scholarly journals Differences in clinical and imaging presentation of maxillary sinus fungus ball with and without intralesional hyperdensity

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pei-Wen Wu ◽  
Ta-Jen Lee ◽  
Shih-Wei Yang ◽  
Yenlin Huang ◽  
Yun-Shien Lee ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Fungus Ball ◽  
Older Individuals ◽  
Treatment Delays ◽  
Male Ratio ◽  
Female Predominance ◽  
Fungal Hyphae ◽  
Heavy Metal Deposition

AbstractMaxillary sinus fungal balls (MSFBs) mostly occur in older individuals and demonstrate female predominance. Early diagnosis is important to avoid treatment delays. Intralesional hyperdensity (IH) indicates the presence of heavy metal deposition within fungal hyphae and has been the most specific characteristic of MSFB on computed tomography (CT). For those without IH on CT, the diagnosis of MSFB remains challenging. This study aimed to characterize clinical presentation of MSFB with and without IH and to study factors contributing to MSFB with no IH formation. We retrospectively identified 588 patients with MSFB. The clinical characteristics and CT findings were reviewed. Patients with unilateral MSFB had a mean age of 57.4 years and demonstrated female predominance (64.63%). The female-to-male ratio was highest at 51–60 years (2.02) and rose to 2.60 in MSFB with IH only. Compared to those with IH, MSFB without IH was significantly more common in males (OR = 2.49), in those with diabetes mellitus (DM) (OR = 1.87), adjacent maxillary odontogenic pathology (OR = 1.75). Complete opacification on CT was less common in MSFB without IH (OR = 0.60). Patients with MSFB without IH were more likely to have DM, no female predominance, adjacent maxillary odontogenic pathology, and partial opacification of the sinus, compared to those with IH. These may be helpful in better understanding of the formation of MSFBs without IH, early identification of them and prevention of post-operative recurrence.

scholarly journals Differences in Clinical and Imaging Presentation of Maxillary sinus fungus ball with and without Intralesional Hyperdensity

2021 ◽  
Author(s):  
Pei-wen Wu ◽  
Ta-Jen Lee ◽  
Shih-Wei Yang ◽  
Yen-Lin Huang ◽  
Yun-Shien Lee ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Maxillary Sinus ◽  
Clinical Characteristics ◽  
Medical Center ◽  
Sinus Surgery ◽  
Fungus Ball ◽  
Older Individuals ◽  
Treatment Delays ◽  
Male Ratio ◽  
Female Predominance

Objectives: Maxillary sinus fungal balls (MSFBs) mostly occur in older individuals and demonstrate female predominance. Early diagnosis is important to avoid treatment delays. This study aimed to elucidate the differences in clinical and imaging presentation of MSFB with and without intralesional hyperdensity (IH). Design and setting: This was a retrospective review in a tertiary medical center. We retrospectively identified 588 patients underwent endoscopic sinus surgery procedures for MSFB between 2005 and 2018. The clinical characteristics and computed tomography (CT) findings including the presence of complete or partial opacification, IH, and odontogenic pathology were reviewed. Participants: 588 MSFB patients Results: Patients with unilateral MSFB had a mean age of 57.4 years and demonstrated female predominance (64.63%). The overall female-to-male ratio was highest at 51-60 years (2.02) and rose to 2.60 in MSFB with IH only. Compared to those with IH, MSFB without IH was significantly more common in males (OR = 2.496; P < .0001), in those with diabetes mellitus (DM) (OR = 2.094; P = .010) and adjacent maxillary odontogenic pathology (OR = 1.697; P = .030). Complete opacification on CT was less common in MSFB without IH (OR = 0.617; P = .025). Conclusion: The highest female-to-male ratio for MSFB at 51-60 years corresponded to the age of menopause. Patients with MSFB without IH were more likely to have DM, no female predominance, adjacent maxillary odontogenic pathology, and partial opacification of the sinus, compared to those with IH. These clinical features may aid earlier identification of MSFB without IH.

scholarly journals Clinical Characteristics Other Than Intralesional Hyperdensity May Increase the Preoperative Diagnostic Accuracy of Maxillary Sinus Fungal Ball

2020 ◽  
Vol 13 (2) ◽  
pp. 157-163 ◽  
Author(s):  
Hyunkyung Cha ◽  
Yoonjae Song ◽  
Yun Jung Bae ◽  
Tae-Bin Won ◽  
Jeong-Whun Kim ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Clinical Characteristics ◽  
Maxillary Sinusitis ◽  
Regression Tree ◽  
Mass Effect ◽  
Sinus Surgery ◽  
Fungus Ball ◽  
Tree Analysis ◽  
Regression Tree Analysis ◽  
Preoperative Diagnostic

Objectives. This study aimed to evaluate the clinical characteristics of maxillary sinus fungus ball (MFB) to increase the preoperative diagnostic accuracy.Methods. A retrospective review of 247 patients who underwent endoscopic sinus surgery for unilateral maxillary sinusitis from January 2015 to December 2017 at a single institution was performed. Patients with pathologically proven MFB were compared to those with unilateral chronic maxillary sinusitis (CMS). Patient demographics and computed tomography (CT) findings were evaluated. The CT features were categorized as intralesional hyperdensity (calcification), the irregular lobulated protruding lesion (fuzzy appearance), maxillary sinus full haziness without mass effect, maxillary sinus full haziness with mass effect, and others. A regression tree analysis was performed.Results. In total, 247 patients were analyzed; among them, 179 (72.5%) had MFB and 68 (27.5%) had CMS. MFB showed predominance in older individuals. Among the radiological features, intralesional hyperdensity was most commonly associated with MFB. The presence of a fuzzy appearance or full opacity with mass effect was also associated with MFB. The highest area under the curve was noted with the regression tree analysis based on the model, which included the presence of intralesional hyperdensity, demographic data (age), and presence of fuzzy appearance or maxillary sinus full haziness with mass effect in case of absence of intralesional hyperdensity (0.904).Conclusion. A simple algorithm to optimize the preoperative diagnosis of MFB was developed. Physicians should be aware of such findings in the management of patients presenting with unilateral CMS.

Hydrocephalus in Spinal Muscular Atrophy: A Case Report and Review of the Literature

2020 ◽  
Author(s):  
Jeetendra P. Sah ◽  
Aaron W. Abrams ◽  
Geetha Chari ◽  
Craig Linden ◽  
Yaacov Anziska
Keyword(s):  
Spinal Muscular Atrophy ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Muscular Atrophy ◽  
Communicating Hydrocephalus ◽  
Type I ◽  
Review Of The Literature ◽  
Radiographic Findings ◽  
Comprehensive Review ◽  
The Relationship

AbstractIn this article, we reported a case of spinal muscular atrophy (SMA) type I noted to have tetraventricular hydrocephalus with Blake's pouch cyst at 8 months of age following intrathecal nusinersen therapy. The association of hydrocephalus with SMA is rarely reported in the literature. Development of hydrocephalus after intrathecal nusinersen therapy is also reported in some cases, but a cause–effect relationship is not yet established. The aim of this study was to describe the clinical characteristics of a patient with SMA type I and hydrocephalus, to review similar cases reported in the literature, and to explore the relationship between nusinersen therapy and development of hydrocephalus. The clinical presentation and radiographic findings of the patient are described and a comprehensive review of the literature was conducted. The adverse effect of communicating hydrocephalus related to nusinersen therapy is being reported and the authors suggest carefully monitoring for features of hydrocephalus developing during the course of nusinersen therapy.

scholarly journals Analysis of Organophosphorus compound poisoning patients attending CMS-TH, Bharatpur, Nepal

2012 ◽  
Vol 7 (4) ◽  
pp. 9-19
Author(s):  
S Laudari ◽  
BS Patowary
Keyword(s):  
Clinical Presentation ◽  
Statistical Significance ◽  
Medical Emergency ◽  
Precipitating Factors ◽  
Medical Sciences ◽  
Treatment And Prevention ◽  
Female Predominance ◽  
Organophosphorus Poisoning ◽  
Planning Treatment ◽  
Psychiatric Problems

Organophosphorus (OP) compound poisoning is a medical emergency. It is important to know its nature, clinical presentation, severity and outcome in order to take up appropriate measures including proper planning, treatment and prevention. This study was aimed to assess the clinical profile of organophosphorus poisoning. This is a prospective hospital based study conducted at CMS-T.H., Bharatpur, Nepal. The study included 111 patients of organophosphorus poisoning during the period November 2008 to July 2011. The incidence was commoner in females than males with female:male ratio being 1.47:1. Majority of the patients(58.56%) belonged to the age group 16 to 30 years with female predominance(2.25:1). Modes of poisoning were suicidal in the majority (94.59%), accidental in 4.50%. and homicidal in 0.90%. Psychiatric problems were the major precipitating factors. Majority of patients(62.16%) had moderate poisoning (POP scale: 4-7).On admission, dyselectrolytemia and respiratory failure were found in 74.77% and 21.62% respectively.8 patients expired (7.69%). Large amount of OP poison ingestion (>40ml) and increased severity of poisoning (POP scale) were found to have statistical significance with the rate of mortality. Journal of College of Medical Sciences-Nepal,2011,Vol-7,No-4, 9-19 DOI: http://dx.doi.org/10.3126/jcmsn.v7i4.6736

scholarly journals Patients Admitted for Variant Alpha COVID-19 Have Poorer Outcomes than Those Infected with the Old Strain

2021 ◽  
Vol 10 (16) ◽  
pp. 3550
Author(s):  
Matteo Vassallo ◽  
Sabrina Manni ◽  
Camille Klotz ◽  
Roxane Fabre ◽  
Paola Pini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Inflammatory Markers ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Severe Pneumonia ◽  
Demographic Parameters ◽  
Background Characteristics ◽  
Risk Of Death ◽  
Mean Delay ◽  
Diabetes And Obesity

Objectives: The variant alpha COVID-19 rapidly spread across Europe in early 2021. While this variant’s increased infectivity has been proven, little is known of its clinical presentation and outcomes compared to the old strain. Methods: We identified patients admitted to the Cannes General Hospital for variant alpha-related COVID-19 infection from January to April 2021. Their main demographic parameters, inflammatory markers and clinical characteristics were recorded. Patients admitted from October to December 2020 for 20E (EU1) COVID-19 were selected as controls. Differences between groups were analyzed. Results: We included 157 patients (mean age 73 years; 58% men; mean delay of symptoms 6.9 days). Comorbidities were present in 92% (mainly hypertension, diabetes and obesity or overweight). The prevalence of comorbidities did not differ between groups. In 28% of cases, patients either died or required transfer to the Intensive Care Unit (ICU). The cause of death or of transfer to the ICU was presumably associated with severe pneumonia. Variant alpha COVID-19 had 3.8-fold higher risk of death or transfer to the ICU compared to the old strain. Discussion: Patients infected with variant alpha COVID-19, despite similar background characteristics, had a higher risk of unfavorable outcomes than those infected with the old strain, suggesting increased virulence related to this variant.

scholarly journals A clinical and epidemiological study on discoid lupus erythematosus

2018 ◽  
Vol 4 (3) ◽  
pp. 396 ◽  
Author(s):  
Geetharani Gopalan ◽  
Sudha R. Gopinath ◽  
Kothandaramasamy R. ◽  
Sathesh Pandian
Keyword(s):  
Lupus Erythematosus ◽  
Severe Disease ◽  
Disease Onset ◽  
Discoid Lupus Erythematosus ◽  
Systemic Involvement ◽  
Male Ratio ◽  
Lupus Panniculitis ◽  
Female Predominance ◽  
Complete Physical Examination ◽  
Cutaneous Lupus

<p class="abstract"><strong>Background:</strong> Discoid lupus erythematosus (DLE) is the commonest form of cutaneous lupus erythematosus.The objective of our study is to analyze the clinical and epidemiological aspects of DLE.</p><p class="abstract"><strong>Methods:</strong> All clinically diagnosed cases of DLE attending the dermatology OPD from October 2010 to September 2012were included in the study. A detailed history, complete physical examination, biopsy for confirmation and other relevant investigations were done in all cases.<strong></strong></p><p class="abstract"><strong>Results:</strong> The incidence was 4.79 per 10000 cases (51 of 106368 dermatology patients) showing female to male ratio of 4.1:1. Localized type was more common than the disseminated type. Few lesions (less than five) in a localized area without head and neck involvement were also classified as localized type in this study. Mucosal, verrucous, tumid and lupus panniculitis were the variants of DLE encountered. The sites involved were face, scalp, trunk, upper and lower limb in descending order of frequency. Antinuclear antibody (ANA) was positive in 22 of 30 cases done (73%). The systemic involvement was seen in 15 patients all of whom were diagnosed as systemic lupus erythematosus (SLE). Squamous cell carcinoma was seen in 2 cases of disseminated DLE.</p><p class="abstract"><strong>Conclusions:</strong> Majority of patients had disease onset at 3<sup>rd</sup> to 5<sup>th</sup> decade showing female predominance. When compared to localized type, disseminated type was found more frequently in males. Early onset and severe disease was noted among offspring born to a patient suffering from disseminated DLE. Serious morbidity like lupus nephritis was observed only in 1 case. The occurrence of DLE over the herpes zoster scar was an interesting observation.</p>

scholarly journals Unilateral Concomitant Antrochoanal Polyp and Fungus Ball in Maxillary Sinus: A Case Report

Cureus ◽  
2021 ◽  
Author(s):  
Ibrahim Issa ◽  
Derar Al-Domaidat ◽  
Adel Danish ◽  
Ro'a Al-shaikh Hasan ◽  
Hadir Elseidi
Keyword(s):  
Case Report ◽  
Maxillary Sinus ◽  
Fungus Ball ◽  
Antrochoanal Polyp

scholarly journals Clinical Characteristics, Immunophenotype and Outcomes of Blastic Plasmacytoid Dendritic Cell Neoplasms in a Peruvian Cohort

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 42-43
Author(s):  
Daniela Dueñas ◽  
Elizabeth Cervantes ◽  
Daniel J Enriquez ◽  
Claudio Flores ◽  
Carlos Barrionuevo ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Dendritic Cell ◽  
Clinical Characteristics ◽  
Conflicts Of Interest ◽  
Plasmacytoid Dendritic Cell ◽  
Age At Diagnosis ◽  
Bone Marrow Infiltration ◽  
Maturation Stage ◽  
Female Predominance ◽  
The Impact

Background:Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and fatal myeloid malignancy characterized by clonal proliferation of immature plasmacytoid dendritic cells. BDCN has been frequently described in men and age above 60 years, and usually involves the skin and bone marrow. Immunophenotyping is based on CD123+, CD4+ and CD56+ expression and is necessary rule out other myeloid malignancies. Objective: We aimed to describe the clinical characteristics and immunophenotype of BPDCN cases diagnosed at two tertiary Peruvian cancer institutions between 2018-2019. Methods: We retrospectively reviewed medical records of patients diagnosed of BPDCN at two tertiary Peruvian cancer centers (Instituto Nacional de Enfermedades Neoplasicas and Oncosalud-AUNA, Lima-Peru) between 2008 and 2019. Clinical characteristics, treatments, outcomes and immunophenotype by pathology or flow cytometry review, were collected. Patients were classified according to their maturation stage using CD34 and CD117 expression into three subgroups: Immature-Intermediate blastic (IIB-BPDCN; partial expression of CD117 and absence or minimal expression of CD34), mature (M-BPDCN; absence of CD34 and CD117) and unknown(U-BPDCN). Overall survival (OS) and event-free survival (EFS) curves were estimated using the Kaplan-Meier method and compared with the Log-rank test to determine the impact of immunophenotype. Results: Thirty-eight cases were included during the study period. The median age at diagnosis was 38 years (7-82), only six (16%) were older than 65 years, and a notorious female predominance (F/M ratio: 1.7:1) was observed. Twenty-four cases had CD34/117 expression available and were classified according to the maturation stage in IIB-BPDCN (13) and M-BPDCN(11), additionally 14 cases had unknown stage (U-BPDCN). Table 1 summarizes clinical characteristics, treatment and outcomes according to their immunophenotype. Bone marrow infiltration was more frequent in immature phenotypes (92% IIB-BPDCN vs 73% M-BPDCN, p=0.001), as well as skin infiltration was more common in mature phenotype (72% vs 31%, p=0.008). CNS infiltration at diagnosis was 15% and 55% in IIB-BPDCN and M-BPDCN, respectively. Sixteen patients received treatment based on ALL-like protocols, 8 AML-like, 5 CHOP-like and 9 patients only palliative care. At 5 years median follow-up, median EFS and OS was 12 and 16 months, respectively. IIB-BPDCN had the lowest survival (4 months EFS and 6 months OS). Conclusions: We describe a Peruvian cohort of BPDCN patients with younger age at diagnosis and female predominance than reported previously by other series, however further studies in Latino population are required to confirm these results. Immature phenotypes based on CD34 and CD117 expression were associated with high rate of bone marrow infiltration and fatal outcomes. New successful target therapies must be warranted for this rare and fatal condition. Disclosures No relevant conflicts of interest to declare.

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