scholarly journals Acute bacterial nephritis. A descriptive study of an underdiagnosed entity

2020 ◽  
Vol 80 (3) ◽  
pp. 1-10
Author(s):  
Pedro Antonio Madero-Morales ◽  
Rigoberto Pallares-Méndez ◽  
Rodrigo Romero-Mata ◽  
Guillermo Vizcarra-Mata ◽  
Andrés Guillén-Lozoya
Keyword(s):  
Acute Pyelonephritis ◽  
Clinical Characteristics ◽  
Clinical Course ◽  
Case Series ◽  
Therapy Response ◽  
Time Frame ◽  
Clinical Findings ◽  
Imaging Features ◽  
Imaging Studies ◽  
Retrospective Case

Background: Acute bacterial nephritis is an infectious process diagnosed through imaging studies. The clinical course of the disease has been shown to be more aggressive than acute pyelonephritis. It continues to be underdiagnosed, thus there are few studies on the entity in the literature. Objective: To describe the clinical characteristics and imaging features of acute bacterial nephritis, as well as its clinical course. Design: A descriptive, retrospective case series was conducted. Materials and methods: Thirty-two cases of acute bacterial nephritis in patients admitted to the hospital within the time frame of 2009 to 2016 were reviewed. The patients’ clinical characteristics upon admission were registered, as well as inpatient clinical progression, culture results, and antibiotic therapy response. The imaging studies were re-evaluated and the diagnostic consistency with either the focal or multifocal disease presentation was confirmed. Results: Cases predominated in women (n=29, 90.62%) and the most frequently associated comorbidities were diabetes (n=16, 50%) and obesity (n=9, 28.25%). The most important clinical findings upon admission were fever (n=15, 46.87%) and leukocytosis (n=27, 84.38%). Escherichia coli was the most commonly isolated bacterium (63.63%). Both acute focal bacterial nephritis and acute multifocal bacterial nephritis were observed in 46.87% (n=15) and 53.13% (n=17) of the patients, respectively. Imaging studies were required for all diagnoses. Conclusion: Fever and leukocytosis are the main findings in acute bacterial nephritis. Imaging studies are necessary for making the diagnosis, given that acute pyelonephritis and acute bacterial nephritis cannot be clinically differentiated.

scholarly journals Granulomatous Lymphocytic Interstitial Lung Disease (GL-ILD): CT Imaging Features and Clinical Findings to Expedite a Timely Diagnosis

2021 ◽  
Author(s):  
Avanthika Wynn ◽  
Eugene A. Berkowitz ◽  
Brent P. Little ◽  
Srihari Veeraraghavan ◽  
Frank Schneider ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Research Question ◽  
Case Series ◽  
Lower Lobe ◽  
Clinical Findings ◽  
Ct Imaging ◽  
Imaging Features ◽  
Retrospective Case ◽  
Case Series Study

Abstract Background: Establishing a diagnosis of Granulomatous Lymphocytic-Interstitial Lung Disease (GL-ILD) is difficult due to the overlapping CT imaging and histologic features, and are often confused with infection, sarcoidosis and/or follicular bronchiolitis. Research Question: Identify specific CT imaging features and clinical characteristics to suggest a confident diagnosis of Granulomatous Lymphocytic-Interstitial Lung Disease (GL-ILD).Study Design and Methods: IRB-approved retrospective case series study involving the review of the electronic medical record and CT chest imaging of eight patients with GL-ILD.Results: Bronchocentric airway-centered lower lobe predominant (part solid nodules more common than ground glass or solid nodules) ranging from 5 to 10 mm in size were found consistently in a majority of the eight patients with GL-ILD. Interpretation: In combination with the above pulmonary nodular pattern, mediastinal and hilar lymphadenopathy in conjunction, either splenomegaly or splenectomy and/or abdominal lymphadenopathy are excellent CT imaging features to prospectively suggest the diagnosis of GL-ILD in a patient with CVID.

scholarly journals Clinical features of cats with aqueous tear deficiency: a retrospective case series of 10 patients (17 eyes)

2018 ◽  
Vol 21 (10) ◽  
pp. 944-950 ◽  
Author(s):  
Lisa K Uhl ◽  
Akihiko Saito ◽  
Hiroko Iwashita ◽  
David J Maggs ◽  
Jonathan P Mochel ◽  
...  
Keyword(s):  
Clinical Features ◽  
Ocular Surface ◽  
Clinical Signs ◽  
Case Series ◽  
Reference Interval ◽  
Clinical Findings ◽  
Response To Therapy ◽  
Ocular Surface Disease ◽  
Retrospective Case ◽  
Schirmer Tear Test

Objectives The aim of this study was to describe the clinical findings, diagnostic test results and response to therapy of cats with Schirmer tear test 1 (STT-1) values below the reference interval. Methods The medical records of three institutions were searched for cats with ocular surface disease and STT-1 values <9 mm/min, confirmed at two or more separate visits. Results Ten cats (17 eyes) were included. The mean ± SD (range) age and STT-1 values in affected eye(s) were 6.1 ± 5.7 (0.2–16) years and 2.4 ± 3.1 (0–8) mm/min, respectively. Concurrent ocular surface disease was bilateral in 5/10 cats. Clinical signs included conjunctivitis (14/17 eyes), corneal ulceration (6/17 eyes), non-ulcerative keratitis (4/17 eyes), symblepharon (4/17 eyes), eosinophilic keratitis (3/17 eyes), corneal sequestrum (3/17 eyes), corneal fibrosis (2/17 eyes) and meibomitis (2/17 eyes). Management included: topically applied lacrimomimetics, antiviral drugs, corticosteroids or immunomodulatory drugs; orally administered famciclovir; or surgical procedures, in various combinations. Response to therapy (defined as an increase in STT-1 value of ⩾5 mm/min) was transient (seen at a single reassessment) in 65% of eyes and sustained (seen at ⩾2 consecutive reassessments) in 18% of eyes. Conclusions and relevance Clinical features seen in cats with low STT-1 values are described, although the association between aqueous deficiency and the reported ocular changes is unknown at this time. We encourage clinicians to assess the tear film in cats with ocular surface disease, and initiate therapy with lacrimomimetics if STT-1 values are repeatedly below normal. Such information will further define aqueous tear deficiency in cats, providing a better understanding of disease prevalence, pathogenesis and treatment.

scholarly journals Tratamento cirúrgico do ceratocisto odontogênico por meio de enucleação e osteotomia periférica: relato de caso

2020 ◽  
Vol 9 (6) ◽  
pp. 531-534
Author(s):  
Diogo Henrique Marques ◽  
Maylson Alves Nogueira Barros ◽  
Vitor Bruno Teslenco ◽  
Cláudio Marcio Santana Junior ◽  
Lucas Marques Meurer ◽  
...  
Keyword(s):  
Case Report ◽  
Meta Analysis ◽  
Benign Lesion ◽  
Dentigerous Cyst ◽  
Case Series ◽  
Odontogenic Keratocyst ◽  
Imaging Features ◽  
Retrospective Case ◽  
Odontogenic Keratocysts

Introdução: Os ceratocistos odontogênicos (CCA) são considerados raros cistos de desenvolvimento, derivados dos remanescentes da lâmina dentária, com atividade intraóssea benigna, porém localmente invasivo e agressivo. O tratamento para o ceratocisto odongênico é variado, podendo-se encontrar modalidades tais como:enucleação, isolada ou associada a curetagem, com osteotomia periférica, aplicação da solução de Carnoy ou crioterapia, descompressão, marsupialização e ressecções. Objetivo: O presente trabalho tem como objetivo relatar um caso de ceratocisto odontogênico, onde foi escolhida abordagem conservadora por curetagem e osteotomia periférica. Relato de caso: Paciente de 68 anos, leucoderma, referiu ao exame clínico dor espontânea em região retromolar esquerda e parestesia em lábio inferior. A paciente foi submetida a biopsia por aspiração e excisional, após confirmação histopatológica foi proposto uma enucleação associada a osteotomia periférica sob anestesia geral. A paciente permanece em acompanhamento clínico e radiográfico, sem sinais de recidiva da lesão. Conclusão: Embora apresentem um comportamento agressivo, os ceratocistos odontogêncios podem ser tratados com segurança, de forma conservadora, por meio de enucleação seguida de osteotomia periférica com mínimo de morbidade. Descritores: Osteotomia; Curetagem; Cistos Odontogênicos. Referências Borghesi A, Nardi C, Giannitto C, Tironi A, Maroldi R, Di Bartolomeo F, Preda L. Odontogenic keratocyst: imaging features of a benign lesion with an aggressive behaviour. Insights Imaging. 2018 Oct;9(5):883-897. Park JH, Kwak EJ, You KS, Jung YS, Jung HD. Volume change pattern of decompression of mandibular odontogenic keratocyst. Maxillofac Plast Reconstr Surg. 2019 Jan 7;41(1):2.  Karaca C, Dere KA, Er N, Aktas A, Tosun E, Koseoglu OT, Usubutun A. Recurrence rate of odontogenic keratocyst treated by enucleation and peripheral ostectomy: Retrospective case series with up to 12 years of follow-up. Med Oral Patol Oral Cir Bucal. 2018 Jul 1;23(4):e443-e448.  Guerra LAP, Silva PS, Dos Santos RLO, Silva AMF, Albuquerque DP. Tratamento conservador de múltiplos tumores odontogênicos ceratocístico em paciente não sindrômico. Rev cir traumatol. buco-maxilo-fac. 2013; 13(2):43-50. Sundaragiri KS, Saxena S, Sankhla B, Bhargava A. Non syndromic synchronous multiple odontogenic keratocysts in a western Indian population: A series of four cases. J Clin Exp Dent. 2018;10(8):e831-6. Freitas AD, Veloso DA, Santos ALF, Freitas VA. Maxillary odontogenic keratocyst: a clinical case report. RGO Rev Gaúch Odontol. 2015; 63(4):484-88. Madhireddy MR, Prakash AJ, Mahanthi V, Chalapathi KV. Large Follicular Odontogenic Keratocyst affecting Maxillary Sinus mimicking Dentigerous Cyst in an 8-year-old Boy: A Case Report and Review. Int J Clin Pediatr Dent. 2018 Jul-Aug;11(4):349-351.  Moura BS, Cavalcante MA, Hespanhol W. Tumor odontogênico ceratocistico. Rev Col Bras Cir., 2016;43(6):466-71. Valori FP, Costa E, Buscatti MY, Oliveira JX, Costa C. Tumor odontogênico queratocístico: características intrínsecas e elucidação da nova nomenclatura do queratocisto odontogênico. J Health Sci Inst. 2010;28(1):80-3. Slusarenko da Silva Y, Stoelinga PJW, Naclério-Homem MDG. The presentation of odontogenic keratocysts in the jaws with an emphasis on the tooth-bearing area: a systematic review and meta-analysis. Oral Maxillofac Surg. 2019;23(2):133-47.

scholarly journals Clinical Analysis of restrictive strabismus secondary to ophthalmic surgery

2021 ◽  
Author(s):  
Lili Guo ◽  
Zhihua Zhao ◽  
Zequn Miao ◽  
Qianru Ouyang ◽  
Xin Xu ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Case Series ◽  
Strabismus Surgery ◽  
Ocular Motility ◽  
Ophthalmic Surgery ◽  
Retrospective Case ◽  
Eye Muscle ◽  
Lateral Ligaments ◽  
Surgical Methods ◽  
Restrictive Strabismus

Abstract Background: This study aimed to report the clinical characteristics and surgical methods of restrictive strabismus secondary to ophthalmic surgery. Methods: This retrospective case series covered 14 restrictive strabismus cases secondary to ophthalmic surgery. After evaluation of the clinical history and the basic ophthalmological findings, the following parameters were examined: squint angles (prism with alternative cover test, Krimsky’s test or Maddox cross), ocular motility, duction test and the forced duction test. All paitients underwent surgery, the strabismus surgery included the excision of adhesions and scar tissue, adhesiolysis, medial and lateral ligaments separated, repositioning of extraocular muscles (according to the degree of deviations). We described the clinical characteristics and evaluated the surgical results in strabismus eyes. Results: All patients were satisfied with the results of surgery, obtained anatomical reduction and partial functional recovery. In nine cases with preoperative diplopia, eight cases had no diplopia after surgery and one patient’s diplopia disappeared after the secondary surgery. The other five cases without preoperative diplopia, but had restricted ocular motility, which improved significantly than before surgery. Conclusions: Orbital surgery, trauma, conjunctival surgery, strabismus surgery and so on, can lead to secondary restrictive strabismus surgery. Strabismus surgical treatments including the full removal of the muscles around the scar, adhesiolysis, medial and lateral ligaments separated, eye muscle surgery, can provide excellent results and patient’s satisfaction.

scholarly journals P.101 Conservative management of meningiomas with a moderate to high peritumoral brain edema index: a single-institution report

2019 ◽  
Vol 46 (s1) ◽  
pp. S40
Author(s):  
H Yan ◽  
B Karmur ◽  
D Jeong ◽  
M Bernstein
Keyword(s):  
Brain Edema ◽  
Medical Management ◽  
Case Series ◽  
Imaging Features ◽  
Retrospective Case ◽  
Patient Morbidity ◽  
Large Spread ◽  
Peritumoral Brain Edema ◽  
Mri Scans

Background: Meningiomas are the most commonly occurring benign intracranial tumors. When presenting with peritumoral brain edema (PTBE), surgical treatment can lead to patient morbidity. This retrospective case series aims to describe the conservative medical management of moderate to large meningiomas with large PTBE. Methods: Patients with suspected meningiomas greater than 2.0cm and edema index greater than 2.0 were identified by screening 3345 MRI scans between 2012-2017. Imaging analysis included MR imaging features of suspected meningiomas and clinical data was gathered from the electronic patient record (patient age, sex, patient symptoms, follow-up duration, and follow-up symptoms). Results: We report on 31 patients who received conservative medical management. Presenting complaints included headache, seizure, weakness; many presented asymptomatically. The average follow-up time was 3.96 years. At the final follow-up appointment, 19 (61%) patients were asymptomatic. Among symptomatic patients, seizures were the most common complaint. There was no mortality reported in our cohort and the average tumor progression was 7.04cm3/year. Conclusions: In this retrospective report of meningioma patients with high edema index, we found that most patients remained asymptomatic or had stable symptoms after at least 1-yr follow up after medical treatment. This study provides insight around the surgical decision-making for meningiomas with large spread of edema.

scholarly journals Clinical characteristics of a group of deaths with COVID-19 pneumonia in Wuhan, China: a retrospective case series

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tao Yao ◽  
Yan Gao ◽  
Qin Cui ◽  
Bo Peng ◽  
Yan Chen ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Antiviral Treatment ◽  
Invasive Mechanical Ventilation ◽  
Laboratory Data ◽  
Case Series ◽  
The Elderly ◽  
Retrospective Case ◽  
Initial Symptoms ◽  
Comorbid Diseases ◽  
Death Cases

Abstract Background With the widespread outbreak of novel coronavirus diseases 2019(COVID-19), more and more death cases were reported, however, limited data are available for the patients who died. We aimed to explore the clinical characteristics of deaths with COVID-19 pneumonia. Methods We abstracted and analyzed epidemiological, demographic, clinical, and laboratory data from 83 death cases with COVID-19 pneumonia in East Hospital of Wuhan University Renmin Hospital, between January 26, 2020, and February 28, 2020. Results Of the 83 deaths, none was the medical staff. The mean age was 71.8 years (SD 13.2; range, 34–97 years) and 53(63.9%) were male. The median from onset to admission was 10 days (IQR 7–14: range, 2–43 days), to death was 17 days (IQR 14–21: range, 6–54 days). Most deaths (66[80%]) had underlying comorbid diseases, the most of which was hypertension [47(57%)]. The main initial symptoms of these 83 deaths were shortness of breath(98.8%), fever(94%), and myalgia or fatigue(90.4%). Laboratory analyses showed the lymphocytopenia in 69(83%) deaths, hypoalbuminemia in 77(93%) deaths, the elevation of lactate dehydrogenase in 79(95%) deaths, procalcitonin in 69(83%) deaths and C-reactive protein in 79(95%) deaths. All 83 patients received antiviral treatment, 81(97.6%) deaths received antibiotic therapy, 54(65.1%) deaths received glucocorticoid therapy, and 20(24.1%) patients received invasive mechanical ventilation. Conclusion Most of the deaths with COVID-19 pneumonia were elderly patients with underlying comorbid diseases, especially those over 70 years of age. The time of death after the onset of the disease was mostly 15–21 days. More care should be given to the elderly in further prevention and control strategies of COVID-19.

Feline retinal degeneration: clinical experience and new findings (1994-1997)

1999 ◽  
Vol 35 (6) ◽  
pp. 511-514 ◽  
Author(s):  
EA Giuliano ◽  
A van der Woerdt
Keyword(s):  
Retinal Degeneration ◽  
Vision Loss ◽  
Clinical Course ◽  
Case Series ◽  
Retrospective Case ◽  
Ocular Complications ◽  
Progressive Retinal Atrophy ◽  
Adaptive Capabilities ◽  
New Findings ◽  
Siamese Cat

A retrospective case series of 26 cats with diffuse retinal degeneration is presented. The most common presenting complaints included bumping into objects, dilated pupils, and reluctance to jump. Ophthalmic examination findings were consistent with those reported in dogs with progressive retinal atrophy. Breed predilection of the Siamese cat was observed. Cats with primary retinal degeneration presented late in the clinical course of their disease, when vision loss was severe. Early symptoms such as night blindness and secondary ocular complications (i.e., cataract and retinal detachment), reported in dogs with progressive retinal degeneration, were not observed in this study. All cats showed excellent adaptive capabilities to blindness.

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