Bilateral dorsal rotation of the talus with tibiotarsal, talocalcaneal, and proximal intertarsal joint subluxation in an alpaca

2021 ◽  
pp. 1-6
Author(s):  
Katja F. Duesterdieck-Zellmer
Keyword(s):  
Hind Limb ◽  
New World ◽  
Steel Wire ◽  
Clinical Findings ◽  
Medial Aspect ◽  
Tarsal Bone ◽  
Screw Head ◽  
History Of ◽  
Intertarsal Joint ◽  
Proximal Screw

Abstract CASE DESCRIPTION A 14-month-old female alpaca presented with a 3-week history of acute left hind limb lameness and swelling of the left tarsal region. CLINICAL FINDINGS Radiography revealed intermittent dorsal rotation of the talus with tibiotarsal, talocalcaneal, and proximal intertarsal joint subluxation. TREATMENT AND OUTCOME In an attempt to stabilize the talus, screws were placed in the distomedial aspect of the talus and the plantaromedial aspect of the central tarsal bone, and a stainless-steel wire was placed around the screws in a figure-eight pattern. The screw head of the proximal screw broke within 4 weeks after surgery, but subluxation did not recur, and the lameness resolved. Seven months later, the same condition was diagnosed in the opposite hind limb and was treated similarly. Implants remained intact on this side, but the animal started to show signs of pain and inability to flex the tarsal joint, prompting removal of the distal screw. Subsequently, the animal became sound and produced 2 healthy crias, but was euthanatized 4 years after the second surgery because of coccidiosis. CLINICAL RELEVANCE Dorsal rotation of the talus with tibiotarsal, talocalcaneal, and proximal intertarsal joint subluxation is a sporadic condition in New World camelids. This report provides the first account of successful treatment by surgical stabilization of the medial aspect of the proximal intertarsal joint.

Scriptural Battlefields: The Old Testament, Legal Culture, and the Polemics of the Spanish New World Empire, 1492–1821

2019 ◽  
Author(s):  
Jorge Cañizares-Esguerra ◽  
Adrian Masters
Keyword(s):  
Old Testament ◽  
Social Order ◽  
New World ◽  
Legal Culture ◽  
Spanish Empire ◽  
Correct Interpretation ◽  
Group Status ◽  
History Of ◽  
New Social Order

Scholars have barely begun to explore the role of the Old Testament in the history of the Spanish New World. And yet this text was central for the Empire’s legal thought, playing a role in its legislation, adjudication, and understandings of group status. Institutions like the Council of the Indies, the Inquisition, and the monarchy itself invited countless parallels to ancient Hebrew justice. Scripture influenced how subjects understood and valued imperial space as well as theories about Paradise or King Solomon’s mines of Ophir. Scripture shaped debates about the nature of the New World past, the legitimacy of the conquest, and the questions of mining, taxation, and other major issues. In the world of privilege and status, conquerors and pessimists could depict the New World and its peoples as the antithesis of Israel and the Israelites, while activists, patriots, and women flipped the script with aplomb. In the readings of Indians, American-born Spaniards, nuns, and others, the correct interpretation of the Old Testament justified a new social order where these groups’ supposed demerits were in reality their virtues. Indeed, vassals and royal officials’ interpretations of the Old Testament are as diverse as the Spanish Empire itself. Scripture even outlasted the Empire. As republicans defeated royalists in the nineteenth century, divergent readings of the book, variously supporting the Israelite monarchy or the Hebrew republic, had their day on the battlefield itself.

scholarly journals Genetic Analysis of a Cohort of 275 Patients with Hyper-IgE Syndromes and/or Chronic Mucocutaneous Candidiasis

2021 ◽  
Author(s):  
Natalie Frede ◽  
Jessica Rojas-Restrepo ◽  
Andrés Caballero Garcia de Oteyza ◽  
Mary Buchta ◽  
Katrin Hübscher ◽  
...  
Keyword(s):  
Screening Method ◽  
Cost Effective ◽  
Illumina Miseq ◽  
Clinical Findings ◽  
Genetic Defects ◽  
Chronic Mucocutaneous Candidiasis ◽  
Mucocutaneous Candidiasis ◽  
Serious Infections ◽  
History Of ◽  
Panel Sequencing

AbstractHyper-IgE syndromes and chronic mucocutaneous candidiasis constitute rare primary immunodeficiency syndromes with an overlapping clinical phenotype. In recent years, a growing number of underlying genetic defects have been identified. To characterize the underlying genetic defects in a large international cohort of 275 patients, of whom 211 had been clinically diagnosed with hyper-IgE syndrome and 64 with chronic mucocutaneous candidiasis, targeted panel sequencing was performed, relying on Agilent HaloPlex and Illumina MiSeq technologies. The targeted panel sequencing approach allowed us to identify 87 (32 novel and 55 previously described) mutations in 78 patients, which generated a diagnostic success rate of 28.4%. Specifically, mutations in DOCK8 (26 patients), STAT3 (21), STAT1 (15), CARD9 (6), AIRE (3), IL17RA (2), SPINK5 (3), ZNF341 (2), CARMIL2/RLTPR (1), IL12RB1 (1), and WAS (1) have been detected. The most common clinical findings in this cohort were elevated IgE (81.5%), eczema (71.7%), and eosinophilia (62.9%). Regarding infections, 54.7% of patients had a history of radiologically proven pneumonia, and 28.3% have had other serious infections. History of fungal infection was noted in 53% of cases and skin abscesses in 52.9%. Skeletal or dental abnormalities were observed in 46.2% of patients with a characteristic face being the most commonly reported feature (23.1%), followed by retained primary teeth in 18.9% of patients. Targeted panel sequencing provides a cost-effective first-line genetic screening method which allows for the identification of mutations also in patients with atypical clinical presentations and should be routinely implemented in referral centers.

#37: Clinical Characterization of the Cases Relating to the Outbreak of Clostridioides difficile, in a Third-level Hospital in Mexico City: Diagnosis, Treatment, and Relay

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S16-S16
Author(s):  
Ortiz Samuel ◽  
Martínez María Elena ◽  
Morayta Ramírez A
Keyword(s):  
Antibiotic Use ◽  
Clinical Findings ◽  
Prevention Measures ◽  
Clostridioides Difficile ◽  
Young Infants ◽  
Plastic Bags ◽  
History Of ◽  
Initial Episode ◽  
Group Sex ◽  
Healthcare Associated

Abstract Background Clostridioides difficile is an important cause of healthcare-associated infections. The epidemiology of C. difficile infection (CDI) in children has changed over the past few decades. There is now a higher incidence in hospitalized children, and there has been an emergence of community-onset infection. Neonates and young infants have high rates of colonization but rarely have symptoms. The well-known risk factor for CDI in children age 2 years or older is antibiotic use. Inflammatory bowel disease and cancer are associated with increased incidence and severity of CDI. Vancomycin or fidaxomicin is recommended for an initial episode of CDI. In environments where access to Vancomycin or Fidaxomycin is limited, it is suggested to use metronidazole for an initial episode of nonsevere CDI only. Methods A series of cases were carried out, in a study period from March to May 2018, total cases 8; the age group, sex, basic diagnosis, clinical findings, diagnostic method, and outcome in hospitalized patients in the Pediatric division of the “CMN 20 de Noviembre, ISSSTE” were described, where there is a total of 377 Sensitive beds, and 53 beds in the pediatric area of which 30 are not sensitive. Results We analyzed 8 cases of diarrhea with identification of C. difficile, in a period of 3 months, where there was a total of 148 admissions to the division of Pediatrics (100%) and presented a prevalence of 0.05% of the total income. Of those 8 cases reported, 37.5% were women and 62.5% men; The age fluctuated between 6 months and 18 years. All children had associated comorbidities. The frequency and type of comorbidities were Cancer 87.5% (Leukemias and Solid Tumors) and Neurological 12.5% ​​(Arterial Malformation and Neurological Sequelae). The main symptom that occurred was mucous diarrhea in 100% of patients, abdominal pain in 25% and evacuation with blood in 12.5% ​​of cases. All had a history of prior treatment with 100% broad-spectrum antibiotics, in a period of less than one month. All were treated with metronidazole (100%) and all presented clinical improvement, without complications; Similarly, all were diagnosed by PCR for toxin B (100%). The attributable risk of presenting Clostridioides disease in patients with Leukemia is 0.11. Conclusions Patients with Leukemia were the most affected during the C. difficile outbreak, of which 11 out of 100 of these patients are at risk of presenting C. difficile disease. The most important thing in these cases is prevention. Therefore, specific prevention measures were implemented to reduce the possibility of future outbreaks, such as handwashing with chlorexidine, contact isolation, handwashing every time there is contact with the patient, use of gloves when performing procedures, insulation of bedding in plastic bags and training of health personnel.

scholarly journals Serial Observations and Mutational Analysis of an Adoptee with Family History of Hypertrophic Cardiomyopathy

2010 ◽  
Vol 2010 ◽  
pp. 1-4
Author(s):  
Bronwyn Harris ◽  
Jean P. Pfotenhauer ◽  
Cheri A. Silverstein ◽  
Larry W. Markham ◽  
Kim Schafer ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Hypertrophic Cardiomyopathy ◽  
Family History ◽  
Mutational Analysis ◽  
Clinical Findings ◽  
Dominant Mode ◽  
Natural Mother ◽  
History Of ◽  
In Cis ◽  
Inherited Cardiac Disease

Hypertrophic cardiomyopathy (HCM) is an inherited cardiac disease with an autosomal dominant mode of transmission. Comprehensive genetic screening of several genes frequently found mutated in HCM is recommended for first-degree relatives of HCM patients. Genetic testing provides the means to identify those at risk of developing HCM and to institute measures to prevent sudden cardiac death (SCD). Here, we present an adoptee whose natural mother and maternal relatives were known be afflicted with HCM and SCD. The proband was followed closely from age 6 to 17 years, revealing a natural history of the progression of clinical findings associated with HCM. Genetic testing of the proband and her natural mother, who is affected by HCM, revealed that they were heterozygous for both the R719Q and T1513S variants in the cardiac beta-myosin heavy chain (MYH7) gene. The proband's ominous family history indicates that the combination of the R719Q and T1513S variantsin cismay be a “malignant” variant that imparts a poor prognosis in terms of the disease progression and SCD risk.

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