scholarly journals Deep Neck Inflammation: Probable Kawasaki Disease in Korean Children

2020 ◽  
Vol 13 (1) ◽  
pp. 77-82
Author(s):  
Sooyeon Lim ◽  
Na Young Lee ◽  
Seung Beom Han ◽  
Dae Chul Jeong ◽  
Jin Han Kang
Keyword(s):  
Computed Tomography ◽  
Kawasaki Disease ◽  
Antibiotic Therapy ◽  
Medical Records ◽  
Empirical Antibiotic Therapy ◽  
Korean Children ◽  
Life Threatening ◽  
Deep Neck Abscess ◽  
Deep Neck Infections ◽  
Prompt Diagnosis

Objectives. Deep neck infections (DNIs) can cause life-threatening complications, and prompt diagnosis and management are necessary. Kawasaki disease (KD) may be accompanied by deep neck inflammation; making it difficult to distinguish from DNIs. This study was performed to evaluate clinical features and outcomes of children with parapharyngeal and retropharyngeal inflammation.Methods. Medical records of the children diagnosed with parapharyngeal and retropharyngeal cellulitis or abscess using cervical computed tomography (CT) between 2013 and 2017 were retrospectively reviewed.Results. A total of 47 children were diagnosed with parapharyngeal and retropharyngeal inflammation. Eleven (23.4%) of them were eventually diagnosed with KD, and 36 (76.6%) were diagnosed with DNIs. There were no significantly different clinical and laboratory characteristics on admission between children diagnosed with KD and DNIs; however, significantly more children with KD were febrile for ≥3 days after admission compared to those with DNIs (P=0.009). Deep neck abscesses on CT were observed in 16 children with DNIs (44.4%) and in no child with KD (P=0.009). Among the 36 children with DNIs, 30 (83.3%) were cured with antibiotic therapy only.Conclusion. A quarter of children presenting with deep neck inflammation were diagnosed with KD. KD should be considered in children showing deep neck inflammation unresponsive to empirical antibiotic therapy after 3 days, especially in those presenting with deep neck cellulitis rather than deep neck abscess.

scholarly journals Diagnosing gastric volvulus in chest X-ray: report of three cases

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Narendra Pandit ◽  
Abhijeet Kumar ◽  
Tek Narayan Yadav ◽  
Qamar Alam Irfan ◽  
Sujan Gautam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Abdomen ◽  
Gastric Volvulus ◽  
X Ray ◽  
Pain Abdomen ◽  
Life Threatening ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Specific Symptoms ◽  
Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

scholarly journals Treatment of Children and Adolescents with Epilepsy with Atomoxetine

2020 ◽  
Vol 17 (5) ◽  
pp. 412-416
Author(s):  
Kee Jeong Park ◽  
Hyunji Ahn ◽  
Mi-Sun Yum ◽  
Tae-Sung Ko ◽  
Hyo-Won Kim
Keyword(s):  
Children And Adolescents ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Preliminary Evidence ◽  
Common Adverse Event ◽  
Response To Treatment ◽  
Adolescent Psychiatrist ◽  
Korean Children ◽  
Life Threatening ◽  
Atomoxetine Treatment

Objective The objective of this study was to assess the effectiveness and safety of atomoxetine in Korean children and adolescents with epilepsy.Methods We retrospectively reviewed the electronic medical records of 105 children and adolescents with epilepsy treated with atomoxetine. Effectiveness was measured with the Clinical Global Impressions-Severity (CGI-S) and/or Clinical Global Impressions-Improvement (CGI-I) scales at baseline, and after 4 and 12 weeks. We defined response to atomoxetine as a CGI-I score less than three at week 12. Safety was evaluated at each visit, based on clinical assessment by a child and adolescent psychiatrist and reports from participants or their caregivers.Results In total participants (n=105), 33 (31.4%) showed a response to treatment: a significant decrease in CGI-S scale score was observed over 12 weeks of atomoxetine treatment. The most common adverse event (AE) was decreased appetite (n=16, 15.2%), and life-threatening AEs were not observed. Seizure aggravation due to atomoxetine was observed in 7.6% (n=8) of total participants, and one of them discontinued atomoxetine.Conclusion Our results provide preliminary evidence of the effectiveness and safety of atomoxetine in children and adolescents with epilepsy.

532: Empirical Antibiotic Therapy in the Management of Elevated Serum PSA- A Viable Option?

2006 ◽  
Vol 175 (4S) ◽  
pp. 172-172
Author(s):  
Chee Kwan Ng ◽  
Gerald Y. Tan ◽  
Khai Lee Toh ◽  
Sing Joo Chia ◽  
James K. Tan
Keyword(s):  
Antibiotic Therapy ◽  
Elevated Serum ◽  
Empirical Antibiotic Therapy ◽  
Viable Option

scholarly journals Computed Tomography Imaging in Simulated Ongoing Cardiopulmonary Resuscitation: No Need to Switch Off the Chest Compression Device during Image Acquisition

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1122
Author(s):  
Jessica Graef ◽  
Bernd A. Leidel ◽  
Keno K. Bressem ◽  
Janis L. Vahldiek ◽  
Bernd Hamm ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Image Acquisition ◽  
Circulatory Arrest ◽  
Motion Artifacts ◽  
Current Standard ◽  
Ct Protocol ◽  
Life Threatening ◽  
Reconstruction Time

Computed tomography (CT) represents the current standard for imaging of patients with acute life-threatening diseases. As some patients present with circulatory arrest, they require cardiopulmonary resuscitation. Automated chest compression devices are used to continue resuscitation during CT examinations, but tend to cause motion artifacts degrading diagnostic evaluation of the chest. The aim was to investigate and evaluate a CT protocol for motion-free imaging of thoracic structures during ongoing mechanical resuscitation. The standard CT trauma protocol and a CT protocol with ECG triggering using a simulated ECG were applied in an experimental setup to examine a compressible thorax phantom during resuscitation with two different compression devices. Twenty-eight phantom examinations were performed, 14 with AutoPulse® and 14 with corpuls cpr®. With each device, seven CT examinations were carried out with ECG triggering and seven without. Image quality improved significantly applying the ECG-triggered protocol (p < 0.001), which allowed almost artifact-free chest evaluation. With the investigated protocol, radiation exposure was 5.09% higher (15.51 mSv vs. 14.76 mSv), and average reconstruction time of CT scans increased from 45 to 76 s. Image acquisition using the proposed CT protocol prevents thoracic motion artifacts and facilitates diagnosis of acute life-threatening conditions during continuous automated chest compression.

Intraorbital Abscess: A Rare Cause of Orbit Compression

FACE ◽  
2021 ◽  
pp. 273250162110050
Author(s):  
Samuel Ruiz ◽  
Rizal Lim
Keyword(s):  
Pediatric Population ◽  
Rare Complication ◽  
Disease Process ◽  
Rare Condition ◽  
External Drainage ◽  
Direct Extension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Intraorbital abscess is a rare complication of rhinosinusitis that affects most commonly the pediatric population. It is thought to be caused by direct extension or venous spread of infections from contiguous sites and can lead to life-threatening complications, like permanent visual loss and cerebral abscesses. Objectives: Intraorbital abscess is a rare condition that requires prompt diagnosis and treatment to avoid serious complications. Our objectives are to provide an overview of this rare disease process and its management including our successful treatment experience. Case Description: We present a 2 case report of a 13-year-old pediatric male and a 66-year-old male with history of chronic sinusitis who presented with a right intraorbital abscess successfully treated with external drainage with decompression of the orbit. Conclusion: When intraorbital abscess is encountered, a high index of suspicion is needed to allow prompt and accurate diagnosis for this infrequent condition. Timely surgical drainage of the abscess is needed to prevent the development of fatal complications.

scholarly journals Adolescents and primary herpetic gingivostomatitis: an Italian overview

2021 ◽  
Author(s):  
Elena Bardellini ◽  
Francesca Amadori ◽  
Federica Veneri ◽  
Giulio Conti ◽  
Alberto Paderno ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Antibiotic Therapy ◽  
Medical Records ◽  
Bacterial Infections ◽  
Group A ◽  
Acid Gel ◽  
Herpetic Gingivostomatitis ◽  
Group B ◽  
Italian Adolescents ◽  
Hyaluronic Acid Gel

Abstract Aim The aim of this study was to investigate the therapies administered to Italian adolescents with primary herpetic gingivostomatitis (PHGS) Methods The medical records of 74 adolescents with PHSG were reviewed. The following data were recorded: age, gender, day of onset, type of treatment, lesions’ severity, pain scoring, eating, and drinking ability. The oral examination was performed at the first evaluation (T0) and after one week (T1). Results All patients showed up at the first visit at least 48 h after the onset of symptoms. No patient was prescribed an antiviral therapy. An antibiotic therapy was prescribed in order to prevent secondary bacterial infections. Fifteen patients had been treated with non alcoholic chlorhexidine rinses (group A), 29 patients with non alcoholic chlorhexidine rinses plus hyaluronic acid gel (group B); 30 patients with non alcoholic chlorhexidine rinses plus Mucosyte® (group C). A significant improvement of the pain scoring and lesions’ severity was noted in group C. Conclusion In Italian adolescents, PHGS is diagnosed at least 48 h after onset and the antibiotic therapy is widely prescribed in order to prevent overinfections. Among topical therapies, an association of verbascoside and sodium hyaluronhate seems to favour a faster healing.

scholarly journals 415 Improving Preoperative Computed Tomography Staging for Men with Suspected Testicular Cancer

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S A Stanley ◽  
C T Berridge ◽  
T R L Griffiths
Keyword(s):  
Computed Tomography ◽  
Testicular Cancer ◽  
Median Time ◽  
University Hospitals ◽  
Treatment Pathway ◽  
Pathway Data ◽  
Life Threatening ◽  
Neo Adjuvant Chemotherapy ◽  
The University ◽  
Urology Clinic

Abstract Introduction Neo-adjuvant chemotherapy may be considered for suspected testicular malignancy if widespread life-threatening metastases are identified on computed tomography (CT) imaging. Staging preoperatively enables this and may prevent delays in ongoing oncological care. This project aimed to increase the proportion of staging scans performed preoperatively in the University Hospitals of Leicester NHS trust. Method All referrals between 01/01/2016 and 31/12/2018 to the urology multidisciplinary team for suspected testicular cancer were reviewed. Exclusion criteria were applied prior to collecting treatment pathway data for each patient. Based on initial audit findings, clinicians were advised to request staging CT scans at the first urology clinic appointment. Re-audit was between 01/01/2019 and 31/12/2019. Results Initial audit included 95 patients and re-audit included 23 patients. The proportion of preoperative scans increased from 28.4% to 82.6% following intervention. Median time from first ultrasound to CT was reduced from 44 days to 17 days without affecting median time to orchidectomy (27 to 23 days) or oncology appointment (61 days). Conclusions Requesting a staging CT scan as part of the first clinic assessment improved the proportion of preoperative scans without affecting time to surgery or oncology appointment.

Analysis of Life-Threatening Complications of Deep Neck Abscess and the Impact of Empiric Antibiotics

ORL ◽  
2008 ◽  
Vol 70 (4) ◽  
pp. 249-256 ◽  
Author(s):  
Shih-Wei Yang ◽  
Ming-Hsun Lee ◽  
Yun-Shien Lee ◽  
Shu-Huan Huang ◽  
Tai-An Chen ◽  
...  
Keyword(s):  
Neck Abscess ◽  
Empiric Antibiotics ◽  
Life Threatening ◽  
Deep Neck Abscess ◽  
The Impact
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