scholarly journals Primary pulmonary nodular Amyloidosis

2005 ◽  
Vol 63 (3) ◽  
Author(s):  
F. Agresta ◽  
A. Marin ◽  
D. Della Libera ◽  
F. Romanzi ◽  
L.F. Ciardo ◽  
...  
Keyword(s):  
Physical Examination ◽  
Laboratory Tests ◽  
Left Lung ◽  
Solitary Nodule ◽  
Radiological Features ◽  
Video Assisted ◽  
Patient’S History ◽  
Benign Course ◽  
Radiologic Characteristics ◽  
Multiple Nodules

Primary nodular amyloidosis of the lung is an uncommon manifestation. The disease runs a benign course, but offers diagnostic problems due to non-specific radiological features entering the big field of the solitary nodule. We describe the case of a 60 year old man with multiple nodules on the left lung operated on diagnostic and therapeutic video-assisted thoracoscopy and discuss the possibilities, if any, of suspecting such a disease through radiologic characteristics along with findings from the patient’s history, physical examination and laboratory tests.

scholarly journals Recém-nascido com deficiência de glicerol quinase: um caso clínico

2018 ◽  
Vol 28 (3) ◽  
pp. 31385
Author(s):  
Cristina Duarte P. V. G. Madureira ◽  
Cláudia Teles-Silva ◽  
Cláudia Melo ◽  
Susana Gama de Sousa
Keyword(s):  
Emergency Department ◽  
Metabolic Acidosis ◽  
Birth Weight ◽  
Physical Examination ◽  
Laboratory Tests ◽  
Neonatal Period ◽  
Glycerol Kinase ◽  
Glutamic Pyruvic Transaminase ◽  
Glycerol Kinase Deficiency ◽  
Hypernatremic Dehydration

AIMS: To report the case of a newborn with glycerol kinase deficiency, in which an isolated mutation not yet described in the GK gene was identified.CASE DESCRIPTION: A neonate with 10 days of age was brought to the emergency department for refusal to feed with 24 hours of evolution. Physical examination showed a loss of 31% of birth weight and signs of dehydration. Laboratory tests revealed a metabolic acidosis with increased anion gap, creatinine 2.41 mg/dL, urea 306 mg/dL, hypernatremia (182 mEq/L), hyperkalemia (6.8 mEq/L), hyperchloremia (151 mEq/L), glutamic-oxalacetic transaminase 879 U/L, glutamic-pyruvic transaminase 243 U/L, triglycerides 725 mg/dL. Chromotagraphy of organic acids revealed hyperglycerolemia and glyceroluria compatible with glycerol kinase deficiency. The genetic study revealed a mutation not yet described: c.187T> C (p.S63P) as hemizygote status in the GK gene.CONCLUSIONS: The most frequent cause of hypernatremic dehydration in the neonatal period is maternal hypogalactia. In more severe cases of dehydration, other etiologies should be considered, including metabolic causes such as glycerol kinase deficiency. In this case a mutation not yet described in the GK gene was found.

scholarly journals Successful Management of Rhabdomyolysis with Acute Infection Resulting from Chronic Sacrococcygeal Pressure Ulcers in a Paraplegic Patient: A Case Report

2020 ◽  
Author(s):  
Kai Huang ◽  
Yansheng Zhu
Keyword(s):  
Physical Examination ◽  
Laboratory Tests ◽  
Pressure Ulcers ◽  
Acute Infection ◽  
Case Presentation ◽  
The Past ◽  
Sacrococcygeal Region ◽  
Skin Sensation ◽  
Life Threatening ◽  
Paraplegic Patient

Abstract Background: Rhabdomyolysis, a potentially life-threatening syndrome, is caused by the breakdown of skeletal muscle cells and leakage of intramyocellular contents into the bloodstream. The treatment of cases with rhabdomyolysis resulting from chronic sacrococcygeal pressure ulcers have been rarely reported.Case presentation: A 62-year-old man suffered from high fever and dark-colored urine. For the past 30 years, the patient has lived with paraplegia, which led to his immobility. According to his physical examination, the wound on his sacrococcygeal region was dehisced and exuded repeatedly with loss of skin sensation. Upon corroboration of a physical examination and laboratory tests, the patient was diagnosed with rhabdomyolysis with an acute infection resulting from sacrococcygeal pressure ulcers. We first debrided the necrotic tissue, and then the chronic ulcer was repaired. The wound dressing was changed frequently, and antimicrobial therapy and nutritional support were included in the treatment. The fever and dark-colored urine were gradually relieved post-operatively. Renal function was also improved according to the typical indicators in laboratory tests. Additionally, the size of the pressure ulcers was reduced, to some extent. The patient was discharged after one month of hospitalization.Conclusions: Accurate diagnosis is critical for clinicians to administer precise treatment to paraplegic patients with progressive rhabdomyolysis.

scholarly journals GAMBARAN KLINIS DAN RADIOLOGIS MENURUT KELLGREN AND LAWRENCE PADA PENDERITA OSTEOARTHRITIS GENU YANG BEROBAT JALAN DI POLOKLINIK ORTOPEDI RSU ANUTAPURA PALU TAHUN 2018

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Mukramin Amran
Keyword(s):  
Physical Examination ◽  
Clinical Picture ◽  
Joint Pain ◽  
Public Hospital ◽  
Joint Stiffness ◽  
Descriptive Research ◽  
History Of ◽  
Kellgren And Lawrence ◽  
Grade 3 ◽  
Patient’S History

Osteoarthritis (OA) is a progressive and degenerative chronic musculoskeletal disease caused by thinning of the cartilage in the joint due to bone rubbing against each other. History of the patient's history, clinical picture of the physical examination and the results of the radiological examination are basic things to diagnose OA. Patient's complaints include joint pain which is a major complaint that brings the patient to the doctor, joint stiffness, crepitation, joint swelling, and changes in gait. Gait changes due to pain are found on a physical examination even though radiologically is still at an initial level. In addition it can be found that crepitus, swollen joints are often asymmetrical. The aim of this study was to determine clinical and radiological features by counselor and Lawrence of outpatient genotypes osteoarthritis patients in the rsu anutapura hammer orthopedic polyclinic in 2018. Descriptive research methods were conducted on 27 people with genital osteoarthritis who were treated at the orthopedic clinic in Anutapura Palu Public Hospital 2018. Consecutive sampling was used and data collection through interviews and observations in the form of pain, joint stiffness, crepitus, joint swelling and gait changes and radiological examinations based on Kellgren and Lawrence criteria. Data analysis using SPSS 25 with frequency distribution test. The results of the study were (1) based on the clinical picture in genu osteoarthritis patients pain (100%), pain accompanied by gait changes (70.37%), pain accompanied by joint stiffness (51.4%), pain accompanied by joint swelling (44, 4%), and pain with crepitus (37.0%). (2) based on radiology in patients with osteoarthritis genu with the highest grade 3 and 4 respectively (33.3%), grade 2 (29.6%), grade 1 (3.7%) and in grade 0 not found. Conclusion: found joint pain and a small portion of pain accompanied by crepitus, radiologists found in most grades 3 and 4 while grade 0 was not found.

Consultation with the specialist

1992 ◽  
Vol 13 (7) ◽  
pp. 273-274
Author(s):  
Frederick H. Lovejoy
Keyword(s):  
Physical Examination ◽  
Case History ◽  
Laboratory Tests ◽  
Deep Inspiration ◽  
Deep Breathing ◽  
Logical Sequence ◽  
History Of ◽  
Difficult Challenge ◽  
Diagnostic Trial ◽  
Rapid Laboratory

Diagnosing poisoning by an unknown agent can be a difficult challenge. Five strategies of assessment may be used in logical sequence, however, to arrive at a diagnosis: (a) history, (b) physical examination, (c) rapid laboratory tests, (d) diagnostic trial, and (e) screening for toxins. This is illustrated by a case history, followed by discussion of a recommended approach and the utilization of these principles to arrive at a diagnosis in the case. Initial Case History A 41/2-year-old boy, with a history of onset of deep breathing following supper, is brought to your office by his mother. He had been alert and well all day, without fever, fully oriented, and without vomiting or diarrhea. He had been playing both in the house and garage in the morning and had spent the afternoon watching television. His temperature is 37.6°C, respiratory rate is 60 breaths per minute with deep inspiration and expiration, and pulse is 100 beats per minute and regular. He is without cyanosis. His pupils are midpoint, his lungs are clear, and his breath has no noticeable odor. What would you ask the mother in an effort to establish a diagnosis? History An unknown agent often can be suspected by history alone. The location of ingestion, if known, can offer clues.

Conventional Assessment of Gastrointestinal Disorders

2019 ◽  
pp. 531-544
Author(s):  
Gerard E. Mullin
Keyword(s):  
Laboratory Tests ◽  
Organ System ◽  
Health Conditions ◽  
Gastrointestinal Disorders ◽  
Genomic Testing ◽  
Conventional Tests ◽  
Out Of Pocket Expenses ◽  
Patient’S History ◽  
Positive Results ◽  
Digestive Health

The gastrointestinal tract is a highly complex and dynamic organ system having a multitude of physiological functions. The choice of laboratory tests should be personalized and not performed in a shotgun manner, which can lead to false positive results and imparts financial stress to patients. The assessment of digestive health conditions requires giving astute attention to the patient’s history and a methodical utilization of laboratory tests to define root causation of illness and opportunities for intervention. This chapter segregates the most common tests and procedures to evaluating gastrointestinal condition into conventional tests that are usually covered by medical insurance and functional medicine and genomic testing that by-in-large have larger out-of-pocket expenses. Strategic utilization of these tests are essential to the proper evaluation of gastrointestinal illness.

Sepsis Syndrome

2012 ◽  
pp. 274-279
Author(s):  
Andrew D Badley
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Physical Examination ◽  
Supportive Care ◽  
Tissue Injury ◽  
Tissue Perfusion ◽  
Sepsis Syndrome ◽  
Systemic Response ◽  
Immune Mediated ◽  
Patient’S History

Systemic inflammatory response syndrome (SIRS) is the specific host systemic response that may be elicited by various stimuli, including infection, burns, pancreatitis, ischemia, trauma, hemorrhage, immune-mediated tissue injury, and exogenous stimuli. 2. Sepsis is SIRS resulting from infection. Sepsis syndrome is sepsis with altered tissue perfusion of vital organs (resulting in oliguria, hypoxemia, elevated levels of lactate, or altered mentation or any combination of these conditions) When a patient has SIRS, the objective is to define its cause. If SIRS is caused by infection, appropriate antibiotics must be administered and supportive care guided by the patient's history and physical examination.

scholarly journals Neuropsychiatric symptoms following sore throat in a young boy

2019 ◽  
Vol 12 (1) ◽  
pp. e227540 ◽  
Author(s):  
Raafat Hammad Seroor Jadah ◽  
Athar Abdul Mujeeb
Keyword(s):  
Physical Examination ◽  
Sleep Disturbance ◽  
Symptom Onset ◽  
Normal State ◽  
Neuropsychiatric Symptoms ◽  
Sudden Onset ◽  
Metabolic Abnormalities ◽  
Streptococcal Infections ◽  
History Of ◽  
Patient’S History

A previously healthy 6-year-old boy was referred to us by his primary provider, with a history of sudden onset behavioural abnormalities including irritability, sleep disturbance and anxiety. Physical examination revealed no significant findings; further analyses were not suggestive of meningitis, encephalitis, metabolic abnormalities, toxicity or any other obvious cause. On rechecking the patient’s history, an episode of throat pain 1 week prior to the symptom onset was noted. Therefore, the possibility of paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) was considered. The antistreptolysin O titre was high (1078 IU/mL), and it increased to 1194 IU/mL 4 weeks later, leading to a diagnosis of PANDAS. He was started on ampicillin and administered one dose of intravenous immunoglobulin. His abnormal behaviours subsided and he returned to a normal state within 48 hours of treatment. This report aims to provide insights into the symptomology and diagnosis of PANDAS in children.

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