scholarly journals Cerebral Tuberculosis in an Active-duty Military Officer That Led to Tinnitus From a TB Brain Abscess; A Case Report; Case Report.

2021 ◽  
Author(s):  
smart asare ◽  
Bello Figuim ◽  
Aubin Sandio ◽  
Ngouatna Serge ◽  
Tamkam Cecillia ◽  
...  
Keyword(s):  
Case Report ◽  
Brain Abscess ◽  
Public Health Problem ◽  
External Genitalia ◽  
Loss Of Consciousness ◽  
Loud Noise ◽  
Army Officer ◽  
Increased Risk ◽  
Developed Nations ◽  
Cerebral Tuberculosis

Abstract Tuberculosis has been a pertinent public health problem for both developing and developed nations. For developed nations, military personal has the higher risk since they do travel to developing nations to embark on their duties. Cerebral tuberculosis is rare and if they occur, they tend to manifest as either meningitis or tuberculoma. Tinnitus is more likely in men particularly persons exposed to loud noises along with other causes. We present a case of cerebral tuberculosis induced tinnitus in a 26-year-old male army officer who presented with a one-week episode of convulsive crises and loss of consciousness after being exposed to a loud noise while on duty. Cranial MRI showed right temporo-parietal and left parietal finger-like hyper-signals with edema on Flair and T2. However, brain CT-scan showed right parieto-temporal and left parietal sub cortical hypodensities and finger-like borders without contrast re-uptake. There was strong suspicion for TB brain abscess leading to a possible manifestation of tinnitus in this patient.Case presentationA 26-year-old male army officer presented with chief complaints of convulsive crisis and loss of consciousness when he heard a loud noise while on duty. He fell to the ground and was found unconscious and drooling by a colleague. He was immediately transferred by non-medical means to our hospital for management. The patient experienced rigidity as well as uncontrolled muscle spasms leading to jerky motions which lasted for about one to two minutes and occurred two hours before admission in a non-febrile context. The convulsive crises occurred two hours prior to admission in a non-febrile state. The patient was then worked up for review of systems (ROS)- SpO2 was 98%; RR was 24 cpm, BP = 125/91 mmHg, Pulse =103 bpm, Glasgow coma scale = 15/15, isochoric iso-reactive pupils, blood sugar = 1,11 g/l; Temperature = 37°C. No motor or sensitive deficits, no meningeal signs, no former convulsive crisis, there was symmetry for chest movements, no signs of respiratory distress, resonant percussion sounds. Also, there was no urine incontinence, dysuria, scrotal swelling and external genitalia deformations. No peripheral lymph nodes (cervical, axillary, inguinal) were palpable.Upon checking the labs, WBC: 5.05, HGB: 12.4 g/l, PLT: 313,000 electrolyte panel reveals all normal except moderate hypomagnesemia. HIV 1 and 2 serology was negative, Cardiovascular examination shows PPP, audible heart sounds at all four auscultation points, no MGR and RRR. On respiratory exam; there were no signs of distress, no tracheal deviation, resonant to percussion, CTAB and no CVAT. On abdominal exam; no HSM and normal bowel movement and sounds. Finally, Neurological; no acute distress (NAD), AAOx3, CN 2-12 intact, MME is normal, recall is 3/3, coordination and concentration intact, follows command and no motor or sensory deficits. Did bronchi fibroscopy along with broncho-alveolar lavage, in search of TB by PCR.ConclusionTinnitus remains the second most prevalent service-connected disability. Patients with cerebral TB abscess are at increased risk for this condition.

scholarly journals A Fatal Sinogenic Brain Abscess in Pregnancy: Case Report and Review of Literature

2017 ◽  
Vol 06 (01) ◽  
pp. 047-049
Author(s):  
Reza Bahrami ◽  
Hossein Safari
Keyword(s):  
Case Report ◽  
Pregnant Woman ◽  
Brain Abscess ◽  
Rare Complication ◽  
Loss Of Consciousness ◽  
Review Of Literature ◽  
Brain Herniation ◽  
Rapid Deterioration ◽  
Good Neurologic Outcome ◽  
In Pregnancy

AbstractCerebral abscess is an extremely rare complication of pregnancy. Among reported cases of pregnancy brain abscess, most patients have shown a good neurologic outcome. Herein, we present a 25-year-old pregnant woman at 28 weeks' gestation with acute loss of consciousness and sudden brain herniation. The patient underwent an emergency craniotomy and brain abscess was evacuated, but she died after surgery. Rapid deterioration and fatal brain herniation were unique among other reports of sinogenic brain abscess during pregnancy.

Tuberculous brain abscess: A case report with a review of the literature in English

1999 ◽  
Vol 19 (3) ◽  
pp. 328-335
Author(s):  
Shanop Shuangshoti Shuangshoti ◽  
Samruay Shuangshoti
Keyword(s):  
Case Report ◽  
Brain Abscess ◽  
Review Of The Literature ◽  
Tuberculous Brain Abscess

Therapeutic options in male osteoporosis

2013 ◽  
Vol 22 (04) ◽  
pp. 271-276 ◽  
Author(s):  
P. Farahmand ◽  
J. D. Ringe
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Public Health Problem ◽  
Male Osteoporosis ◽  
Individual Risk ◽  
Modes Of Action ◽  
Increased Risk ◽  
Study Results ◽  
Long Term Treatment ◽  
Male Patients

SummaryOsteoporosis in men is increasingly recognized as an important public health problem but affected patients are still under-diagnosed and -treated. As in women the diagnostic and therapeutic strategy has to be adapted to the individual case. In the practical management it is very important to detect possible causes of secondary osteoporosis, to explain the possibilities of basic therapy counteracting individual risk factors and communicate that osteoporosis is a chronic disease and adherence to a long-term treatment is crucial. In established severe osteoporosis a careful analgesic therapy is important to avoid further bone loss related to immobility. In elderly men with increased risk of falling insufficient Vitamin D supply or impaired activation of Vitamin D due to renal insufficiency must be taken into consideration. Specific medications available today for the treatment of male osteoporosis comprise among antiresorptive drugs the bis phosphonates alendronate, risedronate and zoledronic acid. Denosumab, the first biological therapy is approved for men with androgen deprivation therapy for prostate cancer. An important advantage of this potent antiresorptive drug is the increased adherence due to the comfortable application by sixmonthly subcutaneous injections. Study results from the 2-year multi-center randomized controlled ADAMO-Study will very soon allow the use of denosumab in all types of male osteoporosis. Teriparatide, the 34 N-terminal amino acid sequence of parathyroid hormone was approved for men with osteoporosis as an anabolic agent based on proven efficacy by different studies. Among drugs with other modes of action the D-hormone pro-drug alfacalcidol can be used in men alone or in combination with the advantage of pleiotropic effects on calcium absorption, parathyroids, bone and muscle. Recently also Strontium-ranelate was approved for male patients with the limitation to exclude men with clinical relevant cardiovascular risk factors. In general the possibilities to treat male osteoporosis have considerably improved during recent years. Today there is a choice of a spectrum of drugs from mild to strong potency with different modes of action on bone turnover to design strategies for individual male patients.

CLINICAL CHALLENGES FOR ANESTHESIOLOGIST FACING PATIENT WITH ACROMEGALY. CASE REPORT

2020 ◽  
Vol 30 (3) ◽  
pp. 56-59
Author(s):  
Jūratė Gudaitytė ◽  
Justina Jermolajevaitė ◽  
Martynas Judickas
Keyword(s):  
Atrial Fibrillation ◽  
Case Report ◽  
General Population ◽  
Metabolic Disorders ◽  
Upper Airway ◽  
Cardiovascular Complications ◽  
Case Presentation ◽  
Increased Risk ◽  
Fluid Regulation ◽  
Class Iv

Background and objectives: Acromegaly is endocri­nal disorder which results in changes involving ge­neral appearance as well as upper airway abnorma­lities, cardiovascular and metabolic disorders which can aggravate the anesthesia and can lead to compli­cations. We aim to discuss the challenges for anesthe­siologist that occurs facing patient with acromegaly and are necessary to investigate before performing any kind of intervention. Case Presentation: 79 years old male patient presen­ted the hospital with recently diagnosed acromegaly for rectal prolapse surgery. From anamnesis he had NYHAIII with cardiomyopathy, atrial fibrillation and arterial hypertension, also multiple old compressive fractures Th10 – L5. He was graded with Mallam­pati score IV and ASA class IV. The complemen­tary examinations were made to assess the possible complications. In induction of general anesthesia the intubation was performed using fibro- bronchoscope and anesthesia went without complications except hypotension which was managed. After surgery the patient was leaded to the postoperative room for furt­her monitoring. Discussion and Conclusion: Acromegalic patients have an increased risk of difficulty during anesthe­sia compared to general population due to difficult intubation, cardiovascular complications , OSA , alte­ration in intraoperative glucose intolerance and fluid regulation. Therefore profound investigation and as­sessment are necessary to predict and prepare for possible difficulties in the surgery room.

scholarly journals Brain Abscess Caused by Nocardia: Case Report and Literature Review

2020 ◽  
Author(s):  
Guilherme Finger ◽  
Maria Eduarda Conte Gripa ◽  
Tiago Paczko Bozko Cecchini ◽  
Tobias Ludwig do Nascimento
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Brain Abscess ◽  
Clinical Signs ◽  
Occipital Lobe ◽  
High Morbidity ◽  
Rare Clinical Entity ◽  
Brain Abscesses

AbstractNocardia brain abscess is a rare clinical entity, accounting for 2% of all brain abscesses, associated with high morbidity and a mortality rate 3 times higher than brain abscesses caused by other bacteria. Proper investigation and treatment, characterized by a long-term antibiotic therapy, play an important role on the outcome of the patient. The authors describe a case of a patient without neurological comorbidities who developed clinical signs of right occipital lobe impairment and seizures, whose investigation demonstrated brain abscess caused by Nocardia spp. The patient was treated surgically followed by antibiotic therapy with a great outcome after 1 year of follow-up.

scholarly journals Paliperidone induced neutropenia in first episode psychosis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Natalie Martos ◽  
William Hall ◽  
Alicia Marhefka ◽  
Thomas W. Sedlak ◽  
Frederick C. Nucifora
Keyword(s):  
Adverse Effect ◽  
Case Report ◽  
The United States ◽  
First Episode Psychosis ◽  
Potential Adverse Effect ◽  
Severe Neutropenia ◽  
First Episode ◽  
Antipsychotic Medications ◽  
Increased Risk ◽  
Episode Psychosis

Abstract Background Neutropenia, a decrease in total number of neutrophils below 1500/mm3 and particularly severe neutropenia, defined as neutrophils less than 500/mm3, is a potential adverse effect of antipsychotic medications that can lead to increased risk of infections and death. However, much of the attention on the potential adverse effect is centered exclusively on clozapine, which remains the only antipsychotic medication in the United States requiring standardized monitoring of blood work. We demonstrate here that paliperidone can also cause neutropenia and therefore clinicians should be aware of this possibility especially during initiation of treatment. Case presentation The following report presents the case of a 23-year-old African American male with first episode psychosis who developed neutropenia after initiation of paliperidone. Neutropenia resolved after discontinuation of paliperidone and initiation of an alternative antipsychotic, haloperidol. Conclusions This case report demonstrates an example of paliperidone induced neutropenia which resolved with a switch to haloperidol. We conclude that when initiating paliperidone, clinicians should be more aware of the risk of neutropenia. Moreover, neutropenia may be a more common and overlooked issue in patients on antipsychotic medications other than clozapine and increased awareness of comparative risk across antipsychotics could help direct treatment.

scholarly journals Quality of life and risk of feminicide in women victims of intimate partner violence in Campinas

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Caicedo Roa ◽  
L Gabrielle Dalaqua ◽  
P Filizola ◽  
R Cordeiro
Keyword(s):  
Quality Of Life ◽  
Domestic Violence ◽  
Intimate Partner Violence ◽  
High Risk ◽  
Women Victims ◽  
Partner Violence ◽  
Public Health Problem ◽  
Intimate Partner ◽  
Increased Risk

Abstract Introduction Violence against women is a public health problem with severe consequences. Most women in situations of domestic violence are emotionally involved and/or economically dependent of their intimate partners contributing to the perpetuation and acceptance of violence. Objectives 1) To characterize the women who join the Reference and Support Center for Women (Ceamo) in Campinas, Southeast Brazil. 2) To measure the quality of life in women victims of intimate partner violence 3) To determine the risk of feminicide. Methods The Ceamo is a public specialized service from the mayor of Campinas, it provides psychological, social and legal guidance to women in situations of gender violence. Inclusion criteria: Women attending Ceamo services, speaking Portuguese, age ≥18 years old and having experienced intimate partner violence. Measure instruments: Danger assessment Scale and WHOQOL-BREF. Results During the 11 months of the study, 78 new users were recruited. Average age 38.3 years old, mostly married/stable union, most of them with children (88%). 64% of women do not work and 36% live with the abusive partner. Prevalent types of violence suffered during by the victims in the last year were psychological n = 76, physical n = 62, moral n = 54 and sexual n = 23. The domain most affected in the assessment of quality of life was the environment (average 42% /100%) and psychological domain (42%/100%). 49% of women were classified with increased risk, 22% with severe risk and 1% with extreme risk of femicide. The questions with the most positive answers were those related to believing that the partner can kill her (77%), jealous of the partner (76%) and controlling behavior (73%), being followed/spied by the partner (67%) and threat death (65%). Conclusions The service in general receive very vulnerable women with low perception of their own quality of life, precarious material conditions and high risk of femicide. Key messages The women in domestic violence situation attended by the Ceamo service are at high risk of femicide. Service users have very low perception of their quality of life and poor social conditions.

scholarly journals Shallow Water Diving-Associated Alveolar Hemorrhage in an Active Duty Sailor: A Case Report

2021 ◽  
Author(s):  
Brannon L Inman ◽  
Rachel E Bridwell ◽  
Amber Cibrario ◽  
Sarah Goss ◽  
Joshua J Oliver
Keyword(s):  
Case Report ◽  
Lung Injury ◽  
Active Duty ◽  
Service Members ◽  
Breath Hold ◽  
Common Complication ◽  
Special Operations ◽  
Increased Risk ◽  
History Of ◽  
And Function

ABSTRACT Breath-hold diving is a common practice as a part of military dive training. An association between prior lung injury and a propensity for lung barotrauma may have the potential to impact mission readiness for combat divers, Pararescue, Combat Controllers, Army Engineer divers, and various units in Naval Special Warfare and Special Operations. Barotrauma is a common complication of diving, typically occurring at depths greater than 30 m (98.4 ft). Individuals with abnormal lung anatomy or function may be at increased risk of barotrauma at shallower depths than those with healthy lungs, rendering these service members unfit for certain missions. We describe the case of a 25-year-old male, with a remote history of polytrauma and resultant pulmonary pleural adhesions, whose dive training was complicated by lung barotrauma at shallow depths. In missions or training utilizing breath-hold diving, the association with secondary alterations in lung or thoracic anatomy and function may limit which service members can safely participate.

Massive Extra-Abdominal Umbilical Vein Varix: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Josef Jackson ◽  
Eumenia Castro ◽  
Michael A. Belfort ◽  
Alireza A. Shamsirshaz ◽  
Ahmed A. Nassr ◽  
...  
Keyword(s):  
Case Report ◽  
Umbilical Cord ◽  
Neonatal Period ◽  
Umbilical Vein ◽  
Fetal Distress ◽  
Fetal Anemia ◽  
Pathologic Examination ◽  
Fetal Demise ◽  
Increased Risk ◽  
Umbilical Vein Varix

Umbilical vein varices are rare umbilical cord anomalies that typically occur intra-abdominally. Extra-abdominal umbilical vein varices are exceedingly rare and usually diagnosed postnatally on gross pathologic examination. Umbilical vein varices have been associated with increased risk of fetal anemia, cardiac abnormalities, and intrauterine fetal demise. This case report discusses a patient who presented with a massive extra-abdominal umbilical vein varix, whose infant was ultimately delivered due to fetal distress and died in the neonatal period. This report also discusses associated fetal conditions and guidelines for antenatal testing and surveillance of known umbilical vein varices.

scholarly journals Overt acts of perceived discrimination reported by British working-age adults with and without disability

2019 ◽  
Author(s):  
Eric Emerson ◽  
Allison Milner ◽  
Zoe Aitken ◽  
Lauren Krnjacki ◽  
Cathy Vaughan ◽  
...  
Keyword(s):  
Public Health ◽  
Negative Impact ◽  
Policy Research ◽  
Secondary Analysis ◽  
People With Disabilities ◽  
Public Health Problem ◽  
Health Staff ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Uk

Abstract Background Exposure to discrimination can have a negative impact on health. There is little robust evidence on the prevalence of exposure of people with disabilities to discrimination, the sources and nature of discrimination they face, and the personal and contextual factors associated with increased risk of exposure. Methods Secondary analysis of de-identified cross-sectional data from the three waves of the UK’s ‘Life Opportunities Survey’. Results In the UK (i) adults with disabilities were over three times more likely than their peers to be exposed to discrimination, (ii) the two most common sources of discrimination were strangers in the street and health staff and (iii) discrimination was more likely to be reported by participants who were younger, more highly educated, who were unemployed or economically inactive, who reported financial stress or material hardship and who had impairments associated with hearing, memory/speaking, dexterity, behavioural/mental health, intellectual/learning difficulties and breathing. Conclusions Discrimination faced by people with disabilities is an under-recognised public health problem that is likely to contribute to disability-based health inequities. Public health policy, research and practice needs to concentrate efforts on developing programs that reduce discrimination experienced by people with disabilities.

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