scholarly journals Is Pulmonary Thromboembolism uncommon in Nigeria? A case series in a private tertiary hospital in Ogun State, Nigeria.

2020 ◽  
Vol 3 (2) ◽  
pp. 45-54
Author(s):  
John Ogunkoya ◽  
Afolashade Oluwole ◽  
Ezuduemoih Daniel ◽  
Osaze Ehioghae ◽  
Oyebimpe Ajiboye
Keyword(s):  
Clinical Symptoms ◽  
Pulmonary Thromboembolism ◽  
Case Series ◽  
The United States ◽  
The Body ◽  
Lower Limbs ◽  
Sub Saharan Africa ◽  
Common Disease ◽  
Tertiary Institution ◽  
Ogun State

Background: Pulmonary thromboembolism is total or partial obstruction of one or more divisions of pulmonary arterial vasculature. It is a common disease presentation that is well studied and documented in the United States of America and Western Europe. It is often the result of part of a thrombotic lesion in deep veins (Deep Vein Thrombosis) elsewhere in the body most commonly the lower limbs and the pelvic region. There are few documented cases in Nigeria and sub-Saharan Africa as a result of poorly equipped hospitals and poorly trained health care personnel. Case presentation: Twenty-Nine (29) cases were seen in a Private Tertiary institution in Ogun State, Nigeria. Computerized Tomography with Pulmonary Angiography had helped to confirm these cases, with prompt intervention thereby reducing morbidity and mortality significantly. Only 3(three) mortality was recorded out of 29 cases seen between July 2016 and June 2020. Discussion and conclusion: Pulmonary thromboembolism is not uncommon in Nigerians and black Africans as available data previously suggested. All hands must be on deck to identify potential cases and investigate at-risk individuals who have clinical symptoms that are often misdiagnosed as other disease entities.

scholarly journals The Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 in a Pediatric Healthcare Network in the United States

2020 ◽  
Vol 9 (5) ◽  
pp. 523-529 ◽  
Author(s):  
William R Otto ◽  
Sarah Geoghegan ◽  
Leila C Posch ◽  
Louis M Bell ◽  
Susan E Coffin ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
Healthcare Providers ◽  
Case Series ◽  
The United States ◽  
Retrospective Case ◽  
White Children ◽  
Healthcare Network ◽  
Pediatric Healthcare

Abstract Background Understanding the prevalence and clinical presentation of coronavirus disease 2019 in pediatric patients can help healthcare providers and systems prepare and respond to this emerging pandemic. Methods This was a retrospective case series of patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across a pediatric healthcare network, including clinical features and outcomes of those with positive test results. Results Of 7256 unique children tested for SARS-CoV-2, 424 (5.8%) tested positive. Patients aged 18–21 years had the highest test positive rate (11.2%), while those aged 1–5 years had the lowest (3.9%). By race, 10.6% (226/2132) of black children tested positive vs 3.3% (117/3592) of white children. By indication for testing, 21.1% (371/1756) of patients with reported exposures or clinical symptoms tested positive vs 3.8% (53/1410) of those undergoing preprocedural or preadmission testing. Of 424 patients who tested positive for SARS-CoV-2, 182 (42.9%) had no comorbidities, 87 (20.5%) had asthma, and 55 (13.0%) were obese. Overall, 52.1% had cough, 51.2% fever, and 14.6% shortness of breath. Seventy-seven (18.2%) SARS-CoV-2–positive patients were hospitalized, of whom 24 (31.2%) required respiratory support. SARS-CoV-2-targeted antiviral therapy was given to 9 patients, and immunomodulatory therapy to 18 patients. Twelve (2.8%) SARS-CoV-2-positive patients required mechanical ventilation, and 2 patients required extracorporeal membrane oxygenation. Two patients died. Conclusions In this large cohort of pediatric patients tested for SARS-CoV-2, the rate of infection was low but varied by testing indication. The majority of cases were mild and few children had critical illness.

scholarly journals Glaucoma and Diabetes: A Sweet Connection

2020 ◽  
Vol 3 ◽  
Author(s):  
Chevy Singh ◽  
Denis Jusufbegovic ◽  
John Lind ◽  
Padmanabhan Pattabiraman
Keyword(s):  
Intraocular Pressure ◽  
Optic Nerve ◽  
The United States ◽  
The Body ◽  
Common Disease ◽  
Many Body ◽  
Related Disorder ◽  
Age Related ◽  
Increase Risk ◽  
Many Body Systems

Background/Objective:   Glaucoma is the leading cause of irreversible blindness in the world. In the United States alone, a little more than three million people live with this disorder which is caused by damage to the optic nerve found in the back of the eye. This is most commonly caused by an increase in the intraocular pressure, or the fluid that maintains the shape and provides nutrients to the eye. Diabetes mellitus (DM), an age-related disorder, is a risk factor for glaucoma. Post-meal, the sugar one eats is managed in the body by the hormone insulin. However, the excess sugar found in diabetics, can exhaust the production of insulin and lead to many adverse complications in the body as well as increase risk of disease. Although some studies suggest a correlation between diabetes and glaucoma, the mechanisms of this association has not been thoroughly investigated. Our objective is to further explore this connection and provide the mechanisms that link diabetes to glaucoma.     Results:  From retrospective literature review, we find that diabetes is known to have an additive effect on neural apoptosis and in the generation of reactive oxygen in patients with high intraocular pressure. DM also impairs retrograde axonal transport, causes an accumulation of fibronectin in trabecular meshwork, changes eye vasculature, causes dysregulation in lipid metabolism, and malabsorption of vitamins.       Conclusion & Scientific/Clinical Policy Impact and Implications:    This study sheds light on one of the most troubling eye conditions worldwide. The symptoms of diabetes described here increase ones’ risk of developing glaucoma. These pathways result in obstruction of aqueous humor drainage or direct damage to the optic nerve cells leading to glaucoma. Diabetes is a common disease that involves many body systems. With knowledge of the relationship between diabetes and glaucoma, measures can be taken to prevent irreversible eye damage in the diabetic population.  

PRIMARY ABDOMINAL TUBERCULOSIS, 2 CASE SERIES REPORT AND LITERATURE REVIEW

2021 ◽  
pp. 20-24
Author(s):  
Júlia Guimarães Pereira ◽  
Renata de Oliveira Belo Custódio dos Santos ◽  
Stephannie Glozan Virgulino ◽  
Giovanna Paliares Monteiro ◽  
Mariana Mussalem Santos ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Case Series ◽  
Abdominal Tuberculosis ◽  
The Body ◽  
Human Beings ◽  
Main Site ◽  
High Clinical Suspicion ◽  
Case Series Report ◽  
Global Health Problem ◽  
Series Report

Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis, is a disease that has affected human beings since antiquity and is still a global health problem. The main site of TB is usually in the lung, from where it can spread to other parts of the body. However, it can also present in extrapulmonary forms, the most common being the abdominal. Abdominal tuberculosis is dened as an infection of the gastrointestinal tract, peritoneum, abdominal solid organs, and/or abdominal lymphatics. Because its clinical symptoms are nonspecic, the diagnosis of abdominal tuberculosis requires a high clinical suspicion, especially in the predisposed population

Design and Modeling of a Prosthetic Venous Valve

2018 ◽  
Author(s):  
Ryan Packer ◽  
Brian D. Jensen ◽  
Anton E. Bowden
Keyword(s):  
Hydrostatic Pressure ◽  
Shear Rate ◽  
Femoral Vein ◽  
The United States ◽  
The Body ◽  
Lower Limbs ◽  
Venous Valve ◽  
Venous Valves ◽  
Prosthetic Valves ◽  
Computational Fluid Dynamics Analysis

Chronic Venous Insufficiency (CVI) is a disease of the lower limbs that affects millions of people in the United States. CVI results from incompetent venous valves. The purpose of venous valves is to prevent retrograde blood flow to the lower limbs. Valve failure can lead to edema, pain, and ulcers. One solution that has great potential is to create an implantable venous valve that could restore function of the venous system. No prosthetic venous valves are clinically used currently because of problems with biocompatiblility and thrombogenicity caused by high shear rates. This paper presents a prosthetic venous valve that could overcome these difficulties by using carbon-infiltrated carbon nanotubes (CI-CNTs). This material has been proven to be thrombo-resistant, biocompatible due to its non-reactive properties, and durable. The valve was designed to be initially open and to close with physiological pressures. Finite element modeling showed that, with a hydrostatic pressure of 20 mmHg (the minimum hydrostatic pressure in the common femoral vein), it fully closed with a maximum stress of 117 MPa, which is below the ultimate strength of CI-CNTs. A computational fluid dynamics analysis demonstrated the valve would cause a maximum shear rate of 225.1 s−1, which is less than the maximum shear rate in the body. Hence, this valve would be less likely than previous prosthetic valves to develop blood clots. Currently, this is the lowest shear rate reported for a prosthetic venous valve. These results demonstrate that a CI-CNT prosthetic venous valve has the potential to be an effective treatment for CVI.

scholarly journals The Neurodevelopmental and Motor Phenotype of SCA21 (ATX-TMEM240)

2020 ◽  
Vol 35 (14) ◽  
pp. 953-962
Author(s):  
Emma D. Burdekin ◽  
Brent L. Fogel ◽  
Shafali S. Jeste ◽  
Julian Martinez ◽  
Jessica E. Rexach ◽  
...  
Keyword(s):  
Neurodevelopmental Disorders ◽  
Clinical Symptoms ◽  
Neurodevelopmental Disorder ◽  
Clinical Manifestations ◽  
Case Series ◽  
The United States ◽  
Autism Spectrum ◽  
Spinocerebellar Ataxia Type ◽  
Neurodevelopmental Outcomes ◽  
Motor Abnormalities

Spinocerebellar ataxia type 21 (SCA21/ATX-TMEM240) is a rare form of cerebellar ataxia that commonly presents with motor, cognitive, and behavioral impairments. Although these features have been identified as part of the clinical manifestations of SCA21, the neurodevelopmental disorders associated with SCA21 have not been well studied or described. Here we present extensive phenotypic data for 3 subjects from an SCA21 family in the United States. Genetic testing demonstrated the c.196 G>A (p.Gly66Arg) variant to be a second recurrent mutation associated with the disorder. Standardized developmental assessment revealed significant deficits in cognition, adaptive function, motor skills, and social communication with 2 of the subjects having diagnoses of autism spectrum disorder, which has never been described in SCA21. Quantitative gait analysis showed markedly abnormal spatiotemporal gait variables indicative of poor gait control and cerebellar as well as noncerebellar dysfunction. Clinical evaluation also highlighted a striking variability in clinical symptoms, with greater ataxia correlating with greater severity of neurodevelopmental disorder diagnoses. Notably, neurodevelopmental outcomes have improved with intervention over time. Taken together, this case series identifies that the manifestation of neurodevelopmental disorders is a key feature of SCA21 and may precede the presence of motor abnormalities. Furthermore, the coexistence of ataxia and neurodevelopmental disorders in these subjects suggests a role for spinocerebellar pathways in both outcomes. The findings in this study highlight the importance of evaluation of neurodevelopmental concerns in the context of progressive motor abnormalities and the need for timely intervention to ultimately improve quality of life for individuals with SCA21.

scholarly journals A case report of COVID-19 infection and management during pregnancy

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110158
Author(s):  
Ifeoma Ogamba ◽  
Linus Chuang ◽  
Erin Panarelli ◽  
Dimitry Zilberman
Keyword(s):  
Clinical Symptoms ◽  
Laboratory Finding ◽  
Case Series ◽  
The United States ◽  
Limited Data ◽  
X Ray ◽  
Cough Headache ◽  
Abnormal Laboratory Finding ◽  
Chest X Ray ◽  
In Pregnancy

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which started in Wuhan, Hubei Province, China, and progressed to a pandemic affecting over 210 countries and territories including the United States. The severity of symptoms range from mild to critical disease involving multi-organ failure; however, many pregnant COVID-19 patients have mild symptoms. The understanding of COVID-19 is evolving and there is limited data about its effects in pregnancy. This case series features two pregnant patients with COVID-19 with a range of symptoms, including fever, non-productive cough, headache, and worsening dyspnea. Both patients had chest x-ray findings notable for lung opacities, and lymphopenia was a consistent abnormal laboratory finding. Both of the patients had hypoxia which was treated with hydroxychloroquine and lopinavir-ritonavir with significant improvement in clinical symptoms and prolongation of pregnancy.

scholarly journals The combined prevalence of classified rare rheumatic diseases is almost double that of ankylosing spondylitis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Judith Leyens ◽  
Tim Th. A. Bender ◽  
Martin Mücke ◽  
Christiane Stieber ◽  
Dmitrij Kravchenko ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Clinical Symptoms ◽  
Therapeutic Option ◽  
Treatment Options ◽  
Connective Tissue Diseases ◽  
Epidemiological Data ◽  
The United States ◽  
Healthcare Systems ◽  
Common Disease ◽  
Adequate Treatment

Abstract Background Rare diseases (RDs) affect less than 5/10,000 people in Europe and fewer than 200,000 individuals in the United States. In rheumatology, RDs are heterogeneous and lack systemic classification. Clinical courses involve a variety of diverse symptoms, and patients may be misdiagnosed and not receive appropriate treatment. The objective of this study was to identify and classify some of the most important RDs in rheumatology. We also attempted to determine their combined prevalence to more precisely define this area of rheumatology and increase awareness of RDs in healthcare systems. We conducted a comprehensive literature search and analyzed each disease for the specified criteria, such as clinical symptoms, treatment regimens, prognoses, and point prevalences. If no epidemiological data were available, we estimated the prevalence as 1/1,000,000. The total point prevalence for all RDs in rheumatology was estimated as the sum of the individually determined prevalences. Results A total of 76 syndromes and diseases were identified, including vasculitis/vasculopathy (n = 15), arthritis/arthropathy (n = 11), autoinflammatory syndromes (n = 11), myositis (n = 9), bone disorders (n = 11), connective tissue diseases (n = 8), overgrowth syndromes (n = 3), and others (n = 8). Out of the 76 diseases, 61 (80%) are classified as chronic, with a remitting-relapsing course in 27 cases (35%) upon adequate treatment. Another 34 (45%) diseases were predominantly progressive and difficult to control. Corticosteroids are a therapeutic option in 49 (64%) syndromes. Mortality is variable and could not be determined precisely. Epidemiological studies and prevalence data were available for 33 syndromes and diseases. For an additional eight diseases, only incidence data were accessible. The summed prevalence of all RDs was 28.8/10,000. Conclusions RDs in rheumatology are frequently chronic, progressive, and present variable symptoms. Treatment options are often restricted to corticosteroids, presumably because of the scarcity of randomized controlled trials. The estimated combined prevalence is significant and almost double that of ankylosing spondylitis (18/10,000). Thus, healthcare systems should assign RDs similar importance as any other common disease in rheumatology.

scholarly journals Papular mucinosis (papular lichen myxedematosus): Clinical and histopathological evaluation

2021 ◽  
Vol 12 (2) ◽  
pp. 113-119
Author(s):  
Khalifa Sharquie ◽  
Raed I Jabbar
Keyword(s):  
Case Series ◽  
Orange Peel ◽  
The Body ◽  
Lower Limbs ◽  
Important Differential Diagnosis ◽  
Female Predominance ◽  
General Investigation ◽  
The Face ◽  
The Common ◽  
Lichen Myxedematosus

Background: Papular mucinosis is a variety of mucinosis characterized by excessive production of mucin by fibroblasts and deposition in the dermis. It manifests itself with fleshy papules or plaques in different sites of the body and taking different clinical morphological cutaneous features. Objective: The objective is to report and evaluate the different clinical and histopathological features of the disease in Iraqi patients. Patients and Methods: This is a case series and a clinical descriptive study in which ten patients with papular mucinosis were reported during the period from 2012 through 2019. The age ranged from 4 to 56 years, with seven females and three males. Clinical evaluation regarding histories of the disease and examination was carried out. General investigation was done and skin biopsy for histopathological assessment was conducted. Results: Nine patients were adults, with their age ranging from 20 to 56 years, a mean of around 35 years, and only one 4-year-old child. It is a disease with a female predominance, as observed in 7 (70%) females. The common sites of involvement were the face but the rash may extend to affect the neck and upper arms. The rash appeared in the form of skin-colored or red fleshy papules and plaques or in diffuse erythematous orange peel-like forms. The rash was asymptomatic in most patients. The pathology of the disease clarified the diffuse deposition of mucin in the dermis, as was demonstrated with H&E staining. Conclusion: Papular mucinosis is a rare disease characterized by mucin deposition in the skin affecting mostly adult females. The face is commonly involved together with other areas such as the neck and upper arms, but the trunk and lower limbs are spared. It manifests itself with different clinical morphological cutaneous features. Papular granuloma annulare must be considered as an important differential diagnosis in all cases of papular mucinosis.

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