scholarly journals Case Report: Furuncular Myiasis in Malawi

2020 ◽  
Vol 5 ◽  
pp. 41
Author(s):  
Janelisa Musaya ◽  
Kelvin Mponda
Keyword(s):  
Wound Care ◽  
Daily Practice ◽  
Patient Treatment ◽  
Common Condition ◽  
Endemic Region ◽  
Cordylobia Anthropophaga ◽  
History Of ◽  
Furuncular Myiasis ◽  
Insect Bites ◽  
Tumbu Fly

Furuncular myiasis results when the larva penetrates healthy skin to cause a furuncle like nodule which may mimic common dermatoses like insect bites and pyoderma leading to misdiagnoses. Tumbu fly (Cordylobia anthropophaga) is the most common cause in Africa and is endemic in Malawi. We describe a case of C. anthropophaga furuncular myiasis from a 6-month-old baby who presented with an acute history of a rash and was initially misdiagnosed on two occasions. Treatment consisted of manual removal of the larva and subsequent local wound care with a good outcome. We believe that much as Malawi is in the endemic region of the Tumbu fly, the disease’s clinical mimicking of common dermatoses and the patients’ preference to treat themselves at home may result in clinicians gaining less experience in managing furuncular myiasis cases in their daily practice leading to misdiagnoses. This report therefore demonstrates the practical challenges which unwary clinicians and patients in Malawi might encounter when faced with this otherwise common condition. It further highlights the importance of dermatologists and other non-dermatologist clinicians to consider furuncular myiasis among differential diagnoses in like lesions which in turn will reduce the unnecessary use of antibiotics and delay correct patient treatment.

Persistent venous leg ulcers complicated by linear morphea: a case report

2020 ◽  
Vol 29 (Sup9) ◽  
pp. S14-S20
Author(s):  
Georgeanne Cornell ◽  
Martin Kade Hardy ◽  
Jonathon Wilson
Keyword(s):  
Venous Insufficiency ◽  
Wound Care ◽  
Venous Stasis ◽  
Term Therapy ◽  
Leg Ulcers ◽  
Common Condition ◽  
Venous Ulcers ◽  
History Of ◽  
Long Term Therapy

Soft tissue ulceration resulting from chronic venous insufficiency is a common condition that requires standardised long-term therapy, which has been thoroughly established. We report a patient with a five-year history of persistent venous stasis ulcers despite treatment consistent with traditional wound care. Resolution of the ulcers began only upon deviation from conventional therapy. This report considers non-standard treatments in patients with venous ulcers that do not progress.

Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Reich-Schupke ◽  
Weyer ◽  
Altmeyer ◽  
Stücker
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Severe Adverse Effect ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Foam Sclerotherapy ◽  
History Of ◽  
One Year ◽  
Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

scholarly journals Limiting the executive power after the Second World War: the invention of administrative science

2021 ◽  
pp. 002085232098559
Author(s):  
Céline Mavrot
Keyword(s):  
Human Rights ◽  
World Order ◽  
Daily Practice ◽  
Second World War ◽  
Executive Power ◽  
World War ◽  
Administrative Power ◽  
History Of ◽  
Second World ◽  
Administrative Science

This article analyses the emergence of administrative science in France in the wake of the Second World War. The birth of this discipline is examined through the history of its founders, a group of comparatist aiming at developing universal administrative principles. The post-war context prompted the creation of checks and balances against administrative power (through oversight of the legality of administrative action) and against the powers of nation states (through human rights and international organizations). Administrative science and comparative law were meant to rebuild international relations. The history of this discipline highlights a legal project to redefine the role and limits of executive power at the dawn of the construction of a new world order. Points for practitioners Looking at long-term developments in the science of administration helps to inform administrative practice by providing a historical and reflective perspective. This article shows how a new understanding of the administrative reality emerged after the fall of the totalitarian regimes of the first half of the 20th century. It highlights the different ways in which administrative power was controlled after the Second World War through greater oversight over administrative legality, the establishment of universal administrative principles and the proclamation of human rights. Questions of administrative legitimacy and the limitation of administrative power are still very much part of the daily practice of executive power, and represent a central aspect of administrative thinking.

Sex, Race, Insurance, and Pain: Do Patient Sociodemographics Influence Postoperative Opioid Prescriptions Among Hand Surgeons?

Hand ◽  
2021 ◽  
pp. 155894472199802
Author(s):  
Connor J. Peck ◽  
Martin Carney ◽  
Alexander Chiu ◽  
Kitae E. Park ◽  
Alexandre Prassinos ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Medical Center ◽  
Carpal Tunnel Release ◽  
Private Insurance ◽  
Academic Medical Center ◽  
Age Groups ◽  
Postoperative Pain Management ◽  
Patient Treatment ◽  
Opioid Prescription ◽  
History Of

Background: Social and demographic factors may influence patient treatment by physicians. This study analyzes the influence of patient sociodemographics on prescription practices among hand surgeons. Methods: We performed a retrospective analysis of all hand surgeries (N = 5278) at a single academic medical center from January 2016 to September 2018. The average morphine milligram equivalent (MME) prescribed following each surgery was calculated and then classified by age, race, sex, type of insurance, and history of substance use or chronic pain. Multivariate linear regression was used to compare MME among groups. Results: Overall, patients with a history of substance abuse were prescribed 31.2 MME more than those without ( P < .0001), and patients with a history of chronic pain were prescribed 36.7 MME more than those without ( P < .0001). After adjusting for these variables and the type of procedure performed, women were prescribed 11.2 MME less than men ( P = .0048), and Hispanics were prescribed 16.6 MME more than whites ( P = .0091) overall. Both Hispanic and black patients were also prescribed more than whites following carpal tunnel release (+19.0 and + 20.0 MME, respectively; P < .001). Patients with private insurance were prescribed 24.5 MME more than those with Medicare ( P < .0001), but 25.0 MME less than those with Medicaid ( P < .0001). There were no differences across age groups. Conclusions: Numerous sociodemographic factors influenced postoperative opioid prescription among hand surgeons at our institution. These findings highlight the importance of establishing more uniform, evidence-based guidelines for postoperative pain management, which may help minimize subjectivity and prevent the overtreatment or undertreatment of pain in certain patient populations.

Cordylobia anthropophaga (Diptera: Calliphoridae) Outside Africa: A Case of Furuncular Myiasis in a Child Returning from Congo

2005 ◽  
Vol 42 (2) ◽  
pp. 187-192 ◽  
Author(s):  
Éric Dehecq ◽  
Placide Nyombe Nzungu ◽  
Jean-Charles Cailliez ◽  
Édouart Guevart ◽  
Laurence Delhaes ◽  
...  
Keyword(s):  
Cordylobia Anthropophaga ◽  
Furuncular Myiasis

scholarly journals Migratory non-itchy rash

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Sami Hoshi ◽  
Keyword(s):  
Physical Examination ◽  
Complete Resolution ◽  
Endemic Region ◽  
The West ◽  
Western Blot Test ◽  
Joint Tenderness ◽  
Mucous Membranes ◽  
The Usa ◽  
History Of

A 58-year-old man presented with 4-day history of multiple, erythematous, non-itchy, painless, patchy spots, along with fatigue and jaw pain. This rash started around the periumbilical area and then spread over his chest and right upper back (Figure 1,2). There was no involvement of face, mucous membranes, and extremities. He denied any sore throat, cough, or other symptoms. Besides the skin rash, his physical examination was unremarkable. There was no temporomandibular joint swelling, or joint tenderness. A month ago, he travelled along with the west coast of Michigan – a Lyme-endemic region of the USA and noted his exposure to mosquitoes. Shortly after his visit, he recalled having fever, chills, myalgia and a similar patchy groin rash which resolved in a few days. At that time, blood work by his family physician revealed mild transaminitis. At the current visit, repeat blood work and electrocardiogram were normal. A clinical diagnosis of early disseminated Lyme disease was made. Lyme Ab IgM and IgG were both elevated, as was his Western blot test. He was given a 10-day course of doxycycline. He reported complete resolution of his symptoms at follow up.

A Handbook for Wellbeing Policy-Making

2021 ◽  
Author(s):  
Paul Frijters ◽  
Christian Krekel
Keyword(s):  
Policy Evaluation ◽  
Subjective Wellbeing ◽  
Cost Benefit ◽  
Daily Practice ◽  
Political Agenda ◽  
Technical Standards ◽  
Policy Practice ◽  
Long Run ◽  
Short Run ◽  
History Of

Around the world, governments are starting to directly measure the subjective wellbeing of their citizens and to use it for policy evaluation and appraisal. What would happen if a country were to move from using GDP to using subjective wellbeing as the primary metric for measuring economic and societal progress? Would policy priorities change? Would we continue to care about economic growth? What role would different government institutions play in such a scenario? And, most importantly, how could this be implemented in daily practice, for example in policy evaluations and appraisals of government analysts, or in political agenda-setting at the top level? This book provides answers to these questions from a conceptual to a technical level by showing how direct measures of subjective wellbeing can be used for policy evaluation and appraisal, either complementary in the short run or even entirely in the long run. It gives a brief history of the idea that governments should care about the happiness of their citizens, provides theories, makes suggestions for direct measurement, derives technical standards, shows how to conduct wellbeing cost-effectiveness and cost-benefit analyses, and gives examples of how real-world policy evaluations and appraisals would change if they were based on subjective wellbeing. In doing so, the book serves the growing interest of governments as well as non-governmental and international organizations in how to put subjective wellbeing metrics into policy practice.

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