scholarly journals Long term complications following polyacrylamide hydrogel breast augmentation: a case report and review of the literature

2021 ◽  
Vol 8 (3) ◽  
pp. 994
Author(s):  
Justin J. Weller
Keyword(s):  
Breast Augmentation ◽  
Polyacrylamide Hydrogel ◽  
Careful Monitoring ◽  
Rare Presentation ◽  
Increased Risk ◽  
Close Observation ◽  
Operative Planning ◽  
Institutional Experience ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Complications from Polyacrylamide hydrogel breast augmentation (PHBA) are a rare cause for presentation in Australia. I reviewed the literature and analysed our institutional experience in order to familiarise clinicians with this rare procedure. I present the case of a 44 year-old female with a three-year history of intermittent right lateral breast pain. She had a background of breast augmentation with Interfall Gel in China in 2000. She was tender over the lateral aspect of her breast which was exacerbated by physical activity. An magnetic resonance imaging (MRI) revealed areas of extravasation bilaterally with no suspicious lesions and the specialist opinion was for close observation in six months. Although a rare presentation, Australia’s population has many emigrates from Asian nations and further presentations are to be expected. The literature clearly supports the importance of careful monitoring of these patients, due to the potential for severe complications such as infection, sepsis, breast auto-inflation, significant tenderness and possibly increased risk of breast malignancy. MRI is also crucial in evaluating these cases, namely to rule out malignancy and for pre-operative planning in severe cases. However, the majority of presentations are suitable for careful monitoring.

scholarly journals Empty Sella Syndrome with Typical Facies: A Case Report

2021 ◽  
Author(s):  
Megha Mukundan ◽  
Prativa Sethi ◽  
Prasan Kumar Panda
Keyword(s):  
Empty Sella ◽  
Total Testosterone ◽  
Ataxic Gait ◽  
Rare Presentation ◽  
Empty Sella Syndrome ◽  
History Of ◽  
Loss Of Libido ◽  
Magnetic Resonance Imaging Mri ◽  
Work Up

Empty Sella syndrome with typical facies is a rare presentation of panhypopituitarism. Here, authors presented a case of 45-year- old male with a history of altered behaviour such as low mood, passivity, talkativeness with low-hoarse voice and spells of cries for three months. He also had headache, vomiting, abdominal pain, ataxic gait, and loss of libido. He had meningitis 10 years back since then he had multiple similar episodes. He had sparse thinned out hair, male pattern temporal balding, madarosis, brownish pigmentation of face and chest and dry coarse skin. Patient had hypotension but without hypoperfusion. Hormone levels including thyroid hormones, Follicle Stimulating Hormone (FSH), Luteinizing hormone (LH), total testosterone cortisol, and plasma Adrenocorticotropic Hormone (ACTH) were less than normal. Magnetic Resonance Imaging (MRI) brain suggested streak pituitary gland (empty sella). He was supplemented with required hormones. On follow-up, he improved significantly. Trio composite hypothyroidism, hypocortisolism, and hypogonadism have characteristic facies. This unique presentation of patient with blank look facies gives a hint of empty sella, thus leading the clinician to diagnose the disease through timely evaluation and work-up.

scholarly journals Multiple myeloma revealed by a sphenoid plasmocytoma: case report and literature review

2016 ◽  
Vol 3 (2) ◽  
pp. 57-59
Author(s):  
Selma Kadiri
Keyword(s):  
Multiple Myeloma ◽  
Positive Staining ◽  
Resonance Imaging ◽  
Rare Presentation ◽  
Sphenoidal Sinus ◽  
Biological Studies ◽  
Plasma Cell Neoplasms ◽  
Gamma Peak ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Plasma cell neoplasms can manifest as a solitary or multiple plasmocytomas and may be associated with or progressing to multiple myeloma (MM). Cranial and intracranial plasmocytomas revealing multiple myeloma are very rare and only few cases are reported in the literature. We report the case of a sphenoid plasmocytoma that revealed a multiple myeloma in a 56 year-old woman with 3 months history of temporal headache and diplopia. Magnetic resonance imaging (MRI) and computed tomography (CT) showed a sphenoid mass. An endoscopic sphenoidal biopsy was performed and the histopathological exams showed a plasmocytoma with a positive staining for CD138. Further biological studies confirmed the diagnosis of multiple myeloma with a monoclonal gamma peak of immunoglobulin (Ig) A. The patient started systemic chemotherapy and received decompressive radiation therapy on the sphenoidal sinus. She remained in remission for 8 months and died from renal dysfunction. Although the sphenoid plasmocytoma is a very rare presentation of multiple myeloma it should be considered for effective patient management and prognosis improvement

scholarly journals Spinal Syphilitic Gumma: A Rare Presentation of an Old Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Dominic Worku ◽  
Angela Houston ◽  
Catherine Cosgrove ◽  
Laura Byrne
Keyword(s):  
White Cell Count ◽  
Treponema Pallidum ◽  
Hiv Positive ◽  
High Dose ◽  
Molecular Testing ◽  
Rare Presentation ◽  
Csf Analysis ◽  
Positive Individual ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Syphilis is an ancient condition which still is of global concern today. Despite better awareness amongst clinicians and improving diagnostics, it remains likely underdiagnosed in part because of its namesake the ‘great imitator.’ While many patients suffer primary or secondary disease, tertiary syphilis characterised by gumma is rare, especially in the context of neurosyphilis. Here, we report a rare case of a well-controlled human immunodeficiency virus- (HIV-) positive gentleman with a history of previous syphilis and epilepsy who presented with progressive left leg weakness leading to immobility and altered bowels and, on neurological examination, Brown-Sequard syndrome. Magnetic resonance imaging (MRI) of the spine revealed two peripherally enhancing cavitating lesions at T4-T5 with associated meningeal thickening and cord oedema. Cerebrospinal fluid (CSF) analysis revealed high protein (3.07 g/dL) and white cell count (7 × 109/L) with negative cryptococcal antigen, tuberculosis molecular testing (GeneXpert), microscopy and culture, and viral polymerase chain reaction (PCR). CSF serology was positive for Treponema pallidum particle agglutination (TPPA) 10240 and RPR 1 in 2 suggesting active disease. While TB treatment had been started prior to these investigations on day 11, 14-day high-dose benzylpenicillin therapy commenced. Repeat MRI of the spine at days 12 and 22 showed incremental improvements in all parameters which correlated with improving functionality and neurology. According to our literature search, this represents the 13th case recorded for spinal syphilitic gumma and the only case recorded in a HIV-positive individual and adds to the evidence that, in the absence of rapidly changing neurology, medical management can lead to good clinical outcomes.

scholarly journals Subdural Hematoma: A Rare Presentation of a Convexity Meningioma

2014 ◽  
Vol 41 (4) ◽  
pp. 506-507 ◽  
Author(s):  
David Pelz ◽  
Adrian B. Levine ◽  
Keith W. MacDougall
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Past Medical History ◽  
Midline Shift ◽  
Resonance Imaging ◽  
Rare Presentation ◽  
History Of ◽  
Ct Head ◽  
Magnetic Resonance Imaging Mri ◽  
Gcs Score

A 69-year-old male presented to a peripheral emergency department with a several day history of increasing confusion and headache. On admission, his Glasgow Coma Scale (GCS) score was 10 (E3 M6 V1). He was mute but would obey commands intermittently. Cranial nerve exam was normal and there was no evidence of weakness. A computed tomogram (CT) head (Figure 1) showed a chronic subdural hematoma with midline shift, as well as a mass within the left frontal region that appeared consistent with a convexity meningioma seen on magnetic resonance imaging (MRI) two years prior (Figure 2). The patient was not on any blood thinners and had no history of falls. Past medical history also included hypertension and prostate cancer.

scholarly journals Spontaneous Pneumomediastinum with a Rare Presentation

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Ehsan Bolvardi ◽  
Elham Pishbin ◽  
Mohsen Ebrahimi ◽  
Azadeh Mahmoudi Gharaee ◽  
Farhad Bagherian
Keyword(s):  
Subcutaneous Emphysema ◽  
Vital Signs ◽  
Physical Exertion ◽  
Rare Presentation ◽  
Benign Condition ◽  
Spontaneous Pneumomediastinum ◽  
Free Air ◽  
Close Observation ◽  
Chest Examination ◽  
History Of

Spontaneous pneumomediastinum is an unusual and benign condition in which air is present in mediastinum. A 20-year-old male patient presented to ED with complaint of hoarseness and odynophagia from the day before, after weightlifting. The patient was nonsmoker and denied history of other diseases. On physical examination he had no dyspnea with normal vital signs. Throat examination and pulmonary auscultation were normal and no crepitation was palpable. We could not find subcutaneous emphysema in neck and chest examination. In neck and chest X-ray we found that air is present around the trachea. There was no apparent pneumothorax in CXR. In cervical and chest CT free air was present around trachea and in mediastinum. Subcutaneous emphysema was also evident. But there was no pneumothorax. The patient was admitted and went under close observation, oxygen therapy, and analgesic. The pneumomediastinum and subcutaneous emphysema gradually resolved within a week by conservative therapy and he was discharged without any complication. Many different conditions could be trigged because of pneumomediastinum but it is rarely seen in intense physical exertion such as weightlifting and bodybuilding. Two most common symptoms are retrosternal chest pain and dyspnea. But the patient here complained of hoarseness and odynophagia.

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

Dental Implant Placement in Patients with a History of Medications Related to Osteonecrosis of the Jaws: A Systematic Review

2020 ◽  
Author(s):  
Judd Sher ◽  
Kate Kirkham-Ali ◽  
Denny Luo ◽  
Catherine Miller ◽  
Dileep Sharma
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Drug Therapy ◽  
Dental Implant ◽  
Case Series ◽  
Cochrane Central Register ◽  
Bisphosphonate Treatment ◽  
Implant Placement ◽  
Increased Risk ◽  
History Of

The present systematic review evaluates the safety of placing dental implants in patients with a history of antiresorptive or antiangiogenic drug therapy. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and OpenGrey databases were used to search for clinical studies (English only) to July 16, 2019. Study quality was assessed regarding randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases using a modified Newcastle-Ottawa scale and the Joanna Briggs Institute critical appraisal checklist for case series. A broad search strategy resulted in the identification of 7542 studies. There were 28 studies reporting on bisphosphonates (5 cohort, 6 case control, and 17 case series) and one study reporting on denosumab (case series) that met the inclusion criteria and were included in the qualitative synthesis. The quality assessment revealed an overall moderate quality of evidence among the studies. Results demonstrated that patients with a history of bisphosphonate treatment for osteoporosis are not at increased risk of implant failure in terms of osseointegration. However, all patients with a history of bisphosphonate treatment, whether taken orally for osteoporosis or intravenously for malignancy, appear to be at risk of ‘implant surgery-triggered’ MRONJ. In contrast, the risk of MRONJ in patients treated with denosumab for osteoporosis was found to be negligible. In conclusion, general and specialist dentists should exercise caution when planning dental implant therapy in patients with a history of bisphosphonate and denosumab drug therapy. Importantly, all patients with a history of bisphosphonates are at risk of MRONJ, necessitating this to be included in the informed consent obtained prior to implant placement. The James Cook University College of Medicine and Dentistry Honours program and the Australian Dental Research Foundation Colin Cormie Grant were the primary sources of funding for this systematic review.

Family History of Diabetes Is Associated with Increased Risk of Recurrent DKA in Pediatric Patients in Rhode Island

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1378-P
Author(s):  
JANAKI D. VAKHARIA ◽  
SUNGEETA AGRAWAL ◽  
JANINE BACIC ◽  
LISA S. TOPOR
Keyword(s):  
Family History ◽  
Rhode Island ◽  
Pediatric Patients ◽  
Family History Of Diabetes ◽  
Increased Risk ◽  
History Of

Magnetic Resonance Imaging of Pseudo-impingement of Rotator Cuff with Strength Training

2019 ◽  
Vol 1 ◽  
pp. 2-6
Author(s):  
Asad Naqvi ◽  
Timothy Ariyanayagam ◽  
Mir Akber Ali ◽  
Akhila Rachakonda ◽  
Hema N. Choudur
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Strength Training ◽  
Radiology Department ◽  
Resonance Imaging ◽  
Subacromial Space ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Training Exercises

Objective: The objective of this study was to outline a novel unique concept of secondary impingement of the muscles, myotendons, and tendons of the rotator cuff from hypertrophy as a result of strength training exercises. Methods: In this retrospective observational study, 58 patients were referred for an magnetic resonance imaging (MRI) by the orthopedic surgeon to the radiology department over a period of 1½ years. All patients gave a history of strength training exercises and presented with clinical features of rotator cuff impingement. Results: We identified features of hypertrophy of rotator cuff muscles, myotendons, and tendons in 12 of these 58 patients. This was the only abnormality on MRI. The hypertrophy of rotator cuff muscles and tendon bulk completely filling the subacromial space to the point of overfilling and resulting in secondary compressive features. Conclusion: Rotator cuff impingement is a common phenomenon that can occur with various inlet and outlet pathological conditions. However, rotator cuff impingement may also result from muscle and tendon hypertrophy from strength training regimens. Hypertrophy of the rotator cuff can result in overfilling of the subacromial space, leading to secondary impingement, which we have termed as “pseudo-impingement.”

CEREBRAL PALSY:A CLINICAL OVERVIEW

2020 ◽  
Vol 3 (1) ◽  
pp. 54-59
Author(s):  
Nargiza Ergasheva ◽  
◽  
Sardor Anorboev ◽  
Gavkhar Kendjaeva ◽  
Keyword(s):  
Brain Area ◽  
Fetal Brain ◽  
Clinical History ◽  
Screening Tests ◽  
Spastic Diplegia ◽  
Team Approach ◽  
Birth Process ◽  
Increased Risk ◽  
Spastic Quadriplegia ◽  
Magnetic Resonance Imaging Mri

Cerebral palsy (CP) is a disorder characterized by abnormal tone, posture and movement. The incidence of CP is 2–4 per 1,000 live births in the world. Prematurityand low birth weight are important risk factors for CP; however, multiple other factors have been associated with an increased risk for CP, including maternal infections and diseases, and abnormal birth process. In most cases of CP the initial injury to the brain occurs during early fetal brain development, later a brain area that is injured cannot function properly in the future. CP is classified clinically based on the predominant motor syndrome—spastic hemiplegia, spastic diplegia, spastic quadriplegia, ataxic and dyskinetic cerebral palsies. The diagnosis of CPis based on a combination of clinical history, use of standardized neuromotor assessment and findings on magnetic resonance imaging (MRI). If there is a suspicionof genetic or inborn metabolic disorders, screening tests should be provided additionally. Because CP is associated with multiple associated and secondary medical conditions, its management requires a multidisciplinary team approach

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