scholarly journals Serological Evidence of IncreasedCoccidioides immitisInfections in Western Canada in 1996

1998 ◽  
Vol 9 (6) ◽  
pp. 377-381 ◽  
Author(s):  
Errol Prasad ◽  
Patricia Diediw ◽  
Donna Fernandes ◽  
Lorreen Hodge ◽  
Katherine Ower ◽  
...  
Keyword(s):  
Enzyme Immunoassay ◽  
Clinical Presentation ◽  
Disease Process ◽  
Pulmonary Infiltrate ◽  
Immunoglobulin M ◽  
Western Canada ◽  
Coccidioides Immitis ◽  
Serological Evidence ◽  
Positive Serology ◽  
The Mean

OBJECTIVE: To investigate the epidemiology ofCoccidioides immitisinfection in persons returning to western Canada fromC immitisendemic zones in southwestern United States.DESIGN: Review ofC immitisserology requests from 1996.METHODS: Data were based on review of enzyme immunoassay and immunodiffusion results from 1993 to 1996 inclusive. Detailed information on clinical presentation, treatment and outcome of disease process was obtained through questionnaires and interviews with physicians who submittedCoccidioidesserology requests in 1996.RESULTS: Positive serology forC immitisincreased from 4.7% to 5.2% (between 1993 and 1995 inclusive) to 10.7% in 1996. Enzyme immunoassay for immunoglobulin G and/or immunoglobulin M or immunodiffusion was positive in 25 patients in 1996. The mean age of these patients was 62 years, and the predominant clinical presentation was pulmonary infiltrate with fever. All patients with positive serology were known to have travelled to central or southwestern Arizona or southern California.CONCLUSIONS: Travel to a defined coccidioidomycosis endemic zone presents a risk for the older traveller. Serology forC immitissupported the clinical, histological and microbiological diagnoses in patients who had travelled to this defined endemic zone.

scholarly journals An imaging-based treatment algorithm for posterior focal retinitis

2018 ◽  
Vol 10 ◽  
pp. 251584141877442
Author(s):  
Rohan Chawla ◽  
Koushik Tripathy ◽  
Shreyas Temkar ◽  
Pradeep Venkatesh ◽  
Atul Kumar
Keyword(s):  
Clinical Presentation ◽  
Treatment Algorithm ◽  
Empirical Approach ◽  
Imaging Features ◽  
First Line ◽  
Positive Serology ◽  
Laboratory Investigations ◽  
The Mean ◽  
Initiation Of Therapy ◽  
Simplex Virus

Background: In this paper, our aim was to describe an imaging-based empirical approach for categorizing and initiating treatment of immunocompetent patients with posterior focal retinitis, prior to the availability of results of expensive laboratory investigations. Materials and methods: The hospital records of 13 patients with posterior focal retinitis were reviewed. Results: Of the 13 patients, 9 were women and 4 were men. The mean age was 24 ± 8 years. Based on similarities in clinical presentation and imaging, we categorized our cases into three groups with different first-line therapeutic strategies. In the first group, patients had presumed toxoplasmosis (treated with oral cotrimoxazole); in the second group, patients had presumed viral (herpetic) etiology (treated with oral valacyclovir); and in the third group, patients had presumed nonherpetic, nontoxoplasma retinitis (treated with oral doxycycline). Positive serology results included Rickettsia (two patients), Borrelia (one patient), Toxoplasma (two patients), and herpes simplex virus (one patient). Conclusion: An empirical approach for early initiation of therapy in retinitis cases based on imaging features is described.

Autoantibodies to Thrombomodulin: Development of an Enzyme Immunoassay and a Survey of their Frequency in Patients with the Lupus Anticoagulant

1992 ◽  
Vol 67 (05) ◽  
pp. 507-509 ◽  
Author(s):  
John Gibson ◽  
Margaret Nelson ◽  
Ross Brown ◽  
Hatem Salem ◽  
Harry Kronenberg
Keyword(s):  
Enzyme Immunoassay ◽  
Lupus Anticoagulant ◽  
Specific Binding ◽  
Technical Problem ◽  
Serum Samples ◽  
Citrate Buffer ◽  
The Mean ◽  
Sample Dilution ◽  
Negative Population ◽  
Serum Components

SummaryIn order to investigate the possibility that autoantibodies to thrombomodulin (TM) may exist in patients with the lupus anticoagulant (LA) and perhaps be implicated in the pathogenesis of recurrent thrombosis seen in such patients, we developed an enzyme-immunoassay to screen serum samples for anti-human TM activity. The major technical problem encountered in developing this assay was to reduce the non-specific binding of serum components from both the LA positive and the negative population. Considerable reduction of non-specific binding was achieved by use of a phosphate/citrate buffer at pH 8.0 and the use of an optimal sample dilution of 1/40. In addition, samples were always tested in parallel in blank wells and results are expressed as an OD ratio. Samples from 113 patients with the LA were assayed and compared to 78 patients referred for LA testing but found to be negative. The mean OD values for the LA positive patients (± SD) was 1.36 (0.44) with a range of 0.78-2.57. This was virtually identical to the values for the LA negative population (1.38 ± 0.40, range 0.76-2.77). The results of this study indicate that there is no evidence for the presence of a significant autoantibody activity to TM in patients with the LA when compared to LA negative patients. If such autoantibodies do exist their frequency must be quite low.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

scholarly journals Is it time to administer acellular pertussis vaccine to childbearing age/pregnant women in all areas using whole-cell pertussis vaccination schedule?

2021 ◽  
Vol 9 ◽  
pp. 251513552110158
Author(s):  
Abdoulreza Esteghamati ◽  
Shirin Sayyahfar ◽  
Yousef Alimohamadi ◽  
Sarvenaz Salahi ◽  
Mahmood Faramarzi
Keyword(s):  
Pregnant Women ◽  
Age Groups ◽  
Vaccination Schedule ◽  
Immunoglobulin M ◽  
Enzyme Linked Immunosorbent Assay ◽  
Childbearing Age ◽  
Cross Sectional ◽  
Whole Cell ◽  
Childbearing Age Women ◽  
The Mean

Background: Whole-cell pertussis (wP) vaccine administration is still advocated for children under 7 years of age in Iran. However, there is no recommendation for the administration of a dose of tetanus, diphtheria, and acellular pertussis (Tdap) vaccine to childbearing age/pregnant women in the Iranian vaccination program and it has increased the risk of infection through waning immunity during women’s childbearing age life. The study aimed to assess the levels of anti- Bordetella pertussis antibodies in childbearing age women of different ages in Iran. Methods: A cross-sectional study was conducted on a total number of 360 childbearing age women divided into six age groups, with 5-year intervals from 15 to 45 years old, in 2018–2019. Then, the levels of immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) antibodies against B. pertussis were evaluated using enzyme-linked immunosorbent assay (ELISA). The IBM SPSS Statistics software (version 16.0) (SPSS Inc., Chicago, IL, USA) was used for data analysis. Results: The mean age of the participants was 30.01 ± 8.35 years (range 14–45 years). All the cases were IgM negative, but two IgA-positive individuals (in the age groups of 14–19 and 30–34 years) were reported. Overall, 239 (66.4%) cases were IgG positive. The mean age of IgG-positive cases was 30.37 ± 8.37 years. The IgG-positive cases were mostly in the age groups of 30–34 and 35–39 years [43 (71.1%)]. The odds of IgG positivity were 1.97. The highest odds of IgG positivity were seen in 30–34 and 35–39 years groups (2.52) and the lowest odds were seen in the 20–24 and 25–29 years groups (1.60). Using the Jonckheere–Terpstra test, the increasing trend of IgG changes in different age groups was not statistically significant (Tπ=5.78, p = 0.09). Conclusion: The infants of women of childbearing age might be prone to pertussis in countries using the wP vaccination schedule. It is suggested to administer a dose of Tdap to women before or during pregnancy to increase the immunity of their infants against this disease during early infancy.

scholarly journals Pituitary apoplexy induced by gonadotropin-releasing hormone (GnRH) agonist administration for treatment of prostate cancer: a systematic review

2021 ◽  
Author(s):  
Rishi Raj ◽  
Ghada Elshimy ◽  
Aasems Jacob ◽  
P. V. Akhila Arya ◽  
Dileep C. Unnikrishnan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Pituitary Adenoma ◽  
Gnrh Agonist ◽  
Tumor Size ◽  
Pituitary Apoplexy ◽  
Clinical Presentation ◽  
Pituitary Surgery ◽  
Laboratory Evaluation ◽  
The Mean

Abstract Objective We aimed to review of literature on the clinical presentation, management and outcomes of pituitary apoplexy following gonadotrophic release hormone (GnRH) agonist administration for the treatment of prostate cancer. Methods We used PRISMA guidelines for our systematic review and included all English language original articles on pituitary apoplexy following GnRH agonist administration among prostate cancer patients from Jan 1, 1995 to Dec 31, 2020. Data on patient demographics, prostate cancer type, Gleason score at diagnosis, history of pituitary adenoma, clinical presentation, GnRH agonist, interval to pituitary apoplexy, laboratory evaluation at admission, radiologic findings, treatment of pituitary apoplexy, time to surgery if performed, pathology findings, and clinical/hormonal outcomes were collected and analyzed. Results Twenty-one patients with pituitary apoplexy met our inclusion criteria. The mean age of patients was 70 (60–83) years. Leuprolide was the most common used GnRH agonist, used in 61.9% of patients. Median duration to symptom onset was 5 h (few minutes to 6 months). Headache was reported by all patients followed by ophthalmoplegia (85.7%) and nausea/vomiting (71.4%). Three patients had blindness at presentation. Only 8 cases reported complete anterior pituitary hormone evaluation on presentation and the most common endocrine abnormality was FSH elevation. Tumor size was described only in 15 cases and the mean tumor size was 26.26 mm (18–48 mm). Suprasellar extension was the most common imaging finding seen in 7 patients. 71.4% of patients underwent pituitary surgery, while 23.8% were managed conservatively. Interval between symptoms onset to pituitary surgery was 7 days (1–90 days). Gonadotroph adenoma was most common histopathologic finding. Clinical resolution was comparable, while endocrine outcomes were variable among patients with conservative vs surgical management. Conclusion Although the use of GnRH agonists is relatively safe, it can rarely lead to pituitary apoplexy especially in patients with pre-existing pituitary adenoma. Physicians should be aware of this complication as it can be life threatening. A multidisciplinary team approach is recommended in treating individuals with pituitary apoplexy.

A survey of variation in the chemical composition of commercial canola meal produced in Western Canadian crushing plants

1991 ◽  
Vol 71 (2) ◽  
pp. 469-480 ◽  
Author(s):  
J. M. Bell ◽  
M. O. Keith
Keyword(s):  
Press Cake ◽  
Neutral Detergent Fiber ◽  
Canola Meal ◽  
Glucosinolate Content ◽  
Western Canada ◽  
Composition Variation ◽  
Gross Energy ◽  
The Mean ◽  
Whole Seed ◽  
Mineral Concentrations

Canola samples of whole seed, press cake and commercial meal (CM) were collected from seven canola-crushing plants in Western Canada over 4 successive weeks to assess nutrient and glucosinolate content and variability. The CM data are described in this report. The mean concentrations in CM (dry matter (DM) basis) were: in %, crude protein (N × 6.25) 41.85; ether extract 3.92; crude fiber 13.13; neutral detergent fiber 23.54; acid detergent fiber 19.09; and in MJ kg−1, gross energy 20.36. The mean mineral concentrations were, in percent, calcium 0.70; magnesium 0.57; phosphorus 1.13; potassium 1.35; sulfur 0.94; and in μg g−1, copper 6.34; iron 157; manganese 54.7; molybdenum 1.5; selenium 1.22; zinc 75.8. Total aliphatic glucosinolate concentrations (oil-free DM basis) ranged from 6.26 to 28.42 μmol g−1 for different plants, mean 16.20; indolyl glucosinolate concentrations were from 0.56 to 9.49 μmol g−1. Small and variable amounts of allyl and hydroxybenzyl glucosinolates due to weed seed contamination were found. Myrosinase activity (thioglucoside glucohydrolase EC 3.2.3.1) averaged 0.15% of that in the corresponding canola seed. Differences among crushing plants were due mainly to regional environmental factors, cultivars used and, for lysine and glucosinolates, processing conditions mainly in the desolventizer toaster stage. Key words: Canola, meal, composition, variation, regional, Western Canada

Evaluation of Allergic Reactions Following Intravenous Infusion of Polyvalent Antivenom in Snakebite Patients

2021 ◽  
Vol 20 ◽  
Author(s):  
Ghafar-Ali Mahmoudi ◽  
Maryam Ahadi ◽  
Ali Fouladvand ◽  
Bareza Rezaei ◽  
Zahra Bodagh ◽  
...  
Keyword(s):  
Rural Areas ◽  
Adverse Reactions ◽  
Standard Treatment ◽  
Clinical Presentation ◽  
Demographic Data ◽  
Maculopapular Rash ◽  
Clinical Feature ◽  
Allergic Reactions ◽  
Related Data ◽  
The Mean

Background: Antivenom is a gold-standard treatment for snakebite envenoming. However, adverse reactions to snake antivenom are common in many parts. Objective: The aim of this study was to evaluate the allergic reactions following intravenous administration of antivenom sera. Methods: This was retrospective study, conducted snakebites patients referred to the Rahimi Hospital in Khorramabad. The files of these patients were accessed for demographic data, snakebite-related data, treatment provided, clinical presentation and allergic reaction status as a result of antivenom treatment. Results: 141 cases were investigated including 73.8% male and 26.2% female patients. The mean age of the patients was 38.1±17.1years. Age group 30-39 years accounted for highest number of snakebite cases (24.1%). A majority of victims (89.4%) were from the rural areas. Most of the patients (51.8%) were bitten in the spring and highest number of snakebite were reported in May (39.1%). The most common site of snakebite was lower extremities (50.4%) and upper extremities (44.7%). Among clinical feature of snakebite, pain was the most prevalent in 135 cases (95.7%) followed by swelling (83.7%). The mean antivenom vials used were 6.5±3.7 vials. Allergic reactions occurred in 6 patients (4.26%); reactions were mild in 5 patients and sever in 1patient. The commonest presentation was maculopapular rash (1.4%) and the least common were headache (0.71%), nausea (0.71%), fever (0.71) and hypotension (0.71%). Conclusion: Snakebite is one of the significantlife-threatening environmental events.Immediate antivenom treatment can reduce mortality however, patients should be carefully monitored for adverse allergic reactions.

scholarly journals Clinical profile of cardiac myxoma: 11 years’ experience of 90 cases

2016 ◽  
Vol 31 (1) ◽  
pp. 18-22
Author(s):  
Md Toufiqur Rahman ◽  
Md Zulfikar Ali ◽  
Md Humayun Kabir ◽  
STM Abu Azam ◽  
AAS Majumder ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Primary Tumour ◽  
Correct Diagnosis ◽  
Cardiac Myxoma ◽  
Benign Neoplasm ◽  
Clinical Feature ◽  
Duration Of Symptoms ◽  
Pedal Oedema ◽  
Mechanical Interference ◽  
The Mean

Introduction: Cardiac myxoma is a benign neoplasm that represents the most common primary tumour of the heart. Because of nonspecific symptoms, early diagnosis may be a challenge. Although the left atrium is the most commonly involved site of origin in 75% of cases, it can arise from any of the cardiac chambers. Symptoms from a cardiac myxoma are more pronounced when the myxomas are left-sided, racemosus, and over 5 cm in diameter. Symptoms are produced by mechanical interference with cardiac function or embolization. Being intravascular and friable, myxomas account for most cases of tumor embolism. The site of embolism is dependent upon the location (left or right atrium) and the presence of an intracardiac shunt. Most atrial myxomas are benign and can be removed by surgical resection.Objectives: To see clinical presentation and echocardiographic profile of cardiac myoxomas.Methods: 90 cardiac myxoma patients who admitted both in cardiology and cardiac surgery departments of National Institute of Cardiovascular Diseases (NICVD), Dhaka from August 2003 to July, 2014 were studied clinically and by echocardiogram. Clinical histories were reviewed, noting age, gender, and clinical presentation.Results: There were 30 males and 60 females, ages ranged from 17 to 76 years. The commonest clinical feature was dyspnoea (94.44%), followed by palpitation (76.67%), chest discomfort (74.44%), constitutional symptoms (50%), pedal oedema (20%), syncope (14.44%), and embolization (7.7%). The mean duration of symptoms was 09.7 months.Conclusion: The clinical presentation of cardiac myxoma is often nonspecific, so high index of clinical suspicion is important for its early and correct diagnosis. The size and appearance of the myxomas correlated with the presenting symptoms.Bangladesh Heart Journal 2016; 31(1) : 18-22

scholarly journals Clinical and histopathological pattern of colorectal malignancies, the experience in a tertiary hospital in south-western region, Saudi Arabia

2018 ◽  
Vol 5 (11) ◽  
pp. 4684
Author(s):  
Majed Saleh M. Aldayhum ◽  
Anas Abdullah R. Alshehri ◽  
Dlaim H. AlQahtani ◽  
Eman Yahia Alfussaily ◽  
Suha Abdulrahman S. Althibait ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Clinical Presentation ◽  
Early Stage ◽  
Tertiary Hospital ◽  
Central Hospital ◽  
Early Stage Disease ◽  
Common Cancer ◽  
Stage Disease ◽  
Common Grade ◽  
The Mean

Background: Colorectal cancer is the third most common cancer all over the world and the second leading cause of the cancer death in both sexes. CRC is the second most common cancer in Kingdom Saudi Arabia. However, this aspect was not recently studied.Methods: This is a retrospectively cohort based study. We collected and analyzed the records of the patients with CRC diagnosed at Aseer Central Hospital, Abha, Saudi Arabia from January 2008 to June 2016. A pre-specified data sheet was used to collect information regarding socio-demographics, age, Altitude, site of tumor, clinical presentation, outcome and prognosis as well as histopathological pattern of cancer and the stages of disease. Descriptive statistics was performed using SPSS.Results: A total of 291 cases of CRC were registered in the Aseer Central Hospital. 171 cases 58.87% were males while 120 cases 41.2% were females. The mean age of patients (SD) at the time of diagnosis was 59.38 years. At the time of diagnosis, 219 patients 84.6% presented with early stage disease and 40 15.4% had distant metastasis advanced stage. The most frequent CRC located in sigmoid 26.5%, rectal 23.7%and 14% in ascending. The moderately differentiate adenocarcinoma grade of tumor is being the most common grade among all variants 75.6%.Conclusions: In this study, we have nearly similar results found in previously published study by Alshehri et al. Males considered most affected, most of the patients were more than 50 years, 84.6% of the patients came with early stage disease. Left side colon were the most common site of CRC.

scholarly journals Kikuchi-Fujimoto Disease: A Study Of 67 Cases From Coastal South India 

2020 ◽  
Author(s):  
Basavaprabhu Achappa ◽  
Nipuni Chamathka Herath ◽  
Jyoti Ramanath Kini ◽  
Ramesh Holla ◽  
Bodhi Sebastian ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Histopathological Examination ◽  
Cervical Lymphadenopathy ◽  
Symptomatic Treatment ◽  
Lymph Node Biopsy ◽  
Unknown Etiology ◽  
Extensive Literature ◽  
Cervical Lymphadenitis ◽  
Benign Condition ◽  
The Mean

Abstract Background Kikuchi-Fujimoto disease is a rare, benign condition, of unknown etiology, presenting as cervical lymphadenitis, usually tender and maybe associated with systemic symptoms. Despite the extensive literature on this disease, it continues to be misdiagnosed owing to its misleading clinical presentation. Results The mean age in our study was 26.9 (±11.3) years with a female majority of 65.7%. The clinical presentation of most cases was, tender swelling over the side of the neck ( n =50, 74.6%). On local examination, the mean length and width were 2.3 (±1.0) cm and 2.2 (±0.7) cm respectively. Histopathological examination revealed that most patients presented in the proliferative stage ( n =40, 59.7%). In 83.6% of the patients lymphadenopathy resolved in less than 2 months. Follow up of these patients over 9 months revealed that a vast majority of the patients underwent full recovery with symptomatic treatment ( n =42, 62.7%). Conclusions The disease is prevalent in young, female patients of Asian descent and often presents as cervical lymphadenopathy. Early diagnosis with excisional lymph node biopsy is crucial to avoid unnecessary investigations and treatment. Treatment is only symptomatic unless complicated, where steroid therapy is considered. Kikuchi’s disease has an excellent prognosis with almost no risk of fatality.

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