Tetracycline-resistant pneumococcal infection. Incidence, clinical presentation, and laboratory evaluation

1969 ◽  
Vol 123 (4) ◽  
pp. 388-393 ◽  
Author(s):  
O. J. Bizzozero
Keyword(s):  
Clinical Presentation ◽  
Pneumococcal Infection ◽  
Laboratory Evaluation ◽  
Infection Incidence

scholarly journals Pituitary apoplexy induced by gonadotropin-releasing hormone (GnRH) agonist administration for treatment of prostate cancer: a systematic review

2021 ◽  
Author(s):  
Rishi Raj ◽  
Ghada Elshimy ◽  
Aasems Jacob ◽  
P. V. Akhila Arya ◽  
Dileep C. Unnikrishnan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Pituitary Adenoma ◽  
Gnrh Agonist ◽  
Tumor Size ◽  
Pituitary Apoplexy ◽  
Clinical Presentation ◽  
Pituitary Surgery ◽  
Laboratory Evaluation ◽  
The Mean

Abstract Objective We aimed to review of literature on the clinical presentation, management and outcomes of pituitary apoplexy following gonadotrophic release hormone (GnRH) agonist administration for the treatment of prostate cancer. Methods We used PRISMA guidelines for our systematic review and included all English language original articles on pituitary apoplexy following GnRH agonist administration among prostate cancer patients from Jan 1, 1995 to Dec 31, 2020. Data on patient demographics, prostate cancer type, Gleason score at diagnosis, history of pituitary adenoma, clinical presentation, GnRH agonist, interval to pituitary apoplexy, laboratory evaluation at admission, radiologic findings, treatment of pituitary apoplexy, time to surgery if performed, pathology findings, and clinical/hormonal outcomes were collected and analyzed. Results Twenty-one patients with pituitary apoplexy met our inclusion criteria. The mean age of patients was 70 (60–83) years. Leuprolide was the most common used GnRH agonist, used in 61.9% of patients. Median duration to symptom onset was 5 h (few minutes to 6 months). Headache was reported by all patients followed by ophthalmoplegia (85.7%) and nausea/vomiting (71.4%). Three patients had blindness at presentation. Only 8 cases reported complete anterior pituitary hormone evaluation on presentation and the most common endocrine abnormality was FSH elevation. Tumor size was described only in 15 cases and the mean tumor size was 26.26 mm (18–48 mm). Suprasellar extension was the most common imaging finding seen in 7 patients. 71.4% of patients underwent pituitary surgery, while 23.8% were managed conservatively. Interval between symptoms onset to pituitary surgery was 7 days (1–90 days). Gonadotroph adenoma was most common histopathologic finding. Clinical resolution was comparable, while endocrine outcomes were variable among patients with conservative vs surgical management. Conclusion Although the use of GnRH agonists is relatively safe, it can rarely lead to pituitary apoplexy especially in patients with pre-existing pituitary adenoma. Physicians should be aware of this complication as it can be life threatening. A multidisciplinary team approach is recommended in treating individuals with pituitary apoplexy.

scholarly journals Lowering of the level of consciousness by bilateral paramedian thalamic infarction due to Percheron’s ischemia (Percheron’s syndrome): a case report

2021 ◽  
Author(s):  
Mariana Sandy Mada
Keyword(s):  
Case Report ◽  
Latin American ◽  
Clinical Presentation ◽  
Altered Mental Status ◽  
Caribbean Literature ◽  
Laboratory Evaluation ◽  
Anatomical Variant ◽  
Loss Of Self ◽  
Thalamic Infarction ◽  
Level Of Consciousness

Context: Ischemia of Percheron’s artery(PA) is a rare neurological occurrence that results in bilateral paramedian thalamic infarction that may affect the midbrain. Among the symptoms are altered mental status, vertical ocular palsy, and memory changes, as well as hemiplegia, cerebellar ataxia, and movement disorders. Objective: To elucidate a case of stroke of the mesencephalic trunk in an uncommon anatomical variant of the thalamus-perfurans arteries Method:Daily neurological and laboratory evaluation in addition to complementary examinations such as skull CT and skull MRI. We also performed a qualitative analysis of articles in Portuguese and English journals indexed in the following databases: PubMed (Public Medical Literature Analysis), Lilacs (Latin American and Caribbean Literature on Health Sciences) and Scielo (Scientific Eletronic Library Online). Case report: A 67 year old male presented with mild to moderate headache for 2 days, reporting chronic cough and decreased level of consciousness for 1 day. He was intubated (Glasgow 6) and sedated for diagnostic elucidation. The CT shows mild cerebral edema and MRI shows bilateral thalamic infarction affecting the PA. The clinical picture evolves to ischemic stroke of the mesencephalic trunk. Discussion: The bilateral infarction of the Percheron artery, as presented in this case, the neurological and neuropsychological manifestations are more severe such as akinetic mutism, thalamic dementia and loss of self psychic activation(Robot Syndrome). In these cases, the neuropsychological disturbance is best noticed when the patient regains consciousness. Conclusion: In the presence of a clinical presentation suggestive of bilateral thalamic infarction, the Percheron Syndrome hypothesis should be suspected.

scholarly journals The clinical and laboratory evaluation of patients with suspected hypocellular marrow failure

Hematology ◽  
2021 ◽  
Vol 2021 (1) ◽  
pp. 134-142
Author(s):  
Siobán Keel ◽  
Amy Geddis
Keyword(s):  
Bone Marrow ◽  
Clinical Utility ◽  
Clinical Presentation ◽  
Bone Marrow Failure ◽  
Neutral Loss ◽  
Laboratory Evaluation ◽  
Short Telomere ◽  
Diagnostic Challenge ◽  
Appropriate Care ◽  
Bone Marrow Failure Syndromes

Abstract The overlap in clinical presentation and bone marrow features of acquired and inherited causes of hypocellular marrow failure poses a significant diagnostic challenge in real case scenarios, particularly in nonsevere disease. The distinction between acquired aplastic anemia (aAA), hypocellular myelodysplastic syndrome (MDS), and inherited bone marrow failure syndromes presenting with marrow hypocellularity is critical to inform appropriate care. Here, we review the workup of hypocellular marrow failure in adolescents through adults. Given the limitations of relying on clinical stigmata or family history to identify patients with inherited etiologies, we outline a diagnostic approach incorporating comprehensive genetic testing in patients with hypocellular marrow failure that does not require immediate therapy and thus allows time to complete the evaluation. We also review the clinical utility of marrow array to detect acquired 6p copy number-neutral loss of heterozygosity to support a diagnosis of aAA, the complexities of telomere length testing in patients with aAA, short telomere syndromes, and other inherited bone marrow failure syndromes, as well as the limitations of somatic mutation testing for mutations in myeloid malignancy genes for discriminating between the various diagnostic possibilities.

scholarly journals Descriptive Study of Pregnancy Dermatoses in Central Region of Gujarat

2021 ◽  
Vol 8 (23) ◽  
pp. 1899-1903
Author(s):  
Meghana Manharlal Kariya ◽  
Maheshkumar Chaturbhai Patel
Keyword(s):  
Clinical Presentation ◽  
Descriptive Study ◽  
Relative Effect ◽  
Laboratory Evaluation ◽  
Physiological Changes ◽  
Cutaneous Manifestations ◽  
Detailed History ◽  
Wide Range ◽  
Systemic Examination ◽  
Dermatoses Of Pregnancy

BACKGROUND The present study was conducted to evaluate the incidence, clinical presentation, course and prognosis of physiological changes of pregnancy i.e. to study the incidence of different dermatoses during pregnancy, cutaneous manifestations associated with pregnancy according to trimester and parity of pregnancy, specific dermatoses of pregnancy, the presence of same or other diseases in the past pregnancy, and observe the relative effect of pregnancy on already existing dermatoses or which are basically not related to pregnancy. METHODS A random hospital based descriptive study of 80 patients with pregnancy, who attended skin outpatient department (OPD) in GMERS Medical College, Himmatnagar, Gujarat, India, was done. Detailed history was taken, and each patient was examined thoroughly. General- and systemic-examination were done and whenever necessary, relevant investigations were done. RESULTS A total of 80 patients were included in the study. Of them 39 (48.7 %) were primipara and 41 (51.3 %) were multipara. Skin changes were grouped into physiological changes (all cases), specific dermatoses (17 cases) and other dermatoses (52 cases). Most common physiological changes were related to pigmentation followed by striae gravidarum. Physiological changes were observed in almost all the patients. CONCLUSIONS Pregnant women are prone to suffer from a wide range of dermatological problems apart from the specific dermatoses of pregnancy. Detailed history and awareness of clinical presentation facilitates the confirmation of diagnosis and will direct the most appropriate laboratory evaluation in an effort to minimize maternal and foetal morbidity. KEYWORDS Pregnancy Dermatoses, Specific Dermatoses, Physiological Changes

scholarly journals B-PO04-172 THE ROLE OF THE LEFT SEPTAL FASCICLE IN FASCICULAR ARRHYTHMIAS: CLINICAL PRESENTATION AND LABORATORY EVALUATION

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S348-S349
Author(s):  
Satoshi Higuchi ◽  
Jose M. Sanchez ◽  
Tomos E. Walters ◽  
Vasanth Vedantham ◽  
Henry H. Hsia ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Laboratory Evaluation

Patterns of Clinical Presentation of Thrombotic Thromboxytopenic Purpura. Is There a Racial Difference?. A Single Institution Experience.)

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4653-4653
Author(s):  
Muath Dawod ◽  
Mohammad Alhyari ◽  
Philip Kuriakose
Keyword(s):  
African Americans ◽  
Clinical Presentation ◽  
Conflicts Of Interest ◽  
Laboratory Evaluation ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Chi Square ◽  
Gi Symptoms ◽  
Serious Disease

Abstract Abstract 4653 Background: Thrombotic thrombocytopenic purpura (TTP) is a rare but serious disease that has been reported more frequently in African-Americans (AA). While recent reports have showed an increased incidence of TTP amongs AA patients, there is no data with regards to the patterns of clinical presentation in this racial subgroup and if there is any difference as compared to other racial subgroups. Patients and methods: In this retrospective study we reviewed characterstics and clinical presentation of 91 patients with the diagnosis of TTP. Sixty four patients were AAs (70%). The second largest racial subgroup was Caucasians (24 patients, 26%). Demographics, lab values and symptoms were compared between AAs and Caucasians. Continuous variables were compared using two-sided two-sample t-tests. Alternatively, the Wilcoxon rank-sum test was used if the data were not normally distributed. Categorical variables were compared using Chi-square tests. Results: AA patients were older [median age of 47.6 years as compared to 40 years, P-value of 0.057] and more likely to be females [68.8%, (n=44/64) as compared to 45.8%, (n=11/24), P-value of 0.048]. As for laboratory evaluation, AA patients were more likely to have positive ANA [44% (n=22/64) as compared to 14.3% (n=2/24), P-value of 0.042] and higher ESR (median of 75.5 as compared to 40.7, P-value 0.03). Other laboratory evaluation including hemoglobin, platelet counts and creatinine were comparable. The most common patterns of clinical presentation in AA patients were in the form of constitutional symptoms (fatigue, malaise and generalized weakness) which were seen in 67% of patients (n=43), followed by neurological symptoms (mainly headache and confusion) in 53% of pateints (n=34). Gastrointestinal (GI) symptoms (nausea, vomiting or abdominal pain) were seen in 44% of patients (n=28). This pattern was comparable to what is seen in Caucasian patients. Skin symptoms were reported less frequently in AA as compared to Caucasians (17.2% vs. 41.7%, p = 0.016). Conclusion: While AA patients are more likely to be females, older and have positive ANA, the clinical presentation of TTP is similar among different racial subgroups (African Americans and Caucasians). Disclosures: No relevant conflicts of interest to declare.

Jansky-Bielschowsky syndrome, a lysosomal disease: First diagnosed cash in Oman

1992 ◽  
Vol 50 (1) ◽  
pp. 632-633
Author(s):  
Line Buhl ◽  
David Muirhead
Keyword(s):  
Mental Retardation ◽  
Clinical Picture ◽  
Neurological Disorder ◽  
Clinical Presentation ◽  
Neuronal Ceroid Lipofuscinosis ◽  
Infantile Form ◽  
Lysosomal Disease ◽  
Juvenile Form ◽  
Progressive Encephalopathy ◽  
Lysosomal Diseases

There are four lysosomal diseases of which the neuronal ceroid lipofuscinosis is the rarest. The clinical presentation and their characteric abnormal ultrastructure subdivide them into four types. These are known as the Infantile form (Santavuori-Haltia), Late infantile form (Jansky-Bielschowsky), Juvenile form (Batten-Spielmeyer-Voght) and the Adult form (Kuph's).An 8 year old Omani girl presented wth myclonic jerks since the age of 4 years, with progressive encephalopathy, mental retardation, ataxia and loss of vision. An ophthalmoscopy was performed followed by rectal suction biopsies (fig. 1). A previous sibling had died of an undiagnosed neurological disorder with a similar clinical picture.

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

Sign in / Sign up

Export Citation Format

Share Document