scholarly journals Platypnea-Orthodeoxia Syndrome in Two Previously Healthy Adults: A Case-based Review

2009 ◽  
Vol 3 ◽  
pp. CMC.S2326 ◽  
Author(s):  
Leon M. Ptaszek ◽  
Fidencio Saldana ◽  
Igor F. Palacios ◽  
Sean M. Wu
Keyword(s):  
Clinical Manifestations ◽  
Healthy Adults ◽  
Oxygen Desaturation ◽  
Device Implantation ◽  
Device Placement ◽  
Intracardiac Shunting ◽  
Case Based

We describe here the clinical manifestations of platypnea-orthodeoxia in two patients with interatrial shunting. In both cases, the patients were asymptomatic prior to developing additional cardiopulmonary issues that apparently enhanced right-to-left intracardiac shunting. The patients were both treated with percutaneously deployed occlusion devices, with excellent results. Symptoms and positional oxygen desaturation resolved after device placement in both cases. In addition, these patients remain symptom-free 30 months after device implantation.

Heartmate II™ Device Placement Five Years following ACORN CorCap™ Device Implantation

2012 ◽  
Vol 27 (2) ◽  
pp. 264-265
Author(s):  
Louis E. Samuels ◽  
Elena Casanova-Ghosh ◽  
Roberto Rodriguez ◽  
Christopher Droogan
Keyword(s):  
Heartmate Ii ◽  
Device Implantation ◽  
Device Placement

scholarly journals Case Report: A Pediatric COVID-19 Patient with Pyelonephritis and Febrile Seizure as a Rare Clinical Manifestations

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Masoud Rezagholizamenjany ◽  
Parsa Yousefichaijan ◽  
Fakhreddin Shariatmadari ◽  
Manijeh Kahbazi ◽  
Vahid Falahati ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Febrile Seizure ◽  
Urine Analysis ◽  
Clinical Manifestations ◽  
Chain Reaction ◽  
Rare Presentation ◽  
Complete Evaluation ◽  
Polymerase Chain ◽  
Primary Evaluation ◽  
Case Based

: In this study, we report a rare presentation of COVID-19 virus, as febrile seizure. The patient was a 13-month-old girl with febrile seizure. Fever of the patient had started three days ago. Also, the patient had chills for five minutes in addition to cyanosis and tachycardia. On the primary evaluation, active urine analysis showed pyelonephritis. After a complete evaluation, the patient was diagnosed as a positive COVID-19 case based on polymerase chain reaction using nasopharyngeal and oropharyngeal swabs.

scholarly journals Antithrombotic Dilemmas after Left Atrial Appendage Occlusion Watchman Device Placement

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Tania Ahuja ◽  
Scarlett Murphy ◽  
Daniel J. Sartori
Keyword(s):  
Antithrombotic Therapy ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion ◽  
Device Implantation ◽  
Watchman Device ◽  
Device Placement

Antithrombotic therapy for stroke prevention in patients with atrial fibrillation (AF) has dramatically shifted from warfarin, a vitamin K antagonist, to the direct oral anticoagulants (DOACs) such as dabigatran, apixaban, and rivaroxaban. In patients with contraindications to oral anticoagulation, left atrial appendage occlusion (LAAO) devices, such as the Watchman™ device, may be considered; however, temporary postimplantation antithrombotic therapy is still a recommended practice. We present a case of complex antithrombotic management, post LAAO device implantation, designed to avoid drug interactions with concomitant rifampin use and remained necessary secondary to subsequent device leak. This case highlights the challenges of antithrombotic therapy post LAAO device placement in a complex, but representative, patient.

scholarly journals Metagenomic Discovery of 83 New Human Papillomavirus Types in Patients with Immunodeficiency

mSphere ◽  
2018 ◽  
Vol 3 (6) ◽  
Author(s):  
Diana V. Pastrana ◽  
Alberto Peretti ◽  
Nicole L. Welch ◽  
Cinzia Borgogna ◽  
Carlotta Olivero ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Rolling Circle Amplification ◽  
Clinical Manifestations ◽  
Hpv Infection ◽  
Healthy Adults ◽  
Term Therapy ◽  
Normal Children ◽  
Whim Syndrome ◽  
Wide Range ◽  
Hpv Types

ABSTRACTSeveral immunodeficiencies are associated with high susceptibility to persistent and progressive human papillomavirus (HPV) infection leading to a wide range of cutaneous and mucosal lesions. However, the HPV types most commonly associated with such clinical manifestations in these patients have not been systematically defined. Here, we used virion enrichment, rolling circle amplification, and deep sequencing to identify circular DNA viruses present in skin swabs and/or wart biopsy samples from 48 patients with rare genetic immunodeficiencies, including patients with warts, hypogammaglobulinemia, infections, myelokathexis (WHIM) syndrome, or epidermodysplasia verruciformis (EV). Their profiles were compared with the profiles of swabs from 14 healthy adults and warts from 6 immunologically normal children. Individual patients were typically infected with multiple HPV types; up to 26 different types were isolated from a single patient (multiple anatomical sites, one time point). Among these, we identified the complete genomes of 83 previously unknown HPV types and 35 incomplete genomes representing possible additional new types. HPV types in the genusGammapapillomaviruswere common in WHIM patients, whereas EV patients mainly shed HPVs from the genusBetapapillomavirus.Preliminary evidence based on three WHIM patients treated with plerixafor, a leukocyte mobilizing agent, suggest that longer-term therapy may correlate with decreased HPV diversity and increased predominance of HPV types associated with childhood skin warts.IMPORTANCEAlthough some members of the viral familyPapillomaviridaecause benign skin warts (papillomas), many human papillomavirus (HPV) infections are not associated with visible symptoms. For example, most healthy adults chronically shedGammapapillomavirus(Gamma) virions from apparently healthy skin surfaces. To further explore the diversity of papillomaviruses, we performed viromic surveys on immunodeficient individuals suffering from florid skin warts. Our results nearly double the number of knownGammaHPV types and suggest that WHIM syndrome patients are uniquely susceptible toGammaHPV-associated skin warts. Preliminary results suggest that treatment with the drug plerixafor may promote resolution of the unusualGammaHPV skin warts observed in WHIM patients.

Morphologic alteration in the muscles of patients with hypokalemic periodic paralysis or myopathy

1990 ◽  
Vol 48 (3) ◽  
pp. 222-223
Author(s):  
T. Shimizu ◽  
Y. Muranaka ◽  
I. Ohta ◽  
N. Honda
Keyword(s):  
Clinical Manifestations ◽  
Quadriceps Muscle ◽  
Honeycomb Structure ◽  
Periodic Paralysis ◽  
Ultrastructural Changes ◽  
Hypokalemic Periodic Paralysis ◽  
Electron Microscopic ◽  
Tubular Aggregates ◽  
Hypokalemic Myopathy ◽  
Transmission Electron

There have been many reports on ultrastructural alterations in muscles of hypokalemic periodic paralysis (hpp) and hypokalemic myopathy(hm). It is stressed in those reports that tubular structures such as tubular aggregates are usually to be found in hpp as a characteristic feature, but not in hm. We analyzed the histological differences between hpp and hm, comparing their clinical manifestations and morphologic changes in muscles. Materials analyzed were biopsied muscles from 18 patients which showed muscular symptoms due to hypokalemia. The muscle specimens were obtained by means of biopsy from quadriceps muscle and fixed with 2% glutaraldehyde (pH 7.4) and analyzed by ordinary method and modified Golgimethod. The ultrathin section were examined in JEOL 200CX transmission electron microscopy.Electron microscopic examinations disclosed dilated t-system and terminal cistern of sarcoplasmic reticulum (SR)(Fig 1), and an unique structure like “sixad” was occasionally observed in some specimens (Fig 2). Tubular aggregates (Fig 3) and honeycomb structure (Fig 4) were also common characteristic structures in all cases. These ultrastructural changes were common in both the hypokalemic periodic paralysis and the hypokalemic myopathy, regardless of the time of biopsy or the duration of hypokalemia suffered.

Age at Full-Time Use Predicts Language Outcomes Better Than Age of Surgery in Children Who Use Cochlear Implants

2019 ◽  
Vol 28 (4) ◽  
pp. 986-992 ◽  
Author(s):  
Lisa R. Park ◽  
Erika B. Gagnon ◽  
Erin Thompson ◽  
Kevin D. Brown
Keyword(s):  
Cochlear Implants ◽  
Time Use ◽  
Expressive Language ◽  
Normal Hearing ◽  
Full Time ◽  
Language Outcomes ◽  
Age At Surgery ◽  
Device Placement ◽  
Device Use ◽  
Better Than

Purpose The aims of this study were to (a) determine a metric for describing full-time use (FTU), (b) establish whether age at FTU in children with cochlear implants (CIs) predicts language at 3 years of age better than age at surgery, and (c) describe the extent of FTU and length of time it took to establish FTU in this population. Method This retrospective analysis examined receptive and expressive language outcomes at 3 years of age for 40 children with CIs. Multiple linear regression analyses were run with age at surgery and age at FTU as predictor variables. FTU definitions included 8 hr of device use and 80% of average waking hours for a typically developing child. Descriptive statistics were used to describe the establishment and degree of FTU. Results Although 8 hr of daily wear is typically considered FTU in the literature, the 80% hearing hours percentage metric accounts for more variability in outcomes. For both receptive and expressive language, age at FTU was found to be a better predictor of outcomes than age at surgery. It took an average of 17 months for children in this cohort to establish FTU, and only 52.5% reached this milestone by the time they were 3 years old. Conclusions Children with normal hearing can access spoken language whenever they are awake, and the amount of time young children are awake increases with age. A metric that incorporates the percentage of time that children with CIs have access to sound as compared to their same-aged peers with normal hearing accounts for more variability in outcomes than using an arbitrary number of hours. Although early FTU is not possible without surgery occurring at a young age, device placement does not guarantee use and does not predict language outcomes as well as age at FTU.

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