A Previously Healthy Teenager with Anasarca.
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ABSTRACT:
SUBMITTER: Berger JH
PROVIDER: S-EPMC8034987 | biostudies-literature | 2021 Mar
REPOSITORIES: biostudies-literature
Publications
A Previously Healthy Teenager with Anasarca.
Berger Justin H JH Jones Andrea A Fainberg Nina N Smith Christopher C Ravishankar Chitra C
Pediatrics in review 20210301 3
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Project description:BackgroundHydrops foetalis is defined as excessive fluid accumulation within the foetal extravascular compartments and body cavities. It has been described in human and veterinary medicine, but despite several descriptive studies its aetiology is still not fully clarified. Pulmonary hypoplasia and anasarca (PHA) syndrome is a rare congenital abnormality in cattle that is characterised by hydrops foetalis including extreme subcutaneous oedema (anasarca) and undeveloped or poorly formed lungs (pulmonary hypoplasia). Until now, sporadic cases of PHA were reported in cattle breeds like Australian Dexter, Belted Galloway, Maine-Anjou, and Shorthorn. This report describes the first known cases of PHA syndrome in Slovenian Cika cattle.Case presentationA 13-year-old cow aborted a male calf in the seventh month of pregnancy, while a male calf was delivered by caesarean section on the due date from a 14-year-old cow. The pedigree analysis showed that the calves were sired by the same bull, the dams were paternal half-sisters and the second calf was the product of a dam-son mating. Gross lesions were similar in both cases and characterized by severe anasarca, hydrothorax, hydropericardium, ascites, hypoplastic lungs, absence of lymph nodes, and an enlarged heart. The first calf was also athymic. Histopathology of the second affected calf confirmed severe oedema of the subcutis and interstitium of the organs, and pulmonary hypoplasia. The lymph vessels in the subcutis and other organs were severely dilated. Histopathology of the second calf revealed also lack of bronchus associated lymphoid tissue and adrenal gland hypoplasia.ConclusionsThe findings were consistent with known forms of the bovine PHA syndrome. This is the first report of the PHA syndrome occurring in the local endangered breed of Cika cattle. Observed inbreeding practice supports that this lethal defect most likely follows an autosomal recessive mode of inheritance. In the light of the disease phenotype it is assumed that a mutation causing an impaired development of lymph vessels is responsible for the hydrops foetalis associated malformations in bovine PHA.
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Project description:To analyse how the specific gender configurations of the adolescent patient and the doctor affect the performance of intimate areas examinations during adolescent well-care visits and the emotions that accompany these examinations, the use of comfort measures, and the subsequent willingness of adolescents to visit the doctor in the future. An anonymous questionnaire was completed by adolescents (n = 1072) and their parents (n = 685) recruited from 80 randomly selected secondary schools in Poland. Genital examination and puberty assessment were performed more often in boys than in girls (OR = 14.1, p < .0001 and OR = 5.5, p < .0001, respectively). Female doctors performed intimate examinations more frequently than male doctors (OR = 2.2, p = .0059). Male doctors were more likely to ask for consent than female doctors, 66.7% vs. 40.2% (p = .0556), and use the screen more often than female doctors, 46.7% vs. 21.7% (p = .0393). Intimate examinations significantly discouraged adolescents from revisiting the doctor, especially when performed by a physician of the opposite sex. The majority of Polish adolescents and their parents believe that routine prophylactic genital region examinations are illegal, especially if girls' genitals are to be examined by male physicians.ConclusionThe implementation of preventive genital region examinations in adolescents depends largely on non-medical factors-the gender of the patient, the physician, and the mutual configuration of these genders. The level of public non-acceptance of these procedures should not be underestimated by experts setting standards of well-care for adolescents.What is known• Although the assessment of sexual maturity is an integral part of the preventive examination of adolescents (both girls and boys) these examinations are often overlooked.What is new• The gender of the physician and the congruence of his/her gender with the gender of the adolescent patient influence whether a puberty assessment will be performed, as well as the social acceptance of such procedures. • Examinations of the intimate area are a significant factor discouraging both adolescent girls and adolescent boys from seeing the doctor again.
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| S-EPMC4550926 | biostudies-other
Project description:IntroductionHerpetic Esophagitis is caused by the Herpes Simplex virus, which generally affects immunocompromised individuals and is rarely seen in healthy individuals. Symptoms are usually self-limiting.Case presentationWe report the case of a 68-year-old female who presented with odynophagia, dysphagia, and epigastric pain with no other underlying disease. Endoscopic findings of soft, nodular, and friable growths just above the squamocolumnar junction with diffuse ulcerations in the distal esophagus, led to the diagnosis. It was confirmed with a histopathological report which revealed multinucleated giant cells with eosinophilic intranuclear inclusions. During follow-up, laboratory investigations revealed iron deficiency anemia, which was the consequence of GI bleeding.Clinical discussionHerpes Simplex virus esophagitis can occur in immunocompetent individuals and even it can cause food impaction and GI bleeding, which can lead to Iron deficiency anemia.ConclusionHence, follow-up of patients is important for early diagnosis and intervention of any complications that may arise.
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Project description:This case report details the presentation of a 24-year-old male presenting with headache, palpitations, gingival bleeding, and pallor. The ultimate diagnosis of thrombotic thrombocytopenic purpura (TTP) is a rare but life-threatening condition which is typically hallmarked by thrombotic microangiopathy (TMA) and dysfunctional ADAMTS13 enzymatic activity. This patient displayed classically described findings, including marked anemia, thrombocytopenia, and acutely elevated creatinine as well as a brief period of newly onset word-finding difficulty while in the emergency department. His diminished ADAMTS13 activity level (<5%) and the presence of autoantibodies against ADAMTS13 confirmed a diagnosis of TTP. Fortunately, the patient's outcome was favorable after treatment with plasmapheresis, prednisone, and rituximab. This case report provides a review of the clinical presentation, diagnostic criteria, potentially confounding differential diagnosis, and expected course of treatment for patients with TTP.TopicsThrombotic thrombocytopenic purpura (TTP), ADAMTS13, anemia.
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