scholarly journals Patient on Immunomodulatory Therapy Experiencing Joint Pain and Skin Lesions: A Case Report

2021 ◽  
Vol 12 ◽  
pp. 215013272110058
Author(s):  
Jason D. Greenwood ◽  
Nathaniel Nielsen ◽  
Nathaniel E. Miller
Keyword(s):  
Opportunistic Infection ◽  
Skin Lesions ◽  
Inpatient Service ◽  
Immunocompromised Patients ◽  
The Family ◽  
Surgical Evaluation ◽  
Histologic Evaluation ◽  
History Of ◽  
Immunosuppressant Medications ◽  
Mycobacterium Haemophilum

A woman in her late fifties was admitted to the Family Medicine Inpatient Service directly from Rheumatology clinic for polyarticular pain and erythema with concern for infection. She was taking immunosuppressant medications for a history of multiple autoimmune diseases. Examination showed increasing erythema and tenderness on the upper and lower extremity joints. Histologic evaluation, surgical evaluation, and cultures were consistent with mycobacterium haemophilum infection. Mycobacterium haemophilum is an uncommon opportunistic infection that usually affects immunocompromised patients. The patient was treated with a multi-drug antibiotic regimen for several months due to drug resistance. Although this opportunistic infection is not common it should be considered in the differential of immunocompromised patients with skin and articular symptoms. Treatment outcomes are usually favorable if it caught earlier in the course.

scholarly journals Psoriatic onycho-pachydermo-periostitis / Psoriatični onihopahidermoperiostitis

2010 ◽  
Vol 2 (2) ◽  
pp. 54-58
Author(s):  
Zorica Perić-Hajzler ◽  
Lidija Kandolf-Sekulović ◽  
Lidija Zolotarevski
Keyword(s):  
Psoriatic Arthritis ◽  
Antibody Therapy ◽  
Skin Lesions ◽  
Treatment Modalities ◽  
Psoriatic Skin ◽  
Symptom Improvement ◽  
Nail Changes ◽  
The Family ◽  
History Of ◽  
Inflammatory Drugs

Abstract Psoriatic onycho-pachydermo-periostitis has been recognized as an uncommon subset of psoriatic arthritis, and to date, only a few cases have been reported. In general, psoriatic onycho-pachydermo-periostitis is regarded as a unique variant of psoriatic arthritis, but its pathology and pathophysiology are not well understood. Although psoriatic onychopachydermo- periostitis is usually found in patients with psoriasis, it can also be found in patients without psoriatic skin lesions. It is characterized by psoriatic nail changes (usually onycholysis), painful swelling of the soft tissue close to the distal phalanges, and radiographic changes of the distal phalanges with periosteal reaction and bone erosions. We present a 58-year-old man with a 3-year history of deformation, thickened nails and pustules on the skin of his fingers and toes, and painful redness of the nail bed accompanied with pain in small joints. The family history was negative. After confirmation of the diagnosis, methotrexate: 15 mg weekly, was initiated which led to symptoms improvement. Treatment of psoriatic onycho-pachydermo-periostitis is difficult. It is based on treatment modalities used for other forms of psoriatic arthritis, such as sulphasalazine, methotrexate, and anti-tumor necrosis factor antibody therapy with adalimumab and etanercept. Nonsteroidal anti-inflammatory drugs are usually ineffective. Retinoids, subungual cyclosporine and corticosteroid therapy also showed inefficient. In our patient, methotrexate has shown efficacy in symptom improvement.

scholarly journals Unusual Localization of an Emergent Bacterium, Raoultella ornithinolytica

2020 ◽  
Vol 2020 ◽  
pp. 1-3 ◽  
Author(s):  
Michele Cavaliere ◽  
Guido Bartoletti ◽  
Pasquale Capriglione ◽  
Antonella Miriam Di Lullo ◽  
Gaetano Motta ◽  
...  
Keyword(s):  
Complete Resolution ◽  
Empirical Therapy ◽  
Human Infection ◽  
External Otitis ◽  
Immunocompromised Patients ◽  
Immunocompetent Host ◽  
First Case ◽  
The Family ◽  
History Of ◽  
Oral Ciprofloxacin

Raoultella ornithinolytica is a bacterium belonging to the family Enterobacteriacae. It is a rare but emergent cause of human pathologies especially in immunocompromised patients. We described the first case in the literature of isolated external otitis sustained by Raoultella ornithinolytica in an immunocompetent host. A 54-year-old Caucasian man with a history of previous myringoplasty came to our attention reporting otalgia and otorrhea. We performed right ear swab for culture examination, meanwhile we started empirical therapy with topic administration of neomycin, without any clinical improvement. The cultural examination showed the presence of a Raoultella ornithinolytica infection. After ten days of treatment with oral ciprofloxacin and topic levofloxacin, there was the complete resolution of pain and inflammation. Raoultella ornithinolytica must be taken into consideration as an emergent cause of human infection, also in case of external otitis. Infection can be severe and can occur both in immunocompromised and in immunocompetent hosts. Culture test is mandatory to choose the proper therapy and avoid potential severe complications.

The Prevalence of Hereditary Antithrombin-III Deficiency in Patients with a History of Venous Thromboembolism

1985 ◽  
Vol 54 (04) ◽  
pp. 744-745 ◽  
Author(s):  
R Vikydal ◽  
C Korninger ◽  
P A Kyrle ◽  
H Niessner ◽  
I Pabinger ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Antithrombin Iii ◽  
Positive Family History ◽  
Normal Range ◽  
The Family ◽  
History Of ◽  
Antithrombin Iii Deficiency ◽  
Recurrent Venous Thrombosis ◽  
Antithrombin Iii Activity ◽  
Slight Deficiency

SummaryAntithrombin-III activity was determined in 752 patients with a history of venous thrombosis and/or pulmonary embolism. 54 patients (7.18%) had an antithrombin-III activity below the normal range. Among these were 13 patients (1.73%) with proven hereditary deficiency. 14 patients were judged to have probable hereditary antithrombin-III deficiency, because they had a positive family history, but antithrombin-III deficiency could not be verified in other members of the family. In the 27 remaining patients (most of them with only slight deficiency) hereditary antithrombin-III deficiency was unlikely. The prevalence of hereditary antithrombin-III deficiency was higher in patients with recurrent venous thrombosis.

Can a Narcissist Ever Marry?: James Fisher and The Uninvited Guest

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Brett Kahr
Keyword(s):  
Clinical Material ◽  
Couple Relationships ◽  
Cocktail Party ◽  
False Self ◽  
Winter's Tale ◽  
Pathological Narcissism ◽  
The Family ◽  
History Of ◽  
Marital Partners

Few books in the burgeoning field of couple psychoanalysis have garnered as much admiration as James Fisher's The Uninvited Guest: Emerging from Narcissism towards Marriage. In this memorial essay, the author pays tribute to the late Dr Fisher and to his perennial book which explores the ways in which pathological narcissism, among other factors, inhibit the development of spousal intimacy, often destroying partnerships entirely. The author describes the creative way in which Fisher drew upon great works of literature, most notably William Shakespeare's A Winter's Tale, and T. S. Eliot's The Cocktail Party, as well as long-forgotten clinical material from Fisher's predecessors at the Family Discussion Bureau (forerunner of the Tavistock Centre for Couple Relationships), in order to understand the ways in which marital partners struggle with false self couplings. The author assesses the importance of Fisher's contribution in the context of the history of couple psychoanalysis.

Faktor-Faktor Determinan yang melatar belakangi Kehamilan Remaja di Desa Pandansari Kecamatan Poncokusumo Kabupaten Malang

2020 ◽  
Vol 7 (2) ◽  
pp. 247-255
Author(s):  
Maria Magdalena Setyaningsih ◽  
Emy Sutiyarsih
Keyword(s):  
Sex Education ◽  
Teen Pregnancy ◽  
Teenage Pregnancy ◽  
Well Being ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
The Family ◽  
History Of ◽  
First Time

Kehamilan remaja adalah kehamilan yang terjadi pada remaja berusia kurang dari 20 tahunan. Kehamilan remaja memberikan banyak kerugian bagi kesehatan, mental dan psikologis, kesejahteraan ekonomi dan peluang karier, kemiskinan dan prospek kehidupan masa depan remaja. Tujuan penelitian mengidentifikasi faktor determinan yang melatarbelakangi terjadinya kehamilan remaja. Jenis penelitian adalah penelitian analitik kategorik jenis survei kuantitatif dengan desain case control. Populasi semua perempuan yang bertempat tinggal di wilayah dusun Wonosari, Sukosari, dan Krajan Pandansari dan pernah/sedang hamil pertama kali pada usia kurang dari 20 tahun. Teknik pengambilan sampel cluster random sampling besar sampel 73. Berdasarkan hasil model akhir analisis multivariat, diketahui bahwa variabel pendidikan, riwayat kehamilan remaja pada keluarga dan usia menikah merupakan variabel yang berhubungan dengan kejadian kehamilan remaja setelah dikontrol oleh variabel akses informasi, responden berpendidikan rendah memiliki peluang 20,8 kali lebih tinggi, responden yang memiliki riwayat kehamilan remaja pada keluarga memiliki peluang 14,9 kali lebih tinggi, responden yang menikah pada usia <20 tahun memiliki peluang 12,1 kali lebih tinggi, responden dengan pemahaman yang kurang baik terkait penggunaan kondom memiliki peluang 5,9 kali lebih tinggi untuk terjadi kehamilan remaja. Oleh karena itu perlu dibangun karakter buiding, sosial karakter suport untuk para ibu remaja dan keluarga sehingga terbangun interaksi yang baik dalam keluarga yang dilandasi dengan pendidikan dan pemahaman yang baik tentang Pendidikan seksualitas. Teen pregnancy is a pregnancy that occurs in adolescents aged less than 20 years old. Teen pregnancy provides many disadvantages for health, mental, psychological, economic well-being, career opportunities, poverty, and the future life. The aim of the study was to identify the determinants underlying teen pregnancy incidence. This study was a quantitative study with categorical analytic method. The study design used a case control with two comparison groups. The groups were control group and case group. The population in this study was all women who lived in the Wonosari, Sukosari, and Krajan Pandansari district and had or were pregnant for the first time at the age of less than 20 years old. Seventy three respondents were recruited using cluster sampling technique. The case group consists of women who were or had pregnant for the first time at the age of less than 20 years old and their children are currently aged ≤ 1 years old. The control group consists of women who were pregnant for the first time at the age of > 20 years old. The data was collected using a questionnaire. The findings showed that education, history of teen pregnancy in family and the age of marriage were related to the incidence of teen pregnancy after being controlled by information access. Low-educated respondents had 20.8 times higher chance of experiencing teen pregnancy; respondents with a history of teen pregnancy in the family had 4.9 times higher chance of experiencing teen pregnancy; respondents who were married at the age of < 20 years old had 12.1 times higher chance of experiencing teen pregnancy; respondents with poor understanding of condom use had 5.9 times higher chance of teenage pregnancy. In conclusion, the findings suggest to build good interactions in the family based on education and a good understanding of sex education.

A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

2019 ◽  
pp. 33
Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  
Keyword(s):  
Back Pain ◽  
Soft Tissue ◽  
Histopathological Examination ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Previous History ◽  
Skin Lesions ◽  
Titanium Implants ◽  
Paravertebral Abscess ◽  
History Of

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

Phytochemistry and Pharmacology of Genus Bombax

2019 ◽  
Vol 9 (3) ◽  
pp. 184-196
Author(s):  
Deepshikha Rathore ◽  
Geetanjali ◽  
Ram Singh
Keyword(s):  
Medicinal Plants ◽  
Health Care Needs ◽  
Human Beings ◽  
Care Needs ◽  
Pharmacological Activities ◽  
Therapeutic Applications ◽  
Chemical Structures ◽  
Supportive Role ◽  
The Family ◽  
History Of

Background: The history of traditional systems of medicine goes parallel with the history of human beings. Even today people have faith in traditional systems of medicine based on medicinal plants to meet primary health care needs. Hence, the scientific evaluation and documentation of extracts and active ingredients of medicinal plants always play a supportive role in their medicinal applications. Objective: This review aims to present the phytochemicals isolated from the genus Bombax and their pharmacological applications. Methods: The literature from research and review papers was analyzed and the information was compiled to present the pharmacological applications of various secondary metabolites from genus Bombax. Results: The genus Bombax belongs to the family Malvaceae and known for its therapeutic applications. The crude, semi-purified and purified extracts of different parts of this plant have shown potential therapeutic applications. A total of 96 articles including research and review papers were referred for the compilation of isolated phytochemicals and their chemical structures. Conclusion: We systematically summarized 176 isolated compounds from the genus Bombax. The findings show that this plant shows potential towards pharmacological activities. The activities were found more from extracts than the single isolated compounds.

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