scholarly journals Massive megarectum secondary to constipation in institutionalized patient

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Dawit Ayalew ◽  
Yahya Alwatari ◽  
Lin M Riccio
Keyword(s):  
Chronic Constipation ◽  
Elderly Population ◽  
The Elderly ◽  
Mental Disability ◽  
Common Cause ◽  
Surgical Options ◽  
Diagnostic Work ◽  
Work Up ◽  
Case Basis ◽  
Diagnostic Work Up

Abstract Chronic constipation is a common cause of morbidity in the elderly and institutionalized population. It can be associated with significant morbidity and socioeconomical burden. Chronic resistance constipation can rarely be associated with megarectum. Herein, we present the case of a patient with physical and mental disability that presented with refractory constipation associated with extreme stool burden and a massive megarectum. We discuss chronic constipation in the elderly population, its etiologies and diagnostic work-up including surgical options. The management of chronic constipation with megarectum should be on a case-by-case basis.

scholarly journals Adult-Onset Severe Hypocalcemia Due Defect in Parathyroid Calcium-Sensing Receptors

2020 ◽  
Vol 5 (07) ◽  
pp. 250-251
Author(s):  
Kamel El-Reshaid ◽  
Shaikha Al-Bader
Keyword(s):  
Case Report ◽  
Adult Onset ◽  
Common Cause ◽  
Autoimmune Polyglandular Syndrome ◽  
Calcium Sensing ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Parathyroidectomy, of the 4 glands, with/without thyroidectomy is the most common cause of hypoparathyroidism. Autoimmunity is a rare etiology, either as an isolated endocrinopathy or as a component of autoimmune polyglandular syndrome 1 (APS 1). In this case report; we describe a patient with an adult-onset hypoparathyroidism and discuss its pathophysiology in relation to calcium-sensing receptors in addition to its diagnostic work up and management.

scholarly journals Utility of serial procalcitonin measurement in management of febrile neutropenia in a resource constrained setting.

2020 ◽  
Author(s):  
Rohan Halder ◽  
Tulika Seth ◽  
Pradeep Chaturvedi ◽  
Manoranjan Mahapatra ◽  
Hara Prasad Pati ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Fungal Infection ◽  
Sensitivity And Specificity ◽  
Febrile Episode ◽  
Common Cause ◽  
Fever Onset ◽  
Diagnostic Work ◽  
Febrile Episodes ◽  
Work Up ◽  
Diagnostic Work Up

Abstract Background: Febrile neutropenia is a common cause in morbidity and mortality during treatment of hematological neoplasms.Methods: Subjects included all cases admitted under hematology department with febrile neutropenia from February to June 2018. Diagnostic work up for each febrile episode was done including Procalcitonin (PCT) was sent at fever onset 0,24,48hour, day 7 and day 14.Results: Data was analyzed for 52 febrile episodes in 50 patients.PCT cut off value at 24 hours of ≤1.2ng/ml had a sensitivity and specificity of 62.5% and 87.5% for discriminating IFI and MDI (p=0.033). PCT had a negative predictive value of 70% for the diagnosis of IFI as compared to MDI. PCT cut-off of 0.4ng/ml on day 7 had a sensitivity and specificity of 60.98% and 100% respectively for discriminating IFI and PUO (p= 0.0001). There was a significant fall in the level of PCT by day 14(median fall in PCT of 10.8) in the group of patients who had both IFI+ MDI when compared to other groups (p=0.047). PCT level at 24 and 48hours can be a predictor of severity of infection.Conclusion: Procalcitonin at 24 hours could discriminate between bacterial and fungal infection and between fever due to fungal infection and disease fever.

Diagnosing Suspected Stroke: A Cost-Effectiveness Analysis

1985 ◽  
Vol 1 (1) ◽  
pp. 147-158 ◽  
Author(s):  
Mona Britton ◽  
Egon Jonsson ◽  
Lars-Åke Marké ◽  
Veronica Murray
Keyword(s):  
The Elderly ◽  
Elderly Persons ◽  
Industrialized Countries ◽  
Public Concern ◽  
Effectiveness Analysis ◽  
Suspected Stroke ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Acute cerebrovascular disease (CBVD) has an annual incidence of 100–300 per 100,000 inhabitants in the industrialized countries (1,2). CBVD occurs mainly in the elderly. Acute mortality is around 15%. Disablement and decreased quality of life are common consequences. Institutionalized care will be needed after the acute phase for around one-third of the patients (3). Considering the volume of patients and the growing proportion of elderly persons in most countries, stroke poses a major problem for health care. An effective diagnostic work-up as the base for therapy to improve the situation is, therefore, a matter of great public concern, for humanitarian as well as economic reasons.

scholarly journals Heart failure in the elderly: A geriatric syndrome. Picture of the modern situation

2019 ◽  
Vol 89 (1) ◽  
Author(s):  
Valentina Fagotto ◽  
Alessandro Cavarape ◽  
Alessandro Boccanelli
Keyword(s):  
Heart Failure ◽  
Older Patients ◽  
Clinical Presentation ◽  
The Elderly ◽  
Geriatric Syndrome ◽  
Diagnostic Work ◽  
Patient’S History ◽  
Work Up ◽  
Diagnostic Work Up

Among the older patients’ cohort, the aetiology of heart failure is peculiar and differs in many ways from the younger one, both in its epidemiology, diagnostic work-up and clinical presentation. Focusing on this population, we could assume that heart failure is a real geriatric syndrome, characterized by several features, which coexist with other comorbidities and require specific and targeted cares. It is therefore necessary to examine the global burden of heart failure and the patient’s history rather than the causal cardiomyopathy - frequently more than one in the elderly - facing with the condition, bearing in mind the quality of life even before its duration.

scholarly journals Bullous Pemphigoid and Other Pemphigoid Dermatoses

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1061
Author(s):  
Valeryia Pratasava ◽  
Vikram Sahni ◽  
Aishwarya Suresh ◽  
Simo Huang ◽  
Abhirup Are ◽  
...  
Keyword(s):  
Bullous Pemphigoid ◽  
Clinical Presentation ◽  
The Elderly ◽  
Mucous Membrane Pemphigoid ◽  
Skin Fragility ◽  
Treatment Refractory ◽  
Diagnostic Work ◽  
Work Up ◽  
Variable Clinical Presentation ◽  
Diagnostic Work Up

The pemphigoid family of dermatoses is characterized by autoimmune subepidermal blistering. The classic paradigm for pemphigoid, and the most common member, is bullous pemphigoid. Its variable clinical presentation, with or without frank bullae, is linked by significant pruritus afflicting the elderly. Mucous membrane pemphigoid is an umbrella term for a group of subepidermal blistering dermatoses that favor the mucosal membranes and can scar. Epidermolysis bullosa acquisita is a chronic blistering disorder characterized by skin fragility, sensitivity to trauma, and its treatment-refractory nature. Clinicians that encounter these pemphigoid disorders may benefit from an overview of their clinical presentation, diagnostic work-up, and therapeutic management, with an emphasis on the most frequently encountered pemphigoid disease, bullous pemphigoid.

Gender Differences in Associated Gastrointestinal Symptoms and the Diagnostic Work-up for Chronic Constipation

2009 ◽  
Vol 104 ◽  
pp. S495
Author(s):  
Donald Pham ◽  
Toyia James-Stevenson ◽  
Fuad M. Azrak ◽  
Shanti Srinivasan ◽  
Jennifer Christie
Keyword(s):  
Gender Differences ◽  
Chronic Constipation ◽  
Gastrointestinal Symptoms ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

scholarly journals Stroke masquerading as cardiac arrest: the artery of Percheron

2021 ◽  
Vol 14 (1) ◽  
pp. e238681
Author(s):  
Megan Quetsch ◽  
Sureshkumar Nagiah ◽  
Stephen Hedger
Keyword(s):  
Cardiac Arrest ◽  
Clinical Assessment ◽  
Altered Consciousness ◽  
Cognitive Changes ◽  
Consciousness Level ◽  
Artery Of Percheron ◽  
Conscious Level ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

The artery of Percheron (AOP) is a rare arterial variant of the thalamic blood supply. Due to the densely packed collection of nuclei it supplies, an infarction of the AOP can be devastating. Here we highlight a patient who had an AOP stroke in the community, which was initially managed as cardiac arrest. AOP strokes most often present with vague symptoms such as reduced conscious level, cognitive changes and confusion without obvious focal neurology, and therefore are often missed at the initial clinical assessment. This case highlights the importance of recognising an AOP stroke as a cause of otherwise unexplained altered consciousness level and the use of MRI early in the diagnostic work-up.

scholarly journals Death of unknown cause? Post-mortem diagnosis of fulminant course of an EBV-associated secondary hemophagocytic lymphohistiocytosis

2021 ◽  
Author(s):  
Josia Fauser ◽  
Stefan Köck ◽  
Eberhard Gunsilius ◽  
Andreas Chott ◽  
Andreas Peer ◽  
...  
Keyword(s):  
Immune Response ◽  
Case Report ◽  
Macrophage Activation ◽  
Post Mortem ◽  
Life Threatening ◽  
Appropriate Therapy ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up ◽  
Secondary Hemophagocytic Lymphohistiocytosis

SummaryHLH is a life-threatening disease, which is characterized by a dysregulated immune response with uncontrolled T cell and macrophage activation. The often fulminant course of the disease needs a fast diagnostic work-up to initiate as soon as possible the appropriate therapy. We present herein the case of a 71-year-old patient with rapidly progressive hyperinflammatory syndrome, which post mortem resulted in the diagnosis of EBV-associated HLH. With this case report, we intend to highlight the relevance of the HScore in the diagnosis of HLH, to create a greater awareness for EBV as a trigger of HLH, and to demonstrate the importance of treating EBV-associated HLH as early as possible.

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