A retrospective study of nine patients with progressive pseudorheumatoid dysplasia: to explore early diagnosis and further treatment

Introduction Tuberculosis can involve any organ or site. Otorhinolaryngologist may encounter tuberculosis affecting lymph nodes, ear, larynx, deep neck spaces, salivary glands etc. which can mimic other chronic granulomatous conditions or malignancy. To ensure early diagnosis, it is important to recognize its cardinal signs and symptoms and to be aware of potential pitfalls in diagnosis. This study was done to learn the clinical presentation of tuberculosis in ear, nose, throat and head and neck region, and to assess the effectiveness of various investigations and treatment done for the same. Materials and Methods A retrospective study done in our institution involving 120 patients suffering from tuberculosis in ear, nose, throat and head and neck region who attended pulmonary medicine or ENT OPD or ward between January 2008 to December 2017 that is, 10 years. Study period for data collection and analysis was 1 month. Results Total 120 patients-69 males and 51 females. Most common site was cervical lymph nodes(77.5% patients), followed by larynx(8.3%),middle ear(7.5%),deep neck spaces(2.5%) and salivary glands and nose(1.7% each). Histopathology was highly sensitive(99. 1%).All except one patient responded to first-line antitubercular drugs, the other patient was given treatment for MDR-TB to which he responded. Conclusion Tuberculosis can involve any site in the head and neck region, most common being cervical lymph nodes mainly presenting as neck swelling. Variable nature of manifestations of tuberculosis makes it essential to have high degree of suspicion for early diagnosis.

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The Significance of Routine Biochemical Markers in Patients With Sepsis

10.21203/rs.3.rs-135063/v1 ◽

2020 ◽

Author(s):

Yan Meng ◽

Yue Wang ◽

Wenbin Qiao ◽

Yumei LIU ◽

Liang Wang ◽

...

Keyword(s):

Retrospective Study ◽

Early Diagnosis ◽

Diagnostic Criteria ◽

Assessment Tool ◽

Diagnostic Value ◽

Sepsis Group ◽

Control Group ◽

Diagnostic Efficiency ◽

Infection Group ◽

D Dimer

Abstract Background: Sepsis is a highly complex and fatal syndrome. It is the main cause of death in the intensive care unit. Early diagnosis is beneficial to reduce the mortality of sepsis and improve the prognosis of patients. Therefore, we look forward to finding cheap and fast diagnostic criteria to quickly assess the patient's condition.Methods: This is a retrospective study. The study enrolled 499 patients in the First Affiliated Hospital of Xinjiang Medical University from January 1, 2018 to June 22, 2020, and 96 healthy cases in the same period. Using the diagnostic criteria of bacterial infection, SIRS criteria and Sepsis-2 consensus criteria, 499 patients and 96 healthy cases were divided into 4 groups: sepsis group (n=300), SIRS group (n=151), infection group (n= 48), the control group (n=96). We collected the results of routine laboratory tests, inflammation indicators and blood culture results of these patients. Results: The sepsis group compared with the control group, MCV, NE, WBC, PLT, HB, D-Dimer, PT, CRP, PCT, IL-6, ALB, TBIL, Cr, LAC, CysC and BNP were statistically significant. D-dimer, CRP and PCT have higher diagnostic efficiency. Compared with the difference between the infection group and the SIRS group, PLT and IL-6 are statistically significant, and have a certain diagnostic value. Sepsis group VS infection group, WBC, IL-6, NE and TBIL showed statistical differences in the comparison. The AUC of NE was 67.6, which was the largest among the three. The specificity (95.8%) was the highest, but the sensitivity (49%) was low.Conclusions: This retrospective study shows that NE, WBC, and D-dimer can help in the early diagnosis of sepsis. D-dimer performs best. WBC and NE may have a differential diagnosis significance between the sepsis group and the infection group. This result can provide a timely and convenient assessment tool for early diagnosis of sepsis.

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Epidemiological, Clinical, Trichoscopic, and Histopathological Features of Lupus Erythematous Mimicking Alopecia Areata: A Multicenter Retrospective Study

Skin Appendage Disorders ◽

10.1159/000520825 ◽

2022 ◽

pp. 1-5

Author(s):

Daniel Fernandes Melo ◽

Paulo Müller Ramos ◽

Matilde Iorizzo ◽

Caren dos Santos Lima ◽

Erica Baptista Pinto ◽

...

Keyword(s):

Retrospective Study ◽

Early Diagnosis ◽

Hair Loss ◽

Alopecia Areata ◽

Lupus Erythematosus ◽

Medical Records ◽

High Specificity ◽

Histopathological Features ◽

Brown Discoloration ◽

Perivascular Inflammation

Introduction: All types of lupus erythematosus (LE) may cause hair loss. Nonscarring alopecia was correlated with systemic LE, based on its high specificity. Discoid LE can also appear as nonscarring patches in early stages. Patchy alopecia LE-specific may also mimic alopecia areata (AA) – which can co-occur with LE. The distinction is fundamental to early diagnosis and effective treatment. This study aims to analyze clinical, epidemiological, trichoscopic, and histopathological features of patients with patchy LE-specific alopecia, nonscarring type, mimicking AA. Methods: This is a multicentric retrospective study. We reviewed the medical records of patients with a confirmed diagnosis of LE mimicking AA. Results: Ten patients were included (90% female) with a mean age of 45.9 years. Clinically, 60% showed erythema and 70% presented incomplete hair loss. The most common trichoscopic findings were interfollicular arborizing vessels (90%) and scattered brown discoloration (80%). On histopathology, perivascular inflammation (85.7%), peribulbar lymphocytes (85.7%), and dermal pigment incontinence (71.4%) were present in most cases. Discussion/Conclusion: Trichoscopy was found as an essential first step for the patchy alopecia diagnosis, enabling to differentiate LE from AA. Putting it mildly, trichoscopy raises the suspicion that leads to a biopsy, increasing the diagnostic accuracy with better outcome for patients.

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Sidroma neuroleptik maligna patofisiologi, diagnosis, dan terapi

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.8.2.2016.12675 ◽

2016 ◽

Vol 8 (2) ◽

Author(s):

Mieke A. H. N. Kembuan

Keyword(s):

United States ◽

Retrospective Study ◽

Mortality Rate ◽

Early Diagnosis ◽

Movement Disorder ◽

Altered Mental Status ◽

Neuroleptic Drug ◽

Fatal Complication ◽

Unknown Mechanism ◽

Physical Findings

Abstract: Neuroleptic malignant syndrome (NMS) is an uncommon, neurological emergency, with a high mortality rate. This syndrome is related with neuroleptic drug consumption. It is potential to bring about fatal complication with physical findings such as fever, movement disorder, rigidity, altered mental status, and autonomic dysfunction. A retrospective study in India showed an incidence rate of 0.14%, while in United States it reached 0.2-1.9%. NMS is related to the disturbance of dopamine receptor due to unknown mechanism. Most people with NMS died from heart, lung, or kidney complications. Early diagnosis, halting the usage of offending drugs, best supportive medical treatment, and specific pharmacotherapy for 14-21 days can give a good clinical outcomeKeywords: NMS, neuroleptic drugsAbstrak: Sindroma neuroleptik maligna (SNM) jarang terjadi namun merupakan suatu kegawatdaruratan neurologi yang berpotensi mengancam nyawa. Sindroma ini berkaitan dengan penggunaan obat-obatan neuroleptik. SNM berpotensi menyebabkan komplikasi fatal yang diakibatkan oleh penggunaan obat-obat antipsikotik dengan gejala klinis berupa demam, gangguan gerak, rigiditas, perubahan kesadaran, dan disfungsi otonom. Suatu penelitian retrospektif di India menunjukkan angka insidens SNM 0,14%, sedangkan di Amerika Serikat angka insidens tersebut mencapai 0,2-1,9%. Patofisiologi sindroma ini berhubungan dengan jalur reseptor dopamin di otak dengan mekanisme yang belum jelas. Morbiditas dan mortalitas pada SNM sering merupakan akibat sekunder dari komplikasi jantung, paru-paru, dan ginjal. Keberhasilan tatalaksana SNM dapat dicapai melalui diagnosis dini yang tepat, penghentian obat-obat neuroleptik, perawatan medis suportif, dan farmakoterapi spesifik selama 14 sampai dengan 21 hari diikuti dengan perbaikan klinis.Kata kunci: SNM, obat-obat neuroleptik

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A Retrospective Study of Nine Patients with Progressive Pseudorheumatoid Dysplasia: To Explore Early Diagnosis and Further Treatment

10.21203/rs.3.rs-243375/v1 ◽

2021 ◽

Author(s):

Lei Yin ◽

Youying Mao ◽

Yunfang Zhou ◽

Yongnian shen ◽

Huijin Chen ◽

...

Keyword(s):

Vitamin D ◽

Retrospective Study ◽

Vitamin D Deficiency ◽

Clinical Manifestations ◽

Normal Range ◽

Radiographic Findings ◽

Progressive Pseudorheumatoid Dysplasia ◽

Abnormal Gait ◽

Laboratory Test Results ◽

Vertebral Bodies

Abstract Background: Most patients with progressive pseudorheumatoid dysplasia (PPRD) are initially misdiagnosed because of disease rarity and lack of awareness by most clinicians. The purpose of this present study was to provide further early diagnostic options and potential treatment to patients with PPRD. Methods: This was a retrospective study. Clinical manifestations, laboratory test results, radiographic features, Sanger Sequencing to determine CCN6 gene variants, treatment and follow-up records were collected in the patients with PPRD. Time to diagnosis, phenotype and genotype correlation were analyzed. Results: Nine PPRD children were included. There were 3 pairs of siblings and one patient had parental consanguinity. Five patients were misdiagnosed as juvenile idiopathic arthritis (JIA). The onset of disease in 8 patients was between 3 to 6 years of age. The interval from onset of symptoms to obtaining the diagnosis for 8 of the patients varied from 3.6 years to 20 years. The onset of symptoms included enlarged and stiff interphalangeal joints of the fingers, gait disturbance or joint pain. Laboratory tests revealed normal range of inflammatory parameters. Serum levels of 25-hydroxyvitamin D3 in six patients were below the normal range. Radiographic findings included different degree of abnormal vertebral bodies, epiphyseal enlargement of the interphalangeal joints with juxta-articular osteopenia, or cyst-like structures femoral head. All the patients harbored CCN6 variants, and a total of 7 variants were identified. After the treatment of calcitriol in 5 patients with low level of 25-hydroxyvitamin D3 for 1.25 years to 1.75 years, two of them kept stable, while 3 of them improved gradually. Conclusions: Combining the patient’s family history, clinical features presenting with abnormal gait or enlarged and stiff interphalangeal joints of the fingers, normal inflammatory markers, and the characteristic radiographic findings, we can obtain the clinical diagnosis of PPRD for the patients at a very early stage of the disease. Anterior blunt of the vertebral bodies could be an early radiological sign in the patient even without obvious clinical symptoms and characteristics yet. The patients with PPRD having c.624dupA variant in CCN6 may have delayed onset. Underlying vitamin D deficiency should be sought and corrected in patients with PPRD. Keywords: progressive pseudorheumatoid dysplasia; noninflammatory; articular cartilage; CCN6 gene variant; vitamin D deficiency

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Impacted Maxillary Canine Prevalence and Its Association with Other Dental Anomalies in a Mexican Population

International Journal of Dentistry ◽

10.1155/2017/7326061 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

José Rubén Herrera-Atoche ◽

María del Rosario Agüayo-de-Pau ◽

Mauricio Escoffié-Ramírez ◽

Fernando Javier Aguilar-Ayala ◽

Bertha Arelly Carrillo-Ávila ◽

...

Keyword(s):

Retrospective Study ◽

Early Diagnosis ◽

Mexican Population ◽

Amelogenesis Imperfecta ◽

Risk Indicators ◽

Control Group ◽

Dental Anomalies ◽

Supernumerary Teeth ◽

Maxillary Canine ◽

Impacted Teeth

Objective. We quantified the prevalence of impacted maxillary canines (IMC) and their association with other dental anomalies (DAs).Materials and Methods. A retrospective study was done with 860 patients 12 to 39 years of age. The prevalence of IMC was calculated and compared by sex. The sample was divided into a control group and an impaction group, and the prevalence was calculated in both for a series of anomalies: agenesis, supernumerary teeth, shape anomalies of the upper laterals (microdontia, peg and barrel shape, and talon cusp), fusion, gemination, other impacted teeth, transposition, and amelogenesis imperfecta. The prevalence values for both groups were compared (Pearson’sχ2test,p≤0.05).Results. IMC were present in 6.04% of the sample with no difference by sex (p=0.540). Other DAs occurred in 51.92% of the IMC group and in 20.17% of the controls (p<0.05). Significant associations (p<0.05) were identified between IMC and four other DAs: microdontia, barrel shape, other impacted teeth, and transposition. The prevalence of all anomalies was lower in the control group.Conclusion. IMC were seen in 6.04% of patients. Patients with this condition also had a higher prevalence of other DAs. These other anomalies should be used as risk indicators for early diagnosis.

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809 Evaluation of the Two Week Wait Colorectal Cancer Pathway in a District General Hospital

British Journal of Surgery ◽

10.1093/bjs/znab134.582 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

O Karadakhy ◽

E Poynton-Smith ◽

G Le ◽

E Mohamed ◽

R G Singh ◽

...

Keyword(s):

Colorectal Cancer ◽

Retrospective Study ◽

Early Diagnosis ◽

Gastrointestinal Cancer ◽

District General Hospital ◽

Bowel Cancer ◽

Patient Records ◽

Electronic Patient Records ◽

Use Of Resources ◽

Referral Criteria

Abstract Introduction Updated guidelines published by the National Institute for Health and Care Excellence in 2015 widened the referral criteria for the two week wait (2WW) pathway for suspected lower gastrointestinal cancer, in an attempt to increase early diagnosis. The aim of this study was to evaluate the compliance of referrals received via the (2WW) pathway for suspected lower gastrointestinal cancer. Method We conducted a retrospective study which utilised a local cancer registry to identify all patients who had been referred to United Lincolnshire Hospitals Trust over a two-month period. Electronic patient records were checked to establish whether patients fulfilled the 2015 referral criteria. Results Out of 615 patients referred, 51 (8%) had colorectal cancer. 92 (15%) referrals did not meet the criteria for the 2WW pathway. Whether or not the referral was ‘appropriate’ had no significant effect on the diagnoses of bowel cancer (X2 = .003, p>.05). Conclusions 16% of all referrals did not meet criteria. This may appear as an inefficient use of resources, however there was no difference in rates of cancer between appropriate and inappropriate referrals. The referral criteria are likely to evolve over the course of time, and perhaps clinicians’ judgement should be taken into account.

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GAMBARAN ELEKTROKARDIOGRAM PADA PASIEN DM TIPE 2 DI POLIKLINIK ENDOKRIN BLU RSUP PROF. DR. R. D. KANDOU MANADO

e-CliniC ◽

10.35790/ecl.3.1.2015.6745 ◽

2015 ◽

Vol 3 (1) ◽

Author(s):

Fikri H. Maradjabessy ◽

Starry Rampengan ◽

Yuanita Asri Langi

Keyword(s):

Retrospective Study ◽

Cardiovascular Diseases ◽

Early Diagnosis ◽

Medical Record ◽

Vascular Diseases ◽

Ischemic Myocardium ◽

Bundle Branch Block ◽

Study Population ◽

Dm Type 2

Abstract: There were so many theories and hypotheses association between DM type 2 and cardiovascular diseases (CVD). 5,1 million mortality due to DM (3/4 associated to CVD as DM complication). Early diagnosis of CVD on DM type 2 is crucial, such as ECG sign. The study population, derived from DM type 2 patients visited in Policlinic of Endocrine Prof. Dr. R. D. Kandou Manado hospital for 1 month (September 2014). We design a descriptive retrospective study consisting of non-randomly selected DM type 2 patients medical record with an ECG traces. We evaluated the altered ECG of DM type 2 patients. During the study, there were 53 LAH/LAE traces, coroner vascular diseases 41 traces (18 ischemic myocardium traces, 23 old myocardium infarct traces), bundle branch block (12 LAHB/LAFB, 7 RBBB complete, 3 RBBB incomplete, 1 LBBB traces), 9 LVH traces. Conclusion: there were a significant number of LAH/LAE, coroner vascular diseases and bundle branch block on DM type 2 patient ECG traces in Policlinic of Endocrine Prof. Dr. R. D. Kandou Manado hospital.Keywords: DM type 2, CVD, ECG.Abstrak: Ada begitu banyak teori dan hipotesis tentang hubungan antara DM tipe 2 dan penyakit kardiovaskular (PKV). 5,1 juta kematian akibat DM (3/4 terkait dengan PKV sebagai komplikasi dari DM). Diagnosis dini untuk PKV pada DM tipe 2 sangat penting, seperti gambaran EKG. Populasi penelitian didapatkan dari kunjungan pasien DM tipe 2 di Poliklinik Endokrin BLU RSUP Prof. Dr. R. D. Kandou Manado selama 1 bulan (September 2014). Penelitian di menggunakan desain deskriptif retrospektif terdiri dari rekam medis pasien DM tipe 2 dengan rekam EKG yang dipilih secara non-random. Kami mengevaluasi kelainan EKG pada pasien DM tipe 2. Selama penelitian, ditemukan 53 gambaran LAH/LAE, gangguan pembuluh darah koroner 41 gambaran (18 gambaran iskemik miokard, 23 gambaran infark miokard lama) , blokade cabang berkas 33 gambaran (12 gambaran LAHB / LAFB, 7 gambaran RBBB, 3 gambaran RBBB lnkomplit , 1 gambaran LBBB), dan 9 gambaran LVH. Simpulan: Ditemukan sejumlah besar gambaran EKG untuk LAH/LAE, pembuluh darah koroner, dan blokade cabang berkas pada pasien DM tipe 2 di Poliklinik Endokrin BLU RSUP Prof. Dr, R. D. Kandou Manado.Kata kunci: DM tipe 2, PKV, EKG.

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The Therapeutic Management Of Retroperitoneal Injuries

Acta Medica Marisiensis ◽

10.2478/amma-2013-0032 ◽

2013 ◽

Vol 59 (3) ◽

pp. 140-143

Author(s):

C Crăciun ◽

L Azamfirei ◽

M F Coroș ◽

A Hintea ◽

D Cozma ◽

...

Keyword(s):

Retrospective Study ◽

Early Diagnosis ◽

Minimally Invasive ◽

Retroperitoneal Fibrosis ◽

Surgical Techniques ◽

Parasitic Diseases ◽

Inflammatory Conditions ◽

Minimally Invasive Surgical ◽

Vascular Factor ◽

Surgical Conditions

Abstract Background: In the retro peritoneum different organs of various origins (vascular, nervous, muscular, fascia, etc.) are located. These represent the source of different surgical conditions that cause, even today, serious problems of early diagnosis and treatment. Material and method: We have conducted a retrospective study throughout a period of 8 years (2004-2011). We followed the incidence, the treatment and the evolution of several types of retroperitoneal lesions. Results: In this period 79 cases of retroperitoneal conditions were encountered, representing 0.51% from the total of 15,284 patients admitted and treated within our clinic. The most common cases were those of tumour conditions and retroperitoneal primitive tumours (RPT). Many inflammatory conditions were also encountered. There were a few cases of retroperitoneal overflows or of parasitic diseases and we did not encounter cases of retroperitoneal fibrosis or malacoplaky. Conclusions: In our study the majority of the retroperitoneal conditions were of tumour nature, especially malignant RPTs. Secondary retroperitoneal tumours (adenopathies, metastases, relapses) were less frequent. The excision of the retroperitoneal tumours is delicate, especially due to the vascular factor caused by anatomical conditions and their own vascularisation. On well-chosen cases we can use minimally invasive surgical techniques (laparoscope, punctures and eco-guided drainages), which enable a favorable post-operative evolution.

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