scholarly journals A 20-year retrospective study of osteoarticular tuberculosis in a pediatric third level referral center

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Napoleón González Saldaña ◽  
Mercedes Macías Parra ◽  
Luis Xochihua Díaz ◽  
Martin Palavicini Rueda ◽  
Ana Jocelyn Carmona Vargas ◽  
...  
Keyword(s):  
High Sensitivity ◽  
Antimicrobial Treatment ◽  
Bone Lesions ◽  
Osteoarticular Tuberculosis ◽  
Mexican Children ◽  
High Prevalence ◽  
Lytic Bone Lesions ◽  
The Mean ◽  
Epidemiological Characteristics ◽  
Microbiological Confirmation

Abstract Purpose The objective of the present study is to describe the clinical, diagnostic, radiological and therapeutic aspects of osteoarticular tuberculosis (OATB) in patients in a tertiary pediatric hospital, to know if the diagnosis of OATB in pediatrics is a challenge due to its insidious clinical presentation. Methods A retrospective, descriptive study of the cases of Tuberculosis (TB) in children was carried out. A total of 159 cases met the condition for the analysis. Results The most frequent TB modality was extrapulmonary in 85%. Out of this, only 29% was OATB. The mean age was 4.9 years (range 8 months–16 years). Eighty-six per cent of cases received Bacille Calmette-Guérin (BCG) vaccination at birth. Median time of symptoms prior to diagnosis was 8 months. Microbiological confirmation was achieved only in five cases, with a high sensitivity to the antimicrobial treatment. Mycobacterium bovis BCG strain Tokio 172 was confirmed in three cases. Mortality rate was 0% during the time of study Conclusion Our study describes the epidemiological characteristics of OATB cases in Mexican children. This data revealed a high prevalence of bone and joint TB infection. Pediatric OATB should be considered in cases with lytic bone lesions, fever and local pain. In countries with BCG immunization program, M. bovis should not be forgotten as an etiological agent. The low detection rate with one technique approach highlights the urgent need for more sensitive test to diagnose OATB in children.

Features of Thrombi and Diagnostic Accuracy of Impedance Plethysmography in Symptomatic and Asymptomatic Deep Vein Thrombosis

1993 ◽  
Vol 70 (02) ◽  
pp. 266-269 ◽  
Author(s):  
Giancarlo Agnelli ◽  
Benilde Cosmi ◽  
Stefano Radicchia ◽  
Franca Veschi ◽  
Enrico Boschetti ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Diagnostic Accuracy ◽  
High Sensitivity ◽  
Impedance Plethysmography ◽  
Surveillance Programme ◽  
Vein Thrombosis ◽  
Asymptomatic Patients ◽  
High Prevalence ◽  
The Mean ◽  
Deep Vein

SummaryImpedance plethysmography (IPG) has high sensitivity and specificity in patients with symptomatic deep vein thrombosis (DVT) while it fails to detect asymptomatic DVT. The aim of this study was to determine whether the features of thrombi such as location, size and occlusiveness could explain the different accuracy of IPG in symptomatic and asymptomatic DVT patients. One-hundred and seventeen consecutive outpatients with a clinical suspicion of DVT and 246 consecutive patients undergoing hip surgery were admitted to the study. In symptomatic patients IPG was performed on the day of referral, followed by venography, while in asymptomatic patients IPG was performed as a surveillance programme, followed by bilateral venography.A venography proved DVT was observed in 37% of the symptomatic patients and 34% of the asymptomatic limbs. A significantly higher proportion of proximal DVTs was found in symptomatic patients than in asymptomatic patients (78% vs 46%; p = 0.001). The mean Marder score, taken as an index of thrombus size, was significantly higher in symptomatic patients than in asymptomatic patients (19.0 vs 9.6; p = 0.0001). A significantly higher proportion of occlusive DVTs was observed in symptomatic than in asymptomatic patients (69% vs 36%; p = 0.001).We conclude that the unsatisfactory diagnostic accuracy of IPG in asymptomatic DVT is due to the high prevalence of distal, small and non occlusive thrombi. Such thrombi are unlikely to cause a critical obstruction of the venous outflow and therefore to produce a positive IPG.

scholarly journals Prevalence of cardiometabolic risk factors among Malaysian obese adults

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Siti Zuhaidah Shahadan ◽  
Azlina Daud ◽  
Muhammad Lokman Md Isa ◽  
Samsul Deraman ◽  
Muhammad Ibrahim
Keyword(s):  
Risk Factors ◽  
Cardiometabolic Risk ◽  
Fasting Blood Glucose ◽  
High Sensitivity ◽  
Obese Adults ◽  
Mean Values ◽  
Reactive Protein ◽  
High Prevalence ◽  
The Mean ◽  
Hs Crp

Introduction: Obese adults are associated with increased cardiometabolic risk (CMR). The study aims to investigate the prevalence of CMR factor abnormalities in obese adults in Kuantan. Methods: Seventy-six obese adults with a mean (standard deviation) age of 33.7 years (9.8 years) participated in this study. All participants had a waist circumference (WC) measured, blood pressure (BP) taken, and assessment of fasting blood glucose (FBG), lipid profile (LP) and high-sensitivity C-reactive protein (hs-CRP) level. Results: For CMR factors, the mean values for WC was 97.2 ± 9.6 cm, mean overall BP was 119 ± 15/76 ± 11 mmHg, mean FBG level was 4.8 ± 0.5 mmol/L and the mean of total cholesterol (TC) and triglyceride (TG) was 5.4 ± 1.0 mmol/L and 1.4 ± 0.7 mmol/L, respectively. Lastly, the mean of hs-CRP was 6.0 ± 6.1 mg/L. The CMR factors with the highest prevalence of abnormal values included WC (male 100%; female 98%) and TC (male 73.1%; female 52%) for both genders, systolic BP (50%) and TG level (61.5%) for male, and hs-CRP level (68%) for female. Out of the nine CMR factors measured, five CMR risk factors were shown to have a high prevalence of abnormalities. Conclusions: The present study suggests that obese adults in Kuantan have multiple CMR factor abnormalities. A larger trial, sensibly informed of this trial, can now build upon and confirm these results.

Prevalence of Self-Medication and Its Factors among University Students in Bandar Abbas City

2018 ◽  
Vol 7 ◽  
Author(s):  
Atefeh Mohammadi
Keyword(s):  
Herbal Medicines ◽  
Target Population ◽  
Easy Access ◽  
Medical Sciences ◽  
Self Medication ◽  
Delay In Diagnosis ◽  
Consumption Culture ◽  
High Prevalence ◽  
The Mean ◽  
Bandar Abbas

Background: Self-medication can lead to the latency of the real severity of disease, delay in diagnosis, a complication of treatment, threatening side effects, and unexpected intoxication. The present research aimed to explore the prevalence of self-medication and its factors among students affiliated to Bandar Abbas universities in 2016. Materials and Methods: This Descriptive Analytic study was performed on 600 students affiliated to the universities in Bandar Abbas; Islamic Azad University, Payam-e-Noor University, and University of Medical Sciences. The sample was selected through a stratified sampling method, and the data were collected by a questionnaire comprised of two parts, demographic information (6 items), and risk factors of self-medication and self-medicated drugs (26 items). SPSS version 19 was used to analyze the data through the required tests. Result: The mean age of the students was 24.11±5.85 years. One hundred and ninety-one subjects (31.8%) were male, and 409 (68.2%) were female. The results revealed the prevalence of self-medication in the target population was 80.2%., the main reasons for self-medication were reported underestimating the disease 461(77.0%), previous experience of the disease 457(76.4%), repeated prescription 441(73.6%), and easy access to drug 423(70.6%). The most prevalent drugs self-medicated by students were acetaminophen, herbal medicines, antibiotics, other drugs, sedatives, and anti-acids, respectively. Conclusion: Considering the high prevalence of self-medication (80.2%) revealed in this research, there is a need for more attentive care for consistent education and drug consumption culture promotion. Specific approaches can help the provision of easy access to medical services in universities.

scholarly journals Belated Diagnosis of a Primary Bone Lymphoma of the Elbow: A Rare Case and Review of the Literature

2020 ◽  
pp. 100-107
Author(s):  
Michele Boffano ◽  
Nicola Ratto ◽  
Martina Rezzoagli ◽  
Andrea Conti ◽  
Pietro Pellegrino ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Rare Disease ◽  
Rare Case ◽  
Early Stage ◽  
Bone Lesions ◽  
Review Of The Literature ◽  
Primary Bone Lymphoma ◽  
Lytic Bone Lesions ◽  
Primary Bone ◽  
Bone Lymphoma

Primary non-Hodgkin bone lymphoma (PBL) is a rare disease that accounts for <2% of all lymphomas in adults. PBL can be monostotic or polyostotic, mainly causing destructive and lytic bone lesions frequently located in the femur, humerus, and pelvis. PBL is rarely considered a differential diagnosis of the osteolytic tumor. In addition, PBL is not uncommonly diagnosed with delay because patients do not experience symptoms nor show objective abnormalities in the early stage of disease. Here, we reported a 60-year-old woman with a PBL of the elbow.

High prevalence of heterotopic ossification after cervical disc arthroplasty: outcome and intraoperative findings following explantation of 22 cervical disc prostheses

2012 ◽  
Vol 17 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Christopher Brenke ◽  
Johann Scharf ◽  
Kirsten Schmieder ◽  
Martin Barth
Keyword(s):  
Neck Disability Index ◽  
Adjacent Segment Degeneration ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Adjacent Segment ◽  
Analog Scale ◽  
Osteophyte Formation ◽  
High Prevalence ◽  
The Mean ◽  
Neck Disability

Object Cervical disc arthroplasty (CDA) has been increasingly used for the treatment of cervical disc herniations. However, the impact of CDA on adjacent-segment degeneration and the degree of heterotopic ossification (HO) of the treated segment remain a subject of controversy. Due to a product failure of the Galileo-type disc prosthesis, 22 of these devices were explanted. The radiological and clinical course in each case was investigated in detail with an emphasis on the incidence of HO and facet joint degeneration 18 months following the operation. Intraoperative findings regarding ossification and implant fixation were documented. Thus, the authors were able to describe the true rate of adjacent-segment degeneration and HO following CDA and the clinical relevance thereof. Methods In all 22 patients, functional radiographic imaging was performed prior to surgery, 3 and 12 months after surgery, and prior to disc prosthesis explantation. At all time points, the range of motion (ROM) in the operated and adjacent segments was determined. A motion index was calculated using the preoperative and all postoperative ROMs (preoperative ROM/postoperative ROM). Computed tomography was used preoperatively to measure the height of the index segment, extent of HO, and the degree of the progression of facet arthrosis, and was used postoperatively prior to prosthesis explantation. Patients completed clinical questionnaires that included a visual analog scale and the Neck Disability Index. Results The motion index of the index segment declined gradually from 1.4 at 3 months postoperative to 1.2 prior to explantation, while the motion index of the adjacent upper segment increased from 0.9 to 1.3. The mean ROM of the index segment was 10.4° ± 6.7°, and fusion was observed in 2 (9%) of the 22 patients. Prosthesis migration was present in 3 patients (13.6%). Severe HO (Grades 3 and 4) was present in 17.4%. Computed tomography showed a significant increase of segmental height of the index segment (1.6 ± 1.1 mm, p = 0.035), and a significant increase of left-sided lateral osteophytes (1.7 ± 2.1 mm, p = 0.009). The incidence of severe osteophyte formation (> 2 mm) occurred in 40%. Intraoperative findings reflected the results from CT, with primary lateral proliferation of osteophytes found in approximately 25% of patients. The mean visual analog scale scores were 3.8 ± 2.7 (neck) and 2.4 ± 2.5 (arms), and the mean Neck Disability Index score was 30 ± 22. No correlation was found between radiological and clinical parameters. Conclusions In this study, a higher incidence of HO after CDA could be demonstrated using CT, compared with studies using fluoroscopy only. However, patient selection and/or the operative technique might have contributed to the high prevalence of osteophyte formation. Thus, the exact indication for CDA has to be reconsidered. Because implant migration was detected, using fixation in the present CDA model appears suboptimal.

Ultrasonically-guided biopsy of lytic bone lesions suspected for metastases

1997 ◽  
Vol 6 (2) ◽  
pp. 121-125 ◽  
Author(s):  
Magdalena Gormsen ◽  
Jens Brøns ◽  
Niels Juul ◽  
Nils Christensen
Keyword(s):  
Bone Lesions ◽  
Guided Biopsy ◽  
Lytic Bone Lesions ◽  
Ultrasonically Guided Biopsy

Predictors of Surgical Intervention in Patients with Inflammatory Bowel Disease

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Hamdy Abd El Megeed ◽  
Shereen Abou Bakr Saleh ◽  
Christina Alphonse Anwar ◽  
Ahmed Elkattary Mohamed Elkattary
Keyword(s):  
Inflammatory Bowel Disease ◽  
Surgical Treatment ◽  
Bowel Disease ◽  
Surgical Intervention ◽  
High Sensitivity ◽  
Medical Patients ◽  
Mayo Score ◽  
Calprotectin Level ◽  
Inflammatory Bowel ◽  
The Mean

Abstract Background Inflammatory bowel disease (IBD) is comprised of two major disorders: Ulcerative Colitis and Crohn’s disease. Ulcerative Colitis affects the colon, where as Crohn’s disease can involve any component of the gastrointestinal tract from the mouth to the perianal area. These disorders have somewhat different pathologic and clinical characteristics, but with substantial overlap; their pathogenesis remains poorly understood. Objective To determine & detect different predictors that help us to characterize patients with high probability of undergoing surgical intervention for inflammatory bowel diseases. Patients and Methods The present study was designed to detect & identify possible factors that can be used to predict surgical intervention in patients with IBD. The present study was a case control study that was conducted on 80 patients with inflammatory bowel disease (either controlled by medical treatment or needed surgical intervention as a part of disease control) who were recruited form Ain-Shams university hospitals and El Quabbary general hospital in Alexandria. In the present study, the mean age of the included patients was 36.67 ±8.5 years old and 50% of the patients were males. The mean age at the onset of the disease was 25.81 ±6.8 years old. Results In the present study, there were statistically significant differences between surgical and medical patients in terms of CDAI for CD (p &lt; 0.001) and Mayo score for UC (p &lt; 0.001). Surgical patients were more likely to have higher scores. CDAI and Mayo score were negative predictors of surgical treatment. CDAI score &gt; 287 and Mayo score &gt; 8.5 achieved high sensitivity and specificity for the detection of surgical treatment. In the present study, we found that there was statistically significant differences between surgical and medical patients in terms of Stool Calprotectin level. Surgical patients were more likely to have higher Stool Calprotectin level. Stool Calprotectin level was negative predictor of surgical treatment at a level of &gt; 341.5 microgm/gm with high sensitivity and specificity. Conclusion Surgical treatment is a common outcome in IBD. Certain clinical features and the extent of disease are risk factors for surgical intervention. Our study indicates that smoking, Chron’s disease, perianal disease, granulomas, higher severity scores, higher stool Calprotectin level, CRP, and ESR were associated with higher risks of surgical intervention. In addition, smoking, peri-anal disease, CDAI, Mayo score, Stool Calprotectin level, and CRP level were predictors of surgical treatment. The findings of our analysis have implications for practice, particularly in the promotion of preoperative individualized risk prediction. The ability to predict which patients will need surgery and target more intensive, early treatment to that group would be invaluable. Further research through large prospective cohort studies is needed to confirm our findings and conclusions.

The effect of sickle cell anemia on the linear growth of Nigerian children

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ugo Nnenna Chikani ◽  
Adaobi Bisi-Onyemaechi ◽  
Ijeoma Ohuche ◽  
Justus Onu ◽  
Shalewa Ugege ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Linear Growth ◽  
Clinical Care ◽  
Growth Failure ◽  
Age At Diagnosis ◽  
Height Velocity ◽  
Prospective Longitudinal Study ◽  
High Prevalence ◽  
The Mean ◽  
Prospective Longitudinal

Abstract Objectives Despite the high prevalence of children with sickle cell anaemia (SCA) in West Africa, there is paucity of data on the height velocity and prevalence of growth failure in SCA patients. With advances in clinical care of SCA patients, could there be a spatial and secular trend in the growth pattern of these children? Hence, the compelling needs to embark on this study. The objectives of the study were to determine the prevalence of growth failure among patients with SCA and its correlation with age, gender and age at diagnosis. Methods A Prospective longitudinal study of a cohort of sickle cell anaemic paediatric patients from Pediatrics SCA Clinic, University of Nigeria Teaching Hospital, Ituku Ozalla. Patients were enrolled over a period of two years using a non-parametric convenient sampling method. Their heights were measured at baseline, three months, six months and at 12 months intervals and subsequently plotted on a standard WHO growth chart. The height velocities at different monthly intervals were calculated and compared with the WHO standard normal linear growth rates) for children (used as control) to identify those with GF. (i.e. <10th percentile). The main outcome measures were the mean height velocities at different months' intervals calculated and compared using the repeated measurement analysis of variance (ANOVA) and the Wilcoxon signed test. Results A cohort of 316 children aged 1–18 years with SCA was evaluated with a male preponderance of 161 (57.4%). The mean age and age at diagnosis were 11.04 ± 5.56 and 4.2 ± 1.7 years, respectively. The prevalence of growth failure and short stature was 84.7%. The burden of GF was highest among post-pubertal participants (94.1%). The most important predictor of growth velocity deficit was age (R2=0.045, standard β coefficient = −0.22, t=−03.51, p=0.001). Conclusions The study demonstrated high prevalence of growth failure in children and adolescents with SCA which intensified with advancement in age and older age at diagnosis.

scholarly journals Sleep patterns and symptoms of anxiety and depression in patients with chronic pain

2009 ◽  
Vol 67 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Martha M.C. Castro ◽  
Carla Daltro
Keyword(s):  
Chronic Pain ◽  
Sleep Disturbances ◽  
Myofascial Pain ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Sleep Patterns ◽  
Symptoms Of Depression ◽  
High Prevalence ◽  
The Mean

BACKGROUND: Sleep disturbances and symptoms of anxiety and depression have been shown to be involved in the genesis and perpetuation of chronic pain. OBJECTIVE: To evaluate sleep patterns and the prevalence of symptoms of anxiety and depression in patients with chronic pain. METHOD: Four hundred consecutive patients referred to a chronic pain outpatient clinic were investigated using patient charts, the numerical Visual Analogue Scale for the evaluation of pain, the Hospital Anxiety and Depression scale and the Mini-Sleep Questionnaire. RESULTS: The mean age of patients was 45.6±11.4 years. The most frequent medical diagnosis was myofascial pain followed by neuropathic pain. The prevalence of symptoms of anxiety was 72.8%, depression 93% and altered sleep patterns 93%. CONCLUSION: This study revealed a high prevalence of symptoms of depression and anxiety and alterations in sleep patterns in patients with chronic pain, justifying investigation into these disturbances in this group of patients.

scholarly journals An Unprecedented Case of p190 BCR-ABL Chronic Myeloid Leukemia Diagnosed during Treatment for Multiple Myeloma: A Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Kosuke Miki ◽  
Naoshi Obara ◽  
Kenichi Makishima ◽  
Tatsuhiro Sakamoto ◽  
Manabu Kusakabe ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Plasma Cells ◽  
Bone Marrow Examination ◽  
Bone Lesions ◽  
Dexamethasone Treatment ◽  
Lytic Bone Lesions

We report the case of a 76-year-old man who was diagnosed as having chronic myeloid leukemia (CML) with p190 BCR-ABL while receiving treatment for symptomatic multiple myeloma (MM). The diagnosis of MM was based on the presence of serum M-protein, abnormal plasma cells in the bone marrow, and lytic bone lesions. The patient achieved a partial response to lenalidomide and dexamethasone treatment. However, 2 years after the diagnosis of MM, the patient developed leukocytosis with granulocytosis, anemia, and thrombocytopenia. Bone marrow examination revealed Philadelphia chromosomes and chimeric p190 BCR-ABL mRNA. Fluorescence in situ hybridization also revealed BCR-ABL-positive neutrophils in the peripheral blood, which suggested the emergence of CML with p190 BCR-ABL. The codevelopment of MM and CML is very rare, and this is the first report describing p190 BCR-ABL-type CML coexisting with MM. Moreover, we have reviewed the literature regarding the coexistence of these diseases.

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