric Cyst in a 24-Year-Old Female

    PubMed Central

    Ponten, Joep B.; Zijta, Frank M.

    2016-01-01

    A mesenteric cyst is a rare cause for abdominal pain. This umbrella term includes cystic entities which reside in the mesentery. We present a case of an infected false mesenteric cyst in a 24-year-old female patient without prior surgery or known trauma. Mainstay of treatment involves surgical resection, although less invasive treatments have been described. Prognosis depends on the origin of the cyst. PMID:27190668

  19. Hamartoma of the urinary bladder in a 15-year-old boy

    PubMed Central

    Al Shahwani, Noora; Alnaimi, Abdulla Rashid; Ammar, Adham; Al-ahdal, Esra M.

    2016-01-01

    Hamartoma of the bladder is an unusual entity described in only eleven patients to date. It may present as painless hematuria, irritative urinary tract symptoms, or inability to void or it may be diagnosed incidentally. Hamartoma of the bladder may be isolated or occur as part of a syndrome. No isolated bladder hamartoma to date has shown malignant potential. We describe here a bladder hamartoma in a 15-year-old boy. PMID:27274896

  20. Pulseless Ventricular Tachycardia During Office-Based Anesthetic in a Four-Year-Old Child

    PubMed Central

    Orr, Timothy M.; Orr, Daniel L.

    2015-01-01

    A 4-year-old 16-kg boy presented for full mouth dental rehabilitation in a private pediatric dental office. The patient had no significant previous medical history. Upon sevoflurane induction by a dentist anesthesiologist, the patient converted from normal sinus rhythm to pulseless ventricular tachycardia. Advanced cardiac life support protocol was initiated. After 2 automatic external defibrillator shocks were delivered in conjunction with epinephrine administration, the patient returned to normal sinus rhythm. The patient was transported via emergency medical service paramedics to a local children's hospital emergency room where he was observed uneventfully for 24 hours prior to discharge. PMID:26650495

  1. The Relation of Parental Depression and Self Esteem to Behavior Problems in Three-Year-Old Sons of Alcoholics.

    ERIC Educational Resources Information Center

    Schneider, Andrew M.; And Others

    Preliminary results from a longitudinal study designed to systematically examine the family life of children reared in a home with an alcoholic father are reported. Analysis is restricted to 15 families from a larger study in which the target child was a 3-year-old male. Parents completed the Beck Depression Inventory, the Progress Evaluation…

  2. Portion Size Variably Affects Food Intake of 6-year-old and 4-year-old Children in Kunming, China

    PubMed Central

    Smith, Lindsey; Conroy, Katharine; Wen, Hongmei; Rui, Li; Humphries, Debbie

    2015-01-01

    Age and portion size have been found to influence food intake in American children but have not been examined in an international context. This study evaluated the association between age and the effects of portion size on the food intake of kindergarteners in Kunming, China. Using a within-subjects crossover design in a classroom setting, 173 children in two age groups, mean age 4.2 years and 6.1 years, were served a predefined reference, small (-30%) and large (+30%) portion of rice, vegetables, and a protein source during lunchtime over three consecutive days. Each portion was weighed before and after the meal to determine amount of food consumed. Linear mixed modeling, controlling for repeated measures and clustering by classroom, was used to compare food intake under small and large portion size conditions to the reference portion. Children ate significantly less food when served small portions. When served a large portion, 6-year-old children increased food intake while 4-year-old children decreased food intake in comparison to the reference portion. Findings indicate that portion size affects food intake in Chinese children 4- to 6-years old. Older children show larger increases in food intake with increased portion size than do younger children. PMID:23702260

  3. [A 61-year-old man with rapidly progressing dementia and gait disturbance].

    PubMed

    Mizuno, Y; Tanaka, S; Mori, H; Kondo, T

    1993-07-01

    We report a 61-year-old male with rapidly progressive dementia and gait disturbance. He was well until spring 1990 as a postmaster, when there was an onset of memory disturbance and mistakes in his job. In May 1990, his wife noted slurring of his speech. In August, there was an onset of gait disturbance. He fell down frequently. In October, he was seen by a neurologist, who found moderate dementia, small step gait, retropulsion, freezing, paratonic rigidity, bradykinesia and a restriction in the vertical gaze on him. His dementia and gait disturbance progressed rapidly and in May 1991, he developed fever and dyspnea and was admitted to Juntendo University Urayasu Hospital. On admission, he was chronically ill and wheezing rale was heard on both lung fields. Neurologically, he was awake but without response to the simplest examiner's command. Cranial nerves appeared intact except for a restriction in the upward gaze. His posture was opisthotonic with a decorticated posture. Marked rigidity was present in all four limbs. He could not sit or stand. Deep reflexes were diminished symmetrically. He was treated by supportive cares, however, he expired 12 days after his admission. In no time myoclonus was observed, nor PSD recorded in his EEG. Cranial CT scans revealed moderate cortical atrophy. The patient was discussed in a neurological CPC, and the chief discussant arrived at the conclusion that he had Creutzfeld-Jakob disease despite the absence of myoclonus and PSD. Postmortem examination revealed diffuse spongy state of the cerebral hemisphere as well as striatum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8398390

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

    PubMed

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

    2003-10-01

    In this study we assess radiographic findings characteristic of mandibular 3rd molars that had required either routine or surgical extraction. X-ray findings relating to acute pericoronitis were also examined. The material was collected by investigating patient records and rotational panoramic radiographs of 20-year-old Finnish male conscripts (n = 738) treated during military service because of 3rd-molar-related problems. The follicle around the crown of mandibular 3rd molars with acute pericoronitis was enlarged in 19% of cases and in 13% of chronic symptom-free pericoronitis cases (not statistically significant difference). Mandibular 3rd molars extracted surgically were more often mesially inclined than those extracted routinely (61% vs. 23%; P < 0.001), partially or totally intrabony impacted (92% vs. 66%; P < 0.001) and deep situated (on average 4.2 mm vs. 2.5 mm under the occlusal plane). Surgical extraction was also associated with the roots completely developed [92% vs. 84% of the teeth routinely extracted, odds ratio (OR) 2.6, 95% confidence interval (CI) 1.2-5.5] and with the absence of radiographic pericoronitis [around 27% vs. 39% of the teeth routinely extracted (OR 0.5, 95% CI 0.3-0.8)]. In 86% of cases the space between 2nd molar and ramus of the mandible was narrower than the 3rd molar extracted surgically, whereas this was 62% in routine extraction cases (P < 0.001). We conclude that there are some typical 3rd-molar findings in rotational panoramic radiographs that show a need for surgical extraction. PMID:14763776

  5. Colonic Necrosis in a 4-Year-Old with Hyperlipidemic Acute Pancreatitis

    PubMed Central

    Patton, Tiffany J.; Sentongo, Timothy A.; Mak, Grace Z.; Kahn, Stacy A.

    2016-01-01

    Here we report the case of a 4-year-old male with severe acute pancreatitis due to hyperlipidemia, who presented with abdominal pain, metabolic abnormalities, and colonic necrosis. This colonic complication was secondary to the extension of a large peripancreatic fluid collection causing direct serosal autodigestion by pancreatic enzymes. Two weeks following the initial presentation, the peripancreatic fluid collection developed into a mature pancreatic pseudocyst, which was percutaneously drained. To our knowledge, this is the youngest documented pediatric case of colonic necrosis due to severe pancreatitis and the first descriptive pediatric case of a colonic complication due to hyperlipidemia-induced acute pancreatitis. PMID:26925282

  6. Suspected disseminated histiocytic sarcoma in a 3-year-old Perro de Presa Canario dog.

    PubMed

    Denstedt, Emily

    2014-02-01

    A 3-year-old intact male Perro de Presa Canario dog was presented with acutely inflamed and edematous right hind limb, scrotum, prepuce, and an enlarged left carpus. Two weeks later the dog returned with weight loss, draining tracts in the right hind limb, dermal nodules, a palpable abdominal mass, and uveitis in the left eye. The dog succumbed to his illness 2 days later and a widely disseminated round cell tumor compatible with histiocytic sarcoma was diagnosed following postmortem examination. PMID:24489399

  7. Suspected disseminated histiocytic sarcoma in a 3-year-old Perro de Presa Canario dog

    PubMed Central

    Denstedt, Emily

    2014-01-01

    A 3-year-old intact male Perro de Presa Canario dog was presented with acutely inflamed and edematous right hind limb, scrotum, prepuce, and an enlarged left carpus. Two weeks later the dog returned with weight loss, draining tracts in the right hind limb, dermal nodules, a palpable abdominal mass, and uveitis in the left eye. The dog succumbed to his illness 2 days later and a widely disseminated round cell tumor compatible with histiocytic sarcoma was diagnosed following postmortem examination. PMID:24489399

  8. Colonic Necrosis in a 4-Year-Old with Hyperlipidemic Acute Pancreatitis.

    PubMed

    Patton, Tiffany J; Sentongo, Timothy A; Mak, Grace Z; Kahn, Stacy A

    2016-01-01

    Here we report the case of a 4-year-old male with severe acute pancreatitis due to hyperlipidemia, who presented with abdominal pain, metabolic abnormalities, and colonic necrosis. This colonic complication was secondary to the extension of a large peripancreatic fluid collection causing direct serosal autodigestion by pancreatic enzymes. Two weeks following the initial presentation, the peripancreatic fluid collection developed into a mature pancreatic pseudocyst, which was percutaneously drained. To our knowledge, this is the youngest documented pediatric case of colonic necrosis due to severe pancreatitis and the first descriptive pediatric case of a colonic complication due to hyperlipidemia-induced acute pancreatitis. PMID:26925282

  9. NASA Administrator Dan Goldin greets 10-year-old VIP.

    NASA Technical Reports Server (NTRS)

    2000-01-01

    NASA Administrator Dan Goldin (left) shares a light moment during his meeting with 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. Behind Goldin is astronaut Doug Wheelock; behind Jonathan is his mother, Penny. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS-99.

  10. Ovarian cavernous hemangioma in an 8-year-old girl.

    PubMed

    Mirilas, P; Georgiou, G; Zevgolis, G

    1999-04-01

    The case of an ovarian cavernous hemangioma with torsion in an 8-year-old girl is described. Current literature records less than 50 cases of which only 8 are in children. The presenting symptoms of acute abdomen and the ultrasonographic study led to the preoperative diagnosis of torsion of an ovarian tumor. Salpingo-oophorectomy and appendicectomy were performed with an uneventful postoperative course. The histological pattern of the tumor was that of an entirely cavernous hemangioma. The case is reported in view of its rarity. PMID:10342121

  11. Linear psoriasis: case report on three year old child*

    PubMed Central

    Figueiras, Daniela de Almeida; Cauas, Renata Cavalcanti; Takano, Daniela Mayumi; Ramos, Ticiana Batista; Marinho, Ayana Karla de Oliveira Ferreira; Bezerra, Milena Sonely Mendonça

    2015-01-01

    Atypical and unusual locations of psoriasis are very frequent. However, localized linear psoriasis is rare, with few cases described in the literature. It is characterized by a linear distribution of psoriasis lesions along Blaschko lines. We report the case of a three years old child, who presented unilateral erythematous scaly plaques arranged along Blaschko lines in the left hemithorax, with no associated symptoms and no lesions in other parts of the body. The differentiation of linear psoriasis from other linear dermatoses is not easy. The combination of a thorough history, a careful examination of the skin and histopathology are essential to ensure the correct diagnosis and appropriate treatment. PMID:26312714

  12. Odontogenic myxoma in a 52-year-old woman

    PubMed Central

    Ram, Hari; Mehta, Gagan; Kumar, Manoj; Lone, Parveen

    2014-01-01

    Odontogenic myxoma (OM) is a rare benign but locally aggressive tumour of the jaws. It is usually seen in the second to third decade of life. Women are more frequently affected than men and it has more predilections for the mandible rather than the maxilla. OM presents as an asymptomatic swelling in most of the cases. Owing to the non-capsulated and aggressive nature of OM, a high rate of recurrence has been reported. Here we present a case of OM in a 52-year-old woman managed by segmental mandibulectomy. Sign of recurrence was seen after 18 months of follow-up. PMID:24859552

  13. Synovial Sarcoma in the Foot of a 5-Year-Old ChildA Case Report.

    PubMed

    Lepow, Gary M; Grimmer, Daniel L; Lemar, Onya V; Bridges, Evan A

    2016-07-01

    The purpose of this case report is to present a rare finding of synovial sarcoma in a 5-year-old child. Most soft-tissue masses of the foot are too often presumed to be small and benign; therefore, compared with soft-tissue sarcomas, they are difficult to clinically differentiate and treat. A 5-year-old girl presented with a painful lesion that was diagnosed as synovial sarcoma after an excisional biopsy was performed. This was an unexpected finding of synovial sarcoma involving the tibialis posterior tendon of her right foot. The patient presented with an 8-month history of tenderness and an antalgic gait. We would like to encourage that all soft-tissue tumors of the foot be preoperatively evaluated with the aid of diagnostic imaging so that a well-planned biopsy assessment can be performed, with adequate margins excised. PMID:27489968

  14. A rare case of gallbladder fistulation with a 60-year-old appendicectomy scar.

    PubMed

    Thiruchandran, Gajendiran; Joyce, Megan; Baggott, Paul James

    2016-01-01

    We present an extremely unusual case of an external biliary fistula in an 87-year-old woman who presented with a 1-day history of spontaneous green discharge from a 60-year-old appendicectomy scar. Examination revealed a sinus in the right iliac fossa overlying her appendicectomy scar, with a raised white cell count and C reactive protein. A CT scan revealed a complex fistula connecting the gallbladder to the subcutaneous tissue in the right flank, which further connected inferiorly with a fistula to the previous appendicectomy scar and a small iliopsoas collection. Endoscopic retrograde cholangiopancreatography revealed several stones in the common bile duct, which were removed using a balloon catheter. The patient was further managed with a long course of antibiotics and discharged with a long-term drainage bag. A literature search revealed no previously reported cases of an external biliary fistula communicating with an appendicectomy scar. PMID:27073150

  15. Coronary artery occlusion after arterial switch operation in an asymptomatic 15-year-old boy.

    PubMed

    Saini, Ashish P; Cyran, Stephen E; Ettinger, Steven M; Pauliks, Linda B

    2016-08-16

    A 15-year-old boy with transposition of the great arteries (TGA) and neonatal arterial switch operation (ASO) presented with complete occlusion of the left main coronary artery (LMCA). Intra-operatively, an intramural left coronary artery was identified. Therefore, since age 7 years he had a series of screening exercise stress tests. At 13 years old, he had 3 to 4 mm ST segment depression in the infero-lateral leads without symptoms. This progressed to 4.2 mm inferior ST segment depression at 15 years old with normal stress echocardiogram. Sestamibi myocardial perfusion scan and cardiac magnetic resonance imaging was inconclusive. Therefore, a coronary angiogram was obtained which showed complete occlusion of the LMCA with ample collateralization from the right coronary artery system. This was later confirmed on a computed tomogram (CT) angiogram, obtained in preparation of coronary artery bypass grafting. The case illustrates the difficulty of detecting coronary artery stenosis and occlusion in young patients with rich collateralization. Coronary CT angiogram and conventional angiography were the best imaging modalities to detect coronary anomalies in this adolescent with surgically corrected TGA. Screening CT angiography may be warranted for TGA patients, particularly for those with known coronary anomalies. PMID:27574609

  16. Coronary artery occlusion after arterial switch operation in an asymptomatic 15-year-old boy

    PubMed Central

    Saini, Ashish P; Cyran, Stephen E; Ettinger, Steven M; Pauliks, Linda B

    2016-01-01

    A 15-year-old boy with transposition of the great arteries (TGA) and neonatal arterial switch operation (ASO) presented with complete occlusion of the left main coronary artery (LMCA). Intra-operatively, an intramural left coronary artery was identified. Therefore, since age 7 years he had a series of screening exercise stress tests. At 13 years old, he had 3 to 4 mm ST segment depression in the infero-lateral leads without symptoms. This progressed to 4.2 mm inferior ST segment depression at 15 years old with normal stress echocardiogram. Sestamibi myocardial perfusion scan and cardiac magnetic resonance imaging was inconclusive. Therefore, a coronary angiogram was obtained which showed complete occlusion of the LMCA with ample collateralization from the right coronary artery system. This was later confirmed on a computed tomogram (CT) angiogram, obtained in preparation of coronary artery bypass grafting. The case illustrates the difficulty of detecting coronary artery stenosis and occlusion in young patients with rich collateralization. Coronary CT angiogram and conventional angiography were the best imaging modalities to detect coronary anomalies in this adolescent with surgically corrected TGA. Screening CT angiography may be warranted for TGA patients, particularly for those with known coronary anomalies. PMID:27574609

  17. A 29-Year-Old Woman With Severe Sepsis and Hemoptysis.

    PubMed

    Aripoli, Allison; Meek, Lucas; Lemons, Steven; Spikes, Leslie

    2016-08-01

    A 29-year-old woman presented with a 1-week history of fever, weakness, anorexia, darkened urine, and mild cough. The patient described her cough as nonproductive and without hemoptysis. She had no chest pain. The patient's medical history was significant for x-linked hypophosphatemia, renal stones, migraine headaches, and chronic back pain managed on prescribed oral opiates for some time. She reported regular cigarette smoking, but denied illicit or IV drug use or any recent travel or sick contacts. The patient also had no known pertinent family history. PMID:27502994

  18. Primary Cardiac Lymphoma in an Immunocompetent 71-Year-Old Man

    PubMed Central

    Montanaro, Claudia; Loiacono, Ferdinando; De Cobelli, Francesco; Foppoli, Marco; Margonato, Alberto

    2015-01-01

    Isolated cardiac lymphomas are very rare, especially in immunocompetent patients. As a consequence, little is known about the best therapeutic management and about patients' outcomes in these cases. Diffuse large B-cell lymphoma is the most frequent subtype; anthracycline-based chemotherapy has been the most successful treatment. We describe the case of a primary cardiac lymphoma in an immunocompetent 71-year-old man. As of December 2015, the patient had been in clinical remission for 2 years. The most relevant literature on primary cardiac lymphoma is reported and discussed. PMID:26664312

  19. An accidental intra-arterial injection of phenytoin in a 43-year-old woman

    PubMed Central

    Khan, ZH; Faghihnassiri, S

    2016-01-01

    We report an accidental intra-arterial injection of phenytoin in a 43-year-old woman undergoing ventriculoperitoneal shunt for hydrocephalus. To flush the arterial line with heparin, mistakenly phenytoin was injected which caused cutaneous gangrene along the radial side of the forearm and an absence of pulsation in the radial artery. After flushing the artery with normal saline and lidocaine, the patient was transferred to the Intensive Care Unit. There the patient was put on intravenous heparin that resolved the problem leading to complete recovery of the patient. The case is being reported to emphasize the importance of close surveillance in injecting drugs through the arterial line access. PMID:27375394

  20. Community Approaches to Serving Four-Year-Old Children in Wisconsin: Lessons Learned from Wisconsin Communities.

    ERIC Educational Resources Information Center

    Rodgers-Rhyme, Anne; Wright, Arlene

    The Wisconsin Forces for Four-Year-Olds Project promotes a collaborative community approach to offering universal access to four-year-old kindergarten services for Wisconsin 4-year-olds. Presented in three major sections, this report offers an overview of a community approach to serving 4-year-olds, summarizes experiences in seven communities…

  1. Category-specific face prototypes are emerging, but not yet mature, in 5-year-old children.

    PubMed

    Short, Lindsey A; Lee, Kang; Fu, Genyue; Mondloch, Catherine J

    2014-10-01

    Adults' expertise in face recognition has been attributed to norm-based coding. Moreover, adults possess separable norms for a variety of face categories (e.g., race, sex, age) that appear to enhance recognition by reducing redundancy in the information shared by faces and ensuring that only relevant dimensions are used to encode faces from a given category. Although 5-year-old children process own-race faces using norm-based coding, little is known about the organization and refinement of their face space. The current study investigated whether 5-year-olds rely on category-specific norms and whether experience facilitates the development of dissociable face prototypes. In Experiment 1, we examined whether Chinese 5-year-olds show race-contingent opposing aftereffects and the extent to which aftereffects transfer across face race among Caucasian and Chinese 5-year-olds. Both participant races showed partial transfer of aftereffects across face race; however, there was no evidence for race-contingent opposing aftereffects. To examine whether experience facilitates the development of category-specific prototypes, we investigated whether race-contingent aftereffects are present among Caucasian 5-year-olds with abundant exposure to Chinese faces (Experiment 2) and then tested separate groups of 5-year-olds with two other categories with which they have considerable experience: sex (male/female faces) and age (adult/child faces) (Experiment 3). Across all three categories, 5-year-olds showed no category-contingent opposing aftereffects. These results demonstrate that 5 years of age is a stage characterized by minimal separation in the norms and associated coding dimensions used for faces from different categories and suggest that refinement of the mechanisms that underlie expert face processing occurs throughout childhood. PMID:24937629

  2. Aging in Place in a Retirement Community: 90+ Year Olds

    PubMed Central

    Paganini-Hill, Annlia

    2014-01-01

    Aging in place, an image of growing old in one’s home and maintaining one’s daily routine, is desired by most older adults. To identify variables promoting such independent living in the oldest-old, we examined the association between living situation of a population-based cohort of 90+ year olds with health and lifestyle variables. Of 1485 participants, 53% still lived in their home at a retirement community designed to foster wellness. Those living at home tended to be healthier, with smaller proportions having chronic diseases or hospitalizations in the preceding year and a greater proportion having normal functional ability. Dementia was the chronic disease most significantly related to living situation. In addition to not having dementia, not using a wheelchair or bath aid, receiving meals on wheels, and being married were jointly related to living at home. With the help of family and friends and with a medical and social support system, many 90+ year olds can age in place. This is often because they have a caregiving spouse or paid caregiver. PMID:25288828

  3. Summary of aging effects on 25-year old nylon parachutes

    SciTech Connect

    Tadios, E.L.

    1989-01-01

    The results of structural evaluations on several parachute systems were examined to determine if any trends could be found that would indicate significant aging in the materials. All of the parachutes were more than 20 years old. Five 64 ft diameter parachutes were evaluated along with three 16.5 ft diameter ribbon parachutes and one 4 ft diameter guide surface parachute. Another group included six 48 ft diameter ribbon parachutes, two 4 ft diameter guide surface parachutes, and two 16.5 ft diameter extraction ribbon parachutes. The parachute systems used in the study were all fabricated from nylon materials. Data were obtained for several material properties such as tensile strength, air permeability and melting point. Military specifications were used as zero-time data base due to lack of raw material data. Generally speaking, after 25 years the material properties of the 64 ft parachutes were within specifications. The same generalization cannot be made for the 48 ft parachutes which were about 23 years old. The explanation for their differences may lie in their respective histories. 10 refs., 2 figs., 5 tabs.

  4. Fibrodysplasia Ossificans Progressiva in a Four year Old Child

    PubMed Central

    Kardile, Mayur; Nayak, Sidhartha; Nagaraja, H S; Mishra, Abani Kanta

    2012-01-01

    Introduction: Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disoder characterized by bone formation within muscles tendons and ligaments. It has an incidence of one in two million. We hereby report a case of FOP in a four year male child from a tribal family in orissa. Case Report: 4 yr old male child presented with gradual development of stiffness of neck and hard nodules on his body for which his parents had sought all sort of indegenous treatment and manipulations by traditional bone setters. Patient returned to our hospital at the age of four years with widespread ossification and stiffness of neck, shoulders and back. He also had upper tibial osteochondromas and scalp nodules and valgus deformity of bilateral great toes. A diagnosis of FOP was made on clinical and radiological examination. Conclusion: Though rare, diagnosis of Myositis ossificans progressiva should be considered in a child with heterotopic bone formation and valgus deformities of great toes. Being a rare condition, treatment guidelines are not clear and this condition need further research.

  5. Improvements in Lung Function and Height among Cohorts of 6-Year-Olds with Cystic Fibrosis from 1994 to 2012

    PubMed Central

    VanDevanter, Donald R.; Pasta, David J.; Konstan, Michael W.

    2014-01-01

    Objective To characterize spirometry and height changes in cohorts of 6-year-olds with cystic fibrosis (CF). Study design Global Lung Initiative (GLI) forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and FEV1/FVC and CDC height-for-age (HFA) Z-scores were generated for 6-year-olds in the from the CF Foundation Patient Registry (CFFPR) each year from 1994 and 2012. Z-score mean differences were analyzed by t-test and time trends of means by least squares regression for all children and for subgroups (sex, F580del mutation genotype, Medicaid insurance, and prenatal/newborn screening identification). Z-score distributions were compared by two-sample Kolmogorov-Smirnov tests. Results 11,670 children with CF were studied, of whom 50.5% were males, 50.2% had the F508del/F508del genotype, and 46.6% were insured by Medicaid. Mean HFA, FEV1 and FVC Z-scores increased significantly over the period in the entire population and all subgroups (P<0.001), but FEV1/FVC Z-scores were below normal and did not change significantly. In 2012, children identified by screening had significantly higher mean HFA (P=0.002), FEV1 (P<0.001) and FVC (P<0.001) Z-scores than those not screened, with 90% of FVC and 71.4% of FEV1 Z-scores greater than predicted by the Normal distribution; FEV1/FVC Z-scores were not different between screening groups. Conclusions Consistent, significant increases in HFA, FEV1, and FVC occurred from 1994–2012, but FEV1/FVC, a measure of airway obstruction, did not appreciably change. FVC and FEV1 Z-score distributions suggest that normative equation reference populations under-predict lung volumes of children with CF, but the reason(s) for this remain unclear. PMID:25134852

  6. A Rare Case Report of A Young Male Patient Presenting with Osteoblastoma of the Talus

    PubMed Central

    Patil, Kiran S; Somayaji, Haridas M; Nandi, Santhosh S

    2014-01-01

    Introduction: Osteoblastoma is a rare (incidence <1%) benign locally aggressive osteoblastic lesion of bone with rare malignant transformation. Benign osteoblastoma is the term used by Jaffe to denote an uncommon neoplasm of bone characterized by vascular osteoid and bone forming matrix rich in osteoblasts. Case Report: Here we report a case of osteoblastoma of talus in eighteen year old male patient from Bijapur with complaints of pain and difficulty in walking for one year. Relevant investigations and radiographs were taken. It was treated with wide excision and bone grafting from ipsilateral ilium and talo-navicular fusion with cannulated cancellous screw fixation. Histopathology of the biopsy confirmed the diagnosis. Patient was immobilized with below knee plaster cast for six weeks later with gradual mobilization. Guarded weight bear was allowed after three months. Patient achieved satisfactory range of movements and full weight bear mobilization after six months. Symptoms relieved with no evidence of any recurrence in one year follow up. Conclusion: Osteoblastoma of talus is a rare benign tumor, if suspected surgical wide excision and talo-navicular fusion with cannulated cancellous screw fixation, with bone grafting is the better treatment of choice. The condition can only be confirmed after histopathological examination.

  7. Development of 1-year-old computational phantom and calculation of organ doses during CT scans using Monte Carlo simulation

    NASA Astrophysics Data System (ADS)

    Pan, Yuxi; Qiu, Rui; Gao, Linfeng; Ge, Chaoyong; Zheng, Junzheng; Xie, Wenzhang; Li, Junli

    2014-09-01

    With the rapidly growing number of CT examinations, the consequential radiation risk has aroused more and more attention. The average dose in each organ during CT scans can only be obtained by using Monte Carlo simulation with computational phantoms. Since children tend to have higher radiation sensitivity than adults, the radiation dose of pediatric CT examinations requires special attention and needs to be assessed accurately. So far, studies on organ doses from CT exposures for pediatric patients are still limited. In this work, a 1-year-old computational phantom was constructed. The body contour was obtained from the CT images of a 1-year-old physical phantom and the internal organs were deformed from an existing Chinese reference adult phantom. To ensure the organ locations in the 1-year-old computational phantom were consistent with those of the physical phantom, the organ locations in 1-year-old computational phantom were manually adjusted one by one, and the organ masses were adjusted to the corresponding Chinese reference values. Moreover, a CT scanner model was developed using the Monte Carlo technique and the 1-year-old computational phantom was applied to estimate organ doses derived from simulated CT exposures. As a result, a database including doses to 36 organs and tissues from 47 single axial scans was built. It has been verified by calculation that doses of axial scans are close to those of helical scans; therefore, this database could be applied to helical scans as well. Organ doses were calculated using the database and compared with those obtained from the measurements made in the physical phantom for helical scans. The differences between simulation and measurement were less than 25% for all organs. The result shows that the 1-year-old phantom developed in this work can be used to calculate organ doses in CT exposures, and the dose database provides a method for the estimation of 1-year-old patient doses in a variety of CT examinations.

  8. [Acute pancreatitis after ingestion of ibuprofen in a 16-year-old boy].

    PubMed

    Bruusgaard-Mouritsen, Mads Emil; Leerhøy, Bonna; Hansen, Mark Berner

    2015-07-01

    This is a case report of a 16-year-old boy with possible drug-induced pancreatitis (DIP) caused by ibuprofen. The patient had a history of psychiatric, but no somatic, disease, and he was admitted with a clinical presentation consistent with acute pancreatitis after a bolus ingestion of 10 g of ibuprofen in a suicidal attempt. No evidence of other causality for acute pancreatitis was identified. The patient was treated with a standard pancreatitis treatment regime and was discharged against medical advice after four days. The case represents a possible causality between ibuprofen and DIP. PMID:26239856

  9. Bullous Dermatitis Artefacta in a 17 Year-old Girl Induced by a Native Herb

    PubMed Central

    Zarei, Mina; Kamali, Mohammad; Bidaki, Reza

    2013-01-01

    Dermatitis artifacta is a factitious dermatological disorder with many forms of presentation of self inflicted skin lesions in any part of the body. Dermatitis artefacta is a rare and difficult condition for diagnosis and treatment mostly because of the patient's denial. The liaison among primary care physicians, psychiatrists and dermatologists can be important in the management of these patients. In this report we describe a 17-year-old girl with dermatitis artefacta which was presented as bullous lesions on her face induced with a native herb combining with fake headaches. PMID:24616800

  10. Bullous Dermatitis Artefacta in a 17 Year-old Girl Induced by a Native Herb.

    PubMed

    Zarei, Mina; Kamali, Mohammad; Bidaki, Reza

    2013-09-01

    Dermatitis artifacta is a factitious dermatological disorder with many forms of presentation of self inflicted skin lesions in any part of the body. Dermatitis artefacta is a rare and difficult condition for diagnosis and treatment mostly because of the patient's denial. The liaison among primary care physicians, psychiatrists and dermatologists can be important in the management of these patients. In this report we describe a 17-year-old girl with dermatitis artefacta which was presented as bullous lesions on her face induced with a native herb combining with fake headaches. PMID:24616800

  11. A Case of Infantile Kyrle-Flegel Disease in a 6-Year-Old Yemeni Girl.

    PubMed

    Alshami, Mohammad Ali; Mohana, Mona Jameel

    2016-01-01

    Kyrle disease (KD) and Flegel disease (FD) are rare variants of primary perforating dermatoses, characterized by transepidermal elimination of abnormal endogenous materials. We describe a 6-year-old Yemeni girl with a 2-year history of generalized asymptomatic, small, reddish-brown keratotic papules with a lenticular central keratotic plug. Although these features are synonymous with FD, the histology of a punch biopsy was consistent with KD. The patient was otherwise healthy, and no family members had a history of similar diseases. The patient was diagnosed with KD-FD, owing to the manifestation of features associated with both diseases. PMID:26933407

  12. A five-year-old child with a subcutaneous forehead nodule.

    PubMed

    Westblade, Lars F; Fischer, Peter U; Haghi, Nina; Schniederjan, Matthew J; Pritt, Bobbi S; Long, John G; Jerris, Robert C; Garola, Robert E

    2015-01-01

    We describe a case of a 5-year-old girl with onchocerciasis. The patient was recently adopted from Ethiopia and presented with a firm, raised nodule on the midportion of the forehead. Initially, Langerhans cell histiocytosis with bone involvement was suspected; however, histopathologic analysis of the excised nodule revealed the presence of a young-adult, female Onchocerca volvulus worm. This case exemplifies the importance of recognizing the key morphologic characteristics of adult O. volvulus worms isolated from pediatric patients in nonendemic areas to ensure adroit clinical management. PMID:25569144

  13. An 81-year-old man with an abnormal right-sided heart shadow on chest radiograph.

    PubMed

    Shah, Rahman; Khan, M Rehan; Fan, Tai-Hwang M; Ruff, Genina; Ramanathan, Kodangudi B

    2015-02-01

    An 81-year-old man presented with a 1-week history of dry cough. He also complained of mild dyspnea, wheezing, and low-grade fever. He denied hemoptysis, fever, rashes, or chest pain. The patient's medical history included coronary artery bypass surgery, hypertension, gastroesophageal reflux disease, and COPD. The patient was a retired welder and an ex-smoker. PMID:25644917

  14. Incidence and prevalence of idiopathic pulmonary fibrosis in US adults 18-64 years old.

    PubMed

    Raghu, Ganesh; Chen, Shih-Yin; Hou, Qiang; Yeh, Wei-Shi; Collard, Harold R

    2016-07-01

    We sought to present the epidemiology of idiopathic pulmonary fibrosis (IPF) in adults 18-64 years old in the USA.From adults aged 18-64 years in a large administrative claims data in 2004-2010, patients with IPF were identified using diagnosis codes. We estimated annual incidence and cumulative prevalence of IPF over time, and examined potential risk factors for the IPF diagnosis.The annual cumulative prevalence increased steadily in the first few years (from 13.4 cases per 100 000 persons in 2005 to 18.2 cases in 2010 per 100 000 persons), which is likely due to a methodological reason, while the annual incidence of IPF decreased over time (from 7.9 cases per 100 000 person-years in 2005 to 5.8 cases in 2010 per 100 000 person-years). The overall decrease was mainly driven by a decreasing trend in the younger patients (aged 18-44 years), while the incidence in older patients remained stable. Consistent trends were observed in subgroups defined by previously published more restrictive algorithms for diagnosis. Older age and male sex were associated with a higher incidence of disease (p<0.05).In US adults younger than 65 years, we observed a decreasing incidence of IPF over time which may partially explain the plateau of cumulative prevalence in the last few years of our data. PMID:27126689

  15. Extrinsic Rewards Diminish Costly Sharing in 3-Year-Olds.

    PubMed

    Ulber, Julia; Hamann, Katharina; Tomasello, Michael

    2016-07-01

    Two studies investigated the influence of external rewards and social praise in young children's fairness-related behavior. The motivation of ninety-six 3-year-olds' to equalize unfair resource allocations was measured in three scenarios (collaboration, windfall, and dictator game) following three different treatments (material reward, verbal praise, and neutral response). In all scenarios, children's willingness to engage in costly sharing was negatively influenced when they had received a reward for equal sharing during treatment than when they had received praise or no reward. The negative effect of material rewards was not due to subjects responding in kind to their partner's termination of rewards. These results provide new evidence for the intrinsic motivation of prosociality-in this case, costly sharing behavior-in preschool children. PMID:27084549

  16. Parathyroid Carcinoma in a 10 Years Old Female Child.

    PubMed

    Rahman, M M; Karim, S S; Joarder, A I; Mubin, S; Abir, M M; Morshed, M S

    2015-07-01

    Parathyroid carcinoma (PC) is a rare cause of hypercalcaemia in children. Only 7 cases of PC have been reported so far in the world journal. The authors report the 8th case of parathyroid carcinoma in children less than 16 years of age. A 10 year old girl presented with difficulty in walking, dorsiflexion and ulnar deviation of both wrist joints and occasional pain in the central abdomen of about two years duration. Biochemical investigations revealed serum calcium 12.2 mg/dL (normal 9-11 mg/dL), serum alkaline phosphate 4992 U/L (normal 50-136 U/L), PTH (parathyroid hormone) 2217 pg/ml (normal 9-80 pg/ml). Parathyroid scintigraphy localized the lesion in the left parathyroid gland. X-ray showed bilateral coxa vera, genu valgus deformity and multiple stress fractures in both wrist joints. Histopathology confirmed PC with capsular and vascular invasion. PMID:26329966

  17. An 86-year-old man with acute abdominal pain.

    PubMed

    van Dam, Paul M E L; Posthouwer, Dirk

    2016-01-01

    An 86-year-old man presented with severe pain in the upper abdomen along with fever. On physical examination, we found an arterial blood pressure of 84/43 mm Hg, a heart rate of 80 bpm and a temperature of 38.3°C. The abdomen was painful and peristalsis was absent. Empiric antibiotic therapy for sepsis was started with amoxicillin/clavulanate and gentamicin. CT scan of the abdomen revealed an emphysematous cholecystitis. Percutaneous ultrasound-guided cholecystostomy was applied. Bile cultures revealed Clostridium perfringens. Emphysematous cholecystitis is a life-threatening form of acute cholecystitis that occurs as a consequence of ischaemic injury to the gallbladder, followed by translocation of gas-forming bacteria (ie, C. perfringens, Escherichia coli, Klebsiella and Streptococci). The mortality associated with emphysematous cholecystitis is higher than in non-emphysematous cholecystitis (15% vs 4%). Therefore, early diagnosis with radiological imaging is of vital importance. PMID:26869625

  18. Two-Year-Olds Distinguish Pretending and Joking.

    PubMed

    Hoicka, Elena; Martin, Catriona

    2016-05-01

    Although children understand intentions to joke and pretend by 2 or 3 years, it is unclear whether they distinguish these intentional acts. Using a normativity paradigm, this study found (N = 72) 2-year-olds protest against jokes more than pretending, suggesting, for the first time, they distinguish these acts. Furthermore, toddlers protested more generally after pretend than literal or joke contexts but only if intentional cues were used. Additionally, children objected more to joking than pretending after pretend and literal contexts but not after joke contexts. Thus, toddlers distinguish the intentional nature of pretending and joking. Furthermore, a pretend intentional context establishes specific rules to be followed, whereas a joke intentional context allows an open space to perform various types of acts. PMID:27170036

  19. Recurrent headache in a five year old boy.

    PubMed

    Saini, Lokesh; Kumar, Ranjith M; Chakrabarty, Biswaroop; Gulati, Sheffali

    2016-01-01

    Headache is infrequent in early childhood. Headache and neurological deficits associated with cerebrospinal fluid (CSF) lymphocytosis (HaNDL), a variant of migraine, is a rare disorder. A 5-year-old boy presented with recurrent episodes of headache for 6 months. Each episode lasted for a week and in the current episode, he was symptomatic for 3 days. All the episodes were associated with paresthesias and CSF lymplocytosis with normal protein and sugar. There was history of migraine in his family. His magnetic resonance imaging (MRI) brain with contrast with magnetic resonance (MR) angiography and venography were normal. Work-up for relevant causes of infection and vasculitis were negative. His symptoms subsided on oral antimigraine prophylaxis and he has been on remission for last 8 months. HaNDL should be considered in relevant clinical scenarios, as it prevents unnecessary investigations, therapy, and hospitalization. PMID:27011651

  20. Two-year-olds use artist intention to understand drawings.

    PubMed

    Preissler, Melissa Allen; Bloom, Paul

    2008-01-01

    Adults appreciate that an abstract visual representation can be understood through inferring the artist's intention. Many investigators have argued that this capacity is a late-emerging developmental accomplishment, a claim supported by findings that preschool children ignore explicit statements about intent when naming pictures. Using a simplified method, we explored picture naming in 2-year-olds. Experiment 1 found that when an adult artist drew an object, children later mapped a novel name for the drawing to the object that the adult had been looking at. Experiment 2 suggests that this response was not merely because there was more attention given to that object. These findings are consistent with the view that children are naturally disposed to reason about artifacts, including artwork, in terms of inferred intention. PMID:17391660

  1. Summary of aging effects on 25-year old nylon parachutes

    SciTech Connect

    Tadios, E.L.

    1988-01-01

    Structural evaluations were conducted on several parachute systems to determine the effects of aging on parachute materials. Most of the parachutes were 25 years old. Five 64 ft parachutes were evaluated along with one 4 ft guide surface parachute and three 16.5 ft ribbon parachutes. The parachute systems used in the study were all fabricated from nylon materials. Results were obtained for several material properties such as tensile strength, air permeability and melting point. Military specifications were used as zero-time data base due to lack of raw material data. The results indicate that over a period of about 25 years, parachute nylon materials do not degrade to unacceptable levels. 7 refs., 2 figs., 3 tabs.

  2. Rapid fast-mapping abilities in 2-year-olds.

    PubMed

    Spiegel, Chad; Halberda, Justin

    2011-05-01

    Learning a new word consists of two primary tasks that have often been conflated into a single process: referent selection, in which a child must determine the correct referent of a novel label, and referent retention, which is the ability to store this newly formed label-object mapping in memory for later use. In addition, children must be capable of performing these tasks rapidly and repeatedly as they are frequently exposed to novel words during the course of natural conversation. Here we used a preferential pointing task to investigate 2-year-olds' (N=72) ability to infer the referent of a novel noun from a single ambiguous exposure and their ability to retain this mapping over time. Children were asked to identify the referent of a novel label on six critical trials distributed throughout the course of a 10-min study involving many familiar and novel objects. On these critical trials, images of a known object and a novel object (e.g., a ball and a nameless artifact constructed in the laboratory) appeared on two computer screens and a voice asked children to "point at the _____ [e.g., glark]." Following label onset, children were allowed only 3s during which to infer the correct referent, point at it, and potentially store this new word-object mapping. In a final posttest trial, all previously labeled novel objects appeared and children were asked to point to one of them (e.g., "Can you find the glark?"). To succeed, children needed to have initially mapped the novel labels correctly and retained these mappings over the course of the study. Despite the difficult demands of the current task, children successfully identified the target object on the retention trial. We conclude that 2-year-olds are able to fast map novel nouns during a brief single exposure under ambiguous labeling conditions. PMID:21145067

  3. [Paranoid-hallucinatory psychosis as primary manifestation of subactue sclerosing panencephalitis (SSPE) in a 19-year-old man].

    PubMed

    Jähnel, Mathias

    2003-05-01

    We report the rare case of a 19-year old man, first diagnosed with schizophrenia but finally shown to have subacute sclerosing panencephalitis (SSPE). Initial symptoms were hallucinations and negative symptoms until the onset of a seizure. Changes in the CSF, MRI, EEG and increasing neurological symptoms led to the correct diagnosis of subacute sclerosing panencephalitis. The EEG results were of particular importance as they already showed the characteristic changes, even while the patient still only presented with psychotic symptoms. This case report demonstrates the importance of ongoing neurological examinations in patients with psychiatric disorders. In the literature, there are only three case reports about children (8, 9 and 10 year old) as well as one of a 21-year old women with subacute sclerosing panencephalitis presenting with psychosis. PMID:14509042

  4. [Therapy for male patients with sexual dysfunction].

    PubMed

    Casella, Roberto

    2010-03-01

    Phosphodiasterase type 5 inhibitors (sildenafil, vardenafil, tadalafil) are the first line symptomatic therapy for patients with erectile dysfunction. The patient should receive a meticolous information on the use of these drugs and their possible side effects. These drugs are safe and can be used even in patients with stable cardiovascular disease. Patients not responding to oral drugs may be offered intraurethral or intracavernous alprostadil. Vacuum constriction devices are a second line option more acceptable to older patients. Penile prosthesis are very seldom used in Switzerland and vascular surgery is a vanishing option. Testosterone substitution is seldom needed in this setting. Treatment of premature ejaculation subdivides into behavioural therapy ("stop-start" or "squeeze" technique) and drug therapy as well. Topical therapy with lidocaine/prilocaine-containing medications to be applied before sexual intercourse and a oral daily off label use therapy with selective serotonin re-uptake inhibitors (paroxetine, fluoxetine, sertraline) can be offered. Dapoxetine, a potent selective serotonin reuptake inhibitor with short half life time, is the first officially approved medication for the treatment of premature ejaculation and should be available soon in Switzerland. PMID:20235039

  5. Quebec public funding facilitates fertility preservation for male cancer patients

    PubMed Central

    Herrero, M.B.; García, A.; Buckett, W.; Tulandi, T.; Chan, P.

    2016-01-01

    Background Sperm cryopreservation remains the only clinically feasible option to preserve male fertility. The quality of counselling provided by the treating physicians and the cost of sperm cryopreservation can both influence a patient’s decision about whether to preserve sperm. On 5 August 2010, the Quebec government introduced provincial coverage of assisted reproductive technologies, with sperm cryopreservation included as a covered service. The aim of the present study was to evaluate whether and how such a program affects the behaviour of cancer patients with respect to sperm cryopreservation. Methods We analyzed the database derived from male patients undergoing sperm cryopreservation from August 2008 to August 2012 at our centre. The retrieved data included patient age, male infertility or oncologic diagnosis, sperm quality parameters, and details about the number of visits for sperm cryopreservation. Results The number of cancer patients who cryopreserved sperm before and after the policy change did not differ significantly, but a marked increase in the number of non-cancer patients was observed. Further analysis revealed that, after implementation of the public funding program, the total number of sperm cryopreservation sessions per patient increased significantly in cancer patients but not in non-cancer patients. Conclusions It appears that cancer patients who are willing to freeze sperm are keen to return for more sessions of sperm banking when no fees are associated with the service. Those findings suggest that cost reduction is an important factor for improving delivery of fertility preservation services to male cancer patients. PMID:26966400

  6. Male genitoplasty for 46 XX congenital adrenal hyperplasia patients presenting late and reared as males

    PubMed Central

    Sharma, Shilpa; Gupta, Devendra K.

    2012-01-01

    Aim: To evaluate the clinical profile and management of 46 XX Congenital Adrenal Hyperplasia (CAH) patients presenting with severe virilization and assigned a male gender. Materials and Methods: Of 173 children diagnosed with CAH at the Pediatric Intersex Clinic since 1980, seven children with CAH presented late with severe virilization and were reared as males. All of them were assigned the male sex with removal of the female adnexa. Six were treated with male genitoplasty. Appropriate hormonal supplementation was offered after puberty. Results: The mean age at presentation was 14.2 years (7 – 21). Six patients had presented after puberty, only one at seven years of age. Staged male genitoplasty comprising of chordee correction, male urethroplasty, and bilateral testicular prosthesis was performed. The female adnexa (uterus, ovaries, most of the upper vagina, and the fallopian tubes) were removed. The mental makeup was masculine in six and bigender in one. Bilateral mastectomy was performed at puberty in all. Hormonal treatment comprised of glucocorticoids and testosterone. Six patients were comfortable with the outcome of the masculinizing genitoplasty. One had a short-sized phallus. One had repeated attacks of urinary tract infection arising from the retained lower vaginal pouch. Social adjustments were good in all, except in one who had a bigender mental makeup. Conclusion: CAH patients with severe virilization presenting late and reared as males are extremely rare. However, the assigned gender can be retained adequately as males, meeting the socioeconomic compulsions of the society. The results are satisfactory following appropriate surgical procedures and hormonal supplementation. PMID:23226638

  7. Racial Differences in Reported Napping and Nocturnal Sleep in 2- to 8-Year-Old Children

    PubMed Central

    Crosby, Brian; LeBourgeois, Monique K.; Harsh, John

    2010-01-01

    Objectives The objectives of this study were to examine racial differences in reported napping and nighttime sleep of 2- to 8-year-old children, to identify factors accounting for these differences, and to determine if variability in napping was related to psychosocial functioning. Methods Caretakers of 1043 children (73.5% non-Hispanic white; 50.4% male) 2 to 8 years old from a community sample reported on their children’s napping behavior and nighttime sleep. Caretakers of 255 preschool children (3–5 years old) also completed the Behavior Assessment System for Children. Results A more gradual age-related decline in napping was found for black children. At age 8, 39.1% of black children were reported to nap, compared with only 4.9% of white children. Black children also napped significantly more days per week, had shorter average nocturnal sleep durations, and slept significantly less on weekdays than on weekend nights. Despite differences in sleep distribution, total weekly sleep duration (diurnal and nocturnal) was nearly identical for the 2 racial groups at each year of age. Logistic regression analysis revealed that demographic variables were related to but did not fully explain napping differences. Napping in a subset of preschoolers was not significantly related to psychosocial functioning. Conclusions There are remarkable racial differences in reported napping and nighttime sleep patterns beginning as early as age 3 and extending to at least 8 years of age. These differences are independent of commonly investigated demographic factors. Differences in napping behavior do not seem to have psychosocial significance in a sample of preschool children. PMID:15866856

  8. Analysis of dental casts of 6-8- and 12-year-old Kenyan children.

    PubMed

    Hassanali, J; Odhiambo, J W

    2000-04-01

    Dental plaster casts of 97 6-8-year-old and 173 12-year-old Maasai, Kikuyu, and Kalenjin children were studied. The Kikuyu are Bantu, while Maasai and Kalenjin are Nilo-Hamitic subjects. The variables measured were palatal depth (PD) and length (PL); maxillary and mandibular anterior arc circumferences (AC1) and (AC2), respectively; posterior arc circumferences (PC1) and (PC2), inter-canine (CC1), and (CC2); inter-molar (MM1) and (MM2) distances, and mandibular length (ML). The data were analysed using SPSS package. The mean values of all the variables were generally higher in the males compared with the females and significant sex differences in the means (P < 0.01) were found in AC1, PC1, PC2, CC1, CC2, MM1, and MM2 in the 12-year-old subjects. The means of all variables, except PL, ML, PC2, and CC2, increased from 6 to 12 years of age and significant differences in the means for age were found in ML, AC1, PC2, PD, MM1, MM2, and CC1. Mean maxillary inter-molar distance increased with age by 0.17-0.34 mm in the three groups. Mean values of mandibular variables were highest in the Kikuyu, while maxillary variables were highest in the Maasai. The Maasai casts showed a marked decrease in CC2, PC2, AC2, and ML compared with the Kikuyu and Kalenjin. Ethnic and sex differences in the dental arches may be masked by anterior tooth positions that are influenced by the dento-alveolar complex and soft tissues. Corresponding mandibular and maxillary variables were strongly correlated and anterior and posterior arc circumferences were correlated with inter-canine and intermolar distances. Details of the norms for dental arch dimensions and changes with age may allow for appropriate assessment of dental occlusion and treatment planning for Kenyan children. PMID:10822886

  9. Management of male neurologic patients with infertility.

    PubMed

    Fode, Mikkel; Sønksen, Jens

    2015-01-01

    Many aspects of fertility rely on intact neurologic function and thus neurologic diseases can result in infertility. While research into general female fertility and alterations in male semen quality is limited, we have an abundance of knowledge regarding ejaculatory dysfunction following nerve injury. Normal ejaculation is the result of coordinated reflex activity involving both the sympathetic and somatic nervous systems. Nerve injury can result in retrograde ejaculation, and anejaculation. With retrograde ejaculation, the ejaculate is propelled into the bladder instead of out through the urethra. In mild cases this condition can be reversed by sympathomimetic medications and, in more severe cases, sperm cells can be extracted from the bladder following ejaculation. With anejaculation, the ejaculatory reflex is not activated by normal sexual stimulation. In such cases, the first choice of treatment is assisted ejaculation, preferably by penile vibratory stimulation. If vibratory stimulation is unsuccessful, then ejaculation can almost always be induced by electroejaculation. In cases where assisted ejaculation fails, sperm can be retrieved surgically from either the epididymis or from the testis. Once viable sperm cells have been obtained, these are used in assisted reproductive techniques, including intravaginal insemination, intrauterine insemination, and in vitro fertilization/intracytoplasmic sperm injection. PMID:26003259

  10. Groin Swelling in a Four-Year-Old Boy: Primary Great Saphenous Vein Aneurysm.

    PubMed

    Çiçek, Mustafa Cüneyt; Çiçek, Ömer Faruk; Yalçınkaya, Adnan; Taşoğlu, İrfan

    2015-11-01

    Primary venous aneurysm, especially in pediatric population, is a very rare clinical entity. We report a case of primary great saphenous vein aneurysm in a 4-year-old boy. He was initially suspected of suffering from inguinal hernia because the soft mass was detected at the inguinal region when the patient was in the standing position, but color Doppler ultrasonography demonstrated the swelling to be a great saphenous vein aneurysm. We decided that surgery was the best option because of potential risk for thromboembolism. PMID:26315793

  11. Gastrointestinal manifestations as initial presenting features in a 40 years old woman with systemic lupus erythematosus.

    PubMed

    Ahmed, Q M; Arafat, S M; Azad, A K; Chowdhury, M J; Hasan, M K; Ahmed, F; Ananna, M A

    2015-01-01

    Gastrointestinal (GI) symptoms are common in patients with systemic lupus erythematosus (SLE). These symptoms can be due to primary GI disorders like peptic ulcer disease, pancreatitis or intestinal obstruction. But they can be due to SLE itself or complications of treatment of SLE. In this case report, we describe a 40 years old woman who presented initially with GI complaints. Later she was diagnosed as a case of SLE with chronic intestinal pseudo-obstruction (CIPO). The problems related to diagnosis and management is also discussed. PMID:25725689

  12. Longstanding Hypoparathyroidism in a Fifty-Two-Year-Old Woman Misdiagnosed as Spondyloarthropathy

    PubMed Central

    Zabihiyeganeh, Mozhdeh; Jahed, Seyed Adel; Akbari, Hounaz

    2014-01-01

    Introduction: Hypoparathyroidism might cause various musculoskeletal findings, resembling Spondyloarthropathies. Case Presentation: We described a 52-year-old woman, diagnosed as a case of undifferentiated spondyloarthropathy for ten years, who was unresponsive to classic anti-inflammatory therapies. She developed anterior ischemic optic neuropathy and had elevated muscle enzymes during the course of disease. On a routine checkup, marked hypocalcemia and suppressed parathyroid hormone levels were found. Calcium and calcitriol therapy led to clinical and laboratory improvement. Conclusions: This case emphasizes the importance of recognizing rheumatic manifestations of hypoparathyroidism to preclude unnecessary treatments. Serum calcium should be included in the diagnostic workup of these patients. PMID:25763244

  13. Extrapyramidal side-effects of low-dose aripiprazole in an 11-year-old child.

    PubMed

    Mohapatra, Satyakam

    2016-01-01

    Partial agonism of D2 and 5-HT1A receptors accounts for the low incidence of extrapyramidal side-effects of aripiprazole. Extrapyramidal symptoms (EPS) during treatment with therapeutical doses of aripiprazole have been reported in adults and children. To the best of our knowledge, no cases of EPS with low doses (5 mg) have been reported until now. In this article, we present an 11-year-old child who developed EPS on low doses (5 mg) aripiprazole. This case emphasizes the need for careful surveillance for the development of EPS in patients treated even with low doses of aripiprazole. PMID:26933364

  14. [Jaundice after Herbage Walking Tour of a 44 Year Old Man].

    PubMed

    Sawatzki, Mikael; Haller, Christoph; Henz, Samuel

    2015-06-01

    We report about a 44-year old patient with severe acute hepatitis E after herbage walking-to ur. Transmission occurred with ingestion of contaminated herbs. Symptoms were jaundice, dark urine, rheumatic pains and distinctive fatigue. We could document a benign self-limiting course under regular clinical controls. Hepatitis Eisa worldwide common cause for acute hepatitis with jaundice. In Switzerland contamination of this autochthonic infection is aquired by consumption of pork and venison (seroprevalence up to 22%). Infection can be without symptoms but also can result in acute liver failure. Extrahepatic symptoms are not uncommon. PMID:26098240

  15. Cerebral venous sinus thrombosis with ophthalmic manifestations in 18-year-olds on oral contraceptives.

    PubMed

    Tan, Jeffrey J; Hassoun, Ameer; Elmalem, Valerie I

    2014-08-01

    Cerebral venous sinus thrombosis (CVST) is a rare and potentially life-threatening cause of stroke. In the past few decades, the incidence and patient demographics have changed because of many factors, including the widespread use of oral contraceptives, improved detection of prothrombotic conditions, and advancement of imaging technology. The presentation of CVST is varied and can include ocular signs and symptoms. We present 2 cases of oral contraceptive-induced CVST in 18-year-old women, whose main presenting findings were ophthalmologic. PMID:24803635

  16. A 61-year-old woman develops polyuria after hip revision

    PubMed Central

    Shaheen, Aisha; Dobish, Mark; Gleason, Vanessa; Setren, Adam; Stem, Jonathan; Kohl, Benjamin A.

    2016-01-01

    A 61-year-old previously healthy woman developed progressive hearing and visual loss over a period of 2–3 months prior to admission. Her medical/surgical history was remarkable for a left hip arthroplasty 11 years ago requiring revision approximately 6 months prior to admission. After dislocating the revised hip, she re-presented to her surgeon and underwent a closed reduction. Several weeks following the reduction, the patient began having polyuria and symptoms of hearing and vision loss along with numbness in her extremities and abdominal region. PMID:27170702

  17. Traumatic spinal epidural hematoma in a 1-year-old boy.

    PubMed

    Tarbé de Saint Hardouin, A-L; Grévent, D; Sainte-Rose, C; Angoulvant, F; Chéron, G

    2016-07-01

    Traumatic spinal epidural hematoma is uncommon in children, making rapid diagnosis difficult. In this report, we present a case of traumatic cervical epidural hematoma in a 1-year-old boy, diagnosed with computed tomography scanning and magnetic resonance imaging (MRI). Management was conservative and the lesion regressed spontaneously. The presentation in childhood is often nonspecific. MRI is the imaging modality of choice for diagnosing these lesions. Conservative treatment has to be considered in cases with a benign clinical course and provided that the patient is followed up neurologically with repeated MRI. PMID:27266638

  18. [Mucoepidermoid carcinoma in a 13-year-old girl; report of a case].

    PubMed

    Fujita, Koichi

    2009-05-01

    A 13-year-old girl was referred to our hospital for chest pain and atelectasis of left upper lobe on chest X-ray film. Bronchoscopy revealed an endobronchial tumor obstructing left main bronchus. Left upper lobectomy with bronchoplasty was performed. The tumor was a polyp 34 x 17 x 17 mm in size and obstructed left main bronchus. Histologically the tumor was a low-grade malignant mucoepidermoid carcinoma with malignant pleural effusin. The patient has been well and free of recurrence for 8 years postoperatively. PMID:19425387

  19. Valproic acid-induced pancreatitis in a 15-year-old boy with juvenile myoclonic epilepsy.

    PubMed

    Veri, Kadi; Uibo, Oivi; Talvik, Inga; Talvik, Tiina

    2013-01-01

    Drug-induced acute pancreatitis is a rare condition in childhood, and information about the incidence of valproic acid-induced acute pancreatitis in the pediatric population is scarce. In this clinical case, we report a first documented pediatric case of valproic acid-induced pancreatitis in Estonia. A 15-year-old boy with juvenile myoclonic epilepsy developed acute pancreatitis after 2-month therapy with valproic acid. The symptoms of pancreatitis subsided within 1 week after the discontinuation of treatment with valproic acid. Acute pancreatitis should be suspected in any pediatric patient with gastrointestinal symptoms during valproate treatment. PMID:24823930

  20. Case Report: Traumatic anterior cerebral artery aneurysm in a 4-year old child

    PubMed Central

    Munakomi, Sunil; Tamrakar, Karuna; Chaudhary, Pramod; Bhattarai, Binod; Cherian, Iype

    2015-01-01

    Traumatic intracranial aneurysm in the proximal part of the anterior cerebral artery in the pediatric population has not been documented so far. Here we report the case of a 4 year-old child who developed a pseudo-aneurysm after minor head trauma and was managed successfully with trapping of the aneurysm. A ventriculo-peritoneal shunt was placed as the child became dependent on extraventricular drain during the post-operative period. The patient made excellent recovery in neurological status within 1 month of post-operative clinical follow up.

  1. 38-year-old woman with recurrent abdominal pain, but no fever

    PubMed Central

    Iwata, Kentaro; Toma, Tomoko; Yachie, Akihiro

    2012-01-01

    A 38-year-old woman presented with 2 days history of left-flank pain. She had similar episodes of abdominal pain as well as chest pain several times, but symptoms disappeared spontaneously. Each time she developed pain, there was no fever. After ruling out common causes of recurrent abdominal pain, familial Mediterranean fever (FMF) was considered as a potential diagnosis. Genetic tests revealed multiple heterozygote mutations, which may be associated with FMF. Patients with Mediterranean fever mutations may present with atypical presentations without fever, like in this case. Astute clinical suspicion is required to make an accurate diagnosis. PMID:22505824

  2. Symptomatic Floor-of-Mouth Swelling with Neck Extension in a 14-Year-Old Girl

    PubMed Central

    Dayton, Kristin; Ryan, Matthew F.

    2014-01-01

    A plunging ranula is a soft-tissue mass stemming from a mucous extravasation cyst of the sublingual gland which can herniate through the mylohyoid muscle. We describe a case in which a 14-year-old girl presented with a rapidly expanding mass on the floor of her mouth affecting her ability to swallow and speak and causing tracheal compression. The patient was initially managed conservatively with antibiotics and steroids; however, the mass continued to expand necessitating emergent bedside incision and drainage and subsequent surgical intervention. The pathophysiology and management options for ranulas are also discussed herein. PMID:25548707

  3. Congenital pulmonic stenosis in a 77-year-old woman successfully treated with percutaneous balloon valvuloplasty

    PubMed Central

    Ayad, Ramy F.; Johnston, Stephen B.; Grayburn, Paul A.; Schmidt, Tyson T.

    2010-01-01

    Congenital pulmonic stenosis (PS) rarely presents in patients over the age of 55 years. A stable asymptomatic course into late adulthood is the usual history of mild to moderate PS. Balloon valvuloplasty has become the procedure of choice for congenital PS, especially in children and young adults. There are rare reports of its use in older adults. Significant valve calcium is believed to limit its success. We present a case of a 77-year-old woman with symptomatic congenital PS and severe valve calcium who underwent successful balloon valvuloplasty. PMID:20157499

  4. A Rare Case of Vesicourachal Diverticulum with Calculus in a 24-Year-Old Man

    PubMed Central

    Atalar, Mehmet Haydar; Salk, Ismail; Cetin, Ali; Bozbiyik, Nisa

    2016-01-01

    Summary Background During embryonal period, complete obliteration of the urachus at the umbilicus and incomplete closure at the bladder level are the cause of vesicourachal diverticulum. This abnormality is a rare finding that is usually discovered incidentally during radiological evaluation. Occasionally, stones have been detected within the diverticulum. Case Report We present a case of a vesicourachal diverticulum with calculus diagnosed by multidetector computed tomography and confirmed surgically and histopathologically in a 24-year-old man. Conclusions During the radiological differential diagnosis of abnormalities of abdominal wall and urinary system, consideration of urachal abnormalities is important especially in symptomatic patients. PMID:27429672

  5. Progressive Dyspnea in a 40-Year-Old Man Caused by Giant Mediastinal Thymolipoma

    PubMed Central

    Rad, Kamelia

    2016-01-01

    Thymolipomas are rare tumors of the anterior mediastinum containing both thymic stroma and an abundance of fat. We present a 40-year-old man with no underlying disease who presented with cough and progressive dyspnea. Clinical evaluation revealed a giant mass of lipid density filling almost the entire left hemithorax with mediastinal shift. Total excision of the 40 × 33 × 8 cm mass weighing 4 kg was performed via a left thoracotomy and the histopathologic diagnosis of the mass was reported as thymolipoma. The patient remains alive and disease-free, twelve months after the intervention. PMID:27293949

  6. [Brain stem infarction, temporal headache, and elevated inflammatory parameters in a 74-year-old man].

    PubMed

    Gehlen, M; Schwarz-Eywill, M; Schäfer, N; Pfeiffer, A; Bösenberg, H; Maier, A; Hinz, C

    2016-06-01

    We report the case of a 74 year old man with a brain stem infarction, temporal headache and elevated inflammatory parameters. Giant cell arteritis with involvement of the temporal and vertebral arteries was proven by histology, duplex sonography and MRI. Although intensive immunosuppressive therapy was started, the patient developed two brain infarcts within 6 months. Initially, C‑reactive protein and erythrocyte sedimentation rate were significantly elevated, but normalized over time. Involvement of the vertebral artery in giant cell arteritis is thought to be rare; steroid refractory courses are very rare. Brain stem infarction might be the consequence. PMID:27055655

  7. [Pseudotumoral-like recurrence of visceral leishmaniasis in a seven-year-old girl].

    PubMed

    Jeziorski, E; Blanchet, C; Ludwig, C; Lalande, M; Coste, V; Dereure, J; Rodière, M

    2009-10-01

    Visceral leishmaniasis is endemic around Mediterranean and is considered by certain authors as an opportunist disease. We report on the case of a 7-year-old girl treated by anti-TNF for an idiopathic juvenile arthritis which has presented a visceral leishmaniasis. Four years later, she presented a pseudotumoral-like recurrence located in a nasal mucous membrane. Leishmania infantum is classically responsible for visceral leishmaniasis but pure mucocutaneous leishmaniasis has been described. It is, for our knowledge, the first observation of a recurrence of visceral leishmaniasis in a mucocutaneous location. Atypical leishmaniasis in the endemic zones can appear in immunodepressed patients and must be evoked when in doubt. PMID:19836676

  8. Extrapyramidal side-effects of low-dose aripiprazole in an 11-year-old child

    PubMed Central

    Mohapatra, Satyakam

    2016-01-01

    Partial agonism of D2 and 5-HT1A receptors accounts for the low incidence of extrapyramidal side-effects of aripiprazole. Extrapyramidal symptoms (EPS) during treatment with therapeutical doses of aripiprazole have been reported in adults and children. To the best of our knowledge, no cases of EPS with low doses (5 mg) have been reported until now. In this article, we present an 11-year-old child who developed EPS on low doses (5 mg) aripiprazole. This case emphasizes the need for careful surveillance for the development of EPS in patients treated even with low doses of aripiprazole. PMID:26933364

  9. Disconnective Hemispherotomy for Medically Intractable Status Epilepticus in an 8-Year-Old Child.

    PubMed

    Bradley, Lucas; Bahgat, Diaa; Sharp, Gregory; Willis, Erin; Ocal, Eylem; Albert, Gregory; Serletis, Demitre

    2015-10-01

    We report here the unusual case of an 8-year-old child with left hemispheric focal epilepsy secondary to a perinatal infarction who presented with new onset absence seizures and eventual nonconvulsive status epilepticus that was refractory to medical management. Following review at our multidisciplinary Epilepsy Surgery conference, the patient underwent disconnective surgical hemispherotomy with immediate cessation of his seizures; and has remained seizure-free at 4 months following surgery. In this context, we present here an overview of hemispherectomy and related procedures, including peri-insular disconnective hemispherotomy, and we discuss the efficacy of surgery for challenging hemispheric epilepsies. PMID:26552284

  10. [Awake Nasotracheal Intubation for a 4-Year-old Boy with an Oral Penetrating Toothbrush Injury].

    PubMed

    Kobayashi, Naoya; Ando, Kokichi; Saito, Kazutomo; Toyama, Hiroaki; Fudeta, Hiroto; Yamauchi, Masanori

    2015-09-01

    We report a case of an oral penetrating injury caused by a toothbrush in a 4-year-old 17-kg boy. The toothbrush was lodged in the right cervical region through the oral cavity, and emergency surgery for removal was planned under general anesthesia. Although mask ventilation was not possible because of the protruding toothbrush handle, awake nasotracheal intubation was successfully performed with a fiber-scope and intravenous fentanyl 25 μg. We conclude that appropriate analgesics could facilitate awake intubation in pediatric patients. PMID:26466500

  11. Appendiceal Hemangioma, Mimicking Acute Appendicitis in a 17-Year-Old Girl

    PubMed Central

    Geramizadeh, Bita; Niakan, Amin; Zolmadjdi, Nadjmeh; Marzban, Mahsa

    2016-01-01

    Epithelial tumors of appendix are not so common, and mesenchymal tumors of the appendix are even less common. Capillary hemangioma of the appendix is an extremely rare event and to the best of our knowledge only 4 cases have been reported in the English literature so far. In this case report we want to explain our experience with an extremely rare occurrence of capillary hemangioma of appendix in a 17-year-old girl presented with right lower quadrant pain that was operated with the clinical impression of acute appendicitis. The patient has been operated as a routine appendectomy with a completely uneventful postoperative period. PMID:27441077

  12. Appendiceal Hemangioma, Mimicking Acute Appendicitis in a 17-Year-Old Girl.

    PubMed

    Geramizadeh, Bita; Niakan, Amin; Zolmadjdi, Nadjmeh; Marzban, Mahsa

    2016-06-28

    Epithelial tumors of appendix are not so common, and mesenchymal tumors of the appendix are even less common. Capillary hemangioma of the appendix is an extremely rare event and to the best of our knowledge only 4 cases have been reported in the English literature so far. In this case report we want to explain our experience with an extremely rare occurrence of capillary hemangioma of appendix in a 17-year-old girl presented with right lower quadrant pain that was operated with the clinical impression of acute appendicitis. The patient has been operated as a routine appendectomy with a completely uneventful postoperative period. PMID:27441077

  13. A rare case of unilateral severe bullous emphysema in a 32-year-old female.

    PubMed

    Lim, Hui Jun; Lim, Chong Hee

    2016-07-01

    Congenital bullous emphysema is defined as large bullae involving at least one-third of a hemithorax. We describe the case of a 32-year-old female who presented with increasing shortness of breath. Radiological investigations revealed severe emphysema with hyperexpansion of the right lung and a mediastinal shift to the left. A lung perfusion scan showed reduced perfusion in the right lung. The patient underwent a right pneumonectomy with a diagnosis of congenital bullous emphysema. She was doing well 6 years later. PMID:27206777

  14. 26-Year-Old Survivor of Kasai Procedure With Native Liver

    PubMed Central

    Siglin, Scott; Laurie, Timothy; Kavin, Hymie

    2016-01-01

    A 26-year old woman with history of congenital biliary atresia and Kasai procedure as a newborn presented with recurrent nausea and abdominal pain. Physical examination showed anicteric sclera and tender right upper quadrant. Elevated liver function tests suggested obstruction and hepatitis. Percutaneous transhepatic cholangiogram showed generalized ductal dilation, innumerable intrahepatic bile duct stones, and multiple filling defects. No anastomotic stenosis was noted. The patient was treated for acute symptoms and referred to a liver transplant center. Long-term survivors of the Kasai procedure with a native liver are rare, and this represents the third known U.S. case in the literature. PMID:27144211

  15. Deep recurrent infection of the hip after tumoral resection in an 18–years old male–a case report

    PubMed Central

    Negrusoiu, M

    2008-01-01

    An 18 years old male was referred to us 4 years after major tumoral surgery. In 2002 he was diagnosed with Ewing sarcoma of the proximal two–thirds of his left femur. Wide resection of the tumor was performed, with a makeshift implant one–stage reconstruction, followed by a combination of chemo and radiotherapy for another 6 months. Eight months after surgery a deep infection of the hip developed, and despite antibiotic treatment and two consecutive debridments and lavage the results were negative. When we first saw the patient in 2006, he still had an active infection in his left hip and a septic general appearance. A two–stage revision was performed and a modular tumoral reconstruction was implanted. At two years follow up the patient presents no signs of recurrence neither of the infection nor of the primary tumor. PMID:20108525

  16. [Fitting a male sheath urinal while respecting the patient's intimacy].

    PubMed

    Derville, Sandrine; Cellard Du Sordet, Paul; Breuzard, Magali; Béguin, Anne-Marie; Malaquin-Pavan, Evelyne

    2015-04-01

    The fitting of a male sheath urinal directly concerns the patient's area of sexual intimacy. The modesty of the patient and caregiver as they interact is tested, leading to discomfort or clumsiness which can provoke a feeling of intrusion. Preparing this care procedure favours the adherence of both parties. PMID:26043631

  17. The steroids of 2000-year-old human coprolites.

    PubMed

    Lin, D S; Connor, W E; Napton, L K; Heizer, R F

    1978-02-01

    Six samples of human coprolites, some more than 2,000 years old, were analyzed for fecal steroid composition. Despite this very lengthy period of storage, the fecal steroids of coprolites were remarkably similar to those of stool samples collected today. The sterol nucleus was clearly rather stable under the dry environmental conditions of the Nevada Caves. The steroid content (microgram/g dried weight) of coprolite was low in comparison to that of modern man. The bile acid/cholesterol and plant sterol/cholesterol ratios of the coprolite, however, were similar to these ratios of the stools of modern man. In the six coprolites, an average 73% of the neutral steroids was digitonin-precipitable. This precipitate was composed of cholesterol and three plant sterols (campesterol, stigmasterol, and beta-sitosterol) and their bacteria-modified products. A portion of the neutral steroids had been converted to products tentatively identified as epimers of these steroids. Individual bile acids were identified in the coprolite. The bile acid composition of the coprolite was similar to that of the stool of modern man. PMID:344825

  18. Slope restoration for a 100-year old canal

    SciTech Connect

    Skaggs, R.L.; Lewis, S.W.; Liebersbach, D.C.

    1995-12-31

    Turlock Irrigation District (TID) is located in the northern portion of the fertile San Joaquin Valley of California. TID`s primary water supply is conveyed from the 100-year-old LaGrange Diversion Dam via their historic Upper Main Canal. The original canal was constructed by excavating into slate bedrock for the uphill (cut) bank, and constructing unmortared rock walls and rock fill for the downhill (fill) embankment; the excavation was then lined with concrete. Soil fill raises of the downhill embankment over the last 30 years have reduced the slope stability to unacceptable levels in the steepest embankment areas. In March of 1994, two surficial slides prompted investigation of the long term embankment stability in the Warehouse Slide Area. Based on results of analysis for various stabilization scenarios, TID chose a stabilization method which included: (1) excavation of an access bench below the existing canal, (2) installation of steel pipe piles through the existing rock fill and into the bedrock, (3) construction of a mechanically stabilized earth (MSE) retaining wall and (4) construction of a soil-cement canal roadway pavement. The design was chosen by the owner because of cost competitiveness compared to other design alternatives and because the construction sequence allowed uninterrupted use of the canal. By using local river cobble for the MSE wall facing material, TID met the desired 50-year design life of the repair while maintaining the area`s historic visual features.

  19. Mitochondrial DNA sequences from a 7000-year old brain.

    PubMed Central

    Pääbo, S; Gifford, J A; Wilson, A C

    1988-01-01

    Pieces of mitochondrial DNA from a 7000-year-old human brain were amplified by the polymerase chain reaction and sequenced. Albumin and high concentrations of polymerase were required to overcome a factor in the brain extract that inhibits amplification. For this and other sources of ancient DNA, we find an extreme inverse dependence of the amplification efficiency on the length of the sequence to be amplified. This property of ancient DNA distinguishes it from modern DNA and thus provides a new criterion of authenticity for use in research on ancient DNA. The brain is from an individual recently excavated from Little Salt Spring in southwestern Florida and the anthropologically informative sequences it yielded are the first obtained from archaeologically retrieved remains. The sequences show that this ancient individual belonged to a mitochondrial lineage that is rare in the Old World and not previously known to exist among Native Americans. Our finding brings to three the number of maternal lineages known to have been involved in the prehistoric colonization of the New World. Images PMID:3186445

  20. Dose estimations for Iranian 11-year-old pediatric phantoms undergoing computed tomography examinations.

    PubMed

    Akhlaghi, Parisa; Miri-Hakimabad, Hashem; Rafat-Motavalli, Laleh

    2015-07-01

    In order to establish an organ and effective dose database for Iranian children undergoing computed tomography (CT) examinations, in the first step, two Iranian 11-year-old phantoms were constructed from image series obtained from CT and magnetic resonance imaging (MRI). Organ and effective doses for these phantoms were calculated for head, chest, abdomen-pelvis and chest-abdomen-pelvis (CAP) scans at tube voltages of 80, 100 and 120 kVp, and then they were compared with those of the University of Florida (UF) 11-year-old male phantom. Depth distributions of the organs and the mass of the surrounding tissues located in the beam path, which shield the internal organs, were determined for all phantoms. From the results, it was determined that the main organs of the UF phantom receive smaller doses than the two Iranian phantoms, except for the urinary bladder of the Iranian girl phantom. In addition, the relationship between the anatomical differences and the size of the dose delivered was also investigated and the discrepancies between the results were examined and justified. PMID:25972393

  1. Prevalence of Oral Habits among Eleven to Thirteen Years Old Children in Jaipur

    PubMed Central

    Sharma, Shantanu; Asopa, Kirti

    2015-01-01

    ABSTRACT Aim: Oral habits that are prevalent well beyond the normal age frequently result in facial deformity and malocclusions. The aim of the present study was to know the prevalence of oral habits in 11 to 13 years old children of Jaipur city. Methodology: The study included 1,000 children of age 11 to 13 years, belonging to different government and private schools of Jaipur city who were screened for any deleterious habits at their school site. The statistical analysis was done using Chi-square test. Results: The result showed that 18% children had a habit of tongue thrusting, 17% mouth breathing and 3% nail biting. Sex-wise prevalence showed 18% females had oral habits and 20% of male had oral habit. Conclusion: The distribution of children aged 11 to 13 years having oral habits was evaluated with tongue thrusting being most prevalent and exhibiting minimal sexual predilection. How to cite this article: Sharma S, Bansal A, Asopa K. Prevalence of Oral Habits among Eleven to Thirteen Years Old Children in Jaipur. Int J Clin Pediatr Dent 2015;8(3):208-210. PMID:26604539

  2. Dose estimations for Iranian 11-year-old pediatric phantoms undergoing computed tomography examinations

    PubMed Central

    Akhlaghi, Parisa; Miri-Hakimabad, Hashem; Rafat-Motavalli, Laleh

    2015-01-01

    In order to establish an organ and effective dose database for Iranian children undergoing computed tomography (CT) examinations, in the first step, two Iranian 11-year-old phantoms were constructed from image series obtained from CT and magnetic resonance imaging (MRI). Organ and effective doses for these phantoms were calculated for head, chest, abdomen–pelvis and chest–abdomen–pelvis (CAP) scans at tube voltages of 80, 100 and 120 kVp, and then they were compared with those of the University of Florida (UF) 11-year-old male phantom. Depth distributions of the organs and the mass of the surrounding tissues located in the beam path, which shield the internal organs, were determined for all phantoms. From the results, it was determined that the main organs of the UF phantom receive smaller doses than the two Iranian phantoms, except for the urinary bladder of the Iranian girl phantom. In addition, the relationship between the anatomical differences and the size of the dose delivered was also investigated and the discrepancies between the results were examined and justified. PMID:25972393

  3. [Genetic variants associated to male infertility in Mexican patients].

    PubMed

    Piña-Aguilar, Raúl Eduardo; Chima-Galán, María del Carmen; Yerena-de-vega, María de la Concepción A; Regalado-Hernández, Miguel Angel; Sánchez-Guerrero, Cecilia; García-Ortiz, Liliana; Santillán-Hernández, Yuritzi; Moreno-García, Jesús Daniel

    2013-05-01

    Recently Mexican Federation of Obstetrics and Gynecology Colleges (Federación Mexicana de Colegios de Obstetricia y Ginecologia, FEMECOG) published the Mexican guideline forthe management of male infertility, which suggests performing genetic laboratory tests as part of diagnosis and management of infertile patients and states that these should receive genetic counseling. This paper reviews the genetic approach proposed by Mexican guideline. A systematic review of medical literature was performed in Pubmed and Web of Knowledge from 1980 to 2012 in order to find reports of genetic variants associated to male infertility in Mexican patients. Also it is discussed the current knowledge of these variants, their clinical implications and finally the guidelines and recommendations for their molecular diagnosis. Most genetic variants in Mexican infertile patients are chromosome abnormalities. In relation to other variants there is only a report of Y chromosome microdeletions, repeated CAG in androgen receptor and more common mutations in CFTR, and other article reporting mutations in CFTR in patients with congenital absence of vas deferens. Little is known about the genetics of Mexican infertile patients apart from chromosome abnormalities. However, the contribution of genetics as etiology of male infertility is taking more relevance and currently the consensual management of infertile male should include the screening of genetic background. This review pretends to be a quick guide for clinicians who want to know about reports of genetic variants related to male infertility in Mexican population and how to approach their diagnosis. PMID:23819425

  4. Serum FSH level below 10 mIU/mL at twelve years old is an index of spontaneous and cyclical menstruation in Turner syndrome.

    PubMed

    Aso, Keiko; Koto, Shinobu; Higuchi, Asako; Ariyasu, Daisuke; Izawa, Masako; Miyamoto Igaki, Junko; Hasegawa, Yukihiro

    2010-01-01

    The gonadal function of patients with Turner syndrome (TS) is variable. Individuals with mosaicism characterized by 45,X/46,XX or 45,X/47,XXX are more likely to experience spontaneous menarche compared with other karyotypes. Prepubertal gonadotropins of TS patients with spontaneous menarche are reportedly normal or significantly lower than those of patients with induced menarche. The present study investigated an index of spontaneous and cyclical menstruation at 10-12 years old in TS. Subjects comprised 50 patients with TS, divided into three groups: Group A (n=7), with spontaneous menarche before 16 years old and regular menstruation for at least 1 year and 6 months; Group B (n=6), with irregular menstruation since menarche leading to secondary amenorrhea despite spontaneous menarche before 16 years old; and Group C (n=37), without spontaneous breast budding before 14 years old or without spontaneous menarche before 16 years old. Karyotype, LH and FSH concentrations at 10 and 12 years old were analyzed retrospectively. Spontaneous and cyclical menstruation was more frequently observed in TS with mosaicism characterized by 45,X/46,XX or 45,X/47,XXX than in TS with other karyotypes, as previously described. Spontaneous and cyclical menstruation in TS was observed when serum FSH level was <10 mIU/mL at 12 years old, suggesting this FSH level as an index of spontaneous and cyclical menstruation in TS. PMID:20798475

  5. [Unexpected cause of acute renal failure in an 85-year-old woman].

    PubMed

    Fabbian, F; Stabellini, N; Catizone, L

    2008-01-01

    Acute postinfectious glomerulonephritis (APIGN) is usually diagnosed in young people, while in elderly people rapidly progressive forms appear to be the most important glomerular disease causing acute renal failure. We report on a 85-year-old woman with acute renal failure due to APIGN. An 85-year-old woman with a history of hypertension and cerebrovascular disease was hospitalized because of diarrhea and syncope associated with atrial fibrillation. She was found to have left lower lobe pneumonia. Serum creatinine was over 2 mg/dL. Fluids were given, without improvement in renal function but leading to volume overload instead. Within a few days serum creatinine reached a level of 5.4 mg/dL with reduction of urine output despite administration of diuretics. The patient developed hematuria and purpura of the feet. Serum IgA was high and the urine sediment showed casts. Methylprednisolone 125 mg i.v. was given for three days followed by prednisone 50 mg daily. The patient's clinical condition gradually improved and serum creatinine decreased to 1.9 mg/dL. Renal biopsy showed APIGN. During hospitalization, three major complications occurred: hemodynamic instability due to atrial fibrillation, Clostridium difficile colitis and urinary tract infections due to Enterococcus faecalis and Candida tropicans, all successfully treated. APIGN should be taken into account as a cause of acute renal failure in hospitalized elderly patients with many comorbidities. PMID:19048577

  6. Intelligence and Visual Motor Integration in 5-Year-Old Children with 22q11-Deletion Syndrome

    ERIC Educational Resources Information Center

    Duijff, Sasja; Klaassen, Petra; Beemer, Frits; Swanenburg de Veye, Henriette; Vorstman, Jacob; Sinnema, Gerben

    2012-01-01

    The purpose of this study was to explore the relationship between intelligence and visual motor integration skills in 5-year-old children with 22q11-deletion syndrome (22q11DS) (N = 65, 43 females, 22 males; mean age 5.6 years (SD 0.2), range 5.23-5.99 years). Sufficient VMI skills seem a prerequisite for IQ testing. Since problems related to…

  7. Molluscum Contagiosum in a 12-Year-Old Child – Report of a Case and Review of Literature

    PubMed Central

    Nandhini, G; Rajkumar, K; Kanth, K Sudheer; Nataraj, Priyadharsini; Ananthakrishnan, Pavithra; Arunachalam, M

    2015-01-01

    Molluscum contagiosum (MC) is an infection of the skin and mucous membrane caused by a DNA virus from the poxvirus family. It usually affects any part of the body and presents as pearly, flesh colored dome shaped nodule with a central umbilication. Clinical diagnosis can be supplemented with histopathology for the confirmed diagnosis of MC. This article presents a case of 12-year-old male child afflicted with MC along with a review of the literature on MC. PMID:25709372

  8. Early onset of colorectal cancer in a 13-year-old girl with Lynch syndrome.

    PubMed

    Ahn, Do Hee; Rho, Jung Hee; Tchah, Hann; Jeon, In-Sang

    2016-01-01

    Lynch syndrome is the most common inherited colon cancer syndrome. Patients with Lynch syndrome develop a range of cancers including colorectal cancer (CRC) and carry a mutation on one of the mismatched repair (MMR) genes. Although CRC usually occurs after the fourth decade in patients with Lynch syndrome harboring a heterozygous MMR gene mutation, it can occur in children with Lynch syndrome who have a compound heterozygous or homozygous MMR gene mutation. We report a case of CRC in a 13-year-old patient with Lynch syndrome and congenital heart disease. This patient had a heterozygous mutation in MLH1 (an MMR gene), but no compound MMR gene defects, and a K-RAS somatic mutation in the cancer cells. PMID:26893603

  9. A 44-year-old woman with metabolic acidosis, high anion gap, and delayed neurologic deterioration.

    PubMed

    Vakil, Abhay; Upadhyay, Hinesh; Sherani, Khalid; Cervellione, Kelly; Trepeta, Scott; Patel, Mahendra C

    2015-01-01

    A 44-year-old woman was brought to the ED from John F. Kennedy International Airport. The patient was returning with her son from a 3-month visit to Bangladesh. Her journey started with a 4-h flight from Dhaka, Bangladesh to Dubai, United Arab Emirates. She consumed 240 mL of whiskey during the flight. This was followed by a 14-h flight from Dubai to New York. According to the patient's son, she did not consume any alcohol during the second flight. The patient was in her usual state of health with normal mentation throughout her journey. Upon landing, she started complaining of shortness of breath. After disembarking, she was witnessed to have seizure-like activity with involuntary passage of urine, following which she collapsed. The patient was intubated by emergency medical services in the field. PMID:25560868

  10. Early onset of colorectal cancer in a 13-year-old girl with Lynch syndrome

    PubMed Central

    Ahn, Do Hee; Rho, Jung Hee; Tchah, Hann

    2016-01-01

    Lynch syndrome is the most common inherited colon cancer syndrome. Patients with Lynch syndrome develop a range of cancers including colorectal cancer (CRC) and carry a mutation on one of the mismatched repair (MMR) genes. Although CRC usually occurs after the fourth decade in patients with Lynch syndrome harboring a heterozygous MMR gene mutation, it can occur in children with Lynch syndrome who have a compound heterozygous or homozygous MMR gene mutation. We report a case of CRC in a 13-year-old patient with Lynch syndrome and congenital heart disease. This patient had a heterozygous mutation in MLH1 (an MMR gene), but no compound MMR gene defects, and a K-RAS somatic mutation in the cancer cells. PMID:26893603

  11. School and the 17-Year-Old: A Comparison of Career Development Skills of 17-Year-Olds Attending School and Those Not Attending.

    ERIC Educational Resources Information Center

    Education Commission of the States, Denver, CO.

    National performance for 17-year-olds in school, 17-year-olds not in school and young adults aged 26-35 in the area of career and occupational development (COD) was assessed to determine whether or not education status and career development skills are related. Within each of the groups, performance of various subgroups was examined, defined by…

  12. Patterns of Weight Control Behavior among 15 year old Girls

    PubMed Central

    Balantekin, Katherine N.; Birch, Leann L.; Savage, Jennifer S.

    2015-01-01

    Objective The objectives were to identify and predict patterns of weight control behavior in 15 year old (yo) girls and to examine weight control group differences in energy intake. Method Subjects included 166 girls assessed every 2 years (ys) from age 5 to 15. Latent class analysis was used to identify patterns of weight control behaviors. Antecedent variables (e.g. inhibitory control at 7ys), and concurrent variables (e.g. BMI and dietary intake at 15ys) were included as predictors. Assessments were a combination of survey, interview, and laboratory measures. Results LCA identified four classes of weight control behaviors, Non-dieters (26%), and three dieting groups: Lifestyle (16%), Dieters (43%), and Extreme Dieters (17%). Levels of restraint, weight concerns, and dieting frequency increased across groups, from Non-dieters to Extreme Dieters. BMI at 5ys and inhibitory control at 7ys predicted weight control group at 15ys; e.g. with every one-point decrease in inhibitory control, girls were twice as likely to be Extreme Dieters than Non-dieters. Girls in the Extreme Dieters group were mostly classified as under-reporters, and had the lowest self-reported intake, but ate significantly more in the laboratory. Discussion Among 15yo girls, “dieting” includes a range of both healthy and unhealthy behaviors. Risk factors for membership in a weight control groups are present as early as 5ys. Patterns of intake in the laboratory support the view that lower reported energy intake by Extreme Dieters is likely due under-reporting as an intent to decrease intake, not actual decreased intake. PMID:26284953

  13. [The 20 to 29 year old population: sociodemographic profile].

    PubMed

    Gonzalez, A

    1990-01-01

    The age group born in 1960-69 and currently 20 to 29 years old is of great interest in Mexico because it has been most affected by changes in fertility, education, and employment. The cohort was born at the period of highest fertility in Mexico¿s history. While families of their parents¿ generation averaged 5 or 6 children, evidence suggests that the 1960-69 cohort will average just 3. Men born in 1960-69 had on average 6.8 years of schooling and women 5.9, compared to 5 years for the population over age 15 as a whole. 88% of the men, 40% of the women, and 64% overall are economically active. The cohort arrived at working age in the midst of an economic crisis marked by declining purchasing power, loss of jobs in noncompetitive industries, and reduced government employment. A high proportion of the cohort had low incomes, with 36% earning less than the minimum salary. Among women, 45% aged 20-24 and 19% aged 25-29 were single, compared to 62% and 46% of men in the same age groups. 10% of the women and 9% of the men in union lived with the partner¿s family. The population aged 20-29 numbered slightly under 16.9 million in 1990 and constituted 18.4% of the total population. The group will increase by nearly 2.9 million between 1990-95, and can be expected to exert considerable pressure on demand for employment and housing. PMID:12158101

  14. Clinical manifestations of neuromyelitis optica in male and female patients.

    PubMed

    Yin, Jianrui; Long, Youming; Shan, Fulan; Fan, Yongxiang; Wu, Linzhan; Zhong, Rong; Gao, Cong; Chen, Xiaohui; Gao, Qingchun; Yang, Ning

    2015-11-01

    Neuromyelitis optica (NMO) is a severe, idiopathic, immuno-mediated, inflammatory demyelinating disease of the central nervous system. We examined the clinical features between male and female NMO patients, for which not much data exist. One hundred and eight Chinese Han patients with NMO were analysed retrospectively, all had been detected for the aquaporin-4 (AQP4) antibody using a cell-based assay. Of 108 NMO patients, 92 were female and 16 were male (female/male = 5.75). Ninety-four (87%) were positive for the AQP4 antibody in their serum and/or cerebral spinal fluid. Aquaporin-4 antibody-positive NMO patients had a higher female/male ratio than the negative group (P = 0.001). Female NMO patients had a higher positive rate of the AQP4 antibody than male NMO patients (92.4 vs 56.3%, P = 0.001). All NMO male patients were divided according to their AQP4 antibody status. 77.8% (7/9) of patients in the seropositive group had initial optic neuritis, while only one patient (14.3%, 1/7) in the negative group had optic neuritis (P = 0.041). Limb paraesthesia was reported in only one patient in the negative group (11.1%), but it was reported in all patients in the positive group (100%) (P = 0.001). The mean length of vertebral segments of the spinal cord lesions was 3.6 ± 1.3 in the positive group, while it was 6.6 ± 2.6 in the negative group (P < 0.0001). The involvement of the cervical spinal cord was found in 88.9% (8/9) of the positive members, but only 11.1% in the negative group (P = 0.009). However, the involvement of the thoracic spinal cord was found in 22.2% of patients in the positive group and 85.7% of patients in the negative members (P = 0.041). In conclusion, male NMO is rare and has a low positive rate of AQP4 antibody. PMID:26213113

  15. An unusual cause of pancreatitis in a 46-year-old returning traveller.

    PubMed

    Pimenta, Dominic; Dawood, Naghum

    2015-01-01

    A 46-year-old previously fit and well man, travelled to Jhelum, Pakistan for 6 weeks in early 2015. Four weeks after returning to the UK, he developed sudden onset epigastric pain, vomiting and fever. C reactive protein was 232 mg/L and amylase was 2061 U/L. He was treated conservatively as pancreatitis, with peripancreatic streaking and left colic gutter fluid on a CT abdominal scan. He was discharged and later attended the Hospital for Tropical Diseases, after coughing up an 8 cm male ascaris worm. He was treated for acute ascariasis infection, complicated by resolved mild-moderate pancreatitis, a common complication in the developing world but rarely seen among travellers. PMID:26240102

  16. A 76-year old man with a torn Freedom SOLO bioprosthesis

    PubMed Central

    Wollersheim, Laurens W.; Li, Wilson W.; van der Meulen, Jan; de Mol, Bas A.

    2014-01-01

    We describe a case of a 76-year old male who presented with progressive dyspnoea. He underwent an aortic valve replacement with a Freedom SOLO bioprosthesis 6 years ago. Transthoracic echocardiography showed a moderate-to-severe leakage of the Freedom SOLO bioprosthesis. During surgical reintervention, a partial tear of the left coronary cusp was seen from the commissure of the right coronary cusp to its base. After radiographic and microscopic examination, no clear cause was found for the failure of this Freedom SOLO bioprosthesis. To our knowledge, this is the third failure of a Freedom SOLO bioprosthesis reported in the literature. When the long-term follow-up of the Freedom SOLO bioprosthesis is available, it has to be compared with other bioprosthesis for long-term durability. PMID:24144803

  17. Multiple fractures in a 22-year-old man after a simple fall

    PubMed Central

    Alattas, Mohammed H.; Dimentberg, Ronald

    2015-01-01

    We present the case of a 22-year-old male with longstanding progressive fatigue, weakness and pain around his hips due to an undiagnosed parathyroid adenoma. The resultant primary hyperparathyroidism ultimately caused pathologic fractures. He was admitted to the hospital for further assessment and excision of the parathyroid adenoma. A few days after admission, he fell down while walking and was referred to our team. X-rays showed a displaced left femoral neck fracture (FNF) and right humeral shaft fracture with poor bone quality. His humeral fracture was treated conservatively, and the FNF was treated with total hip replacement. Three days later, he underwent parathyroidectomy. This case demonstrates the importance of a thorough investigation of progressive weakness even in a young individual and illustrates the importance of early diagnosis of parathyroid adenoma to avoid the devastating end results of this condition. PMID:26429553

  18. Laparoscopic Management of Small Bowel Intussusception in a 16-Year-Old With Peutz-Jeghers Syndrome

    PubMed Central

    Clapp, Benjamin

    2008-01-01

    Introduction: Peutz-Jeghers is a rare autosomal dominant disorder characterized by hamartomatous polyps and discoloration of mucosal membranes. The polyps can occur anywhere in the gastrointestinal tract and can grow large enough to cause bowel obstructions. Case Report: A 16-year-old male presented to the emergency department with signs and symptoms of an acute bowel obstruction. He had 2 days of abdominal pain, obstipation, and vomiting. He had a previous history of a colonoscopy with polypectomy at age 4, and hyperpigmentation of his mucous membranes. Results: Computed tomographic (CT) scan revealed an intussusception of the small intestine. An exploratory laparoscopy found an intussusception of the mid jejunum. A laparoscopic-assisted small bowel resection was performed. Pathology showed a 5-cm polyp that acted as a lead point for the intussusception. Colonoscopy and upper endoscopy revealed 5 more polyps in the stomach and colon that were removed. Conclusion: Small bowel obstructions can be managed successfully with minimally invasive approaches. The treatment of obstruction in these patients is to remove the offending hamartomatous polyp(s). The rest of the intestine needs to be examined and those polyps found should be removed. This can be done intraoperatively with laparoscopic-assisted enteroscopy and colonoscopy. PMID:18765065

  19. Video games use patterns and parenteral supervision in a clinical sample of Hispanic adolescents 13-17 years old.

    PubMed

    Colón-de Martí, Luz N; Rodríguez-Figueroa, Linnette; Nazario, Lelis L; Gutiérrez, Roberto; González, Alexis

    2012-01-01

    Video games have become a popular entertainment among adolescents. Although some video games are educational, there are others with high content of violence and the potential for other harmful effects. Lack of appropriate supervision of video games use during adolescence, a crucial stage of development, may lead to serious behavioral consequences in some adolescents. There is also concern about time spent playing video games and the subsequent neglect of more developmentally appropriate activities, such as completing academic tasks. Self-administered questionnaires were used to assess video game use patterns and parental supervision among 55 adolescent patients 13-17 years old (mean age 14.4 years; 56.4% males) and their parents. Parental supervision /monitoring of the adolescents video games use was not consistent and gender related differences were found regarding their video game use. Close to one third (32%) of the participants reported video game playing had interfered with their academic performance. Parents who understood video games rating system were more likely to prohibit their use due to rating. These findings underscore the need for clear and consistently enforced rules and monitoring of video games use by adolescents. Parents need to be educated about the relevance of their supervision, video games content and rating system; so they will decrease time playing and exposure to potentially harmful video games. It also supports the relevance of addressing supervision, gender-based parental supervisory styles, and patterns of video games use in the evaluation and treatment of adolescents. PMID:22788074

  20. Enterococcal Cerebellopontine Angle Abscess in a 12-year-old Female.

    PubMed

    Sonavane, Alka; Baradkar, Vasant; Kumar, Simit

    2010-01-01

    Despite advances in imaging and antibiotic treatment, brain abscess is still encountered occasionally. Various aerobic and anaerobic bacteria have been reported as causative agents of brain abscess but only a few cases of enterococcal brain abscesses have been reported. Here we report a case of brain abscess in a 12-year-old female patient, who presented with a history of fever, chills, headache, convulsions since seven days and history of altered sensorium and aphasia since the last two days. The patient had chronic suppurative otitis media of both ears following trauma and presented with ear discharge. The diagnosis of brain abscess was done by computerized tomography scan and the pus was aspirated by left suboccipital burr hole operation. Enterococcus species was cultured from the aspirated pus sample. The patient responded to surgical drainage and antibiotic treatment. PMID:20300422