Laparoscopic Diagnosis of Peritoneal Tuberculosis

2021 ◽  
pp. 000313482199867
Author(s):  
Elena Viejo Martínez ◽  
María García Nebreda ◽  
María Luisa de Fuenmayor Valera ◽  
Gloria Paseiro Crespo
Keyword(s):  
Correct Diagnosis ◽  
Developed Countries ◽  
Pathological Examination ◽  
High Morbidity ◽  
Peritoneal Tuberculosis ◽  
Antituberculous Treatment ◽  
Caseous Necrosis ◽  
Visceral Peritoneum ◽  
Antituberculosis Treatment ◽  
Late Treatment

Peritoneal tuberculosis is a rare form of tuberculosis, which involves parietal and visceral peritoneum, omentum, and intestinal mesentery. Its incidence is increasing in developed countries due to HIV infection and immigration. We present a case of peritoneal tuberculosis in a twenty two-year-old patient misdiagnosed with appendicitis. A laparoscopic surgery was performed showing multiple implants on serosal surfaces and adhesions. Laparoscopic appendectomy and peritoneal biopsies were performed. As peritoneal tuberculosis was suspected, an early antituberculous treatment was initiated. A pathological examination of the samples revealed epithelioid granulomas with a centrale caseous necrosis and acid-fast bacilli. Peritoneal tuberculosis is a challenging diagnosis that can mimic other pathologies and should be kept in mind to establish an early antituberculosis treatment avoiding the high morbidity and mortality associated with a late treatment initiation. In case of suspicion of peritoneal tuberculosis, laparoscopy with guided biopsies is useful for the establishment of a correct diagnosis.

scholarly journals Tuberculosis presenting as dacryoadenitis in the USA

2019 ◽  
Vol 12 (11) ◽  
pp. e231694 ◽  
Author(s):  
Harry Ross Powers ◽  
Mark Anthony Diaz ◽  
Julio C Mendez
Keyword(s):  
Correct Diagnosis ◽  
Developed Countries ◽  
Histopathological Analysis ◽  
Orbital Mass ◽  
Antituberculosis Therapy ◽  
The Usa ◽  
History Of ◽  
Patient’S History ◽  
High Degree ◽  
Filipino Woman

A 25-year-old Filipino woman living in the USA was evaluated for a 5-month history of left eye pain and a subsequent orbital mass. Histopathological analysis of the lacrimal mass showed a mixed inflammatory process with necrotising granulomas and positive cultures for Mycobacterium tuberculosis. She was treated with antituberculosis therapy, with resolution of symptoms. Tuberculosis dacryoadenitis is extremely rare in the USA and other developed countries. It requires a high degree of clinical suspicion with special attention to the patient’s history to make the correct diagnosis. It can be treated successfully with antituberculosis therapy.

INNOVATIVE AND EDUCATIONAL PARADIGM OF FORMATION OF SOCIAL SAFETY – PREREQUISITE FOR SUSTAINABLE DEVELOPMENT

2020 ◽  
pp. 103-110
Author(s):  
Vira Kutsenko ◽  
Iryna Kinash ◽  
Hanna Yevtushenko
Keyword(s):  
Sustainable Development ◽  
Positive Impact ◽  
Developed Countries ◽  
The State ◽  
High Morbidity ◽  
Social Production ◽  
Current State ◽  
Political Events ◽  
Close Relationship ◽  
Educational Paradigm

The article is devoted to the consideration of the important issue of the implementation of the principles of sustainable development, in the context of the introduction of innovative education and ensuring social safety. It is noted that an important result of the implementation of the process of sustainable development is social safety as a state of protection of vital rights and freedoms of citizens, as well as a system of social and political events that provides this protection. An important role in ensuring social safety and sustainable development belongs to education, which has an innovative basis. Therefore, it is important to form an innovative and educational paradigm that would contribute to the creation of an optimal socio-economic environment for social safety and sustainable development. The article highlights the problematic issues of social safety and sustainable development that are now taking place in Ukraine. Poverty, unemployment, high morbidity, rising crime – all this negatively affects the living standards of the population and the state of social safety of the country. It is noted that the strengthening of social safety largely depends on the state of human capital and the development of the educational sphere. The development of education, raising the educational level of the population acts as a catalyst for socio-economic processes, allows those working in social production to realize the achievements of scientific and technological progress and participate in its development. The innovative educational paradigm aims to provide high quality educational services, create a competitive educational environment and ensure the training of competitive specialists, which implies the establishment of a close relationship between education and business. It is also necessary to actively use the experience of developed countries to ensure the positive impact of education on the achievement of social safety and sustainable development. In this aspect, the article analyzes the current state of the educational sphere in Ukraine. The ways of achieving stability and optimal development of the educational sphere are proposed, which should contribute to ensuring economic growth on the principles of sustainable development.

Central Nervous System Infections

2017 ◽  
Author(s):  
Anna Finley Caulfield ◽  
Brian G. Blackburn
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Diagnostic Testing ◽  
Developed Countries ◽  
Morbidity And Mortality ◽  
Molecular Diagnostic ◽  
High Morbidity ◽  
Vaccination Programs ◽  
Cns Infections ◽  
Acute Meningitis

Central nervous system (CNS) infections are associated with a high morbidity and mortality. Fortunately, the incidence of acute community-acquired bacterial meningitis has declined with the advancement and implementation of vaccination programs over the past 30 years. Treatment with corticosteroids, along with initial antimicrobial therapy, has also decreased the morbidity and mortality of patients with acute Streptococcus pneumoniae meningitis in developed countries. Molecular diagnostic testing may become a helpful tool to identify bacterial pathogens for targeted treatments. This review covers common CNS infections with a focus on the diagnosis and initial management of the adult patient suspected of having acute meningitis and encephalitis.  Key words: acute meningitis, brain abscess, chronic meningitis, encephalitis, ventriculitis 

Stroke Care Services in Africa: A Systematic Review

2018 ◽  
Vol 1 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Rufus O. Akinyemi ◽  
Olaleye A. Adeniji
Keyword(s):  
Large Scale ◽  
Systems Of Care ◽  
Care Delivery ◽  
Stroke Care ◽  
Developed Countries ◽  
High Morbidity ◽  
New Paradigm ◽  
African Countries ◽  
Care Services ◽  
Stroke Services

Background: Stroke is the second leading cause of death and adult-onset disability globally. Although its incidence is reducing in developed countries, low- and middle-income countries, especially African countries, are witnessing an increase in cases of stroke, leading to high morbidity and mortality. Evidently, a new paradigm is needed on the continent to tackle this growing burden of stroke in its preventative and treatment aspects. Aims and Objectives: The aim of this study was to determine the scope of stroke care services, where they exist, and their relationship with currently existing health systems. Methods: A detailed literature search was undertaken referring to PubMed and Google Scholar for articles from January 1960 to March 2018, using a range of search terms. Of 93 publications, 45 papers were shortlisted, and 21 reviewed articles on existing stroke services were included. Results: The literature on models of stroke services in Africa is sparse. We identified focused systems of care delivery in the hyperacute, acute, and rehabilitative phases of stroke in a few African countries. There is a continent-wide paucity of data on the organization of prehospital stroke services. Only 3 African countries (South Africa, Egypt, and Morocco) reported experiences on thrombolysis. Also, the uptake of dedicated stroke units appears limited across the continent. Encouragingly, there are large-scale secondary prevention models on the continent, mostly within the context of experimental research projects, albeit with promising results. We found only 1 article on the interventional aspects of stroke care in our review, and this was a single-center report. Conclusions: The literature on the organization of stroke services is sparse in Africa. Dedicated action at policy, population, community, and hospital-based levels is urgently needed toward the organization of stroke services to tame the burgeoning burden of stroke on the African continent.

scholarly journals Infected Pseudoaneurysm of the Superficial Femoral Artery in a Patient withSalmonella enteritidisBacteremia

2013 ◽  
Vol 24 (1) ◽  
pp. e24-e25 ◽  
Author(s):  
MA Hussain ◽  
G Roche-Nagle
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Salmonella Enteritidis ◽  
Correct Diagnosis ◽  
Leg Pain ◽  
High Dose ◽  
High Morbidity ◽  
Autologous Reconstruction ◽  
Risk Of Rupture ◽  
Night Sweats

Mycotic aneurysms, defined as irreversible dilation of an artery due to destruction of the vessel wall by infection, are rare but are associated with a high risk of rupture if not treated promptly. The case of a healthy 52-year-old smoker who presented with pyrexia, rigors, night sweats and severe right leg pain with swelling is presented. He was diagnosed with a superficial femoral artery mycotic aneurysm, withSalmonella enteritidisas the causative agent. He was treated with high-dose antibiotics, local debridement and autologous reconstruction. A high index of suspicion is needed to make the correct diagnosis in these cases. Prompt surgical intervention and antimicrobial therapy are the cornerstones of treatment to reduce the associated high morbidity and mortality.

scholarly journals Pitfalls associated with the diagnosis of herpes simplex encephalitis

2013 ◽  
Vol 04 (02) ◽  
pp. 176-179 ◽  
Author(s):  
Ivana Vachalová ◽  
Leila Kyavar ◽  
Josef G Heckmann
Keyword(s):  
Herpes Simplex ◽  
Lumbar Puncture ◽  
Herpes Simplex Encephalitis ◽  
Correct Diagnosis ◽  
Diagnostic Delay ◽  
Cranial Computed Tomography ◽  
Diabetic Woman ◽  
High Morbidity ◽  
Posttraumatic Epilepsy ◽  
Atypical Presentations

ABSTRACTHerpes simplex encephalitis (HSE) still remains a serious illness with high morbidity and mortality. The characteristic presentation of HSE usually consists of fever, headache, and altered mental function. We present three patients with atypical features of HSE. First, a 48‑year‑old man with symptomatic posttraumatic epilepsy, who developed a gastrointestinal infection, seizures, and fever. After significant clinical improvement, the patient had fever again and developed a status epilepticus, which led to the diagnosis of HSE. Second, an 84‑year‑old woman with hyperactive delirium after levofloxacin intake. Cranial computed tomography (CCT) revealed hypodense temporal changes, prompting lumbar puncture and diagnosis of HSE. Third, a 51‑year‑old diabetic woman presented with fever and acute confusion. As CCT and cell count of cerebrospinal fluid (CSF) were normal, infection and hyperglycemia as initial diagnoses were postulated. Due to aphasic symptoms, the differential diagnosis of a stroke was taken into account. Thus a second lumbar puncture led to the correct diagnosis of HSE. These atypical presentations need a high grade of suspicion and a high willingness to reconsider the initial working diagnosis, in order to prevent a diagnostic delay.

scholarly journals Acute brain injury following illicit drug abuse in adolescent and young adult patients: spectrum of neuroimaging findings

2017 ◽  
Vol 30 (2) ◽  
pp. 144-150 ◽  
Author(s):  
Shai Shrot ◽  
Andrea Poretti ◽  
Elizabeth W Tucker ◽  
Bruno P Soares ◽  
Thierry AGM Huisman
Keyword(s):  
Brain Injury ◽  
Illicit Drugs ◽  
Illicit Drug ◽  
Correct Diagnosis ◽  
Altered Mental Status ◽  
Medical Problem ◽  
Adolescent And Young Adult ◽  
White Matter Injury ◽  
High Morbidity ◽  
Drug Induced

The use of illicit drugs is currently a major medical problem among adolescents. Several illicit drugs have a high abuse potential and can be neurotoxic causing high morbidity and mortality. The clinical manifestation of adolescents with acute drug-induced neurotoxicity is often characterized by non-specific symptoms and findings. Early diagnosis is important to prevent death and permanent long-term neurological impairments. We report on clinical and neuroimaging findings in five adolescents with acute brain imaging following illicit drug intoxication to highlight the role of neuroimaging findings in the diagnostic work-up of pediatric acute drug-induced neurotoxicity. Our patients reveal two main neuroimaging patterns of brain injury: diffuse symmetric subcortical white matter injury with preferential cerebellar involvement (leukoencephalopathy pattern) or multiple foci of ischemic infarctions in a non-arterial territory distribution (ischemic pattern). Familiarity with these two neuroimaging patterns of findings in the evaluation of magnetic resonance imaging studies in adolescents with acutely altered mental status may suggest the correct diagnosis, narrow the differential diagnosis, and consequently allow early initiation of targeted laboratory investigations and treatment, potentially improving outcome.

scholarly journals Effectiveness of two rapid influenza tests in comparison to reverse transcription-PCR for influenza A diagnosis

2014 ◽  
Vol 8 (03) ◽  
pp. 331-338 ◽  
Author(s):  
Ramón Zazueta-García ◽  
Adrian Canizalez-Roman ◽  
Hector Flores-Villaseñor ◽  
Javier Martínez-Garcia ◽  
Alejandro Llausas-Vargas ◽  
...  
Keyword(s):  
Influenza A Virus ◽  
Influenza A ◽  
Correct Diagnosis ◽  
Immunofluorescence Assay ◽  
Immunochromatographic Assay ◽  
High Morbidity ◽  
Rt Pcr ◽  
Predictive Values ◽  
Reverse Transcription Pcr ◽  
Influenza A H1n1

Introduction: The influenza A virus is responsible for high morbidity and mortality in children and adults worldwide. Thus, a rapid, sensitive, and specific diagnosis tool is required. Methodology: An immunofluorescence assay (DFA) and a lateral-flow immunochromatographic assay were compared with RT-PCR for detection of the influenza A virus in 113 nasopharyngeal wash samples obtained from pediatric patients. Samples were collected between July and December 2009, during the pandemic outbreak of influenza A H1N1/09. Results: The sensitivity, specificity, and positive and negative predictive values obtained for the DFA were 68.97%, 76.63%, 75.47%, and 70%, respectively, while the values obtained for the immunochromatographic assay were 58.62%, 81.82%, 77.27%, and 65.22%, respectively. The frequency of the influenza A virus was 51.33%, and a total of 27 samples were positive for the pandemic influenza A H1N1/09. Conclusions: DFA and the immunochromatographic assay can be important tools for patient care during influenza season and in outbreaks as they usually provide results within 45 minutes. Furthermore, positive results in conjunction with the patient’s symptoms could provide a correct diagnosis, thus facilitating appropriate patient management. Nonetheless, the results of these assays still require confirmation by RT-PCR.

scholarly journals Late-onset prosthetic valve endocarditis caused by nontoxigenic Corynebacterium diphtheriae

2015 ◽  
Vol 9 (08) ◽  
pp. 905-909 ◽  
Author(s):  
Malak M EL-Hazmi
Keyword(s):  
Saudi Arabia ◽  
Prosthetic Valve ◽  
Late Onset ◽  
Prosthetic Valve Endocarditis ◽  
Developed Countries ◽  
Corynebacterium Diphtheriae ◽  
High Morbidity ◽  
Immunization Programs ◽  
Kingdom Of Saudi Arabia ◽  
Atypical Case

In developed countries, Corynebacterium diphtheriae infection is rare due to efficient immunization programs. However, cases of nontoxigenic strains of C. diphtheriae infections, including endocarditis, have been reported recently. Although the incidence remains low, these infections are associated with high morbidity and mortality. This report describes the first and atypical case of bacteremia and endocarditis caused by nontoxigenic C. diphtheriae var. gravis after introduction of immunization in the Kingdom of Saudi Arabia (KSA).

scholarly journals SIGMOID VOLVULUS

2018 ◽  
Vol 25 (10) ◽  
pp. 1562-1567
Author(s):  
Ali Akbar Ghumro ◽  
Altaf Hussain Ghumro ◽  
Abdul Hakeem Jamali
Keyword(s):  
Primary Repair ◽  
Primary Anastomosis ◽  
Single Layer ◽  
Developed Countries ◽  
Large Bowel Obstruction ◽  
Sigmoid Volvulus ◽  
High Morbidity ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Medical University

Introduction: Sigmoid volvulus is the surgical emergency and significant causeof large bowel obstruction in with high morbidity and mortality. Disease is more prevalent indeveloping countries than developed countries. It contributes 15% of total bowel obstruction.Resection and primary anastomosis is the procedure of choice. It obviates the need ofcolostomy and subsequent reversal. Objectives: To determine the frequency of postoperativecomplications of primary repair in patients with either viable or gangrenous sigmoid volvulus.Study Design: Retrospective study. Setting: Surgical Unit 1 of Peoples Medical CollegeHospital now Medical University. Period: 2007 to Dec. 2013. Methodology: Patients with largebowel obstruction suspected to have sigmoid volvulus on clinical and radiological grounds werestudied. Laparotomy and resection of sigmoid colon followed by restoration of the continuity ofthe colon by single layer primary anastomosis were performed without colostomy. Results: In atotal 50 patients, sigmoid volvulus male female ratio was 9:1. Mean age was 49 years majority ofthe patients were in 6th to 7th decade of age. In 96% cases abdominal pain was the 1st symptomfollowed by constipation and distention, vomiting was the rare symptom. Different postoperativecomplication results were surgical site infection was the commonest complication in 40 (80%)while in 1 (2%) leak was there with mortality of only 1(2%) case. Conclusion: Primary resectionand single stage anastomosis is the best choice for the management of sigmoid volvulusdisease in both possibilities of viable or non viable gut provided patients condition is stable. Itobviates the burden of colostomy

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