scholarly journals Two Individuals with Rare Blocked Antigen Phenomenon and Coinciding Warm Autoantibody Mimicking Alloanti-Jk3 Resolved with JK Analysis

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S162-S162
Author(s):  
J G Zinni ◽  
D Mullins ◽  
P J DeChristopher ◽  
G Ramsey ◽  
B Vission ◽  
...  
Keyword(s):  
Uterine Cancer ◽  
False Negative ◽  
Complement C3 ◽  
Normocytic Normochromic Anemia ◽  
High Prevalence ◽  
History Of ◽  
Normochromic Anemia

Abstract Introduction/Objective Kidd antigens can bind complement (C3) as well as Kidd specific warm autoantibodies (WAAb). An 838G>A single nucleotide variant (SNV) defines JK*01 and JK*02 which codes the antithetical Jka and Jk b, respectively. Both alleles translate the high prevalence (>99%) Jk3 (JK3). The 130G>A is associated with weak Jka and weak Jkb expression. In vivo binding of non-agglutinating globulins can cause false-negative phenotypes by means of the blocked antigen phenomenon (BAP). Methods/Case Report Transfusions were requested for a 74-year-old Caucasian (CA) female with Evan’s Syndrome, and an 85-year-old African American (AA) female with metastatic uterine cancer. Both had a history of nonspecific WAAb. Direct antiglobulin testing (DAT) detected moderate in vivo sensitization of IgG and C3. They phenotyped Jk(a- b-) with untreated and EDTA glycine-acid (EGA) treated IgG DAT-negative cells. Their serum contained anti-Jk3 reactivity, while a panreactive WAAb in the eluate reacted with Jk3- donor and EGA treated DAT-negative autologous cells. Weak anti-Jka and anti-Jkb reactivity remained in the alloadsorbed serum of the antithetical adsorbing cells. Genetic testing of the CA revealed JK*01W.01(130A)/02 alleles, while cDNA confirmed the alleles would be transcribed into mRNA. Sequencing of the AA detected 130G/A, and 838G/A as well as other silent mutations predicting either a Jk(a+wb+) or Jk(a+b+w) phenotype. The CA received one compatible JK:-3 transfusion, and both individuals benefited from multiple least incompatible transfusions of Jk a+ and/or Jk b+ donors with expected hemoglobin increases (1 g/dL per transfusion). The CA serologically phenotyped Jk(a-b+) 132 days later following prolonged immunosuppressive therapy while a normocytic normochromic anemia and the WAAb persisted. No follow up evaluations of the AA are available. Results (if a Case Study enter NA) NA Conclusion Unexpected BAP can confound immunohematology testing and lead WAAbs mimicking alloanti-Jk3 to be mischaracterized as allogeneic. By predicting phenotypes, genetic analysis can aid serological techniques in antibody characterization and help circumvent complications searching for rare JK:-3 donors.

Individualized Behavioural Treatment of Severe Stuttering

1991 ◽  
Vol 19 (4) ◽  
pp. 347-357 ◽  
Author(s):  
Willi Ecker ◽  
Victor Meyer
Keyword(s):  
Oral Reading ◽  
Reading Improvement ◽  
Behavioural Treatment ◽  
Communication Situations ◽  
Cognitive Techniques ◽  
One Year

This case study illustrates the reduction of severe stuttering by an individually tailored treatment programme. Interventions are derived from a tripartite analysis (Lang, 1971) and include EMG biofeedback, regulated breathing, exposure in vivo to stressful communication situations and cognitive techniques to reduce relapse risk. The role of dysfunctional response system interactions in stuttering is emphasized. Treatment resulted in a marked reduction of stuttering and associated facial contortions during videotaped conversations with strangers and oral reading. Improvement was maintained at one-year follow-up.

A Successful Adaptation of Systematic Desensitization in the Treatment of a Phobia of Babies

1985 ◽  
Vol 2 (1) ◽  
pp. 59-64
Author(s):  
Michael Free ◽  
Margaret Beekhuis
Keyword(s):  
Young Woman ◽  
Skin Conductance ◽  
Treatment Strategy ◽  
Physiological Measures ◽  
Systematic Desensitization ◽  
Physiological Measure ◽  
One Year

A case study is presented of a young woman with an unusual phobia, a fear of babies. Barabasz's (1977) technique of systematic desensitization using psycho-physiological measures was chosen as the main treatment strategy. Difficulties arose as the client was unable to visualise scenes involving babies. Nor could she look at photographs of babies long enough for the hierarchy to be ordered using a psycho-physiological measure (skin conductance). A set of photographs was eventually used for the hierarchy, but it was ordered in terms of the length of time the client could look at the various photographs. Systematic desensitization was carried out using the set of photographs instead of imaginary scenes, together with some in vivo exposure in the latter stages of treatment. At termination the client could approach babies without discomfort. Improvement was maintained at one year follow-up.

ATTENTIONAL FOCUS AND FEAR OF BLUSHING: A CASE STUDY

1999 ◽  
Vol 27 (2) ◽  
pp. 153-164 ◽  
Author(s):  
Sandra Mulkens ◽  
Susan M. Bögelts ◽  
Peter J. de Jong
Keyword(s):  
Single Case ◽  
Attentional Focus ◽  
Single Case Study ◽  
Fear Avoidance ◽  
Differential Effects ◽  
Before And After ◽  
Fear Of Blushing

By means of a single case study, the effects of redirecting attention above exposure only on fear of blushing, avoidance, and idiosyncratic dysfunctional beliefs were tested. A social phobic patient with fear of blushing as the predominant complaint received sessions of Task Concentration Training (TCT) and Exposure in Vivo (EXP) alternately, after a steady baseline had been established. The treatment consisted of 14 individual sessions. Assessments were held before and after baseline, after treatment, after 4 weeks follow-up, and after 1-year follow-up. Continuous measurements were held throughout the treatment in order to measure the differential effects of TCT and EXP on fear, avoidance and beliefs. TCT and EXP together, turned out to be an effective treatment for fear of blushing: large effects were observed on all three outcome measurements. When differential effects are closely looked at, EXP seemed more effective in decreasing fear of blushing. However, the patient appeared to have used TCT strategies as well during the EXP weeks, which may have contributed to the favourable effects of EXP.

Refugee and Asylum-Seeking Children in Mae Sot and Bangkok: An Analysis of Unmet Needs and Risks

2020 ◽  
Author(s):  
Paradee Thoresen ◽  
Sue Gillieatt ◽  
Angela Fielding
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Unmet Needs ◽  
Psychological Development ◽  
Longitudinal Case Study ◽  
Children’S Perspectives ◽  
Rights Of The Child ◽  
History Of

Abstract This article reports on a longitudinal case study, which included site visits in Thailand from 2014 to 2015, and participant follow-up to mid-2018. It documents the lived experience of children from Syria, Sri Lanka, Pakistan, Vietnam, and Myanmar in two different locations in Thailand: Bangkok and Mae Sot (a district close to Thailand-Myanmar border with a long history of economic migrants and refugees from Myanmar). It documents perspectives of children and the adults in their lives while in exile. It presents an analysis of the children’s perspectives on needs and how unmet needs for safety, basic materials, health care, and education put them at risk of arrest, detention, abuse, and exploitation, and impact their psychological development. Contextual factors such as available services, existing policies and laws are also discussed in relation to the Convention on the Rights of the Child (CRC).

Reduction of Hemifacial Spasm and Dysarthria Following EMG Biofeedback

1984 ◽  
Vol 49 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Rick T. Rubow ◽  
John C. Rosenbek ◽  
Michael J. Collins ◽  
Gastone G. Celesia
Keyword(s):  
Hemifacial Spasm ◽  
Relaxation Training ◽  
Speech Therapy ◽  
Emg Biofeedback ◽  
Feedback Training ◽  
Facial Spasm ◽  
History Of ◽  
Carry Over

In this case study, a geriatric patient who had an 18-year history of hemifacial spasm was given EMG-biofeedback-assisted relaxation training. No formal speech therapy was provided. Our results confirmed two hypotheses: (a) The patient would learn to reduce frontalis EMG and facial spasm with and then without biofeedback, and (b) as a result, speech would be markedly improved. At both the 1-month and 15-month follow-up the patient retained the ability to relax his facial muscles with similar carry-over to speech. Possible neurophysiologic mechanisms of action mediating the feedback training are discussed.

scholarly journals Association and correlation of thyroid dysfunction with anemia types in pregnant women of northern Andhra Pradesh, India

2021 ◽  
Vol 10 (4) ◽  
pp. 1671
Author(s):  
Prabhavathi V. ◽  
Prasad D. K. V. ◽  
Sravani K.
Keyword(s):  
Pregnant Women ◽  
Andhra Pradesh ◽  
Thyroid Dysfunction ◽  
Hypochromic Anemia ◽  
Normocytic Normochromic Anemia ◽  
Significant Difference ◽  
History Of ◽  
Normochromic Anemia ◽  
Hb Concentration ◽  
Rbc Count

Background: Thyroid dysfunction is a common disorder in pregnancy along with anemia. But no study has evaluated the association between them. To estimate the prevalence of thyroid dysfunction and its association with anemia types in pregnant women during 1st trimester.Methods: Three hundred and eighty pregnant women with <12 weeks of gestational age were selected for the study with no history of thyroid dysfunction and anemia. All the pregnant women were classified into A, euthyroid and B, thyroid dysfunction groups. The B group was again subdivided into hypothyroid, subclinical hypothyroid (SCH), hyperthyroid according to nature of dysfunction. 5 ml of blood sample was collected from all subjects to analyse thyroid hormones and erythrocyte indices.Results: Out of 380 subjects, euthyroid was found to be 77.9%, and rest 22.1% were with thyroid dysfunction. Out of 84 thyroid dysfunction, hypothyroid was found to be 7.9%, SCH 13.9% and hyperthyroid was 0.3%. Out of 296 euthyroid women, anemia was identified in 97 pregnant women (32.8%) whereas in thyroid dysfunction women it was 43 women out of 84 (51.2%) which is a statistically significant. Significantly higher frequency of microcytic hypochromic anemia and normocytic normochromic anemia types were also found in thyroid dysfunction groups compared to euthyroid group (p<0.05). However, no significance between the thyroid dysfunction groups, Statistically significant difference was observed in the Hb concentration, RBC count, MCV, MCH and PCV between euthyroid and different thyroid dysfunction conditions (p<0.05). A statistically significant positive correlation was found between fT4 and erythrocyte indices.Conclusions: As fT4 and TSH correlated with erythrocyte indices, it is advisable to screen for thyroid dysfunction and vice versa so as to prevent the complications associated with anemia and thyroid dysfunction.

scholarly journals Unrecognized tuberculosis in a patient with COVID-19

2021 ◽  
pp. 6-6
Author(s):  
Mihailo Stjepanovic ◽  
Slobodan Belic ◽  
Ivana Buha ◽  
Nikola Maric ◽  
Marko Baralic ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Chronic Illnesses ◽  
Immune Systems ◽  
Indicator Tube ◽  
Global Pandemic ◽  
Severe Clinical Presentation ◽  
History Of ◽  
Growth Indicator

Introduction. COVID-19 is responsible for the current global pandemic. Globally, over 15 million people are currently infected, and just over 600,000 have died due to being infected. It is known that people with chronic illnesses and compromised immune systems can develop more severe clinical presentation. Tuberculosis is still one of the biggest epidemiological problems worldwide. Both of these diseases can be misdiagnosed and can manifest in a similar way. We will present a case study of a patient who was initially treated as a COVID-19 infection, with Tuberculosis being diagnosed later on. The recovery began only after being treated for both diseases simultaneously. Case report. The patient is a 27-year-old male, non-smoker, with no history of any significant diseases. He presented with fever, fatigue and hemoptysis. Computed tomography pulmoangiography had shown massive consolidations and excavations, which could be caused by COVID-19. Despite being treated for COVID-19, there was no clinical improvement. On the follow-up chest X-radiograohy, beside signs of COVID-19, there were also changes that could indicate Tuberculosis. Tuberculosis was detected in sputum, using PCR and Mycobacteria Growth Indicator Tube, and only after being treated for both diseases did his condition improve. Conclusion. There are a few reported cases of COVID-19 and Tuberculosis coinfections, and we believe that there are many more patients with this coinfection being unrecognized.

A DSM insiders’ history of premenstrual dysphoric disorder

2015 ◽  
Author(s):  
Peter Zachar ◽  
Kenneth S. Kendler
Keyword(s):  
Psychiatric Disorder ◽  
Depressive Disorders ◽  
Premenstrual Dysphoric Disorder ◽  
Careful Study ◽  
Medical Report ◽  
Late Luteal Phase ◽  
Behavioral Abnormality ◽  
History Of

Chapter 41 discusses a kind of in vivo case study of the interactions between science and extra-scientific processes involved in the construction of nosological categories of psychiatry. The very first medical report on a cluster of symptoms, regularly affecting some women over their menstrual cycle, the so-called syndrome of premenstrual tension, appeared in 1931. The name changed with time to premenstrual syndrome, subsequently renamed as late luteal phase dysphoric disorder (LLPDD) and is currently known as premenstrual dysphoric disorder (PMDD). It was listed as a psychiatric disorder in the DSM-III, but was later moved to the section on the condition deserving further study (aka the “appendix”). In the DSM-5, PMDD returned to the main section of the manual devoted to depressive disorders as a diagnosis approved for routine clinical use. The PDD is an ideal-type condition to stimulate a controversy about its justification as a psychiatric disorder. By its nature it affects only females (here, feminist issues may arise); it is clearly linked to physiological rhythm (is it not a somatic issue?); does it exist as a distinct behavioral abnormality or is it just a variant of female experience?: does it need to be treated pharmacologically? (the issues of medicalization and “big pharma”). It provides a detailed narrative on the vicissitudes of this psychiatric nosological category, which is not only based on a careful study by interested outsiders but is crucially enriched by the insights of one of the participants of the very process of DSM construction.

Skin endometriosis between the breasts of a young girl: A case study and literature review

2019 ◽  
Vol 11 (4) ◽  
pp. 207-209
Author(s):  
Mohammad Reza Taghavi ◽  
Samaneh Mollazadeh ◽  
Mohammad Bagheri Mansoori ◽  
Mehdi Asadi
Keyword(s):  
Uterine Cavity ◽  
Diagnostic Procedures ◽  
Excision Biopsy ◽  
Common Complication ◽  
Rare Presentation ◽  
Young Females ◽  
Periodic Discharges ◽  
History Of

Objective: Endometriosis is defined as the presence of functional endometrial glands and stroma outside the uterine cavity. Skin involvement is a rare presentation of this common complication. The purpose of this study is to introduce a markedly atypical case of the skin endometriosis with periodic pains located between the breasts of the 24-year-old girl. Care report: In this case, the patient with unknown periodic discharges and painful lesion presented in different consulting diagnostics centers for her complaint. After various diagnostic procedures and treatments, she underwent an excision biopsy to evaluate endometriosis. The history of periodic fluid findings of this case aid to indicate endometriosis. This case also emphasizes the significance of suspecting not only the atypical locations of endometriosis but also presentations of endometriosis. Follow-up tests indicated that she was risk-free of endometriosis relapsing status. Conclusion: The atypical endometriosis sites can present with varied ranges of symptoms, especially ones occurred periodically with menses in young females.

scholarly journals A 45-year-old Female with an Atypical Presentation of Pharyngitis

2020 ◽  
Vol 4 (2) ◽  
pp. 234-240
Author(s):  
Artur Schander ◽  
Andrew Glickman ◽  
Nancy Weber ◽  
Brian Rodgers ◽  
Michael Carney
Keyword(s):  
Sore Throat ◽  
Complete Blood Count ◽  
Differential Diagnoses ◽  
Prescription Medications ◽  
Over The Counter ◽  
Case Presentation ◽  
Common Causes ◽  
History Of

Introduction: Emergency physicians are trained to treat a variety of ailments in the emergency department (ED), some of which are emergent, while others are not. A common complaint seen in the ED is a sore throat. While most sore throats are easily diagnosed and treated, less common causes are often not considered in the differential diagnoses. Therefore, the purpose of this case study was to present an atypical case of sore throat and discuss differential diagnoses. Case Presentation: The patient was a 45-year-old female who presented to the ED with a three-day history of sore throat that was exacerbated by eating and drinking. The patient was not on any prescription medications, but tried over-the-counter medications for the sore throat without any improvement in symptoms. Review of systems was positive for sore throat, fevers, and chills. Physical examination of her oropharynx revealed mildly dry mucous membranes with confluent plaques and white patchy ulcerative appearance involving the tongue, tonsils, hard palate, and soft palate. Rapid streptococcal antigen, mononucleosis spot test, and KOH test were performed and found to be negative. Discussion: After initial testing was negative, a follow-up complete blood count with differential and complete metabolic profile were ordered. The patient was found to have decreased lymphocytes and platelets. Based upon those results, a diagnosis was made in the ED, the patient was started on medication, and further laboratory workup was ordered to confirm the diagnosis. ED providers should consider non-infectious as well as infectious causes for a sore throat, as this might lead to a diagnosis of an underlying condition.

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