scholarly journals Clinical characteristics and outcome of primary brain abscess: a retrospective analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junying Huang ◽  
Haining Wu ◽  
Honghong Huang ◽  
Weiqi Wu ◽  
Bowen Wu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Klebsiella Pneumoniae ◽  
Brain Abscess ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Multivariate Logistic Regression Analysis ◽  
Enteric Bacteria ◽  
Focal Neurological Deficit ◽  
Gram Negative ◽  
Classical Triad

Abstract Background Patients with primary brain abscess often present with atypical symptoms, and the outcome varies. We investigated the demographic, laboratory, and neuroimaging features of patients with brain abscess at our hospital and identified factors associated with their outcomes. Methods We retrospectively collected the data of patients diagnosed with primary brain abscess at our hospital between January 2011 and December 2020. Their clinical characteristics, predisposing factors, laboratory and neuroimaging findings, treatment, and outcome were analyzed. Results Of the 57 patients diagnosed with primary abscess, 51 (89.47%) were older than 40 years, and 42 (73.68%) were male. Only eight patients (14.04%) showed the classical triad of headache, fever, and focal neurological deficit. Fifteen patients (26.31%) had comorbidities, of which diabetes mellitus was the most common. Positive intracranial purulent material cultures were obtained in 46.15% of the patients, and gram-negative enteric bacteria were found in 33.33% of them, with Klebsiella pneumoniae being the most frequently observed. Surgical treatment, most commonly in the form of stereotactic drainage, was received by 54.39% of the patients. Good outcomes were achieved in 75.44% of the patients. Multivariate logistic regression analysis showed that patients with headaches were more likely to have a poor outcome (odds ratio 6.010, 95% confidence interval 1.114–32.407, p = 0.037). Conclusions Male patients and those older than 40 years were more susceptible to brain abscess than female patients and those younger than 40 years, respectively. Only a few patients showed the classical triad of clinical symptoms. Diabetes mellitus was the most common comorbidity. Positive intracranial specimens’ culture results were uncommon, with gram-negative enteric bacteria, especially Klebsiella pneumoniae, being the main organisms found. Most patients had a good outcome, and the presence of headache may influence the outcome.

scholarly journals Clinical Characteristics and Outcome of Primary Brain Abscess: a Retrospective Analysis

2021 ◽  
Author(s):  
Junying Huang ◽  
Haining Wu ◽  
Honghong Huang ◽  
Weiqi Wu ◽  
Bowen Wu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Klebsiella Pneumoniae ◽  
Brain Abscess ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Multivariate Logistic Regression Analysis ◽  
Enteric Bacteria ◽  
Focal Neurological Deficit ◽  
Gram Negative ◽  
Classical Triad

Abstract Background: Patients with primary brain abscess often present with atypical symptoms, and the outcome is varied. We investigated the demographic, laboratory, and neuroimaging features of patients with brain abscess at our hospital and identified factors associated with their outcome.Methods: We retrospectively collected the data of patients diagnosed with primary brain abscess at our hospital between January 2011 and December 2020. Their clinical characteristics, predisposing factors, laboratory and neuroimaging findings, treatment, and outcome were analyzed. Results: Of the 57 patients diagnosed with primary abscess, 51 (89.47%) were older than 40 years and 42 (73.68%) were male. Only eight patients (14.04%) showed the classical triad of headache, fever, and focal neurological deficit. Fourteen patients (24.56%) had comorbidities, of which diabetes mellitus was the most common. Positive pus cultures were obtained in 46.15% of the patients, and gram-negative enteric bacteria were found in 33.33% of them, with Klebsiella pneumoniae being the most frequently observed. Surgical treatment, most commonly in the form of stereotactic drainage, was received by 54.39% of the patients. Good outcomes were achieved in 75.44% of the patients. Multivariate logistic regression analysis showed that patients with headache were more likely to have a poor outcome (odds ratio 6.010, 95% confidence interval 1.114–32.407, p = 0.037).Conclusions: Male patients and those older than 40 years were more susceptible to brain abscess than female patients and those younger than 40 years, respectively. Only a few patients showed the classical triad of clinical symptoms. Diabetes mellitus was the most common comorbidity. Positive pus culture results were uncommon, with gram-negative enteric bacteria, especially Klebsiella pneumoniae, being the main organisms found. Most patients had a good outcome, and the presence of headache may influence the outcome.

scholarly journals Clinical Characteristics, Treatment, and Short-Term Outcome in Patients with Heart Failure and Cancer

2021 ◽  
Vol 11 (4) ◽  
pp. 933-941
Author(s):  
Jędrzej Piotrowski ◽  
Małgorzata Timler ◽  
Remigiusz Kozłowski ◽  
Arkadiusz Stasiak ◽  
Joanna Stasiak ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Renal Function ◽  
Clinical Characteristics ◽  
Troponin T ◽  
Nyha Class ◽  
Multivariate Logistic Regression Analysis ◽  
Hospital Death ◽  
Short Term ◽  
Term Outcome

(1) Our study aimed to look at the clinical characteristics, treatment and short-term outcomes of patients hospitalized due to heart failure with coexisting cancer. (2) Methods: Seventy one cancer (Ca) patients and a randomly selected 70 patients without Ca, hospitalized due to heart failure exacerbation in the same time period constituted the study group (Ca patient group) and controls (non-Ca group), respectively. Data on clinical characteristics were collected retrospectively for both groups. (3) Results: Cancer patients presented with a less advanced NYHA class, had more frequent HFpEF, a higher peak troponin T level, and smaller left atrium size, as compared with controls. The in-hospital deaths of Ca patients were associated with: a higher New York Heart Association (NYHA) class, lower HgB level, worse renal function, higher K and AST levels, presence of diabetes mellitus, and HFpEF. By multivariate logistic regression analysis, impaired renal function was the only independent predictor of in-hospital death in Ca patients (OR-1.15; CI 1.05; 1.27); p = 0.017). The following covariates entered the regression: NYHA class, HgB, GFR, K+, AST, diabetes mellitus t.2, and HFpEF. (4) Conclusions: The clinical picture and the course of heart failure in patients with and without cancer are different.

scholarly journals Demographic and clinical characteristics of severe Covid-19 infections: a cross-sectional study from Mashhad University of Medical Sciences, Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ladan Goshayeshi ◽  
Mina Akbari Rad ◽  
Robert Bergquist ◽  
Abolghasem Allahyari ◽  
Kamila Hashemzadeh ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Age Groups ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Cardiovascular Disorders ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Duration Of Hospitalization ◽  
Polymerase Chain

Abstract Background Coronavirus Disease 2019 (Covid-19) is expanding worldwide. The characteristics of this infection in patients varies from country to country. To move forward, clinical data on infected patients are needed. Here, we report a comparison between fatalities and recovery of patients with severe Covid-19, based on demographic and clinical characteristics. Methods Between 5 March and 12 May 2020 in Mashhad, Iran, 1278 of 4000 suspected Covid-19 patients were confirmed positive by real-time reverse-transcriptase–polymerase-chain-reaction assay of upper respiratory specimens. We compared the demographic, exposure history and clinical symptoms of 925 survivors and 353 fatal cases with confirmed disease. Results Mean (SD) age for all confirmed patients was 56.9 (18.7) years, 67.1 (15.9) years in fatal cases and 53.0 (18.3) years in survivors. Multivariate logistic regression analysis showed that the outcome of patients was associated with age (odds ratio = 1.049, P = 0.0001, 95% CI = 1.040–1.057). Despite a high burden of Covid-19 infections in the 30–39 and 40–49 year age groups, most of these (89.6 and 87.2%, respectively) recovered. The median (IQR) duration of hospitalization was 9.0 (6.0–14.0) days. The most prevalent co-morbidities were cardiovascular disorders (21%) and diabetes (16.3%). Dyspnoea (72.7%), cough (68.1%) and fever (63.8%) were the most frequent clinical symptoms. Healthcare workers, of whom two (3%) died, comprised 5.2% of infected cases. Combination antiviral and antibiotic therapy was used in 43.0% of cases. Conclusions The characteristics of severe Covid-19 varied substantially between fatal cases and survivors, with diabetes and cardiovascular disorders the most prevalent co-morbidities. In contrast to other studies, there were a higher number of fatalities in younger patients in our setting.

scholarly journals A Rare Case of Burkholderia Pseudomallie Presenting as Brain Abscess

2021 ◽  
Vol 3 (1) ◽  
pp. 24-27
Author(s):  
Allen S. Sibil ◽  
Suresh S. Kumar ◽  
Alex Aiswariya
Keyword(s):  
Clinical Symptoms ◽  
Past History ◽  
Maintenance Phase ◽  
Rare Condition ◽  
Abscess Drainage ◽  
Focal Neurological Deficit ◽  
Gram Negative ◽  
Moderate Growth ◽  
Culture And Sensitivity ◽  
Pseudomonas Pseudomallei

Rationale: Meiliodosis is an extremely rare condition in Neurosurgery which is caused by the gram negative organism Burkholderia pseudomallie. Burkholderia pseudomallei (also known as Pseudomonas pseudomallei) is a Gram-negative, bipolar, aerobic, motile rod-shaped bacterium. It is a soil-dwelling bacterium endemic in tropical and subtropical regions worldwide, particularly in Thailand and northern Australia. It infects humans and animals and causes the disease melioidosis. It is also capable of infecting plants. If treatment is below par or delayed, this infection can produce diverse clinical symptoms and result in death. Patient Concerns: A 52 year old female, known case of Type 2 Diabetes mellitus on insulin, presented with complaints of a swelling in the left parieto-occipital region since 2 months & headache since 1 month. She had a past history of a fall from scooter 7 months ago, which then was not radiologically imaged. Patient was, otherwise, conscious, oriented and had no focal neurological deficit. Diagnosis: left parieto-occipital space occupying lesion confirmed by Ct brain and [mri + mrv] brain and culture and sensitivity of fluid aspirate showed moderate growth of burkholderia pseudomallie. Interventions: Intravenous Ceftazidime [1 g/12 h] was administered in-hospital for 4 weeks (Intensive Phase) and Oral Cotrimoxazole (Trimethoprim + sulfomethoxazole) {TAB.BACTRIM DS} twice daily was administered out-hospital (Maintenance Phase). Patient underwent Left parieto-occipital abscess drainage and debridement [Pus sent for Culture and Sensitivity] – Abscess drainage and removal of irregular thinned out bone around the skull defect + Biopsies sent from small extradural collection near the skull defect.Intravenous Ceftazidime was continued and discharged with Oral Cotrimoxazole (Trimethoprim + sulfomethoxazole).

Bladder dysfunction in women with diabetes mellitus

2019 ◽  
pp. 34-40
Author(s):  
Thi Bich Ngoc Hoang ◽  
Hai Thuy Nguyen
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Bladder Dysfunction ◽  
Clinical Symptoms ◽  
Residual Volume ◽  
Cross Sectional ◽  
Diabetic Cystopathy ◽  
Postvoid Residual ◽  
Postvoid Residual Volume

Introduction: Lower urinary tract dysfunctions secondary to type 2 DM are common, chronic and costly disorders. The incidence of diabetic bladder dysfunction was estimated range between 43% and 87% for type 1 and 25% for type 2 diabetes. Ultrasonography is an easy-to-use, fast, safe, non-invasive, painless, pleasant and valuable method of assessing Bladder Post-Void Residual Volume (PVR). Aim: To investigate prevalence of bladder dysfunction and its relation with risk factors, clinical features of diabetic cystopathy in women with diabetes, to identify the values predicting to have postvoid residual volume of the risk factors. Methods: A cross sectional descriptive study, a cohort of 84 female inpatients and outpatients with diabetes mellitus who were treated at Hue University of Medicine and Pharmacy Hospital from 08/2017 to 08/2019 and 84 healthy control subjects were enrolled, the patients were carried out clinical finding, taken blood tests, and estimated postvoid residual volume using 2D ultrasound. Results: the postvoid residual volume was presented in 67 cases (79.80%), the clinical symptoms of diabetic cystopathy were reported in 75% of women with diabetes. Blood glucose, HbA1c, clinical symptoms of diabetic cystopathy, postural hypotension and diabetic peripheral neuropathy were associated with postvoid residual volume. The HbA1c level had a great capability to predict who had postvoid residual volume, at HbA1c cutoff value of 9.1%, Se 65.67%, Sp 94.12%, AUC 0.811, p < 0.001. Conclusion: Bladder dysfunction made up a highly prevalent in women with poor glycemic control. Key words: bladder dysfunction, diabetic cystopathy, bladder postvoid residual volume (PVR)

Prevalence, Biochemical and Clinical Characteristics of Resistant Hypertension

2018 ◽  
Vol 69 (10) ◽  
pp. 2845-2849
Author(s):  
Daniela Gurgus ◽  
Elena Ardeleanu ◽  
Carmen Gadau ◽  
Roxana Folescu ◽  
Ioan Tilea ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Resistant Hypertension ◽  
Clinical Characteristics ◽  
Salt Intake ◽  
Target Organ Damage ◽  
Multivariate Logistic Regression Analysis ◽  
Organ Damage ◽  
Left Ventricular ◽  
High Salt Intake

The objectives of the present study were to evaluate the prevalence of resistant hypertension (RH) in primary care setting and to analyse its biochemical and clinical characteristics. After 3 months of treatment and evaluation, 721 (14.01%) of 5,146 patients with hypertension did not reach target office blood pressure of [ 140/90 mmHg. After exclusion of �white-coat effect� with ambulatory blood pressure, of secondary and pseudo- resistant hypertension, prevalence of RH was 6.74%. Lifestyle factors associated with RH were physical inactivity, obesity, high salt intake, smoking and excessive alcohol ingestion. Compared to controlled hypertension, RH patients presented higher incidence of family history of cardiovascular disease (38.90% vs 25.94%), diabetes mellitus (34.87% vs 19.01%), impaired fasting glucose (21.91% vs 19.07%), target organ damage (29.1% vs 15.95%), and cardiovascular disease (27.09% vs 17.06%). Dyslipidaemia (52.90% vs 42.03%), fasting plasma glucose (116.10�38.9 vs 107.80�37.2), HbA1c (6.41�1.42 vs 5.96�0.94), serum creatinine (1.09�0.27 vs 1.03�0.24) and microalbuminuria (21.90% vs 10.95%) were significantly higher in RH. Predictors of RH, determined by a multivariate logistic regression analysis were left ventricular hypertrophy (OD 2.14, 95% CI 1.32-3.69), renal impairment expressed as eGFR [ 60 ml/min/1.73m2 (OD 1.62, 95% CI 1.21-2.21) and the presence of cardiovascular disease (OD 1.48, 95% CI 1.02-2.16).

scholarly journals Cerebrotendinous Xanthomatosis: diversity of presentation and refining treatment with chenodeoxycholic acid

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Mahjabin Islam ◽  
Nigel Hoggard ◽  
Marios Hadjivassiliou
Keyword(s):  
Chenodeoxycholic Acid ◽  
Clinical Characteristics ◽  
Spastic Paraparesis ◽  
Acid Synthesis ◽  
Bile Acid Synthesis ◽  
Cerebrotendinous Xanthomatosis ◽  
Juvenile Onset ◽  
Progressive Ataxia ◽  
Classical Triad ◽  
High Index Of Suspicion

Abstract Background Cerebrotendinous xanthomatosis (CTX) is a rare but treatable neurometabolic disorder of lipid storage and bile acid synthesis. Whilst CTX is said to present with the classic triad of juvenile onset cataracts, tendon xanthomata and progressive ataxia, the diversity of presentation can be such that the diagnosis may be substantially delayed resulting in permanent neurological disability. Methods A retrospective review of the clinical characteristics and imaging findings of 4 patients with CTX presenting to the Sheffield Ataxia Centre over a period of 25 years. Results Although CTX-related symptoms were present from childhood, the median age at diagnosis was 39 years. Only 1 of the 4 cases had tendon xanthomata, only 2 cases had juvenile onset cataracts and 3 had progressive ataxia with one patient presenting with spastic paraparesis. Serum cholestanol was elevated in all 4 patients, proving to be a reliable diagnostic tool. In addition, cholestanol was raised in the CSF of 2 patients who underwent lumbar puncture. Despite treatment with chenodeoxycholic acid (CDCA) and normalization of serum cholestanol, CSF cholestanol remained high in one patient, necessitating increase in the dose of CDCA. Further adjustments to the dose of CDCA in the patient with raised CSF cholestanol resulted in slowing of progression. Two of the patients who have had the disease for the longest continued to progress, one subsequently dying from pneumonia. Conclusion A high index of suspicion for CTX, even in the absence of the classical triad is essential in reaching such diagnosis. The earlier the diagnosis and treatment, the better the outcome.

Sign in / Sign up

Export Citation Format

Share Document