scholarly journals Focal tetanus involving both thoracic limbs successfully treated with magnesium sulfate in a dog

2020 ◽  
Vol 89 (4) ◽  
pp. 221-225
Author(s):  
E. Royaux ◽  
I. N. Plessas ◽  
P. Smith
Keyword(s):  
Physical Examination ◽  
Magnesium Sulphate ◽  
Muscle Relaxants ◽  
Presumptive Diagnosis ◽  
Tetanus Antitoxin ◽  
Limb Stiffness ◽  
Thoracic Limb ◽  
History Of ◽  
Muscle Spasms ◽  
External Stimuli

A six-year-old, male, neutered Cocker spaniel was referred for a three-week history of progressive thoracic limb stiffness. The dog became non-ambulatory due to severe thoracic limb stiffness, which was exacerbated by external stimuli. The pelvic limbs appeared to be normal. Based on the history and the physical examination, a presumptive diagnosis of focal tetanus of the thoracic limbs was made. The dog was treated supportively with tetanus antitoxin, antimicrobials, sedation and muscle relaxants; however, this treatment did not control the muscle spasms adequately. Magnesium sulphate was added to alleviate the muscle spasms and to reduce the sedation requirements. The dog improved and was discharged after three weeks of intensive treatment.

scholarly journals Recurrent Multiple Fibroadenomas: History of a Case Presented in MDT Meeting With Clinical Discussion and Decision Making

2018 ◽  
pp. 159-162
Author(s):  
Negar Mashoori ◽  
Abdolali Assarian ◽  
Sanaz Zand ◽  
Erica Patocskai
Keyword(s):  
Physical Examination ◽  
Management Plan ◽  
Treatment Modalities ◽  
Presumptive Diagnosis ◽  
Best Management ◽  
New Findings ◽  
History Of ◽  
Single Mass ◽  
Surgical Excisions

Background: Fibroadenoma is a common benign breast disorder in young women which has a low risk of malignant transformation. Most fibroadenomas present as a single mass, but the presence of multiple fibroadenomas can be seen in 15–20% of patients, with average number of 3–4 masses in one breast. In different studies and reports, various treatment modalities-including observation and follow up, surgery, radiofrequency ablation, etc- have been proposed, though the best management for these patients are not determined yet. Case presentation: We present the case of 33-year-old female with history of multiple bilateral benign breast lesions with a presumptive diagnosis of fibroadenomas. She had three previous surgical excisions in the past 14 years. Her case was presented to a breast MDT meeting to obtain a recommendation on appropriate management. Question: The proposed a question in MDT concerned the best and most appropriate management plan for the patient; Does she require further surgical excisions? And if not, how should she be followed? Conclusion: After reviewing past medical history, physical examination, and all documents regarding the patient, MDT members recommended that the patient should be managed with close follow up with physical examination and ultrasound every 6 months. The necessity of further surgical intervention would be determined according to any new findings.

The Aristocracy in England and Tuscany, 1000 - 1250

2019 ◽  
Author(s):  
Peter Coss
Keyword(s):  
Time Frame ◽  
Grand Narrative ◽  
English History ◽  
Internal Dynamics ◽  
Italian Experience ◽  
English Society ◽  
History Of ◽  
External Stimuli ◽  
The Relationship ◽  
Interpretative Framework

Part I of this book is an in-depth examination of the characteristics of the Tuscan aristocracy across the first two and a half centuries of the second millennium, as studied by Italian historians and others working within the Italian tradition: their origins, interests, strategies for survival and exercise of power; the structure and the several levels of aristocracy and how these interrelated; the internal dynamics and perceptions that governed aristocratic life; and the relationship to non-aristocratic sectors of society. It will look at how aristocratic society changed across this period and how far changes were internally generated as opposed to responses from external stimuli. The relationship between the aristocracy and public authority will also be examined. Part II of the book deals with England. The aim here is not a comparative study but to bring insights drawn from Tuscan history and Tuscan historiography into play in understanding the evolution of English society from around the year 1000 to around 1250. This part of the book draws on the breadth of English historiography but is also guided by the Italian experience. The book challenges the interpretative framework within which much English history of this period tends to be written—that is to say the grand narrative which revolves around Magna Carta and English exceptionalism—and seeks to avoid dangers of teleology, of idealism, and of essentialism. By offering a study of the aristocracy across a wide time-frame and with themes drawn from Italian historiography, I hope to obviate these tendencies and to appreciate the aristocracy firmly within its own contexts.

scholarly journals Chronic Endophthalmitis Caused by Pseudomonas stutzeri

2020 ◽  
Vol 11 (3) ◽  
pp. 595-599
Author(s):  
Saeed T. Alshahrani ◽  
J. Fernando Arevalo
Keyword(s):  
Pseudomonas Stutzeri ◽  
Posterior Chamber ◽  
Topical Steroids ◽  
Sensitivity Testing ◽  
Corneal Incision ◽  
Presumptive Diagnosis ◽  
Lens Extraction ◽  
History Of ◽  
Sudden Decrease ◽  
The Right

A patient presented with complaints of a sudden decrease in vision, ocular redness, and pain in the right eye. The patient had a history of clear lens extraction with intraocular lens (IOL) implantation for myopia 2 years previously. He had been prescribed topical steroids for episodes of inflammation that occurred repeatedly every 1–2 months. With a presumptive diagnosis of chronic endophthalmitis, a 23-G transconjunctival sutureless pars plana vitrectomy (PPV) with delivery of intravitreal antibiotics was performed the next day. Culture sensitivity testing of the vitreous sample indicated <i>Pseudomonas stutzeri</i> that was sensitive to ceftazidime and gentamicin. Two weeks later, the patient presented with sudden loss of vision and all the signs of recurrent endophthalmitis. 23-G transconjunctival sutureless PPV was performed along with removal of the posterior chamber IOL through a corneal incision. Complete resolution was only achieved after removal of the IOL, resulting in excellent visual recovery. Due to its chronic and fulminating nature, <i>P. stutzeri</i> can induce endophthalmitis and should be considered in the differential diagnosis. Aseptic measures are the best prevention.

EMBRYOMA OF KIDNEY (WILMS' TUMOR) IN CHILDREN

PEDIATRICS ◽  
1949 ◽  
Vol 4 (2) ◽  
pp. 197-200
Author(s):  
LLOYD B. DICKEY ◽  
L. R. CHANDLER
Keyword(s):  
Survival Rate ◽  
Physical Examination ◽  
Wilms Tumor ◽  
Left Kidney ◽  
Bottle Feeding ◽  
Postoperative Radiation ◽  
History Of ◽  
The Right ◽  
Infants And Young Children ◽  
Careful Physical Examination

A series of 12 cases of Wilms' tumor, in which the diagnosis was confirmed in all instances by examination of the gross or microscopic tissue, is reported, with a survival rate of 33.3%. Four patients are living and well, 4, 8, 10, and 15 years, respectively, after treatment. All recurrences appeared less than 10 months after treatment. The sex incidence, and the sex survival incidence were exactly equal. Six tumors were in the left kidney, and six in the right. Eight of the patients were under 2 years of age when first diagnosed and treated, and all were under 7 years. The history of breast or bottle feeding was irrelevant. In a large number of these and reported cases, the presence of the tumor was the first symptom, and in a considerable number the only symptom. This fact stresses the importance of careful physical examination of infants and young children, regardless of complaint, or of lack of it. The finding of calcification in the tumor is possibly a good prognostic sign. All three patients in whom calcification was noted in the tumor are living and well. Immediate removal of the tumor by transperitoneal nephrectomy, with postoperative radiation to the area, seems to be the advisable treatment.

Migraine in Children: Association With Primary and Familial Dyslipoproteinemias

PEDIATRICS ◽  
1986 ◽  
Vol 77 (3) ◽  
pp. 316-321
Author(s):  
Charles J. Glueck ◽  
Stephen R. Bates
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Degree Relative ◽  
Presumptive Diagnosis ◽  
History Of ◽  
Premature Myocardial Infarction ◽  
Disproportionate Number ◽  
Severe Migraine ◽  
Cerebral Vascular

We studied lipids and lipoprotein cholesterols in 39 children (26 boys, 13 girls) with severe migraine, to examine the hypothesis that primary and familial lipoprotein abnormalities might be associated with or predispose children to the migraine syndrome. Each of the children, 4 to 20 years of age, had severe migraine, leading to pediatric neurologic referral and therapy. Twenty-five of the 39 probands (64%) had a first degree relative with severe migraine, and 18% had a second degree relative with severe migraine. In 11 of the 39 kindreds (28%), there was a family history of premature myocardial infarction and/or cerebral vascular accident (&lt;age 55 years), involving one grandparent from each of ten kindreds and one parent in the 11th kindred. In nine of the 26 boys, low-density lipoprotein cholesterol (LDL-C) levels were greater than or equal to the age-, sex-, race-specific 90th percentile, and in three of these nine children, there was at least one additional first degree relative also having a primary top decile LDL-C level, consistent with the presumptive diagnosis of familial hypercholesterolemia. The finding of more than three times as many boys with migraine headache having top decile LDL-C than expected (9 v 2.6) was significant (x2 = 17.5, P &lt;.01). Also, there were six boys having bottom decile levels of high-density lipoprotein cholesterol (HDL-C); all six came from kindreds with at least one first degree relative also having bottom decile HDL-C. The finding of more than two times as many boys with migraine having bottom decile HDL-C than expected (6 v 2.6) was significant (x2 = 4.94, P &lt; .05). Of the 13 female pediatric probands, two had top decile LDL-C and two had bottom decile HDL-C and came from families with at least one additional first degree family relative also having a primary and similar dyslipoproteinemia. Our observations suggest that the clinical diagnosis of severe migraine in childhood should lead to measurement of lipids and lipoprotein cholesterols, particularly in boys, because they represent a cohort with a disproportionate number of hyper-β- and hypo-α-lipoproteinemic subjects. We speculate that primary and familial lipoprotein abnormalities, particularly those involving high levels of LDL-C and/or low levels of HDL-C, may be etiologically related to migraine, perhaps related to platelet hyperaggregability, and/or increased likelihood of cerebral vascular instability.

BILATERAL PROPTOSIS - INITIAL AND RARE PRESENTATION: AML

2021 ◽  
pp. 17-18
Author(s):  
Tejasvini Chandra ◽  
Perwez Khan ◽  
Lubna Khan ◽  
Anshika Gupta
Keyword(s):  
Myeloid Leukemia ◽  
Blood Count ◽  
Complete Blood Count ◽  
Rare Condition ◽  
Metastatic Tumour ◽  
Blood Picture ◽  
Rare Presentation ◽  
Radiological Investigation ◽  
Presumptive Diagnosis ◽  
History Of

We report bilateral proptosis as the initial presentation of Acute Myeloid Leukemia (AML) in a child. An Eight year child presented with a history of painless proptosis in the both eyes within 10 days. Radiological investigation (CT scan) showed inltration of orbit with the metastatic tumour cell. AML was diagnosed with complete blood count, General Blood Picture (GBP) and bone marrow biopsy. The presumptive diagnosis of leukemic inltration of the orbit is made. We report this case as AML can rarely present in child as a bilateral proptosis due to leukemic inltration. Urgent treatment modality for this rare condition is radiation.

Man with bilateral inguinal lymphadenopathy

2018 ◽  
Vol 35 (8) ◽  
pp. 522.1-522
Author(s):  
Charlotte Delcourt ◽  
Jean Cyr Yombi ◽  
Halil Yildiz
Keyword(s):  
Lymph Node ◽  
Physical Examination ◽  
Sexual Intercourse ◽  
Vital Signs ◽  
List Type ◽  
Cat Scratch Disease ◽  
Night Sweats ◽  
History Of ◽  
Inguinal Lymphadenopathy ◽  
Lymph Node Tuberculosis

Clinical introductionA 37-year-old man with history of lymph node tuberculosis presented with bilateral inguinal swelling with night sweats but no fever for 2 weeks. He had a cat but he had no history of scratches. He had an extraconjugal sexual intercourse a few weeks before. Physical examination revealed 5 cm tender, erythematous and painful bilateral inguinal adenopathy (figure 1A) and a small ulceration at the base of the penis (figure 1B). Vital signs were normal.Figure 1(A) Inguinal lymphadenopathy. (B) Ulceration at the base of the penis.QuestionWhat is the most likely diagnosis?ToxoplasmosisTuberculosisCat-scratch diseaseLymphogranuloma venereumSyphilis

scholarly journals Graham-Little Piccardi Lassueur Syndrome: case report

2012 ◽  
Vol 87 (5) ◽  
pp. 775-777 ◽  
Author(s):  
Raquel Bissacotti Steglich ◽  
Renata Elise Tonoli ◽  
Giselle Martins Pinto ◽  
Fernanda Melo Müller ◽  
Isabelle Maffei Guarenti ◽  
...  
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Hair Follicles ◽  
Rare Disorder ◽  
Rare Syndrome ◽  
Scarring Alopecia ◽  
History Of

A 33-year-old woman presented with a 3-year history of progressive alopecia of the scalp. Past treatment with hydroxicloroquine did not show improvement. Physical examination revealed multiple areas of alopecia with atrophic aspect of the scalp, and axillary and pubic hypotrichosis. Dermoscopy showed hyperkeratosis and accentuation of follicular ostia. Anatomopathological examination revealed decrease in the number of hair follicles, upper perifollicular infiltrate and areas with fibrosis. The Piccardi-Lassueur-Graham-Little syndrome is a rare disorder, characterized by the triad of multifocal scarring alopecia of the scalp, keratotic follicular eruption and hypotrichosis of axillary and pubic regions. Management is a challenge and many medications tried have controversial results. We report a case of this rare syndrome which improved with corticoids.

scholarly journals Migratory non-itchy rash

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Sami Hoshi ◽  
Keyword(s):  
Physical Examination ◽  
Complete Resolution ◽  
Endemic Region ◽  
The West ◽  
Western Blot Test ◽  
Joint Tenderness ◽  
Mucous Membranes ◽  
The Usa ◽  
History Of

A 58-year-old man presented with 4-day history of multiple, erythematous, non-itchy, painless, patchy spots, along with fatigue and jaw pain. This rash started around the periumbilical area and then spread over his chest and right upper back (Figure 1,2). There was no involvement of face, mucous membranes, and extremities. He denied any sore throat, cough, or other symptoms. Besides the skin rash, his physical examination was unremarkable. There was no temporomandibular joint swelling, or joint tenderness. A month ago, he travelled along with the west coast of Michigan – a Lyme-endemic region of the USA and noted his exposure to mosquitoes. Shortly after his visit, he recalled having fever, chills, myalgia and a similar patchy groin rash which resolved in a few days. At that time, blood work by his family physician revealed mild transaminitis. At the current visit, repeat blood work and electrocardiogram were normal. A clinical diagnosis of early disseminated Lyme disease was made. Lyme Ab IgM and IgG were both elevated, as was his Western blot test. He was given a 10-day course of doxycycline. He reported complete resolution of his symptoms at follow up.

scholarly journals Management of Phantom Limb Pain through Thalamotomy of the Centro-Median Nucleus

2021 ◽  
Vol 13 (4) ◽  
pp. 587-593
Author(s):  
Ramiro A. Pérez de la Torre ◽  
Job J. Rodríguez Hernández ◽  
Ali Al-Ramadan ◽  
Abeer Gharaibeh
Keyword(s):  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain ◽  
Surgical Interventions ◽  
Burning Pain ◽  
A Value ◽  
Thoracic Limb ◽  
History Of ◽  
One Year ◽  
The Right

Background: Phantom limb syndrome is defined as the perception of intense pain or other sensations that are secondary to a neural lesion in a limb that does not exist. It can be treated using pharmacological and surgical interventions. Most medications are prescribed to improve patients’ lives; however, the response rate is low. In this case report, we present a case of phantom limb syndrome in a 42-year-old female with a history of transradial amputation of the left thoracic limb due to an accidental compression one year before. The patient underwent placement of a deep brain stimulator at the ventral posteromedial nucleus (VPM) on the right side and removal secondary to loss of battery. The patient continued to have a burning pain throughout the limb with a sensation of still having the limb, which was subsequently diagnosed as phantom limb syndrome. After a thorough discussion with the patient, a right stereotactic centro-median thalamotomy was offered. An immediate response was reported with a reduction in pain severity on the visual analogue scale (VAS) from a value of 9–10 preoperative to a value of 2 postoperative, with no postoperative complications. Although phantom limb pain is one of the most difficult to treat conditions, centro-median thalamotomy may provide an effective stereotactic treatment procedure with adequate outcomes.

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