scholarly journals Aquatic Sports Dermatoses: Clinical Presentation and Treatment Guidelines

10.5772/26483 ◽  
2012 ◽  
Author(s):  
Jonathan S. ◽  
Brook E.
Keyword(s):  
Clinical Presentation ◽  
Treatment Guidelines

Merkel Cell Carcinoma of the Lower Extremity

2014 ◽  
Vol 104 (4) ◽  
pp. 422-425 ◽  
Author(s):  
Dominic J. Roda ◽  
Brian Albano ◽  
Bharti Rathore ◽  
Linda Zhou
Keyword(s):  
Lower Extremity ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Clinical Presentation ◽  
Treatment Guidelines ◽  
Excisional Biopsy ◽  
Lymph Node Biopsy ◽  
Rapid Progression ◽  
Merkel Cell ◽  
Unusual Lesion

Merkel cell carcinoma is a rare, often fatal, neuroendocrine cutaneous malignancy with a highly variable clinical presentation. Due to the rapid progression of the disease, early detection and treatment is vital to survival. Here, we report the case of a 45-year-old woman whose podiatrist noticed an unusual lesion on her lower left leg and referred her to a dermatologist for work-up. A diagnostic excisional biopsy confirmed the diagnosis and was followed by treatment that included wide local excision of the primary lesion with subsequent chemotherapy and radiation. At the time of diagnosis, sentinel lymph node biopsy was positive. Due to the increasing prevalence of Merkel cell carcinoma in the past decade and its propensity to present on the lower extremity, podiatric physicians need to be aware of the clinical presentation and treatment guidelines for this elusive disease.

scholarly journals Patient Assessment: Clinical Presentation, Imaging Diagnosis, Risk Stratification, and the Role of Pulmonary Embolism Response Team

2018 ◽  
Vol 35 (02) ◽  
pp. 116-121 ◽  
Author(s):  
Tamir Friedman ◽  
Keith Quencer ◽  
David Madoff ◽  
Ronald Winokur
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Presentation ◽  
Treatment Guidelines ◽  
The United States ◽  
Imaging Diagnosis ◽  
Patient Assessment ◽  
Timely Manner ◽  
Response Team ◽  
Hospital Deaths

AbstractPulmonary embolism (PE) is currently the third leading cause of death and moreover is likely underdiagnosed. PE remains the most common preventable cause of hospital deaths in the United States, which may be attributable to its diagnostic challenges. Although difficult to diagnose, patient mortality rates are time-dependent, and thus, the suspicion and diagnosis of PE in a timely manner is imperative. Diagnosis based on several criteria which may dictate imaging workup as well as laboratory tests and clinical parameters are discussed. The evolution of treatment guidelines via various clinical trials and recommendations is outlined, setting the stage for the use of fibrinolytics, whether systemic or catheter directed. Treatment, including fibrinolytics, is predicated on patient triage into three large categories—massive, submassive, or low-risk PE. Additionally, a relatively new concept of a multidisciplinary team composed of several subspecialty experts known as the PE response team (PERT) is discussed. PERT's timely and unified recommendations have been shown to optimize care and decrease mortality while tailoring treatment to each individual afflicted by PE.

scholarly journals Prolong psychosis preceding cognitive and motor symptoms; an unusual presentation in Huntington's disease

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S117-S117
Author(s):  
Nida Khan ◽  
Marium Mansoor
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Clinical Presentation ◽  
Treatment Guidelines ◽  
Response To Treatment ◽  
Personal Hygiene ◽  
Psychotic Symptoms ◽  
History Of ◽  
Atypical Presentations ◽  
Diagnostic Delays

ObjectiveTo describe an unusual clinical presentation of Huntington's disease.Case reportA 39-years-old married female, a homemaker, presented to the psychiatry clinic with her husband, with over a nine-year history of decreased sleep, suspiciousness, self-talking, agitation, anger outbursts, aggression, and social isolation. The patient was diagnosed with schizophrenia. Previously, she received various antipsychotics and Electroconvulsive therapy (ECT). The patient showed a partial response to treatment. Over the last 2-3 years, the patient had a progressive decline and later required supervision in her Activities of Daily Living (ADLs). She developed slurred speech limited to 1-2 worded answers, gait disturbance, falls, involuntary movements of the trunk and distal extremities, bowel and bladder incontinence, and severe weight loss. The patient's mother and older brother had a history of death in their early 40s due to an unknown cause.At presentation, the patient was restless, irritable, self-talking incoherently, neither made nor maintained eye contact and tried hitting and biting upon approaching closely. She did not respond to any queries or followed commands. The patient showed poor personal hygiene. On examination, the patient was hemodynamically stable, had a loss of muscle bulk, broad-based gait, and choreiform movements of the trunk and distal extremities. We admitted the patient to the psychiatry ward and also consulted the neurology team. Her blood investigations showed ASMA antibodies positive, MRI brain was suggestive of Huntington's disease (HD), and her genetic test for Huntington gene confirmed the diagnosis of HD. We started the patient on Fluoxetine, Clonazepam, and Olanzapine. The patient showed a decrease in agitation, and her self-talking stopped.DiscussionHD is a rare genetic disease that has well-characterized symptoms. However, as seen in our patient, these symptoms can evolve and progress unusually in the early and middle stages. Psychosis in HD patients is rare but known. Psychosis is rare in HD and usually presents after a clear clinical picture of HD is apparent. Our case discussed psychotic symptoms in the pre-choreic stage of HD which adds to the existing evidence on challenging presentations and management of HD. Further research can help increase confidence in these outcomes and treatment guidelines.ConclusionOur case highlights an unusual clinical presentation of HD, which can be challenging and lead to diagnostic delays. We recommend a thorough approach to history and revision of diagnosis in case of atypical presentations.

scholarly journals COVID-19 Myocarditis Clinical Presentation, Diagnosis and Management: A Narrative Review

2021 ◽  
Vol 1 (1) ◽  
pp. 135-150
Author(s):  
Elie Al Zaghrini ◽  
Nancy Emmanuel ◽  
Victor Zibara ◽  
Wael Terro ◽  
Samia Hanna
Keyword(s):  
Cardiovascular System ◽  
Clinical Presentation ◽  
Treatment Guidelines ◽  
Case Reports ◽  
Narrative Review ◽  
Current Understanding ◽  
Medical Community ◽  
Management Options ◽  
Diagnosis And Management ◽  
Novel Coronavirus

Objective: The purpose of this article is to review the cases of myocarditis in COVID-19 patients and synthesize the current understanding regarding the presentation, diagnosis, and management of myocarditis in the setting of COVID-19 disease. Background: The novel coronavirus disease has shown serious implications for the cardiovascular system, including acute myocardial injury, arrhythmias, venous thromboembolism, and myocarditis. Several cases of myocarditis in COVID-19 patients have been reported since the disease's emergence at the end of 2019. The diagnostic approach and management have been variable. The purpose of this narrative review is to gather the most reliable published material regarding myocarditis in COVID-19 and present it as an overview to simplify the current understanding we have of this disease. Methods: We screened PubMed, Scopus, and Embase. We then selected peer-reviewed and pre-print articles published in English that were related to the involvement of the cardiovascular system in COVID-19, with a focus on myocarditis. We included case reports describing myocarditis in COVID-19 patients and summarized their clinical presentation, diagnosis, and management. References of the selected articles were also screened, and some were included when relevant. Discussion: This article is subdivided into sections that discuss the clinical presentation of COVID-19 myocarditis and move on to various diagnostic approaches and management options. Each subsection presents a brief literature review followed by a summary and interpretation of what was found in the reported cases. Conclusion: After noticing the involvement of the cardiovascular system in COVID-19 patients, specifically through myocarditis, we present this narrative review to provide the medical community with a unified article regarding the current understanding of myocarditis in COVID-19 patients. This article further stresses the necessity of establishing proper treatment guidelines for COVID-19 myocarditis.

scholarly journals Sport-Related Concussions: Symptom Recurrence After Return to Exercise

2017 ◽  
Vol 5 (10) ◽  
pp. 232596711773251 ◽  
Author(s):  
Michael J. O’Brien ◽  
David R. Howell ◽  
Michael J. Pepin ◽  
William P. Meehan
Keyword(s):  
Clinical Presentation ◽  
Treatment Guidelines ◽  
Tertiary Care ◽  
Return To Play ◽  
Outcome Variable ◽  
Symptom Scale ◽  
Level Of Evidence ◽  
Duration Of Symptoms ◽  
Increased Risk ◽  
Symptom Recurrence

Background: Current guidelines dictate a gradual exercise progression after a concussion; however, it is unclear what proportion of athletes experience a recurrence of symptoms once they are symptom free at rest. Estimating the proportion of athletes and predictors of symptom recurrence would help shape return-to-play protocols. Purpose: To determine the proportion and associated risk factors of athletes who have a recurrence of concussion symptoms with exercise after being symptom free at rest. Study Design: Case-control study; Level of evidence, 3. Methods: Between October 1, 2009 and July 31, 2011, we studied patients from a sport concussion clinic located within a tertiary care regional children’s hospital. Patients were queried at every visit using a standardized questionnaire. Our main outcome variable was recurrence of symptoms with exercise after being symptom free at rest at some point in their recovery. Cofactors included age, sex, loss of consciousness with injury, prior concussion (diagnosed and undiagnosed), Post-Concussion Symptom Scale (PCSS) score, time until clinical presentation, and duration of symptoms. Results: Of the 217 patients included, 25 (12%) experienced a return of symptoms. Losing consciousness at the time of injury and a longer duration between injury and clinical presentation were associated with a decreased risk of symptoms recurring with exercise. Conversely, athletes who had sustained previously undiagnosed concussions and had suffered a longer duration of symptoms at rest were at an increased risk of symptom recurrence with exercise. Conclusion: Relatively few athletes who are symptom free at rest after a concussion will have a recurrence of symptoms when they resume exercise. The risk of symptoms recurring with exercise may be greater among those athletes who sustained previously undiagnosed concussions and had a longer period of symptoms at rest. The early identification of athletes who may be at risk of symptom recurrence will help mold treatment guidelines and exercise progression protocols.

Kasabach-Merritt Syndrome

2002 ◽  
Vol 6 (4) ◽  
pp. 335-339 ◽  
Author(s):  
Sheilagh Maguiness ◽  
Lyn Guenther
Keyword(s):  
Clinical Presentation ◽  
Treatment Guidelines ◽  
Case Reports ◽  
Treatment Options ◽  
Vascular Lesion ◽  
Vascular Pathology ◽  
Vascular Tumors ◽  
Kaposiform Hemangioendothelioma ◽  
Laboratory Findings ◽  
Tufted Angioma

Background: Kasabach-Merritt syndrome (KMS) is a consumptive coagulopathy associated with the presence of a large vascular lesion. It is often a frustrating condition to treat and it carries a high mortality rate. There are currently no known treatment guidelines. Kasabach-Merritt syndrome is associated with kaposiform hemangioendothelioma (KHE) and tufted angioma (TA); these lesions, when associated with KMS, are locally invasive, aggressive vascular tumors. Treatment options include supportive care, local therapies, and drug and surgical management. In most recent case reports, a multimodal approach to therapy is taken. Objective and Conclusion: The objective of this article is to provide a comprehensive review of KMS and give an up-to-date summary of treatment options. The clinical presentation, laboratory findings, vascular pathology, and pathophysiology will also be discussed.

Glanders

2011 ◽  
Author(s):  
Sharon J. Peacock ◽  
David A. B. Dance
Keyword(s):  
Infected Animal ◽  
Clinical Presentation ◽  
Treatment Guidelines ◽  
Antimicrobial Treatment ◽  
Burkholderia Mallei ◽  
Serological Testing ◽  
Eradication Programme ◽  
Natural Reservoir ◽  
Control And Prevention ◽  
Current Advice

Glanders is a serious zoonotic disease that primarily affects equids (horses, mules and donkeys). A disease eradication programme based on case detection and destruction of infected domestic animals has been highly successful and the number of reported glanders cases in animals worldwide is now very low. Human glanders is extremely rare and associated with occupations associated with extensive contact with equids. Glanders is caused by Burkholderia mallei, a Gram-negative, non-motile, facultative intracellular organism that is an obligate parasite of equids with no other known natural reservoir. B. mallei is transmitted by direct contact with infected animals, or indirectly via communal food and water sources that have become contaminated by an infected animal. The clinical presentation in equids can be acute or chronic and has been categorized into nasal, pulmonary and cutaneous forms. Diagnosis is based on culturing B. mallei from lesions or exudates and skin or serological testing. Infected animals are usually euthanized. Optimal antimicrobial therapy for human glanders is unknown, and current advice is to adopt antimicrobial treatment guidelines for human melioidosis. There is no vaccine available for either humans or other animals. B. mallei is considered a potential biological weapon and is a Centers for Disease Control and Prevention category B select agent.

Jansky-Bielschowsky syndrome, a lysosomal disease: First diagnosed cash in Oman

1992 ◽  
Vol 50 (1) ◽  
pp. 632-633
Author(s):  
Line Buhl ◽  
David Muirhead
Keyword(s):  
Mental Retardation ◽  
Clinical Picture ◽  
Neurological Disorder ◽  
Clinical Presentation ◽  
Neuronal Ceroid Lipofuscinosis ◽  
Infantile Form ◽  
Lysosomal Disease ◽  
Juvenile Form ◽  
Progressive Encephalopathy ◽  
Lysosomal Diseases

There are four lysosomal diseases of which the neuronal ceroid lipofuscinosis is the rarest. The clinical presentation and their characteric abnormal ultrastructure subdivide them into four types. These are known as the Infantile form (Santavuori-Haltia), Late infantile form (Jansky-Bielschowsky), Juvenile form (Batten-Spielmeyer-Voght) and the Adult form (Kuph's).An 8 year old Omani girl presented wth myclonic jerks since the age of 4 years, with progressive encephalopathy, mental retardation, ataxia and loss of vision. An ophthalmoscopy was performed followed by rectal suction biopsies (fig. 1). A previous sibling had died of an undiagnosed neurological disorder with a similar clinical picture.

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

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