scholarly journals Evaluation of Nail Findings in Patients with COVID-19 History and Wood’s Lamp Examination

2021 ◽  
pp. 1-6
Author(s):  
Irem Yanatma ◽  
Hulya Cenk
Keyword(s):  
Titanium Dioxide ◽  
Ferric Oxide ◽  
Case Reports ◽  
Treatment Options ◽  
History Of ◽  
Day By Day ◽  
Shed Light

<b><i>Introduction:</i></b> Various skin findings due to coronavirus have been identified. There are a few case reports on nail findings after coronavirus (COVID-19) infection. We aimed to document the nail findings of the COVID-19 survivors and shed light on the interesting luminescence seen under the Wood’s light. <b><i>Methods:</i></b> One hundred and seventy-four patients diagnosed with COVID-19 infection in the last 100 days were grouped in terms of the agents used in the treatment. Fifty-seven volunteers without a history of infection were included. <b><i>Results:</i></b> Patients treated with favipiravir had a significantly higher positivity of luminescence (<i>p</i>: 0.0001). The most common nail findings in patients were splinter hemorrhage (13%), followed by leukonychia (12%) and longitudinal ridges (7.9%). <b><i>Discussion/Conclusions:</i></b> The luminescence may be seen due to the accumulation of favipiravir or its excipients (titanium dioxide and yellow ferric oxide) on the nails. Wood’s lamp examination of the plasma taken from a patient after favipiravir’s first dose revealed the same luminescence as we saw on the nails. Accordingly, this accumulation may be seen in the vital organs. Although our knowledge about the virus increases day by day, the potentially hazardous effects of the virus and long-term complications of the treatment options are still being investigated.

scholarly journals Laporan Kasus: Manifestasi Oral Penderita Hipertensi berupa Ginggival Enlargement

2020 ◽  
Vol 17 (2) ◽  
pp. 54
Author(s):  
Anindita L. ◽  
Aris Aji K. ◽  
Arcadia Sulistijo J.
Keyword(s):  
Case Reports ◽  
Gingival Tissue ◽  
High Dose ◽  
Gingival Inflammation ◽  
Gingival Enlargement ◽  
History Of ◽  
Root Planning ◽  
Pro Inflammatory Cytokines

Hypertension presents an increase in blood pressure following the oral manifestations, such as gingival enlargement. A 42-year-old woman came to the General Sudirman University Dental and Oral Hospital complaining of enlarged front gums seven years ago. The patient had a history of hypertension and regularly consumed drugs, amlodipine 5 mg. Extraoral examination revealed no lymphadenopathy and no swelling of the head and neck area. Intraoral examination revealed a gingival enlargement involving the papilla to the gingival margin present on the entire upper and lower labial gingival surface. The patient's diagnosis was gingival enlargement caused by gingival enlargement due to the use of amlodipine. Gingival enlargement has been noted with long-term or high-dose amlodipine use. The mechanism of amlodipine in causing gingival enlargement is through the role of fibroblasts with abnormal susceptibility to the drug, resulting in increased levels of protein synthesis, especially collagen. The role of pro-inflammatory cytokines occurs through an increase in interleukin-1β (IL-1β) and IL-6 in the inflamed gingival tissue due to the gingival fibrogenic response to drugs. Therapies were DHE and scaling and root planning as phase I in periodontal treatment. Plaque elimination is vital to reduce gingival inflammation that may occur. Substitution of the drug amlodipine may be needed if there is no improvement. Based on case reports, hypertension patients who took amlodipine could have gingival enlargement. The therapy given was plaque elimination in the form of DHE and Scaling and regular check-ups with the dentist.

Lessons to Be Learned from Harvard Pilgrim HMO's Fiscal Roller Coaster Ride

2000 ◽  
Vol 28 (3) ◽  
pp. 287-304 ◽  
Author(s):  
Frances H. Miller ◽  
Walter W. Miller
Keyword(s):  
Health Care ◽  
Roller Coaster ◽  
State Legislation ◽  
High Profile ◽  
Financial Difficulties ◽  
Competitive Environments ◽  
Harvard Pilgrim Health ◽  
History Of ◽  
Shed Light

The recent high-profile financial difficulties of Harvard Pilgrim Health Care, the largest HMO in Massachusetts and consistently rated as one of the top ten HMOs in the nation, shed light on many problems common to health insurers throughout the country. This article explores those difficulties in the context of the short but complicated history of Harvard Pilgrim, and its regulatory and competitive environments. The state legislation which made a receivership proceeding possible for Harvard Pilgrim offered some protection for subscribers, but failed to provide the means for achieving a long term solution. The statute merely presented a method for staving off immediate collapse by temporarily protecting the plan from dissolution, and forcing the plan's contracting providers to continue delivering care even if owed money by the plan. The article concludes by drawing lessons for understanding and ideally avoiding similar managed care nearfatalities in the future.

scholarly journals A CASE REPORT ON SYSTEMIC-ONSET JUVENILE IDIOPATHIC ARTHRITIS (SOJIA) WITHOUT MULTIORGAN INVOLVEMENT

2021 ◽  
pp. 4-6
Author(s):  
PATHAN AMANULLA KHAN ◽  
SARAH NOUSHEEN BB ◽  
ASFIYA BEGUM ◽  
RAQSHAN JABEEN ◽  
YOUSUF HUSSAIN
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Reports ◽  
Symptom Relief ◽  
Hip Joints ◽  
Rare Form ◽  
Treatment Measures ◽  
History Of ◽  
Inflammatory Drugs ◽  
Systemic Onset

Systemic-onset juvenile idiopathic arthritis (SoJIA) is a rare form of juvenile idiopathic arthritis (JIA) which manifests as quotidian fevers and arthritis in one or more joints. Features include characteristic salmon pink-colored rash associated with lymphadenopathy, hepatosplenomegaly, and serositis. To the best of our knowledge, this is a rare form of JIA in India and very few cases without multiorgan involvement have been published in literature. The following case reports a 12-year-old male child who presented to the hospital with a history of spiking fevers and arthritis in the knees, ankle, and hip joints. Diagnosis of SoJIA was confirmed after subsequent laboratory investigations; treatment included long-term nonsteroidal anti-inflammatory drugs, and methotrexate. However, due to increased cost of medicines and no guaranteed “cure” for the disease, the present patient switched from allopathic to homeopathic medicines. He still experiences frequent flare-ups associated with the disease, during which aceclofenac is taken for symptom relief. This case also highlights the importance of a “cure” for diseases rather than “symptom-oriented” treatment measures. When a cure is not guaranteed, patients may transition to inexpensive alternate therapies portraying limited efficacy. Further research in the field of rheumatology, specifically for rare diseases, is warranted.

FETAL UROLOGY AND PRENATAL DIAGNOSIS: CURRENT THEMES

2004 ◽  
Vol 15 (4) ◽  
pp. 343-364
Author(s):  
DFM THOMAS
Keyword(s):  
Prenatal Diagnosis ◽  
Urinary Tract ◽  
Case Reports ◽  
Rapid Development ◽  
Posterior Urethral Valves ◽  
High Incidence ◽  
History Of ◽  
Urinary Tract Malformations ◽  
Developed World

Isolated case reports of the prenatal detection of urinary tract malformations first appeared in the literature in the late 1970s and by the mid 1980s prenatal diagnosis had already become a firmly established feature of paediatric urological practice throughout the developed world. The rapid development of prenatal diagnosis of urinary tract malformations can be attributed to the relatively high incidence of congenital anomalies within this system and the fact that the common anomalies are usually associated with dilatation or cystic pathology which is readily visualised by ultrasound. Although many aspects of prenatal diagnosis have been clarified by studies undertaken over the last twenty years some important questions have yet to be fully resolved – for example the long term natural history of asymptomatic uropathies such as pelvi ureteric obstruction and the benefit (if any) of prenatal diagnosis in reducing long term burden of chronic renal failure associated with posterior urethral valves.

scholarly journals Body integrity identity disorder: clinical features and ethical dimensions

2018 ◽  
Vol 25 (3) ◽  
pp. 187-195
Author(s):  
Emma Barrow ◽  
Femi Oyebode
Keyword(s):  
Clinical Features ◽  
Physical Disability ◽  
Parietal Lobe ◽  
Case Reports ◽  
Treatment Options ◽  
List Type ◽  
Bodily Integrity ◽  
Body Integrity Identity Disorder ◽  
History Of ◽  
Self Harm

SUMMARYBody integrity identity disorder (BIID) is a rare and complex identity disorder described by the desire to acquire a physical disability and an associated sense of incompleteness at being able-bodied. Individuals with the disorder often delay presentation until later in life because of perceived stigma about wishing to acquire a physical disability, and may have sought amputation already through ‘underground’ means or self-harm (attempts at self-amputation). In this article we present an account of the recent history and origins of the disorder, from its early descriptions and case reports through to the current neuropsychiatric theory of right superior parietal lobe dysfunction as basis for the disorder. We consider the epidemiology, pathogenesis and clinical features of this identity disorder of bodily integrity, highlighting the associations with conditions such as gender identity disorder. With this we then discuss the ethical considerations for available treatment options, mainly elective surgical amputation.LEARNING OBJECTIVES•Understand the current definition and clinical features of body integrity identity disorder•Be familiar with the conceptual history of the disorder, epidemiology and current neuropsychiatric perspective•Be aware of the ethical aspects of elective surgical amputation as a treatment for the disorderDECLARATION OF INTERESTNone.

Severe Sepsis Caused by Arcanobacterium haemolyticum: A Case Report and Review of the Literature

2008 ◽  
Vol 42 (11) ◽  
pp. 1697-1702 ◽  
Author(s):  
Bridgette L Therriault ◽  
Lindsay Mayer Daniels ◽  
Yvonne L Carter ◽  
Ralph H Raasch
Keyword(s):  
Severe Sepsis ◽  
Case Reports ◽  
Treatment Options ◽  
Penicillin G ◽  
Left Lower Extremity ◽  
Bronchoalveolar Fluid ◽  
History Of ◽  
Pharmacologic Management ◽  
Arcanobacterium Haemolyticum ◽  
Systemic Infections

Objective: To describe a case of severe sepsis, cavitary pneumonia, and pyomyositis caused by Arcanobacterium haemolyticum. Case Summary: An 18-year-old male with a medical history significant for mild asthma presented to the emergency department complaining of a 7-day history of fever, diffuse myalgias, nausea, vomiting, diarrhea, and pain in his right upper quadrant, right shoulder, and left thigh. Cultures of blood, bronchoalveolar fluid, and suríace and surgical swabs from the patient's left lower extremity grew A haemolyticum. The patient was successfully treated with intravenous penicillin G 4 million units every 4 hours and azithromycin 500 mg onca daily for 14 days. Within 36 hours after initiation of focused therapy, he became afebrile, pain decreased, and pulmonary symptoms abated. Oral azithromycin 500 mg/day for an additional 3 weeks was prescribed on discharge, and the patient showed no relapse at 2-month follow-up. Discussion: A. haemolyticum Is a weakly acid-fast, branching gram-positive bacillus most commonly implicated in pharyngitis in healthy adolescents and skin and soft-tissue infections in older, immunocompromised patients. Systemic infections are rarely reported in the literature. This organism remains susceptible to most classes of antimicrobials, Including penicillins, cephalosporins, carba-penems, macrolides, tetracyclines, clindamycin, and vancomycin. Routine resistance has been reported only with trimethoprim/sulfamethoxazole. Conclusions: To our knowledge, there are no published case reports of severe sepsis caused by A. haemolyticum. While treatment options are numerous, we recommend (he use of intravenous penicillin or a cephalosporin as first-line pharmacologic management of deep-seated infections caused by this rare organism.

scholarly journals Linking Past and Present Land-Use Histories in Southern Amazonas, Peru

2021 ◽  
Vol 13 (12) ◽  
pp. 2274
Author(s):  
Daniel Plekhov ◽  
Parker VanValkenburgh ◽  
Paul Abrams ◽  
Amanda Cutler ◽  
Justin Han ◽  
...  
Keyword(s):  
Land Use ◽  
Field Studies ◽  
Remotely Sensed Data ◽  
Land Use Patterns ◽  
Use Patterns ◽  
History Of ◽  
High Resolution Satellite Imagery ◽  
Shed Light ◽  
Past Land Use

This paper analyzes remotely sensed data sources to evaluate land-use history within the Peruvian department of Amazonas and demonstrates the utility of comparing present and past land-use patterns using continuous datasets, as a complement to the often dispersed and discrete data produced by archaeological and paleoecological field studies. We characterize the distribution of ancient (ca. AD 1–1550) terracing based on data drawn from high-resolution satellite imagery and compare it to patterns of deforestation between 2001 and 2019, based on time-series Landsat data. We find that the patterns reflected in these two datasets are statistically different, indicating a distinctive shift in land-use, which we link to the history of Inka and Spanish colonialism and Indigenous depopulation in the 15th through 17th centuries AD as well as the growth of road infrastructure and economic change in the recent past. While there is a statistically significant relationship between areas of ancient terracing and modern-day patterns of deforestation, this relationship ultimately explains little (6%) of the total pattern of modern forest loss, indicating that ancient land-use patterns do not seem to be structuring modern-day trajectories of land-use. Together, these results shed light on the long-term history of land-use in Amazonas and their enduring legacies in the present.

scholarly journals Case Report: Scarring Alopecia After Scalp Avulsion

2021 ◽  
Author(s):  
Nathan C Lorei ◽  
John F Sullivan ◽  
Robert P Lennon ◽  
Edmund A Milder ◽  
John W Roman
Keyword(s):  
Case Reports ◽  
Treatment Options ◽  
Psychological Impact ◽  
Acute Setting ◽  
Humanitarian Mission ◽  
Safety Regulations ◽  
Initial Injury ◽  
Austere Environment ◽  
Developed World

ABSTRACT Scalp avulsion is a rare trauma in the developed world but is a common injury in countries with poorly established infrastructure and safety regulations. This case reports the long-term sequelae of this injury, observed while conducting a humanitarian mission, and discusses immediate actions for management in an acute setting. We aim to increase awareness about this injury, its risk factors, and treatment options to better prepare clinicians in the developed world to provide care for this condition in the austere environment, which may include not only chronic pain, functional, and aesthetic concerns, but also a psychological impact that persists years after the initial injury.

scholarly journals Takotsubo Syndrome: A Complex and Varied Clinical Syndrome

2016 ◽  
Vol 5 ◽  
Author(s):  
Louise Shewan ◽  
Michael Henein ◽  
Andrew Coats
Keyword(s):  
Clinical Presentation ◽  
Myocardial Dysfunction ◽  
Case Reports ◽  
Treatment Options ◽  
Clinical Score ◽  
Clinical Syndrome ◽  
Original Research ◽  
Takotsubo Syndrome ◽  
History Of

<p class="normal">This special issue includes expert reviews and original research on Takotsubo syndrome (TTS) including the history of its identification and the unravelling of the pathophysiology of the different variants of the syndrome. The role of neurological stress or catecholaminergic overload are reviewed, as is the role of CNS disorders triggering TTS. Clinical presentation patterns of TTS and the most useful diagnostic tests are reviewed, including original research into a novel clinical score the ‘GET QT' score to help in rapid differentiation of TTS from STEMI. There is also a review of TTS in the intensive care unit setting.  The mechanisms of TTS including the role and assessment of the microcirculation in generating the classical myocardial dysfunction are reviewed in detail, as are the pathophysiological pathways of recurrent TTS. Lastly Singh, Akashi and Horowitz review the emerging treatment options for TTS. They issue also includes multiple elegant and fascinating case reports. TTS has come of age and now urgently adequate sized RCT’s.  </p>

scholarly journals A Subset of Primary Polydipsia, “Dipsogneic Diabetes Insipidus”, in Apparently Healthy People Due to Excessive Water Intake: Not Enough Light to Illuminate the Dark Tunnel

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 406
Author(s):  
Krishnaraju Venkatesan ◽  
Kumarappan Chidambaram ◽  
Premalatha Paulsamy ◽  
Ramasubbamma Ramaiah ◽  
Ali Al-Qahtani ◽  
...  
Keyword(s):  
Diabetes Insipidus ◽  
Psychiatric Illness ◽  
Case Reports ◽  
Treatment Options ◽  
Urine Osmolality ◽  
Healthy People ◽  
Psychiatric Disease ◽  
Primary Polydipsia ◽  
History Of ◽  
Excessive Intake

Dipsogenic diabetes insipidus (DDI) is a subtype of primary polydipsia (PP), which occurs mostly in healthy people without psychiatric disease. In contrast, PP is characterized by a polyuria polydipsia syndrome (PPS) associated with psychiatric illness. However, the pathogenesis of DDI is not well established and remains unexplored. In order to diagnose DDI, the patient should exhibit excessive thirst as the main symptom, in addition to no history of psychiatric illness, polyuria with low urine osmolality, and intact urine concentrating ability. Treatment options for DDI remain scarce. On this front, there have been two published case reports with successful attempts at treating DDI patients. The noteworthy commonalities in these reports are that the patient was diagnosed with frequent excessive intake of water due to a belief that drinking excess water would have pathologic benefits. It could therefore be hypothesized that the increasing trend of excessive fluid intake in people who are health conscious could also contribute to DDI. Hence, this review provides an overview of the pathophysiology, diagnosis, and treatment, with a special emphasis on habitual polydipsia and DDI.

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