Severe influenza in a paediatric patient with GATA2 deficiency and Emberger syndrome

2020 ◽  
Vol 13 (12) ◽  
pp. e236521
Author(s):  
Marie Louise Naestholt Jensen ◽  
Victor Dahl Mathiasen ◽  
Marinne Ifversen ◽  
Jeppe Sylvest Angaard Nielsen
Keyword(s):  
Intensive Care Unit ◽  
Paediatric Intensive Care Unit ◽  
Good Recovery ◽  
Severe Influenza ◽  
Haematopoietic Cell ◽  
Right Hand ◽  
History Of ◽  
Gata2 Deficiency ◽  
Allogeneic Haematopoietic Cell Transplantation ◽  
The Right

A 9-year-old girl was admitted to the paediatric intensive care unit with acute respiratory failure due to influenza. Nine months earlier, she presented with unexplained lymphoedema of the lower extremities and monocytopenia. She had a history of occasional finger warts and onychomycoses. During hospitalisation, the patient was diagnosed with Emberger syndrome caused by GATA2 deficiency. The admission was complicated by thromboses in the right hand, leading to amputation of multiple fingers. From then on, the patient has been in good recovery, the function of her right hand was improving and an allogeneic haematopoietic cell transplantation has now been successfully performed.

scholarly journals Enhancing teamwork communication and patient safety responsiveness in a paediatric intensive care unit using the daily safety huddle tool

2020 ◽  
Vol 9 (1) ◽  
pp. e000753 ◽  
Author(s):  
Fatima Aldawood ◽  
Yasser Kazzaz ◽  
Ali AlShehri ◽  
Hamza Alali ◽  
Khaled Al-Surimi
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care ◽  
Open Communication ◽  
Frontline Staff ◽  
Safety Issues ◽  
Unit Level ◽  
The Right

BackgroundOpen communication between leadership and frontline staff at the unit level is vital in promoting safe hospital culture. Our hospital staff culture survey identified the failure to address safety issues as one of the areas where staff felt unable to express their concerns openly. Thus, this improvement project using the daily safety huddle tool has been developed to enhance teamwork communication and respond effectively to patient safety issues identified in a paediatric intensive care unit.MethodsWe used the TeamSTEPPS quality approach. TeamSTEPPS is an evidence-based set of teamwork tools developed by the US Agency of Healthcare Research and Quality to enhance teamwork and communication. We applied TeamSTEPPS using a tool called the Daily Safety Huddle, aiming at improving communication and interaction between healthcare workers and building trust by acting immediately when there is any patient safety issue or concern at the unit level.ResultsDuring the period from April to December 2017, the interaction between frontline staff and unit leadership increased through compliance with the daily safety huddle. Initially, compliance was at 73%, but it increased to 97%, with a total of 340 safety issues addressed. The majority of these safety issues pertained to infection control and medication errors (109; 32.05%), followed by communication (83; 24.41%), documentation (59; 17.35%), other issues (37; 10.88%), procedure (20; 5.88%), patient flow (16; 4.7%) and equipment and supplies (16; 4.7%).ConclusionsSystematic use of daily safety huddle is a powerful tool to create an equitable environment where frontline staff can speak up freely about daily patient safety concerns. The huddle leads to a more open and active discussion with unit leadership and to the ability to perform the right action at the right time.

A 76-year-old man with a five-day history of painful swelling of the right hand

JAMA ◽  
1983 ◽  
Vol 250 (11) ◽  
pp. 1441-1442
Author(s):  
J. M. Aronchick
Keyword(s):  
Right Hand ◽  
History Of ◽  
The Right

scholarly journals Mirror writing in a patient with frontal-lobe epilepsy

2021 ◽  
Author(s):  
Vityala Yethindra ◽  
Elmira Mamytova ◽  
Tugolbai Tagaev ◽  
Sagynali Mamatov
Keyword(s):  
Intensive Care Unit ◽  
Frontal Lobe ◽  
Refractory Status Epilepticus ◽  
Frontal Lobe Epilepsy ◽  
Impaired Consciousness ◽  
Refractory Status ◽  
History Of ◽  
Clonic Seizures ◽  
The Right ◽  
Mirror Writing

A 36-year-old male with non-lesional refractory frontal-lobe epilepsy, diagnosed at 16 years of age, and with a history of four hospitalizations for refractory status epilepticus and admitted to the intensive care unit with focal seizures in the right upper limb, impaired consciousness, and recurrent progression to bilateral tonic-clonic seizures.

The Likeness of an Author

2019 ◽  
pp. 101-132
Author(s):  
Niv Allon
Keyword(s):  
Significant Role ◽  
Three Dimensional ◽  
Close Inspection ◽  
Eighteenth Dynasty ◽  
Right Hand ◽  
Military Background ◽  
History Of ◽  
The Right

This chapter shifts to three-dimensional art and studies scribal statues. It traces back the history of this statuary motif through time, studying changes in the texts inscribed on the statue and the gesture of the right hand. Analyzing these elements, the chapter investigates the relationships between statue, patron, and text. A close inspection of this statuary motif reveals a growing emphasis on the act of writing and a reinterpretation of the literacy act. Focusing on the Eighteenth Dynasty patrons who commissioned such statues once again suggests that men of military background like Haremhab play a significant role in disseminating images of literacy through their self-representation.

Intraneural Synovial Sarcoma of the Median Nerve in a 15-Year-Old Male: A Case Report and Review of Literature

Hand ◽  
2021 ◽  
pp. 155894472097513
Author(s):  
Arthur Samia ◽  
Joshua Scarcella ◽  
Richard Zeri ◽  
Yifan Guo
Keyword(s):  
Median Nerve ◽  
Synovial Sarcoma ◽  
Thenar Eminence ◽  
Right Hand ◽  
History Of ◽  
Synovial Sarcomas ◽  
Poorly Differentiated ◽  
Web Space ◽  
The Right

There have been 8 synovial sarcomas of the median nerve reported. We report a case of a 15-year-old male with synovial sarcoma of the right-hand median nerve. Patient presented with a 2-month history of enlarging mass at the base of the right thenar eminence associated with numbness in the median nerve distribution. Physical examination revealed a soft mass over the thenar eminence and paresthesia in the median nerve distribution. He underwent excision of the tumor, which revealed a well-encapsulated lesion encompassing the median nerve, involving the first, second, and radial aspect of the third web space as well as recurrent branches of the median nerve. Following excision of the tumor, a thorough metastatic workup was negative for metastatic disease. He was staged as III, T2b, N0, M0—poorly differentiated monophasic synovial sarcoma of the right median nerve. Postoperatively the patient was started on chemotherapy and radiation. Intraneural synovial sarcoma is extremely rare. Our case is the youngest with the longest follow-up. He is currently at a status of 3 years posttreatment with no signs of recurrence and excellent use of his right hand. This case is of particular interest due to the rarity of the disease along with this being the best outcome reported in the literature to-date.

A cutaneous tuberculosis mimic presented with recurrent soft tissue infection: A case report

2021 ◽  
Vol 9 (1) ◽  
pp. 30-30
Author(s):  
Abu Mansor Matardiah Nor Hashimah ◽  
Lim Ai Lee ◽  
Azman Ali Raymond
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Skin Diseases ◽  
Cutaneous Tuberculosis ◽  
Small Nodule ◽  
Right Hand ◽  
History Of ◽  
The Right ◽  
Work Up ◽  
Immunocompetent Patients

Recurrent cellulitis is one of the cutaneous tuberculosis mimickers. As the skin lesion can mimic other skin diseases, the diagnosis can easily be missed especially in immunocompetent patients without any other risk factors. We present a case of a 62-year-old lady with history of right hand extensor tenosynovitis presented with right hand and forearm swelling and pain, associated with fever. Clinically, her right hand and forearm were erythematous with a small nodule at the right elbow. She was treated for recurrent right upper limb cellulitis and thrombophlebitis complicated by septic shock needing several courses of antibiotics. However, she did not show any significant response to the treatment. Multiple septics work up were carried out and all were negative, except aspiration of her right elbow nodule was positive for Mycobacterium tuberculosis. Anti-tuberculous treatment was started but unfortunately, she succumbed due to nosocomial infection.

scholarly journals Subcutaneous hyalohyphomycosis caused by Acremonium recifei: case report

1995 ◽  
Vol 37 (3) ◽  
pp. 267-270 ◽  
Author(s):  
Clarisse Zaitz ◽  
Edward Porto ◽  
Elisabeth Maria Heins-Vaccari ◽  
Aya Sadahiro ◽  
Ligia Rangel Barbosa Ruiz ◽  
...  
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Histopathological Examination ◽  
Traumatic Injury ◽  
The State ◽  
Right Hand ◽  
History Of ◽  
The Right ◽  
First Time ◽  
Hematoxylin Eosin

We present a case of subcutaneous hyalohyphomycosis due to Acremonium recifei, a species whose habitat is probably the soil, first identified in 1934 by Arêa Leão and Lobo in a case of podal eumycetoma with white-yellowish grains and initially named Cephalosporium recifei. A white immunocompetent female patient from the state of Bahia, Brazil, with a history of traumatic injury to the right hand is reported. The lesion was painless, with edema, inflammation and the presence of fistulae. Seropurulent secretion with the absence of grains was present. Histopathological examination of material stained with hematoxylin-eosin showed hyaline septate hyphae. A culture was positive for Acremonium recifei. Treatment with itraconazole, 200 mg/day, for two months led to a favorable course and cure of the process. We report for the first time in the literature a case of subcutaneous hyalohyphomycosis due to Acremonium recifei in a immunocompetent woman. Treatment with itraconazole 200 mg/day, for two months, resulted in cure.

scholarly journals Multiple Congenital Bilateral Trigger Digits in a 2-Year-Old Child: Case Report

2013 ◽  
Vol 7 (1) ◽  
pp. 75-77 ◽  
Author(s):  
V De Luna ◽  
V Potenza ◽  
L Garro ◽  
P Farsetti ◽  
R Caterini
Keyword(s):  
Bacterial Infections ◽  
Rare Condition ◽  
Trigger Finger ◽  
Left Hand ◽  
Right Hand ◽  
History Of ◽  
One Year ◽  
The One ◽  
The Right

Trigger finger is a rare condition in children. In this paper, we report on a 2-year-old boy with multiple congenital bilateral trigger digits. The patient had no history of perinatal trauma, viral or bacterial infections, or metabolic disorders. The patient was treated with physiotherapy for one year. At the one-year follow-up, the boy presented with six trigger fingers (3 on the right hand, 3 on the left hand). Neither thumb was involved. The six trigger fingers were treated surgically: first, the right-hand trigger fingers and, six months later, those of the left hand. After each operation, a 4-week brace in extension was applied to the operated hand. The symptoms were completely resolved after surgical treatment. Many authors have recommended surgical release for the treatment of trigger finger in children; empirical treatment with physiotherapy may be an option when symptoms present or appear at an older age.

scholarly journals Appendiceal Crohn’s disease: a rare differential of right iliac fossa pain

2020 ◽  
Vol 13 (2) ◽  
pp. e232549
Author(s):  
Adam James Crellin ◽  
Omar Musbahi ◽  
Natasha Onwu ◽  
Sandeep Singh
Keyword(s):  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Crohn's Disease ◽  
Iliac Fossa ◽  
Right Hemicolectomy ◽  
Emergency Unit ◽  
Good Recovery ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
The Right

A 30-year-old man with a history of severe right iliac fossa pain was referred to the surgical emergency unit. His symptoms began 3 days prior as mild, non-specific abdominal pain which progressively localised to the right iliac fossa and worsened in severity. Investigations were suggestive of acute appendicitis, and therefore a laparoscopic appendicectomy was planned. Laparoscopy revealed a thickened, necrotic appendix with a mass at the base of the appendix, in keeping with the appearance of an appendiceal malignancy. Subsequently a right hemicolectomy was performed. Histology revealed active chronic inflammation and granulomas highly suggestive of appendiceal Crohn’s disease. Since, the patient has made a good recovery and presently shows no further signs of Crohn’s disease. This case is demonstrative of one of many rare findings on histological examination of the appendix. It emphasises the need for a wide differential when investigating right iliac fossa pain.

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