These are representative sample records from Science.gov related to your search topic.
For comprehensive and current results, perform a real-time search at Science.gov.
1

Simultaneous double coronary thrombosis in a 47-year-old male patient with acute myocardial infarction  

PubMed Central

Patient: Male, 47 Final Diagnosis: Acute myocardial infarction Symptoms: Chest pain Medication: — Clinical Procedure: — Specialty: Cardiology Objective: Unusual clinical course Background: Double myocardial infarction involving two culprit major vessels is a rarely reported presentation with high incidence of mortality. Case Report: In this study, we report 47-year-old male patient who had an attack of chest pain associated with ST-segment elevation in the antero-lateral leads. Pharmaco-invasive reperfusion approach was adopted with full dose tissue plasminogen activator, followed by transferring the patient to a specialized heart center for Percutaneous Coronary Intervention (PCI). Coronary angiography showed a fresh thrombus totally occluding Left Anterior Descending (LAD) and another thrombus causing distal total occlusion of a dominant Right Coronary Artery (RCA). Two Bare metal stents were placed in both lesions with Thrombolysis in Myocardial Infarction (TIMI) 3 flow post dilatation, but the patient, unfortunately, went into Ventricular Fibrillation (VF) followed by asystole and died 35 minutes later. Conclusions: Acute double vessel coronary artery thrombosis is a serious event that requires prompt diagnosis and management to prevent its complications. PMID:24175009

Ahmed, Mahmoud; Abdul, Arabi

2013-01-01

2

Concomitant aortic leiomyosarcoma and takayasu arteritis in a 55-year-old male patient.  

PubMed

Takayasu arteritis is a form of large vessel granulomatous vasculitis affecting often young or middle-aged women, especially of Asian descent. It mainly affects the aorta and its branches. Primary malignancies, such as leiomyosarcoma of the aorta are extremely rare. This report discusses the exceptional and concomitant association of Takayasu arteritis and aortic leiomyosarcoma in a 55-year-old male. The patient suffered from systemic signs and symptoms related to arteritis together with claudication of left upper limb due to left artery subclavian stenosis. After instrumental evaluation, an infiltrating neoplasm at the level of abdominal aortic wall was detected and the patient underwent en bloc excision of the mass together with abdominal aorta and subsequent aortoaortic by pass reconstruction. Histologic findings showed an arterial leiomyosarcoma combined with elements of arterial inflammation. Patients completed therapeutic scheme with chemotherapy (doxorubicin and isosfamide) and radiotherapy for the cancer condition, as well as medical treatment (prednisone and adalimumab) for Takayasu arteritis. After 12 months, the patient showed no cancer recurrence and complete normalization of inflammatory indexes and symptoms of Takayasu arteritis. PMID:25017783

De Caridi, Giovanni; Butrico, Lucia; Grande, Raffaele; Massara, Mafalda; Spinelli, Francesco; de Franciscis, Stefano; Serra, Raffaele

2014-11-01

3

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

PubMed Central

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

Hudes, Karen

2008-01-01

4

Composite lymphoma of mycosis fungoides and cutaneous small B-cell lymphoma in a 73-year-old male patient.  

PubMed

Composite lymphoma of T-cell and B-cell type is uncommon, and the one occurring primarily on skin is extremely rare. Herein, we report a unique case of composite lymphoma of mycosis fungoides and cutaneous small B-cell lymphoma in a 73-year-old male patient. The patient presented with multiple erythematous patches, plaques, and nodules on the upper arms, scalp, and trunk. Four punch biopsies of arm and scalp lesions demonstrated lymphoid infiltrate in superficial to deep dermis with a characteristic zone distribution of T-cell and B-cell components. T cells were distributed in papillary and perifollicular dermis and displayed a larger size with convoluted nuclei, whereas B cells were small sized, assuming nodular infiltrate in mid-deep dermis with coexpression of CD5. Molecular test detected clonal rearrangement of both TCRG and IGH/K genes with identical amplicons for each gene in all 4 biopsies. Clinical staging revealed no extracutaneous lesions. A multidisplinary approach is emphasized to establish a definitive diagnosis. PMID:23313307

Whitling, Nicholas A; Shanesmith, Rebecca P; Jacob, Leah; McBurney, Elizabeth; Sebastian, Siby; Wang, Endi; Wang, Alun R

2013-04-01

5

Atypical cause of stroke in a 27 year old male  

PubMed Central

Summary Background: Central nervous system (CNS) Tuberculosis (TB) meningitis is a progressive disease that can present in many forms. CNS TB is encountered frequently in areas of high prevalence of tuberculosis and dissemination is common, but TB meningitis is a disease that has a relatively low prevalence in North America. Case Report: 27 year-old African American male presented with complaints of headache, altered mental status (AMS), and seizure activity. He was found to have fever, encephalopathy, and leukocytosis. Work up of his AMS revealed cerebral spinal fluid (CSF) consistent with acute lymphocytic meningitis and magnetic resonance imaging (MRI) revealed right basilar meningeal enhancement with acute right basal ganglia infarction. Given the characteristic CSF and MRI finding for Tuberculosis (TB) a computed tomography (CT) of the chest was performed which revealed right upper lobe nodules with central cavitations. Biopsy results revealed Tuberculosis. The patient showed significant improvement once empiric tuberculosis therapy was begun. Conclusions: CNS TB is a treatable disease that will be fatal if not recognized early. It is imperative to be aware of the key clinical features of TB meningitis, and maintain a high level of suspicion when dealing with CNS infection if the cause is unknown. PMID:23569494

Youngblood, Laura B.; Dooley, Jennifer Whitley

2012-01-01

6

Fifteen-year-old patient with osteopoikilosis  

Microsoft Academic Search

After accidental sport traumatisms, radiological exploration of the injured zone can show infrequent accidental findings.\\u000a We present the case of a 15-year-old girl, with no significant medical history, who on investigating a wrist traumatism revealed\\u000a multiple sclerotic areas in the carpal bones in X-rays with no associated symptoms. This is a rare case of osteopoikilosis.

Fernando Polo Simón; Samuel Pajares Cabanillas; Raúl Parrón Cambero; Carmen Martínez González

2009-01-01

7

[25-year old patient with angina pectoris during religious fasting].  

PubMed

History and presentation at admission | A 25-year-old male patient presented with acute left sided chest pain. The patient reported no physical exercise but daytime fasting (with neither food nor liquid intake) which he had started several days before. Investigations | ECG, echocardiography and chest X-ray were normal, but blood examination revealed elevated levels for creatine kinase (CK) and lactate dehydrogenase (LDH). Ischemic lactate ammonia test revealed no increase of lactate during exercise. Muscle biopsy confirmed suspected diagnosis of glycogen storage disease type V (McArdle's disease) Treatment and course | As causal treatments are unavailable for McArdle's disease, careful counselling regarding adequate exercise and regular, carbohydrate rich nutrition are mandatory to ameliorate symptoms. Conclusion | McArdle's disease represents a rare differential diagnosis of cardiac chest pain and somatoform myalgic complaints. When taking the patient's history, questions regarding the "Second wind"-phenomenon are helpful for initiating the adequate investigations early on. PMID:25658411

Huber, Carlo A; Wunderlich, Gilbert; Brunn, Anna; Blau, Tobias; Fink, Gereon R; Lehmann, Helmar C

2015-02-01

8

Cardiac Operations in Patients 80 Years Old and Older  

Microsoft Academic Search

Background. Because the elderly are increasingly referred for operation, we reviewed results with cardiac surgical patients 80 years old or older.Methods. Records of 600 consecutive patients 80 years old or older having cardiac operations between 1985 and 1995 were reviewed. Follow-up was 99% complete.Results. Two hundred ninety-two patients had coronary grafting (CABG), 105 aortic valve replacement (AVR), 111 AVR +

Cary W Akins; Willard M Daggett; Gus J Vlahakes; Alan D Hilgenberg; David F Torchiana; Joren C Madsen; Mortimer J Buckley

1997-01-01

9

Pathology Case Study: Hematuria and Azotemia in a 60-Year-Old Male with Aortic Aneurysms  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 60-year-old male has an abdominal aortic aneurysm & liver and kidney masses. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in transplant pathology.

Richert, Charles A.

10

Hemophagocytic lymphohistiocytosis in a 19 year old critically ill patient.  

PubMed

Haemophagocytic lymphohistiocytosis (HLH) describes a clinical syndrome of hyperinflammation resulting in an uncontrolled and ineffective immune response. It presents with a clinical picture of likely sepsis, i.e., fever, laboratory evidence of inflammatory response, coagulopathy and thrombocytopaenia should be appropriately investigated and managed for sepsis, but the possible diagnosis of HLH should be borne in mind. Awareness of the clinical symptoms and of diagnostic criteria for HLH is crucial to starting immunosuppressive/immunomodulatory and cytotoxic drugs in time. We present a case of HLH in a 19 year old male who presented with fever, neurological symptoms, cytopaenias, laboratory markers of inflammation and bone marrow aspirate showed hemophagocytosis. PMID:23730021

Desai Nayan; Bhagyalakshmi, S; Karnik Nitin; Jijina Farah; Chandrakala, S

2012-06-01

11

Sudden cardiac death, aborted, in healthy 34-year-old male.  

PubMed

A 34-year-old male, non-hypertensive, non-diabetic, had a sudden onset of cardiac arrest, he was revived and then referred to a cardiologist at an advanced center for further care. His 2D echo revealed hypertrophic obstructive cardiomyopathy, all the other investigations were normal. His father was also found to have a similar condition however the father was asymptomatic. The patient underwent an automated implantable cardioverter-defibrillator implantation and was advised the necessary precautions and care. PMID:25374874

Shah, Hitesh

2014-07-01

12

[Fanconi syndrome in a 22-year-old African patient].  

PubMed

Acquired Fanconi syndrome can occur in patients with monoclonal gammopathy or after exposure to heavy metals or drug agents such as ifosfamide, and some antiretroviral therapies. Fanconi syndrome is characterized by a dysfunctional of the proximal tubular responsible in its complete form for polyuria, hypokalemia, glycosuria, hypophosphatemia and low molecular weight proteinuria. We report the case of a 22-year-old patient hospitalized with an acute renal failure secondary to a tubulo-interstitial nephritis associated with a complete Fanconi syndrome in a context of a poor general condition and fever. We described and analyzed the process leading to the diagnosis. PMID:25439108

Wetzstein, Morgane; Jauréguy, Maïté; Lanoix, Jean-Philippe; Poulain, Coralie; Berrou, Claire; Renou, Marianne; Cordonnier, Carole; Choukroun, Gabriel

2014-11-01

13

Pathology Case Study: 15 Year Old Male With a Left Testicular Mass  

NSDL National Science Digital Library

This genitourinary pathology case study, provided by the University of Pittsburgh Department of Pathology, is an excellent resource for students and instructors in the health science fields. A 15-year-old male with a left testicular mass is the focus of this case. The patientâÂÂs history, gross description, and microscopic description of test results are provided to aid readers in understanding the patientâÂÂs diagnosis. The official final diagnosis is accompanied by a discussion of the contributing doctorâÂÂs findings and a list of references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose patientâÂÂs conditions.

Bastacky, Sheldon; Ionescu, Diana; Molina, J. T.

2009-02-11

14

Multiple aseptic splenic abscesses in a 15 year old patient  

PubMed Central

Background Splenic abscesses in children are rare. In recent years aseptic abscesses have been recognized as a new disease entity, especially in adults. Case presentation We present a rare case of a 15 year old girl with aseptic abscesses, in whom antibiotic therapy comprising metronidazole and meropenem was partly beneficial in improving the patient’s clinical condition and inflammatory parameters. Eventually corticosteroid therapy led to complete and long lasting resolution of symptoms. Further diagnostic work-up revealed autoimmune thyroiditis, but no signs of inflammatory bowel disease. Conclusion Aseptic splenic abscesses should always prompt clinicians to initiate further diagnostics to determine a potential underlying condition and a regular follow-up. Anaerobic bacteria may play a role in the pathogenesis of the disease and besides corticosteroid treatment antibiotics covering anaerobes may be beneficial. PMID:24502393

2014-01-01

15

Diabetic muscle infarction in a 57 year old male: a case report  

PubMed Central

Background Diabetic muscle infarction is a rare complication of diabetes mellitus (DM) and is often misdiagnosed as cellulitis. This complication is usually associated with poor disease prognosis and high mortality with previous studies reporting a risk of 50% recurrence or another macrovascular complication occurring within one year. Thus, there needs to be greater awareness of this complication of diabetes. Case presentation In the current work, we present a case report and literature review of DMI occurring in a calf of a 57 year old male. However, unlike the suspected trend, our patient has performed well after this incident and has not sustained another macrovascular event now > 15 month since his original diabetic muscle infarction. Conclusion Even though diabetic muscle infarction is an uncommon condition, it is important to consider this diagnosis in a diabetic patient. We hope that our findings and literature review will aid clinicians to better diagnose and manage this condition. PMID:23270501

2012-01-01

16

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

PubMed Central

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

Sacheli, Aaron; Bauer, Raymond

2014-01-01

17

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

PubMed Central

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

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

2011-01-01

18

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

PubMed Central

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

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

2014-01-01

19

Extranodal Rosai-Dorfman disease involving the right atrium in a 60-year-old male  

PubMed Central

Rosai-Dorfman disease (RDD) involving the cardiovascular system is extremely rare; to our knowledge, there are only 9 cases in the literature. Here, a case of a 60-year-old male with RDD involving the right atrium is presented. A comprehensive literature review was undertaken to summarize the clinical and pathologic features of this disorder. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2143194139120169. PMID:24916611

2014-01-01

20

Pathology Case Study: Osteolytic Lesion of the Tibia in a 12-Year-Old Male  

NSDL National Science Digital Library

In this case study from the Department of Pathology at the University of Pittsburgh School of Medicine, a 12-year-old male is presented with "an osteolytic lesion of the proximal left tibia." Gross and microscopic images of the bone are provided, and the diagnosis is relayed in the "Final Diagnosis" section. A discussion of the diagnosis, including the pathogenesis and morphology of the disease, is included in the final section.

Nine, Jeff S.

2007-07-25

21

A case report of a 14 year old male with pseudohypoparathyroidism associated with multiple hormonal resistance.  

PubMed

Albright hereditary osteodystrophy (AHO) is a rare hereditary metabolic disorder that may or may not be associated with resistance to parathyroid hormone (pseudohypoparathyroidism) or other hormones. The disorder is commonly characterized by a constellation of dysmorphic physical features and with biochemical levels that demonstrate hypocalcaemia and hyperphosphatemia. We report here a clinical case of a 14 year old male with AHO and we discuss his clinical features, radiographic and laboratory findings along with treatment. PMID:25646052

Mannava, Prasanthi; Masood, Afshan; Devi, Ambika K

2015-01-01

22

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

PubMed Central

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

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

2014-01-01

23

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

PubMed Central

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

Menta, Roger; Howitt, Scott

2014-01-01

24

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

PubMed

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

Menta, Roger; Howitt, Scott

2014-12-01

25

Reference values of thirty-one frequently used laboratory markers for 75-year-old males and females  

PubMed Central

Background We have previously reported reference values for common clinical chemistry tests in healthy 70-year-old males and females. We have now repeated this study 5 years later to establish reference values also at the age of 75. It is important to have adequate reference values for elderly patients as biological markers may change over time, and adequate reference values are essential for correct clinical decisions. Methods We have investigated 31 frequently used laboratory markers in 75-year-old males (n = 354) and females (n = 373) without diabetes. The 2.5 and 97.5 percentiles for these markers were calculated according to the recommendations of the International Federation of Clinical Chemistry. Results Reference values are reported for 75-year-old males and females for 31 frequently used laboratory markers. Conclusion There were minor differences between reference intervals calculated with and without individuals with cardiovascular diseases. Several of the reference intervals differed from Scandinavian reference intervals based on younger individuals (Nordic Reference Interval Project). PMID:22300333

Ryden, Ingvar; Lind, Lars

2012-01-01

26

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

PubMed Central

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

Yedon, Dominique Forand; Howitt, Scott

2011-01-01

27

Pathology Case Study:A 52-Year-Old Male with "Cholelithiasis"  

NSDL National Science Digital Library

This is a gastrointestinal pathology case study presented by the University of Pittsburgh Department of Pathology in which a 52-year-old female has âÂÂcholelithiasis,â intermittant jaundice, recent pancreatitis and gallbladder polyps. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in gastrointestinal pathology.

Schubert, Eric

2007-12-26

28

Pathology Case Study: Maxillary Cyst in a 36-Year-Old Male  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 36-year-old man has a maxillary cyst. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in head and neck pathology.

Schubert, Eric

2007-08-07

29

Pathology Case Study: Gastric Mass in a 70-Year-Old Male with Weight Loss  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 70-year-old man has a stomach ache, decreased appetite, and weight loss. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in gastrointestinal pathology

Richert, Charles A.; Schubert, Eric

2007-08-03

30

Dissociative fugue symptoms in a 28-year-old male Nigerian medical student: a case report  

PubMed Central

Introduction Dissociative fugue is a psychiatric disorder characterized by amnesia coupled with sudden unexpected travel away from the individual’s usual surroundings and denial of all memory of his or her whereabouts during the period of wandering. Dissociative fugue is a rare disorder that is infrequently reported. Before now, no case of it had been reported in a medical student. Case presentation This article focuses on the report of a case of dissociative fugue symptoms in a 28-year-old male Nigerian medical student. Conclusion The observation in this case report brings to the fore that dissociative fugue is often related to stressful life events and can comorbid with a depressive disorder. PMID:23724873

2013-01-01

31

Progressive osseous heteroplasia in a 10-year-old male child  

PubMed Central

We report a sporadic case of progressive osseous heteroplasia (POH) in a 10-year-old male child who developed progressive ossification of the skin and deep connective tissue. The condition needs to be distinguished from other causes of childhood heterotopic ossification, such as fibrodysplasia ossificans progressiva, pseudohypoparathyroidism, and pseudopseudohypoparathyroidism. The cause of POH is an inactivating GNAS1 (guanine nucleotide-binding protein alpha-stimulating activity polypeptide 1) mutation caused only by paternal inheritance of the mutant allele. Most cases are sporadic and only 2 instances of familial transmission have been documented, suggesting an autosomal dominant mode of inheritance with possible somatic mosaicism. The condition is associated with progressive superficial to deep ossification, progressive restriction of range of motion, bleak prognosis, and recurrence if excised. PMID:21559111

Singh, Girish K; Verma, Vikas

2011-01-01

32

Pathology Case Study: 21 Year Old Male With Back Pain and Wobbly Gait  

NSDL National Science Digital Library

This neuropathology case study, provided by the University of Pittsburgh Department of Pathology, is an excellent learning tool for students and instructors in the health science fields. In this case, a 21-year-old man presents with a three-week history of thoracic myelopathy, decreased sensation, and a wobbly gait. Visitors are shown MRI images of the patientâÂÂs spine, along with microscopic images and a gross description of the condition. The official diagnosis found in the âÂÂFinal Diagnosisâ section is accompanied by a discussion of the contributing doctorâÂÂs findings and a list of references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose patientâÂÂs conditions

Krisky, David; Molina, J. T.; Wiley, Clayton

2009-02-16

33

Hospice care for 86 year old male with recurrent breast cancer: a case report  

PubMed Central

Terminal illness poses a tremendous challenge to patients, their families and their health care providers. It is often difficult to determine when hospice is appropriate. Timely referrals are beneficial to both patient and caregivers as a way to offer improved care and support at end of life; when multiple, complicated, co-morbid states affect care. This is especially true when a patient’s psychosocial background would otherwise make it difficult to ensure proper comfort and quality of life. In this report, we present an 86 year old man with a history of right-sided breast cancer, bipolar disorder and dementia. Patient is 20 years status-post a total mastectomy. He declined adjuvant radiation, chemotherapy, and hormone therapy, and did not pursue any further medical follow-up. Patient now presented with a rapidly enlarging, ulcerating right anterior chest wall tumor. Surgical biopsy revealed recurrent infiltrating ductal carcinoma of the breast. Patient was started on tamoxifen and palliative radiation. An oncology evaluation determined that he is not a candidate for curative treatment. Patient’s primary caregiver (wife) concurrently suffers from dementia, one son is Bipolar, and the second son is out of state. A full geriatric assessment concluded that based on the patient’s medical and socioeconomic history, he is an ideal candidate for hospice. With the family’s consent, he was enrolled in one of our local hospice organizations. Currently, he is in a skilled nursing facility with hospice. PMID:19830073

Marcelo, Claudia Dolores; Stringer, Matthew

2009-01-01

34

Chiropractic Management and Rehabilitation of a 38-Year-Old Male with an L5-S1 Disc Herniation  

PubMed Central

Abstract Objective To present a chiropractic treatment plan for a patient with lumbar disc herniation including radicular symptoms below the knee. Clinical Features A 38-year-old male experienced lumbar disc herniation with radicular symptoms to the lower extremities, below the knee. Etiology of this episode included a traumatic injury which was complicated by chronic degenerative joint and disc changes. Intervention and Outcome The treatment regime included chiropractic spinal manipulation, modalities and exercise rehabilitation. Specific rehabilitation exercises were used during various stages of healing in an attempt to stabilize a potential surgical case. Goals of care were to alleviate pain, increase function, and decrease peripheralization related to disc herniation in this case. The patient reached a level of functional biomechanical stability over 15 weeks. Conclusion This case demonstrates that with proper management, rehabilitation of a patient with disc herniation can be reached in a short duration of time. PMID:19674637

Hammer, Christopher J.

2004-01-01

35

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

PubMed

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

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

2008-01-01

36

Symptomatic Solitary Osteochondroma of the Subaxial Cervical Spine in a 52-Year-Old Patient  

PubMed Central

Osteochondromas are the most common benign tumors of the bone. They mostly arise from the appendicular skeleton and present clinically in the second or third decade of life. Ostechondromas arising from the subaxial cervical spine and presenting after the 5th decade of life are extremely rare. We report a 52-year-old male patient who presented with numbness and subjective weakness of left upper and lower limbs and neck pain, and had lobulated bony hard fixed swelling in the right lower cervical paraspinal region. Radiological images revealed a bony swelling arising from C4 and C5 lamina with a cartilaginous cap and intraspinal extension. Excision biopsy with stabilisation of the spine was performed. Histopathalogical examination of the specimen confirmed the diagnosis of osteochondroma. We conclude surgical excision of such rare tumors, including the cartilaginous cap as well as the intraspinal component can reliably produce a good clinical outcome. PMID:24596611

Amritanand, Rohit; Krishnan, Venkatesh; David, Kenny Samuel

2014-01-01

37

Deep recurrent infection of the hip after tumoral resection in an 18–years old male–a case report  

PubMed Central

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

Negrusoiu, M

2008-01-01

38

Renal Replacement in End-Stage Renal Disease Patients over 75 Years Old  

Microsoft Academic Search

Background: Over the last decade, the age of dialysis patients has been increasing steadily in several units in Canada. Our main objective was to assess prevalence, co-morbidity and outcome of ESRD patients over 75 years old at the beginning of dialysis treatment in our center. As a group, they were compared to younger dialysis patients treated simultaneously. Methods: In the

Isabelle Létourneau; Denis Ouimet; Marc Dumont; Vincent Pichette; Martine Leblanc

2003-01-01

39

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

PubMed Central

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

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

2013-01-01

40

Shelbourne's update of the O'Donoghue knee triad in a 17-year-old male Rugby player  

PubMed Central

Acute athletic knee injuries are often caused by a combination of valgus impact with external rotation of the tibia leading to a triad of injuries involving medial collateral and anterior cruciate ligament disruption with associated meniscal damage. This injury pattern has been greatly discussed in the literature with conflicts of opinion and evidence as to whether medial or lateral meniscal pathology has a higher incidence. This case report introduces a 17-year-old male athlete with this unhappy triad It will evaluate the clinical assessment which suggested a medial meniscal lesion follow the patient through arthroscopy revealing a lateral meniscal tear in addition to complete anterior cruciate ligament rupture and grade 2 medial collateral ligament tear. It will go on to look at the evidence base for the relative incidence of lateral and medial meniscal injuries and will evaluate the role of MRI in assessing acute athletic knee injuries. PMID:23349168

Dacombe, Peter Jonathan

2013-01-01

41

Case report: transient small bowel intussusception presenting as right lower quadrant pain in a 6-year-old male  

PubMed Central

In children presenting to the emergency room with right lower quadrant pain, ultrasound is the preferred initial modality. In our patient, a 6-year-old male with a sudden onset of severe right lower quadrant pain, the differential is broad, including appendicitis and intussusception. In order to narrow our differential and secure the diagnosis, our first modality was ultrasonography. With the increased use of point-of-care ultrasound in the emergency department, the diagnosis of appendicitis and ileo-colic intussusception has been made more frequently. In addition, other entities such as transient small bowel intussusception may be identified. As in our case, obstruction secondary to intussusception must be ruled out with observation, serial abdominal exams, clinical improvement, or further imaging. PMID:24982750

2014-01-01

42

Primary internal carotid artery aneurysm in a 15-year-old male: case report and review of the literature.  

PubMed

Extracranial internal carotid artery aneurysms are a rare entity in the adult population. Very little information is known in the pediatric population. We present a case of a 15-year-old male with an isolated internal carotid artery aneurysm and a review of the literature. PMID:25304909

Lopez, Daniel; Sarac, Timur; Lorenz, Robert

2015-01-01

43

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

ERIC Educational Resources Information Center

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)

Holaday, Margot; And Others

1994-01-01

44

Successful Remove of a Metal Axletree Causing Penile Strangulation in a 19-Year-Old Male by Degloving Operation  

PubMed Central

Penile strangulation caused by foreign bodies mostly occurs in adolescents and adult males. When it happens, foreign bodies are often not easy to be removed. Penile strangulation is a rarely described urological emergency, especially in the adolescent population. This paper demonstrates the successful removal of a metal axletree causing penile strangulation in a 19-year-old male with the help of degloving operation. PMID:22924045

Gan, Weidong; Yang, Rong; Ji, Changwei; Lian, Huibo; Guo, Hongqian

2012-01-01

45

[Chronic fatigue. IV--Assessment of a 40-year-old patient].  

PubMed

A forty year old patient was referred by the federal insurance for medical assessment. His presenting complaint was chronic fatigue. The patient had been an intravenous drug user for years and had been infected with hepatitis C. He was treated with interferon. The patient history showed that he also suffered from anaemia and depression. He participated in a methadone substitution program. Our diagnostic procedures showed that he also has Hashimoto's thyroiditis. PMID:18050603

Mettler, J; Battegay, E; Zimmerli, L

2007-11-01

46

[82-year old patient with hyperostosis frontalis, prognathism, makroglossia and cutis gyrata. Acromegaly].  

PubMed

We present a 82 year old female patient with typical acral enlargement. There were no signs of visceromegaly. Magnetic resonance imaging of the pituitary region showed a macroadenoma. Oral glucose tolerance test revealed missing suppression of the Human Growth Hormone (HGH), which could be achieved with a long acting somatostatin analog. A HGH suppressive therapy with a long acting dopamine agonist (Cabergolin) was induced. The patient died one year later following cardiovascular complications. PMID:15160242

Mönnich, H; Böhm, B O; Weidenbach, H

2004-07-01

47

Coronary Bypass Surgery in a 105-Year-Old Patient with Cardiopulmonary Bypass  

PubMed Central

Coronary artery bypass grafting is one of the routine daily surgical procedures in the current era. Parallel to the increasing life expectancy, cardiac surgery is commonly performed in octogenarians. However, literature consists of only seldom reports of coronary artery bypass grafting in patients above 90 years of age. In this report, we present our management strategy in a 105-year-old patient who underwent coronary artery bypass grafting at our institution. PMID:20592988

Ogus, Temucin Noyan; Erdim, Filiz; Selimoglu, Ozer; Tekiner, Fatih; Ugurlucan, Murat

2010-01-01

48

Macular Hole after Laser In Situ Keratomileusis in a 26-Year-Old Patient  

PubMed Central

The purpose of this study is to describe the 26-year-old patient with developed macular hole after bilateral laser in situ keratomileusis (LASIK). A macular hole with sharp margins and irregular surface of surrounding retina appeared in the left eye of the female 26-year-old patient two months after LASIK for correction of myopia (followup of 6 months). Although the best corrected visual acuity (BCVA) after LASIK was 1.0, after the macular hole has developed BCVA became 0.5. After surgery, the final visual acuity recovered to 0.7. Macular hole may develop after LASIK for myopia correction due to unknown changes of vitreoretinal interface. Complete informed consent must be obtained from patients with high myopic eyes before LASIK. PMID:23840997

Oshitari, Toshiyuki; Sakurai, Madoka; Baba, Takayuki; Yamamoto, Shuichi

2013-01-01

49

Ultrasonography and Radiography to Identify Early Post Traumatic Myosistis Ossificans in an 18-Year-Old Male: A Case Report  

PubMed Central

Objective The purpose of this case report is to describe a patient with post traumatic myositis ossificans (PTMO) of the anterior thigh following blunt trauma and discuss the incidence, clinical presentation, management, and imaging findings. Clinical features An 18-year-old male presented to a chiropractic clinic with a chief complaint of left knee pain and reduced range of motion after an impact injury to his left anterior thigh during hurdling 6 weeks earlier. Immediately after the injury, he presented to the emergency department where radiography of the left knee was negative and he was diagnosed with a muscle sprain. Follow-up radiography and ultrasonography of the left knee in a chiropractic radiology department revealed ossification consistent with PTMO within his vastus intermedius. Intervention and outcome The patient underwent a course of rehabilitation for 2 months including ice, class IV cold laser and vibration applied to his anterior thigh, and myofascial release of his quadriceps musculature with targeted and progressive rehabilitative exercises. His left knee pain resolved within 2 weeks of care. He resumed sports participation (American football) pain-free, while wearing protective padding over the affected thigh, 1 month after presentation, which was approximately 2 1/2 months following his injury. Conclusion This case demonstrates that ultrasonography may have the capability to detect early phases of PTMO approximately 2 weeks prior to radiographic evidence and to monitor progression throughout its course.

Yochum, Alicia M.; Reckelhoff, Kenneth; Kaeser, Martha; Kettner, Norman W.

2014-01-01

50

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

PubMed Central

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

Foering, Kristen

2014-01-01

51

The energy cost of household and garden activities in 55- to 65-year-old males  

Microsoft Academic Search

This study measured the energy expenditure of four self-paced household and garden tasks to determine whether 55- to 65-year-old men performed them at a moderate intensity [3–6 metabolic equivalents (METs)] and to predict the activity intensity via indirect methods. Resting metabolic rate and oxygen consumption were measured using Douglas bags in 50 men \\u000a who performed self-perceived moderate paced walking and

Simon M. Gunn; Anthony G. Brooks; Robert T. Withers; Christopher J. Gore; John L. Plummer; John Cormack

2005-01-01

52

Successful Treatment of Retinal Angiomatous Proliferation with Intravitreal Triamcinolone and Ranibizumab Injections in a 67-Year-Old Male  

PubMed Central

A 67-year-old male who presented to the eye casualty department with deterioration in his vision was diagnosed with retinal angiomatous proliferation. After initial deterioration with ranibizumab intravitreal injections, we have demonstrated successful treatment and stabilised vision with ranibizumab and a single intravitreal triamcinolone injection. Stringent follow-up and top-up ranibizumab injections have stabilised his vision and have shown foveal improvement on optical coherence tomography imaging.

Haq, Adnaan; Kapoor, Bharat; Logendran, Maharatnam; Reddy, Gopinath

2014-01-01

53

[Outpatient treatment of selective mutism: long-standing selective mutism in a 17-year-old male].  

PubMed

The present case report describes the successful treatment of a 17 year old male adolescent suffering for 10 years from selective mutism. Following a summary review of recent publications on therapy approaches, the report describes the treatment concept in the present case, including detailed assessment of co-morbid disorders, motivation for change, behaviour therapy with supporting drug intervention, and intensive co-operation with parents and other caretakers. PMID:20047174

Herdener-Pinnekamp, Katharina; Gundelfinger, Ronnie; Steinhausen, Hans-Christoph

2010-01-01

54

Intramuscular dendritic fibromyxolipoma in a 24-year-old male: A case report and review of the literature  

PubMed Central

Dendritic fibromyxolipoma (DFML) is an uncommon, benign soft tumor that usually arises in the subcutis. To date, ~24 cases of DFML have been reported in the literature and only one of these has been in the muscle. The present study reports the case of a 24-year-old male with a slow-growing, painless mass located deep in the triceps brachii in the left shoulder region. The mass was 14.0×8.5×8.0 cm in size, with well-circumscribed margins. Microscopically, the resected mass was characterized by a proliferation of small spindle or stellate cells, prominent abundant myxoid stroma with ropey collagen bundles and admixed mature adipose tissue. Further immunohistochemical staining indicated that the spindle and stellate cells were reactive with cluster of differentiation 34, vimentin and B-cell lymphoma-2, but not with smooth muscle actin and desmin. Fluorescence in situ hybridization showed that the tumor cells did not have the DDIT3 alteration or amplification of MDM2. The tumor was confirmed to be a DFML due to the typical histological, immunophenotypic and genetic findings. To date, subsequent to 4 years of clinical follow-up, there is no sign of recurrence or metastasis. The present study reports a case of DFML in the youngest known patient, and is the second reported case of an intramuscular DFML occurring in the triceps brachii in the left shoulder region. The study discusses the clinicopathological features and the differential diagnosis of DFML, with a review of the literature. PMID:25621027

XU, XIA; XIONG, WEN; ZHENG, LIDUAN; YU, JIE

2015-01-01

55

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

PubMed

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

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

2015-01-01

56

Distinct Clinical and Experimental Characteristics in the Patients Younger than 60 Years Old with Myelodysplastic Syndromes  

PubMed Central

Myelodysplastic syndromes (MDS) mainly occur in elderly individuals in Western countries. However, MDS is commonly found in young individuals (<60 years) in Asia. The reason for the high incidence in younger individuals is still unclear, and the differences in disease features between young and elderly patients with MDS have been not well recognized. To explore these issues, in this study, we analyzed the clinical and experimental characteristics of MDS in the patients younger and older than 60 years old and characterized the potential age-associated differences. The results showed that over half of the patients with MDS (61.9%) were younger than 60 years old upon the first diagnosis. The younger patients were more likely to be female, who have lower risk and less advanced MDS. The occurrence of trisomy 8 and bone marrow failure were more frequent in the younger patients than the older ones. The marrow CD34+ cells in the younger patients showed lower proliferation and higher apoptosis in comparison with that in the older ones. Obvious amplification of T cells and low CFU formation could be found in the younger patients. CFU formation was significantly increased in the younger patients after the removal of activated T cells. In addition, the younger patients had a lower frequency of p15INK4B methylation, longer survival expectancy and less AML transformation. In summary, the younger patients with MDS in China may show more benign disease features than the older ones. Enhanced immunological response may be involved in the pathogenesis of MDS in the patients younger than 60 years. PMID:23468979

Wu, Ling-yun; He, Qi; Xu, Ze-feng; Song, Lu-xi; Zhang, Zheng; Zhou, Li-yu; Su, Ji-ying; Zhang, Xi; Guo, Juan

2013-01-01

57

A Case of Transvenous Pacemaker Implantation in a 10-year-old Patient  

PubMed Central

Objective: The aim of this report was to discuss the type, timing, and surgical techniques of permanent pacemaker implantation in a juvenile patient. Patients: A 17-year-old girl with Down syndrome and congenital heart defects comprised of ventricular septal defects (VSD) and patent ductus arteriosus (PDA) suffered from postoperative complete atrioventricular block (AVB) when she was 7 months old. Methods and Results: An epicardial pacemaker was implanted just after the occurrence of complete AVB. Due to the pacing threshold of a ventricular lead not being good, the battery showed rapid depletion. Her generator had to be exchanged under general anesthesia every 2–3 years. When she was 10 years old, we implanted a permanent pacemaker transvenously by using cutdown, screw-in and subpectoral pocket techniques. She has shown a satisfactory outcome since then. Conclusion: Transvenous pacemaker implantation was safe and effective in our young patient without any complications. The timing of surgery and surgical technique are quite important for pacemaker implantation in juvenile patients.

Liu, Jiajia; Shimada, Yasuyuki

2013-01-01

58

Chloramphenicol Toxicity Revisited: A 12-Year-Old Patient With a Brain Abscess  

PubMed Central

Chloramphenicol, a broad-spectrum antibiotic, is rarely used in the United States due to its well-described adverse effects. Because of its limited use, many clinicians are unfamiliar with its indications, spectrum of activity, and potential adverse drug effects. We describe a 12-year-old patient who presented after two craniotomies for a persistent brain abscess complicated by long-term chloramphenicol administration. Findings for this patient were consistent with many of the adverse drug effects associated with chloramphenicol, including elevated chloramphenicol serum concentrations, anemia, thrombocytopenia, reticulocytopenia, and severe metabolic acidosis. Rare manifestations of chloramphenicol toxicity that developed in this patient included neutropenia, visual field changes, and peripheral neuropathy. Chloramphenicol administration was discontinued, and hemodialysis was initiated for severe metabolic acidosis. The patient recovered with severe visual field deficits. Although chloramphenicol is rarely indicated, it remains an effective antibiotic. Healthcare providers should become familiar with the pharmacology, toxicology, and monitoring parameters for appropriate use of this antibiotic. PMID:23118672

Wiest, Donald B.; Cochran, Joel B.; Tecklenburg, Fred W.

2012-01-01

59

The energy cost of household and garden activities in 55- to 65-year-old males.  

PubMed

This study measured the energy expenditure of four self-paced household and garden tasks to determine whether 55- to 65-year-old men performed them at a moderate intensity [3-6 metabolic equivalents (METs)] and to predict the activity intensity via indirect methods. Resting metabolic rate and oxygen consumption were measured using Douglas bags in 50 men (X +/- SD: 60.6 +/-3.2 years, 175.8 +/- 5.6 cm, 82.6 +/- 10.1 kg ) who performed self-perceived moderate paced walking and self-paced sweeping, window cleaning, vacuuming and lawn mowing. Heart rate, CSA accelerometer counts (hip and arm), Quetelet's index, Borg rating of perceived exertion and respiratory frequency were measured as possible predictors of energy expenditure. Each of the four household and garden activities was performed at a mean intensity of > or = 3.0 METs in both the standardised laboratory environment (sweeping = 3.4, window cleaning = 3.8, vacuuming = 3.0 and lawn mowing = 5.3 METs) and the subjects' homes (sweeping = 4.1, window cleaning = 3.5, vacuuming = 3.6 and lawn mowing = 5.0 METs). Comparisons between the two settings were significantly different (p < or =0.008). Except for window cleaning, the MET values were not different from those of our previous younger sample (35-45 years). Regression analysis yielded prediction equations with 95% confidence intervals of +/-0.8 METs for both the laboratory and home environments. Although the energy expenditure means for these activities indicate that they can contribute to the 30 min day(-1) of moderate intensity physical activity required to confer health benefits, there was substantial inter-individual variability. While the regression equations lack predictive precision at the individual level, they were able to determine whether energy expenditure was above the 3.0 MET threshold with correct classification rates of 91% and 94% in the laboratory and home, respectively. PMID:15815941

Gunn, Simon M; Brooks, Anthony G; Withers, Robert T; Gore, Christopher J; Plummer, John L; Cormack, John

2005-07-01

60

Bladder Cancer versus Hemorrhagic Cystitis: A Case of Mistaken Identity in a 34-Year-Old Male Undergoing Therapy for Granulomatosis with Polyangiitis  

PubMed Central

A 34-year-old male was referred for management of bladder cancer noted on workup for gross hematuria and new-onset irritative voiding symptoms. The patient's history was significant for recently diagnosed granulomatosis with polyangiitis for which he was undergoing treatment with oral cyclophosphamide and corticosteroids. Cystoscopy revealed lesions suspicious for malignancy, but the patient was diagnosed with hemorrhagic cystitis secondary to BK virus infection upon cytology review, and immunostaining confirmed a polyomavirus infection of the urothelium. The patient's symptoms resolved after a modification of his immunosuppressive regimen, and antiviral therapy was ultimately unnecessary. Though symptomatic BK virus infection of the genitourinary tract is common in immunosuppressed transplant patients, its occurrence in a patient undergoing immunomodulation for an autoimmune disease has not been reported yet. This case illustrates the potential for active BK virus infections in atypical patient populations and underscores the importance of rigorous hematuria workup, particularly in patients with multiple risk factors. PMID:25028586

Amatruda, Jonathan; Dieckhaus, Kevin; Hegde, Poornima; Taylor, John

2014-01-01

61

Macular telangiectasia type 2 (MacTel) in a 34-year-old patient.  

PubMed

We report macular telangiectasia type 2 (MacTel) in a 34-year-old man, the youngest patient so far published with MacTel type 2. The patient presented with metamorphopsia and impaired reading ability. Diagnosis was based on bilateral abnormal macular autofluorescence, perifoveal telangiectasia with fluorescein angiographic hyperfluorescence without cystoid oedema, a small foveal avascular zone, asymmetric configuration of the foveal pit, disruptions in the inner segment/outer segment layer and hyper-reflective haze and spots in the outer nuclear layer. Although MacTel usually manifests with a slowly progressive decrease in visual acuity in the fifth to seventh decades of life, younger patients may occasionally be diagnosed with the disease. Awareness of subtle signs of the condition is essential for early diagnosis. PMID:25249218

Nicolai, Heleen; Wirix, Mieke; Spielberg, Leigh; Leys, Anita

2014-01-01

62

Human papillomavirus vaccine uptake among 9–17 year old males in the United States  

PubMed Central

In 2009, a quadrivalent HPV vaccine was approved and “permissively” recommended for US males aged 9 to 26 y to protect against genital warts. The purpose of this study was to examine parental awareness and HPV vaccine uptake among 9–17 y old males during the first year following this recommendation. Data from the 2010 National Health Interview Survey (NHIS) were obtained to assess vaccination status (n = 2973) of this age group. Univariate logistic regression analysis was performed to examine correlates of parental awareness and uptake of the HPV vaccine. Overall, 55% of parents with sons were aware of the HPV vaccine. The likelihood of parental awareness was lower among minorities and adolescents with low family incomes, and higher among adolescents with insurance, higher parental education, and those who had a well-child check up and dental examination in the past year than their counterparts. Only 2.0% and 0.5% of 9–17 y old males initiated (? 1 dose) and completed (? 3 doses) the vaccine series, respectively. Adolescents with a Hispanic origin (odds ratio (OR) 2.03, 95% confidence interval (CI) 1.09–3.78), low family income (OR 2.89, 95% CI 1.48 -5.57), and history of influenza vaccination in the past year (OR 1.89, 95% CI 1.11 -3.22) were more likely than their counterparts to initiate the HPV vaccine. On the other hand, adolescents with private insurance (OR 0.44, 95% CI 0.20 -0.94) and those who had college educated parents (OR 0.45, 95% CI 0.22 -0.89) were less likely to initiate the vaccine. This study showed that very few adolescent males received any doses of HPV vaccine during the first year following its recommendation for this gender. Thus, interventional programs are needed to improve vaccine uptake among adolescent males. PMID:23295743

Laz, Tabassum H.; Rahman, Mahbubur; Berenson, Abbey B.

2013-01-01

63

[A 59-year-old patient with recurrent flushes and bland hepatic cyst].  

PubMed

A 59-year-old patient was admitted to hospital with recurrent flush symptoms and pathologically elevated 5-hydroxyindoleacetic acid (5-HIAA) levels in urine. A known cystic lesion of the liver which had been followed for years by ultrasound examinations and was regarded as a bland hepatic cyst was identified as a metastasis of a neuroendocrine neoplasm of the ileum. In two sequential surgical interventions the primary tumor with mesenteric lymph node metastases as well as the cystic liver metastasis could be resected. After surgical treatment an R1 situation at the mesenteric site and suspicious para-aortic lymph nodes remained. The long established treatment of factor-V Leiden mutation by anticoagulation with phenprocoumon was supplemented by deep subcutaneous injection of lanreotide autogel every 4 weeks. Currently, there is no evidence for progressive disease and the patient is without clinical signs of a carcinoid syndrome. PMID:24449139

Krug, S; König, A; Librizzi, D; Nimphius, W; Gress, T M; Michl, P; Rinke, A

2014-02-01

64

[Recurrent prosthetic endocarditis in a 21-year old patient with renal transplantation treated with allogeneic homograft].  

PubMed

Prosthetic infective endocarditis is a possible complication of implantation of a prosthetic cardiac valve. Without early and effective treatment, it can have fatal consequences. One treatment option is use of an allogeneic cryopreserved homograft. This case report presents a 21-year old patient after kidney transplantation due to hereditary nephrotic syndrome and aortic valve replacement with aortic conduits. After fever was noted in the patient, prosthetic infective endocarditis was diagnosed by echocardiography and also confirmed by CT-3D examination. The cryopreserved aortic homograft was implanted at the Department of Cardiac Surgery. This along with additional conservative management effectively treated the infection. Based on literature data and our own experience, we believe that the treatment of prosthetic endocarditis after aortic valve replacement with cryopreserved homograft can be a method of choice. PMID:22913243

Sabol, F; Jakubová, M; Kolesár, A; Stan?ák, B; Be?a, M; Podracký, J; Podracká, L; Cadník, P; Spatenka, J

2012-06-01

65

Establishment of Normative Chest Expansion Values in Typical 16 to 30 Year Old Males  

Microsoft Academic Search

Introduction and Background. Chest expansion measurements provide information regarding a patient's baseline respiratory status. Repetition of measurements allows for monitoring progression of respiratory muscle function and chest wall mobility. In order for chest expansion measurements to provide interrater and intrarater reliability; consistent measurement sites and positions need to be established. However, current research regarding normal chest expansion measurements, consistent patient

Matthew L. Parks; Aubree J. Swart

2003-01-01

66

A Case of Ocular Syphilis in a 36-Year-Old HIV-Positive Male  

PubMed Central

The incidence of syphilis in the United States has increased markedly over the last decade, particularly among men who have sex with men (MSM). Although uncommon, ocular involvement is a potentially devastating clinical manifestation of syphilis. Human immunodeficiency virus (HIV) infection appears to increase the risk of ocular syphilis. Because of the lack of pathognomonic features for ocular syphilis and its ability to occur in both immunocompetent and immunosuppressed individuals, prompt diagnosis requires a high index of suspicion. Ocular syphilis should therefore be considered in MSM and HIV-infected patients presenting with unexplained visual complaints. Herein, we present a case of ocular syphilis in a patient with newly diagnosed HIV. PMID:25180112

Jenkins, Timothy C.

2014-01-01

67

Traumatic bilateral posterior hip dislocation in 10 year old male child  

PubMed Central

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.

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

2014-01-01

68

Pathology Case Study: Intermittent Fevers in a 43-Year-Old Black Male  

NSDL National Science Digital Library

The University of Pittsburgh School of Medicine's Department of Pathology has compiled a series of case studies to help students and instructors. In this particular study the patient is complaining of intermittent fevers. The case provides test results and data as well as microscopic photos and description. Clicking on the final diagnosis provides a thorough explanation of the diagnosis as well as treatment.

Dorvault, Christine; Richert, Charles A.

2007-08-12

69

Refractory hypoxemia in a 23-year-old patient with Budd-Chiari syndrome.  

PubMed

Antiphospholipid syndrome is an autoimmune disorder characterized by a hypercoagulable state, leading to arterial and venous thrombosis. We present a 23-year-old patient, suspected of having Budd-Chiari syndrome due to antiphospholipid syndrome, who developed severe and progressive hypoxemia, requiring prolonged mechanical ventilation. After a detailed but unsuccessful workup, a contrast CT scan revealed an occluded superior vena cava and azygos vein-superior vena cava junction and massive right-to-left shunting through a network of systemic to pulmonary venous collaterals. Restoring normal blood flow from the azygos vein into the right atrium by stenting the azygos-superior vena cava junction resolved the hypoxemia immediately. Within the same procedure, the hepatic outflow obstruction was successfully treated by stenting a severe stenosis of the suprahepatic inferior vena cava caused by calcified thrombus. PMID:25367480

Bunge, Jeroen J H; Wiersema, Ubbo S; Moelker, Adriaan; van Bommel, Jasper; Tjwa, Eric T T L

2014-11-01

70

Successful Anesthesia and Hip Surgery in a 107-Year-Old Patient  

PubMed Central

Patient: Female, 107 Final Diagnosis: Hip fracture Symptoms: — Medication: — Clinical Procedure: Hip surgery Specialty: Orthopedics and Traumatology Objective: Rare disease Background: In modern societies, elderly populations have increased over the last four decades and have become the main clients of medical services. A hip fracture is a significant injury for anyone, but for older people it can be catastrophic. Case Report: A 107-year-old female was admitted with fracture of the right hip. The patient took a single 200 mL carbohydrate drink orally two hours before surgery. Before induction of spinal anesthesia, routine monitoring was started and an intravenous line was placed. Crystalloids and hydroxyethyl starch in 0.9% sodium chloride solution were administered intravenously during the operation. After sedation with i.v. ketamine and midazolam, spinal puncture was performed with the patient in the sitting position and isobaric bupivacaine were administered. The level of sensory block was observed in T12 and motor blockade (grade 3) of the lower limbs. The surgical procedure lasted 60 minutes without hypotension, bradycardia or decreased oxygen saturation. For safety reason, the patient was transferred to the ICU for monitoring; intravenous hydration was withdrawn and released oral feeding six hours after the end of surgery. The patient was sent to his residence on the morning of the second day. Conclusions: This case showed that with suitable techniques and conduits can perform surgery in a patient with 107 years. PMID:25072535

Imbelloni, Luiz Eduardo; Lima, Umberto; Pedrosa, Francisco Kartney

2014-01-01

71

Pathology Case Study: Neck Mass in a 34-Year-Old Male  

NSDL National Science Digital Library

The University of Pittsburgh School of Medicine presents a case study on Spinal Mass as part of its Neuropathology series. Students can examine the medical history and symptoms presented for the patient. The test results yield high quality molecular images of the unknown mass that can be magnified to enhance the physical description. The final diagnosis provides a good way for med students to obtain practical experience, and for teachers to test their students.

Nine, Jeff S.

72

A western Eurasian male is found in 2000-year-old elite Xiongnu cemetery in Northeast Mongolia.  

PubMed

We analyzed mitochondrial DNA (mtDNA), Y-chromosome single nucleotide polymorphisms (Y-SNP), and autosomal short tandem repeats (STR) of three skeletons found in a 2,000-year-old Xiongnu elite cemetery in Duurlig Nars of Northeast Mongolia. This study is one of the first reports of the detailed genetic analysis of ancient human remains using the three types of genetic markers. The DNA analyses revealed that one subject was an ancient male skeleton with maternal U2e1 and paternal R1a1 haplogroups. This is the first genetic evidence that a male of distinctive Indo-European lineages (R1a1) was present in the Xiongnu of Mongolia. This might indicate an Indo-European migration into Northeast Asia 2,000 years ago. Other specimens are a female with mtDNA haplogroup D4 and a male with Y-SNP haplogroup C3 and mtDNA haplogroup D4. Those haplogroups are common in Northeast Asia. There was no close kinship among them. The genetic evidence of U2e1 and R1a1 may help to clarify the migration patterns of Indo-Europeans and ancient East-West contacts of the Xiongnu Empire. Artifacts in the tombs suggested that the Xiongnu had a system of the social stratification. The West Eurasian male might show the racial tolerance of the Xiongnu Empire and some insight into the Xiongnu society. PMID:20091844

Kim, Kijeong; Brenner, Charles H; Mair, Victor H; Lee, Kwang-Ho; Kim, Jae-Hyun; Gelegdorj, Eregzen; Batbold, Natsag; Song, Yi-Chung; Yun, Hyeung-Won; Chang, Eun-Jeong; Lkhagvasuren, Gavaachimed; Bazarragchaa, Munkhtsetseg; Park, Ae-Ja; Lim, Inja; Hong, Yun-Pyo; Kim, Wonyong; Chung, Sang-In; Kim, Dae-Jin; Chung, Yoon-Hee; Kim, Sung-Su; Lee, Won-Bok; Kim, Kyung-Yong

2010-07-01

73

Combination of Left Ventricular Noncompaction and Partial Atrioventricular Canal Defect in a 21-Year-Old Male: A Case Report  

PubMed Central

Introduction Left ventricular noncompaction (LVNC) is classified as a genetic cardiomyopathy characterized by a progressive systolic dysfunction. It may occur alone or in association with congenital cardiac anomalies. The combination of left ventricular noncompaction with partial atrioventricular canal defect is rare and has not, to our knowledge, been described previously. Case presentation A 21-year-old male who traveled to our center from a neighboring country presented with signs of heart failure. Transthorarcic echocardiography showed prominent trabeculations in the left ventricle predominantly in the left ventricle involving the apical lateral and mid anterolateral segments associated with a partial atrioventricular canal defect. There was a biventricular systolic dysfunction. There was good response to medical treatment. Conclusion This case stresses the importance of maintaining a high degree of suspicion for this rare cardiomyopathy and the need to systematically look for other associated anomalies in order to institute proper short- and long-term managements. PMID:23362371

Bodian, Malick; Jobe, Modou; Lèye, Mohamed; Ndiaye, Mouhamadou Bamba; Kane, Adama; Sarr, Simon Antoine; Mbaye, Alassane; Diao, Maboury; Ba, Fatimata Gatta; Ngaïde, Aliou Alassane; Coly, Sarah Mouna; Thiam, Anna; Sarr, Moustapha; Bâ, Serigne Abdou

2013-01-01

74

Cardiac rehabilitation of a 77-year-old male runner: consideration of the athlete, not the age  

PubMed Central

A 77-year-old geologist with coronary artery disease enrolled in our cardiac rehabilitation program after successful placement of a drug-eluting stent. Unlike the typical sedentary cardiac patient in his age group, he loved to run. He expressed a strong desire to return to his sport, and completion of a self-assessment scale confirmed his high level of athletic identity. Despite the patient's advanced age and long history of unstable blood pressure, we were able to design a special exercise program that enabled him to train safely and thereby reach his goal. When developing a cardiac rehabilitation plan, health care professionals should consider the patient's athletic identity, not just his or her chronological age. PMID:19169393

Schmid, Jack; Cheng, Dunlei

2009-01-01

75

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

PubMed Central

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 ?2 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

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

2014-01-01

76

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

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

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

2014-03-01

77

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

PubMed

"Fire-breathing" or "fire-eating" is a special kind of street art where the acts are always stunning, spectacular and amazing. People exhibiting this kind of show are professionals, not rare amateurs, who use different kind of fuels, usually hydrocarbons, in order to produce a pillar of fire. Intoxications caused by ingestion or inhalation of liquid paraffin, used as a fuel while performing, are numerous and various. We present a clinical case report of a 25-year old, previously healthy, amateur "fire-breather". During October, 2010 this young men arrived at the Emergency Unit of the University Clinic for toxicology and Urgent Internal Medicine in a severe clinical condition, after his unsuccessful attempt to perform real "fire-breathing". He had fever, strong headaches, mild abdominal and chest pain and he also had difficulties breathing and persistent dry cough. The patient was extremely dyspneic with peripheral cyanosis and shortness of breath. "Fire-breathers" must be viewed as a population at risk of paraffin-induced pneumonia, which has low mortality rate, but still is related with numerous and various chronic complications. Our patient was first in a life threatening, extremely serious clinical condition which was urgently treated with appropriate vigorous and effective therapy. This therapeutic protocol led to successful full recovery of these young men, who luckily didn't exhibit any chronic complications. PMID:25066163

Chibishev, Andon; Simonovska, Natasa

2014-08-01

78

Annular Pancreas: A Cause of Gastric Outlet Obstruction in a 20-Year-Old Patient  

PubMed Central

Patient: Female, 20 Final Diagnosis: Annular pancreas Symptoms: Food intolerance • vomiting Medication:— Clinical Procedure: — Specialty: Gastroenterology and Hepatology Objective: Congenital defects/diseases Background: Annular pancreas is a congenital anomaly that consists of a ring of pancreatic tissue partially or completely encircling the descending portion of the duodenum. It is formed due to the failure of the ventral bud to rotate, thus it elongates and encircles the upper part of the duodenum. It can present in a wide range of clinical severities, and can affect neonates to the elderly, making it difficult to diagnosis. Although diagnosis of annular pancreas can be made pre-operatively by upper GI series, upper GI endoscopy, or CT scan, 40% of diagnoses require surgery for confirmation. Case Report: We report the case of a 20-year-old woman presenting with history of vomiting and weight loss since childhood. We present the clinical characteristics, surgical management in the form of bypass procedure done through a duodenojujenostomy, and follow-up of the patient. Conclusions: Annular pancreas occasionally presents in adults. Variable presentations have been described in the literature, including pancreatic neoplasm, pancreatitis, obstructive jaundice, duodenal obstruction, and peptic ulcer diseases. Most studies of these lesions are single case reports or small series, which do not allow a surgeon to accumulate extensive experience; therefore, reliance on the combined experience of others in recognition and appropriate management has been the norm. PMID:25300027

Alahmadi, Raha; Almuhammadi, Saud

2014-01-01

79

Hemolytic Uremic Syndrome in a 65-Year-Old Male Linked to a Very Unusual Type of stx2e- and eae-Harboring O51:H49 Shiga Toxin-Producing Escherichia coli  

PubMed Central

We report on a 65-year-old male patient with a Shiga toxin-producing Escherichia coli O51:H49 gastrointestinal infection and sepsis associated with hemolytic uremic syndrome (HUS) with a fatal outcome. The strains isolated harbored stx2e and eae, a very unusual and new virulence profile for an HUS-associated enterohemorrhagic E. coli. PMID:24501025

Fasel, Dominique; Mellmann, Alexander; Cernela, Nicole; Hächler, Herbert; Fruth, Angelika; Khanna, Nina; Egli, Adrian; Beckmann, Christiane; Hirsch, Hans H.; Goldenberger, Daniel

2014-01-01

80

Autonomous Functioning Thyroid Nodule in a 4-year-old Male Child Treated with Radioiodine (I-131)  

PubMed Central

Autonomous functioning thyroid nodules that cause toxic manifestations (toxic adenomas) are benign monoclonal tumors characterized by their capacity to grow and produce thyroxine (T4) and triiodothyronine (T3) autonomously, i.e. in the absence of thyrotropin thyroid stimulating hormone. Toxic adenomas are a rare presentation of hyperthyroidism in the pediatric population. Radioiodine (I-131) has been widely used for therapy of patients with toxic adenomas and is now accepted as a safe and effective treatment even in the pediatric age group. The authors here present a case of a 4-year-old boy with a solitary hyperfunctioning thyroid nodule, who was successfully treated with radioiodine (I-131) and is presently on follow-up. PMID:25125998

Khare, Abhishek; Bhutani, Puneet; Chauhan, Suneel

2013-01-01

81

Angiosarcoma Arising in a Patient with a 10-Year-Old Hemangioma  

PubMed Central

The transformation of a benign hemangioma into a malignant angiosarcoma has been rarely reported, with only 11 cases reported in the literature. There have been no reports of malignant transformation of hemangioma into angiosarcoma in association with epithelioid hemangioendothelioma, to our knowledge. The existence of precursor malignancies in the tumorigenesis of sarcomas is still not clearly defined. We describe the case of a 40-year-old woman with a preceding history of a suspected hemangioma for ten years, who upon resection was found on histology to have evidence of a hemangioma with an associated area of epithelioid hemangioendothelioma as well as areas of overt high grade epithelioid angiosarcoma. These findings raise the possibility of the evolution of hemangioma to epithelioid hemangioendothelioma, and the latter to overt angiosarcoma. The patient was managed as having a high grade sarcoma with wide resection and radiation. She declined systemic adjuvant chemotherapy after a thorough discussion about the risks and benefits of chemotherapy, and she currently remains disease free one year after the surgery.

Nathenson, Michael J.; Molavi, Diana; Aboulafia, Albert

2014-01-01

82

POEMS Syndrome in a 20-year-old Patient Diagnosed Following a Complaint of Reduced Visual Acuity.  

PubMed

We report a case of POEMS syndrome in a 20-year-old patient diagnosed after visiting an eye clinic with a chief complaint of reduced visual acuity. A male university student aged 20 years was referred to our department complaining of blurred vision in both eyes that had persisted for 1 month. He also noted headache, nausea, and paresthesia in the lower extremities around the same time. The visual acuity of his right and left eye was 20/40 and 20/20, respectively. Optic disc edema and serous retinal detachment were present. Brain magnetic resonance imaging showed no intracranial abnormalities, while elevated cerebrospinal fluid pressure, reduced nerve conduction velocity in both lower extremities, hepatosplenomegaly, M proteinemia, high blood VEGF levels, osteoblastic and osteolytic changes in the spine, and atypical plasma cells in bone lesions were noted. From the above findings, the patient was diagnosed with POEMS syndrome. He received high-dose dexamethasone, thalidomide, and radiotherapy on the sacral mass, followed by high-dose melphalan with autologous stem-cell support, and showed subsequent systemic and ophthalmologic improvement. Here, we report the youngest case ever of POEMS syndrome with ocular manifestation. If patients have optic disc edema in both eyes with no intracranial space-occupying lesion, POEMS syndrome should be considered in differential diagnosis, regardless of age. PMID:25519033

Doi, Shinichiro; Kimura, Shuhei; Morizane, Yuki; Hosogi, Mika; Hosokawa, Mio; Shiode, Yusuke; Kawata, Tetsuhiro; Kondo, Eisei; Shiraga, Fumio

2014-12-01

83

Myocardial infarction in a 17-year-old patient due to neurofibromatosis-associated coronary aneurysm.  

PubMed

Neurofibromatosis is an autosomal dominant multi-system genetic disorder. Extra-cardiac vascular manifestations of neurofibromatosis have been previously described in many reports. However, coronary arterial involvements have been rarely described. A 17-year-old girl with neurofibromatosis presented to our institute with subacute myocardial infarction. Coronary angiogram revealed an aneurysm with thrombus in the left anterior descending artery. PMID:22813835

Evrengul, Harun; Kilic, Dogu I; Zungur, Mustafa; Alihanoglu, Yusuf I; Tanriverdi, Halil

2013-06-01

84

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

PubMed Central

Background: Optimal timing and mode of treatment for patients with coarctation of the aorta (COA) remain controversial, particularly in children. Surgery, balloon dilatation, and stent implantation have all proven effective in the treatment of moderate or severe obstruction. The aim of this study was to investigate the complications of COA stenting angioplasty in pediatric patients. Methods: This retrospective, descriptive study was conducted on patients less than 20 years of age who underwent aortic stenting angioplasty because of congenital COA in the pediatric catheterization laboratory of Rajaie cardiovascular, medical and research Center, Tehran between 2005 and 2010. Results: A total of 26 patients (18 [65.4%] males and 9 [34.6%] females) with congenital COA who had undergone aortic stenting angioplasty were recruited. Nineteen (73.1%) of these patients had native COA and 7 (26.9%) had recurrent COA. Most of the early complications were minor and temporary; only one patient developed early major complications. During the follow-up, whereas none of the native group patients developed late complications, in the re-COA group 28.57% of the patients had re-stenosis and 14.28% had chronic systemic hypertension, requiring drug therapy. Conclusion: Our investigation into post-stenting complications in patients with native COA and re-COA showed that endovascular stenting could be an effective and safe method, even in young patients with native COA. PMID:23074369

Molaei, Akbar; Merajie, Mahmood; Mortezaeian, Hodjjat; Malakan Rad, Elaheh; Haji Heidar Shemirani, Rahele

2011-01-01

85

The Effect of ROSHI Protocol and Cranial Electrotherapy Stimulation on a Nine-Year-Old Anxious, Dyslexic Male with Attention Deficit Disorder: A Case Study  

Microsoft Academic Search

This case study describes diagnosis and treatment of a nine-year-old male with poor reading achievement, attention deficit disorder, and severe generalized anxiety disorder. The goal of the treatment was to significantly increase this young man's reading achievement, reduce his anxiety to a normal level, and to reduce his ADD symptoms so he could concentrate at a normal level for his

Stephen J. Overcash

2005-01-01

86

Treatment of Priapism with Automated Red Cell Exchange and Hyperbaric Oxygen in an 11-year-old Patient with Sickle Cell Disease  

PubMed Central

Priapism affects up to 50% of all males with sickle cell disease, and there is no standard treatment. Delayed and unsuccessful treatment leads to corporal fibrosis and impotence. It is therefore necessary to determine the best treatment methods for this complication in order to offer effective interventions to all affected patients. Herein we report an 11-year-old patient with sickle cell disease that presented with priapism 72 h after onset, and was successfully treated with automated red cell exchange and hyperbaric oxygen following unsuccessful surgical and conventional interventions. PMID:24744672

Az?k, Fatih Mehmet; Atay, Avni; Kürekçi, Ahmet Emin; Ay, Hakan; Kibar, Yusuf; Özcan, Okan

2012-01-01

87

Osteoporosis in Male and Female Leprosy Patients  

Microsoft Academic Search

.   We measured the bone mineral density (BMD) of 353 leprosy patients (197 males 50–89 years old, average age 70.2; and 156\\u000a females 53–90 years old, average age 72.9) and serum levels of free testosterone (FT) in 81 males. The BMD of the lumbar vertebrae\\u000a (L2–L4), diaphysis of the radius (1\\/3 radius), and the neck of the femur (neck) was

S. Ishikawa; A. Ishikawa; K. Yoh; H. Tanaka; M. Fujiwara

1999-01-01

88

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

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…

Jackson, Douglas N.; Rushton, J. Philippe

2006-01-01

89

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

PubMed

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

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

2014-01-01

90

The impact of young age on locoregional recurrence after doxorubicin-based breast conservation therapy in patients 40 years old or younger: How young is 'young'?  

SciTech Connect

Purpose: The aim of this study was to investigate whether patients <35 years old have similar risk of locoregional recurrence after breast conservation therapy compared with patients 35 to 40 years old. Methods and materials: We retrospectively reviewed records of 196 consecutive patients {<=}40 years old who received breast conservation therapy (BCT) from 1987 to 2000 for breast cancer and compared outcomes between patients <35 years old with patients 35 to 40 years old. The majority of patients received neoadjuvant chemotherapy as part of their treatment. Multivariate analysis was performed to assess risk factors for locoregional recurrence. Results: After a median follow-up of 64 months, 22 locoregional recurrences (LRR) were observed. Twenty patients developed locoregional recurrence as their first site of relapse. Two patients had bone-only metastases before their locoregional recurrence. On multivariate analysis, age <35 years was associated with a statistically significant increased risk of locoregional recurrence. The 5-year rate of locoregional control was 87.9% in patients <35 years old compared with 91.7% in patients 35 to 40 years old (p = 0.042). Conclusions: Our finding supports an increased risk of locoregional recurrence as a function of younger age after breast conservation therapy, even among young patients 40 years old and younger.

Oh, Julia L. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)]. E-mail: joh@mdanderson.org; Bonnen, Mark [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Outlaw, Elesyia D. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Schechter, Naomi R. [Department of Radiation Oncology, University of California-San Francisco Mt. Zion Comprehensive Cancer Center, San Francisco, CA (United States); Perkins, George H. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Strom, Eric A. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Babiera, Gildy [Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Oswald, Mary Jane [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Allen, Pamela K. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Thames, Howard D. [Department of Biostatistics and Applied Mathematics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Buchholz, Thomas A. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

2006-08-01

91

Safety and efficacy of radiation and chemoradiation in patients over 70 years old with inoperable esophageal squamous cell carcinoma  

PubMed Central

The aim of the present study was to perform a retrospective analysis to investigate the outcome and toxicity of radiation (RT) and chemoradiation (CRT) in elderly, inoperable patients >70 years old. Between 2003 and 2012, 1,024 patients with squamous cell carcinoma (SCC) of the esophagus were treated at the Department of Thoracic Cancer, West China Hospital (Chengdu, China). Of these patients, 37 were >70 years old and had not undergone surgery, and were selected for analysis. Of these 37 patients, CRT had been administered to 20 (54%). Actuarial survival rates were determined by the Kaplan-Meier method. The one-year survival rate in the CRT group (n=20) was 85%, while 35% of patients in the RT group (n=17) survived for more than one year. The overall and progression-free survival in the CRT group versus the RT group were 17 months [95% confidence interval (CI), 11.861–22.139] versus eight months (95% CI, 6.674–9.326) (P=0.013) and 14 months (95% CI, 9.617–18.383) versus five months (95% CI, 2.311–7.689) (P=0.01), respectively. Patients irradiated with a dose of >50 Gy exhibited an improved survival rate compared with patients who received a dose of ?50 Gy (18 vs. 14 months; P=0.049). Furthermore, patients with an Eastern Cooperative Oncology Group (ECOG) score of ?1 had an improved prognosis compared with those with an ECOG score of 2 (14 vs. seven months; P=0.006). The two regimens were well-tolerated and there were no therapy-associated mortalities. The current retrospective study indicated that patients of >70 years old with inoperable esophageal SCC and a good ECOG score exhibit comparably better safety levels with CRT and improved survival rates compared with RT alone. PMID:24348860

XU, HONG-YU; DU, ZE-DONG; ZHOU, LIN; YU, MIN; DING, ZHEN-YU; LU, YOU

2014-01-01

92

Large granules in the peripheral blood smear and bone marrow aspirate of a 3-year-old male with lymphadenopathy and fever.  

PubMed

A 3-year-old male with oculocutaneous albinism presented with lymphadenopathy and fever. Serological testing revealed Epstein-Barr virus (EBV)-specific immunoglobulin M (IgM) and a diagnosis of infectious mononucleosis was made. A complete blood count and peripheral blood smear demonstrated mild anemia, thrombocytopenia, and neutropenia with leukocytes that contained large azurophilic and eosinophilic granules. Bone marrow examination demonstrated increased hemophagocytic histiocytes along with granulocytes that contained large eosinophilic granules. In addition to hemophagocytic lymphohistiocytosis, presumably due to acute EBV infection, the patient was diagnosed with Chediak-Higashi syndrome based on the pathognomonic granules within peripheral leukocytes and precursors. The differential diagnosis of a young patient with oculocutaneous albinism presenting with an acute viral infection includes a relatively narrow range of genetic syndromes based solely on the history of albinism. This case demonstrates the application of clinical laboratory data to presumptively diagnose Chediak-Higashi syndrome in the midst of a presentation of hemophagocytic lymphohistiocytosis secondary to acute EBV infection. PMID:25051077

McCoy, Morgan H; Mast, Kelley; Relich, Ryan F; Girgis, George; Nassiri, Mehdi

2014-01-01

93

Recurrent vitreous hemorrhage associated with regressed retinopathy of prematurity in a 47-year-old patient: a case report  

PubMed Central

Introduction Vitreous hemorrhage associated with retinopathy of prematurity is often seen in childhood, but adult onset without retinal break is rare. We describe a case of recurrent vitreous hemorrhage associated with regressed retinopathy of prematurity in a 47-year-old patient. Case presentation A 47-year-old Japanese woman with a history of retinopathy of prematurity presented with a visual disturbance in her left eye due to vitreous hemorrhage. Because the vitreous hemorrhage was recurrent and refractory, we performed pars plana vitrectomy combined with lens extraction by phacoemulsification and intraocular lens implantation. No retinal break or retinal detachment was found. No vitreous hemorrhage or other complication occurred in the first six months after surgery. Conclusions Vitrectomy, potentially in combination with lens extraction, should be considered in adult-onset recurrent vitreous hemorrhage associated with retinopathy of prematurity. PMID:24916359

2014-01-01

94

Verocytotoxin-Producing Escherichia coli O128ab:H2 Bacteremia in a 27-Year-Old Male with Hemolytic-Uremic Syndrome  

PubMed Central

Verocytotoxin-producing Escherichia coli (VTEC) strains of serotype O128ab:H2 were isolated from blood and stool of a 27-year-old male presenting diarrhea-associated hemolytic-uremic syndrome complicated by bacteremia. This report once again illustrates the pathogenic potential of a non-O157 VTEC strain carrying a virulence profile previously associated with mild disease. PMID:23467596

Buvens, Glenn; De Rauw, Klara; Roisin, Sandrine; Vanfraechem, Gaëlle; Denis, Olivier; Jacobs, Frédérique; Scheutz, Flemming

2013-01-01

95

Levosimendan reverses right-heart failure in a 51-year-old patient after heart transplantation.  

PubMed

Primary graft failure in the early postoperative period after heart transplantation, remains a main cause of a poor outcome. Current treatment options include pharmacological (catecholamines and phosphodiesterase inhibitors) and mechanical assist device support. Pharmacological support with catecholamines is related to elevated myocardial oxygen consumption and regional hypoperfusion leading to organ damage. On the other hand, levosimendan, as a calcium-sensitizing agent increases cardiac contractility without altering intracellular Ca(2+) levels and increase in oxygen demand. We present a case of a 51-year-old man, who was suffering from acute right-heart failure in the early postoperative period after heart transplantation. As a rescue therapy at the late stage of a low cardiac output state, levosimendan was started as continuous infusion at 0.1 ?g/kg/min for 12 h and thereafter, at 0.2 ?g/kg/min for the following 36 h. Levosimendan demonstrated an advanced pharmacological option as was portrayed in this case, where the right ventricle was under a prolonged severe depression and acutely overloaded after heart transplantation. PMID:24652017

Barisin, Stjepan; Djuzel, Viktor; Barisin, Ana; Rudez, Igor

2014-08-01

96

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

PubMed Central

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

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

2012-01-01

97

The characterisation of mucin in a mature ovarian teratoma occurring in an eight year old patient  

PubMed Central

Introduction: The presence of MUC5AC (M1 antigen) and MUC6 have previously been found in ovarian mucinous cyst. We characterized the mucins in the crude mucus and tissue of a mature ovarian teratoma in an 8 year old girl. Materials and Methods: Mucins were purified from crude mucus by density gradient ultra-centrifugation in CsCl and analysed by gel-filtration and SDS-PAGE analysis. Mucin identification and expression was by western blotting and immunohistochemistry. Results: Histology showed a tumour with solid and cystic areas, with the cysts lined by colonic and respiratory mucosae. Equal volumes of 'sol' and 'gel' phases of approximately 10.0ml of crude mucus were obtained. Gel filtration and SDS-PAGE analyses suggested that the mucin was mainly of the large polymeric type which dissociated upon reduction of disulphide bonds with DTT. The colonic and respiratory epithelia predominantly expressed acidic mucin of the sialated and sulphated types respectively. MUC1 and MUC1c were expressed exclusively in respiratory epithelium, MUC2 and some MUC6 (focal) in the colonic tissue and MUC5AC in both tissues. Western blotting confirmed the presence of MUC2, MUC5AC and MUC5B in the secreted gel. Serine, threonine and proline made up the bulk of the amino acids in the sample. Discussion: Ovarian teratoma produced a highly viscous mucus secretion in which the mucin was largely polymeric and of the MUC2, MUC5AC and MUC5B type. The respiratory component of the teratoma expressed MUC1 and MUC1c and the colonic components of the teratoma expressed MUC2 and some MUC6. MUC5AC was expressed in both components. PMID:17479161

Mall, Anwar Suleman; Tyler, Marilyn; Lotz, Zoe; Davidson, Alan; Rodrigues, Jerry; van der Watt, George; Kahn, Delawir; Govender, Dhirendra

2007-01-01

98

Diagnosis and treatment of a 16-year-old Chinese patient with concurrent hereditary hemochromatosis and Gilbert's syndrome.  

PubMed

Gilbert's syndrome and hereditary hemochromatosis predominantly affect Caucasians with a low incidence in Asians. Here we report the case of a 16-year-old Chinese boy, who was admitted with hepatalgia, jaundice, hyperpigmentation, and splenomegaly to our hospital. After excluding chronic hepatitis, autoimmune disorders, and alcohol or drug injury, genetic analyses of the patient and his parents revealed simultaneous manifestations of Gilbert's syndrome and hereditary hemochromatosis, though his parents did not develop related symptoms. The presented case indicates that diagnoses of Gilbert's syndrome and hereditary hemochromatosis should be taken into consideration when chronic hepatitis is suspected without a clear etiology. PMID:25262004

Wang, Xianbo; Liu, Yanmin; Chang, Yujuan; Liu, Huimin; Wang, Peng

2014-01-01

99

An 87-year-old patient with repeated oligorecurrences over six years whose disease were treated with radiotherapy alone  

PubMed Central

In the clinical state of oligometastases or oligorecurrence, a transitional state between localized and widespread systemic disease, local control of the disease may yield improved systemic control. Radiotherapy may be a good means for controlling oligometastatic tumors, particularly in very old patients for whom surgery may be infeasible. A combination of systemic therapy and local therapy is necessary to prevent systemic progression. Some kinds of cancers found in the elderly are known to be somewhat indolent for systemic progression. So, for very old patients who refuse or cannot tolerate chemotherapy, the use of radical radiotherapy alone to treat oligorecurrences may be very helpful. We successfully treated an 87-year-old patient who had been diagnosed with oligorecurrences three times over six years with radiotherapy alone. The patient is now, about four years after his first radiotherapy for liver metastasis, alive without any evidence of cancer and with fully active performance status. PMID:25568856

2014-01-01

100

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

PubMed Central

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 to hear about it, (3) belief that there is no need to bring it up, and (4) forgetting to bring it up. Facilitators of communication included: (1) having a family member present at doctor visits, (2) doctor-initiated inquiries, and (3) encountering an advertisement that suggested talking with a doctor. Conclusions Overall, participants displayed awareness of potential problems related to online health information seeking. Findings from this study point to a set of barriers as well as facilitators of communication about online health information seeking between patients and doctors. This study highlights the need for enhanced patient communication skills, eHealth literacy assessments that are accompanied by targeted resources pointing individuals to high-quality credible online health information, and the need to remind patients of the importance of consulting a medical professional when they use online health resources to diagnose and treat a health issue. PMID:25586865

2015-01-01

101

Repair of a Large Main Pulmonary Artery Aneurysm in a 71-Year-Old Jehovah's Witness Patient  

PubMed Central

Pulmonary artery aneurysm is a rarely reported and poorly studied entity; most mentions in the literature are in case series and case reports. Cardiac surgery in Jehovah's Witness patients is occurring more frequently because of improved techniques of blood conservation. We report the repair of a large pulmonary artery aneurysm in a 71-year-old woman who was a Jehovah's Witness. Using total cardiopulmonary bypass, we replaced the main pulmonary artery and both branches with Gelweave tube-grafts, because the fragility of a homograft presented possible bleeding problems. The patient recovered rapidly, and her symptoms were greatly improved. We think that a patient's status as a Jehovah's Witness need not preclude potentially life-saving cardiac operations. PMID:23914038

Henn, Lucas W.; Esmailian, Fardad

2013-01-01

102

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

PubMed

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

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

2014-11-21

103

Comparison of Outcomes Following Heart Replacement Therapy in Patients Over 65 Years Old  

PubMed Central

Background There are currently no well-defined, evidence-based guidelines for management of end stage heart failure in patients over 65 and decisions to utilize mechanical circulatory support with left ventricular assist device (LVAD), either as a bridge to transplant or destination therapy, or isolated heart transplant (HTx) remain controversial. We aim to compare outcomes following implementation of thee heart replacement strategies in this high-risk population. Methods We conducted a retrospective, cohort study of all patients between the age of 65–72 receiving a continuous-flow LVAD as bridge to transplant or destination therapy or isolated HTx at our center between 2005–2012. Patients were stratified according to treatment strategy into 3 groups; Group D (destination LVAD, n=23), Group B (bridge to transplant LVAD, n=43), and Group H (HTx alone, n=47). Primary outcomes of interest were survival to discharge and 2-year overall survival. Results Patients in Group D were significantly older, had a higher prevalence of ischemic cardiomyopathy, and a higher pulmonary vascular resistance than patients in Groups B or H. There were no significant differences between groups in survival to discharge (87% D vs. 83.7% B vs. 87.2% H, p=0.88) or 2 year overall survival (75.7% D vs. 68.7% B vs. 80.9% H, log-rank p=0.47). Incidence rates of readmission were 1.1 events/patient*year in Group D and 0.5 events/patient*year in Group H. Conclusions There was no significant difference in perioperative, short, and medium-term survival between treatment groups. However, LVAD patients had a higher incidence of readmission. Larger trials are needed to refine differences in long-term survival, quality of life, and resource utilization for elderly patients requiring heart replacement therapy. PMID:25499474

Sorabella, Robert A.; Yerebakan, Halit; Walters, Ryan; Takeda, Koji; Colombo, Paolo; Yuzefpolskaya, Melana; Jorde, Ulrich; Mancini, Donna; Takayama, Hiroo; Naka, Yoshifumi

2014-01-01

104

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

PubMed Central

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

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

2015-01-01

105

Analysis of the molecular and clinicopathologic features of surgically resected lung adenocarcinoma in patients under 40 years old  

PubMed Central

Introduction The youthful lung cancer may constitute an entity with distinct clinicopathologic characteristics and a controversial prognosis compared with the older counterpart. Whether the youthful lung cancer has the exclusively distinct molecular features has not been well investigated. Methods Thirty-six resected lung adenocarcinomas from young patients under 40 years old were analyzed concurrently for mutations in EGFR, KRAS, HER2, BRAF, AKT1, ALK, RET, TP53 and LKB1 and enrolled as the younger group. Their molecular and clinicopathologic characteristics were compared with those of 87 adenocarcinoma cases from patients above 40 years old which were collected as the older group. Results The comparable overall survival (OS) (P=0.942), more early adenocarcinomas (P=0.033), more wedge resections (P<0.001) and fewer smokers (P=0.004) were seen in the younger group, when compared with the clinicopathologic characteristics in the older group. Nineteen EGFR mutations (52.8%), 3 KRAS mutations (8.3%), 2 EML4-ALK fusions (5.6%) and 1 KIF5b-RET fusion (2.8%) were identified in the younger group. The difference of oncogenic mutations between the two groups was statistically insignificant (P=0.396). Twenty-six TP53 mutations (72.2%) and 4 LKB1 mutations (11.1%) were found in the younger group. When compared with the old patients, young patients showed a higher prevalence of TP53 mutations (P<0.001) and a comparable prevalence of LKB1 mutations (P=0.951). Conclusions The youthful lung cancer unequivocally presented the distinct clinicopathologic characteristics including more early adenocarcinomas and fewer smokers. It showed the similar oncogenic characteristics and higher prevalence of TP53 mutations compared with the older counterpart. PMID:25364516

Ye, Ting; Pan, Yunjian; Wang, Rui; Hu, Haichuan; Zhang, Yang; Li, Hang; Wang, Lei

2014-01-01

106

Autopsy report of a 7-year old patient with the mosaic trisomy 13.  

PubMed

We present here a long survival case of a patient with the mosaic form of trisomy 13 who died of aspiration pneumonia at the age of 7 years and 4 months. The autopsy revealed olfactory aplasia and fenestration of the septum pellucidum, and dilated lateral ventricles and atrophic hippocampus. Furthermore, there were numerous "torpedos" (i.e., swollen fusiform Purkinje cell axons), mostly in the granular layer underneath the Purkinje cell layer, and, occasionally, in the granular layer. Similar neuropathological findings have been reported in elderly cases of essential tremor, Parkinson's disease, or Alzheimer's disease. Precise mechanism for this axonal change is still unclear. These pathological changes have never previously been reported in the literature on trisomy 13, and the present patient is one of the oldest autopsied individuals with the mosaic trisomy 13. PMID:23526188

Imataka, George; Yamanouchi, Hideo; Hirato, Junko; Eguchi, Mitsuoki; Kojima, Masaru; Honma, Koichi; Arisaka, Osamu

2013-11-01

107

Irradiated Male Tsetse from a 40-Year-Old Colony Are Still Competitive in a Riparian Forest in Burkina Faso  

PubMed Central

Background Tsetse flies are the cyclical vectors of African trypanosomosis that constitute a major constraint to development in Africa. Their control is an important component of the integrated management of these diseases, and among the techniques available, the sterile insect technique (SIT) is the sole that is efficient at low densities. The government of Burkina Faso has embarked on a tsetse eradication programme in the framework of the PATTEC, where SIT is an important component. The project plans to use flies from a Glossina palpalis gambiensis colony that has been maintained for about 40 years at the Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES). It was thus necessary to test the competitiveness of the sterile males originating from this colony. Methodology/Principal Findings During the period January–February 2010, 16,000 sterile male G. p. gambiensis were released along a tributary of the Mouhoun river. The study revealed that with a mean sterile to wild male ratio of 1.16 (s.d. 0.38), the abortion rate of the wild female flies was significantly higher than before (p?=?0.026) and after (p?=?0.019) the release period. The estimated competitiveness of the sterile males (Fried index) was 0.07 (s.d. 0.02), indicating that a sterile to wild male ratio of 14.4 would be necessary to obtain nearly complete induced sterility in the female population. The aggregation patterns of sterile and wild male flies were similar. The survival rate of the released sterile male flies was similar to that observed in 1983–1985 for the same colony. Conclusions/Significance We conclude that gamma sterilised male G. p. gambiensis derived from the CIRDES colony have a competitiveness that is comparable to their competitiveness obtained 35 years ago and can still be used for an area-wide integrated pest management campaign with a sterile insect component in Burkina Faso. PMID:22590652

Sow, Adama; Sidibé, Issa; Bengaly, Zakaria; Bancé, Augustin Z.; Sawadogo, Germain J.; Solano, Philippe; Vreysen, Marc J. B.; Lancelot, Renaud; Bouyer, Jeremy

2012-01-01

108

Intravenous Thrombolysis with Recombinant Tissue Plasminogen Activator for Ischemic Stroke Patients over 80 Years Old: The Fukuoka Stroke Registry  

PubMed Central

Objectives The benefit of intravenous recombinant tissue plasminogen activator (rt-PA) therapy for very old patients with acute ischemic stroke remains unclear. The aim of this study was to elucidate the efficacy and safety of intravenous rt-PA therapy for patients over 80 years old. Methods Of 13,521 stroke patients registered in the Fukuoka Stroke Registry in Japan from June 1999 to February 2013, 953 ischemic stroke patients who were over 80 years old, hospitalized within 3 h of onset, and not treated with endovascular therapy were included in this study. Among them, 153 patients were treated with intravenous rt-PA (0.6 mg/kg). For propensity score (PS)-matched case-control analysis, 148 patients treated with rt-PA and 148 PS-matched patients without rt-PA therapy were selected by 1?1 matching with propensity for using rt-PA. Clinical outcomes were neurological improvement, good functional outcome at discharge, in-hospital mortality, and hemorrhagic complications (any intracranial hemorrhage [ICH], symptomatic ICH, and gastrointestinal bleeding). Results In the full cohort of 953 patients, rt-PA use was associated positively with neurological improvement and good functional outcome, and negatively with in-hospital mortality after adjustment for multiple confounding factors. In PS-matched case-control analysis, patients treated with rt-PA were still at lower risk for unfavorable clinical outcomes than non-treated patients (neurological improvement, odds ratio 2.67, 95% confidence interval 1.61–4.40; good functional outcome, odds ratio 2.23, 95% confidence interval 1.16–4.29; in-hospital mortality, odds ratio 0.30, 95% confidence interval 0.13–0.65). There was no significant association between rt-PA use and risk of hemorrhagic complications in the full and PS-matched cohorts. Conclusions Intravenous rt-PA therapy was associated with improved clinical outcomes without significant increase in risk of hemorrhagic complications in very old patients (aged>80 years) with acute ischemic stroke. PMID:25329379

Matsuo, Ryu; Kamouchi, Masahiro; Fukuda, Haruhisa; Hata, Jun; Wakisaka, Yoshinobu; Kuroda, Junya; Ago, Tetsuro; Kitazono, Takanari

2014-01-01

109

Unprotected Left Main Percutaneous Coronary Intervention in a 108-Year-Old Patient  

PubMed Central

With the increase in life expectancy, the proportion of very elderly people is increasing. Coronary artery disease (CAD) is an important cause of mortality and morbidity in this age group, for which myocardial revascularization is often indicated. Percutaneous coronary intervention (PCI) in the very elderly bears the inherent risks of complications and mortality, but the potential benefits may outweigh these risks. A number of observational studies, registries, and few randomized controlled trials have shown the safety and feasibility of PCI in octogenarians and nonagenarians. However, PCI is only rarely done in centenarians; so, the outcome of percutaneous coronary revascularization in this age group is largely unknown. PCI in a centenarian with complex CAD is described here; the patient presented with unstable angina despite optimum medical therapy, and surgery was declined. Good angiographic success was followed by non-cardiac complications, which were managed with a multidisciplinary approach. PMID:24653741

Rahman, Afzalur

2014-01-01

110

Curing a 96-year-old patient afflicted with benign paroxysmal positional vertigo on a motorized turntable  

PubMed Central

Background Dizziness in the elderly is a serious health concern due to the increased morbidity caused by falling. The most common cause of dizziness in the elderly, benign paroxysmal positional vertigo (BPPV), is frequently undiagnosed, and bedside treatment of these patients can be difficult due to neck and back stiffness, which makes repeated and accurate repositioning maneuvers difficult. Case presentation After a fall, a 96-year-old woman was referred by a resident neurologist for intractable BPPV. The patient was placed on a motorized turntable and repositioned to remove the calcite particles from the affected posterior semicircular canal. Video monitoring of the eyes allowed confirmation of the diagnosis, as well as an immediate evaluation of the effectiveness of the maneuver. Conclusion Every patient with dizziness or imbalance, even in the absence of typical complaints of BPPV, should be tested with provocation maneuvers, because the clinical picture of BPPV is not always typical. Even if elderly patients with dizziness are very frail, the completion of provocation maneuvers is imperative, since the therapeutic maneuvers are extremely effective. A motorized turntable is very helpful to perform the repositioning accurately and safely. PMID:24748776

Bockisch, Christopher J; Straumann, Dominik; Weber, Konrad P

2014-01-01

111

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

PubMed Central

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

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

2007-01-01

112

Body Dissatisfaction and Eating Disorder Symptomatology: A Latent Structural Equation Modeling Analysis of Moderating Variables in 18-to-28-Year-Old Males.  

PubMed

ABSTRACT. Although body dissatisfaction is recognized as the strongest risk factor for eating disturbances, a majority of young males are body dissatisfied, but do not concomitantly report severe levels of eating disorder symptomatology. The present investigation was designed to examine five theoretically relevant variables (i.e., body checking, emotional dysregulation, perfectionism, insecure-anxious attachment, and self-esteem) as potential moderators of the relationship between body dissatisfaction and two critical components of male eating disorder symptomatology: drive for muscularity and bulimic behaviors. Data collected from 551 Italian males between 18 and 28 years old were analyzed using latent structural equation modeling. The authors found that emotional dysregulation, body checking, insecure-anxious attachment and perfectionism intensified the relationship between body dissatisfaction and each criterion variable representing male eating disorder symptomatology; the interactions accounted respectively for an additional 2%, 7%, 4% and 5% of variance in drive for muscularity and for an additional 6%, 4%, 5%, and 2% of the variance in bulimic behaviors. By contrast self-esteem weakened this relationship and the interactions accounted for an additional 3% of the variance in both drive for muscularity and bulimic behaviors. Implications of these findings for prevention and treatment of male eating disturbances are discussed. PMID:25495164

Dakanalis, Antonios; Favagrossa, Laura; Clerici, Massimo; Prunas, Antonio; Colmegna, Fabrizia; Zanetti, M Assunta; Riva, Giuseppe

2015-01-01

113

Socio-demographic profile of 15-24 years old male narcotic substance users in a resettlement colony of Delhi.  

PubMed

A community based cross-sectional study was conducted during April 2004-March 2005 in an urban resettlement colony in East Delhi to study the narcotic substance use and the socio-demographic characteristics of users. 208 male narcotic substance users aged 15-24 years were studied. 59.1% of the narcotic substance users were between 21-24 years of age. 78.8% were using ganja and 39.9% each heroin & bhang. 37% were abusers; 36% were dependent users. 58.7% were single at the time of interview. 48% were either illiterate or just literate; 64% belonged to middle socio-economic status. 68% had initiated narcotic substance use out of curiosity. PMID:19806830

Jain, V; Pradhan, S K; Vibha

2009-01-01

114

Concomitant testicular seminoma and ectopic adrenal tissue of the cord in a 45-year-old male  

PubMed Central

Aberrant adrenal tissue near the adrenal gland is common, but the finding of ectopic adrenal tissue in structures around the spermatic cord and testis is rare. We describe a case of concomitant seminoma and ectopic adrenal tissue of the spermatic cord occurring in an adult patient who had undergone orchidopexy as a child. PMID:24678359

Floyd, Michael S.; Itam, Sarah; Nasir, Nyla; Weerasinghe, Suboda M.; Irwin, Paul P.; Maddineni, Satish B.

2014-01-01

115

Bone mineral density and serum testosterone in chronically trained, high mileage 40–55 year old male runners  

PubMed Central

Objectives—To identify physical activity that is beneficial for the maintenance of bone strength with increasing age by examining the relation between bone mineral density (BMD) and chronic endurance training in men. BMD at the proximal femur, its subregions, and the lumbar spine, and serum testosterone were compared between two groups of long distance runners with more than 20 years of training experience and non-athletic controls. Methods—Runners (n = 12) were divided into (a) high volume runners (n = 7), running 64–80 km a week, and (b) very high volume runners (n = 5), running more than 95 km a week, and compared with non-athletic male controls, exercising in non-endurance oriented activities two to four times a week. BMD (g/cm2) at the total proximal femur, femoral neck, trochanteric region, and lumbar spine was measured by dual energy x ray absorptiometry. Total testosterone (nmol/l) and free testosterone (pmol/l) in serum were measured by radioimmunoassay from single fasting blood samples. Results—Height, weight, and age (range = 40–55 years) were not significantly different between groups. The high volume runners had significantly higher BMD at the total proximal femur (1.09 (0.17) v 0.94 (0.056)), femoral neck (0.91 (0.16) v 0.78 (0.071)), and trochanteric region (0.85 (0.14) v 0.73 (0.053)) than controls (p<0.05). The differences in BMD for the proximal femur between the very high volume runners and the other two groups were not significant. There was no difference in lumbar spine BMD, total testosterone, or free testosterone between groups. However, there was a significant negative correlation between total testosterone (r = -0.73, p<0.01) and free testosterone (r = -0.79, p<0.005) and running volume in the distance runners. Conclusions—Long term distance running with training volumes less than 80 km a week had a positive effect on BMD of the proximal femur. With running volumes greater than 64 km a week, training was inversely related to testosterone levels, but levels remained within the normal range. Key Words: exercise; bone mineral density; male athletes; runners; endurance training; testosterone PMID:10953900

MacKelvie, K; Taunton, J; McKay, H; Khan, K

2000-01-01

116

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

PubMed Central

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.

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

117

Acute watery diarrhea as the initial presenting feature of a pheochromocytoma in an 84-year-old female patient.  

PubMed

We report the case of an 84-year-old woman who was initially admitted to the emergency room of our institution for frank dehydration caused by acute and severe secretory diarrheas along with acidosis and hypokalemia. After extensive gastrointestinal investigations, the etiology of the diarrhea remained unclear. Because clinical symptoms and ionogram parameters worsened, despite intravenous fluids and electrolyte replacement, an abdominal CT scan was performed and unexpectedly revealed a 4.5-cm mass in the right adrenal gland. Several separate 24-hour urine catecholamines were shown to be highly elevated. The diagnosis of pheochromocytoma was confirmed by MIBG scintigraphy and MRI. Before the admission, the patient never experienced symptoms suggestive of pheochromocytoma, except dry mouth and fear of impending death on several occasions. After 2 weeks, the diarrhea stopped abruptly and spontaneously without specific medication but after adequate rehydration. The patient subsequently underwent surgical removal of the adrenal medullary mass. Postoperatively, urinary catecholamines returned to normal values. Immunohistochemical study of the tumor confirmed the diagnosis of pheochromocytoma and revealed the presence of VIP-positive cells organized as islets in scattered areas of the tissue. This case illustrates the protean mode of presentation of pheochromocytoma, as well as the ability of medullary neural crest-derived cells to produce various neuropeptides potentially responsible for a large variety of symptoms. PMID:10681641

Van Eeckhout, P; Shungu, H; Descamps, F X; Lanthier, P; Castelain, T; Saey, J P; Rettman, R; Drese, C; Colin, I M

1999-01-01

118

Osler-Weber-Rendu Disease Presenting as Recurrent Portosystemic Encephalopathy in a 75-year-old Female Patient.  

PubMed

Osler-Weber-Rendu disease is a rare autosomal dominant disorder of fibrovascular tissues, characterized by a classic triad of mucocutaneous telangiectasias, recurrent hemorrhages, and a familial occurrence. Portosystemic encephalopathy in a patient with Osler-Weber-Rendu disease is rare, but we experienced a case presenting with recurrent portosystemic encephalopathy in Osler-Weber-Rendu disease. We report on a case of a 75-year-old female presenting with an altered mentality. Initial studies including brain imaging study did not reveal any specific cause for her mental status. She was diagnosed with the rare disease after a series of tests and received conservative treatment. Her neurological status recovered fully without complication after conservative treatment and she was discharged after 18 hospital days. This case demonstrated an extremely rare case of Osler-Weber-Rendu disease presenting as portosystemic encephalopathy treated successfully with conservative treatment. For patients who have shown hepatic encephalopathy without a definite cause, we recommend evaluation for the possibility of Osler-Weber-Rendu disease. Conservative treatment based on treatment of advanced liver cirrhosis could be an alternative solution. (Korean J Gastroenterol 2015;65:57-61). PMID:25603856

Ha, Junghoon; Son, Byoung Kwan; Ahn, Sang Bong; Jo, Young Kwan; Kim, Seong Hwan; Jo, Yun Ju; Park, Young Sook; Jung, Yoon Young

2015-01-25

119

Relationship between Body Mass Index, Skeletal Maturation and Dental Development in 6- to 15- Year Old Orthodontic Patients in a Sample of Iranian Population  

PubMed Central

Statement of the Problem: The prevalence of overweight and obesity has been increasing markedly in recent years. It may influence growth in pre pubertal children. Purpose: The purpose of this study was to determine whether increased Body Mass Index (BMI) is associated with accelerated skeletal maturation and dental maturation in six to fifteen years old orthodontic patients in Shiraz, Iran. Materials and Method: Skeletal maturation and dental development of 95 orthodontic patients (65 females and 30 males), aged 6 to 15 years, were determined. Dental development was assessed using the Demerjian method and skeletal maturation was evaluated by cervical vertebral method as presented by Bacetti. The BMI was determined for each patient. T-test was applied to compare the mean difference between chronologic and dental age among the study groups. A regression model was used to assess the relationship between BMI percentile, skeletal maturation, and dental development. Results: 18.9% of subjects were overweight and obese. The mean differences between dental age and chronologic age were 0.73±1.3 for underweight and normal weight children and 1.8±1.08 for overweight and obese children. These results highlighted the correlation between accelerated dental maturity and increasing BMI percentile (p= 0.002). A new formula was introduced for this relationship. There was not any significant relationship between BMI percentile and skeletal maturation. Conclusion: Children who were overweight or obese had accelerated dental development whereas they did not have accelerated skeletal maturation significantly after being adjusted for age and gender. PMID:25469357

Hedayati, Zohreh; Khalafinejad, Fatemeh

2014-01-01

120

Blinding Bilateral Hyperviscosity Retinopathy in a 43-Year-Old Nigerian Male with Lymphoplasmacytic Lymphoma: A Case Report and Management Challenges  

PubMed Central

Lymphoplasmacytic lymphomas are rare and may present with uncommon and devastating symptoms. We report a case of a 43-year-old male who presented with bleeding gums and sudden onset of bilateral blindness but was not on anticoagulants and had no family history of bleeding disorder. He had bilateral hyperpigmented infraorbital skin lesions, visual acuities (VA) of hand motion in both eyes (blindness), round and sluggish pupils, and bilateral diffuse and extensive retinal haemorrhages obliterating the retinal details with central visual field defects. The optical coherence tomography revealed retinal haemorrhage, oedema, detachment, and diffuse photoreceptors damage. Investigations revealed elevated ESR and ?2 microglobulin, monoclonal peak on serum protein electrophoresis, high IG with lambda restriction on serum, and urine immunofixation with increased lymphocytes and plasma cells in the bone marrow. A diagnosis of lymphoplasmacytic lymphoma complicated by blinding hyperviscosity retinopathy was made. In the absence of an aphaeresis machine, he received four cycles of manual exchange blood transfusion (EBT) and commenced with chlorambucil/prednisolone due to difficulty in obtaining blood for continued EBT. His general condition and VA has improved and he is stable for more than six months into treatment. PMID:24883217

Ayanniyi, Abdulkabir A.; Ejikeme, Uchenna Godswill; Tanko, Yohanna; Muhammad, Rilwan C.; Nnodu, Obiageli E.

2014-01-01

121

Improvements in sleep and handwriting after complementary medical intervention using acupuncture, applied kinesiology, and respiratory exercises in a nine-year-old ADHD patient on methylphenidate.  

PubMed

The case study reports on the effect of pharmacological, complementary, and alternative medicine including acupuncture, Applied Kinesiology, and respiratory exercises in a boy with attention-deficit hyperactivity disorder (ADHD) on methylphenidate. A nine-year-old male patient was referred to treatment with a three-year diagnosis of ADHD, sleeping troubles, and dissatisfaction with methylphenidate. Examination included Applied Kinesiology, the coachman?s test, assessment of breathing pattern disorders, and traditional chinese medicine (TCM) diagnosis. Muscle weakness related to thoracic breathing was found in the coachman?s test. Respiratory exercises, acupuncture with permanent needles, and Applied Kinesiology treatments were given. Within the first treatment, muscle function as assessed by the coachman?s test normalized. After two treatments, sleep behavior improved rapidly, and with further treatments, handwriting was improving. Methylphenidate continues to be given. The results were stable after 15 months. A multimodal approach to ADHD integrating pharmacological treatment and complementary and alternative medicine (CAM) including Applied Kinesiology, breathing exercises, and acupuncture. PMID:25256020

Molsberger, Friedrich; Raak, Christa; Witthinrich, Christiane

2014-01-01

122

EFFECT OF POSTMASTECTOMY RADIOTHERAPY IN PATIENTS <35 YEARS OLD WITH STAGE II–III BREAST CANCER TREATED WITH DOXORUBICIN-BASED NEOADJUVANT CHEMOTHERAPY AND MASTECTOMY  

PubMed Central

Purpose Postmastectomy radiotherapy (PMRT) improves locoregional control (LRC) in patients with high-risk features after mastectomy. Young age continues to evolve as a potentially important risk factor. The objective of this study was to assess the benefits of PMRT in patients <35 years old treated with doxorubicin-based neoadjuvant chemotherapy for Stage II–III breast cancer. Patients and Methods We retrospectively analyzed 107 consecutive breast cancer patients <35 years old with Stage IIA–IIIC disease treated at our institution with doxorubicin-based neoadjuvant chemotherapy and mastectomy, with or without PMRT. The treatment groups were compared in terms of LRC and overall survival. Results Despite more advanced disease stages, the patients who received PMRT (n = 80) had greater rates of LRC (5-year rate, 88% vs. 63%, p = 0.001) and better overall survival (5-year rate, 67% vs. 48%, p = 0.03) than patients who did not receive PMRT (n = 27). Conclusion Among breast cancer patients <35 years old at diagnosis, the use of PMRT after doxorubicin-based neoadjuvant chemotherapy and mastectomy led to a statistically greater rate of LRC and overall survival compared with patients without PMRT. The benefit seen for PMRT in young patients provides valuable data to better tailor adjuvant, age-specific treatment decisions after mastectomy. PMID:17855016

Garg, Amit K.; Oh, Julia L.; Oswald, Mary Jane; Huang, Eugene; Strom, Eric A.; Perkins, George H.; Woodward, Wendy A.; Yu, T. Kuan; Tereffe, Welela; Meric-Bernstam, Funda; Hahn, Karin; Buchholz, Thomas A.

2011-01-01

123

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

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

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

2014-01-01

124

Thymus transplantation. Reconstitution of cellular immunity in a four-year-old patient with T-cell deficiency.  

PubMed Central

The case is reported of a 4-year-old girl affected with recurrent infections; anaemia, thrombocytopenia, haemorrhages and hepatosplenomegaly. Immunological investigations revealed a defect in cellular immunity related to the thymus-dependent system, hypergammaglobulinaemia (especially of class IgE), and very high titres of antibodies against Epstein-Barr virus (EBV). After foetal thymus transplantation, correction of the immunological defect and significant clinical improvement were noted, as well as a decrease of IgE and EBV antibody titres. PMID:171111

Businco, L; Rezza, E; Giunchi, G; Aiuti, F

1975-01-01

125

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

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…

Sinclair-Blake, Leslie C.

2010-01-01

126

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

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.

Neska-Matuszewska, Ma?gorzata; Zimny, Anna; Ka?wak, Krzysztof; S?siadek, Marek J.

2015-01-01

127

Very Late (10YearOld) Bare Metal Stent Thrombosis  

Microsoft Academic Search

We present findings from a 59-year-old male patient who presented with coronary artery disease and refractory angina. Ten years prior, the patient had been implanted with 5 bare metal stents (BMS); he arrived with non-specific ST-T wave abnormalities. Angiographic data revealed a totally occluded right coronary artery at the level of the previously placed BMS, consistent with an acute occlusion

Eric Scot Shaw; Vikas Singh; Pedro Martinezclark; William W. O’Neill

2010-01-01

128

Cardiac muscle AMP-deaminase from a 10-year-old male heterozygous for the AMPD1 C34T mutation.  

PubMed

A C34T mutation in the AMPD1 gene is proposed to cause local or systemic augmentations in blood adenosine level and improvement of prognoses in heart diseases like congestive heart failure or heart ischemic disease. This study examines some physico-chemical properties of AMP-deaminase isolated from cardiac muscle of a 10-year-old boy heterozygote for this mutation. PMID:20544536

Rybakowska, I; Baku?a, S; Klimek, J; Milczarek, R; Smolenski, R T; Kaletha, K

2010-06-01

129

Delaying Shoulder Motion and Strengthening and Increasing Achilles Allograft Thickness for Glenoid Resurfacing Did Not Improve the Outcome for a 30-Year-Old Patient with Postarthroscopic Glenohumeral Chondrolysis  

PubMed Central

Although interposition soft-tissue (biologic) resurfacing of the glenoid with humeral hemiarthroplasty has been considered an option for end-stage glenohumeral arthritis, the results of this procedure are highly unsatisfactory in patients less than 40 years old. Achilles tendon allograft is popular for glenoid resurfacing because it can be made robust by folding it. But one reason that the procedure might fail in younger patients is that the graft is not initially thick enough for the young active patient. Most authors report folding the graft only once to achieve two-layer thickness. We report the case of a 30-year-old male who had postarthroscopic glenohumeral chondrolysis that was treated with Achilles tendon allograft resurfacing of the glenoid and humeral hemiarthroplasty. An important aspect of our case is that the tendon was folded so that it was 50–100% thicker than most allograft constructs reported previously. We also used additional measures to enhance allograft resiliency and bone incorporation: (1) multiple nonresorbable sutures to attach the adjacent graft layers, (2) additional resorbable suture anchors and nonresorbable sutures in order to more robustly secure the graft to the glenoid, and (3) delaying postoperative motion and strengthening. However, despite these additional measures, our patient did not have an improved outcome. PMID:25580331

Skedros, John G.; Henrie, Tanner R.; Mears, Chad S.

2014-01-01

130

Language Development: 1 Year Olds  

MedlinePLUS

... Language Development: 1 Year Olds Ages & Stages Listen Language Development: 1 Year Olds Article Body Early in ... assured, it’s not your imagination. He’s developing his language and comprehension skills right on schedule. This giant ...

131

Language Development: 2 Year Olds  

MedlinePLUS

... Language Development: 2 Year Olds Ages & Stages Listen Language Development: 2 Year Olds Article Body Your two- ... Pay attention to how he also is using language to describe ideas and information and to express ...

132

Emotional Development: 1 Year Olds  

MedlinePLUS

... 1 Year Olds Ages & Stages Listen Emotional Development: 1 Year Olds Article Body Throughout her second year, ... for shelter. She may seem to change from one moment to the next, or she may seem ...

133

Anesthetic management of hypertensive crisis in a three-year-old patient with undiagnosed severe renal artery stenosis: a case report  

PubMed Central

Pediatric hypertensive crisis is a potentially life threatening medical emergency, usually secondary to an underlying disease. Hypertension commonly occurs during general anesthesia, and is usually promptly and appropriately treated by anesthesiologists. However in children with severe, unexplained, or refractory hypertension, it has the potential to cause morbidity and even mortality in susceptible patients. We report an anesthetic management of an unexpected hypertensive crisis that developed during general anesthesia in a three-year-old girl with undiagnosed severe left renal artery stenosis. PMID:25368787

Park, Sang-hee; Min, Too Jae; Kim, Woon Young; Kim, Jae Hwan; Park, Young Cheol

2014-01-01

134

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

SciTech Connect

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.

Blackett, P.R.; Altmiller, D.H. [Univ. of Oklahoma Health Services Center, Oklahoma City, OK (United States); Jelley, D. [Childrens Medical Center, Tulsa, OK (United States); Wilson, D.P. [Driscoll Children`s Hospital, Corpus Christi, TX (United States)

1995-11-20

135

Time to First Shunt Failure in Pediatric Patients over 1 Year Old: A 10-Year Retrospective Study.  

PubMed

Studies comparing alternatives to ventriculoperitoneal (VP) shunting for treatment of hydrocephalus have often relied upon data from an earlier era that may not be representative of contemporary shunt survival outcomes. We sought to determine the shunt survival rate of our cohort and compare our results to previously published shunt survival and endoscopic third ventriculostomy (ETV) success rates. We identified 95 patients between 1 and 18 years of age, who underwent initial VP shunt placement between January 2001 and December 2010. Our study shows a shunt survival rate of 85% at 6 months and 79% at 2 years, for initial shunts in pediatric patients over 1 year of age in this cohort. The overall infection rate was 3%. This compares favorably with published success rates of ETV at similar time points as well as with the rate of infection. This suggests that ventricular shunting remains a viable alternative to ETV in the older child. © 2014 S. Karger AG, Basel. PMID:25471222

Shannon, Chevis N; Carr, Kevin R; Tomycz, Luke; Wellons, John C; Tulipan, Noel

2014-11-27

136

Reappearance of an 11-year-old sequence in an HIV-1 infected patient during treatment interruption.  

PubMed

HIV-1 from a patient with multi-drug resistant virus was identified as wild type during treatment interruption. The aim of the study was to describe how the viral population is affected by treatment interruptions and use phylogeny to reconstruct the evolutionary pattern. 15 samples covering 13 y and 2 treatment interruptions were analysed in both pol and env. The wild type virus found in the sample from the second treatment interruption in 2002 had not been present as a dominant population since 1994. Phylogeny showed that the 2002 sample was more closely related to wild type sequences than to other sequences sampled in 2002. This indicated that the wild type virus was caused by recruitment from the viral archives rather than reversion of previously circulating resistant strains. A few weeks after re-initiated treatment, virus showed full resistance, indicating that resistant virus was present as a subpopulation and reselected due to higher fitness in the presence of drugs. Phylogeny of env showed that CCR5 and CXCR4 viruses coexist in the patient. In conclusion, the study showed that at all times during infection, virus is archived in the cells and can be recruited when the surrounding environment changes and the archived virus is more fit. PMID:17926204

Madsen, Tina Vasehus; Gerstoft, Jan; Nielsen, Claus; Jørgensen, Louise Bruun

2008-01-01

137

The 27 to 29-Year Outcomes of the PCA Total Hip Arthroplasty in Patients Younger Than 50 Years Old.  

PubMed

We previously reported our six and 19.4-year results of arthroplasty with the PCA total hip prosthesis. We now report on the performance of this prosthesis at 27-29years. Eighty-eight consecutive primary THAs using a PCA total hip system were performed in 70 patients (mean age, 45.6±11.1years). The mean follow-up was 28.4years (27-29). The mean Harris hip score was 89 points at final follow-up. Thigh pain was reported in 22 hips (25%). The mean annual polyethylene wear was 0.182±0.03mm. There were 75 acetabular (85%) and 40 femoral (45%) osteolysis. The rate of survival after 28.4years as the end point of revision was 66% for the acetabular component and 90% for the femoral component. PMID:24636903

Kim, Young-Hoo; Park, Jang-Won; Park, Jeong-Soo

2014-12-01

138

Combination of acupuncture and spinal manipulative therapy: management of a 32-year-old patient with chronic tension-type headache and migraine  

PubMed Central

Objective The purpose of this case study is to describe the treatment using acupuncture and spinal manipulation for a patient with a chronic tension-type headache and episodic migraines. Clinical Features A 32-year-old woman presented with headaches of 5 months' duration. She had a history of episodic migraine that began in her teens and had been controlled with medication. She had stopped taking the prescription medications because of gastrointestinal symptoms. A neurologist diagnosed her with mixed headaches, some migrainous and some tension type. Her headaches were chronic, were daily, and fit the International Classification of Headache Disorders criteria of a chronic tension-type headache superimposed with migraine. Intervention and Outcome After 5 treatments over a 2-week period (the first using acupuncture only, the next 3 using acupuncture and chiropractic spinal manipulative therapy), her headaches resolved. The patient had no recurrences of headaches in her 1-year follow-up. Conclusion The combination of acupuncture with chiropractic spinal manipulative therapy was a reasonable alternative in treating this patient's chronic tension-type headaches superimposed with migraine. PMID:23449932

Ohlsen, Bahia A.

2012-01-01

139

Arteriovenous fistula and pseudoaneurysm of the anterior spinal artery caused by an epidural needle in a 5-year-old patient.  

PubMed

Authors present the case of a 5-year-old patient with a spinal arteriovenous fistula (AVF) and pseudoaneurysm of the anterior spinal artery (ASA) caused by a traumatic epidural needle stick injury. A discussion and relevant review of the literature follow. The boy had a remote history of a liver transplant and required neuraxial blockade for an unrelated abdominal surgical procedure. Initial insertion of the epidural needle at the T9-10 interspace yielded blood. A second attempt at T10-11 was successful. Delayed left leg weakness developed on postoperative Day 8, with an MR image showing a track injury through the cord and a ventral subarachnoid hematoma. Laminectomies from T-9 to T-11were performed emergently to decompress the spinal cord. The dura mater was opened, the ventral hematoma was evacuated, and brisk venous bleeding was controlled with cauterization. Postoperative spinal angiography demonstrated an AVF and pseudoaneurysm of the ASA. Repeat angiography at postoperative Week 4 demonstrated complete resolution of the AVF and pseudoaneurysm, probably due to intraoperative cauterization of the draining vein. The patient underwent a short course of rehabilitation and had no clinical or electrophysiological evidence of spinal cord damage at the 20-month follow-up. One should be cognizant of the possibility of a cord injury in a patient with new-onset neurological deficits following an interventional spine procedure. Neuroimaging is essential for prompt diagnosis and treatment. PMID:23311385

Alnaami, Ibrahim; Lam, Fred C; Steel, Graham; Dicken, Bryan; O'Kelly, Cian J; Aronyk, Keith; Mehta, Vivek

2013-03-01

140

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

PubMed Central

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

Ercan, ?erif; Çal??kan, Mustafa; Koptur, Erhan

2014-01-01

141

A Novel (Paternally Inherited) Duplication 13q31.3q32.3 in a 12-Year-Old Patient with Facial Dysmorphism and Developmental Delay  

PubMed Central

We report a 12-year-old boy referred to the Clinical Genetics service in view of facial dysmorphism, learning difficulties and autistic spectrum disorder. 60K arrayCGH revealed an 8.2-Mb duplication on chromosome 13q31.3q32.3, which was paternally inherited. This specific duplication on chromosome 13 has not been previously reported in the medical literature, and there are no familial or de novo patients with the same duplication breakpoints. This region contains 24 OMIM genes, including the glypicans GPC5 and GPC6, and the ZIC2 gene. We discuss the relevance of this chromosome imbalance and discuss the impact of this duplication on our patient's phenotype. Given that the duplication on 13q was paternally inherited, and although initially thought to be of uncertain significance, on exploring the family history further, it became apparent that the father had learning difficulties as a child and previous surgery for congenital diaphragmatic hernia. Here we explore the phenotype in association with this novel duplication on chromosome 13q and add to the existing literature on array findings within this region. PMID:25337073

Atack, E.; Fairtlough, H.; Smith, K.; Balasubramanian, M.

2014-01-01

142

Unintended Harm and Benefit of the Implantable Defibrillator in an Unfortunate 19-Year-Old Male: Featuring a Sequence of Rare Life-threatening Complications of Cardiac Procedures  

PubMed Central

All procedures have inherent risk. Our patient endured a sequence of rare life-threatening complications from commonly preformed procedures. The sequence of these complications was; large pericardial effusion post implantable cardioverter-defibrillator (ICD) implantation with echocardiographic signs of tamponade, left main narrowing post radiofrequency ablation, and late stent thrombosis post coronary intervention with a bare metal stent. All these occurred to one unfortunate young man. Furthermore, our patient demonstrated an unintended benefit of ICD which saved his life. PMID:24086098

Daoulah, Amin; Ocheltree, Ali; Lotfi, Amir; Ocheltree, Sara; Alsheikh-Ali, Alawi A; Al-Habib, Abdul-Karim; El-Sayed, Osama; Haneef, Ali

2013-01-01

143

Identification of an unusual Brucella strain (BO2) from a lung biopsy in a 52 year-old patient with chronic destructive pneumonia  

PubMed Central

Background Brucellosis is primarily a zoonotic disease caused by Brucella species. There are currently ten Brucella spp. including the recently identified novel B. inopinata sp. isolated from a wound associated with a breast implant infection. In this study we report on the identification of an unusual Brucella-like strain (BO2) isolated from a lung biopsy in a 52-year-old patient in Australia with a clinical history of chronic destructive pneumonia. Results Standard biochemical profiles confirmed that the unusual strain was a member of the Brucella genus and the full-length 16S rRNA gene sequence was 100% identical to the recently identified B. inopinata sp. nov. (type strain BO1T). Additional sequence analysis of the recA, omp2a and 2b genes; and multiple locus sequence analysis (MLSA) demonstrated that strain BO2 exhibited significant similarity to the B. inopinata sp. compared to any of the other Brucella or Ochrobactrum species. Genotyping based on multiple-locus variable-number tandem repeat analysis (MLVA) established that the BO2 and BO1Tstrains form a distinct phylogenetic cluster separate from the other Brucella spp. Conclusion Based on these molecular and microbiological characterizations, we propose that the BO2 strain is a novel lineage of the newly described B. inopinata species. PMID:20105296

2010-01-01

144

Giant coronary artery aneurysms in a 58-year-old  

PubMed Central

All giant Kawasaki aneurysms may not regress fully; some may eventually calcify, undergo thrombosis, and get detected in asymptomatic adults at later age. Tomisaku Kawasaki initially described this illness as mucocutaneous lymph node syndrome in childhood in 1967 and coronary arteritis was recognized later. We present a 58-year-old male, possibly one of the oldest surviving patients with giant coronary aneurysms who presented with large secundum atrial septal defect (ASD) with heart failure. This indicates that the disease was perhaps prevalent outside Japan even before the first Kawasaki's description. PMID:24987266

Singhi, Anil Kumar; Pavithran, Sreeja; Sivakumar, Kothandam

2014-01-01

145

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

PubMed Central

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

Faus-Matoses, Vicente; Alegre-Domingo, Teresa; Faus-Matoses, Ignacio; Faus-Llácer, Vicente J.

2014-01-01

146

"Who is the legal patient representative?" or "patient representatives"? Scenario: A 16 year old patient arrives at the reception desk to check in for a new appointment. The  

E-print Network

disease, HIV, mental health care, or for substance abuse (alcohol or drugs). When DCF is involved, it does for health care decisions. You are not sure whether or not the patient should be seen for today's visit not mean necessarily that the parent is no longer the decision-maker for health care, so this needs

Oliver, Douglas L.

147

A 37-year-old spinal cord-injured female patient, transplanted of multipotent stem cells from human UC blood, with improved sensory perception and mobility, both functionally and morphologically: a case study  

Microsoft Academic Search

HLA-matched UC blood-derived multipotent stem cells were directly transplanted into the injured spinal cord site of a 37-year-old female patient suffering from spinal cord injury (SPI). In this case, human cord blood (UCB)-derived multipotent stem cells improved sensory perception and movement in the SPI patient's hips and thighs within 41 days of cell transplantation. CT and MRI results also showed

K-S Kang; SW Kim; YH Oh; JW Yu; K-Y Kim; C-H Song; H Han

2005-01-01

148

A 17-year old patient with DOCK8 deficiency, severe oral HSV-1 and aggressive periodontitis - A case of virally induced periodontitis?  

PubMed

We present a 17-year old girl with DOCK-8 deficiency, severe untreated oral HSV-1 infection and associated aggressive periodontitis. DOCK-8 deficiency is a primary immunodeficiency, caused by biallelicloss-of-function mutations in the DOCK8 gene, often leading to severe viral and fungal mucocutaneous infections. Nevertheless, to date DOCK8 has not been associated with severe periodontitis and inflammatory bone loss around teeth. Understanding whether DOCK8 deficiency or severe HSV-1 infection underlies susceptibility to periodontitis is central to this case and may provide insights into susceptibility factors for periodontitis in the general population. Our clinical and microbiological data suggest that severe HSV-1 infection is the driver of periodontal inflammation in this case. PMID:25600604

Betts, K; Abusleme, L; Freeman, A F; Sarmadi, M; Fahle, G; Pittaluga, S; Cuellar-Rodriguez, J; Hickstein, D; Holland, S M; Su, H; Moutsopoulos, N M

2015-02-01

149

Generalized odontodysplasia in a 5-year-old patient with Hallermann-Streiff syndrome: clinical aspects, cone beam computed tomography findings, and conservative clinical approach.  

PubMed

This article aims to report the main clinical aspects, cone beam computed tomography (CBCT) findings, and conservative oral rehabilitation in a child born from a consanguineous marriage who presented with Hallermann-Streiff syndrome (HSS) and generalized odontodysplasia. A 5-year-old girl presented with a diagnosis of HSS for oral evaluation. Radiographically, all teeth showed wide pulp chambers and roots with thin dentinal walls and open apices, resembling ghost teeth and indicating a diagnosis of odontodysplasia. Oral rehabilitation consisted of partial dentures that were regularly adjusted to conform the device with the pattern of growth and development of the child. CBCT scan provided great insight into HSS, allowing a detailed view of the morphologic aspects and associated trabecular bone pattern. Treatment of these 2 rare conditions in young children must consider the stage of growth and development. Although extremely rare in HSS, odontodysplasia should be investigated and conservatively managed in young children. PMID:25047934

Damasceno, Juliana Ximenes; Couto, José Luciano Pimenta; Alves, Karla Shangela da Silva; Chaves, Cauby Maia; Costa, Fábio Wildson Gurgel; Pimenta, Alynne de Menezes Vieira; Fonteles, Cristiane Sá Roriz

2014-08-01

150

Pulmonary Hernia in a Two-Year-Old Child  

PubMed Central

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

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

2014-01-01

151

Cyst of the Canal of Nuck in a Two Year Old Girl  

PubMed Central

The canal of Nuck is analogous to a patent processus vaginalis in a male, which normally loses its communication to the peritoneal cavity within the first year of life. Failure of obliteration of this tract can result in a hydrocele. We present a rare case of a 2-year-old girl with left-sided groin swelling, diagnosed as inguinal hernia. Patient underwent surgical exploration and establishes definitive diagnosis as cyst of the canal of Nuck. PMID:25568556

Husaric, Edin; Hotic, Nesad; Halilbasic, Amir; Husaric, Senada; Rahmanovic, Emir; Suljendic, Sanimir

2014-01-01

152

Adenocarcinoma at the ureterosigmoidostomy site in a 16-year-old demonstrates the importance of screening in children.  

PubMed

We report the death of a 17-year-old male exstrophy patient from adenocarcinoma arising at the ureterosigmoidostomy. This was detected at reconstructive surgery at the age of 16 years, 13 years after ureterosigmoidostomy. This case highlights the importance of including children in endoscopic surveillance. We recommend annual sigmoid-colonoscopy commencing 10 years after ureterosigmoidostomy irrespective of age. PMID:18631934

Smeulders, Naima; Sudhakaran, Nada; Wilcox, Duncan T; Ransley, Philip G

2008-06-01

153

Sedative Effect of Oral Midazolam/Hydroxyzine versus Chloral Hydrate/Hydroxyzine on 2–6 Year-Old Uncooperative Dental Patients: A Randomized Clinical Trial  

PubMed Central

Objective: Different drugs are used for conscious sedation in pediatric dentistry either single or in combination. This study assessed the comparative effect of midazolam/hydroxyzine and chloral hydrate/hydroxyzine on 2–6 year-old uncooperative children needing dental treatment. Materials and Methods: A double blind cross-over randomized clinical trial was designed and 16 children aged 2–6 years with ASA1 status who were judged with negative to definitely negative behavior (according to Frankl) were chosen. Cases were divided randomly into two groups. The first group received midazolam/hydroxyzine (MH) at the first visit while the second group received chloral hydrate/hydroxyzine (CHH) as the first medication. Both groups received the other regimen at the second visit. Midazolam 0.5mg/kg and chloral hydrate 50mg/kg with 1mg/kg hydroxyzine were administered. Cases were subsequently assessed for sedation and then dental treatment was performed. Blood oxygen saturation (SpO2) and pulse rate (PR) were measured before and after drug administration, as well as during and after dental treatment. The Houpt scale was also used for the level of sedation before, during and after treatment. Data were analyzed using Wilcox-on signed rank test and the paired t-test. Results: Sedative success rate was 64.3% in cases of MH and 33.3% in CHH. The difference between groups was significant (P=0.046). The success rate was significantly different between groups at different measurement stages as well (P<0.05). No difference was found on the child’s behavior scale based on the type of drugs used first; this indicates no carry-over effect. Comparing the PR and SpO2 values at different readings showed no significant differences. Conclusion: Midazolam/hydroxyzine showed a significantly higher sedative effect than chloral hydrate/hydroxyzine in this study. PMID:24910681

Ghajari, Masoud Fallahinejad; Golpayegani, Mojtaba Vahid; Bargrizan, Majid; Ansari, Ghassem; Shayeghi, Shahnaz

2014-01-01

154

Individual Differences in Ghetto Four-Year-Olds.  

ERIC Educational Resources Information Center

Thirty-five disadvantaged Negro 4-year-olds were observed by one or the other of two white male child psychiatrists during a 30-minute play session. After the session, the observer dictated a descriptive summary of the session. He filled out a rating scale on aspects of the child's behavior, including speech and play behavior, nature of social…

Hirsch, Jay G.; And Others

155

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

PubMed

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. © 2014 Wiley Periodicals, Inc. Int J Eat Disord 2015; 48:253-257. PMID:24535846

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

2015-03-01

156

Pace Maker Implantation for Elderly Individuals Over 90 Years Old  

PubMed Central

Objective: The aim of this report was to discuss validity of pacemaker surgery for elderly individuals over 90 years old. Patient: We operated on 12 individuals over 90 years old who had syncope or congestive heart failure in association with bradycardia, between January 2005 and November 2012. Methods: All 12 patients were referred to us by the cardiology department of our hospital for pacemaker surgery. We applied our routine technique: cutdown of the cephalic vein, creation of a subpectoral pocket, use of screw-in leads, and use of generators with an automatic output control system. Results: All of the patients received a dual chamber system with atrial and ventricular leads and recovered uneventfully. The follow-up period was between 1 month and 7 years. Conclusion: An advanced age over 90 years old is not a contraindication for pacemaker surgery.

Shiheido, Eika; Shimada, Yasuyuki

2013-01-01

157

Primary Vesical Actinomycosis in a 23-Year-Old Man  

PubMed Central

Introduction. Actinomycosis can affect any organ of the body, although cutaneous fistulas are common in actinomycotic infections, and other organs such as the bladder are only rarely involved. Case Presentation. Herein we report and discuss a young male patient with primary vesical actinomycosis. A 23-year-old man was hospitalized complaining of intermittent gross hematuria over a 6-month duration. The patient underwent a cystoscopic examination under general anesthesia; an edematous, hyperemic, wide-based mass, which protruded from the dome of the bladder, was seen and incompletely resected. The histopathological examination of the material showed Actinomyces organisms surrounded by inflammation and a photomicrograph showed the microorganism. After confirmation of bladder actinomycosis, the patient received penicillin. A CT scan of the abdomen and pelvis showed no evidence of the mass at the postoperative 6th month. Cystoscopic examination showed complete healing of the transurethral resection area at the dome of the bladder. Conclusion. In conclusion, we believe that the gold standard treatment for vesical actinomycosis should include the combination of a transurethral resection of the mass and long-term penicillin treatment. PMID:25045573

Ziypak, Tevfik; Adanur, Senol; Ozkaya, Fatih; Cal?k, Muhammet; Polat, Ozkan; Ozbey, Isa

2014-01-01

158

Active functional restoration and work hardening program returns patient with 2½-year-old elbow fracture-dislocation to work after 6 months: a case report  

PubMed Central

The rehabilitation of elbow fracture and dislocation is not generally considered a mainstream chiropractic concern. The clinician who is able to successfully manage the elbow articulation will rely upon his/her knowledge of functional anatomy, pathobiomechanics, history and examination principles, when selecting the appropriate treatment available. A case is presented of an individual that sustained a radial head fracture and dislocation following a motor vehicle accident. Subsequent to receiving 1½ years of physiotherapy for post-surgical complications (decreased range of motion, pain, stiffness and tingling to the 4th and 5th fingers), the patient was referred to a multidisciplinary clinic for a Work Hardening/Conditioning Program. This article discusses the need for active functional restoration vs. passive therapy, work hardening regimens and outcome measures. After 6 months of rehabilitation and 3 years following his motor vehicle accident, the patient has successfully returned to his previous work environment. A summary of the sequential steps in providing appropriate management has been provided.

Teperman, Lorne J

2002-01-01

159

Pathology Case Study: A 42-Year-Old Man with Hip Pain  

NSDL National Science Digital Library

This is a genitourinary pathology case study presented by the University of Pittsburgh Department of Pathology in which a 42-year-old male has hip pain and an elevated PSA. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in genitourinary pathology.

Hakam, Ardeshir; Nine, Jeff S.

2007-08-14

160

An 18-Year-Old Man With Hepatitis B Virus Infection and Hepatoblastoma  

PubMed Central

A young man presented with a large liver mass and positive hepatitis B virus markers. This 18-year-old male has developed ascites, jaundice, high serum alpha fetoprotein (AFP) level, liver mass and portal hypertension, without fever or calcification in the mass. All favored the diagnosis of rapidly, progressive hepatocellular carcinoma, however proven hepatoblastoma in liver biopsy. Hepatoblastoma usually manifests prior to the third year of life, but can rarely be seen in older children or adults. Although HCC rarely can be presented in young patients with HBV infection, but in patients without cirrhosis hepatoblastoma should be considered as the first possible diagnosis. PMID:24829653

Mohammadi Bonehi, Seyed Saeid; Vahedi, Homayoon; Saberifiroozi, Mehdi; Vasei, Mohammad; Hashemi Taheri, Amir Pejman

2012-01-01

161

Occipital Horn syndrome in a 2-year-old boy.  

PubMed

The clinical presentation of Occipital Horn syndrome, a rare X-linked recessive condition, in a 2-year-old boy is described. This is the youngest patient reported so far. The major clinical, pathophysiological and molecular aspects of this condition are summarized. PMID:10457850

De Paepe, A; Loeys, B; Devriendt, K; Fryns, J P

1999-07-01

162

Thirty-Three Years Old Modified Senning Operation  

PubMed Central

Numerous technical modifications and various complications of the Senning procedure have been described in the literature. We describe the excellent clinical status and anatomic result of a 33-year-old patient who underwent a modified Senning operation using the left atrial appendage for reconstruction more than 30 years prior to presentation. PMID:25207250

Michalis, Alkiviadis; Kanakis, Meletios A.; Thanopoulos, Vassilios; Laskari, Cleo; Mitropoulos, Fotios A

2014-01-01

163

Anti-Ri antibody positive opsoclonus-myoclonus in a male patient with breast carcinoma  

Microsoft Academic Search

.   A 65-year-old male patient developed truncal ataxia, opsoclonus and myoclonus. In the serum anti-Ri antibodies were found,\\u000a which led to the detection of a small adenocarcinoma of the breast. Other prominent clinical features were an excessive startle\\u000a response and behavioral disorders, such as anxiety and impatience. These features suggest an immune response against both\\u000a Nova-1 and Nova-2 antigens throughout

Paul W. Wirtz; Peter A. E. Sillevis Smitt; Jorrit I. Hoff; Bertie de Leeuw; Gert Jan Lammers; Sjoerd G. van Duinen; Jan J. Verschuuren

2002-01-01

164

The Hybrid III 10-Year-Old Dummy.  

PubMed

This paper describes the design and development of the Hybrid III 10-year-old crash test dummy. The size of the dummy was chosen to fill the gap between the Hybrid III 6-year-old and the Hybrid III small adult female dummy which is also about the size of a 13-year-old teenager. Characteristic dimensions and segment weights of the dummy are based on the anthropometry of the average 10-year-old. Biofidelity response guidelines for forehead, sternum and knee impacts and for fore/aft neck bending are scaled from the midsize adult male biofidelity guidelines taking into account the effects of differences in size, mass and material properties due to the age difference. The dummy is similar in construction to the other Hybrid III dummies except it has an adjustable lumbar spine which allows the dummy to slouch and its neck structure is aligned with its thoracic spine. Data are given showing the responses of the prototype dummy relative to its biofidelity guidelines. The prototype dummy was evaluated in out-of-position air bag tests and three-point belt tests to evaluate its durability and ease of use. The prototype dummy has demonstrated acceptable biofidelity, repeatability and durability and the design has been approved by the SAE Hybrid III Dummy Family Task Group for production. PMID:17458751

Mertz, H J; Jarrett, K; Moss, S; Salloum, M; Zhao, Y

2001-11-01

165

Pachydermodactyly in a 16-year-old adolescent boy.  

PubMed

Pachydermodactyly is a superficial benign fibromatosis of unknown etiology; it is rare, more frequent in adolescent males, and characterized by painless swelling of the proximal interphalangeal joints(PIP) of the hands. Histologic examination of the skin shows epidermal hyperplasia and increased number of dermal fibroblasts and collagen fibers.We report the case of a 16-year-old adolescent boy who presented swelling of the lateral and dorsal regions of all the metacarpophalangeal and PIP joints of the left hand and PIP and metacarpophalangeal joints of the second and fifth fingers of the right hand, with 3 years of evolution and no arthritis or functional impairment. Results of complementary diagnostic examinations were normal, with the exception of hand ultra sound that showed skin thickening, without synovial proliferation or joint effusion. Skin biopsy confirmed pachydermodactyly. The patient under went aesthetic surgery with good outcome, without recurrence.This rare condition should be distinguished from idiopathic juvenile arthritis and other entities such as knuckle pads syndrome. PMID:22832291

Dias, João Madruga; Costa, Maria Manuela; Romeu, José Carlos; Soares-Almeida, Luís; Filipe, Paulo; Pereira da Silva, José Alberto

2012-08-01

166

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

PubMed Central

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.

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

2014-01-01

167

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

SciTech Connect

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.

Boyvat, Fatih [Department of Radiology, Baskent University, Medical School, Fevzi Cakmak Cad. 10., Sok. No:45, Bahcelievler-Ankara (Turkey); Cekirge, Saruhan; Balkanci, Ferhun; Besim, Aytekin [Department of Radiology, Hacettepe University, Medical School, Samanpazari-Ankara (Turkey)

1999-01-15

168

Giant Mediastinal Thymolipoma in 35-Year-Old Women  

PubMed Central

The patient was 35-year-old women with a six-month history of difficulty breathing and chest pain. An anterior-posterior chest radiograph revealed a widened mediastinum with small lung volumes. During his diagnostic evaluation, a computed tomographic scan was performed and with huge mass in the anterior mediastinum with extension to the left and right side of pleural space. With postero-lateral thoracotomy the huge mass was resected. The patient discharged with good condition. PMID:24250956

Aghajanzadeh, Manuchehr; Alavi, Ali; Pourrasouli, Zahra; Aghajanzadeh, Gilda; Massahnia, Sara

2011-01-01

169

Giant mediastinal thymolipoma in 35-year-old women.  

PubMed

The patient was 35-year-old women with a six-month history of difficulty breathing and chest pain. An anterior-posterior chest radiograph revealed a widened mediastinum with small lung volumes. During his diagnostic evaluation, a computed tomographic scan was performed and with huge mass in the anterior mediastinum with extension to the left and right side of pleural space. With postero-lateral thoracotomy the huge mass was resected. The patient discharged with good condition. PMID:24250956

Aghajanzadeh, Manuchehr; Alavi, Ali; Pourrasouli, Zahra; Aghajanzadeh, Gilda; Massahnia, Sara

2011-01-01

170

100-Year Old Adobe Building Destroyed  

USGS Multimedia Gallery

A one hundred year old adobe building in Talca, Chile suffered near-total collapse during the M 8.8 earthquake on Feb. 27, 2010. Adobe, which is made of clay, sand and straw, is no longer used as a building material in Chile, but ancient structures are still common and can pose a hazard to their occ...

171

Case report: prenatal diagnosis of Hb Hammersmith [?42(CD1)Phe?Ser; HBB: c.128T?>?C] in a family with an adult male patient.  

PubMed

Hb Hammersmith [?42(CD1)Phe???Ser; HBB: c.128T?>?C] is a rare, unstable hemoglobin (Hb) variant. In this case report, we describe another male case of Hb Hammersmith. A 39-year-old male had hemolytic anemia, cyanosis and splenomegaly since 6 months after birth. He passed the disease allele to his daughter, a 3-year-old girl, who also had hemolytic anemia and splenomegaly. This mutation was not identified in the parents and two brothers of the father. Early prenatal diagnosis was performed in the second pregnancy in this family. This is the first case of Hb Hammersmith in an adult male patient. PMID:24471820

Li, Ru; Wang, Ting; Xie, Xing-Mei; Li, Dong-Zhi

2014-01-01

172

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

PubMed Central

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.

Bova, Joesph; Sergent, Adam

2014-01-01

173

Epiploic appendagitis in a 24-year-old woman  

Microsoft Academic Search

Epiploic appendagitis is a very rare condition that results from acute inflammation of an appendix epiploica. We report a case involving a 24-year-old woman who presented to the emergency department with abdominal pain localized to the left lower quadrant. The patient was diagnosed with epiploic appendagitis, which was confirmed through findings obtained from a contrast-study computed tomography of the abdomen.

Juan G Bastidas; Laura E Danzy; Lea Blackwell; Robert Hayden; Peter J Bostick

2008-01-01

174

Pregnancy in a 50-year-old.  

PubMed

A 50-year-old women was admitted on suspicion of abdominal tumor. Clinical examination and ultrasonography revealed a living fetus of 24.2 weeks' gestational age. Amniocentesis revealed trisomy 18 (Edwards' syndrome). At 34 weeks the fetus died spontaneously, and by cesarean section a stillborn boy of 770 g was delivered. The risk of pregnancy in women after the age of 45 is emphasized. PMID:3176960

Helm, P; Ovlisen, B

1988-01-01

175

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

SciTech Connect

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.

Melo Lima, V. J. de; Cassola, V. F.; Kramer, R.; Oliveira Lira, C. A. B. de; Khoury, H. J.; Vieira, J. W. [Department of Anatomy, Federal University of Pernambuco, Avenida Professor Moraes Rego 1235, CEP 50670-901, Recife, Pernambuco (Brazil); Department of Nuclear Energy, Federal University of Pernambuco, Avenida Professor Luiz Freire 1000, CEP 50740-540, Recife, Pernambuco (Brazil); Federal Institute of Education, Science and Technology of Pernambuco, Avenida Professor Luiz Freire 500, CEP 50740-540, Recife, Pernambuco, Brazil and Polytechnic School of Pernambuco, University of Pernambuco, Rua Benfica 455, CEP 50751-460, Recife, Pernambuco (Brazil)

2011-08-15

176

Splenic hydatid cysts in a 20-year-old soldier.  

PubMed

Hydatid disease is a parasitic infection of humans and herbivorous animals caused by Echinococcus granulosus. A 20-year-old male soldier from Booshehr province police center was admitted with left upper quadrant pain that began 1 year before admission. Sonography disclosed an echogenic mass measuring 14 x 16 cm near the spleen and kidneys; a computed tomography scan confirmed it as a hypodense mass of the spleen that was 16 x 17 x 18 cm in dimension. Casoni skin test and indirect fluorescent antibody were positive. Through laparatomy, a splenectomy was successfully performed. PMID:14964508

Jahani, Mohammad R; Roohollahi, Ghasem; Gharavi, Mohammad J

2004-01-01

177

A 50-Year-Old Man with Progressive Dyspnea  

PubMed Central

Dental foreign body aspiration is a known complication in patients with maxillofacial trauma. Although diagnosis may be delayed, especially in elderly people with radiolucent dental appliances, clinician must be aware of dental tracheobronchial aspiration to minimize potentially serious consequences. We present a 50-year-old man with three months history of progressive dyspnea due to foreign body aspiration occluding distal trachea. The patient had a history of car accident with facial trauma and denture fracture two years before presentation. Fiberoptic bronchoscopy revealed almost totally obstructing mass-like lesion with nodular infiltration in distal trachea. The patient underwent rigid bronchoscopy and a piece of denture with three teeth was extracted. PMID:25191403

Abedi, Siavash

2012-01-01

178

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

PubMed Central

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

Gerede, Demet Menek?e; Yüksel, Ba?dagül; Tutar, Eralp; Küçük?ahin, Orhan; Uzun, Ça?lar; Atasoy, Kayhan Çetin; Düzgün, Nur?en; Bengisun, U?ur

2013-01-01

179

Epiploic appendagitis in a 24-year-old woman.  

PubMed

Epiploic appendagitis is a very rare condition that results from acute inflammation of an appendix epiploica. We report a case involving a 24-year-old woman who presented to the emergency department with abdominal pain localized to the left lower quadrant. The patient was diagnosed with epiploic appendagitis, which was confirmed through findings obtained from a contrast-study computed tomography of the abdomen. The patient was subsequently taken to the operating room for a diagnostic laparoscopy due to persistent pain. Necrotic epiploic appendagitis was found on the descending colon, which was removed laparoscopically. PMID:18774058

Bastidas, Juan G; Danzy, Laura E; Blackwell, Lea; Bostick, Peter J; Hayden, Robert

2008-09-01

180

[A 74-year-old woman with macrocytic anemia].  

PubMed

A seventy-four years old woman is assessed for asthenia, fatigue, non ulcerous dyspepsia with macrocytic anemia. The patient's medical history taking in Binswanger disease--diagnosed 5 aa before-, epilepsy-2 aa before- and a previous episode of TVP of the left leg, suggested the hypothesis that a B12 deficiency, by a chronic gastritis, would involve an increase of homocysteine cause of the clinical manifestations of megaloblastic anemia, Binswanger disease, tardive epilepsy and previous TVP. The fisic and blood and instrumental exams confirmed the clinical diagnosis. The patient is having vitamin B12. PMID:11963638

Picardi, A; Navajas, F; Spoto, S; Palma Modoni, A; De Galasso, L; Costantino, S

2002-01-01

181

Pilon Fracture: A Case Report of a 45-Year-Old Dental Technician  

PubMed Central

Pilon fractures are complex and difficult-to-treat fractures of the lower extremity that account for about 1% of all lower extremity fractures and up to 10% of tibial fractures. The injury is caused by high energy axial load either from motor vehicle accidents or a fall from height. The treatment of these fractures has caused controversy among surgeons due to mixed outcomes. Here we report a case of pilon fracture in a 45 year old male patient who has sustained the injury as a result of a fall from a height of approximately 12 feet. We describe why it is absolutely crucial that the patient is treated with external fixation initially and evaluate its merits and drawbacks as well as ways to minimize the complications associated with external fixation of open intra-articular distal tibial fractures. PMID:25408785

Mafi, Pouya; Stanley, James; Hindocha, Sandip; Mafi, Reza

2014-01-01

182

Accidental dextromethorphan ingestions in children less than 5 years old  

Microsoft Academic Search

Introduction  The purpose of this study is to evaluate the clinical presentation of accidental dextromethorphan (DXM) ingestions in children\\u000a <5 years old. Two consecutive years of poison center patient encounters were reviewed. Data including age, outcomes, amount\\u000a of DXM ingested, co-ingestions, vital signs, clinical manifestations, hospital admissions, and mortality were abstracted.\\u000a Data were analyzed using descriptive statistics.\\u000a \\u000a \\u000a \\u000a Discussion  A total of 304

Frank LoVecchio; Anthony Pizon; Bradley Riley; Leslie Matesick; Sean O’Patry

2008-01-01

183

A 40-year-old woman ‘off legs’  

PubMed Central

We present the case of a 40-year-old woman with progressive lower-limb weakness resulting in an inability to mobilise independently. This was associated with a degree of confusion and shortness of breath on exertion. This case illustrates rare and severe complications of vitamin B12 deficiency, namely subacute combined degeneration of the spinal cord, megaloblastic anaemia and impaired cognitive function. The patient's condition improved considerably with adequate early resuscitation, followed by administration of synthetic vitamin B12 analogues and neuro-rehabilitation. PMID:23291820

Mehrotra, Prerna; Bhalla, Ashish

2013-01-01

184

[Morbus Addison in five-year-old girl].  

PubMed

This case-report presents a 5-year-old girl with gastrointestinal symptoms, who became increasingly confused over the last day before admission. She was believed to be in septic shock or have meningitis and was treated with normal saline infusion, glucocorticoid and antibiotics intravenously. A few days later she was diagnosed with primary adrenal insufficiency (Morbus Addison), which is a very rare disorder among children. If untreated, the condition is lethal, and should always be considered as a differential diagnosis in severely ill patients. PMID:20470658

Smedegaard, Heidi; Jensen, Rikke Beck; Holm, Kirsten

2010-05-10

185

Hypoglycaemia in a 94-year-old man without diabetes.  

PubMed

Recognising a hypoglycaemic event in a person without a history of diabetes poses quite a challenge. A 94-year-old man without diabetes in an extended care facility (ECF) was found unconscious and non-responsive with a glucose level of 30?mg/dL. The patient required multiple resuscitations with glucagon and intravenous glucose before his blood glucose stabilised. Ultimately the accidental administration of a sulfonylurea was found to be responsible for the event. The patient fortunately recovered after 5?days of hospitalisation. Adults aged 65?years and older carry a significantly higher risk of serious adverse drug events (ADEs) requiring hospitalisation. Antidiabetic drugs cause nearly one-quarter of all hospitalisations from ADEs, with more than 99% due to unintentional overdose. To truly optimise patient care, providers must be cognizant of the risks associated with diabetes management to better monitor and prevent future occurrence of such taxing events. PMID:24849646

Mullens, Dustin James; Shubrook, Jay H

2014-01-01

186

Primary retroperitoneal mucinous cystadenoma with borderline malignancy in a male patient: a case report  

PubMed Central

Introduction Primary retroperitoneal mucinous cystadenoma is a rare tumor prevailing specifically in female gender. Its histogenesis is still unclear and its diagnosis is mainly based on morphological characteristics. Case presentation the subject is a 44 years old man presenting an abdominal pain on the right side, with a palpable mass which appeared four months ago. Abdominal ultrasound (echography) revealed a retroperitoneal cystic process, which was successfully resected through laparotomy. Histopathological examination concluded to a mucinous cystadenoma with borderline malignancy foci. After a year of follow-up, no relapse was noticed in this patient. Conclusion Retroperitoneal mucinous cystadenoma is a rare tumor that should be considered in front of a retroperitoneal cystic process. Several hypotheses may explain the histogenesis of this pathological process. The interest in publishing this case report on primary retroperitoneal mucinous cystadenoma in a male patient lies in the rarity of occurrence of this syndrom in males as compared to females. PMID:20062675

2009-01-01

187

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

PubMed

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

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

2015-03-01

188

Antiretroviral treatment induced catatonia in 16-year-old boy  

PubMed Central

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.

Lingeswaran, Anand

2014-01-01

189

Kikuchi-Fujimoto Disease in 21-Year-Old Man  

PubMed Central

Kikuchi-Fujimoto disease also known as histiocytic necrotizing lymphadenitis is a benign disorder characterized histologically by necrotic foci surrounded by histiocytic aggregates, and with the absence of neutrophils. The patient was a 21-year-old man with chills, fever and cervical lymphadenopathy. He had swelling and tenderness of cervical area. Multiple enlarged lymph nodes were palpable. Cervical lymph node excisional biopsy was performed. Microscopic examination showed reactive follicular hyperplasia with vast areas of necrosis without neutrophilic infiltration. No sign of malignancy was seen. Final diagnosis was Kikuchi-Fujimoto necrotizing lymphadenitis. Kikuchi-Fujimoto disease should be considered as one of the differential diagnoses in patients with prolonged fever and cervical lymphadenopathy. It should be differentiated from tuberculous lymphadenitis in regions where tuberculosis is prevalent. PMID:24049624

Aminiafshar, Saeid; Namazi, Najmeh; Abbasi, Farhad

2013-01-01

190

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

PubMed

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

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

2014-01-01

191

[Irreversible bilateral amaurosis in a 36-year-old immigrant].  

PubMed

We report on a 36-year-old man with a history of mild head trauma. The initial clinical findings and the CT-scan of the brain revealed no pathological result, although the patient suffered from weakness of the right arm and bilateral blindness. Those findings were interpreted as psychogenic disorder. Nine days later he developed an instable gait, a child like attitude, amnesia and enuresis. The CT-scan revealed a subacute bilateral occipital stroke in the region of the arteriae cerebri posteriors. No cause for the stroke was found. In spite of the rareness of cortical blindness in young people as a cause of stroke, a detailed medical history and clinical examination should always be performed, and by unclearness additional investigations should be considered. PMID:15060974

Mäder, P; Baumgartner, M; Arnold, M; Stucki, A; Stanga, Z

2004-02-25

192

Retroperitoneal nongestational choriocarcinoma in a 25-year-old woman  

PubMed Central

Choriocarcinoma is a highly invasive and metastatic neoplasm which arises in women of reproductive age. It can be either gestational or nongestational in origin, but the latter form is very rare. Choriocarcinoma is characterized by the production of human chorionic gonadotropin. It can metastasize to distant organs such as lung, brain, liver, kidney, and vagina in the early stages of disease, but retroperitoneal metastasis is extremely rare. Treatment options include surgical intervention and chemotherapy. We present the case of a 25-year-old nulliparous woman who presented to our department with a retroperitoneal mass and negative urine human chorionic gonadotropin test, who was immunohistopathologically diagnosed with nongestational choriocarcinoma. The patient responded well to surgery and multi-drug chemotherapy. PMID:25469347

Park, Soo Yeon; Lee, Da Eun; Park, Hee Jung; Kim, Kwan Chang

2014-01-01

193

[Cerebellar gangliocytoma in an 11-year-old child].  

PubMed

Cerebellar gangliocytoma can correspond to Lhermitte-Duclos disease, a benign hamartomatous malformation encountered in young adults. It can also be a part of gangliogliomas/gangliocytomas family, which usually encompasses temporal pediatric neoplasms associated with longstanding seizures. We report a case of a young 11-year-old patient who presented with a gangliocytoma of the cerebellum revealed by neurologic manifestations (headache, dyspraxia, equilibrium and gait disturbances). Diagnosis was made on surgical material. Tumour was characterized by dysplastic mature ganglion cells, perivascular lymphocytic infiltrates and no glial neoplastic component. By immunohistochemistry, ganglion cells expressed neurofilaments, MAP2 protein, synaptophysin, chromogranin A and S100 protein. BRAF V600E mutation was absent. Clinical characteristics, radiology, histopathology of the two main diagnoses are discussed. PMID:25499864

Joly, Marie; Valmary-Degano, Séverine; Cattin, Françoise; Vasiljevic, Alexandre; Jouvet, Anne; Viennet, Gabriel

2014-12-01

194

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

PubMed Central

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

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

2014-01-01

195

The Prevalence of Common Cardiovascular Diseases among 17YearOld Israeli Conscripts  

Microsoft Academic Search

Background: There are only few reports on the prevalence of common cardiovascular disorders among adolescents. The previous studies focused on specific diseases, and screened relatively small samples. Objective: The aim of this study was to define the prevalence of different common cardiovascular disorders among 17-year-old Israeli conscripts. A comparison between the morbidity patterns of female and male adolescents was also

Yaron Bar-Dayan; Keren Elishkevits; Liav Goldstein; Avishay Goldberg; Nisim Ohana; Erez Onn; Yehezkel Levi; Yosefa Bar-Dayan

2005-01-01

196

Gout in a 15-year-old boy with juvenile idiopathic arthritis: a case study  

PubMed Central

Joint pain is a common complaint in pediatrics and is most often attributed to overuse or injury. In the face of persistent, severe, or recurrent symptoms, the differential typically expands to include bony or structural causes versus rheumatologic conditions. Rarely, a child has two distinct causes for joint pain. In this case, an obese 15-year-old male was diagnosed with gout, a disease common in adults but virtually ignored in the field of pediatrics. The presence of juvenile idiopathic arthritis (JIA) complicated and delayed the consideration of this second diagnosis. Indeed, the absence of gout from this patient’s differential diagnosis resulted in a greater than two-year delay in receiving treatment. The patients’ BMI was 47.4, and he was also mis-diagnosed with osteochondritis dissecans and underwent medical treatment for JIA, assorted imaging studies, and multiple surgical procedures before the key history of increased pain with red meat ingestion, noticed by the patient, and a subsequent elevated uric acid confirmed his ultimate diagnosis. With the increased prevalence of obesity in the adolescent population, the diagnosis of gout should be an important consideration in the differential diagnosis for an arthritic joint in an overweight patient, regardless of age. PMID:24393408

2014-01-01

197

Primary Mature Cyst?c Teratoma Mimick?ng an Adrenal Mass in an Adult Male Patient  

PubMed Central

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

Ener, Kemal; Aldemir, Mustafa; Isik, Evren; Irkkan, Cigdem; Kayigil, Onder

2014-01-01

198

Clustering of Health-Related Behaviors among 18YearOld Australians  

Microsoft Academic Search

Background.Few studies among young adults have examined clustering of health behaviors affecting risk for lifestyle diseases.Methods.Smoking, alcohol consumption, physical activity, and diet were examined among Australian 18-year-olds (301 males, 282 females) initially recruited at the age of 9 years from 26 schools. Association analysis was used to recognize behavior clustering.Results.Fat intake was greater among male smokers than nonsmokers (36% energy

V. Burke; R. A. K. Milligan; L. J. Beilin; D. Dunbar; M. Spencer; E. Balde; M. P. Gracey

1997-01-01

199

WCMC-Q Researchers Answer Thousand-Year-Old  

E-print Network

WCMC-Q Researchers Answer Thousand-Year-Old Date Palm Question #12;The magazine of Weill Cornell-Q Researchers Answer Thousand- Year-Old Date Palm Question 10 PhotobyMhoammedSulaimanKhalfanAl-Rawah #12;Con anD ProDuCTion The Office of Public Affairs HIGHLIGHTS Uncovering the Gender of the Palm WCMC

200

Ocular alignment and refraction in preterm children at 1 and 6 years old  

PubMed Central

Purpose To investigate cycloplegic refraction and ocular alignment in a population of preterm children at 1 and 6 years old. Patients and methods We included 261 preterm infants with a birth weight ?1,500 g and a gestational age ?32 weeks; there were 217 preterm infants (group 1), 28 preterm infants with mild retinopathy of prematurity (ROP) (group 2), and 16 preterm infants affected by severe ROP (group 3). Each patient underwent retinoscopy, ocular alignment assessment, and fundus examination at 1 and 6 years old. Results The prevalence of refractive errors and ocular alignment abnormalities at 1 year old in groups 2 and 3 compared to group 1 were, respectively (P<0.05): myopia 18% and 40.6% versus 6.9%; hyperopia 28.6% and 22% versus 39.2%; astigmatism 53.4% and 37.4% versus 53.9%; and strabismus 12.5% and 38% versus 5.3%. At 6 years old, they were, respectively (P<0.05): myopia 10.8% and 28.4% versus 7.4%; hyperopia 48.3% and 40.5% versus 62%; astigmatism 40.9% and 31.1% versus 30.6%; and strabismus 25% and 56.25% versus 11.5%. Conclusion At 6 years old, we observed increased rates of both hyperopia and strabismus in all groups compared to 1-year-old children. In preterm children with mild and severe ROP, we recorded increased rates of myopia and strabismus versus preterm children without ROP, and the risk of developing these disorders increased significantly with ROP severity. Astigmatism at 1 year old is not predictive of further development during growth. Patients born prematurely should be informed of the possible risks of ocular alterations due to refractive and ocular component changes. PMID:25061274

Al Oum, Muna; Donati, Simone; Cerri, Luigi; Agosti, Massimo; Azzolini, Claudio

2014-01-01

201

Ewing's Sarcoma of the Zygomatic Arch Presenting in a 69-Year Old: An Unusual Case Report  

PubMed Central

Objective. We report a rare case of Ewing's sarcoma of the zygomatic arch presenting in a 69-year-old patient. Method. Case report and a review of the world literature on Ewing's sarcoma incidence and management. Results. Ewing's sarcoma is a malignant round cell tumour of neuroectodermal origin that typically presents in the pelvis and long bones of children and adolescent boys. This report is the first to document the presentation of ewing's sarcoma of the zygomatic arch in a 69-year-old lady. Our patient underwent surgical excision and radiotherapy and at 4-year followup has no signs of recurrence or metastasis. Conclusion. To our knowledge this is the first case report to document Ewing's sarcoma of this location in a 69-year-old patient. This case report highlights the importance of diagnostic investigations in Ewing's sarcoma and discusses the management issues that this rare presentation raises. PMID:22937369

Mennie, Joanna C.; Reid, Robin; Cowie, Fiona; Hilmi, Omar

2011-01-01

202

Mycobacterium chimaera causes tuberculosis-like infection in a male patient with anorexia nervosa.  

PubMed

Here we present a 27-year-old male patient--with a known prolonged history of anorexia nervosa (AN)--suffering from tuberculosis like infection. At the time he was admitted to clinical treatment, he had developed fever up to 40°C and survived on a body mass index of 11.8. In this case, Mycobacterium chimaera, generally recognized for low pathogenicity, was identified as the causative agent. Remission from lung infection was achieved after antibiotic treatment according to laboratory susceptibility testing while earlier antituberculosis therapies had failed. Because of a large cavity in the upper left lung, surgical excision was necessary to prevent recurrence of lung infection. Moreover, stabilization of the patient general health problem needs to be supported by a lasting psychotherapy. PMID:21656541

Alhanna, Joseph; Purucker, Michael; Steppert, Claus; Grigull-Daborn, Andrea; Schiffel, Gabriele; Gruber, Heribert; Borgmann, Stefan

2012-04-01

203

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

PubMed

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

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

2015-01-01

204

A 55 years old man with pulmonary alveolar microlithiasis  

PubMed Central

Pulmonary alveolar microlithiasis (PAM) is a very rare diffuse chronic lung disease characterized by deposition of small spherules of calcium phosphate within the alveolar cavity. The disease is usually seen from birth up to 40 years of age and is usually diagnosed incidentally during radiography of the chest for other reasons. Most of patients are asymptomatic or having very mild symptoms and the majority of patients either have normal or restrictive pulmonary function test. Clinically, the course of the disease is different; it remains static in few patients or it may progress to pulmonary fibrosis, respiratory failure and cor pulmonale in others. In this case report, we present a 55-year-old man who presented with moderate shortness of breath which has progressed from mild symptoms with in the previous years. His chest high-resolution CT scan showed diffusely scattered, ill-defined little shadowy micronodules which involve the left lung; lingula and left lower lobe in particular. A lung biopsy confirmed the diagnosis of PAM. He was followed up for 1 year with treatment by steroid and alendronate, and no progression was noticed in fact improvement in pulmonary function test noticed. This is the first case report of PAM in Kurdistan. PMID:25125824

Saeed, Rebeen R.; Ali, Kosar M.

2014-01-01

205

A 55 years old man with pulmonary alveolar microlithiasis.  

PubMed

Pulmonary alveolar microlithiasis (PAM) is a very rare diffuse chronic lung disease characterized by deposition of small spherules of calcium phosphate within the alveolar cavity. The disease is usually seen from birth up to 40 years of age and is usually diagnosed incidentally during radiography of the chest for other reasons. Most of patients are asymptomatic or having very mild symptoms and the majority of patients either have normal or restrictive pulmonary function test. Clinically, the course of the disease is different; it remains static in few patients or it may progress to pulmonary fibrosis, respiratory failure and cor pulmonale in others. In this case report, we present a 55-year-old man who presented with moderate shortness of breath which has progressed from mild symptoms with in the previous years. His chest high-resolution CT scan showed diffusely scattered, ill-defined little shadowy micronodules which involve the left lung; lingula and left lower lobe in particular. A lung biopsy confirmed the diagnosis of PAM. He was followed up for 1 year with treatment by steroid and alendronate, and no progression was noticed in fact improvement in pulmonary function test noticed. This is the first case report of PAM in Kurdistan. PMID:25125824

Saeed, Rebeen R; Ali, Kosar M

2014-07-01

206

Virilizing ovarian steroid cell tumor in a 40 year old South Indian female: a case report.  

PubMed

Virilism is the masculinization and enhancement of male secondary sexual characteristics in females. The etiology is usually of adrenal or ovarian origin. Here we report a case of virilizing Leydig cell type, steroid cell tumor of the left ovary, in a 40 year old female who presented with clinical signs and symptoms of virilization: deepening of voice, hirsutism (Ferriman-Gallwey score 26), clitoromegaly, and androgenic alopecia. On further evaluation, laboratory investigations revealed hyperandrogenism in the male range. Basal testosterone values were elevated. Folicle Stimulating Hormone and Luteinising Hormone levels were within normal limits. Dexamethasone suppression test did not alter cortisol or testosterone levels. An ovarian mass was confirmed radiologically. Following a total abdominal hysterectomy with bilateral salpingoophorectomy, histopathological studies confirmed a left sided steroid-cell ovarian tumor, Leydig cell type (stage T(1)N(0)M(0)), which proved to the etiology of virilization in this patient. Post-operatively her serum testosterone levels declined with near-complete reversal of symptoms over time. PMID:19829991

Salim, Shihas; Shantha, Ghanshyam Palamaner Subash; Patel, Amish Dilip; Kumar, Anita A; Ganeshram, Prasanthi; Mehra, Nikita; Rajan, Anish George; Joseph, Tarun; Sudhakar, Lavangi

2009-01-01

207

A 69-Year-Old Presenting With Musculoskeletal Low Back Pain: A Case of Lumbosacral Chordoma  

PubMed Central

Objective The purpose of this case report is to describe the presentation of a patient with lumbosacral chordoma characterized by somatic chronic low back pain and intermittent sacral nerve impingement. Case report A 69-year-old male presenting to an emergency department (ED) with low back pain was provided analgesics and muscle relaxants then referred for a series of chiropractic treatments. Chiropractic treatment included manipulation, physical therapy, and rehabilitation. After 3 times per week for a total of 4 weeks, re-examination showed little relief of his symptoms. His pain symptoms worsened and he presented to the ED for the second time. Magnetic resonance imaging was performed and revealed a high intensity mass. Intervention and outcome The soft tissue mass identified on magnetic resonance imaging was surgically removed. Shortly after the surgery, the patient developed post-operative bleeding and was returned to surgery. During the second procedure, he developed a post-operative hemorrhage related to the development of disseminated intravascular coagulation and subsequently died during the second procedure. A malignant lumbosacral chordoma was diagnosed on pathologic examination. Conclusion This case report describes the presentation of a patient with lumbosacral chordoma presenting with musculoskeletal low back pain. Chordomas are rare with few prominent manifestations. An early diagnosis can potentially make a difference in morbidity and mortality. Due to its insidious nature, it is a difficult diagnosis and one that is often delayed.

Williams, Shawn P.; Beckerman, Bernard; Piña Fonti, Maria Elena

2014-01-01

208

Chiropractic management of a 47-year–old firefighter with lumbar disk extrusion  

PubMed Central

Abstract Objective This case report describes the effect of exercise-based chiropractic treatment on chronic and intractable low back pain complicated by lumbar disk extrusion. Clinical Features A 47-year–old male firefighter experienced chronic, unresponsive low back pain. Pre- and posttreatment outcome analysis was performed on numeric (0-10) pain scale, functional rating index, and the low back pain Oswestry data. Secondary outcome assessments included a 1-rep maximum leg press, balancing times, push-ups and sit-ups the patient performed in 60 seconds, and radiographic analysis. Intervention and Outcome The patient was treated with Pettibon manipulative and rehabilitative techniques. At 4 weeks, spinal decompression therapy was incorporated. After 12 weeks of treatment, the patient's self-reported numeric pain scale had reduced from 6 to 1. There was also overall improvement in muscular strength, balance times, self-rated functional status, low back Oswestry scores, and lumbar lordosis using pre- and posttreatment radiographic information. Conclusion Comprehensive, exercise-based chiropractic management may contribute to an improvement of physical fitness and to restoration of function, and may be a protective factor for low back injury. This case suggests promising interventions with otherwise intractable low back pain using a multimodal chiropractic approach that includes isometric strengthening, neuromuscular reeducation, and lumbar spinal decompression therapy. PMID:19646377

Schwab, Matthew J.

2008-01-01

209

A 78-Year-Old Man with Acute Myeloid Leukemia (AML) and Acute Renal Failure  

PubMed Central

Patient: Male, 78 Final Diagnosis: Acute myeloid leukemia (AML) Symptoms: Dyspnea • fatigue Medication: Idarubicin followed by cytarabine Clinical Procedure: Chemotherapy Specialty: Hematology Objective: Unusual clinical course Background: Renal failure is a common presentation of acute myelomonocytic and monocytic leukemia. It is usually the result of a combined glomerular and tubular dysfunction and is associated with a poor prognosis. No guidelines exist for treatment. Case Report: We herein describe the case of a 78-year-old Caucasian man who presented with acute myeloid leukemia M5, leukostasis with a white count of 340 000/ml, and acute renal failure with a creatinine of 7.7/dL. The patient was initially treated with leukapheresis and 3 days of idarubicin in the setting of continuous renal replacement therapy that resulted in rapid reversal of his renal failure. He then received 7 days of continuous infusion cytarabine and went into a complete remission. Conclusions: Renal failure may complicate the presentation of AML but can be reversible with treatment. Dose adjustment of the chemotherapy is not needed and the treatment can be greatly facilitated with the use of continuous renal replacement therapy, as indicated in our case report. In addition, we emphasize that organ dysfunction, even in elderly patients, is not necessarily a contraindication to aggressive treatment if it is felt to be disease-related and reversible. PMID:25184701

Tapper, Elliot B.; Luptakova, Katarina; Joyce, Robin M.; Tzachanis, Dimitrios

2014-01-01

210

46-year-old man with a spinal cord mass.  

PubMed

Medulloblastoma accounts for only 1% of all adult CNS tumors. Likewise, recurrence of adult medulloblastoma greater than 20 years after initial diagnosis is extremely rare.We describe a case of adult medulloblastoma with late relapse of disease. The patient was 24 years old when first diagnosed and was treated with total tumor resection and craniospinal radiation. At the age of 45, an enhancing 1.3 cm intradural extramedullary spinal cord lesion at T5 was discovered on MRI. This was presumed to be recurrent medulloblastoma in the form of drop metastasis and the patient was treated with spinal radiation. Several months following treatment, at the age of 46, a follow-up MRI demonstrated an enhancing 1.4 cm intradural extramedullary spinal cord lesion at T7. The lesion was resected and histopathologic examination was most consistent with medulloblastoma, late drop metastasis. Although rare, adult medulloblastoma recurring 20 years after initial diagnosis should always be considered in the main differential diagnosis when working up CNS lesions at or outside the primary tumor site. PMID:21129065

Sanders, Mary Ann; Vitaz, Todd; Rosenblum, Marc; Plaga, Alexis R; Parker, Joseph C; Parker, John R

2011-01-01

211

Neuropsychological profile of a male psychiatric patient with a Morgagni-Stewart-Morel syndrome.  

PubMed

In 1765 Giovanni Morgagni described a syndrome consisting of hyperostosis frontalis interna (HFI), obesity and hirsutism. In 1928 Stewart and in 1930 Morel added neuropsychiatric symptoms, e.g. depression and dementia, which led to the definition of the Morgagni-Stewart-Morel Syndrome (MSM). Although mostly women were characterized in literature no gender specifity is demanded. This case report presents the rare case of a 66 year old male psychiatric patient with Morgagni-Stewart-Morel Syndrome. The patient complained of loss of concentration and difficulties with activities of daily living. Admission diagnosis was an opioid misuse on the basis of a chronic pain syndrome. In this case report we are describing clinical features, the patient history and technical (MRI) and neuropsychological tests. Although severe psychiatric symptoms and neuropsychological deficits are commonly seen in these patients, our patient showed only mild symptoms. This case reports shows the possibility of a male patient with MSM. If MSM is a separate entity or just an epiphenomena of hormone dysregulation should be investigated in further studies. PMID:25382447

Hansen, Aksel; Engelhardt, Liliana; Pleschutznig, Wolfgang; Dammann, Gerhard; Vietze, Stephanie

2014-11-10

212

Medical Care and Your 2- to 3-Year-Old  

MedlinePLUS

... Checkups: What to Expect Ebola: What to Know Medical Care and Your 2- to 3-Year-Old ... that often seen with an ear infection Common Medical Problems On average, preschoolers in childcare can get ...

213

Trisomy 18 in a 13 year old girl.  

PubMed Central

A 13 year old girl with trisomy 18 is described. She showed profound mental and growth retardation, severe kyphoscoliosis, and unusual ocular features including discontinuous eyebrows, distichiasis, and blue sclerae. Images PMID:3723555

Mehta, L; Shannon, R S; Duckett, D P; Young, I D

1986-01-01

214

Iatrogenic Hemobilia in 10-Year-Old Boy  

PubMed Central

Background Hemobilia in children is a rare phenomenon which has been described mostly in the context of traumas. The descriptions of massive hemobilia in children after liver biopsy are a rarity in the scientific literature because there are only a few examples of it. Hemobilia rarely develops spontaneously. Generally, this is a complication after a blunt abdominal trauma or after medical (especially surgical) procedures. Correct diagnosis and treatment of hemobilia are essential, especially in the case of patients with severe – sometimes life-threatening – haemorrhage from biliary ducts. It should be remembered that the symptoms of hemobilia do not necessarily occur immediately after surgery or trauma. In some cases hemobilia occurs after a changeable, asymptomatic period of time. Case Report We would like to present a case of a severe form of hemobilia caused by arterio-biliary fistula which developed incidentally after liver biopsy in a 10-year-old boy with chronic hepatitis B. Symptoms of hemobilia appeared on the seventh day after the diagnostic biopsy when the patient’s general condition began to deteriorate. The diagnosis of arterio-biliary fistula was established after angio-CT examination of the liver. A selective embolization of the right hepatic artery was carried out. Hemobilia in children is a rare phenomenon which has been described mostly in the context of traumas. The cases of massive hemobilia in children after liver biopsy are a rarity in the scientific literature because there are only a few examples of it. Hemobilia very rarely develops spontaneously. Generally, this is a complication after a blunt abdominal trauma or after medical (especially surgical) procedures. Results Correct diagnosis and treatment of hemobilia are essential, especially in the case of patients with severe – sometimes life-threatening – haemorrhage from biliary ducts. It should be remembered that the symptoms of hemobilia do not necessarily occur immediately after surgery or trauma. In some cases hemobilia occurs after a changeable, asymptomatic period of time. PMID:25191530

Zaleska-Dorobisz, Urszula; ?asecki, Mateusz; Olchowy, Cyprian; Ugorski, Wojciech; Garcarek, Jerzy; Patkowski, Dariusz; Kurcz, Jacek

2014-01-01

215

A male Fabry disease patient treated with intravenous thrombolysis for acute ischemic stroke.  

PubMed

The use of intravenous thrombolytic therapy for acute ischemic stroke is associated with improved outcomes. Fabry disease is an X-linked glycosphingolipid storage disease with vascular endothelial deposits. Affected males with the classic phenotype develop renal, cardiac, and cerebrovascular disease and die prematurely. However, Fabry disease is rare in young men with first ischemic stroke of undetermined cause. We report a 38-year-old man with acute aphasia and a left M2 segment of the middle cerebral artery thrombus with no recanalization who was finally diagnosed with Fabry disease after left ventricular hypertrophy of undetermined cause had been identified. A gene test revealed a R227X mutation typical of Fabry disease with the classical phenotype. To our knowledge our patient is the first reported male Fabry patient who was given intravenous thrombolytic therapy and the first reported Fabry patient who received intravenous thrombolytic therapy between 3 and 4.5hours of the symptom onset. Despite favorable prognostic indicators on admission imaging, our patient suffered a significant stroke and had an unfavorable clinical outcome. Fortunately, the episode was not complicated by intracranial hemorrhage. Further studies are needed to evaluate the efficacy and safety of intravenous thrombolytic therapy in treating patients with Fabry disease and acute ischemic stroke. PMID:25439755

Saarinen, Jukka T; Sillanpää, Niko; Kantola, Ilkka

2015-02-01

216

A Case of Premature Ovarian Failure in a 33-Year-Old Woman  

PubMed Central

Objective. To assess aetiology of a POF in a 33-year-old woman and, if possible, plan a cure. Design. Case report. Setting. medical genetics diagnostic unit in a university hospital. Patient. A 33-year-old woman with premature ovarian failure (POF). Intervention(s). Genetic counseling, karyotyping, FISH study. Result(s). Turner-like diagnosis. Conclusion(s). Most cases of POF remain idiopathic. Turner syndrome can occur in very different phenotypes; cytogenetic and molecular profiling can provide a definitive diagnosis in cases with nonclassical phenotype. PMID:23509644

Colao, Emma; Granata, Teresa; Vismara, Marco F. M.; Bombardiere, Francesco; Nocera, Donatella; Luciano, Elisa; Perrotti, Nicola; Malatesta, Paola

2013-01-01

217

Epiploic appendagitis in a 27-year-old man  

PubMed Central

Summary Background Epiploic appendagitis is an ischemic infarction of an epiploic appendage caused by torsion or spontaneous thrombosis of the central draining vein. Epiploic appendagitis is self-limited without surgery, and it is imperative for clinicians to be familiar with this entity. Case Report A healthy 27-year-old man was admitted due to acute right lower quadrant abdominal pain. Physical examination showed focal abdominal tenderness with slight rebound tenderness. Laboratory tests showed leukocytosis and an increased serum C-reactive protein level. Computed tomography (CT) showed a fatty ovoid pericolonic mass measuring 12 mm in diameter, with a circumferential hyperdense ring that abutted on the ascending colon and was surrounded by ill-defined fat stranding with a hyperdense ring. These findings were diagnostic of primary epiploic appendagitis. The patient was given high-dose antibiotics due to the secondary inflammation involving the parietal peritoneum. Conclusions Epiploic appendagitis presents with an abrupt onset of focal abdominal pain and tenderness without significant guarding or rigidity; it is an uncommon and difficult diagnosis. With awareness of this condition, however, evaluation by CT can provide an accurate diagnosis of epiploic appendagitis, distinguishing it from conditions with clinically overlapping manifestations. PMID:21959616

Uehara, Ryohei; Isomoto, Hajime; Yamaguchi, Naoyuki; Ohnita, Ken; Fujita, Fumihiko; Ichikawa, Tatsuki; Takeshima, Fuminao; Yamaguchi, Tetsuji; Uetani, Masataka; Nakao, Kazuhiko

2011-01-01

218

Chest wall malignant peripheral nerve sheath tumor in a 21-year old female.  

PubMed

Malignant peripheral nerve sheath tumors are aggressive sarcomas that derive from peripheral nerve cells and are associated with a poor prognosis. We report a rare case of malignant peripheral nerve sheath tumor in the anterior chest wall of a 21-year-old female. The patient underwent induction chemotherapy, and resection of the mass with negative margins. She subsequently underwent radiation therapy. PMID:24585302

Sudhakar, Deepthi; Nelson, Lars; Herrera, Luis

2015-02-01

219

Squamous cell carcinoma of esophagus in a 15-year-old boy  

PubMed Central

A 15-year-old boy with well-differentiated squamous cell carcinoma of the lower esophagus is reported because of its rarity. The patient presented with dysphagia for 3 months and weight loss. The case was treated with radical excision, with excellent immediate response. PMID:20975784

Hedawoo, J. B.; Nagdeve, N. G.; Sarve, G. N.

2010-01-01

220

An isolated renal hydatid cyst in a 6-year-old child: A rare case report  

PubMed Central

Isolated involvement of the kidney is rare in hydatid disease and is even rarer in children. We present a case of primary right renal hydatid cyst in 6-year-old female child who presented with pain right flank of 4 months duration. The patient was managed by nephrectomy. PMID:24949039

Sarmast, Arif Hussain; Sherwani, Afak Yusuf; Dangroo, Sajad Ahmed; Wani, Mohd. Saleem; Hamid, Arif; Showkat, Hakim Irfan

2014-01-01

221

Orbital rosai-dorfman disease in a five-year-old boy.  

PubMed

Rosai-Dorfman disease (RDD) is characterized by histiocytic proliferation and massive cervical lymphadenopathy, although some patients have extra-nodal involvement. We report a case of extranodal RDD in a five-year-old child, initially misdiagnosed as orbital inflammatory disease and treated with oral steroids. A subsequent orbital biopsy three years later confirmed the diagnosis of Rosai Dorfman disease. PMID:22224025

Al-Moosa, Ashref J; Behbehani, Raed S; Hussain, Abdulmohsen E; Ali, Abdullah E

2011-10-01

222

Orbital Rosai–Dorfman Disease in a Five-Year-Old Boy  

PubMed Central

Rosai–Dorfman disease (RDD) is characterized by histiocytic proliferation and massive cervical lymphadenopathy, although some patients have extra-nodal involvement. We report a case of extranodal RDD in a five-year-old child, initially misdiagnosed as orbital inflammatory disease and treated with oral steroids. A subsequent orbital biopsy three years later confirmed the diagnosis of Rosai Dorfman disease. PMID:22224025

Al-Moosa, Ashref J.; Behbehani, Raed S.; Hussain, Abdulmohsen E.; Ali, Abdullah E.

2011-01-01

223

The Role of the Environment in Parkinson's Disease Susan, a 66 year-old office worker,  

E-print Network

The Role of the Environment in Parkinson's Disease Susan, a 66 year-old office worker's disease. Older Adults Parkinson's disease is a chronic neurodegenerative disease, the second most movement. Although 5 to 10 percent of patients are diagnosed before age 50, Parkinson's disease generally

Bezrukov, Sergey M.

224

[Fever of unknown origin in 74-year-old multimorbid man].  

PubMed

A 74-year-old multimorbid man was admitted with fever of unknown origin. Over time the fever ceased spontaneously. The patient developed signs of a right heart failure without evidence of a primarily cardiac pathogenesis and died of acute right heart failure. Miliary tuberculosis that had lead to pulmonary artery hypertension was diagnosed at autopsy. PMID:25301026

Fuchs, A; Elezkurtaj, S; Hortig, P; Ignatius, R; Gross, U; Schneider, T

2014-12-01

225

Use of post-isometric relaxation in the chiropractic management of a 55-year-old man with cervical radiculopathy  

PubMed Central

This case report chronicles the successful management of a 55-year-old patient diagnosed with cervical radiculopathy using spinal manipulative therapy and cervical paraspinal post-isometric relaxation stretches. PMID:22457537

Emary, Peter

2012-01-01

226

Pulmonary actinomycosis in a male patient with a tracheal bronchus  

PubMed Central

BACKGROUND: Tracheal bronchus is a congenital malformation comprising an abnormal bronchus originating from the trachea or other bronchus. This malformation has been associated with recurrent pneumonia in children, but is rarely associated with infection in adults. Actinomyces species are rare causes of necrotizing pneumonias that often masquerade as malignancy, lung abscesses and tuberculosis. METHODS AND RESULTS: A case involving a 46-year-old man with a tracheal bronchus and chronic pneumonia syndrome is presented. Bronchialveolar lavage and transthoracic needle biopsy demonstrated the presence of Actinomyces meyeri and Fusobacterium species. CONCLUSIONS: The present article reports the first documented case of actinomycosis occurring in a patient with a tracheal bronchus. PMID:21499592

Costiniuk, Cecilia T; Voduc, Nha; de Souza, Carolina

2011-01-01

227

Oral Health and Treatment Needs among 18YearOld Iranians  

Microsoft Academic Search

Objective: To investigate the oral health status of 18-year-old Iranians in relation to their gender, place of residence and level of education. Subjects and Methods: Thirty-three calibrated examiners in 2002 collected data as part of a national survey, according to World Health Organization criteria for sampling and clinical diagnoses, across 28 provinces. The study sample was 4,448; male: 2,021 and

Hossein Hessari; Miira M. Vehkalahti; Mohammad J. Eghbal; Hamid Samadzadeh; Heikki T. Murtomaa

2008-01-01

228

Clostridium perfringens Bacteremia in an 85-Year-Old Diabetic Man  

PubMed Central

Emphysematous cholecystitis is an uncommon and dangerous complication of acute cholecystitis. Common risk factors for this disease include male gender, old age, presence of diabetes mellitus and cholelithiasis. The disease is best treated with emergent surgery and parenteral antibiotics. We present the case of an 85-year-old nursing home resident who presented to our institution with a 3-day history of gradually worsening abdominal discomfort.

Mirrakhimov, Aibek E.; Chandra, Gopika; Voore, Prakruthi; Khan, Maliha; Halytskyy, Oleksandr; Elhassan, Ahmed; Ali, Alaa M.

2014-01-01

229

A 26-year-old welder with severe non-reversible obstructive lung disease.  

PubMed

A 26-year-old white male, lifelong non-smoker presented with a history of increased shortness of breath, for approximately 1 year. He had a history of welding aluminum parts. He had evidence of partially reversible reactive airways disease with a non obstructive component as well. VATS biopsy revealed evidence of airway and parenchymal inflammation consistent with aluminum pneumoconiosis. Approximately 5-10% of COPD is attributable to non-smoking causes including occupational exposures. There are studies to suggest that the persistence of aluminum particulate may cause ongoing inflammation despite removal from exposure. It is possible that the persistence of particulate matter from tobacco smoke remaining in the lung may contribute to the persistent inflammatory response found in former smokers. Further study is required to examine the importance of this potential inflammatory mechanism both in occupationally exposed and in cigarette smokers. Reduction of certain particulate components of cigarette smoke may have implications for prevention of disease or at least disease progression in some COPD patients. PMID:17175666

Balkissoon, Ron

2006-03-01

230

A 47-year-old man with neuro-Sweet syndrome in association with Crohn's disease: a case report  

PubMed Central

Introduction Sweet's syndrome is a multi-system inflammatory disorder characterised by painful skin lesions and aseptic neutrophilic infiltration of various organs. We describe a case of Sweet's syndrome with aseptic meningitis in association with Crohn's disease (neuro-Sweet syndrome). This association has never been previously reported. Case presentation A 47-year-old Caucasian male with known Crohn's disease presented with headache, fever and skin lesions resembling erythema nodosum. The cerebrospinal fluid revealed leukocyte pleocytosis and dominant neutrophils, but cultures were negative. A skin biopsy revealed neutrophilic dermatosis compatible with Sweet's disease. The patient made a prompt recovery without the use of corticosteroids. Conclusion Because of its multisystem nature, Sweet's syndrome may present diagnostic difficulty to specialists. Correct diagnosis by skin biopsy will prompt appropriate treatment. PMID:19918283

2009-01-01

231

Safety and tolerability of the novel inhaled corticosteroid fluticasone furoate in combination with the ?2 agonist vilanterol administered once daily for 52?weeks in patients ?12?years old with asthma: a randomised trial  

PubMed Central

Background The inhaled corticosteroid fluticasone furoate (FF) in combination with the long-acting ?2 agonist vilanterol (VI) is in development for asthma and chronic obstructive pulmonary disease. Objective To assess the safety and tolerability of FF/VI over 52?weeks in patients with asthma. Methods Patients (aged ?12?years; on inhaled corticosteroid) were randomised (2:2:1) to FF/VI 100/25?µg or FF/VI 200/25?µg once daily in the evening, or fluticasone propionate (FP) 500?µg twice daily. Safety evaluations included adverse events (AEs), non-fasting glucose, potassium, 24-h urinary cortisol excretion, ophthalmic assessments, heart rate and pulse rate. Results On-treatment AEs were similar across groups (FF/VI 66–69%; 73% FP). Oral candidiasis/oropharyngeal candidiasis was more common with FF/VI (6–7%) than FP (3%). Twelve serious AEs were reported; one (worsening hepatitis B on FP) was considered drug related. Statistically significant cortisol suppression was seen with FP compared with both FF/VI groups at Weeks 12 and 28 (ratios [95% CI] to FP ranged from 1.43 [1.11 to 1.84] to 1.67 [1.34 to 2.08]; p?0.006), but not at Week 52 (ratios to FP were 1.05 [0.83 to 1.33] for FF/VI 100/25?µg and 1.09 [0.87 to 1.38] for FF/VI 200/25?µg). No clinically important changes in non-fasting glucose, potassium, QT interval corrected using Fridericia's formula (QTc[F]) or ophthalmic assessments were reported. Pulse rate (10?min post dose [Tmax], Week 52) was significantly increased with FF/VI versus FP (3.4?bpm, 95% CI 1.3 to 5.6; p=0.002 [FF/VI 100/25?µg]; 3.4?bpm, 95% CI 1.2 to 5.6; p=0.003 [FF/VI 200/25?µg]). Mean heart rate (24-h Holter monitoring) decreased from screening values in all groups (0.2–1.1?bpm FF/VI vs 5?bpm FP; Week 52). Conclusions FF/VI (100/25?µg or 200/25?µg) administered once daily over 52?weeks was well tolerated by patients aged ?12?years with asthma. The overall safety profile of FF/VI did not reveal any findings of significant clinical concern. ClinicalTrials.gov NCT01018186 PMID:23440247

Busse, William W; O'Byrne, Paul M; Bleecker, Eugene R; Lötvall, Jan; Woodcock, Ashley; Andersen, Leslie; Hicks, Wesley; Crawford, Jodie; Jacques, Loretta; Apoux, Ludovic; Bateman, Eric D

2013-01-01

232

Riedel's Thyroiditis in an Elderly Male Patient: A Rare Entity.  

PubMed

Riedel's thyroiditis (RT) is a rare fibrosclerotic infiltrative thyroid disorder of unclear aetiology. It has been reported in 0.06% of thyroid surgeries and is more common in women. A 60-year-old euthyroid male presented with thyroid swelling and sinus discharge since three years, associated with pain and fever. Near total thyroidectomy revealed right lobe measuring 5x2.5x2 cm, well encapsulated, firm to hard with resistance on cutting. Microscopic examination showed variable sized colloid filled follicles with intervening areas of dense fibrosis admixed with lymphocytic aggregates and perivascular fibrosis extending to the thyroid capsule. The diagnosis of Riedel's thyroiditis was made on histopathological examination. Hence, we would like to emphasize that Riedel's thyroiditis requires diagnostic thyroidectomy and histopathological examination for confirmation. PMID:25478360

Bhutia, Chumila Thinley; Das, Deepak

2014-10-01

233

Etiologic and clinical analysis of chronic complex anal and rectal inflammation in children less than 3 years old  

PubMed Central

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.

Huang, Yanlei; Zheng, Shan; Xiao, Xianmin

2014-01-01

234

A manic episode in a 64-year-old man: an adverse effect of varenicline.  

PubMed

Varenicline is a novel treatment for smoking cessation. However, it has not been well studied in patients with medical and psychiatric comorbidity. We report a case of an acute manic episode in a 64-year-old man with a history of bipolar disorder post stroke, who was started on varenicline. This case demonstrates the importance of monitoring neuropsychiatric adverse drug reactions after the start of varenicline therapy in patients with a current or past history of mental illness. PMID:21596218

Ahmed, Amir I A

2011-01-01

235

Anemia secondary to valproic acid therapy in a 13-year-old boy: a case report  

PubMed Central

Introduction Valproic acid is a commonly used anti-epileptic drug. Hematological toxicities are among the occasionally observed adverse effects of this medication. Case presentation We present the case of a 13-year-old Caucasian boy who demonstrated mild anemia 12?months after the introduction of valproic acid therapy. A bone marrow biopsy revealed maturation arrest of proerythroblasts. Conclusion Prompt diagnosis and valproic acid discontinuation resulted in the patient’s recovery. PMID:22883745

2012-01-01

236

Diagnostic approach to the infertile male patient.  

PubMed

There are several objectives to be achieved during the diagnostic evaluation of a male partner of an infertile partnership. The first is to identify whether or not there is a male factor present and, if so, whether this is attributable to an underlying medical illness. The second is to identify the cause of reduced male fertility and whether or not it is amenable to therapeutic intervention. PMID:17543720

Jarow, Jonathan P

2007-06-01

237

[A 37-year-old woman with anogenital warts].  

PubMed

A 37-year-old woman, who had been suffering from Crohn's disease since twenty-two years, visited our dermatology outpatient clinic with complaints of wart-like lesions in the vulvar and perianal regions. On physical examination, nodules, plaques and tumours were seen. Histological examination showed features compatible with Crohn's disease. The diagnosis metastatic Crohn's disease was made. PMID:24893818

Vos, Marlieke J; Hamoen, Karen E; Loots, Miriam A M

2014-01-01

238

Emerging Understanding of Patterning in 4-Year-Olds  

ERIC Educational Resources Information Center

Young children have an impressive amount of mathematics knowledge, but past psychological research has focused primarily on their number knowledge. Preschoolers also spontaneously engage in a form of early algebraic thinking-patterning. In the current study, we assessed 4-year-old children's knowledge of repeating patterns on two occasions…

Rittle-Johnson, Bethany; Fyfe, Emily R.; McLean, Laura E.; McEldoon, Katherine L.

2013-01-01

239

A Three Year Old Learning Literacy at Home  

Microsoft Academic Search

This study provides a record of one day of literacy learning at home of a three year old child. It indicates the wide variety of literacy activities which a young child explores and often initiates. The importance of story readings as well as repeated readings of the same book are noted. However, the use of other print at home, songs

Robin Campbell

1998-01-01

240

Two-Year-Olds Compute Syntactic Structure On-Line  

ERIC Educational Resources Information Center

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.…

Bernal, Savita; Dehaene-Lambertz, Ghislaine; Millotte, Severine; Christophe, Anne

2010-01-01

241

Ovarian remnant syndrome in a 5-year-old bitch.  

PubMed

A 5-year-old German shepherd bitch was presented with a 3-week history of vaginal bleeding. Ovarian remnant syndrome was diagnosed on vaginoscopy, vaginal cytology, serum progesterone levels, ultrasonography, and exploratory laparotomy. The condition resolved following surgical excision of the remaining ovarian tissue. PMID:15759831

Sangster, Cheryl

2005-01-01

242

Recommended Immunizations for Children from 7 Through 18 Years Old  

MedlinePLUS

2014 Recommended Immunizations for Children from 7 Through 18 Years Old 7–10 YEARS 11-12 YEARS13-18 YEARS Tdap 1 ... high risk for pneumococcal disease. 6 Hepatitis A vaccination is recommended for older children with certain medical ...

243

Grammatical Morpheme Production in 4-Year-Old Children.  

ERIC Educational Resources Information Center

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.…

Balason, Denise V.; Dollaghan, Christine A.

2002-01-01

244

Enterobius vermicularis in a 14-Year-Old Girl's Eye ?  

PubMed Central

We report an unusual case of extraintestinal infection with adult Enterobius vermicularis worms in the nares and ocular orbit of a 14-year-old girl in Illinois. Only one other similar case has been reported in the English-language literature. PMID:21956983

Babady, N. Esther; Awender, Erich; Geller, Robert; Miller, Terry; Scheetz, Gayle; Arguello, Heather; Weisenberg, Scott A.; Pritt, Bobbi

2011-01-01

245

Oral Health among 35- to 44YearOld Iranians  

Microsoft Academic Search

Objective: To investigate the oral health status of 35- to 44-year-old Iranians in relation to gender, place of residence and education. Subjects and Methods: In 2002, data (n = 8,301) were collected as part of a national survey using WHO criteria for sampling and clinical diagnoses across 28 provinces by 33 calibrated examiners who performed examinations under a dental light

Hossein Hessari; Miira M. Vehkalahti; Mohammad J. Eghbal; Heikki T. Murtomaa

2007-01-01

246

Two-Year-Old Children Interpret Abstract, Purely Geometric Maps  

ERIC Educational Resources Information Center

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…

Winkler-Rhoades, Nathan; Carey, Susan C.; Spelke, Elizabeth S.

2013-01-01

247

Balancing on a Slackline: 8-Year-Olds vs. Adults  

PubMed Central

Children are less stable than adults during static upright stance. We investigated whether the same holds true for a task that was novel for both children and adults and highly dynamic: single-legged stance on a slackline. We compared 8-year-olds with young adults and assessed the following outcome measures: time on the slackline, stability on the slackline (calculated from slackline reaction force), gaze movement, head-in-space rotation and translation, trunk-in-space rotation, and head-on-trunk rotation. Eight-year-olds fell off the slackline quicker and were generally less stable on the slackline than adults. Eight-year-olds also showed more head-in-space rotation and translation, and more gaze variability around a visual anchor point they were instructed to fixate. Trunk-in-space and head-on-trunk rotations did not differ between groups. The results imply that the lower postural stability of 8-year-olds compared to adults – as found in simple upright stance – holds true for dynamic, novel tasks in which adults lack the advantage of more practice. They also suggest that the lack of head and gaze stability constitutes an important limiting factor in children’s ability to master such tasks. PMID:23626583

Schärli, Andrea Melanie; Keller, Melanie; Lorenzetti, Silvio; Murer, Kurt; van de Langenberg, Rolf

2013-01-01

248

How Do Korean Nine Year Olds Make Historical Inferences?  

ERIC Educational Resources Information Center

This study explores how a group of nine year olds in Korea form historical inferences using pictures of historical paintings. It investigates whether they have the ability to form plausible inferences about the lives of people depicted in these pictures, what they can infer about the lives of people depicted in the pictures using prior knowledge,…

Kang, Sunjoo

2010-01-01

249

Two-Year-Old with Post-Surgical Hypoglossal Nerve Injury and Obstructive Sleep Apnea  

PubMed Central

Background: Airway patency in both children and adults depends on the tonic and phasic activation of muscles of the tongue and pharynx supplied by the hypoglossal nerve arising at the medullary level Methods/Patient: We report a case of a 2-year-old who after resection of fourth ventricle anaplastic ependymoma developed severe sleep disordered breathing and tongue fasciculation. Results: Polysomnography showed severe obstructive sleep apnea with oxygen desaturation to 33%. Magnetic resonance imaging of the brain showed post-surgical effacement of the dorsal lateral medulla. Conclusions: We postulate that damage to the hypoglossal nerve at the level of the medulla contributed to the patient's severe obstructive sleep apnea. Patient was treated with tracheostomy. Citation: DelRosso LM; Hoque R; Gonzalez-Toledo E. Two-year-old with post-surgical hypoglossal nerve injury and obstructive sleep apnea. J Clin Sleep Med 2014;10(1):97-98. PMID:24426827

DelRosso, Lourdes M.; Hoque, Romy; Gonzalez-Toledo, Eduardo

2014-01-01

250

Male nurses and the protection of female patient dignity.  

PubMed

Nurses need to be aware of their professional, legal and ethical responsibilities towards patients. Male nurses in particular face problems in their practice as a result of their gender and the stereotypes associated with male nurses. Such stereotypes can act as a barrier to their duty of care. This article examines the challenges associated with male nurses carrying out intimate, physical care. It discusses the ethical, legal and professional issues that male nurses should consider in relation to maintenance of patient dignity during nursing care provision, particularly in relation to female patients. PMID:21207825

Prideaux, Antony

251

An aged male patient with autoimmune hepatitis complicated by hepatocellular carcinoma.  

PubMed

An 82-year-old male patient was admitted for liver dysfunction. Laboratory test showed the following data; aspartate aminotransferase (AST) 79 IU/l, alanine aminotransferase (ALT) 28 IU/l, total bilirubin (T. Bil) 0.9 U, zinc sulfate turbidity test (ZTT) 48.9 U, gamma-globulin 4.9 g/dl, immunoglobulin G (IgG) 5,046 mg/dl, anti-nuclear antibodies x 320, anti-mitochondrial antibodies (-), hepatitis B virus surface antigen (HBsAg) (-), HBcAb (-), anti-hepatitis C virus (anti-HCV) (-), hepatitis C virus (HCV-RNA) (-), anti-hepatitis G virus (anti-HGV) (-), alpha-fetoprotein 306.8 ng/ml, carcinoembryonic antigen (CEA) 2.3 ng/ml, carbohydrate antigen (CA) 19-9 77.2 U/ml. Abdominal ultrasonography and computed tomography showed a large mass occupying most of the right lobe and portal thrombosis in the liver. Liver biopsy revealed cirrhosis with inactive hepatitis in the nontumorous lesion and well-differentiated hepatocellular carcinoma in the tumorous lesion. We report a rare case of an aged male patient with autoimmune hepatitis complicated by hepatocellular carcinoma. PMID:10397080

Yamazaki, K; Kamiyama, T; Shiba, S; Ebata, A; Sugiura, K; Matsuda, O; Nakamura, K; Tanaka, Y; Sato, C

1999-05-01

252

Cerebral Metastasis from Breast Cancer in a Male Patient with HIV  

PubMed Central

Context. Breast cancer (BC) in men is a rare condition, corresponding to 1% of all neoplasms in this gender. Some studies show that up to 93% of BC cases in men are advanced disease. If its occurrence constitutes an uncommon fact, the appearance of a metastasis to the central nervous system (CNS) is extremely rare. The objective of the present study is to present the case of a male patient, bearer of HIV infection, who presented with BC and later metastasis to the CNS. We also include a brief review of the literature. Case Report. We describe a case of a male patient, 59 years old, with HIV infection and a history of BC treated 4 years earlier, which progressed into headache and vertigo. Neuroimaging exams showed lesions suggestive of cerebral metastasis and a stereotaxic biopsy confirmed BC metastasis. Conclusion. Breast cancer in men with metastasis to the CNS is a rare condition and similar reports were not found in the available databases. It should be pointed out that even though rare, it should be considered among the differential diagnoses for SNC metastases in men, although HIV infection favors the appearance of some types of cancer.

Badke, Guilherme Lellis; de Aguiar, Guilherme Brasileiro; Silva, João Miguel de Almeida; Paiva, Aline Lariessy Campos; da Silva, Eduardo Urbano; Veiga, José Carlos Esteves

2015-01-01

253

Multifocal Meningioangiomatosis: Case report of a 3 year old patient.  

PubMed Central

Meningioangiomatosis consists of benign hamartomatous lesions of the brain and the leptomeninges, which typically present with seizure. Management is predicated on resection and control of seizures with medication. Lesions are typically solitary. Multifocal meningioangiomatosis is extremely rare, with only 2 cases reported in adults and none in children. The authors report the first case, to their knowledge, of multifocal meningioangiomatosis in a child. This unique case highlights therapeutic challenges associated with these lesions and demonstrates that multifocality is possible in the pediatric population. This finding has implications for diagnosis and follow-up for children afflicted with these tumors. PMID:23020197

Jamil, Osama; Ramkissoon, Shakti; Folkerth, Rebecca; Smith, Edward

2013-01-01

254

Frontal Lobe Morphometry with MRI in a Normal Age Group of 6-17 Year-Olds  

PubMed Central

Background Morphometric data of the frontal lobe are important for surgical planning of lesions in the frontal lobe and its surroundings. Magnetic resonance imaging (MRI) techniques provide suitable data for this purpose. Objectives In our study, the morphometric data of mid-sagittal MRI of the frontal lobe in certain age and gender groups of children have been presented. Patients and Methods In a normal age group of 6-17-year-old participants, the length of the line passing through predetermined different points, including the frontal pole (FP), commissura anterior (AC), commissura posterior (PC), the outermost point of corpus callosum genu (AGCC), the innermost point of corpus callosum genu (IGCC), tuberculum sella (TS), AGCC and IGCC points parallel to AC-PC line and the point such line crosses at the frontal lobe surface (FCS) were measured in three age groups (6-9, 10-13 and 14-17 years) for each gender. Results The frontal lobe morphometric data were higher in males than females. Frontal lobe measurements peak at the age group of 10-13 in the male and at the age group of 6-13 in the female. In boys, the length of FP-AC increases 4.1% in the 10-13 age group compared with the 6-9-year-old group, while this increase is 2.3% in girls. Conclusion Differences in age and gender groups were determined. While the length of AGCC-IGCC increases 10.4% in adults, in children aged 6-17, the length of AC-PC is 11.5% greater than adults. These data will contribute to the preliminary assessment for developing a surgical plan in fine interventions in the frontal lobe and its surroundings in children. PMID:23599707

?lkay Ko?ar, M; Ota?, ?lhan; Sabanc?o?ullar?, Vedat; Atalar, Mehmet; Tetiker, Hasan; Ota?, Aynur; Çimen, Mehmet

2012-01-01

255

Lymph node metastasis in gastric cardiac adenocarcinoma in male patients  

PubMed Central

AIM: To reveal the clinicopathological features and risk factors for lymph node metastases in gastric cardiac adenocarcinoma of male patients. METHODS: We retrospective reviewed a total of 146 male and female patients with gastric cardiac adenocarcinoma who had undergone curative gastrectomy with lymphadenectomy in the Department of Surgery, Xin Hua Hospital and Rui Jin Hospital of Shanghai Jiaotong University Medical School between November 2001 and May 2012. Both the surgical procedure and extent of lymph node dissection were based on the recommendations of Japanese gastric cancer treatment guidelines. Univariate and multivariate analyses of lymph node metastases and the clinicopathological features were undertaken. RESULTS: The rate of lymph node metastases in male patients with gastric cardiac adenocarcinoma was 72.1%. Univariate analysis showed an obvious correlation between lymph node metastases and tumor size, gross appearance, differentiation, pathological tumor depth, and lymphatic invasion in male patients. Multivariate logistic regression analysis revealed that tumor differentiation and pathological tumor depth were the independent risk factors for lymph node metastases in male patients. There was an obvious relationship between lymph node metastases and tumor size, gross appearance, differentiation, pathological tumor depth, lymphatic invasion at pN1 and pN2, and nerve invasion at pN3 in male patients. There were no significant differences in clinicopathological features or lymph node metastases between female and male patients. CONCLUSION: Tumor differentiation and tumor depth were risk factors for lymph node metastases in male patients with gastric cardiac adenocarcinoma and should be considered when choosing surgery. PMID:24115823

Ren, Gang; Chen, Ying-Wei; Cai, Rong; Zhang, Wen-Jie; Wu, Xiang-Ru; Jin, Ye-Ning

2013-01-01

256

Primary cutaneous tuberculosis in a 27-year-old medical intern from needle-stick injury: a case report  

PubMed Central

Key Clinical Message The authors report a case of cutaneous tuberculosis in a 27-year-old African male medical intern who contracted primary cutaneous from a needle-stick injury. Cultures of pus aspirated from the finger initially grew Staphylococcus aureus that led to a delay in the diagnosis.

Karoney, Mercy Jelagat; Kaumbuki, Erastus Kanake; Koech, Mathew Kiptonui; Lelei, Lectary Kibor

2015-01-01

257

Ascites associated with uterine leiomyoma in a 22-year-old woman with systemic lupus erythematosus.  

PubMed

Ascites in systemic lupus erythematosus (SLE) patients has a variety of etiologies, which usually require different treatment options. Our case was a 22-year-old patient with an unusual combination of ascites, uterine leiomyoma and SLE. The patient presented with painless ascites of an inflammatory nature. However, the ascites was not related to peritonitis and SLE disease activity. The ascites disappeared following laparotomy and tumor resection without additional medication. Gynecologic benign tumors including uterine leiomyoma can be the cause of ascites in SLE patients. Clinicians should be aware of that possibility in case painless ascites occurs in females with SLE. PMID:24972898

Seo, M R; Sung, J Y; Cho, H J; Ryu, H J; Choi, H-J; Park, C-Y; Baek, H J

2014-10-01

258

Carbamyl phosphate synthase deficiency: Diagnosed during pregnancy in a 41-year-old  

Microsoft Academic Search

Carbamyl phosphate synthase deficiency (CPS) is a rare urea cycle defect. We present a case of a 41-year-old woman diagnosed with CPS deficiency during pregnancy. She is the oldest CPS-deficient patient, at diagnosis, reported to date and the first to be diagnosed during pregnancy. This case highlights the need for consideration of inborn errors of metabolism in adults presenting with

G. Eather; D. Coman; C. Lander; J. McGill

2006-01-01

259

Trisomy 18 mosaicism in a 15-year-old boy with normal intelligence and short stature  

SciTech Connect

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.

NONE

1995-05-08

260

Neurocysticercosis in a 2-year-old boy infected at home.  

PubMed

A 2-year-old boy presented with seizures and two parenchymal brain ring-enhancing lesions. Diagnosis of neurocysticercosis was confirmed by positive serology and response to albendazole therapy. The patients's mother was a Taenia solium carrier, who had most likely infected the child through the fecal-oral route. Household contacts should always be investigated in children with neurocysticercosis. Proper identification and treatment of Taenia solium carriers will reduce the risk of further spread of the disease. PMID:22943549

Del Brutto, Oscar H

2012-05-01

261

Pathology Case Study: A 45-Year-Old Female with Acute Liver Failure  

NSDL National Science Digital Library

The University of Pittsburgh School of Medicine's Department of Pathology has compiled a series of case studies to help both students and instructors. In this particular study a 45-year-old female patient is suffering from acute liver failure. The case study provides test results and images along with microscopic photos and description. Clicking on the final diagnosis provides a thorough explanation of the diagnosis and treatment.

Richert, Charles A.

2007-08-11

262

Germination of 151-year old Acacia spp. seeds  

Microsoft Academic Search

A collection of seeds from five Acacia species was made in Egypt in 1856. Since then, the seeds have been stored at room temperature in different Swedish museums.\\u000a Due to the extreme longevity within the seeds of Acacia and related species, germination tests were performed on the now 151-year old seed. Seeds of two of the five species tested\\u000a germinated.

Matti W. Leino; Johan Edqvist

2010-01-01

263

Mitochondrial haplogroups associated with Japanese centenarians, Alzheimer's patients, Parkinson's patients, type 2 diabetic patients and healthy non-obese young males.  

PubMed

The relationships between five classes of Japanese people (i.e., 96 centenarians, 96 Alzheimer's disease (AD) patients, 96 Parkinson's disease (PD) patients, 96 type 2 diabetic (T2D) patients, and 96 healthy non-obese young males) and their mitochondrial single nucleotide polymorphism (mtSNP) frequencies at individual mtDNA positions of the entire mitochondrial genome were examined using the radial basis function (RBF) network and the modified method. New findings of mitochondrial haplogroups were obtained for individual classes. The five classes of people were associated with the following haplogroups: Japanese centenarians-M7b2, D4b2a, and B5b; Japanese AD patients-G2a, B4c1, and N9b1; Japanese PD patients-M7b2, B4e, and B5b; Japanese T2D patients-B5b, M8a1, G, D4, and F1; and Japanese healthy non-obese young males- D4g and D4b1b. From the points of common haplogroups among the five classes, the centenarians have the common haplogroups M7b2 and B5b with the PD patients and common haplogroup B5b with the T2D patients. In addition, the 112 Japanese semi-supercentenarians (over 105 years old) recently reported were also examined by the method proposed. The results obtained were the haplogroups D4a, B4c1a, M7b2, F1, M1, and B5b. These results are different from the previously reported haplogroup classifications. As the proposed analysis method can predict a person's mtSNP constitution and the probabilities of becoming a centenarian, AD patient, PD patient, or T2D patient, it may be useful in initial diagnosis of various diseases. PMID:19631917

Takasaki, Shigeru

2009-07-01

264

Suspected disseminated histiocytic sarcoma in a 3-year-old Perro de Presa Canario dog  

PubMed Central

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

Denstedt, Emily

2014-01-01

265

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

PubMed Central

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

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

2014-01-01

266

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

PubMed

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

Bains, Satinder Pal Singh; Singh, Vikram; Gill, Manmeet Kaur; Jain, Amit; Arry, Vivek

2014-08-01

267

Immunoglobulin G4-related sclerosing disease with orbital inflammation in a 12-year-old girl.  

PubMed

Immunoglobulin G4-related sclerosing disease is a rare but potentially debilitating cause of orbital inflammation, with a predilection for older males. We report the case of a 12-year-old African girl with immunoglobulin G4-related sclerosing disease, including possible extraorbital involvement. Because of an escalating severity of illness leading to oculomotor nerve palsy and cavernous sinus thrombosis that was resistant to steroids, systemic immunosuppressive therapy with rituximab was used to achieve disease remission. The diagnosis was histologically confirmed with a tissue biopsy. PMID:24160980

Sane, Mona; Chelnis, James; Kozielski, Rafal; Fasiuddin, Airaj

2013-10-01

268

Ashy dermatosis in an 8-year-old Indian child  

PubMed Central

Ashy dermatosis is a disorder of pigmentation, characterized by asymptomatic symmetric ashy gray-colored macules, in the first to third decade of life. It can, however, affect children sometime. But, there is a paucity of similar cases in Indian children. We present a case of ashy dermatosis in an 8-year-old Indian girl who presented to skin OPD with areas of ashy pigmentation, which were distributed symmetrically. Skin biopsy was consistent with lichenoid pattern histology. This case has been reported to highlight the rarity of ashy dermatosis in Indian children. PMID:23439983

Keisham, Chitralekha; Sarkar, Rashmi; Garg, V. K.; Chugh, Shikha

2013-01-01

269

NASA Administrator Dan Goldin greets 10-year-old VIP.  

NASA Technical Reports Server (NTRS)

NASA Administrator Dan Goldin (left) shares a laugh with VIP 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.

2000-01-01

270

NASA Administrator Dan Goldin greets 10-year-old VIP.  

NASA Technical Reports Server (NTRS)

NASA Administrator Dan Goldin (left) listens intently to 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.

2000-01-01

271

NASA Administrator Dan Goldin greets 10-year-old VIP.  

NASA Technical Reports Server (NTRS)

NASA Administrator Dan Goldin (left) watches as 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA, shakes hands with astronaut Dog 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.

2000-01-01

272

Odontogenic myxoma in a 52-year-old woman.  

PubMed

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

Ram, Hari; Mehta, Gagan; Kumar, Manoj; Lone, Parveen

2014-01-01

273

Bronchopulmonary sequestration in a 60 year old man  

PubMed Central

We report a case of bronchopulmonary sequestration (BPS) in a 60 year old man with recurrent cough. After failed antibiotic therapy for presumed left lower lobe (LLL) pneumonia seen on chest radiographs, bronchoscopy was performed revealing cryptogenic organizing pneumonia. Further work-up with thoracic imaging demonstrates a feeding artery from the thoracic aorta to the LLL consolidation indicating the presence of BPS. A brief review of the clinical and radiological features and management options of BPS are listed, with particular emphasis on the various imaging modalities and techniques in the diagnosis and pre-surgical planning of intralobar sequestration. PMID:25426223

Naffaa, Lena; Tank, Jay; Ali, Sara; Ong, Cesar

2014-01-01

274

[Acute limping in children between 1 and 4 years old].  

PubMed

Recent limping in children aged between 1 and 4 years old are often a diagnostic problem because the young child may not be able to show the area of pain. Dominated by the traumatic causes like hairline fracture, the physician should eliminate the most severe, including infectious etiologies that require urgent treatment. The clinical examination is fundamental and simple complementary investigations like standard X-rays and biology (blood count cell, C reactive protein) looking for increased inflammatory parameters will help to find the cause in the majority of cases. The persistence of a limp beyond a week involves the realization of bone scan or MRI imaging. PMID:24686039

Fitoussi, F; Delpont, M

2014-05-01

275

Posttraumatic superior ophthalmic vein thrombosis in a 2 years old.  

PubMed

Superior ophthalmic vein thrombosis (SOVT) usually results from inflammatory, infectious, or malignant causes. This case describes a 2-year-old boy with severe prolapsing chemosis and proptosis due to thrombosis of the right superior ophthalmic vein resulting from midfacial and right orbital fractures 1 week after the initial trauma. Magnetic resonance imaging and internal carotid artery angiogram are essential in the diagnosis of SOVT. The literature on issues surrounding this case was reviewed with emphasis on the diagnostic evaluation, differential diagnoses, and management of posttraumatic SOVT. PMID:24488160

Akingbola, Olugbenga A; Shar, Basil; Singh, Dinesh; Frieberg, Edwin; Petrescu, Matei

2014-02-01

276

Subacute encephalopathy in a 5-year-old boy.  

PubMed

A 5-year-old boy presented with an acute ataxia and altered mental status. Although he initially recovered from these symptoms, he presented a second time with myoclonus and seizures and rapidly became vegetative. Cerebrospinal fluid studies, magnetic resonance imaging, and brain biopsy all confirmed the presence of subacute sclerosing panencephalitis. Despite courses of therapy with cimetidine, amantadine, ribavirin, and inosine, no clinical improvement has been seen. Clinicians need to be alert to the possibility of subacute sclerosing panencephalitis even in the vaccinated child in the appropriate clinical setting. PMID:10522334

Bobele, G B

1999-09-01

277

An 81-year-old man with an abnormal right-sided heart shadow on chest radiograph.  

PubMed

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

Shah, Rahman; Khan, M Rehan; Fan, Tai-Hwang M; Ruff, Genina; Ramanathan, Kodangudi B

2015-02-01

278

JAMA Patient Page: Male Sexual Dysfunction  

MedlinePLUS

... share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424. • Low libido (sexual interest) • Erectile dysfunction (ED, difficulty achieving or maintaining ...

279

Pathology Case Study: Mesenteric Adenopathy in a 57-Year-Old Woman  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 57-year-old woman has had elevated creatinine levels. Visitors are given microscopic and gross descriptions, images, flow cytometry, molecular diagnosis, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in transplant pathology.

Nalesnik, Michael

280

Pathology Case Study: A 73-Year-Old Jewish Female with Anemia of Unknown Etiology  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 73-year-old Jewish woman has anemia of unknown etiology and a low reticulocyte count. Visitors are given the microscopic description, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hematopathology.

Goldblatt, Curtis

281

Pathology Case Sstudy: A 59-Year-Old Female with a Right Atrial Mass  

NSDL National Science Digital Library

This is a cardiovascular pathology case study presented by the University of Pittsburgh Department of Pathology in which a 59-year-old black female has diffuse large cell lymphoma (i.e. right atrial mass). Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in cardiovascular pathology.

Schubert, Eric

282

[Weight loss and chronic diarrhea in a 54-year-old man with HIV infection].  

PubMed

A 54-year-old man presented with a 6-week history of chronic diarrhea and weight loss of 11 kg after returning from a holiday in Thailand. The patient had a 9-year history of an untreated HIV infection. Despite treatment of a culture-proven Shigella enteritis and strongyloidiasis the symptoms persisted. Finally, cytomegalovirus (CMV) colitis was diagnosed by colonoscopy. The patient recovered completely after starting antiretroviral and valganciclovir treatment. An additional opportunistic infection with multiresistant pulmonary tuberculosis was diagnosed. PMID:25583311

Pickel, S; Filipowicz, M; Bruder, E; Battegay, M; Osthoff, M

2015-01-01

283

Pathology Case Study: Right Cerebellopontine Angle Mass in a 64-Year-Old Woman  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 64-year-old woman is complaining of dizziness and hearing loss. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in neuropathology.

Nine, Jeff S.

284

Pathology Case Study: Brain Mass in a 62-Year-Old Woman  

NSDL National Science Digital Library

This is a neuropathology case study presented by the University of Pittsburgh Department of Pathology in which a 62-year-old female has a brain mass. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in neuropathology.

Schubert, Eric

285

Pathology Case Study: Bladder Mass in a 57-Year-Old Woman  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 57-year-old woman has a history of bladder tumors. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in genitourinary pathology.

Hakam, Ardeshir

286

Orbital Rosai–Dorfman Disease in a fifty-eight years old woman  

PubMed Central

Rosai–Dorfman disease (RDD) is rare and characterized by histiocytic proliferation and massive cervical lymphadenopathy. About 40% of patients have extra-nodal involvement. Opthalmic involvement is seen in 10% of cases. A case of orbital Rosai Dorfman disease in a 58 years old woman is presented here, who was misdiagnosed as orbital inflammatory disease initially. The patient did not respond to a course of oral prednisolone. Then complete surgical excision of the mass was performed and the histopathological examination was consistent with a diagnosis of RDD. PMID:24353690

Li, Hui-Yan; Cui, Hong-Guang; Zheng, Xue-Yong; Ren, Guo-Ping; Gu, Yang-Shun

2013-01-01

287

Orbital Rosai-Dorfman Disease in a fifty-eight years old woman.  

PubMed

Rosai-Dorfman disease (RDD) is rare and characterized by histiocytic proliferation and massive cervical lymphadenopathy. About 40% of patients have extra-nodal involvement. Opthalmic involvement is seen in 10% of cases. A case of orbital Rosai Dorfman disease in a 58 years old woman is presented here, who was misdiagnosed as orbital inflammatory disease initially. The patient did not respond to a course of oral prednisolone. Then complete surgical excision of the mass was performed and the histopathological examination was consistent with a diagnosis of RDD. PMID:24353690

Li, Hui-Yan; Cui, Hong-Guang; Zheng, Xue-Yong; Ren, Guo-Ping; Gu, Yang-Shun

2013-07-01

288

Pathology Case Study: A 54-Year-Old Man with a Right Cheek Mass  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 54-year-old man has a recurrent neoplasm in his right cheek. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in head and neck pathology

Nine, Jeff S.; Schubert, Eric

2007-07-29

289

Rabies in a nine-year-old child: The myth of the bite  

PubMed Central

A nine-year-old boy died from rabies encephalitis caused by a rabies virus variant associated with insectivorous bats. The patient was most likely infected in the Laurentian Mountains of western Quebec, but neither the patient nor his parents remembered any direct contact with an animal. The diagnosis was made seven days after the start of symptoms. After examining the most recent cases of rabies in North America, it is obvious that rabies following bat exposure can occur without history of a documented bite. The present case report emphasizes that the general public and medical care providers need better information about the risks associated with exposure to bats. PMID:18159381

Despond, Olivier; Tucci, Marisa; Decaluwe, Hélène; Grégoire, Marie-Claude; S Teitelbaum, Jeanne; Turgeon, Nathalie

2002-01-01

290

Growth Disorders Among 6-Year-Old Iranian Children  

PubMed Central

Background: Sociodemographic factors are important determinants of weight disorders. National representative studies provide a view on this health problem at national and regional levels. Objectives: This study aimed to assess the distribution of growth disorders in terms of body mass index (BMI) and height in 6-year-old Iranian children using geographical information system (GIS). Materials and Methods: In this cross-sectional nationwide survey, all Iranian children entering public and private elementary schools were examined in a mandatory national screening program in 2009. Descriptive analysis was used to calculate the prevalence of underweight, overweight, obesity, and short stature. Then, ArcGIS software was used to draw the figures. Results: The study population consisted of 955388 children (48.5% girls and 76.5% urban). Overall, 20% of children were underweight, and 14.3% had high BMI, consisted of 10.9% overweight and 3.4% obese. The corresponding figure for short stature was 6.6%; however, these growth disorders were not equally distributed across various provinces. Conclusions: Our results confirmed unequal distribution of BMI and height of 6-year-old children in Iran generally and in most of its provinces particularly. The differences among provinces cannot be fully explained by the socioeconomic pattern. These findings necessitate a comprehensive national policy with provincial evidence-based programs. PMID:25068062

Kelishadi, Roya; Amiri, Masoud; Motlagh, Mohammad Esmaeil; Taslimi, Mahnaz; Ardalan, Gelayol; Rouzbahani, Reza; Poursafa, Parinaz

2014-01-01

291

[Clinical investigation of male infertile patients with chromosomal anomalies].  

PubMed

We investigated 470 male patients who came to the Reproduction Medical Center of Yokohama City University Medical Center complaining of infertility between April 2,000 and August 2013. We analyzed the chromosomes of 90 patients whose sperm concentration was below 1.0 × 107/ml. Nineteen of the 90 (21.1%) patients showed sex chromosomal anomalies including 12 Klinefelter syndrome (47, XXY or 46, XY/47, XXY), Robertsonian translocation, 2 autosome-autosome translocation, Y-autosome translocation, 46, X with marker chromosome (46, Xmar?), XX male and Y chromosome macrodeletion (46, XYq-). While patients with chromosomal abnormalities except XX male or some of 46, XYq- may succeed in reproduction using testicular sperm extraction-intracytoplasmic sperm injection, we need to inform the patients about the risks of chromosomal abnormalities in the resulting fetus. PMID:25142955

Kuroda, Shinnosuke; Yumura, Yasushi; Yasuda, Kengo; Yamanaka, Hiroyuki; Takeshima, Teppei; Kobayashi, Masataka; Kato, Yoshitake; Iwasaki, Akira; Noguchi, Kazumi

2014-07-01

292

Social Competence of Male and Female Psychiatric Patients  

Microsoft Academic Search

These twin studies of 90 male and 90 female non-paranoid, paranoid schizophrenia and bi-polar affective disorder patients found group mean scores of sociability and social presence to be associated with specific diagnoses and ages of onset of psychosis at levels beyond that of probability. The findings reveal female patients' mean averages to be closer to the hypothesis of the study

Mary V. Donohue; Harvey Lieberman

1993-01-01

293

NASA Administrator Dan Goldin greets 10-year-old VIP.  

NASA Technical Reports Server (NTRS)

NASA Administrator Dan Goldin (center) presents a bag of special gifts to 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. In the background, between them, are Jonathan's mother, Penny; his grandfather, John Janocka; and his sister, Jaimie.. At left is Mrs. Goldin. 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.

2000-01-01

294

Characterization of 80-million-year-old mollusk shell proteins.  

PubMed Central

Fossil glycoproteins of the soluble organic matrix are present in an 80-million-year-old mollusk shell from the Late Cretaceous Period. Discrete molecular weight components, as determined by gel electrophoresis, are preserved. The fossil organic matrix was compared with the organic matrix of a living representative species of the same superfamily. A particular repeating amino acid sequence, found in contemporary mollusk shell proteins, was identified in the fossil glycoproteins. The ultrastructure, mineralogy, and chemistry of the inorganic components of the fossil and contemporary shells provide information on the state of preservation of the fossil. The use of fossil shell proteins to further our understanding of molecular evolution is discussed. Images PMID:785470

Weiner, S; Lowenstam, H A; Hood, L

1976-01-01

295

NASA Administrator Dan Goldin greets 10-year-old VIP.  

NASA Technical Reports Server (NTRS)

NASA Administrator Dan Goldin (center) talks to 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. In the background, between them, are Jonathan's mother, Penny; his grandfather, John Janocka; and his sister, Jaimie. At left is Mrs. Goldin. 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.

2000-01-01

296

NASA Administrator Dan Goldin greets 10-year-old VIP.  

NASA Technical Reports Server (NTRS)

NASA Administrator Dan Goldin (center) greets 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. In the background, between them, are Jonathan's mother, Penny; his grandfather, John Janocka; and his sister, Jaimie.. At left is Mrs. Goldin. 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.

2000-01-01

297

Pyelonephritis xanthogranulomatosa in a 7-year-old girl  

PubMed Central

Xanthogranulomatous pyelonephritis (XGPN) is rare form of chronic, usually unilateral, renal infection that involves damage to the renal glomeruli and periglomerular tissue and destruction of the renal parenchyma. Nephrectomy is usually necessary and the prognosis is good if XGPN is unilateral and treated early. XGPN typically affects middle-aged females and is extremely rare in children. We report one case of XGPN in a seven-year-old girl who was operated on at our institution be-cause of lower urinary tract dysfunction and renal insufficiency – the left kidney was removed and the bladder was augmented by means of the remaining ureter. The histopathological evaluation of the removed kidney showed chronic XGPN. PMID:24578955

Apozna?ski, Wojciech; Szyde?ko, Tomasz; Patkowski, Dariusz

2012-01-01

298

[Subungual exostosis in a 14 years old boy].  

PubMed

Subungual exostosis is a benign bony outgrowth surrounded by a fibrocartilaginous capsule that mainly affects hallux terminal phalanx with subungual or periungular localization, and that clinically determines variable degree of nail plate or periungular soft tissues alterations, respectively, It is uncommon in childhood and more frequent in females. Clinical suspicion is confirmed by the radiographic finding of a distinct trabecular bone growth arising from the dorsal aspect of the phalanx of the affected finger, on the lateral incidence. Curettage or surgical excision is the treatment of choice. We report a case of subungual exostosis located at the hallux in a 14-year-old boy suffering from subungual exostosis of the hallux that presented the characteristic triad of this entity: subungular tumor with nail plate deformity, digital pain and radiologic typical findings. PMID:19753444

Larralde, Margarita; Boggio, Paula; Abad, María Eugenia; Pagotto, Betina; Castillo, Andrea

2009-08-01

299

Child-directed action promotes 2-year-olds' imitation.  

PubMed

Children are voracious learners and adults are ubiquitous teachers. This project investigated whether the special infant-directed action modifications parents use when teaching their children (called "motionese" by Brand et al., Developmental Science, 2002, Vol. 5, pp. 72-83) improves 2-year-olds' imitation. Children saw an adult perform a series of acts on four novel objects using either an infant-directed style (including larger range of motion and enhanced boundary marking) or an adult-directed style. Children's imitation of the acts was higher in the infant-directed condition relative to the adult-directed condition, and both types of demonstration increased imitation relative to baseline (no demonstration). We propose that motionese provides information about actions, objects, and intentionality, thereby enhancing toddlers' observational learning. PMID:24079611

Williamson, Rebecca A; Brand, Rebecca J

2014-02-01

300

Pulmonary dirofilariasis in a 59-year-old man  

PubMed Central

We present a case of a human pulmonary dirofilariasis in a 59-year-old man. At the medical examination, a chest computed tomography (CT) revealed a mass, measuring 18 × 15 mm in diameter, with an irregular margin on the bottom of the right lower lobe. We could not neglect the possibility of a primary lung cancer, and therefore, a lung partial resection was performed under video-assisted thoracoscopic surgery. The intra-operative pathological findings revealed inflammatory granuloma with coagulation necrosis and no malignant cells. The permanent pathological examination showed occlusion of the peripheral pulmonary artery by worms and formation of a necrotic mass surrounded by reactive inflammation and hemorrhage. Human pulmonary dirofilariasis is an extremely rare zoonotic infection, and sometimes it is difficult to distinguish it from a primary lung cancer on radiographic findings. PMID:25168854

So, Tetsuya; Mitsueda, Reiko; Miyata, Takeaki; Sekimura, Atsushi; Yoshimatsu, Takashi; Nose, Naohiro; Itoh, Hiroshi; Nakano, Shigeo; Yasumoto, Kosei

2014-01-01

301

Diffuse Alveolar Hemorrhage in a 39-year-old Woman: Unusual Initial Presentation of Microscopic Polyangiitis  

PubMed Central

Microscopic polyangiitis (MPA) is a necrotizing vasculitis involving the small vessels without granulomatous inflammation. Most MPA initially presents with renal involvement without pulmonary involvement. Isolated and initially presenting alveolar hemorrhage is very rare. The patient was a 39-year-old female with a progressive cough, dyspnea, and blood-tinged sputum for the previous 5 days. We determined that her condition was MPA though VATS lung biopsy and renal biopsy. After 2 months of steroid therapy, the chest lesions had improved. We report here a rare case of MPA with isolated and initial involvement of the lung with a review of the literature. PMID:22324034

Kim, Jae Jun; Wang, Young-Pil; Park, Hyung Joo; Sung, Sook-Whan; Kim, Do-Yeon

2011-01-01

302

Mixed Squamous Cell and Glandular Papilloma of the Lung in a 64-Year-Old Woman  

PubMed Central

Mixed squamous cell and glandular papilloma of the lung is an extremely rare benign epithelial tumor showing a mixture of squamous and glandular epithelium. Here, we report a case of mixed squamous cell and glandular papilloma that presented as a solitary nodule in the left lower lobe of a 64-year-old woman. Chest computed tomography demonstrated a lobulated mass in the basal segment of the left lower lobe. The patient underwent a lobectomy under the suspicion of lung malignancy. The histopathological diagnosis was mixed squamous cell and glandular papilloma. PMID:24570869

Yun, Ju Sik; Kim, Do Wan; Choi, Yoo Duk; Na, Kook Joo

2014-01-01

303

Unusual association of myasthenia gravis and ulcerative colitis in a 14-year-old boy.  

PubMed

Ulcerative colitis (UC) is a chronic inflammatory condition. Its incidence is 0.8 per 100,000 children per year and median age at diagnosis is 14.1 years in the pediatric population. Extradigestive manifestations are frequent in inflammatory bowel disease (IBD), but neurologic disorders are rarely associated. We report the case of a 14-year-old boy who was diagnosed with UC and thereafter autoimmune hepatitis with primary sclerosing cholangitis. Two months later, he also developed myasthenia gravis, another autoimmune disease. Physicians should be aware of the possibility of an association between several autoimmune diseases in patients with IBD in order to improve disease outcomes. PMID:25440769

Guinet-Charpentier, C; Bilbault, C; Kennel, A; Perrier, P; Peyrin-Biroulet, L; Morali, A

2015-01-01

304

Intraabdominal focal fat infarction in a 75-year-old woman presenting as acute abdomen.  

PubMed

Epiploic appendagitis is a rare, self-limiting inflammation of the epiploic appendices or omental appendices. It presents as abdominal pain often misdiagnosed as appendicitis, cholecystitis, or diverticulitis. Epiploic appendagitis can be treated conservatively with anti-inflammatory and pain medications. It is important to diagnose this etiology of abdominal pain in order to avoid long-term hospital stay and other medical expenses including surgery. In this case report we present a rare case of epiploic appendagitis that presents in a 75 year old female patient. PMID:22424988

Arora, Shitij; Goyal, Hemant; Aggarwal, Prachi; Duffoo, Frantz; Basavaiah, Thara; Patel, Jigar; Hossain, Afzal

2012-11-01

305

Intrapericardial primary thymic carcinoma in a 73-year-old man.  

PubMed

Thymic carcinoma is a rare, highly aggressive type of tumor that typically occurs in the anterior mediastinum. We describe the case of a 73-year-old man who presented with weakness, cough, dyspnea, anorexia, and weight loss. An echocardiogram showed an intrapericardial mass that occupied the space around the lateral walls of the left ventricle and distally compressed the right ventricle. Magnetic resonance imaging and a biopsy confirmed the presence of intrapericardial primary thymic carcinoma. The patient underwent surgical excision of the tumor and died of right ventricular rupture during the procedure. This case highlights the importance of considering thymic carcinoma whenever an otherwise unexplained intrapericardial mass is encountered. PMID:19156242

Calderon, Ana Maria; Merchan, Juan Andres; Rozo, Juan Carlos; Guerrero, Cesar Ivan; Treistman, Bernardo; Sulak, Laura E; Cheong, Benjamin Y C; Rodríguez, German; Mesa, Andrés

2008-01-01

306

Internal jugular vein thrombosis complicating disseminated tuberculosis in a 2-year-old child.  

PubMed

Internal jugular vein (IJV) thrombosis is a serious and potentially life-threatening occurrence in children, and is usually associated with malignancies, prolonged central venous catheterisation or deep seated head and neck infections or trauma. It has not been described in association with tuberculosis in children. The authors describe a 2-year-old child who presented with IJV thrombosis in association with clinical signs and symptoms of disseminated tuberculosis. There was complete resolution of symptoms after starting antitubercular drugs and warfarin. The authors emphasise that an active search for tuberculosis should be made routinely in patients with IJV thrombosis with an underlying mediastinal mass and/or generalised lymphadenopathy. PMID:25234072

Das, Sarthak; Srinivasaraghavan, Rangan; Krishnamurthy, Sriram; Mahadevan, Subramanian

2014-01-01

307

Pathology Case Study: Brainstem Mass in a 2-Year-Old Female  

NSDL National Science Digital Library

The Department of Pathology at the University of Pittsburgh School of Medicine maintains a website with hundreds of case studies and sample diagnoses. These case studies are great learning tools for those studying medicine and planning on entering a medical field. This specific case involves the diagnosis of a 2-year-old female patient suffering from neck pain. A gross description of an MRI scan, and microscopic images are provided. Using the information provided, students are encouraged to make their own diagnosis and then check it against the official findings in the "Final Diagnosis" section.

Nine, Jeff S.

2007-08-09

308

Vogt-Koyanagi-Harada syndrome in a 6-year-old Hispanic boy.  

PubMed

A 6-year-old Hispanic boy presented to the ophthalmology department with complaints of pain, photophobia, and blurry vision of both eyes. He was found to have bilateral granulomatous panuveitis, cataracts, and high intraocular pressures. He later developed multiple asymptomatic, ovoid, hypopigmented patches over the mid-lumbosacral back. Biopsy of lesional skin was significant for low melanocyte counts and a mild lymphocytic infiltrate. The patient was diagnosed with Vogt-Koyanagi-Harada syndrome (VKH). This article reviews the literature regarding the cutaneous presentation of VKH. PMID:21995870

Hernandez, Claudia; LePoole, Caroline; Tessler, Howard H

2012-01-01

309

Symptomatic Floor-of-Mouth Swelling with Neck Extension in a 14-Year-Old Girl  

PubMed Central

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

Dayton, Kristin; Ryan, Matthew F.

2014-01-01

310

Distal femoral cortical proliferative irregularity with excavation in a 6-year-old girl.  

PubMed

The distal femur is a common site for benign or malignant bone tumors in children or adolescents. Distal femoral cortical irregularities at the posterior aspect of the distal femoral metaphysis must be differentiated from malignant bone tumors because they might be misinterpreted as malignant neoplasm. Plain radiographs of a 6-year-old girl complaining of left knee pain for 4 weeks showed cortical proliferation with excavation on her distal femoral metaphysis. Computed tomography, magnetic resonance imaging and bone scan helped to differentiate the cortical irregularity from malignant lesions. Therefore unnecessary invasive surgery was avoided in this patient. PMID:23412247

Seo, Jun-Yeong; Bang, Hyeong Sik; Yoo, Jeong Joon; Kim, Hee Joong; Nam, Kwang Woo

2013-11-01

311

Premature Menarche Associated with Primary Hypothyroidism in a 5.5-Year-Old Girl  

PubMed Central

Children with hypothyroidism generally have delayed pubertal development. Rare association with precocious puberty may occur especially in long standing untreated patients. The cardinal features of hypothyroidism induced pseudo precocious pubertal development include thelarche, galactorrhea and menarche. Other characteristics features are an absence of sexual hair and retardation of linear growth. Its manifestation as isolated menarche has been rarely reported. Recently, a five and half year old girl presented to us with history of one episode of vaginal bleeding. A pelvic ultrasonogram revealed multiple cysts in both ovaries and subsequent investigations led to a diagnosis of autoimmune hypothyroidism. PMID:22937289

Sharma, Dhrubajyoti; Dayal, Devi; Gupta, Anju; Saxena, Akshay

2011-01-01

312

Fatal lymphomatoid granulomatosis with primary CNS-involvement in an immunocompetent 80-year-old woman.  

PubMed

An 80-year-old woman presented with weight loss, fatigue, dizziness and a brain stem lesion. Extensive work-up revealed lymphomatoid granulomatosis (LYG) with primary clinical manifestation in the central nervous system (CNS), a rare Epstein-Barr virus-driven multisystem lymphoproliferative disorder, to be causative for the symptoms. Immunochemotherapy consisting of rituximab and temozolomide was started, but the disease progressed and the patient subsequently died. Histology, diagnostic criteria, differential diagnosis and treatment options for LYG with CNS involvement are discussed. This case demonstrates that LYG with CNS involvement may necessitate more aggressive treatment approaches than combination therapy with rituximab and temozolomide. PMID:25535225

Olmes, David G; Agaimy, Abbas; Kloska, Stephan; Linker, Ralf A

2014-01-01

313

“A 40-year-old female with painless, slow growing prepatellar mass”?  

PubMed Central

A 40-year-old woman from India presented with a mass in the front of her left knee which had been present for 8 months. Local examination revealed a globular mass of approximate size 5 cm × 4 cm × 4 cm in front of the lower pole of left patella. The patient was investigated with imaging studies and laboratory tests. Plain radiograph of the chest was normal. In addition, contrast enhanced Magnetic Resonance Imaging (MRI) of the left knee was performed. Based on the history, physical examination, laboratory and imaging studies, what is the differential diagnosis?

Arora, Sumit; Batra, Sahil; Rao, Seema; Maini, Lalit; Gautam, V.K.

2014-01-01

314

Oral health in 6-year-old schoolchildren from Berisso, Argentina: falling far short of WHO goals  

Microsoft Academic Search

Objectives: Dental diseases in children have been reduced in recent decades in developed countries, although trends remain unclear in other countries. Oral healthcare in Argentina is based on demand and depends on a patients health insurance coverage. The objective of this study was to determine the oral health situation of the population of six-year-olds in Berisso, Buenos Aires province (Argentina).

Gabriela Llompart; Gustavo H. Marin; Martin Silberman; Inés Merlo; Oscar Zurriaga; S GI

2009-01-01

315

In urban South Africa, 16 year old adolescents experience greater health equality than children?  

PubMed Central

Despite the strongly established link between socio-economic status (SES) and health across most stages of the life-course, the evidence for a socio-economic gradient in adolescent health outcomes is less consistent. This paper examines associations between household, school, and neighbourhood SES measures with body composition outcomes in 16 year old South African Black urban adolescents from the 1990 born Birth to Twenty (Bt20) cohort. Multivariable regression analyses were applied to data from a sub-sample of the Bt20 cohort (n = 346, 53% male) with measures taken at birth and 16 years of age to establish socio-economic, biological, and demographic predictors of fat mass, lean mass, and body mass index (BMI). Results were compared with earlier published evidence of health inequality at ages 9–10 years in Bt20. Consistent predictors of higher fat mass and BMI in fully adjusted models were being female, born post term, having a mother with post secondary school education, and having an obese mother. Most measures of SES were only weakly associated with body composition, with an inconsistent direction of association. This is in contrast to earlier findings with Bt20 9–10 year olds where SES inequalities in body composition were observed. Findings suggest targeting obesity interventions at females in households where a mother has a high BMI. PMID:23876525

Griffiths, Paula L.; Johnson, William; Cameron, Noël; Pettifor, John M.; Norris, Shane A.

2013-01-01

316

Intelligence and Visual Motor Integration in 5-Year-Old Children with 22q11-Deletion Syndrome  

ERIC Educational Resources Information Center

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…

Duijff, Sasja; Klaassen, Petra; Beemer, Frits; Swanenburg de Veye, Henriette; Vorstman, Jacob; Sinnema, Gerben

2012-01-01

317

Sciatica as a presenting feature of thyroid follicular adenocarcinoma in a 79-year-old woman  

PubMed Central

The authors describe an unusual case of metastatic thyroid follicular adenocarcinoma presenting with sciatica in a 79-year-old woman. The primary thyroid tumour was undiagnosed until this clinical presentation. The patient gave a short history of back pain and right-sided sciatica, which was progressive and nocturnal in nature. Neuroimaging revealed an enhancing intradural mass lesion, which was completely excised through a right L1-L3 hemilaminectomy. Histopathological examination of the excised tissue revealed a follicular thyroid carcinoma. Subsequent metastatic investigation revealed a heterogeneously attenuating mixed solid cystic mass in a retrosternal thyroid gland, with multiple solid pulmonary nodules suggestive of metastatic disease. She opted for palliative radiotherapy for the primary thyroid cancer and made remarkable postoperative improvement. The authors conclude that surgical treatment of solitary metastatic lesion may produce good symptomatic relief irrespective of patient’s age and primary pathology, while emphasising the need for detailed clinical evaluation of patients with ‘red flag’ symptoms. PMID:22674960

Ogbodo, Elisha; Kaliaperumal, Chandrasekaran; Keohane, Catherine; Bermingham, Niamh; Kaar, George

2011-01-01

318

Recurrent orbital adult-type fibrosarcoma in a 3-year-old girl.  

PubMed

A 3-year-old Filipino girl presented with progressive left-sided ptosis and proptosis after resection of a superomedial orbital tumor 2.5 years ago. She had been followed with serial MRI, which demonstrated interval growth of a recurrent lesion. Repeat resection was undertaken via an eyelid-splitting anterior orbitotomy. The patient's pediatric oncologist and sarcoma specialist did not recommend adjuvant chemotherapy, and the family declined proton radiotherapy. The patient will continue to be monitored with serial imaging. Histopathology, immunohistochemistry, and reverse transcriptase polymerase chain reaction were most consistent with a diagnosis of adult-type fibrosarcoma. This is the first reported case of adult-type fibrosarcoma presenting in the orbit of a child. Fibrosarcoma is a fibroblast-derived tumor that commonly presents in the extremities, usually in patients in their fourth to sixth decades. It is rarely seen in the orbit, with the largest case series to date only including 5 patients. PMID:24833462

Hussain, Rehan M; Erickson, Benjamin P; Rosenberg, Andrew E; Dubovy, Sander R; Johnson, Thomas E

2015-01-01

319

[Familial pulmonary cysts and papular skin lesions in a 37-year-old woman].  

PubMed

A 37-year-old female patient presented with sudden dyspnea and chest pain. Spontaneous pneumothoraces had been observed several times before in this patient and two members of the patient´s family in the last years. Moreover, she exhibited papular facial skin lesions. Radiomorphologically a pneumothorax apical on the left side and basal accentuated cystic lung destruction on both sides could be seen. Pleurodesis and several wedge resections with insertion of a drainage on the left side were performed therapeutically. Histology disclosed multiple cysts, whereby typical differential diagnoses could be excluded by immunohistochemistry. A molecular genetic investigation detected a heterozygous mutation in the gene coding for follikulin (FLCN). Thereby, Birt-Hogg-Dubé syndrome (BHDS) was diagnosed. BHDS follows autosomal dominant inheritance and is characterized by cystic lung lesions with recurrent pneumothoraces, cutaneous fibrofolliculomas and an increased risk of renal carcinomas. It is based on mutations in the gene coding for the protein FLCN on chromosome 17. PMID:23846428

Sander, K E; Schnabel, P A; Heußel, C P; Pfannschmidt, J; Herth, F J; Kreuter, M

2013-08-01

320

A 71-year-old man with anaphylaxis after eating grits  

PubMed Central

The allergist is frequently called on to evaluate patients after episodes of anaphylaxis to determine the cause and implement preventive measures that will reduce the patient’s risk from future episodes. The etiology of anaphylaxis can be the result of numerous causes that may go undiagnosed if a thorough evaluation is not performed. We present a 71-year-old man with no history of food allergy or atopy who presented to the emergency room and then our allergy clinic for evaluation after suffering anaphylaxis after a meal of grits and shrimp. The underlying diagnosis, which was subsequently determined, requires a high index of suspicion and should be included in the differential diagnosis of any patient presenting with unexplained anaphylaxis. PMID:22370536

Posthumus, Jonathon; Borish, Larry

2014-01-01

321

29 CFR 570.129 - Limited driving of automobiles and trucks by 17-year-olds.  

...false Limited driving of automobiles and trucks by 17-year-olds...129 Limited driving of automobiles and trucks by 17-year-olds...16-year-olds, who, as part of their employment, perform...and incidental driving of automobiles and trucks on public...

2014-07-01

322

29 CFR 570.129 - Limited driving of automobiles and trucks by 17-year-olds.  

Code of Federal Regulations, 2011 CFR

...false Limited driving of automobiles and trucks by 17-year-olds...129 Limited driving of automobiles and trucks by 17-year-olds...16-year-olds, who, as part of their employment, perform...and incidental driving of automobiles and trucks on public...

2011-07-01

323

29 CFR 570.129 - Limited driving of automobiles and trucks by 17-year-olds.  

Code of Federal Regulations, 2013 CFR

...false Limited driving of automobiles and trucks by 17-year-olds...129 Limited driving of automobiles and trucks by 17-year-olds...16-year-olds, who, as part of their employment, perform...and incidental driving of automobiles and trucks on public...

2013-07-01

324

29 CFR 570.129 - Limited driving of automobiles and trucks by 17-year-olds.  

Code of Federal Regulations, 2012 CFR

...false Limited driving of automobiles and trucks by 17-year-olds...129 Limited driving of automobiles and trucks by 17-year-olds...16-year-olds, who, as part of their employment, perform...and incidental driving of automobiles and trucks on public...

2012-07-01

325

Video games use patterns and parenteral supervision in a clinical sample of Hispanic adolescents 13-17 years old.  

PubMed

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

Colón-de Martí, Luz N; Rodríguez-Figueroa, Linnette; Nazario, Lelis L; Gutiérrez, Roberto; González, Alexis

2012-01-01

326

Grammatical morpheme production in 4-year-old children.  

PubMed

Despite the importance of grammatical morpheme (GM) production for both clinical decision-making and theoretical accounts of child language impairment, evidence concerning developmental expectations for GM use is inadequate. We studied grammatical morpheme production in 15-minute spontaneous language samples from a large (N = 100), sociodemographically diverse group of 4-year-olds. Substantial variability was observed in both the frequency of obligatory contexts (OCs) and in the percentage of correct usage of GMs. For only one morpheme did all 100 samples contain the minimum number of 3 OCs; for only 7 of the 14 GMs was an adequate number of OCs found in at least half of the 100 samples. Although mean percentages of production from samples with 3 or more OCs were high (> 85%), fewer than 25% of participants contributed to the "group" means for 6 of the 14 GMs. Results from the present investigation indicate a need for caution in interpreting information on GM production derived from samples of this nature from children at this age; the validity of using such data to identify deficits in inflectional morphology for either clinical or research purposes appears questionable. PMID:12381053

Balason, Denise V; Dollaghan, Christine A

2002-10-01

327

Slope restoration for a 100-year old canal  

SciTech Connect

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.

Skaggs, R.L.; Lewis, S.W. [Condor Earth Technologies, Inc., Sonora, CA (United States); Liebersbach, D.C. [Turlock Irrigation District, CA (United States)] [and others

1995-12-31

328

Flunitrazepam abuse and personality characteristics in male forensic psychiatric patients  

Microsoft Academic Search

Sixty male non-psychotic forensic psychiatric patients (aged 16–35 years) were studied after they completed their ordinary forensic psychiatric assessment (FPA). The prevalence of flunitrazepam (FZ) abuse was investigated by using both structured and in-depth interviews with the objective of studying the relationship between the abuse and personality traits. The patient's characteristics, DSM-IV disorders, and actual sentences were obtained by studying

Anna Maria Dåderman; Gunnar Edman

2001-01-01

329

Pericardial cyst in a 2-year-old Maine Coon cat following peritoneopericardial diaphragmatic hernia repair.  

PubMed

A pericardial cyst developed in a 2-year-old male neutered Maine Coon cat following surgery for an incidentally diagnosed congenital peritoneopericardial diaphragmatic hernia. The cyst caused no clinical signs in the cat, although clinical findings included positional right-sided cardiac tamponade and compression of thoracic structures, associated with a cardiac arrhythmia and axis deviation on electrocardiography. Extensive assessment of the cyst included radiography, echocardiography, computed tomography, exploratory thoracotomy, electrocardiography, histopathology and fluid analysis. Surgical removal of the cyst was curative, and the arrhythmia and axis deviation resolved. This report details case management from initial diagnosis to long-term follow-up, adding to the limited body of literature available on feline pericardial cysts. This is also the first report to associate cardiac arrhythmia with a pericardial cyst. PMID:24966244

Hodgkiss-Geere, Hannah M; Palermo, Valentina; Liuti, Tiziana; Philbey, Adrian W; Marques, Ana

2014-06-25

330

A Case of Human Pulmonary Dirofilariasis in a 48-Year-Old Korean Man  

PubMed Central

Dirofilariasis is a rare disease in humans. We report here a case of a 48-year-old male who was diagnosed with pulmonary dirofilariasis in Korea. On chest radiographs, a coin lesion of 1 cm in diameter was shown. Although it looked like a benign inflammatory nodule, malignancy could not be excluded. So, the nodule was resected by video-assisted thoracic surgery. Pathologically, chronic granulomatous inflammation composed of coagulation necrosis with rim of fibrous tissues and granulations was seen. In the center of the necrotic nodules, a degenerating parasitic organism was found. The parasite had prominent internal cuticular ridges and thick cuticle, a well-developed muscle layer, an intestinal tube, and uterine tubules. The parasite was diagnosed as an immature female worm of Dirofilaria immitis. This is the second reported case of human pulmonary dirofilariasis in Korea. PMID:24327784

Kang, Hyo Jae; Park, Young Sik; Lee, Chang-Hoon; Lee, Sang-Min; Yim, Jae-Joon; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo; Chai, Jong-Yil

2013-01-01

331

Genetic and Environmental Contributions to Sleep-Wake Behavior in 12-Year-Old Twins  

PubMed Central

Study Objectives: To examine the role of genetic and environmental factors on sleep behavior in 12-year-old twins matched for family environment. Design: Population-based twin cohort. Setting: Participants were assessed in their home environment. Patients or Participants: One hundred thirty-two adolescent twins comprising 25 monozygotic (MZ) and 41 dizygotic (DZ) twin pairs; aged 12.2 ± 0.1 y (mean ± standard deviation). Interventions: N/A. Measurements and Results: For 2 weeks in their home environment, participants wore a wrist activity monitor and completed a daily sleep diary. Sleep diaries included reports of bedtime, wake time, and estimated sleep onset time. Mean timing, duration, and quality of sleep during the 2 weeks were calculated for each individual and compared within twin pairs. MZ twin correlations were higher than the DZ correlations for total sleep time (MZr = 0.64; DZr = 0.38) and sleep onset latency (MZr = 0.83; DZr = 0.53) and significantly higher for wake after sleep onset (MZr = 0.66; DZr = 0.04) and sleep efficiency (MZr = 0.82; DZr = 0.10). Univariate modeling showed additive genetic factors accounted for 65% of the variance in total sleep time, 83% in sleep onset latency, and 52% and 57% of the variance in wake after sleep onset and sleep efficiency, respectively. A predominant influence of shared environment was found on the timing of sleep (67% for sleep start time, 86% for sleep end time). Conclusions: There is a strong genetic influence on the sleep-wake patterns of 12-year-old adolescents. Genes have a greater influence on sleep initiation and sleep maintenance and a smaller role in sleep timing, likely to be influenced by family environment. Citation: Sletten TL; Rajaratnam SMW; Wright MJ; Zhu G; Naismith S; Martin NG; Hickie I. Genetic and environmental contributions to sleep-wake behavior in 12-year-old twins. SLEEP 2013;36(11):1715-1722. PMID:24179306

Sletten, Tracey L.; Rajaratnam, Shantha M.W.; Wright, Margaret J.; Zhu, Gu; Naismith, Sharon; Martin, Nicholas G.; Hickie, Ian

2013-01-01

332

A 56-year-old woman with stress-induced hoarseness  

PubMed Central

A 56-year-old woman was admitted to hospital due to stress-dependent hoarseness and hypertensive urgency. The patient reported peaks of blood pressure of 210/160 mm Hg in combination with hoarseness. With indirect mirror examination, the ear-nose-and throat doctor diagnosed a paralysis of the vocal cord on the left side. The authors suspected a mass affecting the vagus nerve and performed a CT-scan with iodinated contrast material of the neck and thorax. Surprisingly the CT-scan showed an aneurysm of the aortic arch with a dilatation up to 4.8 cm, a kinking of 120° and a chronic dissection in the aneurysm. During exercise or elevated blood pressure this aneurysm expanded and made a compression of the nervus laryngeus recurrens on the left side. Thus, there is an explanation for the patient’s hoarseness on exertion and during hypertensive urgency. PMID:22604762

Latus, Joerg; Franke, Ulrich; Alscher, M Dominik; Braun, Niko

2012-01-01

333

One to make the diagnosis. A case of non tuberculous mycobacterial mastoiditis in a nine year old female.  

PubMed

Some members of the Non-Tuberculous Mycobacteria family are free living organisms in the environment. They may be pathogenic in the immunocomprimised or in chronic lung disease. We describe a case of a nine year old of Asian descent who presented with clinical mastoiditis where the pathogenic organism was Mycobacterium Gordonae. The decision was made to give the patient full antimycobacterial treatment and subsequently the patient made a full recovery. PMID:18557517

Molloy, J; Shandilya, M; Mahesh, B; McShane, D; El Nazir, B

2008-04-01

334

Robot-assisted laparoscopic bladder diverticulectomy in a seven-year-old child: Case report and points of technique  

PubMed Central

Congenital bladder diverticulum is an uncommon anomaly of the bladder. Patients can present with urinary infection, heamaturia, and/or urinary obstruction. We report the case of a seven-year-old boy who presented with painful micturition and terminal haematuria due to a congenital bladder diverticulum. Robot-assisted laparoscopic diverticulectomy was performed. The patient had an uneventful recovery. We describe the points of technique pertinent to the procedure. PMID:23450060

Ganesamoni, Raguram; Ganpule, Arvind P.; Desai, Mahesh R.

2012-01-01

335

New diagnosis of left atrial myxoma in a 93-year-old woman.  

PubMed

A 93-year-old woman with a history of hypertension was noted to have a mass in the left atrium prolapsing partially through the mitral valve on a routine surface echocardiogram in 2002. A transesophageal echocardiogram was then performed revealing an irregular mass with an appearance of protruding fronds of tissue. The echogenicity of the mass was inhomogeneous with some areas of punctate calcification, and the mass was attached to the interatrial septum. The echocardiographic appearance of the mass was almost pathognomic of atrial myxoma, and this is the oldest patient yet to have been diagnosed with a probable myxoma. The patient did not want surgical removal of the mass. She is still asymptomatic at the age of 95 years. PMID:15891245

Kang, Gurjaipal; Bhullar, Parampal; Kang, Manjot

2005-01-01

336

Benign osteoblastoma of the mandible in a 12-year-old female: A case report  

PubMed Central

Benign osteoblastoma refers to a benign tumor of the bone. Osteoblastoma most commonly affects the vertebrae and long tubular bones, however, in rare cases is observed in the facial bones. The current study presents the case of a 12-year-old female patient with a tumor in the mandibular body. Radiological imaging revealed a lesion with regular contours. The lesion was radically resected and histological analysis of the specimen demonstrated features that are typical of a benign osteoblastoma. The consequential defects of the jaw were reconstructed using titanium implants and autologous bone transplantation. The patient remains disease free subsequent to a five-month follow-up period. The aim of the present report is to present a rare case of benign osteoblastoma of the mandible. This study demonstrated that correct diagnosis and complete surgical excision are important to reduce the risk of recurrence of a benign osteoblastoma. PMID:25364451

MARDALEISHVILI, KONSTANTINE; KAKABADZE, ZURAB; MACHAVARIANI, AVTANDIL; GRDZELIDZE, TEIMURAZ; KAKABADZE, ANNA; SUKHITASHVILI, NATIA; KURASHVILI, TAMAR; SHONIA, NESTAN; MENABDE, GIORGI; ABIATARI, IVANE

2014-01-01

337

Cough syncope in a 43-year-old woman with glomus jugulare tumor?  

PubMed Central

We present an unusual case of recurrent cough syncope in a 43-year-old woman, which was initially thought to be seizures. Syncopal episodes were triggered by paroxysms of cough and were characterized by unresponsiveness and myoclonic jerks in her extremities. She had a left-sided glomus jugulare tumor that extended into the posterior cranial fossa with evidence of worsening communicating hydrocephalus on brain imaging. We postulate that bouts of cough produced increased intracranial pressure both by raising intrathoracic and intraabdominal pressures as well as by transient obstruction to cerebrospinal fluid flow secondary to intermittent tonsillar herniation during cough. This resulted in diffuse decrease in cerebral blood flow causing syncope. The patient's syncopal episodes decreased in frequency once an external ventricular drain was placed followed by a ventriculoperitoneal shunt. Search for factors that can increase intracranial pressure seems warranted in patients with recurrent cough syncope.

Bandyopadhyay, Susanta; Sonmezturk, Hasan; Abou-Khalil, Bassel; Haas, Kevin F.

2014-01-01

338

Subclavian vein thrombosis in an otherwise healthy 9-year-old boy.  

PubMed

We report a previously well 9-year-old boy who presented with an acutely swollen left arm after horse riding. Left subclavian vein thrombosis was demonstrated by MR venography but there was no evidence of an underlying anatomical abnormality. The child was successfully treated with catheter directed thrombolysis and anticoagulation with intravenous unfractionated heparin and warfarin. We have identified 75 previously published case reports of effort-induced upper extremity deep vein thrombosis (UEDVT) and surveyed patient characteristics and precipitating activities. In this case and literature review, we demonstrate that individuals with effort-induced UEDVT show demographic characteristics and presenting features that are distinct from other patient groups with venous thromboembolic disease. We also highlight the difficulties in counselling affected individuals about modifying occupational and recreational activities to minimise the risk of recurrent thrombosis. PMID:24855075

Young, Katie; Tunstall, Oliver; Mumford, Andrew

2014-01-01

339

A 25-Year-Old Woman with Type 2 Diabetes and Liver Disease  

PubMed Central

A 25-year-old female nurse was referred to our diabetes outpatient clinic with poorly controlled type 2 diabetes, obesity and elevated liver function tests (LFTs). Following a liver biopsy she was diagnosed with non-alcoholic steatohepatitis (NASH) and liver fibrosis. Treatment with subcutaneous injections of the glucagon-like peptide-1 receptor (GLP-1R) agonist liraglutide was initiated. After 46 weeks of treatment the patient had lost 16 kg, glycemic control was excellent and LFTs had normalized. Repeat liver biopsy and ultrasound showed reduction in hepatic fat content and inflammatory cells. The biopsy no longer fulfilled the criteria for NASH. The liver biopsies did not express hepatic GLP-1Rs using quantitative polymerase chain reaction. Our case suggests that liraglutide may benefit patients with NASH. PMID:25606030

Junker, Anders Ellekær; Gluud, Lise Lotte; Pedersen, Jens; Langhoff, Jill Levin; Holst, Jens Juul; Knop, Filip Krag; Vilsbøll, Tina

2014-01-01

340

Development of 1-year-old computational phantom and calculation of organ doses during CT scans using Monte Carlo simulation.  

PubMed

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. PMID:25144385

Pan, Yuxi; Qiu, Rui; Gao, Linfeng; Ge, Chaoyong; Zheng, Junzheng; Xie, Wenzhang; Li, Junli

2014-09-21

341

Assessment of Gingival Health Status among 5- and 12-Year-Old Children in Yemen: A Cross-Sectional Study.  

PubMed

Purpose. There are limited data about the gingival health status in Yemeni children. The aim, therefore, was to assess oral hygiene status and prevalence and severity of gingivitis among Yemeni preschool and school children. Materials and Methods. A total of 5396 children were included from 5 representative Yemeni governorates: Sana'a, Hajjah, Hodeida, Hadramaut, and Taiz. Five-year olds (1292) were recruited from private kindergartens while 12-year olds (4104) were selected from public primary schools. Gingival health status was assessed using the plaque index (PI), calculus index (CAI), and gingival index (GI) on the 6 Ramfjord teeth. The latter index was used to categorize gingivitis severity at the subject level. Data were analyzed using simple hypothesis testing, as well as ordinal regression. Results. The 12-year old children had significantly much higher mean PI, CAI, and GI (P < 0.001) with 78.6% presenting with gingivitis and 47.8% with moderate gingivitis. In contrast, the figures were 27.2% and 3.1% in the younger group (P < 0.001). There were significant variations according to gender, area of residence, and governorate. Regression analysis revealed that mean PI (OR = 35), mean CAI (OR = 7.7), male gender (OR = 1.6), living in rural areas (OR = 1.4), and being from Hajjah or Sana'a were independent risk factors of gingivitis severity in the older group. For the 5-year olds, the determinants were mean PI (OR = 122), male gender (OR = 1.4), and living in Sana'a or Taiz. Conclusions. Bad oral hygiene and moderate gingivitis are highly prevalent among Yemeni preschool and school children. Geographical location appeared as important independent risk factors of gingival inflammation. PMID:23878742

Al-Haddad, Khaled A; Ibrahim, Yahia T; Al-Haddad, Ahmed M; Al-Hebshi, Nezar N

2013-01-01

342

Assessment of Gingival Health Status among 5- and 12-Year-Old Children in Yemen: A Cross-Sectional Study  

PubMed Central

Purpose. There are limited data about the gingival health status in Yemeni children. The aim, therefore, was to assess oral hygiene status and prevalence and severity of gingivitis among Yemeni preschool and school children. Materials and Methods. A total of 5396 children were included from 5 representative Yemeni governorates: Sana'a, Hajjah, Hodeida, Hadramaut, and Taiz. Five-year olds (1292) were recruited from private kindergartens while 12-year olds (4104) were selected from public primary schools. Gingival health status was assessed using the plaque index (PI), calculus index (CAI), and gingival index (GI) on the 6 Ramfjord teeth. The latter index was used to categorize gingivitis severity at the subject level. Data were analyzed using simple hypothesis testing, as well as ordinal regression. Results. The 12-year old children had significantly much higher mean PI, CAI, and GI (P < 0.001) with 78.6% presenting with gingivitis and 47.8% with moderate gingivitis. In contrast, the figures were 27.2% and 3.1% in the younger group (P < 0.001). There were significant variations according to gender, area of residence, and governorate. Regression analysis revealed that mean PI (OR = 35), mean CAI (OR = 7.7), male gender (OR = 1.6), living in rural areas (OR = 1.4), and being from Hajjah or Sana'a were independent risk factors of gingivitis severity in the older group. For the 5-year olds, the determinants were mean PI (OR = 122), male gender (OR = 1.4), and living in Sana'a or Taiz. Conclusions. Bad oral hygiene and moderate gingivitis are highly prevalent among Yemeni preschool and school children. Geographical location appeared as important independent risk factors of gingival inflammation. PMID:23878742

Al-Haddad, Khaled A.; Ibrahim, Yahia T.; Al-Haddad, Ahmed M.; Al-Hebshi, Nezar N.

2013-01-01

343

Double-Blinded, Vehicle-Controlled Proof of Concept Study to Investigate the Recurrence of Inflammatory and Noninflammatory Acne Lesions Using Tretinoin Gel (Microsphere) 0.04% in Male Patients after Oral Isotretinoin Use  

PubMed Central

Background. Although isotretinoin orally is commonly used for moderate to severe or scarring acne, it is not a cure. Unfortunately recurrence is unpredictable and varies within the acne population. Objectives. Using a proof of concept study, determine the recurrence of acne after isotretinoin use in male patients. Methods. Twenty males aged 18–45 years old were enrolled. Subjects successfully completed a treatment of acne vulgaris with oral isotretinoin (120–150?mg/kg/course). Subjects were randomized 1 to 1. The study duration was 24 weeks. The primary endpoint measured was the absolute change in lesion counts from baseline to weeks 16 and 24. Local tolerability assessments were measured. Results. There were favorable changes in all outcomes measured. Overall, there was a 38.7% lower lesion count with tretinoin 0.04% microsphere gel use versus vehicle. The active product was well tolerated with great patient satisfaction. There were no significant safety issues. The limitations included the low number of patients enrolled, average age, and percentage of patients lost to follow-up. Conclusion. In summary, the results favored tretinoin 0.04% microsphere gel in the prevention of recurrent acne after isotretinoin use in male patients over 18 years old over a six-month period. PMID:22577372

Vender, Reid; Vender, Ronald

2012-01-01

344

Fever, Rash, and Blindness in a Previously Healthy Young Male *  

PubMed Central

A 31-year-old male presented to the emergency room with a sudden onset of blindness and a rash after a five-day history of myalgia, abdominal pain, and fever. The diagnostic approach and the patient's clinical course are presented. Indications for surgical intervention in staphyloccal endocarditis are discussed. Surgical and autopsy findings are reviewed. PMID:6140794

Sigal, Stephen L.; Smith, G.J. Walker

1983-01-01

345

T8 spinal cord transection in a 6-year-old child  

PubMed Central

Study design:?Case report. Objective:?To describe a case of spinal cord transection in a 6-year-old child. Background information:?Non-missile injury of the spinal cord is not common and its incidence varies according to the country. In addition, to our knowledge, there are no published reports of spinal cord injury (SCI) from a penetrating nail. Here, we report the case of a child who developed complete SCI because of cord transection by a nail. Methods:?A detailed history and physical examination were performed along with careful review of the patient's medical records. In addition, a review of the literature was conducted to assess the incidence and treatment of similar injuries. Case description:?A 6-year-old boy was admitted to the hospital after falling from a tree and landing on a nail. His physical examination revealed an emaciated child with multiple decubitus ulcers, lying on his side in bed. Visible was a well-healed posterior puncture wound at the T8 vertebral level. On neurological examination, the patient had 0/5 muscle strength in his lower extremities, symmetrical areflexia, and hypoesthesia below the T8 level. Plain x-ray of the thoracolumbar spine was normal. Magnetic resonance imaging revealed a transected spinal cord at the T8 vertebra, consistent with his nail puncture wound. Discussion:?This report describes an unusual case of a complete SCI in a pediatric patient caused by penetrating trauma from a nail. To our knowledge, this is the first case to report on complete SCI due to trauma from a nail. PMID:23526907

St Clair, Selvon F.; Silverstein, Michael; Lieberman, Isador

2012-01-01

346

Branching habit of 2-year-old pear branches classified on the basis of length and position of 1-year-old laterals  

Microsoft Academic Search

Two-year-old branches of Pyrus communis L. were classified into groups according to the proleptic (from dormant buds) branching habit, indirectly quantifying the degree of apical control. In winter 1998 upright and flat, 2-year-old branches were randomly sampled from trees of seven pear cultivars, i.e., Forelle (on Quince A and BP1 rootstocks), Abaté Fetel, Flamingo, Packham’s Triumph, Golden Russet Bosc, Rosemarie

Pierre du Plooy; Annalene Sadie; Gerard Jacobs; Nigel C Cook

2002-01-01

347

Study on Growth Rhythm of Juveniles Cistolemmys Flavomarginata for One and Two Years Old  

NASA Astrophysics Data System (ADS)

Growth of one and two year old Cistolemmys flavomarginata is studied. In natural temperature and under artificial feeding condition, juvenile turtles grow for 180 days in Xinyang, one year old turtle average body weight increased from 18.1 g to 54.5 g, the relative growth rate is 204.1%, the absolute growth rate is 0.21. two year old turtle average body weight increased from 46.8 g to 101.1 g, the relative growth rate is 115.98%, the absolute growth rate is 0.30. But two year old turtle growth rate is slower than that of one year old turtle. The body weight, carapace length, carapace width, plastron length, plastron width and carapace high are correlated positively to daily age. The body weight growth equations of one and two year old turtles are deduced. Compared with other reptiles, whole growth cycle is grasped systemically by the growth patterns.

Huang, Bin

348

Morphology of palatal rugae patterns among 5-15 years old children  

PubMed Central

Introduction: “The fibers running anteroposteriorly within the core and in concentric curves across the base of each ruga” determine their orientation and forms. The varying shapes of palatal rugae can be attributed to the fact that rugae develop as localized regions of epithelial proliferation and thickening. Fibroblasts and collagen fibers then accumulate in the connective tissue beneath the thickened epithelium and assume distinct orientation. Aim: The aim of the present study was to assess the morphology, gender difference of rugae pattern in 5-15 year old children. Materials and Methods: The various diagnostic dental stone cast available in Department of Pedodontics were analyzed by the method based on Thomas and Kotze classification in 1983. Results: There was a female prediction in the total count and primary rugae pattern. Comparing the shapes of rugae both in male and female study models showed a predominance in wave shape followed by cure. No circular pattern was observed in the study population. No statistical difference in the direction and unification of rugae among males and females. Conclusion: The fingerprint-like uniqueness of rugae to each individual has become accepted as a possible aid to person identification. This may help narrow the field for identification and give results in conjunction with the other methods such as visual, fingerprints, and dental characteristics in forensic sciences. PMID:23946575

Rajan, Vilvanathan Prabu; John, John Baby; Stalin, Ariudinambi; Priya, Geetha; Abuthagir, Abdul Kareem Syed

2013-01-01

349

Crohn's disease of the vulva in a 10-year-old girl.  

PubMed

Crohn's disease may involve all parts of the gastrointestinal tract and may often involve other organs as well. These non-intestinal affections are termed extraintestinal manifestations. Vulval involvement is an uncommon extraintestinal manifestation of Crohn's disease, and it is very rare in children. Patients with vulval CD typically present with erythema and edema of the labia majora, which progresses to extensive ulcer formation. Vulval Crohn's disease can appear before or after intestinal problems or it may occur simultaneously. We present a 10-year-old girl with intestinal Crohn's disease complicated with perianal skin tags and asymptomatic unilateral labial hypertrophy. The course of her lesion was independent of the intestinal disease and responded significantly to medical treatment including azathioprine and topical steroid. We emphasize that although vulval involvement in childhood is uncommon, Crohn's disease must be considered in the differential diagnosis of nontender, red, edematous lesions of the genital area. PMID:18664090

Kulo?lu, Zarife; Kansu, Aydan; Demirçeken, Fulya; Bozkir, Mehtap; Kundakçi, Nihal; Bingöl-Kolo?lu, Meltem; Girgin, Nurten

2008-01-01

350

Unexplained refractory iron-deficiency anaemia in a 41-year-old woman  

PubMed Central

The clinical and instrumental findings revealed a case of autoimmune polyendocrine syndrome (APS) type 3B+C in a 41-year-old Caucasian woman with unexplained refractory iron-deficiency anaemia secondary to autoimmune atrophic gastritis and a long-term history of two different autoimmune diseases—Hashimoto's disease and vitiligo. Indeed the occurrence in the same patient of three or more autoimmune diseases defines APS. The first classification of APS was suggested by Neufeld and Blizzard in 1980 and it included four main types of APS on the basis of clinical features. The only case of APS type 3B+C was described by Amerio et al in 2006. PMID:22766574

de Matthaeis, N; Rapaccini, G L; Riccardi, L; Pugliese, D

2010-01-01

351

Myxopapillary Ependymoma of the Cauda Equina in a 5-Year-Old Boy  

PubMed Central

Myxopapillary ependymoma in childhood typically occurs in the central nervous system. There are few surgical cases of myxopapillary ependymoma of the cauda equina in children. We report a case of myxopapillary ependymoma of the cauda equina in a 5-year-old boy, who presented with leg pain and abnormal gait. Subtotal resection surgery was performed. Following the subtotal tumor resection, follow-up magnetic resonance imaging evaluation showed a recurrent tumor. As a result, we performed a second subtotal tumor resection and followed with postoperative radiation therapy. No further evidence of the disease has been noted elsewhere in the patient in over ten years of follow-up. Myxopapillary ependymoma of the cauda equina in a young boy was improved by subtotal tumor resection and postoperative radiation therapy.

Uehara, Masashi; Mukaiyama, Keijiro; Kuraishi, Shugo; Shimizu, Masayuki; Ikegami, Shota; Futatsugi, Toshimasa; Sano, Kenji; Hongo, Kazuhiro; Kato, Hiroyuki

2014-01-01

352

Growing teratoma syndrome: first case report in a 4-year-old girl.  

PubMed

Growing teratoma syndrome (GTS) consists of germ cell tumors that grow following chemotherapy despite complete eradication of the malignant cells. They can metastasize to any site, particularly the retroperitoneum, mediastinum and cervical region. It typically affects young adults and adolescents. Here we describe the youngest case reported in a 4-year-old girl with an ovarian mixed germ cell tumor who underwent an oophorectomy. Her tumor markers normalized by the end of her chemotherapeutic treatment; however, she developed a retroperitoneal mass that was subsequently resected. Histopathology revealed a mature teratoma, consisting of a GTS. We stress the need for early recognition and treatment of GTS to avoid the subsequent morbidity and mortality associated with it. Although GTS has an excellent prognosis when completely resected, it is essential that the patient be regularly followed-up with serum tumor markers and imaging. PMID:25256881

Daher, Paul; Riachy, Edward; Khoury, Antoine; Raffoul, Lara; Ghorra, Claude; Rehayem, Caline

2015-02-01

353

Pseudohypoparathyroidism type Ia manifesting as intractable epilepsy in a 23-year-old female  

PubMed Central

Pseudohypoparathyroidism is a rare disorder of calcium metabolism that involves target organ resistance to the action of the parathyroid hormone. As a result, calcium levels may become dangerously low, sometimes leading to seizures and other symptoms. We present a case of a 23-year-old Somalian female on antiepileptic therapy presenting with intractable epilepsy. She was subsequently found to have pseudohypoparathyroidism type Ia. She had multiple reasons accounting for loss of seizure control, including worsening hypocalcemia from resistance to the parathyroid hormone; vitamin D deficiency, which could have resulted from lack of exposure to direct sunlight and her antiepileptic medication; and extensive calcium deposition in the brain due to pseudohypoparathyroidism. The patient was stabilized with intravenous therapy and oral calcium, vitamin D, and calcitriol. Her antiepileptic therapy was changed to a medication that did not interfere with vitamin D metabolism or contribute to worsening hypocalcemia. PMID:23754923

Raghavan, Pooja; Katz, Charles M

2012-01-01

354

[Bacterial pyomyositis in a 12-year-old girl without fever].  

PubMed

Bacterial pyomyositis is generally found in tropical countries. This case report presents pyomyositis in a 12-year-old girl who was admitted without fever to the paediatric department. The only symptom was pain in the left hip. Staphylococcus aureus was cultured from the blood on day 4. Magnetic resonance imaging (MRI) revealed infection in the left m. ileopsoas. Previous ultrasound, computerised tomography, x-ray and bone-scintigraphy were normal. After 11 days of intravenous antibiotic therapy and clinical remission, secondary bone affection was detected by a new MRI. Long-term antibiotic treatment is required in such cases because of the risk of secondary bone affection. This patient was treated for 11 days with intravenous antibiotic therapy and for the subsequent three months with tablets. PMID:19265612

Maagaard, Mathilde; Hindsø, Klaus; Wislander, Steen Bo; Holm, Kirsten

2009-03-01

355

Pesticide-induced quadriplegia in a 55-year-old woman.  

PubMed

Acephate is a commercial organophosphate pesticide formerly used in households and now used primarily for agriculture. Poisoning symptoms include salivation, lacrimation, urination, defecation, gastrointestinal illness, and emesis. In addition to these classic symptoms, neurodegeneration can result from increased and continued exposure of organophosphates. This 55-year-old woman presented with organophosphate-induced delayed neuropathy in the form of quadriplegia due to the commonly used pesticide acephate. She was exposed to this pesticide through multiple sprayings in her work office with underrecognized poisoning symptoms. She presented to her primary care physician with neuropathic pain and paralysis in her arm following the sprayings and eventual complete paralysis. The patient lived for 2 years following her toxic exposure and quadriplegia. A complete autopsy after her death confirmed a transverse myelitis in her spinal cord. We conclude that in susceptible individuals, acephate in excessive amounts can produce severe delayed neurotoxicity as demonstrated in animal studies. PMID:25354225

Beavers, Charles T; Parker, Joseph J; Flinchum, Dane A; Weakley-Jones, Barbara A; Jortani, Saeed A

2014-12-01

356

Hyperimmunoglobulin E Syndrome Presenting as Osteogenesis Imperfecta in a 3 Year Old Child  

PubMed Central

We present a case of hyperimmunoglobulin E (hyper-IgE) syndrome in a three year old boy. There are many pitfalls in diagnosing this disease in the very young population, mainly due to the ambiguity of some diagnostic criteria in this population. Recognizing this syndrome early in life can potentially be very beneficial to the patients involved and the medical system as a whole. Early diagnosis can lead to fewer diagnostic tests, fewer referrals, and more focused exams, thus potentially reducing medical cost while also reducing the number of serious infections later in life, including those which are potentially fatal. Additionally, a wellknown association between lymphoma and hyper-IgE syndrome has been established; while no recommendations are currently in place for screening, early diagnosis could help medical providers have a higher threshold for diagnosis of this disease. PMID:24470957

Gorgas, Stephen; Abuhammour, Walid; Blackwood, R. Alexander

2013-01-01

357

Trichomegaly in a 3-year-old girl with alopecia areata.  

PubMed

We report here a case of bilateral trichomegaly associated with alopecia areata in a 3-year-old girl, healthy except for mild atopic dermatitis. Trichomegaly is a rare condition and, in many cases, is a side effect of medication such as ophthalmic solution prostaglandin analogs and epidermal growth factor receptor inhibitors. Trichomegaly has also been associated with acquired medical conditions such as HIV, systemic lupus erythematosus, anorexia nervosa, porphyria cutanea tarda, hypothyroidism, and dermatomyositis. In very rare circumstances, trichomegaly has been described as part of congenital conditions such as Oliver-McFarlane syndrome. We believe that the development of bilateral trichomegaly in conjunction with alopecia areata in this patient represents a novel finding as it occurred in the absence of any significant health problems, congenital abnormalities, or medications. PMID:19419469

Nazareth, Michael R; Bunimovich, Olga; Rothman, Ilene L

2009-01-01

358

Abdominal lymphangiomatosis in a 38-year-old female: Case report and literature review  

PubMed Central

Lymphangioma is an uncommon benign tumor that develops in the lymphatic system. Abdominal lymphangiomatosis is extremely rare in adult patients, and the clinical symptoms of this condition are complicated and atypical. We report a case of abdominal lymphangiomatosis in a 38-year-old female who presented with intestinal bleeding and protein-losing enteropathy, as well as lesions in the lung and bones. A computed tomography scan revealed multiple small cystic lesions without enhancement. Histological examination revealed microscopic cysts were submucosal, with walls composed of thin fibrous tissue, and D2-40 stained highlight the lining of the lymphatic channels by immunohistochemical method. We make a comparison with the cases reported before, and also discuss the diagnose of diffuse pulmonary lymphangiomatosis and Gorham’s disease. PMID:25009412

Lin, Ruo-Yang; Zou, Hai; Chen, Tan-Zhou; Wu, Wei; Wang, Jian-Hong; Chen, Xiao-Lei; Han, Qing-Xi

2014-01-01

359

22-year-old girl with status epilepticus and progressive neurological symptoms.  

PubMed

A 22-year-old girl presented with convulsive status epilepticus and a previous history of recurrent seizures, myoclonus, ataxia and impaired cognitive functions. Neurological examination revealed rest and action-induced myoclonus, pyramidal signs and opposition hypertonia. Testing revealed severe metabolic acidosis, elevated transaminases and creatine kinase, and respiratory insufficiency. After intubation and ventilation, thiopental was introduced but the patient's condition worsened dramatically with death in a few hours. Autopsy showed profuse periodic acid-Schiff (PAS) positive intracellular inclusions in the CNS (Lafora bodies), most abundant in thalamus, cerebellum, and brainstem, as well as in other organs. Genetic testing revealed a homozygous missense mutation (c.205C > G, P69A) in the EPM2B (NHLRC1) gene, confirming the diagnosis of progressive myoclonic epilepsy Lafora-type. PMID:19744044

Striano, Pasquale; Ackerley, Cameron A; Cervasio, Mariarosaria; Girard, Jean-Marie; Turnbull, Julie; Del Basso-De Caro, Maria Laura; Striano, Salvatore; Zara, Federico; Minassian, Berge A

2009-10-01

360

Abdominal lymphangiomatosis in a 38-year-old female: case report and literature review.  

PubMed

Lymphangioma is an uncommon benign tumor that develops in the lymphatic system. Abdominal lymphangiomatosis is extremely rare in adult patients, and the clinical symptoms of this condition are complicated and atypical. We report a case of abdominal lymphangiomatosis in a 38-year-old female who presented with intestinal bleeding and protein-losing enteropathy, as well as lesions in the lung and bones. A computed tomography scan revealed multiple small cystic lesions without enhancement. Histological examination revealed microscopic cysts were submucosal, with walls composed of thin fibrous tissue, and D2-40 stained highlight the lining of the lymphatic channels by immunohistochemical method. We make a comparison with the cases reported before, and also discuss the diagnose of diffuse pulmonary lymphangiomatosis and Gorham's disease. PMID:25009412

Lin, Ruo-Yang; Zou, Hai; Chen, Tan-Zhou; Wu, Wei; Wang, Jian-Hong; Chen, Xiao-Lei; Han, Qing-Xi

2014-07-01

361

Arrhythmogenic right ventricular cardiomyopathy in a 52-year-old man – clinical presentation mimicking an acute coronary syndrome  

PubMed Central

Arrhythmogenic right ventricular cardiomyopathy is an infrequently diagnosed, genetically determined disease that leads to significant clinical consequences, including progressive heart failure and ventricular arrhythmias accounting for sudden cardiac death. We report the case of a 52-year-old patient who presented with ventricular tachycardia and features of an acute coronary syndrome. However, routine tests excluded critical coronary stenosis and the final diagnosis was arrhythmogenic right ventricular cardiomyopathy. PMID:24570728

Sadowski, Marcin; Kurzawski, Jacek; Janion-Sadowska, Agnieszka

2013-01-01

362

Acute coronary syndrome in a 100-year-old woman treated successfully with primary percutaneous coronary angioplasty  

PubMed Central

We present a case of a 100-year-old woman living alone with ST-elevation myocardial infarction acute coronary syndrome of the infero-lateral wall treated with percutaneous coronary intervention. Coronary angiography revealed critical 99% stenosis in the marginal branch of the circumflex artery and insignificant lesions in other arteries. Two bare metal stents were implanted successfully in the same session. The patient was discharged home in good general condition, able to live and function independently. PMID:24570714

B??kowski, Maciej; Szwed, Hanna; Ciszewski, Andrzej

2013-01-01

363

Bifid mandibular condyle with ankylosis in a 3-year-old child: A rare presentation and review  

PubMed Central

Bifid mandibular condyle with ankylosis is an extremely rare condition and may arise as a developmental or traumatic defect. It may be associated with ankylosis. We here report a case of unilateral bifid mandibular condyle with ankylosis in a 3-year-old child. This is the youngest patient reported with the condition making it one of its first kind in the literature. The detailed description of the case, its radiological findings, and the literature on bifid condyles are reviewed. PMID:22114377

Mainali, Sneedha; Tandon, Shobha

2010-01-01

364

Acute myocardial infarction in a 35-year-old man with coronary artery aneurysm most probably caused by Kawasaki disease  

PubMed Central

We present a 35-year-old man with history of Kawasaki disease who referred with myocardial infarction, and angiography, revealing aneurysm of left main and left anterior descending coronary arteries. The patient underwent percutaneous coronary intervention and thrombectomy and was discharged after 6 d. Coronary artery sequels of Kawasaki disease should be considered as one of the underlying causes of acute myocardial infarction in young adults. PMID:25183138

Parsa, Saeed Alipour; Khaheshi, Isa; Paydary, Koosha; Haybar, Habib

2014-01-01

365

Successful treatment of acquired hemophilia a with rituximab and steroids in a 5-year-old girl.  

PubMed

Acquired hemophilia A is a very rare, serious bleeding disorder. We describe a 5-year-old female who developed an acquired factor VIII inhibitor, and while under treatment with steroids, had an intestinal perforation with peritonitis and septic shock, making her a poor candidate for further immunosuppression. She was treated with rituximab with rapid, complete eradication of the inhibitor. She represents the first published case of a pediatric patient with acquired hemophilia A successfully treated with rituximab. PMID:23588328

Fletcher, Matthew; Crombet, Ofelia; Morales-Arias, Jaime

2014-03-01

366

Effectiveness of Saikokaryukotsuboreito (Herbal Medicine) for Antipsychotic-Induced Sexual Dysfunction in Male Patients with Schizophrenia: A Description of Two Cases  

PubMed Central

Antipsychotics sometimes cause sexual dysfunction in people with schizophrenia. The authors report the effectiveness of Saikokaryukotsuboreito (Japanese traditional herbal medicine, Chai-Hu-Jia-Long-Gu-Mu-Li-Tang in Chinese) for antipsychotic-induced sexual dysfunction in two male patients with schizophrenia. The first patient was a 28-year-old man with schizophrenia who suffered erectile dysfunction induced by olanzapine 10?mg/day; the erectile dysfunction significantly improved following the treatment of Saikokaryukotsuboreito 7.5?g/day. The other case was a 43-year-old man with schizophrenia who was receiving fluphenazine decanoate at 50?mg/month and had difficulties in ejaculation; add-on of Saikokaryukotsuboreito 7.5?g/day recovered his ejaculatory function. There has been no report on the effectiveness of Japanese herbal medicine formulations for antipsychotic-induced sexual dysfunction. Although the effectiveness of Saikokaryukotsuboreito needs to be tested in systematic clinical trials, this herbal medicine may be a treatment option to consider for this annoying side effect. PMID:24587934

Takashi, Tsuboi; Uchida, Hiroyuki

2014-01-01

367

A 34 Year Old Man with Purple Discoloration and Paresthesia  

PubMed Central

Secondary systemic vasculitis and nonbacterial endocarditis are rare events. We report a case presented with different manifestations of underlying malignancy such as systemic vasculitis, non bacterial endocarditis and DIC (disseminated intravascular coagulopathy). Efforts to find the source of malignancy was unsuccessful and due to patient's unwillingness for further evaluation, finally under the diagnosis of metastatic disease of unknown primary, patient is receiving cyclic chemotherapy. PMID:24505550

Mahmoodian, Reihaneh; Haghighi, Anoosheh; Vakili, Masoud; Shahriari-Ahmadi, Ali; Hajsadeghi, Shokoufeh; Arabi, Mohsen

2014-01-01

368

A 34 year old man with purple discoloration and paresthesia.  

PubMed

Secondary systemic vasculitis and nonbacterial endocarditis are rare events. We report a case presented with different manifestations of underlying malignancy such as systemic vasculitis, non bacterial endocarditis and DIC (disseminated intravascular coagulopathy). Efforts to find the source of malignancy was unsuccessful and due to patient's unwillingness for further evaluation, finally under the diagnosis of metastatic disease of unknown primary, patient is receiving cyclic chemotherapy. PMID:24505550

Iranpour, Aida; Mahmoodian, Reihaneh; Haghighi, Anoosheh; Vakili, Masoud; Shahriari-Ahmadi, Ali; Hajsadeghi, Shokoufeh; Arabi, Mohsen

2014-01-01

369

Breast Total Male Breast Reconstruction with Fat Grafting  

PubMed Central

Summary: Cancer of a male breast represents less than 1% of all breast cancer. As with to female patients, mastectomy in men creates a substantial emotional burden. Breast reconstruction may improve the patient’s psychological well-being, compliance with adjuvant treatments, and overall outcome. However, due to the unique anatomy of the male breast, standard reconstructive strategies using anatomic or prosthetic modalities are not entirely applicable. We describe a case of a 68-year-old male patient who underwent successful unilateral breast reconstruction solely with fat grafting technique. PMID:25506540

Al-Kalla, Tarik

2014-01-01

370

From coitus to concurrency: sexual partnership characteristics and risk behaviors of 15–19 year old men recruited from urban venues in Tanzania  

PubMed Central

Understanding the uptake and patterns of sexual partnerships of adolescent males reveals their risky behaviors that could persist into adulthood. Using venue-based sampling, we surveyed 671 male youth ages 15–19 from an urban Tanzanian neighborhood about their sexual partnerships during the past six months. The proportion of males who had ever had sex increased with age (21% at age 15; 70% at age 17; 94% at age 19), as did the proportion who engaged in concurrency (5% at age 15; 28% at age 17; 44% at age 19). Attendance at ?2 social venues per day and meeting a sexual partner at a venue was associated with concurrency. Concurrency was associated with alcohol consumption before sex among 18–19 year olds and with not being in school among 15–17 year olds. We find that concurrency becomes normative over male adolescence. Venue-based sampling may reach youth vulnerable to developing risky sexual partnership patterns. PMID:22990763

Yamanis, Thespina J.; Doherty, Irene A.; Weir, Sharon S.; Bowling, James M.; Kajula, Lusajo J.; Mbwambo, Jessie K.; Maman, Suzanne

2012-01-01

371

Testosterone and hemoglobin in hemodialysis male and female patients.  

PubMed

It has been speculated that testosterone stimulates erythropoiesis. We hypothesized that hemoglobin levels in hemodialysis (HD) patients are associated with serum testosterone concentrations. Testosterone, hemoglobin, and other biochemical parameters were measured in a representative sample of 98 chronic HD patients (50 male, 48 female; age 30-90 years, mean 65±13.9 years). We investigated relations among serum testosterone concentration, hemoglobin, ferritin, albumin, body mass index, lean body mass, total cholesterol, low-density lipoprotein and high-density lipoprotein cholesterol, triglycerides, high-sensitivity C-reactive protein (hsCRP), calcium (Ca), P, intact parathyroid hormone, N-terminal pro-brain natriuretic peptide, Karnofsky performance status, and blood pressure (BP) before and after HD. A statistically significant positive correlation between testosterone and hemoglobin was found in all patients (r=0.25, P<0.01), men (r=0.34, P<0.02), but not in women (r=0.27, P=0.07). Multiple regression analysis for all patients has shown statistically significant association between hemoglobin and testosterone (P<0.001), hsCRP (P<0.005), lean body mass (P<0.05), post-HD systolic (P<0.04), and diastolic BP (P<0.005). Multiple regression analysis in men has shown an association between hemoglobin and testosterone (P<0.04) and post-HD diastolic BP (P<0.04) and in women association between hemoglobin and testosterone (P<0.04), Ca (P<0.03), and post-HD diastolic BP (P<0.03). We found an association between serum testosterone concentration and hemoglobin in male and female HD patients. PMID:24256140

Ekart, Robert; Taskovska, Milena; Hojs, Nina; Bevc, Sebastjan; Hojs, Radovan

2014-07-01

372

Radiographic diagnosis and differentiation of an aggressive angiomyxoma in a male patient  

PubMed Central

Aggressive angiomyxoma is a rare soft-tissue tumor which usually occurs in female patients of reproductive age. Its occurrence in men is even more unusual and as illustrated in this case the difference between pathology suggested by a physical examination and its actual extent can be quite striking. We present a case report of an 81-year-old man with the typical MRI appearances of a pelvic aggressive angiomyxoma, describe imaging and histopathologic features of this rarely seen locally infiltrative neoplasm and also discuss therapeutic options for patients with an aggressive angiomyxoma. PMID:24421942

Karwacki, Grzegorz Marek; Stöckli, Martin; Kettelhack, Christoph; Mengiardi, Bernard; Studler, Ueli

2013-01-01

373

Radiographic diagnosis and differentiation of an aggressive angiomyxoma in a male patient.  

PubMed

Aggressive angiomyxoma is a rare soft-tissue tumor which usually occurs in female patients of reproductive age. Its occurrence in men is even more unusual and as illustrated in this case the difference between pathology suggested by a physical examination and its actual extent can be quite striking. We present a case report of an 81-year-old man with the typical MRI appearances of a pelvic aggressive angiomyxoma, describe imaging and histopathologic features of this rarely seen locally infiltrative neoplasm and also discuss therapeutic options for patients with an aggressive angiomyxoma. PMID:24421942

Karwacki, Grzegorz Marek; Stöckli, Martin; Kettelhack, Christoph; Mengiardi, Bernard; Studler, Ueli

2013-07-01

374

A Doctor Talks to 9-to-12-Year Olds.  

ERIC Educational Resources Information Center

As a part of a series of books written by physicians for their patients, this publication explains heredity, birth, and growth patterns to pre-teen children. The chapters are written in language appropriate for children moving from childhood into their teens and deal with topics like: cells, conception, prenatal development, puberty, and changing…

Larrigo, Marion O.; Cassidy, Michael A.

375

Late onset of adrenocortical failure in GH deficiency with invisible pituitary stalk: a case report of a 48-year-old Japanese man and review of the literature.  

PubMed

ACTH deficiency gradually develops in patients with growth hormone deficiency (GHD) who have abnormalities of the pituitary stalk on magnetic resonance imaging (MRI) following perinatal complications. We report here a rare case of GHD manifesting ACTH deficiency in middle age. A 48-year-old male patient was admitted to our hospital due to fever and hyponatremia. He was diagnosed as GHD and hypothyroidism at the age of 9, and had received lysine treatment until age 20, which was then replaced by thyroid hormone. He was not mentally retarded, but was the shortest in his class throughout his schooldays, reaching a final height of 148 cm. Hormonal examination revealed the presence of hypoadrenalism as indicated by poor responses of plasma cortisol to intravenous administration of corticotropin-releasing hormone (CRH) and insulin-induced hypoglycemia. Plasma ACTH responded well to CRH, but not to insulin-induced hypoglycemia, indicating that his hypoadrenalism was of hypothalamic origin. MRI showed an invisible pituitary stalk and relatively small pituitary gland. Since he had a perinatal abnormality, the damage around the pituitary and GHD could have originated from birth. In the literature, around 60% of GHD patients with pituitary stalk abnormalities develop hypoadrenalism due to ACTH deficiency, and more than 90% of such cases are diagnosed by age 30. We suggest that the appearance of hypoadrenalism should be carefully monitored in GHD patients with pituitary stalk abnormalities even after they reach middle age. PMID:12081244

Makino, Shinya; Kawasaki, Daizo; Irimoto, Hirokazu; Tanimoto, Masaho

2002-04-01

376

Case Report: 16-Year-Old Male with Autistic Disorder with Preoccupation with Female Feet  

ERIC Educational Resources Information Center

This paper highlights clinical challenges faced when diagnosing and then treating an individual presenting to a child and adolescent psychiatry clinic because of unwelcome comments he made to female peers about their feet. Novel use of exposure therapy helped him effectively decrease his comments from 1 to 2 times per month to once every 6 months.…

Early, Maureen C.; Erickson, Craig A.; Wink, Logan K.; McDougle, Christopher J.; Scott, Eric L.

2012-01-01

377

[Hepatitis C virus: 25 years-old, the end?].  

PubMed

The treatment of hepatitis C virus (HCV) infection markedly progressed these two last decades. Since 15 years, the combination of pegylated interferon ? and ribavirin led to a sustained virologic response (SVR) which corresponds to a complete recovery in around 45 % of patients with HCV genotype 1, 65 % with HCV genotype 4, 70 % with HCV genotype 3 and around 85 % with HCV genotype 2. A better understanding of the HCV life-cycle recently resulted in the development of several potential direct-acting antiviral drugs (DAA) targeting viral proteins (NS3/4A protease inhibitors, NS5B nucleosidic and non nucleosidic polymerase inhibitors, NS5A replication complex inhibitors). A lot of data has been reported with the combinations of pegylated interferon ?/ribavirin and the first generation oral DAA, Telaprevir and Boceprevir. These regimens have demonstrated a high level of antiviral efficacy (75 % of SVR) and an acceptable safety profile. After this first major step, the combination of the second generation DAA with pegylated interferon ?/ribavirin will impact antiviral potency (75 to 90 % of SVR) and tolerance and will reduce the duration of therapies and the pill burden. The next step, which is an actual revolution, will be the oral combination of new DAA which is likely to become the standard of care for chronic HCV after 2015. Most studies have been conducted in small numbers of "easy-to-treat" patients with short post-treatment period with outstanding results but we are now waiting for confirming these results in more difficult-to-treat patients (experienced genotype 3-infected or genotype 1-infected patients who failed to first generation protease inhibitors, cirrhotic, HIV co-infected patients, allograft recipients or candidates to transplantation). PMID:24280503

Pol, Stanislas

2013-11-01

378

Fossilized Biophotonic Nanostructures Reveal the Original Colors of 47-Million-Year-Old Moths  

E-print Network

Fossilized Biophotonic Nanostructures Reveal the Original Colors of 47-Million-Year-Old Moths Maria among animals and have been studied most extensively in butterflies and moths (Lepidoptera), which-Million-Year- Old Moths. PLoS Biol 9(11): e1001200. doi:10.1371/journal.pbio.1001200 Academic Editor

Cao, Hui

379

A Comparison of Syntactic Structures in the Speech of Three- and Four-Year-Old Children.  

ERIC Educational Resources Information Center

A group of three-year-old children was compared to one of four-year-old children in the usage of 26 syntactic transformations on the basis of 60 utterances per child. The older group used significantly more sentence transformations per child and significantly fewer simple active declarative sentences than the younger. Among the older group 10 out…

Brannon, John B., Jr.

1968-01-01

380

Story Contexts Increase Susceptibility to the DRM Illusion in 5-Year-Olds  

ERIC Educational Resources Information Center

False recognition in children aged 5, 8, and 11 years was investigated using the standard version of the Deese-Roediger-McDermott (DRM) procedure and an alternative version in which the DRM stimuli were embedded in stories designed to emphasize their overall theme. Relative to the 8- and 11-year-olds, the 5-year-olds falsely recognized fewer…

Dewhurst, Stephen A.; Pursglove, Rhian C.; Lewis, Charlie

2007-01-01

381

South Euclid's Pilot Project for Two-Year-Olds and Parents.  

ERIC Educational Resources Information Center

Describes a feasibility and practicality pilot project of a library story-telling program for two-year-olds. Parent survey results and project experience indicate that such a reading program is worth consideration by children's librarians. Recommended books for two-year-olds and their parents are listed. (CMV)

Kewish, Nancy L.

1979-01-01

382

CASE REPORT Open Access Case report of Ganser syndrome in a 14-year-old  

E-print Network

CASE REPORT Open Access Case report of Ganser syndrome in a 14-year-old girl: another face Révah-Levy1,5 Abstract The Ganser syndrome is rare in children and in adolescents. A case of the Ganser syndrome in a 14-year-old girl, with three of the four essential features, is presented. After rapid

Boyer, Edmond

383

The Semiotic Landscape and 3-Year-Olds' Emerging Understanding of Multimodal Communication Practices  

ERIC Educational Resources Information Center

This article considers the impact of the increasing use of the visual mode in texts found in urban landscapes on two 3-year-olds' understanding of communication practices. The data discussed are taken from a study into a group of 3- to 6-year-olds' interaction with and emerging comprehension of the visual mode and its connection to…

Yamada-Rice, Dylan

2014-01-01

384

Preparatory adjustments during gait initiation in 4–6-year-old children  

Microsoft Academic Search

The preparatory adjustments related to gait initiation in a group of six children (4–6 years old) were studied in comparison to a group of six adults (50–61 years old). Muscle activity, ground reaction forces and body kinematics were recorded during the initiation of gait in subjects standing with one foot on each of two forceplates. Like adults, children had consistent

Francine Malouin; Carol L. Richards

2000-01-01

385

STATIC AND FATIGUE PERFORMANCE OF 40 YEAR OLD PRESTRESSED CONCRETE GIRDERS STRENGTHENED WITH VARIOUS CFRP SYSTEMS  

E-print Network

STATIC AND FATIGUE PERFORMANCE OF 40 YEAR OLD PRESTRESSED CONCRETE GIRDERS STRENGTHENED program aimed at investigating the static and fatigue behavior of 40 year old prestressed concrete bridge fatigue loading conditions. The girders were taken from a decommissioned bridge erected in 1961. Two

386

Program for 1-Year-Olds Tries to Lessen Autism's Impact  

MedlinePLUS

... Spectrum Disorder FRIDAY, Feb. 6, 2015 (HealthDay News) -- Parents of 1-year-olds who appear to be at risk for autism can take simple steps to help them improve, a new study says. Researchers identified 18 families with 1-year-old children with possible signs of autism. At this age, ...

387

Effect of Core Training on 16 Year-Old Soccer Players  

ERIC Educational Resources Information Center

Core trainings have been widely used by trainers recently in order to improve performance of soccer players. In this context, the aim of this study is to examine the effect of core training on some motoric capabilities of 16 years old soccer players. Thirty certified soccer players who were 16 years old from B.B. Bodrumspor Club in 2013-2014…

Afyon, Yakup Akif

2014-01-01

388

Fate of 2 year-old, hatchery-reared trout cod Maccullochella macquariensis (Percichthyidae)  

E-print Network

Fate of 2 year-old, hatchery-reared trout cod Maccullochella macquariensis (Percichthyidae) stocked-grown 2 year-old trout cod Maccullochella macquariensis (Percichthyidae) (a nationally endangered of reintroducing threatened freshwater cod of the genus Maccullochella. The trout cod Maccullochella macquariensis

Cooke, Steven J.

389

Five- to Twelve-Year-Olds' Control of Movement Velocity in a Dynamic Collision Avoidance Task  

ERIC Educational Resources Information Center

We investigated age-related differences in a dynamic collision avoidance task that bears a resemblance to pedestrian road crossing. Five- to seven-year-old children, ten- to twelve-year-old children and adults were instructed to push a doll across a small-scale road between two toy vehicles, which approached one after the other. We analysed the…

te Velde, Arenda F.; van der Kamp, John; Savelsbergh, Geert J. P.

2008-01-01

390

The Young Child Learns: A Guide for Four-Year-Olds.  

ERIC Educational Resources Information Center

The purpose of this teaching guide is to orient preschool teachers to the unique needs and abilities of the four-year-old child and to offer a suggested program of pre-kindergarten activities. Specific capabilities characteristic of the four-year-old are listed, followed by the scope of the preschool program in the areas of cognitive development,…

Corpus Christi Independent School District, TX.

391

Electromyographic Responses to Emotional Facial Expressions in 6-7 Year Olds with Autism Spectrum Disorders  

ERIC Educational Resources Information Center

This study aimed to examine facial mimicry in 6-7 year old children with autism spectrum disorder (ASD) and to explore whether facial mimicry was related to the severity of impairment in social responsiveness. Facial electromyographic activity in response to angry, fearful, sad and happy facial expressions was recorded in twenty 6-7 year old

Deschamps, P. K. H.; Coppes, L.; Kenemans, J. L.; Schutter, D. J. L. G.; Matthys, W.

2015-01-01

392

Brief Report: Screening Tool for Autism in Two-Year-Olds (STAT): Development and Preliminary Data.  

ERIC Educational Resources Information Center

A study examined the validity of the Screening Tool for Autism in Two-Year-Olds (STAT) as a stage 2 screening instrument in a clinic-based sample of two-year-olds with autism (n=12) and with nonautistic developmental disorders (n=21). Results provide preliminary support for the utility of the STAT as an early screening of autism. (Contains…

Stone, Wendy L.; Coonrod, Elaine E.; Ousley, Opal Y.

2000-01-01

393

Orientation discrimination in 5-year-olds and adults tested with luminance-modulated and  

E-print Network

Orientation discrimination in 5-year-olds and adults tested with luminance-modulated and contrast thresholds for discriminating orientation by 5-year-olds and adults for first-order (luminance and condition at a fixed multiple of the contrast threshold for discriminating horizontal from vertical gratings

Maurer, Daphne M.

394

Changes in body image and dieting among 16-19-year-old Icelandic students from 2000 to 2010.  

PubMed

The aim of the study was to evaluate trends in body image and dieting among 16-19-year-old students in Iceland from 2000 to 2010. Data from four cross-sectional surveys conducted among Icelandic students in 26 junior colleges using four time points were compared to examine changes in body image and dieting. In total, 33,801 students with the mean age of 17.3 years participated. Body image became significantly more positive over the 10-year period for both genders. At all time points, females reported more negative body image than males and a higher proportion of dieters were females than males. There was a decrease in the frequency of dieting among females over time but an increase among males, resulting in a narrower gender gap in dieting. Further examination of these trends in body image and dieting may reveal differences in causal mechanisms behind negative body image and dieting between the genders. PMID:24995408

Ingolfsdottir, Gudrun; Asgeirsdottir, Bryndis Bjork; Gunnarsdottir, Thrudur; Bjornsson, Andri Steinthor

2014-09-01

395

A Case of Patent Ductus Arteriosus with Congestive Heart Failure in a 80-Year-Old Man  

PubMed Central

Patent ductus arteriosus (PDA) is a rare clinical finding in adult patients. Considering the increase in cases of PDA discovered incidentally on echocardiograms at young ages, and the life-shortening effect of PDA, it is rare to diagnose PDA in old patients. We report a case of an 80-year-old patient who experienced symptoms of congestive heart failure showed findings suggestive of PDA in echocardiogram and confirmed the diagnosis through a cardiac catheterization and a coronary angiography. After percutaneous occlusion of PDA with an Amplatzer duct occlusion device, symptoms related to congestive heart failure improved. PMID:23323124

Lee, Hye yeon; Park, Mahn Won; Choi, Min Seok; Cho, Jung Sun; Kim, Chan Joon; Kang, Hye Seon; Choi, Yoo A; Ju, Il Nam; Kim, Seon A; Lee, Jong-Ho; Kwon, Jong-Bum; Park, Kuhn

2012-01-01

396

Initial diagnosis of HIV/AIDS in a 56-year-old man with non-healing forearm lesion  

PubMed Central

SUMMARY A 56-year-old Hispanic man with no significant medical problems presented with a 2-month history of a non-healing right forearm lesion that progressed despite several courses of empiric antibiotics. The patient underwent incision and drainage. Warthin-Starry stain with immunohistochemistry testing diagnosed bacillary angiomatosis secondary to Bartonella quintana. Subsequently, the patient was diagnosed with HIV, with a CD4 count of 68 cells/mm3, and a HIV viral load of 47, 914 copies/mL. The patient was treated with doxycycline and started on antiretroviral therapy. The lesion has resolved and he has had no recurrence after 16 months of treatment. PMID:24248316

Zapata, Heidi J; Villanueva, Merceditas; Shenoi, Sheela

2014-01-01

397

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

PubMed

Moyamoya disease is a progressive, occlusive pathology involving the cerebral vasculature with particular involvement of the circle of Willis and its tributaries. The cause of moyamoya disease is unknown, but is believed to be hereditary. Females 20 to 39 years old with moyamoya represent 0.5% of all acute cerebral ischemia and infarcts with risk factors including smoking, estrogen-containing birth control use, coagulopathy, neoplasm, and congenital malformation. This case reports on a 20-year-old Puerto Rican female U.S. soldier with a 1-year history of migraine headaches with worsening right retro-orbital pain, blurred vision, and photophobia. The patient had minimal unilateral neurological deficits despite evidence of significant cerebral infarction on non-contrast computed tomography. Other neuroimaging findings were consistent with moyamoya disease with confirmation via cerebral angiography. This case details the process of diagnosis and treatment as well as discussing its incidence, identification, and treatment options. PMID:25563038

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

2014-12-01

398

Coumadin-induced skin necrosis in a 64 year-old female despite LMWH bridging therapy  

PubMed Central

Summary Background: Coumadin is the standard oral anticoagulant used in a variety of clinical conditions. Coumadin inhibits the vitamin-K dependent gamma-carboxylation of coagulation factors II, VII, IX, X and the anticoagulant proteins C and S. Rarely, skin necrosis occurs when the resultant initial procoagulant state in the first few days of starting coumadin leads to thrombosis and formation of blood clots tin the dermal capillaries. This in turn causes skin necrosis due to interruption in blood supply to the skin. Case Report: We are presenting the case of a 64 year-old female admitted for acute respiratory distress secondary to newly-diagnosed pulmonary embolism. The patient was started on therapeutic doses of low molecular weight heparin (LMWH) and coumadin. After 5 days of treatment, the patient started complaining of pain and numbness in both upper extremities. Overnight, this rapidly progressed to manifest hemorrhagic bullae with necrotic areas. This was immediately recognized as coumadin-induced skin necrosis. Coumadin was stopped immediately. Vitamin K was administered and local wound care was provided. Therapeutic LMWH was continued. The skin lesions began to show improvement after 3 days. Conclusions: In coumadin-induced skin necrosis, the patient initially presents with pain and erythema, followed by petechial lesions which progress to become purpuric. Hemorrhagic bullae with necrosis and eschar formation may soon develop. Once it is suspected, coumadin should be stopped and the patient should be given Vitamin K and FFP to reverse the effects of coumadin. PMID:23569516

Kumar, Mehandar; Abrina, Vanessa Mae; Chittimireddy, Sasikala

2012-01-01

399

Iron autointoxication in a 16-year-old girl: a protective role for hepcidin?  

PubMed

Intentional iron overdose appears to be an increasingly common form of attempted suicide. We present a case of iron overdose in a 16-year-old girl who was found unconscious in her bed and brought to our emergency department. The most remarkable diagnostic findings were the patient's comatose condition, divergent eye position and positive Babinski foot pad reflexes. Laboratory tests showed hyperglycaemia and mild metabolic acidosis. A computed tomography scan of the cerebrum showed no signs of intracerebral haemorrhage or elevated intracerebral pressure. Toxicology screening showed no use of acetaminophen, ethanol or drugs of abuse. The patient was stabilized and monitored on the intensive care ward. When she woke up, she confessed to having taken Fero-Gradumet(®). Retrospectively analysed, the serum iron concentration in the first blood sample (seven hours after ingestion) was 62 ?mol/L which corresponds with moderate iron intoxication. The patient received whole bowel irrigation with 2 L polyethyleneglycol solution and de-ironing treatment with intravenous deferoxamine 20 mg/kg in eight hours. She was discharged from the hospital after three days in a good clinical condition. Retrospectively, serum hepcidin concentrations were determined and evaluated in conjunction with serum iron concentrations and the installed treatment. Before medical de-ironing interventions were started, we saw that the serum iron concentration in our patient was already declining. At the same time, we observed a sharp increase in the serum hepcidin concentration. After normalization of serum iron concentrations, hepcidin normalized as well. PMID:23108765

Simonse, E; Valk-Swinkels, C G H; van 't Veer, N E; Ermens, A A M; Veldkamp, E J M

2013-01-01

400

An 18-year-old woman with a 34-cm metaplastic breast carcinoma  

PubMed Central

Metaplastic breast carcinomas (MBCs) are rare malignancies usually with poor prognosis. We report a case of an 18-year-old African female patient who presented with a 34-cm tumor on the right breast. Biopsy showed an extensively necrotic MBC negative for estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (triple negative). A modified right radical mastectomy was performed, followed by adjuvant chemotherapy. Histology confirmed a widely necrotic undifferentiated malignant tumor, with strong and diffuse expression of vimentin and B-cell lymphoma 2, focal high-molecular-weight keratins and focal CD34 expression; Ki67 was >90%. There was no skin, deep margin or lymph node involvement. Six months after surgery, the patient showed a 9 × 7 cm nodule adjacent to the suture and adherent to the anterior chest wall. The tumor was considered unresectable and the patient evolved with rapid systemic deterioration. The patient had a progression-free survival of 6 months and overall survival of 9 months. PMID:25589538

Gomes, António; Santos, Vanessa; Dias, Gonçalo; Manso, Rita Theias; Gonçalves, Lucília; Coiteiro, Margarida; Gaspar, Helena; Nazaré, Antónia

2015-01-01

401

Malignant Hyperthermia during Thoracoscopic Pulmorrhaphy in a 70-Year-Old Man  

PubMed Central

Malignant hyperthermia (MH) is a rare but potentially fatal complication that may develop under general anesthesia (GA) and is rarely reported in elderly patients. We encountered a case of mild-onset MH in a 70-year-old patient who was receiving an elective thoracoscopic pulmorrhaphy and had a history of several GA procedures. Anesthesia was induced with propofol, fentanyl, and rocuronium and maintained with sevoflurane and remifentanil. His body temperature (BT) was 37.9°C after induction. During the procedure, the end-tidal CO2 (ETCO2) increased steadily to 47–50?mmHg, presumably in response to the single lung ventilation. At the end, BT was 38.1°C and ETCO2 was 47?mmHg under spontaneous breathing. After extubation, the patient wheezed on inspiration and expiration, and his trachea was reintubated. Sixty minutes after surgery, BT increased to 40.5°C and the arterial blood gas analysis showed severe metabolic acidosis. Based on these findings, MH was suspected and a bolus dose of dantrolene was administered. He responded to the dantrolene, and no complications or recurrence of MH was observed postoperatively. In this patient, the initial signs of MH were so subtle that making the diagnosis of MH was difficult. A high degree of suspicion is necessary to prevent a fulminant MH crisis. PMID:24971182

Murakami, Noriko; Kitamura, Yuji; Sato, Shin; Iwama, Hiroshi; Nomura, Akira

2014-01-01

402

Story contexts increase susceptibility to the DRM illusion in 5-year-olds.  

PubMed

False recognition in children aged 5, 8, and 11 years was investigated using the standard version of the Deese-Roediger-McDermott (DRM) procedure and an alternative version in which the DRM stimuli were embedded in stories designed to emphasize their overall theme. Relative to the 8- and 11-year-olds, the 5-year-olds falsely recognized fewer critical lures when the DRM stimuli were presented in lists, but falsely recognized more critical lures when the stimuli were presented in stories. Levels of false recognition in the 8- and 11-year-olds were not affected by study format. We argue that the story context enhanced the ability of the 5-year-olds to make inferences based on the theme of the DRM stimuli. The 5-year-olds then showed higher levels of false recognition than the older children owing to their inability to reject lure words consistent with the stories. PMID:17444977

Dewhurst, Stephen A; Pursglove, Rhian C; Lewis, Charlie

2007-05-01

403

A 44-year-old man with bilateral eyelid swelling.  

PubMed

Swollen eyelids are commonly ascribed to allergic conjunctivitis, contact dermatitis, eczema, angioedema, or acute sinusitis. The differential diagnosis extends to thyroid eye disease; blepharitis; Sjögren's syndrome; Churg-Strauss vasculitis; Wegener's granulomatosis; Gleich syndrome; orbital and ocular lymphoid hyperplasia or adnexal lymphoma; idiopathic orbital inflammatory disease/idiopathic sclerosing orbital inflammation; rarely, orbital parasitosis; and IgG4-related diseases. The likely diagnosis proceeds from the more to the less common in patients without a history of allergy or infection. Both ocular lymphoid hyperplasia and ocular adnexal lymphoma must be considered in the differential diagnosis of persistent disease, and neither of these entities can be recognized or differentiated from one another clinically or radiologically. Early diagnosis is essential because therapy may consist of frequent follow-up and/or active intervention. Outcomes in patients treated early and appropriately are often favorable. PMID:22525399

Ricketti, Anthony J; Cleri, Dennis J; Moser, Robert L; Bilyk, Jurij R; Vernaleo, John R; Unkle, David W

2012-01-01

404

A 17 year old with isolated proximal tibiofibular joint arthritis  

PubMed Central

The proximal tibiofibular joint (TFJ) is rarely affected in rheumatic diseases, and we frequently interpret pain of the lateral knee as the result of overuse or trauma. Nonetheless, the TFJ is a synovial joint that communicates with the tibiofemoral joint in a proportion of patients. While proximal TFJ arthritis has been rarely associated with existing spondyloarthritis, isolated TFJ arthritis as the presenting manifestation of spondyloarthritis has not yet been described. Here, we report the clinical and radiographic presentation of an adolescent with chronic proximal TFJ arthritis heralding spondyloarthritis highly suggestive of ankylosing spondylitis. PMID:23302539

2013-01-01

405

Megaloblastic hematopoiesis in a 20 year old pregnant female  

PubMed Central

Summary Background: Nitrous oxide can cause disordered blood cell proliferation and lead to pancytopenia and altered immune function. Case Report: A young pregnant female patient presented after binge nitrous oxide abuse with altered mental status and abnormal vital signs. From her initial assessment she was noted to have pancytopenia and was found to have megaloblastic, hyper-cellular changes in a subsequent bone marrow biopsy. This presentation was determined to be secondary to toxic effects after heavy use of nitrous oxide. Conclusions: Nitrous oxide exposure, including use as an inhalant, over 12 hours can lead to bone marrow abnormalities such as megaloblastic hematopoiesis. PMID:23569553

Trivette, Evan T.; Hoedebecke, Kyle; Berry-Cabán, Cristóbal S.; Jacobs, Brandy R.

2013-01-01

406

Cerebral infarction in a 24-year-old pilot.  

PubMed

Ischemic stroke is a rare event in young adults. We report on a 24-yr-old pilot with cerebral infarction of undetermined etiology, temporally associated with chain smoking. The patient exhibited dysphasia, stupor (confused consciousness), and right facial-nerve palsy. Computed-tomography revealed a low-density area in the left insular cortex. Cerebroangiography showed severe stenosis in a branch of the left middle cerebral artery. After admission, the patient made a rapid and uneventful recovery within 72 h. MRI showed an area of hyperintensity on T2-weighted images 2 mo after the attack. Based on the hyperintense area on FLAIR (fluid attenuated inversion recovery sequence) images obtained in MRI performed 10 mo after the attack, we diagnosed a cerebral infarction. In the Japan Air Self-Defense Force, cerebral infarction is an aeromedically disqualifying condition. However, in the evaluation 2 mo after the attack, differentiation from reversible ischemic neurological deficit was difficult. We discuss the criteria used for diagnosis and the risk factors for cerebral infarction in young adults, as well as the aeromedical disposition of young pilots. PMID:14556575

Ohashi, Koichiro; Nakanishi, Kuniaki; Miyajima, Daijiro; Fukushima, Koji; Shirotani, Toshiki; Kuwamura, Keiichi; Tong, Andrew

2003-10-01

407

Genome sequence of a 45,000-year-old modern human from western Siberia.  

PubMed

We present the high-quality genome sequence of a ?45,000-year-old modern human male from Siberia. This individual derives from a population that lived before-or simultaneously with-the separation of the populations in western and eastern Eurasia and carries a similar amount of Neanderthal ancestry as present-day Eurasians. However, the genomic segments of Neanderthal ancestry are substantially longer than those observed in present-day individuals, indicating that Neanderthal gene flow into the ancestors of this individual occurred 7,000-13,000 years before he lived. We estimate an autosomal mutation rate of 0.4 × 10(-9) to 0.6 × 10(-9) per site per year, a Y chromosomal mutation rate of 0.7 × 10(-9) to 0.9 × 10(-9) per site per year based on the additional substitutions that have occurred in present-day non-Africans compared to this genome, and a mitochondrial mutation rate of 1.8 × 10(-8) to 3.2 × 10(-8) per site per year based on the age of the bone. PMID:25341783

Fu, Qiaomei; Li, Heng; Moorjani, Priya; Jay, Flora; Slepchenko, Sergey M; Bondarev, Aleksei A; Johnson, Philip L F; Aximu-Petri, Ayinuer; Prüfer, Kay; de Filippo, Cesare; Meyer, Matthias; Zwyns, Nicolas; Salazar-García, Domingo C; Kuzmin, Yaroslav V; Keates, Susan G; Kosintsev, Pavel A; Razhev, Dmitry I; Richards, Michael P; Peristov, Nikolai V; Lachmann, Michael; Douka, Katerina; Higham, Thomas F G; Slatkin, Montgomery; Hublin, Jean-Jacques; Reich, David; Kelso, Janet; Viola, T Bence; Pääbo, Svante

2014-10-23

408

Accident involving a 2-year-old child and Lonomia obliqua venom: clinical and coagulation abnormalities  

PubMed Central

Poisons of caterpillars have different effects on inflammatory and coagulation systems. This is a case report of a 2-year-old child that accidentally came in contact with several caterpillars of the species Lonomia obliqua. At first, the patient's exams presented abnormal coagulation and decreased fibrinogen, but the patient did not evolve to active bleeding or acute renal failure. The patient received antilonomic serum 15 h after the accident and the treatment was repeated after another 12 h due to persistent alterations shown by the coagulation exams. The venom of L. obliqua has several substances that act on the coagulation and inflammatory systems. The event is characterized by a hemorrhagic syndrome with decreases in fibrinogen. L. obliqua Stuart-factor activator (Losac) and L. obliqua prothrombin activator protease (Lopap) are components that act with procoagulatory effects. The pro-inflammatory action occurs due to metalloproteases, hyaluronidases and other substances with inflammatory activity. Studies on caterpillar venom can give new perspectives on the treatment of cancer and other diseases that cause dysfunction of the extra-cellular matrix. PMID:25453657

Medeiros, Daniela Nasu Monteiro; Torres, Hélida Conceição Cavalcante; Troster, Eduarto Juan

2014-01-01

409

Accident involving a 2-year-old child and Lonomia obliqua venom: clinical and coagulation abnormalities.  

PubMed

Poisons of caterpillars have different effects on inflammatory and coagulation systems. This is a case report of a 2-year-old child that accidentally came in contact with several caterpillars of the species Lonomia obliqua. At first, the patient's exams presented abnormal coagulation and decreased fibrinogen, but the patient did not evolve to active bleeding or acute renal failure. The patient received antilonomic serum 15h after the accident and the treatment was repeated after another 12h due to persistent alterations shown by the coagulation exams. The venom of L. obliqua has several substances that act on the coagulation and inflammatory systems. The event is characterized by a hemorrhagic syndrome with decreases in fibrinogen. L. obliqua Stuart-factor activator (Losac) and L. obliqua prothrombin activator protease (Lopap) are components that act with procoagulatory effects. The pro-inflammatory action occurs due to metalloproteases, hyaluronidases and other substances with inflammatory activity. Studies on caterpillar venom can give new perspectives on the treatment of cancer and other diseases that cause dysfunction of the extra-cellular matrix. PMID:25453657

Medeiros, Daniela Nasu Monteiro; Torres, Hélida Conceição Cavalcante; Troster, Eduarto Juan

2014-01-01

410

Clinical reasoning: a 76-year-old man remaining comatose after cardiopulmonary resuscitation.  

PubMed

A 76-year-old man was admitted to the hospital after having a "cardiac arrest" while riding his bicycle and subsequently falling into a canal. Thirty minutes after the accident, he was resuscitated by an ambulance crew. They detected a ventricular tachycardia, which responded to defibrillation. Thereafter, there was a sinus bradycardia, which was treated with atropine and adrenaline. After 30 minutes of resuscitation, there was return of spontaneous circulation (ROSC). At admission to our hospital, the patient was comatose, with a body temperature of 30°C and Glasgow Coma Scale score (GCS) of E1M1V1. According to protocol for presumed acute hypoxic ischemic encephalopathy, he was started on therapeutic hypothermia. The body temperature of the patient was kept at 32°C to 34°C for 24 hours. A few hours after starting hypothermia, twitches around the eyes and mouth were noticed and a neurology consultation was requested. Neurologic examination during hypothermia and under sedation showed a deeply comatose patient with intact pupillary reaction to light bilaterally and present oculocephalic reflex. He had multifocal random twitching movements involving the face, arms, and legs. These shock-like movements were found to increase by external stimuli. PMID:24491976

Li, Simon C; de Graaf, Marieke T; Cherian, Perumpillichira J

2014-02-01

411

Forty-Year-Old Foam Springs Back With New Benefits  

NASA Technical Reports Server (NTRS)

The most recognized and widely used NASA spinoff is at it again. Temper foam, whose origins date back to 1966 when it was developed to absorb shock and, thus, offer improved protection and comfort in NASA s airplane seats, has paid its dividends to Earth repeatedly, and in many different ways. It has padded the helmets of the Dallas Cowboys throughout the 1970s and 1980s, protected bedridden patients from bedsores, and comforted the feet of thousands wearing stylish shoes that incorporate the cushioning material in their insoles. Four decades later, the world has come to realize that there are no bounds to temper foam s benefits. Though the rights to the technology have been shared amongst various manufacturers, the original product maker is still going strong, pushing temper foam into new arenas, including automotives, amusement parks, prosthetics, and modern art.

2005-01-01

412

Breast biopsy in women 30 years old or less.  

PubMed

Forty women 30 years of age or less underwent breast biopsy at Roswell Park Cancer Institute between January 1980 and January 1989. Thirty-eight of the 40 women had a palpable breast mass. Thirty-one of these young women had self-detected breast masses, and the median duration before presentation was 6 months. Physical characteristics were described in 30 of the masses. Twenty-three were described as "fibroadenomas" or smooth, firm, and mobile. Seven masses were described as irregular. The median size of the breast mass was 1.5 cm (range: 0.5 to 9.0 cm). Mammography was performed in 20 patients, but results were reported as abnormal in only 6. Twenty of the masses were described histologically as fibroadenoma. Twelve were described histologically as "fibrocystic disease" or "stromal fibrosis." One case (2.5%) was invasive adenocarcinoma. Probability of serious underlying breast pathology in young women is low but not nil. Noninvasive and minimally invasive techniques are proposed by some authors as cost-efficient methods that may substitute for open biopsy in these patients. Unfortunately, false-negative results persist and are particularly unacceptable in these young women. During the same time period as our study, 54 women aged 30 years or less were referred to Roswell Park Cancer Institute with a previously diagnosed invasive breast cancer. The incidence of breast cancer in this biopsy series was 2.5%. The potential costs of misdiagnosed early breast cancer in young women negate any rationalization for less invasive biopsy techniques. Following aspiration to rule out a benign cyst, and a possible period of brief observation for spontaneous resolution (2 or 3 months), excisional biopsy is recommended for young women with a breast mass. PMID:8506971

Palmer, M L; Tsangaris, T N

1993-06-01

413

Deep Venous Thrombosis of the Leg, Associated with Agenesis of the Infrarenal Inferior Vena Cava and Hypoplastic Left Kidney (KILT Syndrome) in a 14-Year-Old Child  

PubMed Central

Agenesis of the inferior vena cava (IVC) is a rare anomaly which can be identified as incidental finding or can be associated with iliofemoral vein thrombosis. IVC agenesis has a known association with renal anomalies which are mainly confined to the right kidney. We describe a case of a 14-year-old male who presented with left leg swelling and pain. Ultrasonography confirmed the presence of left leg deep vein thrombosis (DVT). No underlying hematologic risk factors were identified. A CT scan was obtained which demonstrated absent infrarenal IVC and extensive thrombosis in the left deep venous system and development of collateral venous flow into the azygous/hemiazygous system, with extension of thrombus into paraspinal collaterals. An additional finding in the patient was an atrophic left kidney and stenosis of an accessory left renal artery. Agenesis of the IVC should be considered in a young patient presenting with lower extremity DVT, especially in patients with no risk factors for thrombosis. As agenesis of the IVC cannot be corrected, one should be aware that there is a lifelong risk of lower extremity DVT.

Bami, Sakshi; Vazquez, Yarelis; Chorny, Valeriy; Amodio, John

2015-01-01

414

Brainstem cavernoma hemorrhage during pregnancy in a 15-year-old: description of a unique neurosurgical approach.  

PubMed

Cavernous haemangiomas, or cavernous malformations, have been reported during pregnancy, most of which have been either supratentorial or spinal lesions. We encountered a 15-year old pregnant patient with a rapidly progressive and haemorrhagic brainstem cavernous haemangioma. The case presented here describes the history and findings of this patient, as well as the less-commonly utilized technique we used to access the floor of the fourth ventricle via occipital craniotomy for complete macroscopic resection of this lesion, resulting in the gradual return of most of her neurological deficits. PMID:23001930

Ranger, Adrianna M; Chaudhary, Navjot; Avery, Michael; Lownie, Stephen

2013-10-01

415

Laparoscopic management of small-bowel intussusception in a 64-year-old female with ileoal lipomas  

PubMed Central

A 64-year-old female patient presented with upper abdominal pain and vomiting. Ultrasonography showed a hyperechoic mass in the right lower abdomen and computed tomography showed a low-density mass with intestinal invagination. An emergency laparoscopic right-hemicolectomy was performed, and the resected specimen was found to contain three tumors, which were identified histopathologically as intestinal lipomas. Adult intussusception is relatively rare and difficult to be diagnosed, since most symptoms of adult intussusception are nonspecific. We report our clinical experience of the diagnosis and emergent laparoscopic surgery for an adult patient with intussusception. PMID:23293737

Hou, Yi-Chung; Lee, Po-Chu; Chang, Jung-Jung; Lai, Peng-Sheng

2012-01-01

416

Prevalence of dental caries among 12–14 year old children in Qatar  

PubMed Central

Background To ensure the oral health of a population, clinicians must deliver appropriate dental services, and local communities need to have access to dental care facilities. However, establishment of this infrastructure must be based on reliable information regarding disease prevalence and severity in the target population. Objectives The aims of this study were to measure the incidence of dental caries in school children aged 12–14 throughout Qatar, including the influence of socio-demographic factors. Materials and methods A cross-sectional study was conducted in Qatar from October 2011 to March 2012. A total of 2113 children aged 12–14 were randomly selected from 16 schools located in different geographic areas. Three calibrated examiners using World Health Organization (WHO) criteria to diagnose dental caries performed the clinical examinations. Data analyses were subsequently conducted. Results The mean decayed, missing, and filled teeth index values were respectively 4.62 (±3.2), 4.79 (±3.5), and 5.5 (±3.7), for 12, 13, and 14 year-old subjects. Caries prevalence was 85%. The mandibular incisors and canines were least affected by dental caries, while maxillary and mandibular molars exhibited the highest incidence of dental caries. Dental caries were affected by socio-demographic factors; significant differences were detected between female and male children, where more female children showed dental caries than male children. In addition, children residing in semi-urban areas showed more dental caries than in urban areas. Conclusion Results indicated that dental caries prevalence among school children in Qatar has reached critical levels, and is influenced by socio-demographic factors. The mean decayed, missing, and filled teeth values obtained in this study were the second highest detected in the Eastern Mediterranean region. PMID:25057232

Al-Darwish, Mohammed; El Ansari, Walid; Bener, Abdulbari

2014-01-01

417

Traumatic dental injuries among 12-year-old Jordanian schoolchildren: an investigation on obesity and other risk factors  

PubMed Central

Background Traumatic dental injury (TDI) is an important public dental health problem among schoolchildren. The aim of the study was to investigate the relationship between TDIs, obesity, and other possible associated factors like gender, overjet, lip coverage, parents’ education level and family income among 12-year old Jordanian schoolchildren. Methods A cross-sectional population-based study examined a total of 1015 schoolchildren attending 34 schools randomly selected from urban and rural areas of Amman-the capital city of Jordan. The epidemiological classification adopted by WHO and modified by Andreasen et al. was used to classify TDIs. Obesity was defined according to the international cut-off points of body mass index for boys and girls between 2 and 20 years old. Results The prevalence of TDIs was 16.3%. Enamel fracture was the most common type of TDIs (65%). Neither parents’ education level nor family income had a significant effect on TDI occurrence (P?>?0.05). Results of multiple logistic regression showed that TDIs were significantly more prevalent among males (OR?=?1.42, CI; 1.01-2.01, P??0.05). Conclusions Being a male with inadequate lip coverage was associated with higher probability of having a TDI. Obesity had no significant effect on the occurrence of TDIs. PMID:25099379

2014-01-01

418

In depth analysis of risk factors for coeliac disease amongst children under 18 years Old in the Gaza strip. A cross sectional study  

PubMed Central

Coeliac disease is an important clinical disorder affecting the human gastrointestinal tract leading to multiple signs and symptoms in different body organs. This disease was the subject of a cross sectional descriptive-analytic study conducted in the Gaza Strip during 2010. Objectives were oriented to identify and verify several variables and attributes affecting the prognosis of coeliac disease in the patients. Ninety five children out of 113 patients were arranged into two groups according to age from 2 to 11 years and from 12 to 18 years old. Results showed the poor interest of health professionals regarding coeliac disease in the Gaza Strip. The mean age of study population was 5.47 years for males and 8.93 years for females. The lifestyle of coeliac patients was directly proportional with better nutritional indictors. Poor recognition of the emblem illustrating gluten in foods implicates effective health awareness or promotion. The more knowledgeable patients or mothers (P?=?0.036) were the more compliant. The compliance to giving gluten free foods outside home was statistically significant (P?=?0.037). Similarly, cautious approach when buying foods or detergents (P?=?0.011). According to BMI 74.4%, 23.4% and 3.2% of all patients were normal, underweight and overweight respectively. Albumin blood level was normal in 32.6% and low in 67.4%. Meanwhile, blood calcium level was normal in 76.8%, low in 21.1% and high in 2.1% of all patients. Conclusion: The study showed that recreation and social activities for coeliac patients are substantially missing in the Gaza Strip. Moreover, the study proved that AEI is a reliable centre for care of coeliac disease patients and conducting relevant studies. Recommendation: There is a need for thorough and continuous community and institutional mobilization regarding coeliac disease in the Gaza Strip and in Palestine. PMID:23164160

2012-01-01

419

[Psychiatry at Leipzig University. A 200 year old tradition].  

PubMed

The University of Leipzig boasts a long tradition in the field of psychiatry. In 1811 Johann Christian August Heinroth was appointed as the first professor of mental health ("psychic therapy") in Europe. He conceived mental illness as based on a person's own guilt, as the consequence of turning away from God and living a life untrue to Christian ethics. After Heinroth retired in 1843 the Leipzig chair remained vacant until 1878 brain researcher Paul Flechsig succeeded him as professor of psychiatry, although not significantly contributing to the progress of this subject. His first assistant was Emil Kraepelin. Flechsig's successors, Oswald Bumke and Paul Schroder, included psychological as well as sociogenetic topics in their research. The latter did pioneering work for the institutionalization of child and adolescent psychiatry. The history of Leipzig psychiatry during the Nazi years has not yet been researched in depth. So far, however, no evidence has been found to prove the university hospital's involvement in German psychiatry's excruciating crimes on patients. It is true, however, that as elsewhere doctors of the Leipzig hospital were members of the Courts of Hereditary Health (Erbgesundheitsgericht) and that e.g. August Bostroem knew of the homicides. In 1943, during the directorship of Werner Wagner, the hospital was totally destroyed. Its reconstruction was mainly the work of Richard Arwed Pfeifer, who also made remarkable contributions to the study of the angiostructure of the brain. With Dietfried Muller-Hegemann, who had a major influence of East-German psychotherapy, the social psychiatric era began, and it was successfully continued under Berhard Schwarz, Klaus Weise and the hospital's present head, Matthias C. Angermeyer, Weise's theoretical and philosophical achievements in the foundation and his demand for an empirical verification of social psychiatric ideas in the whole of Germany are acknowledged until the present day. Last but no least it was him who from 1975 on first tried to implement these concepts into practice in Leipzig. PMID:15633274

Steinberg, Holger

2004-01-01

420

Assessing Physicians' Intentions to Talk about Sex when They Vaccinate Nine-Year-Old to 15-Year-Old Girls against HPV  

ERIC Educational Resources Information Center

The human papillomavirus (HPV) vaccine provides physicians with an opportunity to have conversations with girls about sex and sex-related topics. Current research suggests that these conversations are not happening. This study was designed to assess whether physicians would use the HPV vaccination as an opening to communicate with nine-year-old to…

Askelson, Natoshia M.; Campo, Shelly; Smith, Sandi; Lowe, John B.; Dennis, Leslie; Andsager, Julie

2011-01-01

421

Dermafrac™: An Innovative New Treatment for Periorbital Melanosis in a Dark-Skinned Male Patient  

PubMed Central

Periorbital melanosis (under eye dark circles) is an often idiopathic cosmetically disturbing condition that is poorly responsive to currently available treatment modalities. We present the case of a 48-year-old man (skin phototype V) with significant idiopathic periorbital melanosis and who had good to excellent reduction in periorbital melanosis with the new DermaFrac™, which combines microneedling with simultaneous infusion of a serum containing active ingredients. The possible mechanisms of benefit are discussed. DermaFrac™ may be an innovative and effective new treatment option for patients with periorbital melanosis. PMID:24163534

Sahni, Kanika; Kassir, Martin

2013-01-01

422

Chronic intermittent form of isovaleric aciduria in a 2-year-old boy  

PubMed Central

Isovaleric aciduria (IVA) is caused by an autosomal recessive deficiency of isovaleryl-CoA dehydrogenase (IVD). IVA presents either in the neonatal period as an acute episode of fulminant metabolic acidosis, which may lead to coma or death, or later as a "chronic intermittent form" that is associated with developmental delays, with or without recurrent acidotic episodes during periods of stress, such as infections. Here, we report the case of a 2-year old boy with IVA who presented with the chronic intermittent form. He was admitted to Asan Medical Center Children's Hospital with recurrent vomiting. Metabolic acidosis, hyperammonemia, elevated serum lactate and isovalerylcarnitine levels, and markedly increased urine isovalerylglycine concentration were noted. Sequence analysis of the IVD gene in the patient revealed the novel compound mutations-a missense mutation, c.986T>C (p.Met329Thr) and a frameshift mutation, c.1083del (p.Ile361fs*11). Following stabilization during the acute phase, the patient has remained in a stable condition on a low-leucine diet. PMID:24019846

Cho, Jin Min; Lee, Beom Hee; Kim, Gu-Hwan; Kim, Yoo-Mi; Choi, Jin-Ho

2013-01-01

423

[Acute hepatitis due to infectious mononucleosis in a 21-year-old-man].  

PubMed

A 21-year-old mole was admitted because of fever, fatigue, headache, pharyngitis, abdominal pain, loss of appetite, vomiting and dark urine for three days. The patient denied recent use of medicines or any other drug. His physical examination disclosed jaundice, hepato-splenomegaly, whitish-yellow covered tonsils, bilateral anterior and posterior cervical lymph node enlargement associated with edema on the face and neck. Routine blood tests detected abnormalities in serum bilirubins and liver enzymes (total bilirubin: 14.5 mg/dl, direct-reacting bilirubin: 12.9 mg/dl, AST: 697 U/l, ALT: 619 U/l, alkaline phosphatases: 260 U/l, and GGT: 413 U/l). Serological tests showed negative results for viral hepatitis, cytomegalovirus, HIV-1 and HIV-2, and toxoplasmosis markers, while serology for recent infection by EBV was positive (IgM: 70 and 29 U/ml; EBV IgG: 25 and 156 U/ml). Although infrequently, EBV infection can cause acute hepatitis with accentuated cholestatic jaundice (5% of cases), which may constitute an additional diagnostic challenge for primary care physicians. The patient improved with supportive management and was discharged after 12 days. This case study might contribute to increase the suspicion index about acute hepatitis related to EBV. PMID:24356741

Modesto Dos Santos, Vitorino; Da Costa Arruda, Zilcem; De Farias Polcheira, Maira; Da Silva De Souza, Diogo Wagner; Rodrigues Oliveira Santos, Alessandra Maria; Santos Corrêa Da Costa, Marcela

2013-07-01

424

Helicobacter pylori infection with a duodenal ulcer in a 6-year-old boy.  

PubMed

A 6-year-old boy was hospitalized because of dark feces and facial pallor of 1 weeks duration. Other gastrointestinal symptoms, including vomiting and abdominal pain, were absent, but he felt dizziness when standing and fatigue on effort. Hematologic studies revealed iron-deficiency anemia, and endoscopy showed gastric erosions and a duodenal ulcer. All test results for Helicobacter pylori infection, including H. pylori antigen in stool, anti-H. pylori IgG immunoassay in serum, and the (13)C-urea breath test, were positive. Because an H. pylori-associated gastric ulcer had been diagnosed with endoscopy in the patients father 3 years earlier, father-son transmission was suspected. The patient was treated with triple-agent eradication therapy (proton pump inhibitor [lansoprazol], amoxicillin, and clarithromycin) for 2 weeks. One month after therapy was completed, eradication of H. pylori was confirmed by negative results on the stool antigen test. Peptic ulcer disease can occur in young children, as in this case. The stool antigen test kit is a useful and reliable method that can be used even in preschool children to diagnose H. pylori infection. PMID:17106182

Hajikano, Miharu; Katsube, Yasuhiro; Takita, Yuko; Okada, Takuya; Asai, Makiko; Fujimatsu, Mariko; Nishizawa, Yoshiki; Kamisago, Mitsuhiro; Fujita, Takehisa; Shioya, Takeshi; Tokunaga, Akira

2006-10-01

425

Abscess in Adenomyosis Mimicking a Malignancy in a 54-Year-Old Woman  

PubMed Central

Background: Although there are a few reports describing abscess formation in endometriotic foci no report of abscess formation arising de novo within adenomyosis appears in the literature. Preoperative diagnosis of adenomyosis is frequently difficult because of non-specific signs and symptoms. Synchronous pelvic pathologies such as leiomyoma, endometrial polyp, endometrial hyperplasia, as well as endometrial cancer may cause differential diagnostic problems. Case: A 54-year-old postmenopausal woman complaining of inguinal pain, nightsweats and hot flashes is presented. Radiologic examinations of the pelvis revealed a 95 × 85 mm leiomyoma-like lesion including a 53 × 43 mmcystic space and 9 × 6 mmpapillary formation within the uterus raising clinical suspicion of malignancy. A total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed accompanied by a frozen section diagnosis. The frozen section revealed an abscess formation arising in a focus of adenomyosis. The postoperative period of the patient was uneventful. Conclusion : The present case, to our knowledge, is the first report representing abscess formation in adenomyosis. Abscess arising within adenomyosis can strongly raise the suspicion of endometrial cancer, particularly if the patient is postmenopausal. If endometrial cancer cannot be ruled out with definitive histopathological diagnosis in the preoperative period, a frozen section becomes mandatory during surgical intervention. PMID:12839634

Meydanli, Mehmet M.; Alkan, Alpay; Edali, Mehmet N.; Gokce, Hasan; Kafkasli, Ay?e

2003-01-01

426

Intracranial germinoma as a very rare cause of panhypopituitarism in a 23-year old man.  

PubMed

A 23 year-old patient was referred to the endocrine outpatient clinic with the suspicion of diabetes insipidus as he complained of nycturia and polydipsia since 2-3 months. Further he presented with nausea, vomiting, loss of appetite, rapid weight loss, diffuse body pain and fatigue. No headache, blurred vision, or fever were reported. The clinical examination showed sexual infantilism (poor beard, pubic and axillary hair growth, small testis). The patient's skin was strikingly pale as well as dry and scaly. Lymph node palpation was unremarkable. Endocrine evaluation revealed diabetes insipidus as well as complete anterior pituitary insufficiency. MR imaging demonstrated contrast-enhancing mass lesions at the pineal gland, hypothalamus, and anterior horn of lateral ventricles bilaterally. The localization pattern deemed to be highly suspicious for intracranial germinoma. As beta-HCG and AFP were negative in serum and cerebrospinal fluid the diagnosis of germinoma was confirmed histologically. After radiotherapy with cranio-spinal radiation therapy with 24 Gy followed by two weeks of local tumor boost with 16 Gy, the posttherapy MRI scan indicated complete tumor removal. This case demonstrates a very rare and potentially curable tumor as the cause of panhypopituitarism in adults. PMID:19053025

Reisch, N; Kühne-Eversmann, L; Franke, D; Beuschlein, F; Mueller-Lisse, U G; Reincke, M; Seissler, J

2009-07-01

427

The relationship between health literacy with health status and healthcare utilization in 18-64 years old people in Isfahan  

PubMed Central

Background: Today, much attention has been paid to the patient role as the central factor in the management of their own health. It is focused on the issue that the patient has a more critical role compared with the health-care provider in controlling the patient own health. defines health literacy as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Objective: The objective of this study was to determine health literacy, health status, healthcare utilization and the relationship between them in 18 - 64 years old people in Isfahan. Structure and Design: This study was a descriptive analytical survey, which was conducted on 300 subjects of 18-64 years old in Isfahan with Multi-stage sampling method proportional to selected sample size. Materials and Methods: For collecting the data, questionnaire adapted from CHAP (Consumer Assessment of Healthcare Providers and Systems) health literacy questionnaire was used. Health status was measured based on an assessment of the physical and mental health over the past 6 months by 5° Likert scale. Data analysis was performed by using SPSS 18, descriptive statistics, Chi-square test and multivariate analysis of variance. Results: There was no significant correlation between health literacy, health status and healthcare utilization. Utilization was less in the urban area No. 6 of the city. In the bachelor's degree group, the health status was lower than the other groups in these cases: Older ages, married, women, large family size, undergraduates, and urban area No. 14. Conclusions: Due to the average prevalence of health literacy in 18-64 years old individuals in Isfahan and low- healthcare utilization, the followings are recommended: Necessity of more attention to the issue of health literacy, improving the physician-patient relationship and community awareness, whether through health promotion programs or media for the optimum use of available resources. PMID:25077168

Karimi, Saeed; Keyvanara, Mahmoud; Hosseini, Mohsen; Jazi, Marzie Jafarian; Khorasani, Elahe

2014-01-01

428

Structural Priming of the Dative Form in Children aged 3 and 4 Years Old   

E-print Network

Studies of syntactic priming have convincingly shown that adults have abstract syntactic representations of language. Though studies have found this effect in 5 year old children, the effects have not been consistently found in younger children...

Richoux, Charlotte

429

An Investigation into Understanding of Geological Time among 10- and 11-Year-Old Children.  

ERIC Educational Resources Information Center

Focuses on the understanding of British children (N=189) of geologic time as they participate in related activities. Indicates that 10- and 11-year-old children lack a clear chronology of geologic events. Contains 22 references. (DDR)

Trend, Roger

1998-01-01

430

12 Year Olds More Likely to Use Inhalants Than Cigarettes or Marijuana  

MedlinePLUS

... or Marijuana According to combined data from the 2006 to 2008 National Surveys on Drug Use and ... Inhalants and Other Substances among 12 Year Olds: 2006 to 2008 Lifetime Use of Inhalants and Other ...

431

Persuasion from an Eighteen-Year-Old's Perspective: Perry and Piaget.  

ERIC Educational Resources Information Center

Looks at how the theories of William Perry and Jean Piaget explain choices students made in writing persuasive essays. Examines the implications of their theories for teaching persuasion to eighteen-year olds. (SR)

Dinitz, Sue; Kiedaisch, Jean

1990-01-01

432

Preliminary Design of an Anthropomorphic Dexterous Hand for a 2-Years-Old Humanoid: towards Cognition  

E-print Network

Preliminary Design of an Anthropomorphic Dexterous Hand for a 2-Years-Old Humanoid: towards@unige.it francesco.becchi@telerobot.it Abstract - This paper presents first results in developing an anthropomorphic

Sandini, Giulio

433

Tall, Heavy 1-Year-Olds May Be at Risk for Obesity Later, Study Finds  

MedlinePLUS

... 1-Year-Olds May Be at Risk for Obesity Later, Study Finds But experts say genes aren' ... 2014 Related MedlinePlus Pages Genes and Gene Therapy Obesity in Children Toddler Health TUESDAY, Oct. 21, 2014 ( ...

434

Monitoring candidate gene expression variations before, during and after a first major depressive episode in a 51-year-old man  

PubMed Central

Background Although psychiatric disorders are frequently characterized by clinical heterogeneity, high recurrence, and unpredictable prognosis, studies of mRNA expression variations in blood cells from psychiatric patients constitute a promising avenue to establish clinical biomarkers. We report here, to our knowledge, the first genetic monitoring of a major depressive episode (MDE). Case presentation The subject is a 51-year-old male, who was healthy at baseline and whose blood mRNA was monitored over 67 weeks for expression variations of 9 candidate genes. At week 20 the subject experienced a mild to moderate unexpected MDE, and oral antidepressant treatment was initiated at week 29. At week 36, the patient recovered from his MDE. After 6 months, antidepressant treatment was discontinued and the subject remained free of depressive symptoms. Genetic monitoring revealed that mRNA expression of SLC6A4/5HTT increased with the emergence of a depressive state, which later returned to basal levels after antidepressant treatment and during MDE recovery. PDLIM5, S100A10 and TNF mRNA showed also an interesting pattern of expression with regards to MDE evolution. Conclusion This case demonstrated the applicability of peripheral mRNA expression as a way to monitor the natural history of MDE. PMID:24620999

2014-01-01

435

The Social Development of Two Year Old Children in Residential Nurseries.  

ERIC Educational Resources Information Center

This study focuses upon some aspects of the social behavior of 2-year-old children being reared in long-stay residential nurseries. These children are compared with working class 2-year-old children being raised in two-parent homes in which the mother is not working full-time and there are no older siblings of preschool age. All children were…

Tizard, Jack; Tizard, Barbara

436

Physiological and Behavioral Regulation in Two-Year-Old Children with Aggressive\\/Destructive Behavior Problems  

Microsoft Academic Search

A sample of 99 two-year-old children was selected on the basis of parents' responses to two administrations of the Child Behavior Checklist for two- to three-year-olds. Forty-nine of these children displayed symptoms of aggressive\\/destructive (externalizing) problems that were in the borderline clinical range (labelled “high risk”) and 50 children displayed few such symptoms (“low risk”). The children were assessed in

Susan D. Calkins; Susan E. Dedmon

2000-01-01

437

Reference Values for Craniofacial Structures in Children 4 to 6 Years Old: Review of the Literature  

Microsoft Academic Search

This review article addresses the question as to what methods can be used to investigate cranial structure and growth development\\u000a in children 4 to 6 years old, and what the relevant reference values are for this age group.\\u000a \\u000a We screened the literature for epidemiological, longitudinal and cross-sectional studies investigating healthy children 4\\u000a to 6 years old without abnormalities and orthodontic

Mirjam Hönn; Gernot Göz

2007-01-01

438

Aneurysmal Bone Cyst Presenting as a Pathologic Fracture in a 12-Year-Old Football Player  

PubMed Central

Objective The purpose of this report is to describe a case of an aneurysmal bone cyst presenting as a pathologic fracture in a young athlete. Case report A 12-year-old patient presented to a chiropractic teaching clinic with a 1-week history of posterior neck pain and stiffness following a helmet-to-helmet collision in football practice. Cervical spine radiographs were taken. Lateral view radiograph demonstrated a pathologic fracture through a lytic, expansive lesion in the posterior arch of C7 with mild subluxation of the C7/T1 apophyseal joints and angulation of the C7/T1 disk space. Based upon these findings, additional diagnostic imaging was ordered. Findings on advanced imaging studies included the following: On computed tomography, the C7 lesion showed medullary destruction, cortical thinning and expansion, and a horizontally oriented fracture through the spinous and lamina. Magnetic resonance imaging studies for sagittal T2 and contrast-enhanced T1-weighted magnetic resonance images revealed fluid/fluid levels in the C7 spinous and peripheral enhancement with contrast. Outcome The patient was referred to a local hospital for treatment. The lesion was treated with resection of the posterior arch, and an aneurysmal bone cyst was confirmed histologically. The patient developed a kyphotic deformity at the site of resection and cervical instability. A subsequent fusion was performed. Conclusion Aneurysmal bone cysts are rare lesions. In this case, the initial traumatic history masked the underlying pathology. Although rare, pathologic fracture should be considered in cases of vertebral fracture in young patients. PMID:24711787

Welk, Aaron B.; Norman W., Kettner

2014-01-01

439

A case of Hymenolepis diminuta in a young male from Odisha  

PubMed Central

Hymenolepis diminuta also known as rat tapeworm rarely causes hymenolepiasis in humans. We report a case of H. diminuta infection in an 18-year-old male farmer who presented with intermittent pruritic maculopaular rashes and dull aching left iliac fossa pain for 6 months. Patient was cured with 2 doses of praziquantel 20 mg/kg on day 0 and 7. PMID:24471000

Karuna, T; Khadanga, Sagar

2013-01-01

440

A case of Hymenolepis diminuta in a young male from Odisha.  

PubMed

Hymenolepis diminuta also known as rat tapeworm rarely causes hymenolepiasis in humans. We report a case of H. diminuta infection in an 18-year-old male farmer who presented with intermittent pruritic maculopaular rashes and dull aching left iliac fossa pain for 6 months. Patient was cured with 2 doses of praziquantel 20 mg/kg on day 0 and 7. PMID:24471000

Karuna, T; Khadanga, Sagar

2013-07-01

441

Pregnancy after percutaneous epididymal sperm aspiration in an 81-year-old man with obstructive azoospermia.  

PubMed

There has been observed a trend to delay childbearing, reflecting couple's desire to have children at older ages. Maternal age is a well-known factor that influences the achievement of a pregnancy. In contrast, there are few studies examining the effect of paternal age on the outcomes of assisted reproductive technologies (ART), and results are conflicting. Our patient was vasectomised at the age of 60 years, and his wife was 38 years old. A total of four metaphase II oocytes were inseminated 4 h later (day 0) by intracytoplasmic sperm injection using spermatozoa from percutaneous epididymal sperm aspiration. On day 2, the three resulting embryos were transferred (two had four cells, and one had two cells). Two healthy infants were born at the 37th gestational week by caesarean section. Although the effect of paternal age on ART outcomes and results are conflicting, this case report contributes to point out that advanced age of the man has probably lesser negative influence in the reproductive function. PMID:22385155

Taitson, P F; Melo, C S B; Mancebo, A C A; Melo, U B; B Souza, M C

2012-10-01

442

Stabbing headache in an 8-year-old girl: primary or drug induced headache?  

PubMed

The occurrence of stabbing headaches in children requires a thorough diagnostic approach that excludes secondary headaches. The organic background should be taken into consideration when alarming symptoms occur, such as a purely 1-sided location, a change in the character of the headache, or possibly a link to physical activity. The current study describes the case of an 8-year-old girl who suffered short-lasting stabbing headache attacks. The headaches with increasing intensity and frequency started 1 month before her hospitalization and were usually preceded by physical activity (dancing, running). The pain, which was located in the right supraorbital region, lasted 1 second and occurred several times during the day. No associated symptoms were observed. In addition, the girl suffered from allergic rhinitis and was on antiallergic treatment (levocetirizine, fluticasone nasal spray). On admission she was in good general condition, and a pediatric and neurologic examination revealed no abnormalities. Her brain MRI was normal. The initial diagnosis was that the patient was suffering from primary stabbing headaches. However, during a follow-up visit 4 months later, a relationship was observed between the cessation of the headache attacks and the discontinuation of an antihistaminic drug. Six months later, the girl remained headache free. In cases involving differential diagnoses of stabbing headaches, it is important to consider the adverse reactions of the drugs used. PMID:24664098

Biedro?, Agnieszka; Kaci?ski, Marek; Skowronek-Ba?a, Barbara

2014-04-01

443

Perivascular epithelioid cell tumour of the vagina in an 8 year old girl.  

PubMed

Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal tumor with an unpredictable natural history. We present the first reported case of PEComa of the vagina diagnosed in an 8-year-old girl. This was initially diagnosed on biopsy as an embryonal rhabdomyosarcoma, and the patient underwent 3 cycles of chemotherapy according to the Mesenchymal Malignant Tumour 1989 protocol. A repeat scan, however, revealed an increase in tumor size. Total resection was achieved via a transvaginal (vertical sleeve) partial vaginectomy. The resected tumor had the typical appearance of a PEComa. Immunostains showed positive staining of tumor cells for HMB45, neuron-specific enolase, and calponin but were negative for S100 protein, melaninA, chromogranin, smooth muscle actin, desmin, caldesmon, epithelial membrane antigen, AE1/3, and synaptophysin. Six months after surgery, she remains free of tumor and is on follow-up with regular local examinations under anesthesia and computed tomography scans. Our case highlights the importance of an accurate initial diagnosis, and we stress the importance of regular surveillance over a significant period. PMID:17336201

Ong, Lin Yin; Hwang, Wei Sek; Wong, Adelina; Chan, Mei Yoke; Chui, Chan Hon

2007-03-01

444

Varicella Myopericarditis Mimicking Myocardial Infarction in a 17-Year-Old Boy  

PubMed Central

Varicella (chickenpox), a common childhood infection caused by the varicella-zoster virus, is self-limiting and usually benign. Although atypical manifestations of the virus are occasionally seen, it rarely presents with cardiovascular sequelae. Cardiovascular complications of varicella can include pericarditis, myocarditis, or endocarditis. Herein, we report the case of a 17-year-old boy who had varicella infection and severe chest pain. Examination revealed atypical electrocardiographic findings of pericarditis and remarkably elevated cardiac biomarker levels: peak cardiac troponin I, 37.2 ng/mL; total creatine kinase, 1,209 U/L; and creatine kinase–MB fraction, 133.6 ng/mL. After results of coronary angiography reliably excluded ischemia and myocardial infarction, the diagnosis was varicella myopericarditis. The patient was placed on a medical regimen during and after 5 days of hospitalization. In 2 weeks, he was asymptomatic, and at 6 months, he was doing well and had normal electrocardiographic and echocardiographic results. To our knowledge, cardiac enzyme elevations to these levels have not been reported in cases of cardiovascular sequelae of varicella. We discuss the diagnostic challenges of this atypical case and suggest that clinicians be aware that varicella disease is most often, but not always, benign. PMID:21720475

De, Aliva; Myridakis, Dorothy; Kerrigan, Margot; Kiblawi, Fuad

2011-01-01

445

Amorphous basophilic deposit in the superficial dermis of the lip in an 80 year old.  

PubMed

An 80-year-old woman presented with a 3 mm pearly, translucent papule in her left upper cutaneous lip of 2 months duration which was biopsied to rule out basal cell carcinoma. Histopathologic examination revealed acellular, basophilic material in the superficial dermis, extending to the base of the biopsy. There was neither an epithelial component nor an inflammatory reaction associated with it. The amorphous, nonpolarizable material stained with Alcian Blue (pH 2.5) and with colloidal iron, but was negative with a Periodic acid-Schiff stain, indicative of an acidic mucin, such as weakly sulfated mucin of salivary gland origin or a dermal-origin mucin. The material was digested with hyaluronidase, consistent with the mesenchymal-origin mucin hyaluronic acid (HA). Additional clinical history was obtained; the patient had previous HA (Restylane) injections at another institution. We report a case of superficially applied HA and consider the histopathologic differential diagnosis of endogenous and injected mucin in the dermis. PMID:20110796

Anatelli, Florencia; Chapman, M Shane; Brennick, Jeoffry

2010-05-01

446

Hyponatremia in an 85-year-old hiker: when depletion plus dilution produces delirium.  

PubMed

We report a case of critical exercise-associated hyponatremia in an 85-year-old man, an experienced hiker, during an overnight trek through Yosemite National Park. His medical history was significant for mild renal insufficiency, diastolic dysfunction, and pulmonary hypertension. He was taking a thiazide diuretic (hydrochlorothiazide), without a prior history of an electrolyte imbalance. The hiker drank a modest amount of fluid (3 liters) and urinated only once during the 9-hour descent, from a starting elevation of approximately 3000 meters, before the sudden onset of delirium occurred. He was subsequently airlifted to the nearest hospital. Initial blood sodium concentration ([Na(+)]) was 120 mEq/L, urine [Na(+)] was 21 mEq/L, plasma osmolality was 266 mOsm/kgH(2)O, and urine osmolality 364 mOsm/kgH(2)O. The patient did not respond to infusions of normal saline, but after an intravenous 20 mg bolus of furosemide, a copious diuresis ensued, after which he recovered fully. This case highlights the complexities of fluid and sodium homeostasis during prolonged hiking, as the combination of both environmental factors (extreme temperatures, altitude, and water and sodium availability) and individual factors (hypertension, age) may have all contributed to the development of life-threatening exercise-associated hyponatremia. This case is unique in that neither the water intoxication model nor the sodium depletion model can fully explain the pathophysiologic findings documented in this report. PMID:22656662

Coler, Clark; Hoffman, Martin D; Towle, Gary; Hew-Butler, Tamara

2012-06-01

447

Orthodontics in 12-year old children. Demand, treatment motivating factors and treatment decisions.  

PubMed

Ninety-three per cent of all 12-year old patients at a clinic in western Sweden accepted an invitation to take part in a dental examination in order to evaluate early orthodontic treatment. Treatment in the primary or mixed dentition periods should aim at creating normal craniofacial, occlusal and dental development and, if possible, at reducing the need for later, more complicated treatment. The treatment success was low regarding overjet correction but fairly good with regard to diagnosis and treatment of crossbite/forced occlusion, ectopic eruption and congenitally missing teeth. Whether correction of crossbite had reduced crowding was impossible to evaluate in this study. However, relatively few subjects with a history of crossbite correction desired alignment of teeth. The study confirmed earlier observations that TMD prevention is not a major motivating factor for orthodontic treatment. The majority of the children, including those desiring treatment, judged their dental appearance to be fairly average. The dentists more often than the children regarded the subjects' appearance to be better than average. Prediction of later orthodontic treatment, recorded at the age of 14 years, turned out to have a weak association to evaluation of aesthetics both by the children and the dentists. Nor did recording of TMD improve prediction. The study confirms earlier observations that discussions about orthodontic treatment on mainly aesthetic grounds ought to be postponed well into the permanent dentition period, and by attempting to avoid "making the normal abnormal". PMID:12462877

Mohlin, Bengt; al-Saadi, Emad; Andrup, Lena; Ekblom, Kerstin

2002-01-01

448

A 9-kg Ovarian Mucinous Cystadenoma in a 14-Year-Old Premenarchal Girl  

PubMed Central

Patient: Female, 14 Final Diagnosis: Ovarian mucinous cystadenoma Symptoms: Abdominal enlargement • abdominal pain • constipation Medication: — Clinical Procedure: — Specialty: Obstetrics and Gynecology Objective: Rare disease Background: Although ovarian tumors are most commonly observed in adults, they relatively rarely occur in children. The majority of ovarian masses encountered in the premenarchal or childhood stages are non-neoplastic lesions such as benign functional cysts. Epithelial tumors account for 8–10% of all ovarian tumors and are histologically classified as mucinous or serous. The most common benign epithelial ovarian tumor is cystadenoma. Case Report: We report the case of a 14-year-old premenarchal girl with chronic abdominal pain, constipation, and abdominal enlargement. A computed tomography detected a huge left ovarian cystic tumor. A 9-kg ovarian tumor was removed surgically. Pathology showed a benign mucinous cystadenoma (MCA). Conclusions: Ovarian neoplasms in children present a diagnostic quandary, and very often the diagnoses are missed or delayed. When the diagnosis is made, a prompt and fertility-preserving surgical treatment must be performed and followed to prevent recurrence. PMID:25082433

Biçer, ?enol; Erkul, Zehra; Demiryilmaz, ?smail; Peker, Necla

2014-01-01

449

Recurrent ascites with severe hypoproteinemia in 4-year-old child: A diagnostic dilemma - An atypical presentation of hypothyroidism.  

PubMed

Hypothyroidism is frequently encountered condition to a pediatrician. Passive effusions into serous cavities, sometimes to considerable amount are frequently noted. However, the significant ascites caused by this is rare in a child and in no instance, it is too excessive. So diagnosis is frequently delayed and patient frequently receive unnecessary procedures such as liver, even gastrointestinal biopsies. Analysis of ascitic fluid shows exudative nature with high protein. The case we present here is a 4-year-old female child with recurrent ascites, developmental delay and hypoproteinemia. High index of suspicion can lead to diagnosis. Over all prognosis is excellent after stating replacement therapy with L-thyroxine. PMID:25143889

Mehta, Sudhir; Sanghvi, Jyoti; Kela, Gunjan

2014-07-01

450

46,XY/47,XYY/48,XYYY karyotype in a 3-year-old boy ascertained because of radioulnar synostosis  

SciTech Connect

Chromosome analysis was performed on a 3-year-old boy because of bilateral radioulnar synostosis and demonstrated a mosaic karyotype 46,XY/47,XYY/48,XYYY. He had minor facial anomalies and mild intellectual delay. He appears to be the youngest patient reported with this rare chromosome complement. His father, mother, and brother had normal chromosomes. Fluorescence in situ hybridization (FISH) was performed on the propositus and his father with the Y chromosome heterochromatic probe (pHY3.4) to add to the evaluation of mosaicism. 17 refs., 3 figs., 2 tabs.

James, C.; Robson, L.; Jackson, J. [Children`s Hospital, Sydney (Australia)] [and others

1995-05-08

451

Pheochromocytoma in a Twelve-Year-Old Girl with SDHB-Related Hereditary Paraganglioma-Pheochromocytoma Syndrome  

PubMed Central

A twelve-year-old girl presented with a history of several weeks of worsening headaches accompanied by flushing and diaphoresis. The discovery of markedly elevated blood pressure and tachycardia led the child's pediatrician to consider the diagnosis of a catecholamine-secreting tumor, and an abdominal CT scan confirmed the presence of a pheochromocytoma. The patient was found to have a mutation in the succinyl dehydrogenase B (SDHB) gene, which is causative for SDHB-related hereditary paraganglioma-pheochromocytoma syndrome. Herein, we describe her presentation and medical management and discuss the clinical implications of SDHB deficiency. PMID:25215250

Gooch, Megan; Ye, Zhan; Richer, Edward; Chishti, Aftab; D'Orazio, John

2014-01-01

452

Pneumothorax developing for the first time in a 73-year-old woman diagnosed with Birt-Hogg-Dubé syndrome.  

PubMed

Spontaneous pneumothorax in the elderly commonly occurs due to underlying pulmonary diseases, such as chronic obstructive pulmonary disease, interstitial lung disease, lung cancer, etc. A 73-year-old woman developed pneumothorax for the first time that was a clinical clue to a diagnosis of Birt-Hogg-Dubé syndrome (BHDS), an autosomal dominant condition characterized by fibrofolliculomas of the skin, renal tumors and multiple lung cysts predisposing to pneumothorax. Although BHDS patients frequently develop pneumothorax during their twenties to forties, the present case indicates that BHDS should be considered as an underlying cause of pneumothorax in the elderly with undisclosed BHDS. PMID:24190151

Kunogi Okura, Makiko; Yae, Toshifumi; Nagashima, Osamu; Hirai, Shu; Kumasaka, Toshio; Iwase, Akihiko

2013-01-01

453

Diagnosis and management of nonsyndromic hereditary gingival fibromatosis in a 13 year old girl: Report of a rare case  

PubMed Central

Hereditary gingival fibromatosis is a rare condition characterized by various degree of gingival overgrowth. It usually develops as an isolated disorder but can manifest with multisystem syndrome. We are here presenting a case of a 13-year-old girl who presented with severe enlargement of gingiva covering all most the entire crown involving both maxillary and mandibular arches. Differential diagnosis includes drug-induced and idiopathic gingival enlargement. Excess gingival tissue was removed by full mouth gingivectomy and sent for histopathological examination. Postoperative course was uneventful and patient's esthetics improved significantly. A 12 month postoperative period shows no recurrence. PMID:23230366

Goyal, Lata; Bey, Afshan; Gupta, N. D.; Varshney, Amitabh

2012-01-01

454

[Vascular complications in a 51-year-old female with a primary antiphospholipd syndrome--a case report].  

PubMed

A 51-year-old woman with antiphospholipid syndrome was readmitted to the hospital two years after successful surgical pulmonary thrombendarteriectomy for severe chronic thromboembolic pulmonary hypertension (CTEPH). Exertional dyspnea, chest pain and ECG pattern could suggest relapse of pulmonary thromboembolism. However, no signs of pulmonary hypertension were found at echocardiography. Coronary angiography revealed proximal critical occlusion in the left anterior descending artery which was successfully treated with PTCA and stenting. Coronary artery disease may mimic relapse of CTEPH and this should be remembered especially in patients with antiphospholipid syndrome, who have increased risk of coronary artery disease especially in the presence of other classical risk factors. PMID:17295161

Wieteska, Maria; Szturmowicz, Monika; Kurzyna, Marcin; Hajduk, Bogdan; Biederman, Andrzej; Torbicki, Adam

2007-01-01

455

Cortisol Reactivity in Two-Year-Old Children Prenatally Exposed to Methamphetamine  

PubMed Central

Objective: Until now, the functioning of the hypothalamic–pituitary–adrenal (HPA) axis in children with prenatal methamphetamine exposure (PME) had been unexamined. Previous research indicates that prenatal exposure to stimulant drugs is associated with dose-response alterations in neural growth and connectivity and consequent neurobehavioral deficits. In addition, children of drug-using parents are at an increased risk for exposure to chronic postnatal stress. In this preliminary study, we examined the associations of PME and postnatal environmental stress with cortisol stress reactivity in children with PME. Method: Participants were 2-year-old children (N = 123; 55.3% male) with PME from a multicenter longitudinal Infant, Development, Environment, and Lifestyle Study. Saliva samples were obtained before and after a stress-inducing separation task. Hierarchical multiple regression analyses examined prenatal drug exposure, methodological and postnatal stress covariates, and interactions between levels of PME and postnatal stress. Results: Mild to moderate potential for child physical abuse moderated increased cortisol reactivity in high exposed children with PME. Blunted cortisol reactivity was associated with caregiver’s postnatal alcohol use, child’s behavioral dysregulation, and the interaction between higher levels of PME and caregiver’s psychopathology. Conclusions: Consistent with the known effects of stimulant drugs and chronically stressful environments on the HPA axis and, thus, the toxic stress and allostatic load phenomena, our results imply that elevated PME may be associated with alterations in the programming of the HPA axis reflecting hyperactivity, which under significant and chronic environmental stress then may become hypoactive. PMID:23490574

Kirlic, Namik; Newman, Elana; LaGasse, Linda L.; Derauf, Chris; Shah, Rizwan; Smith, Lynne M.; Arria, Amelia M.; Huestis, Marilyn A.; Haning, William; Strauss, Arthur; Dellagrotta, Sheri; Dansereau, Lynne M.; Abar, Beau; Neal, Charles R.; Lester, Barry M.

2013-01-01

456

Intraosseous ganglion in the subchondral region of the lateral femoral condyle in an 11-year-old girl: a case report  

Microsoft Academic Search

We report the case of a patient with intraosseous ganglion in the lateral femoral condyle. An 11-year-old girl presented with right knee pain following a twisting injury. Plain radiographs of the knee showed a small circumscribed radiolucency with a thin sclerotic margin in the subchondral region of the lateral femoral condyle. Although the image findings and location are not typical,

Hiroshi Nakayama; Masayoshi Yagi; Shinichi Yoshiya

2009-01-01

457

Successful Transcatheter Closure of a Patent Ductus Arteriosus: Using Two Gianturco Coils in a 41YearOld WomanA Case Report  

Microsoft Academic Search

Patent ductus arteriosus (PDA) is a form of congenital heart disease uncommonly diagnosed in adult patients. Transcatheter closure of PDA has been widely used in children. However, the experience is limited in adults especially with use of Gianturco coils. The authors describe a case of successful transcatheter closure of a PDA, inciden tally diagnosed in a 41-year-old woman, by successively

Fadi Shamsham; Tak Kwan; Arshad M. Safi; Luther T. Clark

1999-01-01

458

Chondroblastoma of the Medial Cuneiform Bone in a 32-Year-Old Woman  

PubMed Central

Patient: Female, 32 Final Diagnosis: Chondroblastoma Symptoms: Pain Medication: — Clinical Procedure: — Specialty: Oncology Objective: Unusual clinical course Background: 1% of all bone tumors are Chondroblastomas. Chondroblastomas, initially considered to be an osteoclastoma variant are benign, cartilaginous tumors which usually occur in the epiphysis of long bones, especially in the humerus, tibia, and femur, most common in children and young adults between the ages of 10 and 20 years. 4% of all chondroblastomas settle in the talus whereas cuneiform and other tarsal bones are very rare sites for the development of this benign chondroid lesion. Case Report: A case of chondroblastoma involving the medial cuneiform of the left foot of a 32-year-old woman is described. The patient presented with moderate localized pain and tenderness over the medial aspect of her left foot. Radiographs showed a lytic expansile lesion within the right cuneiform bone indicating a bone tumor. Biopsy demonstrated cellular areas made up of round, polygonal cells, with round-oval nucleus and chondroblasts that appear with a thin calcification rim. Intralesional curettage and synthetic bone grafting with PRP (Platelet-Rich Plasma) application was performed for its treatment. After 18 month follow up, osteointegration was observed with the defect completely filled and the patient was free of disease and pain. Conclusions: A painful, expansile, thin, sclerotic lesion detected at the cuneiform should arise suspicion for chondroblastoma even at age over 20 years. Meticulous curettage of the lesion from a small window with removal of the lesion followed by injectable phosphocalcic cement application with autologous PRP can be considered as a curative and technically simple treatment method. PMID:25072961

Ar?kan, Murat; Aktas, Erdem; To?ral, Guray; Y?ld?r?m, Ahmet; Kandemir, Olcay

2014-01-01

459

Vogt-Koyanagi-Harada disease in an 8-year-old boy.  

PubMed

Vogt-Koyanagi-Harada (VKH) disease is an autoimmune disease involving pigmented tissue in eyes, auditory system, skin, and central nervous system. The pathogenesis is a result of T cell lymphocyte reaction against melanocyte component, tyrosinase and tyrosinase-related protein. This disease uniquely affected pigmented race in Asia and native America, mostly women aged 20-50. We reported an 8-years-old boy complained for visual disturbance since 6 weeks prior admission. Two years earlier, the parents noted the patient eyes were looked red when photographed (suggesting a dilated pupil) preceded by whitened on the right forehead and nose and whitened hair, eyebrow and eyelashes. The examination showed a vitiligo and skin atrophy on right frontal and right nasal, poliosis on the eyebrows, eyelids and hair. The diameter of right pupil was 8 mm, with a paresis on 3rd, 4th, 6th, and 9th nerves. Fundus examination revealed sunset glow appearance. The visual acuity on the right eye: 2/60, left eye: 1-0. There's positive serology for antitoxoplasma IgG, anti Rubella IgG, anti CMV IgG. The patient was diagnosed with a VKH disease and then prescribed with methylprednisolone 1 mg/kg/day. The patient also had further follow up with dermatovenerologist and ophthalmologist. The eye examination revealed an improvement on right eye panuveitis, with a remaining keratic precipitate in the endothelium, and minimal flare and cell on the anterior chamber. ENT consultation revealed no ear inflammation or hearing disturbance. PMID:22053304

Setiabudiawan, Budi; Karfiati, Feti; Ghrahani, Reni; Sapartini, Gartika; Sahril, Indra

2011-07-01

460

[Vascular ring: a rare cause of dyspnea in an elderly male patient. Case report].  

PubMed

Shortness of breath (dyspnea) and changes present in X-rays of the chest are most frequent symptoms indicating further pulmonary diagnostic. Presented is the case of 71-year-old patient reffered from general practitioner due to exacerbation of dyspnea and abnormalities present in the chest X-ray.The patient has been treated for ischemic heart disease and arrythmia for a couple of years.Three-dimensional CT of the chest revealed a vascular ring of aorta.It is a defect characterized by a faulty flow of large vascular trunks, which built a cardiovascular ring that partially or completely enricle the structure of mediastinum (esophagus, trachea).The observed clinical symptoms are a result of pressure applied to the structure of the mediastinum and its intensity. This cardiovascular defect is diagnosed during early stages of childchood development and for it to be recognized in an adult patient is a casuistic case. PMID:25577535

Orwaldi, Magdalena

2015-01-01