Sample records for year-old male patient

  1. [Possible Kawasaki disease in a 56 years-old male patient diagnosed in sequelae phase].

    PubMed

    Asensio Lafuente, Enrique; Montalvo Ramos, T R Aquiles; Linares Rodríguez, Abel

    2015-01-01

    We present a 56 years-old male patient with an acute ischemic episode. The patient showed significant dilation of the left main coronary artery and proximal segments of the left descending artery, as well as a right coronary artery with a 10mm diameter in the proximal and medial segments. These findings are compatible with a Kawasaki's disease in a chronic phase. PMID:25534907

  2. 9.1 cm abdominal aortic aneurysm in a 69-year-old male patient

    PubMed Central

    Saade, Celine; Pandya, Bhavi; Raza, Muhammad; Meghani, Mustafain; Asti, Deepak; Ghavami, Foad

    2015-01-01

    We are presenting a case of one of the largest un-ruptured abdominal aortic aneurysm ever reported. Presented here is a rare case of a 69-year-old active smoker male with history of hypertension and incidental diagnosis of abdominal aortic aneurysm of 6.2 cm in 2003, who refused surgical intervention at the time of diagnosis with continued smoking habit and was managed medically. Patient was subsequently admitted in 2012 to the hospital due to unresponsiveness secondary to hypoglycemia along with diagnosis of massive symptomatic pulmonary embolism and non-ST elevation myocardial infarction. With the further inpatient workup along with known history of abdominal aortic aneurysm, subsequent computed tomography scan of abdomen pelvis revealed increased in size of infrarenal abdominal aortic aneurysm to 9.1 cm of without any signs of rupture. Patient was unable to undergo any surgical intervention this time because of his medical instability and was eventually passed away under hospice care.

  3. 9.1 cm abdominal aortic aneurysm in a 69-year-old male patient.

    PubMed

    Saade, Celine; Pandya, Bhavi; Raza, Muhammad; Meghani, Mustafain; Asti, Deepak; Ghavami, Foad

    2015-03-26

    We are presenting a case of one of the largest un-ruptured abdominal aortic aneurysm ever reported. Presented here is a rare case of a 69-year-old active smoker male with history of hypertension and incidental diagnosis of abdominal aortic aneurysm of 6.2 cm in 2003, who refused surgical intervention at the time of diagnosis with continued smoking habit and was managed medically. Patient was subsequently admitted in 2012 to the hospital due to unresponsiveness secondary to hypoglycemia along with diagnosis of massive symptomatic pulmonary embolism and non-ST elevation myocardial infarction. With the further inpatient workup along with known history of abdominal aortic aneurysm, subsequent computed tomography scan of abdomen pelvis revealed increased in size of infrarenal abdominal aortic aneurysm to 9.1 cm of without any signs of rupture. Patient was unable to undergo any surgical intervention this time because of his medical instability and was eventually passed away under hospice care. PMID:25810816

  4. Primary Antiphospholipid Syndrome Associated with Pneumonia: A Case Report of a 16-Year-Old Male Patient

    PubMed Central

    Yilmaz, Süreyya; Topcu, Fusun; Selimoglu Sen, Hadice; Yildirim, Yasar; Yilmaz, Zülfükar; Kara, Ali Veysel; Akgul Ozmen, Cihan

    2015-01-01

    Antiphospholipid syndrome (APS) is an autoimmune disease characterised by arterial and/or venous thrombosis and/or recurrent pregnancy loss in the presence of antiphospholipid (APL) antibodies. It is evaluated as APS when it develops associated with other systemic autoimmune diseases or primary APS if there is no concomitant disorder. In this study, we present a case of a 16-year-old male patient with primary APS. The patient was admitted with presumptive diagnosis of pneumonia, but multiple pulmonary thromboembolism (PTE) was observed on computerized tomography (CT) pulmonary angiography. APL antibodies positivity and thrombocytopenia developed in our patient. The patient was evaluated as primary APS since another etiology that could explain PTE was not found. Primary APS is a rare disease in children along with adolescents, compared with APS associated with other systemic autoimmune diseases. We present here a young male patient with primary APS and PTE to contribute to the literature. The patient initially had pneumonia but later developed PTE and thrombocytopenia. PMID:25874150

  5. Resistant retinoblastoma in a 23-year-old patient

    PubMed Central

    Yousef, Yacoub A.; Istetieh, Jihad; Nawaiseh, Ibrahim; Al-Hussaini, Maysa; Alrawashdeh, Khalil; Jaradat, Imad; Sultan, Iyad; Mehyar, Mustafa

    2014-01-01

    Retinoblastoma is a very rare disease in adults. We are reporting a rare case of resistant retinoblastoma in 23-year-old patient. A 23-year-old male patient presented with loss of vision in the right eye over one-month duration. Examination showed an epiretinal membrane in the right macula in addition to a white mass located inferiorly and associated with vitreous seeds. The diagnosis of retinoblastoma was established. In order to save the patient's life and to preserve the eye and vision, he was treated with chemotherapy, focal therapy, and radioactive Iodine125 plaque therapy. The tumor was resistant for treatment and recurred two years after plaque therapy, and enucleation showed well-differentiated retinoblastoma. Retinoblastoma may present in adults, and it was resistant to both chemotherapy and plaque radiation therapy in our case. PMID:25378879

  6. 63-year-old male with gastric outlet obstruction.

    PubMed

    Khalsa, Bhavraj; Rudersdorf, Patrick; Dave, Dattesh; Smith, Brian R; Lall, Chandana

    2014-01-01

    We describe a case of a 63-year-old male with complicated Bouveret's syndrome, both in its presentation and in its management. Bouveret's syndrome is a rare cause of gastric outlet obstruction resulting from mechanical obstruction from gallstones at the pyloroduodenal segment. As Bouveret's syndrome can be a diagnostic and therapeutic challenge for clinicians, we aim to identify clinical and radiologic pearls that can lower the threshold for the diagnosis of Bouveret's syndrome. PMID:25298900

  7. Cardiac Operations in Patients 80 Years Old and Older

    Microsoft Academic Search

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

    1997-01-01

    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 +

  8. Simultaneous occurrence of herniated disc and mesothelial cyst in a 16-year-old male

    Microsoft Academic Search

    Nancy E. Epstein; Joseph A. Epstein; Robert Gould; Roger Hyman

    1986-01-01

    The unusual, simultaneous occurrence of both a herniated disc and an intraspinal mesothelial cyst in an adolescent is reported. The patient was a 16-year-old white male who presented with sciatic pain in his left lower extremity. Myelography revealed evidence of a left L4–5 discal herniation, and a L5–S3 midline sacral lesion that proved to be a mesothelial cyst.

  9. Massive intraventricular thrombi in a previously healthy 43-year-old male.

    PubMed

    Szymczyk, Ewa; Lipiec, Piotr; Kasprzak, Jaros?aw

    2009-12-01

    We report a case of 43-year-old previously healthy male admitted to our hospital with symptoms of heart failure. Two-dimensional echocardiography demonstrated a previously undiagnosed dilated cardiomyopathy and massive left intraventricular thrombi. Because patient did not give consent for surgical thrombectomy, thrombolytic treatment with streptokinase was introduced. In the further course of hospitalization, ischaemic stroke was diagnosed despite the resolution of intracardiac thrombi observed on serial control echocardiography. PMID:19793726

  10. Pathology Case Study: Bladder Mass in a 73-Year-Old Male

    NSDL National Science Digital Library

    Hakam, Ardeshir

    This case study, from the University of Pittsburgh School of Medicine's Department of Pathology, presents information about a 73-year-old male patient. According to the patient's history, he has a "history of invasive papillary transitional cell carcinoma with excessive muscular invasion and angiolymphatic invasion." Both gross and microscopic images of the prostate, bladder, pelvic lymph nodes, and the right and left pelvic ureter are provided in this case. Using these images and the provided patient history, students can test their knowledge of pathology and compare their diagnostic findings with the official findings in the "Final Diagnosis" section.

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

    NSDL National Science Digital Library

    Richert, Charles A.

    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.

  12. Pathology Case Study: Renal Tumor in a 44-Year-Old Male

    NSDL National Science Digital Library

    Richert, Charles A.

    This is a case study presented by the University of Pittsburgh Department of Pathology in which a 44-year-old male has hypernephroma, left renal tumor. 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 renal pathology.

  13. Undiagnosed interrupted aortic arch in a 59-year-old male patient with severe aortic valve stenosis: A case report and literature review

    PubMed Central

    Mehrpooya, Maryam; Eskandari, Ramin; Salehi, Mehrdad; Shajirat, Zeinab; Golabchi, Allahyar; Satarzadeh, Roya; Zand-Parsa, Amir Farhang

    2014-01-01

    BACKGROUND Interrupted aortic arch (IAA) is defined by a lack of the luminal continuity between the ascending and descending thoracic aorta. It is a rare, severe congenital heart defect which without surgery is associated with high mortality in the neonatal period. The aims of this study were to present a case with IAA who was alive until the age of 59 years without any surgical intervention and to review the literatures that have presented IAA cases. CASE REPORT The patient was admitted with respiratory distress and pulmonary edema. Echocardiography showed the sever stenosis in aortic valve and sever left ventricular dysfunction. Cardiac catheterization and angiography confirmed interrupted aorta (type A). The descending thoracic aorta was supplied by extensive collateral vessels from the vertebrobasilar system down to the posterior chest wall and the spine. Surgical correction including coronary artery bypass graft and aortic valve replacement and repair of interruption of the aorta was performed. Three weeks later the patient was died due to uncontrollable gastrointestinal bleeding and hospital acquired pneumonia. We described diagnosis and management of our case. CONCLUSION This case was very interesting for us, because the patient had not been diagnosed until the recent presentation. Similar cases with this diagnosis do not reach adulthood, but our patient was alive up to 59 years of age. PMID:25258640

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

    PubMed

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

    2014-11-01

    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

  15. [37-year old patient with fever, diarrhea and lymphadenopathy].

    PubMed

    Kreft, B; Oehme, A; Lübbert, C; Marsch, W C; Kekulé, A S

    2010-08-01

    A 37-year-old homosexual man was admitted because of oropharyngeal pain, fever, diarrhea, loss of weight and lymphadenopathy since one week. Acute retroviral syndrome (ARS) in primary HIV type 1 infection was diagnosed, associated with Giardia lamblia infection. Antiinfective and combined antiretroviral treatment was established, and the general condition of the patient rapidly improved. The presented report demonstrates that in case of acute HIV-infection with diarrhea other infections should be considered, particularly with regard to enteropathogens like Giardia lamblia. PMID:20437163

  16. Retrospective review of cancer patients ? 80 years old treated with chemotherapy at a comprehensive cancer center

    PubMed Central

    Choi, Minsig; Jiang, Peter Q; Heilbrun, Lance K.; Smith, Daryn W.; Gadgeel, Shirish M.

    2008-01-01

    Context The percentage of cancer patients ?80 years old is expected to increase in the next few years. However data on the use of chemotherapy in these patients are limited. Objective We conducted a retrospective review to define the profile of patients ? 80 years old who received chemotherapy at our center and assess their survival. Design, Setting and Participants Patients ? 80 years treated with chemotherapy between 1/1/2000 to 12/31/2004 were included in this analysis. Results Of the 4689 patients treated with chemotherapy over the 5 year period, 133 patients (3%) were ? 80 years old. The median age was 83 years. 61% were females and 39% were males. 16% had hematologic tumors and 84% had solid tumors. Gynecological (32%) and aerodigestive cancers (27%) were the most common sites, and lung cancer (22%) was the most common cancer. During the first regimen, 512 cycles of chemotherapy were delivered with a median of 3 cycles (range 1–24 cycles). 49% received single and 51% multidrug regimens. Carboplatin was the most common single agent and carboplatin and paclitaxel was the most common combination among solid tumor patients. 19% of solid tumor patients received radiation with chemotherapy. The 1 year survival among hematologic cancer and solid tumor patients was 65% and 48%, respectively. Stage of disease was the only statistically significant factor predicting survival. Conclusions In cancer patients ? 80 years old selected for chemotherapy, both single and multi-agent therapy appeared to be feasible. PMID:18599305

  17. Effort Thrombosis (Paget-Schroetter Syndrome) in a 16-Year-Old Male

    PubMed Central

    Spencer, Taylor R.; Lagace, Richard E.; Waterman, George

    2014-01-01

    Patient: Male, 16 Final Diagnosis: Effort thrombosis (Paget-Schroetter Sydnrome) Symptoms: Swollen arms Medication: — Clinical Procedure: — Specialty: Metabolic Disorders and Diabetics Objective: Rare disease Background: Thrombotic events in otherwise healthy pediatric patients are rare. In patients presenting with limb swelling, thrombosis must be considered in the differential diagnosis. In pediatric patients with thrombosis, there has been wide variability in the rates of associated thrombophilia. Many pediatric patients may instead have other contributors such as venous catheters or physical activity. Case Report: We present a case of bilateral upper extremity deep venous thrombi in a previously healthy 16-year-old male. The patient presented with swelling and pain in both arms after several days of weight-bearing exercise. Following emergency department evaluation with ultrasound and laboratory testing, the patient was diagnosed with effort thrombosis – also known as Paget-Schroetter syndrome – and rhabdomyolysis. Conclusions: This case of Paget-Schroetter syndrome is distinguished by elevation in creatine kinase and transaminases. While these findings can be due to physical exertion and effort, effort thrombosis is not classically associated with laboratory abnormalities except an elevated D-dimer. The significance of these laboratory test result abnormalities remains unclear. Given the rarity of effort thrombosis, further epidemiological study is warranted to determine if these laboratory findings are seen in other cases, and, if so, what implications they may have for management and prognosis. PMID:25098327

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

    NSDL National Science Digital Library

    Bastacky, Sheldon

    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 patientâ??s history, gross description, and microscopic description of test results are provided to aid readers in understanding the patientâ??s diagnosis. The official final diagnosis is accompanied by a discussion of the contributing doctorâ??s 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 patientâ??s conditions.

  19. An unusual case of ileocaecal tuberculosis in an 80-year-old Caucasian male.

    PubMed

    Kelly, J; Warren, K; Coutts, M; Jenkins, A

    1999-01-01

    An 80-year-old Caucasian male presented with a seven-week history of diarrhoea and weight loss. Distal duodenal biopsies showed partial villous atrophy but he failed to respond to a gluten-free diet. Subsequently he developed a right iliac fossa mass associated with radiological evidence of ileocaecal ulceration. Colonoscopic biopsies from the caecum showed non-caseating granulomata and Ziehl-Neelsen (ZN) staining and culture for acid-fast bacilli (AFB) were negative. Crohn's disease was diagnosed and he was started on steroids. Although he showed an initial response, his condition then deteriorated and he died after six weeks. ZN staining of tissue at postmortem showed AFBs. Although a rare diagnosis in the UK, a high index of suspicion should be maintained for ileocaecal TB in patients with appropriate clinical features, even if classical risk factors for TB are absent. PMID:10344072

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

    PubMed Central

    Sacheli, Aaron; Bauer, Raymond

    2014-01-01

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

  1. A 17 year old male with a testicular fibrothecoma: a case report

    PubMed Central

    2013-01-01

    We herein report the case of a right-sided testicular fibrothecoma in a 17 year old male and review the pertinent literature relatable to this rare, benign lesion. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7738283021019280. PMID:24044431

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

    PubMed Central

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

    2015-01-01

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

  3. Bilateral Pseudarthrosis of the Femoral Neck in a 25-Year-Old Male with Hereditary Hypophosphatemic Rickets

    PubMed Central

    Ossendorf, Christian; Vetter, Thomas; Habermann, Björn; Rommens, Pol M.

    2014-01-01

    Hereditary hypophosphatemic rickets (HHR) is a rare disorder of renal phosphate wasting and the most common form of heritable rickets. Here, we report a case of an active 25-year-old male with HHR showing atraumatic bilateral femoral neck pseudarthrosis after 4 years of consecutive knee pain. A conservative therapy was administered, taking into account both the risks of surgical treatment and the little impairment even in the sport activities which the patient experienced. PMID:24955267

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    NSDL National Science Digital Library

    Nine, Jeff S.

    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.

  7. Lung mass in a 28-year-old male: A case report of a rare tumor

    PubMed Central

    2010-01-01

    A twenty eight-year-old male presented with a two week history of dyspnea, cough, hemoptysis, chest pain, and fever 38-39°C. He also complained of loss of appetite, general weakness and left leg pain for two months preceding admission. He was referred with suspicion of lung tumor to our institution. Chest X-ray showed almost total atelectasis of the right lung with compensatory overinflation of the contralateral lung. Using computed tomography (CT), a lesion of diameter of 19.3 × 14.1 × 19.1 cm in the right lung, pleuritis, TH3 osteolysis, and compensatory overinflation of the left lung was seen. Bronchoscopy revealed a total obstruction of the right main bronchus due to submucosal infiltration and compression of the right main bronchus with negative histology of bronchial biopsy specimens. transthoracic fine needle aspiration revealed celullae suspectae probabiliter neoplasmaticae suggesting tumor fusocellularis. USG of the abdomen revealed liver with numerous heterogeneous, solid areas hypo- and hyperechogenic, some of them with features of liquid or the disintegration up to diameter of 74 mm. Subsequent fine needle aspirations of the thorax and liver revealed fibrolamellar hepatocarcinoma and carcinoma adenoides of the lung. Patient underwent chemotherapy with 5-FU/DDP/VCR with no response. This report presents a case of a rare lung metastasis from FL-HCC. PMID:21147631

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

    PubMed

    Menta, Roger; Howitt, Scott

    2014-12-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

    Menta, Roger; Howitt, Scott

    2014-01-01

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

  11. A 40-year-old male with an intraventricular tumor. Combined tanycytic ependymoma and subependymoma.

    PubMed

    Arvanitis, Leonidas D; Gattuso, Paolo; Nag, Sukriti

    2013-05-01

    Combined tumors showing histologic features of both ependymoma and subependymoma have been described. In this report we present a case of combined tanycytic ependymoma with foci of subependymoma (WHO grade II), occurring in a 40 year-old male, which arose in the wall of the lateral ventricle. The tanycytic ependymoma component showed elongated fibrillary cells with a fascicular pattern of growth, while the subependymoma component showed clustered cell bodies surrounded by a fibrillary stroma with a microcystic appearance.We consider the present case to be an unusual example of tanycytic ependymoma; which to the best of our knowledge has not been associated with a subependymoma. PMID:23587142

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

    NSDL National Science Digital Library

    Schubert, Eric

    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.

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

    NSDL National Science Digital Library

    Schubert, Eric

    This is a gastrointestinal pathology case study presented by the University of Pittsburgh Department of Pathology in which a 52-year-old female has â??cholelithiasis,â?ť 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.

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

    NSDL National Science Digital Library

    Richert, Charles A.

    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

  15. Pathology Case Study: Painful Left Knee Mass in a 58-Year-Old-Male

    NSDL National Science Digital Library

    Flynn, Kevin J.

    This is a case study presented by the University of Pittsburgh Department of Pathology in which a 58-year-old man has a left knee growth which has developed over many years. 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 skeletal and soft tissue pathology.

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

    PubMed Central

    Scantling, Dane; Ross, Curtis; Altman, Howard

    2013-01-01

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

  17. [52-year-old patient with subcutaneous space-occupying lesion in immunosuppression].

    PubMed

    Kolligs, F T; Gerbes, A L; Dürr, E M; Schauer, R; Kessler, M; Jelinek, T; Löscher, T; Bilzer, M

    2003-06-01

    We report the case of a 52-years-old male patient, who was diagnosed with subcutaneous alveolar echinococcosis 6 months after liver transplantation for HCV-related cirrhosis. Nether the explanted nor the transplantated liver revealed an echinococcus focus. Therefore a rare primary extrahepatic manifestation was likely. Interestingly, the echinococcal larvae had developed protoscolices. The development of mature tapeworms in human is a rarity, which could be related to the immunosuppressive therapy after liver transplantation. The patient was curatively treated by surgical removal of the subcutaneous tumor and a postoperative therapy with albendazole. Furthermore, HCV reinfection (genotype 2b) was successfully treated with interferone alpha 2b and ribavirine for 6 months. PMID:14567110

  18. Four-year-olds' beliefs about how others regard males and females.

    PubMed

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

    2013-03-01

    Children's awareness of how others evaluate their gender could influence their behaviours and well-being, yet little is known about when this awareness develops and what influences its emergence. The current study investigated culturally diverse 4-year-olds' (N = 240) public regard for gender groups and whether exposure to factors that convey status and highlight gender influenced it. Children were asked whether most people thought (i) girls or boys, and (ii) women or men, were better. Overall, children thought others more positively evaluated their own gender. However more TV exposure and, among girls only, more traditional parental division of housework predicted children stating that others thought boys were better, suggesting more awareness of greater male status. Children's public regard was distinct from their personal attitudes. PMID:23331111

  19. [Central retinal artery occlusion in a 21-year-old male amateur bodybuilder].

    PubMed

    Elikowski, Waldemar; Grzybowski, Andrzej; Ma?ek, Ma?gorzata; Swidurski, Wojciech; Kurosz, Jolanta; Zawilska, Krystyna

    2010-06-01

    The etiology of central retinal artery occlusion (CRAO) is usually associated with atherosclerotic risk factors and the presence of intravascular (carotid artery, aortic arch) or intracardiac embolic material. At young age, CRAO may be a manifestation of inherited or acquired thrombophilia. The authors present a case of CRAO in a 21-year-old, previously healthy, non-smoking male, with neither metabolic nor hemostatic abnormalities and with normal echocardiography. However, he had a positive family history of premature coronary heart disease and a history of anabolic-androgenic steroids (AAS) use during amateur bodybuilding. We have not found an example of CRAO in the literature on various, systemic thromboembolic complications following AAS use. PMID:20642105

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

    NSDL National Science Digital Library

    Krisky, David

    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 patientâ??s spine, along with microscopic images and a gross description of the condition. The official diagnosis found in the â??Final Diagnosisâ?ť section is accompanied by a discussion of the contributing doctorâ??s 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 patientâ??s conditions

  1. QUALITY OF LIFE FOLLOWING SPINAL CORD INJURY FOR 20-40 YEAR OLD MALES LIVING IN SRI LANKA

    Microsoft Academic Search

    Paul Chappell; Sheila Wirz

    2003-01-01

    This study aimed to find out the quality of life achieved by 20-40 year old males living in Sri Lanka who have either received rehabilitation or have not following spinal cord injury. The study used both quantitative and qualitative methods to answer the research question. Data was collected by using a questionnaire within semi- structured interviews with 20 SCI males,

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

    PubMed Central

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

    2013-01-01

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

  3. A Puzzle of Hemolytic Anemia, Iron and Vitamin B12 Deficiencies in a 52-Year-Old Male

    PubMed Central

    Liana, Palacci; Ali, Alaa M.; Gilman, Alan D.

    2013-01-01

    A 52-year-old male with no significant past medical history reports increasing generalized fatigue and weakness for the past 2 weeks. Physical examination reveals jaundice and pallor without organomegaly or lymphadenopathy. His hemoglobin was 5.9?g/dL with a mean corpuscular volume of 87.1?fL and elevated red blood cell distribution width of 30.7%. His liver function test was normal except for elevated total bilirubin of 3.7?mg/dL. Serum LDH was 701?IU/L, and serum haptoglobin was undetectable. Further investigation revealed serum vitamin B12 of <30?pg/mL with elevated methylmalonic acid and homocysteine level. In addition, serum ferritin and transferrin saturation were low. The patient was diagnosed with hemolytic anemia secondary to vitamin B12 deficiency with concomitant iron deficiency anemia. PMID:24083040

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

    PubMed

    Dacombe, Peter Jonathan

    2013-01-01

    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

  5. Evaluation of specific anaerobic power in 12–14-year-old male rowers

    Microsoft Academic Search

    Pavle Mikuli?; Lana Ruži?; Goran Markovi?

    2009-01-01

    No previous study had applied the modified Wingate rowing test to young athletes (i.e. children and adolescents). The aims of this study were to evaluate the trial-to-trial reliability of a rowing-modified Wingate test in a group of 12–14-year-old rowers (n=98) and to compare anaerobic power values among the 12-, 13-, and 14-year-old rowers after accounting for differences in physical maturity

  6. Clinical outcome of thymic lymphoepithelioma-like carcinoma: Case report of a 14-year-old male

    PubMed Central

    SEKIHARA, KUNIKO; OKUMA, YUSUKE; KAWAMOTO, HIROSHI; HOSOMI, YUKIO

    2014-01-01

    Thymic carcinoma is a rare type of cancer, which arises from the thymic epithelium and accounts for ~1–4% of anterior mediastinal tumors in the USA. It rarely occurs in children, and is rarer among adults. Thymic lymphoepithelioma-like carcinoma (LELC) is an uncommon subtype of thymic carcinoma in children, however, it is one of the common histological subtypes of thymic carcinoma in adults. In the present study, a 14-year-old male patient presented to the Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital (Tokoyo, Japan) with chest pain due to a large anterior mediastinal mass. The patient was histologically diagnosed with thymic LELC via a needle biopsy specimen, which was obtained from the primary site and indicated the Epstein-Barr virus infection, whose markers are also associated with oncogenesis. Immunohistochemical analysis demonstrated positive staining for keratin (AE1/AE3), epithelial membrane antigen, and latent membrane protein-1 and negative staining for cluster of differentiation 5. Thus, the patient was diagnosed with metastatic thymic LELC. First-line chemotherapy comprising of a cisplatin- and adriamycin-based chemotherapy regimen achieved a partial response, however, the patient succumbed within 10 months of the initial diagnosis due to rapid disease progression and refractory to subsequent cycles of chemotherapy. Thus, the current study, as well as previously reported cases, demonstrates that pediatric patients with thymic LELC continue to have a poor prognosis. PMID:25295106

  7. Clinical outcome of thymic lymphoepithelioma-like carcinoma: Case report of a 14-year-old male.

    PubMed

    Sekihara, Kuniko; Okuma, Yusuke; Kawamoto, Hiroshi; Hosomi, Yukio

    2014-11-01

    Thymic carcinoma is a rare type of cancer, which arises from the thymic epithelium and accounts for ~1-4% of anterior mediastinal tumors in the USA. It rarely occurs in children, and is rarer among adults. Thymic lymphoepithelioma-like carcinoma (LELC) is an uncommon subtype of thymic carcinoma in children, however, it is one of the common histological subtypes of thymic carcinoma in adults. In the present study, a 14-year-old male patient presented to the Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital (Tokoyo, Japan) with chest pain due to a large anterior mediastinal mass. The patient was histologically diagnosed with thymic LELC via a needle biopsy specimen, which was obtained from the primary site and indicated the Epstein-Barr virus infection, whose markers are also associated with oncogenesis. Immunohistochemical analysis demonstrated positive staining for keratin (AE1/AE3), epithelial membrane antigen, and latent membrane protein-1 and negative staining for cluster of differentiation 5. Thus, the patient was diagnosed with metastatic thymic LELC. First-line chemotherapy comprising of a cisplatin- and adriamycin-based chemotherapy regimen achieved a partial response, however, the patient succumbed within 10 months of the initial diagnosis due to rapid disease progression and refractory to subsequent cycles of chemotherapy. Thus, the current study, as well as previously reported cases, demonstrates that pediatric patients with thymic LELC continue to have a poor prognosis. PMID:25295106

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

    PubMed

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

    1999-01-01

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

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

    PubMed

    Lopez, Daniel; Sarac, Timur; Lorenz, Robert

    2015-01-01

    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

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

    ERIC Educational Resources Information Center

    Holaday, Margot; And Others

    1994-01-01

    Discusses how 6 months after psychological intervention for an eating disorder, a 15-year-old male was diagnosed with Crohn's disease, a chronic inflammatory bowel disease. Addresses need for additional training for those from traditional school and counseling psychology programs. Advocates a team approach and consultations. (RJM)

  11. Treatment of advanced gastrointestinal stromal tumors in patients over 75 years old: clinical and pharmacological implications.

    PubMed

    Italiano, A; Saada, E; Cioffi, A; Poulette, S; Bouchet, S; Molimard, M; Adenis, A; Isambert, N; Collard, O; Le Cesne, Axel; Maki, Robert G; Bui, B

    2013-12-01

    Data about the patterns of care and the specific outcome of elderly patients with advanced gastrointestinal stromal tumors (GISTs) are almost nonexistent. Between 2001 and 2009, 44 patients ?75 years old with advanced GISTs started first-line imatinib (400 mg/day) in seven participating institutions. Clinical data were collected by reviewing medical records and were entered in a comprehensive database. During the same period, 160 patients with advanced GIST (136 patients <75 years old, 24 patients ?75 years old) had access to an imatinib blood level testing program. Imatinib plasma concentration (patient dose 400 mg/day) tests were centralized in a single laboratory. Median age was 78 years old (range 75-86). Thirty-six patients (82 %) experienced at least one adverse event (Table 2). Drug-related adverse events were mainly of grades 1 and 2 and were medically manageable. Permanent dose reduction (200-300 mg/day) was required for 20 patients (45.5 %) and was significantly more frequent for patients with performance status (PS) ?2: 33.5 versus 8.5 %, p?=?0.04. Eight patients (18 %) required imatinib interruption for intolerance. Median PFS was 34.4 months (95 % CI 11.5-57.4) (Fig. 1). Median overall survival (OS) was 50.3 months (95 % CI 37-63.5). Performance status <2 was the sole pre-therapeutic factor associated with improved OS. No correlation was found between comorbidities and tolerance or outcome. Imatinib trough plasma concentrations increase with age, although this correlation did not reach statistical significance. First-line imatinib is a feasible and effective treatment in patients with advanced GISTs ?75 years. Aging seems to have only a moderate impact on imatinib pharmacokinetics. Overall survival is similar to that of younger patients. Comorbidities did not result in increased incidence of toxicity. Careful follow-up regarding tolerance issues should be considered in elderly patients with poor PS. PMID:23263874

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  13. Evaluation of specific anaerobic power in 12-14-year-old male rowers.

    PubMed

    Mikuli?, Pavle; Ruzi?, Lana; Markovi?, Goran

    2009-11-01

    No previous study had applied the modified Wingate rowing test to young athletes (i.e. children and adolescents). The aims of this study were to evaluate the trial-to-trial reliability of a rowing-modified Wingate test in a group of 12-14-year-old rowers (n=98) and to compare anaerobic power values among the 12-, 13-, and 14-year-old rowers after accounting for differences in physical maturity and body size. Each subject performed two "all-out" 30-s trials on a Concept II rowing ergometer. The trials were separated by a 15-min active recovery period, which included walking and stretching and ensured the participants' full recovery. The test proved to be highly reliable, with coefficients of variations of 2.4 and 2.9% (CI=2.1-3.4%) and intraclass correlation coefficients of 0.994 and 0.996 (CI=0.991-0.997) for mean power and peak power, respectively. The ANCOVA analyses accounting for differences in body size and level of physical maturity (assessed using indices of pubic hair) and the Bonferroni post hoc tests identified the 14-year-olds as having significantly greater adjusted mean power and peak power values (P<0.01) than the other two age groups, while the differences between the 12- and 13-year-olds in terms of mean power and peak power were not significant. Our findings indicate (1) that the rowing-modified Wingate test may be reliably used for the assessment of specific anaerobic performance in 12-14-year-old rowers and (2) that factors other than physical maturity and body size are partly responsible for the increase in anaerobic power during growth. PMID:18762452

  14. Multifocal cutaneous alternariosis in a 70-year-old Kenyan renal transplant patient.

    PubMed

    Michelon, Melissa; Greenlaw, Sheila; O'Donnell, Patrick; Geist, David; Levin, Nikki A

    2014-07-01

    Alternaria species are a group of dematiaceous fungi that are ubiquitous in nature and are becoming an increasingly important cause of disease in immunocompromised patients. We present a case of a 70 year old renal transplant recipient with multiple areas of cutaneous Alternaria infections likely introduced during local trauma. Treatment has required a combination of systemic therapy and surgical excision. This case illustrates the importance of recognizing fungal infections with cutaneous manifestations, such as alternariosis, in immunosuppressed patients. PMID:25046464

  15. [82-year old patient with hyperostosis frontalis, prognathism, makroglossia and cutis gyrata. Acromegaly].

    PubMed

    Mönnich, H; Böhm, B O; Weidenbach, H

    2004-07-01

    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

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

    PubMed Central

    Foering, Kristen

    2014-01-01

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

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

    PubMed

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

    2010-01-01

    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

  18. Correlates of weight loss and muscle-gaining behavior in 10- to 14-year-old males and females

    Microsoft Academic Search

    Gail McVey; Stacey Tweed; Elizabeth Blackmore

    2005-01-01

    Background. This study examined the influence of appearance and social acceptance esteem, awareness and internalization of media stereotypes, body size acceptance, and teasing on the weight loss and muscle-gaining behaviors of 10- to 14-year-old boys and girls. Methods. Male (n = 670) and female (n = 788) students were drawn from one of four public senior middle schools (grades 6-8)

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

    PubMed Central

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

    2014-01-01

    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. PMID:25566060

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

    PubMed Central

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

    2015-01-01

    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

  1. Imaging observations of pulmonary inflammatory myofibroblastic tumors in patients over 40 years old

    PubMed Central

    WU, JIANG; ZHU, HONG; LI, KAI; YUAN, CAI-YUN; WANG, YAN-FEN; LU, GUANG-MING

    2015-01-01

    Pulmonary inflammatory myofibroblastic tumors (PIMTs) are extremely rare in adults. If occurring in patients >40 years old, PIMT should be rapidly distinguished from lung cancer. The present study aimed to characterize the imaging features of PIMT in patients >40 years old in order to improve the diagnosis of PIMT. The imaging data of 10 patients with PIMT were reviewed retrospectively. Of the patients, eight underwent computed tomography (CT), two underwent positron emission tomography (PET)/CT and four underwent single-photon emission computed tomography (SPECT). Unenhanced CT revealed 10 lesions with a maximum diameter ranging between 5 and 57 mm located in the lower (n=6) or upper (n=4) lobe, in a peripheral (n=9) or central (n=1) region, and that were well- (n=4) or ill-defined (n=6), and round to oval (n=5) or irregular (n=5) in shape. Calcification (n=3), necrosis (n=6), cavity (n=4), air bronchogram (n=6) and obstructive pneumonia (n=1) were also observed in the patients. Contrast-enhanced CT revealed six lesions with moderate to high contrast enhancement in the arterial and venous phases, including four lesions with delayed enhancement. PET/CT identified two lesions with increased tracer uptake that were homogeneous and heterogeneous and each exhibited a maximal standard uptake value (SUVmax) of 6.0 and 5.4, respectively. The delayed PET/CT revealed foci that each exhibited an increased SUVmax of 6.9 and 5.9, respectively. SPECT demonstrated no definitive bone metastases, but did reveal atypical hypertrophic pulmonary osteoarthropathy in one patient. The combined imaging methods may lead to a more precise evaluation of PIMT in patients >40 years old. PMID:25789060

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

    PubMed Central

    Uwatoko, Shugo; Yamamoto, Kentaroh; Sasaki, Takamitsu; Fukumori, Daisuke; Igimi, Hirotsune; Yamamoto, Mami; Yamamoto, Fumio; Yamashita, Yuichi

    2015-01-01

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

  3. Recurrent Anion Gap Acidosis: An Unusual Presentation of X-Linked Adrenoleukodystrophy in a Five-year-old Male

    PubMed Central

    Schwab, Joel; Pena, Loren; Sigman, Laura; Waggoner, Darrel

    2010-01-01

    We are presenting a five-year-old male with recurrent anion gap acidosis. During his last admission, it was detected that he had elevated VLCFA and the evaluation discovered that he had X-linked Adrenooleukodystrophy. He had the Addisonian only phenotype without any clinical or radiographic CNS findings. We were unable to find any other reports of this presentation of ALD. If the work-up of recurrent anion gap acidosis does not uncover an etiology, X-linked ALD should be considered in the differential diagnosis. PMID:23926373

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

    SciTech Connect

    Bouchard, A.; Sanz, N.; Botvinick, E.H.; Phillips, N.; Heilbron, D.; Byrd, B.F. 3d.; Karam, J.H.; Schiller, N.B. (Univ. of California, San Francisco (USA))

    1989-08-01

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

  5. Grade IV renal trauma in a 17–year–old patient

    PubMed Central

    Thimary, Felix; Pummer, Karl

    2013-01-01

    Renal trauma occurs in 1–5% of all trauma cases. The kidney is the most commonly injured genitourinary and abdominal organ. In this case we present a 17–year–old patient with a grade IV trauma of the left kidney with renal rupture, hematoma, and urinoma. He was referred to our hospital in hemodynamic stability; therefore, a conservative approach was chosen. One year after the accident the patient was free from symptoms, and the renal function was normal; CT–scan revealed neither hematoma nor urinoma. Since nothing is known on the long–term outcomes in patients with severe renal traumas, long–term follow up studies are highly recommended. PMID:24579037

  6. Disseminated Mycobacterium haemophilum infection in a 72-year-old patient with rheumatoid arthritis on infliximab

    PubMed Central

    Collins, C Scott; Terrell, Christine; Mueller, Paul

    2013-01-01

    Mycobacterium haemophilum is a slow growing, aerobic, fastidious mycobacterium requiring hemin and a temperature of 30–32° C for optimal growth that is ubiquitous in nature. Disease in immunocompromised adults typically manifests as skin lesions such as papules, pustules and ulcerations. This organism also causes lymphadenitis in immunocompetent children. Antitumour necrosis factor-? (anti-TNF-?) therapy with agents such as infliximab, etanercept and adalimumab is increasingly being used for immunosuppression in patients with various autoimmune conditions. These agents are known to place patients at increased risk for tuberculosis and other granulomatous diseases. However, little is known about illness caused by M haemophilum in patients on immunosuppression with anti-TNF-? therapy. We describe a case of disseminated M haemophilum manifesting as skin lesions in a 72-year-old man with rheumatoid arthritis on infliximab and methotrexate. PMID:23505273

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2014-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  10. Cardiovascular responses to light isometric and aerobic exercise in 21- and 59-year-old males

    Microsoft Academic Search

    Stephen H. Boutcher; Dean Stocker

    1999-01-01

    The effects of aging on the cardiovascular response to continuous light isometric and aerobic exercise remains to be determined.\\u000a Thus, the purpose of this study was to compare the cardiovascular response of young and older males during light handgrip\\u000a and cycle ergometry exercise. Blood pressure, heart rate, rate pressure product, as well as pre-ejection period (derived from\\u000a impedance cardiography) were

  11. Possible hepatotoxicity associated with intravenous acetaminophen in a 36-year-old female patient.

    PubMed

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

    2015-02-01

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

  12. Rupture of a splenic artery aneurysm in a previously healthy 53-year-old male

    PubMed Central

    Papadomichelakis, A; Anyfantakis, D; Kastanakis, M; Karona, P; Bobolakis, E

    2014-01-01

    Splenic artery aneurysms are unusual clinical conditions that may be ruptured resulting into adverse health outcomes. Pregnancy, portal hypertension and atherosclerosis are conditions that predispose to the formation of splenic artery aneurysms. A rare case of a previously healthy man referred to our department by his general practitioner complaining of acute abdominal pain is presented. During the hospital stay, the patient presented hemodynamic instability. Abdominal computed tomography disclosed perihepatic and perisplenic fluid accumulation. A diagnosis of ruptured splenic artery aneurysm was performed and the patient was operated successfully with splenectomy and ligation of the splenic artery. Although the condition is rare, physicians have to be aware of the high mortality rates caused by a ruptured splenic artery aneurysm and include this in the differential diagnosis when they encounter patients with acute abdominal pain and hemodynamic instability.

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

    NSDL National Science Digital Library

    Dorvault, Christine

    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.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

    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

  16. WHO Grade 2 Neuroendocrine Tumor in a 15-Year-Old Male: A Case Report and Literature Review

    PubMed Central

    Nguyen, Van

    2014-01-01

    Neuroendocrine tumors, distinguished from adenocarcinomas by their neuroendocrine differentiation, are the most common pediatric epithelial malignancy that most often occurs in the appendix. In 2010, the WHO classified neuroendocrine neoplasms into three grades based on morphology, mitotic count, and Ki67 proliferation index. A 15-year-old male with a history of anemia and failure to thrive was diagnosed with a well-differentiated neuroendocrine tumor in the jejunum that invaded into the subserosal soft tissue and metastasized to four lymph nodes. Pediatric neuroendocrine tumors frequently arise within hereditary tumor syndromes with pancreatic neuroendocrine tumors being the most common. Several studies also indicate an elevated risk of small intestinal neuroendocrine tumors in which children born to a parent with a history of neuroendocrine tumors in the small intestine have a significant increased risk of developing one. PMID:25525544

  17. Divorce and remarriage in a 65-year-old male following transphenoidal surgery and bromocriptine of hyperprolactinemic impotence: a dilemma.

    PubMed

    Tolis, G; Bertrand, G; Pinter, E

    1979-12-01

    Hyperprolactinemia, hypogonadotropinism, and subnormal plasma testosterone were found in a 65-year-old patient who had an enlarged sella turcica, complained of fatigue, and addmitted to decreased sexual interest and potency. Selective nontotal tumorectomy followed by bromocriptine therapy resulted in normoprolactinemia, increased plasma testosterone, and "rejuvenation difficult to follow" according to his wife. This patient described his sexual status as comparable to that of age 24 when he fathered his only child. Both wife and husband attributed the changes to bromocriptine and requested discontinuation (wife) and continuation (husband) of the treatment; because of the clinical indications, treatment was continued. Legally, a medical certification of a normal state of health was required before divorce--and subsequent marriage to a young woman--were permitted. PMID:545426

  18. Multiple supernumerary teeth in a nonsyndromic 12-year-old female patient - a case report.

    PubMed

    Santos, Thiago de Santana; Silva, Erick Ricardo; Faria, Ana Célia; Mello Filho, Francisco Veríssimo de; Xavier, Samuel Porfírio

    2014-01-01

    Supernumerary teeth (ST) are uncommon alterations of development that may appear in either of the dental arches and that are frequently associated with syndromes such as cleidocranial dysplasia and Gardner syndrome. Multiple ST in individuals with no other disease or syndrome are very rare. In view of this situation, correct diagnosis, treatment and evaluation of ST with the use of appropriate imaging techniques are highly important. This case report presents radiographic images of a nonsyndromic 12-year-old female patient who presented with 14 supernumerary teeth and was treated under general anesthesia, with the extraction of all ST in a single surgical intervention. During the postoperative period, the patient did not complain of pain nor did she present any signs or symptoms of infection. During late follow-up period, due to difficulty in traction of the maxillary right canine and mandibular left first premolar towards the dental arch, it was necessary to extract these teeth under local anesthesia. Radiographic examination 3 years after surgery revealed the absence of ST and of diseases related to the existence of these teeth. PMID:24789298

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

    PubMed

    Chibishev, Andon; Simonovska, Natasa

    2014-08-01

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

  20. [Diagnostic problems in a 17-year-old patient with gastrointestinal manifestations of Fabry disease].

    PubMed

    Buda, Piotr; Wieteska-Klimczak, Anna; Ksiazyk, Janusz; Smorczewska-Kiljan, Anna; Gietka, Piotr; Czartoryska, Barbara; Tylki-Szyma?ska, Anna

    2011-01-01

    Fabry disease is a rare X-linked recessive lysosomal storage disorder caused by deficiency of lysosomal enzyme alpha-galactosidase, which leads to accumulation of globotriasylceramides (GL-3) in visceral tissues and vascular endothelium, causing multi-organ failure. We presenta case of Fabry disease in a 17-year-old patient with mainly gastrointestinal manifestations, diagnosed 10 years after the manifestation of first symptoms. Significant and progressive weight loss with abdominal pain and vomiting, leading to cachexia, were observed in early childhood. The patient was investigated for non-inflammatory bowel diseases, Raynaud syndrome, polimyositis, mitochondrial cytopathies, intestinal lypodystrophies and others. The symptoms of intenstinal pseudo-obstruction syndrome were observed and surgical treatment was instituted because of necrosis of the colon. There was progressive cachexia and parenteral nutrition had to be instituted. Finally, plasma alpha-galactosidase was measured, and its deficit confirmed Fabry disease. In conclusion gastrointestinal symptoms in the course of Fabry disease can obscure other characteristic symptoms, may be prodromal and leading. Heart and renal failure may not occur in children. Unexplained abdominal pain and malnutrition may be gastrointestinal manifestations of metabolic disorders. PMID:21786514

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

    PubMed Central

    Alahmadi, Raha; Almuhammadi, Saud

    2014-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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. PMID:25692058

  3. 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

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

    2014-01-01

    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

  4. Persistent left superior vena cava with an absent right superior vena cava in a 72-year-old male with multivessel coronary artery disease.

    PubMed

    Szymczyk, K; Polguj, M; Szymczyk, E; Majos, A; Grzelak, P; Stefa?czyk, L

    2013-08-01

    Congenital anomalies of systemic veins are usually asymptomatic and found incidentally during ultrasonography, computed tomography (CT) or magnetic resonance examinations performed for other clinical indications. Persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC) is the congenital aberration in the thoracic venous system which occurs in only 0.09%to 0.13% of patients who have congenital heart defects. In this paper, we present the extremely rare case of a 72-year-old male with PLSVC associated with an absence of RSVC, referred for coronary CT angiography. Multidetector CT angiography is a powerful tool for the detection of venous anomalies, which is essential before invasive procedures such as the implantation of pacemakers. PMID:24068691

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

    PubMed Central

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

    2011-01-01

    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

  6. Complex percutaneous coronary intervention of the left coronary artery with rotational atherectomy in an 84-year-old dialysed patient

    PubMed Central

    Kralisz, Pawe?; Bachórzewska-Gajewska, Hanna; Dobrzycki, S?awomir

    2013-01-01

    Coronary artery disease in patients with end-stage renal disease occurs several dozen times more often than in the general population. Atherosclerotic changes in coronary arteries in dialysed patients are more diffused and calcified, which hampers the percutaneous coronary angioplasty. We present a case of an 84-year-old dialysed patient, in whom complex percutaneous coronary intervention of the left anterior descending artery was performed with the use of rotational atherectomy. PMID:24570743

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

    PubMed

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

    2015-03-01

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

  8. Pyonephrosis and urosepsis in a 41-year old patient with spina bifida: Case report of a preventable death

    PubMed Central

    2012-01-01

    Background Urological complications are the major cause of ill health in patients with spina bifida. Urinary sepsis accounted for the majority of admissions in patients with spina bifida. As the patient grows older, changes occur in the adult bladder, leading to increases in storage pressure and consequent risk of deterioration of renal function, which may occur insidiously. Case presentation A 34-year-old male spinal bifida patient had been managing neuropathic bladder by penile sheath. Intravenous urography revealed normal kidneys. This patient was advised intermittent catheterisations. But self-catheterisation was not possible because of long, overhanging prepuce and marked spinal curvature. This patient developed repeated urine infections. Five years later, ultrasound examination of urinary tract revealed hydronephrotic right kidney with echogenic debris within the collecting system. There was no evidence of dilatation of the ureter near the vesicoureteric junction. The left kidney appeared normal. There was no evidence of calculus disease seen in either kidney. Indwelling urethral catheter drainage was established. Two years later, MAG-3 renogram revealed normal uptake and excretion by left kidney. The right kidney showed little functioning tissue. Following a routine change of urethral catheter this patient became unwell. Ultrasound examination revealed hydronephrotic right kidney containing thick hyper-echoic internal septations and debris in the right renal pelvis suspicious of pyonephrosis. Under both ultrasound and fluoroscopic guidance, an 8 French pig tail catheter was inserted into the right renal collecting system. 150?ml of turbid urine was aspirated immediately. This patient developed large left pleural effusion, collapse/consolidation of the left lower lobe, a large fluid collection in the abdomen extending into the pelvis and expired twenty days later because of sepsis and respiratory failure. Conclusion Although penile sheath drainage may be convenient for a spina bifida patient and the carers, hydronephrosis can occur insidiously. With recurrent urine infections, hydronephrotic kidney can become pyonephrosis, which is life-threatening. Therefore, every effort should be made to carry out intermittent catheterisations along with antimuscarinic drug therapy. PMID:22613462

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

    PubMed

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

    2014-01-01

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

  10. Mucinous Cystadenoma Arising in a Mature Cystic Teratoma in a 25-Year-Old Patient

    PubMed Central

    Pintea, Michelle D.

    2014-01-01

    Coexistence of a mucinous cystadenoma arising in a mature cystic teratoma is infrequently reported. Herein a case of a 25-year-old woman diagnosed with a right ovarian mucinous cystadenoma arising in a mature cystic teratoma is reported. She presented with lower right abdominal discomfort. Ultrasound showed a 14.8 × 7.9 × 12.5?cm structure on the right adnexa. She underwent a diagnostic laparoscopy, which was converted to exploratory laparotomy, during which a right salpingo-oophorectomy was performed. PMID:24891964

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

    PubMed

    Ceretti, M; Fanelli, M; Pappalardo, S

    2014-01-01

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

  12. [Spontaneous spinal epidural haematoma causing rapid flaccid paraplegia in a healthy 25-year-old patient].

    PubMed

    Colsy, M; Argote, C; Raimbault, M; Touchard, P

    2007-06-01

    Although clinical presentation of a spinal epidural compressive haematoma is well recognized, causing acute radicular pain shortly followed by cord compression syndrome, its aetiology may pose a quandary. Rare and most commonly seen after trauma, spinal surgery, epidural anaesthesia, anticoagulation therapy, vascular malformation or coagulopathy (haemophilia), spinal epidural haematoma (SHE) can be spontaneous. Surgical decompression remains the mainstay treatment especially when the prognosis depends on the interval to surgery and the severity of preoperative neurological deficit. We report the case of a healthy 25-year-old man who presented, three days after an acute back pain, a flaccid paraplegia with urinary retention. Magnetic resonance imaging of the spinal column identified a compressive SHE extending from T3 to T6, requiring an early laminectomy. After decompression, clinical outcome revealed a complete recovery excepted some mild sensibility trouble remains. PMID:17462853

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

    PubMed Central

    Sheehan, Lisa; Anwar, Adeel; Kommu, Sashi

    2014-01-01

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

  14. Gastric Squamous Papilloma in a 52-Year-Old Female Patient

    PubMed Central

    Jang, Hyung Ha; Kim, Su Jin; Choi, Choel Woong; Park, Su Bum; Song, Byeong Jun; Shin, Dong Hoon; Kang, Dae Hwan

    2014-01-01

    A papilloma is a benign epithelial lesion characterized by finger-like projections of tissue lined by an overgrowth of squamous cells and a core of connective tissue. We report a case of squamous papilloma on the cardia in a 52-year-old asymptomatic female. Endoscopy showed a 1-cm sized is polyp with hyperemic change originating from the cardia adjacent to the esophagogastric junction, the biopsy of which suggested a diagnosis of squamous papilloma. Endoscopic mucosal resection was performed to obtain a definite diagnosis and the polyp was completely removed. The histological result was compatible with squamous papilloma, and its surrounding tissues showed foveolar epithelium, which suggested a stomach origin. This is the first report of endoscopic resection of a gastric squamous papilloma. Squamous papilloma should be considered in the differential diagnosis of a gastric polyp, especially one in the cardia. As the prognostic value of a squamous papilloma is not well known, we recommend endoscopic resection to treat a gastric squamous papilloma, when possible. PMID:25505726

  15. Pheochromocytoma in an 8-year-old patient with Multiple Endocrine Neoplasia Type 2A: Implications for Screening

    PubMed Central

    Rowland, Kathryn J; Chernock, Rebecca D; Moley, Jeffrey F

    2014-01-01

    Background Multiple endocrine neoplasia type 2 (MEN2) is an autosomal dominant hereditary cancer syndrome caused by mutations in the RET proto-oncogene. In patients with MEN 2A and 2B the penetrance of pheochromocytoma is variable and childhood pheochromocytoma in the setting of MEN 2 remains rare. Patient and Intervention We present the case of an 8-year-old female with known MEN 2A, C634Y RET mutation, found to have markedly elevated plasma normetanephrines and total metanephrines, and diagnosed with a 6 cm pheochromocytoma requiring laparoscopic unilateral adrenalectomy. Conclusions Given this patient’s age at diagnosis, current screening guidelines should recommend annual screening beginning at age 8 for patients with MEN 2B or for patients with MEN 2A with codons 630 or 634 RET mutations. PMID:23868299

  16. Classic Kaposi's sarcoma treated with elastic stockings and outpatient follow-up of a 90-year-old patient*

    PubMed Central

    Trevisan, Flavia; Cunha, Paulo Rowilson; Pinto, Clovis Antonio Lopes; Alves, Celia Antonia Xavier de Moraes

    2013-01-01

    Kaposi's sarcoma is a multifactorial angioproliferative disorder. The herpes virus 8 human contributes to its pathogenesis, but it is uncertain whether these lesions are only reactive hyperplasia to the virus or neoplasia. Four clinical types are described: classic, endemic, iatrogenic and HIV-associated. Classic Kaposi's sarcoma has no standard staging or treatment protocols. Some studies have shown the use of compression stockings in the treatment of lymphedema associated with Kaposi's sarcoma. We report the case of a 90 year-old patient with classic Kaposi's sarcoma treated with compression stockings who showed a satisfactory response. PMID:24346919

  17. A rare type of double aortic arch diagnosed by echocardiography in an asymptomatic 9-year-old patient.

    PubMed

    Trapali, Christina; Nika, Angeliki; Papaphylactou, Maria; Maria, Papaphylactou; Iacovidou, Nicoletta

    2010-07-01

    A case of double aortic arch with an atretic left arch distal to the origin of the left subclavian artery was suspected by echocardiography (ECHO) in an asymptomatic 9-year-old girl and confirmed by magnetic resonance imaging (MRI). The authors report their ECHO findings, which could be an important diagnostic tool for symptomatic patients because confusion exists in the literature regarding the differentiation of the aforementioned rare malformation from a right arch with mirror image branching. The authors support their ECHO proposal with an explanation based on the hypothetical double aortic arch plan set by Edwards. PMID:20204347

  18. Acute simultaneous bilateral avulsion fractures of the tibial tubercles in a 15-year-old male hurler: case report and literature review

    Microsoft Academic Search

    C. Hanley; S. J. Roche; J. Chhabra

    2011-01-01

    Background  Avulsion fractures of the tibial tubercle are an unusual injury pattern generally occurring in the adolescent male during\\u000a sporting activities. Bilateral simultaneous fractures are extremely rare. They are often associated with other underlying\\u000a orthopaedic pathology.\\u000a \\u000a \\u000a \\u000a \\u000a Aims  We present a case of bilateral tibial tubercle avulsions occurring in a 15 year-old male hurler. We describe the management\\u000a and necessary investigations required for this

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

    PubMed Central

    2015-01-01

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

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

    PubMed Central

    2014-01-01

    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

  1. Special Report: 26-Year Durability of a Bioprosthesis Implanted in a 21-Year-Old Patient

    PubMed Central

    Holst, Torulv; Reichert, Josef; Haldenwang, Peter; Moustafine, Vadim; Bechtel, Matthias; Strauch, Justus; Knipp, Stephan

    2014-01-01

    The choice of prosthetic heart valve type is largely dependent upon patient's age at implantation and on what, in his eyes, seems more pertinent: avoidance of complications associated with anticoagulation of mechanical valves or structural valve deterioration of bioprosthetic valves. Long lasting and new promising concepts such as transcatheter aortic valve implantation are promoting the use of bioprosthesis even in younger patients. However, it is up to the individual patient to decide. PMID:25798348

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

    PubMed Central

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

    2014-01-01

    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

  3. Primary autoimmune myelofibrosis in a 36-year old patient presenting with isolated extreme anemia

    PubMed Central

    Santos, Fabio P S; Konoplev, Sergej N; Lu, Huifang; Verstovsek, Srdan

    2015-01-01

    Primary autoimmune myelofibrosis is a very rare condition characterized by peripheral blood cytopenias, bone marrow fibrosis with lymphoid aggregates, and by the finding of autoantibodies in peripheral blood, suggesting a systemic autoimmune process. Patients can be frequently misdiagnosed as having the more common disorder primary myelofibrosis, a myeloproliferative neoplasm. We report the case of a patient with primary autoimmune myelofibrosis with emphasis on the clinical and pathological features that lead to the diagnosis. PMID:19748119

  4. Celiac disease and fulminant T lymphoma detected too late in a 35-year-old female patient: Case report

    PubMed Central

    Maruši?, Marinko; Guli?, Saša; Gašparov, Slavko; Bili?, Ante; Jur?i?, Dragan; Vu?kovi?, Branimir; Stani?, Gabrijela; Lueti?, Krešimir; Dominkovi?, Anto; Su?i?, Tena

    2011-01-01

    Celiac disease is the most common chronic gastroenterological autoimmune disease characterized by gluten intolerance. The diagnosis of celiac disease and enteropathy-associated T cell lymphoma is often made when it is too late. Case report describes a 35-year-old female patient managed for one year under the diagnosis of inflammatory bowel disease and admitted to our hospital for exacerbation of the underlying disease. However, inflammatory bowel disease was ruled out by diagnostic work-up, while the clinical picture and the findings obtained raised suspicion of lymphoma. The patient’s condition was additionally complicated by fulminant course of the disease and ileus. Conclusion:Early diagnosis and appropriate treatment of the disease, and follow up of family members are crucial to prevent intestinal lymphoma development. PMID:21875423

  5. Laparoscopic versus Open Radical Cystectomy for Elderly Patients over 75-Year-Old: A Single Center Comparative Analysis

    PubMed Central

    Yu, Xiaowen; Song, Ruixiang; Wei, Rongchao; Zhao, Junjie; Wang, Linhui; Hou, Jianguo; Sun, Yinghao; Xu, Chuanliang

    2014-01-01

    Purpose To explore the morbidity, mortality and oncological results of laparoscopic radical cystectomy (LRC) in the elderly patients over 75-year-old in contrast with open radical cystectomy (ORC). Materials and Methods We analyzed 46 radical cystectomies from January 2009 to December 2013 in patients over 75-year-old in our institute, 21 patients in the LRC group and 25 in the ORC group. Demographic parameters, operative variables and perioperative outcome were retrospectively collected and analyzed between the two groups. Perioperative morbidity and mortality were categorized as early (within 90 days after surgery) or late (more than 90 days) according to the time of occurrence. Results Patients in both groups had comparable preoperative characteristics. A significant longer operative time (418 vs. 337 min, p?=?0.018) and less estimated blood loss (400 vs. 500 ml p?=?0.038) were observed in LRC group compared with ORC group. Infection and ileus were the most common early complications after surgery. Patients underwent ORC suffered from significantly more postoperative ileus (28.0% vs. 4.8%, P?=?0.038) and infection (40% vs. 9.5%, P?=?0.019) than LRC group within 90 days after surgery. The mortality rate was 4.7% (1/21) and 4% (1/25) for LRC group and ORC group respectively. At a median follow-up of 21 months (range 2–61 months), the Kaplan-Meier survival curves and log-rank analysis demonstrate that there were no significant differences between the LRC and ORC groups in the 3-year overall, cancer-specific, or recurrence-free survival rates. Conclusions It is suggested that LRC should be recommended as the primary intervention to treat muscle invasive or high risk non-muscle invasive bladder cancer in elderly patients with a relative long life expectancy. PMID:24901359

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

    Microsoft Academic Search

    S. B. Kennedy; S. Nolen; J. Applewhite; E. Waiters; J. Vanderhoff

    2007-01-01

    The purpose of this pilot project was to develop, administer and assess a brief male-focused and behavioural-driven condom promotion programme for young adult African American males in an urban setting. To achieve the aims of this study, linkages with local community centres were initially fostered and both quantitative and qualitative research methods were employed. Based on relevant tenets of the

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2013-11-01

    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

  10. Perinatal Exposure to a High-Fat Diet Is Associated with Reduced Hepatic Sympathetic Innervation in One-Year Old Male Japanese Macaques

    PubMed Central

    Grant, Wilmon F.; Nicol, Lindsey E.; Thorn, Stephanie R.; Grove, Kevin L.; Friedman, Jacob E.; Marks, Daniel L.

    2012-01-01

    Our group recently demonstrated that maternal high-fat diet (HFD) consumption is associated with non-alcoholic fatty liver disease, increased apoptosis, and changes in gluconeogenic gene expression and chromatin structure in fetal nonhuman primate (NHP) liver. However, little is known about the long-term effects that a HFD has on hepatic nervous system development in offspring, a system that plays an important role in regulating hepatic metabolism. Utilizing immunohistochemistry and Real-Time PCR, we quantified sympathetic nerve fiber density, apoptosis, inflammation, and other autonomic components in the livers of fetal and one-year old Japanese macaques chronically exposed to a HFD. We found that HFD exposure in-utero and throughout the postnatal period (HFD/HFD), when compared to animals receiving a CTR diet for the same developmental period (CTR/CTR), is associated with a 1.7 fold decrease in periportal sympathetic innervation, a 5 fold decrease in parenchymal sympathetic innervation, and a 2.5 fold increase in hepatic apoptosis in the livers of one-year old male animals. Additionally, we observed an increase in hepatic inflammation and a decrease in a key component of the cholinergic anti-inflammatory pathway in one-year old HFD/HFD offspring. Taken together, these findings reinforce the impact that continuous exposure to a HFD has in the development of long-term hepatic pathologies in offspring and highlights a potential neuroanatomical basis for hepatic metabolic dysfunction. PMID:23118937

  11. Orofacial findings and dental treatment in an 8-year-old patient with trisomy 18: a case report.

    PubMed

    de Queiroz, Alexandra Mussolino; Raffaini, Maria Stella Gaspar Gomes; de Camargo, Laura Maria; de Pina Neto, Joăo Monteiro; Melo, Débora Gusmăo; Silva, Raquel A B

    2007-01-01

    Trisomy 18 is characterized by: psychomotor disabilities, dysmorphic features, organ malformations, including mental retardation, growth deficiency, poor motor ability, micrognathia, microcephaly, congenital heart defects, and kidney abnormalities. The oral findings typically observed in these patients are: cleft lip and a high, narrow, and sometimes cleft palate. The degree of severity of the malformations is directly related to life expectancy. Only 5% to 10% of affected infants survive beyond the first year of life. Although trisomy 18 has been widely investigated from a medical standpoint, there is a lack of reports addressing the oral manifestations and dental treatment approach in affected children, presumably due to their shortened life expectancy. The purpose of this article was to present the case of an 8-year-old child diagnosed with trisomy 18 and address the clinical features observed--emphasizing the disease-specific oral, craniofacial, and dental findings. Dental care management of the patient is described. PMID:18430358

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

    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

    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

  14. A 16YearOld Male with Noonan’s Syndrome Develops Progressive Scoliosis and Deteriorating Gait

    Microsoft Academic Search

    Robert A. Sanford; Robin Bowman; Tadanori Tomita; Guillermo De Leon; Peter Palka

    1999-01-01

    Robin Bowman, MD: This is a male aged 16˝ years, with a complex past medical history involving multiple diagnoses, who was admitted for work-up after presenting with decreased muscle function in his lower extremities, requiring assistance to walk, and decreased endurance with dyspnea. He was born at full term via a normal vaginal delivery. He is a second twin of

  15. A 90-year-old patient presenting with postoperative hypotension and a new murmur: a case report

    PubMed Central

    2014-01-01

    Introduction Hospitalists are frequently consulted on postoperative patients with hypotension. Postoperative hypotension is common and can be due to variety of causes. Systolic anterior motion of the mitral valve leading to left ventricular outflow tract obstruction is a rare cause of postoperative hypotension and can occur without prior structural heart disease. A high index of suspicion can lead to early recognition of this unique condition. Case presentation A 90-year-old Caucasian woman with no known structural heart abnormality was admitted to the intensive care unit with hypotension after a left hip arthroplasty revision. A transthoracic echocardiogram revealed systolic anterior motion of the mitral valve and dynamic left ventricular outflow tract obstruction as the likely cause of her hypotension. Our patient was treated with fluid resuscitation and phenylephrine with improvement in blood pressure. A repeat echocardiogram on postoperative day 5 showed resolution of the left ventricular outflow tract obstruction. Intraoperative vasodilatation and volume loss that caused underfilling of the left ventricle likely led to dynamic outflow tract obstruction in our patient. Conclusions Hospitalists should be aware of systolic anterior motion of the mitral valve as a rare peri-operative complication in patients with or without underlying cardiac pathology as it is treated differently than other causes of peri-operative hypotension. Clinical suspicion, early recognition, and prompt treatment can improve clinical outcomes in these patients. PMID:25384414

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

    PubMed

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

    2012-02-01

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

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    2007-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2015-01-01

    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

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

    PubMed Central

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

    2000-01-01

    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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  5. Endoscopic removal of subgaleal hematoma in a 7-year-old patient treated with anticoagulant and antiplatelet agents

    PubMed Central

    Hayashi, Yasuhiko; Kita, Daisuke; Furuta, Takuya; Oishi, Masahiro; Hamada, Jun-ichiro

    2014-01-01

    Background: Subgaleal hematomas frequently occur in children after head trauma and extend over the cranial sutures. Although conservative treatment suffices in most cases, surgical removal of a subgaleal hematoma is indicated when the patient presents with anemia and headache associated with its progressive enlargement. Case Description: We present the case of a 7-year-old boy who was medicated with warfarin and aspirin due to a hypoplastic left ventricle and fell from a rock wherein he hit his head in the frontal region. Although a computed tomography scan of the head revealed no intracranial lesion, an extracranial hematoma was found to extend over the cranial sutures, leading to the diagnosis of subgaleal hematoma. The hematoma continued to grow gradually despite the cessation of warfarin and aspirin therapy immediately after the head trauma. Since the patient's headache and anemia were progressing as the hematoma enlarged, removal of the hematoma was performed 3 days after admission. Endoscopic hematoma removal was planned to enable accurate coagulation of the sites of bleeding and removal of the maximal amount of hematoma through minimal incision. The hematoma was completely removed, and the patient's postoperative course was excellent with alleviation of both the anemia and the headache. No sign of hematoma recurrence could be detected during 2 years follow-up. Conclusion: An angled endoscope can allow visualization of the deep subgaleal space, and this technique enabled direct visualization of the bleeding sites and accurate coagulation to prevent recurrence of hematoma. Endoscopic techniques, such as minimally invasive techniques, can allow sufficient removal of subgaleal hematoma with minimal morbidity, especially in patients such as ours. PMID:25024898

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

    PubMed Central

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

    2015-01-01

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

  7. [Differential diagnostic considerations in eosinophilia with reference to a 19-year-old patients with Löffler endocarditis].

    PubMed

    Eber, B; Schnider, P; Tiran, A; Marak, M; Samitz, M; Domej, W; Aglas, F

    1992-01-01

    In this case report a 19-year-old girl suffering from hypereosinophilia with 3500 cells/mm3 and involvement of the right lung, lymph nodes, skin, serosa and heart is described. Within 10 days of admission an infiltration of the right upper lung lobe disappeared spontaneously and was diagnosed as transient eosinophilic lung infiltration according to Löffler. Both lymph node needle biopsy and several skin biopsies revealed merely general reactive changes whereas a bronchial lavage produced a significant number of eosinophilic granulocytes. Autoimmunologic or infectious-toxic disorders were ruled out as etiologic causes. Within 4 weeks after admission severe mitral and tricuspidal insufficiency as well as AV-block second grade and protodiastolic galloping rhythm developed in addition to progressing polyserositis. The echocardiographic pattern was in accordance with restrictive endocarditis. Due to the greatly reduced left ventricular ejection fraction cortisone (125 mg prednison equivalent) was tentatively administered as therapy. Within 2 weeks heart-, serosa- and lymph-node-findings became normal as well as the eosinophilic count, the scaling skin rash being only partly improved. After 10 months of continuous cortisone therapy (10 mg prednison equivalent) the patient was without evidence of disease. However in conclusion, it may be said that such pattern of findings suggests a hypereosinophilic syndrome with Löffler endocarditis with an unknown future course of disease although generally survival prognosis may not be too high. PMID:1585784

  8. 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

    Hedayati, Zohreh; Khalafinejad, Fatemeh

    2014-01-01

    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

  9. 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

    Molsberger, Friedrich; Raak, Christa; Witthinrich, Christiane

    2014-01-01

    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

  10. Effect of Postmastectomy Radiotherapy in Patients <35 Years Old With Stage II-III Breast Cancer Treated With Doxorubicin-Based Neoadjuvant Chemotherapy and Mastectomy

    SciTech Connect

    Garg, Amit K. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Oh, Julia L. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)], E-mail: joh@mdanderson.org; Oswald, Mary Jane; Huang, Eugene; Strom, Eric A.; Perkins, George H.; Woodward, Wendy A.; Yu, T. Kuan; Tereffe, Welela [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Meric-Bernstam, Funda [Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Hahn, Karin [Department of Breast Medical Oncology, 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)

    2007-12-01

    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.

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

    PubMed Central

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

    2014-01-01

    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

  12. Blinding bilateral hyperviscosity retinopathy in a 43-year-old nigerian male with lymphoplasmacytic lymphoma: a case report and management challenges.

    PubMed

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

    2014-01-01

    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

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

    PubMed Central

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

    2014-01-01

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

  14. Minoxidil induced hypertrichosis in a 2 year-old child

    PubMed Central

    Herskovitz, Ingrid

    2013-01-01

    We report a case of a 2 year-old male patient who developed generalized hypertrichosis after 2 months of treatment with 5% minoxidil foam for alopecia areata. This report highlights the danger of prescribing  topical minoxidil to young children and the need to correctly instruct caretakers about its administration. PMID:24555107

  15. A Unique Case of Primary Ewing's Sarcoma of the Cervical Spine in a 53-Year-Old Male: A Case Report and Review of the Literature

    PubMed Central

    Holland, Marshall T.; Flouty, Oliver E.; Close, Liesl N.; Reddy, Chandan G.; Howard, Matthew A.

    2015-01-01

    Extraskeletal Ewing's sarcoma (EES) is a rare presentation, representing only 15% of all primary Ewing's sarcoma cases. Even more uncommon is EES presenting as a primary focus in the spinal canal. These rapidly growing tumors often present with focal neurological symptoms of myelopathy or radiculopathy. There are no classic characteristic imaging findings and thus the physician must keep a high index of clinical suspicion. Diagnosis can only be definitively made by histopathological studies. In this report, we discuss a primary cervical spine EES in a 53-year-old man who presented with a two-month history of left upper extremity pain and acute onset of weakness. Imaging revealed a cervical spinal canal mass. After undergoing cervical decompression, histopathological examination confirmed a diagnosis of Ewing's sarcoma. A literature search revealed fewer than 25 reported cases of primary cervical spine EES published in the past 15 years and only one report demonstrating this pathology in a patient older than 30 years of age (age = 38). Given the low incidence of this pathology presenting in this age group and the lack of treatment guidelines, each patient's plan should be considered on a case-by-case basis until further studies are performed to determine optimal evidence based treatment. PMID:25802527

  16. Direct evidence of attempted beta cell regeneration in an 89-year-old patient with recent-onset type 1 diabetes

    Microsoft Academic Search

    J. J. Meier; J. C. Lin; A. E. Butler; R. Galasso; D. S. Martinez; P. C. Butler

    2006-01-01

    Aims\\/hypothesis  We investigated whether there was evidence of attempted beta cell regeneration in the pancreas obtained from a patient with recent-onset type 1 diabetes, and if so by what mechanism this occurred.Subjects, materials and methods  We examined pancreas tissue from a lean 89-year-old patient (BMI 18.0 kg\\/m2) with recent-onset type 1 diabetes who had had a distal pancreatectomy to remove a low-grade pancreatic

  17. Limited Impact on Health and Access to Care for 19- to 25-Year-Olds Following the Patient Protection and Affordable Care Act

    PubMed Central

    Kotagal, Meera; Carle, Adam C.; Kessler, Larry G.; Flum, David R.

    2014-01-01

    IMPORTANCE The Patient Protection and Affordable Care Act (PPACA) allowed young adults to remain on their parents’ insurance until 26 years of age. Reports indicate that this has expanded health coverage. OBJECTIVE To evaluate coverage, access to care, and health care use among 19- to 25-year-olds compared with 26- to 34-year-olds following PPACA implementation. DESIGN, SETTING, AND PARTICIPANTS Data from the Behavior Risk Factor Surveillance System and the National Health Interview Survey, which provide nationally representative measures of coverage, access to care, and health care use, were used to conduct the study among participants aged 19 to 25 years (young adults) and 26 to 34 years (adults) in 2009 and 2012. EXPOSURE Self-reported health insurance coverage. MAIN OUTCOMES AND MEASURES Health status, presence of a usual source of care, and ability to afford medications, dental care, or physician visits. RESULTS Health coverage increased between 2009 and 2012 for 19- to 25-year-olds (68.3% to 71.7%). Using a difference-in-differences (DID) approach, after adjustment, the likelihood of having a usual source of care decreased in both groups but more significantly for 26- to 34-year-olds (DID, 2.8%; 95% CI, 0.45 to 5.15). There was no significant change in health status for 19- to 25-year-olds compared with 26- to 34-year-olds (DID, ?0.5%; 95% CI, ?1.87 to 0.87). There was no significant change for 19- to 25-year-olds compared with 26- to 34-year-olds in the percentage who reported receiving a routine checkup in the past year (DID, 0.3%; 95% CI, ?2.25 to 2.85) or in the ability to afford prescription medications (DID, ?0.4%; 95% CI, ?2.93 to 1.93), dental care (DID, ?2.6%; 95% CI, ?5.61 to 0.61), or physician visits (DID, ?1.7%; 95% CI, ?3.66 to 0.26). There was also no change in the percentage who reported receiving a flu shot (DID, 1.9; 95% CI, ?1.93 to 4.93). Insured individuals were more likely to report having a usual source of care and a recent routine checkup and were more likely to be able to afford health care than uninsured individuals. CONCLUSIONS AND RELEVANCE Implementation of the PPACA was associated with increased health insurance coverage for 19- to 25-year-olds without significant changes in perceived health care affordability or health status. Although the likelihood of having a usual source of care declined between 2009 and 2012 for all, this decrease was smaller among 19- to 25-year-olds, and younger adults were more likely than 26- to 34-year-olds to have a usual source of care. PMID:25200181

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

    MedlinePLUS

    ... and Your 13- to 18-Year-Old Male Reproductive System Medical Care and Your 13- to 18-Year- ... Year-Old Your Daughter's First Gynecology Visit Female Reproductive System Talking to Your Child About Menstruation When Will ...

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

    ERIC Educational Resources Information Center

    Sinclair-Blake, Leslie C.

    2010-01-01

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

  20. Blood parameters of one-year-old and seven-year old partridges (Alectoris chukar).

    PubMed

    Woodard, A E; Vohra, P; Mayeda, B

    1983-12-01

    Several blood parameters were determined for 12 1-year-old and 12 7-year-old partridges to establish base line values on blood chemistry of this species. After taking blood samples, the 7-year-old birds were killed and necropsied for gross examination. With aging, there was a significant increase in plasma glucose, glutamic-oxalacetic transaminase (GOT), potassium, cholesterol, uric acid, and albumin. Males generally had a significantly lower lactic dehydrogenase (LDH) than females. The 7-year-old males had a significantly higher plasma cholesterol and GOT than 1-year-old males. There were no differences in plasma potassium, sodium, and calcium between partridges and data previously reported for chickens. Blood glucose levels in young and old partridge appear to be twice that for chickens, whereas cholesterol and lactic dehydrogenase levels were much lower in chickens. PMID:6669515

  1. 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

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

    2014-01-01

    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

  2. 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

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

    2014-01-01

    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

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

    Microsoft Academic Search

    Piers R. Blackett; Dale H. Altmiller; David Jelley; Don P. Wilson

    1995-01-01

    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

  4. A Novel Deletion Mutation of SLC16A2 Encoding Monocarboxylate Transporter (MCT) 8 in a 26-year-old Japanese Patient with Allan-Herndon-Dudley Syndrome

    PubMed Central

    Yamamoto, Sayaka; Okuhara, Koji; Tonoki, Hidefumi; Iizuka, Susumu; Nihei, Noriko; Tajima, Toshihiro

    2013-01-01

    Allan-Herndon-Dudley Syndrome (AHDS), an X linked condition, is characterized by congenital hypotonia that progresses to spasticity with severe psychomotor delays, in combination with altered thyroid hormone levels, in particular, high serum T3 levels. Recently, this disease was proved to be caused by mutations in SLC16A2 coding for the monocarboxylate thyroid hormone transporter 8 (MCT8). Here we describe a 26-year -old Japanese patient with AHDS who had deletion of exon 3 of SLC16A2. PMID:24170966

  5. A Novel Deletion Mutation of SLC16A2 Encoding Monocarboxylate Transporter (MCT) 8 in a 26-year-old Japanese Patient with Allan-Herndon-Dudley Syndrome.

    PubMed

    Yamamoto, Sayaka; Okuhara, Koji; Tonoki, Hidefumi; Iizuka, Susumu; Nihei, Noriko; Tajima, Toshihiro

    2013-10-01

    Allan-Herndon-Dudley Syndrome (AHDS), an X linked condition, is characterized by congenital hypotonia that progresses to spasticity with severe psychomotor delays, in combination with altered thyroid hormone levels, in particular, high serum T3 levels. Recently, this disease was proved to be caused by mutations in SLC16A2 coding for the monocarboxylate thyroid hormone transporter 8 (MCT8). Here we describe a 26-year -old Japanese patient with AHDS who had deletion of exon 3 of SLC16A2. PMID:24170966

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

    PubMed Central

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

    2014-01-01

    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

  7. Language Development: 2 Year Olds

    MedlinePLUS

    ... Development: 2 Year Olds Ages & Stages Listen Language Development: 2 Year Olds Article Body Your two-year- ... At this time, there’s more variation in language development than in any other area. While some preschoolers ...

  8. Multimodal endovascular management of acute ischemic stroke in patients over 75 years old is safe and effective

    PubMed Central

    Ghobrial, George M; Chalouhi, Nohra; Rivers, Lana; Witte, Samantha; Davanzo, Justin; Dalyai, Richard; Gardecki, Michelle L; Jabbour, Pascal; Gonzalez, Fernando; Dumont, Aaron S; Rosenwasser, Robert H; Tjoumakaris, Stavropoula

    2013-01-01

    Introduction Greater attention has been directed to endovascular recanalization of acute ischemic stroke in septuagenarians and above. Technique A retrospective chart review was conducted to include patients treated for acute ischemic stroke from 2006 to 2012. All patients underwent initial neurological assessment and non-contrast head CT. Patients treated from 2009 to 2012 additionally received emergent CT angiogram and CT perfusion. 51 patients met the clinical and radiographic criteria and underwent multimodal endovascular revascularization for acute ischemic events. Results All patients underwent cerebral angiography and met angiographic criteria for endovascular thrombolysis. 34 patients (67%) were older than 80?years of age. 23 patients (45%) received intravenous tissue plasminogen activator prior to admission. Eight (16%) patients underwent stent placement after intra-arterial thrombolysis, 10 (20%) underwent balloon angioplasty and seven (14%) underwent both angioplasty and stent placement. 21 (41%) required only intra-arterial thrombolytics. An improvement in Thrombolysis in Myocardial Infarction score was noted in 34 patients (67%). The average modified Rankin Scale score on discharge was 3.9. Symptomatic intracranial hemorrhage occurred in three patients (6%); none required surgery. One patient (1.9%) had a postoperative retroperitoneal hematoma, which was managed conservatively. Two fatalities resulted from intraoperative vessel rupture (3.9%), with a combined morbidity and mortality of 27.5%. Conclusions Multimodal endovascular recanalization of acute ischemic stroke is a relatively safe treatment option in patients older than 75?years of age. Careful patient selection by clinical and radiographic inclusion criteria is necessary for the successful management of stroke in this age group. PMID:22791182

  9. [Forty-six year old baby].

    PubMed

    Vahip, I?il; Onen Sertöz, Ozen

    2003-01-01

    In this paper, an extraordinary mother-son relationship involving 46 year-old, married, male patient with three children is discussed. He had never had any psychiatric complaint until his mother's death. However, he developed severe depressive and somatic symptoms following his 80 year-old mother's death. He showed no significant improvement after previous outpatient treatments and was admitted to the Psychiatric Department of Ege University School of Medicine with complaints of tension, insomnia, fatigue, anhedonia, hopelessness and pain all over his body. It was discovered that this man, who was loved and respected by both his family and his peers, used to suck his mother's breast twice daily. This act was no secret and was not considered a reason for seeking psychiatric help, a symptom of a disorder, or a source of distress for the son, mother, or any other family member. A phenomenon like this has never been reported in the literature before. We discuss this phenomenon through the dynamic formulation of the case using data from his psychiatric and developmental history as well as direct observation and psychological tests. PMID:14569474

  10. 13-year-old tuberous sclerosis patient with renal cell carcinoma associated with multiple renal angiomyolipomas developing multifocal micronodular pneumocyte hyperplasia

    PubMed Central

    2013-01-01

    Background The autosomal dominant tumor syndrome tuberous sclerosis complex is caused by the mutated TSC1 gene, hamartin, and the TSC2 gene, tuberin. Patients with this complex develop typical cutaneus symptoms such as peau chagrin or angiofibromas of the skin as well as other lesions such as astrocytomas in the brain and lymphangioleiomyomatosis in the lung. Only a few tuberous sclerosis patients have been described who showed a multifocal micronodular pneumocyte hyperplasia of the lung. Another benign tumor which often occurs together with tuberous sclerosis is the angiomyolipoma of the kidney. Furthermore, an increased incidence of renal cell carcinoma in connection with tuberous sclerosis has also been proven. Case presentation We report a 13-year-old white girl with epilepsy and hypopigmented skin lesions. Radiological studies demonstrated the typical cortical tubers leading to the diagnosis of tuberous sclerosis. In the following examinations a large number of angiomyolipomas were found in both kidneys. One lesion showed an increasing size and tumor like aspects in magnetic resonance imaging. The pathological examination of the following tumorectomy demonstrated an unclassified renal cell carcinoma. Four months postoperatively, a follow-up computer tomography revealed multiple bilateral pulmonary nodules. To exclude lung metastases of the renal cell carcinoma, multiple open-lung biopsies were performed. Conclusion Here we report a diagnostically challenging case of a 13-year-old patient with tuberous sclerosis and angiomyolipomas of the kidney who developed an unclassified renal cell carcinoma as well as multifocal micronodular pneumocyte hyperplasia. PMID:23379654

  11. Astrocytoma development following complete multiple myeloma remission in a 49-year-old patient: A case report

    PubMed Central

    HAN, XIAOYAN; JIN, DIAN; ZHENG, GAOFENG; LUO, YI; CAI, ZHEN

    2013-01-01

    Multiple myeloma (MM), one of the B-cell non-Hodgkin lymphomas, is a bone marrow-derived, antibody-producing cancer of the plasma cells. In the advanced stages, the cancer cells frequently cause widespread osteolytic bone damage; however, in rare cases, MM also manifests as an intracranial plasmacytoma. In the present study, we describe a case in which a patient, initially treated for MM and with subsequent complete remission, was admitted to hospital with a lesion in the right cerebellar hemisphere and neurological symptoms of a brain tumor. Our initial diagnosis was an MM relapse with the rare occurring intracranial manifestation. However, pathological tests confirmed the diagnosis of a high-grade astrocytoma. In this case report, we describe the characteristics, as well as the treatment issues, diagnoses and clinical developments of this patient. PMID:24137217

  12. [Tunnelled internal jugular vein catheters with taurolidine lock: an acceptable challenge to arterio-venous fistula in 70 years old haemodialyzed patients: a prospective pilot study].

    PubMed

    Branger, Bernard; Reboul, Pascal; Prelipcean, Camélia; Noguera, Maria Eugenia; Cariou, Sylvain; Granolleras, Céline; Vecina, Frédérique; Zabadani, Bachir; Boubenider, Samir; Rousseau, Philippe; Deshodt, Gérard; Ramperez, Pierre; Hory, Bernard; Picard, Eric; Branchereau, Pascal; Fabbro-Peray, Pascale; Fourcade, Jacques

    2011-07-01

    Arteriovenous fistula (AVF) is still in 2010 the gold standard of vascular(2) access in haemodialysis (HD) patients. Nevertheless it may be difficult to obtain and/or to use AVF in elderly. With this prospective randomised pilot study, we compare two strategies of vascular access in 70 years old or more new HD patients. AVF were compared to tunnelled jugular vein catheters (TIJC) with taurolidine as bacterial lock solution. Results were as follow: [table: see text] The responses with the visual analogic scale of comfort was 8/10 for TIJC and 5/10 with AVF * P<0.05. In five TIJC patients, heparin was added with success to taurolidine because of partial clotting of catheters. Albuminemia was significantly lower in AVF failure patients compared to AVF success patients (24.8g/L vs 31.1g/L). This pilot study allows to conclude that TIJC is an acceptable challenge to AVF in haemodialysed patients of 70 years or more in a two years long use. PMID:21601549

  13. Language Development: 1 Year Olds

    MedlinePLUS

    ... Language Development: 1 Year Olds Ages & Stages Listen Language Development: 1 Year Olds Article Body Early in the second year, your toddler will ... Teach him the correct names of objects and body parts, and stop using cute substitutes ... By providing a good language model, you’ll help him learn to talk ...

  14. ["Iatrogenic acute coronary syndrome"--59 year old patient with adenocarcinoma of ascending colon and stenocardia while receiving adjuvant chemotherapy with 5-fluorouracil].

    PubMed

    Gundling, F; Fuchs, M; Nowak, L; Antoni, D; Hoffmann, E; Schepp, W

    2006-09-01

    Fluorouracil-associated cardiotoxic adverse events represent a relevant but underestimated problem in 5-fluorouracil treatment. After right hemicolectomy for adenocarcinoma of the rightsided colonic flexure a 59-year old patient was referred to our hospital for adjuvant chemotherapy according to MOSAIC-protocol with oxaliplatin and 5-fluorouracil. The patient's history was unremarkable for any cardiopulmonary disease and for any cardiovascular risk factors. 24 hours after completing the first cycle the patient was readmitted to our emergency department because of thoracic pain combined with significantly elevated cardiac enzymes and ischaemic changes in ECG. Coronary angiography was performed revealing no coronary artheriosclerosis. Clinical symptoms and pathological ischaemic serum parameters returned to normal range within 12 hours. Diagnosis of 5-FU-induced acute coronary syndrome could be made. Because of the high rate of recurring cardiotoxicity the patient's chemotherapy was modified to an alternative regimen containing raltitrexed instead of 5-fluorouracil. Immediate diagnosis of 5-FU-induced cardiotoxicity and differentiation from preexisting coronary heart disease is still a major problem in daily oncological practice. PMID:16981070

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

    PubMed Central

    2013-01-01

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

  16. 70-year old female patient with mismatch between hematocrit and hemoglobin values: the effects of cold agglutinin on complete blood count

    PubMed Central

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

    2014-01-01

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

  17. A novel (paternally inherited) duplication 13q31.3q32.3 in a 12-year-old patient with facial dysmorphism and developmental delay.

    PubMed

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

    2014-08-01

    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

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

    Pawlu?, Aleksander; Szyma?ska, Kinga; Kaczorowski, Krzysztof; Soko?owska-D?bek, D?brówka; Olchowy, Cyprian; Markiewicz, Bartosz D.; Zaleska-Dorobisz, Urszula

    2015-01-01

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

  20. Hyperthyroidism of Graves' disease: evidence for only unilateral involvement of the thyroid gland in a 31-year-old female patient.

    PubMed

    Dimai, H P; Ramschak-Schwarzer, S; Lax, S; Lipp, R W; Leb, G

    1999-03-01

    Hyperthyroidism of Graves' disease (Morbus Basedow) is known to involve the thyroid gland in toto, unlike Graves' ophthalmopathy which clinically may either be unilateral or bilateral. We report a 31-year-old Caucasian female patient who presented with unilateral goiter and clinical and laboratory evidence for hyperthyroidism. High-resolution ultrasonography of the thyroid gland revealed a morphology indicative of an autoimmune thyroid disease strictly limited only to the right lobe. 123I-scintiscanning showed a homogenous but several fold increased uptake of the radionuclide in the right lobe of the thyroid gland, whereas the uptake in the left lobe did not differ from the uptake in normal controls. Cytology of the fine needle aspirate of the right lobe revealed a remarkable inflammatory background mainly by presence of lymphocytes, a finding which was not seen in the cytology of the left lobe. Furthermore, both serum antibodies to TSH-receptors and thyroid peroxidase were significantly increased. Consequently, hyperthyroidism of Graves' disease with the involvement of only one lobe of the thyroid gland was diagnosed. PMID:10219891

  1. Unexpected finding of T-cell lymphoma in a previously healthy 16-year-old patient after a thorax trauma: a case report

    PubMed Central

    2014-01-01

    Introduction We describe the clinical course and emphasize the difficulties in diagnosing T-cell lymphoblastic lymphoma. The differential diagnostic difficulties have previously been described in regard to pneumonia, but to the best of the authors’ knowledge this is the first case report to describe lymphoma in relation to trauma. Case presentation A previously healthy 16-year-old Danish boy presented to our hospital with chest pain and accentuated protruding thoracic veins. Ten days prior to hospitalization he had suffered a blunt thoracic trauma while playing soccer. After drainage of an excessive amount of pleural fluid, he developed severe respiratory distress. A chest tube was inserted and he was transferred to a level 1 trauma centre. Here, a computed tomography scan unexpectedly revealed significantly swollen mediastinal and retroperitoneal lymph nodes, and he was later diagnosed with T-cell lymphoblastic lymphoma. Conclusions This case emphasizes the importance of reacting to an unexplained large amount of pleural fluid after a patient suffers thoracic trauma and to consider possible underlying causes. This report is mainly addressed to emergency personnel, but it is also relevant to pediatricians, surgeons, anesthesiologists, and general practitioners. PMID:25403976

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

    PubMed Central

    2013-01-01

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

  3. Risk factors for bone mineral density at the calcaneus in 40–59 year-old male workers: A cross-sectional study in Korea

    PubMed Central

    Seo, Hyun-Ju; Kim, Soo-Geun; Kim, Chong-Soon

    2008-01-01

    Background Few epidemiologic studies have attempted to investigate the prevalence and risk factors for osteopenia and osteoporosis in middle-aged Asian men. We performed this study to determine the prevalence and risk factors of osteopenia and osteoporosis in this population. Methods This cross-sectional study was conducted from March to July, 2004. The subjects were 2,073 males aged from 40 to 59 years in the KHNP (Korea Hydro & Nuclear Power) workplace-based cohort. Bone mineral density (BMD) was measured by peripheral, dual-energy, X-ray absorptiometry (DXA) at the calcaneus. Anthropometric and lifestyle factors were investigated using a standard, self-reported questionnaire. Results BMD was 0.60 ± 0.09 g/cm2 (mean ± standard deviation) and was negatively correlated with age (r = -0.18, P < 0.001), but positively correlated with waist-to-hip ratio (WHR; r = 0.15, P < 0.001), body fat (r = 0.10, P < 0.001), BMI (r = 0.35, P < 0.001), height (r = 0.26, P < 0.001), and weight (r = 0.43, P < 0.001). In multiple linear regression analysis, the independent determinants associated with BMD were increasing age (coefficient = -0.002, P < 0.001), physical activity (? 2/week vs. ? 3/week; coefficient = 0.017, P < 0.001), WHR (coefficient = -0.796, P < 0.001), body mass index (BMI; coefficient = 0.023, P < 0.001) and smoking status (never vs. ever; coefficient = -0.018, P < 0.001). Conclusion We suggest that BMD of the calcaneus is correlated negatively with exposure to smoke and increased WHR, but positively with regular exercise and increased BMI. PMID:18647418

  4. 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

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

    2005-01-01

    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

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

    PubMed

    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

    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

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

    PubMed

    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

    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

  7. Free tendon grafts in elder patients, a case report of repair of flexor pollicis longus tendon with a free palmaris longus graft in an 89-year-old woman.

    PubMed

    de Panafieu, E; Upex, P; Doursounian, L; Robert, N

    2014-10-22

    Flexor tendon rupture is a potential complication after volar plating of distal radius fracture. Palliative procedures such as tenodesis and arthrodesis are usually employed in elder patients with imperfect results. We report a case of delayed flexor pollicis longus rupture seven years after volar plating of a distal radius fracture occurring in an 89-year-old woman. The repair with a free tendon graft of palmaris longus was successful in terms of strength and range of motion. Free tendon grafts should not be limited to younger patients and could be used in elder patients after careful selection. PMID:25447212

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

    PubMed Central

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

    2015-01-01

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

  9. Adenocarcinoma of the lung presenting as a diffuse interstitial process in a 25-year-old man.

    PubMed

    Mapel, D W; Fei, R H; Crowell, R E

    1996-09-01

    Adenocarcinoma of the lung is rare in young adults, particularly in persons below the age of 30. Younger patients tend to present with advanced stages of carcinoma, and often have a rapidly deteriorating course. We describe a 25-year-old male who presented with diffuse interstitial lung disease which was found at autopsy to be lymphangitic carcinomatosis of probable pulmonary origin. PMID:8882991

  10. Long-standing pain in a 25-year-old patient with a non-diagnosed cervical osteoblastoma: a case report

    Microsoft Academic Search

    A. Combalia Aleu; D. Popescu; J. Pomes; A. Palacin

    2008-01-01

    Benign osteoblastomas are infrequent tumors, representing less than 1% of all bone tumors. The spinal location accounts for\\u000a 40–50% of all osteoblastomas from which only 20% are located in the cervical spine. The majority of the spinal osteoblastomas\\u000a arise from the posterior elements: pedicles, laminas, transverse or spinous processes. We present a case report of a young\\u000a male that due

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

    PubMed

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

    2015-03-01

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

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

    SciTech Connect

    Shikama, Naoto [Department of Radiology, Shinshu University School of Medicine, Matsumoto (Japan)]. E-mail: shikama@hsp.md.shinshu-u.ac.jp; Oguchi, Masahiko [Department of Radiation Oncology, Cancer Institute Hospital, Tokyo (Japan); Isobe, Koichi [Department of Radiology, Chiba University Hospital, Chiba (Japan); Nakamura, Katsumasa [Department of Radiology, Kyushu University Graduate School of Medicine, Fukuoka (Japan); Tamaki, Yoshio [Department of Radiology, Gunma Prefectural Cancer Center, Gunma (Japan); Hasegawa, Masatoshi [Department of Radiation Oncology, Nara Medical University, Nara (Japan); Kodaira, Takeshi [Department of Radiation Oncology, Aichi Cancer Center, Nagoya (Japan); Sasaki, Shigeru [Department of Radiology, Shinshu University School of Medicine, Matsumoto (Japan); Kagami, Yoshikazu [Department of Radiation Oncology, National Cancer Center, Tokyo (Japan)

    2006-09-01

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

  13. How Grammatical Are 3-Year-Olds?

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  14. Association of incipient disc degeneration and instability in spondylolisthesis. A magnetic resonance and flexion-extension radiographic study of 20-year-old low back pain patients.

    PubMed

    Paajanen, H; Tertti, M

    1991-01-01

    The concurrence of early disc degeneration and abnormal segmental motion in spondylolysis of young low back pain patients (n = 14) was investigated using magnetic resonance imaging (MRI) and flexion-extension radiography. Seven patients with L5 spondylolisthesis had normal discs on MRI and 7 had disc degeneration below the slipped vertebra. The parallel motion, angular mobility and centre of motion were similar in the degenerated discs and in normal discs. The present study shows that in adolescents the motion pattern and hydration of discs associated with spondylolysis and spondylolisthesis are not always abnormal. The early dehydration and degeneration of lumbar discs observed on MRI are not always associated with abnormal mobility of the corresponding motion segment. PMID:1837728

  15. Pace Maker Implantation for Elderly Individuals Over 90 Years Old

    PubMed Central

    Shiheido, Eika; Shimada, Yasuyuki

    2013-01-01

    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. PMID:25649073

  16. Comparison of Acceptance, Preference, and Efficacy Between Jet Injection INJEX and Local Infiltration Anesthesia in 6 to 11 Year Old Dental Patients

    PubMed Central

    Arapostathis, Konstantinos Nikolaos; Dabarakis, Nikolaos Nestoras; Coolidge, Trilby; Tsirlis, Anastasios; Kotsanos, Nikolaos

    2010-01-01

    Abstract Needleless devices have been developed to provide anesthesia without injections. Little controlled research has examined the acceptability of needleless devices in pediatric patients. The aims of the study were to compare children’s acceptance and preference for one type of needleless jet injection with classical local infiltration as well as to evaluate the efficacy of the needleless anesthesia. Eighty-seven nonfearful children with no previous experience of dental anesthesia were studied using a split-mouth design. The first dental procedure was performed with the classical infiltration anesthesia. The same amount of anesthetic was administered using the INJEX needleless device in a second session 1 week later, during which a second dental procedure was performed. Patients rated their acceptance and preference for the 2 methods, and the dentist recorded data about the need for additional anesthesia. More negative experiences were reported for the INJEX method. Most (73.6%) of the children preferred the traditional method. Among the 87 treatment procedures attempted following the use of INJEX, 80.5% required additional anesthesia, compared with 2.3% of those attempted following traditional infiltration. Traditional infiltration was more effective, acceptable, and preferred, compared with the needleless INJEX. PMID:20331333

  17. Primary Vesical Actinomycosis in a 23-Year-Old Man

    PubMed Central

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

    2014-01-01

    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

  18. A 1,100-year-old founder effect mutation in IL12B gene is responsible for Mendelian susceptibility to mycobacterial disease in Tunisian patients.

    PubMed

    Ben-Mustapha, Imen; Ben-Ali, Meriem; Mekki, Najla; Patin, Etienne; Harmant, Christine; Bouguila, Jihčne; Elloumi-Zghal, Houda; Harbi, Abdelaziz; Béjaoui, Mohamed; Boughammoura, Lamia; Chemli, Jalel; Barbouche, Mohamed-Ridha

    2014-01-01

    Mendelian susceptibility to mycobacterial disease (MSMD) is a rare disorder predisposing apparently healthy individuals to infections caused by weakly virulent mycobacteria such as bacille Calmette-Guerin (BCG), environmental mycobacteria, and poorly virulent Salmonella strains. IL-12p40 deficiency is the first reported human disease due to a cytokine gene defect and is one of the deficiencies that cause MSMD. Nine mutant alleles only have been identified in the IL12B gene, and three of them are recurrent mutations due to a founder effect in specific populations. IL-12p40 deficiency has been identified especially in countries where consanguinity is high and where BCG vaccination at birth is universal. We investigated, in such settings, the clinical, cellular, and molecular features of six IL-12p40-deficient Tunisian patients having the same mutation in IL12B gene (c.298_305del). We found that this mutation is inherited as a common founder mutation arousing ~1,100 years ago. This finding facilitates the development of a preventive approach by genetic counseling and prenatal diagnosis especially in affected families. PMID:24127073

  19. Coexistence of renal cell carcinoma of clear cell type with sarcomatoid cell type component and adrenal mature ganglioneuroma with myelolipoma - a case of 69-year-old female patient.

    PubMed

    Lewitowicz, Piotr; Wincewicz, Andrzej; Horecka-Lewitowicz, Agata; Matykiewicz, Jaros?aw; Kozie?, Dorota; G?uszek, Stanis?aw; Sulkowski, Stanis?aw

    2014-01-01

    This report presents a case of 69-year-old woman, who was operated due to renal tumor. Apart from renal neoplasm, the adjacent adrenal gland contained another one tumor in medulla of the organ. The renal lesion was diagnosed renal cell carcinoma, clear cell type with undifferentiated cell sarcomatoid component. The adrenal neoplasm was composed of wavy S100-positive, Schwann-like cells and dispersed chromogranin A-reactive ganglion cells to be consistent with mature ganglioneuroma. It was accompanied by coexistent myelolipoma that contained hematopoietic cells including clearly visible megakaryocytes and foci of fat. To our knowledge, our paper is the first to report sporadic clear cell renal cell carcinoma with sarcomatoid cell type component and mature adrenal ganglioneuroma with myelolipoma in the same patient. PMID:24969996

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

    NSDL National Science Digital Library

    Hakam, Ardeshir

    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.

  1. [13-Year old boy with abdominal pain].

    PubMed

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

    2012-01-01

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

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

    PubMed

    Zada, Almira; Mundhofir, Farmaditya E P; Pfundt, Rolph; Leijsten, Nico; Nillesen, Willy; Faradz, Sultana M H; de Leeuw, Nicole

    2014-01-01

    We present a 20-year-old female patient from Indonesia with intellectual disability (ID), proportionate short stature, motor delay, feeding problems, microcephaly, facial dysmorphism, and precocious puberty who was previously screened normal for conventional karyotyping, fragile X testing, and subtelomeric MLPA analysis. Subsequent genome wide array analysis was performed on DNA from blood and revealed a 1.1?Mb deletion in 14q32.2q32.31 (chr14:100,388,343-101,506,214; hg19). Subsequent carrier testing in the parents by array showed that the deletion had occurred de novo in the patient and that her paternal 14q32 allele was deleted. The deleted region encompasses the DLK1/GTL2 imprinted gene cluster which is consistent with the maternal UPD(14)-like phenotype of the patient. This rare, recurrent microdeletion was recently shown not to be mediated by low copy repeats, but by expanded TGG repeats, flanking the 14q32.2q32.21 deletion boundaries, a novel mechanism of recurrent genomic rearrangement. This is another example how the application of high resolution genome wide testing provides an accurate genetic diagnosis, thereby improving the care for patients and optimizing the counselling for family. PMID:24800088

  3. A 4-year-old Nigerian boy with cerebral palsy?

    PubMed

    Bodensteiner, John B

    2014-06-01

    A four year old with a diagnosis of congenital infection leading to cerebral palsy is presented. The patient instead has a condition called Leukoencephalopathy with bilateral temporal lobe cysts which can be differentiated from congenital CMV by the clinical and MRI findings. PMID:25149944

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

    Microsoft Academic Search

    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

    .   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

  5. Neurocysticercosis in a 23-year-old Chinese man

    PubMed Central

    Vecchio, Rosa Fontana Del; Pinzone, Marilia Rita; Nunnari, Giuseppe; Cacopardo, Bruno

    2014-01-01

    Patient: Male, 23 Final Diagnosis: Neurocysticerosis Symptoms: Diplopia • fever • headache • insomnia • neck stiffness • vomiting Medication: Albendazole Clinical Procedure: — Specialty: Neurology Objective: Challenging differential diagnosis Background: Neurocysticercosis is a brain infection caused by the larval stage of the tapeworm Taenia (T.) solium. It is the most important parasitic disease of the human central nervous system and represents the most common cause of acquired epilepsy in developing countries. Case Report: Here, we report the case of a 23-year-old Chinese man who presented to the emergency department with a 7-day history of helmet headache radiating to the nuchal region and associated with vomiting, confusion, and fever. Cerebrospinal fluid (CSF) was clear, with increased pressure, lymphocytic pleocytosis, decreased glucose, and increased protein levels. Bacterial antigen detection test on CSF was negative, as were CSF bacterial and fungal cultures. Despite broad-spectrum antibiotic and antiviral therapy, the patient still complained of insomnia, diplopia, headache, neck stiffness, and pain in the sacral region. A second LP was performed and CSF had the same characteristics as the first LP. A brain and spinal cord MRI revealed widespread arachnoiditis and small septated cysts with CSF-like signal in the cisterna magna, within the fourth ventricle, and at the level of L3–L4. Cysticercus-specific immunoglobin G antibodies were detected by ELISA in the CSF. The patient received albendazole (15 mg/kg/day) and dexamethasone (5 mg/day) for 4 weeks, with progressive resolution of neurological symptoms. Conclusions: This case shows that, even if rare, neurocysticercosis may be responsible for meningeal symptoms and should be included in the differential diagnosis, especially in patients from endemic countries. PMID:24459541

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

    PubMed Central

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

    2014-01-01

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

  7. Hyposalivation in a 16-year-old girl: a case of salivary gland aplasia.

    PubMed

    Frydrych, A M; Koong, B

    2014-03-01

    Salivary gland aplasia is a rare condition with only a small number of cases reported worldwide. It is more commonly seen in males and can occur either in isolation or association with other defects or syndromes. It may or may not occur with a hereditary background. Scant literature exists detailing the status of sublingual salivary glands in patients with any form of major salivary gland aplasia. This case report describes the clinical and magnetic resonance imaging presentation of a 16-year-old girl with major salivary gland aplasia detailing the status of all six major salivary glands. PMID:24495170

  8. Closure of a moderately large atrial septal defect with a self-fabricated fenestrated Amplatzer septal occluder in an 85-year-old patient with reduced diastolic elasticity of the left ventricle.

    PubMed

    Holzer, Ralf; Cao, Qi-Ling; Hijazi, Ziyad M

    2005-04-01

    Percutaneous closure of an atrial septal defect (ASD) in the elderly with reduced diastolic elasticity of the left ventricle poses a significant management challenge. We report on the case of an 85-year-old patient who was admitted for percutaneous device closure of a moderately large secundum atrial septal defect. Hemodynamic evaluation documented an increase in left atrial pressure from a mean of 12 mm Hg to a mean of 32 mm Hg after balloon test occlusion of the ASD. Two months later, after adequate pretreatment with diuretics and afterload-reducing substances, he underwent successful closure of the ASD using a self-fabricated fenestrated Amplatzer septal occluder, which resulted in a postimplantation left atrial pressure of a mean of 18 mm Hg. Recovery was unremarkable and the fenestration has remained patent for 3 months since implantation of the device. This unique case highlights the feasibility of using a self-fabricated fenestrated Amplatzer septal occluder to close interatrial communications in elderly patients with diastolic dysfunction of the left ventricle. PMID:15789387

  9. Thirteen for Thirteen-Year-Olds

    ERIC Educational Resources Information Center

    Instructor, 2011

    2011-01-01

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

  10. 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...

  11. Determinants of loneliness in Jerusalem's 70-year-old population.

    PubMed

    Stessman, J; Ginsberg, G; Klein, M; Hammerman-Rozenberg, R; Friedman, R; Cohen, A

    1996-08-01

    This study aims to find the determinants of feelings of loneliness in 70 year olds living in Jerusalem. Results based on home interviews (n = 605) of a 40% systematic sample of 70 year olds in the electoral register showed that around 46.3% of females and 21.3% of males reported being lonely. Persons of European/North American origin felt less lonely than those of Asian or African origin, probably due to the former's wider social support network, perceiving friends, neighbors or other relatives as being available to back up children in an emergency. The major factors associated with loneliness were: being depressed, having a poor self-assessed health status, not attending synagogue, and being widowed but not remarried. Factors that did not reduce loneliness included having paid employment, watching TV or listening to the radio. No association was found between cognitive status and loneliness. Our systems model suggests a strong reciprocal relationship between loneliness and depression. PMID:8816874

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

    PubMed Central

    Bova, Joesph; Sergent, Adam

    2014-01-01

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

  13. [Chest pain in a 37-year-old Sikh].

    PubMed

    Schiltknecht, M; Furrer, J

    2002-01-23

    Chest pain can be the only sign of osteomalacia. The case of a 37 years old patient from India, member of the religious group of the sikh, with vitamin D deficiency is presented. The disease developed as a consequence of reduced sun exposure (covering a substantial part of the body for ethnic reasons). The pathogenesis, clinical picture and implications for daily practice are discussed. PMID:11851040

  14. Pott's puffy tumor in a 12-year-old boy.

    PubMed

    Avcu, Gülhadiye; Belet, Nursen; Kurnaz, Senem Cengel; Karli, Arzu; Sensoy, Gülnar

    2015-02-01

    Pott's puffy tumor (PPT) is a rare complication of sinusitis characterized by subperiosteal abscess and osteomyelitis of the frontal bone. Early diagnosis and treatment is vital before it causes intracranial complications such as subdural empyema or brain abscess. Herein we describe the case of a 12-year-old patient who developed preseptal cellulitis and PPT, and was successfully treated with abscess drainage, sinus surgery and long-term antibiotic therapy. PMID:25711256

  15. Epiploic appendagitis in a 24-year-old woman

    Microsoft Academic Search

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

    2008-01-01

    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.

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

    SciTech Connect

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

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

  17. Xanthogranulomatous pyelonephritis in a 1-year old boy.

    PubMed

    Ottem, Derek P; Macneily, Andrew E; McAuley, Iain W

    2005-12-01

    Xanthogranulomatous pyelonephritis (XGP) is a rare, chronic inflammatory lesion of the kidney associated with both chronic infection and obstruction. Most common in middle-aged females, it is important to recognize in children because it may be confused with childhood renal malignancies particularly Wilms' tumor. We report a case of a 1-year old male with antenatally detected and postnatally confirmed hydronephrosis. Further investigation revealed a left incomplete duplex collecting system with obstructing lower pole stones, pelvicaliectasis and widespread foci of calcification. He underwent a left nephroureterectomy with the pathological report noting XGP. PMID:16401378

  18. Breast adenoid cystic carcinoma in a 19-year-old man: a case report and review of the literature.

    PubMed

    Tang, Peng; Yang, Shiping; Zhong, Xiaojie; Yao, Jia; Zhang, Yu; Dong, Huaying; Li, Guanqiao

    2015-12-01

    Adenoid cystic carcinoma (ACC) of the breast is very rare in males. There have been only eight previous articles published on breast ACC in males. Here, we will report on the first case of this type of tumor in the Chinese province of Hainan. The patient was a 19-year-old male, and he underwent a radical mastectomy (RM) with axillary lymph node dissection. The histopathological examination specimen revealed that surgical margins were negative; none of the 41 axillary lymph nodes excised were positive for malignancy. The patient is alive and well 67 months after radical mastectomy. In the present study, we discuss the diagnosis and treatment options for male breast ACC based on previous English publications. PMID:25778021

  19. Assessing physicians' intentions to talk about sex when they vaccinate nine-year-old to 15-year-old girls against HPV

    Microsoft Academic Search

    Natoshia M. Askelson; Shelly Campo; Sandi Smith; John B. Lowe; Leslie Dennis; Julie Andsager

    2011-01-01

    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 15-year-old female patients about sex using the Theory of Planned

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

    PubMed Central

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

    2014-01-01

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

  1. Pilon fracture: a case report of a 45-year-old dental technician.

    PubMed

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

    2014-01-01

    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

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

    PubMed

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

    2012-04-01

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

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

    PubMed

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

    2015-02-01

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

  4. Blowout Fracture in a 3-Year-Old

    PubMed Central

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

    2013-01-01

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

  5. Cervical hibernoma in a two year old boy

    PubMed Central

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

    2013-01-01

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

  6. Traumatic Dental Injuries Among 12-15-Year-Old-School Children in Panchkula

    PubMed Central

    Chopra, Amandeep; Lakhanpal, Manav; Rao, NC; Gupta, Nidhi; Vashisth, Shelja

    2014-01-01

    Background: Traumatic dental injury (TDI) in children and adolescents has become one of the most serious dental public health problems. Despite such a high prevalence of dental trauma, very less attention has been paid to TDI, its etiology, and prevention. Objectives: To determine the prevalence of anterior tooth traumatic dental injuries in 12-15-year-old school children of Panchkula district, India, and to find any correlation with the cause, gender, extent of overbite as well as over-jet, and previous treatment. Patients and Methods: A multistage sample of 12-15-year-old school children (n = 810) in Panchkula district, Haryana, was selected. The children were screened using WHO criteria for oral examination and a trained dental surgeon examined the children. Those with clinical TDI were examined further for the type of traumatic injuries using Elis classification modified by Holland. Overjet and overbite were recorded. After examination, questions regarding the cause of trauma and its treatment were asked. Data were subjected to statistical analysis using the Chi square and Mantel-Haenszel tests by SPSS version 20.0. Results: The results showed that out of 810 children, 86 (10.2 %) had TDI. Males had higher prevalence of trauma than females (P < 0.05). The common cause of trauma was fall (51.11%) followed by sports injuries (41.86%). Enamel-dentin fracture without pulpal involvement was the most common type of trauma and the most frequent involved teeth were maxillary central incisors. A significant association was observed between overjet and overbite and trauma. Only 3.5% of the children affected with trauma had received treatment. Conclusions: The prevalence of traumatic injuries to permanent incisors in 12-15-year-old Panchkula school children was relatively high. TDI was associated with gender, overjet, and lip competence. There was a great unmet treatment need. PMID:25032172

  7. Remission of classic rapid cycling bipolar disorder with levothyroxine augmentation therapy in a male patient having clinical hypothyroidism.

    PubMed

    Chen, Pao-Huan; Huang, Yu-Jui

    2015-01-01

    The literature suggests that patients with bipolar disorder, particularly females, have greater vulnerability to rapid cycling features. Levothyroxine therapy might be potentially useful to attenuate mood instability in this patient group. In contrast, reports on male patients remain limited and controversial. Herein, we report a 32-year-old male patient who had bipolar 1 disorder for 12 years who developed a breakthrough rapid cycling course and first-onset clinical hypothyroidism at the age of 31 years during lithium therapy. After levothyroxine augmentation therapy was introduced, the patient had remission from the rapid cycling illness course along with normalization of serum levels of free T4 and thyroid stimulating hormone in the subsequent year. This observation suggested that investigation of both levothyroxine pharmacology and thyroid pathology in male patients with rapid cycling bipolar disorder might be of much value. PMID:25709457

  8. Remission of classic rapid cycling bipolar disorder with levothyroxine augmentation therapy in a male patient having clinical hypothyroidism

    PubMed Central

    Chen, Pao-Huan; Huang, Yu-Jui

    2015-01-01

    The literature suggests that patients with bipolar disorder, particularly females, have greater vulnerability to rapid cycling features. Levothyroxine therapy might be potentially useful to attenuate mood instability in this patient group. In contrast, reports on male patients remain limited and controversial. Herein, we report a 32-year-old male patient who had bipolar 1 disorder for 12 years who developed a breakthrough rapid cycling course and first-onset clinical hypothyroidism at the age of 31 years during lithium therapy. After levothyroxine augmentation therapy was introduced, the patient had remission from the rapid cycling illness course along with normalization of serum levels of free T4 and thyroid stimulating hormone in the subsequent year. This observation suggested that investigation of both levothyroxine pharmacology and thyroid pathology in male patients with rapid cycling bipolar disorder might be of much value. PMID:25709457

  9. Five-year-olds punish antisocial adults.

    PubMed

    Kenward, Ben; Osth, Therese

    2014-11-18

    The human tendency to impose costs on those who have behaved antisocially towards third parties (third-party punishment) has a formative influence on societies, yet very few studies of the development of this tendency exist. In most studies where young children have punished, participants have imposed costs on puppets, leaving open the question as to whether young children punish in real third-party situations. Here, five-year-olds were given the opportunity to allocate desirable or unpleasant items to antisocial and neutral adults, who were presented as real and shown on video. Neutral individuals were almost always allocated only desirable items. Antisocial individuals were instead usually allocated unpleasant items, as long as participants were told they would give anonymously. Most participants who were instead told they would give in person did not allocate unpleasant items, although a minority did so. This indicates that the children interpreted the situation as real, and that whereas they genuinely desired to punish antisocial adults, they did not usually dare do so in person. Boys punished more frequently than girls. The willingness of preschoolers to spontaneously engage in third-party punishment, occasionally even risking the social costs of antagonizing an anti-social adult, demonstrates a deep-seated early-developing punitive sentiment in humans. Aggr. Behav. 9999:XX-XX, 2014. © 2014 Wiley Periodicals, Inc. PMID:25408386

  10. Duplicated ectopic ureter in a nine-year-old Labrador.

    PubMed

    Novellas, R; Stone, J; Pratschke, K; Hammond, G

    2013-07-01

    A nine-year-old male neutered Labrador retriever presented with a history of chronic urinary tract infections and occasional dribbling of urine. Abdominal ultrasound showed changes suggestive of a left ectopic ureter. A pneumocystogram revealed an air-filled distended tubular and tortuous structure extending from the region of the prostatic urethra to the left kidney, consistent with an ectopic ureter. Intravenous urography depicted the presence of an additional left ureter with only slightly larger diameter than the right and with normal insertion in the bladder neck. A duplicated ectopic left ureter was suspected and confirmed during surgery. To the authors' knowledge, this is the first description of a duplicated ectopic ureter in the canine species. The combination of ultrasound and contrast radiography was important to reach the diagnosis. PMID:23551207

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

    PubMed

    Mullens, Dustin James; Shubrook, Jay H

    2014-01-01

    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

  12. Multifocal tumoral calcinosis in a 4-year-old girl

    PubMed Central

    Sayar, Ilyas; Peker, Kemal; Kap?s?z, Alparslan; Bostanc?, Is?l Esen; Gürbüzel, Mehmet; Isik, Arda; Peker, Necla Ayd?n

    2014-01-01

    Patient: Female, 4 Final Diagnosis: Tumoral calcinosis Symptoms: Hard immobile mass Medication: — Clinical Procedure: — Specialty: Surgery Objective: Congenital defects Background: Tumoral calcinosis is an uncommon condition associated with the deposition of painless calcific masses. It is more common in childhood or early adolescence of African-American females. Case Report: We present a case of a 4-year-old girl with tumoral calcinosis treated surgically. The case is rather rare in terms of the age of the patient and the localization of the masses (gluteal site). In our patient, the biochemical findings were normal, except for hyperphosphatemia and elevated alkaline phosphatase. Conclusions: Total excision appears to lead to a good clinical outcome and a low incidence of local relapse. PMID:24644527

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

    PubMed

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

    2015-03-01

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

  14. Molecular cytogenetic analysis of a ring-Y infertile male patient.

    PubMed

    Carvalho, F M; Wolfgramm, E V; Degasperi, I; Verbeno, B M; Vianna, B A; Chagas, F F; Perroni, A M S; Paula, F; Louro, I D

    2007-01-01

    In the present study, we report on the case of a 43-year-old male patient seeking for fertility assistance, who showed a seminal analysis and testicular biopsy of complete azoospermia. Peripheral blood culture for chromosome studies revealed a karyotype of 46 chromosomes with a ring-Y-chromosome that lost the long arm heterochromatin. Molecular analysis of genomic DNA from the patient detected the presence of the sex-determining region of the Y-chromosome (SRY) but the complete absence of regions involved in spermatogenesis (AZFa, AZFb, AZFc). Several molecular markers distributed along the Y-chromosome were tested through PCR amplification, and a breakpoint was established close to the centromere, predicting the deletion of the growth control region, in agreement with the short stature observed in this patient. All results obtained through molecular cytogenetic characterization are in accordance with the clinical features observed in this patient. PMID:17469055

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

    PubMed

    Lingeswaran, Anand

    2014-01-01

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

  16. Metastatic spiradenocarcinoma occurring in an 8-year-old boy.

    PubMed

    Miedema, Jayson R; Burgon, Eric; Burkhart, Craig; Stitzenberg, Karyn; Hipps, John; Zedek, Daniel

    2015-01-01

    We recently saw the case of an 8-year-old boy with histologic findings of spiradenocarcinoma. Malignant adnexal tumors in children are exceedingly rare, and cases of spiradenocarcinoma in children are absent in the literature. We report the case of an 8-year-old boy with metastatic spiradenocarcinoma. A biopsy 2 years before his presentation at our institution was interpreted as a benign lesion, but when the lesion regrew, a repeat biopsy was performed that demonstrated ominous findings, prompting a reexcision. This reexcision demonstrated an area with significant necrosis, many mitoses, and cellular pleomorphism apparently arising out of a sharply demarcated, adjacent, lower-grade area. The histologic features of this patient's biopsies were those of spiradenocarcinoma, potentially arising out of a preexisting spiradenoma, a finding that has not been documented previously in this age group. Staging studies demonstrated multiple bilateral pulmonary nodules, which were confirmed using thoracoscopic biopsy to be metastatic disease. His chemotherapy regimen has included several cycles of cisplatin and 5-flourouracil, with ongoing disease progression of pulmonary disease. It has been 16 months since he presented to our institution (>3 years since the appearance of his initial lesion). Imaging studies demonstrate a slowly increasing size and number of pulmonary lesions. The long-term prognosis is guarded. PMID:23581574

  17. The national trend of blood lead levels among Chinese children aged 0-18 years old, 1990-2012.

    PubMed

    Li, Min-ming; Cao, Jia; Xu, Jian; Cai, Shi-zhong; Shen, Xiao-ming; Yan, Chong-huai

    2014-10-01

    We analyzed the epidemiological data during 1990-2012 that investigated the blood lead level (BLL) in the population aged 0-18 years old in China mainland and provided evidence of the benefits of implementing policies to prevent lead pollution based on the dynamic changes of BLL. Data were collected through databases including China Knowledge Resource Integrated Database (CNKI), CBM disc, Wanfang Data, Pubmed and Medline. The inclusion criteria were: 1. Epidemiological study in healthy population not included studies limited to specific patient; 2. Study subject was not the specific lead exposure population; 3. Sample size should be no less than 100 (for neonatal, no less than 50); 4. BLL detection was under strict quality control; and 5. Results should be presented as BLL (arithmetic mean level or geometric mean level). 62 articles were included in this study. All the surveys in these articles contained 189,352 subjects in 19 provinces, autonomous regions and municipalities. Linear regression analysis showed a significant decrease between 1990 and 2012 with an estimated regression coefficient of 3.05/year (SE=0.01, p<0.001). BLL gradually declined since early 21st century. Median levels of BLL among the three economic zones were 51.4 ?g/L in the eastern zone, 52.72 ?g/L in the central zone and 46.2 ?g/L in the western zone respectively. Median BLLs in male and female population aged 0-18 years old of China were 48.8 ?g/L and 46.1?g/L. Median levels of BLL among the different age ranges were 74.9 ?g/L in newborn, 46.4 ?g/L in 0 to 3 years old, 57.6 ?g/L in 3 to 7 years old and 55.6 ?g/L in above 7 years old respectively. In conclusion, the BLL in the Chinese population of 0-18 years old has gradually dropped in the past 10 years. The decline in temporal trend still remains under potential impacts of several factors such as economical level, gender and age difference. Although, China has made significant achievements in the control prevention of lead pollution, concerted efforts are still warranted to reduce children lead poisoning. PMID:25000556

  18. Talocalcaneal coalition in a 15 year old female basketball player

    PubMed Central

    Schenkel, David; deGraauw, Jennifer; deGraauw, Christopher

    2010-01-01

    This case reports an adolescent athlete with activity related chronic bilateral dorsal foot pain and stiffness. A 15 year old competitive female basketball player presented to a chiropractor subsequent to an unsuccessful course of conservative treatment for posterior tibial dysfunction. The patient’s plain films were incorrectly read as normal and a CT scan obtained by the radiologist called the findings bilateral osteoarthritis. The patient was awaiting a referral to a rheumatologist at the time of initial consultation with the chiropractor. Examination revealed limited subtalar mobility and review of the images revealed bilateral non-osseous talocalcaneal coalition. The patient was subsequently directed to a pediatric orthopedic surgeon and is scheduled for a resection of the coalition. Primary care practitioners should be aware of this uncommon, but not rare, variable clinical presentation as misdiagnosis and mismanagement could lead to suboptimal patient outcomes. To our knowledge this is the first case report of a patient with tarsal coalition published in chiropractic literature. In addition, this case is the first to report radiographic evidence of chronic mechanical stress to the second metatarsal associated with tarsal coalition. PMID:21120013

  19. Sigmoid volvulus in 16-year-old boy with an associated anomalous congenital band.

    PubMed

    Albert, Ann A; Nolan, Tracy L; Weidner, Bryan C

    2013-11-01

    Sigmoid volvulus, a condition generally seen in debilitated elderly patients, is extremely rare in the pediatric age group. Frequent predisposing conditions that accompany pediatric sigmoid volvulus include intestinal malrotation, omphalomesenteric abnormalities, Hirschsprung's disease, imperforate anus and chronic constipation. A 16-year-old previously healthy African American male presented with a 12 hour history of sudden onset abdominal pain and intractable vomiting. CT was consistent with sigmoid volvulus. A contrast enema did not reduce the volvulus, but it was colonoscopically reduced. Patient condition initially improved after colonoscopy, but he again became distended with abdominal pain, so he was taken to the operating room. On exploratory laparotomy, a band was discovered where the mesenteries of the sigmoid and small bowel adhered and created a narrow fixation point around which the sigmoid twisted. A sigmoidectomy with primary anastomosis was performed. The diagnosis of sigmoid volvulus may be more difficult in children, with barium enema being the most consistently helpful. Seventy percent of cases do not involve an associated congenital problem, suggesting that some pediatric patients may have congenital redundancy of the sigmoid colon and elongation of its mesentery. The congenital band found in our patient was another potential anatomic factor that led to sigmoid volvulus. Pediatric surgeons, accustomed to unusual problems in children, may thus encounter a condition generally found in the debilitated elderly patient. PMID:24165246

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

    PubMed

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

    2014-12-01

    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

  1. Thoracic aortic dissection in a 38-year-old man.

    PubMed

    Tilney, Peter

    2010-01-01

    A few days before Christmas, a flight team was activated for an interfacility transfer of a 38-year-old man with a history of hypertension and spinal stenosis diagnosed with a thoracic aortic dissection. The patient was presented to a local community hospital complaining of nearly 5 days of left-sided rib pain. This afternoon when he stood up from a chair, he experienced a near-syncopal episode. Concurrently, he had an abrupt onset of a tearing sensation in his chest that radiated to thoracic spine in the region between his shoulder blades. Ground emergency medical services (EMS) was called, and the patient was transported to the community hospital. During the initial transport and evaluation by the emergency department (ED) staff, the patient was noted to be hypertensive, with a systolic blood pressure greater than 180 mmHg. In the ED, the patient received aspirin, morphine, and Lopressor. He underwent a chest x-ray (Figure 1) and computed tomography (CT) scan and was diagnosed with a type B thoracic aorta dissection, which was noted to start on the descending thoracic aorta distal to the left subclavian artery and extend to the level of the celiac trunk (Figure 2). Despite the initial beta blockade, the patient was noted to be profoundly hypertensive, with initial blood pressure greater than 190 mmHg systolic. The flight team was activated for hemodynamic management and rapid transport to a facility capable of vascular and cardiothoracic surgery. PMID:20599144

  2. Papuloerythroderma of Ofuji in a 41-year-old woman

    PubMed Central

    Paluchowska, Elwira; Owczarek, Witold; Majewski, Sebastian

    2013-01-01

    Papuloerythroderma, described by Ofuji in 1984, is characterized by the occurrence of polygonal, erythematous-brown papules, covering the entire skin surface, except skin folds; these changes are accompanied by pruritus and eosinophilia. We report a case of a 41-year-old female patient with melanoerythroderma that has been intensifying since August 2010. The patient's personal and family history for atopy were negative. No triggering factors were identified in the course of hospitalizations. Preceding infections and neoplasms were excluded. The diagnosis of papuloerythroderma of Ofuji was established on the basis of major and minor criteria proposed by Torchia et al. The patient met all the five major criteria: 1) erythroderma-like eruption formed by coalescence of flat-topped, red-to-brown papules with a cobblestone-like appearance, 2) itch, 3) sparing of skin folds and creases, 4) histopathological exclusion of cutaneous lymphoma and other skin diseases, 5) absence of the causative factors such as tumors, infections, drugs and atopy. Regarding the 5 minor criteria, the patient met the following three: 1) peripheral (33.8%) and tissue eosinophilia, 2) elevated level of the total serum IgE (10935 IU/ml), 3) lymphopenia (6.6%). The patient went into remission after 9-month treatment with cyclosporine at a dose of 3 mg/kg. PMID:24353495

  3. Clinical detection of abdominal aortic aneurysm in a 74-year-old man in chiropractic practice

    PubMed Central

    de Boer, Nathan J.; Knaap, Simone F.C.; de Zoete, Annemarie

    2010-01-01

    Objective The purpose of this article is to present a case of abdominal aortic aneurysm to illustrate its clinical detection through history and physical examination and the importance of this condition to the chiropractic clinical setting. Clinical Features A 74-year-old retired man consulted a doctor of chiropractic for chronic low back pain. The history and physical examination confirmed chronic sacroiliac and a lumbar facet dysfunction. After 5 weeks, the patient stated he had stomach cramps. After this, a more thorough abdominal examination was done. The doctor of chiropractic detected an enlarged pulsatile mass upon abdominal palpation. Intervention and outcome The patient was sent to the cardiologist and had successful surgery within weeks. Conclusion An abdominal aortic aneurysm has specific symptoms and associated risk factors. If known risk factors are present, a clinical examination needs to be carried out, even though sensitivity of the clinical examination may be low. It should be a differential diagnosis in every male patient older than 50 years with low back pain. In case of suspicion, the patient should be referred for advanced imaging. PMID:21629398

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

    MedlinePLUS

    ... What to Expect Growth and Your 2- to 3-Year-Old KidsHealth > Parents > Growth & Development > Growth > Growth and Your 2- to 3-Year-Old Print A A A Text Size ... 1.8 kilograms) and grow about 2 to 3 inches (5 to 8 centimeters). They're extremely ...

  5. True or False: Do 5-Year-Olds Understand Belief?

    ERIC Educational Resources Information Center

    Fabricius, William V.; Boyer, Ty W.; Weimer, Amy A.; Carroll, Kathleen

    2010-01-01

    In 3 studies (N = 188) we tested the hypothesis that children use a perceptual access approach to reason about mental states before they understand beliefs. The perceptual access hypothesis predicts a U-shaped developmental pattern of performance in true belief tasks, in which 3-year-olds who reason about reality should succeed, 4- to 5-year-olds

  6. Deformities due to Leprosy in Children under Fifteen Years Old as an Indicator of Quality of the Leprosy Control Programme in Brazilian Municipalities

    PubMed Central

    Lana, Francisco Carlos Félix; Fabri, Angélica da Conceiçăo Oliveira Coelho; Lopes, Fabiana Nascimento; Carvalho, Ana Paula Mendes; Lanza, Fernanda Moura

    2013-01-01

    The present study aims at analysing the degree of deformity in leprosy cases diagnosed in children under 15 years old and its relationship with operational and epidemiological factors. This epidemiological cross-sectional study was carried out at municipalities of three microregions in a Brazilian hyperendemic area. Data between 1998 and 2010 was collected from the Information System for Notifiable Diseases database. The average coefficient of detection was 32.96/100.000 inhabitants; 7.61% of new cases were diagnosed in children under 15 years old; 5% in this age group were grade 2 deformity at diagnosis. Prevalence of leprosy cases in children under 15 years old with deformity was higher in males (PR = 2.65;P = 0.032; CI 95%: 1.09–6.45) and in multibacillary patients (PR = 14.68;P < 0.001; CI 95%: 3.54–60.87) and lower when the detection mode was passive (PR = 0.73,P = 0.47, CI 95%: 0.31–1.73). Such context suggests high transmissibility and early exposure to Mycobacterium leprae since a lot of cases were diagnosed in children under fifteen years old and the incubation period of the leprosy bacillus varies from 02 to 07 years. This situation contributes to maintaining the chain of disease transmission in the area and indicates that health care services should intensify leprosy control. PMID:23577038

  7. A 55 years old man with pulmonary alveolar microlithiasis.

    PubMed

    Saeed, Rebeen R; Ali, Kosar M

    2014-07-01

    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

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

    PubMed Central

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

    2014-01-01

    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. PMID:25685125

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

    PubMed Central

    Schwab, Matthew J.

    2008-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  12. Linezolid-Associated Hypoglycemia in a 64YearOld Man With Type 2 Diabetes

    Microsoft Academic Search

    Timothy Bodnar; Katelyn Starr; Jeffrey B. Halter

    2011-01-01

    BackgroundOlder diabetic patients are at increased risk for skin infections, often with methicillin-resistant Staphylococcus aureus (MRSA). Linezolid offers oral therapy with MRSA coverage. We present a case of linezolid-associated hypoglycemia in a 64-year-old diabetic patient with presumed MRSA cellulitis.

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

    PubMed

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

    2015-02-01

    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

  14. Primary Pleural Angiosarcoma in a 63-Year-Old Gentleman

    PubMed Central

    Mohammed, Shamayel

    2013-01-01

    Primary pleural angiosarcomas are extremely rare. As of 2010, only around 50 case reports have been documented in the literature. Herein, we report the case of a 63-year-old gentleman who presented with a 3-month history of right-sided chest pain, dyspnea, and hemoptysis. Chest X-ray showed bilateral pleural effusion with partial bibasilar atelectasis. Ultrasound-guided thoracocentesis showed bloody and exudative pleural fluid. Cytologic examination was negative for malignant cells. An abdominal contrast-enhanced computed tomography (CT) scan showed two right diaphragmatic pleural masses. Whole-body positron emission tomography/computed tomography (PET/CT) scan showed two hypermetabolic fluorodeoxyglucose- (FDG-) avid lesions involving the right diaphragmatic pleura. CT-guided needle-core biopsy was performed and histopathological examination showed neoplastic cells growing mainly in sheets with focal areas suggestive of vascular spaces lined by cytologically malignant epithelioid cells. Immunohistochemical analysis showed strong positivity for vimentin, CD31, CD68, and Fli-1 markers. The overall pathological and immunohistochemical features supported the diagnosis of epithelioid angiosarcoma. The patient was scheduled for surgery in three weeks. Unfortunately, the patient died after one week after discharge secondary to pulseless ventricular tachycardia arrest followed by asystole. Moreover, we also present a brief literature review on pleural angiosarcoma. PMID:23844302

  15. Breast mass in a 69-year-old woman

    SciTech Connect

    Hermann, G.; Schwartz, I.S.; Slater, G.

    1986-02-21

    A 69-year-old woman was initially seen with constant abdominal pain in the epigastrium and right upper quadrant, with nausea and vomiting of three days' duration. On examination, moderate tenderness and guarding in the right upper quadrant of the abdomen were noted. A leukocytosis of 11,000/cu mm, with a mild shift to the left, was present. Findings from a sonogram and hepatobiliary scan were consistent with a diagnosis of acute cholecystitis for which intravenous (IV) antibiotic therapy was instituted. Results of radiological studies performed on the second hospital day showed a small-bowel obstruction. On surgical exploration, a gangrenous segment of the terminal ileum was resected and an end-to-end anastomosis was performed. The resected bowel demonstrated hemorrhagic infarction with evidence of focal organizing venous thrombosis in the mesentery. The patient was initially started on a regimen of IV heparin and then switched to oral coumarin. On the fourth day of coumarin therapy, massive swelling, tenderness, and erythema were noted to involve the entire right breast. Six months later, the patient was readmitted because of an acute pulmonary embolism. A residual 4x5-cm mass was present in the central portion of the right breast. The overlying skin was slightly retracted. Mammography showed an extensive masslike density behind the right nipple, with evidence of periareolar retraction. Coumarin-induced mammary necrosis was diagnosed.

  16. Hypercalcemia in a male-to-female transgender patient after body contouring injections: a case report

    PubMed Central

    2014-01-01

    Introduction Body contouring injections by non-licensed providers are frequently sought out by a subset of the male-to-female transgender community. Although short-term side effects such as pulmonary embolism and injection site infection are well known, long-term consequences of such practices are less well studied. Case presentation Here we describe the case of a 40-year-old African American male-to-female transgender patient who presented to our institution with hypercalcemia and acute renal failure secondary to body contouring injections with industrial strength silicone by non-licensed providers, a decade prior to her visit. Work-up revealed an extensive granulomatous inflammatory process in the injection area resulting in electrolyte abnormalities and kidney injury. The patient’s lab results and symptoms responded well to long-term corticosteroid treatment and correlated with treatment adherence. Conclusion Affected patients can sometimes present with unusual clinical symptoms many years after silicone injections. In a constantly growing transgender community that often utilizes non-licensed providers for silicone injections, the medical community will likely face an increasing number of patients with long-term side effects of such practices. Therefore, it is imperative for physicians to recognize such cases promptly and initiate potentially life-saving treatment. PMID:24572248

  17. Four years old, one eye, pars planitis and cataract: surgical challenges give challenging surprises.

    PubMed

    García-Rojas, Leonardo; Matiz-Moreno, Humberto; Chávez-Mondragón, Eduardo

    2013-01-01

    Pars planitis (PP) is an intermediate form of uveitis, which, if left untreated, can result in vision loss. Although phacoemulsification with IOL implantation in eyes with PP often results in improved vision, it represents a surgical challenge due to inflammatory sequelae and the possibility of postoperative complications. This case report describes a 4-year-old male who was admitted for poor visual acuity and severe photophobia. The patient previously received vitreo-retinal surgery on his right eye due to an 'unknown disease'. Ophthalmological evaluation revealed NLP, pupillary seclusion and band keratopathy in the right eye; echographic scans revealed funnel retinal detachment. The left eye had a visual acuity of CF at 1 foot, minimal band keratopathy, posterior synechiae and the following echographic findings: abundant vitreous opacities and increased chorioretinal thickness (1.6 mm). Complete medical and laboratory assessments found no infectious pathologies. The patient was diagnosed with PP. Anti-inflammatory and immunological therapy was given in order to control inflammation. Within four months, the inflammation was controlled. Slow motion phacoemulsification with iris-retractors was performed. During the surgery, an unexpected challenge was identified: an opaque-vascular retrolental membrane. The membrane was cauterized with diathermy. Primary posterior capsulotomy and membranectomy were performed, followed by a limited anterior vitrectomy. An in-the-bag IOL was implanted successfully, with no postoperative complications, and visual acuity improved to 20/200. PMID:23626571

  18. Communication and Your 13-to 18-Year-Old

    MedlinePLUS

    ... the Flu Pregnancy Precautions Checkups: What to Expect Communication and Your 13- to 18-Year-Old KidsHealth > ... games, and talking about current events. Vocabulary and Communication Teens essentially communicate as adults, with increasing maturity ...

  19. Generalized morphea and primary biliary cirrhosis coexisting in a male patient.

    PubMed

    González-López, Marcos A; Drake, Marta; González-Vela, M Carmen; Armesto, Susana; Llaca, Héctor F; Val-Bernal, J Fernando

    2006-10-01

    We present further evidence that generalized morphea (GM) and primary biliary cirrhosis (PBC) may be associated. As far as we know, only six cases with this association have been previously reported in the published work, all of which were observed in women. We describe the case of a 62-year-old man diagnosed with M2-antibody-positive PBC who developed multiple generalized indurated plaques on the trunk and extremities 3 years later. Clinical history, laboratory data and histopathological examination were consistent with the diagnosis of GM. The coexistence in a male of these two entities that predominantly affect females reinforces the hypothesis that a pathogenic link exists between GM and PBC. Consequently, PBC should be looked for in all patients with GM. PMID:17040502

  20. Anal phyllodes tumor in a male patient: a unique case presentation and literature review

    PubMed Central

    2013-01-01

    Abstract Lesions of anogenital mammary-like glands are rare, and only 44 female cases have been reported. Herein, we describe a particularly rare case of phyllodes tumor of anogenital mammary-like glands in a 41-year-old male presenting anal bleeding. Papillectomy was performed. The excised tumor was circumscribed in shape, and after it was sliced into sections, it was noted that there were leaf-like slits on the surface of cut side. Under the microscope, the tumor was found to be biphasic, with a bland glandular epithelium and low-to-intermediate cellular stroma, which together created the leaf-like slits. Gynecomastoid hyperplasia was evident at the periphery. The epithelium showed immuno-activity for ER, PR(focal), AR, and GCDFP-15. The stromal cells showed positive staining for CD34 and vimentin. The morphology and immunophenotype were similar to benign phyllodes tumors of breast. To the best of our knowledge, this case report represents the first case of phyllodes tumor of anogenital mammary-like glands with gynecomastoid hyperplasia at the periphery in a male patient. To make a diagnosis, we had to differentiate this lesion from hidradenoma papilliferum of skin appendage, phyllodes tumor of ectopic prostatic tissue, and other tumors of anogenital mammary-like glands analogous to the breast tumor (e.g., fibroadenoma phyllodes, periductal stromal sarcoma, and spindle cell carcinoma). While gynecomastia of male breast is usually a result of hormone imbalance, our patient’s tumor did not seem to be related to peripheral hormone status in the anogenital mammary-like glands. Nevertheless, because hormone imbalance has been strongly related to male breast cancer, hormone levels may need to be followed in male patients who have this rare malady. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1509145815899177 PMID:23531415

  1. Pulmonary adiaspiromycosis in a two year old girl.

    PubMed Central

    Nuorva, K; Pitkänen, R; Issakainen, J; Huttunen, N P; Juhola, M

    1997-01-01

    A case of disseminated bilateral pulmonary adiaspiromycosis is reported in a two year old Finnish girl. She recovered from this rare infection after treatment with amphotericin B. She is the first human case of adiaspiromycosis in Scandinavia and she is the youngest child with this disease reported so far. Electron microscopy showed that the three layers of the spore wall were not typical; rather, there seemed to be a gradual transition between the main wall zones, which may be split into an indefinite number of thin layers. Varying numbers and thicknesses were seen with different staining methods, and in different spores. Diagnosis relies on recognition of the fungus in a pulmonary biopsy specimen, because there are no reliable serological tests and culture of the fungus is time consuming and not always successful. It was thought that this patient had become infected as a result of contact with soil dust containing the spores in the yard surrounding her home, and as a result of her mother's work in a large garden shop. Images PMID:9059367

  2. A 47-year-old returning traveler with shock.

    PubMed

    Soni, Hardik; Gandhi, Viral; Varma, Sohan; Kaur, Deepinder; Epelbaum, Oleg

    2015-01-01

    A 47-year-old man with no significant past medical history, originally from Indonesia, was brought to the ED of an urban US medical center after being found collapsed on the sidewalk in respiratory distress and with an altered sensorium. Upon arrival to the ED, he was tachypneic, with increased work of breathing and an oxygen saturation of 88% on 100% nonrebreather mask, so he was immediately intubated. Following intubation, he became profoundly hypotensive, requiring aggressive crystalloid resuscitation and vasopressor support. Broad-spectrum antimicrobials were administered, including ceftriaxone, vancomycin, levofloxacin, and oseltamivir. Further history elicited subsequently from family members revealed that the patient had returned from a 2-week vacation in Indonesia 6 days prior to presentation. According to relatives, he appeared to be in his usual state of health upon his return and was not seen by anyone thereafter, but in the interim he reportedly had an episode of epistaxis, and text messages received from him became progressively more bizarre. PMID:25560874

  3. Epiploic appendagitis in a 27-year-old man

    PubMed Central

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

    2011-01-01

    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

  4. A Spinal Arteriovenous Fistula in a 3-Year Old Boy

    PubMed Central

    Crijnen, Thomas E. M.; Voormolen, Maurits H. J.; Robert, Dominique; Jorens, Philippe G.; Ramet, Jose

    2014-01-01

    We present a case of a 3-year-old boy with neurodegeneration. Family history reveals Rendu-Osler-Weber disease. Magnetic resonance imaging (MRI) of the spinal cord and spinal angiography showed a spinal arteriovenous fistula with venous aneurysm, causing compression of the lumbar spinal cord. Embolisation of the fistula was executed, resulting in clinical improvement. A week after discharge he was readmitted with neurologic regression. A second MRI scan revealed an intraspinal epidural haematoma and increase in size of the aneurysm with several new arterial feeders leading to it. Coiling of the aneurysm and fistulas was performed. Postoperative, the spinal oedema increased despite corticoids, causing more extensive paraplegia of the lower limbs and a deterioration of his mental state. A laminectomy was performed and the aneurysm was surgically removed. Subsequently, the boy recovered gradually. A new MRI scan after two months showed less oedema and a split, partly affected spinal chord. This case shows the importance of excluding possible arteriovenous malformations in a child presenting with progressive neurodegeneration. In particular when there is a family history for Rendu-Osler-Weber disease, scans should be performed instantly to rule out this possibility. The case also highlights the possibility of good recovery of paraplegia in paediatric Rendu-Osler-Weber patients. PMID:24707424

  5. Achalasia in a sixty-four-year-old man.

    PubMed Central

    Komisaruk, E. A.; Seymour, N. E.

    1998-01-01

    Achalasia is an esophageal motility disorder characterized by increased lower esophageal sphincter pressure and absence of peristalsis in the lower esophagus. Patients typically present with complaints of progressive difficulty swallowing over a period of several years. Diagnosis is confirmed by esophageal manometry. Complications of achalasia include esophagitis, aspiration and possibly an increased risk of esophageal carcinoma. Medical treatment options include pneumatic dilatation, esophageal bougienage, nitrates, calcium channel blockers and botulinum toxin injections. The primary method of surgical treatment is the Heller myotomy, in which longitudinal incisions are made in the muscle fibers of the lower esophageal sphincter to reduce sphincter pressure. Frequently, a fundoplication is performed in addition to the myotomy to decrease the likelihood of development of gastroesophageal reflux. In recent years, the Heller myotomy has been performed both thoracoscopically and laparoscopically. An additional development has been the placement of an endoscope in the esophagus to provide transillumination during surgery; intraoperative endoscopy allows improved assessment of the depth of myotomy incisions and reduces the risk of esophageal perforation. The case report below describes a 64-year-old-man with achalasia who presented with persistent dysphagia despite multiple attempts at medical treatment. A laparoscopic Heller myotomy with Toupet fundoplication was performed with subsequent eradication of symptoms. A discussion of the epidemiology, etiology, clinical presentation, diagnosis and treatment of achalasia follows the case report. Images Figure 1 PMID:9713952

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed Central

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

    2011-01-01

    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

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

    E-print Network

    Bezrukov, Sergey M.

    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

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

    PubMed Central

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

    2014-01-01

    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

  10. All-cause mortality from obstructive sleep apnea in male and female patients with and without continuous positive airway pressure treatment: a registry study with 10 years of follow-up

    PubMed Central

    Jennum, Poul; Třnnesen, Philip; Ibsen, Rikke; Kjellberg, Jakob

    2015-01-01

    Background More information is needed about the effect on mortality of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA), especially in women. Methods We employed a historical cohort study design, using data from 25,389 patients with a diagnosis of OSA selected from the Danish National Patient Registry for the period 1999–2009. We used Cox proportional hazard function to evaluate the all-cause mortality from OSA in middle-aged and elderly males and females who were treated, or not, with CPAP. Results Female OSA patients had a lower mortality than males, irrespective of whether they received CPAP treatment. CPAP treatment improved survival, as illustrated by the hazard ratio of 0.62 (P<0.001). This effect was dependent on gender: CPAP had no significant effect on 20- to 39-year-old males and females, but the overall mortality in this age group was small. Survival was increased by CPAP in 40- to 59-year-old and ?60-year-old males, but no such effect was observed in females. Positive predictors of survival were young age, female gender, higher educational level, and low 3-year prior comorbidity as estimated by the Charlson Comorbidity Index. Negative predictors for survival were male gender, age ?60 years, no CPAP treatment, prior comorbidity, and low educational level. Conclusion CPAP therapy is associated with reduced all-cause mortality in middle-aged and elderly males, but no significant effect was found in females.

  11. Abnormal glucose tolerance in young male patients with nonalcoholic fatty liver disease

    PubMed Central

    Yun, Jung Won; Cho, Yong Kyun; Park, Jung Ho; Kim, Hong Joo; Park, Dong Il; Sohn, Chong Il; Jeon, Woo Kyu; Kim, Byung Ik

    2009-01-01

    Objective The association of nonalcoholic fatty liver disease (NAFLD) with insulin resistance and metabolic syndrome has been documented for obese men and middle-aged men. This study was designed to determine the relationship between NAFLD and the oral glucose tolerance test (OGTT) to predict preclinical diabetes in nondiabetic young male patients (<30 years old). Methods A total of 75 male patients who had elevated liver enzymes and who were diagnosed with NAFLD were enrolled in this study. A standard 75 g OGTT was carried out on all patients. Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were defined as a fasting plasma glucose (FPG) level ?100 mg/dl but <126 mg/dl, and a 2-h post-load glucose on the OGTT of ?140 mg/dl, but <200 mg/dl respectively. Results According to the OGTT results, 24 (32%) patients were diagnosed as having IGT and 12 (16%) patients were diagnosed as having diabetes. Among the 48 patients with normal fasting glucose, 18 (37.6%) patients showed abnormal glucose tolerance (15 had IGT and three had diabetes). The NAFLD patients with abnormal glucose tolerance showed significant differences in age, weight, body mass index, waist–hip ratio, alanine aminotransferase, total bilirubin, total cholesterol, low-density lipoprotein cholesterol, triglyceride, insulin, FPG and homeostasis model for insulin resistance (HOMA-IR). Multiple regression analysis showed that age, FPG and HOMA-IR were independent predictors of abnormal glucose tolerance. Conclusions Although the patients were young men, an OGTT should be recommended for NAFLD patients with elevated liver enzymes and IFG to predict the risk of type 2 diabetes. PMID:19323780

  12. A Two-Year-Old with Rickets: Diet History, Treatment and Follow-Up

    Microsoft Academic Search

    K. R. Kramer; S. M. Phillips; J. Radcliffe

    1998-01-01

    AJ, a 2-year-old African-American male, was referred to a nutrition and gastroenterology clinic with the diagnosis of rickets and iron deficiency anemia, both of which were secondary to poor nutrition. All of the classic signs of rickets were present: frontal bossing, rachitic rosary, enlarged joints, and bowed legs with the latter condition making it impossible for AJ to walk without

  13. Objective tinnitus due to essential palatal tremor in a 5-year-old.

    PubMed

    MacDonald, John T

    2007-03-01

    A healthy 5-year-old male reported a clicking sound in both ears. Neurologic examination was normal except for an audible clicking noise that could be heard when within 10 cm of either ear and bilateral rapid rhythmic movements of the soft palate. All tests were normal including magnetic resonance imaging brain scan. One year after onset, his objective tinnitus and palatal tremor were no longer present. PMID:17352951

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

    PubMed Central

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

    2014-01-01

    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. PMID:25685130

  15. [Sexuality in children 9-14 years old].

    PubMed

    Ballester Arnal, Rafael; Gil Llario, María Dolores

    2006-02-01

    The aim of this study was to analyze sexual behaviors and attitudes of children 9-14 years old in Spain. In this article we present data from 470 children of which 52% are boys and 48% girls. In order to evaluate the sample, Information, Attitudes and Behaviors related to Health Questionnaire (CIACS-II) was used. Results evidence that boys 9 years old already show behaviors that evidence their interest towards sexuality. 8% have sometimes masturbated and 9% have used pornography for becoming excited. 14% of children 11-12 years old have already had sexual relations and 38% state to have sexual fantasies. Girls start to masturbate and to have sexual relations later than boys and show a prevalence of sexual fantasies and use of pornography very lower. It is necessary sexual education programs to be implanted since early ages in schools. PMID:17296005

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

    PubMed Central

    Huang, Yanlei; Zheng, Shan; Xiao, Xianmin

    2014-01-01

    Objective: To analyze the etiology and clinical diagnostic method for chronic complex anal and rectal inflammation in children less than 3 years old. Method: Seven children (5 males and 2 females; 1 year 8 months to 3 years of age at the time of physician evaluation) with chronic complex anal and rectal inflammation were enrolled between May 2008 and May 2013 at our hospital. Clinical history, results of auxiliary examinations, and empirical treatment of the children were analyzed retrospectively combined with the etiologic diagnosis. Results: Four patients were confirmed to have Crohn’s disease and one patient was confirmed to have intestinal tuberculosis; two patients were suspected to have Crohn’s disease. Anemia and low pre-albumin level were common (seven patients); serologic testing revealed four patients with elevated IgG levels and seven patients with elevated IgA levels; there were no patients with positive tuberculosis antibody titers and two patients were weakly positive for C-ANCA (one patient with Crohn’s disease and one patient intestinal tuberculosis). Colonoscopies revealed that the entire colon was affected in one patient, the left hemicolon was affected in four patients, and the sigmoid colon and rectum were affected in two patients. Two patients with Crohn’s disease and one patient with intestinal tuberculosis were diagnosed by colonoscopies in combination with histopathologic examinations. Two patients with Crohn’s disease were confirmed after empirical drug treatment, and two other patients were not definitely diagnosed. Conclusion: The possibility of Crohn’s disease or intestinal tuberculosis should be considered in the clinical diagnosis of complex chronic anal and rectal inflammation in younger children. Local surgery is sometimes unnecessary. Empirical drug treatment should be used if necessary. PMID:25550910

  17. Male nurses and the protection of female patient dignity.

    PubMed

    Prideaux, Antony

    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

  18. Veillonella spondylodiscitis in a healthy 76-year-old lady

    Microsoft Academic Search

    Thomas J. Kishen; Steven T. Lindstrom; Greg Etherington; Ashish D. Diwan

    Purpose  To report a case of Veillonella spondylodiscitis in a healthy 76-year-old lady.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A previously healthy 76-year-old lady presented with worsening axial back pain at the thoracolumbar junction, fever and loss\\u000a of weight. Examination revealed deep tenderness over the thoracolumbar junction with painful and restricted spinal movements.\\u000a The lower limb motor power, sensation and reflexes were normal.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Radiographs of the lumbosacral

  19. Correlates of Intimate Partner Violence Among Male Alcoholic Patients

    Microsoft Academic Search

    Christopher M. Murphy; Timothy J. OFarrell; William Fals-Stewart; Michael Feehan

    2001-01-01

    Male-to-female partner violence was investigated in heterosexual couples with an alcoholic male partner. Partner violent (PV) alcoholic patients (n = 183), when compared with nonviolent (NV) alcoholic patients (n = 120), had more antisocial personality characteristics, greater alcohol problem severity, greater use of other drugs, higher relationship distress, and stronger beliefs in the link between alcohol consumption and relationship problems.

  20. Systemic Lupus erythematosus Presenting with Hyporeninemic Hypoaldosteronism in a 10YearOld Girl

    Microsoft Academic Search

    Gregory A. Kozeny; Morrison Hurley; Raoul Fresco; Leonard L. Vertuno; Vinod K. Bansal; Jessie E. Hano

    1986-01-01

    Hyperkalemia has been noted to occur spontaneously in patients with long-standing systemic lupus erythematosus who did not have advanced renal insufficiency. The patients previously described all had relatively normal renin-aldoserone systems, and the hyperkalemia was thus presumed to be secondary to a primary defect in renal tubular potassium secretion. We describe at 10-year-old girl with lupus nephritis, without significant renal

  1. Allograft Reconstruction After Sarcoma Resection in Children Younger Than 10 Years Old

    Microsoft Academic Search

    D. Luis Muscolo; Miguel A. Ayerza; Luis Aponte-Tinao; German Farfalli

    2008-01-01

    Preservation of limb function in pediatric oncology patients is challenging with the ongoing growth of limbs contralateral\\u000a to reconstructed limbs. We analyzed 22 patients younger than 10 years old who received an allograft after resection of a bone\\u000a sarcoma with a minimum followup of 2 years (mean, 4 years; range, 2–14 years). The mean age was 7 years (range, 2–10 years).\\u000a There were 16 boys and

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

    PubMed

    Ahmed, Amir I A

    2011-01-01

    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

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

    PubMed Central

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

    2013-01-01

    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

  4. Cerebral Metastasis from Breast Cancer in a Male Patient with HIV

    PubMed Central

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

    2015-01-01

    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. PMID:25694836

  5. Meaning from Syntax: Evidence from 2-Year-Olds

    ERIC Educational Resources Information Center

    Arunachalam, Sudha; Waxman, Sandra R.

    2010-01-01

    When toddlers view an event while hearing a novel verb, the verb's syntactic context has been shown to help them identify its meaning. The current work takes this finding one step further to reveal that even in the absence of an accompanying event, syntactic information supports toddlers' identification of verb meaning. Two-year-olds were first…

  6. Service Organization for Four Year Old Children with Auditory Handicaps.

    ERIC Educational Resources Information Center

    Morrow-Lettre, Christiane

    1984-01-01

    An oral program for four-year-old children with hearing impairments features teamwork among direct interventionists (teacher, speech therapist, audiologist, psychologist, social workers, and parents) on rehabilitative speech therapy activities as well as integration of hearing with hearing impaired children. (CL)

  7. Two-Year-Olds Compute Syntactic Structure On-Line

    ERIC Educational Resources Information Center

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

    2010-01-01

    Syntax allows human beings to build an infinite number of new sentences from a finite stock of words. Because toddlers typically utter only one or two words at a time, they have been thought to have no syntax. Using event-related potentials (ERPs), we demonstrated that 2-year-olds do compute syntactic structure when listening to spoken sentences.…

  8. Eric Piel, 26 years old, French 68 rue de Rivoli

    E-print Network

    Piel, Éric

    Education 2004-2007 · PhD thesis at the Université des Sciences et Technologies de Lille (USTL), France- logy (UTC), France. 2002 · Fall semester spent at the Tampere University of Technology (FinlandEric Piel, 26 years old, French 68 rue de Rivoli 59800 Lille France Tel: +33 (0)6 87 22 69 36 E

  9. 20-year-old injury: an unusual cause of stroke

    PubMed Central

    Lim, V W L; Flynn, C A; O'Connor, M; Lyons, D

    2013-01-01

    A 62-year-old man presented with a 2-day history of headache, nausea and dizziness on a background of recently diagnosed stage 2c prostate carcinoma and controlled hypertension. Imaging confirmed bilateral cerebellar strokes; on further investigations, he was found to have undiagnosed subclavian steal syndrome following severe injury to his left arm more than 20?years earlier. PMID:23606391

  10. Teaching Language to a Two-Year-Old with Autism

    Microsoft Academic Search

    Shiri Bartman; Nancy Freeman

    2003-01-01

    This research examined the rate of communication acquisition of a two-year old girl with autism using the principles of Applied Behaviour Analysis (ABA) with an emphasis on B. F. Skinner's analysis of language. The primary treatment goal was to teach communication by providing as many manding\\/requesting opportunities as possible through manipulation and control of the environment. The primary communication system

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

    PubMed

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

    2013-01-01

    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

  12. Rheumatic Fever in a 2YearOld Child

    Microsoft Academic Search

    Hema Nirmal; Pooja Vani; Manoj Chhabra; Nitin Ron

    2008-01-01

    A 2-year-old boy with a history of presumed viral pharyngitis presented with rheumatic fever. The episode of pharyngitis was\\u000a not treated with antibiotic at five years of age, physicians should be aware of the sequelae of untreated group A beta-hemolytic\\u000a streptococcal pharyngitis.

  13. Gallbladder mucocele in a 12-year-old cocker spaniel

    PubMed Central

    Norwich, Alison

    2011-01-01

    A 12-year-old, spayed cocker spaniel was presented for panting behavior which had increased over the past several months. A diagnosis of hyperadrenocorticism was made, and ultrasound imaging revealed the presence of a gallbladder mucocele. While often an incidental finding, gallbladder mucoceles can have consequences and require intervention. The etiology, diagnosis, and management of gallbladder mucoceles are discussed. PMID:21629430

  14. Cryptogenic organising pneumonia in a 92 year old

    Microsoft Academic Search

    Helen Kenealy; Geoffrey Green

    We report a case of a 92-year-old lady with cryptogenic organising pneumonia (COP). She was referred for assessment by her family doctor with raised inflammatory markers. She gave a history of a severe viral illness 2 months prior. Her symptoms at the time of review were a dry cough with minimal sputum production. Respiratory examination was unremarkable, except for mild

  15. Similarity Predicts Liking in 3-Year-Old Children

    ERIC Educational Resources Information Center

    Fawcett, Christine A.; Markson, Lori

    2010-01-01

    Two studies examined the influence of similarity on 3-year-old children's initial liking of their peers. Children were presented with pairs of childlike puppets who were either similar or dissimilar to them on a specified dimension and then were asked to choose one of the puppets to play with as a measure of liking. Children selected the puppet…

  16. The Passive in 3- and 4-Year-Olds

    ERIC Educational Resources Information Center

    de Barros Pereira Rubin, Maraci Coelho

    2009-01-01

    This paper argues that analyzing the patterns of individual subject performance in tests of comprehension of passives might give insight into how little children interpret passives: 3 and 4 year-olds seem to go through a range of passive interpretation, that varies from actual comprehension to total non-comprehension. The fact that some small…

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

    ERIC Educational Resources Information Center

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

    2013-01-01

    In two experiments, 2.5-year-old children spontaneously used geometric information from 2D maps to locate objects in a 3D surface layout, without instruction or feedback. Children related maps to their corresponding layouts even though the maps differed from the layouts in size, mobility, orientation, dimensionality, and perspective, and even when…

  18. The Structure of Executive Function in 3-Year-Olds

    ERIC Educational Resources Information Center

    Wiebe, Sandra A.; Sheffield, Tiffany; Nelson, Jennifer Mize; Clark, Caron A. C.; Chevalier, Nicolas; Espy, Kimberly Andrews

    2011-01-01

    Although the structure of executive function (EF) during adulthood is characterized by both unity and diversity, recent evidence suggests that preschool EF may be best described by a single factor. The latent structure of EF was examined in 228 3-year-olds using confirmatory factor analysis. Children completed a battery of executive tasks that…

  19. Decreasing Pilfering Behavior of an Eleven Year Old Boy.

    ERIC Educational Resources Information Center

    Klann, Harriet; Shannon, Neil

    A contract and point system were used to decrease the pilfering behavior of an 11-year-old boy. Under the contract system, the boy kept a daily record of his progress and earned points toward a trip to the planetarium. After introduction of the contract the pilfering dropped from at least two times a week to none at all. (LS)

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

    PubMed Central

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

    2013-01-01

    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

  1. A 54-year-old man referred with nonresolving pneumonia.

    PubMed

    Catteeuw, Julie; Koegelenberg, Coenraad F N; Bruwer, Johannes W; Sissolak, Gerhard; Schroeter, Leocardea; Mohamed, Nooroudien; Irusen, Elvis M

    2014-09-01

    A 54-year-old man was referred with nonresolving pneumonia. He had been treated for community-acquired pneumonia 6 weeks earlier. He reported grade 2 dyspnea, malaise, and a nonproductive cough. He had also experienced three episodes of minimal hemoptysis but denied weight loss, fever, or any other constitutional symptoms. He was a nonsmoker and was being treated for dyslipidemia. PMID:25180750

  2. [A 15-year old boy with abdominal pain].

    PubMed

    Raats, Jelle W; Donker, Jeroen M W; van der Laan, Lijckle

    2014-01-01

    A 15-year-old boy came to the emergency department with abdominal pain in the left lower quadrant. The medical history included surgery for malrotation of bowel in two of his brothers. A CT-abdomen showed malrotation of the colon with a left-sided appendicitis and polysplenia. An emergency laparoscopic appendectomy was performed. Recovery was uneventful. PMID:24618236

  3. Localized secondary erythromelalgia in an 11-year-old boy.

    PubMed

    Wu, Hui-Hui; Wang, Ming-Jun; Luo, Di-Qing; Lin, Qing

    2013-01-01

    We report an 11-year-old boy with localized secondary erythromelalgia on his left medial thigh. The episodes responded well to indomethacin and prednisone but recurred after the medications were stopped. The disease was stable after being treated for 5 months. PMID:22612394

  4. "Generalist Genes" and Mathematics in 7-Year-Old Twins

    ERIC Educational Resources Information Center

    Kovas, Y.; Harlaar, N.; Petrill, S. A.; Plomin, R.

    2005-01-01

    Mathematics performance at 7 years as assessed by teachers using UK national curriculum criteria has been found to be highly heritable. For almost 3000 pairs of 7-year-old same-sex twins, we used multivariate genetic analysis to investigate the extent to which these genetic effects on mathematics performance overlap with genetic effects on reading…

  5. 043. A 28-year-old woman with hemoptysis

    PubMed Central

    Galanou, Artemis; Markopoulou, Katerina; Renesis, Basileios; Karaiskos, Theodoros; Dimitriadis, Ioannis; Tryfon, Stavros; Tsara, Venetia

    2015-01-01

    Objective To describe a rare case of bronchogenic cyst of the lung. Case report ? 28-year-old female presented with hemoptysis over the past few hours and left-sided chest pain for the past four days. Past medical history was notable for treated compulsive disorder, peptic ulcer [2000] and ovarian and mammary cysts under observation. She was a smoker with nine p-y history. The chest X-ray (CXR) showed a large fluid level over the left hemidiaphragm. A year ago CXR was normal. Chest computed tomography revealed an abscess with fluid level supradiaphragmatically at the left lower lobe (LLL), with bronchiectases and peribronchiectatic lesions in the same lobe. During bronchoscopy there was hemorrhage from B9 with signs of pressure from outside, without endobronchial lesions. Cytology of bronchial fluid was negative for malignancy and antibodies for echinococcus were also negative. During hospitalization the patient was afebrile and without respiratory insufficiency. Because of continuing hemoptysis and worsening chest pain she was referred for surgery. A stemmed mediastinal cyst arising from the diaphragmatic surface of the LLL was found and it was excised with sparing of the lung parenchyma. Pathology was consistent was bronchogenic cyst. A month later the patient has a normal CXR and is symptom-free. Discussion Bronchogenic cysts are rare congenital cystic malformations arising from the embryonic foregut and are located in the mediastinum or the lungs as fluid-filled formations that do not communicate with the tracheobronchial tree except if they are infected (when they enlarge suddenly due to a valve mechanism). They usually present with chest pain. Hemoptysis is rare and is thought to be due to pressure effects. Diagnosis is possible by determining the density of the cyst content (by computed tomography or magnetic resonance imaging). Stalks that connect the cyst to various intrathoracic structures have been described in up to 46% of cases. In our case, due to the fluid level, an abscess was included in the differential diagnosis. Treatment involves observation, fine needle aspiration of the contents and surgical excision. Due to the low complication rate the latter is recommended more often, before cyst complications, such as in our case, develop.

  6. [Clinical courses and pathological findings in two gay male patients with acquired immunodeficiency syndrome infected in Japan].

    PubMed

    Takamizawa, S; Kaito, K; Hori, S; Kikuchi, A; Hashimoto, T; Shimada, J; Miyahara, T; Jyo, K; Ushigome, S; Nikaido, T

    1990-02-01

    This is a report on the clinical courses and pathological findings in two gay male patients with acquired immunodeficiency syndrome (AIDS) infected in Japan. Case 1. A 39 year-old Japanese homosexual male was diagnosed as amebic dysentery complicated with liver abscess on admission. He was placed on Metronidazole with complete relief. Serological tests was positive for AIDS. On second admission, he was found to have pneumocystis carinii pneumonia (PCP) and cytomegalo-viral uveitis. Administration of Pentamidine was partially effective, however the therapy with Azidothimidine was discontinued by bone marrow suppression. On his third admission, he suffered from cryptococcal meningitis and therapy-resistant fungusemia. Finally he died of recurrent pneumonia regardless of appropriate therapies. Autopsy proved extended cryptococcal infection in the brain, meninx, lungs, liver and kidney, and cytomegalo-infection in the lungs, liver and kidney. Furthermore, atypical mycobacteriosis was found in the lymph nodes. There was no active findings compatible with PCP. Case 2. A 44 year-old Japanese homosexual male was admitted with oral candidiasis and diagnosed as AIDS related complex. He suffered from pneumonia with marked improvement on sulfamethoxazole-Trimethoprim. On his second admission, he developed diarrhea and was found to be infected with Giardia lambia. In addition, cytomegalo-viral infection damaged his eye sight. He died of pneumonia and meningitis shortly there after. Autopsy proved a cytomegalo-viral infection in the lung and colon, old lesions possibly caused by PCP in the lungs, and suppurative meningitis in the meninx. These experiences confirm that AIDS patients can be exposed to several opportunistic infections at the same time in the multiple organs. Furthermore, it is suggested that homosexual patients with AIDS may have unique opportunistic infections such as amebic dysentery or Giardia lamblia unlike other AIDS patients related to hemophilia. PMID:2338506

  7. Ten years survival with excellent outcome after living donor liver transplantation from 70 years old donor for primary hepatic neuroendocrine carcinoma: Case report

    PubMed Central

    Alekseev, Denis; Goralczyk, Armin; Lorf, Thomas; Ramadori, Giuliano; Obed, Aiman

    2011-01-01

    BACKGROUND Primary hepatic carcinoid tumors (PHCT) are rare entities; they are even rarer than extrahepatic neuroendocrine gastrointestinal tumors with only about 95 cases reported in the literature. An extrahepatic primary tumor must be excluded to confirm the diagnosis of PHCT. CASE PRESENTATION We report a case of a 42-year-old male patient with a primary hepatic neuroendocrine carcinoma, who successfully underwent living donor liver transplantation from his 70 years old mother with 10 years follow-up. Both donor and recipient are still alive and in the good health. CONCLUSION Living liver donation from elderly donors for the patients with irresectable neuroendocrine liver malignancies can be as safe as deceased donation or liver donation from young donors (age < 50). Living donation from elderly donors might significantly expand the donor pool for patients with liver neuroendocrine tumors (NET) and potentially reduce waiting list mortality. Especially young patients with irresectable NET can benefit from this option. However, case–control studies are needed to verify the advantage of living liver transplantation (LDLT) for the patients with irresectable liver NET and to define selection criteria for these patients. PMID:22288038

  8. Internet Use and Psychological Well-Being among 10-Year-Old and 11-Year-Old Children

    ERIC Educational Resources Information Center

    Devine, Paula; Lloyd, Katrina

    2012-01-01

    This paper uses data from the 2009 Kids' Life and Times Survey, involving 3657 children aged 10 or 11 years old in Northern Ireland. The survey indicated high levels of use of Internet applications, including social-networking sites and online games. Using the KIDSCREEN-27 instrument, the data indicate that the use of social-networking sites and…

  9. Traction alopecia in Sikh male patients.

    PubMed

    James, Jinny; Saladi, Rao N; Fox, Joshua L

    2007-01-01

    This article reports on traction alopecia among Sikh males as a result of stress on the hair from wearing a turban. Treatment for this condition in such a population is difficult. Permanent removal of the turban is religiously forbidden. Therefore, the traction continues, as will the alopecia, possibly accompanied by seborrheic dermatitis and psoriasis. PMID:17823469

  10. A case report of urethral prolapse in a 38 year old female with 46XY karyotype.

    PubMed

    Watson, Helena; Stasiowska, Ewa

    2014-06-01

    A 38-year old female presented with the acute onset of a vulval mass associated with pain and vaginal bleeding. She is female phenotype but has 46XY karyotype and Complete Androgen Insensitivity Syndrome (CAIS). At 15 years old she had a laparotomy and bilateral orchidectomy. Following admission, an examination under anaesthesia and cystoscopy was performed. A diagnosis of strangulated complete urethral prolapse was made. The lesion was excised with diathermy and the meatal skin was reanastomosed to the urethra. At follow-up, the urethra was well healed. The patient now attends Menopause Clinic for oestrogen-replacement therapy. We hope this case raises awareness of the possibility of urethral prolapse in younger women who are oestrogen deficient. It provides further incentive for compliance with hormone replacement therapy for patients with CAIS following gonadectomy, or other women with premature menopause. PMID:25017598

  11. Gastric carcinoid tumor in a 14-year old girl.

    PubMed

    Kirsaclioglu, Ceyda Tuna; Kuloglu, Zarife; Kansu, Aydan; Ensari, Arzu; Siklar, Zeynep; Berbero?lu, Merih; Ocal, Gönül

    2014-11-01

    Gastric carcinoid tumors (GCT) are rare lesions that constitute 2.6-8.7% of all gastrointestinal carcinoids, mostly affect middle-aged females but the incidence in children is unknown. We present a 14-year-old girl, with GCT. She was treated with recombinant human growth hormone (GH) for complete GH deficiency, and endoscopy was performed to identify iron-deficiency anemia. Upper gastrointestinal endoscopy revealed a gastric polyp, and biopsies were compatible with GCT. PMID:25180819

  12. The cause of 50 million-year-old colour.

    PubMed

    Parker, Andrew R; McKenzie, David R

    2003-11-01

    Multilayer reflectors cause structural, 'metallic' colours in a diversity of animals today, yet are unknown in extinct species. We identify a multilayer reflector, causing structural colour, in a 50-million-year-old beetle from Messel, Germany. It is proposed that the original material of this reflector has been preserved, although this is not a precondition for determining original colours from ancient multilayer reflectors. Therefore, the potential exists to reveal the original colours of other (particularly arthropod) extinct species. PMID:14667366

  13. Three Years Old Child Neck Finite Element Modelisation

    Microsoft Academic Search

    Raphaël Dupuis; Frank Meyer; Rémy Willinger

    Despite of recent progresses in occupant safety, the protection of children is still not optimal. To offer a better comprehension\\u000a of child injury mechanisms, we developed a human-like finite element of a three years old child's neck. The subject was scanned\\u000a with a medical scanner. The images were first semiautomatically segmented in order to extract the soft tissues and the

  14. Ablation of supraventricular tachycardia in a 96 year old

    Microsoft Academic Search

    IHAB G. DIAB; M ARK J. EARLEY

    2007-01-01

    Atrioventricular nodal re-entrant tachycardia (AVNRT) is a common arrhythmia that is frequently encountered in clinical practice. Though more common in the younger population, it affects individuals of all ages. The elderly in particular are usually more symptomatic and more frequently require emergency treatment including urgent hospital admissions. We report on a 96-year-old lady who presented with troublesome supraventricular tachycardia that

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

    PubMed

    Herman, S P

    1983-01-01

    Markedly effeminate behavior in a young boy is a source of concern and confusion for parents, teachers, and the child. It also represents a therapeutic dilemma for the child psychiatrist. The case of a five-year-old boy with gender identity disorder of childhood is presented and the literature on hypotheses of etiology, treatment, and long-term follow-up is reviewed. The ethical and philosophical questions posed by such a case are discussed. PMID:6880245

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

    Microsoft Academic Search

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

    2009-01-01

    We report a case of histopathologically proven autoimmune pancreatitis in an 11-year-old boy. Abdominal US and MRI showed\\u000a a focal swelling of the pancreatic head, the latter also showing delayed contrast enhancement. There was diffuse irregular\\u000a pancreatic duct narrowing, compression of the intrapancreatic common bile duct, and mild proximal biliary dilatation on MR\\u000a cholangiopancreatography. Laboratory results revealed normal serum IgG

  17. A Five-Year-Old Child with Renal Hydatidosis

    PubMed Central

    Moscatelli, Guillermo; Moroni, Samanta; Freilij, Héctor; Salgueiro, Fabián; García Bournissen, Facundo; Altcheh, Jaime

    2013-01-01

    Hydatidosis is a zoonosis of worldwide distribution caused by the parasite Echinococcus granulosus. Clinical manifestations include cyst formation, most commonly in the liver (67–89%) and lungs (10–15%). Renal localizations are rare. We report a case of renal hydatidosis in a five-year-old child treated in a tertiary pediatric hospital in Argentina. After the diagnosis was made, elective surgery was performed, which led to a rapid recovery. PMID:23897992

  18. Dietary Habits of Welsh 12-13 Year Olds

    ERIC Educational Resources Information Center

    Thomas, Non-Eleri; Cooper, Stephen-Mark; Graham, Mike; Boobier, Wyndham; Baker, Julien; Davies, Bruce

    2007-01-01

    This study examined the dietary habits of Welsh 12-13 year olds. A cohort of 84 boys and 81 girls, age 12.9 SD 0.3 years; body mass 51.3 SD 12.6kg; and stature 1.54 SD 0.08m, completed a food frequency questionnaire and seven-day food diary. Mean daily kilocalories (kcal/d), and percentages of total fat, saturated fat, carbohydrate, and protein,…

  19. Treatment of a four-year-old victim of incest

    Microsoft Academic Search

    Judith V. Becker; Linda J. Skinner; Gene G. Abel

    1982-01-01

    A case study describing the use of behavior techniques in the treatment of a four—year—old sexual assault victim is presented. The target behaviors included eating, phobic behaviors, self—injurious behaviors, and comments made about the father (the perpetrator) and the paternal grandmother. The child's mother served as both data collector and therapist. The study demonstrates that child victims can experience a

  20. Double Uvula in a Fifty-Six-Year-Old Woman

    PubMed Central

    Catli, Tolgahan

    2014-01-01

    Introduction: Deformities of the uvula are considered as the dark area of otorhinolaryngology practice. This little and plain part of the human organism has various functions and its abnormalities might cause serious disabilities. Case Presentation: In our case report, we present a unique deformity of the uvula in a 56-year-old woman. Discussion: The aim of this report was to present a very rare condition, unique case “polyuvula”, and to review the literature regarding other uvula abnormalities.

  1. Heart Health...Your Choice. 11-14 Year Olds.

    ERIC Educational Resources Information Center

    National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD.

    The purpose of this illustrated booklet is to teach 11-14 year old students that all healthy Americans, 2 years of age or older, should eat in a way that is low in saturated fat and cholesterol to help reduce the risk of heart disease. The guide is designed to promote changes in eating patterns, to show children how to switch to good eating…

  2. Painful ulcers in a 5-year-old girl

    Microsoft Academic Search

    Maria do Socorro Costa da Silva; Ellem Ramos Ferreira; Leonardo Rodrigues Campos; Márcio Tadeu Vieira Brito; Patricia Ferreira; Rodrigo Silva Grilo

    2011-01-01

    A 5-year-old girl was admitted to our clinic with several painful ulcers spreading from the right elbow to the armpit. The\\u000a right axillary lymph node was palpable. She was previously treated in another service with oral amoxicillin for 10 days due\\u000a to a diagnosis of impetigo. There was no resolution of the lesion after the treatment, so she looked for another

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

    NSDL National Science Digital Library

    Richert, Charles A.

    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.

  4. Renal Cell Carcinoma in a 3 year-old Girl: a case report

    Microsoft Academic Search

    Fei-Shih Ya ng; Shin-Lin Shih; Chung Shan

    2008-01-01

    A 3-year-old girl presented with vomiting for two days. Abdominal ultrasonogram revealed a mass at the lower pole of left kidney. Non-contrast enhanced abdominal computed tomography(CT) scan revealed high attenuation of the tumor and calcified lymphadenopathies in the retroperito - neum. On a contrast-enhanced CT scan, the mass was enhanced heterogenously. The patient under - went left radical nephrectomy and

  5. A 53-year-old woman with muscular atrophy showing hypersomnia and respiratory failure

    Microsoft Academic Search

    Seiitsu Ono

    2008-01-01

    A 53-year-old female patient noticed weakness and wasting of limb muscles at age 30 years.Over the following years, the sternocleidomastoid muscles became atrophic and wasted, with frontal baldness. At age 43, her eyesight began to fail because of bilateral cataracts. She had expe- rienced increasing sleepiness since adolescence. She was always very apt to drop off to sleep and always

  6. Incidental paraganglioma of the urinary bladder in a 66-year-old woman

    PubMed Central

    Christodoulidou, Michelle; Lucky, Marc; Mansour, Paul; Gammal, Mohsen

    2013-01-01

    A 66-year-old female patient was referred to drology department when a bladder mass was incidentally found on a transvaginal ultrasound scan. Cystoscopy revealed a small, smooth mass just above the trigone which appeared to be covered with normal urothelium. The histology from this growth after transurethral resection revealed a paraganglioma of the bladder. We will discuss the management of this case and literature review of this finding in this study. PMID:23505281

  7. Supraorbital blowin fracture presenting as an ocular dystopia in a nine-year-old girl.

    PubMed

    Nallamothu, Ranganadh; Kallam, Shanmukha Reddy; Gunturu, Srikanth; Singh, Sukumar; Rachalapally, Vijay Kumar

    2013-01-01

    A 9-year-old girl was referred to a trauma centre with severe head injury. 3D CT scan revealed depressed fracture involving the frontal bone on the right side, right parietal bone, and right superior orbital margin, right lamina papyracea. The frontal table was managed conservatively and open reduction and internal fixation was done for the supraorbital blow in to correct the ocular dystopia. The clinical course, possible mechanism, and management of the patient are discussed. PMID:23956885

  8. Supraorbital Blowin Fracture Presenting as an Ocular Dystopia in a Nine-Year-Old Girl

    PubMed Central

    Nallamothu, Ranganadh; Kallam, Shanmukha Reddy; Gunturu, Srikanth; Singh, Sukumar; Rachalapally, Vijay Kumar

    2013-01-01

    A 9-year-old girl was referred to a trauma centre with severe head injury. 3D CT scan revealed depressed fracture involving the frontal bone on the right side, right parietal bone, and right superior orbital margin, right lamina papyracea. The frontal table was managed conservatively and open reduction and internal fixation was done for the supraorbital blow in to correct the ocular dystopia. The clinical course, possible mechanism, and management of the patient are discussed. PMID:23956885

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

    SciTech Connect

    NONE

    1995-05-08

    We report a 15-year-old boy with mosaicism for trisomy 18 and normal intelligence. Approximately 50% of his leukocytes are trisomic. This patient represents the sixth report of an individual with trisomy 18 mosaicism and normal intelligence. Those individuals with trisomy 18 mosaicism and normal intelligence need to be advised of increased risks for offspring with chromosome abnormalities and offered the option of prenatal diagnosis for cytogenetic anomalies. 6 refs.

  10. A 20-year-old man with back pain and lower extremity weakness.

    PubMed

    Etherton, Mark R; Neagu, Martha R; Oakley, Derek H; Koch, Matthew J; Shin, John H; Frosch, Matthew P; Berkowitz, Aaron L; Dietrich, Jorg

    2015-03-01

    A 20-year-old man presented with 1 week of low back pain and progressive lower extremity weakness. Results of cerebrospinal fluid analysis demonstrated elevated total protein and a mildly elevated white blood cell count with lymphocytic predominance. Findings from imaging studies revealed a multifocal, heterogeneously enhancing, intramedullary lesion involving the cervicothoracic spinal cord and nodular enhancement of the cauda equina. The patient eventually underwent spinal surgery for tissue diagnosis. The differential diagnosis, pathologic findings, and diagnosis are discussed. PMID:25621865

  11. Bilateral temporomandibular joint dislocation in a 29-year-old man: a case report

    Microsoft Academic Search

    Tanujan Thangarajah; Neil Mcculloch; Suthan Thangarajah; Judith Stocker

    2010-01-01

    INTRODUCTION: A dislocation of the temporomandibular joint represents three percent of all reported dislocated joints. The treatment entails reduction of the deformity and this can often be achieved in a ward setting. CASE PRESENTATION: We present the case of a 29-year-old Caucasian man with a non-traumatic bilateral anterior temporomandibular joint dislocation. Following several unsuccessful attempts, due to both inadequate patient

  12. [A 68-year-old woman with dementia and parkinsonism].

    PubMed

    Yokoyama, Kazumasa; Ikebe, Shin-ichiro; Komatsuzaki, Yasuko; Takanashi, Masafumi; Mori, Hideo; Mochizuki, Hideki; Mizuno, Yoshikuni

    2002-02-01

    We report a 68-year-old woman who developed progressive dementia and parkinsonism. She was well until 1990 when she was 58 years of age. She started to show memory loss. Four years later, she developed difficulty in dressing and behavioral problems such as eating rice with her hands, going out of her house without purposes, and difficulty in finding the rest room in her house. She was admitted to the neurology service of Hatsuishi Hospital on January 19, 1996, when she was 64 years of the age. On admission, she was alert but markedly demented. The score of Hansegawa Dementia Scale was 0/30. She was unable to make any coherent conversation. She appeared to have dressing apraxia but did not appear to have aphasia. Cranial nerves were intact. She walked in small steps with stooped posture. She did not have motor weakness but she showed plastic rigidity in all four limbs. No tremor or ataxia was noted. Deep tendon reflexes were within normal limits but the plantar response was extensor bilaterally. She continued to deteriorate after admission. In May of 1998, she started to fall. In June of 1998, she had a generalized convulsion. In January of 1999, she became unable to take foods orally and a gastrostomy was placed. She expired on May 29, 1990. She was discussed in a neurological CPC and the chief discussant arrived at the conclusion that the patient had Alzheimer's disease. The question was whether her parkinsonism was a part of her Alzheimer's disease or she had an additional disease to explain her parkinsonism. Post-mortem examination revealed moderate to marked atrophy of the frontal and the temporal lobes as well as in the limbic areas with dilatation of the lateral ventricles. Marked neuronal loss was noted in the CA 1 to the subiculum region with gliosis. Neurofibrillary tangles were seen in the remaining neurons. Neuropil threads were seen by Gallyas-Braak staining. Similar changes were seen in the parahippocampal gyrus and in the entorhinal cortex. Senile plaques were seen in the insular cortex and in other cortical areas. Cortical type Lewy bodies were seen in the cingulate cortex. The Meynert nucleus showed marked neuronal loss and gliosis. The substantia nigra and the locus coeruleus showed moderate loss of pigmented neurons. Lewy bodies were seen in these regions. The dorsal motor nucleus of the vagal nerve was retained, however, one Lewy body was observed. Pathologic diagnosis was Alzheimer's disease plus Parkinson's disease. It is an interesting question whether or not her parkinsonism was due to nigral lesion or frontal lesions. It is known that parkinsonism may complicate in advanced Alzheimer's disease not necessarily due to nigral lesion. On the other hand, in incidental Lewy body disease, the substantia nigra shows mild Parkinson's disease-like change without clinical parkinsonism. This patient appeared to have been a true complication of Alzheimer's disease and Parkinson's disease. PMID:11889767

  13. How to Be 80 Year Old and Have a VO2max of a 35 Year Old

    PubMed Central

    Karlsen, Trine; Leinan, Ingeborg Megĺrd; Bćkkerud, Fredrik Hjulstad; Lundgren, Kari Margrethe; Tari, Atefe; Steinshamn, Sigurd Loe; Střylen, Asbjřrn; Rognmo, Řivind

    2015-01-01

    Background. To discuss the cardiovascular and pulmonary physiology and common risk factors of an 80-year-old man with a world record maximal oxygen uptake of 50?mL·kg?1·min?1. Methods. Case report. Results. His maximal oxygen uptake of 3.31?L·min?1, maximal heart rate of 175?beats·min?1, and maximal oxygen pulse of 19?mL·beats?1 are high. He is lean (66.6?kg) and muscular (49% skeletal muscle mass). His echo parameters of mitral flow (left ventricular filling, E = 82?cm·s?1 and E/A = 1.2) were normal for 40- to 60-year-old men. Systolic and diastolic function increased adequately during exercise, with no increase in left ventricular filling pressure. He has excellent pulmonary function (FVC = 4.31?L, FEV1 = 3.41, FEV1/FVC = 0.79, and DLCO = 12.0?Si1) and normal FMD and blood volumes (5.8?L). He has a high level of daily activity (10,900?steps·day?1 and 2:51?hours·day?1 of physical activity) and a lifelong history of physical activity. Conclusion. The man is in excellent cardiopulmonary fitness and is highly physically active. His cardiac and pulmonary functions are above expectations for his age, and his VO2max is comparable to that of an inactive 25-year-old and of a normal, active 35-year-old Norwegian man. PMID:25788946

  14. De novo mutation in a male patient with Fabry disease: a case report

    PubMed Central

    2014-01-01

    Background Fabry disease is an X-linked inherited metabolic condition where the deficit of the ?-galactosidase A enzyme, encoded by the GLA gene, leads to glycosphingolipid storage, mainly globotriaosylceramide. To date, more than 600 mutations have been identified in human GLA gene that are responsible for FD, including missense and nonsense mutations, small and large deletions. Such mutations are usually inherited, and cases of de novo onset occur rarely. Case presentation In this article we report an interesting case of a 44-year-old male patient suffering from a severe form of Fabry disease, with negative family history. The patient showed signs such as cornea verticillata, angiokeratomas, cardiac and neurological manifestations, an end-stage renal disease and he had low ?-galactosidase A activity. We detected, in this subject, the mutation c.493 G?>?C in the third exon of the GLA gene which causes the amino acid substitution D165H in the protein. This mutation affects the amino acid - belonging to the group of buried residues - involved, probably, in the preservation of the protein folding. Moreover, studies of multiple sequence alignment indicate that this amino acid is highly conserved, thus strengthening the hypothesis that it is a key amino acid to the enzyme functionality. The study of the relatives of the patient showed that, surprisingly, none of the members of his family of origin had this genetic alteration, suggesting a de novo mutation. Only his 11-year-old daughter - showing acroparaesthesias and heat intolerance with reduced enzymatic activity - had the same mutation. Conclusions We suggest that a non-inherited mutation of the ?-galactosidase A gene is responsible for Fabry disease in the patient who had reduced enzyme activity and classical clinical manifestations of the disease. In a family, it is rare to find only one Fabry disease affected subject with a de novo mutation. These findings emphasize the importance of early diagnosis, genetic counselling, studying the genealogical tree of the patients and starting enzyme replacement therapy to prevent irreversible vital organ damage that occurs during the course of the disease. PMID:24398019

  15. Dirofilariasis in a 22-year-old airman deployed to the Mediterranean.

    PubMed

    Udall, Don N

    2011-09-01

    A 22-year-old male U.S. Navy airman with new nontender subcutaneous, 4-cm mass inferior to the right anterior costal margin was sent for routine biopsy. Sudden appearance of axillary lymph nodes prompted immediate excisional biopsy of the primary mass. Pathological evaluation was initially read as Onchocerca volvulus, the filarial nematode classically responsible for river blindness. Subsequent evaluation by Armed Forces Institute of Pathology resulted in a change of diagnosis to Dirofilaria species, not pathogenic in humans. The author discusses the literature of Dirofilaria infestations in humans, and how they may affect U.S. servicemen and women traveling to endemic areas. PMID:21987970

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

    Denstedt, Emily

    2014-01-01

    A 3-year-old intact male Perro de Presa Canario dog was presented with acutely inflamed and edematous right hind limb, scrotum, prepuce, and an enlarged left carpus. Two weeks later the dog returned with weight loss, draining tracts in the right hind limb, dermal nodules, a palpable abdominal mass, and uveitis in the left eye. The dog succumbed to his illness 2 days later and a widely disseminated round cell tumor compatible with histiocytic sarcoma was diagnosed following postmortem examination. PMID:24489399

  18. 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 ...

  19. A rare case report of tracheal leech infestation in a 40-year-old woman.

    PubMed

    Zhang, Peng; Zhang, Rui; Zou, Jian; Zhu, Tao

    2014-01-01

    Leeches are the very rare types of airway foreign body. Here we report a rare case of a 40-year-old woman with tracheal leech infestation. A 40-year-old woman presented 2-month history of dyspnea, occasional haemoptysis. There were foreign body sensation in throat, cough and hoarseness. Computed Tomography (CT) revealed some soft tissue shadow in the upper trachea. Eventually a 5 cm long living leech was smoothly removed from trachea by rigid bronchoscopy under sevoflurane general anesthesia. The airway leech infestation should be kept in mind especially in patients presenting with unexplained haemoptysis, dyspnea, hoarseness and a foreign body sensation in the throat and a history of drinking infested water from streams, pools and spring. General anesthesia might be necessary for the removal of the leech. PMID:25419405

  20. [Therapy for male patients with sexual dysfunction].

    PubMed

    Casella, Roberto

    2010-03-01

    Phosphodiasterase type 5 inhibitors (sildenafil, vardenafil, tadalafil) are the first line symptomatic therapy for patients with erectile dysfunction. The patient should receive a meticolous information on the use of these drugs and their possible side effects. These drugs are safe and can be used even in patients with stable cardiovascular disease. Patients not responding to oral drugs may be offered intraurethral or intracavernous alprostadil. Vacuum constriction devices are a second line option more acceptable to older patients. Penile prosthesis are very seldom used in Switzerland and vascular surgery is a vanishing option. Testosterone substitution is seldom needed in this setting. Treatment of premature ejaculation subdivides into behavioural therapy ("stop-start" or "squeeze" technique) and drug therapy as well. Topical therapy with lidocaine/prilocaine-containing medications to be applied before sexual intercourse and a oral daily off label use therapy with selective serotonin re-uptake inhibitors (paroxetine, fluoxetine, sertraline) can be offered. Dapoxetine, a potent selective serotonin reuptake inhibitor with short half life time, is the first officially approved medication for the treatment of premature ejaculation and should be available soon in Switzerland. PMID:20235039

  1. Malignant Fibrous Histiocytoma of the Breast in Young Male Patient: A Case Report and a Review of the Literature

    PubMed Central

    Kocak Uzel, Esengul; Figen, Metin; Bek, Tuba Tulin; Inanc, Kubilay; Onder, Senem; Kizilkaya, Hazim orhan

    2013-01-01

    Malignant Fibrous Histiocytoma (MFH) is a fairly common tumor in the deep soft tissues: the most frequent primary sites are the lower (49%) and upper (19%) limbs, but it has been reported even in the retroperitoneum and abdomen (16%), while localization in the breast is extremely rare (1-2). Breast cancer is rarely seen in males, accounts for approximately 1% of all breast cancer, and the breast sarcomas constitute less than 1% of breast tumors in both sexes. In the review of the literature, this is the third male and first young male with MFH. Here, we present a 37-years-old male patient who is diagnosed to have malignant fibrous histiocytoma in a variant of pleomorphic fusiform cell localized in the left breast. Following the wide local excision, the patient was given an adjuvant 50?Gy of external radiotherapy. He remained alive and well after 42 months of followup. We believe that reporting such few cases would contribute to forming treatment algorithms of rare tumors. PMID:23573437

  2. Suspected oesophageal cancer in a 33 year old lady

    PubMed Central

    Tay, Chee Wei; Deans, Derek Andrew Christopher; Khor, Jen Lock Christopher; Seet, Ju Ee; So, Bok Yan Jimmy

    2010-01-01

    A previously healthy 33 year old lady presented with acute dysphagia with endoscopic and CT features of oesophageal carcinoma. Endoscopic ultrasound (EUS) revealed a large subcarinal lymph node compressing at the mid-oesophagus. Fine-needle aspiration (FNA) showed a single well-formed epithelioid granuloma with no evidence of malignancy. Molecular analysis showed the aspirate to be positive for Mycobacterium tuberculosis. She continues to improve with standard anti-TB medication without surgery. This is a rare case of acute dysphagia secondary to primary tuberculous mediastinal lymphadenopathy. EUS and FNA have completely altered the clinical management of this lady. PMID:22096676

  3. Odontogenic myxoma in a 52-year-old woman.

    PubMed

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

    2014-01-01

    Odontogenic myxoma (OM) is a rare benign but locally aggressive tumour of the jaws. It is usually seen in the second to third decade of life. Women are more frequently affected than men and it has more predilections for the mandible rather than the maxilla. OM presents as an asymptomatic swelling in most of the cases. Owing to the non-capsulated and aggressive nature of OM, a high rate of recurrence has been reported. Here we present a case of OM in a 52-year-old woman managed by segmental mandibulectomy. Sign of recurrence was seen after 18?months of follow-up. PMID:24859552

  4. Alimentary lymphosarcoma in a 4-year-old Labrador retriever.

    PubMed

    Lowe, Andrew D

    2004-07-01

    Lymphosarcoma, a common canine hematopoietic neoplasm, occurs in multicentric, alimentary, mediastinal, and extranodal forms. Alimentary lymphoma accounts for approximately 5% of cases and is less easily diagnosed than the more common multicentric form. Chemotherapy is often effective, but recent therapeutic advances hold great promise for success in treating canine lymphoma. A 4-year-old, black Labrador retriever was presented (day 1) with a 2-day history of vomiting, polyuria/polydipsia, lethargy, and anorexia. The heart and respiratory rates were within normal limits, and the rectal temperature was 38.9 degrees C. Abdominal splinting was noted on palpation, which elicited urination. No obvious additional abnormalities were detected. PMID:15317395

  5. Familial collagenous colitis involving a 6-year old child.

    PubMed

    Phull, Perminder S; Vijayan, Balasubramaniam; Bisset, William M; Murray, Graeme I

    2012-06-01

    Collagenous colitis is a recognised cause of persistent, non-bloody, watery diarrhoea. There are few cases of collagenous colitis reported in children or occurring within families. To our knowledge, no familial cases under 14 years of age have been reported previously; we describe a case of familial collagenous colitis affecting a 6-year old girl and her mother. The relevant published literature is reviewed and management is discussed. Colonic mucosal biopsies should be considered in both adults and children presenting with persistent watery diarrhoea even in the absence of any macroscopic abnormality at colonoscopy. PMID:22398039

  6. Bronchopulmonary sequestration in a 60 year old man

    PubMed Central

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

    2014-01-01

    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

  7. A 50-Year-Old Woman Addicted to Heroin

    PubMed Central

    O’Brien, Charles P.

    2011-01-01

    Heroin addiction is a complicated medical and psychiatric issue, with well-established as well as newer modes of treatment. The case of Ms W, a 50-year-old woman with a long history of opiate addiction who has been treated successfully with methadone for 9 years and who now would like to consider newer alternatives, illustrates the complex issues of heroin addiction. The treatment of heroin addiction as a chronic disease is reviewed, including social, medical, and cultural issues and pharmacologic treatment with methadone and the more experimental medication options of buprenorphine and naltrexone. PMID:18594026

  8. Rivastigmine-Induced REM Sleep Behavior Disorder (RBD) in a 88-Year-Old Man with Alzheimer's Disease

    PubMed Central

    Yeh, Shih-Bin; Yeh, Po-Yen; Schenck, Carlos H.

    2010-01-01

    We report the case of an 88-year-old man with Alzheimer's disease (AD) of 8 years duration (emerging shortly after the de novo onset of sleeptalking) who developed REM sleep behavior disorder (RBD) after increasing the nightly dose of rivastigmine, an acetylcholinesterase inhibitor, from 1.5 mg to 3 mg (total daily dose, 4.5 mg), as therapy for his dementia. His family then became aware of recurrent nocturnal episodes arising from sleep of his leaving bed, and he sustained multiple abrasion injuries from falling down. Polysomnography (PSG), utilizing a seizure montage with fast paper speed, conducted with the patient taking rivastigmine 3 mg at bedtime, documented 3 abrupt episodes of bilateral arm-waving with moaning and shouting that emerged exclusively during each of the 3 REM sleep periods, with the duration of the episodes lasting 8 to 25 seconds. No epileptiform discharge appeared with the onset of these REM sleep behaviors. Therapy with clonazepam, 0.5 mg at bedtime (with ongoing 3 mg bedtime and 4.5 mg total daily rivastigmine therapy), fully suppressed the sleep-related events, with prompt relapse whenever clonazepam was not taken. This is the second reported case (both males with AD) of rivastigmine-induced RBD, and the oldest reported case of RBD; and it represents reversible, medication-induced, acute RBD. Citation: Yeh SB; Yeh PY; Schenck CH. Rivastigmine-induced rem sleep behavior disorder (RBD) in a 88-year-old man with alzheimer's disease. J Clin Sleep Med 2010;6(2):192-195. PMID:20411699

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

    PubMed

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

    2015-02-01

    An 81-year-old man presented with a 1-week history of dry cough. He also complained of mild dyspnea, wheezing, and low-grade fever. He denied hemoptysis, fever, rashes, or chest pain. The patient's medical history included coronary artery bypass surgery, hypertension, gastroesophageal reflux disease, and COPD. The patient was a retired welder and an ex-smoker. PMID:25644917

  10. Aging in Place in a Retirement Community: 90+ Year Olds

    PubMed Central

    Paganini-Hill, Annlia

    2014-01-01

    Aging in place, an image of growing old in one’s home and maintaining one’s daily routine, is desired by most older adults. To identify variables promoting such independent living in the oldest-old, we examined the association between living situation of a population-based cohort of 90+ year olds with health and lifestyle variables. Of 1485 participants, 53% still lived in their home at a retirement community designed to foster wellness. Those living at home tended to be healthier, with smaller proportions having chronic diseases or hospitalizations in the preceding year and a greater proportion having normal functional ability. Dementia was the chronic disease most significantly related to living situation. In addition to not having dementia, not using a wheelchair or bath aid, receiving meals on wheels, and being married were jointly related to living at home. With the help of family and friends and with a medical and social support system, many 90+ year olds can age in place. This is often because they have a caregiving spouse or paid caregiver. PMID:25288828

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

    NASA Astrophysics Data System (ADS)

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

    2014-09-01

    With the rapidly growing number of CT examinations, the consequential radiation risk has aroused more and more attention. The average dose in each organ during CT scans can only be obtained by using Monte Carlo simulation with computational phantoms. Since children tend to have higher radiation sensitivity than adults, the radiation dose of pediatric CT examinations requires special attention and needs to be assessed accurately. So far, studies on organ doses from CT exposures for pediatric patients are still limited. In this work, a 1-year-old computational phantom was constructed. The body contour was obtained from the CT images of a 1-year-old physical phantom and the internal organs were deformed from an existing Chinese reference adult phantom. To ensure the organ locations in the 1-year-old computational phantom were consistent with those of the physical phantom, the organ locations in 1-year-old computational phantom were manually adjusted one by one, and the organ masses were adjusted to the corresponding Chinese reference values. Moreover, a CT scanner model was developed using the Monte Carlo technique and the 1-year-old computational phantom was applied to estimate organ doses derived from simulated CT exposures. As a result, a database including doses to 36 organs and tissues from 47 single axial scans was built. It has been verified by calculation that doses of axial scans are close to those of helical scans; therefore, this database could be applied to helical scans as well. Organ doses were calculated using the database and compared with those obtained from the measurements made in the physical phantom for helical scans. The differences between simulation and measurement were less than 25% for all organs. The result shows that the 1-year-old phantom developed in this work can be used to calculate organ doses in CT exposures, and the dose database provides a method for the estimation of 1-year-old patient doses in a variety of CT examinations.

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

    PubMed Central

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

    2013-01-01

    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

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

    NSDL National Science Digital Library

    Schubert, Eric

    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.

  14. Recurrent Sigmoid Volvulus Associated With Eventration of Diaphragm in a Twenty-Six-Year-Old Man

    PubMed Central

    Prabhu, Shailesh Mukund; Venkatesan, Bhuvaneswari; Shetty, Gurucharan; Narula, Mahender Kaur; Chauhan, Udit; Udiya, Alok Kumar

    2015-01-01

    Recurrent sigmoid volvulus is a clinical entity characterized by recurrent episodes of partial or complete sigmoid volvulus. Although it is commonly seen in the elderly, it can be occasionally seen in younger patients. Patients with recurrent partial sigmoid volvulus are relatively asymptomatic or present with mild abdominal pain. Early diagnosis and treatment is essential to prevent conversion to acute gangrenous volvulus. We present a case of recurrent partial sigmoid volvulus in association with eventration of diaphragm in a 26-year-old man. PMID:25901269

  15. Systemic lupus erythematosus presenting with hyporeninemic hypoaldosteronism in a 10-year-old girl.

    PubMed

    Kozeny, G A; Hurley, R M; Fresco, R; Vertuno, L L; Bansal, V K; Hano, J E

    1986-01-01

    Hyperkalemia has been noted to occur spontaneously in patients with long-standing systemic lupus erythematosus who did not have advanced renal insufficiency. The patients previously described all had relatively normal renin-aldosterone systems, and the hyperkalemia was thus presumed to be secondary to a primary defect in renal tubular potassium secretion. We describe at 10-year-old girl with lupus nephritis, without significant renal insufficiency, who had hyperkalemia from hyporeninemic hypoaldosteronism postulated to be due to vasculitis involving the afferent/efferent arterioles and juxtaglomerular apparatus. PMID:3535507

  16. Pathology Case Study: A 68-Year-Old Woman with Brain Mass in Temporal Lobe

    NSDL National Science Digital Library

    Schubert, Eric

    This is a neuropathology case study presented by the University of Pittsburgh Department of Pathology in which a 68-year-old female has a temporal tumor with extensive edema. 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.

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

    NSDL National Science Digital Library

    Nine, Jeff S.

    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.

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

    NSDL National Science Digital Library

    Schubert, Eric

    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.

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

    NSDL National Science Digital Library

    Nalesnik, Michael

    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.

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

    NSDL National Science Digital Library

    Hakam, Ardeshir

    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.

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

    NSDL National Science Digital Library

    Nine, Jeff S.

    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

  2. Pathology Case Study: A 33-Year-Old Man with a Testicular Lesion

    NSDL National Science Digital Library

    Horn, Kevin D.

    This is a case study presented by the University of Pittsburgh Department of Pathology in which a 33-year-old morbidly obese man has a testicular lesion. 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.

  3. Pathology Case Study: An 80-Year-Old Female with a Neck Mass

    NSDL National Science Digital Library

    Schubert, Eric

    This is an ear nose & throat case study presented by the University of Pittsburgh Department of Pathology in which an 80-year-old female has insular carcinoma of the thyroid (i.e. a neck 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 ear, nose, and throat medicine.

  4. Traumatic brain injury in infants and toddlers, 0–3 years old

    PubMed Central

    Gorgan, MR; Tascu, A; Sandu, AM; Rizea, RE

    2011-01-01

    Object: Children 0–3 years old present a completely different neurotraumatic pathology. The growing and the development processes in this age group imply specific anatomical and pathophysiological features of the skull, subarachnoid space, CSF flow, and brain. Most common specific neurotraumatic entities in children 0–3 years old are cephalhematoma, subaponeurotic (subgaleal) hematoma, diastatic skull fracture, grow skull fracture, depressed (‘ping–pong’) skull fracture, and extradural hematoma. Methods: We present our 10 years experience in neuropediatric traumatic brain injuries, between 1999 and 2009, in the First Department of Neurosurgery and Pediatric Intensive Care Unit. Including criteria were children, 0–3 years old, presenting only traumatic brain injury. We excluded patients with politrauma, who require a different management. Results: We present the incidence of these specific head injuries, clinical and imagistic features, treatment, and outcome. We found 72 children with diastatic skull fracture, 61 cases with depressed (‘ping–pong’) skull fracture, 22 cases with grow skull fracture, 11 children harboring intrusive skull fracture, 58 cephalhematomas, 26 extradural hematomas, and 7 children with severe brain injury and major posttraumatic diffuse ischemia (‘black–brain’). Usually, infants and toddlers present with seizures, pallor, and rapid loss of consciousness. First choice examination, in all children was cerebral CT–scan, and for follow–up, we performed cerebral MRI. We emphasize on the importance of seizure prevention in this age group. Children presenting with extensive diffuse ischemia (‘black–brain’) had a poor outcome, death occurring in all 7 cases. Conclusion: Children 0–3 years old, present with a total distinctive pathology than adults. Children with head injury must be addressed to a pediatric department of neurosurgery and pediatric intensive care unit. Prophylaxis pays the most important role in improving the outcome. PMID:22567045

  5. Disseminated peritoneal leiyomyomatosis in an 18-year-old girl.

    PubMed

    Arneja, Sarabjeet Kaur

    2011-06-01

    Disseminated peritoneal leiomyomatosis (DPL) is a rare hormone-dependent disease entity occurring primarily in women of reproductive age group subjected to an altered hormonal milieu. The lesion is characterized by numerous subperitoneal nodules of benign smooth muscle proliferations which usually mimic the macroscopic appearance of metastatic malignancy. In 70% of cases, the underlying cause of hormonal alteration is pregnancy and in the remaining cases, the causes are oral contraceptives or hormone-secreting tumors. This indicates that endocrine factors are of importance in the development of this condition. This is an unusual case, hitherto unreported, of DPL with multiple uterine leiomyoma, occurring in a 18-year-old girl, who had previously undergone several laparoscopic surgical resections of uterine leiyomyomas. Her disease was unrelated to pregnancy or to any other obvious sources of hormonal elevation. PMID:21397533

  6. 'Generalist genes' and mathematics in 7-year-old twins.

    PubMed

    Kovas, Y; Harlaar, N; Petrill, S A; Plomin, R

    2005-09-01

    Mathematics performance at 7 years as assessed by teachers using UK national curriculum criteria has been found to be highly heritable. For almost 3000 pairs of 7-year-old same-sex twins, we used multivariate genetic analysis to investigate the extent to which these genetic effects on mathematics performance overlap with genetic effects on reading and general intelligence (g) as predicted by the 'generalist genes' hypothesis. We found substantial genetic overlap between mathematics and reading (genetic correlation=0.74) and between mathematics and g (0.67). These findings support the 'generalist genes' hypothesis that most of the genes that contribute to individual differences in mathematics are the same genes that affect reading and g. Nonetheless, the genetic correlations are less than unity and about a third of the genetic variance on mathematics is independent of reading and g, suggesting that there are also some genes whose effects are specific to mathematics. PMID:19319204

  7. Acute selenium poisoning of a 2-year-old child.

    PubMed

    Lombeck, I; Menzel, H; Frosch, D

    1987-05-01

    After ingestion of an unknown amount of a gun blueing compound containing selenious acid (11 ml from the bottle fluid were missing, equivalent to 2.9 g Se) a 2-year-old girl suffered from continuous hyper-salivation, vomiting, diarrhoea, restlessness and muscle spasm. Blood pressure and pulse rate were increased. Symptomatic treatment was performed by parenteral fluid administration. The plasma Se concentration was increased to 20 times normal 5 h after ingestion. Erythrocyte Se exceeded plasma Se, 24 h after intoxication. Urinary Se excretion decreased parallel to the plasma Se concentration. Ten weeks later, the Se content of hair had risen to 10 times normal. The plasma glutathione peroxidase activity showed only a slight increase during the first 36 h, erythrocyte glutathione peroxidase, catalase and superoxide dismutase activities were not significantly altered. The child fully recovered. PMID:3595654

  8. A 31-year-old pregnant woman with angioedema.

    PubMed

    Speck, Aimee L; Killen, Paul D; Greenhawt, Matthew J

    2015-03-01

    Angioedema is swelling of the deep layers of the dermis and subcutaneous tissue due to an increase in vascular permeability. Angioedema sometimes occurs concomitantly with urticaria and represents an allergic disease. In other cases, angioedema is not associated with an allergic condition. We present the case of a 31-year-old woman with new-onset angioedema in the setting of her first pregnancy. After detailed history, physical examination, and laboratory evaluation, a cause for her angioedema was found that had not been considered previously and had significant implications for future management, particularly in light of her current pregnancy. Because allergists are commonly called on to evaluate and treat angioedema, we should be aware of the many disease processes that can present with this symptom and be well-versed in the workup of new-onset angioedema. PMID:25715245

  9. Pulmonary dirofilariasis in a 59-year-old man

    PubMed Central

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

    2014-01-01

    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

  10. Late Established Mutans Streptococci in Children over 3 Years Old

    PubMed Central

    Okada, Mitsugi; Taniguchi, Yoshiko; Hayashi, Fumiko; Doi, Takako; Suzuki, Junji; Sugai, Motoyuki; Kozai, Katsuyuki

    2010-01-01

    Acquisition of mutans streptococci has been reported to most commonly occur at approximately 26 months of age. In the present study, we detected Streptococcus mutans and S. sobrinus using polymerase chain reaction (PCR) assays in children, then re-examined the subjects to determine the time of acquisition of these bacteria over a 1-year period. The subjects were 57 children ranging in age from 3 to 5 years old, each with primary dentition. Plaque samples were collected from all erupted tooth sites using a sterile toothbrush. PCR assays were performed to detect the targeted mutans streptococci at the beginning of the study (baseline) and after 1 year. At the baseline examination, the prevalence of S. mutans and S. sobrinus was 61.4% and 54.4%, respectively, in all subjects, of whom 14 (24.6%) were positive for S. mutans alone, 10 (17.5%) for S. sobrinus alone, and 21 (36.8%) for both S. mutans and S. sobrinus, with 12 (21.1%) negative for both. After 1 year, 4 of 22 (18.2%) subjects newly had acquired S. mutans and 15 of 26 (57.7%) had aquired S. sobrinus, while 5 (8.8%) remained negative for both bacteria. The age of the first positive S. mutans finding ranged from 49 to 71 months, while that for S. sobrinus ranged from 49 to 81 months old. Our results suggest that S. sobrinus becomes established later than S. mutans in the oral cavities of children over the age of 3 years old. PMID:20339489

  11. A 51-year-old man with seizures and progressive behavioral changes.

    PubMed

    Cable, Casey A; Freeman, William D; Rubin, Mark N; Khoor, Andras; Karnatovskaia, Lioudmila V

    2015-03-01

    A 51-year-old man was admitted for evaluation of new-onset generalized seizures in the context of progressive and significant behavioral change. His medical history was only notable for previous outbreaks of genital herpes. He took no medications. He had occasional social alcohol use and no illicit drug use but was a 35-pack-year current smoker. The patient had no relevant occupational exposure history but had recently traveled to Panama. Initially, the patient's significant other noticed a progressive flattening of his affect. The patient then started to experience episodes of "passing out" that led to injuries prompting ED visits. He was prescribed antiseizure medications and scheduled for an outpatient workup. However, with progressive gait instability, lethargy, and an increase in frequency of generalized seizures, the patient was admitted for treatment of suspected viral encephalitis. Despite initiation of antimicrobial and antiviral therapy, the patient's level of alertness continued to decline, ultimately leading to intubation for airway protection. PMID:25732477

  12. Flunitrazepam abuse and personality characteristics in male forensic psychiatric patients

    Microsoft Academic Search

    Anna Maria Dĺderman; Gunnar Edman

    2001-01-01

    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

  13. Correlates of Violent Assault Among Young Male Primary Care Patients

    Microsoft Academic Search

    MPH John A. Rich; Lisa M. Sullivan

    2001-01-01

    Correlates of violent assault (defined here as having been shot, stabbed, shot at, or beaten) were identified among young male primary care patients. Data were analyzed from a cohort of young men ages 17 to 29 during their initial visits to an urban primary care facility. Each underwent a clinical assessment, including a self-report health inventory and provider history. In

  14. Sexual dysfunction in the male patient with uremia: A reappraisal

    Microsoft Academic Search

    Warren R Procci; David A Goldstein; Janice Adelstein; Shaul G Massry

    1981-01-01

    Sexual dysfunction in the male patient with uremia: A reappraisal. Partial or complete impotence is common in uremia. It is not clear whether the impotence is organic or psychogenic in nature and whether uremia itself or the state of chronic illness is responsible for it. We examined these questions, by psychiatric interviews and nocturnal penile tumescence (NPT), in 50 normal

  15. Longstanding Hypoparathyroidism in a Fifty-Two-Year-Old Woman Misdiagnosed as Spondyloarthropathy

    PubMed Central

    Zabihiyeganeh, Mozhdeh; Jahed, Seyed Adel; Akbari, Hounaz

    2014-01-01

    Introduction: Hypoparathyroidism might cause various musculoskeletal findings, resembling Spondyloarthropathies. Case Presentation: We described a 52-year-old woman, diagnosed as a case of undifferentiated spondyloarthropathy for ten years, who was unresponsive to classic anti-inflammatory therapies. She developed anterior ischemic optic neuropathy and had elevated muscle enzymes during the course of disease. On a routine checkup, marked hypocalcemia and suppressed parathyroid hormone levels were found. Calcium and calcitriol therapy led to clinical and laboratory improvement. Conclusions: This case emphasizes the importance of recognizing rheumatic manifestations of hypoparathyroidism to preclude unnecessary treatments. Serum calcium should be included in the diagnostic workup of these patients.

  16. Intrascrotal lipoblastoma in a ten year old: case report and review of literature

    PubMed Central

    Nakib, Ghassan; Calcaterra, Valeria; Avolio, Luigi; Guazzotti, Marinella; Goruppi, Ilaria; Viglio, Alessandra; Pelizzo, Gloria

    2013-01-01

    Lipoblastoma is a rare benign soft tissue tumor encountered almost exclusively in infancy and early childhood. The location of tumors varies, but most occur in the extremities, trunk, head and neck. Less frequently, lipoblastomas have been reported in the mediastinum, the retroperitoneum and the inguinal region. Only 7 cases of lipoblastoma in the scrotum have been reported so far in the English literature, with none of the patients older than 8. We report an intrascrotal lipoblastoma in a 10 year-old boy. The differential diagnosis is discussed with reference to the literature. PMID:23772297

  17. Isolated intramedullary spinal cysticercosis in a 10-year-old female showing dramatic response with albendazole

    PubMed Central

    Azfar, Shah F.; Kirmani, Sanna; Badar, Farheen; Ahmad, Ibne

    2011-01-01

    Neurocysticercosis is the most common parasitic infection of the central nervous system caused by larvae of Taenia solium. Spinal cysticercosis is an uncommon site of cysticercal infection, and isolated intramedullary involvement is even rarer. We present a case of 10-year-old girl who presented with gradual onset paraparesis with sensory loss and bowel and bladder incontinence. Magnetic resonance imaging (MRI) of spine revealed a cystic lesion with mural nodule (scolex) which was diagnostic for cysticercosis. Patient was treated with antihelminthic, which led to marked clinico-radiological improvement. PMID:21977090

  18. Isolated intramedullary spinal cysticercosis in a 10-year-old female showing dramatic response with albendazole.

    PubMed

    Azfar, Shah F; Kirmani, Sanna; Badar, Farheen; Ahmad, Ibne

    2011-01-01

    Neurocysticercosis is the most common parasitic infection of the central nervous system caused by larvae of Taenia solium. Spinal cysticercosis is an uncommon site of cysticercal infection, and isolated intramedullary involvement is even rarer. We present a case of 10-year-old girl who presented with gradual onset paraparesis with sensory loss and bowel and bladder incontinence. Magnetic resonance imaging (MRI) of spine revealed a cystic lesion with mural nodule (scolex) which was diagnostic for cysticercosis. Patient was treated with antihelminthic, which led to marked clinico-radiological improvement. PMID:21977090

  19. Incidentally detected unilateral pulmonary artery agenesis with pulmonary hypoplasia in a 67 year old woman

    PubMed Central

    Muthusami, Prakash; Ananthakrishnan, Ramesh; Elangovan, S.

    2010-01-01

    Unilateral pulmonary artery agenesis is commonly seen associated with other congenital cardiovascular defects, when it is detected early in life, but isolated absence of the pulmonary artery is a rare entity, usually detected in adulthood. The latter patients are usually asymptomatic or might present with varied non-specific manifestations such as respiratory tract infections and hemoptysis. This report describes the imaging findings of a 67 year old female with absence of the right pulmonary artery. The embryology and clinical manifestations of the condition are reviewed. PMID:22470700

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

    NSDL National Science Digital Library

    Nine, Jeff S.

    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.

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

    PubMed Central

    Dayton, Kristin; Ryan, Matthew F.

    2014-01-01

    A plunging ranula is a soft-tissue mass stemming from a mucous extravasation cyst of the sublingual gland which can herniate through the mylohyoid muscle. We describe a case in which a 14-year-old girl presented with a rapidly expanding mass on the floor of her mouth affecting her ability to swallow and speak and causing tracheal compression. The patient was initially managed conservatively with antibiotics and steroids; however, the mass continued to expand necessitating emergent bedside incision and drainage and subsequent surgical intervention. The pathophysiology and management options for ranulas are also discussed herein. PMID:25548707

  2. Compartment syndrome in a five-year-old child following femoral cannulation for cardiopulmonary bypass.

    PubMed

    Williams, P H; Bhatnagar, N K; Wisheart, J D

    1989-01-01

    The compartment syndrome is uncommon in children. It has been seen following bony trauma and has also been reported in two patients following cardiac catheterisation. We report its occurrence in a 5-year-old child following femoral artery and femoral vein cannulation for cardiopulmonary bypass. We believe that the presence of a cannula in the femoral vein as well as in the artery was an important factor in impeding the circulation and thus causing the compartment syndrome. Prompt diagnosis and early fasciotomy saved the limb from amputation; however, a residual footdrop persists. The development of the compartment syndrome following femoral cannulation for cardiopulmonary bypass has not been reported previously. PMID:2635931

  3. Complex coronary sinus fistula in a 58-year-old female.

    PubMed

    Blackham, Ruth E; Yamen, Eric; Hockings, Bernard E F; Vanden Driesen, Rohan I; Alvarez, John M

    2009-08-01

    Coronary artery aneurysms and arterio-venous fistulae are uncommon malformations. We report the case of a 58-year-old woman with a large aneurysmal fistula arising from the left coronary tree and involving the entire coronary sinus venous system, resulting in significant left-to-right shunt. We discuss the management of aneurysmal fistulae of the coronary arteries, and the merits of prophylaxis for thrombotic complications of large aneurysms. We recommend consideration of warfarinisation in addition to aspirin of such patients post-operatively. PMID:18450509

  4. Palatal myoclonus and clicking tinnitus in a 12-year-old girl--case report.

    PubMed

    Jero, J; Salmi, T

    2000-01-01

    Palatal myoclonus is a rare neurological disorder of the soft palate and other oropharyngeal muscles, which causes clicking tinnitus. The latter is audible both to the patient and to an observer. The aetiology may be a brain stem lesion, and it is only rarely that a cause cannot be identified. The condition has been described in adults, but seldom in children. We present here a case of palatal myoclonus with distressing tinnitus in a 12-year-old girl and its successful treatment with electromyography (EMG)-guided injections of Clostridium botulinum toxin. PMID:10908979

  5. [Surgery for spontaneous pneumothorax in a 102-year-old woman].

    PubMed

    Okutani, Daisuke; Andou, Akio; Higashi, Ryohei

    2014-12-01

    We report a 102-year-old female who underwent surgery for spontaneous pneumothorax. As leakage did not disappear for over one month, she was referred to our hospital for surgery. Video-assisted thoracoscopic surgery was performed. Multiple small bullae were observed, and one of which was the cause of leakage. She was successfully treated by pleural covering with polyglycolic acid sheet and fibrin glue. Patients of such advanced age can be good candidates for surgical treatment of spontaneous pneumothorax, when they have no severe underlying diseases. PMID:25434541

  6. Isolated Spontaneous Celiac Artery Dissection in a 47-Year-Old Man with von Willebrand Disease

    PubMed Central

    Rehman, Aziz Ur; Nadella, Srikanth; Sohail, Umair

    2014-01-01

    Isolated spontaneous dissection of the celiac artery is rare, and its occurrence without aortic dissection is even rarer. The typical symptom of this dissection is acute-onset abdominal pain. Complications of the condition include aneurysm formation, rupture, and abdominal-organ ischemia or infarction, especially in the liver or spleen. We report the case of a 47-year-old man with von Willebrand disease who had an isolated spontaneous dissection of the celiac artery. We used computed tomography and computed tomographic angiography in the diagnosis and characterization of the dissection. To our knowledge, this is the first report of celiac artery dissection in a patient with von Willebrand disease. PMID:24955061

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

    PubMed

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

    2015-01-01

    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

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

    PubMed

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

    2014-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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?

  10. Serum FSH level below 10 mIU/mL at twelve years old is an index of spontaneous and cyclical menstruation in Turner syndrome.

    PubMed

    Aso, Keiko; Koto, Shinobu; Higuchi, Asako; Ariyasu, Daisuke; Izawa, Masako; Miyamoto Igaki, Junko; Hasegawa, Yukihiro

    2010-01-01

    The gonadal function of patients with Turner syndrome (TS) is variable. Individuals with mosaicism characterized by 45,X/46,XX or 45,X/47,XXX are more likely to experience spontaneous menarche compared with other karyotypes. Prepubertal gonadotropins of TS patients with spontaneous menarche are reportedly normal or significantly lower than those of patients with induced menarche. The present study investigated an index of spontaneous and cyclical menstruation at 10-12 years old in TS. Subjects comprised 50 patients with TS, divided into three groups: Group A (n=7), with spontaneous menarche before 16 years old and regular menstruation for at least 1 year and 6 months; Group B (n=6), with irregular menstruation since menarche leading to secondary amenorrhea despite spontaneous menarche before 16 years old; and Group C (n=37), without spontaneous breast budding before 14 years old or without spontaneous menarche before 16 years old. Karyotype, LH and FSH concentrations at 10 and 12 years old were analyzed retrospectively. Spontaneous and cyclical menstruation was more frequently observed in TS with mosaicism characterized by 45,X/46,XX or 45,X/47,XXX than in TS with other karyotypes, as previously described. Spontaneous and cyclical menstruation in TS was observed when serum FSH level was <10 mIU/mL at 12 years old, suggesting this FSH level as an index of spontaneous and cyclical menstruation in TS. PMID:20798475

  11. Carpal Tunnel Syndrome Presenting as Sclerodactylia, Nail Dystrophy and AcroOsteolysis in a 60YearOld Woman

    Microsoft Academic Search

    J. Romaní; L. Puig; G. de Miguel; J. M. de Moragas

    1997-01-01

    Skin changes associated with carpal tunnel syndrome have rarely been reported. A 60-year-old patient was referred to our Department of Dermatology for evaluation of an aseptic gangrene of the distal phalanx of the third finger of her left hand, progressive nail dystrophy, sclerodactylia and spontaneous uleerations. These features were seen on the digits with sensory supply from the median nerve.

  12. Infant Brain Atlases from Neonates to 1- and 2-Year-Olds

    PubMed Central

    Shi, Feng; Yap, Pew-Thian; Wu, Guorong; Jia, Hongjun; Gilmore, John H.; Lin, Weili; Shen, Dinggang

    2011-01-01

    Background Studies for infants are usually hindered by the insufficient image contrast, especially for neonates. Prior knowledge, in the form of atlas, can provide additional guidance for the data processing such as spatial normalization, label propagation, and tissue segmentation. Although it is highly desired, there is currently no such infant atlas which caters for all these applications. The reason may be largely due to the dramatic early brain development, image processing difficulties, and the need of a large sample size. Methodology To this end, after several years of subject recruitment and data acquisition, we have collected a unique longitudinal dataset, involving 95 normal infants (56 males and 39 females) with MRI scanned at 3 ages, i.e., neonate, 1-year-old, and 2-year-old. State-of-the-art MR image segmentation and registration techniques were employed, to construct which include the templates (grayscale average images), tissue probability maps (TPMs), and brain parcellation maps (i.e., meaningful anatomical regions of interest) for each age group. In addition, the longitudinal correspondences between age-specific atlases were also obtained. Experiments of typical infant applications validated that the proposed atlas outperformed other atlases and is hence very useful for infant-related studies. Conclusions We expect that the proposed infant 0–1–2 brain atlases would be significantly conducive to structural and functional studies of the infant brains. These atlases are publicly available in our website, http://bric.unc.edu/ideagroup/free-softwares/. PMID:21533194

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

    PubMed Central

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

    2013-01-01

    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

  14. First preoperative functional mapping via navigated transcranial magnetic stimulation in a 3-year-old boy.

    PubMed

    Coburger, Jan; Karhu, Jari; Bittl, Markus; Hopf, Nikolai J

    2012-06-01

    Preoperative functional mapping in children younger than 5 years old remains a challenge. Awake functional MRI (fMRI) is usually not an option for these patients. Except for a description of passive fMRI in sedated patients and magnetoencephalography, no other noninvasive mapping method has been reported as a preoperative diagnostic tool in children. Therefore, invasive intraoperative direct cortical stimulation remains the method of choice. To the authors' knowledge, this is the first case of a young child undergoing preoperative functional motor cortex mapping with the aid of navigated transcranial magnetic stimulation (nTMS). In this 3-year-old boy with a rolandic ganglioglioma, awake preoperative mapping was performed using nTMS. A precise location of Broca area 4 could be established. The surgical approach was planned according to the preoperative findings. Intraoperative direct cortical stimulation verified the location of the nTMS hotspots, and complete resection of the precentral tumor was achieved. Navigated TMS is a precise tool for preoperative motor cortex mapping and is feasible even in very young pediatric patients. In children for whom performing the fMRI motor paradigm is challenging, nTMS is the only available option for functional mapping. PMID:22656259

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

    PubMed

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

    2015-01-01

    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

  16. Endometrial carcinoma in women 40 year old or younger: a case report and literature review.

    PubMed

    Gerli, S; Spanň, F; Di Renzo, G C

    2014-01-01

    Endometrial cancer is the most frequent gynecologic cancer. Although it mainly occurs in menopausal women, it can hit younger patients as well. Only few cases of affected women under the age of 30 are reported. A case of a 23-year-old patient with endometrioid carcinoma grade II-III is presented. Hysterectomy is considered the standard treatment and it could represent a problem for those young women who desire to preserve fertility. A conservative management can be offered to these patients when the tumor is well differentiated and advanced stage is excluded. Several studies are available in literature about fertility sparing approach. Progestin treatment, combined or not with hysteroscopic ablation seem to be the most validated conservative management. Anyhow this treatment is not free risk, because it is not always effective and disease progression during or after treatment is possible. Then a strict evaluation and selection of patients before starting treatment is mandatory. PMID:25027334

  17. [Fever, coughing and dyspnea in a 38-year-old female kidney transplant recipient].

    PubMed

    Porsche, M; Künzli, E; Dickenmann, M; Hirsch, H H; Battegay, M; Khanna, N

    2012-12-01

    This article reports on a 38-year-old kidney transplant patient who presented with fever, coughing and dypnea. The patient was immunosuppressed with mycophenolate and prednisone. Due to the suspicion of community acquired pneumonia antibiotic treatment was initiated and the patient was admitted to the intensive care unit. Despite antibiotic treatment the condition did not improve and in the subsequently performed bronchioalveolar lavage parainfluenza virus was diagnosed.Infections with respiratory viruses can be fatal in immunosuppressed patients. Human parainfluenza virus is the third most common pathogen of viral pneumonia. Molecular genetic detection methods allow fast and sensitive diagnosis of respiratory materials. As the treatment options are limited for these infections prophylactic measurements are important. PMID:23104574

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

    PubMed Central

    Posthumus, Jonathon; Borish, Larry

    2014-01-01

    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

  19. A 44-year-old woman with metabolic acidosis, high anion gap, and delayed neurologic deterioration.

    PubMed

    Vakil, Abhay; Upadhyay, Hinesh; Sherani, Khalid; Cervellione, Kelly; Trepeta, Scott; Patel, Mahendra C

    2015-01-01

    A 44-year-old woman was brought to the ED from John F. Kennedy International Airport. The patient was returning with her son from a 3-month visit to Bangladesh. Her journey started with a 4-h flight from Dhaka, Bangladesh to Dubai, United Arab Emirates. She consumed 240 mL of whiskey during the flight. This was followed by a 14-h flight from Dubai to New York. According to the patient's son, she did not consume any alcohol during the second flight. The patient was in her usual state of health with normal mentation throughout her journey. Upon landing, she started complaining of shortness of breath. After disembarking, she was witnessed to have seizure-like activity with involuntary passage of urine, following which she collapsed. The patient was intubated by emergency medical services in the field. PMID:25560868

  20. Molluscum contagiosum in a 12-year-old child - report of a case and review of literature.

    PubMed

    Nandhini, G; Rajkumar, K; Kanth, K Sudheer; Nataraj, Priyadharsini; Ananthakrishnan, Pavithra; Arunachalam, M

    2015-01-01

    Molluscum contagiosum (MC) is an infection of the skin and mucous membrane caused by a DNA virus from the poxvirus family. It usually affects any part of the body and presents as pearly, flesh colored dome shaped nodule with a central umbilication. Clinical diagnosis can be supplemented with histopathology for the confirmed diagnosis of MC. This article presents a case of 12-year-old male child afflicted with MC along with a review of the literature on MC. PMID:25709372

  1. Molluscum Contagiosum in a 12-Year-Old Child – Report of a Case and Review of Literature

    PubMed Central

    Nandhini, G; Rajkumar, K; Kanth, K Sudheer; Nataraj, Priyadharsini; Ananthakrishnan, Pavithra; Arunachalam, M

    2015-01-01

    Molluscum contagiosum (MC) is an infection of the skin and mucous membrane caused by a DNA virus from the poxvirus family. It usually affects any part of the body and presents as pearly, flesh colored dome shaped nodule with a central umbilication. Clinical diagnosis can be supplemented with histopathology for the confirmed diagnosis of MC. This article presents a case of 12-year-old male child afflicted with MC along with a review of the literature on MC. PMID:25709372

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    The purpose of this study was to explore the relationship between intelligence and visual motor integration skills in 5-year-old children with 22q11-deletion syndrome (22q11DS) (N = 65, 43 females, 22 males; mean age 5.6 years (SD 0.2), range 5.23-5.99 years). Sufficient VMI skills seem a prerequisite for IQ testing. Since problems related to…

  3. Evaluating Estradiol Levels in Male Patients with Colorectal Carcinoma

    PubMed Central

    Seth, Shashi; Arora, Kanchan; Verma, Monica

    2015-01-01

    Background: Globally more than 1 million people suffer from colorectal cancer (CRC) per annum, resulting in about 0.5 million deaths. The role of estrogen in CRC is being researched with great interest; expression of estrogen receptors (alfa and beta) is being explored. Aims and Objective: Our objective was to compare the serum estradiol levels in diagnosed male patients of CRC, with age-matched controls; and to study the estradiol levels across the different stages of CRC. Setting and design: A cross-sectional study was conducted from January, 2012 to March, 2013 at a tertiary care hospital in north India. Materials and Methods: Fifty one male preoperative CRC patients were enrolled along with 50 age-matched male controls. Ethical approval and informed written consent from each participant were duly obtained. CRC patients were staged as per TNM (T- Tumour, N- Node, M- Metastasis; I, II, III and IV) criteria. Serum estradiol level was measured by Chemiimmunofluroscence method (normal = 11.6 - 41.2 pg/ml). Statistical analysis used: We used student’s t test and ANOVA (analysis of variance) to analyse the data (SPSS version 17.0, SPSS, Inc., Chicago, Illinois) Result: The mean serum estradiol level among CRC patients (43.4, sd=27.1) was significantly more than that among controls (mean=24.7, sd=17.5), (p<0.0001). Across the four TNM stages of CRC patients, mean estradiol level was highest in Stage II (55.9, sd=15.5); followed by Stages III (44.1, sd=24.9), IV (36.3, sd=30.0) and I (26.4, sd=38.8). However, significant difference was obtained only between Stages I and II. Conclusion: Our study revealed increased levels of serum estradiol in Indian male CRC patients. Further research is warranted to corroborate this finding, and to understand the role of estradiol across different TNM stages of CRC. PMID:25737973

  4. Dementia paralytica in a fifteen-year-old boy.

    PubMed

    Goeman, J; Hoksbergen, I; Pickut, B A; Dom, L; Crols, R; De Deyn, P P

    1996-12-01

    A 15-year-old boy, whose history revealed an unremarkable pregnancy, birth and neonatal period and who had shown a normal motor and mental development, presented at the hospital with deterioration of cognitive functions since the age of 7. He was bedridden with manifest ataxia involving all limbs, anisocoria and a sluggish to absent pupil reaction to light. Syphilis serology was positive with a Venereal Disease Research Laboratory (VDRL) titer of 1:256 and a Treponema pallidum Haemagglutination Assay (TPHA) titer of 1:163840. Cerebrospinal fluid (CSF) protein concentration was 55 mg/dl and CSF-leucocyte count was 14/mm3 (85% mononuclear cells). CSF-VDRL-titer was 1:16. A diagnosis of congenitally acquired dementia paralytica was made, since the boy's parents' clinical exam and serology results were suggestive for latent syphilis. Although cognition was still very much deteriorated five months following penicillin treatment, clinical examination revealed partial recuperation. Screening for syphilis should be part of routine testing in every subject presenting with cognitive deterioration, regardless of age. PMID:8994127

  5. Fantasy play in 5- and 6-year-old children.

    PubMed

    Wall, S M; Pickert, S M; Gibson, W B

    1989-05-01

    We studied the verbal pretend play of 5- and 6-year-old boys and girls to delineate age and sex differences during the later preoperational period. Sixteen children with average language ability were paired by age and sex and were videotaped for three 15-min intervals. Verbal interactions were transcribed, and the pretend play was classified as object fantasy, imaginative action plans/themes, or fantasy roles. Language used for pretend play increased in proportion to all utterances with age. Older children referred to more invented objects than younger ones but primarily in the service of realistic action formats. Girls' conversations were scored as having significantly more verbal pretending than boys' and a higher proportion of it referred to play roles. There were both age and sex differences in the types of themes, toys used, and roles enacted, including more sex-typed behavior in older children. The continued increase in the proportion of pretend play to all verbal interaction with age and the characteristics of play behavior is consistent with developmental theory. PMID:2754631

  6. Slope restoration for a 100-year old canal

    SciTech Connect

    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

    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.

  7. [Primary adrenal insufficiency as the form of onset of adrenoleukodystrophy in a 4-year-old boy].

    PubMed

    Tornero Patricio, Sebastián; de la Vega, José Antonio Bermúdez; Nehme Alvarez, Daniel; Gentil González, Francisco Javier; Lluch Fernández, María Dolores; González Hachero, José

    2009-01-01

    X-linked adrenoleukodystrophy is an inherited metabolic disease caused by the accumulation of saturated very long chain fatty acids (VLCFA). Given that the form of presentation can be primary adrenal insufficiency, diagnosis in affected males is important. Patient was a 4-year-old boy with attention deficit hyperactivity disorder, cutaneous-mucosal hyperpigmentation, and dehydration with hyponatremia and hyperpotassemia was diagnosed with adrenoleukodystrophy presenting as primary adrenal insufficiency. Antiadrenal antibodies: negative. Plasma VLCFA: C(26:0)=1.25mg/ml (0.18-0.48), C(24:0)/C(22:0) =1.53 (< 1), and C(26:0)/ C(22:0)=0.04 (< 0.02). Abdominal computed tomography: small adrenal glands. Cranial magnetic resonance imaging and evoked potentials: normal at diagnosis and with signs of white matter demyelination after 2 years of follow-up. Testing for an autoimmune etiology and adrenoleukodystrophy is important in boys with primary adrenal insufficiency before Addison's disease is diagnosed. PMID:19627707

  8. Rivastigmine-induced REM sleep behavior disorder (RBD) in a 88-year-old man with Alzheimer's disease.

    PubMed

    Yeh, Shih-Bin; Yeh, Po-Yen; Schenck, Carlos H

    2010-04-15

    We report the case of an 88-year-old man with Alzheimer's disease (AD) of 8 years duration (emerging shortly after the de novo onset of sleeptalking) who developed REM sleep behavior disorder (RBD) after increasing the nightly dose of rivastigmine, an acetylcholinesterase inhibitor, from 1.5 mg to 3 mg (total daily dose, 4.5 mg), as therapy for his dementia. His family then became aware of recurrent nocturnal episodes arising from sleep of his leaving bed, and he sustained multiple abrasion injuries from falling down. Polysomnography (PSG), utilizing a seizure montage with fast paper speed, conducted with the patient taking rivastigmine 3 mg at bedtime, documented 3 abrupt episodes of bilateral arm-waving with moaning and shouting that emerged exclusively during each of the 3 REM sleep periods, with the duration of the episodes lasting 8 to 25 seconds. No epileptiform discharge appeared with the onset of these REM sleep behaviors. Therapy with clonazepam, 0.5 mg at bedtime (with ongoing 3 mg bedtime and 4.5 mg total daily rivastigmine therapy), fully suppressed the sleep-related events, with prompt relapse whenever clonazepam was not taken. This is the second reported case (both males with AD) of rivastigmine-induced RBD, and the oldest reported case of RBD; and it represents reversible, medication-induced, acute RBD. PMID:20411699

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

    PubMed

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

    2012-01-01

    Video games have become a popular entertainment among adolescents. Although some video games are educational, there are others with high content of violence and the potential for other harmful effects. Lack of appropriate supervision of video games use during adolescence, a crucial stage of development, may lead to serious behavioral consequences in some adolescents. There is also concern about time spent playing video games and the subsequent neglect of more developmentally appropriate activities, such as completing academic tasks. Self-administered questionnaires were used to assess video game use patterns and parental supervision among 55 adolescent patients 13-17 years old (mean age 14.4 years; 56.4% males) and their parents. Parental supervision /monitoring of the adolescents video games use was not consistent and gender related differences were found regarding their video game use. Close to one third (32%) of the participants reported video game playing had interfered with their academic performance. Parents who understood video games rating system were more likely to prohibit their use due to rating. These findings underscore the need for clear and consistently enforced rules and monitoring of video games use by adolescents. Parents need to be educated about the relevance of their supervision, video games content and rating system; so they will decrease time playing and exposure to potentially harmful video games. It also supports the relevance of addressing supervision, gender-based parental supervisory styles, and patterns of video games use in the evaluation and treatment of adolescents. PMID:22788074

  10. "To Sleep, Perchance to Dream": The Role of Sleep Disturbance in the Multidimensional Treatment of a Male Bulimic.

    ERIC Educational Resources Information Center

    Rybicki, Daniel J.; Levitt, John

    Eating disorders within males are relatively uncommon, with estimates suggesting incidence rates of only five percent of the sample. This single-subject, reversal design case study examines the etiological variables of a 22-year-old male bulimic patient. Consultation for treatment was made by the patient's parents. Family assessment made in the…

  11. School and the 17-Year-Old: A Comparison of Career Development Skills of 17-Year-Olds Attending School and Those Not Attending.

    ERIC Educational Resources Information Center

    Education Commission of the States, Denver, CO.

    National performance for 17-year-olds in school, 17-year-olds not in school and young adults aged 26-35 in the area of career and occupational development (COD) was assessed to determine whether or not education status and career development skills are related. Within each of the groups, performance of various subgroups was examined, defined by…

  12. Children's Readiness Gains in Publically Funded, Community-Based Pre-Kindergarten Programs for 4 Year Olds and Preschool for 3 Year Olds

    ERIC Educational Resources Information Center

    Goldstein, Peggy; Warde, Beverly; Peluso, Paul

    2013-01-01

    Background: Many states provide public funding to facilitate school readiness for community-based pre-K and preschool programs for 4 year old children and "at risk" 3 year old children. Little research exists on the school readiness gains of children participating in these "garden variety" community-based programs. Objective:…

  13. Advanced Marjolin's ulcer of the scalp in a 13-year-old boy treated by excision and free tissue transfer: Case report and review of literature

    PubMed Central

    Daya, M.; Balakrishan, T.

    2009-01-01

    Marjolin's ulcer originates in chronic scars and wounds of diverse origin. This relatively rare tumour is most commonly a squamous cell carcinoma. The reason for malignant transformation is not well understood. The burn scar is a common predilection. We present the youngest patient in the literature, a 13-year-old male with a locally advanced squamous cell carcinoma of the scalp with intracranial extension following an unhealed burn injury at the age of three. Bilateral cervical lymphadenopathy was also noted. The tumour was excised and the large defect overlying the brain was covered by free latissimus dorsi musculocutaneous flap. At four weeks a therapeutic bilateral selective neck dissection was done. Adjuvant chemotherapy was administered. This report reiterates the importance of early diagnosis. Free tissue transfer further enhances our ability to cover complex defects associated with excision of advanced lesions. PMID:19881030

  14. Acute hepatic sequestration associated with pneumococcal infection in a 5-year-old Boy with sickle beta degrees -thalassemia: a case report and review of the literature.

    PubMed

    Ahmed, Nabil; Chizhevsky, Vladislav

    2007-10-01

    A 5-year-old black male with sickle beta degrees -thalassemia presented with fever and a vaso-occlusive crisis. Within hours, he developed progressive hepatomegaly with an acute drop in the hemoglobin level that was refractory to repeated red blood cell transfusion. His condition deteriorated and eventually he succumbed to cardiorespiratory failure related to sepsis. Blood cultures grew Streptococcus pneumoniae. To the best of our knowledge, this is the first reported case of hepatic sequestration in a young child and the first reported in a patient with sickle beta degrees -thalassemia. We describe here the clinicohematologic and pathologic features of this case consistent with acute hepatic sequestration and present a review of the relevant literature. PMID:17921856

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

    PubMed Central

    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

    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

  16. Breaking the silence: what homeless 18- to 24-year-olds say about HIV vaccine trials.

    PubMed

    Koniak-Griffin, Deborah; Nyamathi, Adeline; Tallen, Louise; González-Figueroa, Evelyn; Dominick, Ernestina

    2007-08-01

    Development of a global HIV vaccine will require enrollment of a large number of adults and adolescents in clinical trials. Involvement of homeless young adults in these trials will be particularly important because they often practice high-risk behaviors and are disproportionately infected by HIV. This qualitative study explores factors that might affect future participation of homeless 18- to 24-year-olds of diverse racial/ethnic backgrounds in HIV vaccine trials (HIVVTs). Twenty males and females attended focus groups. Participants expressed concern about seroconversion, the trustworthiness of the researchers and/or government agencies conducting trials, vaccine side effects, and possible negative behavior change as a result of being vaccinated. Understanding the personal perspectives of high-risk young adults will enable researchers to tailor protocols to their individual needs and cultural values and, in so doing, potentially enhance willingness to participate in HIVVTs. PMID:17675723

  17. Cushing syndrome secondary to CRH-producing Wilms tumor in a 6 year old.

    PubMed

    Lee, Moon Hee; Cho, Uiju; Lee, Jae-Wook; Cho, Won-Kyoung; Jung, Min Ho; Chung, Nak Gyun; Cho, Bin; Choi, Yeong Jin; Lee, Myung Duk; Suh, Byung-Kyu

    2014-11-01

    Abstract Cushing syndrome is caused by prolonged exposure to elevated serum cortisol. It is uncommon in children, and etiology includes pituitary adenoma, adrenal tumor, and exogenous glucocorticoid administration. Rarely, it is paraneoplastic in origin. We present a case of paraneoplastic Cushing syndrome due to Wilms tumor that secreted corticotropin-releasing hormone (CRH). A 6-year-old male presented with polyphagia and weight gain. He showed Cushingoid appearance, hypertension, and palpable left flank mass. Serum cortisol and adrenocorticotropic hormone (ACTH) levels were elevated. Computed tomography showed a neoplasm originating from the left kidney. Pathologic diagnosis of Wilms tumor was made upon nephroureterectomy. Immunohistochemical staining was positive for CRH and negative for ACTH. All features of Cushing syndrome disappeared after surgery. This represents a rare case of Cushing syndrome secondary to Wilms tumor in which CRH production has been demonstrated. PMID:25153573

  18. Medullary sponge kidney in a 10-year-old Shih Tzu dog.

    PubMed

    Akihara, Y; Shimoyama, Y; Ohya, K; Hirayama, K; Yoshida, K; Matsuda, K; Okamoto, M; Taniyama, H

    2006-11-01

    Medullary sponge kidney was diagnosed in a 10-year-old male Shih Tzu dog with a long history of hyposthenuria, but with no other findings indicating renal failure or hormonal aberration. At the dog's death from heart failure, an autopsy was performed. On gross morphology, bilateral kidneys were normal size and had many cysts ranging from the corticomedullary junction to renal papillae. Histopathologic findings showed that almost all of the cysts were lined by monolayered or multilayered and columnar or cuboidal epithelium with chilium similar to epididymis. Immunohistochemically, all of these cells were strongly positive for AE1/AE3 and negative for vimentin. Many of these cells were positive for cytokeratin 7 (CK7), and only a few cells were positive for desmin. The results of staining are the same as those for epithelium of the collecting duct of normal canine kidney. This is the first report of this pathologic entity in the canine kidney. PMID:17099162

  19. Poor sleep in adolescents: a study of 869 17-year-old Italian secondary school students.

    PubMed

    Manni, R; Ratti, M T; Marchioni, E; Castelnovo, G; Murelli, R; Sartori, I; Galimberti, C A; Tartara, A

    1997-03-01

    Subjective sleep quality and its related factors were investigated in 869 (530 F, 339 M) 17-year-old adolescents, who were selected from the pupils of state-run secondary schools in the city of Pavia in the north west of Italy. The study was conducted cross sectionally, and it consisted of a questionnaire based survey. One hundred and forty-two subjects (16.5% of the whole sample, 19% of the females and 11.7% of the males) met the criteria chosen for definition as poor sleepers (namely, a complaint of 'non restorative nocturnal sleep', 'often' or 'always' over the previous 12 mo). A significant association was found between chronic poor sleep and (1) gender (female) (2) emotional factors, such as worries, anxiety and depression (3) poor sleep hygiene (4) arousal related parasomnia. Only 4% of poor sleepers took sleep promoting drugs (including benzodiazepines, homeopathic products and other medications), generally without seeking medical advice. PMID:9125698

  20. Atlantoaxial rotatory subluxation as a cause of torticollis in a 5-year-old girl.

    PubMed

    Bagouri, Elmunzar; Deshmukh, Sandeep; Lakshmanan, Palaniappan

    2014-01-01

    Many patients present to the emergency department complaining of a sore or stiff neck and lateral flexion of the neck with contralateral rotation. Under the pressure of the breaching time and busy shifts some of the patients are discharged to the care of their general practitioners without adequate investigations. While most of the cases are due to benign causes, torticollis can be due to many congenital and acquired pathologies, some of which may need further investigation and urgent management. Atlantoaxial subluxation (AAS), tumours of the base of the skull and infections are among these causes. Delayed diagnosis may lead to worsening neurology and complicate the management. We report a case of a 5-year-old girl who presented to our fracture clinic with a fractured clavicle and torticollis; her subsequent investigations confirmed the diagnosis of AAS. Our patient responded to non-operative treatment and improved with no neurological complications. PMID:24832710

  1. Fatal case of luteinized thecoma with sclerosing peritonitis in a 40-year-old woman.

    PubMed

    Bahar, Burak; Hu, Zhihong; Szpaderska, Anna; Liotta, Margaret; Potkul, Ronald K; Smith, Donna; Er?ahin, Ça?atay

    2014-01-01

    We describe the pathologic and clinical presentation of a very rare, fatal case of luteinized thecoma with sclerosing peritonitis in a 40-year-old woman, who had a history of total abdominal hysterectomy and a left salpingo-oophorectomy in 2003. The patient presented with abdominal pain, and radiologic examinations revealed a 10-cm heterogenous right pelvic mass with partial necrosis. The patient eventually underwent an exploratory laparotomy, which revealed an ovarian tumor with multiple implants in the peritoneal cavity. The ovarian lesion was made up of spindle cells among clusters of luteinized stromal cells that expanded to the ovarian cortex. Tumor cells were positive for vimentin, estrogen and progesterone receptors, and CCD68 (focally) and negative for CD34, ?-smooth muscle actin, ?-catenin, and desmin by immunohistochemical studies. Luteinized cells were positive for ?-inhibin and calretinin. Tumor cells exhibited low Ki-67 proliferation indices. The patient died because of the sclerosing peritonitis component of the disease. PMID:24300532

  2. Distinct Molecular Phenotypes in Male and Female Schizophrenia Patients

    PubMed Central

    Ramsey, Jordan M.; Schwarz, Emanuel; Guest, Paul C.; van Beveren, Nico J. M.; Leweke, F. Markus; Rothermundt, Matthias; Bogerts, Bernhard; Steiner, Johann; Bahn, Sabine

    2013-01-01

    Background In schizophrenia, sex specific dimorphisms related to age of onset, course of illness and response to antipsychotic treatment may be mirrored by sex-related differences in the underlying molecular pathways. Methodology/Principal Findings Here, we have carried out multiplex immunoassay profiling of sera from 4 independent cohorts of first episode antipsychotic naive schizophrenia patients (n?=?133) and controls (n?=?133) to identify such sex-specific illness processes in the periphery. The concentrations of 16 molecules associated with hormonal, inflammation and growth factor pathways showed significant sex differences in schizophrenia patients compared with controls. In female patients, the inflammation-related analytes alpha-1-antitrypsin, B lymphocyte chemoattractant BLC and interleukin-15 showed negative associations with positive and negative syndrome scale (PANSS) scores. In male patients, the hormones prolactin and testosterone were negatively associated with PANSS ratings. In addition, we investigated molecular changes in a subset of 33 patients before and after 6 weeks of treatment with antipsychotics and found that treatment induced sex-specific changes in the levels of testosterone, serum glutamic oxaloacetic transaminase, follicle stimulating hormone, interleukin-13 and macrophage-derived chemokine. Finally, we evaluated overlapping and distinct biomarkers in the sex-specific molecular signatures in schizophrenia, major depressive disorder and bipolar disorder. Conclusions/Significance We propose that future studies should investigate the common and sex-specific aetiologies of schizophrenia, as the current findings suggest that different therapeutic strategies may be required for male and female patients. PMID:24244349

  3. Fornix Integrity and Hippocampal Volume in Male Schizophrenic Patients

    PubMed Central

    Kuroki, Noriomi; Kubicki, Marek; Nestor, Paul G.; Salisbury, Dean F.; Park, Hae-Jeong; Levitt, James J.; Woolston, Sophie; Frumin, Melissa; Niznikiewicz, Margaret; Westin, Carl-Fredrik; Maier, Stephan E.; McCarley, Robert W.; Shenton, Martha E.

    2009-01-01

    Background The hippocampus has been shown to be abnormal in schizophrenia. The fornix is one of the main fiber tracts connecting the hippocampus with other brain regions. Few studies have evaluated the fornix in schizophrenia, however. A focus on fornix abnormalities and their association with hippocampal abnormalities might figure importantly in our understanding of the pathophysiology of schizophrenia. Methods Line-scan diffusion tensor imaging (DTI) was used to evaluate diffusion in the fornix in 24 male patients with chronic schizophrenia and 31 male control subjects. Maps of fractional anisotropy (FA) and mean diffusivity (Dm), which are indices sensitive to white-matter integrity, were generated to quantify diffusion within the fornix. We used high spatial resolution magnetic resonance imaging (MRI) to measure hippocampal volume. Results FA and cross-sectional area of the fornix were significantly reduced in patients compared with control subjects. Dm was significantly increased, whereas hippocampal volume was bilaterally reduced in patients. Reduced hippocampal volume was correlated with increased mean Dm and reduced cross-sectional area of the fornix for patients. Patients also showed a significant correlation between reduced scores on neuropsychologic measures of declarative-episodic memory and reduced hippocampal volumes. Conclusions These findings demonstrate a disruption in fornix integrity in patients with schizophrenia. PMID:16406249

  4. Sleep Habits and Symptoms in Male Medical and Surgical Patients

    PubMed Central

    Johns, M. W.; Egan, P.; Gay, T. J. A.; Masterton, J. P.

    1970-01-01

    A questionary survey of symptoms and sleep habits at home among 100 adult male medical and surgical patients showed that the duration of sleep at night was similar to that reported for the general population, decreasing with age from 20 to 50 years and increasing again after 60 years. The duration of daytime sleep increased with age. The degree of sleep disturbance in different patients was compared in terms of the total duration of sleep and the time spent lying awake in bed at night. Increasing age, ischaemic heart disease, and neurotic illness were the main factors associated with long-term disturbances. PMID:5428715

  5. Monoclonal Gammopathy of the Immunoglobulin A Class in a Two-Year-Old Girl with Ataxia Telangiectasia

    Microsoft Academic Search

    P. S. McDonald; D. Cora-Bramble; L. De Palma

    1998-01-01

    Ataxia telangiectasia is an autosomal recessive neurologic disorder which is frequently associated with a deficiency of IgA\\u000a immunoglobulin. We report an unusual case of monoclonal gammopathy of the IgA kappa type in a 2-year-old female patient newly\\u000a diagnosed with ataxia telangiectasia. Quantitative analysis of the patient's immunoglobulins revealed a marked elevation in\\u000a the IgA fraction with a value of 672

  6. Screening for metabolic liver diseases crucial to increase SVR to patients with CHC.

    PubMed

    El Badawy, Reda M; El Defrawy, Manal; Elhenawy, Ahmed; Morsy, Mahmoud M; Ramadan, Ibrahim Ghoneam

    2011-12-01

    Liver diseases and its complications is common health problem worldwide. The emergence of metabolic disorders as a cause after exclusion of viral hepatitis nowadays is important. This is retrospective study on 200 patient's age range from 6months to 18 years old (50 females and 150 males). The patients divided into 2 groups according to age < 5 years & >5 years and all investigations done was collected and statistically processed. Abdominal enlargement was observed in 166/200 of all patients, 48/166 (67.6%) in patients <5 years old and 118/166 (91.5%) in patients >5 years old with statistical significant, jaundice was present in 34/200 of patients, 23/34 (32.4%) in patients <5 years old and 11/34(8.5%) in patients >5 years old, with statistical significant difference, CBC was normal in 58/200 of all age groups. 10/58 (14.1%) in patients <5 years old, 48/58 (73.2%) in patients <5 years old, with statistical significant difference and abnormal CBC in 142/200 (61/142, 62.8%) in age group > 5 years old, 81/142 (85.9%) in age group <5 years. Metabolic disorders was normal in 124/200 of all age groups, 23/124 (32.4%) in patients <5 years old. Metabolic disorders was abnormal in 76/200 of all, 48/76(67.6%) in patients >5 years old and 28/76 (21.7%) in patients < 5 years old, with statistical significant difference & for both age groups. The sensitivity of modalities used in the diagnosis of liver disease was as follow for US, study of metabolic profile, abnormal liver functions and abnormal CBC, 83.1%, 65.2%, 61.6% and 66.1% consequently. PMID:22435164

  7. Prevalence of overweight and obesity in preschool children (2–5?year-olds) in Birjand, Iran

    PubMed Central

    2012-01-01

    Background Childhood overweight and obesity have increased progressively in developing countries and nowadays they are considered as a global epidemic. The aim of the present study was to determine prevalence of overweight and obesity in 2–5?year-old children in kindergartens of Birjand in 2008. Findings This cross- sectional and descriptive- analytical study was conducted on 500 children, who were 2–5?years-old, in kindergartens of Birjand selected through census. It was found that prevalence of overweight was 10.6% (11.7% in females and 9.6% in males) and obesity 7.6% (6.3% in females and 9.6% in males). Prevalence of overweight and obesity were statistically significant regarding birth weight, mother's occupation and father's level of education. Conclusion Prevalence of overweight and obesity in pre-schoolchildren is more than that of 7–18?year-old group in Birjand, but it is less than the result of similar studies in Tehran and most studies in other countries. Further studies are recommended to identify risk factors in obese children. Periodic studies are necessary to compare the changes in prevalence of obesity in children in future. PMID:23009667

  8. [Tetraplegia, resuscitation and epileptic seizures after partial colon resection in a 41-year-old woman].

    PubMed

    Wagner, W

    2014-01-01

    A 41-year-old woman, suffering from continuous abdominal pain, only presented a non-specific inflammation of the whole colon and an unclaryfied hyponatriaemia; in spite of the only doubtful explanation by an enormous elongation of the colon, it was partially resected. Thereafter, the patient's decline, hypaesthesia, areflexia and tetraparesis required intensive care. Despite immunoglobulin therapy, assuming a Guillain-Barré syndrome, the patient needed resuscitation, followed by signs of severe hypoxia (high level of neuron-specific enolase, hippocampal lesions). The abdominal pain, hyponatriaemia, persistent tachycardia, sensory deficits, tetraplegia, circulation arrest, later epileptic seizures and unusual urine color were finally explained by an acute intermittent porphyria (AIP). Although the symptoms were classic, the disease was recognized only very late. Indeed, it is so rare that most physicians will never be confronted with an AIP or only once or twice. PMID:24399476

  9. Multiple fibroadenomas in bilateral breasts of a 46-year-old Indian woman – A case report?

    PubMed Central

    Panda, Sangram Keshari; Patro, Byomokesh; Mishra, Jagadananda; Dora, Rajesh Kumar; Subudhi, B. Swagat Kumar

    2014-01-01

    INTRODUCTION Fibroadenomas are among the most common tumours of the female breast, occurring most frequently in women of child-bearing age, especially those under 30 years. PRESENTATION OF CASE We report a case with a total of 27 fibroadenomas presenting bilaterally of a 46-year-old woman. The histopathologic and immunophenotypic features of the fibroadenomata are described. DISCUSSION Most fibroadenomas are present as single mass, however the presence of multiple fibroadenomata can be seen in 15–20% of the patients. It has been reported that the average number of masses in cases of multiple fibroadenomas is 3–4 in a single breast but occurrence of more than five fibroadenomas in an individual patient is much less common. CONCLUSION There are few reports of multiple fibroadenomas. We report this case hoping to expand the literature and to provide insight to aetiology of multiple fibroadenoma formation and advice on management. PMID:24709623

  10. Cor triatriatum dexter and atrial septal defect in a 43-year-old woman.

    PubMed

    Vukovic, Petar M; Kosevic, Dragana; Milicic, Miroslav; Jovovic, Ljiljana; Stojanovic, Ivan; Micovic, Slobodan

    2014-08-01

    Cor triatriatum dexter is a rare congenital heart anomaly in which a membrane divides the right atrium into 2 chambers. We report the case of a 43-year-old woman who had cor triatriatum dexter and a large atrial septal defect. During attempted percutaneous closure, the balloon disrupted the membrane and revealed that the defect had no inferior rim, precluding secure placement of an Amplatzer Septal Occluder. Surgical treatment subsequently proved to be successful. In patients with an incomplete membrane and a septal defect with well-defined rims, percutaneous treatment can be the first choice. In patients who have cor triatriatum dexter and unfavorable anatomic features or concomitant complex heart anomalies, open-heart surgery remains the gold standard for treatment. PMID:25120397

  11. A 69-year-old man with excessive sweating of the right hemithorax

    PubMed Central

    Gil-Diaz, Aida; Conde-Martel, Alicia; Betancor-Leon, Pedro

    2011-01-01

    The pure autonomic failure is a rare entity, with only a few cases reported in the literature. The authors describe a case with compensatory excessive sweating of the right hemithorax as an initial manifestation of a pure autonomic failure, and the authors review the clinical characteristics of this disease. A 69-year-old man presented excessive sweating of the right hemithorax. Physical examination revealed orthostatic hypotension. No other neurological features were present. The autonomic study showed a low heart rate response to the Valsalva maneuver and reduced supine plasma norepinephrine levels. A pure autonomic failure was diagnosed. Treatment did not improve patient’s symptoms. Anhidrosis with asymmetrical compensatory hyperhidrosis can be the only symptom of a pure autonomic failure. The authors highlight an unusual form of presentation of a rare disease, difficult to diagnose if it is not taken into consideration. PMID:22696755

  12. Videophone support for an eight-year-old boy undergoing paediatric bone marrow transplantation.

    PubMed

    Bensink, Mark; Shergold, Jill; Lockwood, Liane; Little, Margaret; Irving, Helen; Russell, Trevor; Wootton, Richard

    2006-01-01

    We report the use of an Internet-based videophone to support a child undergoing bone marrow transplantation (BMT). Over the Christmas period, an eight-year-old boy with an underlying diagnosis of attention-deficit/hyperactivity disorder (ADHD) and a history of absconding and aggressive non-compliant behaviour was treated by BMT. We installed an Internet-based videophone in the patient's hospital room two days post-transplant. A second videophone was installed in the patient's home and used the existing home telephone line. In all, 14 videophone calls were made over a nine-day period. The videophone improved interfamily social and emotional support, and appeared to reduce some of the inherent anxiety and distress resulting from paediatric bone marrow transplantation. PMID:16848941

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

    PubMed

    Kang, Gurjaipal; Bhullar, Parampal; Kang, Manjot

    2005-01-01

    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

  14. A new form of shoulder dysplasia in an 11-year-old boy.

    PubMed

    Bichler, Jennifer; Arbogast, Martin; Krumrey-Langkammerer, Manuela; Hugle, Boris

    2014-07-01

    Pain and impaired function in the shoulder can result from a variety of conditions. Dysplasias of the shoulder girdle are usually asymptomatic; previous literature reports on shoulder malformation have focused on glenoid dysplasia or complete agenesis of the clavicle. We report the case of an 11 year old patient with severe shoulder pain after strenuous physical exercise. Physical inspection showed a prominent clavicle and anteriorly displaced humerus. X-ray demonstrated an abnormally shortened clavicle and a hypoplastic acromion; MRI imaging revealed an elongated deltoid muscle leading over the humeral head. The patient recovered with analgesics and careful mobilization. This is the first reported case of a dysplasia of both the acromion and the clavicle. This developmental abnormality can lead to significant pain, but apparently responds well to conservative treatment. It is possible that this condition is underdiagnosed or represents significantly delayed development. PMID:25426235

  15. Langerhans cell histiocytosis of the clavicle in a 13-year-old boy.

    PubMed

    Parikh, Shital N; Desai, Vishal R; Gupta, Anita; Anton, Christopher G

    2014-01-01

    Langerhans Cell Histiocytosis (LCH) is a rare neoplasm characterized by abnormal proliferation of histiocytic cells. In this case report, we describe a unique case of a 13-year-old boy who presented to the clinic with an insidious onset of mid-clavicular pain. The provisional radiologic diagnosis of Langerhans Cell Histiocytosis of the clavicle was confirmed by an incisional biopsy of the left mid-clavicle lesion. The patient's lesion was treated by curettage, bone grafting, and internal fixation, due to the presence of pathologic fracture. At the 2-year followup, the patient was asymptomatic, and the lesion showed complete resolution without recurrence. The case report highlights the characteristic features of Langerhans Cell Histiocytosis in an unusual location, the knowledge of which would help avoid delayed or missed diagnosis in the future. PMID:24516764

  16. Cardiomyopathy Induced by Pulmonary Sequestration in a 50-Year-Old Man

    PubMed Central

    Chatelain, Shaun; Comp, Robert A.; Grace, R. Randal

    2015-01-01

    A 50-year-old black man presented at the emergency department with midsternal, nonradiating chest pressure and chronic dyspnea on exertion. Four years before the current admission, he had been diagnosed with nonischemic cardiomyopathy at another facility. After our complete evaluation, we suspected that his symptoms arose from left-to-left shunting in association with pulmonary sequestration, a congenital malformation. Our preliminary diagnosis of secondary dilated cardiomyopathy was confirmed by normalization of the patient's ventricular size and function after lobectomy. To our knowledge, this patient is the oldest on record to present with cardiomyopathy consequent to pulmonary sequestration. His case is highly unusual because of his age and the rapid resolution of his symptoms after lobectomy. We believe that pulmonary sequestration should be included in the differential diagnosis of dilated cardiomyopathy. PMID:25873803

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

    PubMed Central

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

    2014-01-01

    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. PMID:25667888

  18. A 62-year-old women with persistent severe asthma, skin rash, and eosinophilia.

    PubMed

    Lataifeh, Abdel Rahman; Deas, Steven; Shalin, Sara C; Khasawneh, Khaled R

    2014-08-01

    A 62-year-old white woman was admitted with shortness of breath, wheezing, and cough. While in the hospital a generalized pruritic skin rash developed on her trunk and upper and lower extremities. She did not have any fevers, chills, or night sweats. The patient was known to have chronic, difficult-to-control asthma despite being compliant with a treatment regimen consisting of inhaled albuterol, high-dose inhaled steroids, salmeterol, and montelukast. Her medical history was significant for hypertension and gout. She had no family history of asthma. The patient was a life-long nonsmoker and did not drink alcohol. During this hospitalization, she was started on prednisone 40 mg/d po in addition to her home medications. PMID:25091763

  19. A 26-year-old female with metastatic primary gastrointestinal malignancy presenting as menorrhagia

    PubMed Central

    Bhatti, Ravinder Pal; Mukherjee, Sarbajit; Ali, Alaa M.; Gilman, Alan D.; Mirrakhimov, Aibek E.; Iroegbu, Nkemakolam

    2015-01-01

    Krukenberg tumor is a metastatic malignant tumor of the ovary arising from a wide variety of primary sources, with the stomach being the most common. The presenting symptoms are non-specific and the primary source is often un-identified. Here, we describe a case of a 26-year-old Hispanic gravida 4, para 3 female who presented to our hospital with dysuria, pelvic pain and irregular, heavy menstrual cycles for three months duration. An endometrial biopsy was suggestive of carcinosarcoma. The patient underwent debulking surgery with partial cystectomy and bladder repair. A week later, she presented with hematemesis and an endoscopic biopsy revealed a diagnosis of poorly differentiated gastric adenocarcinoma. The tissue specimen obtained during the initial surgery was identified as Krukenberg tumor. The patient underwent adjuvant chemotherapy with FOLFOX along with gastrectomy with intraperitoneal chemotherapy. PMID:25830046

  20. Preventive orthodontics for the 5- to 7-year-old with the Nite-Guide technique.

    PubMed

    Bergersen, E O

    2009-01-01

    This preventive orthodontic technique is applicable for the 5- to 7-year-old to prevent problems involving crowding, spacing, rotations, overbite, overjet, gummy smiles, Class II molar relations, and TMJ dysfunction from developing. The technique is based on accepted published research on the development of the dentition. Patients are typically started at 5 or 6 years of age and wear two preformed appliances only while sleeping. The active stage lasts about 2 years. The same appliance is used as a retainer until 12 years when the patient is dismissed About 75% to 80% do not require further orthodontics. The total procedure takes about 2 to 3 hours of total chair time. PMID:20128328

  1. A case of premature ovarian failure (POF) in a 31-year-old woman with a 47,XXX karyotype.

    PubMed

    Ska?ba, Piotr; Cygal, Anna; Gierzy?ska, Zuzanna

    2010-01-01

    A case of POF in a 31-year-old woman with karyotype 47,XXX. The aim of the study was to discuss a case of POF in a 31-year-old patient with polysomy 47,XXX. The described karyotype is not usually associated with this characteristic physical phenotype. In some rare cases, menstrual disorders, sterility, secondary amenorrhoea, premature menopause, and low intelligence are found. Our observations revealed the necessity for cytogenetic examination in all women at reproductive age with symptoms of premature ovarian failure. According to the data found in literature, patients with POF and karyotype disorders belong to the risk group of premature death, mostly for cardiological reasons. Raising patient awareness about the risk may have a positive effect on quality of life and regularity of check-ups. PMID:20464710

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

    PubMed

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

    2013-01-01

    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

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

    PubMed Central

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

    2013-01-01

    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

  4. Acquired central hypothyroidism in a male thalassaemic patient with severe iron overload.

    PubMed

    De Sanctis, Vincenzo; Giovannini, Michela

    2011-03-01

    Acquired central hypothyroidism (CH) is a rare form of hypothyroidism that results from a variety of conditions affecting the hypothalamus and the pituitary gland. This pathology remains difficult to diagnose in patients with chronic disease. The Authors describe a 21-year-old patient with thalassaemia (TM) who was referred for the evaluation of short stature and hypogonadism, and was found to have CH.This case report stresses the importance of following thyroid function in TM patients and underlines the criteria for diagnosis and treatment. PMID:21705986

  5. The Case of an Elderly Male Patient with Unknown Primary Mucinous Adenocarcinoma within Presacral Teratoma (Teratoma with Malignant Transformation)

    PubMed Central

    Cokmert, Suna; Koca, Emine; Bulut, Naki; Gul, Suha; Yilmaz, Nevin

    2015-01-01

    Teratomas are rarely seen in adults, and presacral region is an area where they rarely settle in. Similarly, only about 1% of teratomas show malignant transformation. Malignant transformation is often associated with the area where teratoma settles in. Malignant transformation of mediastinal teratomas is more frequent than the ones located in retroperitoneal area and gonad. They most commonly show rhabdomyosarcoma, primitive neuroectodermal tumor, enteric adenocarcinoma, and leukemia transformation. In teratomas showing malignant transformation, the clinical course is aggressive; and survival of patients with metastatic disease is very low. The primary treatment of teratomas with malignant transformations is surgical. Effect of radiotherapy and chemotherapy is not clear in patients, to whom surgical operation cannot be applied, or those who are with residual tumor, even if surgical operation can be applied to them, or those who are at metastatic stage. In this paper, we presented a 76-year-old male patient due to the histologic diagnosis of mucinous adenocarcinoma within teratoma, in whom approximately 7?cm presacral mass was found during the radiographic examination made by the reason of low back pain and pelvic pain.

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

    PubMed Central

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

    2012-01-01

    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

  7. Analysis of halo-orthoses application in children less than three years old

    PubMed Central

    Arkader, Alexandre; Hosalkar, Harish S.; Drummond, Denis S.

    2007-01-01

    Purpose To evaluate the safety and efficacy of halo immobilization in children younger than 3 years. Methods All children less than 3 years of age who were placed in a halo-orthosis at a tertiary pediatric center were reviewed to determine the indications, safety, and efficacy of this method. Adequacy of immobilization and correct technique was established considering the chronology of maturation (skull and brain development). The functional outcome was analyzed. Results Ten patients (<3 years old) were identified from a total of 150 where halo ring/vest immobilization was used. There were six boys and four girls, with an average age of 2 years (range 10 months to 2 years and 10 months). The average time of immobilization in the halo-orthosis was 75 days (range 33–168 days), and the average follow-up time was 5 years and 2 months (range 1–12 years). There were two halo-related problems and four related to the index procedure. Halo-related problems included pin-site infection in one patient, and three pins loosening in another. There were four complications associated with the index procedure, all early in the series, including three cases of pseudarthrosis and one patient that had an insufficient decompression of basilar invagination. Two of the three failed fusions occurred at the occipito-cervical junction, which prompted us to develop new techniques for fusion at this level. Conclusions Halo-orthosis is a relatively safe and reliable device for immobilization of the upper cervical spine in children less than 3 years old. Understanding the developmental anatomy and a limited CT scan are helpful in pin placement. We recommend the use of a multiple pin construct, perpendicular insertion, and precise tightening with good pin-site care and frequent follow-up. The benefits seem to outweigh the risks in this population, considering the mechanical advantages of the halo-orthosis. PMID:19308529

  8. 75 FR 76636 - Anthropomorphic Test Devices; Hybrid III 6-Year-Old Child Test Dummy, Hybrid III 6-Year-Old...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-09

    This final rule makes two changes to the agency's specifications for the Hybrid III six-year-old child dummy, and the Hybrid III six-year-old weighted child test dummy. First, to improve the durability of the dummies' femurs we are changing the design of and material used for the femur assembly. Second, we correct the drawings for the abdomen insert so that the abdominal insert dimensions on the......

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

    NASA Astrophysics Data System (ADS)

    Huang, Bin

    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.

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

    PubMed Central

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

    2013-01-01

    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

  11. Anal duplication in a one-year-old girl

    PubMed Central

    Cheng, Lily S.; Courtier, Jesse; MacKenzie, Tippi C.

    2015-01-01

    We report a case of a patient with anal duplication discovered incidentally at 1 year of age. Pre-operative evaluation excluded any complications or associated anomalies. She underwent surgical excision with an excellent outcome.

  12. Angiosarcoma of the ovary in an 11 year old girl: Case report and review of the literature

    PubMed Central

    Iljazovi?, Ermina; Tomi?, Snježana; Mustedanagi?-Mujanovi?, Jasminka; Karasalihovi?, Zinaida; Kuljanin, Majda; Fatuši?, Zlatan; Konji?, Elvira; Husari?, Edin; Latifagi?, Amila; Arnautali?, Lejla

    2011-01-01

    Sarcomas of the female genital tract in general are rare and ovarian sarcomas comprise less than 1% of ovarian malignancies. In the literature there are 15 reported angiosarcomas of patients 21 year old and younger with no one originated in the ovary. We report a case of ovarian angiosarcoma in an 11 year old girl, presented with left side hip pain. MRI of abdomen and pelvis confirmed expansive solid and cystic mass occupied both ovaries. Imunohistochemistry staining was performed, CD34, Factor VIII, CD31, in order to confirm the diagnosis. Final diagnosis was angiosarcoma. The patient received 6 cycles of chemotherapy, according to the CWS-2002P protocol. 8 months after the diagnosis was established, there were no signs of any tumors according to the ultrasound, CT scan, and MRI. Although, extremely rare, angiosarcoma can also affect children and this diagnosis should be considered carefully in tumor with rich vascular network, necrosis and brisk mitotic activity PMID:21619563

  13. Early attachment predicts emotion recognition at 6 and 11 years old

    Microsoft Academic Search

    Howard Steele; Miriam Steele; Carla Croft

    2008-01-01

    This paper reports on findings from a sample of 63 children at 6 years old, and 49 children at 11 years old, all from the same cohort who had been observed with mother in the Strange Situation at 1-year-old. At 6 and 11 years, the children responded to the task of providing verbal labels for line-drawn (caricatures of) emotion faces.

  14. Large laryngeal vascular malformation in a 5-year-old child.

    PubMed

    Danstrup, Christian Sander; Madsen, Mette Hjřrringgaard; Bille, Jesper

    2015-01-01

    A 5-year-old boy was admitted with stridor, which was initially interpreted as subglottic laryngitis. He had a history of prolonged hoarseness and his voice was deep for his age. The stridor persisted despite treatment with epinephrine inhalations and intravenous glucocorticoids. A direct laryngoscopy and blood work up did not support the suspected diagnosis. A MRI was then carried out, followed by angiography. The latter revealed an arteriovenous malformation (AVM) involving the lingual and superior thyroid arteries bilaterally. Owing to the rareness and extent of such an AVM, the patient was referred to Paris for further treatment. This case presents the difficulties in diagnostics and emphasises the importance of diagnostics and multidisciplinary approaches with regard to treatment of AVMs. PMID:25795744

  15. A 10-year-old child with status asthmaticus, hypercapnia and a unilateral dilated pupil.

    PubMed

    Udy, Andrew

    2005-12-01

    This article reports the case of a 10-year-old child with an exacerbation of asthma requiring mechanical ventilation. His immediate course was complicated by significantly elevated arterial CO(2) tensions and a unilateral dilated pupil. A computed tomography scan of his brain failed to demonstrate any evidence of intracranial hypertension or cerebral edema, and he went on to make an uncomplicated recovery, with no evidence of neurological sequelae. The most likely diagnosis appeared to be local contamination with ipratropium when he was receiving frequent nebulizers prior to mechanical ventilation. Similar cases reported in the literature are reviewed, with a discussion of clinical management, implications of permissive hypercapnia and neurological complications in ventilating asthmatic patients and the importance of safe drug handling by staff members. PMID:16324036

  16. Systemic lupus erythematosus presenting with pulmonary thromboembolism in a 15-year-old girl.

    PubMed

    Dell'Era, L; Corona, F; Defilippi, A C; Esposito, A; Principi, N; Esposito, S

    2012-09-01

    Pulmonary embolism is rare in children aged less than 15 years in whom its estimated annual incidence is 0.2 cases per 100,000, against the approximately 700 cases per 100,000 in patients aged more than 85 years. We describe the case of a 15-year-old girl who had a history of thrombocytopenia with anti-platelet and anti-nuclear antibodies. Misdiagnosed chest pain and dyspnea were treated for 6 weeks as community-acquired pneumonia, but proved to be the onset of pulmonary thromboembolism. Although this life-threatening event is rare in paediatrics, the presence of lupus anticoagulant combined with previously asymptomatic thrombocytopenia allowed a diagnosis of systemic lupus erythematosus (SLE). The combination of a history of thrombocytopenia and the presence of antinuclear antibodies, even in the absence of any other diagnostic criteria, should always suggest considering SLE as a differential diagnosis, particularly when the course of a clinical manifestation is atypical. PMID:20376666

  17. A 33-year-old Haitian immigrant with 7 months of abdominal pain and progressive distension.

    PubMed

    Farhadian, Shelli; Shenoi, Sheela V; Villanueva, Merceditas S

    2014-01-01

    We report a case of a 33-year-old previously healthy Haitian immigrant with a 7-month history of abdominal pain, fever and ascites. He had a history of positive tuberculin skin test but never underwent treatment for latent tuberculosis (TB) infection. Initial examination showed abdominal distension. Abdominal CT scan showed mild ascites, abnormal soft tissue in the greater omentum and small bowel mesentery, retroperitoneal adenopathy, peritoneal thickening and dilated loops of small bowel. Paracentesis and thoracentesis were initially non-diagnostic. HIV testing was negative. The differential diagnosis included lymphoma and TB peritonitis. The omental mass was biopsied under ultrasound guidance, and histopathology revealed non-necrotising granulomas. Sputum cultures and omental biopsy cultures subsequently grew Mycobacterium tuberculosis, and a diagnosis was made of pulmonary TB with TB peritonitis. The patient responded well to the initiation of anti-TB treatment. PMID:25008341

  18. Postpartum ovarian vein thrombosis in a 29-year-old woman with ulcerative colitis.

    PubMed

    Bhandari, Harish M; Jeevan, David; Slinn, Jessica; Goswami, Kavita

    2014-01-01

    A 29-year-old woman with known ulcerative colitis developed a right-sided abdominal pain a day after preterm vaginal delivery at 30?weeks. She did not have any nausea, vomiting and had normal bowel movements. The observations were within normal limits and white cell counts were marginally elevated with a normal C reactive protein. A large ovarian vein thrombosis on the left side was an incidental finding on a CT of the abdomen and pelvis undertaken to establish the cause for abdominal pain. The patient was managed by a multidisciplinary team and was treated with anticoagulants for 6?months. This case illustrates that the incidence of pelvic venous thrombosis may be higher in pregnancy and puerperium. PMID:25471109

  19. Abdominal lymphangiomatosis in a 38-year-old female: Case report and literature review

    PubMed Central

    Lin, Ruo-Yang; Zou, Hai; Chen, Tan-Zhou; Wu, Wei; Wang, Jian-Hong; Chen, Xiao-Lei; Han, Qing-Xi

    2014-01-01

    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

  20. Anti-laminin-332 mucous membrane pemphigoid in a 9-year old girl.

    PubMed

    Kahn, Estelle; Spence Shishido, Allyson; Yancey, Kim B; Lawley, Leslie P

    2014-01-01

    Mucous membrane pemphigoid (MMP), an autoimmune subepithelial blistering disease that predominantly affects the mucous membranes, is usually diagnosed in elderly adults. Early diagnosis of MMP is crucial because it tends to run a chronic and progressive course with the potential for devastating scarring of the mucous membranes that may lead to blindness and airway compromise. A subtype of MMP, anti-laminin-332 MMP, is a rare blistering disorder in which autoantibodies are directed against laminin-332 (formerly epiligrin), a structural protein of the epidermal basement membrane. Herein we report what we believe to be the youngest patient diagnosed with anti-laminin-332 MMP, a 9-year-old girl with disease affecting only the oral, pharyngeal, and laryngeal mucosa, with no skin involvement. PMID:24138321

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

    PubMed

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

    2010-01-01

    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

  2. Solid variant of papillary thyroid carcinoma in a 14-year-old girl.

    PubMed

    Abdul Rahman, Wan Faiziah Wan; Md Hashim, Mohd Nizam; Win, Thin Thin; Bakrin, Ikmal Hisyam

    2013-01-01

    Solid variant of papillary thyroid carcinoma (PTC) is a rare, poorly characterised variant and predominantly reported in children with a history of radiation exposure. This variant has a high propensity for extra-thyroidal extension and cervical lymph node metastases. A 14-year-old Malay girl who had no history of radiation exposure, presented with multiple cervical lymphadenopathy and it was clinically suspicious for tuberculosis or lymphoma. An incisional biopsy revealed a metastatic PTC. The patient underwent total thyroidectomy with bilateral lateral neck dissection and histopathology report was solid variant of PTC. Whole-body I(131) scan was performed which revealed an intense tracer uptake in the neck. She was planned for radioactive iodine ablation and now on regular follow-up for monitoring of possible tumour metastasis. PMID:23749834

  3. De Garengeot's hernia in a 60-year-old woman: a case report

    PubMed Central

    2011-01-01

    Introduction De Garengeot first described the presence of the appendix within a femoral hernia in 1731. Case presentation We report the case of a 66-year-old Caucasian woman who presented with acute appendicitis within an incarcerated femoral hernia. This is the first reported case of de Garengeot's hernia in the Balkan area. Conclusions Appropriate management without incurring any delay for radiological imaging can be promising for an uneventful postoperative course. The treatment of choice of this disease entity is emergency surgery and consists in simultaneous appendectomy through the hernia incision and primary hernia repair. In patients with large hernia defects or in older people the use of mesh for repairing the hernia defect can be an excellent choice. PMID:21718485

  4. Frontal bone tuberculosis presenting with blindness in a 14-year-old girl: a case report

    PubMed Central

    2009-01-01

    Introduction The occurrence of tuberculosis in the flat bones of the skull is very rare. Only eight cases of tuberculosis of the frontal bone have been reported in the literature. Case presentation A 14-year-old girl of Asian ethnicity presented with gradual loss of vision. A computed tomography scan of her head showed a diffuse, homogeneously ill-defined hyperdense lesion of size 2.9 × 5.3 cm (anteroposterior × thickness) involving the right orbit. Biopsy of the lesion confirmed the presence of epithelioid cells and Langerhans giant cells with caseous material. After surgical debridement with antitubercular treatment, the patient had an uneventful recovery. Conclusion Although rare, tuberculosis can affect the flat bones of the skull. Tuberculosis of the frontal bone can be included in the differential diagnosis of blindness. PMID:19830221

  5. Trichomegaly in a 3-year-old girl with alopecia areata.

    PubMed

    Nazareth, Michael R; Bunimovich, Olga; Rothman, Ilene L

    2009-01-01

    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

  6. Treatment of essential palatal myoclonus in a 10-year-old girl with botulinum neurotoxin.

    PubMed

    Krause, Eike; Leunig, Andreas; Klopstock, Thomas; Gürkov, Robert

    2006-08-01

    Palatal myoclonus (PM) is a rare neurotological disorder but is being reported with increasing frequency. Two forms, symptomatic and essential PM, have been identified as separate clinical entities and probably also have separate etiologies. In essential PM, brain imaging is unremarkable and a clicking noise caused by peritubal muscle contractions and often audible by the examiner usually is the patients' chief complaint. The treatment of essential PM with systemic application of anticonvulsants and related substances as well as by destructive surgical means has yielded unsatisfactory results. Recently, the use of botulinum neurotoxin has emerged as a new treatment option that seems particularly attractive due to its safety, complete reversibility, very few side effects, and minimal invasiveness. We report the case of essential PM in a 10-year-old girl who was successfully treated with botulinum toxin injections under eletromyographic guidance and we review the literature on the use of botulinum toxin in PM. PMID:16868515

  7. Severe visual loss caused by unrecognized malignant hypertension in a 15-year-old girl.

    PubMed

    Cortina, Gerard; Hofer, Johannes; Giner, Thomas; Jungraithmayr, Therese

    2015-04-01

    A 15-year-old girl presented with acute bilateral loss of central visual acuity due to hypertensive retinopathy level IV. She was found to have unrecognized malignant arterial hypertension associated with end-stage renal failure. At the time of diagnosis she also had severe left ventricular hypertrophy (LVH). Hypertension was successfully treated with combined anti-hypertensive therapy, but renal function did not recover. The patient underwent successful kidney transplant 4 months later and over a period of 20 months hypertensive retinopathy and LVH gradually resolved. This report emphasizes the importance of routine measurement of blood pressure and describes the possible consequences of unrecognized arterial hypertension in children. Early diagnosis and appropriate treatment are necessary to avoid development and progression of target organ damage and promote better long-term cardiovascular prognosis. PMID:25868960

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

    PubMed

    Daher, Paul; Riachy, Edward; Khoury, Antoine; Raffoul, Lara; Ghorra, Claude; Rehayem, Caline

    2015-02-01

    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

  9. Leiomyosarcoma of the Spermatic Cord in a Seventy-Five-Year-Old man

    PubMed Central

    Dehghan, Arash; Sami, Ghazal; Eskandari, Nika

    2014-01-01

    Introduction: Leiomyosarcoma is a malignant soft tissue tumor that can arise from any tissue containing smooth muscle. Leiomyosarcomas of the spermatic cord are rare tumors of non-testicular origin, which drain into the retroperitoneal lymph nodes and have been reported in less than 150 cases in the literature until now. Radical inguinal orchiectomy and high ligation of the cord is the standard primary surgical procedure in spermatic cord leiomyosarcoma. Case Presentation: Here we reported a 75-year-old man who presented with a painless lump in the right hemiscrotum. A right radical orchiectomy was performed. Histopathology confirmed a neoplastic tissue with mesenchymal origin in spermatic cord; further evaluation revealed a leiomyosarcoma of the spermatic cord. The patient was followed up for 1-year and shows no signs of recurrence Conclusions: Preoperative diagnosis of spermatic cord leiomyosarcma is difficult and commonly made by histological examination and immunochemical staining. PMID:25738126

  10. Leishmaniasis, malaria, and schistosomiasis concurrently in an 8-year-old boy.

    PubMed

    Bin Mohanna, Mabrook A

    2015-04-01

    An overlap in the distribution of the 2 diseases (leishmaniasis and malaria) was reported in endemic areas, and it can cause significant delay in the diagnosis of leishmaniasis. Here, an 8-year-old Yemeni boy who was initially diagnosed as malaria and schistosomiasis, and later on as leishmaniasis is reported. He presented with prolonged fever, hepatosplenomegaly, and diarrhea. His blood film was positive for Plasmodium falciparum malaria, and his stool was positive for Schistosoma mansoni. Although a full therapeutic course of antimalarial and schistosoma was administered, his fever, weight loss, and increased hepatosplenomegaly continued. Bone marrow aspiration was carried out revealing Leishman-Donovan bodies (amastigote form). He was successfully treated with a full course of sodium stibogluconate. This case stresses the importance of alertness among the treating physicians to this disease occurring in a patient from an endemic area, presenting with prolonged fever, and hepatosplenomegaly. PMID:25828290

  11. A 45-year old man with recurrent syncope: an unusual presentation of coronary artery disease

    PubMed Central

    Adeoye, Abiodun Moshood; Adekunle, Aina Nnodim; Adebiyi, Adewole Adesoji; Mullassari, Ajit; Vijayakumar, Subban; Nwafor, Chibuike Eze

    2013-01-01

    A 45-year old normotensive, euglycaemic, non-smoker was referred from a peripheral hospital to the Cardiology unit of the University College Hospital, Nigeria for evaluation of recurrent exercise induced syncope. Initial 12-lead electrocardiogram (ECG), 24-hr ambulatory ECG, trans-thoracic echocardiogram and electroencephalogram (EEG) were normal. A repeat episode of syncope warranted further investigation. Immediate post syncope ECG showed deeply inverted symmetrical T waves in the anterior leads. He underwent coronary angiogram which revealed distal left main disease and 70-80% stenosis of the proximal Left Anterior Descending Artery (LAD). The Circumflex artery was non dominant with normal Right Coronary artery. He subsequently had Percutaneous Transluminal Coronary Angioplasty (PTCA) of the LAD. Post-revascularisation course has been satisfactory with no recurrence of syncope. In view of the rising trend of cardiac death in the country, there is the need for high index of suspicion in making diagnosis of coronary artery disease in patients with syncope. PMID:23646207

  12. Pulmonary veno-occlusive disease in an 11-year-old girl: diagnostic pitfalls.

    PubMed

    Kano, Gen; Nakamura, Keiko; Sakamoto, Izumi

    2014-02-01

    Pulmonary veno-occlusive disease (PVOD) is a rare chronic lung disease that is difficult to diagnose due to non-specific clinical findings. Little is known about the pathogenesis of PVOD. Reported herein is the case of an 11-year-old girl who initially presented with 'bat-wing' shadows on chest radiography. This finding, coupled with prominent hemosiderosis in bronchoalveolar lavage fluid, initially led to a misdiagnosis of idiopathic pulmonary hemosiderosis. Oral prednisolone dramatically improved signs and symptoms initially, but her condition then gradually deteriorated during maintenance therapy with corticosteroids and other immunosuppressants. PVOD was suspected but not confirmed owing to a lack of hallmark radiographic findings and contraindications for lung biopsy. Three years later, while arranging for lung transplantation, the patient experienced sudden onset of fatal massive pulmonary edema. PVOD was confirmed at autopsy. This case provides insights regarding an unfamiliar presentation of PVOD and may help physicians to avoid diagnostic pitfalls. PMID:24548200

  13. Temperament and character profiles of male COPD patients

    PubMed Central

    Orhan, Fatma Ozlem; Sucakli, Mustafa Haki; Ozer, Ali; Koksal, Nurhan; Sen, Bilal

    2013-01-01

    Background Chronic obstructive pulmonary disease (COPD) is a respiratory disorder, and is characterized by persistent airflow obstruction. These patients are exposed to severe physical limitations and substantial psychosocial trouble. The aims of this study were to determine the temperament and character profiles of personality in patients with COPD and to compare the results with those of healthy controls. Methods Thirty-nine male COPD patients and 67 age- and gender-matched healthy controls completed the self-administered 240-item temperament and character inventory (TCI) and 14-item hospital anxiety and depression scale. The relationships between temperament and character personality profiles and clinical factors such as severity of COPD, anxiety, and depression were evaluated. Results COPD patients had significantly higher mean scores of Harm avoidance and lower mean score of Self-directedness than those of healthy controls. In the COPD patients, the anxiety score was significantly higher (P=0.03) and the depression score was found to be insignificantly higher than that of control group. The TCI profiles were not correlated with the severity of COPD. In COPD patients, Self-directedness and Cooperativeness traits of TCI character negatively correlated with anxiety, but any of traits did not correlate with depression. Conclusions The present study defined the Harm avoidance score was higher and Self-directedness was lower in COPD patients and the COPD severity did not correlate with any of the personality trait. We suggest that during evaluation of COPD patients for treatment, personality trait should also be considered in clinical practice. PMID:23991295

  14. A Report of a Desmoplastic Ganglioglioma in a 12-year-old Girl with Review of the Literature

    Microsoft Academic Search

    I. Pommepuy; M. Delage-Corre; J. J. Moreau; F. Labrousse

    2006-01-01

    Summary  Desmoplastic infantile ganglioglioma is a supratentorial tumor that typically occurs in infants below the age of 24 months.\\u000a Rare tumors with the same radiological and histological characteristics have been described in older subjects. We report a\\u000a case of desmoplastic ganglioglioma in a 12-year-old girl with a 13 years follow-up. The patient presented with an inaugural\\u000a generalized seizure. CT scan demonstrated a large

  15. Montelukast once daily inhibits exercise-induced bronchoconstriction in 6- to 14-year-old children with asthma

    Microsoft Academic Search

    James P. Kemp; Robert J. Dockhorn; Gail G. Shapiro; Ha H. Nguyen; Theodore F. Reiss; Beth C. Seidenberg; Barbara Knorr

    1998-01-01

    Objective: To determine whether montelukast, a leukotriene receptor antagonist, attenuates exercise-induced bronchoconstriction (EIB) in 6- to 14-year-old children with asthma.Study design: Double-blind, multicenter, 2-period crossover study. Children (n = 27) with forced expiratory volume in 1 second (FEV1 ) ?70% of the predicted value and a fall in FEV1 ? 20% after exercise on 2 occasions. Patients received montelukast (5-mg

  16. Allograft Reconstruction After Sarcoma Resection in Children Younger Than 10 Years Old

    PubMed Central

    Ayerza, Miguel A.; Aponte-Tinao, Luis; Farfalli, German

    2008-01-01

    Preservation of limb function in pediatric oncology patients is challenging with the ongoing growth of limbs contralateral to reconstructed limbs. We analyzed 22 patients younger than 10 years old who received an allograft after resection of a bone sarcoma with a minimum followup of 2 years (mean, 4 years; range, 2–14 years). The mean age was 7 years (range, 2–10 years). There were 16 boys and six girls with 17 osteosarcomas and five Ewing’s sarcomas. Thirteen reconstructions were performed with an intercalary allograft and nine with an osteoarticular allograft. Physes were uninvolved in five patients and one physis in 17. We documented outcomes using the Musculoskeletal Tumor Society functional and the International Society of Limb Salvage radiographic scoring systems. At last followup, three of the 22 patients died of their tumor, one was alive but with an amputation, and 18 retained their limbs. These 18 patients had an average functional score of 27 points and a mean radiographic score of 94%. Eight complications required a second surgery; in four, the allograft was removed (one infection, one local recurrence, two fractures) and in four, the allograft was preserved (two local recurrences, one fracture, one nonunion). We consider biologic reconstruction with allografts after sarcoma resection an appropriate reconstructive procedure in young children. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18506559

  17. Radiographic diagnosis and differentiation of an aggressive angiomyxoma in a male patient.

    PubMed

    Karwacki, Grzegorz Marek; Stöckli, Martin; Kettelhack, Christoph; Mengiardi, Bernard; Studler, Ueli

    2013-07-01

    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

  18. [Hepatitis C virus: 25 years-old, the end?].

    PubMed

    Pol, Stanislas

    2013-11-01

    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

  19. Case Report: 6YearOld Male with Autism and Systemic Onset Juvenile Rheumatoid Arthritis

    Microsoft Academic Search

    Gail Williams; Richard H. McChane; Ken Schikler

    2004-01-01

    Autism is a developmental disorder characterized by pervasive social and communication impairments and restricted range of interests and activities. Although the specific cause is unknown, proposed etiologies for autism have included autoimmune dysregulation of cellular or humoral components and maternal–fetal immunoregulation problems. Juvenile rheumatoid arthritis (JRA) constitutes several heterogeneous arthritides with onset in childhood. JRA is believed to be an

  20. Case Report: 16-Year-Old Male with Autistic Disorder with Preoccupation with Female Feet

    ERIC Educational Resources Information Center

    Early, Maureen C.; Erickson, Craig A.; Wink, Logan K.; McDougle, Christopher J.; Scott, Eric L.

    2012-01-01

    This paper highlights clinical challenges faced when diagnosing and then treating an individual presenting to a child and adolescent psychiatry clinic because of unwelcome comments he made to female peers about their feet. Novel use of exposure therapy helped him effectively decrease his comments from 1 to 2 times per month to once every 6 months.…

  1. The prevalence of middle ear diseases among 7- to 13-year-old primary school students in Yozgat province.

    PubMed

    Ozkiri?, Mahmut; Kapusuz, Zeliha; Saydam, Levent

    2012-01-01

    External and/or middle ear pathologies are commonly encountered by otolaryngologists, family practitioners and pediatricians. If left undiagnosed, these conditions may result in significant irreversible damage such as varying degree of hearing loss that can affect the social or professional performance of the individuals in later stages of life. In this study, we aimed to investigate the prevalence of several external and/or middle ear diseases among 7-13-year-old primary school students in Yozgat province. The province of Yozgat serves as a transition point between the Central Anatolian and Black Sea regions of Turkey. Nine hundred and seventy-eight primary school students were included in the study between March 1, 2012 and March 15, 2012. All subjects underwent a routine ear examination in school with a diagnostic otoscope. The students with pathologic ear findings were further evaluated to identify the underlying process. The age range of 978 students (527 males, 451 females) was 7 to 13 (mean: 10.5) years. Tympanic membrane (TM) pathology was detected in 33 (3.37%) of the cases overall. Of the cases, 3 (0.30%) had TM perforation, 11 (1.12%) had myringosclerosis (MS), 13 (1.32%) had serous otitis media, 1 (0.10%) had atresia of the left ear, and 4 (0.40%) had retraction pocket. One patient (0.10%) had undergone a left cochlear implantation procedure. The results of our study seem to be comparable with the other studies reported in the literature. Routine periodic ear examinations during the primary school ages are mandatory to obtain the exact prevalence of these pathologies in the entire population. We believe that early childhood screening of middle ear disease will have a positive effect on treatment. PMID:23427512

  2. 14-year-old boy with painful nail changes.

    PubMed

    Nag, Shudeshna; Weinstein, Miriam; Greenberg, Saul

    2015-03-01

    Doxycycline is a classically implicated cause of phototoxic reactions. Photo-onycholysis is a rare manifestation of phototoxicity. Nail changes may typically include nail pain, subungual hemorrhages, or distal onycholysis. Self-resolution can be expected in 3 to 6 months. Patients prescribed doxycycline should be counseled about the potential for phototoxicity and the need for appropriate sun protection while taking the medication. PMID:25733769

  3. Popliteal Fossa Pain in 24 Year-old Female

    PubMed Central

    Yoon, Kyung Bong; Yoon, Duck Mi; Kim, Do Hyeong

    2012-01-01

    The pain around the posterior knee, called 'popliteal fossa', has been known to be caused by a variety of disease entities. Venous malformation is a very rare cause of popliteal area pain, and its diagnosis is frequently delayed, missed, or given incorrectly. Here, we report a case of a patient with popliteal fossa pain for 2 years and was diagnosed as intramuscular venous malformation using ultrasound. PMID:23091691

  4. A 94-year-old man with recurrent hypoglycemia caused by non-islet cell tumor hypoglycemia (NICTH)

    PubMed Central

    Alharbi, Mariam S.

    2014-01-01

    Non-islet cell tumor hypoglycemia (NICTH) is a rare but serious paraneoplastic syndrome in which a tumor secretes the high molecular weight form of IGF-II, causing hypoglycemia and requiring early diagnosis and management. Here, I report a rare case of NICTH caused by fibrosarcoma in a 94-year-old male with recurrent hypoglycemia. This case report describes the clinical presentation and diagnostic and management issues involved in a case of NICTH that was diagnosed at a tertiary care institute. PMID:25780362

  5. An Unusual Clinical Presentation of Kimura's Disease Occurring on the Buttock of a Five-year-old Boy

    PubMed Central

    Choi, Won Jun; Hur, Jae; Ko, Joo Yeon; Yeo, Kwang Yeoll; Kim, Joung Soo

    2010-01-01

    Kimura's disease is a rare inflammatory disorder of unknown etiology primarily seen in young Asian males. It is characterized by painless subcutaneous masses, blood and tissue eosinophilia, and markedly elevated serum immunoglobulin E (IgE) levels. Clinically, the subcutaneous nodules occur predominantly in the head and neck. However, we report the case of a five-year-old boy presenting with an asymptomatic solitary brown pigmented nodule on the left buttock diagnosed with Kimura's disease. Here we describe the diagnosis and treatment of this unusual case. PMID:20548883

  6. Initial diagnosis of HIV/AIDS in a 56-year-old man with non-healing forearm lesion.

    PubMed

    Zapata, Heidi J; Villanueva, Merceditas; Shenoi, Sheela

    2013-01-01

    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/mm(3), 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

  7. Initial diagnosis of HIV/AIDS in a 56-year-old man with non-healing forearm lesion

    PubMed Central

    Zapata, Heidi J; Villanueva, Merceditas; Shenoi, Sheela

    2014-01-01

    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

  8. Malignant Hyperthermia during Thoracoscopic Pulmorrhaphy in a 70-Year-Old Man.

    PubMed

    Sakai, Michihiro; Murakami, Noriko; Kitamura, Yuji; Sato, Shin; Iwama, Hiroshi; Nomura, Akira

    2014-01-01

    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

  9. Iron autointoxication in a 16-year-old girl: a protective role for hepcidin?

    PubMed

    Simonse, E; Valk-Swinkels, C G H; van 't Veer, N E; Ermens, A A M; Veldkamp, E J M

    2013-01-01

    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

  10. An 18-year-old woman with a 34-cm metaplastic breast carcinoma

    PubMed Central

    Gomes, António; Santos, Vanessa; Dias, Gonçalo; Manso, Rita Theias; Gonçalves, Lucília; Coiteiro, Margarida; Gaspar, Helena; Nazaré, Antónia

    2015-01-01

    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

  11. Symptoms mimicking dementia in a 60-year-old woman with bipolar disorder: a case report

    PubMed Central

    2014-01-01

    Background Dementia is generally considered an irreversible process of cognitive decline that can be caused by different neurodegenerative diseases. However, in some cases, dementia is caused by a non-neurodegenerative disease, such as an affective disorder. In these cases, the dementia can be reversible. Nevertheless, cognitive symptoms due to an affective disorder are often difficult to distinguish from a depressed mood due to a neurodegenerative disease. Especially in elderly patients with a history of affective disorder, a potentially reversible cause can be missed. Case presentation We describe a 60-year-old white woman with bipolar disorder, depressive symptoms, a movement disorder and severe cognitive impairment, in whom a neurodegenerative disease was seriously considered. She was referred to our clinic for further investigation because initial treatment of the depressive episode with antidepressants, mood stabilizers and electroconvulsive therapy (ECT) had not been successful. However, despite extensive evaluation, we could not find evidence for a neurodegenerative disease and the patient mostly recovered after discontinuation of different psychotropic medications and treatment with nortriptyline. Conclusions Our case shows that improvement of severe cognitive impairment in individual cases is possible. In our opinion, this underlines the necessity of a careful re-evaluation of the patient’s symptoms at presentation and the course of the disease as well as a critical review of the prescribed medications. PMID:24951023

  12. Unilateral visual loss in a previously healthy 15-year-old girl: monosymptomatic neuromyelitis optica?

    PubMed

    Kerrigan, John F; Chrisman, Christina; Rastogi, Reena Gogia

    2014-06-01

    We report a previously healthy 15 year old girl with acute onset of unilateral visual loss consistent with a diagnosis of monosymptomatic optic neuritis. Her symptoms responded well to the use of high-dose intravenous methylprednisolone. With very brief follow-up (2 months) she has had no subsequent difficulties. However, testing was positive for the presence of anti-aquaporin-4 antibodies in both serum and cerebrospinal fluid, which have been associated with neuromyelitis optica (NMO). While NMO antibodies lack complete sensitivity, there is high degree of specificity. Our patient does not meet currently accepted diagnostic criteria for NMO, but is likely at high-risk to develop myelitis or recurrent optic neuritis. There are no evidence-based guidelines for whether this patient should undergo disease-modifying treatment. Based upon the high-risk for clinical relapse, we have recommended immunosuppressive therapy with rituximab (anti-B cell monoclonal antibodies). While randomized trials for patients with this clinical scenario are unlikely, observational studies of a cohort of such patients would provide better guidance on the natural history and merits of disease-modifying therapy. PMID:25149951

  13. Diastematomyelia Presenting With no Pain in a 53-Year-Old Man: A Case Report

    PubMed Central

    Azimi, Parisa; Mohammadi, Hassan Reza

    2013-01-01

    Initial presentation of diastematomyelia is rarely seen in adults. The purpose of this case report is to present a case of clinically silent diastematomyelia unrecognized into adulthood and review of the literature. A 53-year-old Persian man was admitted to our hospital with gait disturbance, weakness of the right lower extremity, sensory loss of the left and right lower extremity of two weeks’ duration, with no pain or sphincter dysfunction. The patient underwent radiological examinations, and diastematomyelia was diagnosed. The deteriorating condition of our patient led to the decision to perform a surgery. A laminectomy was performed from L-3 to L-5 with resection of the soft-tissue mass and excision of the bony spur, and the patient was followed for 6 months. Postoperatively, the patient did not show new neurologic deficit and he returned to work 4 months after surgery. Our case was unique because of the absence of any pain, neurologic signs, and precipitating acute event leading to diagnosis, until 53 years of age. Surgical decompression of bony spur provided relative improvement of his symptoms. PMID:24349753

  14. An 18-year-old woman with a 34-cm metaplastic breast carcinoma.

    PubMed

    Gomes, António; Santos, Vanessa; Dias, Gonçalo; Manso, Rita Theias; Gonçalves, Lucília; Coiteiro, Margarida; Gaspar, Helena; Nazaré, Antónia

    2015-01-01

    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

  15. Malignant Hyperthermia during Thoracoscopic Pulmorrhaphy in a 70-Year-Old Man

    PubMed Central

    Murakami, Noriko; Kitamura, Yuji; Sato, Shin; Iwama, Hiroshi; Nomura, Akira

    2014-01-01

    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

  16. Effects of a Resistance Training Programme on Isokinetic Peak Torque and Anaerobic Power of 13-16 Years Old Taekwondo Athletes Running Head: Resistance Training and Taekwondo Athletes

    Microsoft Academic Search

    Woo Mei Teng; Chen Chee Keong; Asok Kumar Ghosh; Visvanathan Thimurayan

    The purpose of this study was to determine the effect of a 12 week (2 days per week) resistance training programme at an intensity of 50% of 1RM in adolescent males (13-16 years old) male taekwondo athletes on their isokinetic peak torque and anaerobic power. The intervention group (n=12) aged 14±1 years, participated in the prescribed resistance training programme along

  17. Creating a Community Approach to Serving Four-Year-Old Children in Wisconsin. Public Awareness Packet.

    ERIC Educational Resources Information Center

    Landsverk, Ruth Anne

    The Wisconsin Forces for Four-Year-Olds Project promotes the community approach to offering universal access to quality care and learning services for Wisconsin 4-year-olds. Based on the view that quality early education opportunities have life-long benefits for children and the communities in which they live, this public awareness packet…

  18. Fate of 2 year-old, hatchery-reared trout cod Maccullochella macquariensis (Percichthyidae)

    E-print Network

    Cooke, Steven J.

    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

  19. Electromyographic Responses to Emotional Facial Expressions in 6-7 Year Olds with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Deschamps, P. K. H.; Coppes, L.; Kenemans, J. L.; Schutter, D. J. L. G.; Matthys, W.

    2015-01-01

    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

  20. The Relationship of Five-Year-Olds' Academic Readiness and Perceptions of Competence and Acceptance.

    ERIC Educational Resources Information Center

    Anderson, Peggy L.; Adams, Phyllis J.

    1985-01-01

    Seventy-six five-year-olds were administered the Woodcock-Johnson Psycho-Educational Battery and The Pictorial Scale of Perceived Competence and Acceptance for Young Children. The significant relationship found between cognitive competence and academic readiness suggests that five-year-olds are more realistic in assessing their own achievement…

  1. The Young Child Learns: A Guide for Four-Year-Olds.

    ERIC Educational Resources Information Center

    Corpus Christi Independent School District, TX.

    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,…

  2. Social Context Effects in 2- and 4-Year-Olds' Selective versus Faithful Imitation

    ERIC Educational Resources Information Center

    Yu, Yue; Kushnir, Tamar

    2014-01-01

    This study asked whether children's tendency to imitate selectively (ignore causally unnecessary actions) versus faithfully ("overimitate" causally unnecessary actions) varies across ages and social contexts. In the first experiment, 2-year-olds and 4-year-olds were randomly assigned to play 1 of 3 prior games with a demonstrator: a…

  3. Five- to Twelve-Year-Olds' Control of Movement Velocity in a Dynamic Collision Avoidance Task

    ERIC Educational Resources Information Center

    te Velde, Arenda F.; van der Kamp, John; Savelsbergh, Geert J. P.

    2008-01-01

    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…

  4. South Euclid's Pilot Project for Two-Year-Olds and Parents.

    ERIC Educational Resources Information Center

    Kewish, Nancy L.

    1979-01-01

    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)

  5. 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

  6. The Semiotic Landscape and 3-Year-Olds' Emerging Understanding of Multimodal Communication Practices

    ERIC Educational Resources Information Center

    Yamada-Rice, Dylan

    2014-01-01

    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…

  7. Perception and Production of Lexical Tones by 3-Year-Old, Mandarin-Speaking Children

    ERIC Educational Resources Information Center

    Wong, Puisan; Schwartz, Richard G.; Jenkins, James J.

    2005-01-01

    The present study investigated 3-year-old children's perception and production of Mandarin lexical tones in monosyllabic words. Thirteen 3-year-old, Mandarin-speaking children participated in the study. Tone perception was examined by a picture-pointing task, and tone production was investigated by picture naming. To compare children's productions…

  8. 29 CFR 570.129 - Limited driving of automobiles and trucks by 17-year-olds.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2011-07-01 false Limited driving of automobiles and trucks by 17-year-olds. 570...Exemptions § 570.129 Limited driving of automobiles and trucks by 17-year-olds. ...occasional and incidental driving of automobiles and trucks on public highways...

  9. 29 CFR 570.129 - Limited driving of automobiles and trucks by 17-year-olds.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 false Limited driving of automobiles and trucks by 17-year-olds. 570...Exemptions § 570.129 Limited driving of automobiles and trucks by 17-year-olds. ...occasional and incidental driving of automobiles and trucks on public highways...

  10. 29 CFR 570.129 - Limited driving of automobiles and trucks by 17-year-olds.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 false Limited driving of automobiles and trucks by 17-year-olds. 570...Exemptions § 570.129 Limited driving of automobiles and trucks by 17-year-olds. ...occasional and incidental driving of automobiles and trucks on public highways...

  11. 29 CFR 570.129 - Limited driving of automobiles and trucks by 17-year-olds.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 false Limited driving of automobiles and trucks by 17-year-olds. 570...Exemptions § 570.129 Limited driving of automobiles and trucks by 17-year-olds. ...occasional and incidental driving of automobiles and trucks on public highways...

  12. y daughter Rachel remarked recently that Alex, her thirteen year old

    E-print Network

    M y daughter Rachel remarked recently that Alex, her thirteen year old brother with autism squelched the idea with a firm Hes my son and he stays with ussomeone had to cut the grass and clear dates. When Alex was about seven years old, we hung a poster from MillesgĂĄrden in my daughter Susannahs

  13. Megaloblastic hematopoiesis in a 20 year old pregnant female

    PubMed Central

    Trivette, Evan T.; Hoedebecke, Kyle; Berry-Cabán, Cristóbal S.; Jacobs, Brandy R.

    2013-01-01

    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

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

    PubMed

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

    2014-12-01

    Moyamoya disease is a progressive, occlusive pathology involving the cerebral vasculature with particular involvement of the circle of Willis and its tributaries. The cause of moyamoya disease is unknown, but is believed to be hereditary. Females 20 to 39 years old with moyamoya represent 0.5% of all acute cerebral ischemia and infarcts with risk factors including smoking, estrogen-containing birth control use, coagulopathy, neoplasm, and congenital malformation. This case reports on a 20-year-old Puerto Rican female U.S. soldier with a 1-year history of migraine headaches with worsening right retro-orbital pain, blurred vision, and photophobia. The patient had minimal unilateral neurological deficits despite evidence of significant cerebral infarction on non-contrast computed tomography. Other neuroimaging findings were consistent with moyamoya disease with confirmation via cerebral angiography. This case details the process of diagnosis and treatment as well as discussing its incidence, identification, and treatment options. PMID:25563038

  15. [A 100 year old thesis. Amanuensis Hans Christian Geelmuyden].

    PubMed

    Bremer, J

    1997-12-10

    Hans Christian Geelmuyden (1861-1945) was amanuensis (assistant professor) at the Institute of Physiology, University of Oslo from 1889 to 1931. In 1897 he was awarded the degree "Doctor of Medicine" for his thesis "Om aceton som stofvexelprodukt" (On acetone as a metabolic product). The Nobel laureate Feodor Lynen referred to this thesis, which was also published in German, stating that Geelmuyden was the first to establish that ketone bodies are formed from fatty acids. Geelmuyden also established that acetone is metabolized in rabbits and dogs. Geelmuyden was a prolific writer on fat metabolism and diabetes and wrote a series of extensive reviews on these topics in Ergebnisse der Physiologie. Geelmuyden was active in the treatment of diabetic patients. PMID:9456588

  16. Forty-Year-Old Foam Springs Back With New Benefits

    NASA Technical Reports Server (NTRS)

    2005-01-01

    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.

  17. Cardiomyopathy in a male patient with neutropenia and growth delay

    PubMed Central

    2014-01-01

    Neutropenia encompasses a family of neutropenic disorders, both permanent and intermittent, ranging from severe (<500 neutrophils/mm3) to mild (500–1500 neutrophils/mm3), which may also affect other organ systems such as the pancreas, central nervous system, heart, muscle and skin. Neutropenia can lead to life-threatening pyogenic infections whose severity is roughly inversely proportional to the circulating neutrophil counts. When neutropenia is detected, an attempt should be made to establish the etiology, and to distinguish acquired forms (the most frequent, including post viral neutropenia and autoimmune neutropenia) and congenital forms (rare disorders) that may be either isolated or part of a complex rare genetic disease. We report on a male patient initially diagnosed with isolated neutropenia who later turned out to be affected with Barth syndrome, a rare complex inherited disorder. PMID:24887148

  18. Presumed Idiopathic Central Serous Chorioretinopathy in a 12-Year-Old Girl

    PubMed Central

    Velazquez-Martin, Juan P.; Fulda, Emiliano; Domville, Daniela; Graue-Wiechers, Federico; Krema, Hatem

    2012-01-01

    Idiopathic central serous chorioretinopathy (CSC) typically affects middle-aged males. To date, only one case of idiopathic CSC in a prepubertal subject has been reported. Atypical idiopathic CSC presentation may be challenging to diagnose. Exclusion of secondary causes of serous retinal detachment (SRD) is warranted. We describe the atypical case of a 12-year-old female with a circumscribed SRD that resolved spontaneously and with fluorescein angiography (FA) findings that were compatible with idiopathic CSC. Optical coherence tomography (OCT) and systemic assessment were performed to exclude other etiologies. FA demonstrated multiple focal leaks in early phases, with subretinal leakage and pooling in late phases. OCT showed a localized circumscribed retinal detachment. Complete blood count was within normal limits. Serum cortisol was normal (22.1 ?g/dl) and mean arterial blood pressure was 100/60 mm Hg, thereby excluding secondary causes of CSC. This is the second reported case of idiopathic CSC in a prepubertal female and the first one documented by FA and OCT, as well as other studies to exclude secondary causes. Albeit rare, idiopathic CSC should be considered in the differential diagnosis of SRD in this (prepubertal) age group, after excluding secondary ocular or systemic etiologies. PMID:22615694

  19. Genome sequence of a 45,000-year-old modern human from western Siberia.

    PubMed

    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

    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

  20. Accident involving a 2-year-old child and Lonomia obliqua venom: clinical and coagulation abnormalities.

    PubMed

    Medeiros, Daniela Nasu Monteiro; Torres, Hélida Conceiçăo Cavalcante; Troster, Eduarto Juan

    2014-01-01

    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