scholarly journals Surgical Management of Keratoconus in a Young Adult with Cognitive and Behavioral Disability

2020 ◽  
pp. 1-4
Author(s):  
W. Walker Motley ◽  
Patricia I. Cobb ◽  
W. Walker Motley
Keyword(s):  
Cognitive Impairment ◽  
Surgical Management ◽  
Aggressive Behaviour ◽  
Treatment Plan ◽  
Behavioural Treatment ◽  
Behavioral Issues ◽  
Post Operative Pain ◽  
History Of ◽  
Corneal Collagen Crosslinking ◽  
Behavioral Disability

Case Presentation: A 25-year-old man with cognitive impairment (CI) and behavioral issues presented for corneal collagen crosslinking (CXL) surgical management of progressive keratoconus. Results: The conventional CXL technique was modified to avoid complications due to potential postoperative behavioral issues. Conclusions: Significant post-operative pain and aggressive behaviour can occur following epi-on CXL. Aggressive behaviour can result in significant complications in relatively low-risk eye surgery. Preoperatively, it is appropriate to devise a multifaceted surgical, medical and behavioural treatment plan including psychotropic if needed in patients with history of cognitive impairment and aggressive behaviour.

scholarly journals Présentation atypique de la trichotillomanie : un cas clinique avec revue de la littérature

2021 ◽  
Vol 8 (2) ◽  
pp. 182-184
Author(s):  
Fayçal Walid Ikhlef ◽  
Keyword(s):  
Mental Illness ◽  
Access To Health Care ◽  
Treatment Plan ◽  
Prior History ◽  
Behavioral Issues ◽  
Cultural Variations ◽  
History Of ◽  
Cas Clinique ◽  
Attitudes Toward Mental Illness ◽  
Elevated Rate

Trichotillomania is a chronic mental illness with an elevated rate of psychiatric comorbidities. Patients with Trichotillomania often have a low insight putting them at risk for serious health problems such as depression, social dysfunction, body damage, malnutrition, even death in severe cases if untreated. Not all patients have access to health care, most of them live in difficult environments with different cultural variations and attitudes toward mental illness making them more vulnerable. The literature suggests that there is a variety of psychotherapies and medications that may help in managing Trichotillomania. The present case is of a woman with no prior history of mental illness, who was brought by her father for behavioral issues. During her evaluation we observed various symptoms associated with different pathologies, exemplifying the difficulties to diagnose individuals with Trichotillomania and to prepare a treatment plan for them

Surgical Management of Bilateral Maxillary Buccal Exostosis in a patient with polydactyly and distomolars - A Rare Case Report

2020 ◽  
Vol 7 ◽  
Author(s):  
Sultan Alanazi
Keyword(s):  
Surgical Management ◽  
Rare Case ◽  
Treatment Plan ◽  
Nonsurgical Periodontal Therapy ◽  
Gingival Enlargement ◽  
Rare Case Report ◽  
Operative Evaluation ◽  
History Of ◽  
The Right ◽  
Oral Hygiene Instructions

Introduction: Buccal exostosis is bony prominence located on buccal side of alveolar ridge of maxilla or mandible. It is commonly seen in maxilla than mandible, whereas the etiology remains unclear. This article presents a rare case of bilateral maxillary buccal exostosis, distomolars and polydactyly along with surgical management of exostosis.Case Report: A 39-year-old Yemeni male patient came to the dental OPD with a chief complain of swelling in the right and left back region of upper jaw from 12 years, which was a cosmetic concern to the patient. Patient was medically healthy with no familial history of gingival overgrowth. On examination, patient had polydactyly and bilateral mandibular distomolars. These isolated findings couldn’t be related to any syndrome after thorough examination and medical consultation. Finally, the treatment plan consisted of, oral hygiene instructions, mechanical debridement and periodontal resective osseous surgery, so as to reduce gingival inflammation and improve esthetic by removing the exostosis. Nonsurgical periodontal therapy alone did not reduce the gingival enlargement because of the bony nature of enlargement, thus necessitating surgical intervention.Conclusion: Post-operative evaluation at 1, 3 and 12 months reveled an uneventful healing and no sign of recurrence at surgical sites.

Case Exercise: Toxic Exposure-Related Illness: Causation, Diagnosis, and Permanent Impairment

2007 ◽  
Vol 12 (2) ◽  
pp. 4-8
Author(s):  
Frederick Fung
Keyword(s):  
Concentration Level ◽  
Treatment Plan ◽  
Toxic Exposure ◽  
Dose Response Relationship ◽  
Specialty Board ◽  
History Of ◽  
Subjective Complaints ◽  
Based Medicine ◽  
Illness Causation ◽  
Rule Out

Abstract A diagnosis of toxic-related injury/illness requires a consideration of the illness related to the toxic exposure, including diagnosis, causation, and permanent impairment; these are best performed by a physician who is certified by a specialty board certified by the American Board of Preventive Medicine. The patient must have a history of symptoms consistent with the exposure and disease at issue. In order to diagnose the presence of a specific disease, the examiner must find subjective complaints that are consistent with the objective findings, and both the subjective complaints and objective findings must be consistent with the disease that is postulated. Exposure to a specific potentially causative agent at a defined concentration level must be documented and must be sufficient to induce a particular pathology in order to establish a diagnosis. Differential diagnoses must be entertained in order to rule out other potential causes, including psychological etiology. Furthermore, the identified exposure at the defined concentration level must be capable of causing the diagnosis being postulated before the examiner can conclude that there has been a cause-and-effect relationship between the exposure and the disease (dose-response relationship). The evaluator's opinion should make biological and epidemiological sense. The treatment plan and prognosis should be consistent with evidence-based medicine, and the rating of impairment must be based on objective findings in involved systems.

Enhanced Vocational Rehabilitation: A Pilot for Veterans With Cognitive Impairment and a History of Mild TBI

2012 ◽  
Author(s):  
Maureen K. O'Connor ◽  
Lisa Mueller ◽  
Alicia Semiatin ◽  
Charles E. Drebing ◽  
Shihwe Wang
Keyword(s):  
Cognitive Impairment ◽  
Vocational Rehabilitation ◽  
Mild Tbi ◽  
History Of

Surgical management of choke through oesophagotomy in a buffalo: A case report

2017 ◽  
Vol 12 (3) ◽  
Author(s):  
Devasee Borakhatariya ◽  
A. B. Gadara
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Thoracic Inlet ◽  
Cervical Oesophagus ◽  
Foreign Objects ◽  
History Of ◽  
Oesophageal Obstruction ◽  
Large Animals

Oesophageal disorders are relatively uncommon in large animals. Oesophageal obstruction is the most frequently encountered clinical presentation in bovine and it may be intraluminal or extra luminal (Haven, 1990). Intraluminal obstruction or “choke” is the most common abnormality that usually occurs when foreign objects, large feedstuff, medicated boluses, trichobezoars, or oesophageal granuloma lodge in the lumen of the oesophagus. Oesophageal obstructions in bovine commonly occur at the pharynx, the cranial aspect of the cervical oesophagus, the thoracic inlet, or the base of the heart (Choudhary et al., 2010). Diagnosis of such problem depends on the history of eating particular foodstuff and clinical signs as bloat, tenesmus, retching, and salivation

Voltage-gated potassium channel limbic encephalitis presenting as functional cognitive impairment

2020 ◽  
Vol 13 (12) ◽  
pp. e233179
Author(s):  
Eric Garrels ◽  
Fawziya Huq ◽  
Gavin McKay
Keyword(s):  
Cognitive Impairment ◽  
Case Report ◽  
Potassium Channel ◽  
Limbic Encephalitis ◽  
Psychiatric Symptoms ◽  
Differential Diagnoses ◽  
Visual Hallucinations ◽  
Voltage Gated ◽  
History Of ◽  
Impaired Cognition

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.

Occurrence of seromucinous borderline tumours in the peritoneal lesions after bilateral salpingo-oophorectomy

2020 ◽  
Vol 13 (12) ◽  
pp. e234692
Author(s):  
Taihei Yamada ◽  
Satoko Eguchi ◽  
Ikuko Yokoo ◽  
Takahide Arimoto
Keyword(s):  
Malignant Transformation ◽  
Surgical Management ◽  
Previous History ◽  
Cancer Antigen ◽  
History Of

A 65-year-old woman with a previous history of bilateral salpingo-oophorectomy had peritoneal cysts, increasing in size over 15 years and an increasing cancer antigen 19–9 (CA 19–9) level. The size of the cysts eventually reached 86 mm and 70 mm. As malignant transformation of endometriosis was suspected, we performed peritoneal cystectomy and hysterectomy. Histopathology revealed seromucinous borderline tumours (SMBTs) derived from endometriosis. One month after surgery, her CA 19-9 level had decreased. It is rare for SMBT to occur after bilateral salpingo-oophorectomy; surgical management is the best treatment at present.

scholarly journals Autologous Graft in the Anterior Maxilla—A Case Report

2021 ◽  
Vol 5 (1) ◽  
pp. 36
Author(s):  
Rodolfo Vaz ◽  
Pedro Gameiro ◽  
Pedro Sottomayor ◽  
Bernardo Saldanha ◽  
Pedro Rodrigues
Keyword(s):  
Bone Regeneration ◽  
Gold Standard ◽  
Treatment Plan ◽  
Previous History ◽  
Guided Bone Regeneration ◽  
Bone Thickness ◽  
Anterior Maxilla ◽  
Patient Morbidity ◽  
History Of ◽  
Palatal Bone

A 44-year-old male patient was referred to the Egas Moniz Dental Clinic, with a previous history of failed bone regeneration, resulting in a reduced buccal-palatal bone thickness and aesthetic compromise of the gingival margin of the anterior maxilla. Since the use of autologous bone is considered the “gold-standard” in guided bone regeneration, the treatment plan consisted of an autologous mental graft into the maxilla, with a simultaneous guided bone regeneration with a xenograft and absorbable membrane. This allowed a predictable volumetric bone regeneration with low patient morbidity and posterior fixed rehabilitation.

scholarly journals The fat anchor orchiopexy technique: results and outcomes from 150 cases surgical experience

2021 ◽  
Author(s):  
Claudio Spinelli ◽  
Alessia Bertocchini ◽  
Gianmartin Cito ◽  
Marco Ghionzoli ◽  
Silvia Strambi
Keyword(s):  
Undescended Testis ◽  
Healing Process ◽  
Day Surgery ◽  
Post Surgery ◽  
Post Operative Pain ◽  
Surgical Wounds ◽  
Bilateral Cryptorchidism ◽  
Long Time ◽  
History Of

Abstract Purpose The purpose of the study is to evaluate results and outcomes in a long-time follow-up period, by performing a novel testicular fixation procedure, known as “fat anchor orchidopexy” (FAO), for the treatment of palpable low inguinal undescended testis. Materials and methods We retrospectively reviewed all patients who underwent scrotal orchiopexy technique, from May 2013 to May 2019, at the Pediatric Surgery Division of Department of Surgical Pathology, University of Pisa (Italy). FAO (Spinelli’s technique) consists in anchoring the testicles to sub-scrotal fat with a single trans-scrotal incision. All the patients enrolled had history of unilateral or bilateral undescended testis. Data collected included patient’s age, operative times and complications. Results A total of 150 children with cryptorchidism were treated using a single trans-scrotal orchiopexy. Of them, 130 patients (86.7%) had unilateral undescended testis and 20 (13.3%) bilateral cryptorchidism. Mean patient’s age was 21 months (range: 14–28 months). All the procedures were planned in a day-surgery setting. Trans-scrotal orchiopexy was successful in all cases and no patients required an additional groin incision. No intraoperatively and postoperatively major complications were observed. Patients’ post-operative pain was mild (mean pediatric visual analog scale = 2). In all cases, the healing process was rapid and no surgical wounds infections were reported during the post-operative period, referring excellent cosmesis results. During a mean 48-month follow-up period, no testicular retraction, recurrence or testis atrophy was reported. Conclusion The original Spinelli’s technique (FAO) proves to be a safe and effective method for the treatment of palpable or distal-to-external-inguinal-ring testes. No immediate and delayed post-surgery complications were reported. In all cases, the anchored testicle remained in the scrotal position with normal vascularization. This novel surgical technique could give better options for scrotal fixation in case of low-lying cryptorchid testes.

The Psychiatric Interview and Mental Status Examination

2017 ◽  
Author(s):  
Donald W. Black
Keyword(s):  
Differential Diagnosis ◽  
Social History ◽  
Mental Status ◽  
Treatment Plan ◽  
Essential Elements ◽  
Comprehensive Treatment ◽  
Psychiatric Interview ◽  
Psychomotor Activity ◽  
History Of ◽  
Mental Status Examination

The interview and mental status examination are integral to the comprehensive patient assessment and typically follow a standard approach that most medical students and residents learn. The psychiatrist should adjust his or her interview style and information-gathering approach to suit the patient and the situation. For example, inpatients are typically more symptomatic than outpatients, may be in the hospital on an involuntary basis, and may be too ill to participate in even the briefest interview. Note taking is an essential task but should not interfere with patient rapport. The interview should be organized in a systematic fashion that, although covering all essential elements, is relatively stereotyped so that it allows the psychiatrist to commit the format to memory that, once learned, can be varied. The psychiatrist should start by documenting the patient’s identifying characteristics (age, gender, marital status) and then proceed to the chief complaint, history of the present illness, past medical history, family and social history, use of drugs and alcohol, medications, and previous treatments. A formal mental status includes assessment of the patient’s appearance, attitude, and behavior; orientation and sensorium; mood and affect; psychomotor activity; thought process, speech, and thought content; memory and cognition (including attention and abstraction); and judgment and insight. With the data collected, the psychiatrist will construct an accurate history of the symptoms that will serve as the basis for developing a differential diagnosis, followed by the development of a comprehensive treatment plan. This review contains 1 figure, 3 tables, and 12 references. Key words: assessment, differential diagnosis, interviewing, mental status examination, treatment plan

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