scholarly journals Clinical Presentation and Magnetic Resonance Findings in Sellar Tuberculomas

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Dulce Bonifacio-Delgadillo ◽  
Yolanda Aburto-Murrieta ◽  
Citlaltepetl Salinas-Lara ◽  
Julio Sotelo ◽  
Ivonne Montes-Mojarro ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Tuberculous Infection ◽  
Enhancement Pattern ◽  
Signal Suppression ◽  
Chronic Inflammatory Reaction ◽  
Low Levels ◽  
Sellar Lesion ◽  
Age Range ◽  
Visual Disturbances

Background and Importance. Sellar tuberculomas are extremely rare lesions with nonspecific clinical manifestations. The tuberculous infection of the pituitary gland and sellar region is characterized by the presence of an acute or chronic inflammatory reaction and may occur in the absence of systemic tuberculosis. The diagnosis is difficult prior to the surgery. An adequate diagnostic and antituberculous drugs usually result in a good outcome.Clinical Presentation. We report four cases of sellar tuberculoma, 3/1 female/male, age range: 50–57 years. All patients had visual disturbances and low levels of cortisol.Conclusion. The clinical diagnosis of sellar tuberculoma is a challenge and should be suspected when a sellar lesion shows abnormal enhancement pattern and stalk involvement, and absence of signal suppression in FLAIR.

Social and Temporal Comparisons as Moderators of Psychological Resources Associations With Wellbeing

2016 ◽  
Vol 37 (2) ◽  
pp. 96-104 ◽  
Author(s):  
Hasida Ben-Zur
Keyword(s):  
Life Satisfaction ◽  
Positive Affect ◽  
Subjective Wellbeing ◽  
Social Comparisons ◽  
Self Esteem ◽  
Psychological Resources ◽  
Low Levels ◽  
Age Range ◽  
General Wellbeing

Abstract. The current study investigated the associations of psychological resources, social comparisons, and temporal comparisons with general wellbeing. The sample included 142 community participants (47.9% men; age range 23–83 years), who compared themselves with others, and with their younger selves, on eight dimensions (e.g., physical health, resilience). They also completed questionnaires assessing psychological resources of mastery and self-esteem, and three components of subjective wellbeing: life satisfaction and negative and positive affect. The main results showed that high levels of psychological resources contributed to wellbeing, with self-enhancing social and temporal comparisons moderating the effects of resources on certain wellbeing components. Specifically, under low levels of mastery or self-esteem self-enhancing social or temporal comparisons were related to either higher life satisfaction or positive affect. The results highlight the role of resources and comparisons in promoting people’s wellbeing, and suggest that self-enhancing comparisons function as cognitive coping mechanisms when psychological resources are low.

Influence of Obesity on Clinical Manifestations and Response to Therapy in Cutaneous Leishmaniasis caused by Leishmania braziliensis

2021 ◽  
Author(s):  
Tainã Lago ◽  
Lucas Carvalho ◽  
Mauricio Nascimento ◽  
Luiz H Guimarães ◽  
Jamile Lago ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Healing Time ◽  
Response To Therapy ◽  
Leishmania Braziliensis ◽  
Cutaneous Lesions ◽  
Cytokine Levels ◽  
Cure Rates ◽  
The Impact

Abstract Background Cutaneous leishmaniasis (CL) caused by L. braziliensis is characterized by a single ulcer or multiple cutaneous lesions with raised borders. Cure rates below 60% are observed in response to meglumine antimoniate therapy. We investigated the impact of obesity on CL clinical presentation and therapeutic response. Methods A total of 90 age-matched CL patients were included (30 obese, 30 overweight and 30 with normal BMI). CL was diagnosed through documentation of L. braziliensis DNA by PCR or identification of amastigotes in biopsied skin lesion samples. Serum cytokine levels were determined by chemiluminescence. Antimony therapy with Glucantime (20mg/kg/day) was administered for 20 days. Results Obese CL patients may present hypertrophic ulcers rather than typical oval, ulcerated lesions. A direct correlation between BMI and healing time was noted. After one course of Antimony, cure was achieved in 73% of patients with normal BMI, 37% of overweight subjects, yet just 18% of obese CL patients (p<0.01). Obese CL cases additionally presented higher leptin levels than overweight patients or those with normal BMI (p<0.05). Conclusions Obesity modifies the clinical presentation of CL and host immune response, and is associated with greater failure to therapy.

Estimation of Na\K - ATPase Enzyme Activity and Endogenous Digitalis in Patients with Diabetic Neuropathy

2021 ◽  
Vol 19 (5) ◽  
pp. 95-103
Author(s):  
Eman Hameed Al-Rikabi ◽  
Mazin J. Mousa ◽  
Oda M. Yasser
Keyword(s):  
Enzyme Activity ◽  
Diabetic Neuropathy ◽  
Inhibitory Activity ◽  
Strong Association ◽  
Clinical Manifestations ◽  
Gradual Loss ◽  
Study Results ◽  
Healthy Control ◽  
The Mean ◽  
Age Range

Background: Among the most common complications of diabetes is diabetic neuropathy (DN). Diabetic neuropathy is a heterogeneous group of disorders, which involves a different part of somatic and autonomic nervous systems, with a gradual loss of neural conductivity. Some studies have shown that they reduce the activity of the Na/K ATPase, however, elevated levels of endogenous sodium pump inhibitor in diabetic individuals, including those with neuropathy. Changes in this transfer enzyme are believed to be due to several diabetes complications. Objective: The study had designed to evaluate the Na/K ATPase enzymatic activity in the erythrocyte-membrane among three groups. The first group had represented the patients with type 2 diabetes mellitus (DM2) and neuropathy. The second group is diabetics without neuropathy. The third group was a healthy subject. As well, the study had estimated the inhibitory activity of endogenous digitalis among patient groups. Furthermore, the aim of this research was to see whether there was a connection between red blood cell membrane Na-K ATPase activity and the medical facts of the analysis subjects. Design and Methods: One-hundred fifty subjects had enrolled in this case-control study; 80 patients complained of diabetic neuropathy of both sexes, the mean age 59.3 years with an age range of 40-81, 40 DM2 without neuropathy (53.9 years), (35 – 70), and 30 healthy controls (30 years, 25 to 45). Patients in the first group were selected carefully according to their clinical manifestations and the nerve conduction study results. The evaluations of both inhibitory activities of endogenous digitalis and Na/K ATPase had completed using a spectrophotometer. Enzyme activity had expressed in micrograms of phosphate concentration per grams of red cell ghost total protein concentration. Results: The mean enzyme activity of Na/K ATPase was significantly lower (p<0.001) in patients with diabetic neuropathy (381±17.9) compared with the diabetic group without neuropathy (498±22.9) and the normal controls (837±61.43). There was a significant inhibitory activity of endogenous digitals (17.87±2.15) in patients with DNP, compared with the diabetics without neuropathy (8.78±0.89) and healthy control (5.3±1.33). There was a significant association of enzyme activity with the following parameters: duration of diabetes, age, level of glycated hemoglobin and endogenous digitalis with the respective p-values (0.000, 0.000, 0.000 and 0.021). Gender showed no significant relationship with enzyme activity (p 0.43). Conclusions: In DM2 with neuropathy, hyperglycemia can much reduce the activity of erythrocyte Na/K ATPase. In addition, it may enhance the inhibitory activity of endogenous digitals. The timedependent increase in diabetic complications can be due to a strong association between diabetes duration and erythrocyte Na/K-ATPase activities.

Relationships between Clinical Presentation, Serology, Histology, and Duodenal Deposits of Tissue Transglutaminase Antibodies in Pediatric Celiac Disease

2018 ◽  
Vol 36 (5) ◽  
pp. 369-376 ◽  
Author(s):  
Nurit Loberman-Nachum ◽  
Michael Schvimer ◽  
Camila Avivi ◽  
Iris Barshack ◽  
Avishay Lahad ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Immunohistochemical Staining ◽  
Clinical Presentation ◽  
Tissue Transglutaminase ◽  
Mucosal Damage ◽  
High Serum ◽  
Tissue Transglutaminase Antibodies ◽  
Antibody Levels ◽  
Age Range ◽  
Multiple Symptoms

Background: The clinical, histological, and serological spectrum of celiac disease (CD) vary widely. We aimed to examine relationships between symptoms, serum anti-tissue transglutaminase antibodies (tTG) levels, mucosal damage, and mucosal anti-tTG deposits in pediatric CD. Methods: A retrospective single-center, cohort study of children referred for endoscopy with suspected CD during 2011–2014. We retrieved the clinical data, blindly reviewed duodenal biopsies, and performed immunohistochemical staining for anti-tTG deposits. Patients were classified as monosymptomatic or polysymptomatic. Mucosal anti-tTG deposits were classified according to the location of deposits, dominant intensity, maximal intensity, and percentage of stained area. Results: Of 252 patients with confirmed CD, complete data were available for 100: 37 males in the age range 1.3–16.7 with median 4.0 years. Monosymptomatic patients (n = 54) presented at an older age than polysymptomatic patients (1.3–15.5, median 8.1 vs. 1.3–16.7, median 6.3 years, p = 0.026). Marsh 2–3c was more prevalent in polysymptomatic patients (93 vs. 78%, p = 0.028). The intensity of mucosal anti-tTG deposits correlated with serum anti-tTG levels but not with the clinical presentation. Conclusions: Multiple symptoms and high serum anti-tTG antibody levels correlated with mucosal damage in children with CD. The role of immunohistochemical staining for intestinal anti-tTG mucosal deposits in the diagnosis of borderline CD is not yet established.

scholarly journals Clinical manifestations of chronic subdural hematoma in the elderly: Literature Review

2021 ◽  
Author(s):  
Gabriela Ferreira Kalkmann ◽  
Carlos Umberto Pereira ◽  
Francisco de Assis Pereira ◽  
Débora Moura da Paixão Oliveira ◽  
Nicollas Nunes Rabelo
Keyword(s):  
Early Diagnosis ◽  
Literature Review ◽  
Subdural Hematoma ◽  
Elderly Population ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Chronic Subdural Hematoma ◽  
Signs And Symptoms ◽  
The Elderly ◽  
Study Results

Introduction: The clinical manifestations of chronic subdural hematoma (CSDH) are often confused with other medical entities in the elderly, making their early diagnosis difficult or difficult. Early diagnosis is important, since its prognosis is directly associated with the preoperative neurological state, thus resulting in a worse vital and functional prognosis. Objectives: Report through a literature review the clinical manifestations of CSDH in the elderly population. Methods: Literature review, with the search terms: “Signs and Symptoms”, “Chronic Subdural Hematoma”, Aged, Diagnosis and Prognosis. In which PubMed, Lilacs, Scielo, Cochrane and TripDataBase data platforms were used. The inclusion criteria were: original studies published in any language. Articles in which full reading was prevented were excluded. With the application of the inclusion and exclusion criteria, 110 articles were included in the study. Results: Clinical presentation depends on the location, volume of the hematoma, rapid growth, the location of the CSDH, whether unilateral or bilateral, and the clinical conditions of the patient. Because the forms of clinical presentation of CSDH are variable, it is necessary that health professionals linked to the elderly (geriatrician, psychiatrist, general practitioner) have knowledge of this clinical entity. Conclusions: The recognition of classic forms as well as the identification of risk factors in the elderly favors the timely diagnosis and treatment of CSDH in the elderly population.

Aeromedical Implications of Cerebral Cavernomas

2021 ◽  
Vol 92 (2) ◽  
pp. 120-123
Author(s):  
Tania Jagathesan ◽  
Michael OBrien
Keyword(s):  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Civil Aviation ◽  
Complication Rates ◽  
Cerebral Cavernous Malformations ◽  
Cavernous Malformations ◽  
Medical Certification ◽  
The Uk ◽  
Age Range ◽  
The Brain

BACKGROUND: Cavernomas, cavernous angiomas, or cerebral cavernous malformations are clusters of endothelium-lined blood vessels usually found in the brain. With the increasing use of radiological imaging, these are being detected incidentally in asymptomatic aircrew. The UK Civil Aviation Authority (CAA) experience of cavernomas is described and the aeromedical concerns, that is, the risk of epilepsy, hemorrhage, and the development of a neurological deficit, are considered.METHODS: A search of the CAA database between 1990 and 2020 was performed for the term cavernoma. The gender, age at diagnosis, class of certification held, clinical presentation, location, and size of the lesion were noted. A PubMed literature review for papers with complications of cavernoma was performed.RESULTS: Six cases of cavernoma have been declared to the CAA: five professional pilots and one private pilot. Five were men and one was a woman. The age range was between 38 and 60 yr, with a mean of 48 yr. Two cases presented with clinical symptoms and four were asymptomatic. Complication rates for seizure and hemorrhage were extracted from the published literature together with the significance of other factors such as cavernoma size, family history, multiplicity, and the development of new lesions.DISCUSSION: A policy for the medical certification of aircrew with cavernomas that have presented with clinical symptoms and those that are detected incidentally is proposed.Jagathesan T, OBrien M. Aeromedical implications of cerebral cavernomas. Aerosp Med Hum Perform. 2021; 92(2):120123.

A STUDY OF CLINICAL PRESENTATION AND MANAGEMENT OF PITUITARY TUMORS

2021 ◽  
pp. 58-60
Author(s):  
Manthan Patel ◽  
Naimish Patel
Keyword(s):  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Pituitary Tumors ◽  
Csf Leak ◽  
Total Removal ◽  
Diagnostic Investigation ◽  
Subtotal Removal ◽  
Visual Disturbances ◽  
Bitemporal Hemianopia

The study includes 25 cases of pituitary adenomas. Most common age group by pituitary tumors falls between 41-50 years of age. Male: Female incidence of these tumors is 1: 2.12. Most common clinical symptoms in our series are visual disturbances followed by headache. Optic nerve involvement is other common clinical nding presenting in form of decreased vision or loss of vision, eld defect or fundus changes. Commonest eld defect is bitemporal hemianopia. MRI is the diagnostic investigation of choice in pituitary tumors to dene extent, invasion and relationship to major vessels and nerves. Approximately half (44%) of the patients exhibited normal preoperative pituitary function in form of baseline hormone prole. Increased GH level (32%) followed by hyperprolactinemia (20%) are the most common endocrinologic abnormalities. Total/near total removal was done in 21 patients (84%) and subtotal removal done in 4 patients (16%). Adjuvant therapies were given in 5 patients. Two patients were given radiotherapy and 3 were given pharmacotherapy. Post operative complications were CSF leak, diabetes insipidus and meningitis. 20 patients (80%) had improvement in their symptoms including relief from headache, improvement in vision and endocrinal dysfunction. Post operatively visual functions improved in 13 patients (52%) and it remained stationary in 11 (44%) patients. Only one patient (4%) complained of worsening of his visual function and it was improved in follow up period

Acute Isoniazid Neurotoxicity in an Urban Hospital

PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 700-704
Author(s):  
Binita R. Shah ◽  
Karen Santucci ◽  
Richard Sinert ◽  
Phillip Steiner
Keyword(s):  
New York ◽  
Case Series ◽  
Pediatric Emergency ◽  
Tuberculous Infection ◽  
Urban Hospital ◽  
Average Delay ◽  
Number Of Children ◽  
Refractory Seizures ◽  
Age Range ◽  
Increasing Trends

Objectives. To describe the presentation and treatment of acute isoniazid (INH) neurotoxicity appearing at an inner-city municipal hospital. Design. Case series. Participants. Seven patients (eight patient visits) with an age range of 5 days to 14.9 years. Results. At our institution, no children appeared with acute INH neurotoxicity in the period 1985 through 1990, whereas seven patients were treated from 1991 through 1993. This paralleled the rise in the number of children with tuberculous infection and disease seen at our institution, from an average 96 per year to 213 per year during these two time periods. All seven patients were receiving INH daily for tuberculosis (TB) prophylaxis. Accidental ingestion (five episodes) and suicidal attempts (three episodes) accounted for these visits. The total amount ingested range from 14.3 to 99.3 mg/kg (mean, 54 mg/kg). All but one patient presented with afebrile seizures. One patient presented twice with seizures. Acute INH neurotoxicity was not suspected on the first admission; however, when readmitted 4 weeks later with another seizure, the diagnosis of acute INH neurotoxicity was made. Intervention. Intravenous pyridoxine was used in five episodes. Because it was not a stocked item in our pediatric emergency cart (as well as at another hospital, necessitating a transfer of a patient with refractory seizures to our hospital), the average delay was 5.8 hours (range, 1.3 to 13 hours) before it was given. Two patients with refractory seizures failed to respond to anticonvulsants, and their seizures were controlled only after parenteral pyridoxine. Conclusions. We have seen an increased incidence of acute INH neurotoxicity because of the resurgence of TB in New York City. Others as well may see a similar rise based on local trends in TB infection and disease. Acute INH toxicity should be suspected in children presenting with seizures with or without fever. In patients with a known access to INH, seizures should be considered to be caused by INH toxicity unless proved otherwise. Parenteral pyridoxine, the specific antidote for INH-induced refractory seizures, should be readily available in every emergency department in the areas similarly experiencing increasing trends of TB.

Basic Clinical Syndromes and Definitions

2018 ◽  
pp. 1-21
Author(s):  
Aparna Pendurthi ◽  
Maxim Mokin
Keyword(s):  
Emergency Department ◽  
Acute Stroke ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Transient Ischemic Attacks ◽  
Stroke Patients ◽  
Duration Of Symptoms ◽  
Surgical Interventions ◽  
Clinical Syndromes

The goal for neurological evaluation in the Emergency Department is to appropriately route potential acute stroke patients toward medical or surgical interventions in the most expedient manner possible. This chapter focuses on familiarizing the reader with main stroke subtypes and clinical manifestations associated with specific syndromes. Acute neurologic episodes being evaluated in the emergent setting for stroke workup can be divided into broad categories based on duration of symptoms, clinical presentation, and findings from basic imaging. This chapter explores the most common of these stroke syndromes and discusses the classification and clinical characteristics of transient ischemic attacks and ischemic and hemorrhagic strokes.

scholarly journals Carcinomatous encephalitis as clinical presentation of occult lung adenocarcinoma: case report

2007 ◽  
Vol 65 (3b) ◽  
pp. 841-844 ◽  
Author(s):  
Henrique Barbosa Ribeiro ◽  
Tadeu Ferreira de Paiva Jr ◽  
Gustavo Pignatari Rosas Mamprin ◽  
Milton Luiz Gorzoni ◽  
Antônio José da Rocha ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Mass Effect ◽  
Pulmonary Adenocarcinoma ◽  
Rare Entity ◽  
Resonance Imaging ◽  
Clinical Imaging ◽  
Magnetic Resonance Imaging Mri

Carcinomatous encephalitis is a rare entity, originally described by Madow and Alpers in 1951, which is characterized by tumoral spreading perivascular, without mass effect. Clinical manifestations such as hemiparesis, seizures, ataxia, speech difficulties, cerebrospinal fluid findings as well as computed tomography are nonspecific. This leads the physician to pursue more frequent diseases that could explain those manifestations - toxic, metabolic, and/or infectious encephalopathy. A magnetic resonance imaging (MRI) with gadolinium, the method of choice, presumes the diagnosis. Previous reports of this unusual form of metastatic disease have described patients with prior diagnosis of pulmonary adenocarcinoma. We present the case of carcinomatous encephalitis in a 76-years-old woman as the primary manifestation of occult pulmonary adenocarcinoma with its clinical, imaging, and anatomopathological findings.

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