scholarly journals Imaging diagnosis of paranasal sinus mucocele in a Yorkshire Terrier dog

2021 ◽  
Author(s):  
D Noh ◽  
B Shin ◽  
HG Shin ◽  
K Lee
Keyword(s):  
Bacterial Culture ◽  
Poor Response ◽  
Pharmacological Therapy ◽  
Imaging Diagnosis ◽  
Cytologic Examination ◽  
Fluid Content ◽  
Imaging Characteristics ◽  
History Of ◽  
Histopathologic Findings ◽  
Yorkshire Terrier

An 8-year-old, neutered male Yorkshire Terrier dog presented with left ventromedial canthus swelling over a one-month period, refractory to pharmacological therapy. There was no history of trauma. On ultrasonography, the lesion had a cystic character filled with anechoic fluid and hyperechoic sedimenting debris. The computed tomography (CT) and CT-dacryocystography showed a cystic lesion protruding from the lacrimal sac fossa and occupying a defect in the orbital plate and an ethmoidal ectoturbinate surrounded by a bony structure with an intact nasolacrimal system. The dog underwent the surgical resection of the cyst and its fluid content was aspirated. Ethmoid mucocele was diagnosed based on the CT, cytologic examination, bacterial culture and histopathologic findings. This case describes the imaging characteristics of an ethmoid mucocele and highlights the importance of CT and CT-dacryocystography in dogs with ventromedial canthus swelling that had poor response to medical treatment.

Stridor: a rare presentation of motor neuron disease

2021 ◽  
Vol 14 (7) ◽  
pp. e241923
Author(s):  
Brian Gordon ◽  
Eimear Joyce ◽  
Timothy J Counihan
Keyword(s):  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Vocal Cord ◽  
Poor Response ◽  
Vocal Cord Palsy ◽  
Pharmacological Therapy ◽  
Rare Presentation ◽  
Emergency Tracheostomy ◽  
Life Threatening ◽  
History Of

A 74-year-old farmer presented to the emergency department with a subacute history of progressive dyspnoea, wheeze and dysphonia. He was treated for an exacerbation of asthma with poor response to pharmacological therapy. Investigation of dysphonia via laryngoscopy identified a bilateral vocal cord palsy. Subsequently, the patient developed an episode of life-threatening stridor and hypercapnic respiratory failure requiring an emergency tracheostomy. Neurology input identified evidence of widespread muscle fasciculations on clinical examination. MRI of the brain and cervical spine were unremarkable. Electromyogram testing identified changes of acute denervation in several limbs consistent with a diagnosis of motor neuron disease (MND). Bilateral vocal cord palsy has been rarely reported in the literature as the heralding symptom resulting in the diagnosis of MND. In patients with a subacute onset of dysphonia, dyspnoea and stridor, MND should be a differential diagnosis.

scholarly journals Pre-Operative Imaging and Pathological Diagnosis of Localized High-Grade Pancreatic Intra-Epithelial Neoplasia without Invasive Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 945
Author(s):  
Ryota Sagami ◽  
Kentaro Yamao ◽  
Jun Nakahodo ◽  
Ryuki Minami ◽  
Masakatsu Tsurusaki ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Invasive Carcinoma ◽  
Current Knowledge ◽  
Precancerous Lesions ◽  
Ductal Adenocarcinoma ◽  
Pancreatic Ducts ◽  
High Grade ◽  
Cytologic Examination ◽  
Imaging Characteristics ◽  
Retention Cysts

Pancreatic ductal adenocarcinoma (PDAC) arises from precursor lesions, such as pancreatic intra-epithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasm (IPMN). The prognosis of high-grade precancerous lesions, including high-grade PanIN and high-grade IPMN, without invasive carcinoma is good, despite the overall poor prognosis of PDAC. High-grade PanIN, as a lesion preceding invasive PDAC, is therefore a primary target for intervention. However, detection of localized high-grade PanIN is difficult when using standard radiological approaches. Therefore, most studies of high-grade PanIN have been conducted using specimens that harbor invasive PDAC. Recently, imaging characteristics of high-grade PanIN have been revealed. Obstruction of the pancreatic duct due to high-grade PanIN may induce a loss of acinar cells replaced by fibrosis and lobular parenchymal atrophy. These changes and additional inflammation around the branch pancreatic ducts (BPDs) result in main pancreatic duct (MPD) stenosis, dilation, retention cysts (BPD dilation), focal pancreatic parenchymal atrophy, and/or hypoechoic changes around the MPD. These indirect imaging findings have become important clues for localized, high-grade PanIN detection. To obtain pre-operative histopathological confirmation of suspected cases, serial pancreatic-juice aspiration cytologic examination is effective. In this review, we outline current knowledge on imaging characteristics of high-grade PanIN.

scholarly journals The Temporomandibular Joint in a Rheumatoid Arthritis Patient after Orthodontic Treatment

2009 ◽  
Vol 79 (4) ◽  
pp. 804-811 ◽  
Author(s):  
Kenichi Sasaguri ◽  
Rika Ishizaki-Takeuchi ◽  
Sakurako Kuramae ◽  
Eliana Midori Tanaka ◽  
Takashi Sakurai ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Mouth Opening ◽  
Pharmacological Therapy ◽  
Open Bite ◽  
Anterior Open Bite ◽  
Orthodontic Therapy ◽  
Japanese Female ◽  
Severe Erosion ◽  
Old Japanese ◽  
History Of

Abstract A 32-year-old Japanese female patient consulted the authors' dental clinic with a 4.5-year history of rheumatoid arthritis (RA). She complained of pain during mouth opening and difficulty in eating due to masticatory dysfunction caused by an anterior open bite. Imaging showed severe erosion and flattening of both condyles. RA stabilized after pharmacological therapy and became inactive during the orthodontic therapy aimed at reconstructing an optimal occlusion capable of promoting functional repositioning of the mandible. At present, 4 years and 2 months postretention, the reconstructed occlusion remains stable, and both condyles continue to be remodeled. The distance from reference position to intercuspal position has gradually decreased throughout the 4-year posttreatment and postretention periods. Orthodontic therapy that comprehensively reconstructs occlusion and enhances the functioning of the mandible can induce remodeling of eroded condyles, even those with a history of rheumatoid arthritis.

scholarly journals Venipuncture Induced Complex Regional Pain Syndrome Presenting as Inflammatory Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Punit Pruthi ◽  
Pramod Arora ◽  
Manoj Mittal ◽  
Anugrah Nair ◽  
Waqia Sultana
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Inflammatory Arthritis ◽  
Young Male ◽  
Pain Syndrome ◽  
Poor Response ◽  
History Of ◽  
Diagnostic Modalities ◽  
Musculoskeletal Ultrasonography ◽  
The Right

Venipuncture is one of the most commonly done medical procedures. We report a unique case of a 23-year-old young male who presented with features suggestive of inflammatory arthritis. The symptoms, which initially started on the right side, also involved the other side after a few weeks. Although the patient’s symptoms and signs were simulating inflammatory arthritis, he had atypical features like poor response to anti-inflammatory medicines and normal laboratory parameters. His musculoskeletal ultrasonography was also not suggestive of arthritis. His history was reviewed and on direct questioning he revealed a history of venipuncture for blood sample withdrawal, done from right antecubital region for routine health check on the day prior to the onset of symptoms. Complex regional pain syndrome was suspected and triple-phase radioisotope bone scan was done which was highly suggestive of this diagnosis. The patient was managed with multidimensional approach and responded very well to the treatment. Complex regional pain syndrome is usually not thought of in the initial differential diagnosis of inflammatory arthritis. In this report we highlight the need to elicit the often overlooked history of trivial trauma like venipuncture, especially in atypical cases of arthritis. Also the role of newer diagnostic modalities in such cases is emphasized.

Phlegmonous gastritis in 2 yearling horses

2022 ◽  
pp. 104063872110650
Author(s):  
Julie B. Engiles ◽  
Francisco A. Uzal ◽  
Mauricio A. Navarro ◽  
Virginia B. Reef ◽  
Susan J. Bender
Keyword(s):  
Clinical Signs ◽  
Poor Response ◽  
Abdominal Ultrasound ◽  
Mucosal Injury ◽  
Response To Treatment ◽  
Bacterial Populations ◽  
Proliferative Enteropathy ◽  
Mucosal Involvement ◽  
Phlegmonous Gastritis ◽  
History Of

Phlegmonous gastritis was diagnosed in 2 yearling fillies that were presented with a 1-wk history of fever, lethargy, and hypoproteinemia, associated with a previous diagnosis of equine proliferative enteropathy based on clinical signs and PCR assay detection of Lawsonia intracellularis in fecal samples. Abdominal ultrasound revealed enlargement of the stomach and expansion of its submucosal layer with hypoechoic fluid, as well as thickened hypomotile small intestinal segments. Given the poor prognosis and poor response to treatment, both horses were euthanized, one on the day of presentation and the other after 3 wk of intensive medical management including a combination of antimicrobials, analgesics, and intravenous colloids. At autopsy, acute mural gastritis characterized by severe submucosal edema with suppurative inflammation (i.e., phlegmonous gastritis) and necroulcerative enteritis compatible with the necrotizing form of equine proliferative enteropathy were identified in both horses. The gastric inflammation was associated with thrombosis and mixed bacterial populations, including Clostridium perfringens, that were confined to the submucosa without evidence of mucosal involvement; toxin genes compatible with C. perfringens type C were identified in one case. Human phlegmonous gastritis is an uncommon, often-fatal pyogenic infection that is often associated with mucosal injury, bacteremia, or immunocompromise. Our finding of this unusual gastric lesion in 2 horses with similar signalment, clinical disease, and spectrum of postmortem lesions suggests a similar etiopathogenesis that possibly involves local, regional, or distant hematogenous origin, and should be considered a potential complication of gastrointestinal mucosal compromise in horses.

scholarly journals Transcranial Brain Stimulation Techniques For Major Depression: Should We Extend TMS Lessons to tDCS?

2014 ◽  
Vol 10 (1) ◽  
pp. 92-93 ◽  
Author(s):  
Bernardo Dell’Osso ◽  
A. Carlo Altamura
Keyword(s):  
Major Depression ◽  
Brain Stimulation ◽  
Randomized Clinical Trials ◽  
Cortical Excitability ◽  
Poor Response ◽  
Electrical Current ◽  
Non Invasive ◽  
Dorsolateral Prefrontal ◽  
History Of ◽  
Patient’S History

Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation techniques that, by means of magnetic fields and low intensity electrical current, respectively, aim to interefere with and modulate cortical excitability, at the level of dorsolateral prefrontal cortex, in patients with major depression and poor response to standard antidepressants. While the clinical efficacy of TMS in major depression has been extensively investigated over the last 10 years, tDCS has attracted research interest only in the last years, with fewer randomized clinical trials (RCTs) in the field. Nevertheless, in spite of the different rationale and mechanism of action of the two techniques, tDCS recent acquisitions, in relation to the treatment of major depression, seem to parallel those previously obtained with TMS, in terms of treatment duration to achieve optimal benefit and patient's history of drug-resistance. After briefly introducing the two techniques, the article examines possible common pathways of clinical use for TMS and tDCS, emerging from recent RCTs and likely orienting future investigation with non invasive brain stimulation for the treatment of major depression.

scholarly journals Identifying Cutaneous Allodynia in Chronic Migraine Using a Practical Clinical Method

Cephalalgia ◽  
2007 ◽  
Vol 27 (2) ◽  
pp. 111-117 ◽  
Author(s):  
A Ashkenazi ◽  
M Sholtzow ◽  
JW Shaw ◽  
R Burstein ◽  
WB Young
Keyword(s):  
Chronic Migraine ◽  
Demographic Data ◽  
Poor Response ◽  
Practical Method ◽  
Episodic Migraine ◽  
Entire Study ◽  
Clinical Method ◽  
Cutaneous Allodynia ◽  
History Of ◽  
Acute Headache

Cutaneous allodynia is common in migraine. In the majority of previous studies on allodynia in migraine, only patients with episodic migraine (EM) were included. Little is known on patterns of allodynia in chronic migraine (CM). Since the presence of allodynia is associated with a poor response to triptans, a clinically practical method to test migraine patients for allodynia would be useful to the clinician. The aim of this study was to assess the prevalence of dynamic mechanical (brush) allodynia (BA) in CM, using a clinically practical method. Eighty-nine CM patients were prospectively recruited. Patients were given a structured questionnaire regarding demographic data and migraine characteristics. Allodynia was tested using a 10 x 10-cm gauze pad to brush various areas of the skin lightly. The prevalence of BA in the entire study population and in different patient subgroups was calculated. BA was present in 42.7% (38/89) of the patients. The presence of allodynia was unrelated to age, disease duration or to the occurrence of an acute headache exacerbation at the time of testing. Allodynia was positively associated with a history of migraine aura. BA was most common in the cephalic area, but was also seen in cervical dermatomes. BA is common in CM and, unlike in EM, is not significantly affected by the occurrence of an acute headache exacerbation. This suggests that central trigeminovascular neurons are chronically sensitized in patients experiencing migraine headache >15 days per month. The testing of BA in the clinical setting is possible using a simple and brief approach. It allows the clinician to determine whether the patient is sensitized, a diagnosis that affects treatment decisions.

The Role of Tobacco Cessation, Antiplatelet and Lipid-Lowering Therapies in the Treatment of Peripheral Arterial Disease

1997 ◽  
Vol 2 (3) ◽  
pp. 243-251 ◽  
Author(s):  
Alan T Hirsch ◽  
Diane Treat-Jacobson ◽  
Harry A Lando ◽  
Dorothy K Hatsukami
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Pharmacological Therapy ◽  
Current Data ◽  
Lipid Lowering ◽  
History Of ◽  
Medical Therapies ◽  
Peripheral Arterial ◽  
Interventional Therapies

Despite the widely held belief that there are no effective medical therapies for peripheral arterial disease (PAD), current data suggest that medical therapies can effectively modify the natural history of atherosclerotic lower extremity arterial occlusive disease. The ideal medical therapy would improve claudication, forestall the onset of limb-threatening events, decrease rates of invasive interventional therapies and improve long-term patient survival. These ideal outcomes might be achieved through the use of smoking cessation interventions, including behavioral and pharmacological therapy, and the administration of antiplatelet and lipid-lowering medications in patients with PAD.

Diagnosis and treatment of Candida glabrata proventriculitis in an eclectus parrot (Eclectus roratus)

2021 ◽  
pp. 1-8
Author(s):  
Kyra J. Berg ◽  
David Sanchez-Migallon Guzman ◽  
Joanne Paul-Murphy ◽  
Michelle G. Hawkins ◽  
Barbara A. Byrne
Keyword(s):  
Candida Glabrata ◽  
Fungal Infections ◽  
Clinical Signs ◽  
Antifungal Treatment ◽  
Coelomic Fluid ◽  
Fecal Culture ◽  
Cytologic Examination ◽  
Contrast Enhanced Ct ◽  
History Of ◽  
Upper Gastrointestinal

Abstract CASE DESCRIPTION An 8-year-old sexually intact female eclectus parrot (Eclectus roratus) with a 4-day history of hyporexia and lethargy and a 1-day history of tenesmus was examined. CLINICAL FINDINGS Severe leukocytosis characterized by severe heterophilia and moderate monocytosis was present. Marked dilation of the proventriculus and ventriculus and ascites were identified by means of radiography, coelomic ultrasonography, and contrast-enhanced CT, with no clinically relevant motility noted on ultrasonography. Results of coelomic fluid analysis were consistent with pyogranulomatous effusion. Endoscopy of the upper gastrointestinal tract following proventricular and ventricular lavage showed a thick caseous plaque occupying 30% of the caudal proventricular mucosa. Abundant yeast organisms were evident during cytologic examination of a proventricular and ventricular wash sample, and fecal culture yielded Candida glabrata. TREATMENT AND OUTCOME The bird was treated with SC fluids, assisted feedings, nystatin, fluconazole, amoxicillin–clavulanic acid, enrofloxacin, gastroprotectants, maropitant, and analgesics and slowly improved during hospitalization. A marked decrease in proventricular dilation was evident on serial radiographs obtained over a 12-month period. One year after diagnosis, the bird was presented with a 1-week history of hyporexia and lethargy, and fecal culture grew C glabrata. Antifungal treatment was resumed for 3 months. The bird had no clinical signs of infection 16 months after this recurrence, and subsequent fecal cultures were negative for fungal growth. CLINICAL RELEVANCE Findings illustrate the importance of upper gastrointestinal endoscopy in diagnosing proventricular and ventricular dilation in birds and emphasize the need for long-term antifungal treatment and monitoring in birds with fungal infections.

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