scholarly journals Infections of the hand: an overview

2019 ◽  
Vol 4 (5) ◽  
pp. 183-193 ◽  
Author(s):  
Dimitrios A. Flevas ◽  
Sophia Syngouna ◽  
Emmanouel Fandridis ◽  
Sotirios Tsiodras ◽  
Andreas F. Mavrogenis
Keyword(s):  
Primary Care Physicians ◽  
Clinical Suspicion ◽  
Correct Identification ◽  
Orthopaedic Surgeons ◽  
Appropriate Treatment ◽  
High Clinical Suspicion ◽  
Inappropriate Treatment ◽  
The Social ◽  
History Of ◽  
Common Infections

Infections of the hand are common entities that are frequently encountered by orthopaedic surgeons and primary care physicians. A high clinical suspicion and a thorough medical history with information about the social and working history of the patients, correct identification of the type and cause of the infection, and prompt initiation of appropriate treatment by the infectious diseases physicians and orthopaedic surgeons are required. Late diagnosis and inappropriate treatment may be a significant cause of morbidity for the hand and mortality for the patients. This article reviews the clinical spectrum and microbiology of the most common infections of the hand, and discusses the current concepts for their treatment. The aim is to increase the awareness of the treating physicians of the diagnosis and management of infections in the hand. Cite this article: EFORT Open Rev 2019;4:183-193. DOI: 10.1302/2058-5241.4.180082

scholarly journals Acquired Abdominal Intercostal Hernia: A Case Report and Literature Review

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Salim Abunnaja ◽  
Kevin Chysna ◽  
Inam Shaikh ◽  
Giuseppe Tripodi
Keyword(s):  
Clinical Presentation ◽  
Stab Wound ◽  
Treatment Strategies ◽  
Clinical Suspicion ◽  
Appropriate Treatment ◽  
Obese Female ◽  
High Clinical Suspicion ◽  
Intercostal Hernia ◽  
History Of ◽  
Abdominal Intercostal Hernia

Acquired abdominal intercostal hernia (AAIH) is a rare disease phenomenon where intra-abdominal contents reach the intercostal space directly from the peritoneal cavity through an acquired defect in the abdominal wall musculature and fascia. We discuss a case of a 51-year-old obese female who arrived to the emergency room with a painful swelling between her left 10th rib and 11th rib. She gave a history of a stab wound to the area 15 years earlier. A CT scan revealed a fat containing intercostal hernia with no diaphragmatic defect. An open operative approach with a hernia patch was used to repair this hernia. These hernias are difficult to diagnose, so a high clinical suspicion and thorough history and physical exam are important. This review discusses pathogenesis, clinical presentation, complications, and appropriate treatment strategies of AAIH.

Postauricular swelling secondary to salmonella extradural abscess in a toddler: a near miss condition

2021 ◽  
Vol 14 (7) ◽  
pp. e243412
Author(s):  
Chee Chean Lim ◽  
Jeyasakthy Saniasiaya ◽  
Jeyanthi Kulasegarah
Keyword(s):  
Infectious Disease ◽  
Rare Case ◽  
Clinical Suspicion ◽  
Near Miss ◽  
Emergency Setting ◽  
History Taking ◽  
Suppurative Otitis Media ◽  
High Clinical Suspicion ◽  
Life Threatening ◽  
History Of

Postauricular swelling is usually encountered in an emergency setting in otorhinolaryngology, resulting from complication of acute or chronic suppurative otitis media. Besides that, postauricular swelling may occur secondary to various other conditions including infectious disease, tumour, vascular malformation, granulomatous condition and even trauma. Children less than 2 years old are prone to fall and up to 10% sustain traumatic brain injury without any obvious signs of neurological deficit. We describe a rare case of a postauricular swelling in a toddler which turned out to be salmonella extradural abscess from an infected traumatic haematoma. The importance of high clinical suspicion especially in a child with a history of fall cannot be emphasised more because a missed brain abscess could lead to potentially life-threatening problems. We would like to highlight that meticulous history taking along with prompt assessment and intervention is prudent for a better prognosis and recovery.

scholarly journals 974 Paget-Schroetter Syndrome in A Young Fitness Enthusiast with A Negative D-Dimer. Highlighting the Balance Between Clinical Suspicion and Diagnostic Modalities

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Gani ◽  
G Lucas ◽  
C Ellis ◽  
A El-Karim ◽  
J Refson
Keyword(s):  
Great Saphenous Vein ◽  
Clinical Suspicion ◽  
Venous Obstruction ◽  
Risk Profiling ◽  
High Clinical Suspicion ◽  
Rare Manifestation ◽  
History Of ◽  
Diagnostic Modalities ◽  
D Dimer ◽  
Collateral Formation

Abstract This case illustrates an athletic 22-year-old, who presented to the hospital with a 3-week history of spontaneous right arm ache, discolouration and swelling. His blood tests were normal, with a negative D-dimer (<150ng/ml). He underwent a CT venogram for suspicion of venous obstruction which was unremarkable. However due to a high clinical suspicion, an ultrasound doppler was performed. This identified the presence of axillary-subclavian thrombosis which in conjunction with other clinical and radiological parameters confirmed the diagnosis of Paget-Schroetter Syndrome (PSS). Our patient was commenced on anticoagulation as the venous obstruction was suspected to be sub-acute with clinical suggestion of collateral formation. Unfortunately, his symptoms failed to resolve over a 6-month period, and he underwent an elective right rib resection with right subclavian bypass using the great saphenous vein with good outcome post-operatively. PSS is a rare manifestation of venous thoracic outlet syndrome (TOS) commonly seen in young, healthy, athletic individuals. Despite the high effectiveness of D-Dimers in ruling out acute thrombotic process and the accuracy of dedicated CT angiography in excluding vascular thrombotic events, both tests proved inconclusive in this particular case. This latter observation highlights the importance of the clinical context, and risk profiling in guiding results interpretation.

scholarly journals Complications of refractory juvenile dermatomyositis: a case report and literature review

2021 ◽  
Vol 11 (1) ◽  
pp. 8-12
Author(s):  
Rhett Orgeron
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Juvenile Dermatomyositis ◽  
Disease Process ◽  
Interdisciplinary Approach ◽  
Underlying Disease ◽  
Clinical Suspicion ◽  
Treatment Resistant ◽  
High Clinical Suspicion ◽  
History Of

We present a 29-year-old male with a history of treatment resistant juvenile dermatomyositis (JDM). The patient was admitted for complaints of nausea, diarrhea and abdominal pain and was subsequently found to have intestinal perforation on imaging. The patient had also exhibited classic dermatologic findings alongside rare dermato-pathological manifestations of JDM on examination; likely consequences of his underlying disease process. This case serves to present these rare findings and analyze the similarities of JDM and adult dermatomyositis (DM). In addition, overall diagnosis and treatment of resistant/severe JDM is explored. High clinical suspicion alongside an interdisciplinary approach is warranted for such patients given their extensive risk factors for future complications.

scholarly journals Primary Aortoenteric Fistulae: What Every Surgeon Should Know About Its Diagnosis and Treatment

2021 ◽  
Author(s):  
Mohammad Hassani ◽  
Sina Zarrintan ◽  
Mohamad Moradmand ◽  
Peyman Bakhshaei Shahrbabaki
Keyword(s):  
Clinical Suspicion ◽  
The Other ◽  
Aortoenteric Fistula ◽  
Gi Bleeding ◽  
Aortic Graft ◽  
Rare Finding ◽  
The Third ◽  
High Clinical Suspicion ◽  
Artificial Graft ◽  
History Of

Aortoenteric fistula is a rare finding that is potentially fatal and is usually seen as a fistula between the aorta or an aortic graft and the third part of the duodenum. The type without the presence of an artificial graft is considered as primary and the other type as secondary. The patients usually present with the heralding symptom of minor hematemesis, which later leads to massive and mortal GI bleeding. The most important factor in the diagnosis of an aortoenteric fistula is to have a high clinical suspicion after taking an appropriate and accurate history. In hemodynamically stable patients with clinical suspicion, performing an intravenouscontrast-CT scan of the abdomen and pelvis is of assistance in diagnosis. In general, stable hemodynamics greatly reduces the suspicion for diagnosis. Treatment is often surgical, and in regard to the severity of abdominal contamination or the level of visible infection, the extra anatomical or insitu graft repair is considered as the method of choice. This article tries to transfer our experiences in two patients, each of whom presented with hematemesis and melena without a history of underlying aortic aneurysm.

scholarly journals A rare cause of acute compartment syndrome in the thigh: a case report

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Henry J T Slade ◽  
Koen De Ridder
Keyword(s):  
Compartment Syndrome ◽  
Case Reports ◽  
Clinical Suspicion ◽  
Acute Compartment Syndrome ◽  
Low Energy ◽  
Crush Injury ◽  
Posterior Compartment ◽  
Literature Research ◽  
High Clinical Suspicion ◽  
History Of

Abstract Acute compartment syndrome (ACS) is an orthopaedic emergency that requires urgent fasciotomy and decompression to avoid significant morbidity. It is most commonly caused by a fracture or crush injury. We present a case of a patient who developed ACS of the posterior compartment of the thigh secondary to a low energy fall and avulsion of sclerotic arterioles. There was no fracture and the patient was not anti-coagulated. They had fasciotomy and embolization of responsible vessels. This case demonstrates the need for high clinical suspicion needed for ACS and the morbidity associated with a delayed fasciotomy. A literature research demonstrated no case reports of a patient developing ACS with no fracture, no crush injury and no history of anti-coagulation.

scholarly journals Scrub Typhus Case Report; Acute Febrile Illness in a Young Lady

2018 ◽  
Vol 3 (4) ◽  
Keyword(s):  
Early Diagnosis ◽  
Andhra Pradesh ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Detailed Examination ◽  
Clinical Suspicion ◽  
Acute Febrile Illness ◽  
High Clinical Suspicion ◽  
History Of ◽  
The Right

We are reporting a case of young Indian lady with history of recent travel to India, presented with acute febrile illness. Initially she was treated with antibiotics with diagnosis of sepsis but she did not respond. Thorough investigations were done to find out the cause of her illness but all the workup was negative. Later on detailed examination revealed an eschar on the right thigh. Based upon the fact that she has a history of recent travel to Andhra Pradesh that is endemic for scrub typhus, with the presence of eschar on the right thigh, empirical treatment with doxycycline was started. Patient responded very well to the treatment and was discharged home. High clinical suspicion of scrub typhus is necessary for early diagnosis and treatment in patients coming from endemic area. Presence of eschar is pathognomic but its absence does not make the disease unlikely. Early diagnosis is associated with better outcomes.

The Social Origins and Provenance of the English Bishops during the Reign of Edward II

1959 ◽  
Vol 9 ◽  
pp. 51-79
Author(s):  
K. Edwards
Keyword(s):  
Middle Ages ◽  
Social Background ◽  
Early Career ◽  
The Political ◽  
Social Origins ◽  
Political Activities ◽  
Edward Ii ◽  
The Social ◽  
Complete Study ◽  
History Of

During the last twenty or twenty-five years medieval historians have been much interested in the composition of the English episcopate. A number of studies of it have been published on periods ranging from the eleventh to the fifteenth and early sixteenth centuries. A further paper might well seem superfluous. My reason for offering one is that most previous writers have concentrated on analysing the professional circles from which the bishops were drawn, and suggesting the influences which their early careers as royal clerks, university masters and students, secular or regular clergy, may have had on their later work as bishops. They have shown comparatively little interest in their social background and provenance, except for those bishops who belonged to magnate families. Some years ago, when working on the political activities of Edward II's bishops, it seemed to me that social origins, family connexions and provenance might in a number of cases have had at least as much influence on a bishop's attitude to politics as his early career. I there fore collected information about the origins and provenance of these bishops. I now think that a rather more careful and complete study of this subject might throw further light not only on the political history of the reign, but on other problems connected with the character and work of the English episcopate. There is a general impression that in England in the later middle ages the bishops' ties with their dioceses were becoming less close, and that they were normally spending less time in diocesan work than their predecessors in the thirteenth century.

Individual differences, social attention, and the history of the social motivation hypotheses of autism

2019 ◽  
Vol 42 ◽  
Author(s):  
Peter C. Mundy
Keyword(s):  
Individual Differences ◽  
Early Development ◽  
Emotional Development ◽  
Social Motivation ◽  
Social Attention ◽  
Social Emotional Development ◽  
Social Emotional ◽  
Precise Understanding ◽  
The Social ◽  
History Of

Abstract The stereotype of people with autism as unresponsive or uninterested in other people was prominent in the 1980s. However, this view of autism has steadily given way to recognition of important individual differences in the social-emotional development of affected people and a more precise understanding of the possible role social motivation has in their early development.

Special Considerations for Evaluation and Treatment of Spanish-Speaking Patients with Cleft Palate

2016 ◽  
Vol 1 (5) ◽  
pp. 41-49
Author(s):  
Ellen Moore
Keyword(s):  
Cleft Palate ◽  
The United States ◽  
Culturally Competent ◽  
Speech Language Pathology ◽  
Spanish Speaking ◽  
Appropriate Treatment ◽  
Oral Pressure ◽  
Language Pathology ◽  
History Of ◽  
Spanish Speaking Population

As the Spanish-speaking population in the United States continues to grow, there is increasing need for culturally competent and linguistically appropriate treatment across the field of speech-language pathology. This paper reviews information relevant to the evaluation and treatment of Spanish-speaking and Spanish-English bilingual children with a history of cleft palate. The phonetics and phonology of Spanish are reviewed and contrasted with English, with a focus on oral pressure consonants. Cultural factors and bilingualism are discussed briefly. Finally, practical strategies for evaluation and treatment are presented. Information is presented for monolingual and bilingual speech-language pathologists, both in the community and on cleft palate teams.

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