scholarly journals 2128. Murine Typhus and Pregnancy: Case Series and Literature Review

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S720-S721
Author(s):  
Melinda Tanabe ◽  
Lucas Blanton ◽  
Mauricio La Rosa de Los Rios ◽  
Camille Webb Camminati
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Febrile Illness ◽  
The United States ◽  
Murine Typhus ◽  
Worldwide Distribution ◽  
Hepatic Transaminases ◽  
Pubmed Database ◽  
Prolonged Duration ◽  
In Pregnancy

Abstract Background Murine typhus is an arthropod borne disease of worldwide distribution with recent reemergence in the United States of America. There is limited data about the presentation, treatment and outcomes in the pregnant population. We report two cases of murine typhus in pregnancy, as well as a case series based in literature published between 1990 and 2019. Methods A comprehensive search in Pubmed database using words murine typhus, pregnancy, R. typhi and endemic typhus was done. Exclusion criteria were asymptomatic murine typhus in pregnancy and undiagnosed febrile illness in pregnancy. Results Six articles met the criteria of symptomatic pregnant murine typhus infection. Four case reports plus our own 2 case reports, and 2 observational population studies. A total of 35 pregnancy patients were identified. Distribution was worldwide. Gestational age at presentation varied. Patients frequently presented with prolonged duration of fevers prior to presentation, headache, rash, thrombocytopenia and elevated hepatic transaminases. Diagnosis was mainly based on serology. Treatment varied and 8 cases did not receive any treatment at all. Overall pregnancy outcome was favorable, except in an Asian cohort reporting 6 patients with poor pregnancy outcomes. Conclusion The lack of data about murine typhus in pregnancy is of serious concern. Increase awareness of different presentations is needed in this population. Murine typhus infection can mimic other pregnancy-related pathologies that have very different treatments and outcomes. More data are needed about effective treatment and safety of doxycycline use during pregnancy. Disclosures All authors: No reported disclosures.

scholarly journals Murine Typhus Infection in Pregnancy: Case Series and Literature Review

Pathogens ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 219
Author(s):  
Melinda B. Tanabe ◽  
Lucas S. Blanton ◽  
Mauricio La Rosa ◽  
Camille M. Webb
Keyword(s):  
Large Scale ◽  
Case Series ◽  
The United States ◽  
Limited Data ◽  
Murine Typhus ◽  
Worldwide Distribution ◽  
Hepatic Transaminases ◽  
Pubmed Database ◽  
Prolonged Duration ◽  
Comprehensive Search

Murine typhus is a flea-borne disease of worldwide distribution with a recent reemergence in the United States of America. There are limited data about the presentation, treatment, and outcomes in the pregnant population. We report on two cases of murine typhus during pregnancy and review the literature to compile previously reported cases. A comprehensive search was performed via the PubMed database for published articles between 1990 and 2020. Seven articles met the criteria of symptomatic pregnant murine typhus infection. A total of 37 patients were identified. Patients frequently presented with a prolonged duration of fevers prior to presentation, headache, and elevated hepatic transaminases. The diagnosis was predominantly based on serology. Treatment varied. Overall, the pregnancy outcome was favorable. Murine typhus can mimic other pregnancy-related pathologies. More exclusive and large-scale studies are needed to learn more of murine typhus during pregnancy.

scholarly journals Villoglandular adenocarcinoma of the uterine cervix: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Anna K. Dietl ◽  
Matthias W. Beckmann ◽  
Konrad Aumann
Keyword(s):  
Systematic Review ◽  
Uterine Cervix ◽  
Case Reports ◽  
Case Series ◽  
Disease Free Survival ◽  
Conservative Group ◽  
Pubmed Database ◽  
Significant Difference ◽  
Stage Ia ◽  
Invasive Management

Abstract Purpose Villoglandular adenocarcinoma (VGA) of the uterine cervix has been classified as a rare subtype of cervical adenocarcinoma with good prognosis. A conservative surgical approach is considered feasible. The main risk factor is the presence of other histologic types of cancer. In this largest systematic review to date, we assess oncological outcomes associated with conservative therapy compared to those associated with invasive management in the treatment of stage Ia and Ib1 VGA. Methods Case series and case reports identified by searching the PubMed database were eligible for inclusion in this review (stage Ia–Ib1). Results A total of 271 patients were included in our literature review. 54 (20%) patients were treated by “conservative management” (conization, simple hysterectomy, and trachelectomy) and 217 (80%) by “invasive management” (radical hysterectomy ± radiation, hysterectomy, and radiation). Recurrences of disease (RODs) were found in the conservative group in two (4%) cases and in the invasive group in nine (4%) cases. There was no significant difference in disease-free survival (DFS) according to conservative or invasive treatment (p = 0.75). The histology of VGA may be complex with underlying usual adenocarcinoma (UAC) combined with VGA. Conclusion The excellent prognosis of pure VGA and the young age of the patients may justify the management of this tumor using a less radical procedure. The histological diagnosis of VGA is a challenge, and pretreatment should not be based solely on a simple punch biopsy but rather a conization with wide tumor-free margins.

scholarly journals Neuroendocrine Testicular Tumors: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 10 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Mseddi M. Amine ◽  
Bouzguenda Mohamed ◽  
Hadjslimane Mourad ◽  
Hamza Majed ◽  
Charfi Slim ◽  
...  
Keyword(s):  
Survival Rate ◽  
Neuroendocrine Tumors ◽  
Carcinoid Syndrome ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Palpable Mass ◽  
Pubmed Database ◽  
Evolutionary Features ◽  
Radical Orchiectomy

Purpose: The purpose of this study is to study the main epidemiological, clinical, para clinical, pathological, therapeutic, and evolutionary features of patients with testicular neuroendocrine tumors (TNET). Materials and Methods: Nine case series and sixteen case reports were identified by searching PubMed database and qualified for inclusion in this study. We added the data of one case treated in the department of urology in Habib Bourguiba Hospital in Sfax, to the published cases. Results: A total of 132 cases were collected. Median age at diagnosis was 39 years old (range 10- 83 years). The most common presenting symptom was either a testicular mass or a swelling in 38.46% of cases. Carcinoid syndrome was documented in 10.60% of patients. The clinical examination revealed a palpable mass in 44.70% of patients. This mass was painless and firm in most cases. Serum tumor markers (β-gonadotrophine chorionique humaine, α-feto protein, and lactate dehydrogenase) were within normal limits in all patients except in one case. Most testicular neuroendocrine tumors (76.52%) were primary and pure. The tumors were positive for chromogranin (100%), synaptophysin (100%) and cytokeratin (93.10%). Metastases were detected at time of diagnosis in eight cases (6.06%). The main treatment was radical orchiectomy performed in 127 patients (96.21%). The 5-year overall survival rate was 78.70% and the 5-year specific survival rate was 84.30%. Conclusion: The diagnosis of testicular carcinoids is based on the immunohistochemistry study. The treatment of choice for these tumors is radical orchiectomy. Somatostatin analogues were reported to be effective in patients with carcinoid syndrome.

scholarly journals Hepatitis C Virus in Pregnancy: Case Reports and Literature Review

1995 ◽  
Vol 3 (6) ◽  
pp. 248-251 ◽  
Author(s):  
Gary M. Joffe
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Vertical Transmission ◽  
Case Reports ◽  
Sexual Transmission ◽  
Severity Of Illness ◽  
The United States ◽  
Maternal Disease ◽  
In Pregnancy

Background: Hepatitis C virus (HCV) is now recognized as the cause of 90% of non-A, non-B (NANB) hepatitis. This virus is responsible for a large percentage of chronic persistent and chronic active hepatitis in the United States. Parenteral and sexual transmission are well described, so a significant population of pregnant patients is at risk. Vertical transmission of the virus to the fetus is dependent upon the level of maternal viremia.Case: The cases described in the following report demonstrate that fulminant disease may present in pregnancy. They also demonstrate the cofactors promoting the severity of illness, methods of diagnosis, potential treatment, and outcome of the infection.Conclusion: HCV may be encountered in pregnancy. Although most acute-phase illness will be self limiting, some patients will manifest liver failure during gestation. Because vertical transmission to the fetus is possible, the pediatrician should be informed of the maternal disease. Chronic hepatitis is almost the rule rather than the exception, so patients require close postpartum follow-up. Interferon, which may alter the course of the chronic disease, has been used on rare occasions in pregnancy.

Real-world risk of anosmia with cancer directed systemic therapy: A pharmacovigilance assessment using FDA Adverse Events Reporting System (FAERS) database.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18790-e18790
Author(s):  
Anahat Kaur ◽  
Shuai Wang ◽  
Arlene Yu ◽  
Tarek N. Elrafei ◽  
Lewis Steinberg ◽  
...  
Keyword(s):  
Adverse Events ◽  
Reporting System ◽  
Case Reports ◽  
Descriptive Analysis ◽  
Package Insert ◽  
Case Series ◽  
The United States ◽  
Chemotherapeutic Agents ◽  
United States Food ◽  
Pharmacovigilance Database

e18790 Background: Anosmia is a rare and under-reported adverse event associated with the use of several oncologic drugs. Instances of olfactory disturbances following administration of chemotherapeutic agents have been sporadically documented in case reports and case series. We aimed to conduct a more comprehensive study to generate signal for anosmia as adverse effect of drugs used for oncologic indications. Methods: The United States Food and Drug Administration (FDA) Adverse Events Reporting System (FAERS) database, a pharmacovigilance database, was used to extract data. All reported cases of anosmia in the database were filtered for an indication of cancer. Descriptive analysis was conducted using SPSS 26. Results: Total 10250 cases of anosmia were extracted from FAERS database. Out of these, cancer as an indication for medication use was noted in 139 cases. Some of the most common suspect medications exclusively associated with more than one case of anosmia were palbociclib (n=16), enzalutamide (13), pazopanib (8), cabozantinib (8), letrozole (6), leuprolide (5), niraparib (5), rucaparib (4), tamoxifen (4), capecitabine (3), everolimus (3), anastrazole (2), exemestane (2), zoledronic acid (2), vandetanib (2) and vismodegib (2). Detailed description of medications with highest number of reported cases is listed in Table. Median age at diagnosis was 66 years (interquartile range 58-71). Anosmia was reported more commonly in females (64% ) as compared to males (33.8%). Reactions were reported to the FDA more commonly by consumers (56.8%) as compared to healthcare professionals (40.3% cases). Out of 139 patients with anosmia, 93 (66.9%) had concomitant ageusia, 8 (5.7 %) had dysgeusia and 6 (4.3%) patients had neuropathy. Conclusions: This study demonstrates a signal for anosmia as side effect in patients receiving select oncologic medications based on the FAERS database. It is worth noting that none of the suspect medications identified in this study have anosmia listed as known adverse reaction on accompanying package insert. Further studies need to be conducted to confirm if causal relationship exists between use of these drugs and olfactory function compromise. [Table: see text]

scholarly journals 373. Immune Reconstitution Inflammatory Syndrome in Patients with HIV/AIDS and Histoplasmosis: A Case Series

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S195-S195 ◽  
Author(s):  
Afroditi Boulougoura ◽  
Elizabeth Laidlaw ◽  
Gregg Roby ◽  
Yolanda Mejia ◽  
Alice Pau ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Histoplasma Capsulatum ◽  
Case Reports ◽  
Case Series ◽  
The United States ◽  
Inflammatory Syndrome

Abstract Background Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV infection is the unexpected clinical deterioration due to worsening (paradoxical) or uncovering (unmasking) of an infection or malignancy upon initiation of antiretroviral therapy (ART). Histoplasma capsulatum (H. capsulatum) is the most common endemic mycosis in patients with AIDS, usually manifesting as disseminated disease at CD4 counts < 150 cells/μl. In the ART era, histoplasmosis IRIS has been described in case reports, but there has been a limited description regarding clinical presentations and pathogenesis in the United States. Methods ART-naive HIV+ patients with a CD4+ T-cell count < 100 cells/µL enrolled in prospective studies at the National Institutes of Health (NIH) (NCT00286767, NCT02147405) were evaluated to identify those with histoplasmosis and followed after ART initiation to identify those who would eventually develop IRIS. Results From a total of 271 patients, we identified 9 patients with histoplasmosis. The median age, CD4+ count and HIV VL of these 9 patients was 36 years, 40 cells/mm3 and 193,184 copies/mL, respectively. Two patients developed IRIS only to histoplasmosis (1 unmasking and 1 paradoxical), 2 patients developed IRIS to both histoplasmosis and nontuberculous mycobacteria (NTM) and 3 patients developed IRIS to other infections (1 VZV, and 2 NTM). The manifestations of histoplasmosis IRIS in our cohort ranged from worsening lymphadenopathy to small bowel obstruction and worsening pulmonary symptoms. Conclusion Histoplasma-related IRIS can present with worsening lymphadenopathy, small bowel obstruction, and worsening pulmonary symptoms. The emergence of IRIS appears to be very common in people with HIV and disseminated histoplasmosis but the underlying trigger may be histoplasma, other co-infections or both. Disclosures All authors: No reported disclosures.

scholarly journals Quality of Modern Total Ankle Arthroplasty Research

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0016
Author(s):  
Daniel Bohl ◽  
Emily Vafek ◽  
Simon Lee ◽  
Johnny Lin ◽  
George Holmes ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Case Reports ◽  
Case Series ◽  
The United States ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthritis ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
End Stage

Category: Ankle Arthritis Introduction/Purpose: Total ankle arthroplasty (TAA) is gaining popularity as an alternative to ankle arthrodesis in the setting of end-stage ankle arthritis. However, compared to hip and knee arthroplasty, there is a relative dearth of evidence to support its use. This study assesses the quality of literature surrounding modern TAA designs. Methods: A search of all peer-reviewed, English-language journals was conducted to identify publications involving TAA. The initial search identified 444 articles published during 2006-2016. Of these, 182 were excluded because they were not clinical outcomes studies, 46 because the TAA implant was no longer available, and 15 because the primary outcome of the study was not related to TAA, leaving 201 articles for analysis. Results: No Level I studies were identified. Seventeen (8%) studies were Level II, 48 (24%) Level III, 128 (64%) Level IV, and 8 (4%) Level V. One hundred forty-three studies (71%) were retrospective in nature. Stratification by study design revealed 128 (64%) case series, 33 (16%) experimental cohort studies, 19 (10%) case-control studies, 13 (6%) observational cohort studies, and 8 (4%) case reports. The number of studies published each year steadily increased from 2006 to 2016. A total of 51% of TAA research was published in only two journals: Foot and Ankle International and the Journal of Bone and Joint Surgery. Publications from the United States accounted for 36% of total publications. The most published implant was the Scandinavian Total Ankle Replacement (Figure 1). Conclusion: While the number of TAA studies published each year has steadily increased since 2006, the quality of this research as measured by level of evidence remains suboptimal. This analysis highlights the need for continued improvement in methodology and development of robust prospective registries to advance our knowledge of TAA as a treatment for end-stage ankle arthritis.

Proposed modified diagnostic criteria for recurrent painful ophthalmoplegic neuropathy: Five case reports and literature review

Cephalalgia ◽  
2020 ◽  
Vol 40 (14) ◽  
pp. 1657-1670
Author(s):  
Yinglu Liu ◽  
Miao Wang ◽  
Xiangbing Bian ◽  
Enchao Qiu ◽  
Xun Han ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Cranial Nerve ◽  
Current Knowledge ◽  
Case Reports ◽  
Case Series ◽  
Oculomotor Nerve ◽  
Multiplanar Reformation ◽  
Unilateral Headache ◽  
Pubmed Database ◽  
Recurrent Painful Ophthalmoplegic Neuropathy

Background Recurrent painful ophthalmoplegic neuropathy (RPON) is an uncommon disorder characterized by recurrent unilateral headache attacks associated with ipsilateral ophthalmoplegia. We intend to study the clinical picture in our case series along with the published literature to discuss the pathogenesis and propose modified diagnostic criteria for recurrent painful ophthalmoplegic neuropathy. Methods We reported five cases diagnosed as ophthalmoplegic migraine/RPON in our medical centers and reviewed the published literature related to RPON from the Pubmed database between 2000 and 2020. In one of these cases, a multiplanar reformation was performed to look at the aberrant cranial nerve. Results The mean onset age for RPON was 22.1 years, and the oculomotor nerve was the most commonly involved cranial nerve (53.9%) in 165 reviewed patients. In most patients, ophthalmoplegia started within 1 week of the headache attack (95.7%, 67/70). Additionally, 27.6% (40/145) of patients presented enhancement of the involved nerve(s) from MRI tests. Finally, 78 patients received corticosteroids, out of which 96.2% benefited from them. Conclusion This is the first time multiplanar reformation has been performed to reveal the distortion of the oculomotor nerve. Modified diagnostic criteria are proposed. We hope to expand the current knowledge and increase the detection of recurrent painful ophthalmoplegic neuropathy in the future.

scholarly journals Case report of the patient source of the Babesia microti R1 reference strain and implications for travelers

2017 ◽  
Vol 25 (1) ◽  
Author(s):  
Philipp Stahl ◽  
Yves Poinsignon ◽  
Pascal Pouedras ◽  
Vasilica Ciubotaru ◽  
Laurence Berry ◽  
...  
Keyword(s):  
Cell Biology ◽  
Febrile Illness ◽  
Clinical Information ◽  
The United States ◽  
Babesia Microti ◽  
Cape Cod ◽  
Antibody Testing ◽  
Worldwide Distribution ◽  
The Usa ◽  
Endemic Areas

AbstractBackgroundIn 2002, a previously healthy 69-year-old man travelled to France from the United States and presented to our hospital with a febrile illness that subsequently was determined to be babesiosis. The blood isolated from this patient served as a source for propagation of the Babesia microti R1 strain with subsequent sequencing and annotation of the parasite genome.MethodsUpon admission, we obtained a medical history, performed a physical examination, and examined his blood for the presence of a blood borne pathogen by microscopy, PCR and indirect immunofluorescence antibody testing. Once the diagnosis of babesiosis was made, we reviewed the literature to assess the distribution of B. microti-associated babesiosis cases in immunocompetent patients from outside the USA.ResultsThe patient recalled a tick bite during the previous month on Cape Cod, Massachusetts. The diagnosis was confirmed by identification of Babesia-infected red blood cells on blood smears, amplification of B. microti DNA in blood by PCR and the presence of B. microti antibody in the serum. This strain was the first isolate of B. microti to be fully sequenced and its annotated genome serves as a reference for molecular and cell biology studies aimed at understanding B. microti pathophysiology and developing diagnostic tests and therapies. A review of babesiosis cases demonstrates a worldwide distribution of B. microti and identifies potential emerging endemic areas where travelers may be at risk of contracting B. microti infection.ConclusionThis case provides clinical information about the patient infected with the R1 isolate and a review of travel risk, diagnosis and treatment of babesiosis in endemic and non-endemic areas.

scholarly journals Russian-language publication activities of medical researchers during the COVID-19 pandemic: results of the year

2021 ◽  
Vol 26 (4) ◽  
pp. 4451
Author(s):  
O. T. Kim ◽  
O. M. Drapkina ◽  
Yu. V. Rodionova
Keyword(s):  
Randomized Clinical Trials ◽  
Case Reports ◽  
Case Series ◽  
Healthcare Management ◽  
Russian Language ◽  
Original Research ◽  
Global Trends ◽  
Pubmed Database ◽  
Number Of Publications ◽  
Study Designs

Aim. To study the dynamics and patterns of medical publications in Russian, made during the year from February 2020, in order to assess the completeness of data on the etiology, pathogenesis, prevention and treatment of coronavirus disease 2019 (COVID-19), as well as rehabilitation and healthcare management during a pandemic.Material and methods. We searched for publications using the Pubmed database and the Elpub platform. The search was carried out using the following requests: “COVID-19” and “SARS-CoV-2”. Thematic sections were allocated according to source type, specialization and research design. The publications were classified according to keywords and meaning. The publication time was estimated by the date it was accepted for publication. Values were assessed using numerical values and graphs.Results. One hundred fifteen (28,5%) publications presented data from original research, while 288 (71,5%) — reflected the results of already existing sources. An increase in proportion of primary sources with the pandemic spread was established. There were following most common study designs: case series — 87 (77,7%); case reports — 15 (13,4%); cohort studies — 8 (7,1%); randomized clinical trials — 2 (1,8%). By topic, the largest number of articles are devoted to the diagnosis and treatment of COVID-19 — 250 (62%), epidemiology — 36 (8,9%), etiology and pathogenesis — 36 (8,9%), healthcare management — 30 (7,4%), “Other” — 20 (4,9%), and policy papers from expert communities — 13 (3,25%). The smallest number of publications is directly related to cardiology and prevention, including immunoprophylaxis — 12 (2,9%), as well as rehabilitation — 6 (1,5%).Conclusion. The dynamics and patterns of publications on COVID-19 in Russian are generally in line with global trends and reflect the pandemic characteristics in Russia. Due to disease novelty, there is currently a knowledge gap in the treatment, prevention and long-term outcomes of COVID-19. In the future, studies with a higher evidence level are needed on possible methods of treatment, prevention, including cardiology issues and vaccination, as well as rehabilitation.

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