scholarly journals Frequency and phenotype of headache in covid-19: a study of 2194 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
David García-Azorín ◽  
Álvaro Sierra ◽  
Javier Trigo ◽  
Ana Alberdi ◽  
María Blanco ◽  
...  
Keyword(s):  
Reference Population ◽  
Prior History ◽  
Health Administration ◽  
Castilla Y Leon ◽  
First Case ◽  
Headache Onset ◽  
Severe Intensity ◽  
History Of ◽  
Systemic Symptoms ◽  
Carlos Iii

AbstractTo estimate the frequency of headache in patients with confirmed COVID-19 and characterize the phenotype of headache attributed to COVID-19, comparing patients depending on the need of hospitalization and sex, an observational study was done. We systematically screened all eligible patients from a reference population of 261,431 between March 8 (first case) and April 11, 2020. A physician administered a survey assessing demographic and clinical data and the phenotype of the headache. During the study period, 2194 patients out of the population at risk were diagnosed with COVID-19. Headache was described by 514/2194 patients (23.4%, 95% CI 21.7–25.3%), including 383/1614 (23.7%) outpatients and 131/580 (22.6%) inpatients. The headache phenotype was studied in detail in 458 patients (mean age, 51 years; 72% female; prior history of headache, 49%). Headache was the most frequent first symptom of COVID-19. Median headache onset was within 24 h, median duration was 7 days and persisted after 1 month in 13% of patients. Pain was bilateral (80%), predominantly frontal (71%), with pressing quality (75%), of severe intensity. Systemic symptoms were present in 98% of patients. Headache frequency and phenotype was similar in patients with and without need for hospitalization and when comparing male and female patients, being more intense in females.Trial registration: This study was supported by the Institute of Health Carlos III (ISCIII), code 07.04.467804.74011 and Regional Health Administration, Gerencia Regional de Salud, Castilla y Leon (GRS: 2289/A/2020).

scholarly journals Cesarean Section in a Pregnant Woman with COVID-19: First Case in Portugal

2020 ◽  
Vol 33 (6) ◽  
pp. 429 ◽  
Author(s):  
Joana Lyra ◽  
Rita Valente ◽  
Marta Rosário ◽  
Mariana Guimarães
Keyword(s):  
Cesarean Section ◽  
Healthy Woman ◽  
Maternity Hospital ◽  
Prior History ◽  
Protective Equipment ◽  
Bishop Score ◽  
Term Pregnancy ◽  
First Case ◽  
History Of ◽  
Maternal And Neonatal Outcomes

We report the first cesarean delivery in a woman with COVID-19 in a level III hospital in Portugal. It refers to a healthy woman with a term pregnancy that tested positive for COVID-19 on the day of labor induction. Given a Bishop score < 4 and the prior history of a cesarean section, the team decided to perform a surgical delivery. Appropriate personal protective equipment and safety circuits were employed, as described in more detail in the case report. Both the mother and the newborn are well. With this report we aimed to share our concerns, clinical management, maternal and neonatal outcomes, and to present our current circuits and adjustments regarding the COVID-19 pandemic in our maternity hospital.

scholarly journals An Unconventional Diagnostic Method for Cryptosporidial Enteritis in a Healthy Host: Never Call It Quits!

2019 ◽  
Vol 13 (3) ◽  
pp. 526-531
Author(s):  
Shivantha Amarnath ◽  
Cheikh Talal El Imad ◽  
Kingsley Ebare ◽  
Hueizhi Wu ◽  
Stephen Mulrooney
Keyword(s):  
Diagnostic Method ◽  
Stool Culture ◽  
Watery Diarrhea ◽  
Peptic Ulcers ◽  
Unique Case ◽  
First Case ◽  
The Usa ◽  
History Of ◽  
Rising Incidence ◽  
Systemic Symptoms

Cryptosporidial enteritis has a rising incidence in the USA, mostly affecting immunocompromised individuals and children. It has a self-limiting course in healthy hosts. Herein, we present a unique case of a healthy middle-aged female who presented with a 1-month history of voluminous watery diarrhea and acute blood loss anemia. Cryptosporidial enteritis was diagnosed based on endoscopy with biopsy-proven evidence of 2 jejunal peptic ulcers infected with Cryptosporidiumspp. that was originally missed on routine stool culture, ova and parasite tests. The patient was successfully treated with nitazoxanide,and eradication of the protozoan was also confirmed on repeat endoscopic biopsies of the ulcer that were carried out 6 months later. To our knowledge, this is the first case to be reported in the literature with infective colonization of peptic ulcers with Cryptosporidiumspp.with consequent systemic symptoms.

Arthropathy Secondary to Ciprofloxacin in an Adult Cystic Fibrosis Patient

1993 ◽  
Vol 27 (3) ◽  
pp. 302-303 ◽  
Author(s):  
Wayne M. Samuelson ◽  
Roy A. Pleasants ◽  
Martha S. Whitaker
Keyword(s):  
Cystic Fibrosis ◽  
Adult Patient ◽  
Cystic Fibrosis Patient ◽  
Pediatric Patients ◽  
Prior History ◽  
Case Summary ◽  
First Case ◽  
Acute Exacerbations ◽  
History Of ◽  
Possible Cause

OBJECTIVE: To report a case of possible ciprofloxacin-induced arthropathy in an adult patient with cystic fibrosis (CF). CASE SUMMARY: A 25-year-old man with CF received three separate courses of ciprofloxacin therapy at usual doses for acute pulmonary exacerbations of his disease. During the second and third courses, the patient experienced bilateral swelling of his knees between two to three weeks after initiation of each course. Both times symptoms markedly decreased after discontinuation of the drug. The patient had no prior history of arthropathy. Furthermore, during the last two acute exacerbations of his CF, he did not receive ciprofloxacin and did not experience any symptoms of arthropathy. DISCUSSION: Prior cases of quinolone-induced arthropathy involving pediatric CF patients or adult patients without CF have been reported in the literature. We report the first case of such an arthropathy in an adult patient with CF. The findings are supported by a rechallenge with the drug. CONCLUSIONS: It is likely that ciprofloxacin may produce arthropathy in adult as well as pediatric patients with CF. Quinolones should be considered as a possible cause of arthropathy in adult CF patients.

scholarly journals Testicular cancer in two brothers of a quadruplet: a case report and a review of literature

2017 ◽  
Vol 24 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Agnė Ulytė ◽  
Albertas Ulys ◽  
Kęstutis Sužiedėlis ◽  
Aušvydas Patašius ◽  
Giedrė Smailytė
Keyword(s):  
Risk Factors ◽  
Testicular Cancer ◽  
Rare Events ◽  
Multiple Birth ◽  
Prior History ◽  
Review Of Literature ◽  
Factors Associated ◽  
First Case ◽  
Increased Risk ◽  
History Of

Introduction. Testicular cancer and a multiple birth are both rare events, and the risk of testicular cancer is increased in twins. In Lithuania, only five quadruplets have been recorded since the middle of the 20th century. In this report, we present two rare events in one family: testicular cancer in two brothers of a quadruplet (three brothers and a sister). Case description. Both patients were diagnosed at 21 years of age and died within two years from the  diagnosis despite treatment. The  third symptomless brother did not have testicular pathology. We also review the  risk factors associated with testicular cancer, and the  proposed hypotheses how a multiple birth results in an increased risk. The most consistent risk factors for testicular cancer are cryptorchidism, prior history of testicular cancer, and a positive familial history. According to different studies, the risk of testicular cancer in twins is higher from 22% to 30%, compared to the general population. Conclusions. To our knowledge, we have presented the first case of testicular teratoblastoma in brothers of a quadruplet.

scholarly journals Dexamethasone Implant Migration through an Iris Coloboma

2020 ◽  
Vol 11 (1) ◽  
pp. 73-78 ◽  
Author(s):  
Yoav Glidai ◽  
Shulamit Schwartz ◽  
Eyal Cohen
Keyword(s):  
Macular Edema ◽  
Anterior Chamber ◽  
Cystoid Macular Edema ◽  
Corneal Edema ◽  
Lens Capsule ◽  
Prior History ◽  
Dexamethasone Implant ◽  
Implant Migration ◽  
First Case ◽  
History Of

Ozurdex® 0.7 mg (dexamethasone 0.7 mg implant, Allergan, Dublin, Ireland), an intravitreal biodegradable implant, is indicated for cystoid macular edema due to various causes. One of its known and uncommon complications is implant migration to the anterior chamber, causing corneal edema that, in some cases, is irreversible. Reported risk factors for device migration are open or defective lens capsule and prior history of vitrectomy. We present a case of dexamethasone implant migration through a congenital iris coloboma in a pseudophakic patient with an intact lens capsule. The patient is a 56-year-old pseudophakic man with a history of congenital iris coloboma, myopia, retinal tears, and a branch retinal vein occlusion with subsequent cystoid macular edema resistant to anti-VEGF medications but responsive to corticosteroids. He presented with sudden painless decreased vision in his left eye, 8 weeks following dexamethasone implant (Ozurdex) injection to the same eye. Upon presentation, he was diagnosed with corneal edema caused by anterior chamber migration of the implant. He was referred for immediate surgical intervention to extract the implant, with a resolution of the corneal edema within 2 weeks postoperatively. To conclude, this is the first case that reports Ozurdex implant migration through an iris coloboma in the setting of an intact posterior capsule. In addition, we describe a novel surgical approach for implant removal from the anterior chamber that is simple and efficient.

Novel G6PC3 Mutations in patients with Congenital Neutropenia: Case reports and Review of the Literature

2021 ◽  
Vol 21 ◽  
Author(s):  
Seyed Farzad Maroufi ◽  
Zoha Shaka ◽  
Helia Mojtabavi ◽  
Mona Sadeghalvad ◽  
Elham Rayzan ◽  
...  
Keyword(s):  
Heart Defects ◽  
Case Reports ◽  
Severe Neutropenia ◽  
Prior History ◽  
Compound Heterozygous ◽  
Missense Mutations ◽  
Severe Congenital Neutropenia ◽  
Congenital Neutropenia ◽  
First Case ◽  
History Of

Background: Severe congenital neutropenia (SCN4) caused by mutations in glucose-6-phosphatase catalytic subunit 3 (G6PC3) is characterized by recurrent infections due to severe neutropenia, and it may be accompanied by other extra-hematopoietic manifestations; including structural heart defects, urogenital abnormalities, prominent superficial venous markings, growth retention, and inflammatory bowel diseases with rare incidence. The homozygous or compound heterozygous mutations of G6PC3 are responsible for most cases of autosomal recessive SCN4. Herein, we present two cases of SCN4 affected by novel mutations in the G6PC3, in addition to a summarized list of variants in G6PC3 gene that are reported as pathogenic and related to the SCN4 phenotype. Case presentation: Herein we present two cases of SCN4; the first case was a three-months old boy with severe neutropenia and prior history of hospitalization due to umbilical separation, umbilical herniation, omphalitis, and pyelonephritis; and the second case was an eight-year-old with a history of neutropenia, recurrent and severe episodes of intractable diarrhea, refractory rectovaginal and rectoperineal fistula, congenital inguinal hernia, and ASD type 2. Whole exome sequencing was performed for both cases and revealed two novel homozygous missense mutations in G6PC3 that were predicted to be deleterious; c.337G>A, p. Gly113Arg in the first case and c.479C>T; P. Ser160Leu in the second case. To our knowledge, both of these two mutations has not been reported in the G6PDC3 gene. Conclusions: In patients with severe neutropenia with varying extra hematopoietic syndrome, mutation of G6PC3 should be suspected after ruling out other mutations related to neutropenia. This study pointed toward novel G6PC3 mutations, that should be considered in order to diagnose patients with severe congenital neutropenia.

scholarly journals The Effects of Vitamin D Supplementation and 25-hydroxyvitamin D Levels on The Risk of MI and Mortality

2021 ◽  
Author(s):  
Prakash Acharya ◽  
Tarun Dalia ◽  
Sagar Ranka ◽  
Prince Sethi ◽  
Olurinde A Oni ◽  
...  
Keyword(s):  
Vitamin D ◽  
Lower Risk ◽  
Prior History ◽  
Health Administration ◽  
Hydroxyvitamin D ◽  
All Cause Mortality ◽  
History Of ◽  
Group A ◽  
25 Hydroxyvitamin D ◽  
Group B

Abstract Objective Aim of the study was to examine the effects of the vitamin D (Vit-D) treatment and non-treatment on Vit-D-deficient patients without a prior history of myocardial infarction (MI). Materials and Methods This is an retrospective, observational, nested case-control study of patients (N=20,025) with low 25-hydroxyvitamin D [(25-OH)D] levels (&lt;20 ng/ml) who received care at the Veterans Health Administration from 1999-2018. Patients were divided into three groups: Group A (untreated, levels ≤20 ng/ml), Group B (treated, levels 21-29 ng/ml), and Group C (treated, levels ≥30 ng/ml). The risk of MI and all-cause-mortality were compared utilizing propensity score-weighted cox-proportional hazard models. Results Among the cohort of 20,025 patients, the risk of MI was significantly lower in Group C, compared to Group B [hazard ratio (HR) 0.65, 95% CI; 0.49-0.85, P=.002] and Group A (HR 0.73, 95% CI; 0.55-0.96), P=.02). There was no difference in the risk of MI between Group B and Group A (HR 1.14, 95% CI; 0.91-1.42, P=.24]. Compared to Group A, both Group B (HR 0.59, 95% CI; 0.54-0.63, P&lt;.001] and Group C (HR 0.61, 95% CI; 0.56-0.67, P&lt;.001] had significantly lower all-cause-mortality. There was no difference in all-cause-mortality between Group B and Group C (HR 0.99, 95% CI; 0.89-1.09, P=.78). Conclusions In patients with Vit-D-deficiency and no prior history of MI, treatment to the (25-OH)D level of &gt;20 ng/ml and &gt;30 ng/ml was associated with a significantly lower risk of all-cause-mortality. The lower risk of MI was observed only in individuals maintaining the (25-OH)D levels ≥30 ng/ml.

scholarly journals Dexamethasone implant (Ozurdex®) migration to anterior chamber through a congenital iris coloboma: A case report

2019 ◽  
Author(s):  
Yoav Glidai ◽  
Shulamit Schwartz ◽  
Eyal Cohen
Keyword(s):  
Macular Edema ◽  
Anterior Chamber ◽  
Cystoid Macular Edema ◽  
Corneal Edema ◽  
Lens Capsule ◽  
Prior History ◽  
Dexamethasone Implant ◽  
Implant Migration ◽  
First Case ◽  
History Of

Abstract Background: Ozurdex® 0.7 mg (dexamethasone 0.7 mg implant, Allergan, Dublin, Ireland), an intra-vitreal biodegradable implant indicated for cystoid macular edema due to variable causes. One of its known complications is implant migration to the anterior chamber, causing corneal edema that in some cases might be irreversible. Reported risk factors for device migration are open or defective lens capsule and prior history of vitrectomy. We present a case of dexamethasone implant migration through a congenital iris coloboma in a pseudophakic patient with intact lens capsule. Case presentation: 56-year-old pseudophakic man with a history of congenital iris coloboma, myopia, retinal tears and a Branch Retinal Vein Occlusion (BRVO) with subsequent Cystoid Macular Edema (CME) which was resistant to anti-VEGF medications but responsive to corticosteroids. He presented with sudden painless decreased vision in his left eye, eight weeks after dexamethasone implant (Ozurdex®) injection to the same eye. Upon presentation he was diagnosed with corneal edema caused by anterior chamber migration of the implant. He was referred for immediate surgical intervention and the implant was extracted, with the edema completely resolved within two weeks post-op. Conclusions: This is the first case reported of implant migration through an iris coloboma in the setting of intact posterior capsule. In addition, we describe a novel approach for implant removal surgery that is simple and efficient. This case sheds a light on another risk factor that should be taken into consideration in the management of this patient population.

scholarly journals 212. Measuring the Morbidity of Infectious Complications of the Opiate Epidemic: A Retrospective Cohort Study

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S214-S214
Author(s):  
Leah Harvey ◽  
Hassen Abdulkerim ◽  
Jacqueline Boudreau ◽  
Judith Strymish ◽  
Justeen Hyde ◽  
...  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Retrospective Cohort ◽  
Bacterial Infections ◽  
Viral Infections ◽  
Optimal Strategies ◽  
Prior History ◽  
Veterans Health ◽  
Health Administration ◽  
History Of

Abstract Background Many states have reported that the incidence of invasive bacterial and viral infections has risen alongside rates of opiate use and injection drug use. The aim of this exploratory project is to characterize the incidence of invasive bacterial infections (IBI) over time in a national Veteran population, describe screening for substance use among Veterans with IBI, and assess engagement in harm reduction services. Methods A national, multicenter, retrospective cohort of Veterans admitted to the Veterans Health Administration (VA) between 10/1/2008 – 9/30/2018 with a positive blood culture was created using electronic health record (EHR) data. Patients’ demographics, clinical characteristics, microbiologic cultures, prescription history, laboratory values, and administrative coding data were extracted from the EHR. All analyses were performed in Microsoft Excel. Results Among 5,158,137 inpatient admissions during the study period, we identified 257,926 unique patients with bacteremia (5.0%). The incidence of bacteremia/sepsis increased consistently during the study period, rising from 2.29 per 10,000 patient-days to 5.97 per 10,000 patient-days across the national VA healthcare system (Figure 1). Among Veterans with bacteremia, 17,436 (6.8%) had prior history of substance use and 24,927 (9.7%) had a history of hepatitis C virus infection. In 196,295 cases (76.1%), no urine toxicology screening was completed or the result was negative. 34,005 (13.2%) of patients with bacteremia had at least one urinary toxicology positive for opiates and of these, 6,173 (18.1%) had documentation of a prescription for either naltrexone or buprenorphine/naloxone prior to admission or on hospital discharge. Conclusion Similar to findings in other populations, the incidence of IBI has steadily increased within the national VA. Despite limited screening, a high proportion of patients admitted to the VA with IBI were found to have underlying substance use. Additional work, including increased screening, is needed to assess the uptake of evidence-based interventions, such as naloxone, and to identify optimal strategies for improving adoption of other harm reduction services in this population. Disclosures All Authors: No reported disclosures

scholarly journals Dysencephalia Splanchnocystica, AKA Meckel–Gruber syndrome: A Systematic Review and the First Case Report from Iraq

2019 ◽  
Vol 13 (2) ◽  
pp. 149
Author(s):  
Mohammed Hussein Assi ◽  
Ahmed Al-Imam
Keyword(s):  
Case Report ◽  
Cochrane Library ◽  
Prior History ◽  
Medical Subject Headings ◽  
Level Of Evidence ◽  
Meckel Syndrome ◽  
First Case ◽  
Mesh Terms ◽  
History Of ◽  
The Cochrane Library

Background: Meckel-Gruber syndrome is categorised under the broad &ldquo;umbrella&rdquo; of syndromic ciliopathies. There is a shortage of epidemiological studies surveying the region of the Middle East and Arabic countries. Materials and methods: The review of the literature was conducted systematically, from the 1st to the 9th of June 2018, across medical and paramedical electronic databases including PubMed-NCBI, the Cochrane Library, and Elsevier database via predefined Medical Subject Headings (MeSH) terms. The words used included all possible combinations of synonyms for Meckel syndrome, Meckel-Gruber syndrome, Gruber syndrome, Dysencephalia Splanchnocystica, ciliopathies, and syndromic ciliopathies. Results: The total number of hits for all databases was 2089963 distributed as 2085668 (NCBI-PubMed), 1052 (The Cochrane Library), and 3243 (Elsevier). The most informative combination of keywords was [(Ciliopathies AND &ldquo;Meckel syndrome type-1&rdquo;]. The total number of reference material was restricted to twenty-six. The level-of-evidence of our study is level-2b, by the categorisation scheme adopted by the Oxford Centre for Evidence-based Medicine. Our case report represents the first documented case in literature from Iraq. The diagnosis was based on the history of consanguinity of the parents, prior history of induced abortion of a malformed male fetus, and the diagnostic clinical triad postnatally of occipital encephalocele, post-axial polydactyly, and polycystic kidneys manifested as bilateral abdominal distension primarily affecting the loin. Conclusion: Future cases from Iraq should be investigated, via ecological and aggregate analytics, in correlation with chemical and radiological exposure following the American invasion of Iraq.

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