scholarly journals Diagnosis and Management of Antibiotic Allergies

2021 ◽  
Vol 96 (4) ◽  
pp. 328-336
Author(s):  
Joo-Hee Kim
Keyword(s):  
Clinical History ◽  
Adverse Outcomes ◽  
Safe Alternative ◽  
Provocation Tests ◽  
Immune Mediated ◽  
Clinical Presentations ◽  
Common Causes ◽  
Detailed Clinical History ◽  
Alternative Medications ◽  
The Individual

Drug allergies encompass a spectrum of immune-mediated hypersensitivity reactions with various mechanisms and clinical presentations. β-lactam drugs are common causes of drug allergies. A detailed clinical history as well as skin and drug provocation tests, are essential to diagnose drug allergies. The key to successful treatment is avoidance or discontinuation of the offending drug, and replacing it with a safe alternative. Cross-reactivities among β-lactam antibiotics should be considered when choosing alternative medications. Proper management of β-lactam allergies is important at the individual and population levels, to reduce the likelihood of drug allergies and prevent antibiotic-related adverse outcomes.

scholarly journals Clinical History and Colliquative Myocytolysis Are Keys to the Diagnosis of Shoshin Beriberi

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Toshiki Kuno ◽  
Hiroshi Nakamura ◽  
Yutaka Endo ◽  
Kohei Saito ◽  
Hiroyuki Yamazaki ◽  
...  
Keyword(s):  
Present Report ◽  
Fatal Outcome ◽  
Clinical History ◽  
Lactate Accumulation ◽  
Appropriate Treatment ◽  
Clinical Presentations ◽  
Detailed Clinical History ◽  
Leg Edema ◽  
Thiamine Level ◽  
Made In

Cardiovascular beriberi presents as either the fulminant (Shoshin beriberi) or chronic form. Shoshin beriberi is a rare disease that may lead to a fatal outcome if the patient does not receive appropriate treatment. In the present report, we describe the case of a 66-year-old man presenting with leg edema and dyspnea at rest. Clinical presentations were nonalcoholic Shoshin beriberi and lactate accumulation; however, clinical improvement was observed after the administration of thiamine. His pretherapy thiamine level (2.1 μg/dL) was consistent with a diagnosis of beriberi. Based on the findings of the present case, we believe that a diagnosis can be made in patients with a clinical history that is consistent with that of Shoshin beriberi, combined with low thiamine levels, lactate accumulation, and colliquative myocytolysis.Learning Objective.Shoshin beriberi is often misdiagnosed because of its rarity; a detailed clinical history and characteristic myocardial histopathology changes may be useful for making a definite diagnosis.

Impairment Tutorial: Functionally Limiting Upper Extremity Pain: Controversies in Impairment Rating

2003 ◽  
Vol 8 (5) ◽  
pp. 4-12
Author(s):  
Lorne Direnfeld ◽  
James Talmage ◽  
Christopher Brigham
Keyword(s):  
Upper Extremity ◽  
Radicular Pain ◽  
Illness Behavior ◽  
Orthopedic Surgeon ◽  
First Case ◽  
Clinical Presentations ◽  
Whole Person ◽  
Physical Examinations ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract This article was prompted by the submission of two challenging cases that exemplify the decision processes involved in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). In both cases, the physical examinations were normal with no evidence of illness behavior, but, based on their histories and clinical presentations, the patients reported credible symptoms attributable to specific significant injuries. The dilemma for evaluators was whether to adhere to the AMA Guides, as written, or to attempt to rate impairment in these rare cases. In the first case, the evaluating neurologist used alternative approaches to define impairment based on the presence of thoracic outlet syndrome and upper extremity pain, as if there were a nerve injury. An orthopedic surgeon who evaluated the case did not base impairment on pain and used the upper extremity chapters in the AMA Guides. The impairment ratings determined using either the nervous system or upper extremity chapters of the AMA Guides resulted in almost the same rating (9% vs 8% upper extremity impairment), and either value converted to 5% whole person permanent impairment. In the second case, the neurologist evaluated the individual for neuropathic pain (9% WPI), and the orthopedic surgeon rated the patient as Diagnosis-related estimates Cervical Category II for nonverifiable radicular pain (5% to 8% WPI).

scholarly journals Autoantibody profiles and clinical association in Thai patients with autoimmune retinopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aulia Rahmi Pawestri ◽  
Niracha Arjkongharn ◽  
Ragkit Suvannaboon ◽  
Aekkachai Tuekprakhon ◽  
Vichien Srimuninnimit ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Age Of Onset ◽  
Male Gender ◽  
Blurred Vision ◽  
Autoimmune Retinopathy ◽  
Immune Mediated ◽  
Underlying Malignancy ◽  
Clinical Presentations ◽  
Treatment Plans ◽  
Autoantibody Profiles

AbstractAutoimmune retinopathy (AIR) is a rare immune-mediated inflammation of the retina. The autoantibodies against retinal proteins and glycolytic enzymes were reported to be involved in the pathogenesis. This retrospective cohort study assessed the antiretinal autoantibody profiles and their association with clinical outcomes of AIR patients in Thailand. We included 44 patients, 75% were females, with the overall median age of onset of 48 (17–74, IQR 40–55.5) years. Common clinical presentations were nyctalopia (65.9%), blurred vision (52.3%), constricted visual field (43.2%), and nonrecordable electroretinography (65.9%). Underlying malignancy and autoimmune diseases were found in 2 and 12 female patients, respectively. We found 41 autoantibodies, with anti-α-enolase (65.9%) showing the highest prevalence, followed by anti-CAII (43.2%), anti-aldolase (40.9%), and anti-GAPDH (36.4%). Anti-aldolase was associated with male gender (P = 0.012, OR 7.11, 95% CI 1.54–32.91). Anti-CAII showed significant association with age of onset (P = 0.025, 95% CI − 17.28 to − 1.24), while anti-α-enolase (P = 0.002, OR 4.37, 95% CI 1.83–10.37) and anti-GAPDH (P = 0.001, OR 1.87, 95% CI 1.32–2.64) were significantly associated with nonrecordable electroretinography. Association between the antibody profiles and clinical outcomes may be used to direct and adjust the treatment plans and provide insights in the pathogenesis of AIR.

scholarly journals Toxicity of Corymbia citriodora essential oil compounds against Ascia monuste (Linnaeus, 1764) (Lepidoptera: Pieridae) and Plutella xylostella (Linnaeus, 1758) (Lepidoptera: Plutellidae)

2020 ◽  
Vol 2 ◽  
pp. ec02013
Author(s):  
Renata C. Santos ◽  
Jhersyka S. Paes ◽  
Arthur V. Ribeiro ◽  
Abraão A. Santos ◽  
Marcelo C. Picanço
Keyword(s):  
Plutella Xylostella ◽  
The Other ◽  
Biotic Factors ◽  
Safe Alternative ◽  
Toxic Compounds ◽  
Low Toxicity ◽  
Abiotic And Biotic Factors ◽  
The Individual ◽  
Corymbia Citriodora ◽  
Essential Oil Compounds

Essential oils (EO’s) have been investigated as a safe alternative to pest management. The toxicity of an EO can vary due to abiotic and biotic factors. The individual compounds of different EO’s have shown promise to insect control and they may present toxicity similar to or greater than the EO’s. In this study, we determined the toxicity of Corymbia citriodora EO compounds against Ascia monuste (Linnaeus, 1764) and Plutella xylostella (Linnaeus, 1758). Citronellal, trans-caryophyllene, and citronellol (LD50 = 23.24, 24.17 and 27.84 μg/mg, respectively) were the most toxic compounds to A. monuste. On the other hand, α-pinene and β-pinene presented low toxicity to this pest. For P. xylostella, citronellol and citronellal were the most toxic compounds (LD50 = 22.36 and 25.53 μg/mg, respectively). The other compounds presented lower toxicity with similar doses. Thus, the individual compounds of C. citriodora EO can be an alternative for A. monuste and P. xylostella control.

scholarly journals Younger Age in Adolescent Pregnancies Is Associated with Higher Risk of Adverse Outcomes

2021 ◽  
Vol 18 (16) ◽  
pp. 8514
Author(s):  
Maria de la Calle ◽  
Jose L. Bartha ◽  
Cristina M. Lopez ◽  
Miriam Turiel ◽  
Nuria Martinez ◽  
...  
Keyword(s):  
Maternal Age ◽  
Clinical History ◽  
Developed Countries ◽  
Adverse Outcomes ◽  
Young Adolescents ◽  
Maternal Complications ◽  
Breastfeeding Intention ◽  
Labor Complications ◽  
Fetal Complications ◽  
Adolescent Pregnancies

Adolescent pregnancy remains a health issue worldwide also in developed countries, since it has been associated with adverse maternal and neonatal outcomes. Some data suggest that very young adolescents have higher risk, likely due to immaturity. Therefore, we aimed to assess the influence of maternal age on complications during gestation and labor in pregnant women between 13 and 19 years of age. In particular, we evaluated the possible association between maternal age and obstetric, fetal and labor complications. This is a retrospective, observational and exploratory study conducted at Hospital Universitario La Paz (HULP, Madrid, Spain). The clinical history of 279 women who delivered between 2013 and 2018 was analyzed. Maternal age and the presence of maternal, fetal and labor complications, as well as risk of postpartum depression and breastfeeding intention, were recorded. General regression models were used to analyze the contribution of maternal age on each complication. The percentage of adolescent pregnancies at HULP between 2013 and 2018 was 0.9%. The risk of all the maternal complications analyzed decreased significantly with every year of age of the mother (hyperemesis, lower back pain, anemia, gestational diabetes mellitus, and threat of premature labor and premature rupture of membranes). Every year of maternal age decreased 0.8-fold [0.8; 0.9] the prevalence of fetal complications and also reduced the risk of C-section, postpartum hemorrhage and obstetrical hysterectomy. Furthermore, higher maternal age increased 1.1-fold [1.0; 1.2] the breastfeeding intention. In conclusion, young adolescents are at higher risk of complications during pregnancy and labor.

scholarly journals The Clinical Spectrum of Young Onset Dementia Points to Its Stochastic Origins

2021 ◽  
pp. 1-17
Author(s):  
Peter K. Panegyres
Keyword(s):  
Small Vessel Disease ◽  
Age Of Onset ◽  
Gene Mutations ◽  
Lewy Body Disease ◽  
Corticobasal Degeneration ◽  
Young Onset ◽  
Clinical Presentations ◽  
Eeg Data ◽  
Common Causes ◽  
Young Onset Dementia

Background: Dementia is a major global health problem and the search for improved therapies is ongoing. The study of young onset dementia (YOD)—with onset prior to 65 years—represents a challenge owing to the variety of clinical presentations, pathology, and gene mutations. The advantage of the investigation of YOD is the lack of comorbidities that complicate the clinical picture in older adults. Here we explore the origins of YOD. Objective: To define the clinical diversity of YOD in terms of its demography, range of presentations, neurological examination findings, comorbidities, medical history, cognitive findings, imaging abnormalities both structural and functional, electroencephagraphic (EEG) data, neuropathology, and genetics. Methods: A prospective 20-year study of 240 community-based patients referred to specialty neurology clinics established to elucidate the nature of YOD. Results: Alzheimer’s disease (AD; n = 139) and behavioral variant frontotemporal (bvFTD; n = 58) were the most common causes with a mean age of onset of 56.5 years for AD (±1 SD 5.45) and 57.1 years for bvFTD (±1 SD 5.66). Neuropathology showed a variety of diagnoses from multiple sclerosis, Lewy body disease, FTD-MND, TDP-43 proteinopathy, adult-onset leukoencephalopathy with axonal steroids and pigmented glia, corticobasal degeneration, unexplained small vessel disease, and autoimmune T-cell encephalitis. Non-amnestic forms of AD and alternative forms of FTD were discovered. Mutations were only found in 11 subjects (11/240 = 4.6%). APOE genotyping was not divergent between the two populations. Conclusion: There are multiple kinds of YOD, and most are sporadic. These observations point to their stochastic origins.

scholarly journals Study of etiological factors in unilateral maxillary chronic sinusitis

2016 ◽  
Vol 3 (1) ◽  
pp. 88
Author(s):  
D. Chandrika ◽  
Anantharaju G. S.
Keyword(s):  
Maxillary Sinusitis ◽  
Clinical History ◽  
Causative Factor ◽  
Successful Outcome ◽  
Dental Infection ◽  
Deviated Nasal Septum ◽  
Detailed Clinical History ◽  
Chronic Maxillary Sinusitis ◽  
Symptoms And Signs

<p class="abstract"><strong>Background:</strong> Chronic rhinosinusitis is an extremely prevalent disorder which has significant effect on quality of life of affected individual. Varied symptomatology and varied etiology of unilateral chronic maxillary rhinosinusitis requires a comprehensive approach by otorhinolaryngologist. The objectives of the study were to evaluate the causative factor of unilateral chronic maxillary sinusitis and to study clinical presentation of unilateral chronic maxillary sinusitis<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> 50 patients with symptoms and signs suggestive of unilateral chronic maxillary sinusitis were evaluated. All were subjected to detailed clinical history, ENT examination including complete orodental examination, diagnostic nasal endoscopy, intra oral peri apical radiographs, CT scan of para nasal sinuses<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Of total of 50 patients studied, gross deviated nasal septum (DNS) is commonest cause of chronic unilateral maxillary sinusitis followed by dental infection of upper premolars<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> This study was carried out with an effort to find out etiology of unilateral chronic maxillary sinusitis as identification of etiology will help in successful outcome of the treatment<span lang="EN-IN">.</span></p>

scholarly journals CLINICAL STUDY OF PAIN IN RIGHT ILIAC FOSSA

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Saurabh Kothari ◽  
Manjula Kothari ◽  
Shree Mohan Joshi ◽  
Kalp Shandilya
Keyword(s):  
Iliac Fossa ◽  
Signs And Symptoms ◽  
Clinical History ◽  
X Ray ◽  
Pain Abdomen ◽  
Detailed Clinical History ◽  
Right Iliac Fossa Pain ◽  
Chest X Ray ◽  
The Right ◽  
Appendicular Mass

Background: A mass in the right iliac fossa is a common diagnostic problem encountered in clinical practice, requiring skill in diagnosis. Methods: 100 patients with signs and symptoms of right iliac fossa mass admitted in Hospital were identified and were studied by taking detailed clinical history, physical examination and were subjected to various investigations like x ray erect abdomen, chest x-ray, contrast x-ray . Result: In this study of out of 100 cases, 65.00% of cases were related to appendicular pathology either in the form of appendicular mass or appendicular abscess. There were 12.00% cases of ileocaecal tuberculosis. Conclusion: Appendicular lump remains the most common cause for right iliac fossa pain. Ileocaecal tuberculosis is one of the most important differential diagnoses for pain abdomen. Keywords: Appendicular Mass, Ileocaecal Tuberculosis, Carcinoma Caecum, Right Iliac Fossa Mass.

scholarly journals Clinical spectrum of facial hypermelanosis: a descriptive study from a tertiary care centre

2020 ◽  
Vol 6 (2) ◽  
pp. 212
Author(s):  
Mohammed Thoyyib ◽  
Roshni Menon ◽  
Brinda G. David
Keyword(s):  
Tertiary Care ◽  
Clinical History ◽  
Climatic Conditions ◽  
Research Centre ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Pigmentary Disorders ◽  
Number Of Patients ◽  
The Face ◽  
Detailed Clinical History

<p class="abstract"><strong>Background:</strong> Facial melanosis (FM) which refers to brown, black or blue pigmentation over the face is a common cosmetic concern in Indian patients. This increased incidence could be due to remarkable diversity of Indian ethinic population. Pigmentary disorders of the face are a great cosmetic and psychological concern for the patients.</p><p class="abstract"><strong>Methods:</strong> This is an extensive descriptive clinico epidemiological study comprising of 1024 patients, conducted at Sri Venkateshwara Medical College Hospital and Research Centre, Puducherry, for a period of one and a half years. A detailed clinical history and examination was done, and all the clinical photographs and data were recorded. Necessary investigations like skin biopsy and patch testing was done wherever required.<strong></strong></p><p class="abstract"><strong>Results:</strong> The maximum number of patients belong to the age group of 21-35 years with a female predominance (67.2%). Among patients of FM, post inflammatory pigmentation (35.3%) was the most common comprising of 362 patients, followed by melasma (17.2%), periorbital melanosis (15.7%), seborrheic melanosis (7.5%) followed by other causes.</p><p><strong>Conclusions:</strong> FM is common in Indian skin, several of which have overlapping features, and some have defined clinical classification. Additionally, climatic conditions, cosmetic usage and social parameters predispose to the increased incidence of FM.</p>

Sign in / Sign up

Export Citation Format

Share Document