scholarly journals Case Report: Primary Pulmonary Angiosarcoma With Brain Metastasis

2022 ◽  
Vol 9 ◽  
Author(s):  
Xiangjun Tang ◽  
Jing Zhu ◽  
Fangcheng Zhu ◽  
Hanjun Tu ◽  
Aiping Deng ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Brain Edema ◽  
Mediastinal Lymph Node ◽  
Clinical Manifestations ◽  
Epileptic Seizures ◽  
Vascular Tumor ◽  
Intracranial Lesions ◽  
History Of ◽  
Persistent Headache ◽  
And Control

Primary pulmonary angiosarcoma (PPA) is a rare malignant vascular tumor, of which early diagnosis is challenging due to lack of specific clinical manifestations and a low level of suspicion. Here, we report a case of PPA presented with advanced brain metastasis. A 21-year-old patient with 1 week history of headache and mild cough was hospitalized for a head injury. Head MRI showed multiple intracranial lesions with brain edema. Chest CT displayed bilateral pulmonary infiltrates with mediastinal lymph node enlargement. After 2 months of anti-tuberculosis treatment, the patient was readmitted for persistent headache and cough with occasional hemosputum along with worsening pulmonary and intracranial lesions. Despite seizure prophylaxis and control of intracranial pressure and brain edema, his symptoms progressively aggravated, accompanied by cough with bloody sputum, frequent epileptic seizures, and hypotension. He eventually developed coma and died within 3 months of onset of symptoms. An autopsy confirmed PPA with brain metastasis.

scholarly journals Towards Central Nervous System Involvement in Adults with Hereditary Myopathies

2020 ◽  
Vol 7 (4) ◽  
pp. 367-393
Author(s):  
Jens Reimann ◽  
Cornelia Kornblum
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Neuromuscular Disorders ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Central Nervous System Involvement ◽  
Epileptic Seizures ◽  
System Involvement ◽  
History Of ◽  
Neuroimaging Techniques

There is increasing evidence of central nervous system involvement in numerous neuromuscular disorders primarily considered diseases of skeletal muscle. Our knowledge on cerebral affection in myopathies is expanding continuously due to a better understanding of the genetic background and underlying pathophysiological mechanisms. Intriguingly, there is a remarkable overlap of brain pathology in muscular diseases with pathomechanisms involved in neurodegenerative or neurodevelopmental disorders. A rapid progress in advanced neuroimaging techniques results in further detailed insight into structural and functional cerebral abnormalities. The spectrum of clinical manifestations is broad and includes movement disorders, neurovascular complications, paroxysmal neurological symptoms like migraine and epileptic seizures, but also behavioural abnormalities and cognitive dysfunction. Cerebral involvement implies a high socio-economic and personal burden in adult patients sometimes exceeding the everyday challenges associated with muscle weakness. It is especially important to clarify the nature and natural history of brain affection against the background of upcoming specific treatment regimen in hereditary myopathies that should address the brain as a secondary target. This review aims to highlight the character and extent of central nervous system involvement in patients with hereditary myopathies manifesting in adulthood, however also includes some childhood-onset diseases with brain abnormalities that transfer into adult neurological care.

The PAI-I Gene 4G/5G Polymorphism and Central Nervous System Bleeding In Factor XIII Deficiency

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4782-4782 ◽  
Author(s):  
Majid Naderi ◽  
Akbar Dorgalaleh ◽  
Shaban Alizadeh ◽  
Shadi Tabibian ◽  
Bamedi Taregh ◽  
...  
Keyword(s):  
Factor Xiii ◽  
Conflicts Of Interest ◽  
Clinical Manifestations ◽  
Control Group ◽  
Severe Bleeding ◽  
Bleeding Tendency ◽  
Intraparenchymal Hemorrhage ◽  
Factor Xiii Deficiency ◽  
History Of ◽  
And Control

Background FXIII deficiency is one of the rare bleeding disorder (RBD) that has a highest incidence in Sistan and Baluchistan province around the world. This disorder represents with different clinical manifestations ranging from mild to severe bleeding tendency including CNS bleeding. The aim of this study is to evaluate the role of PAI-14G/5Gpolymorphism in central nervous bleeding (intra and extracranial hemorrhage) system in factor XIII deficiency. Methods In this case control study was studied 32 FXIII deficient patients with CNS bleeding and also 32 patients with factor XIII deficiency without history of CNS bleeding as control group. Initially both groups were evaluated for the previously reported polymorphism of factor XIII (Trp187Argpolymorphism) in order to confirm their disorder. Then all patients were assessed for PAI-14G/5G polymorphism. Eventually obtained data was analyzed by SPSS software. Results The result of this study revealed that all study patients were homozygote for Trp187Arg polymorphism. We also found that the equal numbers of patients (4 individuals) in case and control groups were heterozygote for PAI-14G/5G polymorphism and none of patients were homozygote for this polymorphism. All heterozygote patients had intracranial hemorrhage and patients with extracranial hemorrhage had no mutation of PAI-14G/5G. Intraparenchymal was the most common site of hemorrhage and was observed in 26 patients (92.8%).We also observed subdural and epidural hemorrhage in two patients (7.1%).Anatomic regions in patients with intraparenchymal hemorrhage, were temporal in nine (32.2%), occipital in eight (28.6%), diffused intraparenchymal hemorrhage in seven (25%), tempro-occipital in two (7.1%) and subdural with temporal in two (7.1%) patients. Conclusion: It seems that PAI-14G/5G polymorphism did not any effect on occurrence of intra and extracranial hemorrhage in patients with factor XIII deficiency. Disclosures: No relevant conflicts of interest to declare.

scholarly journals 1219 A CASE OF A NIGHT TIME AFFAIR

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A466-A466
Author(s):  
Hamed Ali ◽  
Suzanne Stevens
Keyword(s):  
Clinical Manifestations ◽  
Epileptic Seizures ◽  
Clinical History ◽  
Neurological Deficits ◽  
Acting Out ◽  
Night Time ◽  
Sleep Study ◽  
Interictal Spike ◽  
Obstructive Sleep ◽  
History Of

Abstract Introduction Sleep associated seizures especially Nocturnal Frontal Lobe Epilepsy (NFLE) represents a spectrum of challenging clinical manifestations presenting as complex nocturnal movements/behaviors, making the diagnosis often difficult. Report of Case A 64 y/o male, with history of ongoing complex movements occurring during his sleep, with no history of strokes or neurological deficits. Had extensive neurologic workup (all negative) including routine electroencephalogram (EEG), prolonged inpatient EEG (12 hours), and MRI of the brain. Home sleep study showing moderate obstructive sleep apnea (OSA) AHI 24/hour successfully treated with CPAP therapy (residual AHI 1.7/hour) with improved nighttime symptoms initially. Wife recalls events as happening only at night while sleep, as patient often confused upon waking up in the morning, at times appear to sit up and smack his lips. No nighttime hallucinations, sleep paralysis, or acting out dreams were reported. Had two episodes associated with tongue biting and loss of bladder control. Another episode happened after a daytime nap, patient went outside and was mowing his lawn, went “completely blank “, appeared confused. No daytime or nighttime seizures were ever noticed. Patient do not recall any of the above events. Repeat EEG was normal. MRI/MRA of the head /neck showed small tiny focus in left frontoparietal lobe, suggesting remote cortical ischemic injury. Polysomnography (PSG) with seizure montage showed Interictal epileptic discharges (IEDs) foci recorded in the frontal/frontopolar leads without accompanying body movements. Interictal spike and wave activity seen during stage N2. Initially treated with carbamazepine (had skin reaction) switched to levetiracetam with complete resolution of his symptoms. Conclusion This case illustrates the importance of reviewing the clinical history, behavior semiology, and diagnostic ancillary testing such as polysomnography with EEG monitoring in distinguishing nocturnal epileptic seizures from other nocturnal complex behavior disorders and parasomnias.

scholarly journals Clinical characteristics of non-pneuminia COVID-19 infection adults in Shanghai, China

2020 ◽  
Author(s):  
Tao Li ◽  
Linjing Gong ◽  
Lijuan Hu ◽  
Haiying Ji ◽  
Zhilong Jiang ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Asymptomatic Infection ◽  
Ct Imaging ◽  
Adult Patients ◽  
Control Measures ◽  
Clinical Center ◽  
History Of ◽  
Family Aggregation ◽  
Prevention And Control Measures ◽  
And Control

Abstract Background Adult patients diagnosed as COVID-19 in Shanghai were accepted in Shanghai Public Health Clinical Center. We found around 4.91% of cases showed non-pneumonia on CT imaging when they were confirmed. Understanding the characteristics of non-pneumonia cases is of great significance to guide clinical treatment and improve prevention and control measures.Methods All dataset of demography, epidemiology, clinical manifestation, laboratory test, diagnosis, classification, condition change, treatment and outcome were obtained by retrospective investigation.Results 16 cases were confirmed COVID-19 with non-pneumonia with clear epidemiological history. The median age of patients was 37 years old and 81.25% were female. The median incubation period was 15.25 days. 75% patients were familial clusters. These patients were presented with mild clinical manifestations, such as bronchitis, common cold and asymptomatic infection with or without laboratory abnormalities. 4(25%)cases had underlying diseases. 3 of them had mild pneumonia on chest CT imaging during hospitalization. All of the cases were cured and discharged after support treatment.Conclusions A few of adult patients after COVID-19 infection had non-pneumonia, with mild clinical manifestations and long incubation time. It usually occurred in young women and history of family aggregation. The mild clinical symptom may be caused by the decreasing pathogenicity after multiple generation of virus replication. However, we should be on alert that the virus is still contagious to human. Therefore, an intensive attention should be paid to these patients to avoid misdiagnosis and overlook, because these patients are potential viral source in infection of other people.

scholarly journals Electroencephalogram and clinical manifestations of Rett syndrome in children

2016 ◽  
Vol 43 (4) ◽  
pp. 121
Author(s):  
E S Herini ◽  
I Mangunatmadja ◽  
Purboyo S ◽  
Hardiono D Pusponegoro ◽  
Sunartini Sunartini
Keyword(s):  
Rett Syndrome ◽  
Clinical Stage ◽  
Clinical Manifestations ◽  
Epileptic Seizures ◽  
Spike Discharge ◽  
History Of ◽  
Cortical Involvement ◽  
Almost All ◽  
Electroencephalogram Eeg ◽  
Epileptic Spike

Background Rett Syndrome (RS) is a severe neurodevelopmentaldisorder. Epileptic seizures occur in 80-90%; grandmal, psychomo-tor (complex partial), and focal motor seizures have been reported.The electroencephalogram(EEG) is almost always abnormal.Objective This study aimed to investigate the EEG and clinicalmanifestations of children with RSResults We investigated EEG on 5 patients with RS aged 30–66month. One patient was in clinical stage II and 4 patients in clini-cal stage III. Four patients had history of seizures, however onlytwo patients suffered from epilepsy. The EEG demonstrated slow-ing background activity in occipital region in two patients. In addi-tion, epileptic form activities were observed in 4 of 5 patients.Conclusion We concluded that epileptic spike discharge with orwithout clinical seizures were found in almost all of our RS pa-tients. These paroxysmal discharges suggested the process andthe sequences of cortical involvement. Compelling clinical, neuro-physiological evidences were very important to decide the stageof Rett disorder

THE RISK FACTORS OF MOLAR PREGNANCY

2017 ◽  
pp. 53-58
Author(s):  
Lam Huong Le
Keyword(s):  
High Risk ◽  
Gestational Trophoblastic Disease ◽  
Living Standard ◽  
Control Group ◽  
Uterine Perforation ◽  
Molar Pregnancy ◽  
Health It ◽  
Pregnancy Risk ◽  
History Of ◽  
And Control

Objectives: Molar pregnancy is the gestational trophoblastic disease and impact on the women’s health. It has several complications such as toxicity, infection, bleeding. Molar pregnancy also has high risk of choriocarcinoma which can be dead. Aim: To assess the risks of molar pregnancy. Materials and Methods: The case control study included 76 molar pregnancies and 228 pregnancies in control group at Hue Central Hospital. Results: The average age was 32.7 ± 6.7, the miximum age was 17 years old and the maximum was 46 years old. The history of abortion, miscarriage in molar group and control group acounted for 10.5% and 3.9% respectively, with the risk was higher 2.8 times; 95% CI = 1.1-7.7 (p<0.05). The history of molar pregnancy in molar pregnancy group was 9.2% and the molar pregnancy risk was 11.4 times higher than control group (95% CI = 2.3-56.4). The women having ≥ 4 times births accounted for 7.9% in molar group and 2.2% in control group, with the risk was higher 3.8 times, 95% CI= 1.1-12.9 (p<0.05). The molar risk of women < 20 and >40 years old in molar groups had 2.4 times higher than (95% CI = 1.1 to 5.2)h than control group. Low living standard was 7.9% in molar group and 1.3% in the control group with OR= 6.2; 95% CI= 1.5-25.6. Curettage twice accounted for 87.5%, there were 16 case need to curettage three times. There was no case of uterine perforation and infection after curettage. Conclusion: The high risk molar pregnancy women need a better management. Pregnant women should be antenatal cared regularly to dectect early molar pregnancy. It is nessecery to monitor and avoid the dangerous complications occuring during the pregnancy. Key words: Molar pregnancy, pregnancy women

Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

2020 ◽  
Vol 20 ◽  
Author(s):  
Sara Abolghasemi ◽  
Mohammad Alizadeh ◽  
Ali Hashemi ◽  
Shabnam Tehrani
Keyword(s):  
Chlamydia Trachomatis ◽  
Clinical Symptoms ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
Urinary Frequency ◽  
Serological Tests ◽  
Duration Of Symptoms ◽  
Two Samples ◽  
History Of ◽  
Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

Work and Technological Change

2020 ◽  
Author(s):  
Stephen R. Barley
Keyword(s):  
Artificial Intelligence ◽  
Historical Context ◽  
Energy Transformation ◽  
History Of ◽  
Work And Organizations ◽  
Role Based ◽  
Control Technologies ◽  
And Control ◽  
Work And Employment

The four chapters of this book summarize the results of thirty-five years dedicated to studying how technologies change work and organizations. The first chapter places current developments in artificial intelligence into the historical context of previous technological revolutions by drawing on William Faunce’s argument that the history of technology is one of progressive automation of the four components of any production system: energy, transformation, and transfer and control technologies. The second chapter lays out a role-based theory of how technologies occasion changes in organizations. The third chapter tackles the issue of how to conceptualize a more thorough approach to assessing how intelligent technologies, such as artificial intelligence, can shape work and employment. The fourth chapter discusses what has been learned over the years about the fears that arise when one sets out to study technical work and technical workers and methods for controlling those fears.

Galileo Unbound

2018 ◽  
Author(s):  
David D. Nolte
Keyword(s):  
Free Fall ◽  
The Sun ◽  
Quantum Field ◽  
Many Worlds ◽  
Quantum Particles ◽  
Light Rays ◽  
History Of ◽  
And Control ◽  
The Universe ◽  
Insight Into

Galileo Unbound: A Path Across Life, The Universe and Everything traces the journey that brought us from Galileo’s law of free fall to today’s geneticists measuring evolutionary drift, entangled quantum particles moving among many worlds, and our lives as trajectories traversing a health space with thousands of dimensions. Remarkably, common themes persist that predict the evolution of species as readily as the orbits of planets or the collapse of stars into black holes. This book tells the history of spaces of expanding dimension and increasing abstraction and how they continue today to give new insight into the physics of complex systems. Galileo published the first modern law of motion, the Law of Fall, that was ideal and simple, laying the foundation upon which Newton built the first theory of dynamics. Early in the twentieth century, geometry became the cause of motion rather than the result when Einstein envisioned the fabric of space-time warped by mass and energy, forcing light rays to bend past the Sun. Possibly more radical was Feynman’s dilemma of quantum particles taking all paths at once—setting the stage for the modern fields of quantum field theory and quantum computing. Yet as concepts of motion have evolved, one thing has remained constant, the need to track ever more complex changes and to capture their essence, to find patterns in the chaos as we try to predict and control our world.

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