scholarly journals An Unusual Presentation of Pyelonephritis: Is it COVID-19 Related?

2021 ◽  
Author(s):  
Liseanne van 't Hof ◽  
Lucy Pellikaan ◽  
Darius Soonawala ◽  
Hossain Roshani
Keyword(s):  
Late Onset ◽  
Blood Clot ◽  
Vascular Occlusion ◽  
Time Frame ◽  
Late Complications ◽  
Organ Injury ◽  
Persistent Fever ◽  
Lower Back ◽  
The Right ◽  
Renal Infection

Abstract IntroductionIn severe cases of COVID-19, late complications such as coagulopathy and organ injury are increasingly described. In milder cases of the disease, the exact time frame and causal path of late onset complications has not yet been determined. Although direct and indirect renal injury by SARS-CoV-2 has been confirmed, hemorrhagic renal infection or coagulative problems in the urinary tract have not yet been described.Case PresentationThis case report describes a 35-year-old female without relevant medical history who, five days after having recovered from an infection with SARS-CoV-2, had an unusual course of acute pyelonephritis of the right kidney and persistent fever under targeted antibiotic treatment. A hemorrhagic ureteral obstruction and severe swollen renal parenchyma preceded the onset of fever and was related to the developing pyelonephritis. Sudden thrombotic vascular occlusion in the right eye appeared during admission. Symmetrical paresthesia in de limbs in combination of severe lower back pain and gastro-intestinal manifestation was documented and not been explained despite of intensive investigation.ConclusionWe present the unusual combination of culture confirmed bacterial hemorrhagic pyelonephritis with a blood clot in the proximal right ureter, complicated by a retinal venous thrombosis, in a patient who had recovered from SARS-CoV-2-infection five days before presentation. The case is suspect of a COVID-19 related etiology.

scholarly journals An Unusual Presentation of Pyelonephritis: Is It COVID-19 Related?

2021 ◽  
Author(s):  
L. J. van ‘t Hof ◽  
L. Pellikaan ◽  
D. Soonawala ◽  
H. Roshani
Keyword(s):  
Late Onset ◽  
Blood Clot ◽  
Time Frame ◽  
Venous Occlusion ◽  
Late Complications ◽  
Organ Injury ◽  
Vein Thrombosis ◽  
Lower Back ◽  
The Right ◽  
Renal Infection

AbstractIn severe cases of COVID-19, late complications such as coagulopathy and organ injury are increasingly described. In milder cases of the disease, the exact time frame and causal path of late-onset complications have not yet been determined. Although direct and indirect renal injury by SARS-CoV-2 has been confirmed, hemorrhagic renal infection or coagulative problems in the urinary tract have not yet been described. This case report describes a 35-year-old female without relevant medical history who, five days after having recovered from infection with SARS-CoV-2, had an unusual course of acute pyelonephritis of the right kidney and persistent fever under targeted antibiotic treatment. A hemorrhagic ureteral obstruction and severe swollen renal parenchyma preceded the onset of fever and was related to the developing pyelonephritis. Sudden thrombotic venous occlusion in the right eye appeared during admission. Symmetrical paresthesia in the limbs in combination with severe lower back pain and gastro-intestinal complaints also occurred and remained unexplained despite thorough investigation. We present the unusual combination of culture-confirmed bacterial hemorrhagic pyelonephritis with a blood clot in the proximal right ureter, complicated by retinal vein thrombosis, in a patient who had recovered from SARS-CoV-2-infection five days before presentation. The case is suspect of a COVID-19-related etiology.

Late-onset malignant glaucoma

2020 ◽  
Vol 3 ◽  
pp. 1
Author(s):  
Ramiro José Daud ◽  
Horacio Freile ◽  
Mauricio Freile ◽  
Soledad Mariano
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Acute Pain ◽  
Late Onset ◽  
Slit Lamp ◽  
Normal Range ◽  
Slit Lamp Examination ◽  
Complete Occlusion ◽  
Malignant Glaucoma ◽  
The Right

A case report on a 49-year-old female with diagnoses of ocular hypertension in her left eye (LE) treated with 250 mg/day acetazolamide for 2 years. During the slit-lamp examination, complete occlusion of both iridocorneal angles was detected. Intraocular pressure (IOP) was 10 and 35 mmHg in the right eye and LE, respectively. Phacotrabeculectomy was performed in the LE. After 1 month of the procedure, the patient developed a slowly progressive miopization from −1 to −3 diopters (D) the following months. Approximately 3 months after surgery, the patient developed an episode of acute pain, athalamia, and IOP 45 mmHg in her LE. Late-onset malignant glaucoma was suspected and the patient was treated with topical hypotensive and cycloplegic agent until a prompt vitrectomy was performed. Deepening of the anterior chamber and restoration of IOP to normal range was obtained after surgery.

Construct Validity

2017 ◽  
Author(s):  
Richard McCleary ◽  
David McDowall ◽  
Bradley J. Bartos
Keyword(s):  
Time Series ◽  
Construct Validity ◽  
Hypothesis Test ◽  
Secondary Data ◽  
Time Frame ◽  
Primary Data ◽  
Optimal Time ◽  
Intervention Model ◽  
Right Hand ◽  
The Right

Chapter 8 focuses on threats to construct validity arising from the left-hand side time series and the right-hand side intervention model. Construct validity is limited to questions of whether an observed effect can be generalized to alternative cause and effect measures. The “talking out” self-injurious behavior time series, shown in Chapter 5, are examples of primary data. Researchers often have no choice but to use secondary data that were collected by third parties for purposes unrelated to any hypothesis test. Even in those less-than-ideal instances, however, an optimal time series can be constructed by limiting the time frame and otherwise paying attention to regime changes. Threats to construct validity that arise from the right-hand side intervention model, such as fuzzy or unclear onset and responses, are controlled by paying close attention to the underlying theory. Even a minimal theory should specify the onset and duration of an impact.

scholarly journals Spontaneous Resolution of Late-Onset, Symptomatic Fluid Collection Localized in the Meningioma Resection Cavity: A Case Report and Suggestion of Possible Pathogenesis

2021 ◽  
Vol 11 (3) ◽  
pp. 299
Author(s):  
Yeong Jin Kim ◽  
Tae-Young Jung ◽  
In-Young Kim ◽  
Shin Jung ◽  
Kyung-Sub Moon
Keyword(s):  
Brain Imaging ◽  
Late Onset ◽  
Fluid Collection ◽  
Good Condition ◽  
Treatment Strategies ◽  
Imaging Studies ◽  
Resection Cavity ◽  
Perilesional Edema ◽  
Posterior Neck ◽  
The Right

Postoperative complications after brain tumor surgery occur occasionally and it is important for clinicians to know how to properly manage each complication. Here, we described a rare case of late-onset, subdural fluid collection localized at the resection cavity that caused motor weakness after convexity meningioma resection, requiring differentiation from an abscess, to help clinicians determine treatment strategies. A 58-year-old right-handed female was admitted to the hospital with a headache and posterior neck pain. Brain computed tomography (CT) scans and magnetic resonance (MR) images showed a homogeneously enhanced, calcified, and multi-lobulated mass adjacent to the right motor strip without perilesional edema. The patient underwent surgery without incident or residual deficit and was discharged from the hospital in good condition. Six weeks after surgery, the patient complained of left arm monoparesis without infection-related symptoms. Brain imaging studies showed a localized fluid collection in the resection cavity with an enhanced margin and perilesional edema. Diffusion restriction was not detected. After three months of conservative treatment without surgery or antibiotics, she recovered from the neurologic deficits, and brain imaging studies showed the spontaneous regression of the fluid collection and perilesional edema. Late-onset, localized fluid collection at the resection cavity, which is similar to an abscess, could occur three to eight weeks after meningioma resection. When there are predisposing factors, including blood components and hemostatic materials in the surgical cavity, it is important for clinicians to understand this type of complication and choose conservative management as a feasible strategy.

scholarly journals Cervical artery dissection—an easily neglected cause of stroke: a case report

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ya -Hui Lian ◽  
Xin Chen ◽  
De- Rui Kong ◽  
Wei Chen ◽  
Ming-Chao Shi ◽  
...  
Keyword(s):  
Young People ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Vascular Occlusion ◽  
Artery Dissection ◽  
High Signal ◽  
Cervical Artery Dissection ◽  
Cervical Artery ◽  
The Right

Abstract Background In recent years, the incidence of stroke has gradually increased in young people. There are many reasons causing stroke, including atherosclerosis, artery embolization, and cervical artery dissection and so on. However, cervical artery dissection is a major cause of stroke in young people. We present a case of ischemic stroke caused by dissection, whose distal vascular occlusion due to detachment of the thrombosis in the right internal carotid artery. Case presentation A 33-year-old male patient was admitted to the hospital because of stroke. Imaging examination showed that there was no visualization of the right middle cerebral artery and there were a large number of mural thrombus in the C1 segment of the right internal carotid artery. After emergency surgery, the patient had vascular recanalization and the symptoms were significantly improved. Magnetic resonance imaging showed a high signal in the C1 segment of the right internal carotid artery, the abnormal signal disappeared after antiplatelet therapy. Conclusions When a patient has symptoms of stroke, we need to explore the root cause of stroke. Especially in young people, cervical artery dissection is an important reason that can’t be ignored. Through review and analysis of this case, we hope to improve the understanding of radiologists and clinicians about the cervical artery dissection, reduce the rate of misdiagnosis, and improve patients’ prognosis.

scholarly journals Clinical and morphological study of calf enlargement following S-1 radiculopathy

1992 ◽  
Vol 50 (3) ◽  
pp. 383-386 ◽  
Author(s):  
Osvaldo J. M. Nascimento ◽  
Marcos R. G. de Freitas ◽  
Myrian D. Hahn ◽  
Abelardo Q. C. Araújo
Keyword(s):  
Gastrocnemius Muscle ◽  
Rare Condition ◽  
Satisfactory Explanation ◽  
Lower Back ◽  
Left Buttock ◽  
Left Calf ◽  
One Year ◽  
The Right ◽  
Gastrocnemius Muscles

Calf enlargement following sciatica is a rare condition. It is reported the case of a 28-year-old woman who complained of repeated episodes of lower back pain radiating into the left buttock and foot. One year after the beginning of her symptoms, she noticed enlargement of her left calf. X-ray studies disclosed L5-S1 disk degeneration. EMG showed muscle denervation with normal motor conduction velocity. Open biopsies of the gastrocnemius muscles were performed. The left gastrocnemius muscle showed hypertrophic type 2 fibers in comparison with the right gastrocnemius. Electron microscopy showed mildly increased number of mitochondria in these fibers. A satisfactory explanation for denervation hypertrophy has yet to be provided.

scholarly journals Lower back pain with sciatic disorder following L5 dermatome caused by herpes zoster infection

2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Roslind Karolina Hackenberg ◽  
Arnd Von den Driesch ◽  
Dietmar Pierre König
Keyword(s):  
Back Pain ◽  
Herpes Zoster ◽  
Lower Back Pain ◽  
Pain Treatment ◽  
Acute Onset ◽  
Mri Scan ◽  
Lower Back ◽  
Acyclovir Treatment ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

We report the case of a 62-year-old patient with lower back pain radiating into the right leg accompanied by numbness. The pain had an acute onset and was resistant to conservative pain treatment. A magnetic resonance imaging (MRI) scan of the lumbar spine showed no degenerative discovertebral lesions, but a swelling of the nerve root supplying the affected dermatome. For pain treatment the patient received lumbar epidural infiltrations. During this treatment the patient suddenly developed a skin rash with grouped vesicular blisters on an erythematous ground. After the diagnosis of a lumbar herpes zoster and an acyclovir treatment, the patient could be discharged in an ameliorated condition. This case demonstrates the importance to consider rare causes of lumbosciatic pain and disorders and to acknowledge unspecific changes in a MRI scan.

Volumetric reduction in various cortical regions of elderly patients with early-onset and late-onset mania

2010 ◽  
Vol 23 (1) ◽  
pp. 149-154 ◽  
Author(s):  
Shou-Hung Huang ◽  
Shang-Ying Tsai ◽  
Jung-Lung Hsu ◽  
Yi-Lin Huang
Keyword(s):  
Elderly Patients ◽  
Early Onset ◽  
Late Onset ◽  
Cingulate Gyrus ◽  
Posterior Cingulate Gyrus ◽  
Left Caudate ◽  
Cortical Regions ◽  
The Right ◽  
Bipolar Patients ◽  
Left Middle

ABSTRACTBackground: Few studies have examined alterations of the brain in elderly bipolar patients. As late-onset mania is associated with increased cerebrovascular morbidity and neurological damage compared with typical/early-onset mania, we investigated differences in the volume of various cortical regions between elderly patients with early-onset versus late-onset mania.Methods: We recruited 44 bipolar patients aged over 60 years, who underwent volumetric magnetic resonance imaging at 1.5 T. The analytic method is based on the hidden Markov random field model with an expectation-maximization algorithm. We determined the volume of each cortical region as a percentage of the total intracranial volume. The cutoff age for defining early versus late onset was 45 years.Results: The study participants consisted of 25 patients with early-onset mania and 19 patients with late-onset mania; their mean ages were 65.7 years and 62.8 years, respectively. The demographic variables of the two groups were comparable. The volumes of the left caudate nucleus (p = 0.022) and left middle frontal gyrus (p = 0.013) were significantly greater and that of the right posterior cingulate gyrus (p = 0.019) was significantly smaller in the late-onset group. More patients with late-onset mania had comorbid cerebrovascular disease (p = 0.072).Conclusions: The right posterior cingulate gyrus is smaller and the left caudate nucleus and left middle frontal gyrus are larger in patients with late-onset mania compared with those with early-onset mania. Volumetric change in brain regions may vary in elderly bipolar patients with early and late-onset mania.

scholarly journals THE INFLUENCE OF EXTERNAL AND INTERNAL FACTORS ON THE CHEWING EFFICIENCY OF THE DENTITION

2019 ◽  
Vol 15 (1) ◽  
pp. 109-116
Author(s):  
Сергей Лазарев ◽  
Sergey Lazarev ◽  
Тху Чанг Ле ◽  
Thu Chang Le
Keyword(s):  
Spinal Column ◽  
Cervical Vertebra ◽  
Weight Lifting ◽  
Internal Factors ◽  
Left Hand ◽  
Lower Jaw ◽  
Lower Back ◽  
Chewing Efficiency ◽  
Weightlessness Condition ◽  
The Right

Subject. Going upright in human evolution changed the position of the spinal column and head. The position of the spine affects the occlusion through the rotational movements of the first cervical vertebra. The dentofacial system also evolved: the gaps disappeared between the canines and the adjacent teeth; sex differences of teeth were almost erased. As a result, the chewing became more adapted to speech reducing the dominant influence of the canines. Food influenced on the shape of teeth, the occlusion, the lower jaw movement. People use premolars and first molars for chewing soft food, which diminished the chewing efficiency of second molars. The function-dominant chew side also develops dentofacial system. Aim ― research regularities of jaw chewing in stress strain. Methods. Silicone occlusion impressions were obtained from each subject in stress conditions and physical activities. Results. Subjects with a dominant right hand have more amounts of match supracontacts at the right jaw side than at the left one. At opposite side of the spectrum, subjects with a dominant left hand have more amounts of match supracontacts at the left jaw side than at the right one. Ambidextrousnesses have approximately equal amounts at the right and left jaw sides. This is evidence of the force movement at the dominant chewing side. Conclusion. While subjects were falling, the low jaw moved forward resting up against on the canines. In other words, in weightlessness condition the falling subjects were searching for the point of support, which was the occlusion. In the results, it redirected and reduced the kinetic energy of falling bodies and levers of operating forces. The number of supracontact points during lifting is less than in the position of weightlessness. In other words, during the weight lifting the subjects have support points: the lower back and legs. And the occlusion becomes the third point of support only when lifting the extreme physical exertions.

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