scholarly journals First case of fungal keratitis due to Aspergillus minisclerotigenes in Iran

2019 ◽  
Author(s):  
Mahmoud Karimizadeh Esfahani ◽  
Alireza Eslampoor ◽  
Somayeh Dolatabadi ◽  
Mohammad J. Najafzadeh ◽  
Jos Houbraken
Keyword(s):  
Severe Pain ◽  
Corneal Transplantation ◽  
Common Species ◽  
Fungal Keratitis ◽  
Transplantation Surgery ◽  
First Case ◽  
Body Sensation ◽  
Uncontrolled Diabetes ◽  
Causative Agents

Background and Purpose: Herein, we report the first case of fungal keratitis due to Aspergillus minisclerotigenes in a 68-year-old rural woman admitted to the Ophthalmology Center of Khatam-Al-Anbia Hospital in Mashhad, northeast of Iran. Case report: The patient presented with severe pain, burning, foreign body sensation, and reduced vision in her right eye. She had long-term uncontrolled diabetes and was not able to close her eye due to an anatomical problem with the eyelid. The cornea smear sample was cultured, and the fungus was initially identified as Aspergillus flavus. The isolated strain was further identified by sequencing a part of the calmodulin gene as A. minisclerotigenes. The patient did not respond to any antifungal treatments (e.g., amphotericin B and voriconazole drops, and fluconazole 300 mg/day); therefore, she was eventually subjected to corneal transplantation surgery. Conclusion: Fungal keratitis can be caused by the less common species. The reliable identification of the causative agents can be accomplished by the implementation of molecular methods.

Lumbar periarticular cysts of arcorray joint

2020 ◽  
pp. 47-57
Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Lumbar Region ◽  
Results Of Treatment ◽  
Invasive Method ◽  
Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

scholarly journals COVID-19 Response in Thailand and Its Implications on Future Preparedness

2021 ◽  
Vol 18 (3) ◽  
pp. 1089
Author(s):  
Wijitbusaba Marome ◽  
Rajib Shaw
Keyword(s):  
Early Stage ◽  
Health Resources ◽  
Holistic Approach ◽  
Disaster Risk ◽  
Community Level ◽  
Multilateral Cooperation ◽  
First Case ◽  
Multiple Dimensions ◽  
Economic And Social Impacts

Thailand has been affected by COVID-19, like other countries in the Asian region at an early stage, and the first case was reported as early as mid-January 2020. Thailand’s response to the COVID-19 pandemic has been guided by the “Integrated Plan for Multilateral Cooperation for Safety and Mitigation of COVID-19”. This paper analyses the health resources in the country and focuses on the response through community-level public health system and legislative measures. The paper draws some lessons on future preparedness, especially with respect to the four priorities of Sendai Framework for Disaster Risk Reduction. At the end, the paper puts some key learning for future preparedness. While Thailand’s response to COVID-19 has been effective in limiting the spread of the disease, it falls short at being able to address the multiple dimensions of the crisis such as the economic and social impacts. The socioeconomic sectors have been hardest hit, with significant impact on tourism sectors. Sociopolitical system also plays an important role in governance and decision-making for pandemic responses. The analysis suggests that one opportunity for enhancing resilience in Thailand is to strive for more multilevel governance that engages with various stakeholders and to support grassroots and community-level networks. The COVID-19 pandemic recovery is a chance to recover better while leaving no one behind. An inclusive long-term recovery plan for the various impacted countries needs to take a holistic approach to address existing gaps and work towards a sustainable society. Furthering the Health Emergency Disaster Risk Management (HEDRM) Framework may support a coordinated response across various linked sectors rather than straining one particular sector.

scholarly journals Hypocalcemic cardiomyopathy after parathyroidectomy in a patient with uremia: A case report and literature review

2020 ◽  
Vol 48 (7) ◽  
pp. 030006052094211
Author(s):  
Wei Zhang ◽  
Feng Xue ◽  
Quandong Bu ◽  
Xuemei Liu
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Secondary Hyperparathyroidism ◽  
Calcium Supplementation ◽  
Severe Heart Failure ◽  
Cardiac Complications ◽  
Refractory Heart Failure ◽  
First Case ◽  
Insight Into

Hypocalcemia is a rare, but reversible, cause of dilated cardiomyopathy. Although cardiomyopathy may cause severe heart failure, calcium supplementation can reverse heart failure. We report here a patient with uremia and secondary hyperparathyroidism, who was complicated by persistent hypocalcemia and refractory heart failure. The cardiac failure was refractory to treatment with digitalis and diuretics, but dramatically responded to calcium therapy and restoration of normocalcemia. As a result, the patient was eventually diagnosed with hypocalcemic cardiomyopathy. To the best of our knowledge, this is the first case of this disease to be reported in a patient with uremia. Findings from our case may help clinicians to better understand hypocalcemic cardiomyopathy. Our case might also provide new insight into long-term cardiac complications and prognoses of patients undergoing parathyroidectomy due to secondary hyperparathyroidism.

The Effects of the Opioid Epidemic on Prescribing Practices in Long-Term Care Residents

2019 ◽  
Vol 34 (4) ◽  
pp. 258-267
Author(s):  
Lisa Yamagishi ◽  
Olivia Erickson ◽  
Kelly Mazzei ◽  
Christine O'Neil ◽  
Khalid M. Kamal
Keyword(s):  
Severe Pain ◽  
Long Term Care ◽  
Care Facility ◽  
The United States ◽  
Self Report ◽  
Prescribing Practices ◽  
Term Care ◽  
Data Set ◽  
Opioid Prescribing

OBJECTIVE: Evaluate opioid prescribing practices for older adults since the opioid crisis in the United States.<br/> DESIGN: Interrupted time-series analysis on retrospective observational cohort study.<br/> SETTING: 176-bed skilled-nursing facility (SNF).<br/> PARTICIPANTS: Patients admitted to a long-term care facility with pain-related diagnoses between October 1, 2015, and March 31, 2017, were included. Residents discharged prior to 14 days were excluded. Of 392 residents, 258 met inclusion criteria with 313 admissions.<br/> MAIN OUTCOME MEASURE: Changes in opioid prescribing frequency between two periods: Q1 to Q3 (Spring 2016) and Q4 to Q6 for pre- and postgovernment countermeasure, respectively.<br/> RESULTS: Opioid prescriptions for patients with pain-related diagnoses decreased during period one at -0.10% per quarter (95% confidence interval [CI] -0.85-0.85; P = 0.99), with the rate of decline increasing at -3.8% per quarter from period 1 and 2 (95% CI -0.23-0.15; P = 0.64). Opioid prescribing from top International Classification of Diseases, Ninth Revision category, "Injury and Poisoning" decreased in prescribing frequency by -3.0% per quarter from Q1 to Q6 (95% CI -0.16-0.10; P = 0.54). Appropriateness of pain-control was obtained from the Minimum Data Set version 3.0 "Percent of Residents Who Self-Report Moderate to Severe Pain (Short Stay)" measure; these results showed a significant increase in inadequacy of pain relief by 0.28% per quarter (95% CI 0.12-0.44; P = 0.009).<br/> CONCLUSION: Residents who self-report moderate- to severe pain have significantly increased since October 2015. Opioid prescriptions may have decreased for elderly patients in SNFs since Spring 2016. Further investigation with a larger population and wider time frame is warranted to further evaluate significance.

scholarly journals A Review of the Treatment of Opioid-induced Constipation with Methylnaltrexone Bromide

2010 ◽  
Vol 2 ◽  
pp. CMT.S1168
Author(s):  
Francisco M. Abarca ◽  
Theodore J. Saclarides ◽  
Marc I. Brand
Keyword(s):  
Adverse Reaction ◽  
Side Effects ◽  
Severe Pain ◽  
Database Search ◽  
Mu Receptor ◽  
Quaternary Derivative ◽  
Term Administration ◽  
Data Source ◽  
Common Adverse Reaction

Objectives Review and summarize the mechanism of action of methylnaltrexone bromide (methylnaltrexone) and its effectiveness in the treatment of opioid-induced constipation. Data Source A multi-database search was conducted using PubMed and MEDLINE databases, in addition to electronic links to related articles and references. Background Opioids are effective medications for the management of moderate to severe pain, but they are associated with a number of side effects, especially within the gastrointestinal system. Constipation is a very common adverse reaction in patients with late-stage, adverse illness, who require long term administration of opioids on a chronic basis to help alleviate pain. In April 2008, the Food and Drug Administration approved the use of methylnaltrexone, a quaternary derivative of naltrexone which does not cross the blood brain barrier, for the management of patients with opioid-induced constipation. Methylnaltrexone acts as a selective peripheral Mu-receptor antagonist, without affecting the effects of opioids on central analgesia. Conclusions Studies have been shown that methylnaltrexone can be used safely in the treatment of opioid-induced constipation without either interfering with opioid effects on central anesthesia or precipitating opioid withdrawal.

scholarly journals Secondary Adrenal Insufficiency after Treatment with Budesonide for Autoimmune Hepatitis

2018 ◽  
Vol 12 (3) ◽  
pp. 597-601 ◽  
Author(s):  
Filip De Maeyer ◽  
Bruno Lapauw ◽  
Anne Hoorens ◽  
Anja Geerts ◽  
Hans Van Vlierberghe ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Adrenal Insufficiency ◽  
Attractive Alternative ◽  
Secondary Adrenal Insufficiency ◽  
Systemic Activity ◽  
Immunosuppressive Medication ◽  
Systemic Corticosteroids ◽  
First Case ◽  
First Pass

Autoimmune hepatitis (AIH) is a rare cause of chronic liver disease. The backbone of treatment is immunosuppressive medication, typically prednisolone as induction therapy and azathioprine as a maintenance therapy. Side effects of the long-term use of systemic corticosteroids are well known and have led to the use of alternative induction regimens. An attractive alternative is budesonide, a nonhalogenated glucocorticosteroid characterized by a high first-pass effect in the liver (90%), resulting in a high topical anti-inflammatory activity and a low systemic activity. It should be stressed that budesonide is contraindicated in patients with established cirrhosis with portal hypertension and portocaval shunting. In this case report, we present the first case of adrenal insufficiency following treatment with budesonide for AIH.

scholarly journals Understanding the patient voice in gout: a quantitative study conducted in Europe

BJGP Open ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. bjgpopen20X101003 ◽  
Author(s):  
Marc De Meulemeester ◽  
Elsa Mateus ◽  
Hilda Wieberneit-Tolman ◽  
Neil Betteridge ◽  
Lucy Ireland ◽  
...  
Keyword(s):  
Severe Pain ◽  
Online Survey ◽  
Online Questionnaire ◽  
Social Burden ◽  
Long Term Effect ◽  
Key Barrier ◽  
Treatment Expectation ◽  
Insight Into

BackgroundAlthough commonly diagnosed, gout often remains a poorly managed disease. This is partially due to a lack of awareness of the long-term effect of gout among patients and healthcare professionals.AimTo understand unmet needs for patients and provide insight into achieving better treatment.Design & settingA quantitative online questionnaire collected from 1100 people with gout from 14 countries within Europe.MethodPatients were recruited to complete an online survey via healthcare professional (HCP) referral, patient associations, or market research panels. Patients were included if they had been diagnosed with gout by a physician. Prior to commencement, patients were made aware that this study was sponsored by Grünenthal. The responses collected were collated and analyses were performed.ResultsPatients had an average of 2.9 gout flares within a 12-month period. Although 79% of patients were satisfied with treatment, inadequate gout control was also reported by 71% of patients. Furthermore, 84% experienced moderate-to-severe pain with their most recent flare. Of those who acknowledged treatment dissatisfaction, only 24% discussed other options with their GP. Most patients reported irregular follow-up and serum uric acid (sUA) monitoring. In addition, loss of belief that more can be done was a key barrier for patients.ConclusionPatients reported severe pain and social burden, coupled with low treatment expectation and lack of awareness of target sUA. Education around knowing and reaching sUA target is needed so that patients can receive and GPs can deliver higher quality management.

scholarly journals An Unusual Case of Perirenal Abscess Caused by Campylobacter and Peptostreptococcus Species

2022 ◽  
Vol 2022 ◽  
pp. 1-3
Author(s):  
Krystal Hasel ◽  
Ahlaa Salim ◽  
Paul Adjei ◽  
Jeremy D. Gradon
Keyword(s):  
Case Reports ◽  
Thoracic Wall ◽  
Perinephric Abscess ◽  
Oral Infections ◽  
Oral Transmission ◽  
Abdominal Abscesses ◽  
First Case ◽  
Intestinal Infections ◽  
Causative Agents ◽  
Campylobacter Infection

Intra-abdominal abscesses mostly derive from the intra-abdominal viscera. Campylobacter spp. are Gram-negative rods which are known to cause oral infections but rarely have been documented to cause extra-intestinal infections resulting in abscesses. We report an atypical case of Campylobacter rectus (C. rectus) and Peptostreptococcus spp. bacteria isolated from a perinephric abscess presenting as abdominal pain. Abscesses originating from outside the gastrointestinal tract have been reported in other similar case reports infecting the head, brain, and thoracic wall amongst others. The potential source and development of such a Campylobacter infection could be due to multiple hypotheses. This is a first case report of perinephric abscess development. Studies have suggested person-to-person (fecal-oral) transmission along with insects serving as primary reservoirs. Seeding of bacteria through infections in the oral cavity or through infections in the bowel microperforations has also been considered as plausible reasons. Since C. rectus has been isolated in such rare instances, it should be kept in mind when considering differential diagnosis of potential causative agents for extra-oral infections such as invasive abscess formations.

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