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Sample records for year-old male patient

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

    PubMed Central

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

    2014-01-01

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

  2. An 11-year-old male patient with refractory asthma and heartburn.

    PubMed

    Al-Abdoulsalam, Tareq; Anselmo, Mark A

    2011-01-01

    Achalasia is characterized by obstruction of the distal esophagus and subsequent dilation of the proximal esophagus, and is considered to be a rare disorder in children. Patients commonly present with gastrointestinal (GI) symptoms such as dysphagia; however, pulmonary symptoms may also occur. Rare pulmonary symptoms due to achalasia are dyspnea and wheeze due to tracheal compression. The authors describe an 11-year-old boy who was referred to a pediatric respiratory clinic for asthma that was not responsive to inhaled medications. The child presented with a one-year history of dyspnea on exertion, cough and wheeze. He also complained of chronic dyspepsia. The presence of GI symptoms, in addition to abnormalities on chest radiograph and spirometry, suggested the presence of achalasia. The diagnosis was confirmed and the patient subsequently underwent surgical myotomy that relieved his GI and pulmonary symptoms, and normalized spirometry. The present article is an illustrative case report to remind pediatricians to consider other diagnoses when a patient does not respond to asthma medications. PMID:21499591

  3. Diagnosis and treatment difficulties in 18-year-old male patient with hereditary hemochromatosis, chronic hepatitis B, Gilbert syndrome and ulcerative colitis.

    PubMed

    Sikorska, Katarzyna; Liberek, Anna; Romanowski, Tomasz; Szlagatys-Sidorkiewicz, Agnieszka; Landowski, Piotr; Bielawski, Krzysztof P

    2011-01-01

    Among possible causes of chronic hepatitis in adolescents most common are infections, autoimmune disorders and metabolic diseases. Thus, diagnostic procedures should be multidirectional. This study reports diagnosis and treatment difficulties in an 18-year-old male patient with hereditary hemochromatosis (HH), ulcerative colitis (UC), chronic hepatitis B (CHB) and Gilbert syndrome. The presented case illustrates problems in diagnostics related to the presence of numerous disease conditions in one patient. It should be taken into consideration that these diseases coexisting in one patient can mutually affect their symptoms creating specific diagnostic difficulties. PMID:21633730

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

    PubMed

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

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  6. Atypical cause of stroke in a 27 year old male

    PubMed Central

    Youngblood, Laura B.; Dooley, Jennifer Whitley

    2012-01-01

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

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

    PubMed

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

    2014-09-01

    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 Iodine(125) 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

  8. 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

  9. [Bromo-Dragonfly poisoning of 18-year-old male].

    PubMed

    Nielsen, Visti Torbjørn; Høgberg, Lotte C G; Behrens, Jens Kristian

    2010-05-10

    Bromo-Dragonfly (BDF) is a designer drug chemically related to LSD and amphetamine. The first registration in Denmark was in October 2007. In the present case an 18-year-old man ingested about 2 ml BDF and developed acute psychosis. At the hospital the patient displayed, hyperpyrexia, tachycardia, tachypnea and hypertension. Because of severe hallucinations and agitation the patient was detained at the hospital and received symptomatic treatment with large doses of benzodiazepines. Four days after hospitalization, the patient discharged himself without significant symptoms or paraclinical findings. PMID:20470659

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  13. A 16-year-old male with dizziness, parasthesias, and ataxia.

    PubMed

    Tsien, Margaret Z; Brorson, James R; Lukas, Rimas V; Dawson, Emily C

    2014-05-01

    A 16-year-old African-American male with no past medical history presented with gait instability and somnolence. He had intermittent neurological complaints during the prior 4 months, including dizziness, left arm paresthesias, decreased hearing, and inability to control his hands. After an initial diagnosis of vertigo, his symptoms progressed, leading to reevaluation and a second emergency department head computed tomography (CT) scan, which revealed a large area of hypodensity in the cerebellum. Repeat head CT on arrival to the intensive care unit showed a large, left cerebellar hemispheric stroke. This case study discusses the findings of the patient's cerebral angiogram, the diagnosis of fibromuscular dysplasia, and the aggressive treatment that likely prevented further devastating strokes in the brainstem, thalamus, and occipital lobe. This case serves as a reminder that strokes are not just an adult disease and that classic presentations can occur even in unconventional patients. PMID:24877493

  14. Glycogen hepatopathy in a 13-year-old male with type 1 diabetes

    PubMed Central

    Aljabri, Khalid S.; Bokhari, Samia A.; Fageeh, Sanaa M.; Alharbi, Abdullah M.; Abaza, Mohamad A.

    2011-01-01

    Glycogenic hepatopathy (GH ) is a rare cause of serum transaminase elevations in type 1 diabetes mellitus. We describe a 13-year-old male with a history of poorly controlled type 1 diabetes mellitus who presented with hepatomegaly and severe transaminase flares. Liver histology confirmed GH. Treatment consists of improving glycemic control. Hepatomegaly due to excess glycogen storage in poorly controlled type 1 diabetics has been associated with younger patients with poor glycemic control, occurring about 2-4 weeks after starting insulin treatment, and resolving upon glucose stabilization. We conclude that glycogenic hepatopathy can cause hepatomegaly and significant transaminase elevations in individuals with type I diabetes mellitus, The recovery of severe transaminase elevations in this patient illustrates the more benign course of GH, which is a condition with a far better prognosis. Clinician awareness of GH should prevent diagnostic delay and will provide better insight into the prevalence of GH. PMID:21727748

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

    PubMed Central

    Winter, Michael W.; Lee, Steven

    2015-01-01

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

  16. 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

  17. Disseminated Primary Herpes Simplex Virus Type 2 Infection in a 22-Year-Old male

    PubMed Central

    Erdmann, Nathan; Hewitt, Benjamin A.; Atkinson, Thomas Prescott; Van Wagoner, Nicholas

    2015-01-01

    We present a case of primary disseminated herpes simplex virus type 2 (HSV-2) cutaneous disease in a 22-year-old male. We discuss the immune response to HSV-2 infection as well as the extragenital manifestations of HSV-2 observed in immune-competent and immune-suppressed persons. PMID:26180838

  18. Secretory carcinoma of breast in a 17-year-old male

    PubMed Central

    Kavalakat, Alfie J; Covilakam, Ramani K; Culas, Terence B

    2004-01-01

    Background Secretory carcinoma of the male breast (juvenile carcinoma) is a rare neoplasm. Only a few cases have been reported in the literature. Case report We report here a case in a 17-year old male presenting with recurrent breast swelling. Conclusions Though considered an indolent neoplasm, secretory carcinoma does metastasise to lymph nodes and recur after local excision. Surgery in form of mastectomy with axillary clearance is the treatment of choice. PMID:15175103

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

    PubMed

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

    2016-03-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2011-01-01

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

  2. Myocardial injury in a 41-year-old male treated with methylphenidate: a case report

    PubMed Central

    2014-01-01

    Background Elevated cardiac troponin levels are consistent with the diagnosis of an acute coronary syndrome, but may also represent adverse drug reactions. Psychostimulating drugs raise both blood pressure and heart rate, and case reports of sudden death, stroke, and myocardial infarction have led to regulatory and public concern about the cardiovascular safety of these drugs. Case presentation We present a case where a 41-year-old Norwegian male with radiating chest pain, elevated troponins, and supraventricular tachycardia was hospitalized. Tentative diagnosis was acute coronary syndrome. Percutaneous coronary angiography, but not cardiac magnetic resonance imaging, was performed and medical antiplatelet treatment started. Because of an attention deficit/hyperactivity disorder the patient had recently increased his dose of methylphenidate, but still within the therapeutic dose range. Apart from venlafaxine, also in a therapeutic dose, the patient took no other drugs. An acute coronary syndrome was excluded during hospitalization, and a drug effect was suspected. Conclusions When interpreting troponin results it is important to take into account the context of the patient’s clinical presentation, including the possibility of adverse drug reactions. The adverse drug reaction could include a combination of vasospasm and/or increased oxygen demand due to tachycardia. This case should be borne in mind before a diagnosis of myocardial infarction is given, or a decision to perform invasive coronary angiography is made in patients that use methylphenidate or related substances. Cardiac magnetic resonance imaging could be of diagnostic value in such cases. PMID:25073534

  3. 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

  4. Blue Thursday? Homicide and suicide among urban 15-24-year-old black male Americans.

    PubMed Central

    Greenberg, M; Schneider, D

    1992-01-01

    A comparative analysis was made of day of the week variations in homicide and suicide deaths among 15-24-year-old white males, black males, white females, and black females in the 22 counties with the most black persons in the United States. Thirty-seven percent of black Americans and 14 percent of white Americans lived in these densely populated counties. The authors expected a weekend excess of homicide and a Monday excess of suicide. They found a pronounced excess of homicides on weekends, especially among white males. A slight excess of suicide was observed on Monday, but other slight excesses of suicide were also found. Young black males exhibited an unexpected excess of homicides and suicides on Thursday. On Thursdays the black male-white male ratio for homicide was 1.43 and for suicide, 1.26. Possible explanations for the young black males' blue Thursday phenomenon are offered. PMID:1594735

  5. 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

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

    PubMed Central

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

    2016-01-01

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

  7. Periappendicitis during adalimumab treatment for ileocecal Crohn's disease in a 29-year-old male.

    PubMed

    Mizuno, Shinta; Nakazawa, Atsushi; Ogawa, Ayumi; Hisamatsu, Tadakazu; Hirose, Shigemichi; Tsukada, Nobuhiro

    2015-06-01

    A 29-year-old male was diagnosed with ileocolic Crohn's disease (CD) approximately 2 years ago. Adalimumab was prescribed as CD remission induction therapy. Three months after beginning adalimumab, watery diarrhea and lower abdominal pain developed. He was admitted under a diagnosis of CD exacerbation. Despite fasting and antibiotic treatment, symptoms of acute panperitonitis appeared. He was diagnosed as acute appendicitis and we performed emergency surgery for peritoneal drainage and ileocecal resection on the fifth hospital day. We diagnosed periappendicitis based on the operative findings. This is the first report of periappendicitis with CD during adalimumab treatment. PMID:26023062

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  10. Emphysematous Cholecystitis in 24-Year-old Male Without Predisposing Factors

    PubMed Central

    Gunbey, Hediye Pinar

    2015-01-01

    Emphysematous cholecystitis (EC) is a life threatening condition characterized by gangrene of the gallbladder due to an infection with gas-forming organisms. It is more common in elderly men and has been associated with systemic disease, especially diabetes and vascular disease. Computed tomography is the most important and accurate imaging modality for the diagnosis of EC. EC should be thought of when the radiographic presence of gas is detected within the gallbladder wall or lumen. Emergency surgical intervention and antibiotic treatment for the gas-forming organism should be initiated after the diagnosis of the EC. Here, we present the imaging and pathologic findings of a 24-year-old male with EC without any predisposing factors, successfully treated with laparoscopic cholecystectomy. PMID:26393182

  11. Eosinophilic granulomatous gastroenterocolitis and hepatitis in a 1-year-old male Siberian Husky.

    PubMed

    Brellou, G D; Kleinschmidt, S; Meneses, F; Nolte, I; Hewicker-Trautwein, M

    2006-11-01

    A case of eosinophilic granulomatous gastroenterocolitis and hepatitis in a 1-year-old male Siberian Husky is described. The dog presented with a history of diarrhea, weakness, lethargy, and anorexia of several months' duration. Hematologic and biochemical examinations, abdominal ultrasonography, computer tomography, and exploratory laparotomy were performed. Histopathologic examination of full-thickness biopsies from the gastrointestinal tract and liver revealed the presence of eosinophilic granulomatous lesions in the submucosa and tunica muscularis of stomach, jejunum, ileum, colon, and liver. Infectious agents were not detected by light microscopic and electron microscopic examination or by immunohistochemistry. On the basis of the findings, it is concluded that the disease in this dog represents an unusual manifestation of chronic idiopathic inflammatory bowel disease. PMID:17099165

  12. A SEVEN-YEAR-OLD MALE WITH CIRCULATING RED BLOOD CELLS SHOWING A THERMAL INJURY-LIKE MORPHOLOGY.

    PubMed

    Shackelford DO Ph, R; Dansari Md, J; Veillon Md, D; Ong Md, M; Jusino Bs, T; Jeroudi Md, M; Cotelingam Md, J

    2016-01-01

    A seven-year-old African-American male presented with a history of hematuria, proteinuria, jaundice, and anemia occasionally treated with transfusions since early childhood. The family history included a father and sister with similar symptoms of anemia, both of which had been diagnosed with hereditary pyropoikilocytosis. Due to the patient's family history and symptoms indicating a possible hematologic problem, a blood draw was performed. Laboratory studies showed an elevated alkaline phosphatase and bilirubin, and hemolytic anemia with unusual erythrocyte indices. The patient's vital signs and abdominal ultrasound were normal, and he had no known allergies. Examination of the patient's peripheral blood smear revealed extreme erythrocyte poikilocytosis with bizarre forms resembling the erythrocyte morphology sometimes seen in individuals with severe thermal burns. PMID:26986859

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

    PubMed

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

    2015-09-01

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

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

    PubMed Central

    Pan, Koushik

    2015-01-01

    Erasmus syndrome is a rare entity in which systemic sclerosis develops following exposure to silica with or without silicosis. Few case reports are available in literature. We report here a case of Erasmus syndrome in a 42-year-old manual labourer. The patient presented with arthralgia, Raynoud’s phenomenon, skin tightening and microstomia along with features of Interstitial Lung Disease (ILD) and pulmonary arterial hypertension. Evidence of Interstitial Lung Disease (ILD) with mediastinal lymphadenopathy as well as pulmonary arterial hypertension with vascular reactivity was found in appropriate investigations. Serological markers of systemic sclerosis were strongly positive. After a diagnosis of Erasmus syndrome was made, a combination of drugs including Prednisone, Cyclophosphamide and Nifedipine was instituted this led to moderate improvement in his symptoms over 6 months. PMID:26155508

  15. Oral health status of 12-year-old male schoolchildren in Medina, Saudi Arabia.

    PubMed

    Bhayat, A; Ahmad, M S

    2014-11-01

    Studies from Saudi Arabia have reported that the prevalence of dental caries among children is relatively high compared with other developing countries The aim was to determine the oral hygiene status and significant caries (SiC) index of 12-year-old males in Medina . In a cross-sectional, analytical study 360 students participated from 4 boys' schools. Dental caries, plaque, gingivitis, fluorosis and malocclusion were recorded using standard methods and indices. The mean DMFT score was 1.53 (SD 1.88). Caries prevalence was low (57.2%) but the mean SiC index was relatively high [3.63 (SD 1.66)]. The prevalences of plaque and gingivitis were high (82.8% and 70.8% respectively). Lower molars had the highest rate of caries. No children presented with dental fluorosis and 82.5% had a class I jaw relationship. Oral hygiene awareness programmes at schools, together with brushing and flossing programmes, are recommended in order to maintain and improve the oral health of young children in Medina. PMID:25601812

  16. 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

  17. 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)

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

    ERIC Educational Resources Information Center

    Petray, Clayre K.; Krahenbuhl, Gary S.

    1985-01-01

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

  19. 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…

  20. 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

  1. Neurodegeneration with Brain Iron Accumulation in an Eleven-Year-Old Jamaican Male

    PubMed Central

    Johnson, Peter; Melbourne-Chambers, Roxanne; Desai, Nilesh; Greenaway, Emma

    2014-01-01

    We present a case of an eleven-year-old boy presenting with progressive extrapyramidal signs and dementia. His imaging findings demonstrated the classic eye-of-the-tiger sign on T2W magnetic resonance imaging. He was diagnosed with pantothenate kinase-associated neurodegeneration (PKAN). This is a rare autosomal recessive inborn error of coenzyme A metabolism, caused by mutations in PANK2. This is the first reported case of PKAN from the Caribbean. PMID:24600523

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

    PubMed

    Sauvageau, Anny; Geberth, Vernon J

    2009-01-01

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

  3. [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

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

    PubMed

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

    2012-03-01

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

  5. Severe anorexia nervosa in a 20-year-old male with pericardial effusion and cortical atrophy.

    PubMed

    Shapiro, Michael; Davis, Amelia A; Nguyen, Mathew L

    2014-01-01

    This case report describes a 20-year-old man with a severe presentation of anorexia nervosa. His case is unique in that he presented at 49% of his ideal body weight and had a body mass index (BMI) of 11.59. In addition, he had cognitive slowing on exam and had cortical atrophy on a head CT. Other medical complications included pericardial tamponade that was treated with an open window pericardiocentesis, hepatitis, and anemia. He was treated nutritionally, first with a Dobb-Hoff tube and then with oral feedings, as well as had group, individual, and family therapies. He responded well to treatment, his labs normalized and he was discharged at 75% of his ideal body weight after a weight increase of 40 pounds and after 106 days of hospitalization at our facility. In addition, a head CT was repeated and the cortical atrophy had resolved. PMID:25377150

  6. 8-year old patient with giant hydatid cyst consulted with chest wall asymmetry.

    PubMed

    Uygun, Saime Sündüs; Arıbaş, Olgun Kadir; Pekcan, Sevgi

    2015-12-01

    Cystic echinococcosis, a zoonotic disease, is common in Turkey and is caused by the Echinococcus granulosus tapeworm. We describe the case of an 8-year-old girl who was admitted to hospital with chest wall asymmetry after a fall from height, without any other symptoms. Cystic lesion was identified on radiology, and serology supported the diagnosis of hydatid cyst. The patient underwent thorax surgery. Postoperatively, she was treated with benzimidazoles for 2 months. Rarely, hydatid cysts can reach a size sufficiently large to cause chest deformity. PMID:26711916

  7. Unusual case of a surgically treated ACL tear in a 4-year-old patient.

    PubMed

    Astur, Diego Costa; Castro, Saulo; Bernardes, Adilio; Cohen, Moises

    2015-01-01

    Anterior cruciate ligament injury in children is an increasingly common disease. We report a rare case of surgical treatment of a 4-year-old patient who presented with an anterior cruciate ligament tear after a high-energy trauma followed by chronic spontaneous subluxation during knee flexion and extension. An extra-articular ligamental reconstruction technique was performed and the child is clinically well 4?years after surgery. Historically, non-surgical treatment has been the main treatment option, however, the indication for surgical reconstruction is increasing as we better understand the histological characteristics of the immature skeleton. PMID:26346958

  8. A 73-Year-Old Male with Cervical Spine Osteomyelitis Presenting as Urosepsis

    PubMed Central

    Kakarlapudi, H.; Speirs, S.; Lal, A.P.; Alaie, D.; Petrillo, R.; Ashraf, M.B.; Kolanuvada, B.; Bhargava, M.

    2015-01-01

    Vertebral osteomyelitis is a serious debilitating infection if not detected early. Involvement of cervical vertebrae is usually seen in the presence of specific risk factors. Urinary tract infection commonly spreads to the lumbar vertebrae. This is a case presentation of an elderly male who, in the absence of specific risk factors for cervical osteomyelitis, presented with symptoms of urinary tract infection and was found to have cervical spine osteomyelitis. PMID:26715867

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

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

    2015-02-01

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

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

    SciTech Connect

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

    1989-08-01

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

  12. Mediastinal Teratoma with Neuroendocrine Features in 34-Year-Old Male with Syncope

    PubMed Central

    Chang, Qing; Kong, Fanyi; Rosell, Frank M.

    2015-01-01

    Neuroendocrine tumors that arise in an extragonadal teratoma are extremely rare. Somatic-type malignancy, defined as any sarcoma, carcinoma, leukemia, or lymphoma developing in a germ cell tumor, occurs in approximately 2% of all germ cell tumors. Our case represents a mediastinal mass that was incidentally found in a patient with syncope. Surgical resection confirmed mature teratoma with neuroendocrine features. PMID:26783486

  13. Mature (Benign) Cystic Retroperitoneal Teratoma Involving the Left Adrenal Gland in a 22-Year-Old Male: A Case Report and Literature Review

    PubMed Central

    2013-01-01

    Primary retroperitoneal teratomas involving adrenal glands are exceedingly uncommon accounting for only 4% of all primary teratomas. They are more common in childhood and rarely occur in adults. Only a very few case reports have been documented in literature so far. Herein, we report a mature (benign) cystic retroperitoneal teratoma in the region of left adrenal gland in a 22-year-old otherwise healthy male patient who presented with a 1-month history of left flank pain. In addition, a literature review on teratomas is included. PMID:23762690

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

    PubMed Central

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

    2016-01-01

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

  15. Synthetic cannabinoid overdose in a 20-year-old male US soldier.

    PubMed

    Berry-Cabán, Cristóbal S; Ee, Juliana; Ingram, Victoria; Berry, Carlos E; Kim, Eugene H

    2013-01-01

    Popularity of synthetic cannabinoids among US military service members has risen over the last several years, leading to an increase in hospitalizations and legal actions stemming from its use and possession. Although synthetic cannabinoids, collectively referred to as "Spice," are similar in structure to the active metabolites found in cannabis, significant concerns exist regarding the severity of short- and long-term medical and psychiatric sequelae. This article presents a case, in which a patient experienced severe medical and psychiatric symptoms far exceeding the severity and duration typically resulting from cannabis use. PMID:23327506

  16. Successful free osteocutaneous scapular flap transfer for mandibular reconstruction in a 93-year-old patient.

    PubMed

    Niitsuma, Katsunori; Hatoko, Mitsuo; Kuwahara, Masamitsu; Tanaka, Aya; Iioka, Hiroshi; Fukuda, Takehiko; Yane, Katsunari

    2004-01-01

    With the extension of the average life span and the development of surgical technique, anesthesia, and pre- and postoperative management, operations for elderly patients have become more widely accepted. In the field of plastic surgery, free-flap transfers using microvascular techniques have become a common surgical procedure in reconstruction of the head and neck region after surgical removal of a cancer. There have been several reports of free-flap transfer in patients older than 90 years, but the authors know of no reports of free osteocutaneous flap transfer for mandibular reconstruction, which is a very invasive free-flap surgery, for such patients. The mandible plays a significant role in various kinds of dynamic functions, such as mastication, deglutition, and articulation. Disorder of these functions causes a deterioration in the patient's quality of life. The authors have performed a mandibular reconstruction using an osteocutaneous scapular free flap after resection of a gingival cancer invading the mandibular bone in a 93-year-old Japanese woman. In our case, an osteocutaneous scapular free flap, which permits the patient rapid rehabilitation of the lower leg, is thought to be a good choice because it allows the patient to get out of bed as quickly as possible in the postoperative period to minimize additional complications. PMID:14704572

  17. A 66-year-old male with lower abdominal lump: an unusual presentation of an uncommon abdominal pathology

    PubMed Central

    Noormohamed, Mohamed Saleem; Neophytou, Christodoulos; Jain, Yogesh; Rawat, Saumitra

    2012-01-01

    A 66-year-old Caucasian male was admitted following symptoms of intermittent umbilical pain aggravated after meals and associated with vomiting of contents. Physical examination revealed a tender, partially reducible swelling suspicious of complicated umbilical hernia. Abdominal x-ray revealed dilated small bowel loops which appeared consistent with clinical diagnosis. He underwent a laparotomy subsequently which revealed a small defect in the linea alba with viable small bowel and two firm mesenteric masses encroaching the lumen approximately two feet from the ileocaecal junction. The histology of the excised bowel and masses revealed that the tumour composed of bland spindle cells with slender to plump nuclei and eosinophilic cytoplasm. Mesenteric fibromatosis are the most common primary tumours of the mesentery and constitute about 3.5% of all fibrous tissue tumours. Intra-abdominal desmoids are very rare and benign tumours but are very aggressive and should be considered in the differential diagnosis of acute abdominal pain. PMID:22605811

  18. A 66-year-old male with lower abdominal lump: an unusual presentation of an uncommon abdominal pathology.

    PubMed

    Noormohamed, Mohamed Saleem; Neophytou, Christodoulos; Jain, Yogesh; Rawat, Saumitra

    2012-01-01

    A 66-year-old Caucasian male was admitted following symptoms of intermittent umbilical pain aggravated after meals and associated with vomiting of contents. Physical examination revealed a tender, partially reducible swelling suspicious of complicated umbilical hernia. Abdominal x-ray revealed dilated small bowel loops which appeared consistent with clinical diagnosis. He underwent a laparotomy subsequently which revealed a small defect in the linea alba with viable small bowel and two firm mesenteric masses encroaching the lumen approximately two feet from the ileocaecal junction. The histology of the excised bowel and masses revealed that the tumour composed of bland spindle cells with slender to plump nuclei and eosinophilic cytoplasm. Mesenteric fibromatosis are the most common primary tumours of the mesentery and constitute about 3.5% of all fibrous tissue tumours. Intra-abdominal desmoids are very rare and benign tumours but are very aggressive and should be considered in the differential diagnosis of acute abdominal pain. PMID:22605811

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

    PubMed

    Derk, Gwendolyn Rose; Aboulhosn, Jamil; Reardon, Leigh C

    2016-02-01

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

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

    PubMed Central

    Aboulhosn, Jamil; Reardon, Leigh C.

    2016-01-01

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

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

    PubMed

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

    2016-03-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-09-01

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

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

    PubMed Central

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

    2015-01-01

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

  5. A case of melphalan sustained accumulation in an 80-year old patient.

    PubMed

    Jolivot, Pierre-Alain; Poinsignon, Vianney; Paci, Angelo; Guidet, Bertrand; Pichereau, Claire; Fernandez, Christine; Hindlet, Patrick

    2015-12-01

    Case We report the case of melphalan accumulation in an 80-year old female with multiple myeloma. Her initial health status was good except for a moderate chronic renal failure (estimated glomerular filtration rate: 31 ml/min) and anemia. Among other drugs, her usual treatment included trimethoprim/sulfamethoxazole and the patient received melphalan from day 1 to day 4 for multiple myeloma. On day 13, she was admitted in intensive care unit for acute renal failure and severe sepsis with pancytopenia. Usual treatments were stopped. Melphalan blood concentrations were 123.6 ng/ml on day 16 and 87.5 ng/ml on day 17 while cerebrospinal fluid concentration was 173.8 ng/ml on day 25. Patient recovered on day 30. Melphalan accumulation may be explained by substrate competition between sulfamethoxazole and melphalan in metabolism pathway and chronic renal failure. Conclusion close clinical and renal monitoring should be performed in patient receiving melphalan and sulfamethoxazole. PMID:26394785

  6. Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40-year-old patients

    PubMed Central

    Khakshoor, Hamid; Razavi, Fatemeh; Eslampour, Alireza; Omdtabrizi, Arash

    2015-01-01

    Background: Keratoconus is a contraindication for photorefractive keratectomy (PRK). In the recent decade, some efforts have been made to perform PRK in patients with keratoconus whose corneas are stable naturally or by doing corneal collagen crosslinking. These studies have suggested residual central corneal thickness (CCT) ≥450 μm. Aims: The aim was to evaluate the long-term outcomes of PRK in patients with mild to moderate keratoconus in patients older than 40 with residual CCT ≥ 400 μm. Settings and Design: This prospective study was conducted in our Cornea Research Center, Mashhad, Iran. Materials and Methods: Patients over 40 years old, with a grade I/II keratoconus without progression in the last 2 years were recruited. Patients with a predicted postoperative CCT < 400 μm were excluded. PRK with tissue saving protocol was performed with Tecnolas 217 Z. Mitomycin-C was applied after ablation. The final endpoints were refraction parameters the last follow-up visit (mean: 35 months). Paired t-test and Chi-square were used for analysis. Results: A total of 38 eyes of 21 patients were studied; 20 eyes (52.6%) with a grade I and 18 eyes (47.4%) with grade II keratoconus. The mean uncorrected visual acuity, best corrected visual acuity (BCVA), spherical equivalent, cylindrical power and keratometric readings were significantly improved at the final endpoint compared to preoperation measurements (P < 0.001). Two eyes (5%) lost two lines of BCVA at the final visit. No case of ectasia occurred during the follow-up course. Conclusions: PRK did not induce keratoconus progression in patients older than 40 with a grade I/II keratoconus. Residual CCT ≥ 450 μm seems to be sufficient to prevent the ectasia. PMID:25827548

  7. 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

  8. 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

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

    PubMed

    Dell'Osso, Liliana; Dalle Luche, Riccardo; Cerliani, Corrado; Bertelloni, Carlo Antonio; Gesi, Camilla; Carmassi, Claudia

    2015-08-01

    This paper highlights the clinical challenges faced when assessing patients with stalking behaviors with psychotic disorders, suggesting the need for an accurate assessment of adult autism spectrum symptoms. A 25-year-old man with a diagnosis of delusional disorder, erotomanic type, was hospitalized for acute psychotic symptoms occurred in the framework of a repeated stalking behavior towards his ex girlfriend. When assessed for adult autism spectrum symptoms upon an accurate clinical evaluation, he reported elevated scores in the mentalizing deficit and social anxiety domains by means of the 14 item Ritvo Autism and Asperger Diagnostic Scale (RAADS-14). Authors discuss a possible role of adult (subthreshold) autism spectrum symptoms, generally disregarded in adult psychiatry, on the type of psychotic features and stalking behavior developed that may help for appropriate diagnosis and treatment. PMID:26031384

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

    ERIC Educational Resources Information Center

    Phipps, Jonathan Lanier

    2013-01-01

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

  11. A rare case of an aldosterone secreting metastatic adrenocortical carcinoma and papillary thyroid carcinoma in a 31-year-old male

    PubMed Central

    Wanta, Stephen M.; Basina, Marina; Chang, Steven D.; Chang, Daniel T.; Ford, James M.; Greco, Ralph; Kingham, Kerry; Merritt, Robert E.; Kunz, Pamela L.

    2011-01-01

    We report a rare synchronous presentation of adrenocortical carcinoma (ACC) and papillary thyroid carcinoma (PTC). A 31-year-old male first presented with a large left adrenal mass that was identified during the workup for refractory hypertension due to hyperaldosteronism. The mass was removed surgically with pathology showing ACC. The patient was then treated with adjuvant radiation therapy and mitotane chemotherapy. Four months post ACC resection, metastatic ACC to the right upper lung and PTC in the left lobe of the thyroid were found in surveillance imaging. He subsequently developed pulmonary, contralateral adrenal and brain metastases from his ACC. Li Fraumeni syndrome and Multiple Endocrine Neoplasia Type I (MEN I) were considered, but testing of both P53 and menin genes showed no mutation. We also performed a review of the literature and found three similar cases, however gene mutation analysis was not performed.. PMID:22355500

  12. Atrioventricular thrombus in a 14-year-old patient: a case report

    PubMed Central

    2010-01-01

    Right atrioventricular thrombus was diagnosed by echocardiography in a 14-year-old boy. Thrombus was reached through the right ventricle to the pulmonary artery and it was caused to tricuspit valve insufficiency. Surgical thrombectomy was performed and, he was treated with oral anticoagulation in postoperative period. PMID:20181068

  13. ED-26ATYPICAL TERATOID/RHABDOID TUMOR OF THE CENTRAL NERVOUS SYSTEM IN A 27-YEARS OLD PATIENT

    PubMed Central

    Rivas, Rodrigo; Carrasco, Paula; Ayach, Freddy

    2014-01-01

    INTRODUCTION: Atypical Teratoid/Rhabdoid Tumor (ATRT), according to the World Health Organization (WHO) Classification of Tumors, is a highly malignant neoplasm (grade IV) of the Central Nervous System (CNS) that preferentially manifests in children less than three years of age. These tumors are mainly composed of rhabdoid cells, with the addition or not of areas demonstrating characteristics of primitive neuroectodermal tumor. Less than 40 cases were published in the literature about this neoplasm. OBJECTIVE: In this context our aim is to present an unusual case of ATRT. MATERIAL AND METHOD: A 27-year old male, with intellectual disability. He referred headache, nausea and vomiting and was associated with progressive left femoral brachial paresis, so he consulted in the clinic in March 2013. Brain CT and magnetic resonance (MRI) spectroscopy revealed a solid cystic mass in the right temporal medial lobe of 65x57 mm, with an intense contrast (gadolinium) enhancement, the tumor compressed the third ventricles, displacing the midline and deforming the ventricles. RESULTS: The neoplasm was totally excised, histological and immunohistochemical analysis demonstrated atypical rhabdoid cells strongly and diffusely positive for EMA and Vimentin as well as focally immunoreactive for GFAP. The patient was treated with chemotherapy (vincristine) and radiotherapy. The patient finally died in Abril 2014. CONCLUSIONS: Few previous case of ATRT have been reported in adults, thus far. This unusual presentation underlines the necessity of considering this devastating neoplasm in the differential diagnosis of malignant brain tumor of young adults.

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

    PubMed

    Koch, Horst J

    2015-01-01

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

  15. [71-year old patient with sepsis, pericardial effusion and pulmonary infiltrates].

    PubMed

    Leopold, M; Schellong, S

    2011-11-01

    A 71-year old man with sepsis, hemorrhagic pericardial effusion and pulmonary embolism was admitted on the intensive care unit. In blood cultures and in pericardial effusion, Staphylococcus aureus was isolated. Transeosophageal echocardiography showed a massive pulmonary valve endocarditis. Right-sided endocarditis is a rare variant of endocarditis and may occur in consequence of contaminated drug solutions or infected intravenous catheter. The prognosis is relatively good, worse prognosis show fungal infections and vegetation with a length >20 mm. PMID:21253681

  16. Isolated huge aneurysm of the left main coronary artery in a 22-year-old patient with type 1 neurofibromatosis.

    PubMed

    Pontailler, Margaux; Vilarem, Didier; Paul, Jean-François; Deleuze, Philippe H

    2015-03-01

    A 22-year-old patient with neurofibromatosis type 1 presented with acute chest pain. A computed tomography scan and coronary angiography revealed a partially thrombosed huge aneurysm of the left main coronary artery. Despite medical treatment, the patient's angina recurred. The patient underwent a coronary bypass grafting operation and surgical exclusion of the aneurysm. Postoperative imaging disclosed good permeability of the 3 coronary artery bypass grafts and complete thrombosis of the excluded aneurysm. PMID:25742828

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

    PubMed Central

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

    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

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

    PubMed

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

    2016-03-01

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

  19. Intratubular Large Cell Hyalinizing Sertoli Cell Tumor of the Testes in a 4-Year-Old Male With Peutz-Jeghers Syndrome.

    PubMed

    Armijo, Beeling; Bocklage, Theresa; Heideman, Richard

    2015-04-01

    Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant disorder that typically displays familial inheritance. Gastrointestinal polyposis and cutaneous pigmentation is a classic presentation of this syndrome. The reported lifetime cumulative cancer risk in PJS patients is >76% when compared with the general public with females affected more often than males. The prepubertal testicular tumor registry found Sertoli cell tumors (SCTs) to compose approximately 1% of all pediatric solid tumors. Prepubertal testicular masses are relatively rare. Only a small number of SCT cases have been reported in the first decade of life. The concurrence of PJS and feminizing SCTs of the testes is an increasingly recognized cause of prepubertal gynecomastia. The testicular lesions observed in patients with PJS primarily represent multifocal intratubular large cell hyalinizing SCTs with a distinct morphology that differs from large cell calcifying SCTs and sex cord tumors with annular tubules. Here, we describe the diagnosis and treatment course of a 4-year-old male with a SCT of the testes and diagnosis of PJS. PMID:25171448

  20. A 9-year-old male with a duplication of chromosome 3p25.3p26.2: clinical report and gene expression analysis.

    PubMed

    Bittel, Douglas C; Kibiryeva, Nataliya; Dasouki, Majed; Knoll, Joan H M; Butler, Merlin G

    2006-03-15

    We describe a 9-year-old male referred for genetic evaluation for Prader-Willi syndrome (PWS). PWS is the most common genetically defined cause of life-threatening obesity and results from a functional loss of paternally expressed genes from the chromosome 15q11-q13 region. The patient presented with pervasive developmental disorder, delayed speech, and rapid onset of obesity at age 4 years, all features similar to PWS. However, chromosome 15q11-q13 methylation testing and fragile X studies were normal. GTG-banding and fluorescence in situ hybridization (FISH) with whole chromosome 3 paint probe (WCP3) and a chromosome 3p subtelomeric probe suggested a duplication of 3p25.3p26.2, a finding supported by comparative genomic hybridization (CGH). This region of chromosome 3p contains genes which contribute to obesity and behavioral problems, most notably, ghrelin (GHRL), an oxytocin receptor (OXTR), solute carrier family six members (gamma-aminobutyric acid (GABA) neurotransmitter transporters, SLC6A1 and SLC6A11), and peroxisome proliferator-activated receptor gamma (PPARG). To characterize these obesity and behavior related genes in our subject, we performed quantitative RT-PCR and compared expression levels with similarly aged male subjects (four non-obese males, four obese males, and four PWS males-two with 15q11-q13 deletions and two with maternal disomy 15). Our studies suggest increased expression of several genes in the 3p duplication region, including GHRL and PPARG, which may contribute to the phenotypic features in our 3p duplication subject. PMID:16470700

  1. 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

  2. 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

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

    PubMed Central

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

    2013-01-01

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

  4. [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

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

    PubMed Central

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

    2016-01-01

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

  6. 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

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

    PubMed Central

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

    2016-01-01

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

  8. 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

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

    PubMed Central

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

    2016-01-01

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

  10. 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

  11. Special report: 26-year durability of a bioprosthesis implanted in a 21-year-old patient.

    PubMed

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

    2014-12-01

    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

  12. Impact of Body Mass Index on the Clinical Outcomes after Percutaneous Coronary Intervention in Patients ≥75 Years Old

    PubMed Central

    He, Pei-Yuan; Yang, Yue-Jin; Qiao, Shu-Bin; Xu, Bo; Yao, Min; Wu, Yong-Jian; Wu, Yuan; Yuan, Jin-Qing; Chen, Jue; Liu, Hai-Bo; Dai, Jun; Li, Wei; Tang, Yi-Da; Yang, Jin-Gang; Gao, Run-Lin

    2015-01-01

    Background: The impact of body mass index (BMI) on the clinical outcomes after percutaneous coronary intervention (PCI) in patients ≥75 years old remained unclear. Methods: A total of 1098 elderly patients undergoing PCI with stent implantation were recruited. Patients were divided into four groups by the value of BMI: Underweight (≤20.0 kg/m2), normal weight (20.0–24.9 kg/m2), overweight (25.0–29.9 kg/m2) and obese (≥30.0 kg/m2). Major clinical outcomes after PCI were compared between the groups. The primary endpoint was defined as in-hospital major adverse cardiovascular events (MACEs), which included death, myocardial infarction (MI) and target vessel revascularization. The secondary endpoint was defined as 1 year death. Logistic regression analysis was performed to adjust for the potential confounders. Results: Totally, 1077 elderly patients with available BMIs were included in the analysis. Patients of underweight, normal weight, overweight and obese accounted for 5.6%, 45.4%, 41.5% and 7.5% of the population, respectively. Underweight patients were more likely to attract ST-segment elevation MI, and get accompanied with anemia or renal dysfunction. Meanwhile, they were less likely to achieve thrombolysis in MI 3 grade flow after PCI, and receive beta-blocker, angiotensin converting enzyme inhibitor or angiotensin receptor blocker after discharge. In underweight, normal weight, overweight and obese patients, in-hospital MACE were 1.7%, 2.7%, 3.8%, and 3.7% respectively (P = 0.68), and 1 year mortality rates were 5.0%, 3.9%, 5.1% and 3.7% (P = 0.80), without significant difference between the groups. Multivariate regression analysis showed that the value of BMI was not associated with in-hospital MACE in patients at 75 years old. Conclusions: The BMI “obese paradox” was not found in patients ≥75 years old. It was suggested that BMI may not be a sensitive predictor of adverse cardiovascular events in elderly patients. PMID:25698196

  13. Hetero- and isosexual pseudoprecocity associated with testicular sex-cord tumors in an 8 year-old male.

    PubMed

    Diamond, F B; Root, A W; Hoover, D L; Monteforte, H

    1996-01-01

    Enlargement of the right breast, axillary hair, and acceleration of linear growth rate were first noted at 8 years of age in an otherwise healthy male with no known exposure to exogenous hormones. At 9.5 years of age the right subareolar mass was excised; histologic examination revealed fibrous breast tissue. Subsequently pubic hair appeared. At 10.7 years of age, the patient complained of right inguinal pain after a minor injury. Examination revealed a tall (height age 12.7 years), mature, muscular boy with enlarged (R: 5 x 3 x 2 cm; L: 3 x 2 x 3 cm) firm, irregular testes, Tanner stage II pubic hair, and modest axillary hair. No perioral pigmentation was present. Testicular ultrasonography revealed multilobular echogenic foci with calcifications. Bone age was 13 years, the LH and FSH secretory responses to GnRH were minimal (LH: < 0.038-->0.28 mIU/ml; FSH: < 0.063-->0.11 mIU/ml), and basal serum testosterone (< 10 ng/dl) and estradiol (< 10 pg/ml) values were undetectable. Following administration of human chorionic gonadotropin (hCG), the serum testosterone concentration increased to 275 ng/dl, while estradiol remained unmeasurable. Spermatic vein concentrations of testosterone were undetectable in the basal state and increased after hCG administration. After bilateral orchiectomy, pathologic examination revealed multifocal tumors composed of brightly eosinophilic, large polygonal cells arranged in nests, cords, and clusters within dense connective tissue or mucinous stroma with lamellar calcifications of varying sizes. These pathologic findings were compatible with a large cell calcifying Sertoli cell (sex-cord)tumor of the testes. Testosterone, estradiol, immunoreactive and bioactive aromatase activity were not detectable in the tumor. Thus, both heterosexual (gynecomastia) and isosexual (increased musculature, pubic and axillary hair) precocious puberty may occur in boys with testicular sex-cord tumors. PMID:8887151

  14. Overdose of dolutegravir in combination with tenofovir disaproxil fumarate/emtricitabine in suicide attempt in a 21-year old patient.

    PubMed

    Lee, Marcel; Eyer, Florian; Felgenhauer, Norbert; Klinker, Hartwig Hf; Spinner, Christoph D

    2015-01-01

    A 21 year old MSM patient with newly diagnosed HIV infection was hospitalized in our department after ingestion of an overdose of his antiretroviral therapy (ART) comprising dolutegravir (DTG - Tivicay®) and tenofovir disaproxil fumarate/emtricitabine (Truvada®) in suicidal intention. On admission, the patient did not show any clinical signs of intoxication and laboratory findings were unremarkable. After 6 hours of intensive care monitoring, the patient was referred to a psychiatric clinic. 5 days after the day of intoxication, serum creatinine levels increased to high normal values (1.2 mg/dl). However, levels never exceeded the upper threshold. 8 and 12 weeks later, serum creatinine normalized to levels measured prior to the intoxication. No other adverse events occurred, and the patient does not suffer from permanent impairments. PMID:26045712

  15. 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

  16. 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

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

    PubMed

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

    2013-01-01

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

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

    PubMed

    Chen, Lin; Cui, Jianxin

    2016-05-25

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

  19. DISTAL RADIAL FRACTURES IN PATIENTS OVER 60 YEARS OLD: ORTHOGONAL PLATES VERSUS VOLAR PLATE

    PubMed Central

    de França Bisneto, Edgard Novaes; de Paula, Emygdio José Leomil; de Resende, Marcelo Rosa; Júnior, Rames Mattar; Zumiotti, Arnaldo Valdir

    2015-01-01

    Objective: To compare the results from surgical treatment between volar plates with angular stability and orthogonal plates in unstable distal radius fractures, in patients aged over 60 years. Methods: The patients were divided into two groups that were treated with volar plates or orthogonal plates. Clinical and radiographic results were analyzed prospectively. Results: The study groups presented similar clinical and radiographic results six months after the operation. However, three months after the surgery, the volar plate group had superior results. Conclusion: Both group presented good functional results. Surgical treatment enabled early rehabilitation. The orthogonal plate technique required a longer learning curve, presented more complications and worse initial results.

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

    PubMed Central

    2009-01-01

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

  1. 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

  2. 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

  3. 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

  4. [52 year-old patient with severe heart failure due to multiple myeloma].

    PubMed

    Morbach, C; Breunig, M; Weidemann, F; Topp, M; Ritter, C; Schneider, P; Einsele, H; Störk, S; Angermann, C E

    2009-02-01

    Cardiac amyloidosis represents a prognostically relevant comorbidity in multiple myeloma. We report the case of a patient in whom severe heart failure symptoms as a consequence of cardiac AL-amyloidosis resolved after tandem high-dose melphalan therapy followed by autologous blood-stem cell transplantation. Partial regression of cardiac amyloid deposits and improvement of cardiac function were objectified. PMID:19183921

  5. [Acute febrile disease with splenomegaly and pancytopenia. A 66-year-old Greek patient with a prosthetic mitral valve].

    PubMed

    Hoffmann-Tonn, K; Geis, S; Peckelsen, C; Berna, G; Fleischmann, E; Bretzel, G; Löscher, T

    2007-07-01

    We report on a 66-year-old patient originating from Greece and living in Germany with a prosthetic mitral valve because of a combined vitium following juvenile rheumatic fever. The patient fell ill with acute fever, splenomegaly, and pancytopenia. After unsuccessful antibiotic therapy because of presumed endocarditis or sepsis with unknown focus, visceral leishmaniasis was suspected because of recent travel to Greece. Subsequently, this diagnosis was confirmed by serology. Considering thrombocytopenia and concurrent anticoagulation after prosthetic mitral valve replacement, we avoided a bone marrow biopsy usually required for definite proof of leishmania infection. Instead, infection with Leishmania infantum was diagnosed by PCR of a peripheral blood sample. After treatment with liposomal amphotericin B the patient recovered fully. PMID:17541531

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

    PubMed Central

    Henn, Lucas W.; Esmailian, Fardad

    2013-01-01

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

  7. Diagnosis of a 64-year-old patient presenting with suspected lumbar spinal stenosis: an evidence-based case report

    PubMed Central

    Emary, Peter C.

    2015-01-01

    Objective: To present an evidence-based case report on the diagnosis of a patient with suspected lumbar spinal stenosis (LSS). Case: A 64-year-old man presented with signs and symptoms suggestive of LSS, but physical examination and diagnostic imaging findings were inconclusive. Other co-morbidities included diabetes, congestive heart failure, and left hip joint osteoarthritis. Outcome: PubMed was searched for systematic reviews of diagnostic studies on LSS. Two recent articles were found and appraised with respect to their validity, importance, and applicability in diagnosing the current patient. Copies of his magnetic resonance imaging were also obtained and used in combination with the appraised literature, including diagnostic test specificities and likelihood ratios, to confirm an LSS diagnosis. Summary: This case illustrates how research evidence can be used in clinical practice, particularly in the diagnosis of an individual patient. PMID:25729085

  8. Perinatal care for incarcerated patients: a 25-year-old woman pregnant in jail.

    PubMed

    Clarke, Jennifer G; Adashi, Eli Y

    2011-03-01

    More than 6 million men and 1 million women are under US correctional control, be it jail, prison, probation, or parole. On any given day, about 250,000 women and adolescent girls are behind bars, a number well in excess of those documented for all other sovereign nations. Moreover, women and girls represent the fastest-growing segment of the prison and jail populations. Approximately 75% of these women are mothers of minor children (leaving 200,000 children "motherless") and as many as 10,000 may be pregnant. Primarily designed for male offenders, the US correctional system is struggling to meet the specialized needs of its female inmates. Although incarceration during pregnancy is both stressful and dehumanizing, most studies paradoxically document better outcomes for pregnancies managed behind bars than for women of similar socioeconomic status whose pregnancies are managed in the community. Using the case of Ms A as a springboard for discussion, the issues, benefits, and challenges of caring for an incarcerated pregnant woman are addressed, as is the importance of family planning services to those about to be released. PMID:21304069

  9. AB117. Laparoscopic versus open radical cystectomy for elderly patients over 75-year-old: a single center comparative analysis

    PubMed Central

    Zeng, Shuxiong; Xu, Chuanliang; Zhang, Zhensheng; Lu, Xin; Wei, Rongchao; Zhao, Junjie; Li, Huizhen; Yang, Bo; Hou, Jianguo; Sun, Yinghao

    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 cancerin elderly patients with a relative long life expectancy.

  10. 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

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

    PubMed Central

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

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

    PubMed Central

    Martin, Brett R.; Seaman, David R.

    2015-01-01

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

  14. Cobalamin F disease detected by newborn screening and follow-up on a 14-year-old patient.

    PubMed

    Oladipo, Olajumoke; Rosenblatt, David S; Watkins, David; Miousse, Isabelle Racine; Sprietsma, Laurie; Dietzen, Dennis J; Shinawi, Marwan

    2011-12-01

    The cobalamin F (cblF) defect is caused by disturbed lysosomal release of cobalamin (vitamin B(12)) into the cytoplasm caused by mutations in the LMBRD1 gene. We present the clinical and biochemical characterization of a patient with newly diagnosed cblF disease and a follow-up on a 14-year-old patient. The new patient presented with elevation of propionyl carnitine found on a newborn screen. The patient was small for gestational age, exhibited dysmorphic features and mild developmental delay, and had trigonocephaly and ventricular septal defect. There was biochemical normalization and clinical improvement within 3 weeks of parenteral cobalamin treatment. The other patient presented at 4 weeks of life with failure to thrive and feeding difficulties. She was treated only with monthly cyanocobalamin shots. The patient has never experienced metabolic decompensation. She had short stature and was an average student with no behavioral concerns. Her metabolic derangements normalized after switching to weekly hydroxycobalamin. The available data on 14 patients with confirmed cblF disease suggest variability in age of onset, presenting symptoms, response to treatment, and long-term complications. Common clinical findings include small for gestational age, feeding difficulties, growth failure, and developmental delays. Some patients have congenital heart defects, dysmorphic features, and other congenital anomalies. PMID:22065268

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

    PubMed Central

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

    2014-01-01

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

  16. 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

  17. The use of medicinal leeches in fingertip replantation without venous anastomosis - case report of a 4-year-old patient.

    PubMed

    Streit, L; Dvořák, Z; Novák, O; Stiborová, S; Veselý, J

    2014-01-01

    Replantation of amputated fingertip is a technical challenge to the microsurgeons. The success rate depends directly on the availability and the size of preserved vessels and on the degree of their damage. In distal digital amputations, veins are usually not easily recovered or even absent, and thus high number of replantation procedures fails because of the venous congestion. The use of medicinal leeches is a treatment option for venous congestion of replanted fingers. A case report of a 4-year-old patient after fingertip replantation without venous anastomosis when temporary venous drainage was provided by an application of medicinal leeches is reported together with literature review. We observed an unusually short duration of venous congestion (48 hours) and there was no need of blood transfusion. PMID:25484274

  18. Recurrent small bowel obstruction in a 60-year-old celiac patient: a rare entity of a common disease

    PubMed Central

    Har-Noy, Ofir; Amitai, Michal; Carter, Dan

    2014-01-01

    AbstractA 60-year-old woman with a medical history of celiac disease was evaluated due to recurrent episodes of small bowel obstruction. Upper and lower endoscopies were normal. The small bowel pathology consisted of celiac disease, and the anti-endomysial antibody was positive. Dilatation of small bowel loops was demonstrated on abdominal computed tomography. Further evaluation was conducted using video capsule endoscopy that demonstrated regional narrowing and severe ulceration in the middle of the small bowel. Upper and lower double balloon endoscopies failed to demonstrate the lesion. On explorative laparotomy a small bowel mass in the proximal ileum was excised. Pathology revealed ulcerated, well to moderately differentiated adenocarcinoma without regional nodal involvement. We discuss the etiology and treatment of small bowel carcinoma. This case emphasizes that a high level of suspicion is required in order to diagnose early stage small bowel adenocarcinoma in celiac patients. PMID:24733274

  19. Management of nasopharyngeal angiofibroma in a 72-year-old male through a sublabial and buccolabial incision approach: A case report and literature review

    PubMed Central

    ZHANG, HUAN-KANG; WANG, JING-JING; LIU, ZHUO-FU; WANG, DE-HUI

    2015-01-01

    Nasopharyngeal angiofibroma (NA) primarily affects adolescent males. The incidence of NA in the elderly, however, is extremely low. The present study describes a 72-year-old male with NA that presented with typical symptoms and radiological findings. The location and extension of the tumor was too lateral and inferior to be effectively resected by an endoscopic approach. Therefore, a combination of endoscopic and open approaches was considered. The tumor was completely resected using an image-guided endoscopic-assisted sublabial and buccolabial incision approach. The post-operative histopathological and immunohistochemical analysis confirmed the diagnosis of NA. The present study demonstrated the occurrence of NA in the elderly, and highlighted the potential of an image-guided endoscopic-assisted sublabial and buccolabial incision approach for the treatment of NA in the elderly. PMID:26622661

  20. Management of a 59-year-old female patient with adult degenerative scoliosis using manipulation under anesthesia

    PubMed Central

    Morningstar, Mark W.; Strauchman, Megan N.

    2010-01-01

    Objective Manipulation under anesthesia (MUA) is an outpatient procedure that is performed to restore normal joint kinematics and musculoskeletal function. This article presents a case of a patient with idiopathic lumbar degenerative scoliosis who developed intractable pain as an adult and reports on the outcomes following a trial of MUA. Clinical Features A 59-year-old female patient presented to a chiropractic office with primary subjective symptoms of lower back and bilateral hip pain. Numerical pain rating scores were reported at 8 of 10 for the lower back and 9 of 10 for the sacroiliac joint/gluteal region. A disability score using a functional rating index demonstrated a score of 26 of 40 (or 64% disability). Over the preceding 5 years, the patient had tried a number of conservative therapies to relieve her pain without success. Intervention and Outcome The patient was evaluated for MUA. The patient was scheduled for a serial MUA over 3 days. Numerical pain rating scores 8 weeks after the MUA were 1 of 10 for the lower back and 3 of 10 for the sacroiliac joint. Her disability rating decreased to 11 of 40 (28%). Radiological improvements were also observed. These outcomes were maintained at 6-month follow-up. Conclusion Pain, functional, and radiographic outcomes demonstrated improvements immediately following treatment for this patient. PMID:21629554

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

    PubMed

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

    2016-05-01

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

  2. 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.

  3. Chiropractic management of a 40-year-old female patient with Ménière disease

    PubMed Central

    Emary, Peter C.

    2010-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a patient with Ménière disease. Clinical Features A 40-year-old woman presented with a diagnosis of Ménière disease including a 2-month history of vertigo and a 16-month history of left-sided tinnitus, low-frequency hearing loss, and aural fullness. The patient's other symptoms included left-sided neck pain, temporomandibular joint pain, and headaches. Examination revealed left-sided upper cervical joint dysfunction along with myofascial trigger points in the middle and upper trapezius muscle. Intervention and Outcome Treatment included primarily high-velocity, low-amplitude spinal manipulation to the upper cervical and thoracic spine, along with soft-tissue trigger-point therapy, and stretching exercises. Within 2 weeks of treatment, the patient's tinnitus had resolved; and all other symptoms (including vertigo) were improved. The patient's headaches, neck pain, and vertigo were subsequently resolved within 3 months of treatment. The patient experienced only 2 minor episodes of self-resolving “light-headedness” over that time. After 2½ years of follow-up, any occasional episodes of mild aural fullness and/or light-headedness are either self-resolving or relieved with cervical spinal manipulation and soft-tissue treatment. Conclusion This case report suggests that chiropractic care, including upper cervical spinal manipulation and soft-tissue therapy, may be beneficial in treating some patients with Ménière disease. PMID:21629395

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

    PubMed Central

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

    2015-01-01

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

  5. A rare case of delayed subarachnoid anesthetic blockade effects in a 103-year-old female patient

    PubMed Central

    Ghaly, Ramsis F.; Anantamongkol, Utchariya; Candido, Kenneth D.; Knezevic, Nebojsa Nick

    2015-01-01

    Background: The elderly represent a unique challenge for the effects of regional anesthesia, and very few cases of block onset delay have been described. Their delayed response is attributed to a number of factors that include: Physiologic deterioration, musculoskeletal contractures, degenerative joint disease, autonomic regulatory dysfunction, cognitive dysfunction, altered pharmacokinetics, and pharmacodynamics of local anesthetics and adjuvants. Case Description: In this report we present the rare case of 45-min delay between the administration and onset of action of a subarachnoid blockade in a 103-year-old female, who was scheduled for left hip pinning, for repair of a femoral neck fracture. Patient received an injection of hyperbaric bupivacaine, 1.5 ml of 0.75% (11.25 mg), with 15 mcg of fentanyl into the subarachnoidal space and underwent the surgical procedure without complications. Conclusions: Delayed responses to subarachnoid anesthesia can be expected in extremely elderly patients. Anesthetic procedures should be monitored and managed on a case-by-case basis. PMID:26060597

  6. Efficacy and tolerability of EPs 7630 in patients (aged 6–18 years old) with acute bronchitis

    PubMed Central

    Kamin, W; Maydannik, VG; Malek, FA; Kieser, M

    2010-01-01

    Aim: For EPs-7630, a herbal drug preparation from Pelargonium sidoides roots, therapeutic effects in respiratory tract infections outside the strict indication for antibiotics have already been demonstrated in adults. Now, a dose-finding study for EPs-7630 was performed in children and adolescents. Methods: A total of 400 patients (aged 6–18 years) were randomized to receive either 30 mg, 60 mg or 90 mg EPs-7630 or placebo daily. Primary outcome criterion was the change in the Bronchitis Severity Score (BSS) from day 0 to day 7. Results: After 7 days of treatment, the change in the BSS total score was significantly better in the 60 mg and 90 mg groups compared with placebo that of the without relevant differences between these two dosages. Especially ‘coughing’, ‘sputum’ and ‘rales at auscultation’ improved under EPs-7630. Onset of effect was faster, time of bed rest shorter and treatment outcome and satisfaction with treatment were rated better. Tolerability was comparable with placebo in all treatment groups. Conclusion: EPs-7630 is effective in acute bronchitis outside the strict indication for antibiotics in 6–18 years old patients, with a dose of 60 mg or 90 mg daily offering the best benefit/risk ratio. EPs-7630 significantly reduces the severity of symptoms, leads to a more favourable course of the disease and a faster recovery from acute bronchitis compared with the placebo, and is well tolerated. PMID:20070280

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

    PubMed

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

    2016-04-01

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

  8. A rare case of NiemannPick disease type C without neurological involvement in a 66-year-old patient

    PubMed Central

    Greenberg, C.R.; Barnes, J.G.; Kogan, S.; Seargeant, L.E.

    2015-01-01

    The case of a 66year-old female the oldest known living patient with NiemannPick disease type C (NP-C) who remains free of any neurological or psychiatric manifestations 18years after presentation is presented. An incidental finding of massive splenomegaly was detected during a routine pelvic ultrasound. The pathology report after splenectomy showed the presence of lipid-laden macrophages. Fibroblasts cultured in LDL-enriched medium revealed abnormal filipin staining consistent with cholesterol-filled vesicles and the rate of cholesterol esterification in response to stimulation of LDL-cholesterol uptake was significantly depressed at 6% of that seen in cells from normal controls, but at a level similar to that observed in an NP-C positive control. Molecular genetic testing later revealed a compound heterozygous mutant NP-C genotype comprising two previously described disease-causing mutations in the NPC1 gene, one in exon 8 (c.1133T>C [V378A]) and one in exon 13 (c.1990G>A [V664M]). These findings confirmed the diagnosis of NP-C. Only three patients with this disorder aged >53years have previously been reported, all of whom presented with neurological or neuropsychiatric manifestations. Our patient is the first reported NP-C patient, now in her seventh decade of life, who has to date only manifested splenomegaly. This case highlights the extreme clinical variability of NP-C, and the need to consider this disease in the differential diagnosis of organomegaly, even in the absence of neurological, psychiatric and related clinical signs. Synopsis An elderly female patient with confirmed NP-C and isolated splenomegaly has remained asymptomatic for neurological, cognitive, psychiatric or ophthalmologic abnormailities into her seventh decade of life.

  9. Clinical significance of age at diagnosis among young non-small cell lung cancer patients under 40 years old: a population-based study

    PubMed Central

    Liu, Mina; Cai, Xuwei; Yu, Wen; Lv, Changxing; Fu, Xiaolong

    2015-01-01

    Background Young non-small cell lung cancer (NSCLC) patients under the age of 40 can further be categorized into different age subgroups. Whether they have homogeneous clinical features and survival outcomes remains unexplored. Methods Information of 4623 NSCLC patients up to 40 years old from 1988 to 2012 was retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Clinicopathologic characteristics and survival outcomes were compared between patients diagnosed at 18–30 years old (younger group) and those at 31–40 years old (older group). Results The proportion of patients in the younger group among all lung cancer patients was stable between 1988 and 2012. However, the proportion of patients in the older group decreased from 1.2% to 0.5%. The younger patients had a higher proportion of adenocarcinoma (P = 0.016), a lower proportion of large cell carcinoma (P = 0.008), a higher proportion of stage I disease (P = 0.002) and a lower proportion of stage III disease (P < 0.001). The younger patients had significantly better lung cancer-specific survival (LCSS) in the whole cohort (P < 0.001) and in the subgroup of patients with stage I (P = 0.038) or stage IV (P < 0.001) disease. Multivariate survival analysis showed that patients under 30 years old was an independent predictor of both better LCSS (P = 0.010) and overall survival (OS) (P = 0.018). Conclusions Adult NSCLC patients under 30 years old had distinctive clinicopathologic characteristics and survival outcomes compared to patients diagnosed at 31–40 years old. PMID:26517681

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

    PubMed

    Broughton, Henare Renata

    2009-01-01

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

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

    PubMed

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

    2012-03-01

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

  12. 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

  13. 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

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

    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.

  15. 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

  16. 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

  17. Comparison of Outcome of Femoral Shaft Fracture Fixation with Intramedullary Nail in Elderly Patient and Patients Younger than 60 Years Old

    PubMed Central

    Elmi, Asghar; Rohani, Ali Reza; Tabrizi, Ali; Esmaili, Seyed-Masood

    2014-01-01

    Background: Although intramedullary nailing (IMN) is an established and accepted operative treatment for femoral shaft fracture in patients younger than 60, there is a lack of data on the results of this treatment on those over 60. The purpose of this study was to determine if the outcome of IMN for femoral shaft fracture in elderly patients is also acceptable. Particular challenges in this group of patients included osteopenia and other associated multiple medical problems frequently observed. Methods: The outcome of 84 patients who had IMN for femoral shaft fracture was reviewed and the results were compared between two groups of patients (younger than 60 and over 60 year old patients). Complications and mortality was analyzed for each group, and then compared between the two groups by testing the null hypothesis that the outcome of treatment in the two groups are similar (P>0.05). Results: The mean duration of follow up was 57.3 months (range: 10-94 months). Incidence of malunion, nonunion, infection, DVT, and dependence on walker/crutch in the groups were similar and differences were not significant (P>0.05). However, incidence of mortality (P<0.05), knee pain, loss of motion, and dependence on cane were significantly higher in elderly patients (P<0.05). Conclusions: There is no significant difference between the outcomes of femoral shaft fracture treatment with IMN fixation in younger patients when compared with elderly patients. However, elderly patients with IMN have more symptoms when compared with younger patients. PMID:25207327

  18. The diagnostic value of circulating microRNAs for middle-aged (40–60-year-old) coronary artery disease patients

    PubMed Central

    Md Sayed, Ali Sheikh; Xia, Ke; Li, Fei; Deng, Xu; Salma, Umme; Li, Tingbo; Deng, Hai; Yang, Dafeng; Haoyang, Zhou; Yang, TianLun; Peng, Jun

    2015-01-01

    OBJECTIVE: Circulating microRNAs have been recognized as promising biomarkers for various diseases. The present study aimed to explore the potential roles of circulating miR-149, miR-424 and miR-765 as non-invasive biomarkers for the diagnosis of coronary artery disease in middle-aged (40–60-year-old) patients. METHODS: Sixty-five stable coronary artery disease patients (49–57 years old), 30 unstable coronary artery disease patients (49–58 years old), and 32 non-coronary artery disease patients (49–-57 years old) who were matched for age, sex, smoking habits, hypertension and diabetes were enrolled in this study. Total RNA was isolated from plasma with TRIzol reagent. Circulating miRNA levels were measured by quantitative real-time polymerase chain reaction. RESULTS: Circulating miR-149 levels were decreased 4.49-fold in stable coronary artery disease patients (1.18 ± 0.84) and 5.09-fold in unstable coronary artery disease patients (1.04 ± 0.65) compared with non-coronary artery disease patients (5.30 ± 2.57) (p<0.001). Circulating miR-424 levels were reduced 3.6-fold in stable coronary artery disease patients (1.18 ± 0.60) and 5-fold in unstable coronary artery disease patients (0.86 ± 0.54) compared with non-coronary artery disease patients (4.35 ± 2.20) (p<0.001). In contrast, circulating miR-765 levels were elevated 3.98-fold in stable coronary artery disease patients (6.09 ± 2.27) and 5.33-fold in unstable coronary artery disease patients (8.17 ± 2.77) compared with non-coronary artery disease patients (1.53 ± 0.99) (p<0.001). Receiver operating characteristic curve analysis revealed that the respective areas under the curve for circulating miR-149, miR-424 and miR-765 were 0.938, 0.919 and 0.968 in stable CAD patients and 0.951, 0.960 and 0.977 in unstable coronary artery disease patients compared with non-coronary artery disease patients. CONCLUSION: Our results suggest that circulating miR-149, miR-424 and miR-765 might be novel, non-invasive biomarkers for the diagnosis of coronary artery disease in middle-aged patients. However, future prospective trials in large patient cohorts are necessary before reaching a solid conclusion. PMID:26017792

  19. Primary hyperparathyroidism caused by a parathyroid carcinoma in a 16-year-old male neutered cat with concurrent chronic kidney disease.

    PubMed

    Faucher, Mathieu R; Freiche, Valérie; Bongrand, Yannick; German, Alexander J

    2014-01-01

    A 16-year-old domestic shorthaired cat with chronic kidney disease was presented with a subacute history of weakness and anorexia. Severe hypercalcaemia was identified and attributed to a cervical mass, diagnosed as a parathyroid carcinoma after surgery. Renal function, as evaluated by plasma creatinine, initially worsened during hypercalcaemia but fully returned to previously documented values two months post-operatively. PMID:24593857

  20. 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…

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

    PubMed Central

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

    2015-01-01

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

  2. [A 73-year-old female patient after liver and kidney transplantation with dull pain in the epigastrium and recurrent epistaxis].

    PubMed

    Zinser, M E; Salzer, H J F; Stein, A; von Petersdorff, M; Koops, A; Holzhüter, J

    2015-05-01

    A 73-year-old female patient who had received a liver and kidney transplantation presented with symptomatic pancytopenia and right-sided upper abdominal pain. The histological investigation of a bone marrow biopsy showed the extremely rare manifestation of a disseminated Merkel cell carcinoma with infiltration of the bone marrow and suppression of hematopoiesis. Also a Coombs test positive hemolytic anemia did not show a significant response to high-dose steroid therapy. Palliative chemotherapy with carboplatin and etoposide at reduced dosage had to be terminated due to deterioration of the patient's general condition. The patient died 2 days after initiation of chemotherapy. PMID:25874738

  3. Emotional Development: 1 Year Olds

    MedlinePlus

    ... Children > Ages & Stages > Toddler > Emotional Development: 1 Year Olds Ages & Stages Listen Español Text Size Email Print Share Emotional Development: 1 Year Olds Page Content Article Body Throughout her second year, ...

  4. Emotional Development: 2 Year Olds

    MedlinePlus

    ... Children > Ages & Stages > Toddler > Emotional Development: 2 Year Olds Ages & Stages Listen Español Text Size Email Print Share Emotional Development: 2 Year Olds Page Content Article Body It’s so difficult to ...

  5. 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

  6. [Forty-six year old baby].

    PubMed

    Vahip, Işil; 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

  7. Short-Term Outcomes of Hip Fractures in Patients Aged 90 Years Old and Over Receiving Surgical Intervention

    PubMed Central

    Lin, Wei-Ting; Chao, Chien-Ming; Liu, Hsuan-Chih; Li, Yi-Ju; Lee, Wei-Jing; Lai, Chih-Cheng

    2015-01-01

    Background The knowledge about short-term outcomes of nonagenarians undergoing surgery for hip fracture in Asian is limited. Methods The patients with hip fractures who underwent hip hemiarthroplasty and open reduction with internal fixation (ORIF) for management during the period from 2008 to 2012 were identified and their medical record was retrospectively reviewed. Results During the study period, a total of 101 patients underwent surgery for management of hip fractures, and the age of patients ranged from 90 to 96 years. The sites of hip fracture were intertrochanteric (n = 57, 56.4%) and the neck of the femur (n = 44, 43.6%). Most of the patients had American Society of Anesthesiologists scores of 3(n = 55) or 4 (in 44 patients). 80.2% (n = 81) underwent the operation within one day after admission; however, there were 13 patients (12.9%) that underwent surgery 48 or more hours later. ORIF and hemiarthroplasty were performed for 63 (62.4%) and 38 (37.6%) patients, respectively. Overall, the 30-day and 1-year mortality rates were 9.9% (10/101) and 17.3% (13/75), respectively. Multivariate analysis showed that the 30-day mortality was significantly associated only with end-stage renal disease (ESRD) (Odds ratio, 11.13, 95% confidence interval, 1.275–97.881, P = .029). Conclusions The short-term outcome of surgical management for Asian nonagenarians with hip fractures is favorable in selected patients. PMID:25978368

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

    PubMed Central

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

    2016-01-01

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

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

    SciTech Connect

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

    1995-11-20

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

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

    PubMed Central

    Encarnación-Martínez, Juan; Barberá-Alacreu, Manuel

    2015-01-01

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

  11. Prevalence and Impact of Anxiety and Depression on Type 2 Diabetes in Tunisian Patients over Sixty Years Old

    PubMed Central

    Masmoudi, Jawaher; Damak, Rahma; Zouari, Hela; Ouali, Uta; Mechri, Anouar; Zouari, Nouri; Jaoua, Abdelaziz

    2013-01-01

    Objectives. To estimate the prevalence of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) in a population aged over sixty years with type 2 diabetes and to study the impact of anxiety and depression on glycemic balance and disease outcome. Results. The prevalence of anxiety and depression in the 62 subjects included in the study was, respectively, 40.3% and 22.6%. We found a relationship between these disorders and complicated diabetes. The subjects having an imperfectly balanced diabetes had a higher average anxiety score than those having a good glycemic control (9.1 ± 4.2 versus 6.5 ± 3.1; P = 0.017). No relationship was found between diabetes balance and depression. Conclusion. Association between anxiety and depressive disorders and diabetes is frequent and worsens patients' outcome, in terms of diabetes imbalance as well as in terms of diabetic complications. Our study shows that there is need for physicians to detect, confirm, and treat anxiety and depressive disorders in elderly diabetic patients. PMID:23853718

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  14. [Treatment failure as a consequence of the diagnostic difficulties in a 52-year-old patient treated for the pancreatic abscess].

    PubMed

    Pawłowski, Wiktor; Dorobisz, Tadeusz; Ziomek, Agnieszka; Leśniak, Michał; Chabowski, Mariusz; Janczak, Dariusz

    2015-10-01

    Hodgkin Lymphoma (HL) is a neoplastic disease of the lymphatic system, primary involving lymph nodes and extranodular organs. Despite successful combined chemotherapy, a proper and prompt diagnosis remains a difficult challenge. The case report documents the case of a 52-year-old patient, who had been diagnosed in various internal medicine wards for nonspecific diseases during last two years. Due to the worsening of patient's general condition and suspected inflammatory, probably purulent, abdominal process, he was operated twice. Unexplained symptoms of the uncertain origin resulted in the further lack of successful diagnosis and therapy. The patient died from multiple organ failure on the 2nd day after the second operation. The final histopathological and immunohistochemical examination of the liver biopsy revealed the primary cause of death, i.e. Hodgkin lymphoma. The thorough analysis of the patient's documentation revealed a full-featured image of the classic HL. A special emphasis was placed upon misleading symptoms and difficulties in correct interpretation of more sophisticated diagnostic methods. The significant features of these patients can provide sufficient guidance to proper diagnosis and treatment of this rare disease. PMID:26608491

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

    PubMed Central

    LI, HONGYU; PENG, BING

    2016-01-01

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

  16. Language Development: 2 Year Olds

    MedlinePlus

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

  17. Social Development:: 2 Year Olds

    MedlinePlus

    ... appreciate the importance of being a good role model, by demonstrating that children often do as we do, not as we say. The best way for your two-year-old to learn how to behave around other people ...

  18. A quantitative study on the condom-use behaviors of eighteen- to twenty-four-year-old urban African American males.

    PubMed

    Kennedy, Stephen B; Nolen, Sherry; Applewhite, Jeffrey; Pan, Zhenfeng; Shamblen, Stephen; Vanderhoff, Kenneth J

    2007-05-01

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

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

    PubMed Central

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

    2007-01-01

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

  20. Three novel germ-line VHL mutations in Hungarian von Hippel-Lindau patients, including a nonsense mutation in a fifteen-year-old boy with renal cell carcinoma

    PubMed Central

    2013-01-01

    Background Von Hippel-Lindau disease is an autosomal dominantly inherited highly penetrant tumor syndrome predisposing to retinal and central nervous system hemangioblastomas, renal cell carcinoma and phaeochromocytoma among other less frequent complications. Methods Molecular genetic testing of the VHL gene was performed in five unrelated families affetced with type I VHL disease, including seven patients and their available family members. Results Molecular genetic investigations detected three novel (c.163 G > T, c.232A > T and c.555C > A causing p.Glu55X, p.Asn78Tyr and p.Tyr185X protein changes, respectively) and two previously described (c.340 + 1 G > A and c.583C > T, resulting in p.Gly114AspfsX6 and p.195GlnX protein changes, respectively) germline point mutations in the VHL gene. Molecular modeling of the VHL-ElonginC-HIF-1alpha complex predicted that the p.Asn78Tyr amino acid exchange remarkably alters the 77-83 loop structure of VHL protein and destabilizes the VHL-HIF-1alpha complex suggesting that the mutation causes type I phenotype and has high risk to associate to renal cell carcinoma. The novel p.55X nonsense mutation associated to bilateral RCC and retinal angioma in a 15-year-old male patient. Conclusion We describe the earliest onset renal cell carcinoma in VHL disease reported so far in a 15-year-old boy with a nonsense VHL mutation. Individual tailoring of screening schedule based on molecular genetic status should be considered in order to diagnose serious complications as early as possible. Our observations add to the understanding of genotype-phenotype correlation in VHL disease and can be useful for genetic counseling and follow-up of VHL patients. PMID:23298237

  1. 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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Haghnegahdar, Ali; Sedighi, Mahsa

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

    2010-01-01

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

  6. Language Development: 1 Year Olds

    MedlinePlus

    ... Stages Listen Español Text Size Email Print Share Language Development: 1 Year Olds Page Content Article Body ... assured, it’s not your imagination. He’s developing his language and comprehension skills right on schedule. This giant ...

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

    ERIC Educational Resources Information Center

    Hernandez, Amanda Martinez; Caçola, Priscila

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Hernandez, Amanda Martinez; Caola, Priscila

    2015-01-01

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

  9. Evaluation the treatment outcomes of intracapsular femoral neck fractures with closed or open reduction and internal fixation by screw in 18–50-year-old patients in Isfahan from Nov 2010 to Nov 2011

    PubMed Central

    Javdan, Mohammad; Bahadori, Mehran; Hosseini, Alireza

    2013-01-01

    Background: There is conflict of interest in the treatment of intracapsular femoral neck fractures and the outcomes. The aim of this study was evaluation the treatment outcomes of closed and open reduction and internal fixation with screw in 18–50-year-old patients. Materials and Methods: This clinical randomized study was conducted in Ayatollah Kashani Center in Isfahan from Nov 2010 to Nov 2011. In 42 patients selected in a randomized manner, fractures were reduced by closed reduction or open if necessary and C-ARM was controlled in AP and lateral plans. Movement range and femur pain severity were evaluated according to Visual analogue Scale (VAS) score at 3 and 6 months after surgery. Data were analyzed by SPSS 18. Chi-square, t-test, one-way analysis of variance (ANOVA), and descriptive statistics such as frequency distribution, mean, and mean deviation were used. Results: Forty-two patients with femoral neck fracture were treated by open [31 patients (73.8%)] or closed reduction [11 patients (26.2%)] and also osteosynthesis. Their mean age was 47.3 ± 9.8 years; 29 of them were males and 13 were females. Twelve patients had bad range of motion (ROM) (28.6%), 16 had intermediate ROM (38%), and 14 had good ROM (33.4%). After 6 months, 12 patients (28.6%) had bad ROM, 10 (23.8%) had intermediate ROM, and 20 (47.6%) had good ROM. There were 11 cases of non-union (35.5%) in the open reduction group and 4 in the closed group. Conclusion: This study showed that femoral neck fracture is associated with several complications, especially if open reduction was necessary. So, the surgical method and necessary equipments such as radiolucent bed, C-ARM machine, and implant cannulated screw set should be considered. PMID:23930259

  10. [Anaplastic thyroid carcinoma in a 14-year-old boy].

    PubMed

    Szalecki, Mieczysław; Nawrotek, Jolanta; Lange, Dariusz; Skotarczyk-Kowalska, Elzbieta; Mogielska, Beata; Piatkowska, Ewa; Jałowiec, Irena; Biernacka-Florczak, Izabela; Jarzab, Barbara; Perek, Danuta

    2005-01-01

    We report a case of anaplastic cancer of thyroid in 14-year-old male. The diagnosis was supported on: pace of changes, clinical image, disease course, no effect of therapy, histopathological examination. PMID:15850538

  11. 3-D printout of a DICOM file to aid surgical planning in a 6 year old patient with a large scapular osteochondroma complicating congenital diaphyseal aclasia.

    PubMed

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

    2012-01-01

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

  12. [A 62-year-old patient with congenital coronary arteriovenous fistula demonstrating dilatation and contortion that corresponded to the aorta in thickness: a case report].

    PubMed

    Aoki, I; Horikoshi, S; Mizuno, A; Miyamoto, M; Suzuki, H

    2000-12-01

    A 62-year-old female, cardiac echography and catheterization revealed against aneurysming right coronary arteriovenous fistula. To avoid rupture of the aneurysm, the right coronary orifice was closed. Subsequently, the arteriovenous fistula orifice adjacent to the coronary venous sinus was closed. In addition, to avoid transfer of a thrombus in the aneurysm to the RCA, suture ligature of the right coronary aneurysm was performed, and surgery was completed. The postoperative course was uneventful. Postoperative heart catheterization showed good collateral blood circulation from the LAD to the RCA. PMID:11127558

  13. 3-D printout of a DICOM file to aid surgical planning in a 6 year old patient with a large scapular osteochondroma complicating congenital diaphyseal aclasia

    PubMed Central

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

    2012-01-01

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

  14. Interstitial deletion at 11q14.2-11q22.1 may cause severe learning difficulties, mental retardation and mild heart defects in 13-year old male.

    PubMed

    Papoulidis, Ioannis; Paspaliaris, Vassilis; Siomou, Elisavet; Orru, Sandro; Murru, Roberta; Sifakis, Stavros; Nikolaidis, Petros; Garas, Antonios; Sotiriou, Sotirios; Thomaidis, Loretta; Manolakos, Emmanouil

    2015-01-01

    Interstitial deletions of the long arm of chromosome 11 are rare, and they could be assumed as non-recurrent chromosomal rearrangements due to high variability of the size and the breakpoints of the deleted region. The exact region of the deletion was difficult to be determined before the use of molecular cytogenetic techniques such as array comparative genomic hybridization (aCGH). Here, a 13-year old boy with severe learning difficulties, mental retardation and mild heart defects is described. Conventional G-band karyotyping was performed and it is found that the patient is a carrier of a de novo interstitial deletion on the long arm of chromosome 11, involving 11q14 and 11q22 breakpoints. Further investigation, using aCGH, specified the deleted region to 11q14.2-11q22.1. There was a difficulty in correlating the genotype with the phenotype of the patient due to lack of similar cases in literature. More studies should be done in order to understand the genetic background that underlies the phenotypic differences observed in similar cases. PMID:26388939

  15. The Safety and Effectiveness of Low-Dose Recombinant Tissue Plasminogen Activator (0.6 mg/kg) Therapy for Elderly Acute Ischemic Stroke Patients (≥ 80 Years Old) in the Pre-endovascular Era

    PubMed Central

    TAKAYANAGI, Shunsaku; OCHI, Takashi; HANAKITA, Shunya; SUZUKI, Yasutaka; MAEDA, Keiichiro

    2014-01-01

    There are still few studies of low-dose recombinant tissue plasminogen activator (rtPA) therapy (0.6 mg/kg) for acute ischemic stroke (AIS) patients ≥ 80 years old, though most strokes occur in elderly people. The safety and effectiveness of this form of thrombolysis without endovascular therapy were evaluated in AIS patients ≥ 80 years old at our hospital. The data were collected from August 2006 to April 2010, before approval of the Mechanical Embolus Removal in Cerebral Ischemia (MERCI) retriever in Japan. Intravenous rtPA was administered to patients within 3 hours of stroke onset. The incidence of intracerebral hemorrhage (ICH), the recanalization rate of the occluded artery, and the modified Rankin Scale (mRS) score 3 months after stroke were examined. The patients who received rtPA therapy were stratified into two age groups: a younger group (< 80 years) and an older group (≥ 80 years). Of the 87 patients who received rtPA therapy, 17 (19.5%) were ≥ 80 years old. The incidence of symptomatic ICH was not significantly different between the younger (4.3%) and older (0%) groups (p = 0.61). The recanalization rate of the occluded artery was not significantly different between the younger (54%) and older (50%) groups (p = 0.78). The rate of an mRS score of 0–2, 3 months after stroke was significantly higher in the younger (44.3%) than in the older group (11.8%) (p = 0.013). Low-dose rtPA therapy appears to be as safe and feasible for AIS patients ≥ 80 years old as it is for younger people. This therapy should not be withheld because of age. PMID:24670312

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

    PubMed

    Papavasileiou, Evangelia; Lobo, Ann-Marie

    2015-01-01

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

  17. 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

  18. Diagnosis of cardiac metastasis from cervical cancer in a 33-year-old patient using multimodal imaging studies: a case report and literature review

    PubMed Central

    Hoksch, Beatrix; Schwerzmann, Markus; Puig, Stefan; Klink, Thorsten

    2014-01-01

    We report a case of a 33-year-old woman with emergency admission due to dyspnoea and fever. History included squamous cell carcinoma of the cervix in complete remission. Contrast-enhanced computed tomography (CT) scanning of the chest, which was indicated to rule out pneumonia, revealed an infiltrative cardiac mass. Further assessment of the tumour by echocardiography and cardiac magnetic resonance imaging (MRI) showed transmural infiltration of the apical interventricular septum with a mass extending into the left and right ventricle cavities. The mass was highly suspicious for a cardiac metastasis. Cardiac metastases from cervical cancer are extremely rare. Recurrence of cervical carcinoma involving the heart should be considered even after a curative therapy approach. Non-invasive imaging plays a paramount role in investigating cardiac masses. Echocardiography, CT and MRI are complementary imaging modalities for complete work-up of intracardiac lesions. PMID:25346849

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

    PubMed Central

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

    2013-01-01

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

  20. Cognitive Development: Two-Year-Old

    MedlinePlus

    ... Children > Ages & Stages > Toddler > Cognitive Development: Two-Year-Old Ages & Stages Listen Español Text Size Email Print Share Cognitive Development: Two-Year-Old Page Content Article Body Think back to your ...

  1. 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

    2016-02-01

    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

  2. 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

  3. Outcome of conditioning intensity in acute myeloid leukemia with monosomal karyotype in patients over 45 year-old: A study from the acute leukemia working party (ALWP) of the European group of blood and marrow transplantation (EBMT).

    PubMed

    Poiré, Xavier; Labopin, Myriam; Cornelissen, Jan J; Volin, Liisa; Richard Espiga, Carlos; Veelken, J Hendrik; Milpied, Noël; Cahn, Jean-Yves; Yacoub-Agha, Ibrahim; van Imhoff, Gustaaf W; Michallet, Mauricette; Michaux, Lucienne; Nagler, Arnon; Mohty, Mohamad

    2015-08-01

    Acute myeloid leukemia with monosomal karyotype (MK AML) carries a very poor prognosis, even after allogeneic stem cell transplantation (SCT). However, SCT remains the only curative option in this high-risk population. Because myeloablative conditioning regimen (MAC) is associated with less relapse, we hypothesized that more intensive conditioning regimen might be beneficial for MK AML patients. We reviewed 303 patients over age 45 diagnosed with either de novo or secondary MK AML. One hundred and five patients received a MAC and 198 a reduced-intensity conditioning (RIC). The median age at SCT was 57-year-old, significantly lower in the MAC (53-year-old) than in the RIC group (59-year-old). The median follow-up was 42 months (range, 3 - 156 months). The 3-year overall survival (OS), leukemia-free survival (LFS), and relapse rate (RR) were not significantly different between both groups with overall values of 34%, 29%, and 51%, respectively. On the contrary, the 3-year nonrelapse mortality (NRM) was significantly higher in MAC recipients (28%) compared with RIC patients (16%, P = 0.004). The incidence of Grades II to IV acute graft-versus-host disease (GvHD) was significantly higher after a MAC (30.5%) than after a RIC (19.3%, P = 0.02). That of chronic GvHD was comparable between both groups (35%) and did not impact on LFS. Interestingly, within our MK AML cohort, hypodiploidy was significantly associated with worse outcomes. Due to reduced toxicity and comparable OS, LFS, and RR, RIC appears as a good transplant option in the very high-risk population, including older patients, diagnosed with MK AML. PMID:26010466

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

    ERIC Educational Resources Information Center

    Bamberg, Michael

    2004-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  7. Recurrent hemoptysis in a 62-year-old smoker.

    PubMed

    Gowrinath, Karanam; Ramakrishna, Baddukonda Appala; Shanthi, Vissa; Sujatha, Gogineni

    2013-04-01

    Tracheal papillary adenoma is a rare benign tumor. We report a case of papillary adenoma in a 62-year-old male smoker who presented with recurrent hemoptysis. The tumor was located in the upper third of trachea and forceps biopsy through flexible bronchoscopy was uncomplicated and diagnostic. PMID:23741099

  8. Recurrent hemoptysis in a 62-year-old smoker

    PubMed Central

    Gowrinath, Karanam; Ramakrishna, Baddukonda Appala; Shanthi, Vissa; Sujatha, Gogineni

    2013-01-01

    Tracheal papillary adenoma is a rare benign tumor. We report a case of papillary adenoma in a 62-year-old male smoker who presented with recurrent hemoptysis. The tumor was located in the upper third of trachea and forceps biopsy through flexible bronchoscopy was uncomplicated and diagnostic. PMID:23741099

  9. 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

  10. 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…

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

    PubMed Central

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

    2016-01-01

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

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

    2006-09-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  15. Cardiovascular events and geriatric scale scores in elderly (70 years old and above) type 2 diabetic patients at inclusion in the GERODIAB cohort.

    PubMed

    Bauduceau, Bernard; Doucet, Jean; Le Floch, Jean-Pierre; Verny, Christiane

    2014-01-01

    OBJECTIVE To analyze the relationships between cardiovascular complications and geriatric scale scores in French elderly (≥70 years of age) type 2 diabetic patients at inclusion in the GERODIAB cohort. RESEARCH DESIGN AND METHODS GERODIAB is the first French multicenter, prospective, observational survey designed to analyze the influence of glycemic control on morbidity/mortality in type 2 diabetic patients aged ≥70 years during a 5-year follow-up period. This study analyzed the relationships between classical macroangiopathic complications and geriatric scale scores in 987 patients at baseline, using bivariate and multivariate analyses. RESULTS Cardiac ischemia (31.2%) was significantly associated with impaired activities of daily living (ADL) scores (P < 0.001). Stepwise logistic regression included hypercholesterolemia, ADL, sex, and hypertension successively (70.3% concordance; P < 0.001). Heart failure (10.1%) was associated with impaired Mini Mental State Examination (MMSE), instrumental ADL (IADL) (P < 0.05), and ADL scores (P < 0.001). With the logistic model, waist circumference, age, and HDL cholesterol were significant factors (70.7% concordance; P < 0.001). Arterial disease of the lower limbs (25.6%) was associated with impaired IADL and ADL scores (P < 0.001). Significant factors using the logistic model were duration of diabetes, IADL score, hypertension, and sex (62.8% concordance; P < 0.001). Cerebral ischemia (15.8%) was associated with impaired MMSE, Mini Nutritional Assessment, ADL, and IADL scores (P < 0.01). IADL, sex, hypertension, and ADL were included in the logistic model successively (65.6% concordance; P < 0.001). CONCLUSIONS In this specific population, impaired geriatric scale scores were found to be associated with classical macrovascular complications, notably using multivariate analyses. This suggests the benefits of thorough screening and management of cognitive and functional decline in elderly type 2 diabetic patients. PMID:23990512

  16. [A 47-year-old patient with longstanding nicotine abuse, increasing dyspnea on exertion and lower and peripheral lung predominant ground-glass opacities].

    PubMed

    Heiss, P; Kundel, C; Schulz, C; Feuerbach, S; Hamer, O W

    2009-05-01

    The causal relationship between cigarette smoking and a number of interstitial lung diseases continues to evolve. These "smoking-related interstitial lung diseases" (SR-ILD) are a heterogeneous group of entities which have overlapping imaging findings and which can coexist. The presented case of a patient with smoking history and pulmonary ground-glass opacities demonstrates that thorough knowledge of the various manifestations of SR-ILD is essential for a confident diagnosis. PMID:18958443

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

    PubMed Central

    Teperman, Lorne J

    2002-01-01

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

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

    PubMed Central

    Zujalovic, Benedikt; Barth, Eberhard

    2015-01-01

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

  19. 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

  20. Primary vesical actinomycosis in a 23-year-old man.

    PubMed

    Ziypak, Tevfik; Adanur, Senol; Ozkaya, Fatih; Calık, Muhammet; Polat, Ozkan; Aksoy, Yilmaz; 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

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

    PubMed Central

    Ziypak, Tevfik; Adanur, Senol; Ozkaya, Fatih; Calık, 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

  2. Assessing prescribing and patient care indicators for children under five years old with malaria and other disease conditions in public primary health care facilities.

    PubMed

    Nsimba, Stephen Elias Damson

    2006-01-01

    A prospective descriptive observational study using WHO indicator forms and questionnaire was carried out in Kibaha district public primary health care facilities. We assessed knowledge about drugs in mothers/guardians of sick children under age five years immediately after consulting clinicians and after receiving drugs from the dispenser. The questionnaires had closed- and open-ended questions. Interviews were administered by trained nurses and the authors. The prescribing, dispensing practices, including drug labeling and instructions given to mothers/guardians on how to use drugs at home, in these health facilities which are under the Essential Drugs Program (EDP), was assessed. A total of 652 prescriptions from mothers/guardians with sick children under age five years were observed, recorded and analyzed. Prescribing indicators were used as stipulated by the WHO/DAP/93.1 how to investigate drug use in health facilities. The diagnosis for malaria cases made by the clinicians on average per facility were as follows: malaria alone 25, diarrhea alone 3, pneumonia alone 3, malaria and diarrhea 4 cases, malaria and pneumonia 2 cases and malaria and other conditions 14 cases. The average number of drugs per prescription in these facilities was 2.3 and the percentage generic prescribing was 87.0, antibiotics 30.5, and injections 26.2, with 93.5 % of all prescribed drugs being within the Essential Drugs List (EDL). The overall average dispensing time was 1.4 minutes per patient, of the drugs prescribed, 54.7 % were dispensed, whereas 21.4 % of drugs dispensed to mothers/guardians were adequately labeled, and 37.2 % of mothers knew how to administer drugs correctly to their sick children after receiving the drugs from the dispenser. These results suggest the need for educational intervention for prescribers (health care providers) on rational prescribing of drugs, such as antimalarials, antibiotics, injections, proper dispensing, and adequate labeling drugs in packets, while the dispensing time for drugs was too short. It is necessary to correct these malpractices of irrational prescribing and dispensing drugs for treatment of malaria and other childhood illnesses in public primary health care facilities (PHC). Furthermore, inadequate physical examination and short consultation time needs to be improved. There is a need to advise the Ministry of Health to develop health education programs on a regular basis for all health care providers in the country and mothers/guardians of children in general public/rural communities on how to use/administer antimalarials and other drugs at home. All these can be achieved through well planned health education training programs. PMID:16771236

  3. [A Case of Kartagener's Syndrome in Infertile Male Patients].

    PubMed

    Mori, Kohei; Yumura, Yasushi; Takeshima, Teppei; Yamanaka, Hiroyuki; Kuroda, Shinnosuke; Sanjyo, Hiroyuki; Yasuda, Kengo; Noguchi, Kazumi

    2015-12-01

    The patient was a 33-year-old man attending the infertility clinic with primary infertility of 3 years duration. The semen examination showed oligozoospermia and suspected primary male infertility. He had a history of chronic sinusitis and respiratory disease. His chest X-ray showed dextrocardia. Abnormality of the ultrastructure of the cilia of the tract epithelium was found by electron microscopy, and further examination revealed bronchoectasis. We gave him a diagnosis of Kartagener syndrome from these findings. Kartagener syndrome consists of bronchiectasis, sinusitis and situs inversus and is considered a form of primary ciliary dyskinesia (PCD). PCD is also a cause of motor impairment of sperm flagella. This case had successful in-vitro fertilization pregnancy with spermatozoa from the patient. PMID:26790766

  4. Adenomatoid odontogenic tumour in a 20-year-old woman

    PubMed Central

    Virupakshappa, Deepti; Rajashekhara, Bhari Sharanesha; Manjunatha, Bhari Sharanesha; Das, Nagarajappa

    2014-01-01

    Adenomatoid odontogenic tumour is a relatively rare and distinct odontogenic tumour that is exclusively odontogenic epithelium in origin. It comprises 3% of all odontogenic tumours. This report describes the surgical therapy, clinical course and morphological characteristics of an adenomatoid odontogenic tumour that developed in the left maxilla of a 20-year-old patient. PMID:24810436

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

    PubMed

    Wollenberg, Andreas; Butnaru, Cristina; Oppel, Tilmann

    2002-01-01

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

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

    PubMed

    Foerster, K; Foerster, G; Roth, E

    1976-01-01

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

  7. Language in the Two-year Old

    ERIC Educational Resources Information Center

    Goldin-Meadow, Susan; And Others

    1976-01-01

    Two stages in the vocabulary development of two-year-olds are reported. In the earlier Receptive stage, the child says many fewer nouns than he understands and says no verbs at all although he understands many. The child then enters a Productive stage in which he says virtually all the nouns he understands plus his first verbs. (Author/DEP)

  8. 100-Year Old Adobe Building Destroyed

    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...

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  12. Primary retroperitoneal mucinous cystadenocarcinoma in a male patient.

    PubMed

    Thamboo, T P; Sim, R; Tan, S-Y; Yap, W-M

    2006-06-01

    Primary retroperitoneal mucinous cystadenocarcinomas (PRMCs) are rare. This is the first reported case in the literature in English of PRMC in a man. The 64-year-old man presented with a large retroperitoneal cystic tumour measuring 24 x 20 x 16 cm3, which was removed intact. Areas ranging from a benign mucinous cyst to borderline mucinous tumour to mucinous cystadenocarcinoma were observed on microscopy. Strong patchy staining for cytokeratins 7 and 20 and strong diffuse staining for MUC2 and MUC5AC core peptides, similar to staining patterns in ovarian mucinous tumours, were shown in the benign and atypical epithelium. Staining for CA19.9 and carcinoembryonic antigen was also shown by both components. The theory of its origin from the mucinous metaplasia of peritoneal (mesothelial) inclusion cysts, rather than from ectopic ovarian tissue or ovarian teratomas, is supported by the occurrence of such a tumour in a male patient. PMID:16731606

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

    PubMed

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

    2015-01-01

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

  14. Multiple eruptive pilomatricomas in a 9-year-old boy with glioblastoma.

    PubMed

    Hollmig, S Tyler; Tollefson, Megha M; Kim, Jinah; Khuu, Phuong

    2013-01-01

    A 9-year-old male presented to our dermatology clinic with a recent history of developing numerous cutaneous pilomatricomas, and was subsequently discovered to have sustained a recurrence of his glioblastoma multiforme. Immunohistochemical staining of a representative pilomatricoma and his original brain tumor revealed upregulation and nuclear localization of beta-catenin, a sign associated with poor prognosis in glioblastoma. We hypothesize that the development of multiple pilomatricomas may have been a hallmark of this patient's tumor recurrence and provide support for a recent report of an association between multiple pilomatricomas and gliomatosis cerebri. PMID:22304393

  15. 17-Year-Old Boy with Renal Failure and the Highest Reported Creatinine in Pediatric Literature

    PubMed Central

    Master Sankar Raj, Vimal; Garcia, Jessica; Gordillo, Roberto

    2015-01-01

    The prevalence of chronic kidney disease (CKD) is on the rise and constitutes a major health burden across the world. Clinical presentations in early CKD are usually subtle. Awareness of the risk factors for CKD is important for early diagnosis and treatment to slow the progression of disease. We present a case report of a 17-year-old African American male who presented in a life threatening hypertensive emergency with renal failure and the highest reported serum creatinine in a pediatric patient. A brief discussion on CKD criteria, complications, and potential red flags for screening strategies is provided. PMID:26199780

  16. 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

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

    PubMed

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

    2014-12-01

    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

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

    SciTech Connect

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

    1999-01-15

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

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

    PubMed Central

    Royston, Eric; Bush, Lisabeth

    2015-01-01

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

  20. Effects of Cardiopulmonary Bypass on Mediastinal Drainage and the Use of Blood Products in the Intensive Care Unit in 60- to 80-Year-Old Patients Who Have Undergone Coronary Artery Bypass Grafting

    PubMed Central

    Aygün, Fatih; Özülkü, Mehmet; Günday, Murat

    2015-01-01

    OBJECTIVE The present study consisted of patients who underwent on-pump coronary artery bypass grafting (CABG) and off-pump CABG and investigated effect of using cardiopulmonary bypass (CPB) on the amount of postoperative drainage and blood products, red blood cell (RBC), free frozen plasma (FFP) given in the intensive care unit in 60-80-year-old patients who underwent CABG. METHODS The present study comprises a total of 174 patients who have undergone coronary artery bypass graft (off-pump or on-pump CABG) surgery in our clinic in between 2012-2015 year. RESULTS It was observed that the amount of drainage in the first 24 postoperative hours was lower in the on-pump CABG group (Group 1) when compared to off-pump group (Group 2) (Group 1 vs. Group 2; 703.5±253.8 ml vs. 719.6±209.4 ml; P =0.716). However, the amount of drainage in the second 24 hours was statistically significantly lower in the off-pump CABG group (Group 1 vs. Group 2; 259.8±170.6 ml vs. 190.1±129.1 ml; P =0.016). With regard to the amount of overall drainage, no statistically significant difference was observed between the two groups. Group 1 needed RBC transfusion higher than Group 2 (Group 1 vs. Group 2; 2.2±1.3 bag vs. 1.2±0.9 bag; P <0.001). CONCLUSION We can say that CPB influences the amount of second 24-hour drainage which indexed body surface area. In addition, CPB decreases hct, hb, thrombocyte count in ICU arrived, after 24 hours in postoperative period. Reduced thrombocyte counting effect can be appeared after 48 hours in the postoperative period of CPB. PMID:26934397

  1. 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

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

    PubMed Central

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

    2016-01-01

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

  3. Fasciolopsiasis in a five year old girl.

    PubMed

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

    2013-04-01

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

  4. An 81 Year Old with Back Pain

    PubMed Central

    Dubb, Sukhpreet S.; Farrant, Joanna M.; Praveen, B.V.; Miles-Dua, Sascha

    2013-01-01

    You see an 81-year-old man in the emergency department. He has been troubled by abdominal and back pain that has been worsening over the last two days. He has smoked 20 cigarettes a day for the last 60 years. On examination his heart rate is 110 beats per minute and his blood pressure is 130/80 mmhg. He is tender over the central abdomen and you feel a pulsatile mass above the umbilicus. You request a CT scan of the abdomen.

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

    SciTech Connect

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

    2011-08-15

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

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

    PubMed

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

    2016-03-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-09-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

    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

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

    PubMed

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

    2013-11-01

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

  13. Generalized lentiginosis in an 11 year old boy.

    PubMed

    Gozali, Maya Valeska; Zhou, Bing-Rong; Luo, Dan

    2015-01-01

    Generalized lentiginosis refers to generalized lentigines without systemic abnormalities, characterized by multiple brown or black macules owing to increased proliferation of melanocytes. There are also lentiginosis syndromes associated with systemic abnormalities such as Peutz-Jeghers syndrome, Leopard syndrome, and Carney complex. Generalized lentiginosis can be diagnosis by patient's history, physical and laboratory examination, and histopathology. We report an 11-year-old boy who presented with multiple dark brown macules, varying in size, but less than 0.5 cm, with no abnormalities of other systemic organs. PMID:26437287

  14. 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

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

    PubMed

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

    2015-11-01

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

  16. Five-year-olds punish antisocial adults.

    PubMed

    Kenward, Ben; Östh, Therese

    2015-09-01

    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. 41:413-420, 2015. © 2014 Wiley Periodicals, Inc. PMID:26918430

  17. 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

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

    PubMed Central

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

    2016-01-01

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

  19. Growth and Your 1- to 2-Year-Old

    MedlinePlus

    ... Allergies Growth and Your 1- to 2-Year-Old KidsHealth > For Parents > Growth and Your 1- to 2-Year-Old Print ... Learning, Play, and Your 1- to 2-Year-Old Your Child's Growth Your Child's Checkup: 1.5 Years (18 Months) ...

  20. A 45-year-old woman with an anticholinergic toxidrome.

    PubMed

    Verheijden, N A F; Koch, B C; Brkic, Z; Alsma, J; Klein Nagelvoort-Schuit, S C E

    2016-03-01

    Intentional or accidental intoxications are common in the emergency department, but are not always sufficiently recognised. When intoxication is suspected, the causative agent or combination of agents often remain unclear, making these patients a diagnostic challenge. We present here a 45-year-old woman who was admitted due to altered consciousness. The clinical presentation fitted the anticholinergic toxidrome and an intoxication with venlafaxine (her known prescribed medication) was suspected. Plasma venlafaxine concentrations, however, were very low. After 24 hours the patient recovered completely. Further testing after discharge revealed high concentrations of promethazine, confirming the suspected diagnosis. This case illustrates the importance of knowledge of toxidromes and good collaboration with the hospital pharmacist. Because of the thorough testing the patient could receive proper treatment. PMID:27020994

  1. An 85-year-old woman with Miller Fisher syndrome

    PubMed Central

    Wang, Shu-hui; Zhang, Yong-bo; Xie, Yan-chen; Wang, De-xin; Li, Ji-mei

    2013-01-01

    Miller Fisher’s syndrome (MFS) commonly presents in the fourth and fifth decades and are rare in people over 70 years. An 85-year-old female with no significant medical history presented with upper extremity anesthesia, ptosis, and unsteady gait. The patient had a history of hypertension and diabetes mellitus. Physical examination showed bilateral total external ophthalmoplegia, areflexia, and cerebellar ataxia. Radiological and laboratory studies were unremarkable. Lumbar puncture showed albuminocytological dissociation. The combined history, physical examination, and lumbar puncture results established a presumptive diagnosis of MFS. Intravenous immunoglobulin was given for 5 days. The patient gradually improved 10 days after the onset of symptoms. Ophthalmoplegia had fully recovered after 6 months. To the best of our knowledge, this case represented the oldest patient with MFS. PMID:24353740

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

    PubMed Central

    Sayar, Ilyas; Peker, Kemal; Kapısız, Alparslan; Bostancı, Isıl Esen; Gürbüzel, Mehmet; Isik, Arda; Peker, Necla Aydın

    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

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

    PubMed Central

    Belsha, Dalia; Thomson, Mike

    2015-01-01

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

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

    PubMed

    Wöllner, Kirsten; Doberentz, Elke; Madea, Burkhard

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  6. 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

  7. Endometrial Adenocarcinoma in a 27-Year-Old Woman

    PubMed Central

    Fadhlaoui, Anis; Ben Hassouna, Jamel; Khrouf, Mohamed; Zhioua, Fethi; Chaker, Anis

    2010-01-01

    Background Endometrial adenocarcinoma usually occurs after menopause, but in 2%14% of cases, it occurs in young patients (less than 40 years of age) who are eager to preserve their fertility. Its treatment includes hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy, and, in some cases, radiation therapy. Aim To describe a case of endometrial adenocarcinoma occurring in a young woman and to undertake a literature review of risk factors and therapeutic options proposed for young women wishing to preserve their fertility. Case We report a case of endometrial cancer in a 27-year-old woman treated for resistant menorrhagia and cared for in our department as well as in the Salah Azaiez Institute. Conclusion Endometrial adenocarcinoma rarely occurs in young women. In such cases, other therapeutic options can be proposed: progesterone therapy and LH-RH (Luteinzing-Hormone-Releasing-Hormone) agonists therapy in order to preserve fertility in younger patients. PMID:21769252

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

    PubMed

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

    2014-01-01

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

  9. A 62-year-old man with dyspnea

    PubMed Central

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

    2016-01-01

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

  10. A 62-year-old man with dyspnea.

    PubMed

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

    2016-01-01

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

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

    PubMed

    Feng, William; Coady, Michael

    2016-06-01

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

  12. Systemic lupus erythematosus in 50 year olds.

    PubMed Central

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

    1992-01-01

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

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

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

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

  15. A 3-year-old girl with thin hair.

    PubMed

    Becker, Lauren; Chamlin, Sarah L

    2013-01-01

    CME EDUCATIONAL OBJECTIVES: 1.Identify the clinical features of loose anagen syndrome.2.Distinguish between loose anagen syndrome and other types of alopecia in a young child.3.Understand the natural history of loose anagen syndrome. A healthy 3-year-old white girl presented to the pediatric dermatology clinic for evaluation of thin hair. She was born with little hair and slowly grew thin blond hair. Her hair has always remained short, and she has only had one haircut. The patient's mother never noted any scalp abnormalities such as scale or dermatitis. The child does not seem to play with her hair. Her mother notes times when clumps of hair pull out without discomfort. A laboratory work-up prior to presentation revealed normal thyroid studies and an incidental iron deficiency anemia for which she was on oral iron replacement. There was no family history of alopecia, thin hair, or autoimmune disorders. PMID:23316829

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

    PubMed

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

    2008-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

    Terlikowska-Brzsko, Agnieszka; Paluchowska, Elwira; Owczarek, Witold; Majewski, Sebastian

    2013-10-01

    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

  20. Context and Linguistic Politeness in 7- and 9-Year-Old Italian Children.

    ERIC Educational Resources Information Center

    Axia, Giovanna; Argenti, Emanuela

    The development of linguistic politeness in 7- and 9-year-old Italian children was examined. A total of 80 subjects, 40 males and 40 females, produced requests according to different contexts which were graphically presented. Factors considered for such contexts were: sex of the speaker; sex of the addressee; status of the addressee, either peer

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

    PubMed Central

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

    2014-01-01

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

  2. [Epstein-Barr virus cerebellitis in an 11-year-old girl].

    PubMed

    Cotton, J B; Capdeville, R; Abeille, A; Grenier, J L; Nicolas, A

    1986-12-01

    The authors report an eleven year old girl who manifested predominantly an acute cerebellar syndrome secondary to infection by Epstein Barr Virus. This complication is unusual and males are predominantly affected. The diagnostic and common physiopathological hypothesis are discussed. PMID:3033597

  3. Risk Factors for Speech Delay of Unknown Origin in Three-Year-Old Children.

    ERIC Educational Resources Information Center

    Campbell, Thomas F.; Dollaghan, Christine A.; Rockette, Howard E.; Paradise, Jack L.; Feldman, Heidi M.; Shriberg, Lawrence D.; Sabo, Diane L.; Kurs-Lasky, Marcia

    2003-01-01

    Compared 100 three-year-olds with speech delay of unknown origin and 539 same-age peers with respect to 6 speech disorder variables; also examined abnormal hearing in a subset of 279 children. Found significant odds ratios only for low maternal education, male sex, and positive family history; a child with all 3 factors was 7.71 times as likely to

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

    ERIC Educational Resources Information Center

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

    2001-01-01

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

  5. ST segment depression in asymptomatic male patient with normal coronary arteries.

    PubMed

    Mitu, O; Mitu, F; Leon, Maria Magdalena; Roca, M; Graur, Mariana

    2015-01-01

    ST segment depression and T waves inversion are electrocardiographic (ECG) repolarization abnormalities often encountered in clinical medical practice that have been proved to predict future cardiovascular events. We present the case of a 62-year-old male patient, asymptomatic, with ST segment depression and inverted T waves discovered incidentally on resting ECG. Echocardiographic and laboratory examinations ruled out multiple causes of ECG abnormalities. Suspecting a silent myocardial ischemia, an ECG exercise stress test was performed; it revealed pseudo normalization of T waves during exercise and early recovery phase. Being inconclusive, a coronary CT was the final election test; it showed normal coronary arteries with no stenosis, the patient being scheduled for regular follow-up. The possible causes of ST segment depression are reviewed since it is important that early cardiovascular signs especially in asymptomatic patients to be prevented and detected. PMID:25970951

  6. [Oral hygiene customs in 6-12 year old schoolchildren].

    PubMed

    Hernndez-Martnez, Csar Tadeo; Medina-Sols, Carlo Eduardo; Robles-Bermeo, Norma Leticia; Mendoza-Rodrguez, Martha; Veras-Hernndez, Miriam; De la Rosa-Santillana, Rubn; Escoffi-Ramrez, Mauricio; Mrquez-Rodrguez, Sonia

    2014-01-01

    OBJECTIVE. To characterize utilization of oral hygiene devices and customs in schoolchildren. MATERIAL AND METHODS. We performed a cross-sectional study in 1,404 schoolchildren (6- 12 year olds) from 14 public schools in Pachuca, Hidalgo, Mxico, using a questionnaire for sociodemographic variables and 1) Tooth brushing frequency (<1/d vs. at least 1/d), 2) Use of toothpaste (not always vs. always), 3) Flossing (never, does not know vs. at least 1/week), 4) Use of mouthwash (never, does not know vs. at least 1/week). Analyses were performed with nonparametric tests. RESULTS. Mean age was 8.97 1.99 years; 50.1% were male. Prevalence of utilization of oral hygiene devices and associated customs were 85.5% tooth brushing, 90.9% toothpaste, 19.4% flossing, and 28.2% mouthwash. Only 11.8% of participants reported utilization in all 4 categories. We observed differences (p < 0.05) across sexes only in the use of toothpaste, as women used it more often. Differences across age were observed (p < 0.05) for tooth brushing (younger children brushed more often) and flossing (older children flossed more often). CONCLUSIONS. Tooth brushing was the oral hygiene practice more often performed in this sample, with other frequencies being relatively low. There were differences by age and sex across some variables. PMID:24960326

  7. 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

  8. 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…

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

    PubMed

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

    2015-01-01

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

  10. 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

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

    PubMed

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

    2007-03-01

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

  12. Clavicle nonunion in a 10-year-old boy.

    PubMed

    Pourtaheri, Neema; Strongwater, Allan M

    2012-03-01

    Posttraumatic clavicle nonunion is rare, particularly in children. Four cases of clavicle fracture nonunion in patients aged 10 years and younger have been reported. A variety of techniques have been used to treat pediatric clavicle nonunions. A 10-year-old boy presented to our institution after a fall, sustaining a right closed midshaft clavicle fracture. No other injuries occurred, and neurovascular examination of the right upper extremity was normal. The fracture was initially treated with a sling for >4 months, and the fracture progressed to a hypertrophic nonunion. Serial radiographs failed to demonstrate progression to union. The patient continued to have pain with activity 4 months after his injury. Clavicle pseudarthrosis was considered; however, radiographs did not have the characteristic appearance of this condition. This fracture nonunion was treated with internal fixation and united with no complication. The patient was back to full activities of daily living 6 months postoperatively. He reported no tenderness at the fracture site or along the hardware. The treating surgeon (A.M.S.) prefers to remove hardware in young children, but the family declined removal. Pediatric posttraumatic nonunion of the clavicle is rare but can be safely treated with plate fixation, with excellent results. PMID:22385461

  13. Intracystic Papillary Carcinoma of the Breast in a Male Patient

    PubMed Central

    Hu, Zishuo Ian; Liu, Chengbao; Fisher, Paul R.; Cohen, Jules A.

    2016-01-01

    We report a case of intracystic papillary carcinoma of the right breast in a 59-year old man presenting with bloody nipple discharge for 1 week prior to presentation. Mammography, ultrasonography, and core needle aspiration were consistent with intracystic papillary carcinoma. The patient underwent right simple mastectomy. Pathology was also consistent with low grade intracystic papillary carcinoma. The 21-gene assay revealed a recurrence score of 0, corresponding to a 3% risk of distant recurrence at 10 years. A patient did not receive chemotherapy or post-mastectomy radiotherapy. The patient was placed on tamoxifen and has been free of disease to date. PMID:27134706

  14. Unusual presentation of dermatofibrosarcoma protuberans in a male patient's breast: a case report and review of the literature.

    PubMed

    Al Tarakji, Mohannad; Toro, Adriana; Di Carlo, Isidoro; Junejo, Kulsoon

    2015-01-01

    We herein present a case report and literature review of dermatofibrosarcoma protuberans in the breast of a male patient. A 27-year-old man presented with a painless lump in his right breast with areas of bluish skin discoloration. The diagnostic work-up comprised clinical examination, ultrasonography, core biopsy, mammography, and magnetic resonance imaging. After surgical excision, the preoperative diagnosis of dermatofibrosarcoma protuberans was proven by pathological examination and immunohistochemistry. The patient was still free of recurrence 1 year after surgical excision. This extremely rare case is, to the best of our knowledge, the fifth such case reported in the literature. PMID:25896773

  15. [Case of successful prevention of multiple organ dysfunctions in 74 years old patient with sepsis after Crawford surgery complicated with pleural empyema, chest wall tissues infection and osteomyelitis of ribs].

    PubMed

    Babaev, M A; Eremenko, A A; Charchian, É R; Kononets, P V; Bazarov, D V; Ziuliaeva, T P; Oreshkina, T D; Bogopol'skaia, O M; Kim, S Iu; Titova, I V; Fedorov, D S

    2014-01-01

    The article deals with a clinical case demonstrating that patient's elderly age is not an absolute contraindication for complex surgery in spite of high risk of postoperative complications. Early diagnostics, target treatment of the infection cite with vacuum-assisted therapy for wounds and the treatment of infectious complications based on individual characteristics of elderly patient with sepsis as an outcome of prosthetic thoracoabdominal aortic repair allowed avoiding multiple organ dysfunctions in the patient. PMID:24749312

  16. Management of a 3-year-old child with ambiguous genitalia.

    PubMed

    Kumar, Amarendra; Narain, Chandra Mohan; Kumar, Rajnish

    2015-01-01

    True hermaphrodites have characteristics tissue both sex in the form of presence of vagina uterus, fallopian tubes and ovaries as in female and presence of testis seminiferous tubules but penis as in penoscrotal hypospadias and bifid scrotal sac confuses as well developed labia majora. Determination of sex as per parents view in our social set up. The case was provisionally diagnosed as intersex. Total abdominal hysterectomy, bilateral salphingo-oophorectomy and colpectomy were conducted. A 3-year-old child referred by a pediatrician to Nalanda Medical College, child surgical department for investigation and management of his ambiguous genitalia having following features like, urine was not passing from the tip of penis; penis along with apparently looking female genitalia was taken under treatment. Examination under general anesthesia showed a presence of both male/female internal genitalia and gonads with features of external genitalia of both sexes. After total abdominal hysterectomy and human chorionic gonadotrophin treatment growth of phallus and testicle was noted. The child was made male after extirpation of female genitals. This case illustrates that gender correction can be made as per patients consent in adult but at this stage social customs and parents consent dictated the treatment. PMID:26692684

  17. Oral squamous cell carcinoma in a 10 year old boy.

    PubMed

    Khan, M H; Naushad, Q N

    2011-01-01

    Squamous cell carcinoma of the oral cavity a type of Oral Cancer in young patients is a very rare occurrence particularly during the first decade of life. Oral cancer is predominantly an aggressive neoplasm of middle-aged people where 96% of the patients are more than 40 years of age and it occurs mainly due to the excessive consumption of tobacco and alcohol. In South-East Asia it has a higher rate of occurrence than the rest of the world, partly due to increased consumption of chewing tobacco and various harmful spices, areca nuts and betel quids. These rare varieties of aggressive neoplasm commonly affect tongue and lip. This report describes a case of squamous cell carcinoma in a 10 year old boy who had an exophytic type of granulomatous lesion with some indurated borders which diffusely involved the left side of the hard palate, alveolar mucosa, left maxillary antrum and aggressively emerged within the left orbit by engulfing the left inferior rectus muscle. The purpose of this case report is to provide information that younger group can suffer from oral squamous cell carcinoma though it is very rare and this younger group would appear to have a biologically more aggressive tumor and they require more complex treatment. The role of more aggressive initial therapy must be considered. PMID:21240180

  18. 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.

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

    PubMed Central

    Williams, Shawn P.; Beckerman, Bernard; Piña 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

  20. A case of accessory mammary cancer in a male patient and a literature review.

    PubMed

    Gao, Y G; Zhang, S H; Wang, Y

    2014-01-01

    A 68-year-old Chinese male patient was referred to the present hospital because of a right axillary lump in May 2011. Physical examination showed a rigid movable mass measuring 35 mm in diameter in the right axilla. No mass was palpable in either breast. Mammograms were normal. Physical and imaging examination of the head and neck region, lung, and upper and lower gastrointestinal tract also revealed no evidence of a primary tumor. Ultrasonography and resonance imaging (MRI) revealed no evidence of tumors in the bilateral mammary glands. Fine needle histological biopsy for suspected malignancy was performed, and the patient underwent tumor resection with axillary lymph node dissection on Jun 2011. Moderately differentiated adenocarcinoma in ectopic breast tissue was diagnosed based on the pathologic result, the tumor was immunohistochemically positive for ER, PR, and HER-2. PMID:25118491

  1. Medical Care and Your 6- to 12-Year-Old

    MedlinePlus

    ... sleep disorders, bedwetting, strep throat , and colds . Some preteens also may be injured playing sports or other ... Parents MORE ON THIS TOPIC Connecting With Your Preteen Fitness and Your 6- to 12-Year-Old ...

  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. Draft Genome Sequence of Corynebacterium striatum 1961 BR-RJ/09, a Multidrug-Susceptible Strain Isolated from the Urine of a Hospitalized 37-Year-Old Female Patient.

    PubMed

    Mattos-Guaraldi, Ana L; Guimarães, Luis C; Santos, Carolina S; Veras, Adonney A O; Carneiro, Adriana R; Soares, Siomar C; Ramos, Juliana N; Souza, Cassius; Vieira, Veronica V; Hirata, Raphael; Azevedo, Vasco; Pacheco, Luis G C; Silva, Artur; Ramos, Rommel T J

    2015-01-01

    Corynebacterium striatum commonly colonizes the normal skin and nasopharyngeal tract of humans; however, this potentially pathogenic bacterium has been identified as the causative agent of several nosocomial infections. The current study describes the draft genome of strain 1961 BR-RJ/09, isolated from the urine of a hospitalized patient from Brazil. PMID:26251495

  4. Draft Genome Sequence of Corynebacterium striatum 1961 BR-RJ/09, a Multidrug-Susceptible Strain Isolated from the Urine of a Hospitalized 37-Year-Old Female Patient

    PubMed Central

    Guimarães, Luis C.; Santos, Carolina S.; Veras, Adonney A. O.; Carneiro, Adriana R.; Soares, Siomar C.; Ramos, Juliana N.; Souza, Cassius; Vieira, Veronica V.; Hirata, Raphael; Azevedo, Vasco; Pacheco, Luis G. C.; Silva, Artur

    2015-01-01

    Corynebacterium striatum commonly colonizes the normal skin and nasopharyngeal tract of humans; however, this potentially pathogenic bacterium has been identified as the causative agent of several nosocomial infections. The current study describes the draft genome of strain 1961 BR-RJ/09, isolated from the urine of a hospitalized patient from Brazil. PMID:26251495

  5. Four Years Old, One Eye, Pars Planitis and Cataract: Surgical Challenges Give Challenging Surprises

    PubMed Central

    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

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

    PubMed Central

    2014-01-01

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

  7. Vanishing bile duct syndrome associated with azithromycin in a 62-year-old man.

    TOXLINE Toxicology Bibliographic Information

    Juricic D; Danica J; Hrstic I; Irena H; Radic D; Davor R; Skegro M; Mate S; Coric M; Marijana C; Vucelic B; Boris V; Francetic I; Igor F

    2010-01-01

    Vanishing bile duct syndrome is a severe cholestatic disease associated with toxic effects of medications. Stevens-Johnson syndrome is a hypersensitivity disorder that may also be caused by medications. We present a case of a 62-year-old male patient who developed vanishing bile duct syndrome a month after Stevens-Johnson syndrome. These adverse drug reactions were associated with the use of azithromycin (500 mg daily for 3 days). The patient was initially treated for Stevens-Johnson syndrome with steroids, antihistamines and proton pump inhibitors and fully recovered. However, a month after the beginning of Stevens-Johnson syndrome, he developed vanishing bile duct syndrome and was treated with steroids, ursodeoxycholic acid, antihistamines and tacrolimus. Unfortunately, the treatment was unsuccessful and he was listed for liver transplantation which was performed 7 months after the beginning of jaundice. This is the first case of vanishing bile duct syndrome associated with the use of azithromycin and one of few that reports vanishing bile duct syndrome and Stevens-Johnson syndrome co-occurrence.

  8. Vanishing bile duct syndrome associated with azithromycin in a 62-year-old man.

    PubMed

    Juricic, Danica; Danica, Juricic; Hrstic, Irena; Irena, Hrstic; Radic, Davor; Davor, Radic; Skegro, Mate; Mate, Skegro; Coric, Marijana; Marijana, Coric; Vucelic, Boris; Boris, Vucelic; Francetic, Igor; Igor, Francetic

    2010-01-01

    Vanishing bile duct syndrome is a severe cholestatic disease associated with toxic effects of medications. Stevens-Johnson syndrome is a hypersensitivity disorder that may also be caused by medications. We present a case of a 62-year-old male patient who developed vanishing bile duct syndrome a month after Stevens-Johnson syndrome. These adverse drug reactions were associated with the use of azithromycin (500 mg daily for 3 days). The patient was initially treated for Stevens-Johnson syndrome with steroids, antihistamines and proton pump inhibitors and fully recovered. However, a month after the beginning of Stevens-Johnson syndrome, he developed vanishing bile duct syndrome and was treated with steroids, ursodeoxycholic acid, antihistamines and tacrolimus. Unfortunately, the treatment was unsuccessful and he was listed for liver transplantation which was performed 7 months after the beginning of jaundice. This is the first case of vanishing bile duct syndrome associated with the use of azithromycin and one of few that reports vanishing bile duct syndrome and Stevens-Johnson syndrome co-occurrence. PMID:19906050

  9. Epithelial Dysplasia in Ameloblastic Fibrosarcoma Arising from Recurrent Ameloblastic Fibroma in a 26-Year-Old Iranian Man

    PubMed Central

    Mohsenifar, Zhaleh; Behrad, Samira; Abbas, Fatemeh Mashhadi

    2015-01-01

    Patient: Male, 26 Final Diagnosis: Ameloblastic fibrosarcoma Symptoms: Swelling Medication: — Clinical Procedure: Hemimandibulectomy Specialty: Dentistry Objective: Rare disease Background: Ameloblastic fibrosarcoma (AFS) is a rare malignant odontogenic tumor with a mesenchymal component, showing sarcomatous features and epithelial nests resembling ameloblastic fibroma (AF). Case Report: We report a case of AFS showing epithelial dysplasia arising in a recurrent AF in the left mandible after 3 years in a 26-year-old man, which is regarded as an uncommon histopathologic finding in AFS. We also emphasize the comprehensive clinical, radiographic, and histopathologic evaluation, and immunohistochemical staining of this patient. Conclusions: We conclude that it is important to consider malignancy alternations in the epithelial component of AFS, along with that of the mesenchymal component, to provide a proper diagnosis and treatment of recurrent AF. PMID:26289384

  10. Postobstructive Pulmonary Edema following Tonsillectomy/Adenoidectomy in a 2-Year-Old with Poland-Moebius Syndrome

    PubMed Central

    Powell, Tanisha; Sharma, Nirupma; McKie, Kathleen T.

    2016-01-01

    A 2-year-old male with Poland-Moebius syndrome was transferred from a local hospital to the Pediatric ICU at Children's Hospital of Georgia for suspected postobstructive pulmonary edema (POPE) after tonsillectomy/adenoidectomy (T&A). The patient's respiratory status ultimately declined and he developed respiratory failure. Imaging suggested pulmonary edema as well as a left-sided pneumonia. Echocardiogram showed pulmonary hypertension and airway exam via direct fiberoptic bronchoscopy revealed tracheomalacia and bronchomalacia. He developed acute respiratory distress syndrome (ARDS) and remained intubated for ten days. This case highlights the association between congenital upper body abnormalities with cranial nerve dysfunction and the development of POPE with delayed resolution of symptoms. Patients with upper body abnormalities as above are at great risk of postoperative complications and should therefore be managed in a tertiary-care facility. PMID:26942029

  11. Endometrial Adenocarcinoma in A 31-Year Old Woman: A Case Report

    PubMed Central

    Ahmadi, Firoozeh; Akhbari, Farnaz; Rashidi, Zohreh; Hemmat, Mandana

    2015-01-01

    Endometrial adenocarcinoma (EC) usually occurs after menopause, whereas in 2-14% of cases, it occurs in young patients (less than 40 years old) who may desire to keep their fertility. It is of importance to evaluate women for EC when they develop polycystic ovarian syndrome and abnormal uterine bleeding. Its treatment includes hysterectomy, bilateral salpingo-oo- phorectomy and pelvic lymphadenectomy and in some cases, radiation therapy. We report a case of EC in a 31-year-old woman who presented to Royan Institute. She complained about oligomenorrhea with a 10-year history of primary infertility. PMID:26246886

  12. The first report of fetal alcohol effect in a 12 year-old child in Korea.

    PubMed

    Bhang, Soo Young; Ahn, Dong Hyun; Lee, Young Jin; An, Ho Young; Ahn, Joon Ho

    2009-03-01

    We present the first report of fetal alcohol effect in a 12 year-old child in Korea. The mother had consumed 162 g of alcohol per week continuously during pregnancy. His first febrile seizure occurred before he was 1 year old, and became more frequent 2 years later. He started showing signs of right paraplegia when he was 3.5 years old and brain MRI revealed periventricular leucomalacia near the left ventricle. He was microcephalic and his growth was retarded. He was irritable, impatient, impulsive, and inattentive, and showed disinterest in school activities and aggressive and dangerous behavior. After the diagnosis of attention deficit/hyperactivity disorder was made, psychopharmacological treatment and family support was initiated. After 10 months, he still had intermittent ideas of reference, although the aggressive behavior, inattentiveness, and impulsivity had improved. Using this case study, we stress the importance of maternal alcohol history in patients with these characteristics. PMID:20046374

  13. Efficacy of topical azathioprine and betamethasone versus betamethasone-only emollient cream in 2-18 years old patients with moderate-to-severe atopic dermatitis: A randomized controlled trial

    PubMed Central

    Iraji, Fariba; Farhadi, Sadaf; Faghihi, Gita; Mokhtari, Fatemeh; Basiri, Akram; Jafari-Koshki, Tohid; Nilforoushzadeh, Mohammad Ali

    2015-01-01

    Background: Atopic dermatitis is a chronic skin disease with increasing prevalence worldwide and a considerable burden especially among children. To circumvent the problems related to oral azathioprine (AZT) we aimed to evaluate its topical variant and assess its efficacy in patients aged 2–18. Materials and Methods: In a single-blind trial, we randomized the patients into two groups, one treated with topical emollient containing AZT and betamethasone (BM), and the other treated solely with topical emollient of BM. The treatments were administered twice a day for 8 weeks in both groups. The efficacy, recurrence, and the presence of side effects were evaluated using SPSS 20. Results: The amount of reduction in severity scoring for atopic dermatitis (SCORAD) score was significantly greater in the group treated with the topical AZT (P = 0.024). Incidentally, there were no difference between two treatments in difference in proportions of recurrence and adverse effects as well as SCORAD reduction in subgroups of sex and age (all P > 0.05). Conclusions: Our results showed the superiority of topical AZT over BM with a low recurrence and adverse effects. No expectation of severe side effects, like those of oral AZT, is the major advantage of topical AZT. The sample size was an issue in uncovering the value of AZT in the subgroups. Conducting prolonged studies of quality-of-life and comparing the topical AZT potency relative to the common alternatives are recommended areas of future work. PMID:26623403

  14. Iatrogenic Hemobilia in 10-Year-Old Boy

    PubMed Central

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

    2014-01-01

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

  15. Lymphangioleiomyomatosis in a Male.

    PubMed

    Wakida, Kazuhiro; Watanabe, Yui; Kumasaka, Toshio; Seyama, Kuniaki; Mitani, Keiko; Hiraki, Tsubasa; Kamimura, Go; Nagata, Toshiyuki; Nakamura, Yoshihiro; Sato, Masami

    2015-09-01

    We report a 17-year-old male with a histopathologic diagnosis of lymphangioleiomyomatosis after surgery for a pneumothorax. In general, lymphangioleiomyomatosis has been considered a female-specific disease. However, there are a few lymphangioleiomyomatosis cases reported in males, and our patient is the youngest case reported. Spontaneous pneumothorax occurs most commonly in males in their late teens and early twenties. Histopathologic diagnosis cannot always be performed in young males with pneumothorax. However, simple diagnosis should be avoided, and lymphangioleiomyomatosis should be considered as an underlying disease. This remarkable case provides new and valuable clinical insights into young male pneumothorax. PMID:26354644

  16. [Acute kidney failure and renal replacement therapy after colonoscopy in a 63-year-old woman].

    PubMed

    Bös, D

    2015-11-01

    A 63-year-old woman presented with intestinal disorder, alternating between obstipation and diarrhoea. Sodium phosphate/diphosphate (Fleet®) was used in preparation for colonoscopy. Within 24 h the patient developed severe hyperphosphatemia and oliguric acute kidney failure with the need of renal replacement therapy. This case illustrates the rare event of phosphate nephropathy after colonoscopy. PMID:26482077

  17. Tetralogy of Fallot with Dextrocardia and Situs Inversus in a 7-Year-Old Boy

    PubMed Central

    DiLorenzo, Michael; Weinstein, Samuel; Shenoy, Rajesh

    2013-01-01

    Tetralogy of Fallot is one of the most frequently diagnosed congenital cardiac abnormalities; however, its association with dextrocardia and situs inversus is reported only rarely. We report a case of these findings in a 7-year-old boy, describe the patient's postoperative course, and review the medical literature relevant to these combined conditions. PMID:24082385

  18. Fifty-six-year-old man with anaphylaxis: A novel delayed food hypersensitivity reaction.

    PubMed

    Wagner, Kendall D; Bell, Matthew C; Pesek, Robert D; Kennedy, Joshua L

    2015-11-01

    Anaphylaxis and urticaria are commonly seen in both primary care and allergy clinics. Foods, drugs, and insects are frequent culprits for immediate reactions; however, the trigger for recurring and/or chronic episodes is often unclear. We present a 56-year-old male with recurrent symptoms of urticaria, angioedema, and anaphylaxis found to be triggered by sensitization to galactose-alpha 1, 3-galactose (alpha-gal), a novel food allergen. PMID:26625604

  19. Primary biliary cirrhosis associated with Graves' disease in a male patient.

    PubMed

    Suzuki, Yuji; Ishida, Kazuyuki; Takahashi, Hiroshi; Koeda, Norihiko; Kakisaka, Keisuke; Miyamoto, Yasuhiro; Suzuki, Akiko; Takikawa, Yasuhiro

    2016-04-01

    Primary biliary cirrhosis (PBC), which predominantly affects women, has been associated with various autoimmune diseases. Although hypothyroidism accompanying PBC is well documented, the concomitance of PBC and hyperthyroidism is rare. Herein, we report the case of a 62-year-old man who was diagnosed with PBC several years after the development of Graves' disease. This is the first case of a male patient developing PBC with Graves' disease. Both serum alanine aminotransferase levels and serum thyroid hormone levels were normalized after the administration of thiamazole for Graves' disease. However, the cholestatic liver enzyme abnormalities continued, indicating that the PBC was actualized by the administration of thiamazole. After starting ursodeoxycholic acid treatment, cholestatic liver enzyme abnormalities improved. Taken together, when a cholestatic pattern of liver enzymes is observed during follow-up for Graves' disease, an association between Graves' disease and PBC should be considered as a differential diagnosis. PMID:26935935

  20. [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

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

    PubMed Central

    Emary, Peter

    2012-01-01

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

  2. A 15-year-old boy with snoring and molar tooth sign.

    PubMed

    El-Kersh, Karim; Senthilvel, Egambaram

    2015-04-01

    A 15-year-old boy presented for evaluation of snoring and sleep-disordered breathing. The parents noted that the patient snored every night and that he had episodes when he stopped breathing, ending with gasping for air. He had no history of sleep walking, night terrors, tongue biting, or seizures. The patient had two healthy siblings, but he had a history of intellectual disability and developmental delay. The patient had a history of adenotonsillectomy. PMID:25846539

  3. Thigh Pain in a Ten-Year-Old Boy

    PubMed Central

    Annen, A. Albert

    1983-01-01

    The ability to obtain a good history is still an essential skill, but various unforeseen obstacles can mislead the physician. In the case described, a ten-year-old boy was unable to give an accurate history without his parents present. Then, his parents seemed relatively unconcerned about some fairly dramatic symptoms. Finally, even after the full history was obtained, there was a further two-month delay in making the correct diagnosis because it was so unlikely in a ten-year-old. PMID:21283304

  4. Measurement of Temperament in One to Three Year Old Children.

    ERIC Educational Resources Information Center

    Prior, Margot; And Others

    1987-01-01

    This study was designed to (1) gather Australian data on the Toddler Temperament Scale (TTS), (2) assess age differences on temperament in the one- to three-year-old group; (3) assess the psychometric properties of the TTS; and (4) consider some issues of concurrent validity in the measurement of temperament and behavioral adjustment. (Author)

  5. 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)

  6. Two-Year-Olds Will Name Artifacts by Their Functions.

    ERIC Educational Resources Information Center

    Nelson, Deborah G. Kemler; Russell, Rachel; Duke, Nell; Jones, Kate

    2000-01-01

    Three studies examined lexical categorization in 2-year- olds. Findings indicated that even with minimal opportunities to familiarize themselves with novel artifacts, children generalized their names in accordance with the objects' functions, even when they had to discover the functions on their own or when all the test objects had some…

  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. Development of Velar Consonants among Normal Two-Year-Olds.

    ERIC Educational Resources Information Center

    Dyson, Alice T.

    1986-01-01

    The study examined the frequency of occurrence of velar deviations in spontaneous single-word utterances over a six-month period for 40 children (2 to 3-years-old). Results indicated that velars presented difficulty for less than half of the children. Velar difficulty was associated with position in the word and the vowel environment. (Author/DB)

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

    PubMed

    Norwich, Alison

    2011-03-01

    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

  10. The Mathematical Abilities of Dyslexic 10-Year-Olds.

    ERIC Educational Resources Information Center

    Miles, T. R.; Haslum, M. N.; Wheeler, T. J.

    2001-01-01

    Seventy-two items testing various aspects of mathematics were given to 12,131 10-year-old British children. Despite the absence of difference in intelligence level, the mean scores on the mathematics test for children with dyslexia was not only lower than that of normal achievers, but also lower than that of underachievers. (Contains references.)…

  11. 68-Year-Old Man with PR Bleed

    PubMed Central

    Dubb, Sukhpreet S.; Farrant, Joanna M.; Praveen, B.V.; Miles-Dua, Sascha

    2013-01-01

    A 68-year-old man is referred to the colorectal clinic by his GP. He has lost 10 kg in weight over the last two months. He also noticed that his bowel motions have been loose and sometimes contain blood. You review the full blood count and faecal occult blood test the GP requested. What should you do next?

  12. Language Parameters in Written Compositions of Nine Year Old Children.

    ERIC Educational Resources Information Center

    Rubin, Rosalyn; Buium, Nissan

    The purpose of this study was to develop a foundation for reliable and effective measurement of significant parameters in the development of written language skills in school age children. The subjects for the study were 25 nine-year-old children, 12 boys and 13 girls, who were randomly selected from among 1,559 participants. The findings…

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

    PubMed Central

    Schrli, 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 childrens ability to master such tasks. PMID:23626583

  14. [White small finger in a 45 year old teacher].

    PubMed

    Clemens, R K; Husmann, M; Amann-Vesti, B R; Thalhammer, C

    2011-02-01

    We report the case of a 45 year old teacher with a digital ischemia of the small finger of the right hand. Non invasive diagnostics showed a hypothenar hammer syndrome caused by repetitive trauma due to mechanical working, use of a classical espresso machine and playing drums. Diagnostics, etiology and therapeutic options are discussed. PMID:21290375

  15. What the Nine-year-olds Did with Logo.

    ERIC Educational Resources Information Center

    Moore, Mary Jo

    1984-01-01

    Describes the activities of nine-year-old students during a six-week session designed to introduce them to computers and to the LOGO programming languages. Sample programs written by the students are included. Indicates that these students needed very little instruction or even assistance. (JN)

  16. Five-Year-Olds' Fascination for Television: A Comparative Study.

    ERIC Educational Resources Information Center

    Hake, Karin

    2001-01-01

    Compared 5-year-olds' understanding of and fascination with a public service and a commercial television program; also compared parents' and children's perspectives. Found that children were particularly fascinated by sequences containing conflicts and aggression. Sixteen of 20 children chose the commercial channel program. Parents showed insight…

  17. Emerging Understanding of Patterning in 4-Year-Olds

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  18. Early Childhood Program Standards for Three and Four Year Olds.

    ERIC Educational Resources Information Center

    Franklin, Sandra Putnam; Lamana, Annette; Van Thiel, Lisa

    This document presents the Massachusetts Early Childhood Program Standards and Learning Guidelines for Three- and Four-Year-Olds, required for programs receiving funding through Community Partnerships for Children (CPC). The standards were developed in accord with the accreditation process of the National Association for the Education of Young…

  19. [Pincoffs-Bard's syndrome in a 15-year old girl].

    PubMed

    Pakulski, C; Pankowski, J; Swiniarski, A; Król-Pakulska, E

    1996-01-01

    A case of primary stomach carcinoma (or Pincoff's-Bard syndrome) with extensive radiologic shadows on chest X-ray and clinical signs of respiratory failure has been presented. The case concerned a 15-year-old girl being diagnosed in several hospital because of pulmonary lesions. The diagnosis was made on a basis of the autopsy. PMID:9162328

  20. 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

  1. Distance Education Needs for 16 to 19 Year Olds.

    ERIC Educational Resources Information Center

    Guthrie, Hugh; Krzemionka, Zofia

    A study examined the distance education needs of a specific subgroup of the off-campus population: 16- to 19-year-olds. It set out to determine: reasons for this group's choosing to study in the external mode; the nature and extent of required provision of external education; special curriculum, delivery, counseling, and support needs; and…

  2. Triadic Interaction among Newly Acquainted 2-Year-Olds

    ERIC Educational Resources Information Center

    Ishikawa, Fumiko; Hay, Dale F.

    2006-01-01

    Are children as young as 2 years old able to interact in groups of three? The study applied the family triad model first introduced by Parke, Power, and Gottman (1979) to the case of peer interaction. In Experiment 1, the model was refined for use in studies of peer interaction and applied to an existing dataset of 16 triads of newly acquainted…

  3. 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

  4. 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…

  5. 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…

  6. 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…

  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. Grammatical Morpheme Production in 4-Year-Old Children.

    ERIC Educational Resources Information Center

    Balason, Denise V.; Dollaghan, Christine A.

    2002-01-01

    Grammatical morpheme (GM) production was studied in 15-minute spontaneous language samples from 100 4-year-olds. Substantial variability was observed in both the frequency of obligatory contexts and in the percentages of correct usage of GM. For only one morpheme did all 100 participants contain the minimum number of 3 obligatory contexts.…

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  10. Moral and Faith Development in Seventeen-year Old Students.

    ERIC Educational Resources Information Center

    Gorman, Margaret

    Subjects were 50 17 year-old students from a variety of types of schools (parochial, private, public) in two New England areas were interviewed for moral and faith development according to the theories of Kohlberg and Fowler. Socioeconomic level and IQ were highly correlated with faith and moral scores. Experiences of the death of someone close…

  11. Intraductal papilloma of the male breast

    PubMed Central

    de Vries, Fleur E.E.; Walter, Armin W.; Vrouenraets, Bart C.

    2016-01-01

    We report the case of a 29-year-old male patient who presented with a painless lump of his left breast that was found to be an intraductal papilloma. This is an extremely rare, but benign disease in the male breast. We subsequently discuss radiologic tests and treatment options. PMID:26860828

  12. 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 Α 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.

  13. Sclerosing mucoepidermoid carcinoma with eosinophilia of thyroid gland in a male patient: a case report and literature review

    PubMed Central

    Lai, Chi-Yun; Chao, Tzu-Chieh; Lin, Jen-Der; Hsueh, Chuen

    2015-01-01

    Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) was first described by Chan et al in 1991. It is characterized by nest or strands of epidermoid tumor cells with squamous differentiation, rare mucous cells, prominent sclerotic stroma, eosinophilic and lymphoplasmacytic infiltration, and a background of chronic lymphocytic thyroiditis in the non-neoplastic thyroid gland. It is important to recognize SMECE of thyroid and differentiate it from squamous cell carcinoma or other neoplasms with squamous differentiation/metaplasia. In published cases, the SMECE of thyroid gland predominantly occurs in women. We report a case of SMECE of thyroid in a 45-year-old male patient. All cases in male patients were Caucasian described in English literature, and our case is the first one in Asian. PMID:26191325

  14. Sclerosing mucoepidermoid carcinoma with eosinophilia of thyroid gland in a male patient: a case report and literature review.

    PubMed

    Lai, Chi-Yun; Chao, Tzu-Chieh; Lin, Jen-Der; Hsueh, Chuen

    2015-01-01

    Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) was first described by Chan et al in 1991. It is characterized by nest or strands of epidermoid tumor cells with squamous differentiation, rare mucous cells, prominent sclerotic stroma, eosinophilic and lymphoplasmacytic infiltration, and a background of chronic lymphocytic thyroiditis in the non-neoplastic thyroid gland. It is important to recognize SMECE of thyroid and differentiate it from squamous cell carcinoma or other neoplasms with squamous differentiation/metaplasia. In published cases, the SMECE of thyroid gland predominantly occurs in women. We report a case of SMECE of thyroid in a 45-year-old male patient. All cases in male patients were Caucasian described in English literature, and our case is the first one in Asian. PMID:26191325

  15. A Rare Case of a 15-Year-Old Boy with Two Accessory Nipples: One in the Forearm and One in the Milk Line.

    PubMed

    Tauchen, Alexander J; Kueberuwa, Essie; Schiffman, Kenneth; Mudaliar, Kumaran M; Noland, Shelley S

    2015-01-01

    A 15-year-old male presented for evaluation of a volar forearm mass that he noticed four years before. The mass was not painful and his main concern was cosmesis. The mass was two centimeters in diameter with a pinpoint central sinus and scant drainage. After excision, the pathology report noted pilosebaceous units and smooth muscle bundles, consistent with an accessory nipple. In addition, the patient had another accessory nipple in the "milk line" on his torso. While accessory nipples and breast tissue have been reported in numerous locations throughout the body, this is the first reported case of an accessory nipple on the forearm. PMID:26783489

  16. Gender, Popularity and Notions of In/Authenticity amongst 12-Year-Old to 13-Year-Old School Girls

    ERIC Educational Resources Information Center

    Read, Barbara; Francis, Becky; Skelton, Christine

    2011-01-01

    This paper draws on data from a research project investigating gendered identities and interactions of high-achieving students in Year Eight in England (12-13 years old), particularly in relation to students' "popularity" amongst their peers. As part of this study 71 students were interviewed from nine different schools in urban, rural and small…

  17. 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…

  18. 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

  19. Partial Response to First-Line Crizotinib in an Elderly Male Patient with ROS1 Translocation-Positive Lung Cancer

    PubMed Central

    Overbeck, Tobias R.; Schmitz, Katja; Engelke, Christoph; Sahlmann, Carsten-Oliver; Hugo, Sara; Kellner, Laura; Trümper, Lorenz; Schildhaus, Hans-Ulrich

    2016-01-01

    We report on a 90-year-old male patient with a ROS1-translocated adenocarcinoma of the lung who was treated with crizotinib as first-line therapy. After 11 months of treatment, we noticed complete metabolic response as measured by 18F-FDG-PET/CT scan and a partial response according to RECIST criteria. This patient indicates that ROS1 translocations are not restricted to young age, female gender and low stage. Furthermore, this case illustrates exemplarily that crizotinib therapy is effective and manageable even as first-line treatment in elderly patients with comorbidities. Based on our findings, we recommend to include elderly patients with advanced pulmonary adenocarcinomas in molecular screening approaches for ROS1 translocations. PMID:27065847

  20. Giant left anterior descending coronary artery aneurysm in an adult male patient with ST elevation myocardial infarction

    PubMed Central

    Sadeghi, Mohsen Mirmohammad; Jouzdani, Saeid Rezaei

    2016-01-01

    Coronary artery aneurysm is a rare clinical entity encountered incidentally 0.3–5% among patients who undergo coronary angiography. Even giant coronary artery aneurysm is much rarer with an incidence of 0.02% among all atherosclerotic cases. Due to rare occurrence and lack of controlled trials, clinical presentation, prognosis and management of giant coronary artery aneurysm are under controversies in the literature. We report a 43-year-old male patient admitted to our hospital with a typical chest pain associated with ST elevation changes in anterior chest leads and elevated cardiac enzymes. Coronary angiography of the patient revealed a large (1.5 cm × 3 cm) aneurysm of proximal left anterior descending coronary artery. We performed a successful surgical excision and coronary bypass surgery. The patient had an uncomplicated course. PMID:27021297

  1. Meaning from Syntax: Evidence from 2-year-olds

    PubMed Central

    Arunachalam, Sudha; Waxman, Sandra R.

    2009-01-01

    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 introduced to dialogues incorporating novel verbs either in transitive or intransitive sentences, but in the absence of any relevant referent scenes (see Yuan & Fisher, 2009). Next, toddlers viewed two candidate scenes: a) two participants performing synchronous actions, b) two participants performing a causative action. When asked to “find mooping”, toddlers who had heard transitive sentences chose the causative scene; those who had heard intransitive sentences did not. These results demonstrate that 2-year-olds infer important components of meaning from syntactic structure alone, using it to direct their subsequent search for a referent in a visual scene. PMID:19945696

  2. A 41-Year-Old Woman with Migratory Panniculitis

    PubMed Central

    Vanegas, Edgar S.; Cendejas, Rafael Franco; Mondragón, Arturo

    2014-01-01

    A 41-year-old woman had two months of intermittent migratory swellings in the trunk, face, and limbs associated with erythema, pruritus, and pain. Laboratory analysis showed moderate eosinophilia. The triad of eosinophilia, migratory lesions (nodular panniculitis), and raw fish consumption was highly suggestive of cutaneous gnathostomiasis. She was successfully treated with albendazole (400 mg twice a day for 21 days) and showed complete and permanent resolution of the lesions. PMID:24808244

  3. 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,…

  4. 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…

  5. 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,

  6. A five-year-old child with renal hydatidosis.

    PubMed

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

    2013-09-01

    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

  7. 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

  8. Idiopathic Choroidal Neovascularization in a 23-Year-Old Girl.

    PubMed

    Mohammadpour, Mehrdad; Lashay, Alireza; Saeedi Anari, Ghasem; Abdi, Fatemeh; Kermanshahani, Abbas

    2015-07-01

    A 23-year-old girl presented with blurred vision in her left eye since 2 months ago. Her past medical history was unremarkable. On presentation, her left best corrected visual acuity was 20/80. Anterior segment exam was unremarkable. Posterior segment exam showed an ill-defined green gray elevation in the fovea with surrounding subretinal fluid. The right eye exam was normal. Fluorescein Angiography and Optic Coherence Tomography of the left eye was compatible with Choroidal Neovascularization (CNV). PMID:26161712

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

    PubMed Central

    Herman, S. P.

    1983-01-01

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

  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. 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

  12. Concurrent Testicular and Bladder Cancer in a 57-year-old Man.

    PubMed

    Han, Esther; Stein, Daniel M; Shi, Dongping; Miocinovic, Ranko

    2015-09-01

    We present a rare finding of concurrent right testis non-seminomatous mixed germ cell tumor and muscle invasive urothelial carcinoma of the bladder in a 57-year-old homeless man. The socioeconomic factors and the disease presentation caused a treatment dilemma in terms of the appropriate type of neoadjuvant chemotherapy. The patient ultimately underwent upfront surgery with retroperitoneal lymph node dissection and radical cystoprostatectomy followed by adjuvant cisplatin-based chemotherapy. PMID:26793541

  13. 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

  14. 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

  15. Complete paroxysmal atrioventricular block in a 2-year-old girl.

    PubMed

    Holst, Line M; Dixen, Ulrik; Jeppesen, Dorthe L

    2015-10-01

    We present a case of atypical syncope in a 2-year-old, otherwise healthy girl. The patient presented with three episodes of syncope without any precipitating factors and no family history of sudden unexpected death. Holter monitoring revealed 24 events of complete atrioventricular block lasting up to 6 seconds. A normal 12-lead electrocardiogram does not necessarily exclude cardiac disease, and Holter monitoring is warranted in children with atypical syncope. PMID:25428604

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

    SciTech Connect

    1995-05-08

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

  17. A 44-Year-Old Man With Chronic Cough, Weakness, and a Mediastinum Mass.

    PubMed

    Theofilos, Dimitrios; Triantafillidou, Christina; Zetos, Athanasios; Bisirtzoglou, Danai; Konstantinou, Froso; Marketos, Charalampos; Politis, Georgios

    2015-09-01

    A 44-year-old white man presented with a 3-month history of dry cough and weakness. He had already been treated with antibiotics without any relief. He did not report dyspnea, fever, or expectoration. The patient's medical history was significant for mild arterial hypertension and autoimmune thyroiditis with normal thyroid hormone levels. He was a nonsmoker and had been in excellent health until symptom onset. PMID:26324142

  18. Concurrent Testicular and Bladder Cancer in a 57-year-old Man

    PubMed Central

    Han, Esther; Stein, Daniel M.; Shi, Dongping; Miocinovic, Ranko

    2015-01-01

    We present a rare finding of concurrent right testis non-seminomatous mixed germ cell tumor and muscle invasive urothelial carcinoma of the bladder in a 57-year-old homeless man. The socioeconomic factors and the disease presentation caused a treatment dilemma in terms of the appropriate type of neoadjuvant chemotherapy. The patient ultimately underwent upfront surgery with retroperitoneal lymph node dissection and radical cystoprostatectomy followed by adjuvant cisplatin-based chemotherapy. PMID:26793541

  19. A 45-Year-Old Man With Delayed Onset of OSA Events During Polysomnography.

    PubMed

    Barone, Daniel A; Krieger, Ana C

    2016-04-01

    A 45-year-old man with a medical history that included asthma and chronic nasal congestion presented for an evaluation of possible OSA. He reported loud snoring, witnessed apneas in sleep, and daytime sleepiness. The patient's score on the Epworth Sleepiness Scale was 12 of 24, indicating excessive sleepiness. His nasal congestion had been treated with frequent use of an over-the-counter nasal decongestant. PMID:27055717

  20. A 26-Year-Old Retained Demised Abdominal Pregnancy Presenting with Umbilical Fistula

    PubMed Central

    Daniel, Nnadi; Bashir, Bello; Ibrahim, Ango; Swati, Singh

    2014-01-01

    This is a report on a 72-year-old postmenopausal woman who presented with passage of fetal bones through an umbilical fistula. She was diagnosed as a case of demised abdominal pregnancy, which had been retained for 26 years. She subsequently had exploratory laparotomy, evacuation of the abdominal pregnancy, hysterectomy, and bowel resection. The patient's condition remained unstable throughout the postoperative period and she died from septicemia on the eleventh day. PMID:24639908

  1. A 26-year-old retained demised abdominal pregnancy presenting with umbilical fistula.

    PubMed

    Daniel, Nnadi; Bashir, Bello; Ibrahim, Ango; Swati, Singh

    2014-01-01

    This is a report on a 72-year-old postmenopausal woman who presented with passage of fetal bones through an umbilical fistula. She was diagnosed as a case of demised abdominal pregnancy, which had been retained for 26 years. She subsequently had exploratory laparotomy, evacuation of the abdominal pregnancy, hysterectomy, and bowel resection. The patient's condition remained unstable throughout the postoperative period and she died from septicemia on the eleventh day. PMID:24639908

  2. A 74-year-old unoperated univentricular heart: the oldest reported survival.

    PubMed

    Gesuete, Valentina; Fabi, Marianna; Bonvicini, Marco

    2016-04-01

    Univentricular heart is a rare congenital heart malformation. Nowadays prognosis is considered to be strictly linked to surgical intervention, and survival into late adulthood is unusual. In some patients native haemodynamic circulation balances pulmonary and systemic blood flow, allowing long-term survival without the need for surgery. We report the case of a 74-year-old man with a univentricular heart in natural history, and we discuss the factors that might contribute to his extraordinary long-term survival. PMID:26508431

  3. [B symptoms, lymphadenopathy and signs of systemic disease in a 21-year-old female].

    PubMed

    Mühlhausen, J; Müller, G A; Eiffert, H; Wulf, G; Holke, K; Koziolek, M

    2012-07-01

    Sarcoidosis is a multi-systemic disease. A 21-year-old female patient was admitted to our department with lymphadenopathy, B symptoms, erythema nodosum and joint pain. Sarcoidosis showed a very atypical course, lacking any pulmonary symptoms or typical laboratory values. The diagnosis was finally confirmed histologically and thus various differential diagnoses such as microbiological and malignant diseases could be excluded. Oral steroid medication led to remission. PMID:22484921

  4. Clinicopathological conference: A 71-year-old female with neurological deficits, chest pain, and electrocardiographic changes.

    PubMed

    Narang, Aneesh T; Alian, Andrus

    2010-10-01

    The authors present a case of a 71-year-old female who presented to the emergency department with slurred speech, left sided facial droop, and right arm and leg weakness. During her ED stay, she developed left sided chest pain and right arm numbness in the setting of EKG changes. The patient's clinical course is outlined and a discussion of the potential etiologies as well as the clinical management is provided. PMID:21040102

  5. Acute Abdominal Pain Caused by an Infected Mesenteric Cyst in a 24-Year-Old Female

    PubMed Central

    Ponten, Joep B.; Zijta, Frank M.

    2016-01-01

    A mesenteric cyst is a rare cause for abdominal pain. This umbrella term includes cystic entities which reside in the mesentery. We present a case of an infected false mesenteric cyst in a 24-year-old female patient without prior surgery or known trauma. Mainstay of treatment involves surgical resection, although less invasive treatments have been described. Prognosis depends on the origin of the cyst. PMID:27190668

  6. Solitary Atypical Adenomatous Hyperplasia in a 12-Year-Old Girl

    PubMed Central

    Jin, Moran; Lee, Yang-Haeng; Kim, Bomi; Yoon, Young Chul; Wi, Jin Hong

    2016-01-01

    Atypical adenomatous hyperplasia is a premalignant lesion reflecting a focal proliferation of atypical cells. These lesions are usually observed as incidental findings in lungs that have been resected due to other conditions, such as lung cancer. We report the youngest case of atypical adenomatous hyperplasia on record in a 12-year-old girl. In this patient, the lesion was found in association with pneumothorax. PMID:27065090

  7. An 11-year-old girl with syndrome of inappropriate antidiuretic hormone secretion.

    PubMed

    Breningstall, G N

    1999-09-01

    An 11-year-old girl presented with a syndrome of inappropriate antidiuretic hormone secretion, which was transitory and, initially, of obscure origin. Subsequently, the patient's hypothalamic disorder emerged as a component of a steroid-responsive relapsing encephalomyelitis with cerebral pathology restricted to the basal ganglia and brainstem. Where such a disorder fits in the spectrum from acute disseminating encephalomeylitis to multiple sclerosis is discussed. PMID:10522340

  8. [Secondary retroperitoneal fibrosis in a 39-year-old man after rectal cancer].

    PubMed

    Jarosch, A; Tiller, M; Rohrbach, H; Leimbach, T; Schepp, W

    2016-05-01

    A 39-year-old man had been treated for rectal cancer 6 years ago by lower anterior resection of the rectum and perioperative radiochemotherapy. Since then follow-up had been unremarkable but now the patient presented with unspecific lower abdominal pain. The cause of the pain was identified as paraneoplastic retroperitoneal fibrosis secondary to metachronous pulmonary metastases of the rectal cancer. PMID:26895316

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

    PubMed Central

    Karlsen, Trine; Leinan, Ingeborg Megård; Bækkerud, Fredrik Hjulstad; Lundgren, Kari Margrethe; Tari, Atefe; Steinshamn, Sigurd Loe; Støylen, Asbjørn; Rognmo, Øivind

    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

  10. Portion Size Variably Affects Food Intake of 6-year-old and 4-year-old Children in Kunming, China

    PubMed Central

    Smith, Lindsey; Conroy, Katharine; Wen, Hongmei; Rui, Li; Humphries, Debbie

    2015-01-01

    Age and portion size have been found to influence food intake in American children but have not been examined in an international context. This study evaluated the association between age and the effects of portion size on the food intake of kindergarteners in Kunming, China. Using a within-subjects crossover design in a classroom setting, 173 children in two age groups, mean age 4.2 years and 6.1 years, were served a predefined reference, small (-30%) and large (+30%) portion of rice, vegetables, and a protein source during lunchtime over three consecutive days. Each portion was weighed before and after the meal to determine amount of food consumed. Linear mixed modeling, controlling for repeated measures and clustering by classroom, was used to compare food intake under small and large portion size conditions to the reference portion. Children ate significantly less food when served small portions. When served a large portion, 6-year-old children increased food intake while 4-year-old children decreased food intake in comparison to the reference portion. Findings indicate that portion size affects food intake in Chinese children 4- to 6-years old. Older children show larger increases in food intake with increased portion size than do younger children. PMID:23702260

  11. The Relation of Parental Depression and Self Esteem to Behavior Problems in Three-Year-Old Sons of Alcoholics.

    ERIC Educational Resources Information Center

    Schneider, Andrew M.; And Others

    Preliminary results from a longitudinal study designed to systematically examine the family life of children reared in a home with an alcoholic father are reported. Analysis is restricted to 15 families from a larger study in which the target child was a 3-year-old male. Parents completed the Beck Depression Inventory, the Progress Evaluation…

  12. Communicative Gestures of the Hand and Arm when 4-Year-Old Sons and Their Mothers Interact.

    ERIC Educational Resources Information Center

    Elmslie, Tom J.; Brooke, John D.

    1982-01-01

    Investigates a wide range of communicative hand/arm gestures of four-year-old males interacting with their mothers. One trained observer coded videotaped behavior for the incidence of "deictic,""pantomimic," and "semantic-modifying and relational" hand or arm gestures. Results are viewed as demonstrating the link between cognitive development and…

  13. A 32-year-old Man with Normokalemic Thyrotoxic Periodic Paralysis

    PubMed Central

    Valizadeh, Neda; Zarrin, Sahar

    2013-01-01

    Thyrotoxic Periodic Paralysis (TPP) is a rare and life threatening condition commonly occurring in young Asian males. It is characterized by acute paralytic attacks and hypokalemia in association with thyrotoxicosis. Serum potassium levels may be normal in rare cases of TPP. The diagnosis of normokalemic TPP may be overlooked and/or delayed in most cases. Here, we describe a 32-year-old Iranian man with normokalemic TPP misdiagnosed as somatization disorder with the correct diagnosis made one year after the onset of symptoms. PMID:23613659

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

    PubMed

    Denstedt, Emily

    2014-02-01

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

  15. 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

  16. Traumatic amputation of a supernumerary digit: a 16-year-old boy's perspective of suture ligation.

    PubMed

    Hartzell, Tristan L; Taylor, Helena

    2009-01-01

    Traditionally, the duplicated digit in an infant with polydactyly is managed by suture ligation and the digit is allowed to auto-amputate. However, painful neuromas may result from this commonly used technique and sharp excision has been suggested as a superior alternative. We present a case of a 16-year-old male who requested revascularization after a traumatic partial amputation of a supernumerary digit on his left hand. He requested revascularization because suture ligation of a duplicated digit on his right hand as an infant had resulted in a neuroma and considerable pain. PMID:19250423

  17. Colonic Necrosis in a 4-Year-Old with Hyperlipidemic Acute Pancreatitis

    PubMed Central

    Patton, Tiffany J.; Sentongo, Timothy A.; Mak, Grace Z.; Kahn, Stacy A.

    2016-01-01

    Here we report the case of a 4-year-old male with severe acute pancreatitis due to hyperlipidemia, who presented with abdominal pain, metabolic abnormalities, and colonic necrosis. This colonic complication was secondary to the extension of a large peripancreatic fluid collection causing direct serosal autodigestion by pancreatic enzymes. Two weeks following the initial presentation, the peripancreatic fluid collection developed into a mature pancreatic pseudocyst, which was percutaneously drained. To our knowledge, this is the youngest documented pediatric case of colonic necrosis due to severe pancreatitis and the first descriptive pediatric case of a colonic complication due to hyperlipidemia-induced acute pancreatitis. PMID:26925282

  18. NASA Administrator Dan Goldin greets 100-year-old VIP.

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Among the VIPs attending the launch of STS-99 is Captain Ralph Charles (left), standing next to NASA Administrator Dan Goldin. Charles hopes to have his wish fulfilled of watching a Shuttle launch in person. The 100-year-old aviator has experienced nearly a century of flight history, from the Wright Brothers to the Space Program. He took flying lessons from one of the first fliers trained by Orville Wright, first repaired then built airplanes, went barnstorming, operated a charter service in the Caribbean, and worked as a test pilot for the Curtiss Wright Airplane Co. Charles is the oldest licensed pilot in the United States, and is still flying.

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

    PubMed Central

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

    2014-01-01

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

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

    NASA Technical Reports Server (NTRS)

    2000-01-01

    NASA Administrator Dan Goldin (left) watches as 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA, shakes hands with astronaut Dog Wheelock. Behind Jonathan is his mother, Penny. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS-99.

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

    NASA Technical Reports Server (NTRS)

    2000-01-01

    NASA Administrator Dan Goldin (left) listens intently to 10-year- old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. Behind Goldin is astronaut Doug Wheelock; behind Jonathan is his mother, Penny. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS- 99.

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

    NASA Technical Reports Server (NTRS)

    2000-01-01

    NASA Administrator Dan Goldin (left) shares a laugh with VIP 10- year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. Behind Goldin is astronaut Doug Wheelock; behind Jonathan is his mother, Penny. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS- 99.

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

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Ten-year-old Jonathan Pierce (second from right), who is garbed in a protective cooling suit, without the helmet, which was designed by NASA, poses with (left to right) NASA Administrator Dan Goldin, Mrs. Goldin, and astronaut Doug Wheelock. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS- 99.

  4. Linear psoriasis: case report on three year old child*

    PubMed Central

    Figueiras, Daniela de Almeida; Cauas, Renata Cavalcanti; Takano, Daniela Mayumi; Ramos, Ticiana Batista; Marinho, Ayana Karla de Oliveira Ferreira; Bezerra, Milena Sonely Mendonça

    2015-01-01

    Atypical and unusual locations of psoriasis are very frequent. However, localized linear psoriasis is rare, with few cases described in the literature. It is characterized by a linear distribution of psoriasis lesions along Blaschko lines. We report the case of a three years old child, who presented unilateral erythematous scaly plaques arranged along Blaschko lines in the left hemithorax, with no associated symptoms and no lesions in other parts of the body. The differentiation of linear psoriasis from other linear dermatoses is not easy. The combination of a thorough history, a careful examination of the skin and histopathology are essential to ensure the correct diagnosis and appropriate treatment. PMID:26312714

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

    NASA Technical Reports Server (NTRS)

    2000-01-01

    NASA Administrator Dan Goldin (left) shares a light moment during his meeting with 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. Behind Goldin is astronaut Doug Wheelock; behind Jonathan is his mother, Penny. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS-99.

  6. Gastroblastoma in a 12-year-old Chinese boy.

    PubMed

    Ma, Yangyang; Zheng, Jicui; Zhu, Haitao; Dong, Kuiran; Zheng, Shan; Xiao, Xianmin; Chen, Lian

    2014-01-01

    Gastrablastoma is a rare epitheliomesenchymal biphasic tumor of stomach in children and young adults first reported by Miettinen et al in 2009. Five cases have been reported up to date including only one case with the nodal metastasis and distant metastases. With little atypism gastroblastoma is suggested to be a low-grade malignancy. Here we report one case of gastroblastoma in a 12-year-old boy with review of the literature. This is the first case of gastroblastoma in Chinese to our knowledge. PMID:25031764

  7. Stridor in an 11-year-old child.

    PubMed

    Abraham, Deepu; Karuvattil, Rajesh; Fitzpatrick, Maggie

    2013-01-01

    Stridor in older children can be due to diverse aetiology that includes infections, anaphylaxis and rarely systemic conditions leading to hypocalcaemia. We report the case of a previously asymptomatic 11-year-old girl who presented to the casualty with stridor due to hypocalcaemia. The aetiological investigations for hypocalcaemia uncovered previously undetected chronic renal failure, possibly due to a rare autosomal recessive condition called nephronophthisis. We report this case to highlight the importance of widening the diagnostic focus for children presenting with stridor, especially when they fall outside the usual age group for infections like croup, or when the history is atypical. PMID:24326434

  8. 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

  9. PCDH19-related epilepsy in two mosaic male patients.

    PubMed

    Terracciano, Alessandra; Trivisano, Marina; Cusmai, Raffaella; De Palma, Luca; Fusco, Lucia; Compagnucci, Claudia; Bertini, Enrico; Vigevano, Federico; Specchio, Nicola

    2016-03-01

    PCDH19 gene mutations have been recently associated with an epileptic syndrome characterized by focal and generalized seizures. The PCDH19 gene (Xq22.1) has an unusual X-linked inheritance with a selective involvement for female subjects. A cellular interference mechanism has been hypothesized and male patients can manifest epilepsy only in the case of a mosaicism. So far about 100 female patients, and only one symptomatic male have been described. Using targeted next generation sequencing (NGS) approach we found a PCDH19 point mutation in two male patients with a clinical picture suggestive of PCDH19-related epilepsy. The system allowed us to verify that the two c.1352 C>T; p.(Pro451Leu) and c.918C>G; p.(Tyr306*) variants occurred in mosaic status. Mutations were confirmed by Sanger sequencing and quantified by real-time polymerase chain reaction (PCR). Up to now, the traditional molecular screening for PCDH19-related epilepsy has been targeted to all females with early onset epilepsy with or without cognitive impairment. Male patients were generally excluded. We describe for the first time two mosaic PCDH19 point mutations in two male patients with a clinical picture suggestive of PCDH19-related epilepsy. This finding opens new opportunities for the molecular diagnoses in patients with a peculiar type of epilepsy that remains undiagnosed in male patients. PMID:26765483

  10. Primary Cardiac Lymphoma in an Immunocompetent 71-Year-Old Man

    PubMed Central

    Montanaro, Claudia; Loiacono, Ferdinando; De Cobelli, Francesco; Foppoli, Marco; Margonato, Alberto

    2015-01-01

    Isolated cardiac lymphomas are very rare, especially in immunocompetent patients. As a consequence, little is known about the best therapeutic management and about patients' outcomes in these cases. Diffuse large B-cell lymphoma is the most frequent subtype; anthracycline-based chemotherapy has been the most successful treatment. We describe the case of a primary cardiac lymphoma in an immunocompetent 71-year-old man. As of December 2015, the patient had been in clinical remission for 2 years. The most relevant literature on primary cardiac lymphoma is reported and discussed. PMID:26664312

  11. A rare case of gallbladder fistulation with a 60-year-old appendicectomy scar.

    PubMed

    Thiruchandran, Gajendiran; Joyce, Megan; Baggott, Paul James

    2016-01-01

    We present an extremely unusual case of an external biliary fistula in an 87-year-old woman who presented with a 1-day history of spontaneous green discharge from a 60-year-old appendicectomy scar. Examination revealed a sinus in the right iliac fossa overlying her appendicectomy scar, with a raised white cell count and C reactive protein. A CT scan revealed a complex fistula connecting the gallbladder to the subcutaneous tissue in the right flank, which further connected inferiorly with a fistula to the previous appendicectomy scar and a small iliopsoas collection. Endoscopic retrograde cholangiopancreatography revealed several stones in the common bile duct, which were removed using a balloon catheter. The patient was further managed with a long course of antibiotics and discharged with a long-term drainage bag. A literature search revealed no previously reported cases of an external biliary fistula communicating with an appendicectomy scar. PMID:27073150

  12. Airway problems caused by hypogonadism in male patients undergoing neurosurgery.

    PubMed

    Manikandan, Sethuraman; Neema, Praveen Kumar; Rathod, Ramesh Chandra

    2005-12-01

    Unanticipated difficult endotracheal intubations can pose challenges for the anesthesiologist. Risks include airway injury, hypoxemia, and death. There is intubation difficulty in various conditions including Downs syndrome, achondroplasia, acromegaly, and dwarfism. We describe difficulty in intubating the trachea with an appropriate sized endotracheal tube in two young male patients with hypogonadism presenting for neurosurgical procedures under general anesthesia. We discuss the role of hypogonadism and the effects of gonadotropin hormones on pubertal laryngeal growth in male patients. PMID:16301264

  13. Summary of aging effects on 25-year old nylon parachutes

    SciTech Connect

    Tadios, E.L.

    1989-01-01

    The results of structural evaluations on several parachute systems were examined to determine if any trends could be found that would indicate significant aging in the materials. All of the parachutes were more than 20 years old. Five 64 ft diameter parachutes were evaluated along with three 16.5 ft diameter ribbon parachutes and one 4 ft diameter guide surface parachute. Another group included six 48 ft diameter ribbon parachutes, two 4 ft diameter guide surface parachutes, and two 16.5 ft diameter extraction ribbon parachutes. The parachute systems used in the study were all fabricated from nylon materials. Data were obtained for several material properties such as tensile strength, air permeability and melting point. Military specifications were used as zero-time data base due to lack of raw material data. Generally speaking, after 25 years the material properties of the 64 ft parachutes were within specifications. The same generalization cannot be made for the 48 ft parachutes which were about 23 years old. The explanation for their differences may lie in their respective histories. 10 refs., 2 figs., 5 tabs.

  14. Growth Disorders Among 6-Year-Old Iranian Children

    PubMed Central

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

    2014-01-01

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

  15. Category-specific face prototypes are emerging, but not yet mature, in 5-year-old children.

    PubMed

    Short, Lindsey A; Lee, Kang; Fu, Genyue; Mondloch, Catherine J

    2014-10-01

    Adults' expertise in face recognition has been attributed to norm-based coding. Moreover, adults possess separable norms for a variety of face categories (e.g., race, sex, age) that appear to enhance recognition by reducing redundancy in the information shared by faces and ensuring that only relevant dimensions are used to encode faces from a given category. Although 5-year-old children process own-race faces using norm-based coding, little is known about the organization and refinement of their face space. The current study investigated whether 5-year-olds rely on category-specific norms and whether experience facilitates the development of dissociable face prototypes. In Experiment 1, we examined whether Chinese 5-year-olds show race-contingent opposing aftereffects and the extent to which aftereffects transfer across face race among Caucasian and Chinese 5-year-olds. Both participant races showed partial transfer of aftereffects across face race; however, there was no evidence for race-contingent opposing aftereffects. To examine whether experience facilitates the development of category-specific prototypes, we investigated whether race-contingent aftereffects are present among Caucasian 5-year-olds with abundant exposure to Chinese faces (Experiment 2) and then tested separate groups of 5-year-olds with two other categories with which they have considerable experience: sex (male/female faces) and age (adult/child faces) (Experiment 3). Across all three categories, 5-year-olds showed no category-contingent opposing aftereffects. These results demonstrate that 5 years of age is a stage characterized by minimal separation in the norms and associated coding dimensions used for faces from different categories and suggest that refinement of the mechanisms that underlie expert face processing occurs throughout childhood. PMID:24937629

  16. [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

  17. Quebec public funding facilitates fertility preservation for male cancer patients

    PubMed Central

    Herrero, M.B.; García, A.; Buckett, W.; Tulandi, T.; Chan, P.

    2016-01-01

    Background Sperm cryopreservation remains the only clinically feasible option to preserve male fertility. The quality of counselling provided by the treating physicians and the cost of sperm cryopreservation can both influence a patient’s decision about whether to preserve sperm. On 5 August 2010, the Quebec government introduced provincial coverage of assisted reproductive technologies, with sperm cryopreservation included as a covered service. The aim of the present study was to evaluate whether and how such a program affects the behaviour of cancer patients with respect to sperm cryopreservation. Methods We analyzed the database derived from male patients undergoing sperm cryopreservation from August 2008 to August 2012 at our centre. The retrieved data included patient age, male infertility or oncologic diagnosis, sperm quality parameters, and details about the number of visits for sperm cryopreservation. Results The number of cancer patients who cryopreserved sperm before and after the policy change did not differ significantly, but a marked increase in the number of non-cancer patients was observed. Further analysis revealed that, after implementation of the public funding program, the total number of sperm cryopreservation sessions per patient increased significantly in cancer patients but not in non-cancer patients. Conclusions It appears that cancer patients who are willing to freeze sperm are keen to return for more sessions of sperm banking when no fees are associated with the service. Those findings suggest that cost reduction is an important factor for improving delivery of fertility preservation services to male cancer patients. PMID:26966400

  18. Gender identity disorder and autism spectrum disorder in a 23-year-old female.

    PubMed

    Lemaire, Mathieu; Thomazeau, Barbara; Bonnet-Brilhault, Frédérique

    2014-02-01

    We describe the case of a 23-year-old woman with Gender Identity Disorder (GID) asking for a cross-sex hormonal treatment with sex reassignment surgery and who was recently diagnosed with Autism Spectrum Disorder (ASD). Gender identity clinics are now reporting an overrepresentation of individuals with ASD among GID patients. The prevalence of ASD is 10-fold higher among GID patients than in general population. However, few case reports or studies have explored the co-occurrence of ASD and GID. This co-occurrence is relevant for diagnostic and clinical management and also raises important theoretical issues. PMID:23835847

  19. Circummandibular Wiring of Symphysis Fracture in a Five-Year-Old Child

    PubMed Central

    Priya Vellore, Krishna; Gadipelly, Srinivas; Dutta, Brahmananda; Reddy, Vijay Bhaskar; Ram, Sri; Parsa, Arun

    2013-01-01

    The treatment of pediatric maxillofacial fractures is unique due to the psychological, physiological, developmental, and anatomical characteristics of children. Method. This case report describes the management of symphysis fracture of mandible in a 5-year-old boy. The fracture was treated by acrylic splint with circummandibular wiring. Results. The splint was removed after 3 weeks. The patient had no complaints, and radiograph revealed a healed fracture. Conclusion. The clinical outcome in the present case indicates the management of mandibular fractures in pediatric patients using acrylic splint with circummandibular wiring. PMID:23864964

  20. Bullous Dermatitis Artefacta in a 17 Year-old Girl Induced by a Native Herb

    PubMed Central

    Zarei, Mina; Kamali, Mohammad; Bidaki, Reza

    2013-01-01

    Dermatitis artifacta is a factitious dermatological disorder with many forms of presentation of self inflicted skin lesions in any part of the body. Dermatitis artefacta is a rare and difficult condition for diagnosis and treatment mostly because of the patient's denial. The liaison among primary care physicians, psychiatrists and dermatologists can be important in the management of these patients. In this report we describe a 17-year-old girl with dermatitis artefacta which was presented as bullous lesions on her face induced with a native herb combining with fake headaches. PMID:24616800

  1. Bullous Dermatitis Artefacta in a 17 Year-old Girl Induced by a Native Herb.

    PubMed

    Zarei, Mina; Kamali, Mohammad; Bidaki, Reza

    2013-09-01

    Dermatitis artifacta is a factitious dermatological disorder with many forms of presentation of self inflicted skin lesions in any part of the body. Dermatitis artefacta is a rare and difficult condition for diagnosis and treatment mostly because of the patient's denial. The liaison among primary care physicians, psychiatrists and dermatologists can be important in the management of these patients. In this report we describe a 17-year-old girl with dermatitis artefacta which was presented as bullous lesions on her face induced with a native herb combining with fake headaches. PMID:24616800

  2. A Case of Infantile Kyrle-Flegel Disease in a 6-Year-Old Yemeni Girl.

    PubMed

    Alshami, Mohammad Ali; Mohana, Mona Jameel

    2016-01-01

    Kyrle disease (KD) and Flegel disease (FD) are rare variants of primary perforating dermatoses, characterized by transepidermal elimination of abnormal endogenous materials. We describe a 6-year-old Yemeni girl with a 2-year history of generalized asymptomatic, small, reddish-brown keratotic papules with a lenticular central keratotic plug. Although these features are synonymous with FD, the histology of a punch biopsy was consistent with KD. The patient was otherwise healthy, and no family members had a history of similar diseases. The patient was diagnosed with KD-FD, owing to the manifestation of features associated with both diseases. PMID:26933407

  3. Schwannoma of the tongue in a ten-year old child.

    PubMed

    Husain, Salina; Husain, Salima; Yunus, Mohammad Razif Muhammad; Yunus, Mohammad Razif Mohammad; Ramli, Roszalina; Ramli, Rozalina; Athar, Primuharsa Putra Sabir Husin

    2011-05-01

    The case of a 10-year-old girl is presented who had a slow-growing, painless swelling on the left side of the tongue since six months. This was associated with disturbances in mastication and phonation. Examination revealed a 5 cm x 4 cm. globular smooth, mobile mass on left side of the tongue. There was no neurological deficit and no neck nodes palpable. She underwent excision of the mass under general anaesthesia. Complete enucleation with primary closure was carried out. The patient had an uneventful postoperative recovery and histological evaluation was consistent with schwannoma. The patient was recurrence free after one year. PMID:22204190

  4. A Case of Infantile Kyrle-Flegel Disease in a 6-Year-Old Yemeni Girl

    PubMed Central

    Alshami, Mohammad Ali; Mohana, Mona Jameel

    2016-01-01

    Kyrle disease (KD) and Flegel disease (FD) are rare variants of primary perforating dermatoses, characterized by transepidermal elimination of abnormal endogenous materials. We describe a 6-year-old Yemeni girl with a 2-year history of generalized asymptomatic, small, reddish-brown keratotic papules with a lenticular central keratotic plug. Although these features are synonymous with FD, the histology of a punch biopsy was consistent with KD. The patient was otherwise healthy, and no family members had a history of similar diseases. The patient was diagnosed with KD-FD, owing to the manifestation of features associated with both diseases. PMID:26933407

  5. A 16-year-old with ST elevation myocardial infarction: case report and review of the literature.

    PubMed

    Hill, Dustin; Waldman, Adam; Vivek, Deepak

    2016-02-01

    Chest pain in young adults presents a unique diagnostic challenge, placing young patients at an increased risk to be misdiagnosed, as this patient population typically does not demonstrate the traditional risk factors associated with cardiovascular disease. This study details the case of a 16-year-old male who presented with new-onset chest pain and ST elevation on electrocardiogram. His history was unremarkable for known cardiac risk factors, but laboratory evaluation demonstrated markedly elevated troponins and electrocardiographic findings confirmed ST-segment elevation myocardial infarction. Coronary angiography demonstrated 100% occlusion of the left anterior descending artery, which was managed with percutaneous transluminal coronary angioplasty, thrombectomy, and bare-metal stenting. The patient had an uneventful recovery. This study examines the major causes of ST elevation myocardial infarction in young adults and reviews the major differences between younger and older myocardial infarction populations with emphasis on risk factor profile, pathophysiological mechanisms, clinical presentation, angiographic findings, and prognosis. This review highlights the need for consideration of a wide differential in younger subsets of the population presenting with chest pain and ST elevation. The implementation of current adult management protocols and guidelines for ST elevation myocardial infarction should not be overlooked due to age. Given the potential for premature death and long-term disability with resulting individual and societal consequences, it is crucial to understand the importance of correct diagnostic evaluation in this clinical scenario. PMID:26427535

  6. Management and sequelae of a 41-year-old jehovah's witness with severe anhydrous ammonia inhalation injury.

    PubMed

    Ortiz-Pujols, Shiara; Jones, Samuel W; Short, Kathy A; Morrell, Matthew R; Bermudez, Christian A; Tilley, Stephen L; Cairns, Bruce A

    2014-01-01

    Anhydrous ammonia is a commonly used chemicals that are found in fertilizer, refrigeration, and in other occupational environments. Lung damage because of inhalation of ammonia can be devastating, producing debilitating lung disease and can ultimately lead to death. This is the case of a 41-year-old male, previously healthy, Jehovah's Witness, who was working at a poultry plant facility when an explosion occurred exposing him to toxic levels of anhydrous ammonia. Our patient developed end-stage lung disease after sustaining a severe ammonia inhalation injury. Despite aggressive pulmonary rehabilitation, the patient continued to deteriorate, and his only option for a chance at improved quality of life was a double-lung transplant. To our knowledge, this is the first report of a bloodless lung transplantation for inhalational lung injury in the literature. Further study is needed to better understand the effects of ammonia on lung physiology in order to better manage and treat patients who develop acute and chronic lung complications after exposure. PMID:24784905

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

    NASA Astrophysics Data System (ADS)

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

    2014-09-01

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

  8. Similarity predicts liking in 3-year-old children.

    PubMed

    Fawcett, Christine A; Markson, Lori

    2010-04-01

    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 whose food preferences or physical appearance matched their own. Unpacking the physical appearance finding revealed that the stable similarity of hair color may influence liking more strongly than the transient similarity of shirt color. A second study showed that children also prefer to play with a peer who shares their toy preferences, yet importantly, show no bias toward a peer who is similar on an arbitrary dimension. The findings provide insight into the earliest development of peer relations in young children. PMID:20092828

  9. Two-year-olds will name artifacts by their functions.

    PubMed

    Kemler Nelson, D G; Russell, R; Duke, N; Jones, K

    2000-01-01

    Do young children take functional information into account in naming artifacts? In three studies of lexical categorization, 112 children 2 years of age learned new names for novel artifacts with novel functions and then extended the names to new objects. The objects were designed to have functions that were causally related in simple and compelling ways to perceptible aspects of their physical structure. Despite only minimal opportunity to familiarize themselves with the objects, children generalized the names in accordance with the objects' functions. This result obtained even when children had to discover the functions of the named objects on their own (Experiment 2) and when all the test objects had some discernible function (Experiment 3). Two-year-olds name by function when they can make sense of the relation between the appearances and the functions of artifacts. PMID:11108096

  10. NASA Administrator Dan Goldin greets 100-year-old VIP.

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Astronaut Andy Thomas (left) greets 100-year-old Captain Ralph Charles, one of the VIPs attending the launch of STS-99. Charles also met NASA Administrator Dan Goldin. An aviator who has the distinction of being the oldest licensed pilot in the United States, Charles is still flying. He has experienced nearly a century of flight history, from the Wright Brothers to the Space Program. He took flying lessons from one of the first fliers trained by Orville Wright, first repaired then built airplanes, went barnstorming, operated a charter service in the Caribbean, and worked as a test pilot for the Curtiss Wright Airplane Co. Charles watches all the Shuttle launches from his home in Ohio and his greatest wish is to be able to watch one in person from KSC.

  11. A 6-Year-Old With Leg Cramps.

    PubMed

    Jenssen, Brian P; Lautz, Andrew J; Orthmann-Murphy, Jennifer L; Yum, Sabrina W; Waanders, Angela; Fox, Elizabeth

    2015-10-01

    A 6-year-old girl presented with a history of leg pain and cramping that progressively worsened over a 2- to 3-week period of time. Her examination was notable for normal vital signs, limited range of motion of her left hip, and a limp. Inflammatory markers were slightly elevated, but the serum electrolytes, calcium, and magnesium, complete blood cell count and differential, and creatine kinase level were normal. She was hospitalized for further diagnostic evaluation and was noted to have abnormal muscle movements classified as myokymia (continuous involuntary quivering, rippling, or undulating movement of muscles). Electromyography confirmed the myokymia but did not reveal evidence of a myopathy or neuropathy, prompting additional evaluation for a systemic etiology. PMID:26371189

  12. Recurrent headache in a five year old boy.

    PubMed

    Saini, Lokesh; Kumar, Ranjith M; Chakrabarty, Biswaroop; Gulati, Sheffali

    2016-01-01

    Headache is infrequent in early childhood. Headache and neurological deficits associated with cerebrospinal fluid (CSF) lymphocytosis (HaNDL), a variant of migraine, is a rare disorder. A 5-year-old boy presented with recurrent episodes of headache for 6 months. Each episode lasted for a week and in the current episode, he was symptomatic for 3 days. All the episodes were associated with paresthesias and CSF lymplocytosis with normal protein and sugar. There was history of migraine in his family. His magnetic resonance imaging (MRI) brain with contrast with magnetic resonance (MR) angiography and venography were normal. Work-up for relevant causes of infection and vasculitis were negative. His symptoms subsided on oral antimigraine prophylaxis and he has been on remission for last 8 months. HaNDL should be considered in relevant clinical scenarios, as it prevents unnecessary investigations, therapy, and hospitalization. PMID:27011651

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

    NASA Technical Reports Server (NTRS)

    2000-01-01

    NASA Administrator Dan Goldin (center) talks to 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. In the background, between them, are Jonathan's mother, Penny; his grandfather, John Janocka; and his sister, Jaimie. At left is Mrs. Goldin. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS-99.

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

    NASA Technical Reports Server (NTRS)

    2000-01-01

    NASA Administrator Dan Goldin (center) presents a bag of special gifts to 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. In the background, between them, are Jonathan's mother, Penny; his grandfather, John Janocka; and his sister, Jaimie.. At left is Mrs. Goldin. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS-99.

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

    NASA Technical Reports Server (NTRS)

    2000-01-01

    NASA Administrator Dan Goldin (center) greets 10-year-old Jonathan Pierce (right), who is garbed in a protective cooling suit designed by NASA. In the background, between them, are Jonathan's mother, Penny; his grandfather, John Janocka; and his sister, Jaimie.. At left is Mrs. Goldin. Jonathan suffers from erythropoietic protoporphyria, a rare condition that makes his body unable to withstand ultraviolet rays. The suit allows him to be outside during the day, which would otherwise be impossible. Jonathan's trip was funded by the Make-A-Wish Foundation and included a visit to Disney World. He and his family were among a dozen VIPs at KSC to view the launch of STS-99.

  16. Summary of aging effects on 25-year old nylon parachutes

    SciTech Connect

    Tadios, E.L.

    1988-01-01

    Structural evaluations were conducted on several parachute systems to determine the effects of aging on parachute materials. Most of the parachutes were 25 years old. Five 64 ft parachutes were evaluated along with one 4 ft guide surface parachute and three 16.5 ft ribbon parachutes. The parachute systems used in the study were all fabricated from nylon materials. Results were obtained for several material properties such as tensile strength, air permeability and melting point. Military specifications were used as zero-time data base due to lack of raw material data. The results indicate that over a period of about 25 years, parachute nylon materials do not degrade to unacceptable levels. 7 refs., 2 figs., 3 tabs.

  17. An 86-year-old man with acute abdominal pain.

    PubMed

    van Dam, Paul M E L; Posthouwer, Dirk

    2016-01-01

    An 86-year-old man presented with severe pain in the upper abdomen along with fever. On physical examination, we found an arterial blood pressure of 84/43 mm Hg, a heart rate of 80 bpm and a temperature of 38.3°C. The abdomen was painful and peristalsis was absent. Empiric antibiotic therapy for sepsis was started with amoxicillin/clavulanate and gentamicin. CT scan of the abdomen revealed an emphysematous cholecystitis. Percutaneous ultrasound-guided cholecystostomy was applied. Bile cultures revealed Clostridium perfringens. Emphysematous cholecystitis is a life-threatening form of acute cholecystitis that occurs as a consequence of ischaemic injury to the gallbladder, followed by translocation of gas-forming bacteria (ie, C. perfringens, Escherichia coli, Klebsiella and Streptococci). The mortality associated with emphysematous cholecystitis is higher than in non-emphysematous cholecystitis (15% vs 4%). Therefore, early diagnosis with radiological imaging is of vital importance. PMID:26869625

  18. Recurrent headache in a five year old boy

    PubMed Central

    Saini, Lokesh; Kumar, Ranjith M.; Chakrabarty, Biswaroop; Gulati, Sheffali

    2016-01-01

    Headache is infrequent in early childhood. Headache and neurological deficits associated with cerebrospinal fluid (CSF) lymphocytosis (HaNDL), a variant of migraine, is a rare disorder. A 5-year-old boy presented with recurrent episodes of headache for 6 months. Each episode lasted for a week and in the current episode, he was symptomatic for 3 days. All the episodes were associated with paresthesias and CSF lymplocytosis with normal protein and sugar. There was history of migraine in his family. His magnetic resonance imaging (MRI) brain with contrast with magnetic resonance (MR) angiography and venography were normal. Work-up for relevant causes of infection and vasculitis were negative. His symptoms subsided on oral antimigraine prophylaxis and he has been on remission for last 8 months. HaNDL should be considered in relevant clinical scenarios, as it prevents unnecessary investigations, therapy, and hospitalization. PMID:27011651

  19. Parathyroid Carcinoma in a 10 Years Old Female Child.

    PubMed

    Rahman, M M; Karim, S S; Joarder, A I; Mubin, S; Abir, M M; Morshed, M S

    2015-07-01

    Parathyroid carcinoma (PC) is a rare cause of hypercalcaemia in children. Only 7 cases of PC have been reported so far in the world journal. The authors report the 8th case of parathyroid carcinoma in children less than 16 years of age. A 10 year old girl presented with difficulty in walking, dorsiflexion and ulnar deviation of both wrist joints and occasional pain in the central abdomen of about two years duration. Biochemical investigations revealed serum calcium 12.2 mg/dL (normal 9-11 mg/dL), serum alkaline phosphate 4992 U/L (normal 50-136 U/L), PTH (parathyroid hormone) 2217 pg/ml (normal 9-80 pg/ml). Parathyroid scintigraphy localized the lesion in the left parathyroid gland. X-ray showed bilateral coxa vera, genu valgus deformity and multiple stress fractures in both wrist joints. Histopathology confirmed PC with capsular and vascular invasion. PMID:26329966

  20. [Venous air emboli in a 4 year old child].

    PubMed

    Neidecker, J; Blaise, B; Ninet, J

    2012-05-01

    A 4 year old girl is referred to our institution for resection of a nephroblastoma with an extension of the tumor into the lumen of the inferior vena cava. To perform a correct resection of the tumor, the operation was conducted under cardiopulmonary bypass. At the end of the procedure, a bilateral mydriasis was noticed. A CT-scan concluded to a massive venous air emboli. As the procedure was unventful, and no other cause of air emboli was found, the etiology of this emboli is problably retrograde because of the large opening of the inferior vena cava that was required to remove the tumor. To avoid similar case the use of transcranial doppler monitoring may be of interest. PMID:22721513

  1. [Fitting a male sheath urinal while respecting the patient's intimacy].

    PubMed

    Derville, Sandrine; Cellard Du Sordet, Paul; Breuzard, Magali; Béguin, Anne-Marie; Malaquin-Pavan, Evelyne

    2015-04-01

    The fitting of a male sheath urinal directly concerns the patient's area of sexual intimacy. The modesty of the patient and caregiver as they interact is tested, leading to discomfort or clumsiness which can provoke a feeling of intrusion. Preparing this care procedure favours the adherence of both parties. PMID:26043631

  2. [Paranoid-hallucinatory psychosis as primary manifestation of subactue sclerosing panencephalitis (SSPE) in a 19-year-old man].

    PubMed

    Jähnel, Mathias

    2003-05-01

    We report the rare case of a 19-year old man, first diagnosed with schizophrenia but finally shown to have subacute sclerosing panencephalitis (SSPE). Initial symptoms were hallucinations and negative symptoms until the onset of a seizure. Changes in the CSF, MRI, EEG and increasing neurological symptoms led to the correct diagnosis of subacute sclerosing panencephalitis. The EEG results were of particular importance as they already showed the characteristic changes, even while the patient still only presented with psychotic symptoms. This case report demonstrates the importance of ongoing neurological examinations in patients with psychiatric disorders. In the literature, there are only three case reports about children (8, 9 and 10 year old) as well as one of a 21-year old women with subacute sclerosing panencephalitis presenting with psychosis. PMID:14509042

  3. Increased plasma endothelin levels in patients with male hypogonadism.

    PubMed

    Kumanov, Ph; Tomova, A; Kirilov, G; Dakovska, L; Schinkov, A

    2002-02-01

    Endothelin has various paracrine and endocrine effects on the male reproductive system. Testosterone is probably responsible for the higher endothelin levels in males. In addition, there is much ambiguity about the relationship between gonadotrophic hormones and endothelin. In order to study in more detail the relationship of endothelin with the hypothalamo-pituitary-gonadal axis in the male, we investigated 18 male patients with various forms of hypogonadism (seven with hypergonadotrophic hypogonadism and 11 with hypogonadotrophic hypogonadism). Eight age-matched healthy males served as controls. The basal endothelin levels in patients with hypogonadism (0.95 +/- 0.53 fmol ml(-1)) were significantly higher than those of the controls (0.54 +/- 0.06 fmol ml(-1); P < 0.05). Males with hypergonadotrophic hypogonadism had significantly increased endothelin concentrations (1.05 +/- 0.57 fmol ml(-1); P < 0.05), whereas those with hypogonadotrophic hypogonadism (0.89 +/- 0.53 fmol ml(-1)) had nonsignificantly (P > 0.05) elevated levels. No significant correlation was found between plasma endothelin levels and gonadotrophin, prolactin and testosterone concentrations. The results of this study suggest that plasma endothelin levels are increased in males with hypogonadism. PMID:11996179

  4. Invasive Ductal Breast Carcinoma Underneath a Lipoma in a Male Patient

    PubMed Central

    Landero, James; Glick, Bradley P.

    2012-01-01

    Male breast cancer is a rare malignancy and accounts for less than one percent of all cancers in men. The authors describe the case of a 76-year-old Caucasian man with invasive ductal breast carcinoma who presented with a common lipoma. This paper reviews the current literature on epidemiology, risk factors, etiology, different types of breast cancer, clinical presentation, imaging, diagnostic workup, and treatment. PMID:23125888

  5. Analysis of dental casts of 6-8- and 12-year-old Kenyan children.

    PubMed

    Hassanali, J; Odhiambo, J W

    2000-04-01

    Dental plaster casts of 97 6-8-year-old and 173 12-year-old Maasai, Kikuyu, and Kalenjin children were studied. The Kikuyu are Bantu, while Maasai and Kalenjin are Nilo-Hamitic subjects. The variables measured were palatal depth (PD) and length (PL); maxillary and mandibular anterior arc circumferences (AC1) and (AC2), respectively; posterior arc circumferences (PC1) and (PC2), inter-canine (CC1), and (CC2); inter-molar (MM1) and (MM2) distances, and mandibular length (ML). The data were analysed using SPSS package. The mean values of all the variables were generally higher in the males compared with the females and significant sex differences in the means (P < 0.01) were found in AC1, PC1, PC2, CC1, CC2, MM1, and MM2 in the 12-year-old subjects. The means of all variables, except PL, ML, PC2, and CC2, increased from 6 to 12 years of age and significant differences in the means for age were found in ML, AC1, PC2, PD, MM1, MM2, and CC1. Mean maxillary inter-molar distance increased with age by 0.17-0.34 mm in the three groups. Mean values of mandibular variables were highest in the Kikuyu, while maxillary variables were highest in the Maasai. The Maasai casts showed a marked decrease in CC2, PC2, AC2, and ML compared with the Kikuyu and Kalenjin. Ethnic and sex differences in the dental arches may be masked by anterior tooth positions that are influenced by the dento-alveolar complex and soft tissues. Corresponding mandibular and maxillary variables were strongly correlated and anterior and posterior arc circumferences were correlated with inter-canine and intermolar distances. Details of the norms for dental arch dimensions and changes with age may allow for appropriate assessment of dental occlusion and treatment planning for Kenyan children. PMID:10822886

  6. A 52-Year-Old Man With a Tuft Fracture and Hand Cellulitis.

    PubMed

    McCallum, James; Kamienski, Mary

    2015-01-01

    A 52-year-old man presented to the emergency department (ED) 1 week after getting his right index finger shut in a car door. The patient complained of right index finger pain. His entire hand was edematous and reddened. After evaluation in the ED and x-ray, the patient was diagnosed with a tuft fracture, right index finger/hand cellulitis, and possible osteomyelitis. The patient received tetanus diphtheria i.m., vancomycin 1 g i.v., and ceftriaxone (Rocephin) 2 g i.v. while in the ED and was admitted with referral to a hand specialist. The patient was discharged after 10 days of parental antibiotics. He has a history of sarcoidosis, hypertension, diabetes mellitus, and scleroderma. He is currently not taking any medications and denies allergies to medications and latex. The patient had no significant somatic findings. He was afebrile. PMID:26375833

  7. Family poverty accounts for differences in lower-extremity amputation rates of minorities 50 years old or more with diabetes.

    PubMed Central

    Wachtel, Mitchell S.

    2005-01-01

    Rates of leg amputations in diabetics are known to differ among racial/ethnic groups, but the relationship between family poverty and the risk of amputation has not been fully addressed. One-hundred-seven diabetic patients, all 50 or more years old and all from ZIP code tabulation area 778, underwent their first amputations at one hospital. Linear regression evaluated differences in age and atherosclerosis severity among African-American, Hispanic-American and other patients. chi2 statistics evaluated differences among African-American, Hispanic-American and other patients, with respect to sex and type of amputation. chi2 statistics evaluated differences among fractions of African- American, Hispanic-American and other patients, with respect to those residents 50 years old and older and those of poor families. Patient groups did not differ in regard to age, atherosclerosis severity, sex or type of amputation (P>0.05). The percents who were African-American, Hispanic-American, and other (33%, 21%, and 47%, respectively) differed markedly from those of persons 50 or more years old [13%, 7%, and 79%, (w=0.81, P<0.00001)] and mirrored those of poor families [37%, 19%, and 44% (w=0.08, P>0.05)]. Family poverty accounts for differences in diabetic amputation rates of African Americans, Hispanic Americans and other persons 50 or more years old. PMID:15779497

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

    PubMed Central

    Negrusoiu, M

    2008-01-01

    An 18 years old male was referred to us 4 years after major tumoral surgery. In 2002 he was diagnosed with Ewing sarcoma of the proximal two–thirds of his left femur. Wide resection of the tumor was performed, with a makeshift implant one–stage reconstruction, followed by a combination of chemo and radiotherapy for another 6 months. Eight months after surgery a deep infection of the hip developed, and despite antibiotic treatment and two consecutive debridments and lavage the results were negative. When we first saw the patient in 2006, he still had an active infection in his left hip and a septic general appearance. A two–stage revision was performed and a modular tumoral reconstruction was implanted. At two years follow up the patient presents no signs of recurrence neither of the infection nor of the primary tumor. PMID:20108525

  9. Primary Pulmonary Valve Leiomyosarcoma in a 35-Year-Old Woman

    PubMed Central

    Vakilian, Farveh; Shabestari, Mahmoud M.; Teshnizi, Mohammad Abbasi; Allahyari, Abolghasem; Memar, Bahram

    2016-01-01

    Primary cardiac leiomyosarcomas are rare, with a high incidence of local recurrence. Herein, we report the case of a 35-year-old woman who was admitted with right ventricular failure and suspected pulmonary embolism. Upon echocardiography, we detected a mass in the pulmonary trunk that involved the pulmonary valve and led to valvular stenosis. The optimal protocol for treating these tumors is as yet unclear. Complete resection can rarely be achieved. However, palliative surgery is usually undertaken because many patients present with mechanical obstruction, such as significant pulmonary stenosis.

  10. A 54-year-old woman with chronic cough and an endobronchial mass.

    PubMed

    Behnia, Mehrdad M; Catalano, Philip W

    2011-01-01

    We report a case of a 54-year old female who presented with chronic cough. Computerized tomography (CT) scan of the chest was not remarkable. She underwent empirical treatment for common causes of chronic cough for months to no avail, after which flexible bronchoscopy revealed right lower lobe endobronchial mucoepidermoid carcinoma. Surgical resection resulted in complete resolution of the cough. In patients with refractory cough who do not respond to conventional medical therapy, examination of endobronchial tree by bronchoscopy is strongly recommended. PMID:25191366

  11. Groin Swelling in a Four-Year-Old Boy: Primary Great Saphenous Vein Aneurysm.

    PubMed

    Çiçek, Mustafa Cüneyt; Çiçek, Ömer Faruk; Yalçınkaya, Adnan; Taşoğlu, İrfan

    2015-11-01

    Primary venous aneurysm, especially in pediatric population, is a very rare clinical entity. We report a case of primary great saphenous vein aneurysm in a 4-year-old boy. He was initially suspected of suffering from inguinal hernia because the soft mass was detected at the inguinal region when the patient was in the standing position, but color Doppler ultrasonography demonstrated the swelling to be a great saphenous vein aneurysm. We decided that surgery was the best option because of potential risk for thromboembolism. PMID:26315793

  12. Extrapyramidal side-effects of low-dose aripiprazole in an 11-year-old child.

    PubMed

    Mohapatra, Satyakam

    2016-01-01

    Partial agonism of D2 and 5-HT1A receptors accounts for the low incidence of extrapyramidal side-effects of aripiprazole. Extrapyramidal symptoms (EPS) during treatment with therapeutical doses of aripiprazole have been reported in adults and children. To the best of our knowledge, no cases of EPS with low doses (5 mg) have been reported until now. In this article, we present an 11-year-old child who developed EPS on low doses (5 mg) aripiprazole. This case emphasizes the need for careful surveillance for the development of EPS in patients treated even with low doses of aripiprazole. PMID:26933364

  13. Oral squamous cell carcinoma in a 7-year-old Brazilian boy.

    PubMed

    Ribeiro, C M B; Gueiros, L A M; Leon, J E; do Carmo Abreu e Lima, M; de Almeida, O P; Leão, J C

    2011-09-01

    Squamous cell carcinomas (SCCs) are amongst the commonest malignancies in adults but in paediatric patients are exceptionally rare, particularly those involving the oral mucosa. The aim of the present report is to describe the features of a gingival well-differentiated SCC in a 7-year-old Brazilian boy. Immunostaining for p53, Ki-67 and Mcm2 showed increased cellular proliferation compared with normal epithelium. In situ hybridization failed to identify human papilloma virus infection. Correct diagnosis of well-differentiated squamous carcinoma can be difficult in children and differentiation from pseudoepitheliomatous hyperplasia is essential to establish proper treatment. PMID:21550206

  14. 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

  15. Chronic pruritic dermatitis and peripheral eosinophilia in a 42-year-old man.

    PubMed

    Belser, Kate; Reddy, Vinitha; Marks, James; Ishmael, Faoud; Kelbel, Theodore

    2016-03-01

    Chronic pruritic dermatitis with or without accompanying peripheral eosinophilia can be caused by a vast array of underlying disorders broadly classified as allergic/immunologic, infectious, or neoplastic. An organized and thorough work up is crucial in order to arrive at a definitive diagnosis enabling appropriate treatment. We present the case of a 42-year-old man with a history of chronic pruritic dermatitis and peripheral eosinophilia in a patient-oriented, problem-solving format including the clinical presentation, physical findings, results of pertinent lab/radiologic studies, differential diagnosis, and final diagnosis with discussion. PMID:26932174

  16. [Mucoepidermoid carcinoma in a 13-year-old girl; report of a case].

    PubMed

    Fujita, Koichi

    2009-05-01

    A 13-year-old girl was referred to our hospital for chest pain and atelectasis of left upper lobe on chest X-ray film. Bronchoscopy revealed an endobronchial tumor obstructing left main bronchus. Left upper lobectomy with bronchoplasty was performed. The tumor was a polyp 34 x 17 x 17 mm in size and obstructed left main bronchus. Histologically the tumor was a low-grade malignant mucoepidermoid carcinoma with malignant pleural effusin. The patient has been well and free of recurrence for 8 years postoperatively. PMID:19425387

  17. Giant parietal lobe infantile gliosarcoma in a 5-year-old child.

    PubMed

    Savant, Hemant V; Balasubramaniam, Srikant; Mahajan, Vijay

    2015-01-01

    The relative frequency of pediatric gliosarcoma (GSM) is 1.9% among glioblastomas and 0.5% among pediatric central nervous system tumors. A 5-year-old female child came to us with history of fever and loss of appetite since 2 weeks and right sided weakness since 4 days. Magnetic resonance imaging showed a large heterogeneously enhancing space occupying lesion in the left parieto-occipital region. A parieto-occipital craniotomy with radical excision of tumor was performed. The patient was given adjuvant therapy following surgery and survived until 9 months following surgery. The etiopathogenesis, treatment modalities and prognosis of GSM is discussed. PMID:26167224

  18. 26-Year-Old Survivor of Kasai Procedure With Native Liver

    PubMed Central

    Siglin, Scott; Laurie, Timothy; Kavin, Hymie

    2016-01-01

    A 26-year old woman with history of congenital biliary atresia and Kasai procedure as a newborn presented with recurrent nausea and abdominal pain. Physical examination showed anicteric sclera and tender right upper quadrant. Elevated liver function tests suggested obstruction and hepatitis. Percutaneous transhepatic cholangiogram showed generalized ductal dilation, innumerable intrahepatic bile duct stones, and multiple filling defects. No anastomotic stenosis was noted. The patient was treated for acute symptoms and referred to a liver transplant center. Long-term survivors of the Kasai procedure with a native liver are rare, and this represents the third known U.S. case in the literature. PMID:27144211

  19. [Awake Nasotracheal Intubation for a 4-Year-old Boy with an Oral Penetrating Toothbrush Injury].

    PubMed

    Kobayashi, Naoya; Ando, Kokichi; Saito, Kazutomo; Toyama, Hiroaki; Fudeta, Hiroto; Yamauchi, Masanori

    2015-09-01

    We report a case of an oral penetrating injury caused by a toothbrush in a 4-year-old 17-kg boy. The toothbrush was lodged in the right cervical region through the oral cavity, and emergency surgery for removal was planned under general anesthesia. Although mask ventilation was not possible because of the protruding toothbrush handle, awake nasotracheal intubation was successfully performed with a fiber-scope and intravenous fentanyl 25 μg. We conclude that appropriate analgesics could facilitate awake intubation in pediatric patients. PMID:26466500

  20. Congenital pulmonic stenosis in a 77-year-old woman successfully treated with percutaneous balloon valvuloplasty

    PubMed Central

    Ayad, Ramy F.; Johnston, Stephen B.; Grayburn, Paul A.; Schmidt, Tyson T.

    2010-01-01

    Congenital pulmonic stenosis (PS) rarely presents in patients over the age of 55 years. A stable asymptomatic course into late adulthood is the usual history of mild to moderate PS. Balloon valvuloplasty has become the procedure of choice for congenital PS, especially in children and young adults. There are rare reports of its use in older adults. Significant valve calcium is believed to limit its success. We present a case of a 77-year-old woman with symptomatic congenital PS and severe valve calcium who underwent successful balloon valvuloplasty. PMID:20157499

  1. A 61-year-old woman develops polyuria after hip revision

    PubMed Central

    Shaheen, Aisha; Dobish, Mark; Gleason, Vanessa; Setren, Adam; Stem, Jonathan; Kohl, Benjamin A.

    2016-01-01

    A 61-year-old previously healthy woman developed progressive hearing and visual loss over a period of 2–3 months prior to admission. Her medical/surgical history was remarkable for a left hip arthroplasty 11 years ago requiring revision approximately 6 months prior to admission. After dislocating the revised hip, she re-presented to her surgeon and underwent a closed reduction. Several weeks following the reduction, the patient began having polyuria and symptoms of hearing and vision loss along with numbness in her extremities and abdominal region. PMID:27170702

  2. Massive malignant pleural effusion due to lung adenocarcinoma in 13-year-old boy.

    PubMed

    Afghani, Reza; Hajimohammadi, Amir; Azarhoush, Ramin; Kazemi-Nejad, Vahideh; Yari, Behrouz; Rezapour Esfahani, Mona

    2016-05-01

    A 13-year-old boy with no risk factors for lung cancer presented with a massive left-sided pleural effusion and a mediastinal shift on chest radiography and computed tomography. A chest tube drained bloody pleural fluid with an exudative pattern. A pleural biopsy and wedge biopsy of the left lower lobe revealed mucinous adenocarcinoma in the left lower lobe wedge biopsy and metastatic adenocarcinoma in the pleural biopsy. The patient is currently undergoing chemotherapy. Radiotherapy is planned after shrinkage of the tumor. Adenocarcinoma of the lung is very rarely seen in teenagers or children, especially in the absence of risk factors. PMID:26857800

  3. A 38-year-old hairdresser with irritant-associated vocal cord dysfunction.

    PubMed

    Herin, F; Poussel, M; Renaudin, J-M; Leininger, A; Moreau-Colson, C; Menard, O; Paris, C

    2012-01-01

    The present case study reports the first case of a 38-year-old hairdresser with irritant-associated vocal cord dysfunction (VCD) due to alkaline persulfate, who was referred on suspicion of occupational asthma. Several tests were performed, including specific inhalation challenge and upper airway endoscopy. During the specific inhalation challenge to alkaline persulfate, the patient experienced dysphonia and a non-significant decrease in forced expiratory volume in 1 second on spirometry. Upper airway endoscopy was then performed and revealed VCD. A specific inhalation challenge test is therefore essential in cases of VCD to exclude possible concomitant occupational asthma. PMID:22236860

  4. Multiple intracerebral metastases of a 17-year-old girl with previously diagnosed neurofibromatosis type I.

    PubMed

    Maschke, M; Kastrup, O; Reinhardt, V; Keidel, M

    1999-01-01

    We report a case of a 17-year-old girl with multiple intracerebral tumors. Previously, a neurofibroma in the posterior mediastinum and neurofibromatosis had been diagnosed. She developed a spastic tetraparesis with a prominent hemiparesis of the right side within several weeks. On admission we found clinical signs of elevated intracranial pressure. Cranial CT and MRI scans showed multiple space-occupying intracerebral tumors, thought to be multiple meningeoma. The patient was referred to the neurosurgical department, where two of the intracerebral tumors were excised. The histological examination revealed metastases of a neurosarcoma. PMID:9988138

  5. Warty Condylomatous Squamous Cell Carcinoma of the Penis in a 19-Year-Old?

    PubMed Central

    Tarbunou, Yauhen; Davis, Cindy L.; Costa, Joseph; Williams, Christopher

    2014-01-01

    Warty carcinoma of the penis is an unusual neoplasm and a variant of penile squamous cell carcinoma. As with other types of penile cancer, risk factors include human papillomavirus infection, poor personal hygiene, and being uncircumcised. The typical case is an exophytic mass arising from the glans penis, frequently large (4-5 cm), and with invasion into corpus spongiosum. The diagnosis is typically made by tumor biopsy. Treatment depends on the stage of disease and includes partial vs total penectomy, with or without prophylactic or therapeutic bilateral lymphadenectomy. We present an unusual case of penile cancer in a 19-year-old patient.

  6. Extrapyramidal side-effects of low-dose aripiprazole in an 11-year-old child

    PubMed Central

    Mohapatra, Satyakam

    2016-01-01

    Partial agonism of D2 and 5-HT1A receptors accounts for the low incidence of extrapyramidal side-effects of aripiprazole. Extrapyramidal symptoms (EPS) during treatment with therapeutical doses of aripiprazole have been reported in adults and children. To the best of our knowledge, no cases of EPS with low doses (5 mg) have been reported until now. In this article, we present an 11-year-old child who developed EPS on low doses (5 mg) aripiprazole. This case emphasizes the need for careful surveillance for the development of EPS in patients treated even with low doses of aripiprazole. PMID:26933364

  7. Primary Hyperparathyroidism with Extensive Brown Tumors and Multiple Fractures in a 20-Year-Old Woman

    PubMed Central

    Choi, Ju Hee; Kim, Kyoung Jin; Lee, Ye Jin; Kim, Sun Hwa; Kim, Sin Gon; Jung, Kwang Yoon; Choi, Dong Seop

    2015-01-01

    A brown tumor is a benign fibrotic, erosive bony lesion caused by localized, rapid osteoclastic turnover, resulting from hyperparathyroidism. Although brown tumors are one of the most pathognomonic signs of primary hyperparathyroidism, they are rarely seen in clinical practice. In this report, we present a case of 20-year-old woman with recurrent fractures and bone pain. Plain digital radiographs of the affected bones revealed multiple erosive bone tumors, which were finally diagnosed as brown tumors associated with primary hyperparathyroidism due to a parathyroid adenoma. This case shows that multiple, and clinically severe form of brown tumors can even occur in young patients. PMID:26354493

  8. 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

  9. Dose estimations for Iranian 11-year-old pediatric phantoms undergoing computed tomography examinations

    PubMed Central

    Akhlaghi, Parisa; Miri-Hakimabad, Hashem; Rafat-Motavalli, Laleh

    2015-01-01

    In order to establish an organ and effective dose database for Iranian children undergoing computed tomography (CT) examinations, in the first step, two Iranian 11-year-old phantoms were constructed from image series obtained from CT and magnetic resonance imaging (MRI). Organ and effective doses for these phantoms were calculated for head, chest, abdomen–pelvis and chest–abdomen–pelvis (CAP) scans at tube voltages of 80, 100 and 120 kVp, and then they were compared with those of the University of Florida (UF) 11-year-old male phantom. Depth distributions of the organs and the mass of the surrounding tissues located in the beam path, which shield the internal organs, were determined for all phantoms. From the results, it was determined that the main organs of the UF phantom receive smaller doses than the two Iranian phantoms, except for the urinary bladder of the Iranian girl phantom. In addition, the relationship between the anatomical differences and the size of the dose delivered was also investigated and the discrepancies between the results were examined and justified. PMID:25972393

  10. Prevalence of Oral Habits among Eleven to Thirteen Years Old Children in Jaipur

    PubMed Central

    Sharma, Shantanu; Asopa, Kirti

    2015-01-01

    ABSTRACT Aim: Oral habits that are prevalent well beyond the normal age frequently result in facial deformity and malocclusions. The aim of the present study was to know the prevalence of oral habits in 11 to 13 years old children of Jaipur city. Methodology: The study included 1,000 children of age 11 to 13 years, belonging to different government and private schools of Jaipur city who were screened for any deleterious habits at their school site. The statistical analysis was done using Chi-square test. Results: The result showed that 18% children had a habit of tongue thrusting, 17% mouth breathing and 3% nail biting. Sex-wise prevalence showed 18% females had oral habits and 20% of male had oral habit. Conclusion: The distribution of children aged 11 to 13 years having oral habits was evaluated with tongue thrusting being most prevalent and exhibiting minimal sexual predilection. How to cite this article: Sharma S, Bansal A, Asopa K. Prevalence of Oral Habits among Eleven to Thirteen Years Old Children in Jaipur. Int J Clin Pediatr Dent 2015;8(3):208-210. PMID:26604539

  11. Early onset of colorectal cancer in a 13-year-old girl with Lynch syndrome

    PubMed Central

    Ahn, Do Hee; Rho, Jung Hee; Tchah, Hann

    2016-01-01

    Lynch syndrome is the most common inherited colon cancer syndrome. Patients with Lynch syndrome develop a range of cancers including colorectal cancer (CRC) and carry a mutation on one of the mismatched repair (MMR) genes. Although CRC usually occurs after the fourth decade in patients with Lynch syndrome harboring a heterozygous MMR gene mutation, it can occur in children with Lynch syndrome who have a compound heterozygous or homozygous MMR gene mutation. We report a case of CRC in a 13-year-old patient with Lynch syndrome and congenital heart disease. This patient had a heterozygous mutation in MLH1 (an MMR gene), but no compound MMR gene defects, and a K-RAS somatic mutation in the cancer cells. PMID:26893603

  12. 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

  13. Early onset of colorectal cancer in a 13-year-old girl with Lynch syndrome.

    PubMed

    Ahn, Do Hee; Rho, Jung Hee; Tchah, Hann; Jeon, In-Sang

    2016-01-01

    Lynch syndrome is the most common inherited colon cancer syndrome. Patients with Lynch syndrome develop a range of cancers including colorectal cancer (CRC) and carry a mutation on one of the mismatched repair (MMR) genes. Although CRC usually occurs after the fourth decade in patients with Lynch syndrome harboring a heterozygous MMR gene mutation, it can occur in children with Lynch syndrome who have a compound heterozygous or homozygous MMR gene mutation. We report a case of CRC in a 13-year-old patient with Lynch syndrome and congenital heart disease. This patient had a heterozygous mutation in MLH1 (an MMR gene), but no compound MMR gene defects, and a K-RAS somatic mutation in the cancer cells. PMID:26893603

  14. 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

  15. 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…

  16. 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

  17. 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

  18. Dysregulation of male sex hormones in chronic hepatitis C patients.

    PubMed

    El-Serafi, A T; Osama, S; El-Zalat, H; El-Deen, I M

    2016-02-01

    Chronic hepatitis C (HCV) infection is a serious problem all over the world and has a special importance in Egypt, where the prevalence of infection is 14.7% of population. In males, HCV is associated with sexual dysfunction and changes in the semen parameters. This study aimed at estimation of a panel of the most important related hormones in the serum of patients and illustration of their correlation to the routine laboratory investigations. The four studied hormones showed alteration in the patients in comparison with the controls. While androstenedione, prolactin and testosterone were significantly increased in patients, dehydroepiandrosterone sulphate was decreased. These changes in the hormones were not related to the liver functions, pathological grade or even viral load. We hypothesised a model of how HCV can induce these hormonal changes and recommended to add these hormones to the follow-up panel of male patients with HCV. PMID:25912488

  19. 80 FR 35858 - Hybrid III 10-Year-Old Child Test Dummy; Corrections; Incorporation by Reference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2015-06-23

    ... entitled, ``Parts/Drawing List, Part 572 Subpart T, Hybrid III 10 Year Old Child Test Dummy (HIII-10C... List and Drawings, Part 572 Subpart T, Hybrid III 10 Year Old Child Crash Dummy (HIII-10C), March 2015... Drawings, Part 572 Subpart T, Hybrid III 10 Year Old Child Crash Dummy (HIII-10C), March 2015,''...

  20. Dynamics of hand preference in 4 year-old children.

    PubMed

    Rostoft, M S; Sigmundsson, H; Whiting, H T A; Ingvaldsen, R P

    2002-04-15

    Hand preference in groups of 4 year-old children towards either end of the skill continuum (as determined by the Movement ABC test) was explored by means of a catching task in which the 'direction of approach of the ball' was used as a control parameter within a dynamical systems framework. In Condition 1, the ball direction was systematically scaled in degrees from the right side of the subject to the left and vice versa. In Condition 2, the spatial location of the ball direction was varied randomly, rather than systematically, over the same range as for Condition 1. In both conditions, the two groups of children were shown to switch between hands (from left to right and vice versa) at well-defined positions on the scale. The different scale values obtained when ball direction was scaled from left to right compared with right to left were used to define hysteresis areas. These areas were more extensive and located more to the left of the midline for the group towards the less skilled end of the continuum than for those towards the more skilled end. Additionally, the less-skilled children were shown to use the right hand more to catch the balls delivered to the left side than did the more skilled children. In Condition 3, objects were placed on the table of the ball-delivery apparatus in order to make the catching action more complicated. The less skilled group were shown to use the right hand more than the left hand in all catching positions whereas the more skilled group showed an equal usage of both catching regimes. PMID:11853858

  1. Prevalence of attention-deficit/hyperactivity disorder symptoms in 4- to 17-year-old children in the general population.

    PubMed

    Pineda, D; Ardila, A; Rosselli, M; Arias, B E; Henao, G C; Gomez, L F; Mejia, S E; Miranda, M L

    1999-12-01

    The purposes of this study were (a) to estimate the prevalence of Attention-Deficit/Hyperactivity Disorder (AD/HD) symptoms in the general preschool and school population; and (b) to analyze the influence of gender, age, and socioeconomic status (SES) variables on AD/HD symptoms. Out of the 80,000 preschool and schoolchildren living in Manizales, Colombia, a random sample of 540 children was selected. Two gender, three age (4- to 5-year olds, 6- to 11-year olds, and 12- to 17-year olds), and three SES (low, middle, and high) groups were used. The 18 DSM-IV symptoms corresponding to AD/HD Criterion A were assessed on a scale of 0 (never) to 3 (almost always). All three demographic variables established statistically significant differences: AD/HD symptoms were more frequent in 6- to 11-year-old, low-SES, male participants. DSM-IV Criterion A for AD/HD was fulfilled by 19.8% of the boys and 12.3% of the girls. However, this difference was marginally significant only in the AD/HD Subtype I: Combined. It was concluded that demographic variables are significant correlates of the AD/HD diagnosis. The prevalence found in this study was higher than usually reported, even though only the symptomatic DSM-IV AD/HD criterion was analyzed. We failed to confirm the assumed AD/HD gender ratio. PMID:10821627

  2. Fatal bleeding due to a heparin-like anticoagulant in a 37-year-old woman suffering from systemic mastocytosis.

    PubMed

    Sucker, Christoph; Mansmann, Georg; Steiner, Stefan; Gattermann, Norbert; Schmitt-Graeff, Anette; Loncar, Robert; Scharf, Rudiger E; Stockschlader, Marcus

    2008-07-01

    A 37-year-old female patient with systemic mastocytosis who was admitted with severe unexplained bleeding symptoms is studied. Laboratory procedures established the diagnosis of a patient-derived-heparin-like anticoagulant as a very rare hemostatic abnormality predisposing to bleeding. The patient died from refractory disease despite therapy with protamine, initiation of chemotherapy, and supportive measures. The case illustrates the clinical presentation and diagnosis of heparin-like anticoagulants. Etiology, pathophysiology, and therapeutic options are discussed. PMID:18160568

  3. An unusual cause of pancreatitis in a 46-year-old returning traveller.

    PubMed

    Pimenta, Dominic; Dawood, Naghum

    2015-01-01

    A 46-year-old previously fit and well man, travelled to Jhelum, Pakistan for 6 weeks in early 2015. Four weeks after returning to the UK, he developed sudden onset epigastric pain, vomiting and fever. C reactive protein was 232 mg/L and amylase was 2061 U/L. He was treated conservatively as pancreatitis, with peripancreatic streaking and left colic gutter fluid on a CT abdominal scan. He was discharged and later attended the Hospital for Tropical Diseases, after coughing up an 8 cm male ascaris worm. He was treated for acute ascariasis infection, complicated by resolved mild-moderate pancreatitis, a common complication in the developing world but rarely seen among travellers. PMID:26240102

  4. Multiple fractures in a 22-year-old man after a simple fall

    PubMed Central

    Alattas, Mohammed H.; Dimentberg, Ronald

    2015-01-01

    We present the case of a 22-year-old male with longstanding progressive fatigue, weakness and pain around his hips due to an undiagnosed parathyroid adenoma. The resultant primary hyperparathyroidism ultimately caused pathologic fractures. He was admitted to the hospital for further assessment and excision of the parathyroid adenoma. A few days after admission, he fell down while walking and was referred to our team. X-rays showed a displaced left femoral neck fracture (FNF) and right humeral shaft fracture with poor bone quality. His humeral fracture was treated conservatively, and the FNF was treated with total hip replacement. Three days later, he underwent parathyroidectomy. This case demonstrates the importance of a thorough investigation of progressive weakness even in a young individual and illustrates the importance of early diagnosis of parathyroid adenoma to avoid the devastating end results of this condition. PMID:26429553

  5. A Case of an 11-year-old With Cough, Diarrhea, and Findings of Concern in His Lungs and Spleen.

    PubMed

    Darby, John B; Rees, Chris A; Bocchini, Claire E; Cruz, Andrea T; Kellermayer, Richard; Finegold, Milton J; Barlow, Sarah E

    2016-03-01

    This is the case of a previously healthy, 11-year-old male of Indian descent who presented to the emergency department with a 2-month history of nausea, vomiting, diarrhea, fatigue, cough, and 7-lb weight loss. Acutely, he developed 5 days of fever as high as 39.4°C. He had a remote travel history to the Middle East. On physical examination, he was febrile and tachycardic, was thin but otherwise had a normal examination. His inflammatory markers were elevated: erythrocyte sedimentation rate was 93 mm/hour and his C-reactive protein was 25.4 mg/L. A complete blood count revealed a white blood cell count of 17 000 × 10(3)/µL with increased bands. His hemoglobin level was 8.8 g/dL with a mean corpuscular volume of 81 fl. Platelets were 556 × 10(3)/µL. A chest radiograph was concerning for a cavitary lung lesion and an abdominal ultrasound revealed multiple hypoechoic lesions in his spleen. Our panel of experts reviews his case and examines the workup of this patient with diverse symptoms and focal findings on chest radiograph and abdominal ultrasound. PMID:26908705

  6. Laparoscopic Management of Small Bowel Intussusception in a 16-Year-Old With Peutz-Jeghers Syndrome

    PubMed Central

    Clapp, Benjamin

    2008-01-01

    Introduction: Peutz-Jeghers is a rare autosomal dominant disorder characterized by hamartomatous polyps and discoloration of mucosal membranes. The polyps can occur anywhere in the gastrointestinal tract and can grow large enough to cause bowel obstructions. Case Report: A 16-year-old male presented to the emergency department with signs and symptoms of an acute bowel obstruction. He had 2 days of abdominal pain, obstipation, and vomiting. He had a previous history of a colonoscopy with polypectomy at age 4, and hyperpigmentation of his mucous membranes. Results: Computed tomographic (CT) scan revealed an intussusception of the small intestine. An exploratory laparoscopy found an intussusception of the mid jejunum. A laparoscopic-assisted small bowel resection was performed. Pathology showed a 5-cm polyp that acted as a lead point for the intussusception. Colonoscopy and upper endoscopy revealed 5 more polyps in the stomach and colon that were removed. Conclusion: Small bowel obstructions can be managed successfully with minimally invasive approaches. The treatment of obstruction in these patients is to remove the offending hamartomatous polyp(s). The rest of the intestine needs to be examined and those polyps found should be removed. This can be done intraoperatively with laparoscopic-assisted enteroscopy and colonoscopy. PMID:18765065

  7. 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

  8. Pseudoangiomatous stromal hyperplasia of the breast in a 10-year-old girl.

    PubMed

    Baker, Michael; Chen, Hui; Latchaw, Laurie; Memoli, Vincent; Ornvold, Kim

    2011-08-01

    Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign lesion, characterized by a dense proliferation of stromal mesenchymal cells of myofibroblastic origin forming empty, slitlike channels. The development of PASH is subject to hormonal influence and is most commonly seen in premenopausal women. In adolescent patients, PASH is rarely reported. Here we report a case of PASH presenting in a 10-year-old girl. After the presentation and inconclusive radiographic findings, incisional biopsy revealed a soft nodule with histopathologic features characteristic of PASH. Immunoperoxidase studies showed positive immunoreactivity for CD34 and bcl-2 and negative immunoreactivity for CD31 and desmin, supporting the diagnosis of PASH. Because of the benign nature of the lesion, excisional biopsy was deferred to minimize damage to the patient's developing breast. To our knowledge, this case represents the youngest female patient with unequivocal PASH in reported literature. PMID:21843705

  9. Erythropoietic Protoporphyria Masquerading as Angioedema in a 4-Year-Old Female

    PubMed Central

    2006-01-01

    Angioedema is a common presentation with a broad differential, including rare disorders with which an allergist must be familiar. Our objective was to report a case of swelling of the hands and feet mimicking angioedema with hepatomegaly in a 4-year-old girl. The patient was evaluated for painful swelling of the hands and feet after exposure to sun. Examination revealed edema and erythema of the extremities and hepatomegaly. Laboratory evaluation included elevated liver transaminases and plasma protoporphyrin, with normal urine porphyrins. Liver biopsy confirmed the diagnosis of erythropoietic protoporphyria, a disorder of heme biosynthesis in which patients may present with photosensitivity and angioedema. It is important for allergists to recognize this entity in patients with cutaneous disorders of unclear etiology in order to prevent possible life-threatening sequelae. PMID:20529216

  10. Case Report: A case report of Moyamoya disease in a 36 year old African American woman

    PubMed Central

    Gudepu, Rohit Kumar; Qureshi, Mohtashim A.; Qureshi, Ihtesham A.; Rao, Lakshman

    2014-01-01

    Moyamoya is a rare idiopathic progressive vaso-occlusive disease characterized by irreversible condition of main blood vessels to the brain as they enter into the skull. We present a case of 36 year old African American female presenting to the Out Patient Clinic with headache which were on and off for 4-6 months and did not relieve on routine medical therapy. It was associated with weakness on right side for last few days. The patient was investigated with CT Angiogram, diagnosed as Moyamoya disease and operated. She has been followed up for the last 5 years and the patient has not complained of any headaches or focal neurological symptoms. PMID:25717369

  11. Carbon monoxide poisoning in a 55-year-old man after a suicide attempt.

    PubMed

    Tilney, Peter

    2011-01-01

    A flight team was activated for a scene call in rural Vermont for a patient with apparent carbon monoxide (CO) poisoning. Per ground emergency medical services (EMS) personnel, this 55-year-old man with a history of coronary artery disease (CAD) was found unresponsive in his parked vehicle in his garage. "Dryer hose" tubing ran from the tailpipe into the rear window of his sedan. EMS providers also stated that a variety of unidentified pills were found on the floormat. There were no pill bottles in the vehicle or in the home to identify the medications. Whether the pills had been consumed was unclear. Ground EMS removed the patient from the vehicle and immediately placed the patient on high-flow oxygen. The duration of the exposure was unknown. PMID:21549280

  12. Mediastinal Granular Cell Tumor in a 16-Year-Old Boy: A Surgical and Pathologic Perspective.

    PubMed

    Winchester, Lacey M; Puckett, Yana; Greenspon, Jose; Vogler, Carole A

    2016-01-01

    Granular cell tumor is a benign tumor of likely neural or neuroectodermal origin that occurs most commonly in the subcutaneous tissues of the trunk, breast, and extremities of adults. Congenital gingival lesions comprise the majority of the pediatric granular cell tumors. Granular cell tumors are generally small and asymptomatic, and while 1 in 10 patients has multiple tumors, recurrence and malignancy are very rare. Mediastinal granular cell tumors have been reported, most occurring in young adult or middle-aged women. We present a case of a 16-year-old asymptomatic boy with a large mediastinal granular cell tumor incidentally identified after a motor vehicle accident, and we review the intraoperative, microscopic, and ultrastructural features of this tumor. Both the patient's age and anatomical location are unusual for this tumor, which presented technical and diagnostic challenges to the patient care team. PMID:26186035

  13. Dermatosis neglecta in a case of multiple fractures, shoulder dislocation and radial nerve palsy in a 35-year-old man: a case report

    PubMed Central

    Qadir, Syed Nurul Rasool; Ejaz, Amer; Raza, Naeem

    2008-01-01

    Introduction Dermatosis neglecta is an often misdiagnosed and under-diagnosed condition. In dermatosis neglecta, a progressive accumulation of sebum, sweat, keratin and other dirt and debris, occurs due to inadequate local hygiene resulting in a localized hyperpigmented patch or a verrucous plaque. Vigorous rubbing with alcohol-soaked gauze or soap and water results in a complete resolution of the lesion. This is the first case of dermatosis neglecta reported in a patient with multiple traumatic injuries. Case presentation We report a case of a 35-year-old male Caucasian of Pakistani origin, with multiple fractures, neurological deficit and immobility sustained in a fall, leading to the development of dermatosis neglecta of the left hand. Conclusion Early and prompt clinical recognition of this condition eliminates the need for aggressive diagnostic and therapeutic procedures. PMID:19014627

  14. Understanding male cancer patients' barriers to participating in cancer rehabilitation.

    PubMed

    Handberg, C; Lomborg, K; Nielsen, C V; Oliffe, J L; Midtgaard, J

    2015-11-01

    The aim was to describe male cancer survivors' barriers towards participation in cancer rehabilitation as a means to guiding future targeted men's cancer rehabilitation. Symbolic Interactionism along with the interpretive descriptive methodology guided the study of 35 male cancer survivors representing seven cancer types. Data were generated through a 5-month fieldwork study comprising participant observations, semi-structured individual interviews and informal conversations. The analyses revealed two overarching findings shedding light on male cancer survivors' barriers to rehabilitation: 'Fear of losing control' and 'Striving for normality'. While 'Fear of losing control' signified what the men believed rehabilitation would invoke: 'Reduced manliness', 'Sympathy and dependency' and 'Confrontation with death', 'Striving for normality' was based on what the men believed rehabilitation would hinder: 'Autonomy and purpose', 'Solidarity and fellowship' and 'Forget and move on'. This study of male cancer survivors' and cancer rehabilitation documents how masculine ideals may constitute barriers for participation in rehabilitation and provides insights about why men are underrepresented in rehabilitation. The findings can guide practice to develop research-based rehabilitation approaches focused on preserving control and normality. Further empirical evidence is needed to: (1) explore the conduct of health professionals' towards male cancer patients and (2) address gender inequalities in cancer rehabilitation. PMID:26223855

  15. Multiple Granuloma Annulare in a 2-year-old Child

    PubMed Central

    Siddalingappa, Karjigi; Murthy, Sambasiviah Chidambara; Herakal, Kallappa; Kusuma, Marganahalli Ramachandra

    2015-01-01

    Granuloma annulare is a benign, self-limiting, inflammatory and granulomatous disease of unknown etiology occurring in both adults and children. An 18-month-old male child had multiple progressive annular plaques over the lower extremities. Clinical and histopathological features were consistent with granuloma annulare. Localized granuloma annulare is the most common form in children. We report a young child with multiple, progressive granuloma annulare over the lower extremities. PMID:26677301

  16. 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

  17. X-linked adrenoleukodystrophy in a 6-year-old boy initially presenting with psychiatric symptoms.

    PubMed

    İncecik, Faruk; Hergüner, M Özlem; Mert, Gülen; Önenli-Mungan, Neslihan; Ceylaner, Serdar; Kör, Deniz; Altunbaşak, Şakir

    2014-01-01

    X-linked adrenoleukodystrophy (ALD) leads to demyelination of the nervous system, adrenal insufficiency and accumulation of long-chain fatty acids. Most young patients with X-linked ALD develop seizures and progressive neurologic deficits, and die within the first two decades of life. We present the case of a 6-year-old with childhood-onset ALD, first presenting with psychiatric symptoms and progressive gait difficulties, slurred speech and cognitive impairment. Genetic testing was performed and a p.R401Q (c.1202G>A) mutation detected in the ABCD1 gene. ALD should be considered in the differential diagnosis of patients presenting with behavior changes and white matter disease in neuroimaging. PMID:26388597

  18. Oral submucous fibrosis: a premalignant condition in a 14-year-old Indian girl.

    PubMed

    Deshpande, Anshula; Kiran, Shital; Dhillon, Steffi; Mallikarjuna, Rachappa

    2013-01-01

    A 14-year-old Indian girl presented with difficulty in mouth opening and burning sensation while eating. On examination, blanching of the oral mucosa with diffuse white pigmented lesion of size 3.5 to 2 cm along with melanotic pigmentation was seen on the left buccal mucosa posteriorly. The patient was diagnosed with oral submucous fibrosis. A comprehensive treatment plan was made based on conservative management that included motivation and intense counselling of the patient and her parents so that she quits the habit of chewing areca nut and tobacco, along with systemic treatment of vitamin B complex supplements, antioxidants, multivitamins and oral physiotherapy. We present this case to highlight the difficulties faced by the clinical practitioners in providing treatment because of the taboos and myths associated with surgical treatment modality in rural population as well as to emphasise the menace of increasing consumption and availability of tobacco and areca nut to children. PMID:24334472

  19. Walterinnesia aegyptia envenomation in a 22-year-old female: a case report.

    PubMed

    Lifshitz, Matitiahu; Maimon, Nimrod; Livnat, Shachar

    2003-03-01

    A 22-year-old woman was bitten on the third finger of her left hand by a Walterinnesia aegyptia (desert black cobra). Local signs included a marked swelling of the entire hand with pain along the left upper limb. Systemic reactions were irritability, fever, tachycardia, ventricular premature beats, nausea and high blood leukocytes count. About 15 h post-envenomation the patient had no symptoms except for a mild swelling of the hand. Despite the severe toxic venom composition of the W. aegyptia, the clinical course of our patient was relatively benign. This could be explained by the snake's behavior and the mechanism by which the venom penetrates the body. A survey of the literature revealed only a few clinical cases reported. Most of the information concerning W. aegyptia was collected from laboratory and animal studies. PMID:12657325

  20. Tenosynovial chondromatosis of the flexor hallucis longus in a 17-year-old girl.

    PubMed

    Winters, Nichelle I; Thomson, A Brian; Flores, Raina R; Jordanov, Martin I

    2015-11-01

    Tenosynovial chondromatosis is a benign chondrogenic metaplasia of extra-articular synovial tissue. The most common locations for tenosynovial chondromatosis to develop are the hands and feet. The condition has rarely been reported in children. We present a case of tenosynovial chondromatosis of the flexor hallucis longus in a 17-year-old girl. The presentation was unusual not only due to the location and young age of the patient but also the absence of any palpable mass on physical exam and complete lack of calcification of the cartilage bodies. Initial diagnosis was made by MRI. The patient underwent tenosynovectomy with an excellent postoperative recovery at 6-month follow-up. Histopathology confirmed the diagnosis of tenosynovial chondromatosis. PMID:26008872

  1. Oral submucous fibrosis: a premalignant condition in a 14-year-old Indian girl

    PubMed Central

    Deshpande, Anshula; Kiran, Shital; Dhillon, Steffi; Mallikarjuna, Rachappa

    2013-01-01

    A 14-year-old Indian girl presented with difficulty in mouth opening and burning sensation while eating. On examination, blanching of the oral mucosa with diffuse white pigmented lesion of size 3.5 to 2 cm along with melanotic pigmentation was seen on the left buccal mucosa posteriorly. The patient was diagnosed with oral submucous fibrosis. A comprehensive treatment plan was made based on conservative management that included motivation and intense counselling of the patient and her parents so that she quits the habit of chewing areca nut and tobacco, along with systemic treatment of vitamin B complex supplements, antioxidants, multivitamins and oral physiotherapy. We present this case to highlight the difficulties faced by the clinical practitioners in providing treatment because of the taboos and myths associated with surgical treatment modality in rural population as well as to emphasise the menace of increasing consumption and availability of tobacco and areca nut to children. PMID:24334472

  2. Rare Perilunate Injury as a Result of Chronic Trauma in 3-Year-Old Girl.

    PubMed

    Tomaszewski, Ryszard

    2015-12-01

    A 3-year-old girl was reported to have perilunate dislocation. The child had suffered, approximately 18 months before, a repetitive wrist injury by means of frequent pulling and bending of the hand by the father who may have physically abused the child for approximately 2 months. At the age of 3 years and 4 months, we performed the reduction of the perilunate dislocation and the plasty of the dorsal scapholunate ligament using the capsular flap prepared from the extensor retinaculum. The wrist was immobilized for 6 weeks. Two months after surgery, patient started the physiotherapy for 3 months. The patient could flex up the wrist to 40 degrees and extend up to 45 degrees (mobility of the healthy wrist was 60, 50 degrees) during the examination 24 months' post-op. Only the surgical treatment of the perilunate dislocation can lead to obtain the good surgical result. PMID:26788457

  3. Rare Perilunate Injury as a Result of Chronic Trauma in 3-Year-Old Girl

    PubMed Central

    Tomaszewski, Ryszard

    2015-01-01

    A 3-year-old girl was reported to have perilunate dislocation. The child had suffered, approximately 18 months before, a repetitive wrist injury by means of frequent pulling and bending of the hand by the father who may have physically abused the child for approximately 2 months. At the age of 3 years and 4 months, we performed the reduction of the perilunate dislocation and the plasty of the dorsal scapholunate ligament using the capsular flap prepared from the extensor retinaculum. The wrist was immobilized for 6 weeks. Two months after surgery, patient started the physiotherapy for 3 months. The patient could flex up the wrist to 40 degrees and extend up to 45 degrees (mobility of the healthy wrist was 60, 50 degrees) during the examination 24 months' post-op. Only the surgical treatment of the perilunate dislocation can lead to obtain the good surgical result. PMID:26788457

  4. Cold-water immersion in a 22-year-old service member.

    PubMed

    Harman, Kenneth R; Herndon, Thomas M

    2006-05-01

    Cold-water immersion can include aspects of both hypothermia and near drowning. We present a case of a 22-year-old active duty service member who became a victim of cold-water immersion in Alaska. His rescue by the U.S. Coast Guard and subsequent treatment in a small community emergency room are reviewed using a case management format. Care of the cold-water immersion patient with limited resources is highlighted and the potential complications of cold-water immersion are emphasized. Disturbances in acid base balance, pulmonary function, and cardiac rhythm are discussed. Changes in some of the hematological indices seen in the cold-water immersion patient are reported for the first time. PMID:16761900

  5. Diffuse sterile pustular eruption with changing clinical features in a 2-year old.

    PubMed

    Mazzatenta, Carlo; Martini, Patrizia; Luti, Laura; Domenici, Raffaele

    2005-01-01

    We report a 2-year-old girl with diffuse pustular eruptions occurring in close association with respiratory tract infections. The pustular eruption had different clinical characteristics over time, evolving from circinate to von Zumbush pustular psoriasis, and finally to subcorneal pustular dermatosis. Treatment with acitretin 1 mg/kg/day gave good results. A relapse showing striking clinical characteristics of subcorneal pustular dermatosis was treated with dapsone (1 mg/kg/day) followed by ultraviolet B-narrowband (UV-B-NB) phototherapy. The patient subsequently had several relapses over 1 year, which were well controlled with short cycles of UV-B-NB. This patient's findings demonstrate that pustular eruptions can vary over time, assuming clearly different clinical patterns, and highlight the difficulty of classifying pustular eruptions as separate diseases. PMID:15916577

  6. Pertussis Accompanying Recent Mycoplasma Infection in a 10-Year-Old Girl

    PubMed Central

    Cheon, Mi Kyung; Na, Hyunju; Han, Seung Beom; Kwon, Hyo Jin; Chun, Yoon Hong

    2015-01-01

    Recently, the incidence of pertussis has been increasing; however, reports on mixed infection of pertussis with other respiratory pathogens are rare in highly immunized populations. We report the case of a 10-year-old girl who presented with cough, post-tussive emesis, and fever. She was subsequently diagnosed with bronchopneumonia. Although she had received five doses of diphtheria-tetanus-acellular pertussis vaccine, polymerase chain reaction of her nasopharyngeal aspirate confirmed Bordetella pertussis infection. In addition, serologic testing for Mycoplasma pneumoniae was also positive. The patient was treated with roxithromycin without any complications. This is the first report of mixed B. pertussis and M. pneumoniae infection in Korea. To avoid under-diagnosis, pertussis should be considered in patients with chronic cough even when other respiratory pathogens have been documented. PMID:26483996

  7. Cockroach allergy and asthma in a 30-year-old man.

    PubMed Central

    O'Connor, G T; Gold, D R

    1999-01-01

    A growing body of evidence has implicated allergens derived from cockroaches as an important environmental factor that may aggravate asthma in sensitized persons. We present the case of a 30-year-old man with asthma and a cockroach allergy. Allergy skin testing confirmed hypersensitivity to cockroach extract, and a home visit revealed visual evidence of infestation and the presence of Bla g 1 German cockroach allergen in vacuumed dust. As is typical of patients with a cockroach allergy and asthma, multiple factors in addition to cockroach allergen appeared to aggravate the patient's asthma. A multimodality therapeutic regimen, which included medications as well as cleaning of the home, integrated pest management, and professional application of chemical controls, resulted in substantial clinical improvement. The pathophysiology, epidemiology, and clinical features of cockroach-allergic asthma are reviewed, and an approach to diagnosis and management is suggested. Images Figure 1 Figure 2 PMID:10064555

  8. [A case of gynandroblastoma in a 16-year old girl and review of literature].

    PubMed

    Marinova, P; Ivanova, R; Vaselinova, T; Jordanova, B

    2014-01-01

    An ovarian tumor (gynandroblastoma) in a 16-year old girl is reported. Clinical presentation include abdominal pain, signs of virilization and irregular menstrual cycles. Ultrasound scan examination reveals a cystic mass in a left ovary. The patient underwent a left ovariosalpingectomy Grossly, a cystic mass (73x 42 x 36 mm) with smooth outersurface and with many cysts was found in the left ovary The intraoperative diagnosis was ovarian adenocarcinoma. Postoperative histological examination reveals that the tumor was presented by two patterns - nodules and nests of juvenile granulose cell pattern admixed with Sertoli-Leydig pattern as tubules and cyst and scanty Sertoli cells. On immunohistochemical staining the Granulosa cells were negative for cytokeratin AE1-AE3 and positive for Vimentin. The Sertoli cells were androgen receptor positive. A yar after operation the patient had no abdominal pain, the menstrual cycles are regular, but virilization persist. Histogenesis and differential diagnosis are discussed. PMID:25509647

  9. [A case of gynandroblastoma in a 16-year old girl and review of literature].

    PubMed

    Marinova, P; Ivanova, R; Veselinova, T; Jordanova, B

    2015-01-01

    An ovarian tumor (gynandroblastoma) in a 16-year old girl is reported. Clinical presentation include abdominal pain, signs of virilization and irregular menstrual cycles. Ultrasound scan examination reveals a cystic mass in a left ovary. The patient underwent a left ovariosalpingectomy. Grossly, a cystic mass (73 x 42 x 36 mm) with smooth outer surface and with many cysts was found in the left ovary. The intraoperative diagnosis was ovarian adenocarcinoma. Postoperative histological examination reveals that the tumor was presented by two patterns- nodules and nests of juvenile granulose cell pattern admixed with Sertoli-Leydig pattern as tubules and cyst and scanty Sertoli cells. On immunohistochemical staining the Granulosa cells were negative for cytokeratin AE1-AE3 and positive for Vimentin. The Sertoli cells were androgen receptor positive. A year after operation the patient had no abdominal pain, the menstrual cycles are regular but the virilization persist. Histogenesis and differential diagnosis are discussed. PMID:25909131

  10. Delayed retropneumoperitoneum following vaginal laceration in a 7-year-old girl.

    PubMed

    Min, Kyung-Jin; Im, Hyesook; Lee, Sanghoon; Hong, Jin Hwa; Song, Jae-Yun; Lee, Jae-Kwan; Lee, Nak Woo

    2016-05-01

    We describe an unusual case of delayed retropneumoperitoneum caused by a deep vaginal laceration as a result trauma from a water jet in a fountain. A 7-year-old premenarcheal girl presented to the emergency department after experiencing an injury from a water jet at a fountain park. Initially, the patient's vital sign and perineum were within normal range. Because the patient's vital signs became unstable 12 hours after vaginal injury, we carried out abdomino-pelvic computed tomography resulting in retropneumoperitoneum. Arterial bleeding from vaginal lateral wall was founded and controlled by electrocoagulation. No damage to the rectum was laparoscopically confirmed. A diagnostic laparoscopy, not laparotomy, should be considered in cases of retropneumoperitoneum with an ambiguous cause first. PMID:27200319

  11. Delayed retropneumoperitoneum following vaginal laceration in a 7-year-old girl

    PubMed Central

    Min, Kyung-Jin; Im, Hyesook; Lee, Sanghoon; Hong, Jin Hwa; Song, Jae-Yun; Lee, Jae-Kwan

    2016-01-01

    We describe an unusual case of delayed retropneumoperitoneum caused by a deep vaginal laceration as a result trauma from a water jet in a fountain. A 7-year-old premenarcheal girl presented to the emergency department after experiencing an injury from a water jet at a fountain park. Initially, the patient's vital sign and perineum were within normal range. Because the patient's vital signs became unstable 12 hours after vaginal injury, we carried out abdomino-pelvic computed tomography resulting in retropneumoperitoneum. Arterial bleeding from vaginal lateral wall was founded and controlled by electrocoagulation. No damage to the rectum was laparoscopically confirmed. A diagnostic laparoscopy, not laparotomy, should be considered in cases of retropneumoperitoneum with an ambiguous cause first. PMID:27200319

  12. Collagenous gastroduodenitis with recurrent gastric ulcer in 12-year-old girl.

    PubMed

    Koide, Tatsuo; Mochizuki, Takahiro; Kawai, Naoki; Yashiro, Kenta; Inoue, Takeshi; Tsujimoto, Masahiko; Nishigaki, Toshinori

    2015-08-01

    This report describes a rare case of collagenous gastroduodenitis found in a 12-year-old Japanese girl who had recurrent hematemesis. Gastrointestinal endoscopy showed many lotus leaf-like lesions on the gastric mucosa surrounded by atrophic gastric mucosa in the antrum, with a cobblestone appearance and a scarred duodenal ulcer in the duodenal bulb. A biopsy of the gastric mucosa indicated subepithelial collagen band. The patient was treated with H2-blockers for her symptoms for 4 years following the endoscopic findings. Follow-up endoscopy showed the same appearance as before. The pathology, however, showed a more prominent subepithelial collagen deposition. To make the correct diagnosis, it is critical to know from which part the pathological biopsy specimens were taken because there were numerous collagen bands in the atrophic membrane. It is important to monitor the patient regularly for evaluation of the etiology, pathogenesis and prognosis of this rare disease. PMID:26011716

  13. Primary hepatic angiosarcoma in a 64-year-old man: A case report

    PubMed Central

    CHEN, GEN; LI, JIANFENG; WAN, RENHUA; WANG, GUORONG; SHI, JUN

    2016-01-01

    Primary hepatic angiosarcoma (PHA) is rare, does not possess any characteristic tumor markers, is primarily observed in the elderly, and often presents with nonspecific symptoms, including discomfort or distension of the abdomen, weight loss and fatigue. Thus, PHA is difficult to diagnose, particularly if the patient presents no history of exposure to carcinogens, and its definitive diagnosis requires histological examination following surgery. Patients with PHA present poor long-term survival, and surgical resection of the tumor is currently the best treatment option for PHA. In the present report, the case of a 64-year-old man initially diagnosed with hydatid cyst, who was subsequently diagnosed with a giant PHA in the middle of the liver, is described. Further studies are required to investigate the diagnosis and treatment of PHA. PMID:27073495

  14. Tracheoinnominate Fistula: Endovascular Treatment with a Stent Graft in a 4-Year-Old Child.

    PubMed

    Cavalcante, Rafael Noronha; Motta-Leal-Filho, Joaquim Maurício; Maciel, Macello José Sampaio; Carnevale, Francisco Cesar

    2016-02-01

    A 4-year-old boy presented with acute and profuse bleeding at the tracheostomy site. An emergency angiography was performed and identified a pseudoaneurysm at the innominate artery. A selective catheterization of the artery was executed and 2 Advanta V12 balloon-expandable covered stents were implanted in an overlapping manner to occlude the pseudoaneurysm. Final angiography demonstrated patency of the innominate artery and no signs of bleeding. The patient had no postoperative complications and no further bleeding during follow-up. A contrasted computed tomography scan was performed after 20 days and demonstrated no signs of pseudoaneurysm or bleeding. After 4 months, the patient was readmitted to tracheal dilatation and change of T-tube and died of respiratory complications. PMID:26597239

  15. Salter-Harris type-IV displaced distal radius fracture in a 5-year-old.

    PubMed

    Huntley, Samuel R; Summers, Spencer H; Stricker, Stephen J

    2016-03-01

    Displaced Salter-Harris type-IV fractures are rare in young children and can result in articular incongruity or premature physeal arrest. We describe a 5-year-old boy who sustained a displaced left distal radial Salter-Harris type-IV fracture. The patient had normal wrist function and physeal growth at the 3-year postoperative follow-up. Our patient is by far the youngest reported child with a displaced Salter-Harris type-IV fracture of the distal radius. Prompt anatomic reduction and fixation of a displaced distal radial Salter-Harris type-IV fracture can result in excellent short-term wrist motion with maintenance of physeal function. PMID:26426506

  16. [Anesthetic Management of a 105-year-old Man Undergoing Emergency Abdominal Surgery].

    PubMed

    Komasawa, Nobuyasu; Nishihara, Isao; Minami, Toshiaki

    2016-02-01

    As Japan's population ages, the number of cases of emergency abdominal surgery at advanced ages is increasing. A 105-year-old man weighing 37 kg combined with aortic stenosis and regurgitation was scheduled for emergency surgery for incarcerated inguinofemoral hernia. General anesthesia was induced with short-acting analgesics and sedatives. The patient was extubated uneventfully in the operating room and discharged without any major complications. Anesthetic management of elderly patients requires appropriate preoperative evaluation of complicating diseases, degree of consciousness, and nutritional condition. For those aged 100 years and older in particular, their quality of life should be considered. Close and cooperative communication between surgeons and anesthesiologists are also an important aspect in treating these charged without any major complications. PMID:27017779

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

    PubMed

    Young, Katie; Tunstall, Oliver; Mumford, Andrew

    2014-01-01

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

  18. A posterior ring apophyseal fracture and disc herniation in a 21-year-old competitive basketball player: a case report

    PubMed Central

    Deleo, Trevor; Merotto, Samuel; Smith, Colyn; D’Angelo, Kevin

    2015-01-01

    Objective: To describe the diagnosis and management of a competitive male basketball player with discogenic low back pain and presence of an old posterior ring apophyseal fracture (PRAF). This case will highlight the importance of early recognition and considerations regarding patient management for this differential of radiating low back pain. Clinical Features: A 21-year-old provincial basketball player presented with recurrent radiating low back pain into the left groin and lower limb. After several weeks of persistent symptoms including pain, muscle weakness, and changes in the Achilles deep tendon reflex, imaging was obtained that revealed a large disc extrusion with an old posterior ring apophyseal fracture. In collaboration with a spine surgeon and family physician, the patient was treated using a conservative, multimodal approach. Treatment consisted of graded mobilizations, spinal manipulative therapy, interferential current, and soft tissue therapy to the lumbar spine. Rehabilitation exercises focused on centralizing symptoms and improving strength, proprioception and function of the lower limb. After a period of 8 weeks, the patient was able to complete all activities of daily living without pain in addition to returning to basketball practice. Summary: PRAF is a unique condition in the immature spine and recent evidence suggests that those involved in sports requiring repetitive motion of the lumbar spine may be at increased risk. The astute clinician must consider this differential in young populations presenting with discogenic low back pain, as a timely diagnosis and necessary referral may allow for effective conservative management to reduce symptoms. Equally as important, one must be aware of the complications from PRAF as a contributing source of low back pain and dysfunction into adulthood. Knowing when to refer for advanced imaging and/or a surgical consult given the variable clinical presentation and prognosis is an essential component to care. PMID:26816414

  19. First report of Actinomyces europaeus bacteraemia result from a breast abscess in a 53-year-old man

    PubMed Central

    Nielsen, H.L.

    2015-01-01

    This is the first report of Actinomyces europaeus bacteraemia in a 53-year-old man. The bacteraemia was the result of a breast abscess. Identification was established by matrix-assisted desorption ionization–time of flight mass spectrometry and confirmed by 16S rRNA gene sequencing. The patient was treated with surgical drainage and penicillin for 4 weeks; the patient did not experience any relapse during 6 months of follow-up. PMID:26110063

  20. Treatment of atrophic nonunion of middle phalanx in a nine-year-old boy with external distraction and bone grafting.

    PubMed

    Dhamangaonkar, Anoop C; Patankar, Hemant S

    2014-01-01

    Nonunion of phalangeal fractures is uncommon and even rarer in the paediatric age group. There is paucity of literature relating to the treatment of atrophic non-union of phalangeal fractures in the paediatric age group. We present a case of five years old atrophic non-union of the middle phalanx of the index finger of the dominant hand in a nine-year-old male child, managed with a staged treatment protocol of initial fracture site distraction with a threaded external fixator followed by delayed bone grafting. This treatment was successful in attaining length and bony union in case of atrophic non-union of the middle phalanx with a good pinch strength and gaining a good range of motion at the proximal interphalangeal joint with little soft tissue dissection. PMID:25155710