scholarly journals Endoscopic findings, microbiological and cytological evaluation of tracheal aspirates in a population of Standardbred horses with poor performances

2009 ◽  
Vol 54 (No. 9) ◽  
pp. 444-450 ◽  
Author(s):  
F. Laus ◽  
A.R. Attili ◽  
M. Cerquetella ◽  
A. Spaterna ◽  
B. Tesei ◽  
...  
Keyword(s):  
Burkholderia Cepacia ◽  
Regional Distribution ◽  
Endoscopic Examination ◽  
Statistical Association ◽  
Cytological Evidence ◽  
Airway Diseases ◽  
Streptococcus Equi ◽  
Prolonged Recovery ◽  
History Of ◽  
Tracheal Aspirates

Sixty-two Standardbred horses housed at the same racetrack, with history of reduced exercise tolerance, cough lasting for at least two weeks and/or prolonged recovery time were clinically examined. An endoscopic examination of the nasopharynx, larynx and trachea to the level of the carina was performed, amount of mucus in trachea was registered and samples of tracheal wash for cytological and microbiological examinations was collected. A strong statistical association between amount of mucus in trachea and neutrophils percentage in tracheal wash was found. Bacteria isolated included <i>Streptococcus equi</i> subsp. <i>zooepidemicus</i> (14 horses), <i>Streptococcus pneumoniae</i> (four horses), <i>S. mutans</i> (four horses), <i>S. equinus</i> (four horses) and <i>Burkholderia cepacia</i> (10 horses). <i>S. zooepidemicus</i> and <i>S. pneumoniae</i> were associated with elevated amount of mucus and increased neutrophilic percentage. <i>B. cepacia</i> was associated with cytological evidence of haemosiderophages but its role in racehorses needs further investigations. <i>Mycoplasma</i> spp. and <i>Pasteurella</i> spp. have not been isolated, suggesting that, as for the other putative causes of inflammatory airway diseases, infection could have a regional distribution among horse populations. This study shows that various types of airway inflammations exist in the examined population and that <i>S. zooepidemicus</i> and <i>S. pneumoniae</i> could play an important role in etiopathogenesis of airway inflammation in some horses. Particulate matter, pro-inflammatory agents or noxious gases present in the stables or on the track matter, could be the cause of inflammation in non infected horses.

An Obscure Colon Dilatation and its Underlying Cause: Case Report and Literature Review

2020 ◽  
pp. 1-5
Author(s):  
Anton Stift ◽  
Kerstin Wimmer ◽  
Felix Harpain ◽  
Katharina Wöran ◽  
Thomas Mang ◽  
...  
Keyword(s):  
Case Report ◽  
Sigmoid Colon ◽  
Immunohistochemical Staining ◽  
Late Onset ◽  
Hirschsprung Disease ◽  
Endoscopic Examination ◽  
Case Presentation ◽  
Idiopathic Megacolon ◽  
History Of ◽  
Cells Of Cajal

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.

scholarly journals Schwannoma of the Supraglottis

2021 ◽  
pp. 014556132110185
Author(s):  
Reena Gupta ◽  
Ariel M. Azhdam ◽  
Michela Borrelli
Keyword(s):  
Endoscopic Examination ◽  
Airway Compromise ◽  
Operative Site ◽  
History Of

Hoarseness lasting greater than 2 weeks should be thoroughly evaluated. Here, a case is presented of a 38-year-old female with a 10-year history of dysphonia. Endoscopic examination confirmed the presence of a supraglottic mass, for which operative biopsy and imaging were performed. Pathology confirmed the diagnosis of supraglottic schwannoma. This was excised endoscopically with close management postoperatively to monitor for rapid recurrence and airway compromise. At one month postoperatively, the patient is still mildly dysphonic but vocally improved and the operative site continues to heal well.

scholarly journals TWO YEARS FOLLOW UP AFTER ERADICATION THERAPY OF PEPTIC ULCER

2020 ◽  
pp. 28-31
Author(s):  
HASSAN KHUDER RAJAB ◽  
ALI ESMAIL AL-SNAFI
Keyword(s):  
Peptic Ulcer ◽  
Eradication Therapy ◽  
Endoscopic Examination ◽  
Urea Breath Test ◽  
Ulcer Recurrence ◽  
Follow Up Study ◽  
History Of ◽  
Second Year ◽  
H Pylori

Objective: This study was performed to detect the recurrence rate for two years after eradication therapy of peptic ulcer. Methods: Sixty-nine patients included in this study in Kirkuk city from January 2004 to January 2005 as 1st year follow up, and 49 patients from January 2005 to January 2006 as second year follow up study. A urea breath test and re-endoscopic examination were carried out to confirm peptic ulcer recurrence. A questionnaire was prepared to take the history of the disease and other relevant data of each patient. Results: The recurrence was occurred in 6 (8.7%) and 8 patients (16.33%) in the 1st and 2nd years after eradication therapy. Highly risk of recurrence was smoking, age below 50 y and stress in 1st year follow up, and stress was the highly risk in the 2nd year follow up. Conclusion: After triple and quadruple therapy of peptic ulcer, the recurrence is low, However, the possibility of H. pylori resistance should be considered.

scholarly journals Prevalence of Gerlach tonsil: a mucosa associated lymphoid tissue aggregation in the nasopharynx

2020 ◽  
Vol 7 (1) ◽  
pp. 39
Author(s):  
Ramesh Varadharajan ◽  
Sonee Thingujam
Keyword(s):  
Lymphoid Tissue ◽  
Nasal Polyposis ◽  
Chronic Sinusitis ◽  
Past History ◽  
Endoscopic Examination ◽  
Adult Patients ◽  
Nasal Endoscopy ◽  
Adult Study ◽  
History Of ◽  
Serous Otitis Media

<p class="abstract"><strong>Background:</strong> The major aggregate of mucosa associated lymphoid tissue located in the nasopharynx is the adenoid. The minor aggregate located in the nasopharynx is the Gerlach tonsils or tubal tonsils. The Gerlach tonsils are well described in the text books. But unlike the adenoids they are rarely visualized during routine endoscopic examination. Several studies conducted in children for recurrence of adenoids or serous otitis media after surgery; have reported tubal tonsil hypertrophy widely. This study in adults aims to see the prevalence of Gerlach or tubal tonsils visible during nasal endoscopy.</p><p class="abstract"><strong>Methods:</strong> The case records of 155 adult patients, aged between 18-50 years, who underwent pre-operative diagnostic nasal endoscopy for the management of septal deviations, chronic Sinusitis, nasal polyposis or eustachian dysfunction between Jan. 2019 to March 2020 are retrospectively reviewed and the endoscopy findings analyzed and presented.   </p><p class="abstract"><strong>Results:</strong> Gerlach tonsil hypertrophy is reported to be more prevalent in children than in adults.  When hypertrophied, the Gerlach tonsils can cause symptoms in adults also and can be visualized during nasal endoscopy. In this adult study, we report a 0.6% incidence of Gerlach tonsil hypertrophy.  </p><p class="abstract"><strong>Conclusions:</strong> The possibility of a Gerlach tonsil hypertrophy is to be remembered during nasal endoscopy in adult patients presenting with symptoms of eustachian dysfunction and past history of allergic rhinitis and adeno tonsillectomy. Comparing the size of the contra lateral torus tubaris and the eustachian tube opening during the act of swallowing is helpful in diagnosis.</p>

scholarly journals Acquired Tracheo-Esophageal Fistula : A Rare Case Report of the Neglected Denture

2018 ◽  
Vol 5 ◽  
Author(s):  
Sharir Asrul Bin Asnawi ◽  
Mohamad Bin Doi ◽  
Abdul Rahman Hikmet Shaker ◽  
Mawaddah Binti Azman
Keyword(s):  
Foreign Body ◽  
Endoscopic Examination ◽  
Esophageal Fistula ◽  
Medical Assessment ◽  
Radiological Investigation ◽  
Rare Case Report ◽  
Patient Will ◽  
Ingested Foreign Body ◽  
History Of ◽  
Background History

Introduction: Dentures are common accidental ingested foreign body (FB) especially among elderly. It is frequent to have foreign body impacted at esophagus in adults however it is very unsual to have Tracheo-esophageal fistula (TEF) caused by denture. The diagnosis of TEF is challenging due to two reasons. Firstly, most of the dental prosthesis is radiolucent and not visible in routine radiological investigation. Secondly, patient with history of swallowed dentures prosthesis may be asymptomatic initially and develops symptoms over time. In contrary, prolonged history of FB in esophagus with TEF has higher risk to develop serious complication such as pneumonia and lung abscess.Case Presentation: We report a case of 62 year old gentleman with background history of hypertension and temporal lobe epilepsy presented with history of choking on taking solid and liquid associated with significant weight loss past 2 months. He had lost his denture for almost 1 year during sleep. Endoscopic examination of the larynx showed normal anatomy but pooling of saliva. CT thorax showed foreign body within a tracheoesophgeal fistula. OGDS showed denture within a well formed tracheoesophageal fistula. He had acquired TEF secondary to the dentures. Conclusion: Symptomatic elderly who lose their denture during sleep should not be neglected. They need immediate medical assessment thus will reduce further debilitating complication. Failing to identify and treat this condition urgently, patient will suffer acquired trachea-oesophageal fistula on which the treatment is challenging and the morbidity and mortality is high.

scholarly journals Unusual presentations of a severe type 2 leprosy reaction mimicking sepsis induced by helminth infection

2021 ◽  
Vol 15 (7) ◽  
pp. e0009453
Author(s):  
Sri Linuwih Menaldi ◽  
Anastasia Asylia Dinakrisma ◽  
Hok Bing Thio ◽  
Iris Rengganis ◽  
Salma Oktaria
Keyword(s):  
Septic Shock ◽  
Unusual Case ◽  
Helminth Infection ◽  
Endoscopic Examination ◽  
Course Of Illness ◽  
Source Of Infection ◽  
Helminth Infections ◽  
History Of ◽  
Severe Type

We describe an unusual case of type 2 leprosy reaction (T2R) with septic shock–like features induced by helminth infection in a 31-year-old Moluccan male patient with a history of completed treatment of WHO multidrug therapy (MDT)–multibacillary (MB) regimen 2 years before admission. During the course of illness, the patient had numerous complications, including septic shock, anemia, and disseminated intravascular coagulation (DIC). Nevertheless, antibiotic therapies failed to give significant results, and the source of infection could not be identified. Helminth infection was subsequently revealed by endoscopic examination followed by parasitological culture. Resolution of symptoms and normal level of organ function–specific markers were resolved within 3 days following anthelmintic treatment. This report demonstrated the challenge in the diagnosis and treatment of severe T2R. Given that helminth infections may trigger severe T2R that mimics septic shock, health professionals need to be aware of this clinical presentation, especially in endemic regions of both diseases.

scholarly journals Protestant cemeteries in Czechia: a necrogeographical perspective

Geografie ◽  
2016 ◽  
Vol 121 (1) ◽  
pp. 187-207
Author(s):  
Zdeněk R. Nešpor
Keyword(s):  
20Th Century ◽  
18Th Century ◽  
Regional Distribution ◽  
Social Geography ◽  
Data Sources ◽  
Important Research ◽  
History Of ◽  
Research Questions ◽  
Czech Lands ◽  
The Impact

The article introduces the field of necrogeography to Czech social geography and provides information on existing (nationwide) data sources. The author takes the issue of Protestant confessional cemeteries as an example, briefly outlines the history of these special types of burial fields (established principally from the end of the 18th century until approximately the mid-20th century), and provides a historical geographical analysis of their regional distribution in the Czech Lands. The article proves the impact of religious and geographical factors on the emergence (and eventual demise) of non-Catholic Christian confessional cemeteries and, at the same time, the research unveiled a number of important research questions to be addressed by Czech necrogeography in the future.

scholarly journals Diagnostic Exercise: Equine Rhabdomyolysis

2011 ◽  
Vol 48 (6) ◽  
pp. E52-E59 ◽  
Author(s):  
E. M. Quist ◽  
J. J. Dougherty ◽  
M. K. Chaffin ◽  
B. F. Porter
Keyword(s):  
Skeletal Muscles ◽  
Nasal Discharge ◽  
Muscular Pain ◽  
Immune Mediated ◽  
Muscular Disorders ◽  
Streptococcus Equi ◽  
Quarter Horse ◽  
History Of ◽  
Polymerase Chain ◽  
Muscle Groups

A 1.5-year-old Quarter Horse gelding with a history of chronic nasal discharge and leukocytosis presented with signs of increased lethargy and muscular pain. The horse quickly became recumbent and unable to rise and was euthanized due to a poor prognosis. At necropsy, severe bilateral guttural pouch empyema was observed, as well as numerous well-demarcated areas of pallor within the skeletal muscles of all major muscle groups. Polymerase chain reaction testing of the guttural pouch exudate confirmed an infection with Streptococcus equi subsp. equi, and an S. equi–associated immune-mediated rhabdomyolysis was initially considered to be the most likely diagnosis. This report briefly discusses the various etiologies that should be considered in cases of equine myopathy, and it demonstrates the complexity of these poorly understood muscular disorders.

Adult-onset otitis media with effusion: results following ventilation tube insertion

2001 ◽  
Vol 115 (11) ◽  
pp. 874-878 ◽  
Author(s):  
M. W. Yung ◽  
R. Arasaratnam
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Previous History ◽  
Endoscopic Examination ◽  
Lateral Nasal Wall ◽  
Adult Onset ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Prick Test ◽  
History Of

The outcome of otitis media with effusion (OME) in children is generally good. However, it is less clear in adults. All adult patients who had a ventilation tube inserted for OME at the Ipswich Hospital between 1996 and 1997 were studied. Of 53 patients studied, 28 had had a previous history of ventilation tube insertion. Furthermore, at 15–27 months following ventilation tube insertion, the ventilation tube had already extruded in 31 patients and the OME had already recurred in 19 of these. Endoscopic examination revealed that many patients still had evidence of inflammation at the lateral nasal wall (26.4 per cent) and at the eustachian tube orifice (51 per cent). There is also a strong history of atopy in the studied group and the skin prick test was positive in 57 per cent of the patients. This study shows that many patients with adult-onset OME have underlying pathology that could lead to recurrence of OME following ventilation tube extrusion.

scholarly journals Predictors of delayed recovery following pediatric sports-related concussion: a case-control study

2016 ◽  
Vol 17 (4) ◽  
pp. 491-496 ◽  
Author(s):  
Joseph H. Miller ◽  
Clarence Gill ◽  
Elizabeth N. Kuhn ◽  
Brandon G. Rocque ◽  
Joshua Y. Menendez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Symptom Severity ◽  
Case Control Study ◽  
Case Control ◽  
Health Concern ◽  
Female Sex ◽  
Prolonged Recovery ◽  
History Of ◽  
Delayed Recovery ◽  
Control Study

OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51–8.95), presenting SCAT2 score < 80 (aOR 5.58, 95% CI 2.61–11.93), and female sex (aOR 3.48, 95% CI 1.43–8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93–10.07 and aOR 3.87, 95% CI 1.13–13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28–5.26 and OR 2.17, 95% CI 0.99–7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.

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