scholarly journals Deep neck abscesses-a diagnostic and therapeutic challenge

2021 ◽  
Vol 7 (11) ◽  
pp. 1788
Author(s):  
Aishwarya Ullal ◽  
Arun P. Ajith
Keyword(s):  
Adult Population ◽  
Age Groups ◽  
Case Series ◽  
Retropharyngeal Space ◽  
Diagnostic Challenge ◽  
Predisposing Factor ◽  
Male Predominance ◽  
Complex Anatomy ◽  
Emergency Tracheostomy ◽  
One Year

<p><strong>Background:</strong> Deep neck space infections pose a diagnostic challenge, as they traverse complex anatomy, these patients develop devastating complications if the diagnosis is not made early.</p><p><strong>Methods:</strong> This was a case series over a period of one year, reporting unusual presentation of deep neck abscesses. Patients were subjected to detailed history and clinical examination. Routine investigations, were done. After taking high risk consent, intra oral drainage of abscesses was done.</p><p><strong>Results:</strong> In the present study of 30 cases age group affected was 10 to 30 years with male predominance. Peritonsillar abscesses were seen in the adolescent age groups whereas retropharyngeal space infections   were seen more in the adult population. Tuberculosis was the most common predisposing factor followed by diabetes. Dysphagia was the most common presenting symptom, followed by neck swelling. Intraoral drainage was done in 23 patients, intraoral drainage and ultrasound guided aspiration was done in 6 patients and 3 patient required emergency tracheostomy for securing of the airway.</p><p><strong>Conclusions:</strong> Deep cervical abscesses still occur in the antibiotic era and may cause life-threatening complications.</p>

Isolated tricuspid valve endocarditis in immunocompetent juvenile patients: a series of three cases

2021 ◽  
Vol 14 (8) ◽  
pp. e244312
Author(s):  
Atanu Chandra ◽  
Shrestha Ghosh ◽  
Uddalak Chakraborty ◽  
Debojyoti Ray
Keyword(s):  
Risk Factors ◽  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Age Groups ◽  
Case Series ◽  
Venous Catheter ◽  
Diagnostic Challenge ◽  
Native Valve ◽  
Younger Age ◽  
High Index Of Suspicion

Right-sided native valve infective endocarditis is common in patients with congenital or valvular heart disease, intracardiac device, central venous catheter and intravenous drug abuse, usually manifesting in adulthood. However, in the absence of predisposing risk factors and in younger age groups, this disease may pose a diagnostic challenge. We report a case series of three juvenile patients with isolated tricuspid valve infective endocarditis without any risk factors and paucity of cardiovascular findings in two of them, in an attempt to highlight the importance of maintaining a high index of suspicion to arrive a timely diagnosis.

scholarly journals Sinonasal Polyps: A Diagnostic Challenge

2019 ◽  
Vol 27 (3) ◽  
pp. 243-250
Author(s):  
Sucharita Sarkar ◽  
Rama Saha ◽  
Mou Das ◽  
Samares Sardar
Keyword(s):  
Treatment Protocol ◽  
Case Series ◽  
Olfactory Neuroblastoma ◽  
Mass Lesion ◽  
Diagnostic Challenge ◽  
Basal Cell Adenocarcinoma ◽  
Adenoid Cystic ◽  
Malignant Lesions ◽  
One Year ◽  
Gross Examination

Introduction Sinonasal polyps, presenting as mass lesion of nose and paranasal sinuses ranges pathologic entity including infective diseases to malignant lesions. 80% are non-neoplastic lesions and less than 1% are malignant. They all present with symptoms of nasal stuffiness or obstruction and mass lesion, producing significant diagnostic challenges as they possess extremely varied clinical behaviour, etiopathogenesis, treatment protocol as well as prognosis.   Case Series During period of one year (March 2017 to February 2018), we had six patients presenting with nasal polyp having special features that need attention. After proper investigation each case was operated and gross examination followed by histopathology was done. They   revealed six different diagnoses e.g., Olfactory neuroblastoma, Adenoid Cystic Carcinoma, Basal Cell Adenocarcinoma, Sinonasal Mucosal Melanoma, Primitive Neuroectodermal Tumour (PNET) and Aspergilloma. Discussion Clinicians’ attention is drawn to the fact that, similar presentation may have varied differential diagnoses, some of which may be very rare and histopathology is essential for coming to definitive diagnosis.

scholarly journals Clinical, biological, therapeutic and evolving profile of malignant hemopathies in adults at the central hospital of Yaounde

2021 ◽  
Vol 7 (3) ◽  
pp. 89-96
Author(s):  
Ngo Sack Françoise ◽  
◽  
Lontsi Sonkwa Edgard ◽  
Chetcha Tchemegni Bernard ◽  
◽  
...  
Keyword(s):  
Medical Oncology ◽  
Age Groups ◽  
Central Hospital ◽  
Male Predominance ◽  
Myeloid Leukemias ◽  
Diagnostic Difficulties ◽  
Common Group ◽  
One Year ◽  
Few Data ◽  
Lymphoproliferative Syndromes

Malignant hemopathies designate neoplasias of hematopoietic tissues, characterized by a disorder of the multiplication and differentiation of cells from one or more blood lines; Very few related studies are carried out in Africa due to diagnostic difficulties. We have carried out the present study to enrich the data on these pathologies. An analytical retrospective study was carried out in the hematology and medical oncology department of the Central Hospital of Yaoundé in Cameroon over 10 years, from January 1, 2008 to December 31, 2017. A technical sheet in which the epidemiological variables were noted, clinical, biological, therapeutic and evolutionary has been developed. Of the 167 files selected, the average age of the patients was 52 years +/- 16, with extremes of 21 and 87 years. Acute myeloid leukemias (AML) was more common in patients aged 45 to 54 (8 cases) and the disease affected more women than men at this age group (1H / 7F). Lymphoproliferative syndromes were the most common group of malignant hemopathies, accounting for 52.7% (88 patients). Non hodgkin lymphomas (NHL) were represented at all age groups with a male predominance. Patients with multiple myeloma clinically presented osteoarticular pain in 66.7% of cases. The chemotherapy protocols were varied according to the pathologies and their evolutionary stages. Toxic events were rare. Survival after one year was 9% for AML cases, 30% for CML cases. Few data being available on malignant hemopathies, this work allowed us to measure the importance of this group of pathologies in our context and to identify the clinical-biological profiles and the survival of the patients

Relative contribution of spring- and summer-spawned bluefish cohorts to the adult population: effects of size-selective winter mortality, overwinter growth, and sampling bias

2013 ◽  
Vol 70 (2) ◽  
pp. 233-244 ◽  
Author(s):  
James W. Morley ◽  
Jeffrey A. Buckel ◽  
Thomas E. Lankford
Keyword(s):  
United States ◽  
Adult Population ◽  
Age Groups ◽  
Sampling Bias ◽  
Winter Mortality ◽  
Pomatomus Saltatrix ◽  
Relative Contribution ◽  
Before And After ◽  
One Year ◽  
Overwinter Mortality

Length distributions of juvenile bluefish (Pomatomus saltatrix) are bimodal, consisting of spring- and summer-spawned fish. Research during the 1990s from the northeastern United States suggested that the summer cohort contributes little to the adult population and that overwinter mortality may limit their survival. We examined length distributions of juvenile bluefish from before and after winter and found that the mean length of the summer cohort increased during winter. Based on a winter-growth experiment and temperatures from the two winters examined, changes in mean length were due to size-selective mortality for one year class and growth for the other. Despite evidence for winter mortality, summer-spawned bluefish were commonly caught at age 1. We reexamined the relative contribution of each cohort to the adult population using archived scales from North Carolina fisheries. Cohort origin of adults was determined by back-calculating length at age 1. One-third of adults consisted of summer-spawned fish, contrasting with previous research from the northeast. The differences in relative cohort abundance between the northeastern and southeastern United States arise from sized-based migration in age-1 and age-2 bluefish (the dominant age groups sampled in these studies) and the size-selective gear and sampling season in which they were collected.

Isolated Articular Fractures of the Canine Talus: Diagnosis and Signalment in Fourteen Dogs

2020 ◽  
Author(s):  
Elena Carbonell Buj ◽  
Neil Burton ◽  
John R. Mosley ◽  
Richard L. Meeson ◽  
Alison Major ◽  
...  
Keyword(s):  
Case Series ◽  
Inclusion Criteria ◽  
Bone Pathology ◽  
Diagnostic Challenge ◽  
Articular Fractures ◽  
Complex Anatomy ◽  
Fracture Configuration ◽  
Talar Fractures ◽  
Age Range ◽  
Labrador Retrievers

Abstract Objective The aim of this retrospective multicentre case series was to describe signalment, presenting signs and imaging findings in dogs with isolated articular fractures of the talus. Study Design Medical records (2008–2019) of dogs with isolated articular talar fractures were reviewed. Results Fourteen dogs met the inclusion criteria; affected breeds were four German Pointer (three shorthair and one wirehaired), three Labrador Retrievers, two Rottweilers, two Springer Spaniels, one cross breed, one Greyhound and one Great Münsterländer. The age range was 1 to 8 years with a median of 4.7 years. Lameness was usually acute in onset and had been present for a range of 4 to 540 days prior to referral.The most common fracture configuration involved the lateral trochlear ridge only (n = 9). Two of the fourteen fractures affected both trochlear ridges. Thirteen dogs were initially assessed radiographically with classic orthogonal views, but a fracture was only visible in five cases. The remainder were confirmed with further radiographic projections (n = 4) or computed tomography (n = 5). In one case, the lameness was located to the tarsus by scintigraphy. Conclusion Isolated articular fracture of the talus is rare and may prove a diagnostic challenge due to the varied presentations and complex anatomy of the bone. Pathology of the talus may be suspected in any case of lameness localized to the tarsus and oblique/skyline radiographic views or advanced imaging should be performed if standard radiographic views are unremarkable.

scholarly journals IgG4-related intracranial disease

2018 ◽  
Vol 32 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Shahine Goulam-Houssein ◽  
Jeffrey L Grenville ◽  
Katerina Mastrocostas ◽  
David G Munoz ◽  
Amy Lin ◽  
...  
Keyword(s):  
Plasma Cells ◽  
Surgical Intervention ◽  
Case Series ◽  
Hypertrophic Pachymeningitis ◽  
Diagnostic Challenge ◽  
Perineural Spread ◽  
Related Disease ◽  
The Third ◽  
Igg4 Related Disease ◽  
Intracranial Involvement

IgG4-related disease (IgG4-RD) is a multi-organ chronic inflammatory process caused by infiltration of IgG4-positive plasma cells in one or more organs. Intracranial involvement has only recently become better recognized. Our case series adds to the growing literature on the varying presentations of intracranial IgG4 by describing the clinical and imaging findings of three patients who presented to our institution with intracranial involvement. Our first patient presented with a mass-forming IgG4 pachymeningitis mimicking a sphenoid wing meningioma, which is to our knowledge the largest mass-forming pachymeningitis published in the literature. Our second case depicts another presentation of extensive IgG4 pachymeningitis involving both cavernous sinuses and surrounding Meckel’s caves. The third case describes a patient with presumed lymphocytic hypophysitis, which was later determined to be IgG4-related hypophysitis with concomitant pachymeningitis and perineural spread along the optic nerves. The delayed diagnoses in our cases illustrates the diagnostic challenge that clinicians face in differentiating intracranial IgG4-RD from other infiltrative diseases such as sarcoidosis, granulomatous disease, tuberculosis and lymphoma. Earlier consideration of IgG4-related hypophysitis and hypertrophic pachymeningitis in the differential diagnosis can prevent significant morbidity including unnecessary surgical intervention and organ failure secondary to extensive fibrosis.

scholarly journals A review of malignant pleural mesothelioma in a large North East UK pleural centre

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Declan C. Murphy ◽  
Alexander Mount ◽  
Fiona Starkie ◽  
Leah Taylor ◽  
Avinash Aujayeb
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Survival Rates ◽  
Case Series ◽  
Pleural Mesothelioma ◽  
Retrospective Case ◽  
Pleural Thickening ◽  
North East ◽  
Total Cohort ◽  
Anti Cancer ◽  
One Year

AbstractObjectivesThe National Mesothelioma Audit 2020 showed Northumbria to have low rates of histopathological confirmation, treatment and one-year survival rates for malignant pleural mesothelioma (MPM). We hypothesized that an internal analysis over a 10-year period provides valuable insights into presentation, diagnosis, treatment and outcomes.MethodsA single-centre retrospective case series of all confirmed MPM patients between 1 January 2009 and 31 December 2019 was performed. Demographics, clinical, radiological and histopathological characteristics and outcomes were collected. Statistical analysis was performed using SPSS V26.0.ResultsA total of 247 patients had MPM. About 86% were male, mean age 75.7 years. Dyspnoea (77.4%) and chest pain (38.5%) were commonest symptoms. 64.9 and 71.4% had pleural thickening and effusion, respectively. About 86.8% had at least one attempt to obtain a tissue biopsy, but histopathological confirmation in only 108 (43.7%). About 66.3% with PS 0 and 1 (62.7% of total cohort) had at least one anti-cancer therapy. Death within 12 months was associated with disease progression within 6 months (p≤0.001). Chemotherapy (p≤0.001) and epithelioid histological subtype (p=0.01) were protective.ConclusionsThis study confirms known epidemiology of MPM, demonstrates variability in practices and highlights how some NMA recommendations are not met. This provides the incentive for a regional mesothelioma multi-disciplinary meeting.

scholarly journals Evolution of the prevalence of obesity in the adult population in France, 2013–2016: the Constances study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sébastien Czernichow ◽  
Adeline Renuy ◽  
Claire Rives-Lange ◽  
Claire Carette ◽  
Guillaume Airagnes ◽  
...  
Keyword(s):  
Linear Trend ◽  
Adult Population ◽  
Age Groups ◽  
French Population ◽  
Obesity Prevalence ◽  
Point Change ◽  
Men And Women ◽  
Class 1 ◽  
Prevalence Of Obesity ◽  
Age And Sex

AbstractThis study provides trends in obesity prevalence in adults from 2013 to 2016 in France. 63,582 men and women from independent samples upon inclusion from the Constances cohort were included. Anthropometrics were measured at Health Screening Centers and obesity defined as a Body mass index (BMI) ≥ 30 kg/m2; obesity classes according to BMI are as follows: class 1 [30–34.9]; class 2 [35–39.9]; class 3 [≥ 40 kg/m2]. Linear trends across obesity classes by sex and age groups were examined in regression models and percentage point change from 2013 to 2016 for each age category calculated. All analyses accounted for sample weights for non-response, age and sex-calibrated to the French population. Prevalence of obesity ranged from 14.2 to 15.2% and from 14 to 15.3% in women and men respectively from 2013 to 2016. Class 1 obesity category prevalence was the only one to increase significantly across survey years in both men and women (p for linear trend = 0.04 and 0.01 in women and men respectively). The only significant increase for obesity was observed in the age group 18–29 y in both women and men (+ 2.71% and + 3.26% point increase respectively, equivalent to an approximate rise of 50% in women and 93% in men, p = 0.03 and 0.02 respectively). After adjustment for survey non-response and for age and sex distribution, the results show that class 1 obesity prevalence has significantly increased in both women and men from 2013 to 2016, and only in young adults in a representative sample of the French population aged 18–69 years old.

Highly selective diversion with proactive leakage management after low anterior resection for rectal cancer

2021 ◽  
Author(s):  
K Talboom ◽  
I Vogel ◽  
R D Blok ◽  
S X Roodbeen ◽  
C Y Ponsioen ◽  
...  
Keyword(s):  
Low Anterior Resection ◽  
Case Series ◽  
Fecal Diversion ◽  
Single Center ◽  
Single Centre ◽  
Diverting Stoma ◽  
Faecal Diversion ◽  
One Year ◽  
Diversion Rate

Abstract In this single center case series with nine percent primary diversion, 86 of 94 patients alive and with complete follow-up at one year had a functioning anastomosis. Seventy-five of the initial 99 patients never had a stoma. Meaning: Highly selective fecal diversion in combination with proactive leakage management, low anastomoses can be preserved safely, and the majority of patients will be spared all disadvantages of a diverting stoma. In this single-centre case series, with a primary diversion rate of 9 per cent, 86 of 94 patients who were alive and had complete follow-up at 1 year had a functioning anastomosis. Seventy-five of the initial 99 patients never had a stoma. The results indicate that, with highly selective faecal diversion in combination with proactive leakage management, low anastomoses can be preserved safely, and the majority of patients will be spared the disadvantages of a diverting stoma.

scholarly journals Analysing the impact of the COVID-19 outbreak on everyday travel behaviour in Germany and potential implications for future travel patterns

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Viktoriya Kolarova ◽  
Christine Eisenmann ◽  
Claudia Nobis ◽  
Christian Winkler ◽  
Barbara Lenz
Keyword(s):  
Public Transport ◽  
Online Survey ◽  
Adult Population ◽  
Activity Patterns ◽  
Age Groups ◽  
Travel Behaviour ◽  
German Population ◽  
Travel Patterns ◽  
Home Office ◽  
The Impact

Abstract Introduction The global Coronavirus (COVID-19) pandemic is having a great impact on all areas of the everyday life, including travel behaviour. Various measures that focus on restricting social contacts have been implemented in order to reduce the spread of the virus. Understanding how daily activities and travel behaviour change during such global crisis and the reasons behind is crucial for developing suitable strategies for similar future events and analysing potential mid- and long-term impacts. Methods In order to provide empirical insights into changes in travel behaviour during the first Coronavirus-related lockdown in 2020 for Germany, an online survey with a relative representative sample for the German population was conducted a week after the start of the nationwide contact ban. The data was analysed performing descriptive and inferential statistical analyses. Results and Discussion The results suggest in general an increase in car use and decrease in public transport use as well as more negative perception of public transport as a transport alternative during the pandemic. Regarding activity-related travel patterns, the findings show firstly, that the majority of people go less frequent shopping; simultaneously, an increase in online shopping can be seen and characteristics of this group were analysed. Secondly, half of the adult population still left their home for leisure or to run errands; young adults were more active than all other age groups. Thirdly, the majority of the working population still went to work; one out of four people worked in home-office. Lastly, potential implications for travel behaviour and activity patterns as well as policy measures are discussed.

Sign in / Sign up

Export Citation Format

Share Document