Hyperpigmented nodular rash in a 61-year-old African American female

2022 ◽  
pp. 42-44
Author(s):  
Danielle C. Ware
Keyword(s):  
African American ◽  
Family Health ◽  
Aneurysm Rupture ◽  
African American Female ◽  
The Past ◽  
Below The Knee ◽  
Back Face ◽  
History Of ◽  
Skin Nodules

A 61-year-old African American female presents to an outpatient family health center with a hyperpigmented nodular rash of 2 months’ duration. The rash first appeared on her abdomen before spreading across her upper arms, lower leg, back, face and scalp. She has a history of controlled type 2 diabetes mellitus, cerebral aneurysm rupture, Sjögren’s syndrome, asthma and a left below-the-knee amputation due to osteomyelitis. She smokes cigarettes but does not use alcohol or illicit substances. She has also noticed a dry cough with mild dyspnea on exertion over the past 6 months. On physical exam, hyperpigmented nodules are palpable in both the intradermal and subcutaneous layers of the skin. Nodules are firm, mobile and nontender. Alopecia is noted where scalp nodules are present. Her lungs exhibit diminished air movement throughout, with scattered, end-expiratory wheezing.

Possible GoLytely-Associated Cardiac Arrest: A Case Report and Literature Review

2019 ◽  
Vol 33 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Yoonsun Mo ◽  
Shiv Gandhi ◽  
Jose Orsini
Keyword(s):  
Cardiac Arrest ◽  
Abdominal Pain ◽  
Sudden Cardiac Arrest ◽  
Lower Abdominal Pain ◽  
The Past ◽  
Life Threatening ◽  
History Of ◽  
Artery Disease ◽  
Possible Cause

Purpose: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). Summary: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. Conclusion: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.

scholarly journals MON-084 Hyperosmolar Hyperglycemic State as Initial Presentation of Type 1 Diabetes in Children

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Fabiola D’Ambrosio ◽  
Isabella Marranzini-Rodriguez ◽  
Roxana Aguirre Castaneda ◽  
Claudia Boucher-Berry
Keyword(s):  
African American ◽  
Early Recognition ◽  
Fluid Management ◽  
Low Frequency ◽  
Serum Glucose ◽  
African American Female ◽  
Appropriate Treatment ◽  
Hyperosmolar Hyperglycemic State ◽  
History Of ◽  
Sugary Beverages

Abstract INTRODUCTION: We present 2 pediatric patients with Hyperosmolar Hyperglycemic State (HHS) at diabetes onset. CASE 1: 3 year old African American female presented to the pediatrician office with a 5 day history of polydipsia, polyuria and emesis. POCT glucose read high and patient was transferred to the PICU. Laboratory studies were significant for serum glucose of 1032 mg/dl, Na 128 mMOL/L (corrected 142mMOL/L), VBG showed pH 7.36, HCO3 20 mMOL/L, Serum osm 331 mOsm/Kg. Patient received a 20ml/kg bolus of 0.9%NaCl, followed by 2 times maintenance IV fluids and glargine 2 units. Glucose dropped from 418 to 122 mg/dl in 3 hours. Due to this Dextrose was added and IVF rate was decreased. CASE 2: 8 year old African American obese male was admitted to the PICU for management of new onset diabetes. He presented with 3 days of flu-like symptoms and worsening drowsiness. Patient had increased consumption of large quantities of sugary beverages due to increased thirst. Laboratory workup: serum glucose of 2309 mg/dl, Na 133 mMOL/L (corrected 168 mMOL/L), pH 7.13, HCO3 10 mMOL/L. Patient was given 30 cc/kg NS bolus followed by an insulin drip of 0.1 u/kg/hour. Repeat studies 3 hours later showed a serum glucose of 1,414 mg/dl, Na 152 mMol/L (corrected 184 mMOL/L), pH 7.19, HCO3 17 mMOL/L, and serum osmolality of 408 mOsm/Kg. IVF were adjusted to correct the water deficit and insulin drip was decreased to 0.05u/kg/hour. DISCUSSION: HHS continues to be a challenging diagnosis due to its low frequency compared with Diabetic Ketoacidosis especially when presenting at a very young age. Most practitioners will mistake the presentation for DKA and start an insulin drip. The early use of insulin is not necessary in the setting of HHS due to the risk of complications. A fast drop in glucose decreases the osmotic pressure and compromises the circulatory status with a higher chance of thromboembolism. In mixed HHS and DKA, the management aligns more with the DKA management but the amount of fluids needed is higher and insulin infusion may cause fast drop of glucose with potential decrease of intravascular volume as in our second patient. It is imperative that the diagnosis of HHS is made early so that the appropriate treatment can be instituted. CONCLUSION: Appropriate fluid administration and delay in insulin administration are key in the management of HHS. The awareness of this possible presentation and the early recognition and appropriate fluid management are needed to improve outcomes. REFERENCE: Zeitler, Phil, et al. “Hyperglycemic Hyperosmolar Syndrome in Children: Pathophysiological Considerations and Suggested Guidelines for Treatment.” The Journal of Pediatrics, vol. 158, no. 1, 2011, doi:10.1016/j.jpeds.2010.09.048

Factor VII Deficiency - A Restrospective Case Review.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4011-4011
Author(s):  
Randi J. Katz ◽  
Amir Steinberg ◽  
Robert Klafter
Keyword(s):  
African American ◽  
Tooth Extraction ◽  
Descriptive Study ◽  
Factor Vii ◽  
Bleeding Complications ◽  
African American Female ◽  
Factor Level ◽  
Factor Vii Deficiency ◽  
Factor Deficiency ◽  
History Of

Abstract Factor VII deficiency is a rare autosomal recessive disorder. Its incidence is thought to be 1 in 500,000. Symptoms vary from mild to severe. Factor VII deficient patients usually do not experience bleeding if their level of factor VII is less than 10%. Manifestations are seen with levels less than 5%, and severe bleeding can occur with levels less than 1%. Surgical hemostasis is obtained with levels greater than 25%. Factor VII deficiency is notable for causing a prolonged PT with a normal aPTT, making the diagnosis easy to determine. This is a descriptive study based on a population of patients from our community based teaching hospital with severe Factor VII deficiency. We reviewed lab data and found any patients with less than a 5% factor deficiency from March 2004- June 2006. In our experience we have noted varying manifestations in moderate factor deficiency patients. We describe four patients with varying symptoms, all with factor levels less than 3%. Their charts were reviewed, and three of the patients were available for a telephone interview. Patient A is a 75 yo African American female found to have factor deficiency after an increased Prothrombin time (PT) of 31.2 seconds, INR 5.9, and Partial thromboplastin time (PTT) of 34.9 seconds on routine blood work. This patieny’s factor level was found to be 1.86%. Patient A denied any history of bleeding complications, including an uncomplicated tooth extraction. Patient B is a 46 yo African American female with a long history of bleeding complications. Laboratory data revealed a PT of 26 seconds, INR 4.2, PTT 22 seconds and a Factor level of 1%. She experienced years of heavy menstrual periods and nose bleeds. A hysterectomy was performed secondary to bleeding fibroids. She required multiple doses of novoseven as well as FFP. Patient C was diagnosed at the age of 11. Laboratory results revealed a factor level of 1.87 %, and a PT of 25.1 seconds and an INR of 4.1. She has had minor bleeding events, such as gum bleeding. She did receive FFP prior to a foot surgery, and tooth extraction. Patient D is a 46 year old Hispanic man found to have and INR of 4.3 and, factor VII 1.45. Pt had an uncomplicated cholocystectomy. This is a descriptive study of four different patients with factor VII levels of less than 2%. These four cases demonstrate the wide range of clinical manifestations that factor VII patients may experience. One patient did require novoseven prior to a hysterectomy. Though, as our cases illustrate, some patients do not experience any bleeding manifestations, and therefore, prophylactic plasma may not be required. Furthermore, treatment of factor VII deficient patients needs to be individualized, and guided by personal history. Coagulation Studies of our Patients Patient Prothrombin Time INR Factor VII A 31.2 5.9 1.86% B 26 4.2 1% C 25.1 4.1 1.87% D 46 4.3 1.45%

scholarly journals The Nickel: A History of African-Descended People in Houston’s Fifth Ward

Genealogy ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. 33
Author(s):  
Denise Frazier
Keyword(s):  
African American ◽  
African Americans ◽  
Research Review ◽  
Early 20Th Century ◽  
Port City ◽  
East Texas ◽  
Religious Groups ◽  
The Past ◽  
History Of ◽  
Over Time

This paper will chronicle the unique stories that have come to exemplify the larger experience of Fifth Ward as a historically African American district in a rapidly changing city, Houston. Fifth Ward is a district submerged in the Southern memory of a sprawling port city. Its 19th century inception comprised of residents from Eastern Europe, Russia, and other religious groups who were fleeing persecution. Another way to describe Fifth Ward is much closer to the Fifth Ward that I knew as a child—an African American Fifth Ward and, more personally, my grandparents’ neighborhood. The growing prosperity of an early 20th century oil-booming Houston had soon turned the neighborhood into an economic haven, attracting African Americans from rural Louisiana and east Texas. Within the past two decades, Latino communities have populated the area, transforming the previously majority African American ward. Through a qualitative familial research review of historic documents, this paper contains a cultural and economic analysis that will illustrate the unique legacies and challenges of its past and present residents. I will center my personal genealogical roots to connect with larger patterns of change over time for African Americans in this distinct cultural ward.

scholarly journals Historiography in “Beginnings: Malcolm” by Amiri Baraka

2014 ◽  
Vol 40 ◽  
pp. 22-28
Author(s):  
Maryam Hosseini ◽  
Hossein Pirnajmuddin
Keyword(s):  
African American ◽  
Black People ◽  
Amiri Baraka ◽  
Western Literature ◽  
The Past ◽  
History Of ◽  
Literature Culture ◽  
Insight Into ◽  
The Way

This article discusses Aimiri Baraka‘s concern with the history of black people in his poem ―Beginnings: Malcolm‖. The writers try to shed some light on the way Baraka‘s historiography challenges the white supremecist discourses through a rewriting of the African American past that blurs the boundaries of myth and history, fact and fiction, in a postmodern manner. It is argued that through the use of the central African myth of Esu/Elegba and drawing on traditions of Christianity and Western literature/culture, Baraka‘s poem offers an uncanny insight into the past.

A Case of HPP with a Novel Combination of α and β Spectrin Mutations.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1736-1736
Author(s):  
Kavita Natarajan ◽  
Ferdane Kutlar ◽  
Tao Li ◽  
Patrick Gallagher ◽  
Abdullah Kutlar
Keyword(s):  
African American ◽  
Sequence Data ◽  
Novel Mutation ◽  
African American Female ◽  
Red Cell ◽  
Red Cell Membrane ◽  
Amino Terminal ◽  
Blood Disorder ◽  
Immune Hemolytic Anemia ◽  
History Of

Abstract Hereditary pyropoikilocytosis (HPP) is a red cell membrane disorder classified under the broad umbrella of hereditary elliptocytosis (HE). It is usually the most severe form of HE and is inherited in an autosomal recessive manner. HE results from alterations in RBC membrane cytoskeleton proteins: spectrin, ankyrin, pallidin, band 4.1, and band 3. Quantitative or qualitative deficiencies result in varying clinical syndromes. In general, mutations in the α gene are closer to the amino terminal, and those in the β spectrin gene are nearer the carboxyl terminal and affect the formation of tetramers. We describe a patient associated with a novel mutation in the β and α spectrin genes. A 19 year old black female with a lifelong history of anemia and jaundice that worsened since age 15 presented with history of early satiety of a few months duration. Neither parent had a history of a blood disorder; a maternal uncle had history of splenectomy in his thirties. Her pre-splenectomy labs showed a Hb of 4.8g/dl with a MCV of 62, RDW of 38.8, and chemistries consistent with non-immune hemolytic anemia. Imaging and clinical exam revealed a spleen of 19cms and bizarre red cell morphology including RBC fragmentation and microcytosis. Post splenectomy the patient is entirely asymptomatic with a Hb of 13.2 with pathologic exam of the spleen showing benign, enlarged, red pulp consistent with hypersplenism. Genomic DNA was extracted from peripheral blood. Sequencing of the β-spectrin exon 30 was undertaken at the MCG Sickle Cell Center that revealed a GCT → CCT mutation (Ala → Pro) in codon 2053. This mutation has been previously reported in the homozygous state in a young boy from Mali with HPP (β spectrin Kayes). Since we could not explain the relatively severe phenotype in this patient with heterozygous β spectrin Kayes, further molecular analyses was performed at Yale. This revealed a mutation in the α-spectrin exon 5; L207P, α spectrin St.Louis. This is the 2nd reported case of HPP due to compound heterozygosity for an α and β spectrin mutation and the first combination of α spectrin St. Louis and β spectrin Kayes. African American female, 19 years old Diagnoses: “Pyropoikilocytosis” Sequence data: Spectrin bate-Kayes African American female, 19 years old Diagnoses: “Pyropoikilocytosis” Sequence data: Spectrin bate-Kayes

Gnatophyma and Otophyma

2009 ◽  
Vol 13 (5) ◽  
pp. 266-272 ◽  
Author(s):  
Navid Ezra ◽  
Joseph F. Greco ◽  
Jennifer C. Haley ◽  
Melvin W. Chiu
Keyword(s):  
African American ◽  
African American Male ◽  
Line Treatment ◽  
Epidermal Hyperplasia ◽  
First Line ◽  
The Past ◽  
The Face ◽  
History Of ◽  
End Stage ◽  
First Line Treatment

Background: Phymas are slowly progressive, disfiguring disorders of the face and ears that represent the end stage of rosacea. The most common phyma is rhinophyma, yet similar swellings may occur on the chin (gnatophyma), forehead (metophyma), one or both ears (otophyma), and eyelids (blepharophyma). Objective: Unlike rhinophyma, otophyma is rarely seen. We report two rare phymas: a case of gnatophyma and a case of otophyma. Methods: A 56-year-old African American man presented with a history of bumps on his chin that had begun about 7 years earlier. Physical examination was remarkable for lobulated plaques on the chin, coalescing into hypertrophic nodules and dilated pores. A 73-year-old African American male presented with bilateral cauliflower-like earlobe growths for the past 17 years. Results: A skin biopsy was performed for each patient demonstrating cystic follicular dilatation with keratin plugging, dermal scarring, psoriasiform epidermal hyperplasia, and chronic inflammation of some of the follicles. Conclusion: This case report describes a relatively rare gnatophyma and otophyma. Surgical management is well accepted as the best mode of therapy to treat rhinophyma and is becoming a first-line treatment for all phymas.

Literacy and the Decolonization of Africa's Intellectual History

2011 ◽  
Vol 38 ◽  
pp. 35-46 ◽  
Author(s):  
Esperanza Brizuela-Garcia
Keyword(s):  
African American ◽  
Intellectual History ◽  
Intellectual Development ◽  
Complex Nature ◽  
African History ◽  
The Past ◽  
Middle Way ◽  
History Of ◽  
Written Sources

In his book In My Father's House Anthony Appiah made a powerful argument for historians and intellectuals at large to recognize the diverse and complex nature of Africa's cultural and historical experiences. He stated, for instance, that: “ideological decolonization is bound to fail if it neglects either endogenous ‘tradition’ or exogenous ‘Western’ ideas, and that many African (and African American) intellectuals have failed to find a negotiable middle way.”During the past fifty years, Africanist historians have focused much of their efforts on the goals of decolonizing or Africanizing the study of the African past. These have been guided by the need to produce a more authentic and relevant history of the continent. The search for such authenticity has shown that African cultures and societies are often the result of a broad range of influences and that the notions of what is indigenous or authentically African needs to take into account this historical complexity. Intellectual historians, in particular, have faced this question with regards to written sources. The question of literacy and its impact on the intellectual development of Africa is an interesting example of how historians have made some strides towards redefining the notion of a decolonized African history.

Theatricality in Contemporary Visual and Performance Art on New World Slavery

2016 ◽  
Author(s):  
Ilka Saal
Keyword(s):  
African American ◽  
Case Studies ◽  
Visual Arts ◽  
Performance Art ◽  
New World ◽  
Racial Stereotypes ◽  
The Past ◽  
Traumatic History ◽  
History Of ◽  
And Performance

This article examines forms and uses of theatricality in recent African American productions on slavery in the performing and the visual arts. It argues that by deploying modes of the comic, such as satire and parody, along with racial stereotypes, in their engagement with the traumatic history of slavery, contemporary artworks aim to provoke their audiences into an affective relationship with the artwork and the history it represents. In this manner, they seek to bring into focus not the past itself but our present-day reactions to it, asking viewers to reflect on their involvement with the ongoing mimetic and affective legacies of New World slavery. The article discusses Suzan-Lori Parks’s 1996 playVenusand Kara Walker’s 2014 installation ASubtlety or the Marvelous Sugar Babyas case studies.

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