Evaluation of a Case Series of Patients With Palmoplantar Pustulosis in the United States

2021 ◽  
Author(s):  
Megan H. Noe ◽  
Marilyn T. Wan ◽  
Arash Mostaghimi ◽  
Joel M. Gelfand ◽  
Ritesh Agnihothri ◽  
...  
Keyword(s):  
United States ◽  
Case Series ◽  
The United States ◽  
Palmoplantar Pustulosis

Clinical Characteristics of Patients Diagnosed with Strongyloidiasis in a United States Urban Outpatient Dermatology Department: A Case Series

2017 ◽  
Vol 1 (3) ◽  
pp. 156-160
Author(s):  
Jacqueline Watchmaker ◽  
Sean Legler ◽  
Dianne De Leon ◽  
Vanessa Pascoe ◽  
Robert Stavert
Keyword(s):  
United States ◽  
Case Series ◽  
The United States ◽  
Screening Tools ◽  
Dermatology Department ◽  
Cutaneous Manifestations ◽  
Serologic Testing ◽  
Patient Reported ◽  
History Of ◽  
Endemic Areas

Background: Although considered a tropical disease, strongyloidiasis may be encountered in non-endemic regions, primarily amongst immigrants and travelers from endemic areas.  Chronic strongyloides infection may be under-detected owing to its non-specific cutaneous presentation and the low sensitivity of commonly used screening tools. Methods: 18 consecutive patients with serologic evidence of strongyloides infestation who presented to a single urban, academic dermatology clinic between September 2013 and October 2016 were retrospectively included.  Patient age, sex, country of origin, strongyloides serology titer, absolute eosinophil count, presenting cutaneous manifestations, and patient reported subjective outcome of pruritus after treatment were obtained via chart review.  Results: Of the 18 patients, all had non-specific pruritic dermatoses, 36% had documented eosinophila and none were originally from the United States. A majority reported subjective improvement in their symptoms after treatment. Conclusion:  Strongyloides infection and serologic testing should be considered in patients living in non-endemic regions presenting with pruritic dermatoses and with a history of exposure to an endemic area.Key Points:Chronic strongyloidiasis can be encountered in non-endemic areas and clinical manifestations are variableEosinophilia was not a reliable indicator of chronic infection in this case series Dermatologists should consider serologic testing for strongyloidiasis in patients with a history of exposure and unexplained pruritus

scholarly journals A Case Series: Describing the Coronavirus Pandemic Response in Small Naval OCONUS Military Treatment Facilities

2021 ◽  
Vol 186 (Supplement_2) ◽  
pp. 61-67
Author(s):  
Emily R Latimer ◽  
Christopher A Parker ◽  
Pauline A Swiger
Keyword(s):  
United States ◽  
Case Series ◽  
The United States ◽  
Staff Protection ◽  
Treatment Facilities ◽  
Pandemic Response ◽  
Future Work ◽  
Military Treatment Facilities ◽  
Communication Methods ◽  
Prolonged Stress

ABSTRACT Introduction The European SARS-CoV-2 (COVID-19) outbreak threatened military beneficiaries receiving care outside of the United States. Military treatment facilities located outside the United States were the first to respond to the pandemic, requiring immediate action to establish novel protocols. The purpose of this case series is to describe challenges, solutions, and future recommendations during a pandemic response at three small naval military treatment facilities located outside the continental United States (OCONUS). Results The analysis and discussion reviews challenges in information processing, communication methods and patterns, process changes, actions for staff protection, and change fatigue experienced during this time. Conclusions Recommendations for future work include filling the gaps in the evidence for a prolonged pandemic response and crisis management, such as the current SARS-CoV-2 pandemic, including best practices to communicate, maintain staff resilience, and manage or mitigate associated prolonged stress and uncertainty.

Anterior Dental Extractions among Dinka and Nuer Refugees in the United States: A Case Series

2005 ◽  
Vol 25 (4) ◽  
pp. 193-198 ◽  
Author(s):  
Mary S. Willis ◽  
Ryan N. Schacht ◽  
Randy Toothaker
Keyword(s):  
United States ◽  
Case Series ◽  
The United States

scholarly journals 1146. Lactococcus species Catheter-Related Bloodstream Infections in Pediatrics: A Case Series

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S665-S665
Author(s):  
Sarah E Firmani ◽  
Holly Maples ◽  
Archana Balamohan
Keyword(s):  
United States ◽  
Case Series ◽  
The United States ◽  
Generation Cephalosporin ◽  
Definitive Treatment ◽  
Common Source ◽  
Beta Lactam ◽  
Sensitivity Testing ◽  
Pubmed Database ◽  
Definitive Therapy

Abstract Background Central venous catheters (CVC), may lead to central line-associated blood stream infections (CLABSIs). In the past, Lactococcus species have seldom been considered pathogenic. However, clinically significant infections have been reported, of which few are pediatric cases, all outside the United States. Methods We retrospectively identified pediatric patients with bacteremia secondary to Lactococcus spp. admitted to a tertiary pediatric hospital from January 2018 - December 2020. We reviewed the PubMed database for cases of pediatric Lactococcus spp. infections in English, peer-reviewed literature. Results We identified 3 patients with Lactococcus spp. bacteremia. The average patient was 17 months old (range, 6–24 months). All had a CVC; two had short bowel syndrome and 1 had nephrotic syndrome. None received probiotics. Empiric treatment for all included vancomycin. Two of 3 patients were de-escalated to ceftriaxone. All isolates were susceptible to penicillin. Duration of treatment was 10-14 days. Two of 3 were managed with CVC retention and none had recurrence of infection. A literature review revealed 9 additional cases (Table 1). The most common source of infection was blood (33%), with 66% (2/3) occurring in patients with central lines. Other sources included liver abscess (11%), brain abscess (11%), cerebrospinal fluid (11%), urine (11%), and endocarditis (22%). Median patient age was 12 months (range, 14 days-14 years). Five of 9 patients had an underlying risk factor. Duration of therapy ranged from 7-40 days. Most definitive treatment regimens consisted of a third-generation cephalosporin (44%). Of bacteremia, 2/3 received vancomycin as part of their definitive therapy. Five of 9 reported quantitative antimicrobial sensitivity testing (AST) or interpretation of AST to beta-lactam antibiotics; 80% (4/5) were susceptible. Conclusion To the best of our knowledge, these are the first reported pediatric cases of Lactococcus infections in the United States and suggests Lactococcus spp. should be considered pathogenic in the appropriate circumstances. This series adds to the limited literature, including AST. Continued accrual of susceptibility data may raise the possibility of using a 3rd generation cephalosporin as empiric therapy for Lactococcus bacteremia. Disclosures All Authors: No reported disclosures

scholarly journals Association between rotavirus gastroenteritis and intussusception: suggested evidence from a retrospective study in claims databases in the United States. Corresponding author: Corinne Willame, MPH, GSK, 20 Avenue Fleming, Wavre, Belgium

2019 ◽  
Author(s):  
Corinne Willame ◽  
Brigitte Cheuvart ◽  
Emmanuel Aris ◽  
Volker Vetter ◽  
Catherine Cohet
Keyword(s):  
United States ◽  
Sensitivity Analysis ◽  
Case Series ◽  
The United States ◽  
Temporal Association ◽  
Administrative Claims ◽  
Fracture Group ◽  
Rotavirus Gastroenteritis ◽  
Risk Period ◽  
Post Hoc

Abstract Background: The etiology of intussusception (IS), a serious medical condition of acute gastrointestinal obstruction, remains unclear. Limited evidence suggests a role for viral infections, including rotavirus infection. This study aimed to explore the risk of IS after rotavirus gastroenteritis (RV GE) in the first year of life, where the incidence of IS is highest. Methods: In this retrospective, self-controlled case series (SCCS), we assessed the risk of IS after RV GE in infants <1 year of age, using data extracted from administrative claims databases in the United States. Incidence rate ratios (IRR) of IS were calculated for the 7- and 21-day risk periods after RV GE (main analysis) or after fracture (sensitivity analysis using a control event) in subjects presenting with claims for these conditions. Post-hoc analyses were also performed. Results: Out of the 290,912,068 subjects screened, 42 subjects presented claims for RV GE and IS (RV GE group) and 66 presented claims for fracture and IS (fracture group). The IRR of IS after RV GE was 79.6 (95% confidence interval, CI: 38.6–164.4) in the 7-day risk period and 25.5 (95% CI: 13.2–49.2) in the 21-day risk period. The sensitivity analysis also showed an association between IS and fracture for the two risk periods: IRR was 6.1 (95% CI: 3.0–12.7) and 2.8 (95% CI: 1.5–5.4) in the 7- and 21-day risk periods, respectively, which suggested potential confounding such as by history of rotavirus vaccination, or a visit effect. Post-hoc analyses investigating these points did not confirm an association between fracture and IS, but still suggested a possible association between RV GE and IS. Conclusions: A temporal association between RV GE and IS was detected using the SCCS design in United States claims databases. However, due to some limitations identified through additional analyses, further studies are needed to confirm this association.

scholarly journals Clinical Features and Outcomes of Isolated Myeloid Sarcoma in the United States: Analysis Using a National Dataset

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1618-1618
Author(s):  
Gaurav Goyal ◽  
Adam C Bartley ◽  
Aref Al-Kali ◽  
William J Hogan ◽  
Mark Litzow ◽  
...  
Keyword(s):  
United States ◽  
Overall Survival ◽  
Research Funding ◽  
Median Overall Survival ◽  
Case Series ◽  
The United States ◽  
Myeloid Sarcoma ◽  
Anatomical Distribution ◽  
Mediastinal Disease ◽  
Significant Difference

Abstract Introduction Isolated myeloid sarcoma is a rare form (<1%) of acute myeloid leukemia presenting as extramedullary tumor. Contemporary clinical data are mostly limited to institutional case series. Using the National Cancer Database, the largest public cancer registry covering >70% of all newly diagnosed cancers in the United States, we determined the patterns of anatomical presentation and clinical outcome of myeloid sarcoma. Methods We identified patients with a histologically confirmed diagnosis of isolated myeloid sarcoma from 2004-2013 using International Classification of Diseases for Oncology version 3 (ICD-O-3) code: 9930. To allow at least 1 year of follow-up, only patients diagnosed from 2004-2012 were included in the survival analysis using Kaplan-Meier estimates. Results A total of 746 patients were included in the study. The median age of patients was 59 years (range, 41 to 73) and 56% were males. The anatomical distribution and median overall survival of patients are depicted in the Table. The top 3 most common sites of presentation were connective/soft tissues (31.3%), skin/breast (12.3%), and digestive system (10.3%). Compared to other races, Blacks were more likely to have presentation in bones/joints (11.8% vs 6.3% in others), lymph nodes/spleen (22.1% vs. 9%), and less likely in skin/breast (4.4% vs. 13.8%). Asians were more likely to present with cardiopulmonary/mediastinal disease as compared to other races (13.6% vs. 4.2%). According to outcomes, we can categorize the patients into 3 groups: good (median overall survival >30 months: reproductive and digestive systems), intermediate (median overall survival 15-30 months: head/neck and kidney/bladder/retroperitoneum/adrenal), and poor (median overall survival <15 months: nervous system, connective/soft tissue, and bones/joints). There was no significant difference in overall survival between males and females (P =0.06). Among the races, Blacks had the worst overall survival (P =0.02; Figure). Conclusions This is the largest registry-based study on isolated myeloid sarcoma in the United States. Isolated myeloid sarcoma has a diverse anatomic clinical presentation and the overall survival varied significantly according to sites of presentation and racial subgroups. The results of our study may aid the prognostication of patients for treatment decision making and in the understanding of the biological differences by anatomic sites of presentation. Table Anatomical distribution and median overall survival of isolated myeloid sarcoma Table. Anatomical distribution and median overall survival of isolated myeloid sarcoma Figure Overall survival by sex and race in isolated myeloid sarcoma Figure. Overall survival by sex and race in isolated myeloid sarcoma Disclosures Al-Kali: Onconova Therapeutics, Inc.: Research Funding; Celgene: Research Funding.

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