scholarly journals Pure neural leprosy or amyloid neuropathy? systematic review and clinical case report

2021 ◽  
Author(s):  
Carlos Dornels Freire de Souza ◽  
Lucas Gomes Santos ◽  
João Paulo Silva de Paiva ◽  
Thiago Cavalcanti Leal ◽  
Gibson Barros de Almeida Santana ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Sural Nerve ◽  
Clinical Case ◽  
Polarized Light ◽  
Final Diagnosis ◽  
Lower Limbs ◽  
Moderate Intensity ◽  
Cross Sectional ◽  
Amyloid Polyneuropathy

Objective: To review the literature, including a clinical case discussion with suspicion of pure neural leprosy and final diagnosis of amyloid neuropathy. Methods: The study was conducted on May 28, 2020. A systematic review of the literature was conducted, with searches in PubMed, Medline, Lilacs and BVS MS using the descriptors: neuritic leprosy, pure neural leprosy, primary neural leprosy, pure neuritic leprosy, amyloid polyneuropathy, amyloid neuropathies, amyloid polyneuropathy. Clinical trials, cohorts, cross-sectional, clinical cases and case studies, published in Portuguese, English or Spanish between 2010 and 2020 were included. Then, a case report with an initial suspicion of pure neural leprosy was presented. Laboratory tests, electroneuromyography, ultrasound and biopsy of the sural nerve were requested. Results: 23 scientific texts were included. No publications with the two themes together were found. Diagnosis of pure neural leprosy and the possibility of using auxiliary resources were the most prominent themes in the studies. In the clinical case, the patient’s electroneuromyography showed sensitive and motor polyneuropathy of lower limbs, symmetrical, of moderate intensity, of the mixed type (axono- demyelinating), sensitive and axonal. Ultrasonography of the sural nerve revealed changes in the contour of the deep fibular nerves and biopsy of the sural nerve demonstrated the accumulation of amorphous eosinophilic material in the nerve path and Congo red staining showed birefringence of the deposit in applegreen under polarized light. The final diagnosis was amyloidotic neuropathy. Conclusion: Clinical diagnosis was amyloidotic neuropathy. Diagnosis of pure neural leprosy in endemic areas of Brazil is a challenge for the health system.

Value of glycolic acid analysis in ethylene glycol poisoning: A clinical case report and systematic review of the literature

2018 ◽  
Vol 290 ◽  
pp. e9-e14 ◽  
Author(s):  
Gaspar Tuero ◽  
Jesús González ◽  
Laura Sahuquillo ◽  
Anna Freixa ◽  
Isabel Gomila ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Ethylene Glycol ◽  
Glycolic Acid ◽  
Clinical Case ◽  
Review Of The Literature ◽  
Ethylene Glycol Poisoning

scholarly journals Spondylodiscitis and early diagnosis: a case report

2021 ◽  
Author(s):  
Mariana Moreira Soares de Sa ◽  
Emanuelle Ferreira Barreto ◽  
Marina Soares Vilela ◽  
Roberta Kelly Netto Vinte Guimarães ◽  
Vanessa Alves Lobato ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Early Diagnosis ◽  
Lower Limb ◽  
Clinical Case ◽  
Lower Limbs ◽  
Lumbosacral Spine ◽  
Low Back ◽  
Left Lower Limb

Context: Spondylodiscitis is a term that includes vertebral osteomyelitis, spondylitis and discitis. Among the vertebrae, the most affected are the lumbar (45%), followed by the thoracic (35%). Adults present themselves progressively, with a predominant complaint of low back pain and pain on palpation of the affected site, with significant limitation of movement due to muscle spasms. Report a clinical case with an emphasis on the possibility of early diagnosis and correct treatment aimed at the recovery of patients with neurological sequelae. Analysis of medical records in a patient admitted to the neurology ward of Santa Casa de Belo Horizonte. Clinical Case report: A.I.S. patient, 45 years old, with chronic low back pain due to asymmetry of the left lower limb. History of wear of the femoral head diagnosed in adolescence. Evolving for 2 months with progressive weakness in the lower limbs, associated with paresis and paresis in the left lower limb. He performed abdominal USG which showed hepatosplenomegaly with collateral circulation, increased caliber of the portal, splenic and superior mesenteric veins. Tomography of the lumbosacral spine with osteolytic lesions in the joints of L2-L3, L3-L4 and L4-L5., With almost total osteolysis of the L4 vertebral body, retropulsion of much later at this level, suggesting spondylodiscitis. The resonance of the lumbar spine performed with acute spondylodiscitis L2-L3 and L3-L4, compressing the roots of the equine tail with a comprehensive potential, remains as the emerging emerging roots. Liquid filling of the L3- L4 intervebral disc compatible with acute spondylodiscitis. Staphylococcus aureus and enterobacteria are responsible for more than half of the cases of non-tuberculosis. Conclusion: The diagnosis of discitis can be quite difficult, due to the rarity of the disease, the insidious symptoms and the high prevalence of low back pain in the general population. It is considered an important morbidity factor, as it causes an important neurological sequel. In addition, it points to the importance of differential diagnosis of low back pain in the population.

scholarly journals Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report

2021 ◽  
Author(s):  
Lucas Oliveira dos Santos ◽  
Tânia Rita Moreno de Oliveira Fernandes ◽  
Thamyres Rats de Souza Barbosa ◽  
Jemima Araujo da Silva Batista ◽  
Carlos Dornels Freire de Souza
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Clinical Case

scholarly journals The "disease of the crazy hatman" and the effects of human exposure to mercury: A case report / A "doença do homem do chapéu maluco" e os efeitos da exposição humana ao mercúrio: Um relato de caso

2021 ◽  
Vol 7 (12) ◽  
pp. 120602-120610
Author(s):  
Túlio Mohammad da Costa Sahori ◽  
Ana Luísa Sena Morais Gratão ◽  
Bárbara Queiroz De Figueiredo ◽  
Diogo Gonçalves Souto ◽  
Gardênia Silva Amorim ◽  
...  
Keyword(s):  
Case Report ◽  
Small Amplitude ◽  
Human Exposure ◽  
Clinical Case ◽  
Motor Coordination ◽  
Inorganic Mercury ◽  
Mercury Vapor ◽  
Lower Limbs ◽  
Motor Speed ◽  
Behavioral Impairment

INTRODUCTION: Mercury, in addition to being a heavy metal, is considered a neurotoxin, that is, a substance capable of negatively affecting the neurological functions of the human body. Nowadays, ““Mad Hatter's Disease”” is the name used to characterize these neurological disorders caused by mercury. PURPOSE: to report a clinical case of the manifestation of “Mad Hatter's Disease”, as well as to discuss about the effects of human exposure to mercury. METHODOLOGY: this is a clinical case report, in which the patient is essential. CASE REPORT: A 45-year-old male patient, gold miner, from a riverside community in the Amazon, was referred to the hospital with complaints of headache, extremities tremor, diarrhea, tiredness, discouragement, irritability, depression, unusual shyness and hallucinations. On physical examination, the patient was anxious, irritable, symmetrical small-amplitude tremors in the extremities, hyperreflexia ++/4+ in the upper limbs, +/4+ in the lower limbs, normal muscle strength, mild ataxia of the right hand, stained skin and mucous membranes, and acyanotic, with erythematous-scaly lesions, confluent on the trunk, palms and soles of the feet. Screening for mercury poisoning was performed, where it was found, both in blood and urine, the presence of mercury 20 times above the biological tolerance limit. A battery of specific neuropsychological tests was carried out in neurotoxicological assessments and these demonstrated impairment of the cognitive domains (deficit of memory, attention, concentration, reasoning and abstraction) and alterations in motor functions, showing reduced coordination and motor speed. The diagnosis of hydrargyrism or occupational chronic metallic mercuralism (MMCO) was given. DISCUSSION: Chronic occupational exposure to inorganic mercury can cause subclinical abnormalities, as well as long-term psychomotor and neuromuscular behavioral impairment. Neuropsychiatric abnormalities (inattention, memory, interpretation, and motor performance) appear to be dose-related. FINAL CONSIDERATIONS: chronic exposure to metallic mercury vapor characteristically compromises the nervous system, initially with nonspecific symptoms and, later, with characteristic motor disorders - small amplitude tremor, paresis, dysreflexia and difficulty in motor coordination, which gives rise to the "Disease of the Mad Hatter”, and inhaling large amounts of mercury vapor can be lethal.

scholarly journals Presentation of Intrahepatic Cholangiocarcinoma with Fulminant Hepatic Failure: A Case Report

2019 ◽  
Vol 02 (02) ◽  
pp. 135-139
Author(s):  
Thara Pratap ◽  
Muhammed Jasim Abdul Jalal ◽  
Pushpa Mahadevan ◽  
Abraham Koshy ◽  
Roy J. Mukkada ◽  
...  
Keyword(s):  
Case Report ◽  
Fulminant Hepatic Failure ◽  
Intrahepatic Cholangiocarcinoma ◽  
Hepatic Failure ◽  
Fatal Outcome ◽  
Final Diagnosis ◽  
Rare Entity ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

AbstractFulminant hepatic failure as initial presentation due to diffuse parenchymal infiltration by cholangiocarcinoma is a rare entity. We present the case of a 49-year-old female patient who had a fatal outcome with acute liver failure due to diffuse intrahepatic cholangiocarcinoma. No definite mass lesion was identified on cross-sectional imaging. The final diagnosis was made on transjugular liver biopsy. This discussion highlights the possibility of infiltrative cholangiocarcinoma as a rare cause of fulminant hepatic failure.

scholarly journals High-Energy Transsyndesmotic Ankle Fracture Dislocation: A Case Report and Systematic Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yinshuan Deng ◽  
Chenhui Dong ◽  
Xiaojie Yang ◽  
Rui Liu ◽  
Feiyi Hou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Literature Review ◽  
Ankle Fracture ◽  
Clinical Case ◽  
High Energy ◽  
Fracture Dislocation ◽  
High Energy Trauma ◽  
Ovid Medline ◽  
Type Of Injury

High-energy trauma can cause transsyndesmotic ankle fracture dislocation. These fractures are quite rare. Here we present a clinical case of a male patient with this type of injury. A systematic review of PubMed, Ovid MEDLINE, and Embase electronic databases revealed only two prior publications on a similar topic. We discuss the typical clinical features of these injuries, the treatment of high-energy trauma which can cause transsyndesmotic ankle fracture dislocation, and its prognosis.

scholarly journals The effects of physical activity on human gut microbiota composition: a systematic review

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B Dorelli ◽  
M Iachini ◽  
M Zaccarin ◽  
J Preziosi Standoli ◽  
F Galle ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Gut Microbiota ◽  
Moderate Intensity ◽  
Microbiota Composition ◽  
Human Gut ◽  
Cross Sectional ◽  
Human Gut Microbiota ◽  
Cross Sectional Studies ◽  
Gut Microbiota Composition

Abstract Background Gut microbiota development and composition can be influenced by an existing dynamic balance between host physiology and lifestyle. This systematic review aims to assess the impact of physical activity on human gut microbiota. Methods PubMed, Scopus and Web of Science were searched until May 2019. Full-text in English were recruited if focused on gut microbiota in healthy athletes or active people, without age or gender restrictions, collected on faecal samples and analysed with genome sequencing of rRNA 16S. All types of study design were included as long as they performed a comparison with a sedentary control group. No specific time frame for the publication date was applied. Quality assessment was performed using the JBI Critical Appraisal Checklist for Analytical Cross Sectional Studies (2017) and Cochrane Risk of Bias Tool for Randomized Controlled Trials. Results The analysis yielded 7/985 articles: five cross-sectional studies and two clinical trials, published from 2014 to 2019. The overall methodological assessment was of fair quality. Types of exercise included in the studies were: rugby, running, aerobic exercise, bodybuilding. More in detail, regarding the exercise load, some studies were conducted on elite professional athletes, such as rugby players, marathon runners or bodybuilders, with rigorous training, while other studies included a few weeks of aerobic and resistance training at a moderate intensity. Shannon diversity index increased in three studies. Concerning phyla, Firmicutes were increased in five studies and three studies described a significant decrease in Bacteroides. Conclusions This systematic review confirms the direct correlation between microbiota composition and physical activity, but further studies are needed to establish the possible presence of a causal link between the two factors. Key messages Exercise can play an important role as an environmental factor in determining gut microbiota composition. Further studies are needed to gain robust evidence of physical activity influence on gut microbiota variability.

Norrie disease: мain symptoms and importance of early genetic analysis (case report)

2021 ◽  
pp. 96-99
Author(s):  
A.M. Khoteeva ◽  
◽  
M.F. Shurygina ◽  
I.A. Mishina ◽  
◽  
...  
Keyword(s):  
Case Report ◽  
Retinal Detachment ◽  
Clinical Case ◽  
Genetic Diagnosis ◽  
Final Diagnosis ◽  
Modern Method ◽  
Norrie Disease ◽  
Typical Sign ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing

We present a clinical case of Norrie disease in a 6-year-old boy. The parents had in time an ophthalmologist consultation when the child was 4 months old, but the final diagnosis was made more than 5 years later. A specific feature of this case in addition to vitreoretinopathy and bilateral retinal detachment was the presence of a congenital malformation of the iris - aniridia, which is not a typical sign of Norrie disease. A modern method of genetic testing (next generation sequencing - NGS) made it possible to detect a previously undescribed mutation in the NDP gene and make a final clinical and genetic diagnosis. Key words: Norrie disease; vitreoretinopathy; retinal detachment; NDP gene.

scholarly journals Isolated Resistance Training Programs to Improve Peripheral Muscle Function in Outpatients with Chronic Obstructive Pulmonary Diseases: A Systematic Review

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1397
Author(s):  
Simone Pancera ◽  
Nicola F. Lopomo ◽  
Luca N. C. Bianchi ◽  
Paolo Pedersini ◽  
Jorge H. Villafañe
Keyword(s):  
Systematic Review ◽  
Skeletal Muscle ◽  
Resistance Training ◽  
Muscle Function ◽  
Lower Limbs ◽  
Chronic Obstructive ◽  
Eligibility Criteria ◽  
Skeletal Muscle Function ◽  
Cross Sectional ◽  
Peripheral Muscle

This systematic review aims to establish which isolated resistance training (RT) programs have been used in outpatients with chronic obstructive pulmonary disease (COPD) and their impact on all aspects of peripheral skeletal muscle function. Electronic databases were systematically searched up to June 2021. The eligibility criteria were: (1) randomized controlled trials investigating the effects of supervised and isolated RT programs in outpatients with COPD and (2) RT programs lasting 8–12 weeks, (3) including at least one outcome measure related to trainable muscle characteristics. Initially, 6576 studies were identified, whereas 15 trials met the inclusion criteria. All the included trials reported that isolated RT improved both upper and lower limbs’ maximal strength. Muscle endurance and power also increased after RT but received less attention in the analysis. Furthermore, few studies assessed the effect of RT on muscle mass and cross-sectional area, reporting only limited improvement. Isolated RT programs carried out 2–3 days a week for 8–12 weeks improved skeletal muscle function in individuals with COPD. The RT program should be specifically focused to the trainable muscle characteristic to be improved. For this reason, we further encourage the introduction of a detailed assessment of muscle function and structure during the pulmonary rehabilitation practice.

scholarly journals Association Between Active or Passive Smoking and Allergic Rhinitis: an Evidence-Based Case Report

2021 ◽  
Vol 9 (1) ◽  
pp. 56
Author(s):  
Lupita Reksodiputro ◽  
Thalia Mufida ◽  
Niken Poerbonegoro ◽  
Mirta Hediyati Reksodiputro
Keyword(s):  
Systematic Review ◽  
Allergic Rhinitis ◽  
Case Report ◽  
Passive Smoking ◽  
Statistical Significance ◽  
Research Question ◽  
Evidence Based ◽  
Active Smoking ◽  
Cross Sectional ◽  
University Of Oxford

This evidence-based case report (EBCR) aims to investigate the association between active or passive smoking with allergic rhinitis by summarizing existing studies on the topic. A literature search was done on major databases with keywords related to this study’s research question. The literature was appraised using CEBM University of Oxford for etiology study and systematic review sheets. The search obtained two articles for critical appraisal, includes a meta-analysis and a cohort study. The studies were appraised as valid, important, and applicable to the writer’s setting. Saulyte et al’ s2 article described RR active smoking with allergic rhinitis of 1.02 (95%CI 0.92-1.15), with no significant association. They resolved the heterogeneity by making subgroups. The cross-sectional subgroup with RR 1.09 (95%CI 1.06-1.12) is statistically significant. There was a significant association in passive smoking and obtained RR 1.10 (95%CI 1.06-1.15). In the study by Mlinaric et al4 the RR of active and passive smoking compared to non-smoker are 1.82 and 2.00; both show statistical significance. Both active and passive smoking is associated with a high risk of allergic rhinitis in adults and children. Keywords active smoking, passive smoking, allergic rhinitis.   Hubungan Perokok Aktif dan Pasif dengan Rhinitis Alergi: Laporan Kasus Berbasis Bukti Abstrak Pada laporan kasus berbasis bukti ini bertujuan untuk menginvestigasi hubungan antara perokok aktif dan perokok pasif pada pasien dengan rinitis alergi. Dilakukan pencarian literatur menggunakan kata kunci yang berhubungan dengan kasus pada beberapa search engine, kemudian dilakukan penilaian kelayakan dengan lembar appraisal dari CEBM University of Oxford for etiology study and systematic review sheet. Dari pencarian didapatkan dua artikel yang mepresentasikan kasus tersebut, yaitu studi meta analisis dan studi cohort. Studi meta analisis oleh Saulyte et al2 menyatakan RR pada perokok aktif dengan rinitis alergi adalah 1,02 (95%CI 0,92-1,15). Pada subgrup potong lintang didapatkan perbedaan bermakna dengan RR 1,09 (95%CI 1,06-1,12). Pada studi cohort oleh Minaric et al didapatkan RR pada perokok aktif 1,82 dan pada perokok pasif 2,00, keduanya menunjukan angka yang signifikan. Pada perokok aktif dan pasif berhubungan dengan risiko tinggi pada rinitis alergi di pasien dewasa dan anak-anak. Kata kunci: perokok aktif, perokok pasif, rhinitis alergi.

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