1/22. Aspiration of an avulsed primary incisor. A case report.A 7-year-old girl had injured her maxillary primary incisors in a playground. One of the already-mobile incisors had been avulsed. The child who had a cough and breathing difficulties during sleep was diagnosed as suffering from upper respiratory infection and was treated with antibiotics. A few days later because her body temperature was elevated a chest radiograph was taken. The radiograph revealed an aspirated tooth in her right bronchus with atelectasis of the lower lobe. The tooth was removed by bronchoscopy. dentists should suspect any tooth that has been avulsed and not found as possibly aspirated.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
2/22. Successful treatment of pseudomonas aeruginosa respiratory tract infection with a sugar solution--a case report on a lectin based therapeutic principle.BACKGROUND: Airway infections with pseudomonas aeruginosa often represent a life-threatening event in immuno-compromised patients or patients with cystic fibrosis. The adhesion of this bacterium to surfaces such as the airway epithelium is mediated by two lectins, sugar binding proteins. In addition to their adhesive properties, these lectins have been shown to stop human ciliary beating thus compromising the mucociliary clearance as an important non-specific defence mechanism of the airways. Inhibition of these lectins by their specific sugars galactose and fucose, respectively, could therefore be of benefit in the elimination therapy of P. aeruginosa. CASE REPORT: An infant suffering from P. aeruginosa airway infection after chemotherapy for neuroblastoma, which could not successfully be treated by antibiotics, was subjected to a series of additional galactose/fucose inhalations, which eliminated the germ as evidenced by microbiological testing. This is the first report suggesting the effectiveness of a lectin-based therapeutic principle in P. aeruginosa airway infection. CONCLUSION: The competitive inhibition of P. aeruginosa lectins by the lectin specific sugars galactose and fucose may overcome particular mechanisms of bacterial resistance in patients with P. aeruginosa airway infection. This underlying biochemical mechanism and the outcome of our patient suggest a clinical benefit of this novel therapeutic approach for immunocompromised patients or patients with cystic fibrosis suffering from infection with P. aeruginosa.- - - - - - - - - - ranking = 2keywords = suffering (Clic here for more details about this article) |
3/22. death in Antarctica.Antarctic tourism is flourishing, but Antarctic cruises are often more physically demanding than typical "tropical" cruises. An 82-year-old Antarctic tourist died of probable septic shock secondary to lower respiratory tract infection six days after sustaining a suspected vertebral fracture in a minor fall from an inflatable boat. This case highlights the need for Antarctic cruise ships to be equipped to provide life support and for better screening and education of prospective Antarctic tourists.- - - - - - - - - - ranking = 0.33312296356826keywords = physical (Clic here for more details about this article) |
4/22. situs inversus totalis.The etiology of situs inversus totalis remains uncertain. However, the literature establishes that isolated situs inversus totalis is usually asymptomatic in the neonate. This case study illustrates the importance of physical assessment skills in identifying situs inversus totalis in the neonate. Current research may reveal the etiology of this rare but fascinating abnormality.- - - - - - - - - - ranking = 0.33312296356826keywords = physical (Clic here for more details about this article) |
5/22. Long-time microdialysis in a patient with meningoencephalitis.As part of invasive neuromonitoring, long-time microdialysis was performed in a 32-year-old patient suffering from meningoencephalitis. Cerebral magnetic resonance imaging (MRI) revealed marked global brain oedema. An intracranial pressure (ICP) probe, brain tissue oxygen pressure measurement (pTiO(2)), and intraparenchymal microdialysis were used for intensive neuromonitoring. Despite high ICP, only intensive care therapy was applied for 16 days using deep propofol sedation, hyperventilation, and intermittent mannitol therapy. One year later, the condition of the patient was excellent. Intracerebral microdialysis with bedside measuring of lactate, pyruvate, glycerol, glucose, and glutamate is a useful additional tool for the monitoring of ICP management.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
6/22. Non-invasive management of an acute chest infection for a patient with ALS.We describe a man diagnosed with non-bulbar amyotrophic lateral sclerosis (ALS) who uses 24-h non-invasive ventilator at home, and assisted cough through the use of the mechanical insufflation-exsufflation (MAC) device (CoughAssist, J.H. Emerson). This was essential for the removal of bronchial secretions in order to provide successful non-invasive management (and indeed less suffering for the patient) during an acute respiratory tract infection with hypoxemia and failure of manually assisted cough.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
7/22. Multiple airway abnormalities in a patient with rothmund-thomson syndrome.rothmund-thomson syndrome (RTS) is a rare autosomal recessive disorder that is characterized by skin manifestations, juvenile cataracts, and extracutaneous manifestations. The presence of congenital airway abnormalities has not previously been documented in rothmund-thomson syndrome. We report the case of a child with rothmund-thomson syndrome suffering from multiple airway abnormalities. Our case highlights the importance of suspecting multiple airway abnormalities in any child with respiratory distress with other systemic anomalies. This necessitates meticulous anatomical and dynamic examination of the laryngotracheo-broncheal tree.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
8/22. A coughing child: could it be asthma?BACKGROUND: A child presenting with cough is common in general practice. Usually the cough is due to an upper respiratory tract infection, however, parents are often concerned that the cough may be asthma. OBJECTIVE: This article focusses on identifying various causes of persistent cough, especially asthma. DISCUSSION: Significant causes of an acute cough need to be considered such as inhaled foreign bodies, aspiration, infections such as pertussis and pneumonia, and asthma. Clinical history, followed by physical examination and consideration of special investigations will guide the diagnosis. cough as the sole symptom of asthma is unusual. There is usually associated wheeze and shortness of breath. A family or personal history of atopic symptoms lend weight to the possibility of asthma. In children with asthma, physical examination and even spirometry may be normal between episodes. In some cases where asthma is suspected, a trial of bronchodilation with formal assessment of response may be appropriate.- - - - - - - - - - ranking = 0.66624592713652keywords = physical (Clic here for more details about this article) |
9/22. Occipital neuralgia secondary to respiratory tract infection.Occipital neuralgia is an extracranial pain that may be confused with other headaches. It can be attributed to multiple causes. The authors report the case of a 55-year-old woman suffering from right occipital neuralgia secondary to respiratory tract infection that began 6 days before the pain started. The patient suffered from a sharp and burning pain with paroxysms in the right occipital region and at the top of the right ear. sensation was decreased in the affected area, and hypersensitivity to touch and cold water was also noted. Tinel's sign was present, and local anesthetic block produced pain relief. The combination of gabapentin and amitriptyline did not provide significant pain relief but led to marked adverse effects. carbamazepine (300 mg/d) was required for pain control. A month later the patient appeared totally pain-free. The treatment was continued for 3 months, and the patient remained pain-free over a subsequent follow-up period of more than 6 months. Thus, in the case of occipital pain, a careful assessment of symptoms and a thorough history are necessary to obtain the correct diagnosis and to choose the appropriate treatment plan.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
10/22. Recurrent infections and joint pain.A seven-year-old white male presented with recurrent bouts of paranasal sinusitis, streptococcal pharyngotonsillitis, lower respiratory tract infections, continuous low-grade fever, and conjunctivitis, which required frequent use of antibiotics over a period of two years. A careful review of systems also revealed a six-month history of arthralgia affecting his knees, elbows, and hands, which limited his daily activities. Prominent in the history were recurrent bouts of a generalized salmon-red, nonpruritic rash, which was most pronounced on the face and trunk and which was exacerbated by fever. His past medical history revealed severe bouts of gastroesophageal reflux disease, chronic intermittent bloody mucous diarrhea, and atopic dermatitis. A detailed review of the patient's family pedigree over five generations revealed a strong genetic predisposition for autoimmune diseases of several types. His physical examination revealed a thin, pale, chronically ill-appearing male, bilateral conjunctivitis, and pale nasal mucosae with no lymphadenopathy, organomegaly, arthritis, or rash. All laboratory results were unremarkable except for a positive rheumatoid factor and a suboptimal antibody response to immunization with pneumococcal vaccine. A diagnosis of juvenile rheumatoid arthritis of the systemic onset type was established, and, based upon his humoral immune deficiency, treatment with intravenous immunoglobulin was initiated with remarkable improvement in his symptomatology.- - - - - - - - - - ranking = 0.33312296356826keywords = physical (Clic here for more details about this article) |
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