scholarly journals 1674. Orthopedic Complications of Congenital Zika Syndrome in Brazil

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S613-S613
Author(s):  
Nilson Nogueira Mendes Neto ◽  
Igor T Queiroz ◽  
Jessika T da S. Maia ◽  
Marcelo Zacarkim ◽  
A Desiree Labeaud ◽  
...  
Keyword(s):  
Lower Limb ◽  
Upper Limbs ◽  
Rehabilitation Center ◽  
Congenital Vertical Talus ◽  
Clinical Presentations ◽  
Congenital Zika Syndrome ◽  
History Of ◽  
Vertical Talus ◽  
Social Profiles

Abstract Background Congenital Zika Syndrome (CZS) has a broad spectrum of clinical presentations that are still being described. This cohort study aimed to describe the orthopedic complications in children with microcephaly (MCP) related to Zika virus (ZIKV). Methods We evaluated 36 children with CZS up to 17 months of age followed at a pediatric rehabilitation center in the northeast of Brazil. Cohort enrollment occurred with children born between January 2015 and May 2016. We assessed their social profiles and orthopedic findings. Results Of the 36 cases, 25 were male. All of them lived in rural area. 25 had at least one congenital orthopedic alteration. Hip subluxation was the most common problem detected (n = 15); other lower limb abnormalities included knee subluxation (n = 7), clubfoot (n = 7); congenital vertical talus (n = 4); plano-valgus foot (n = 5). In relation to the upper limbs, 11 children presented with some shoulder and/or elbow abnormality and 16 had some alteration in the hand and/or on the wrist. Conclusion Orthopedic problems appear to be common in children with CZS and should be a focus of larger clinical studies. An initial orthopedic assessment may provide a better quality of life by helping children avoid further complications/deformities. Our results emphasize the orthopedic problems associated with CZS and the need to better describe many complications in the natural history of this infection. Disclosures All authors: No reported disclosures.

scholarly journals The prevalence of ulnar neuropathy at the elbow and ulnar nerve dislocation in recreational wheelchair marathon athletes

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243324
Author(s):  
Mari Kakita ◽  
Yukio Mikami ◽  
Tatsuru Ibusuki ◽  
Takashi Shimoe ◽  
Yoshi-ichiro Kamijo ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ulnar Nerve ◽  
Lower Limb ◽  
Ulnar Neuropathy ◽  
Upper Limbs ◽  
Wheelchair Sports ◽  
Increased Risk ◽  
History Of ◽  
Physical Examinations ◽  
Or History

Background Ulnar neuropathy at the elbow is an entrapment neuropathy, while ulnar nerve dislocation might also be involved in its incidence and severity. Wheelchair marathon athletes may be at an increased risk for Ulnar Neuropathy. However, there is a paucity of research into the prevalence of Ulnar Neuropathy and ulnar nerve dislocation in this population. Objective To investigate the prevalence of ulnar neuropathy at the elbow and ulnar nerve dislocation in wheelchair marathon athletes. Participants Wheelchair marathon athletes (N = 38) who participated in the 2017, 2018, and 2019 Oita International Wheelchair Marathon. 2 athletes participated only one time, 36 athletes repeatedly. Data from athletes`latest assessment were used. Methods The day before the race, questionnaires, physical examinations, and ultrasonography were conducted to screen for Ulnar Neuropathy in both upper limbs. Ulnar nerve dislocation was confirmed by physical examination and ultrasonography. Results 11 (29%) athletes were diagnosed with Ulnar Neuropathy. There were no significant differences in age, height, weight, Body Mass Index, or history of primary illness between athletes with and without Ulnar Neuropathy. In the group without Ulnar Neuropathy, 44% of athletes reported to have been engaging in other wheelchair sports, compared to 9% in the group with Ulnar Neuropathy (p = 0.037). Ulnar nerve dislocation was diagnosed in 15 (39%) athletes by ultrasonography. Out of the 14 elbows of 11 athletes diagnosed with Ulnar Neuropathy, 9 (64%) elbows had ulnar nerve dislocation. Conclusion The prevalence of Ulnar Neuropathy in wheelchair marathon athletes was higher than previously reported in able-bodied, non-athlete individuals and lower than in non-athletes with lower limb dysfunction. Therefore, while wheelchair sports may provide some protection against Ulnar Neuropathy, this study further supports the importance of screening for Ulnar Neuropathy, as well as for ulnar nerve dislocation as a potential risk factor for the development of Ulnar Neuropathy.

A Case Report on Budd Chiari Syndrome – Which Mimics Multiple Disorders

2021 ◽  
Vol 2 (3) ◽  
pp. 4-7
Author(s):  
Niveditha Dileep ◽  
John Thomas ◽  
Jisha James ◽  
Abhijith V
Keyword(s):  
Liver Parenchyma ◽  
Sinusoidal Obstruction Syndrome ◽  
Biliary Disease ◽  
Budd Chiari Syndrome ◽  
Clinical Presentations ◽  
Chiari Syndrome ◽  
History Of ◽  
Clinical Variants ◽  
Diagnostic Approaches

Background: Budd Chiari Syndrome (BCS) is the king of disorders which will mimic other disorders like chronic biliary disease, constrictive pericarditis, sinusoidal obstruction syndrome and so on, as it be like that, it is less diagnosed and treated in many countries. The prevalence of BCS is one in one million population, so it is a very rare case therefore it should be treated properly because many disorders like hematologic or malignant disease are the complications of BCS [1], [2]. Objective: To access the clinical variants of BCS along with the similarities and differences in clinical presentation, diagnostic approaches, and general treatment pattern which mimic, BCS thus gives the physician a clear outline about those disorders. Method: A man of 42 years old having BCS was taken for the study to carry out the differences in clinical features of BCS which distinguish the mimicking disorders. Clinical presentations were noted. Laboratory tests and diagnostic tests showed that the patient is having comorbidities including fatty liver with cholelithiasis, mild splenomegaly, liver parenchyma diseases, large esophageal varies with signs of recent hemorrhage, port hypertensive gastropathy and minimal ascites [3]. Patient get discharged after feeling better. Result: This patient is having chronic BCS with DIPS dysfunction. The patient had no history of liver disease before diagnosing BCS. BCS is almost curable when it is diagnosed correctly as early as possible. If not diagnosed early and treated well, comorbidities will occur, and it will affect the patient quality of life. Discussion: Early detection and proper treatment will help to control the disease up to an extent. This is depending on the physician’s knowledge. Hence, this case study clearly explains the disorders which mimic BCS for better understanding.

scholarly journals Lipoid Proteinosis presenting as beaded papules of the eyelid: report of three cases

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhenyu Wei ◽  
Antoine Labbe ◽  
Qingfeng Liang
Keyword(s):  
Gene Sequence ◽  
Inherited Disease ◽  
Case Presentation ◽  
Ocular Irritation ◽  
Lipoid Proteinosis ◽  
Gene Sequence Analysis ◽  
Clinical Presentations ◽  
History Of ◽  
Histological Characteristics

Abstract Background Lipoid proteinosis (LP) is a rare multisystem inherited disease. We report here in three LP cases with beaded papules of the eyelid. Their clinical presentations, histological characteristics, and genetic findings are described and discussed. Case presentation A 12-year-old boy reported to our hospital with a complaint of ocular irritation, redness, and tearing for two years. He had a history of hoarseness since childhood. His younger brother (5 years old) also complained of hoarseness. Another patient, a 26-year-old woman, described many beaded papules on the edge of her eyelids since age 11 years. She additionally reported hoarseness since 4 years of age. Careful slit-lamp examination in these cases revealed waxy beaded papules on the margins of both eyelids and mild conjunctival congestion. Physical examination showed irregular, rugged scars on their facial skin. Genetic analysis showed the mutation located in exon 6 of the ECM1 gene. Conclusions Three LP cases first diagnosed by ophthalmologists are presented. The presence of eyelid papules should prompt the ophthalmologist to pay close attention to the patient’s voice. If there is a definite history of hoarseness, these patients should undergo gene sequence analysis. If necessary, otorhinolaryngology and dermatology consults may help confirm the diagnosis. Treatment is primarily symptomatic to improve patients’ quality of life.

Probiotics in gastroenterology – from a different angle

2013 ◽  
Vol 154 (8) ◽  
pp. 294-304 ◽  
Author(s):  
György Miklós Buzás
Keyword(s):  
Side Effects ◽  
Beneficial Effect ◽  
Analytical Data ◽  
Well Being ◽  
Gastrointestinal Diseases ◽  
Convincing Evidence ◽  
Probiotic Treatment ◽  
History Of ◽  
Irritable Bowel

After a short overview of the history of probiotics, the author presents the development of human intestinal microflora based on the newest genetic data and the microbiological features of main probiotics. The indications of probiotic administration have been defined and extended in recent years. The author reviews significant results of probiotic treatment in some gastrointestinal diseases based on meta-analytical data. Probiotics are useful in preventing and treating diarrhoea caused by antibiotics and Clostridium difficile caused diarrhoea. In the treatment of Helicobacter pylori infection, preparations containing certain Lactobacillus,Bifidobacterium strains or Saccaromyces boulardii could enhance by 5–10% the rate of successful eradication and reduce the incidence and severity of the side effects. Some symptoms of irritable bowel syndrome and thus the quality of life can be improved by probiotics. Their beneficial effect in ulcerative colitis was proven, while in Crohn’s disease has not yet been defined. The use of probiotics is not included in guidelines, with the exception of the Maastricht IV/Florence consensus. For each disease it is advisable to use probiotics containing strains only with proven beneficial effect. The efficiency of preparations containing mixed strains has not yet been properly investigated. The author reviews the rare but potentially serious side effects of probiotics. In Hungary, there are many probiotic preparations available which can be purchased in pharmacies without prescription: their use is more empirical than evidence-based. The European Food Safety Authority has recently rejected claims for probiotics to be classed as medicines given the lack of convincing evidence on the effects of probiotics on human health and well-being. Clearly, further research is needed to collect evidence which could be incorporated into the international guidelines. Orv. Hetil., 2013, 154, 294–304.

EXPLORING HEALTHCARE ARCHITECTURE THROUGH THE MEDIUM OF FILM: Motives and Techniques

2014 ◽  
Vol 8 (1) ◽  
pp. 29
Author(s):  
Stephen Verderber
Keyword(s):  
Real World ◽  
The Real ◽  
Healthcare Settings ◽  
Interdisciplinary Field ◽  
Body Of Knowledge ◽  
Behavior Setting ◽  
Physical Environments ◽  
Scant Attention ◽  
History Of

The interdisciplinary field of person-environment relations has, from its origins, addressed the transactional relationship between human behavior and the built environment. This body of knowledge has been based upon qualitative and quantitative assessment of phenomena in the “real world.” This knowledge base has been instrumental in advancing the quality of real, physical environments globally at various scales of inquiry and with myriad user/client constituencies. By contrast, scant attention has been devoted to using simulation as a means to examine and represent person-environment transactions and how what is learned can be applied. The present discussion posits that press-competency theory, with related aspects drawn from functionalist-evolutionary theory, can together function to help us learn of how the medium of film can yield further insights to person-environment (P-E) transactions in the real world. Sampling, combined with extemporary behavior setting analysis, provide the basis for this analysis of healthcare settings as expressed throughout the history of cinema. This method can be of significant aid in examining P-E transactions across diverse historical periods, building types and places, healthcare and otherwise, otherwise logistically, geographically, or temporally unattainable in real time and space.

РАССКАЗЫ В.ШУКШИНА И ПРОБЛЕМЫ ПЕРЕВОДА ИХ НА КЫРГЫЗСКИЙ ЯЗЫК

2020 ◽  
pp. 77-81
Author(s):  
Джээнбүбү Бегеева
Keyword(s):  
Key Words ◽  
Russian Literature ◽  
Main Task ◽  
Stylistic Variation ◽  
Psychological Feature ◽  
Translation Analysis ◽  
History Of ◽  
The Creation ◽  
Problems Of Translation

Аннотация. В статье анализируется качество переводов рассказов В.Шукшина, осуществленных в середине 70-х годов С. Наматбаевым. Переводоведческий анализ вывил многочисленные стилевые расхождения между оригиналом и переводом. При переводе одного из лучших рассказов Шукшина «Чудик» искажения стиля не передали психологические тонкости рассказа. При переводе рассказа «Дядя Ермолай» философский аспект рассказа выпал, так как переводчик исказил жанровую специфику. Перевод рассказа «Два письма» оказался более качественным по сравнению с предыдущими. Переводчик рассказа «Два письма» сумел приблизиться к оригиналу, расшифровать его основную тональность, воспроизвести атмосферу напряженных поисков истины героем рассказа Николаем Иванычем. Этот перевод оказался более качественно выполненным по сравнению с предыдущим рассказом «Дядя Ермолай». Причину переводческого успеха можно объяснить, прежде всего, доступностью содержания рассказа, да и сам герой не столь сложная и глубокая личность, как повествователь в рассказе о дяде Ермолае. В целом, переводы С.Наматбаева являются своеобраз- ным этапом в переводческом деле. В настоящее время необходимо более полное и глубокое восприятие творчества В.Шукшина и создания новых адекватных переводов. Ключевые слова: качество переводов, стилевые расхождения, психологические тонкости, философский аспект, этапом. Аннотация. Макалада В.Шукшиндин аңгемелеринин кыргыз тилине которуудагы сапаты каралат, котормолор 1970-жылдары котормочу С.Наматбаев аркылуу жаралган. Котормонун сапатына талдоо жүргүзгөндө көпчүлүк каталар табылган, алардын эң олуттуусу стилдердин айырмасы, негизги чыгарма менен котормонун ортосунда. Мисалы, “Чудик” деген аңгеменин психологиялык мүнөздөмөсү жоголуп кеткен. “Ермолай байке” деген аңгемеде жанрдын туура эмес берилишинен жазуучунун негизги ою жоголуп кеткен. “Эки кат” деген аңгеме беркилерге караганда сапаттуу которулган. Котормочу " Эки кат" деген аңгемени оригиналга жакындатып которгон. Башкы каарман Николай Иванычтын изденүүлөрүн, ойлорун, чындыкты табууга аракеттерин Шукшинден кем эмес окуучуларга жеткирген. Котормочунун жетишкендиги аңгеменин түшүнүктүү мазмуну менен түшүндүрсө болот, жана Николай Ивановичтин жөнөкөйлүгү менен. С.Наматбаевдын котормолору каталарына карабастан котормочулук иште алдыга жылуу болгон. Бирок, азыркы заманда сапаттуу котормо жаратууда мезгил келди. Түйүндүү сөздөр: которуудагы сапаты, стилдердин айырмасы, психологиялык мүнөздөмөсү, негизги ою жоголуп. Annotation. The quality of translation of the Shukshins stories is analyzed in the Middle 70- years. By S.Namatbaev. The translation analysis had idenh hed numerous style discrepancies between the original and the translation. The psychological feature of the compasihion were not be hansfered by the translation one the bestand famous story by. V.Shukshin due to distorhion of the style. By the translation of the story “The uncle Ermolai” had full a phisichal aspect of the story, because the translator had distorted the genre specifics. The translation of the stories “Two letters” was wade more qualitative comparated with another stories. Generally, the Namatbaevs translation are a sui generis stage in the translatiobs. We need currently more total and profound perception of the creation by V.Shukshin. The create of the new adeavate translation is the main task. The head of the theory and history of Russian literature department. V. Shukshin’s stories and problems of translation them into Kyrgyz language. This article is analysed the quality of translation of V. Shukshin’s stories, which were written in 70 th with S. Namatbaev. Translation analyse deduced many stylistic variations between translated version and original. There is a misrepresentation, was not transmitted psychological subtleties of the story in translation of one of the best V. Shuk- shin’s story “Wierdo”. Metaphysical dimension is disappeared in translation of the story “Uncle Ermolai”, since translator destort the genre specificity. The translation of the story “Two letters” has been more qualitative in comparison with previous translations. In common, S. Namatbaev’s translation is a genius stage in translation. It needs more full and deep comprehension of S. Shukshin’s work and to establish new suitable translation. Key words: Quality of translation, stylistic variation, psychological subtleties, metaphysical dimension, stage.

Sustainability Failure in the Antimicrobial Stewardship Program in a Secondary Care Hospital from Cuba: A Historical Review of 30 Years and 3 Shots

2020 ◽  
Vol 18 ◽  
Author(s):  
Humberto Guanche Garcell ◽  
Juan José Pisonero Socias ◽  
Gilberto Pardo Gómez
Keyword(s):  
Antimicrobial Stewardship ◽  
Historical Review ◽  
Original Data ◽  
Care Hospital ◽  
Antimicrobial Stewardship Program ◽  
Continuous Quality ◽  
Stewardship Program ◽  
History Of ◽  
Health Organization

Background: During the last 30 years an antimicrobial stewardship program (ASP) was implemented in a facility with periods of weakness. We aim to describe the history of the sustainability failure in the local ASP. Methods: A historical review was conducted using original data from the facility library and papers published. An analysis of factors related to the failure was conducted based on the Doyle approach. Results: The first ASP was implemented from 1989 to 1996 based on the international experiences and contributes to the improvement in the quality of prescription, reduction of 52% in cost and in the incidence of nosocomial infection. The second program restarts in 2008 and decline in 2015, while the third program was guided by the Pan-American Health Organization from 2019. This program, in progress, is more comprehensive than previous ones and introduced as a novel measure the monitoring of antibiotic prophylaxis in surgery. The factors related to the sustainability were considered including the availability of antimicrobials, the leader´s support, safety culture, and infrastructure. Conclusions: The history behind thirty years of experiences in antimicrobial stewardship programs has allowed us to identify the gaps that require proactive strategies and actions to achieve sustainability and continuous quality improvement.

Sacral plexus disorder caused by a wooden toothpick in the rectum

2021 ◽  
Vol 14 (1) ◽  
pp. e238690
Author(s):  
Takuro Endo ◽  
Taku Sugawara ◽  
Naoki Higashiyama
Keyword(s):  
Lower Limb ◽  
Spinal Nerve ◽  
Leg Pain ◽  
Sacral Plexus ◽  
Lateral Recess ◽  
Lateral Recess Stenosis ◽  
Preoperative Ct ◽  
History Of ◽  
History Of Pain ◽  
The Right

A 67-year-old man presented with a 2-month history of pain in his right buttock and lower limb. MRI depicted right L5/S1 lateral recess stenosis requiring surgical treatment; however, preoperative CT showed an approximately 7 cm long, thin, rod-shaped structure in the rectum, which was ultimately determined to be an accidentally ingested toothpick. It was removed surgically 6 days after diagnosis, because right leg pain worsened rapidly. The pain disappeared thereafter, and the symptoms have not recurred since. The pain might have been localised to the right buttock and posterior thigh in the early stages because the fine tip of the toothpick was positioned to the right of the anterior ramus of the S2 spinal nerve. Although sacral plexus disorder caused by a rectal foreign body is extremely rare, physicians should be mindful to avoid misdiagnosis.

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