An Unusual Cause of Refractive Chronic Bilateral Leg Ulceration

2004 ◽  
Vol 8 (6) ◽  
pp. 432-437 ◽  
Author(s):  
Laila M. Sabet ◽  
Denise Wexler ◽  
Samih Salama ◽  
Bing Siang Gan
Keyword(s):  
Conventional Treatment ◽  
Elderly Population ◽  
Unusual Case ◽  
The Elderly ◽  
Complete Healing ◽  
Venous Hypertension ◽  
Histopathologic Examination ◽  
Knee Amputation ◽  
History Of ◽  
The Right

Background: Ulceration of the lower extremities is a common disorder that can be very painful. It occurs most frequently in the elderly population as a result of venous hypertension. We report an unusual case of a 32-year-old man with an 11-year history of extensive, painful, bilateral leg ulcers resistant to conventional treatment necessitating above-knee amputation of the left leg. Eventually, the patient was treated with prednisone, which led to almost complete healing of the ulcers of the right leg. Objective: The objective of this report is to discuss a rare cause of chronic bilateral leg ulceration. Methods: Detailed histopathologic examination showed a complex pattern of overlapping features of several specific dermatologic conditions, including necrobiosis lipoidica (NL), necrobiotic xanthogranuloma (NXG), and the destructive form of granuloma annulare (GA). Conclusion: The characteristics of our patient suggest a variant of a cutaneous necrobiotic disorder that has not been previously reported. When clinicians are confronted with recalcitrant ulcerations in the lower extremity, this group of disorders should be considered in the differential diagnosis.

scholarly journals Spontaneous Thrombosis of a Middle Meningeal Arteriovenous Fistula With Subsequent Pseudoaneurysm Formation: Case Report and Review of Literature

2020 ◽  
Vol 1 (3) ◽  
Author(s):  
Pouya Nazari ◽  
Pedram Golnari ◽  
Madhav Sukumaran ◽  
Ali Shaibani ◽  
Michael C Hurley ◽  
...  
Keyword(s):  
Unusual Case ◽  
Middle Meningeal Artery ◽  
Complete Healing ◽  
Spontaneous Thrombosis ◽  
Pseudoaneurysm Formation ◽  
Arteriovenous Fistulas ◽  
History Of ◽  
The Right ◽  
Repeat Imaging

ABSTRACT BACKGROUND AND IMPORTANCE Middle meningeal artery (MMA) pseudoaneurysms and middle meningeal arteriovenous fistulas (MMAVFs) are rarely reported after head injury. We report an unusual case of delayed MMA pseudoaneurysm formation after spontaneous thrombosis of an MMAVF, and review existing literature on MMAVF treatment and results. CLINICAL PRESENTATION A 59-yr-old male presented with a 5-d history of worsening left-sided headaches, followed by nausea, lethargy, and difficulty with speech. Non-contrast computed tomography demonstrated a left temporal intraparenchymal hemorrhage (IPH) and an acute left-sided subdural hematoma (SDH). Cerebral angiography found abnormal shunting between the right MMA and the right sphenoparietal sinus, consistent with an MMAVF. During the course of admission, the patient's neurological condition deteriorated requiring craniotomy for evacuation of SDH and IPH. Given the presumed incidental nature of the contralateral MMAVF, conservative management was recommended. Follow-up imaging 2 mo after surgery revealed spontaneous thrombosis of the right MMAV. Repeat imaging 5 mo later revealed an MMA pseudoaneurysm at the prior fistulous site, which was subsequently embolized with Onyx, occluding the pseudoaneurysm and the MMA both proximal and distal to the pseudoaneurysm. CONCLUSION Spontaneous thrombosis of an MMAVF is rare and only seen in 13.1% of cases. However, subsequent delayed formation of an MMA pseudoaneurysm has not been described. Our case therefore demonstrates that MMAVF thrombosis may not indicate complete healing of the underlying injury to the MMA, and suggests the need for continued follow-up of such lesions despite initial apparent resolution.

scholarly journals Predictive factors of epilepsy outcome in a sample of Egyptian pre-elderly and elderly population

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Steven Emil Gerges ◽  
Mahmoud Hemeda El Rakawy ◽  
Naglaa Mohammed El Khayat ◽  
Yousry Abo Elnaga Abdelhamid ◽  
Ahmed Mohammed Hazzou ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Elderly Population ◽  
Laboratory Data ◽  
The Elderly ◽  
Medical Comorbidities ◽  
Mri Brain ◽  
Group Data ◽  
History Of ◽  
Eeg Changes ◽  
International League

Abstract Background Elderly people with epilepsy are large, but neglected group. Data on the predictive factors for recurrent seizures in the elderly population are inconclusive or are not known for the majority of patients. This is especially true for the Egyptian population as no specific study was concluded to address this issue before. Objectives The aim of this study was to detect the predictive factors of epilepsy outcome in a sample of Egyptian aged population. Materials and methods A total of 100 patients aged 50 years or older with epilepsy diagnosed according to International League Against Epilepsy (ILAE) latest definition were included in the study and followed up for 6 months as regards seizure control. All participants were prospectively evaluated for epidemiological, clinical, radiological, electrodiagnostic, and laboratory data. Results The outcome was statistically significant affected in relation to absence of medical comorbidities (P = 0.037), seizure etiology (P = 0.007), history of status epilepticus (P <  0.001), MRI brain findings (P = 0.005), EEG changes (P <  0.001), Ca (P = 0.01), and Mg level (P = 0.046). Conclusion We conclude that aged Egyptian epileptic population with no medical comorbidities, normal MRI brain, or normal EEG can be predicted to have good outcome of their epilepsy while patients with post stroke epilepsy, abnormal MRI brain, and abnormal EEG, with low serum Ca or Mg level can be predicted to have poor outcome.

scholarly journals An Unusual Case of Acute Appendicitis due to Metastatic Prostatic Adenocarcinoma

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Numbereye Numbere ◽  
Andrew Dunn ◽  
Aaron R. Huber
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Acute Appendicitis ◽  
Unusual Case ◽  
The Elderly ◽  
Prostatic Adenocarcinoma ◽  
Metastatic Spread ◽  
Histopathologic Examination ◽  
Appendiceal Neoplasm ◽  
Surgical Emergency

Acute appendicitis is a common surgical emergency in older adults. In the elderly, like in younger cohorts, acute appendicitis most commonly arises without neoplastic underpinnings. However, the occurrence of acute appendicitis in a patient with a concurrent abdominopelvic malignancy should trigger suspicion for the possibility of a metastatic appendiceal neoplasm. We present the case of a 66-year-old man with a background of a biochemically recurrent prostatic adenocarcinoma who presented to the emergency department with acute appendicitis. Histopathologic examination of the resected appendix revealed an unexpected metastatic spread from his prostatic adenocarcinoma.

scholarly journals Beware of the Anticoagulated Elderly with Minor Head Injury

2005 ◽  
Vol 12 (2) ◽  
pp. 108-111
Author(s):  
CH Chung
Keyword(s):  
Head Injury ◽  
Subdural Haematoma ◽  
The Elderly ◽  
Minor Head Injury ◽  
Loss Of Consciousness ◽  
X Rays ◽  
Acute Subdural Haematoma ◽  
History Of ◽  
The Right ◽  
Burr Holes

A 69-year-old man first presented to the emergency department after a fall. He had no history of loss of consciousness or vomiting. He sustained a 3 cm long laceration over the right occipital region of the head. There was no fracture in the X-rays of the skull. He was on warfarin because of cardiac problem. He was discharged after suturing. He re-attended the next morning because of left sided weakness. Non-contrast brain computed tomogram showed acute subdural haematoma. Burr holes were performed subsequently. Special precautions should be undertaken in managing the elderly with minor head injury, with a lower threshold for computed tomography and coagulation profile studies.

scholarly journals Isolated Cecal Necrosis: Report of 2 Cases

2021 ◽  
Author(s):  
Nizar Kardoun ◽  
Zied Hadrich ◽  
Rahma Daoud ◽  
Houssem Harbi ◽  
Salah Boujelben ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Appendicitis ◽  
Rare Variant ◽  
Ischemic Colitis ◽  
Elderly Population ◽  
The Elderly ◽  
Female Patients ◽  
History Of

Isolated cecal necrosis is a rare variant of ischemic colitis which typically simulates the presentation of acute appendicitis. The elderly population is the most affected. We report 2 cases of isolated caecal necrosis, which were preoperatively diagnosed, in 2 female patients with a history of hypertension and renal failure.

scholarly journals Background Factors Involved in the Epidemiology of Functional Constipation in the Japanese Population

2021 ◽  
Author(s):  
Sayuri Yamamoto ◽  
Wataru Ohashi ◽  
Yoshiharu Yamaguchi ◽  
Shunsuke Inamoto ◽  
Akira Koshino ◽  
...  
Keyword(s):  
Japanese Population ◽  
Elderly Population ◽  
Clinical Symptoms ◽  
Functional Constipation ◽  
The Elderly ◽  
Internet Survey ◽  
Comprehensive Management ◽  
History Of ◽  
Characteristic Features

Abstract Background: Little is known about the prevalence and epidemiology of functional constipation (FC), a functional bowel disorder with symptoms of constipation. This study aimed to examine the prevalence, population composition, lifestyle, quality of life, and clinical characteristics of individuals with and without FC and of individuals with a strong or weak awareness of constipation. Methods: An internet survey revealed that 262 (8.7%) out of 3,000 respondents from the general Japanese population were diagnosed with FC. Moreover, all respondents were classified according to their awareness of constipation (i.e. strong or weak), and their characteristic features were compared. Results: FC occurrence was associated with the elderly population, females, and homemakers. Its onset was associated with a change in the frequency of bowel movement, sensation of incomplete or hardly any evacuation, and the use of manual maneuvers, which are consequential clinical symptoms of FC. Subjects with FC also frequently skipped breakfast, had insufficient sleep, had more severe constipation, and had purchased laxatives in pharmacies or online more often than individuals without FC. A strong awareness of constipation was significantly more prevalent among women and homemakers. A history of anemia and cardiovascular disease was significantly more frequent in the strong awareness group, whereas a history of hypertension was more frequent in the weak awareness group.Conclusions: Based on the understanding of the characteristic features of FC, appropriate and comprehensive management considering the patient’s symptoms and lifestyle should be provided.

scholarly journals Warning with chronic subdural hematomas in the elderly

2021 ◽  
Vol 11 (4) ◽  
pp. 114-117
Author(s):  
Dinh Thi Phuong Hoai ◽  
Nguyen Thi My Dung ◽  
Hoang Manh Cuong ◽  
Huynh Thi Kieu Oanh ◽  
Ngo Thuy Tram ◽  
...  
Keyword(s):  
Left Hemisphere ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Mass Effect ◽  
The Elderly ◽  
Brain Parenchyma ◽  
History Of ◽  
Apparent Reason ◽  
The Right ◽  
Contrast Ct

Chronic subdural hematoma (cSDH) is a disorder in which blood collects between the dura and arachnoid mater of meninges around the brain. It's more common among the elderly and usually triggered by a head injury. We report a case of a 78-year-old male patient who had previously been diagnosed with a left hemisphere subdural hematoma for no apparent reason with a history of hypertension. Two days before hospitalizing, he had a symptom of weakness in the right extremities. Non-contrast CT of head reveals a crescent-shaped, heterodense lesion over the lateral aspect of the left hemisphere measuring 11x5x1 cm with mass effect to the adjacent brain parenchyma. Burr hole drainage was performed for the patient. His symptoms improved after the surgery.

scholarly journals Primary extraskeletal chondroblastic osteosarcoma of the pericardium: a case report and literature review

2020 ◽  
Vol 4 (4) ◽  
pp. 1-7 ◽  
Author(s):  
Qianqian Wang ◽  
Xiaojie Wang ◽  
Qing Zhu ◽  
Xinghua Gu ◽  
Peng Gao ◽  
...  
Keyword(s):  
Unusual Case ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Surgical Trauma ◽  
Rare Tumour ◽  
Case Summary ◽  
Large Pericardial Effusion ◽  
History Of ◽  
Rare Site ◽  
Chondroblastic Osteosarcoma

Abstract Background Primary extraskeletal chondroblastic osteosarcoma has very poor prognosis, especially in the elderly. The pericardium is an extremely rare site for this tumour. Case summary A 67-year-old man presented with a large pericardial effusion and an intrapericardial mass. His past medical history of pulmonary tuberculosis led us to initially suspect tuberculous pericarditis. Primary extraskeletal chondroblastic osteosarcoma arising from the pericardium was diagnosed by the pathologist after surgery. The patient suffered severe intraoperative blood loss and surgical trauma. He went into shock and died a few hours after surgery. Discussion Extraskeletal chondroblastic osteosarcoma is a very rare tumour with a grim prognosis. Clinical manifestations frequently are not specific and can be explained by associated pathology. In this report, we describe an unusual case of primary extraskeletal chondroblastic osteosarcoma located in the pericardium and present a review of the literature.

Missing Links or to the History of the Second Century AD Bosporan Kingdom under Eupator: by numismatic data

2021 ◽  
pp. 93-106
Author(s):  
Michael Choref ◽  
Keyword(s):  
The Elderly ◽  
Second Century ◽  
Short Hair ◽  
Marcus Aurelius ◽  
Similar Image ◽  
History Of ◽  
The Right

Under the Bosporan king Eupator, sestercii were issued with two busts on the obverse: an elderly bearded man in a ray crown and a woman in a high openwork crown, as well as two men: a young one, with or without a beard, and an elderly, bearded one. All men have long hair. The elderly man is no doubt Eupator. Together with him, as is commonly believed, they portrayed Aphrodite Urania and Marcus Aurelius. But this is hardly the case. After all, a very similar image of a woman, framed by the legend “Β … ΕΥΝΟΜΙΑC”, is imprinted on the reverse of the Bosporan sesterces with two male busts on the obverse. But the figures of the deities on the Bosporan coins were not signed. Judging by the crown, this was a Sarmatian queen. We believe that Eunomia, who is mentioned in the coin legend, was the wife and co-ruler of Eupator. The Roman emperors on the Bosporan coins were always depicted with short hair. We believe that the studied sestercii had portraits of Eupator, his wife Eunomia, and also their son, who ruled the Bosporus from 170/171 to 174/175 without the sanction of Rome and, as a result, did not receive the right to issue coins and did not leave lapidary inscriptions.

Traumatic craniolateral shoulder luxation and fracture of the lesser tubercle of the humerus in a dog

2011 ◽  
Vol 24 (06) ◽  
pp. 474-477 ◽  
Author(s):  
M. S. Bergh ◽  
J. L. Huck
Keyword(s):  
Surgical Repair ◽  
Articular Surface ◽  
Weight Bearing ◽  
Complete Healing ◽  
Joint Function ◽  
Thoracic Limb ◽  
Anatomic Reduction ◽  
History Of ◽  
The Right ◽  
Displaced Fracture

SummaryA five-year old, spayed female, Bearded Collie was presented with a 24-hour history of non-weight-bearing lameness of the right thoracic limb after sustaining vehicular trauma. Radio-graphs revealed a craniolateral scapulohumeral luxation and a distally and medially displaced fracture of the lesser tubercle of the humerus. Open reduction and internal fixation of the fracture was achieved with lag screw fixation and an anti-rotational Kirsch-ner wire. Surgical repair resulted in compression across the fracture line, anatomic reduction of the articular surface, and a stable scapulohumeral joint following reduction of the humeral head in the glenoid. Six weeks postoperatively, the patient exhibited no evidence of pain or lameness on the right thoracic limb and radiographs revealed complete healing of the fracture and normal articulation of the scapulohumeral joint. This is the first report of a lesser tubercle fracture associated with a craniolateral shoulder luxation. Surgical intervention resulted in the return of full shoulder joint function in this dog.

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