Outbreak of mycoplasmal round pneumonia in an adult population: A case series

2018 ◽  
Vol 12 (12) ◽  
pp. 2659-2667
Author(s):  
Wen Wen ◽  
Lei Gu ◽  
Guo Qing Yu ◽  
Ai Ming Wang ◽  
Hua Zeng ◽  
...  
Keyword(s):  
Adult Population ◽  
Case Series ◽  
Round Pneumonia

scholarly journals Psychosis in youth in Singapore: a case series

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S117-S117
Author(s):  
Pei Ling Lim ◽  
Roselyne Shirley ◽  
Pat Fong
Keyword(s):  
Adult Population ◽  
Psychiatric Service ◽  
Case Series ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Term Outcome ◽  
Duration Of Symptoms ◽  
Long Term Outcome ◽  
Paediatric Hospital ◽  
Seeking Help

ObjectiveIn this report, we present a case series of children with psychotic symptoms referred to a child consultation liaison psychiatric service within a tertiary paediatric hospital in Singapore. The purpose of this case series is to identify common symptoms at presentation, review the current practices in our hospital for investigation and treatment of first episode psychosis and short-term outcomes.Case reportWe identified 9 cases over a 1 year period, for which 7 were seen whilst admitted to hospital and 2 in the outpatient clinic. There were 6 females and 5 males ranging in age from 11 to 16 years old. The commonest symptoms on presentation were perceptual disturbance (88%) most commonly auditory hallucinations and altered behaviour (55%). Of the 7 children admitted to hospital, all were seen by the neurology team prior to the request for a psychiatric opinion. All admitted patients had blood and radiological investigations carried out. Most of the children were started on a short course of antipsychotic medication with the majority continuing to attend follow-up outpatient.DiscussionOnly 9 cases were identified in this case series over a 1 year period highlighting that psychosis is not a common presentation in the paediatric population. From the history alone, it can be challenging to distinguish between primary and secondary causes of psychosis. Acute onset of symptoms and the presence of other neurological signs should raise the suspicion of an underlying organic cause. Out of 9 cases, only 1 case was treated for a presumed organic aetiology, which is consistent with findings from other authors who only found underlying organic factors in 12.5% of cases.In this case series, we also noted that 45% of cases reported having symptoms for over 1 year before seeking help. This is also seen in the adult population in Singapore. Stigma, denial and lack of information about psychosis may all contribute to delay in seeking help. Although prolonged duration of untreated psychosis has been shown to be associated with poor long-term outcome, we found in our case series that even patients who reported a long duration of symptoms still responded well to medication.ConclusionThere is room for collaboration with our neurology colleagues in the approach towards children with first presentation of psychosis, both in terms of investigations and management. Identifying reasons for disengagement from psychiatric care is an area for further investigations to improve outcomes in our patients.

Experiences of choledochal cyst in pediatric and adult population: A case series

2019 ◽  
Vol 7 (4) ◽  
pp. 138
Author(s):  
SanjayKumar Bhat ◽  
AK Roy ◽  
Rahul Bhushan ◽  
NisarAhmed Ansari ◽  
PK Mishra ◽  
...  
Keyword(s):  
Choledochal Cyst ◽  
Adult Population ◽  
Case Series

scholarly journals Supratentorial and Infratentorial Ependymomas in Adult Population - A 10-year single institution case series

2019 ◽  
Vol 21 (Supplement_4) ◽  
pp. iv19-iv19
Author(s):  
Shami Acharya ◽  
Athanasius Ishak ◽  
Priya Sekhon ◽  
Jose Pedro Lavrador ◽  
Asfand Malik ◽  
...  
Keyword(s):  
Adult Population ◽  
Case Series ◽  
Poor Response ◽  
Extent Of Resection ◽  
Good Prognosis ◽  
Single Institution ◽  
Single Centre ◽  
Who Grade ◽  
Oncological Treatment ◽  
Grade 3

Abstract Objectives Analyse clinical characteristics and treatment provided to an adult population diagnosed with intracranial ependymomas between 2009–2018. Methods Single centre retrospective cohort study. Variables reviewed: demographics, extent of resection, adjuvant oncological treatment and molecular genetics. Results 17 patients were included (6 females, 11 males). Average age at presentation was 51.3 yrs (range 19-74yrs). 4 supratentorial (2 intraventricular, 1 temporal lobe and 1 frontal lobe) and 13 infratentorial lesions were identified. In the supratentorial subgroup the following treatment was performed: GTR (1 patient), STR (1 patient) and Biopsy (2 patients); 2 patients underwent post-operative radiotherapy. 3 patients had a WHO grade 2 tumour (1 patient - insufficient tissue for grading). 3 recurrences were identified and 2 patients had re-debulking. 2 patients had postoperative hemiparesis, 1 patient died during treatment and 3 are currently being followed up. In the infratentorial subgroup the following treatment was performed: GTR (5 patients), STR (7 patients) and biopsy (1 patient). 3 patients underwent post-operative radiotherapy. 1 patient was WHO grade 1, 11 patients were WHO grade 2 and 1 patient was WHO grade 3. 2 patients had tumour recurrences of which 1 was re-operated. 7 patients develop new post-operative deficits after surgery; 1 patient died and the rest are currently being followed up. Conclusion Even though this case series supports the good prognosis in terms of overall survival in adults with intracranial ependymomas, they represent a challenge to manage given the morbidity of optimal surgical resection and their poor response to adjuvant treatment.

scholarly journals MPL Y252H and MPL F126fs mutations in essential thrombocythemia: Case series and review of literature

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Ahmed G. Elsayed ◽  
Aeesha Ranavaya ◽  
Muhammad Omer Jamil
Keyword(s):  
Bone Marrow ◽  
Somatic Mutation ◽  
Essential Thrombocythemia ◽  
Adult Population ◽  
Case Series ◽  
Clinical Importance ◽  
The Other ◽  
Review Of Literature ◽  
Bone Marrow Disease ◽  
Stat Pathway

Essential thrombocythemia (ET) is a clonal bone marrow disease, characterized by increased production of platelets along with other clinical and bone marrow findings. Most patients with ET will have a somatic mutation in one of the known gene locations of JAK2, CALR , or MPL that can upregulate the JAK-STAT pathway. MPL mutation is present in 5% of cases with the most common mutations being W515L and W515K. In this report we describe 2 cases of patients with clinical and laboratory picture of ET. One patient carried MPLY252H mutation which is previously unreported in the adult population but has been shown to be a gain-of-function mutation. The other patient carried MPL F126fs mutation which is not known to be of clinical importance and has not been previously reported.

scholarly journals Adult Bilateral Ureteroceles Presenting with Lower Urinary Tract Symptoms and Acute Urinary Retention

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Alexis Rompré-Brodeur ◽  
Sero Andonian
Keyword(s):  
Urinary Tract ◽  
Urinary Retention ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Acute Urinary Retention ◽  
Adult Population ◽  
Case Series ◽  
Invasive Approach ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Ureterocele is a well-known pathologic entity in the pediatric urology population but remains a diagnostic and treatment challenge in the adult population. Adult ureteroceles remain a diagnostic challenge for the adult urologist. Its prevalence is estimated between 1/500 and 1/4000 patients with a wide variety of clinical presentations. We present the case of a 30-year-old female patient who presented with severe lower urinary tract symptoms (LUTS) and acute urinary retention secondary to prolapsing bilateral single-system orthotopic ureteroceles. She was successfully treated with transurethral unroofing of her bilateral ureteroceles and she is currently asymptomatic. This case represents the first reported case of bilateral ureteroceles presenting with severe LUTS and subsequent urinary retention from the prolapse of one of the ureteroceles. We provide a review of the most recent case series of adult ureteroceles and their outcomes. Transurethral unroofing of the ureterocele is a safe and minimally invasive approach for this disease.

scholarly journals Laparoscopic Choledochal Cyst Resection with Simplified Common Bile Duct Reconstruction in an Adult Population: A Case Series

2019 ◽  
Vol 12 (2) ◽  
pp. 76-82
Author(s):  
Daniel Gomez ◽  
Jean A Pulido ◽  
Ricardo Villarreal ◽  
Andres C Mendoza ◽  
Daniela Moreno ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Adult Population ◽  
Case Series ◽  
Bile Duct Reconstruction

scholarly journals Acute Neurologic Dysfunction in Critically Ill Children: The PODIUM Consensus Conference

PEDIATRICS ◽  
2022 ◽  
Vol 149 (Supplement_1) ◽  
pp. S32-S38
Author(s):  
Mark S. Wainwright ◽  
Kristin Guilliams ◽  
Sujatha Kannan ◽  
Dennis W. Simon ◽  
Robert C. Tasker ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Critically Ill ◽  
Task Force ◽  
Data Extraction ◽  
Adult Population ◽  
Case Series ◽  
Consensus Conference ◽  
Critically Ill Children ◽  
Coma Scale ◽  
Neurologic Dysfunction

CONTEXT Acute neurologic dysfunction is common in critically ill children and contributes to outcomes and end of life decision-making. OBJECTIVE To develop consensus criteria for neurologic dysfunction in critically ill children by evaluating the evidence supporting such criteria and their association with outcomes. DATA SOURCES Electronic searches of PubMed and Embase were conducted from January 1992 to January 2020, by using a combination of medical subject heading terms and text words to define concepts of neurologic dysfunction, pediatric critical illness, and outcomes of interest. STUDY SELECTION Studies were included if the researchers evaluated critically ill children with neurologic injury, evaluated the performance characteristics of assessment and scoring tools to screen for neurologic dysfunction, and assessed outcomes related to mortality, functional status, organ-specific outcomes, or other patient-centered outcomes. Studies with an adult population or premature infants (≤36 weeks' gestational age), animal studies, reviews or commentaries, case series with sample size ≤10, and studies not published in English with an inability to determine eligibility criteria were excluded. DATA EXTRACTION Data were abstracted from each study meeting inclusion criteria into a standard data extraction form by task force members. DATA SYNTHESIS The systematic review supported the following criteria for neurologic dysfunction as any 1 of the following: (1) Glasgow Coma Scale score ≤8; (2) Glasgow Coma Scale motor score ≤4; (3) Cornell Assessment of Pediatric Delirium score ≥9; or (4) electroencephalography revealing attenuation, suppression, or electrographic seizures. CONCLUSIONS We present consensus criteria for neurologic dysfunction in critically ill children.

scholarly journals VISUAL FIELD DEFECTS;

2017 ◽  
Vol 24 (10) ◽  
pp. 1527-1533
Author(s):  
Muhammad Khalid ◽  
Mehwish Aslam ◽  
Umer Farooq Raina ◽  
Khaleeq UZ Zaman
Keyword(s):  
Visual Field ◽  
Adult Population ◽  
Case Series ◽  
Female Gender ◽  
Visual Field Defects ◽  
International Studies ◽  
Case Series Study ◽  
Computerized Perimetry ◽  
Series Study ◽  
Field Defects

Objectives: To obtain and compare the exact visual status before and afterexcision of sella supra sellar tumors using the computerized perimetry as a standard measuringtools and then compare with the international studies. Background: Sella suprasellar tumorsare though not so common but affect visual acuity of patients and their quality of life drops.These tumors include pituitary adenoma commonest in the adult population, meningioma,Craniopharyngioma, astrocytic glioma, Optic nerve Glioma, Germinoma, Dermoid, Pituitarymetastases. We planned a descriptive case series study to compare the pre and post excisionvisual field defects using computerized perimetry. Study Design: Case series study. Setting:Department of Neurosurgery, Pakistan Institute of Medical Sciences, SZABMU, and Islamabad.Period: 2 years from January 2015 to December 2016. Methods: A total of 73 patients withsella suprasellar tumors were identified and enrolled. Patients between the age of 10 and55 years were selected on the basis of having sella supra sellar tumor on CT/MRI brain withcontrast. Patients whose age was less than 10 years and more than 55 years were excluded.Moreover, patients with post radiation necrosis diagnosed on MRI and MR spectroscopy brain,those operated for other eye pathology and patients with sella supra sellar SOL having comorbiditieslike diabetes mellitus, hypertension etc. were also excluded from the study. Thestudy outcome was measured in terms of comparison of visual field defects after excision ofsella suprasellar tumors using computerized perimetry. Results: The average age of patientswas 42.1 + 6.8 years ranging from 10 to 55 years. Female gender was predominant; therewere 40 (54.8%) female patients. The mean computerized perimetry was 0.65 + 0.34 LogMARbefore surgery which improved to 0.19 + 0.12 LogMAR after surgery. Overall, of the 73 cases,63 (86.4%) had improvement whereas 10 (13.6%) study cases had no improvement in thevisual field on follow-up. Conclusion: It can be concluded that after craniotomy and excisionof sella suprasellar tumors, perimetry showed improvement in the majority of the study cases.

scholarly journals Long-term Outcomes of Coalition Resection in Adult Tarsal Coalition

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0012
Author(s):  
Thomas B. Bemenderfer ◽  
Jacob B. Boersma ◽  
Donald R. Bohay ◽  
John G. Anderson ◽  
John D. Maskill
Keyword(s):  
Wound Care ◽  
Adult Population ◽  
Case Series ◽  
Tarsal Coalition ◽  
Vas Score ◽  
Calcaneonavicular Coalition ◽  
Additional Surgery ◽  
Significant Difference ◽  
Orthopaedic Literature

Category: Hindfoot; Other Introduction/Purpose: Although the diagnosis, treatment, and natural history of tarsal coalitions has been well described in the adolescent population, there remains a paucity of orthopaedic literature on outcomes associated with coalition resection with or without interposition in the adult population. This study is the first to evaluate clinical and radiographic outcomes in adult patients with tarsal coalition resection without interposition. Methods: All patients with symptomatic tarsal coalition (subtalar, calcaneonavicular, or talonavicular) who failed conservative management and underwent coalition resection with concomitant procedures as indicated by their pathology between January 2006 and December 2014 were included in our retrospective case series. Demographics, clinical outcomes, patient comorbidity information, visual analogue scale (VAS) pain scores were collected. Advanced imaging (CT or MRI) was reviewed to determine fibrocartilaginous or osseous coalition. The primary outcome was reoperation. Secondary outcomes were change in visual analog score (VAS), and minor complications (local wound care, use of antibiotics, and skin dehiscence). Results: 68 patients (52.9% males, 47.1% females; average age 35.9 years old, range 18 to 70) met inclusion. Calcaneonavicular, subtalar, and talonavicular coalitions were resected in 45.6% (n=31), 54.4% (n=37), and 0% of patients, respectively. At average final clinical follow up of 36 months, there were a total of 33 reoperations in 33.8% of patients (n=23) most commonly including subsequent fusion (n=11), exostectomy (n=10), and removal of hardware (n=15). There was no significant difference in reoperation (42.3% versus 63.1%, p=0.454) or fusion (19.4% versus 19.2%, p=0.99) following subtalar or calcaneonavicular coalition resection. Average VAS score preoperatively and postoperatively was 5.8 to 3.0. Minor complications were present in 16.2% of patients (n=11; 3 local wound care, 10 use of antibiotics, and 0 skin dehiscence). Conclusion: The present study demonstrates overall improvement in VAS score by an average of 2.8 points following subtalar and calcaneonavicular coalition resection. Although 33.8% of patients may anticipate additional surgery, the majority of patients may expect long-term maintenance of improvement in pain without subsequent fusion.

Adult malignancy-associated hemophagocytic lymphohistiocytosis: Case series.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19579-e19579
Author(s):  
Inês Leão ◽  
Maria Eduarda Couto ◽  
Joana Catarina Lima Marinho ◽  
Isabel Oliveira ◽  
Ângelo Martins ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Diagnostic Criteria ◽  
Median Time ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Adult Population ◽  
Case Series ◽  
B Cell Lymphoma ◽  
Intrathecal Methotrexate ◽  
Early Evaluation ◽  
Short Period

e19579 Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening hyperinflammatory syndrome, with a challenging diagnosis (pediatric HLH-2004 criteria) and treatment (HLH-1994 protocol). Recently, HScore has adapted these diagnostic criteria to the adult population. Malignancy-associated HLH (M-HLH) can occur as the first manifestation of an unknown malignancy or after / during the treatment of a known cancer. This study evaluates features and outcomes of M-HLH in adult patients. Methods: Retrospective cohort study of all patients diagnosed with M-HLH in a single institution during 2013-2020. HLH-2004 and HScore criteria were used for diagnosis. Patients’ demographics, clinical and laboratory features, treatment and mortality were reviewed. Results: Eleven patients were analyzed. Ten fulfilled 5 of the HLH-2004 diagnostic criteria and one other had a HScore > 190 (80% probability of M-HLH). Median age was 68 years (IQR 62-71), and 54.5% were females. The median time between hospital admission and M-HLH diagnosis was 9 days (IQR 7-16). The most common malignancy was diffuse large B-cell lymphoma (36.4%), followed by Hodgkin lymphoma (18.2%), multiple myeloma (18.2%), myelodysplastic syndrome, T-cell and follicular lymphoma (9.1% each). Malignancy and HLH diagnosis were simultaneous in 54.5% of the cases (4 newly diagnose, 2 disease-progression); the remaining 5 patients were in remission (median time from cancer diagnosis to HLH of 9.9 months (IQR 5.1–38.3)). One patient also had an autoimmune disorder. An infectious co-trigger was identified in 81.8% of patients (virus in 45.5%, fungous in 36.4%, bacteria in 27.3%). The triad of fever, splenomegaly and cytopenia was present in 36.4% of patients. All had increased sCD25 and ferritin, with a median concentration of 7612U/mL (IQR 2631–34161) and 13269µg/L (IQR 6381–17911), respectively. The ratio between sCD25 and ferritin was 1.09 (IQR 0.13–3.05). Morphological M-HLH was documented in 8 out of the 9 biopsied cases. The HLH-1994 protocol was prescribed in 54.5% of patients (including intrathecal methotrexate in 2 patients), steroids as monotherapy were used in 18.2% and malignancy-specific chemotherapy in 36.4%. All but one patient initiated broad spectrum antibiotics at hospital admission, with an antifungal in 45.5% and an antiviral (valganciclovir) in 27.3%. At the time of analysis 63.6% of patients had died (overall, 54.5% within 3 months since M-HLH diagnosis). Conclusions: Most symptoms of M-HLH are common and unspecific, demanding a clinical suspicion and an early evaluation of ferritin, sCD25, triglycerides and fibrinogen. Co-triggers are frequent and their treatment is advisable. The disease has an unfavorable prognosis in a short period of time. This rare case series increases awareness about M-HLH (urgent need of updated diagnostic criteria and more efficient adult-adapted treatment strategies).

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