scholarly journals “Whiplash” cervical trauma with fracture and migration of carotid stent fragments

2020 ◽  
Vol 11 ◽  
pp. 329
Author(s):  
Danilo Almeida Silva ◽  
Guilherme Brasileiro de Aguiar ◽  
Maurício Jory ◽  
Mario Luiz Marques Conti ◽  
José Carlos Esteves Veiga
Keyword(s):  
Asymptomatic Patient ◽  
Stent Fracture ◽  
Carotid Stent ◽  
Distal Embolization ◽  
Automobile Accident ◽  
Rare Manifestation ◽  
History Of ◽  
And Migration ◽  
Associated Risk Factors ◽  
Actual Prevalence

Background: Angioplasty using a carotid stent is a treatment modality for carotid stenosis, with results similar to those obtained with endarterectomy, as demonstrated by important studies. The increasing use of this procedure has also led to a larger number of reports of complications, stent fractures among those. Stent fracture is a rare manifestation and hence needs further studying so that its actual prevalence can be determined, as well as its associated risk factors and proper clinical management. The current study reports the case of a patient who had previously undergone angioplasty with a carotid stent and, after an automobile accident, presented with a stent fracture and distal embolization of fragments thereof with neurological manifestation. Case Description: A male patient, 40 years old, presented with a history of previously stent carotid angioplasty. He had been involved in an automobile accident and suffered a stent fracture with distal fragment migration. As he was an asymptomatic patient (NIHSS 0, Rankin zero), we opted for a conservative treatment with oral anticoagulant. Conclusion: Angioplasty is an effective treatment for extracranial atherosclerosis and, albeit rare, stent fractures can result in the migration of fragments thereof. This occurrence should be suspected in patients who have sustained severe neck injuries due to sudden deceleration and may be associated with thromboembolism.

Intraocular tuberculosis, a challenge in diagnosis and treatment

2020 ◽  
Vol 3 ◽  
pp. 4
Author(s):  
Martina Larroude ◽  
Gustavo Ariel Budmann
Keyword(s):  
Developing Countries ◽  
Clinical Signs ◽  
Steady Increase ◽  
Ocular Tuberculosis ◽  
Industrial Countries ◽  
Choroidal Granuloma ◽  
History Of ◽  
And Migration ◽  
Ocular Tb

Ocular tuberculosis (TB) is an extrapulmonary tuberculous condition and has variable manifestations. The incidence of TB is still high in developing countries, and a steady increase in new cases has been observed in industrial countries as a result of the growing number of immunodeficient patients and migration from developing countries. Choroidal granuloma is a rare and atypical location of TB. We present a case of a presumptive choroidal granuloma. This case exposes that diagnosis can be remarkably challenging when there is no history of pulmonary TB. The recognition of clinical signs of ocular TB is extremely important since it provides a clinical pathway toward tailored investigations and decision making for initiating anti-TB therapy and to ensure a close follow-up to detect the development of any complication.

Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

scholarly journals Giant Fibrovascular Polyp as an Unusual Cause of Globus Pharyngeus

2021 ◽  
pp. 014556132110039
Author(s):  
Jelena Sotirović ◽  
Ljubomir Pavićević ◽  
Stanko Petrović ◽  
Saša Ristić ◽  
Aleksandar Perić
Keyword(s):  
Differential Diagnosis ◽  
Asymptomatic Patient ◽  
Histopathological Examination ◽  
Complete Resection ◽  
Airway Compromise ◽  
Endoscopic Removal ◽  
Globus Sensation ◽  
Fibrovascular Polyp ◽  
History Of ◽  
Fatal Complications

Differential diagnosis of globus sensation in an otherwise asymptomatic patient should include hypopharyngeal fibrovascular polyp to avoid potentially fatal complications like airway compromise following regurgitation. We present a case of a 74-year-old man with a 13-cm long hypopharyngeal fibrovascular polyp with 9 months history of globus sensation. A narrow stalk of the giant polyp allowed endoscopic removal and complete resection with the CO2 laser. Histopathological examination was conclusive for the fibrovascular polyp.

Syphilis among men who have sex with men attending a large HIV clinic in Trinidad

2021 ◽  
pp. 095646242199719
Author(s):  
Robert Jeffrey Edwards ◽  
Isshad John ◽  
Selena Todd ◽  
Leon-Omari Lavia ◽  
David Musa ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Chart Review ◽  
Laboratory Data ◽  
Previous History ◽  
History Of ◽  
Review Study ◽  
Sex With Men ◽  
Associated Risk Factors ◽  
Living With Hiv ◽  
Age Range

A chart review study was conducted to determine the prevalence of syphilis and explore the associated risk factors among men who have sex with men (MSM) who attended a large HIV clinic in Trinidad during the period January–December 2019. Patients were routinely screened for syphilis annually, and demographic, clinical, and laboratory data were extracted from the medical records. Descriptive and bivariate analyses were performed, and factors significantly associated with a syphilis diagnosis were assessed using multivariate logistic regression. During the period, 218 MSM were seen, age range 19–67 years, and median age 34.0 years. The prevalence of syphilis was 41.3% (90/218), and 71.1% (64//90) of these infections were asymptomatic. Multivariate analysis using logistic regression showed that MSM living with HIV in the 30–34 years old-age group (OR, 4.32; 95% CI, 1.04–18.02), and those with a previous history of treated syphilis (OR, 10.18; 95% CI, 4.60–22.53) were more likely to be diagnosed with syphilis. The prevalence of syphilis is high among MSM attending the HIV clinic in Trinidad, and most of these infections were asymptomatic; hence, targeted and sustained interventions to reduce syphilis transmission are urgently required. Repeat episodes of syphilis may play a role in the transmission dynamics of syphilis in MSM.

scholarly journals Asymptomatic Eosinophilic Infiltration with Endoscopic and Histological Findings Consistent with Eosinophilic Gastritis

2021 ◽  
pp. 652-656
Author(s):  
Kazuki Yamamoto ◽  
Takeshi Okamoto ◽  
Katsuyuki Fukuda
Keyword(s):  
Asymptomatic Patient ◽  
Gastrointestinal Symptoms ◽  
The Body ◽  
Eosinophilic Infiltration ◽  
Histological Findings ◽  
High Power Field ◽  
Medical Checkup ◽  
Endoscopic Findings ◽  
Eosinophilic Gastritis ◽  
History Of

Eosinophilic gastritis often presents with gastrointestinal symptoms in the absence of abnormal endoscopic findings. On the other hand, endoscopic changes due to eosinophilic infiltration in an asymptomatic patient are rare. A 29-year-old woman with a history of asthma on steroid inhalers presented for an annual medical checkup. Esophagogastroduodenoscopy revealed diffuse white granular patches in the body of the stomach, suggestive of eosinophilic gastritis. Histology showed over 100 eosinophils per high-power field, also consistent with eosinophilic gastritis. As the absence of symptoms precluded the diagnosis of eosinophilic gastritis, the patient was diagnosed with asymptomatic eosinophilic infiltration of the stomach.

Pattern of Congenital Heart Diseases and Associated Risk Factors among Children at a Tertiary Care Hospital

2021 ◽  
Vol 15 (9) ◽  
pp. 2451-2453
Author(s):  
Shahid Iqbal ◽  
Muhammad Fareed Khan ◽  
Raja Imtiaz Ahmed ◽  
Shahab Saidullah ◽  
Nisar Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Folic Acid ◽  
Congenital Heart ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Care Hospital ◽  
Younger Age ◽  
History Of ◽  
Associated Risk Factors

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.

How Accurately Can Bruises Be Aged in Abused Children? Literature Review and Synthesis

PEDIATRICS ◽  
1996 ◽  
Vol 97 (2) ◽  
pp. 254-257
Author(s):  
ARI J. SCHWARTZ ◽  
LAWRENCE R. RICCI
Keyword(s):  
Child Abuse ◽  
Interobserver Reliability ◽  
Severe Case ◽  
Future Research ◽  
Abused Children ◽  
Color Wheel ◽  
The Us ◽  
Us Supreme Court ◽  
History Of ◽  
Associated Risk Factors

Unlike the severe abuse that was reported in early child abuse literature, more moderate injuries comprise 60% of physical child abuse. These less-severe abuse cases, many with limited, ill-defined bruising, may be more difficult to diagnose than a severe case with multiple-system injury or a child with specific, clearly imprinted bruising. Additionally, as the US Supreme Court observed, "Child abuse is one of the most difficult crimes to detect and prosecute in large part because there often are no witnesses except the victim. Estimates of ages of bruises along with the aging of other injuries such as fractures and brain trauma may offer the only way to associate an injury with a particular perpetrator. Yet, as an aid to child abuse diagnosis and perpetrator identification, visual aging of bruises remains an inexact science, despite recent composite charts that suggest otherwise. Even though it has been stated that it is not possible to age bruises accurately based on color, these opinions have not been represented in the child abuse literature. The study of Langlois and Gresham, to date the only research-based study of bruise aging by appearance, has not yet been cited in the medical literature (Science Citation Index search, August 1994). The available literature does not permit the estimation of a bruise's age with any precision based solely on color. Even for the practitioner to state, as Wilson suggests, that a particular bruise is "consistent with" a specific age implies a level of certainty not supported by the literature. Bruises may be described as "older" if yellow, brown, or green are present, but practitioners should note the limitations of bruise age analysis. Of course, the practitioner must continue to describe the size, shape, location, and color of each bruise accurately. This is best done by written description and drawings along with careful photographic representation. Photographs of a bruise, however, depending on available light and technique, may not represent color accurately. A standard color wheel in the photograph may help. Future research should focus on a number of questions. A study of the aging of bruises, using contusions of known age and history-blinded examiners, could determine how accurate clinical estimates are. Interobserver reliability may also be assessed in such a study. The study of Langlois and Gresham should be repeated to confirm or to refute their findings. A photographic sequence of various bruises from appearance to resolution would give researchers and clinicians a reference of possible colors in different-aged bruises for standardized description. The estimated age of a bruise should never be the sole criteria for a diagnosis of child abuse, but, rather, one component of a comprehensive assessment that incorporates a careful history of the injury, past medical history, family history, associated risk factors, a detailed physical examination, and appropriate laboratory testing.

scholarly journals Prevalence of postnatal depression and associated risk factors among South Asian mothers living in a newly developing country

2016 ◽  
Vol 9 (6) ◽  
pp. 57
Author(s):  
Hashim Mohamed
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Primary Health Care ◽  
South Asian ◽  
Postnatal Depression ◽  
Marital Problems ◽  
Primary Health ◽  
History Of ◽  
Associated Risk Factors ◽  
Asian Mothers

AbstractIntroductionPostnatal Depression (PND) is a major health problem affecting mother, her child and family.  Its prevalence and associated risk factors among South Asian mothers (SAM) living  in Qatar remain unknown. The objectives of this study were to estimate the prevalence of PND among (SEAM) in Qatar and to correlate risk factors contributing to the development of PND.Materials and methodsA total of (285 ) (SAM)females who were six months  postpartum were interviewed as  part of a prospective study conducted in primary health care centers in Qatar.  PND symptoms were defined as present when subjects had an Edinburgh Postnatal Depression Scale score of 10 or higher. Descriptive statistics were used for summarizing the study and outcome variables. The χ2 test and ORs with 95% confidence intervals (CIs) were used for observation and quantifying the association between different variables. Multivariate binary logistic regression was used to identify the independent associated factors of PPD. P≤0.05 was considered significant. Variables included were age , occupation, education level ,previous psychiatric history ,comorbidities , ,history of depression during current  pregnancy, history of anxiety during current pregnancy, number of previous pregnancies, strong social support, husband support, marital problem before pregnancy and ongoing marital problems during current pregnancy.Results The prevalence of postnatal depression among 285 respondents was 33.2% .several psychosocial risk factors were significantly associated with postnatal depression and, after multiple regression analysis, a history of depressive illness ,anxiety ,marital problems before delivery ,a history of diabetes and asthma ,history of congenital malformations ,and lack of mother support.Other variables, including age, parity, education, occupation, and delivery type, were not significantly correlated (P=0.15–0.95), but marginally indicative of the risk of depressive symptoms.ConclusionThis study showed a high rate of depressive symptoms among(SAM) six months Postpartum . Future screening protocols  must be employed at primary care level and hospital based clinics in Qatar to detect and treat post natal depression.Keywords: postnatal  depression,  South Asians, primary health care ,Doha, EPDS  

Endovascular Treatment of an Acute Superior Mesenteric Artery Occlusion following Failed Surgical Embolectomy

2003 ◽  
Vol 10 (2) ◽  
pp. 386-391 ◽  
Author(s):  
Saim Yilmaz ◽  
Alihan Gürkan ◽  
Okan Erdoğan ◽  
Timur Sindel ◽  
Kağan Çeken ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Occlusion ◽  
Distal Embolization ◽  
Primary Stenting ◽  
History Of ◽  
Surgical Embolectomy ◽  
Failed Surgery ◽  
Symptom Recurrence

Purpose: To present the successful primary stenting of a superior mesenteric artery (SMA) occlusion following failed surgical embolectomy. Case Report: A 65-year-old woman with a history of atrial fibrillation underwent surgical embolectomy of an acute embolic occlusion of the superior mesenteric artery (SMA). The following day, symptom recurrence suggested reocclusion, which was confirmed with emergent arteriography. Two balloon-expandable stents were deployed primarily, which ameliorated the patient's symptoms. Follow-up angiography at 3 months showed continued SMA patency, with no evidence of distal embolization or restenosis. The patient remains asymptomatic at 9 months after the stent procedure. Conclusions: Although more experience is required, primary stenting may be a valuable alternative in the treatment of acute SMA occlusions, in particular, for reocclusions after failed surgery.

scholarly journals ECCLESIASTIC TYPIKON FROM THE SCIENTIFIC LIBRARY OF KYIV UNIVERSITY: ATTRIBUTION OF MANUSCRIPT

2018 ◽  
pp. 24-29
Author(s):  
S. Voloshchenko
Keyword(s):  
Key Words ◽  
Construction Materials ◽  
The State ◽  
Slavonic Language ◽  
National University ◽  
History Of ◽  
Rare Books ◽  
And Migration

The principles of scientific attribution of liturgical cyrillic manuscripts, which has been worked out by author, are examined. The thorough study of Jerusalem Ecclesiastic Typikon from the rare books and manuscripts department’s collection of Maksymovych Scientific Library of Taras Shevchenko National University of Kyiv is conducted. The stages of manuscript attribution are analyzed, including the date identification and localization of its origins and use. The type and the title of the codex have been identificated by the analysis of book’s texts. The linguistic variant of Church Slavonic language, used for re-writing the copy, is revealed, which has helped to localize the place of creation. Detailed watermark analysis of paper, which the copy had been made of, has allowed to estimate date range of its production. The problematic ascertainment of the date of creation has been also supported by the analysis of the textual sources, studying of palaeographic peculiarities of cyrillic script book, the inner book’s decorative features. The problem of binding production date, its construction, materials and design, is formulated. The state of preservation of manuscript is analysed, which led the author to understanding the extent of book’s relevance for its readers. The history of manuscript restoration and its stages have been studied. The places of use and migration of the copy are revealed on the basis of provenance examination up till its arrival to Maksymovych Scientific Library’s rare books collection. Key words: Jerusalem Ecclesiastic Typikon, manuscript, Cyrillic manuscript, attribution, codicology, Maksymovych Scientific Library of Taras Shevchenko National University of Kyiv.

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